Marriage and mental health among young adults

The Development of a Measure Assessing U.S. Adults' Motives for Marriage

Despite the existing literature assessing various aspects of marriage, there is a lack of understanding of adults' motives for pursuing marriage. Thus, this research advanced the literature by assessing adults' motives for marriage via four novel studies in which the Motives for Marriage Scale (MMS) was developed, refined, and validated. In study one, semi-structured focus groups were conducted to capture the range of motives for marriage. In study two, the factor structure of the MMS was assessed. The factor structure was then validated and the psychometric properties were established in study three. Finally, the temporal consistency of the scale was established in study four. The results confirmed that adults' marital motives are complex and that they are best conceptualized using Social Determination Theory (i.e., intrinsic, extrinsic, and instrumental motives). Investigation of the psychometric properties demonstrated the MMS to be reliable and valid. Implications for investigators and practitioners are discussed.

The impact of financial stress on student wellbeing in Lebanese higher education

BACKGROUND

The financial crisis has indirectly affected Lebanese university students, leading to economic distress. Accordingly, this study aimed to assess the substantial negative impact of financial stress on the mental health and well-being of Lebanese college students.

METHODS

A quantitative research approach was applied and took place from June 13th to July 25th, 2023, targeting 1272 university students aged 17 and above from private and public universities across Lebanon through convenience sampling. The InCharge Financial Distress/Financial Well-Being scale (IFDFW), Pittsburgh Sleep Quality Index (PSQI), Beirut Distress Scale (BDS-10), Perceived Stress Scale (PSS-10), and Well-Being Index (WHO-5) were used to assess the students' well-being. Descriptive analyses of the data was performed using SPSS software version 25.

RESULTS

1272 university students participated in this study, mostly females, with a mean age of 21.64 (± 4.43) years. Participants reported a lack of financial independence, unemployment, and no income. Positive associations were obtained between the BDS total scale as well as the PSS total and PSQI scores, while there was a significant negative relationship between IFDFW and PSQI scores. Those with a higher GPA, majoring in science/health and medicine, living in rural areas, and graduate students were linked to lower PSQI and BDS-10 scores. Financial aid and financial independence were associated with lower PSQI and BDS-10 scores. PSS-10 scores were higher among students majoring in science/health and medicine. Higher scores on the IFDFW scale correlated with lower BDS-10 and PSS-10 scores. In contrast, females had higher BDS-10 and PSS-10 scores. Scoring higher on the PSS-10 and PSQI scales, living off campus, or majoring in science/health and medicine, were associated with higher on the WHO-5 scale.

CONCLUSIONS

A significant impact of financial stress on college students in Lebanon was obtained, affecting their well-being and mental health aspects. Marital status, gender, academic major, region of living, and financial independence also influences students' experiences. Tailored support and further research are needed to address these multifaceted challenges.

How Do Mental Disorders and Combinations of Disorders Affect the Odds of Injuries and Poisoning?

ABSTRACT

Injuries and poisoning are associated with mental disorders. The association may be stronger if comorbid mental illness is involved. This study explores whether selected mental disorders (stress, anxiety, depression, attention deficit hyperactivity disorder [ADHD], bipolar, obsessive-compulsive disorder [OCD], schizophrenia) are associated with injuries and poisoning and if the presence and frequency of comorbid mental illness affect these associations. Analyses utilize medical claims data for adult employees of a large corporation during 2017-2021. Approximately half or more of the index mental disorders experience comorbid mental illness. Odds of injury and poisoning are significantly greater for each mental disorder and tend to be significantly greater when comorbid mental illness exists ( vs . the mental disorder alone), especially for the associations involving poisoning. Schizophrenia alone and in combination with other mental illness has the strongest associations with injury and poisoning. OCD is only associated with injury and poisoning, and ADHD is only associated with poisoning, if accompanied by comorbid mental illness.

Emophilia: psychometric properties of the emotional promiscuity scale and its association with personality traits, unfaithfulness, and romantic relationships in a Scandinavian sample

Emophilia is a suggested stable phenomenon referring to how often and easily an individual falls in love (Jones, 2011). The current study investigated the psychometric properties of the Emotional Promiscuity Scale (EPS, i.e., a measure of emophilia) and its association with personality traits, romantic relationships, and unfaithfulness in a Scandinavian sample. The sample consisted of 2,607 participants, who were recruited through Norwegian and Swedish newspapers. Descriptive analyses of the EPS and a confirmatory factor analysis (CFA) to verify the previously obtained two-factor structure were conducted. Correlations between emophilia and the Big Five and Dark Triad traits were calculated to investigate the discriminative validity of the EPS. Lastly, negative binomial regression analyses were run in which emophilia comprised the independent variable and the number of romantic relationships and number of times being unfaithful constituted the dependent variables. The EPS had satisfactory internal reliability and the responses to the items were normally distributed. The CFA indicated a two-factor structure, although the two factors correlated highly, justifying collapsing them into one dimension. Emophilia showed satisfactory discriminant validity (r < 00.40) against the personality traits included. Lastly, emophilia was positively associated with the number of romantic relationships and times being unfaithful. Future research should aim to improve our understanding of the psychological and behavioral aspects of emophilia.

Religious minority identity associates with stress and psychological health among Muslim and Hindu women in Bangladesh and London

OBJECTIVES

This study examined the association of minority religious identification (Hindu or Muslim) with self-reported stress and psychological symptoms among sedentee and immigrant Bangladeshi women.

METHODS

Women, aged 35-59 (n = 531) were drawn from Sylhet, Bangladesh and London, England. Muslim immigrants in London and Hindu sedentees in Sylhet represented minority religious identities. Muslim sedentees in Sylhet and Londoners of European descent represented majority religious identities. In bivariate analyses, minority religious identity was examined in relation to self-reported measures of stress, nervous tension, and depressed mood. Logistic regression was applied to examine the relationship between these variables while adjusting for marital status, parity, daily walking, and perceived financial comfort.

RESULTS

In bivariate analyses, religious minorities reported more stress than religious majorities in all group comparisons (p < .05), and minority Muslims reported more nervous tension and depressed mood than majority Muslims (p < .05). In logistic regression models, minority Muslims had greater odds of high stress than majority Muslims (OR 2.00, 95% CI 1.18-3.39). Minority Muslims had greater odds of stress (OR 3.05, 95% CI 1.51-6.17) and nervous tension (OR 3.37, 95% CI 1.66-6.87) than majority Londoners. Financial comfort reduced odds of stress and symptoms in all models.

CONCLUSIONS

Socioeconomic situation, immigration history, and minority ethnicity appear to influence the relationship between religious identity and psychosomatic symptoms in Bangladeshi women. Attention to personal and socioeconomic context is important for research examining the association between religion and mental health.

