The effects of social isolation stress and discrimination on mental health

"I've always felt like I'm on the outside": identity and social inclusion among young adults with mental illness and complex needs - a qualitative study

PURPOSE

Addressing social inclusion often involves objective measures and means related to work, education, housing and economy. However, important subjective factors, such as the relationship between identity on social inclusion among young adults with mental illness and complex needs, are understudied. The study objective is to explore how young adults with mental illness and complex needs experience their identity in relation to social inclusion.

MATERIALS AND METHODS

The study adopted a qualitative, explorative, and participatory design. Seven young adults (three males/four females, aged 22-29) were recruited though Flexible Assertive Community Treatment (FACT) Teams, and semi-structured interviews were conducted. Reflexive thematic analysis was employed in the analysis.

RESULTS

The analysis resulted in two main themes. Theme one, "Who they are", included three subthemes: "A lifelong sense of being someone on the outside", "Feeling different from others", and "Someone who is worthless and doesn't matter". Theme two, "Who they want to be", included two subthemes "Wanting to be someone else", and "The need to redefine oneself".

CONCLUSIONS

This study underlines the importance of working systematically on subjective aspects such as identity, in addition to objective measures, to address social exclusion in a vulnerable and marginalized group. Future directions for research and the development of a more tangible and holistic approach to promote social inclusion are suggested.

Discrimination and manic symptoms in early adolescence: A prospective cohort study

PURPOSE

This study aims to investigate the prospective associations between four types of perceived discrimination (country of origin, race and ethnicity, sexual orientation, and weight) and the development of manic symptoms in a diverse, nationwide sample of adolescents aged 9-14 years in the U.S.

METHODS

We analyzed prospective cohort data from the Adolescent Brain Cognitive Development Study (N = 7466; ages 9-14 years at Year 1 or 2 in 2017-2020; 48.5 % female; 39.4 % racial/ethnic minority). Multiple zero-inflated negative binomial analyses were conducted to examine the associations between Year 1 or 2 discrimination (by country of origin, race and ethnicity, sexual orientation, weight, sum score), and Year 3 manic symptoms (7 Up Mania scale), adjusting for covariates (age, sex, race and ethnicity, household income, parental education, sipping alcohol, puffing tobacco, anxiety symptoms, depressive symptoms, Year 1 manic symptoms, and study site).

RESULTS

After adjusting for covariates, perceived discrimination based on country of origin (incidence rate ratio [IRR] = 1.46; 95 % confidence interval [CI] 1.15-1.86), sexual orientation (IRR = 1.36; 95 % CI 1.21-1.53), race and ethnicity (IRR = 1.28; 95 % CI 1.13-1.46), weight (IRR = 1.21 95 % CI 1.09-1.34), and sum scores (IRR = 1.18 5 % CI 1.12-1.24), were significantly associated with higher manic symptoms.

CONCLUSION

Perceived discrimination based on country of origin, race and ethnicity, sexual orientation, weight, and sum scores, are prospectively associated with greater manic symptoms in adolescents. These findings underscore the need for targeted interventions to address discrimination and associated psychological impacts. Efforts to reduce discrimination and to support affected adolescents are important components of comprehensive mental health care and public health strategies.

The Experiences of Hijab and Non-Hijab-Wearing Muslim Women Students: Exploring Social Isolation and Discrimination in Delhi, India

Research suggests that Muslim women wearing the hijab may be particularly vulnerable to the experiences of stigmatization as the hijab represents a dominant marker of "otherness." Using the relational demography perspective, this paper explored the viewpoints of hijab and non-hijab-wearing Muslim women in Delhi regarding the different forms of discrimination and/or social isolation they may have experienced. Thematic analysis was used to explore the participant's narratives, gathered by means of six focus group discussions (n = 38). For the hijab-wearing group, two emergent themes were evident: "Journey of my hijab" and "The two sides of the hijab." For the non-hijab-wearing group, the emergent themes included: "My name is (un)safe" and "Not Muslim enough." The study findings can inform the development of intervention strategies to integrate the community more meaningfully by preventing "othering" and providing agency and autonomy.

Association of meeting 24-hour movement guidelines with anxiety and depressive symptoms in adults

There is growing evidence on the association between meeting the recommendations of isolated movement behaviors (physical activity, sedentary time, and sleep) with anxiety and depressive symptoms. However, the joint association of meeting the 24 h movement guidelines with anxiety and depressive symptoms is still unknown. The aim of this study was to analyze the association of meeting 24-hour movement guidelines with symptoms of anxiety and of depression in adults. The sample included 212 participants. Anxiety and depressive symptoms were evaluated using the Hospital Anxiety and Depression Scale (HADS), while physical activity and sedentary time were evaluated by accelerometry, and daily slept hours were self-reported. Age, sex, socioeconomic status, accelerometer wear time, and waist circumference were covariates. Poisson regression models (crude and adjusted by covariates) were used to analyze association between variables. Meeting isolate recommendations of 24-hour movement guidelines were not associated with symptoms of anxiety or depression. However, meeting two or three recommendations was inversely associated with symptoms of anxiety (β= -0.235; 95%CI= -0.447; -0.024); (β= -0.569; 95%CI= -0.853; -0.285) and of depression (β= -0.275; 95%CI= -0.509; -0.040); (β= -0.551; 95%CI= -0.877; -0.224), respectively. Intervention strategies for reducing anxiety and depressive symptoms should target the meeting of more than one movement guidelines, such as increasing physical activity, reducing sedentary time, and promoting adequate sleep time for adults.

Barriers and facilitators for social inclusion among people with concurrent mental health and substance use problems. A qualitative scoping review

BACKGROUND

People with concurrent mental health and substance use problems are among the most socially excluded groups in our society, yet little attention has been paid to what socially excluded people see as central to promoting their social inclusion. The aim of this qualitative scoping review is to provide an overview of barriers and facilitators for social inclusion among people with concurrent mental health and substance use problems, based on first-person perspectives, to help guide future research, policies, and practice.

METHODS

We explored first-person perspectives on social inclusion among people with concurrent mental health and substance use problems, employing Arksey and O'Malleys framework. We searched Medline, PsycINFO, Embase, Scopus, Cinahl, and other sources for studies published between January 2000 and September 2023. We employed content analysis and followed the PRISMA checklist.

RESULTS

We included 55 articles included in our review and identified sub themes of: Intrapersonal baseline (identity, belonging), Components of social inclusion (relationships, meaningful activities, employment, economy), and Systemic failure or success (housing, public health and welfare services, the criminal justice system).

CONCLUSION

Social inclusion is rarely studied outside the context of direct services. Our results point to knowledge gaps in addressing social inclusion in a broad, societal context; implementing gaps in services; and developing policies to assure the fundamental needs and human rights of socially excluded persons.

Relations Between Optimism-Pessimism and Loneliness in Sexually Minoritized Men: The Moderating Role of Chronicity-Based Discrimination

Loneliness has reached epidemic proportions, affecting nearly one-in-two adults in the United States and is particularly potent in sexually minoritized men (SMM). Individual differences in optimism and pessimism may exert protective or maladaptive effects for the impact of discrimination on loneliness. This study investigated interrelationships between optimism/pessimism, discrimination, and loneliness within a sample of sexual minoritized men (SMM). Self-report data from 103 SMM were used from a six-month study from August 2020 to February 2022 in South Florida. A novel chronicity-based coding approach was used to determine whether associations of optimism/pessimism and loneliness vary based on different frequencies of exposure to discrimination. Hierarchical multivariable regression models were conducted to examine associations of optimism-pessimism and the moderating effect of chronicity-based discrimination on loneliness. SMM reporting higher pessimism and lower optimism reported greater levels of loneliness and exposure to discrimination, and chronicity-based discrimination was negatively associated with optimism, and positively associated with pessimism. Associations of optimism, but not pessimism, with loneliness were moderated by discrimination. Among the sample, optimism had a protective effect on loneliness for those experiencing moderate exposure to discrimination. Future research should consider the longitudinal impact of optimism/pessimism and discrimination on loneliness among SMM.

Gender-Specific Insights into Depression in Patients with Ischemic Heart Disease: Findings from a Pilot Study Using a Self-Developed Questionnaire

BACKGROUND/OBJECTIVES

Ischemic heart disease (IHD) significantly affects mental health, with gender-specific differences being observed in psychological responses. This pilot study aimed to explore these differences in the demographic, clinical, psychological, psychiatric, and social profile of patients diagnosed with IHD.

