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.

Breaking the cycle: Psychological and social dimensions of pediatric functional gastrointestinal disorders

BACKGROUND

Functional gastrointestinal disorders (FGIDs) in children present with chronic symptoms like abdominal pain, diarrhea, and constipation without identifiable structural abnormalities. These disorders are closely linked to gut-brain axis dysfunction, altered gut microbiota, and psychosocial stress, leading to psychiatric comorbidities such as anxiety, depression, and behavioral issues. Understanding this bidirectional relationship is crucial for developing effective, holistic management strategies that address physical and mental health.

AIM

To examine the psychiatric impacts of FGIDs in children, focusing on anxiety and depression and their association with other neurodevelopmental disorders of childhood, such as attention-deficit/hyperactivity disorder, emphasizing the role of the gut-brain axis, emotional dysregulation, and psychosocial stress. Key mechanisms explored include neurotransmitter dysregulation, microbiota imbalance, central sensitization, heightening stress reactivity, emotional dysregulation, and symptom perception. The review also evaluates the role of family dynamics and coping strategies in exacerbating FGID symptoms and contributing to psychiatric conditions.

METHODS

A narrative review was conducted using 328 studies sourced from PubMed, Scopus, and Google Scholar, covering research published over the past 20 years. Inclusion criteria focused on studies examining FGID diagnosis, gut-brain mechanisms, psychiatric comorbidities, and psychosocial factors in pediatric populations. FGIDs commonly affecting children, including functional constipation, abdominal pain, irritable bowel syndrome, gastroesophageal reflux, and cyclic vomiting syndrome, were analyzed concerning their psychological impacts.

RESULTS

The review highlights a strong connection between FGIDs and psychiatric symptoms, mediated by gut-brain axis dysfunction, dysregulated microbiota, and central sensitization. These physiological disruptions increase children’s vulnerability to anxiety and depression, while psychosocial factors - such as chronic stress, early-life trauma, maladaptive family dynamics, and ineffective coping strategies - intensify the cycle of gastrointestinal and emotional distress.

CONCLUSION

Effective management of FGIDs requires a biopsychosocial approach integrating medical, psychological, and dietary interventions. Parental education, early intervention, and multidisciplinary care coordination are critical in mitigating long-term psychological impacts and improving both gastrointestinal and mental health outcomes in children with FGIDs.

Connectome modeling of discrimination exposure: Impact on your social brain and psychological symptoms

Discrimination is a social stressor that is associated with adverse health outcomes, but the underlying neural mechanisms remain unclear. The fusiform, including the fusiform face area (FFA) plays a critical role in face perception especially regarding hostile faces during discrimination exposure; and are key regions involved in social cognition. We compared resting-state spontaneous activity and connectivity of the fusiform and FFA, between 153 individuals (110 women) with high (N = 73) and low (N = 80) levels of discrimination (measured by the Everyday Discrimination Scale) and evaluated the relationships of these brain signatures with psychological outcomes and stress-related neurotransmitters. Discrimination-related group differences showed altered fusiform signal fluctuation dynamics (Hurst exponent) and connectivity. These alterations predicted discrimination experiences and correlated with anxiety, depression, and cognitive difficulties. A molecular architecture analysis using cross-modal spatial correlation of brain signatures and nuclear imaging derived estimates of stress-related neurotransmitters demonstrated overlap between discrimination-related connectivity and dopamine, serotonin, gamma-aminobutyric acid (GABA), and acetylcholine. Discrimination exposure associated with alterations in the fusiform and face processing area may reflect enhanced baseline preparedness and vigilance towards facial stimuli and decreased top-down regulation of potential threats. These brain alterations may contribute to increased vulnerability for the development of mental health symptoms, demonstrating clinical relevance of social cognition in stressful interpersonal relationships.