An evaluation of early marriage and the mental state of Roma women: A cross-sectional study

Early marriage (i.e., at less than 18 years of age) is a significant global problem threatening the well-being of women. This cross-sectional study evaluated early marriage and the mental health of Roma women in Adana, Turkey. Data were collected between March 2019 and September 2019 using the Descriptive Characteristics Form and the Brief Symptom Inventory. We interviewed 272 married Roma women over 18 years of age, of whom 59.6% (n = 162) had married before the age of 18 years; of these, 14.2% had done so before the age of 15. Significant positive correlations were found between the duration of the marriage and measures of interpersonal sensitivity, somatization, depression, anxiety, phobia, paranoid ideation, psychoticism, and the Global Severity Index in the women who had married early. Among women who married after 18, the duration of marriage had a significant positive relationship with somatization and phobic anxiety. Early marriage and a longer duration of marriage were associated with more symptoms of psychological distress.

Prevalence of depression and its associated factors among undergraduate admission candidates in Bangladesh: A nation-wide cross-sectional study

BACKGROUND

The undergraduate admission test is one of the most stressful assessments in a student's life, as it is required for admission to any of Bangladesh's public universities or medical colleges. Those taking the admissions test are under a lot of pressure to perform well. This study aimed to determine the prevalence of clinical depression among Bangladeshi admission candidates and the factors that contribute to it.

METHODOLOGY

Patient Health Questionnaire (PHQ-9) and other socio-demographic information were collected from 5263 students from all over Bangladesh. Apart from descriptive statistics and chi-square tests, an ordinal logistic regression model was also applied to determine the factors associated with depression.

RESULTS

The study revealed that among the undergraduate admission applicants, 74% of individuals were affected by depression, while 26% experienced moderate depression, 26% experienced moderately severe depression, and 22% experienced severe depression. The level of depression among females was 1.8 times higher than the male admission candidates. Our analyses found that gender (p <0.001), exercise (p <0.001), pre-marital relationships (p <0.001), daily study time less than 3 hours (p <0.001), practice of religion (p <0.001), victim of blackmail (p <0.001), family unrest (p <0.001), major illness (p <0.001), COVID-19 infection (p <0.001), GPA in higher secondary (p <0.001), mental problem (p <0.001), all categories of the variable confidence level for exam preparation (p <0.001) had a significant impact on increasing depression.

CONCLUSION

The research found a severe rate of depression among Bangladeshi undergraduate admission candidates. Interactive mental health care programs must include family and teachers to tackle the problem. To alleviate mental stress and depression, students should learn to nurture their mental health.

Unplanned Costs and Benefits: Gender and Spousal Spillover Effects of Retirement on Health

Objective

Our study assesses how women and men's health indicators are shaped by their spouse's retirement.

Background

The retirement process can reshape the health of a retiree, but these effects can also extend onto the health of spouses. Although past research has largely focused on how men's retirement might negatively shape their wife's health outcomes, it is possible that wives' retirement has detrimental effects on their husband's health as well.

Method

Using data from the Health and Retirement Study (HRS), we employ a fuzzy regression discontinuity design to identify the causal effects of spousal retirement on indicators of physical and mental health in married older adults.

Results

Our results suggested that men, not women, experience the most negative spousal spillover effects of retirement on their health outcomes. We found the most support for spillover effects on spouses' physical health outcomes. Additionally, men who are not working when their spouse retires experienced the most negative health effects.

Conclusion

Women and men's health is differentially affected by spousal retirement, where men might be the most negatively affected by their spouses' transition in the U.S. context. These results contradict conventional wisdom that undergirds numerous untested assumptions underlying prior research on this significant life transition.

The collaborative study on the genetics of alcoholism: Genetics

This review describes the genetic approaches and results from the family-based Collaborative Study on the Genetics of Alcoholism (COGA). COGA was designed during the linkage era to identify genes affecting the risk for alcohol use disorder (AUD) and related problems, and was among the first AUD-focused studies to subsequently adopt a genome-wide association (GWAS) approach. COGA's family-based structure, multimodal assessment with gold-standard clinical and neurophysiological data, and the availability of prospective longitudinal phenotyping continues to provide insights into the etiology of AUD and related disorders. These include investigations of genetic risk and trajectories of substance use and use disorders, phenome-wide association studies of loci of interest, and investigations of pleiotropy, social genomics, genetic nurture, and within-family comparisons. COGA is one of the few AUD genetics projects that includes a substantial number of participants of African ancestry. The sharing of data and biospecimens has been a cornerstone of the COGA project, and COGA is a key contributor to large-scale GWAS consortia. COGA's wealth of publicly available genetic and extensive phenotyping data continues to provide a unique and adaptable resource for our understanding of the genetic etiology of AUD and related traits.

The Role of Social Support and Socioeconomic Factors in the Prediction of Depression among First-Year Undergraduate Students

Aim

This study was devoted to determining the role of social support and socioeconomic factors in predicting students' depression.

Methods

In this cross-sectional study, all first-year undergraduate students in the Shahrekord University of Medical Sciences, Iran, during the 2019-2020 academic year were included via the census method. Data collection tools include a researcher-made checklist about demographic and socioeconomic status, a standard questionnaire of perceived social support, and Beck's depression questionnaire. Smoothly clipped absolute deviation (SCAD) linear regression was used to model the role of social support and socioeconomic factors in predicting depression.

Results

Out of the 220 first-year undergraduate students, 174 (79.1%) were female, and 176 (80.0%) were single. The mean ± SD of depression score among the first-year undergraduate students was 10.56 ± 5.19, and the mean ± SD of social support score was 48.86 ± 5.46. The mean score of depression was significantly higher in female students than in males (11.09 versus 8.59, P = 0.001) but was not statistically significant in different categories of age (P = 0.70), marital status (P = 0.37), ethnicity (P = 0.10), parents' education, and the other demographic variables. Pearson's correlation showed an inverse and significant correlation between depression and social support (R = -0.20, P = 0.003). The mean score of depression was at the highest level for students of public health and environmental health majors and was the lowest for students of laboratory sciences, which was statistically significant (P < 0.001). After adjusting the other variables, SCAD regression showed that social support plays a key role in depression prediction, and increasing social support leads to a decrease in depression score.

Conclusion

Considering the existence of an inverse and significant correlation between depression and social support, any intervention to promote social support for first-year undergraduate students may decrease depression.

What explains the link between romantic conflict with gambling problems? Testing a serial mediational model

Introduction

While individuals have many motives to gamble, one particularly risky motive for gambling is to cope with negative affect. Conflict with one's romantic partner is a strong predictor of negative affect, which may elicit coping motives for gambling and, in turn, gambling-related problems. Support for this mediational model was demonstrated in relation to drinking-related problems. We extended this model to gambling.