METHODS

A descriptive, cross-sectional design was used, recruiting 183 adult patients diagnosed with coronary artery disease and depression at the Psychiatry Department of Arad County Emergency Hospital, Romania, between May 2021 and May 2024. Data were collected using a self-developed tool, named the Depression Assessment in Ischemic Heart Disease Questionnaire (DA-IHDQ), alongside standardized assessments. Statistical analysis was performed using JASP statistical software (Version 0.19.1, University of Amsterdam, Amsterdam, Netherlands), employing binomial and multinomial tests for categorical data, and Cronbach's alpha was used to assess internal consistency.

RESULTS

This study found significant demographic differences, with female patients exhibiting higher levels of emotional distress and severe depression compared with the male subjects. Women reported greater social isolation and a stronger desire to seek for psychological or psychiatric support. Furthermore, a positive correlation between depression severity and physical symptoms was observed in both genders.

CONCLUSIONS

These findings highlight the importance of recognizing gender-specific responses to IHD, emphasizing the need for tailored interventions in mental healthcare and cardiac rehabilitation. Future research should further explore these differences to enhance the understanding of the psychosocial/psychiatric aspects of IHD and improve patient outcomes.

Nationwide trends in sadness, suicidal ideation, and suicide attempts among multicultural and monocultural adolescents in South Korea during the COVID-19 pandemic, 2011-2022

BACKGROUND

Researches on the mental health of Korean adolescents during COVID-19 have largely focused on those from monocultural families, but there is limited data on sadness, suicidal ideation, and suicide attempts in multicultural adolescents.

METHODS

This nationwide serial cross-sectional study included 688,708 adolescents aged 12-18 years who participated in the Korean Youth Risk Behavior Web-based Survey from 2011 to 2022. We compared and analyzed the prevalence of sadness, suicidal ideation, and suicide attempts among multicultural and monocultural adolescents. Multicultural adolescents were defined as those with at least one non-Korean parent.

RESULTS

In 2021, the prevalence of sadness among multicultural adolescents was 31.86% [95% confidence interval (CI) 30.00-33.71], suicidal ideation 17.17% (15.74-18.61), and suicide attempts 4.25% (3.51-4.99). Among monocultural adolescents, the prevalence rates were 26.09% (25.50-26.69) for sadness, 12.41% (11.97-12.85) for suicidal ideation, and 1.92% (1.76-2.67) for suicide attempts. Adolescents from multicultural backgrounds were found to have higher rates of sadness, suicidal ideation, and suicide attempts. In the general population, these rates had decreased during the pre-pandemic period but increased after the onset of the pandemic then stabilized from 2020 to 2021. Female gender, smoking, alcohol use, and low school performance emerged as significant risk factors. However, no distinct risk factors specifically linked to suicide attempts were identified. Joinpoint regression analysis results aligned with the beta slope values in the main findings, reflecting a consistent pattern across both analyses.

CONCLUSIONS

This study revealed that sadness, suicidal ideation, and suicide attempts increased during the pandemic, reversing a pre-pandemic decline. Multicultural adolescents faced these issues more than monocultural ones, underlining the need for targeted public health measures to support at-risk adolescents during pandemics.

Relationship Between Social Deprivation and Access to Catheter Ablation for Atrial Fibrillation: A Population-Level Study

Background

Access to catheter ablation for atrial fibrillation (AF) may vary due to social deprivation.

Objectives

This study sought to characterize the correlation between our outcomes of interest (rates of AF diagnoses, ablation referrals, and procedures) and the association between social deprivation and our outcomes.

Methods

Rates and correlations of AF diagnoses, ablation referrals, and procedures were reported across 49 census divisions in Ontario, Canada. We used the Ontario Marginalization Index to determine the relationship between dependency, material deprivation, ethnic concentration, and residential instability and our outcomes.

Results

Between April 2016 and March 2020, there were 146,366 patients diagnosed with AF; 6,506 patients were referred for ablation; and 4,673 patients underwent de novo ablation. The median age was 72 years (IQR: 61-81 years; 45% female) for the AF cohort and 62 years (IQR: 55-69 years, 33% to 34% female) for the referral and procedure cohorts. There was geographic variation and a weak concordance between AF diagnoses, ablation referrals, and procedures (correlation coefficients 0.33-0.36). Increased material deprivation was associated with more AF diagnoses (rate ratio [RR]: 1.13), but fewer ablation referrals (RR: 0.49) and procedures (RR: 0.48). Increased residential instability was associated with more AF diagnoses (RR: 1.02), but fewer ablation referrals (RR: 0.63) and procedures (RR: 0.64). Higher ethnic concentration was associated with fewer AF diagnoses, ablation referrals, and procedures.

Conclusions

In a jurisdiction with universal health care, greater material deprivation and residential instability were associated with more AF diagnoses but less access to ablation, suggesting substantial social gradients in equitable access to AF care.

Translational Approach to Social Isolation During a Global Pandemic: Hippocampal Somatic Mutation and Stress

OBJECTIVE

The coronavirus disease-2019 (COVID-19) pandemic's social isolation has significantly impacted mental health, increasing depression and anxiety. This study explores the effects of social isolation on both humans and mice, focusing on behavioral changes and hippocampal protein expression. It also investigates genetic alterations through single-cell RNA and whole-genome sequencing (WGS).

METHODS

Here we conducted behavioral studies, protein expression studies, single-nucleus sequencing (snRNAseq), and WGS of the hippocampus of mice that underwent early maternal separation and social isolation, and a demographic study of community populations who had been self-quarantined owing to COVID-19 exposure to investigate the link between somatic mutations and stress due to social isolation.

RESULTS

The demographic study demonstrated more negative mental health findings among individuals who live alone or are single. Mice subjected to early maternal separation and social isolation demonstrated increased anxiety-like behaviors and stress-related corticotropin-releasing hormone receptor 1, and neurogenesis-related sex-determining region Y-box 2 and doublecortin expression. In snRNA-seq, differences, such as transthyretin increase, were observed in the maternal separation group, and somatic mutations, including insertion in the intron site of Tmem267, were observed in the social isolation group on WGS.

CONCLUSION

The results of this study suggest that stress, such as social isolation, can cause changes at the genetic level, as well as behavioral and brain protein changes.

Exploring the anti-depressant effects and nitric oxide modulation of quercetin: A preclinical study in Socially Isolated mice

OBJECTIVES

This study investigates the effects of quercetin, an antioxidant and nitric oxide (NO) modulator, on depressive-like behaviours triggered by social isolation stress (SIS) in mice. SIS, known to harm psychosocial functioning and increase the risk of depression, involves oxidative stress and NO in its pathophysiology.

METHODS

72 male mice were divided into nine groups, including the social (SC) group as the control group (stress-free with normal saline intake). The isolation (IC) groups received normal saline, quercetin at doses of 10, 20, and 40 mg/kg, the nitric oxide synthetase inhibitor L-NAME at a dose of 5 mg/kg, the NO precursor L-arginine at a dose of 100 mg/kg, an ineffective dose of quercetin combined with L-NAME and an effective dose of quercetin combined with L-arginine. Behavioural tests (open-field, forced swimming, and splash tests) were conducted, followed by measuring hippocampal nitrite levels.

RESULTS

Quercetin significantly reduced immobility in the forced swimming test, increased activity in the open-field test, and enhanced grooming behaviour, particularly at 40 mg/kg. Co-administration of an ineffective dose of quercetin (10 mg/kg) with L-NAME increased immobility and grooming activity time. Interestingly, co-administration of the effective dose of quercetin (40 mg/kg) with L-arginine increased immobility time in the FST. Additionally, administration of quercetin at doses of 20 and 40 mg/kg significantly reduced the nitrite level in the hippocampus of SIS mice. Furthermore, co-administration of L-NAME and L-arginine with ineffective and effective doses of quercetin decreased and increased nitrite levels in the hippocampus and increased immobility time in the FST compared to their respective counterparts administered alone.

CONCLUSIONS

These results suggest quercetin's potential in alleviating depression by modulating NO levels, pointing to its promise in treating depression associated with chronic stressors like social isolation.

Minibox: Custom solo or semi-group housing chambers for long term housing of rats with miniscopes

In this detailed procedure, we include open-source methodologies using 'solidworks' designs for creating solo or semi-group housing units for rats wearing miniscopes for long periods of time. Builds are optimized to preserve rat health and prevent hardware destruction. We include all prices and suggestions for purchasing strategies to reduce overall build-costs.•Chambers are optimized for long-term housing to protect rats wearing delicate headstages (e.g., miniscopes).•Designed to be low-cost, efficient supplement to operant chambers and provides numerous benefits to long-term miniscope imaging. The housing chambers can be augmented by installing cameras, commutators, or different types of floor grids depending on experimental conditions.•The chambers can also be secured to one another to create "rat-duplexes", allowing experimenters to control the degree of social isolation.