Population dependent rearing modifies sleep and decision-making ability with the involvement of noradrenaline: a study conducted using zebrafish as a model

Sleep is an instinct phenomenon, which affects cognitive processes including learning, memory and decision-making. Its quality, quantity and pattern vary in species through evolution. Living in groups (compared to living individually) with an increased population (as a family and a society) is an important contributing factor influencing the evolution of many behaviours. We hypothesized that rearing (upbringing) among many individuals (as compared to in isolation) and socialization might have influenced the quality, quantity and pattern of optimum sleep (a fundamental behaviour), which in turn affected animal behaviour(s) including learning and decision-making. To confirm, using zebrafish (which expresses shoaling) as a model we evaluated their sleep pattern as well as decision-making ability when reared post-birth under isolated (individually) or populated conditions. We observed that zebrafish reared under isolation affected sleep and compromised their decision-making ability when exposed to predator, which otherwise threatens their survivability. Also, the adverse effects of isolation were improved when the zebrafish were either reared in shoal or, by α1-adrenoceptor antagonist, prazosin, suggesting the role of noradrenaline in mediating the responses. Based on our findings we propose that one of the physiological benefits of living in a society is better (optimum) sleep health, which in turn helps with quality living.

Evaluating the role of simple assistive devices in promoting motivation and self-care in chronic disease management

OBJECTIVE

This study evaluates the development and distribution of simple assistive devices designed to support individuals in managing their health conditions at home. The focus is on older adults from lower socio-economic groups in Stoke-on-Trent and Newcastle-under-Lyme, UK.

METHODS

Assistive kits were distributed to participants between December 2021 and April 2022, addressing weight management, diabetic foot care, mental wellbeing, and daily living independence. Each kit contained affordable and accessible assistive devices, including portion plates, exercise bands, and remote-operated plugs, alongside educational materials to promote self-care. Feedback was collected between March and June 2022 to assess user satisfaction and engagement. A qualitative analysis, informed by self-determination theory, explored how these kits supported autonomy, competence, and relatedness in self-management.

RESULTS

Over 90 % of recipients reported using the kits more than once weekly and an increased confidence in managing their health conditions independently. Qualitative analysis indicated that the kits facilitated motivation towards self-management by enhancing users' autonomy, competence, and social connectedness. However, barriers such as cost, availability, and lack of support were identified as limiting factors for broader adoption.

CONCLUSIONS

This study highlights the potential of affordable, simple assistive devices to empower individuals in managing their health and wellbeing. The initiative demonstrates a promising approach to addressing health management challenges in lower socio-economic groups. Further research is needed to expand access and refine interventions to maximise impact and improve quality of life.

Perceived discrimination among migrants in Germany: Does social capital moderate harmful effects on mental health?

BACKGROUND

The harmful mental health effects of perceived discrimination for migrant populations are well established. The potential buffering effect of regional-level social capital, however, has not previously been explored.

METHODS

Using data from the German Socio-Economic Panel (SOEP; 2009-2018) we apply multilevel models to assess the effect of frequent or infrequent perceived discrimination on mental health (MCS subscale of the SF-12) adjusting for individual- and regional-level confounding in a cross-sectional research design. We assess interaction with general social capital (civic engagement, electoral participation, generalised trust) and migrant-specific resources (proportion of non-nationals). We juxtapose non-refugee migrants (n = 13478) with refugees subject to mobility restrictions (n = 5558) to account for bias introduced by selective mobility into regions.

RESULTS

In the non-refugee sample, we confirm the negative effects of discrimination experiences on MCS (ß frequent: -3.74, 95%-CI: [-4.40; -3.09]/ß infrequent: -1.88, 95%-CI: [-2.24; -1.52]). Moderation analyses among non-refugees show no buffering of general social capital, but a negative interaction effect of the proportion of non-nationals with experiences of discrimination (ß frequent: -0.54, 95%-CI: [-0.87; -0.21]/ß infrequent: -0.68, 95%-CI: [-1.29; -0.07]). Analyses among refugees also demonstrate a negative effect of discrimination on MCS with stronger overall effects than in the migrant sample (ß frequent: -6.24, 95%-CI: [-7.44; -5.05]/ß infrequent: -3.56, 95%-CI: [-4.25; -2.86]). In the refugee sample, the effect is exacerbated by the proportion of non-nationals (ß frequent: -1.70, 95%-CI: [-2.84; -0.56]) and buffered by generalised trust (ß: 0.87, 95%-CI: [0.13; 1.60]).