Method

Using a cross-sectional design, we examined links between romantic conflict (Partner-Specific Rejecting Behaviors Scale), negative affect (Depression, Anxiety, and Stress Scales-21), coping gambling motives (Gambling Motives Questionnaire, coping subscale), and gambling-related problems [Problem Gambling Severity Index (PGSI)] in 206 regular gamblers (64% men; mean age = 44.7 years; mean PGSI = 8.7) who were in a romantic relationship and recruited through Qualtrics Panels in July 2021.

Results

Results supported our hypothesis that the association between romantic conflict and gambling-related problems would be sequentially mediated through negative affect and coping gambling motives, β = 0.38, 95% CI [0.27, 0.39], and also showed a strong single mediation pathway through negative affect alone, β = 0.27, 95% CI [0.17, 0.38].

Discussion

Negative affect and coping gambling motives partially explain the link between romantic conflict and gambling-related problems. Interventions should target both negative affect and coping gambling motives in response to romantic conflict to reduce gambling-related problems in partnered gamblers.

Romantic Unions and Mental Health: The Role of Relationship Churning

The stress process perspective suggests that romantic relationship transitions can be stressors that impair mental health. Research on romantic relationships and mental health has ignored one common stressor, on-again/off-again relationships, or churning. Using five waves of data from the Fragile Families and Child Wellbeing Study (N = 3,176), we examine associations between relationship churning and mothers' mental health. We find that mothers experiencing relationship churning have worse mental health than mothers in stably together relationships, net of characteristics associated with selection into relationship instability; these associations persist over four years. Mothers experiencing relationship churning have similar mental health as their counterparts who experience union dissolution (with or without repartnering). Current relationship status and quality explain some of the differences between churning and stably together mothers. Findings emphasize attending to multiple types of family stressors-even stressors and instability in ongoing relationships-and the micro-level ecological factors that shape mental health.

"Lovesick": Mental Health and Romantic Relationships among College Students

This research investigated the interpersonal impact of self-reported mental health diagnoses and/or perceptions on undergraduate students' current or most recent romantic relationship. Analysis of data from a 43-item online questionnaire completed by 267 undergraduates revealed that 68.3% of women and 52.5% of men reported having either been professionally diagnosed with a mental illness or perceive themselves to be mentally ill based on DSM criteria, with women and white students reporting significantly higher levels. Sociologically speaking, mental illness was found to influence relationship initiation, maintenance, and dissolution in this study. The mental health of the respondents' potential partners was an important consideration in deciding to form a relationship, particularly for male, white, heterosexuals. When the respondents reported relationship problems, men were more likely to blame such problems on mental health issues than women. Finally, though more respondents reported having broken up with a romantic partner who had mental health issues than had romantic partners break up with them, there were no significant gender, race, or sexual orientation differences in the termination of these romantic relationships. Study findings emphasize the importance of acknowledging and providing mental health resources-particularly interpersonal options-for emerging adults in the college setting.

Union and Family Formation During Young Adulthood: Insights From the Add Health

Family formation patterns among US young adults are shifting, reflecting an accelerating retreat from marriage coupled with significant increases in cohabitation and nonmarital childbearing. Drawing on a selection of published longitudinal studies, this article reviews key contributions to the literature on these trends in union and family formation that have stemmed from research conducted using the National Longitudinal Study of Adolescent to Adult Health, or Add Health. Add Health is integral to deciphering the adolescent precursors to young adult union formation and childbearing, allowing researchers to gauge the roles of multiple social contexts such as family, schools, peers, and adolescent romance, with attention to variation across racial-ethnic groups and by socioeconomic status. In turn, researchers use Add Health to assess how young adult family formation behaviors are related to numerous indicators of health and well-being, ranging from mental and physical health to relationship quality and stability, interpersonal violence, and crime. With its sibling and couples samples, genetic data, and detailed partnership histories for both different- and same-sex relationships, Add Health is an invaluable data source for tracking the familial experiences (formation and dissolution) of a large cohort from adolescence into middle age.

The association between early marriage and mental disorder among young migrant and non-migrant women: a Norwegian register-based study

Background

Marriage is considered beneficial for mental health when stable and of high quality. Yet, it is unclear whether marriage is equally advantageous for everyone regardless of marital timing or migrant background. This study aimed to investigate the association between early marriage and mental disorder, defined by outpatient mental healthcare (OPMH) service use, and whether the association varies between migrant and non-migrant women.

Methods

Using data from four Norwegian national registers, we applied discrete-time logistic regression analyses to study the aims of interest, among 602 473 young women aged 17–35 years. All women were followed from 2006 or the year they turned 17, and until first OPMH consultation, 2015 (study end), the year they turned 35, when emigrated, died, or changed marital status from married to separated, divorced, or widowed.

Results

Results show that unmarried and early married women had increased odds of mental disorder when compared to on-time married women. However, the differences between the early and on-time married women were explained by differences in educational level. There was no significant interaction between marital status and migrant background.

Conclusions

Differences in mental health between early- and on time married women are attributed to poorer educational attainment of women who marry early. Furthermore, migrant background seems to have a limited role in the association between marital timing and mental disorder. The promotion of formal education among young women could contribute to the accumulation of socioeconomic and psychosocial resources, thus, reducing the risk of mental disorder, also among early married women.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12905-022-01836-5.

Marital experiences and depressive symptoms among older adults in rural South Africa

This paper advances the understanding of how marital transitions may influence mental health by investigating these associations among a population of rural, Black South Africans aged 40+ that was directly impacted by apartheid. Using two waves of data from 4,176 men and women in Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI), we investigated associations between marital experiences and depressive symptoms, by gender, and explored whether economic resources is a moderator of these associations. We found that experiencing a marital dissolution was associated with more depressive symptoms than remaining married for both men and women. We also found that men, but not women, report greater depressive symptoms if they remained separated/divorced, remained widowed, or remained never married between waves. We found no evidence that a decline in wealth moderated the impact of marital dissolution on depressive symptoms for women or men. These findings suggest that the documented benefits of marriage for mental health, and differences by gender in those benefits, may extend to older, rural South Africans, despite the unique experiences of this population.