Investigating the impact of COVID-19 related worries and loneliness on alcohol consumption: an ecological momentary assessment

Adverse alcohol consumption is a major public health concern, which might have been further increased by the COVID-19 pandemic. In this study we investigated the impact of a lockdown stage on the association between alcohol consumption, loneliness, and COVID-19-related worries. We used smartphone-based Ecological Momentary Assessment (EMA) conducted during the COVID-19 pandemic in Germany. We recruited 280 participants from the general population, who experienced at least mild loneliness and distress due to the COVID-19 pandemic. We assessed daily alcohol intake, loneliness, and COVID-19-related worries every evening for 7 consecutive days across a no-lockdown [8th August 2020-1st November 2020] and lockdown stage [2nd November 2020-11th March 2021]. We did not find that a lockdown stage, compared to a no-lockdown stage, is associated with increased alcohol consumption. We found that loneliness, previous day drinking, and COVID-19-related worries were not associated with increased, but with decreased alcohol consumption. Moreover, COVID-19-related worries were more negatively associated with alcohol consumption during a no-lockdown stage compared to a lockdown stage. We found that the effect of COVID-19 related worries on alcohol consumption is mediated by loneliness. Our study suggests that heightened levels of worry can decrease alcohol intake. This association can be explained by loneliness: individuals who worry more are lonelier and thus less likely to engage in social drinking. However, during a lockdown stage, the negative association between worrying and drinking diminishes.

Does internet use promote the health of empty-nest older adults in rural China? The mediating role of social participation using a propensity score matching approach

Background

The rapid growth of internet use among older adults in rural China offers a unique opportunity to examine its potential impact on their health. This study seeks to explore the relationship between internet use and the emotional, physical, and cognitive health of empty-nest older adults in rural China, while also considering the mediating role of social participation in this relationship.

Methods

A total of 3,478 empty-nest older adults were selected from the China Health and Retirement Longitudinal Survey (CHARLS) in 2020. Among them, 820 individuals were included in the study using a propensity score matching (PSM) method to reduce the impact of selection bias. The participants' depression, physical health, and cognitive health were measured using the Center for Epidemiological Studies Depression Scale (CES-D), the Activities of Daily Living (ADL) scale, and a composite cognition score, respectively. Social participation was assessed based on engagement in various activities over the past month.

Results

After controlling for confounding factors through PSM, it was found that older adults who used the internet exhibited significantly lower level of depression and higher physical health compared to older adults who did not use the internet. However, there was no significant difference in cognitive health between the two groups. The mediating effect analysis revealed that social participation partially mediated the relationship between internet use and physical health, but not emotional health.

Conclusion

The study suggests that internet use can improve emotional and physical health of older adults living in rural China without children at home, with social participation being a mediator in the relationship between internet use and physical health. Future research should explore the underlying mechanisms and develop targeted interventions to promote internet use and social engagement in this population.

One-year ecological momentary assessment of alcohol use, mood, and stress among individuals with alcohol use disorder during SARS-CoV-2 pandemics: a gender-specific reflection

Alcohol consumption (AC) is a leading risk factor for death, morbidity, and disability worldwide. Gender-specific differences in AC and its moderators, which may serve as markers for preventing severe alcohol use disorders (AUD), showed inconsistent results. Additionally, the impact of COVID-19-related lockdowns on these differences remains unclear. We examined gender-specific differences in short- and long-term factors affecting AC in individuals at risk for alcohol dependence, focusing on mood, stress, and the influence of restriction-dependent lockdown phases. 358 subjects with AUD aged 16 to 65 were studied over one year. Daily electronic diaries and monthly questionnaires were conducted from 10/01/2020 to 09/30/2021, assessing real-world trajectories of AC, mood (MDMQ), and stress (PSS-10) during Germany's second COVID-19 wave. Multi-level models were used to assess associations between these measures and with several within- and between-subject variables. During lockdown, women experienced lower and even decreasing mood (valence: β = - 0.2, p < .039; calmness: β = - 0.3, p < .010), while men's mood increased from the most restrictive lockdown phase (valence: β = 0.2, p < .001; calmness: β = 0.3, p < .001) to post-lockdown (valence: β = 0.5, p < .001; calmness: β = 0.6, p < .001). Stress increased earlier (β = 0.8, p < .001) and more prolonged (β = 0.4, p = .021) in women than in men. For both genders, daily mood was positively associated with daily AC (valence: β = 0.6, p = .004; calmness: β = 0.4, p = .013), leading to stronger drinking on days with elevated mood. Conversely, average mood was negatively associated with average AC (valence: β = - 1.6, p = .011; calmness: β = - 1.2, p = .041), indicating higher overall consumption with worse overall mood. Our findings highlight the need for interventions targeting mental distress in women with AUD during pandemics, as this group faces increased mental burden during social isolation and increased risk of alcohol dependence during persistent distress.

Hair Cortisol Concentrations in the Prediction of Early Substance Use Engagement in Youth

OBJECTIVE

Understanding factors associated with early onset of substance use is critical as using alcohol or drugs at a young age is a strong predictor of later substance dependency. Experiencing stressful life events is associated with increased risk for early substance use in youth. Hair cortisol concentration (HCC) is considered a biomarker of psychological stress experienced over longer periods of time. We examined whether HCC could predict early substance use engagement in youth followed over 5 years.

METHODS

Participants were 395 young adolescents (50% female, age range 10-15 years, Mage = 12.3, SD = 1.1 at baseline). Demographic data, socioeconomic factors, and substance use habits were collected at four waves between 2015 and 2021. HCC was assayed from hair collected at a home visit between Wave 1 and Wave 2. Analytic models tested a) HCC in relation to latent class membership of substance use and b) whether HCC moderated the relation between self-reports of stress and substance use.

RESULTS

HCC did not add to the prediction of early substance use engagement in any of the models, while self-reports of stressful life events and everyday discrimination predicted early substance use engagement in the models comparing 'Early' vs 'Late/No' substance use class membership.

CONCLUSION

We found no evidence of HCC to be associated with early substance use engagement in youth. Nevertheless, our results do confirm that self-reports of stressful everyday life experiences predict earlier substance use engagement, underscoring the role of psychosocial stressors as significant predictors of substance use engagement in youth.

The Influence of Multiple Factors on Musicology Doctoral Students' Academic Performance: An Empirical Study Based in China

As doctoral education evolves globally, the focus intensifies on doctoral candidates' academic performance and psychological well-being. Previous research has studied the effects of individual, societal, and environmental factors on students' academic achievements. However, there is still a lack of investigation into how these factors interact, especially in the domains of arts. This study surveyed 213 Chinese musicology doctoral students and adopted Partial Least Squares Structural Equation Modeling (PLS-SEM) to evaluate how various factors affect academic and mental health outcomes. The analysis shows that factors including teacher support, student engagement, and well-being positively influence academic performance, while academic anxiety negatively impacts academic performance. Moreover, variables help diminish academic anxiety, encompassing self-efficacy, parental support, time management skills, and student engagement. Meanwhile, enhanced doctoral students' well-being is related to robust teacher support, facilitating conditions, and active student engagement. Notably, students who experience academic anxiety about their studies generally have lower well-being. These findings indicate that alleviating academic anxiety, refining academic resources, and reinforcing mental health supports can foster academic and psychological outcomes for doctoral students. Our study contributes vital empirical data to developing higher education policies, benefiting doctoral students' mental health and academic success.

Quality of Life and Coping Strategies in Children with and Without Learning Disabilities from the Perspective of Their Parents and Caregivers

BACKGROUND

Children with learning disability (LD) often experience a poor quality of life (QOL) compared to their peers without a known history of LD. Coping strategies are known to play a role in influencing their QOL.

OBJECTIVES

This study aims to compare the QOL and coping strategies between children with and without LD. Additionally, it seeks to evaluate how coping strategies impact the QOL of children with LD in the Eastern Governorate of Saudi Arabia.

METHOD

A representative sample of 6 to 18-year-old children with (n = 97) and without (n = 89) LD were recruited from different schools. The Short Form-12 (SF-12) health survey was used to assess both physical and mental health components, while the validated Coping Orientation to Problems Experienced Inventory (Brief-COPE) measured coping strategies. Data analysis included descriptive statistics (mean, standard deviation, percentage), independent t-tests, Spearman's correlation, and binary logistic regression.