CONCLUSIONS

When faced with experiences of discrimination, levels of community trust seem to buffer the negative mental health impacts for refugees. We do not find buffering effects of social capital on the mental health of non-refugee migrants, possibly due to established social networks. Furthermore, our results suggest that the proportion of non-nationals within a community may have a negative reinforcing impact on the relationship between discrimination and mental health for both migrant samples. As this dynamic is currently underexplored in the German context, more community-based research is needed to develop appropriate policy interventions.

Mental health of young adults pursuing higher education in Tier-1 cities of India: A cross-sectional study

India, with its vast youth population, grapples with significant mental health issues among young adults in higher education, due to factors such as academic pressure, social isolation, stigma, economic uncertainty, screen time, sedentary lifestyles, and pandemic-related stresses. Though the issue has garnered attention, there's a gap in post-pandemic mental health research for Indian students. This study aims to address this by investigating anxiety, depression, and overall mental well-being among students aged 18-29 in higher educational institutions across eight major Indian cities, categorized by gender, zone, city, and institution type. Using a cross-sectional design and multi-stage sampling, we surveyed 1628 students (47.1 % males, 52.9 % females) using the Mental Health Inventory (MHI-38). Female students reported higher distress levels than males. Students from the Western and Southern zones showed higher positivity and well-being. Kolkata students reported low positivity but superior well-being. Hyderabad students reported low depression levels. Central University students reported more depression, while government arts and science college students reported lower life satisfaction. The majority exhibited moderate to high levels of anxiety (69.9 %), depression (59.9 %), loss of behavioral/emotional control (65.1 %), and distress (70.3 %). These statistics underscore the burden of mental health issues faced by this demographic. Despite the prevalence, a minimal number of young adults accessed mental health services, often due to stigma and cultural biases. This study highlights how the post-pandemic context has exacerbated these barriers, revealing significant mental health issues among participants and underscoring the urgent need for targeted interventions in educational institutions amidst rising suicide rates in this demographic.

Sleep Quality and Mental Health Among Medical Students: A Cross-Sectional Study

Background: Sleep disturbances and mental health disorders represent a significant public health concern. Medical students, in particular, experience intense academic pressure, long study hours, irregular schedules, and the emotional burden of clinical training, all of which may contribute to the development of sleep disturbances and mental health issues. This study aims to assess sleep quality and the prevalence of symptoms of depression, anxiety, and stress among medical students, as well as their interrelationships. Methods: This multicentric cross-sectional study was conducted in January and February 2025 among medical students from two medical faculties in Croatia. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), while symptoms of depression, anxiety, and stress were evaluated using Depression, Anxiety, and Stress Scale-21 (DASS-21). Results: The study included 386 participants, of whom 96 were male and 290 were female students. It was found that 67.9% of students had poor sleep quality, while symptoms of depression, anxiety, and stress were reported by 38.8%, 45.3%, and 40.4% of participants, respectively. Female students exhibited higher PSQI scores (U = 10,205, p < 0.001), as well as higher levels of depression (U = 10,372, p < 0.001), anxiety (U = 10,328, p < 0.001), and stress scores (U = 10,560, p < 0.001). Additionally, significant moderate positive correlations were observed between the total PSQI score and depression (ρ = 0.566, p < 0.001), anxiety (ρ = 0.489, p < 0.001), and stress scores (ρ = 0.503, p < 0.001). Moreover, an increase in depression (β = 0.178, p < 0.001) and anxiety scores (β = 0.141, p < 0.001) contributed to a higher total PSQI score, indicating poorer sleep quality. Conclusions: A high prevalence of poor sleep quality and symptoms of depression, anxiety, and stress was observed among medical students, with female students exhibiting higher levels of these variables. Furthermore, poorer sleep quality was associated with higher levels of depression, anxiety, and stress.