Marital Commitment and Mental Health in Different Patterns of Mate Selection: A Comparison of Modern, Mixed, and Traditional Patterns

Objective: Marital commitments and mental health are the important indicators of marital quality. Considering the modern and mixed marriage pattern in recent years, compared to the traditional pattern, as well as the increase in divorce rates due to reduced marital commitment, the present study was conducted to compare marital commitment and mental health in various patterns of mate selection among married women. Method : This cross-sectional study was performed on 160 married women aged 15-49 years in Babol city, Iran, who were selected by convenience sampling from health centers under the auspices of Babol University of Medical Sciences. Data collection tools included the spouse-selecting style, marital commitment (Adams and Jones), and general health questionnaires. Data analysis was performed in SPSS V.25 software, using analysis of variance (ANOVA), and Chi square tests. Results: Results showed that the mean score of marital commitment and its three dimensions (commitment to spouse, commitment to marriage and sense of commitment); general health; physical, anxiety and sleep disorders; as well as social function of married women are not significantly different in traditional, mixed and modern marriage patterns. There was a significant difference in the mean score of depression between traditional, mixed and modern marriage patterns. Pairwise, ANOVA revealed that the mean of the depression score was significantly higher in traditional marriage than in the mixed marriage pattern (P = 0.012). Different marriage patterns had statistically significant differences in demographic variables such as age, the place of birth of the wife and the husband, duration of marriage, number of children and the level of education (P < 0.05). Conclusion: It seems that there is a kind of convergence in marital commitment in various patterns of marriage among married women in Babol city.

Supportive, Delegated, and Common Dyadic Coping Mediates the Association between Adult Attachment Representation and Relationship Satisfaction: A Dyadic Approach

The aim of this study was to examine intrapersonal (actor) and interpersonal (partner) associations between attachment, assessed by the Adult Attachment Interview, and satisfaction with the relationship, as well as to establish the possibility of the mediatory effect of supportive, delegated, and common dyadic coping on the aforementioned associations. A dyadic approach has been introduced, using the actor–partner interdependence mediation model and data from 114 heterosexual couples, aged 26 to 60. It has been shown that one’s own secure attachment can be perceived as the predictor of one’s own relationship satisfaction in women and men and the predictor of a partner’s relationship satisfaction in men. The findings support the partially mediating role of dyadic coping in the association between attachment and relationship satisfaction and are a significant contribution to the issue of dyadic coping in general. Adults’ secure representations of their childhood experiences may be effective in using their partners as a secure base and also in serving as a secure base themselves, but it is not the sole influence on the quality of the couple’s experience together. The we-ness phenomenon and resulting clinical implications were discussed.

Changes in marriage, divorce and births during the COVID-19 pandemic in Japan

Introduction

Marriage, divorce and fertility are declining in Japan. There is concern that the COVID-19 pandemic may have accelerated the decrease in marriages and births while increasing the number of divorces. Changes in partnership behaviours and fertility have significant implications for mental health, well-being and population demographics.

Methods

Japanese vital statistical data were collected for December 2011–May 2021. We used the Farrington algorithm on the daily numbers of marriages, divorces and births (per month) in order to determine whether any given month between January 2017 and May 2021 had a significant excess or deficit. Analyses were conducted at the national and regional levels.

Results

During the pandemic, significant deficits in the national number of marriages were noted in January 2020, April 2020, May 2020, July 2020, September 2020 and April 2021. Regional marriage patterns reflected national trends. Divorces were noted to be in deficit during April 2020, May 2020 and May 2021 at the country level. Regional analyses mirrored national divorce trends with the exception of Shikoku, which showed no deficits during the pandemic. Significant deficits in the number of total births were noted in December 2020, January 2021 and February 2021. Regionally, birth deficits were concentrated in Chubu, Kansai and Kanto. After the start of the pandemic, no significant excesses in marriages, divorces or births were noted at the national or regional level.

Conclusions

Marriages and divorces declined during the pandemic in Japan, especially during state of emergency declarations. There were decreased births between December 2020 and February 2021, approximately 8–10 months after the first state of emergency, suggesting that couples altered their pregnancy intention in response to the pandemic. Metropolitan regions were more affected by the pandemic than their less metropolitan counterparts.

Life Course Statuses and Sibling Relationship Quality during Emerging Adulthood

Using the National Longitudinal Study of Adolescent to Adult Health (N = 1,366), we examine how major life course statuses are related to sibling relationships during emerging adulthood with attention to similarities and differences in these statuses between sibling dyads. We find that full-time employment, marriage/cohabitation, and parenthood are related to more distant sibling relationships, whereas college education is related to closer sibling relationships. Similarities in employment between the siblings are related to closer relationships, but differences in education, marriage/cohabitation, and parenthood are related to closer relationships, in that respondents report more help-seeking and emotional closeness with their siblings who have higher education than theirs; unpartnered respondents report more calls and fewer fights with their partnered siblings; and childless respondents report more visits and emotional closeness with their parenting siblings. Examining both one's and one's sibling's life course statuses is important in understanding life course variations in sibling relationships.

Gender Differences in the Factors Associated with Alcohol Binge Drinking: A Population-Based Analysis in a Latin American Country

Alcohol consumption is a public health problem in Peru, fostered by traditional practices, where promoting social interaction in celebrations, facilitating field work as a source of energy and warmth, and achieving objectives in certain labor negotiations, play an important role. However, research on the risk factors of binge drinking according to gender is limited. The study aim was to determine the factors associated with binge drinking in the Peruvian adult population by gender. An analytical study of secondary data from the 2018 Peruvian Demographic and Family Health Survey was conducted. The dependent variable was binge drinking in the last 30 days. Adjusted prevalence ratios (aPR) were estimated for the association between sociodemographic and health-related variables with binge drinking. A total of 32,020 adults were included. Binge drinking was found in 22.4%. Men (32.6%; 95% confidence interval [CI]: 31.4–33.8) presented a higher consumption pattern compared to women (12.8%; 95% CI: 12.0–13.6). For both genders, differences were found in binge drinking according to sociodemographic characteristics (age and wealth quintile was associated in both genders while the educational level was associated only for men, and ethnic self-identification and marital status for women) and health- characteristics related (health insurance, smoking in the last 30 days, overweight and obesity were associated in both genders). Several factors are associated with binge drinking according to gender in the Peruvian population, including age and education level among men, as well as marital status and ethnic self-identification among women.

Early marriage, stressful life events and risk of suicide and suicide attempt: a case-control study in Iran

BACKGROUND

Early Marriage (EM) and associated Stressful Life Events (SLEs) and consequences such as psychological and physical well-being issues can lead to suicide and suicide attempts (SA). The study aimed to investigate the risk of suicide and SA among early married people who experienced SLEs.

METHODS

A case-control study was conducted based on the registry for suicide in Malekan county in Iran during 2016-18. Cases included 154 SAs and 32 suicides. Simultaneously, 201 outpatients from the emergency department were chosen as controls. Holms and Rahe life event questionnaire was used to assess SLEs. Sub-group analysis (Mantel-Haenszel) by sex and age groups and multiple logistic regression were used to calculate adjusted Odds Ratios (ORs) with 95% Confidence Intervals (CIs) for the association between EM and suicide risk after adjusting for the potential confounders.