RESULTS

The results reveal that participants with LD show poor QOL in terms of role functioning, bodily pain, general health, vitality, social functioning, role emotion, and mental health in comparison to non-disabled children. Participants with LD show greater reliance on substance abuse and religious coping than non-disabled children. The results clearly indicate a fairly to moderately strong correlation between the physical component summary and all approaches to coping strategies except religious coping. Of all the approaches to coping methods, we observe a weak correlation among denial (r = -0.17, p < 0.05), substance abuse (r = -0.15, p < 0.05), and behavioral disengagement (r = -0.18, p < 0.05) with the mental component summary aspect of QOL. The results of logistic regression analysis indicate that grade (OR = 3.79; p = 0.01) is significantly related to LD. The physical component summary score is significantly associated with denial (β = -0.33, CI = -6.87--2.19, p < 0.01), and substance abuse (β = -0.14, CI = -4.96-0.40, p < 0.05), while the mental component summary is significantly associated with active coping (β = -0.30, CI = -4.50-0.76, p < 0.01), behavioral disengagement (β = -0.20, CI = -4.48-0.30, p < 0.05), and humor coping strategy (β = 0.22, CI = 0.06-4.55, p < 0.05).

CONCLUSION

These findings are relevant to researchers, psychologists, special educators, teachers, and clinicians, given the need to understand the coping variables to improve the QOL of these learning-disabled children.

Balancing life with type 1 diabetes mellitus: A qualitative study of jordanian adolescents

OBJECTIVES

To explore the lived experiences of Jordanian adolescents with type 1 diabetes mellitus (T1DM) and identify their specific needs.

METHODS

Qualitative interviews were conducted with 10 Jordanian adolescents. Thematic analysis was used to identify key themes.

RESULTS

Three main themes emerged: (1) Living with diabetes as a constant struggle, including emotional turbulence, social withdrawal, and difficulty with treatment regimens; (2) Restoring balance in life through social support, following treatment protocols, and accepting the disease; and (3) Adolescents' needs for a better environment, including improved knowledge, resources, and social integration.

CONCLUSIONS

Adolescents with T1DM face significant challenges, including emotional distress, social isolation, and difficulties managing their disease. This study provides valuable insights into their experiences and highlights the importance of comprehensive support.

PRACTICE IMPLICATIONS

To effectively support adolescents with T1DM, healthcare providers and educators should focus on providing emotional support, social support, and practical assistance. Additionally, improving knowledge and awareness about T1DM among adolescents and their families is crucial, as well as increasing access to resources that can help them manage their disease and live fulfilling lives.

Burnout among emergency and surgery residents: An exploration of contributing factors and implications

OBJECTIVES

To assess the prevalence of burnout among emergency and surgical residents and explore the associated factors.

METHODS

This study was carried out at King Faisal University, Al Hofuf, Saudi Arabia, through the period from January to march 2024. A cross-sectional survey design was employed, utilizing the Maslach burnout inventory-human services survey and the resilience scale-14 to measure burnout and resilience. The survey included demographic information, health-related questions, and specific burnout-related items. Descriptive statistics, frequency distributions, and inferential analyses were carried out to explore the relationships between burnout, demographic factors, and resilience.

RESULTS

The study revealed a diverse representation across demographic factors, with variations in burnout prevalence. Approximately 63% of participants reported experiencing burnout, with high levels of emotional exhaustion (55%) and depersonalization (28%). Resilience levels varied across different demographic characteristics. Significant associations were found between burnout and factors such as gender, marital status, having children, specialty, length of experience, and enrollment in postgraduate programs.

CONCLUSION

The findings underscore the urgent need for targeted interventions to address burnout in healthcare professionals. The nuanced relationships between burnout, resilience, and demographic factors highlight the importance of tailored strategies to mitigate burnout effectively. Addressing burnout is crucial not only for the well-being of healthcare professionals but also for maintaining high-quality patient care.

[Climate crisis and psychiatry]

BACKGROUND

The climate crisis is increasingly leading to negative consequences for mental health and is of growing importance for psychiatric and psychotherapeutic care.

OBJECTIVE

The effects of the climate crisis on mental health and its significance for psychiatric and psychotherapeutic care are presented. Recommendations for sustainability in psychiatric and psychotherapeutic practice are provided.

MATERIAL AND METHODS

A narrative review of the literature was conducted for this article.

RESULTS

The climate crisis has direct, indirect and intersectional negative effects on mental health. Sustainable and preventive recommendations for the practice include promoting health literacy, faster access to psychotherapy and online counselling, supporting social networks, promoting employment and reducing poverty, homelessness and social isolation. It is recommended to increase the proportion of outpatient care and to streamline administrative processes. The use of disposable products should be minimized and the application of instrumental diagnostics and materials should be optimized according to guidelines. Digital interventions should be considered more frequently in the clinical practice and sustainable facility management should be improved. Access to green spaces for the general population and patients should be facilitated.

CONCLUSION

Due to the negative impact of the climate crisis on mental health, sustainability should be promoted in psychiatric and psychotherapeutic care.

Experiences of discrimination are associated with microbiome and transcriptome alterations in the gut

Background

Discrimination is a recognized psychosocial stressor that has been linked to various negative health outcomes. This study explored the impact of discrimination on gut health, specifically focusing on microbiome changes, predicted metagenomic differences, transcriptomic profiles, and the potential for using a multi-omic approach to predict discrimination to identify discrimination status for an individual. Methods: We conducted a comprehensive investigation involving male and premenopausal female participants, using the Everyday Discrimination Scale to classify them into either high or low discrimination. Multiple questionnaires were administered to evaluate participants' physiological, psychological, and perceived stressors. Two diet questionnaires were also administered. Stool samples were collected for microbiome analysis and RNA sequencing. Microbial composition changes were analyzed using the Shannon index and Chao1 richness estimator for alpha diversity and the Aitchison distance metric for beta diversity. Differential abundance was evaluated using MaAsLin2, followed by metatranscriptomics sequencing and annotation. A multi-omic approach utilizing random forest was used to assess the predictability of discrimination.

Results

The study results showed that high discrimination was linked to higher gut microbiome species richness (Chao1, p = 0.02) and significant beta diversity differences (p = 0.04). Prevotella and Ruminococcaceae were both less abundant in the high discrimination group. High discrimination participants also reported higher levels of depression, anxiety, perceived stress, early life adversity, visceral sensitivity, and neuroticism than those in the low discrimination group. Gene expression analysis revealed distinctive patterns, with significant changes in genes associated with environmental sensing (two-component system) and metabolic pathways. In a plot comparing gene transcription to DNA content, certain genes showed higher expression levels in participants who experienced both high and low levels of discrimination. Our random forest classifier demonstrated the capability to accurately differentiate individuals with high and low discrimination in our training cohort (AUC = 0.91).

Conclusion

These findings illuminate the substantial impact of discrimination on gut health, encompassing microbiome composition, gene expression, and functional pathways. These findings suggest that discrimination is associated with internal biological changes that can be associated with negative health outcomes, opening research to examine novel pathways that can be used to mitigate the negative health effects of discrimination.

Mental health vulnerability in multicultural families: Risk factors among homogenous country

We investigate the mental health of multicultural families (CFs) in South Korea, identify risk factors, and propose interventions to improve mental health. Adults over 19 years of age were analyzed using the Community Health Survey 2019 in South Korea, consisting of 228,952 individuals including 3,524 from multi-CFs. We employed chi-squared tests and multiple logistic regression to compare mental health between multi- and mono-CFs, exploring the influence of various factors. Multi-CFs had significantly higher levels of stress recognition (P-value = 0.010) and experiences of extreme sadness or despair (P-value = 0.002) than mono-CFs. In multi-CFs, younger group, households with lower income and people with unhealthy behaviors regarding walking or sleeping were at risk of mental health. Socially isolated families, relative to the families participating in active social gatherings, had about a 1.36 times higher risk of stress, 2 times higher experiences of extreme sadness or despair and 5.32 times higher depressive symptoms. Multi-CFs are vulnerable to mental health problems, and even within multi-CFs, groups with relatively low socioeconomic status should be prioritized since problems are more significant among them. Activated social networks can help multi-CFs integrate into society and promote mental health.

Cigarette Smoking, Mental Health, Depression, Maryland Behavioral Risk Factor Surveillance System Survey, 2020

Background

Smoking cessation is linked to improved mental health that encompasses the overall well-being and psychological functioning of an individual.

Objective

Examine relationships between smoking, mental health, and social connectedness among adults in Maryland, US in 2020.