School Performance and Learning Challenges in Children and Adolescents with Congenital Heart Disease

Children with congenital heart disease are at risk for neurocognitive and neurodevelopmental challenges, learning disabilities, and psychosocial difficulties. Our narrative review draws literature-based evidence for the effect of congenital heart disease on school performance. We conducted a literature review and extracted relevant articles from Google Scholar, Medline, and PubMed. Evidence showcases that school performance is impacted directly by congenital heart disease. This seems to be underlined by different factors inherent to congenital heart disease, like inattention, language difficulties, and decreased fine and gross motor skills. Moreover, the operative and postoperative periods present various physical challenges that can hinder development, ultimately affecting daily activities and quality of life. The consequent stressors in childhood can have long-lasting effects, leading to an increased prevalence of anxiety and depression affecting patients as they transition into adolescence and adulthood and placing significant social and emotional burdens on their direct environment. Children with congenital heart disease face both direct and indirect challenges related to their disease. These challenges are most likely to be the source of poor school performance and learning, as suggested by the literature. Close monitoring, early interventions, and multidisciplinary care are essential to address these vulnerabilities and improve educational outcomes in children with congenital heart disease.

Should my Chatbot Health Coach be Certified and Regulated?

Artificial intelligence shows both perils and promises as a way to address the difficulties in accessing professional support such as health coaching and health counseling. Chatbots are being used by millions of users to address their loneliness, to provide emotional support and to provide coaching and motivation. This editorial reviews the ethics and controversies attendant to the use of AI in mental health. ChatGPT is put to the test by this author, a trained health coach, who came away impressed with a Bot's capacity for connecting psychological theories to the practice of health coaching. Still, many unanswered questions need the attention of health promotion professionals to help distinguish between the benefits compared to the risks of employing AI in health coaching and mental health counseling.

New York City Faith-Based Leaders' Views on COVID-19's Impact on the Mental Health Needs of Black/African American Communities

This investigation sought to understand the mental health needs of Black/African Americans during the COVID-19 pandemic and explore the church leaders' perspectives and experiences in supporting the mental health of their communities during this time. This exploratory qualitative study uses semi-structured interviews with 21 church leaders from predominantly Black neighborhoods in Brooklyn and Harlem, New York City (NYC), which were most adversely impacted by COVID-19. Neighborhoods were selected based on COVID-19 infection and mortality data from the NYC Department of Health. Transcripts were coded and thematically analyzed using Dedoose software. Four overarching themes and one subtheme emerged: (1) The COVID-19 pandemic amplified underlying community quality of life challenges, creating a "downward cascade" of mental health, (1a) COVID-19 is a source of collective grief and trauma; (2) Faith-based leaders play a key role in providing mental health support to their community; (3) Faith-based leaders seek strategies to reduce mental health stigma, normalize conversations around mental health; and (4) Faith-based leaders often operate in isolation from citywide mental health services, disconnected from existing programs and resources. Leaders anticipate a higher demand for mental health services. On the road to emotional wellness post-pandemic, public awareness of symptoms of mental health issues must be emphasized and available resources utilized to reduce stigma and encourage help-seeking behavior. Addressing these implications requires comprehensive multi-sector community driven efforts that include collaboration with faith-based communities to support community resilience and improve mental healthcare access.

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.

Social isolation induces sexually aggressive behaviour in male Wistar rats

BACKGROUND

Sexual violence, a pervasive global issue, significantly impacts individuals and societies, necessitating a deeper understanding of its underlying biological mechanisms. This study aimed to elucidate the role of stress-induced dysregulation of the hypothalamus-pituitary-adrenocortical axis in sexual aggression in male Wistar rats. Employing a sexual aggression paradigm, we investigated the effects of social isolation on aggression, anxiety-like behaviour, and neurochemistry in virgin adult male Wistar rats.