RESULTS

The proportion (female vs male) of EM among suicides, controls, and SAs was 31.25% (18.7 vs 12.5%), 15.92% (11.9 vs 4.0%), and 13.0% (11.7 vs 1.3%), respectively. In subgroup analyses by sex, EM was associated with an increased risk of suicide in both females and males 2.64 and 2.36 times, respectively. Likewise, subgroup analysis by age groups revealed that EM increased suicide risk in subjects aged 10-15 years, while no association was found for age groups of 26-40 and > 40. After adjusting for the potential confounders, EM (OR: 3.01; 95% CI: 1.15 -7.29), financial problems (OR = 4.50; 95% CI: 1.83 -9.07), and family problems (OR = 2.60; 95% CI: 1.19-9.59), were associated with an increased risk of suicide. However, no association was found between EM, various types of SLEs, and the risk of SA.

CONCLUSIONS

We found EM and SLEs were correlated with suicide risk, while no evidence found that EM increased the risk of SA. Progress in reducing EM and addressing its serious consequences can occur by a stronger political commitment and by sharing the experiences and voices of the early married. Our study provided preliminary findings to guide future studies; however, methodological and longitudinal studies are needed to understand and address the effect of EM on suicidal behaviors.

Factors associated with mental health outcomes among caregivers of older adults in long-term care facilities during COVID-19 post-epidemic era in Shandong, China

BACKGROUND

COVID-19 pandemic has altered the work mode in long-term care facilities (LTCFs), but little is known about the mental health status of caregivers of older adults.

METHODS

A total of 672 formal caregivers of older adults in LTCFs and 1,140 formal patient caregivers in hospitals (comparison group) responded to an online survey conducted from March 25, 2022 to April 6, 2022. Five psychological scales, including Insomnia Severity Index (ISI), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), The 5-item World Health Organization Wellbeing Index (WHO-5) and Perceived Stress Scale-14 item (PSS-14), were applied to assess participants' mental health status. Factors, including sex, profession, marital status, economic conditions, length of working experience, frequent night shift beyond 1 day per week and having organic diseases, were included in logistic regression analysis to identify associated factors with mental health outcomes of formal caregivers of older adults in LTCFs.

RESULTS

Caregivers of older adults in LTCFs developed similar severe psychological symptoms with patient caregivers in hospital setting. For caregivers of older adults in LTCFs, unmarried status was a potent risk factor for insomnia, anxiety, impaired wellbeing and health risk stress, with odds ratios ranging from 1.91 to 3.64. Frequent night shift beyond 1 day per week was associated with higher risks of insomnia, depression and impaired wellbeing. Likewise, having organic disease or inferior economic condition, and being nurses appeared to be independent predictors for multiple mental health-related outcomes.

CONCLUSION

During COVID-19 post-epidemic era, caregivers of older adults in LTCFs had a higher prevalence of psychological symptoms, especially those with particular risk factors. Special attention should be paid to promote their mental health.

The role of siblings in the process of forming life satisfaction among young adults – moderating function of gender

The main aim of the study was to explore the relationship between life satisfaction and sibling bond quality, with gender playing a moderating role. The sample consisted of 276 young adults with a single biological sibling. The participants completed three questionnaires: a sociodemographic survey, the STQ-Now (quality of the sibling relationship) and the SWLS (level of life satisfaction). No difference was observed between men and women regarding life satisfaction; however, the gender constellation in a sibling dyad was found to be statistically significant. Same-sex pairs scored higher on life satisfaction than cross-sex siblings. A positive relationship with a brother or a sister based on mutuality correlated with high overall satisfaction with life, while criticism, competition and apathy were associated with lower general satisfaction. Additionally, two of these relations (i.e. mutuality and apathy) were moderated by gender. Lastly, representatives of the Supportive type of relationships obtained higher levels of life satisfaction than the Ambivalent or the Reluctant types. The findings suggest that siblings play an essential role in shaping psychological well-being. As early adulthood is a stage characterised by multitasking and various challenges, the formation of positive, adaptive and supportive sibling bond may maintain good life satisfaction. The findings also underline the significance of gender combination in the relationship.

Socio-economic and demographic patterns of mental health complaints among the employed adults in Estonia

Background

Mental health problems follow a distinct socio-economic gradient and contribute to the health inequalities. The study aims to analyse the socio-economic and demographic factors of self-reported mental health complaints (stress, depressiveness, overtiredness, suicidal thoughts) among employed adult population in Estonia.

Methods

Data on 4041 employed respondents (2064 men and 1977 women) aged 20–64 years from nationally representative health surveys from years 2016 and 2018 in Estonia were used for the study. Dependent variables included self-reported stress, depressiveness, overtiredness, and suicidal thoughts. Descriptive statistics and both log-binomial and Poisson regression analysis were used to describe the socio-economic and demographic variations in these mental health complaints.

Results

More than half of the respondents had either stress, depressiveness, overtiredness or suicidal thoughts with 25% reporting two or more of mental health complaints. Lower personal income was associated with higher rates of all mental health complaints (stress, depressiveness, overtiredness, and suicidal thoughts) among employed adults in Estonia. Additionally, lower education was associated with higher prevalence of depressiveness and lower job skills predicted higher prevalence of suicidal thoughts. Higher prevalence ratios for depressiveness and overtiredness were found for women compared to men whereas Estonians had higher prevalence ratios for stress and suicidal thoughts compared to non-Estonians. All mental health complaints were more frequently reported at younger ages (compared to 50-64-year olds) and by not married or cohabiting respondents.

Conclusion

High prevalence of mental health complaints and their socio-economic and demographic patterning refer to considerable inequalities in mental health among employed adults. Policy actions targeting especially younger adults and those with financial difficulties are needed to address these early manifestations of mental health problems.

Does marriage protect mental health? Evidence from the COVID-19 pandemic

Using weekly variation from April 23 to June 23 2020, we exploit the surge in unemployment over the coronavirus pandemic to identify the effects on mental health outcomes and the role of marital status as a protective factor for households. We find that married respondents are 1-2 percentage points less likely, relative to their unmarried counterparts, to experience mental health problems following declines in work-related income since the start of the pandemic. Our results suggest that the combination of intrafamily substitution and the psychological benefits of marriage helps insure against unanticipated fluctuations in job and income loss.

Moving in together, marriage, and motherhood: A follow up study of relationships in psychiatric patients with personality disorders

BACKGROUND

Personality disorders (PDs) are related to poor psychosocial function, including fewer relationships with friends and romantic partners.