Methodology

This cross-sectional study used data from the Maryland 2020 Behavioral Risk Factor Surveillance System Survey of adults during the onset of COVID-19. Primary outcomes measured include demographics, depression, and number of not good mental health days among individuals with current and former smoking statuses compared to those who have never smoked.

Results

Compared to those who never smoked, individuals who currently smoked had an increased relative risk of reporting 14 or more days of not good mental health (RRR = 1.63, 95% CI: 1.35-1.97, P < .001) and a history of depression (RRR = 1.99, 95% CI: 1.69-2.35, P < .001). Individuals with former smoking status also showed elevated risk, with RRR = 1.24 (95% CI: 1.06-1.45, P = .006) for 14 or more days of not good mental health and RRR = 1.46 (95% CI: 1.28-1.66, P < .001) for a history of depression. Widowed, separated, or divorced; unemployed or unable to work; without a high school diploma; or recent physical exam were inclined to have a current or former smoking status.

Conclusion

We identify critical subpopulations vulnerable to life-long smoking behaviors amid the COVID-19 pandemic including adults under 35 years old, and those suffering from depression, a lack of social connectedness due to unemployment, changes in marital status, and outdated physical exams. The US Surgeon General's 2023 Advisory on the epidemic of loneliness and the 2021 Youth Mental Health Report emphasize the mental health crises among the young in which these findings serve as a compelling call to action for innovating targeted public health interventions.

Exploring factors affecting nurse anxiety in Northwest Ethiopia: a multicenter study

Introduction

Anxiety is a commonly reported mental health disorder that significantly contributes to the global burden of disease. However, proper counseling, problem-solving strategies, and promotion of healthy lifestyle practices have a positive effect on reducing nurse anxiety, but there is limited evidence in Ethiopia, particularly in this study area. Therefore, this study aimed to assess the prevalence and identify factors affecting nurse anxiety in Northwest Ethiopia's comprehensive specialized hospitals.

Methods

An institution-based cross-sectional study was conducted among 746 study participants from April 14 to May 20, 2023. A simple random sampling technique was used. An interviewer-administered questionnaire was used. Data were entered into EpiData version 4.6.0 and exported to STATA version 17 for analysis. In binary logistic regression, variables with a p-value of less than 0.25 were considered candidates for multivariable logistic regression. An association was declared at a p-value of less than 0.05 with a 95% confidence interval.

Result

In this study, the prevalence of anxiety was 33.9%. Thus, being female [adjusted odds ratios (AOR) = 1.53, 95% CI = 1.08, 2.22], working in an emergency department (AOR = 3.65, 95% CI = 1.83, 7.28), working night duty shifts (AOR = 3.12, 95% CI = 2.19, 4.46), having conflict with coworkers (AOR = 1.7, 95% CI = 1.14, 2.51), and having poor social support (AOR = 2.13, 95% CI = 1.23, 3.69) were variables significantly associated with anxiety.

Conclusion

This study revealed that one-third of nurses experienced anxiety, which is a critical indicator of mental health within this population. Important factors that were found to be significantly associated with anxiety include being female, working in the emergency department, having a conflict with coworkers, having poor social support, and working night duty shifts. These findings show the need for the implementation of counseling services and the adaptation of effective coping strategies for nurses working at comprehensive specialized hospitals. Understanding the impact of anxiety on nurses is important to design interventions aimed at improving their mental health and job satisfaction.

Determinants of and barriers to diabetes care among patients with serious mental illness: A scoping review with recommendations

AIM

We performed a scoping review to identify the diabetes care determinants and barriers in patients with serious mental illness (SMI), in view of limited evidence and clarity.

METHODS

We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Guidelines. PubMed, EMBASE, and Scopus were searched from inception to September 2023 to identify eligible studies. Observational studies that reported the determinants of and barriers to diabetes care among SMI patients were considered. A narrative synthesis of review results was performed to gather evidence. Recommendations were framed in the context of this evidence.

RESULTS

Of the 8727 non-duplicate records, only 10 studies that met the inclusion criteria were considered for this review. Of these, four were cohort, two were case-control, and four were cross-sectional in design. All 10 studies were observed to have robust methodologies. Diabetes measures examined in these studies included not only the Healthcare Effectiveness Data and Information Set (HEDIS) measures (HbA1c, retinopathy, nephropathy, and blood pressure), but also lipid, foot, and BMI. Factors contributing to inadequate diabetes care can be attributed to the healthcare system, healthcare providers, and at the patient-level.

CONCLUSION

Currently, there is lack of evidence on determinants of quality diabetes care among SMI patients. Further, adequately powered long term follow-up studies are needed to understand the impact of diabetes care on their clinical outcomes.

Urban resilience reduces depressive symptoms among middle-aged and elderly adults: A multidimensional analysis based on China longitudinal healthy longevity survey

With the rapid urbanization and aging population, depression has become a severe public health issue globally, affecting millions of individuals and significantly impacting their quality of life and healthcare costs. Urban resilience refers to a city's ability to absorb, recover, and prepare for future shocks, ensuring sustainable development despite challenges. This study aims to explore the impact of urban resilience on depressive symptoms among middle-aged and elderly adults. Using data from the China Health and Retirement Longitudinal Study (CHARLS), we analyzed five dimensions of urban resilience: economic, social, ecological, institutional, and infrastructural resilience. The results of cox proportional hazards model indicate that high levels of urban resilience significantly reduce the risk of depressive symptoms (HR = 0.875, 95% CI: 0.832-0.920, P < 0.001). Specifically, economic resilience (HR = 0.883, 95% CI: 0.846-0.921, P < 0.001), social resilience (HR = 0.916, 95% CI: 0.876-0.958, P < 0.001), ecological resilience (HR = 0.670, 95% CI: 0.516-0.869, P = 0.003), institutional resilience (HR = 0.922, 95% CI: 0.886-0.960, P < 0.001), and infrastructural resilience (HR = 0.875, 95% CI: 0.826-0.926, P < 0.001) all show significant negative correlations with depressive symptoms. Furthermore, the mitigation of depressive symptoms risk resulting from improved urban resilience disproportionately benefits vulnerable groups and those with healthy living habits. These findings provide scientific evidence for urban planning and policy formulation, contributing to the promotion of mental health and healthy aging among middle-aged and elderly populations.

The posterior intralaminar thalamic nucleus promotes nose-to-nose contacts leading to prosocial reception in the sequence of mouse social interaction

Efficient social interaction is essential for an adaptive life and consists of sequential processes of multisensory events with social counterparts. Social touch/contact is a unique component that promotes a sequence of social behaviours initiated by detection and approach to assess a social stimulus and subsequent touch/contact interaction to form prosocial relationships. We hypothesized that the thalamic sensory relay circuit from the posterior intralaminar nucleus of the thalamus (pIL) to the paraventricular nucleus of the hypothalamus (PVN) and the medial amygdala (MeA) plays a key role in the social contact-mediated sequence of events. We found that neurons in the pIL along with the PVN and MeA were activated by social encounters and that pIL activity was more abundant in a direct physical encounter, whereas MeA activity was dominant in an indirect through grid encounter. Chemogenetic inhibition of pIL neurons selectively decreased the investigatory approach and sniffing of a same-sex, but not an opposite-sex, stimulus mouse in an indirect encounter situation and decreased the facial/snout contact ratio in a direct encounter setting. Furthermore, chemogenetic pIL inhibition had no impact on anxiety-like behaviours or body coordinative motor behaviours, but it impaired whisker-related and plantar touch tactile sense. We propose that the pIL circuit can relay social tactile sensations and mediate the sequence of nonsexual prosocial interactions through an investigatory approach to tactile contact and thus plays a significant role in establishing prosocial relationships in mouse models.

Mpox in sports: A comprehensive framework for anticipatory planning and risk mitigation in football based on lessons from COVID-19

The World Health Organization's declaration of mpox (formerly known as monkeypox) as a public health emergency of international concern (PHEIC) in July 2022, followed by its resurgence in 2024, has sparked concerns about its potential impact on sports, especially contact sports such as football. Although mpox is not a pandemic (as of late September 2024), the coronavirus disease 2019 (COVID-19) experience offers valuable lessons for proactive planning in sports. Our conceptual framework has been designed to draw insightful lessons from the COVID-19 pandemic to assist sports organizations in planning for and preventing similar situations. We aimed to draw lessons from COVID-19 to help sports organizations enhance practical preparedness through effective planning and mitigation strategies. Accordingly, we sought to assess the potential impact of mpox on sports, with a focus on football (soccer), and to develop strategies for prevention, management, and preparedness based on epidemiological insights and lessons from COVID-19 pandemic experience. Here we review mpox's pathophysiology and possibility of transmission in sports settings and discuss tailored strategies, including risk assessments, testing protocols, hygiene measures, and return-to-play policies. This review highlights key differences between mpox and COVID-19 in transmission, incubation, and management, emphasizing the need for customized prevention and control measures in sports. We propose innovative risk assessment methods using global positioning system tracking and machine learning for contact analysis, alongside tailored testing and hygiene protocols. We emphasize the importance of proactive planning, noting improved preparedness in the sports community compared to the early days of COVID-19. In conclusion, our proposed framework provides sports organizations with practical tools to manage potential risks associated with mpox, ensuring the continuity of activities while prioritizing public health.