RESULTS

The results showed that social isolation significantly escalated aggressive behaviours and induced anxiety-like responses in male rats. The sexual aggression test revealed that socially isolated males exhibited heightened aggression towards non-receptive females. Neurochemical analyses indicated significant alterations in key markers, such as corticotrophin-releasing hormone, oxytocin, and arginine vasopressin, correlating with the observed behavioural changes. Gene expression analyses revealed significant findings, particularly in the expression of the oxytocin receptor (OXTR) and vasopressin receptor 1 A (AVPR1A) genes. Social isolation and the duration of aggressive behaviour prior to the sexual aggression test significantly influenced OXTR expression in the hippocampus and AVPR1A expression in both the prefrontal cortex and hippocampus, highlighting the complex interplay between environmental stressors, neurochemical responses, and gene expression in the manifestation of sexual aggression behaviour.

CONCLUSIONS

This study underscores the critical impact of stress and social isolation on sexual aggression, providing valuable insights into possible neurobiological underpinnings of sexual violence. Understanding these mechanisms is crucial for developing effective interventions to mitigate the consequences of sexual aggression.

Physical Inactivity and Cardiovascular Health in Aging Populations: Epidemiological Evidence and Policy Implications from Riyadh, Saudi Arabia

BACKGROUND

Cardiovascular Diseases (CVDs) are the leading cause of morbidity and mortality globally, particularly among older adults. Physical inactivity, a modifiable risk factor, is strongly associated with the development and progression of CVD through its correlation with hypertension, diabetes, obesity, and hyperlipidemia. This study examines the association between physical inactivity and cardiovascular health among older adults in the Riyadh region, Saudi Arabia.

METHODS

A cross-sectional study was conducted on 168 participants aged 60 years and older attending a tertiary hospital in Riyadh. Data were collected using a structured questionnaire, the Physical Activity Scale for the Elderly (PASE), anthropometric measurements, and medical record reviews. Cardiovascular health indicators and risk factors were analyzed using descriptive statistics, chi-square tests, and multivariate logistic regression.

RESULTS

Participants with low physical activity levels had a higher prevalence of hypertension (78.2%), diabetes (64.4%), and obesity (51.3%) compared to those with high activity levels (41.8%, 28.7%, and 22.3%, respectively). Multivariate analysis showed that physical inactivity was significantly associated with an increased likelihood of CVD (adjusted OR: 1.98, p < 0.001), with hypertension and diabetes also being strong predictors.

CONCLUSIONS

Physical inactivity is strongly correlated with adverse cardiovascular outcomes in older adults. Interventions targeting increased physical activity are essential to reducing the CVD burden. Community-based programs and policy-driven initiatives tailored to the Riyadh region's specific environmental and cultural factors are crucial in promoting active lifestyles among aging populations.

Mental Health and Lifestyle Factors Among Higher Education Students: A Cross-Sectional Study

This study aimed to describe the lifestyle factors and mental health levels among higher education students and identify their predictors. A cross-sectional study with a sample of 745 students was conducted with students from the Polytechnic of Porto using the Depression Anxiety Stress Scales (DASS-21), Clinical Outcomes in Routine Evaluation (CORE)-18, and FANTASTICO Lifestyle Questionnaire. The findings indicate that while students generally exhibited a positive lifestyle, they also experienced mild levels of depression, anxiety, and stress, nearing the moderate threshold. The DASS-21 Depression subscale was a significant predictor of both CORE-18 and FANTASTICO scores, underscoring the strong relationship between depression and overall well-being. Anxiety and stress were also predictors of CORE-18 scores, reflecting the negative impact of stress on students' psychological well-being. Perceived health status and the male sex were associated with better outcomes on the DASS-21 and CORE-18, while the female sex predicted a healthier lifestyle, as measured by FANTASTICO. These findings highlight the importance of targeted interventions that address mental health and promote healthy lifestyle choices in educational settings.