METHODS

One-hundred eighty-six psychiatric patients were included in a study cohort in 2002-2003. In 2017, data regarding living arrangements and marital status between 2003 and 2016 were collected for these participants and from a matched control group. Data on birth of first child during the study period were collected for women. The former patients were divided into two groups based on occurrence of PD or not. Groups were compared with each other and with the controls.

RESULTS

The proportion of participants with PD who lived together with someone did not increase at the same rate as in the other groups. PD was associated with a reduced likelihood of getting married during the study period. Women in the PD group had children to a lower extent than females in the other groups.

CONCLUSION

Personality disorder was associated with an increased likelihood of living alone and being unmarried. Female participants with PD had a decreased likelihood of having children compared with controls. © 2021 The Authors Personality and Mental Health Published by John Wiley & Sons Ltd.

Using a developmental perspective to examine the moderating effects of marriage on heavy episodic drinking in a young adult sample enriched for risk

Many studies demonstrate that marriage protects against risky alcohol use and moderates genetic influences on alcohol outcomes; however, previous work has not considered these effects from a developmental perspective or in high-risk individuals. These represent important gaps, as it cannot be assumed that marriage has uniform effects across development or in high-risk samples. We took a longitudinal developmental approach to examine whether marital status was associated with heavy episodic drinking (HED), and whether marital status moderated polygenic influences on HED. Our sample included 937 individuals (53.25% female) from the Collaborative Study on the Genetics of Alcoholism who reported their HED and marital status biennially between the ages of 21 and 25. Polygenic risk scores (PRS) were derived from a genome-wide association study of alcohol consumption. Marital status was not associated with HED; however, we observed pathogenic gene-by-environment effects that changed across young adulthood. Among those who married young (age 21), individuals with higher PRS reported more HED; however, these effects decayed over time. The same pattern was found in supplementary analyses using parental history of alcohol use disorder as the index of genetic liability. Our findings indicate that early marriage may exacerbate risk for those with higher polygenic load.

Is early marriage practice a problem for women living in Istanbul? A qualitative study

Early marriages (EM) adversely affect women's physical and mental health, education, and social status. The current study aimed to analyze effects of EM through the thoughts, experiences, and suggestions of women who were married under the age of eighteen in Istanbul, Turkey, and the key informants (e.g., social worker, psychologist, obstetrician) who have encountered EM. In-depth interviews were conducted with fifteen women who were married before age 18, recruited from psychiatry outpatient department and eleven key informants. Thematic analysis was used. Low educated, poor family environment with domestic violence and neglect of children, loss of parents, lack of access to education, and traditional social structure were stated as causes for EM. Families' attitudes about EM were characterized as their daughter's reputation would be tarnished which implied the daughter's premarital relationships would be perceived as immoral by community. All women experienced traditional, aggressive rituals for the first night of marriage, husbands were mostly insensitive, and coercive resulting a traumatic experience. Women were subjected to physical, sexual, psychological, and emotional violence; most of them were socially isolated after marriage with restrictions imposed by their spouses and spouses' family that limited communication with their loved ones. The women generally felt unprepared for adult sexual life and motherhood. In order to prevent EM, raising parents' awareness about EM, supporting girls' education, and enforcing legitimate regulations were recommended. Early marriages violate human rights, cause negative consequences for health both physically and mentally, and deepen social inequality for women. All the participants suggested a better functioning legislative arrangement. The male dominated society that legitimizes child marriages and other harmful traditional practices should be addressed.

Meaningful activities during COVID-19 lockdown and association with mental health in Belgian adults

BACKGROUND

The spread of COVID-19 has affected people's daily lives, and the lockdown may have led to a disruption of daily activities and a decrease of people's mental health.

AIM

To identify correlates of adults' mental health during the COVID-19 lockdown in Belgium and to assess the role of meaningful activities in particular.

METHODS

A cross-sectional web survey for assessing mental health (General Health Questionnaire), resilience (Connor-Davidson Resilience Scale), meaning in activities (Engagement in Meaningful Activities Survey), and demographics was conducted during the first Belgian lockdown between April 24 and May 4, 2020. The lockdown consisted of closing schools, non-essential shops, and recreational settings, employees worked from home or were technically unemployed, and it was forbidden to undertake social activities. Every adult who had access to the internet and lived in Belgium could participate in the survey; respondents were recruited online through social media and e-mails. Hierarchical linear regression was used to identify key correlates.

RESULTS

Participants (N = 1781) reported low mental health (M = 14.85/36). In total, 42.4% of the variance in mental health could be explained by variables such as gender, having children, living space, marital status, health condition, and resilience (β = -.33). Loss of meaningful activities was strongly related to mental health (β = -.36) and explained 9% incremental variance (R2 change = .092, p < .001) above control variables.

CONCLUSIONS

The extent of performing meaningful activities during the COVID-19 lockdown in Belgium was positively related to adults' mental health. Insights from this study can be taken into account during future lockdown measures in case of pandemics.

Associations between relationship status and mental well-being in different life phases from young to middle adulthood

The aim of this study was to assess the associations between relationship status and mental well-being in four different phases during the life course, and to identify whether relationship quality moderated these associations. We used a broader concept of relationship status (instead of marital status) and also included the positive dimension of mental health. Participants in a Finnish cohort study were followed up at ages 22 (N = 1,656), 32 (N = 1,471), 42 (N = 1,334), and 52 (N = 1,159). Measures in all study panels covered relationship status (marriage, cohabitation, dating, single and divorced/widowed), Short Beck Depression Inventory (S-BDI), self-esteem (seven items) and relationship quality (six items). Analyses were carried out using linear regression.

Compared to marriage, being single or being divorced/widowed were associated with depressive symptoms at every age in men. For women, in turn, being single – but not being divorced/widowed – was associated with depressive symptoms. Among men, being single or being divorced/widowed were also associated with lower self-esteem at age 32, 42 and 52, but in women, only one association between lower self-esteem and being single was found at age 32. Of the age stages, the age 32 is highlighted in men, at which point all relationship statuses were risk factors compared to marriage. There were only few indications of the moderating role of the relationship quality.

Compared to marriage, being single or being divorced/widowed were quite consistently associated with poorer mental well-being during the life course, especially among men. For dating and cohabiting the associations were more fragmented depending on age and gender; particularly among women, these relationship statuses tended not to differ from marriage in terms of mental well-being. These observations on mental well-being across five relationship statuses are important in our contemporary society, where the number of marriages is decreasing, and other forms of relationships are becoming more common.

•

Associations of relationship status showed more consistency than variation by age.

•

Singles and divorcees experienced poorer mental well-being, especially in men.

•

Presence of partner may be more important than the institution of marriage.