Social isolation and loneliness among people living with experience of homelessness: a scoping review

Social isolation and loneliness (SIL) are public health challenges that disproportionally affect individuals who experience structural and socio-economic exclusion. The social and health outcomes of SIL for people with experiences of being unhoused have largely remained unexplored. Yet, there is limited synthesis of literature focused on SIL to appropriately inform policy and targeted social interventions for people with homelessness experience. The aim of this scoping review is to synthesize evidence on SIL among people with lived experience of homelessness and explore how it negatively impacts their wellbeing. We carried out a comprehensive literature search from Medline, Embase, Cochrane Library, PsycINFO, CINAHL, Sociological Abstracts, and Web of Science's Social Sciences Citation Index and Science Citation Index for peer-reviewed studies published between January 1st, 2000 to January 3rd, 2023. Studies went through title, abstract and full-text screening conducted independently by at least two reviewers. Included studies were then analyzed and synthesized to identify the conceptualizations of SIL, measurement tools and approaches, prevalence characterization, and relationship with social and health outcomes. The literature search yielded 5,294 papers after removing duplicate records. Following screening, we retained 27 qualitative studies, 23 quantitative studies and two mixed method studies. SIL was not the primary objective of most of the included articles. The prevalence of SIL among people with homelessness experience varied from 25 to 90% across studies. A range of measurement tools were used to measure SIL making it difficult to compare results across studies. Though the studies reported associations between SIL, health, wellbeing, and substance use, we found substantial gaps in the literature. Most of the quantitative studies were cross-sectional, and only one study used health administrative data to ascertain health outcomes. More studies are needed to better understand SIL among this population and to build evidence for actionable strategies and policies to address its social and health impacts.

Clemastine improves emotional and social deficits in adolescent social isolation mice by reversing demyelination

Adolescence is a critical period for social experience-dependent oligodendrocyte maturation and myelination. Adolescent stress predisposes to cause irreversible changes in brain structure and function with lasting effects on adulthood or beyond. However, the molecular mechanisms linking adolescent social isolation stress with emotional and social competence remain largely unknown. In our study, we found that social isolation during adolescence leads to anxiety-like behaviors, depression-like behaviors, impaired social memory and altered patterns of social ultrasonic vocalizations in mice. In addition, adolescent social isolation stress induces demyelination in the prefrontal cortex and hippocampus of mice, with decreased myelin-related gene expression and disrupted myelin structure. More importantly, clemastine was sufficient to rescue the impairment of emotional and social memory by promoting remyelination. These findings reveal the demyelination mechanism of emotional and social deficits caused by social isolation stress in adolescence, and provides potential therapeutic targets for treating stress-related mental disorders.

Evaluating the Impact of Motivational Enhancement Therapy on Tobacco Cessation in Schizophrenia: A Comprehensive Review

Tobacco use is markedly prevalent among individuals with schizophrenia, presenting significant challenges to their physical health and psychiatric treatment. This comprehensive review evaluates the impact of motivational enhancement therapy (MET) on tobacco cessation in this population. Schizophrenia, a chronic mental disorder characterized by symptoms such as delusions and hallucinations, is frequently accompanied by high rates of smoking, which exacerbates health risks and complicates treatment regimens. MET, a client-centered approach rooted in motivational interviewing, aims to enhance intrinsic motivation for behavior change through empathetic and non-confrontational therapeutic sessions. This review synthesizes evidence from clinical studies on MET's effectiveness in promoting smoking cessation among individuals with schizophrenia. The review highlights the therapy's strengths, including its adaptability and client-focused nature, which are particularly beneficial for addressing the unique challenges faced by this population. It also discusses the broader health benefits of smoking cessation, such as improved physical health and enhanced efficacy of psychiatric medications. Despite promising results, the review identifies limitations and challenges in applying MET, such as potential barriers to implementation and the need for further research. In conclusion, MET offers a valuable intervention for tobacco cessation in individuals with schizophrenia, with the potential to significantly improve health outcomes and quality of life. Future research should focus on optimizing MET strategies and exploring their broader impacts on this vulnerable population.

Prevalence and incidence of suicide, suicidal ideation and self-harm in caregivers of cancer patients: A systematic review and meta-analysis

OBJECTIVE

Caregiving burden is set to increase with the rising incidence of cancer globally. The meta-analysis seeks to investigate the prevalence of suicide, suicidal ideation and self-harm among the caregivers of patients with cancer (CPCs).

METHODS

This PRISMA-adherent systematic review involved a systematic search of PubMed, Embase, Cochrane and PsycINFO for all studies that evaluated the prevalence of suicide, suicidal ideation and self-harm in CPCs. Random effects meta-analyses were used for primary analysis.

RESULTS

Eleven studies were included. Meta-analyses indicated that the prevalence of suicidal ideation in CPCs was 11% (95%CI:6-18), suicide prevalence was 6% (95%CI:3-12), and self-harm prevalence was 15% (95%CI:8-26). Subgroup analyses revealed that CPCs above the age of 50 experienced a greater prevalence of suicidal ideation (17%, 95%CI:10-28) as compared to CPCs below 50 (6%, 95%CI:3-12). Family caregivers particularly spouses were also found to have a higher prevalence of suicidal ideation (17%, 95%CI:13-23), as compared to children (5%, 95%CI:2-10) or mothers (3%, 95%CI:1-8). Systematic review found that having a pre-existing mental health condition and lower socioeconomic status increased likelihood of suicidality.

CONCLUSION

We highlight the need for more support of CPCs at risk of suicidality. Additional research is warranted to identify other risk and protective factors.

Moxie begets MOXI: The journey to a novel hypothesis about Mu-opioid and OXytocin system Interactions

This narrative review summarizes the early life of the author, Khalin E. Nisbett, and highlights the factors that led to her career in research and her development of two novel research hypotheses: the Mu-opioid and OXytocin system Interaction (MOXI) hypothesis and Mu-Opioid receptor antagonist and OXytocin receptor Agonist In Combination (MOXAIC) treatment hypothesis. Notably, Nisbett's career began in the era after countless studies demonstrated that oxytocin is not just a female neurotransmitter and not just a female reproductive hormone, an era in which researchers are exploring the role of oxytocin in emotion regulation, social interaction, and cognitive processing across both sexes. As such, the previously held perspective that oxytocin is "just a female hormone" did not impede Nisbett's ideas. Intrigued by science, emotion regulation, and social interaction, she began to explore the role of oxytocin and opioids in emotion regulation. On the heels of earlier theories, such as the Tend-and-Befriend theory and Opioid Theory of Social Attachment, she began to develop the MOXI hypothesis, which postulates that the μ-opioid receptor and oxytocin systems interact to mediate social interaction and emotion regulation. In this narrative review, Nisbett summarizes two studies that explored (i) the role of oxytocin in anxiety- and depression-like behavior and (ii) the effect of opioid receptor blockade on the anxiolytic-like effect of oxytocin, which led to a revision of the MOXI hypothesis and postulation of the Mu-Opioid receptor antagonist and OXytocin receptor Agonist In Combination (MOXAIC) treatment hypothesis. Nisbett also discusses several limitations of these hypotheses and her current research interests and aspirations.

S, Sachin, Rajendrasinh VU, Arunlal BS, Dineshbhai SR, Meghabhai CS. Comparative analysis of stress levels among working and non-working Indian women in rural Gujarat

Stress is derived from the Latin word "stringers" manifests as the body's response to various demands and pressures, affecting individuals' health and well-being. Therefore, it is of interest to evaluate stress levels in employed and unemployed women, recognizing the differential stress experiences in various life domains. A quantitative non-experimental comparative research design was employed, with data collected through structured questionnaires from 120 women in Visnagar, Gujarat. Results: Non-working women demonstrated lower stress levels compared to working women in pre-test measures. Post-intervention, non-working women experienced a reduction in stress, while working women showed no change. Demographic factors like age, education, and family structure did not significantly influence stress levels, except for monthly income, which correlated with lower stress across both groups. The study underscores significant disparities in stress levels between employed and unemployed women in rural Visnagar. Tailored interventions effectively reduced stress among non-working women but showed limited efficacy for working women. Financial stability emerged as a crucial factor in mitigating stress. Younger working women reported higher stress levels, suggesting the need for targeted interventions addressing career and familial pressures.