The Roles of Anxiety and Depressive Symptoms in the Relationship Between School Bullying Victimization and Suicidal Ideation Among South Korean College Students: A Serial Multiple Mediation Model

This study examined the sequential mediating roles of anxiety and depressive symptoms in the effect of school bullying victimization on suicidal ideation. This study utilized a convenience sample of college students across South Korea, and an online survey was conducted. This quantitative research analyzed data collected from 1037 participants. The sample consisted of an equal gender distribution, with a mean age of 23.65 years (range: 18-30). Additionally, 30% of participants reported a household income of four million won or less (approximately USD $3076). More than half of the participants' parents had attained a college education or higher. Also, multiple mediation analyses were conducted to examine whether anxiety and depressive symptoms mediated the relationship between school bullying victimization and suicidal ideation. In the results, multiple mediation analyses showed that school bullying victimization does not have a direct effect on suicidal ideation. On the other hand, school bullying victimization has an indirect effect on suicidal ideation through anxiety and depressive symptoms, controlling for covariates. Based on these research results, implications for school bullying prevention and intervention were discussed.

Validation of a composite outcome measure for inpatient psychiatry using scales from the interRAI-MH

Background

Inpatient psychiatry is a critical service in a community-based care system for persons with serious mental illness (SMI). Currently, there are few generally accepted or widely used outcomes to assess the effectiveness of inpatient treatment.

Method

Following a Donabedian Model of Health Care Quality, we utilized eight scales from the RAI Mental Health assessment to derive a clinician-scored outcome measure consisting of 4 domains (Psychosis, Depression, Impairment, and Aggression). We combined subscales measuring these domains into a Composite Measure. We used this measure to assess the entire population (N=719) of our large specialized mental health hospital at the beginning (T1) and end (T2) of three months in the hospital (or admission to discharge in shorter stays). We evaluated the content validity of the measure by comparing items and scales with a list of putative contributors to hospital admission (symptoms and complications). To evaluate concurrent validity, we compared mean scores among hospital units with varying lengths of stay and clinical complexity (acute versus chronic versus complex chronic). We used ROC analysis to evaluate the CIIMHS's ability to predict discharge from the hospital. To evaluate construct validity, we examined the measure's responsiveness to changes among patients after treatment in the hospital.

Results

We found strong evidence for all four kinds of validity.

Conclusions

The composite measure represents a valid measure of inpatient mental health status and will serve as a valuable measure of the quality of care for inpatient psychiatry.

Social Vulnerability and Child Food Insecurity in Developed Countries: A Systematic Review

Food insecurity (FI) is a serious public health concern in economically developed countries, mainly due to unequal resource distribution. Identifying social vulnerability factors [i.e., characteristics of a person or group regarding their capacity to anticipate, cope with, resist, and recover from the effects of child FI (CFI)] and their positive or negative relationship with CFI is important to support targeted action with a scale and intensity that is proportionate to the level of disadvantage. This review aimed to systematically and comprehensively identify key social vulnerability contributors to CFI in economically developed countries and discuss the factors in the context of the socio-ecological model. Five research databases were searched for observational studies published in 2000 assessing social vulnerability factors related to FI in children residing in developed countries. Data screening and extraction were independently conducted by 2 reviewers who recorded factors related to CFI. The QualSyst tool was used to assess risk of bias. From the studies identified (N = 5689), 49 articles, predominantly from the United States and Canada, met the inclusion criteria. The identified social vulnerability factors associated with CFI were grouped into 5 based on the socio-ecological model: 1) individual child, 2) parental, 3) household, 4) community, and 5) societal factors. The most frequently reported contributors to CFI were income (household factor). Other social vulnerability factors were identified, including the child's age, parental depression, household crowdedness, social connection, poverty, and residential instability. The lack of consistent measures to define both social vulnerability and CFI in diverse population subgroups impeded meaningful pooling and interpretation of factors interacting with CFI. Recommendations for future studies are to use comparable measures to estimate the extent and severity of CFI and to investigate the relation between social vulnerability, severity, and trajectories of CFI in developed countries. This trial was registered at PROSPERO as CRD42022291638.