•

Results were clearer and stronger in relation to depressive symptoms than self-esteem.

Influence of Psychosocial Variables on the Health of People Living in Housing Exclusion

The aim of this study was to analyze the influence of some personal characteristics, health variables, and social support on the self-rated health of people in housing exclusion in Spain. For that purpose, we used the FOESSA Survey of Social Integration and Needs database, with a final sample of 1574 households. Being more educated and reporting a good life satisfaction stood out as the main factors preventing worse health status. Furthermore, results showed that being female, experiencing poverty-related food insecurity, not having health insurance, experiencing widowhood or partner bereavement, and having caring responsibilities for others or having a disabled person in the household are associated with increased reporting of regular or poor health. On the other hand, being young, having a diagnosed/long-term illness, and a big household size are preventive factors for good health. These results allowed identifying risk and prevention factors to inform interventions to improve the health of those living in housing exclusion. Promoting better education levels, social support, and overall life satisfaction could be important to improve health in this population. Developing social support policies for caring responsibilities and food insecurity must be a priority to improve the health of people living in housing exclusion.

The herbivore's dilemma: Trends in and factors associated with heterosexual relationship status and interest in romantic relationships among young adults in Japan-Analysis of national surveys, 1987-2015

BACKGROUND

It has been suggested that an increasing proportion of young adults in Japan have lost interest in romantic relationships, a phenomenon termed "herbivorization". We assessed trends in heterosexual relationship status and self-reported interest in heterosexual romantic relationships in nationally representative data.

METHODS

We used data from seven rounds of the National Fertility Survey (1987-2015) and included adults aged 18-39 years (18-34 years in the 1987 survey; sample size 11,683-17,675). Current heterosexual relationship status (married; unmarried but in a relationship; single) was estimated by sex, age group and survey year, with singles further categorized into those reporting interest vs. no interest in heterosexual romantic relationships. Information about same-sex relationships were not available.

RESULTS

Between 1992 and 2015, the age-standardized proportion of 18-39-year-old Japanese adults who were single had increased steadily, from 27.4 to 40.7% among women and from 40.3 to 50.8% among men. This increase was largely driven by decreases in the proportion of married women aged 25-39 years and men aged 30-39 years, while those in a relationship had increased only slightly for women and remained stable for men. By 2015, the proportion of single women was 30.2% in those aged 30-34 years and 24.4% in those aged 35-39 years. The corresponding numbers for men were 39.3% and 32.4%. Around half of the singles (21.4% of all women and 25.1% of all men aged 18-39 years) reported that they had no interest in heterosexual romantic relationships. Single women and men who reported no interest in romantic relationships had lower income and educational levels and were less likely to have regular employment compared to those who reported such an interest.

CONCLUSIONS

In this analysis of heterosexual relationships in nationally representative data from Japan, singlehood among young adults had steadily increased over the last three decades. In 2015 around one in four women and one in three men in their thirties were unmarried and not in a heterosexual relationship. Half of the singles reported no interest in romantic relationships and these women and men had lower income and educational levels and were less likely to have regular employment.

Differences in how spouses influence each other's alcohol use in same- and different-sex marriages: A daily diary study

RATIONALE

Different-sex spouses influence each other's alcohol consumption, with women having more influence on their spouses than men. Because women drink less than men, this long-term influence partly explains why married men and women consume less alcohol than their unmarried peers. However, much less is known about possible gender differences in the ways spouses influence each other's alcohol use on a day-to-day basis in same-compared to different-sex marriages. Because sexual minority people are at higher risk for alcohol use disorders compared to their heterosexual counterparts, such knowledge could shed light on ways to reduce this risk and alcohol use disparities between sexual minority and heterosexual people.

METHOD

We use 10 days of diary data collected in 2014-2015 in the United States from 157 female same-sex, 106 male same-sex, and 115 different-sex married couples in midlife (ages 35-65) to examine how one spouse's drinking influences how much the other spouse drinks on the following day.

RESULTS

Men reported higher levels of daily drinking than women; after including covariates, men in different-sex marriages reported drinking at the highest levels. Results from actor-partner interdependence models show that men in same- and different-sex marriages drink more, and women in different-sex marriages drink less when their spouse drinks more the previous day. Female same-sex spouses did not change their drinking behaviors in response to their spouse's drinking.

CONCLUSIONS

Overall higher rates of drinking among men in same-sex marriages suggest an accumulation effect of drinking that may contribute to sexual minority health disparities. Women and men in different-sex marriages may be engaging in social control or navigating masculinity norms. Women in same-sex marriages may not feel the need to adjust to low levels of drinking by their spouses. Findings suggest that spousal influence over alcohol consumption unfolds differently in same-sex compared to different-sex marriages.

Psychosocial factors affecting sleep misperception in middle-aged community-dwelling adults

Sleep misperception has long been a major issue in the field of insomnia research. Most studies of sleep misperception examine sleep underestimation by comparing the results of polysomnography conducted in a laboratory environment with patients' sleep diary entries. We aimed to investigate psychosocial characteristics of adults who underestimated or overestimated sleep time in a nonclinical, middle-aged community-dwelling population. We collected one week of sleep data with wrist-worn accelerometers. We used egocentric social network analysis to analyze the effects of psychosocial factors. Among 4,060 study participants, 922 completed the accelerometer substudy. Underestimation was defined as an accelerometer-measured sleep time ≥ 6 h and a subjective sleep time < 6 h. Overestimation was defined as an objective sleep time < 6 h and a subjective sleep time ≥ 6 h. Psychosocial characteristics of the sleep misperception group were evaluated using multivariate regression analysis. A total of 47 participants underestimated sleep time, and 420 overestimated sleep time. Regression analysis revealed that women, living with spouse, economic satisfaction, and bridging potential had protective effects against sleep underestimation. Blame from a spouse involved a 3.8-times higher risk of underestimation than the control group (p = 0.002). In men, discussing concerns with a spouse had a protective effect against underestimation (p < 0.001). Economic satisfaction, feeling social network-based intimacy, and support from a spouse were associated with overestimation in women. In men, feeling social network-based intimacy was also associated with overestimation (p < 0.001). We found that social relationship quality was related to sleep overestimation and underestimation. This association was marked in women. Good social relationships may have positive effects on sleep misperception via attenuation of negative emotional reactions and effects on emotional regulation.