Coping efforts made: Psychological burden of people living with tuberculosis due to social stigma in society. A qualitative phenomenology study

The psychological burden is greatly felt by people living with tuberculosis because the characteristics of the disease are very visible and very contagious, and the obligation to take the right dose of medication with long treatment. This is what makes tuberculosis a very stigmatic disease. The aim of this research is to explore the psychological burden felt by people living with tuberculosis due to social stigma by society and how coping efforts are made. This research uses a qualitative phenomenological design through in-depth face-to-face interviews which take place in a semi-structured manner with the hope of obtaining complete data. The purposive sampling method was used in this research with Participatory Interpretative Phenomenology analysis involving 25 participants consisting of 16 men and 9 women. This research produced several themes, including 1) "The Perception of stigma limiting space and time", 2) "The Opportunities for interpersonal interaction become narrow", 3) "The mental stress as a challenging emotion", and 4) " Expanding coping efforts". The psychological burden is felt by people living with tuberculosis because society's treatment is felt to be very discriminatory due to the social stigma that has developed in society so they lose the opportunity to interact with society. For that reason, they tried to explore some of the personal and environmental resources used to modify adaptive coping in resolving perceived psychological burdens. Given the possibility of ongoing stigma and discrimination during tuberculosis treatment programs, it is important to consider the psychological burden in this context, both on the general population and on groups affected by stigma.

Incidence and influencing factors related to social isolation among HIV/AIDS patients: Protocol for a systematic review and meta-analysis

BACKGROUND

People living with HIV (PLWH) are susceptible to social isolation as a result of stigma and discrimination, which not only diminishes adherence to antiretroviral therapy but also heightens the risks of hospital readmission, depression, and mortality. However, there is currently no systematic review addressing the occurrence and impact of social isolation in individuals with HIV. Therefore, this study undertook a comprehensive systematic review and meta-analysis of existing literature to examine the prevalence and influencing factors associated with social isolation among PLWH.

METHODS AND ANALYSIS

PubMed, EMBASE, CINAHL, Cochrane Library, Web of Science, Google Scholar, China Science and Technology Journal Database, The China National Knowledge Infrastructure, WanFang Data and Chinese Biomedicine Literature Database will be searched from the establishment of the database to the latest search date. Literature screening, data extraction and literature quality assessment will be done independently by two researchers and results will be cross-referenced. Data analysis will be performed using stata15.1 software. Risk of publication bias will be assessed using Begg's and Egger's methods. Heterogeneity between studies will then be assessed using the I2 index and its 95% CI and Q statistics. Sources of heterogeneity will be accounted for by subgroup and sensitivity analyses.

RESULTS

The results may reveal the prevalence of social isolation among PLWH and provide data support for understanding its etiology and prevention.

CONCLUSION

By systematically reviewing the existing literature on social isolation among PLWH, this study aims to provide a comprehensive understanding of the prevalence of social isolation within this population, elucidate the detrimental effects it poses for people affected by HIV, and effectively inform targeted interventions for high-risk groups. Furthermore, these findings offer valuable insights to support evidence-based decision-making in public health policy.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration number: CRD42024499044.

Supportive care of female hormones in brain health: what and how?

Female hormones, functioning as neuroactive steroids, are utilized beyond menopausal hormone therapy. The rapid onset of allopregnanolone analogs, such as brexanolone and zuranolone, in treating depression, and the effectiveness of megestrol acetate in addressing appetite and weight gain, prompted the Food and Drug Administration to authorize the use of progesterone for treating postpartum depression and cancer-related cachexia. Progesterone has also been found to alleviate neuropathic pain in animal studies. These off-label applications offer a promising option for patients with advanced cancer who often experience various mood disorders such as depression, persistent pain, social isolation, and physical complications like cachexia. These patients have shown low tolerance to opioids and mood-regulating medications. However, the potential risks and uncertainties associated with hormone therapy treatment modalities can be daunting for both patients and medical professionals. This review aims to offer a comprehensive understanding of the non-reproductive functions and mechanisms of female hormones in brain health.

Understanding Internalized Stigma's Role in Sex-Specific Suicidal Ideation among Individuals with Bipolar Disorder

Background: The experience of stigma can exert a profound impact on the mental health and well-being of individuals with bipolar disorder (BD). Our study explores which factors of internalized stigma are associated with suicidal ideation and how they differ between the two sexes in a clinical sample of BD patients. Methods: The study follows a cross-sectional study design, employing the Clinical Global Impression for Bipolar Patients (CGI-BP) to evaluate the overall severity of illness and the alteration in patients affected by bipolar disorder, the Internalized Stigma of Mental Illness (ISMI) assessing self-stigma among individuals experiencing mental disorders, and the Columbia Suicide Severity Rating Scale (C-SSRS) identifying and assessing individuals vulnerable to suicide. Descriptive analyses, analysis of variance (ANOVA), and logistic regression analysis were conducted, and 344 BD subjects were recruited. Results: Our ANOVA results revealed a significant association between sex and suicide across ISMI sub-items (p = 0.000). Logistic regression analysis comprised three phases: Discrimination was consistently significant across all phases (p < 0.001), while Alienation and Stereotype emerged as additional predictors of suicide in later phases of the analysis (p < 0.001). Conclusions: Our study contributes to the growing body of literature on internalized stigma, sex, and suicidality among individuals with bipolar disorder. Early intervention programs and prevention strategies are needed.

Implementing a social prescribing program in primary care units in Portugal: A qualitative study exploring enablers, barriers and lessons learned from the perspectives of stakeholders involved in the program implementation

Social prescribing (SP) is a promising intersectoral strategy of integrated and person-centered care that can improve individual health and well-being by going beyond medical treatment, potentially reducing overall disease burden on health system. SP addresses health and social determinants of health by linking patients to community responses, i.e. services and initiatives fostering social interaction, physical activity and creativity, among other health-promoting aspects, provided by local public, private, and non-profit entities. There is limited research on the implementation processes of SP beyond the UK, hindering improvement and scale-up. This study aims to identify enablers and barriers of implementation of an SP program conducted in Portugal. A participatory and qualitative approach was used to assess the implementation of an SP program in health units. Semi-structured interviews were conducted with family doctors, social workers and representatives of community partners who participated in SP implementation. The Consolidated Framework for Implementation Research was used to conduct thematic analysis. The main enablers of SP implementation included its recognition as an evolution towards a holistic model of health, the personal characteristics of professionals as being proactive, motivated, and concerned with social determinants of health, and the communication strategy used to engage the stakeholders. Perceived challenges included raising users' awareness of SP and ensuring intervention adherence. Lack of preparedness for intersectoral working processes, including insufficient communication channels, limited community responses and the need for a more systematic collection of data on activities adherence and progress were also highlighted as barriers to SP implementation. SP implementation seems simple, but the results show that in practice, we are facing a complex intervention with multiple stakeholders, diverse community responses and factors influencing project success. A deeper understanding of SP specificities, local context, enablers, and barriers is vital to develop strategies for improvement and successful implementation, ensuring scalability and sustainability.

Social Isolation Induces Changes in the Monoaminergic Signalling in the Rat Medial Prefrontal Cortex

(1) Background: The effects of short-term social isolation during adulthood have not yet been fully established in rats behaviourally, and not at all transcriptomically in the medial prefrontal cortex (mPFC). (2) Methods: We measured the behavioural effects of housing adult male rats in pairs or alone for 10 days. We also used RNA sequencing to measure the accompanying gene expression alterations in the mPFC of male rats. (3) Results: The isolated animals exhibited reduced sociability and social novelty preference, but increased social interaction. There was no change in their aggression, anxiety, or depression-like activity. Transcriptomic analysis revealed a differential expression of 46 genes between the groups. The KEGG pathway analysis showed that differentially expressed genes are involved in neuroactive ligand-receptor interactions, particularly in the dopaminergic and peptidergic systems, and addiction. Subsequent validation confirmed the decreased level of three altered genes: regulator of G protein signalling 9 (Rgs9), serotonin receptor 2c (Htr2c), and Prodynorphin (Pdyn), which are involved in dopaminergic, serotonergic, and peptidergic function, respectively. Antagonizing Htr2c confirmed its role in social novelty discrimination. (4) Conclusions: Social homeostatic regulations include monoaminergic and peptidergic systems of the mPFC.