The impact of sociodemographic, psychological, and quality of life factors on dual-task performance in elderly individuals: a cross-sectional study in Iraq

OBJECTIVE

This study aims to explore how sociodemographic, psychological, and quality of life factors impact dual-task performance among elderly individuals in Iraq.

METHODS

This cross-sectional study included 384 healthy community-dwelling participants aged 60 years and over, recruited from Najaf, Iraq. Data were collected using the Depression Anxiety Stress Scales-21 (DASS-21), Mindful Attention Awareness Scale (MAAS), and the World Health Organization Quality of Life Brief Form (WHOQOL-BREF). Dual-task performance was assessed using the Nine-Hole Peg Test (NHPT) combined with a cognitive task of counting backward by threes. Correlation and multivariate regression analyses were conducted to determine the predictors of cognitive dual-task performance.

RESULTS

Among the WHOQOL domains, only physical health significantly predicted dual-task performance for both dominant and non-dominant hands (β = 0.234, p = 0.041; β = 0.263, p = 0.025, respectively), underscoring the importance of physical well-being in cognitive-motor functions. Psychological factors (depression, anxiety, and stress) measured by DASS-21 did not significantly predict dual-task performance. The model explained a small part of the variance in dual-task performance, suggesting that other factors may influence these abilities in elderly individuals.

CONCLUSION

While psychological factors measured by DASS-21 did not significantly impact dual-task performance, the overall quality of life remained essential. These insights can inform the design of elderly care programs.

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.

Real-time mechanism-based interventions for daily alcohol challenges: Protocol for ecological momentary assessment and intervention

Background

Advancing evidence-based, tailored interventions for substance use disorders (SUDs) requires understanding temporal directionality while upholding ecological validity. Previous studies identified loneliness and craving as pivotal factors associated with alcohol consumption, yet the precise directionality of these relationships remains ambiguous.

Objective

This study aims to establish a smartphone-based real-life intervention platform that integrates momentary assessment and intervention into everyday life. The platform will explore the temporal directionality of contextual influences on alcohol use among individuals experiencing loneliness and craving.

Methods

We will target 180 individuals aged 18 to 70 in Germany who report loneliness, alcohol cravings, and meet risk or binge drinking criteria (over 14 standard drinks per week or five drinks in a single day for males, and over seven drinks per week or four drinks in a single day for females). Using a Within-Person-Encouragement-Design and Just-In-Time-Adaptive-Interventions, we will manipulate the contexts of loneliness and alcohol craving with cognitive reappraisal and physical activity interventions against a control condition (working memory task).

Results

Recruitment started in June 2024, with data collection and processing expected by June 2027.

Conclusion

Our real-life intervention platform endeavors to serve as a robust tool for discerning the directionality of the effects from time series data in everyday life influences on alcohol use for the future study. Ultimately, it will pave the way for low-threshold prevention, clinical treatment, and therapy to target diverse contexts of everyday life in SUD.

Trial registration

German Clinical Trials Register DRKS00033133.

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.

Sex and Gender Differences in Face and Upper Extremity Allotransplantation: A Narrative Review of Implications and Impact

Sex and gender differences play a significant role in vascularized composite allotransplantation (VCA), impacting both surgical outcomes and postoperative care. While sex refers to biological distinctions and gender encompasses life experiences and behaviors, both factors are closely interrelated in transplantation. Biological sex differences, such as immune responses, hormonal fluctuations, and anatomical features influence graft adaptation and healing, while both sex and gender-specific factors affect psychological and functional recovery. Studies indicate that men have higher mortality and reoperation rates, whereas women are more susceptible to adverse effects from immunosuppressive therapies. Unlike solid organ transplantation (SOT), which is primarily lifesaving, VCA focuses on life-enhancing outcomes, requiring careful attention to patients' social, psychological, and functional well-being. Lifelong immunosuppression in VCA carries risks, including infections and cancer, complicating patient management. Psychological readiness is crucial for candidate selection and long-term success, with women often expressing greater concerns about outcomes. Although no significant gender differences in functional recovery have been observed, individualized rehabilitation plans based on anatomical and physiological differences remain essential for optimal recovery.