Depressive Symptoms among Psychiatric Nurses in a Hospital: An Analytical Research

BACKGROUND

Psychiatric nurses are vulnerable to the menace of negative emotions due to the nature of their work and the closed environment in which they work. In this study, we aimed to investigate the incidence and influencing factors of depression among psychiatric nurses.

METHODS

A cross-sectional survey method was adopted to investigate 64 nurses working in the psychiatric department of a hospital from June 2022 to June 2023. The Beck Depression Inventory (BDI) questionnaire was administered to all included respondents, who were divided into depressed group (>4 points) and non-depressed group (≤4 points) according to the BDI scores. General sociological and disease-related characteristics of these two groups were measured, and items with significant differences were analyzed by logistic regression to derive factors that have an impact on the occurrence of depression among psychiatric nurses.

RESULTS

Twelve psychiatric nurses in the surveyed hospital exhibited signs of depressive symptoms, with a rate of 18.75%. The univariate analysis unveiled differences between the depressed group and the non-depressed group in terms of daily sleep time, weekly working hours, professional title, working pressure, physical exercise, length of service, and physical condition. Further analysis through logistic regression revealed that daily sleep time, weekly working hours, and physical condition were factors affecting the occurrence of depression among psychiatric nurses.

CONCLUSION

The vulnerability of psychiatric nurses to depression, which are potentially influenced by daily sleep hours, weekly working hours, and physical condition, deserves clinical attention so that countermeasures can be developed for early intervention.

Social context modulates multibrain broadband dynamics and functional brain-to-brain coupling in the group of mice

Although mice are social, multiple animals' neural activities are rarely explored. To characterise the neural activities during multi-brain interaction, we simultaneously recorded local field potentials (LFP) in the prefrontal cortex of four mice. The social context and locomotive states predominately modulated the entire LFP structure. The power of lower frequency bands-delta to alpha-were correlated with each other and anti-correlated with gamma power. The high-to-low-power ratio (HLR) provided a useful measure to understand LFP changes along the change of behavioural and locomotive states. The HLR during huddled conditions was lower than that during non-huddled conditions, dividing the social context into two. Multi-brain analyses of HLR indicated that the mice in the group displayed high cross-correlation. The mice in the group often showed unilateral precedence of HLR by Granger causality analysis, possibly comprising a hierarchical social structure. Overall, this study shows the importance of the social environment in brain dynamics and emphasises the simultaneous multi-brain recordings in social neuroscience.

Maintaining a Dynamic Brain: A Review of Empirical Findings Describing the Roles of Exercise, Learning, and Environmental Enrichment in Neuroplasticity from 2017-2023

Brain plasticity, also termed neuroplasticity, refers to the brain's life-long ability to reorganize itself in response to various changes in the environment, experiences, and learning. The brain is a dynamic organ capable of responding to stimulating or depriving environments, activities, and circumstances from changes in gene expression, release of neurotransmitters and neurotrophic factors, to cellular reorganization and reprogrammed functional connectivity. The rate of neuroplastic alteration varies across the lifespan, creating further challenges for understanding and manipulating these processes to benefit motor control, learning, memory, and neural remodeling after injury. Neuroplasticity-related research spans several decades, and hundreds of reviews have been written and published since its inception. Here we present an overview of the empirical papers published between 2017 and 2023 that address the unique effects of exercise, plasticity-stimulating activities, and the depriving effect of social isolation on brain plasticity and behavior.

The Text-Picture Integration Scale for Perspectives on Mental Illness: Development and Validation

IMPORTANCE

Understanding the root cause of mental illness stigma is necessary to adopt effective management strategies.

OBJECTIVE

To establish a stable and effective text-picture integration rating scale to predict public perspectives on mental illness and to examine its reliability and validity.

DESIGN

Descriptive cross-sectional study using internet survey data.

SETTING

Online.

PARTICIPANTS

Two hundred volunteers.

RESULTS

The 10-item the Text-Picture Integration Scale for Perspectives on Mental Illness was developed. The authors conducted data analysis using SPSS to evaluate the reliability and criterion-related validity of the Mental Health Literacy Scale (MHLS). The Text-Picture Integration Scale's item-level content validity index ranged from 0.83 to 1.00, and the scale-level content validity index was 0.97. The scale demonstrated acceptable reliability (Cronbach's α = .80). The mean value of individual items ranged from 3.18 to 4.48, and the mean total score was 39.44 (SD = 8.47). The Text-Picture Integration Scale exhibited satisfactory criterion-related validity with the MHLS (r = .76, p < .001).

CONCLUSIONS AND RELEVANCE

Preliminary analyses support that the Text-Picture Integration Scale is a stable and effective rating scale to determine public perspectives on mental illness and is appropriate for evaluating destigmatization efforts. Plain-Language Summary: The study findings support the use of the Text-Picture Integration Scale as a stable and effective rating scale to determine public perspectives on mental illness. The scale is also appropriate for evaluating ways to address the stigmas that people associate with mental illness, which pose challenges for people in recovery. Occupational therapists can leverage their understanding of public perspectives on mental illness when choosing interventions to support the overall well-being of their clients with mental illness.

Evidence-based health messages increase intention to cope with loneliness in Germany: a randomized controlled online trial

Loneliness poses a formidable global health challenge in our volatile, post-pandemic world. Prior studies have identified promising interventions to alleviate loneliness, however, little is known about their effectiveness. This study measured the effectiveness of educational entertainment ("edutainment") and/or evidence-based, written health messages in alleviating loneliness and increasing intention to cope with loneliness. We recruited 1639 German participants, aged 18 years or older. We compared three intervention groups who received: (A) edutainment and written health messages, (B) only edutainment, or (C) only written health messages, against (D) a control group that received nothing. The primary outcomes were loneliness and intention to cope with loneliness. Participants were also invited to leave comments about the interventions or about their perception or experiences with loneliness. We found a small (d = 0.254) but significant effect of the written messages on increased intention to cope with loneliness (b = 1.78, t(1602) = 2.91, P = 0.004), while a combination of edutainment and written messages significantly decreased loneliness scores (b = -0.25, t(1602) = -2.06, P = 0.04) when compared with the control, even after adjusting for covariables including baseline values, self-esteem, self-efficacy, and hope. We also observed significantly higher self-esteem scores after exposure to a combination of edutainment and written messages (b = 0.821, t(1609) = 1.76, one-tailed P = 0.039) and significantly higher hope scores after exposure to edutainment-only (b = 0.986, t(1609) = 1.85, one-tailed P = 0.032) when compared with the control group. Our study highlights the benefits of using written messages for increasing intention to cope with loneliness and a combination of edutainment and written messages for easing loneliness. Even in small "doses" (less than 6 min of exposure), edutainment can nurture hope, and edutainment combined with written messages can boost self-esteem.

Enhancing ventrolateral prefrontal cortex activation mitigates social pain and modifies subsequent social attitudes: Insights from TMS and fMRI

Social pain, a multifaceted emotional response triggered by interpersonal rejection or criticism, profoundly impacts mental well-being and social interactions. While prior research has implicated the right ventrolateral prefrontal cortex (rVLPFC) in mitigating social pain, the precise neural mechanisms and downstream effects on subsequent social attitudes remain elusive. This study employed transcranial magnetic stimulation (TMS) integrated with fMRI recordings during a social pain task to elucidate these aspects. Eighty participants underwent either active TMS targeting the rVLPFC (n = 41) or control stimulation at the vertex (n = 39). Our results revealed that TMS-induced rVLPFC facilitation significantly reduced self-reported social pain, confirming the causal role of the rVLPFC in social pain relief. Functional connectivity analyses demonstrated enhanced interactions between the rVLPFC and the dorsolateral prefrontal cortex, emphasizing the collaborative engagement of prefrontal regions in emotion regulation. Significantly, we observed that negative social feedback led to negative social attitudes, whereas rVLPFC activation countered this detrimental effect, showcasing the potential of the rVLPFC as a protective buffer against adverse social interactions. Moreover, our study uncovered the impact role of the hippocampus in subsequent social attitudes, a relationship particularly pronounced during excitatory TMS over the rVLPFC. These findings offer promising avenues for improving mental health within the intricate dynamics of social interactions. By advancing our comprehension of the neural mechanisms underlying social pain relief, this research introduces novel intervention strategies for individuals grappling with social distress. Empowering individuals to modulate rVLPFC activation may facilitate reshaping social attitudes and successful reintegration into communal life.