Reactions, Reality, and Resilience in Adults with Crohn's Disease: A Qualitative Study

Background

Crohn's disease (CD) is a lifelong condition that poses unique challenges. This study reports findings from a person's perspective of living with CD to help enhance the understanding of an individual's specific care and support needs.

Methods

Semi-structured telephone interviews were conducted with a convenience sample of adults with Crohn's disease recruited from Newcastle Hospitals NHS Foundation Trust. Data were analyzed after data collection using thematic analysis.

Results

Forty-one (68% female) participants aged 49.1 ± 12 years with a disease duration between 1 and 55 years were interviewed. Three overarching themes emerged, along with 12 subthemes: (1) reactions to presenting symptoms, emotions, and challenges at diagnosis; (2) reality of living with the condition, seeking information, decision making, psychological challenges, experiencing symptoms/complications during remission and the impact on social life, education, employment, and relationships; (3) Resilience involving emotional adaptations, strategies on self-management, social comparisons as a means of coping and barriers to resilience.

Conclusions

The results highlight the complex health journey and challenges faced by people living with Crohn's disease and provide health care professionals with a greater insight into the psychological challenges and emotional complexities of the condition to facilitate a more holistic approach to planning care.

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.

Addressing the Triple Trauma of Factors Leading to Perinatal Health and Mental Health Consequences in Two Upstate New York Communities

This article focuses on the impact of trauma experienced by individuals, families and groups, and neighborhoods in Rochester and Syracuse, New York. Using the levels of analysis put forward in Bronfenbrenner's ecological systems theory (i.e., individual, family, and community), we argue that trauma operates at each of those levels. This mixed-methods study reviews the findings of seven previously published studies (with data collection ranging from 2000 to 2019), each of which addresses trauma among low-income residents. Specific methods include secondary analyses of births, qualitative interviews of persons who delivered a baby within the past two years, a community survey of residents living in high-crime areas, and secondary birth data to document the impact of socio-ecological risk factors on the trauma of birthing persons, their children, and their partners. Individuals and families living in high-risk neighborhoods (e.g., where residents experience frequent gun shots, racially disproportionate incarceration, and poverty) had more negative health outcomes including posttraumatic stress disorder, intrauterine growth restriction, and depression. Interventions focused on community-based practices that address individual, family, and community-level trauma must also address the multiple risk factors for trauma located in the environmental and social stressors.

Determine the psychosocial well-being of elderly residents living in old-age homes

BACKGROUND

Old-age homes provide crucial care for elderly individuals facing physical, mental, or social challenges. Ensuring their psychosocial well-being is vital for fulfilling life. This study addresses the gap in the literature by comprehensively assessing factors like anxiety, feeling of security, and desire for longevity aiming to inform interventions for better support systems in old-age homes.

MATERIAL AND METHODS

Methodologically, a cross-sectional design was employed involving 100 elder populations in Pune City, Maharashtra. The time taken to conduct the study was 1 month. Data was collected using the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) tools. Interviews were conducted personally, with assistance from caretakers, maintained confidentiality, and addressed social gerontological considerations.

RESULT

The study findings revealed that the majority of male participants (78%) expressed a desire for a longer and healthier life, while a smaller percentage (22%) showed no interest in longevity. Among females, (85%) expressed a wish for an extended life with improved mental and physical health, while (15%) expressed no such desire. However, the correlation between anxiety and feelings of security did not reach statistical significance.

CONCLUSION

In conclusion, these findings emphasize the significance of seeing individual preferences in conniving interventions aimed at promoting psychosocial well-being in such settings. Furthermore, the lack of statistically significant correlation between anxiety and feelings of security suggests the complexity of factors influencing the mental and emotional states of elderly individuals in institutional care.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.