Relationship quality and mental health during COVID-19 lockdown

Catastrophes are known to have an impact on relationships as well as on mental health. This study evaluated differences in several mental health and well-being measures according to relationship quality during the Coronavirus Disease (COVID-19) pandemic and related lockdown measures. A cross-sectional online survey was launched four weeks after lockdown measures were implemented in Austria. Relationship quality was measured with the Quality of Marriage Index (QMI), and mental health measures included quality of life (WHO-QOL BREF psychological domain), well-being (WHO-5), depression (PHQ-9), anxiety (GAD-7), stress (PSS-10), and sleep quality (ISI). ANOVAs with Bonferroni-corrected post-hoc tests and Chisquared tests were applied. In all mental health scales, individuals with good relationship quality (n = 543) scored better than individuals with poor relationship quality (n = 190) or without relationship (n = 272). The odds ratios (OR) between the poor and good relationship quality groups were 3.5 for the PHQ-9, 3.4 for the GAD-7, and 2.0 for the ISI. Additionally, individuals without no relationship scored better on all scales than individuals with poor relationship quality (all p-values < .05). Relationship quality was related to mental health during COVID-19. The prevalence of depressive symptoms increased according to relationship quality from 13% up to 35%. Relationship per se was not associated with better mental health, but the quality of the relationship was essential. Compared to no relationship, a good relationship quality was a protective factor whereas a poor relationship quality was a risk factor.

The prevalence of mental distress and association with social changes among postgraduate students in China: a cross-temporal meta-analysis

OBJECTIVE

This study aims to estimate the mental distress prevalence of Chinese postgraduate students and the association with the social changes based on the data between 2000 and 2019.

STUDY DESIGN

This is a cross-temporal meta-analysis study.

METHODS

The literature was retrieved with both English and Chinese electronic databases, including articles published from 2002 to 2019. Statistical analyses were performed with R 3.6.1 and SPSS 22.

RESULTS

Eighty-nine primary studies with 99 reports were included in our meta-analysis, totaling 54,722 Chinese postgraduate students. The result showed that: (a) the prevalence of mental distress was 28% (95% confidence interval [CI]: 25%-31%), and the prevalence of moderately positive symptoms was 9% (95% CI: 7%-11%); (b) the prevalence of positive symptoms was negatively correlated with the years of data collection and the prevalence of mental distress decreased by at least 16% from 2000 to 2019; and (c) social changes, particularly the policies of mental health and the educational environment had a significant contribution to these changes.

CONCLUSIONS

More than a quarter of postgraduate students have mental illness in China, whereas the prevalence of their mental distress has been decreasing. Social changes are shown to play an important role in contributing to this change.

The association between marital transitions and the onset of major depressive disorder in a south asian general population

BACKGROUND

Marriage in general is associated with better mental health in high-income industrialized countries, but it is unknown to what extent this is also the case in South Asia.

METHODS

The Chitwan Valley Family Study (CVFS) in Nepal is a 24-year family panel study with a recent representative survey to investigate the association between sociodemographic changes and mental health (N = 10,516). We investigated timing of marital transitions and timing of onset of MDD in both male and female respondents, controlling for key confounders.

RESULTS

In this setting the transition to marriage is associated with increased odds of subsequent MDD first onset (median OR=2.28). For female respondents, divorce (OR=2.68), early widowed (OR=11.25), and even getting married significantly increased the odds of subsequent MDD onset (OR=3.03). For male respondents, only becoming widowed increased the odds of subsequent MDD (OR=16.32), but marriage did not reduce the odds of MDD.

LIMITATIONS

Limitations of the study include large-scale protocol that may have resulted in underreporting of MDD and the exclusion of sub-threshold cases that may otherwise have qualified as a case in a clinical setting.

CONCLUSIONS

In the Nepalese general population, marital transitions increase the odds of subsequent depression, especially among the female population. Results provide basic but essential vital health data that can guide clinicians to proactively plan sustainable healthcare both within South Asia and among many South Asians living in other places.

Social support, rural/urban residence, and depressive symptoms among Chinese adults

This study aims to examine the extent to which people are socially integrated and the association between social support and depressive symptoms among Chinese adults, with regard to the moderating effect of the rural or urban residence. The author used data from the China health and longitudinal study (CHARLS), a nationally representative longitudinal survey of the population of adults aged over 45 in China. A total of 16,372 participants were included in this study, and the mean age of the sample was 59.7. Three variables were used to measure participants' social support: family size, proximity of support, and social involvement. The Chinese version of 10-item center for epidemiologic studies depression scale was used as a measurement tool for depressive symptoms. The findings demonstrate that small family size, living with a spouse, frequency of contact with children, and a number of social activities have significant effects on depressive symptoms. For all aspects of social support, the influence on depressive symptoms is not significantly different between urban and rural areas. Family support, especially the support of a spouse is crucial to prevent depression. This study also identifies the vital effect of social activity and encourages the government to improve public services, especially in rural areas.

Gender Differences in the Pattern of Socio-Demographics Relevant to Metabolic Syndrome Among Kenyan Adults with Central Obesity at a Mission Hospital in Nairobi, Kenya

INTRODUCTION

Metabolic syndrome (MetS) is a risk factor for cardiovascular-related morbidity and mortality. Although the risk factors for MetS are well documented, differences in gender-based demographics among Kenyan adults with central obesity are lacking.

AIM

Determine gender differences in the pattern of socio-demographics relevant to metabolic syndrome among Kenyan adults with central obesity at a mission hospital, Nairobi.

METHODS

A cross-sectional baseline survey involving adults (N = 404) with central obesity aged 18-64 years, as part of a community-based lifestyle intervention study. Respondents were systematically sampled using the International Diabetes Federation definition for MetS. Lifestyle characteristics, anthropometric, clinical and biochemical markers were measured and analyzed using SPSS.

RESULTS

High (87.2%) MetS prevalence associated with advanced age in males (p < 0.001) and females (p = 0.002) was observed. MetS was likely among divorced/separated/widowed (p = 0.021) and high income males (p = 0.002) and females (p = 0.017) with high income. Unemployed males (p = 0.008) and females with tertiary education (p = 0.019) were less likely to have MetS. Advanced age was likely to lead to high blood pressure, fasting blood glucose and triglycerides (p < 0.05). Males were more likely (p = 0.026) to have raised triglycerides, while females (p < 0.001) had low high density lipoproteins.

CONCLUSION

A high prevalence of MetS associated with social and gender differences among Kenyan adults with central obesity. These underscore the need to look beyond the behavioral and biological risks and focus on every nuance of gender differences in addressing MetS and CVDs.

Determinants of harmful use of alcohol among urban slum dwelling adults in Kenya

BACKGROUND

Harmful alcohol use is a public health problem associated with negative health and socio-economic impacts. However, patterns and dynamics of alcohol use among slum-dwellers in Kenya are poorly understood.

OBJECTIVE

To establish determinants of harmful alcohol use among adults in an urban slum setting in Kenya.

MATERIALS AND METHODS

Cross-sectional study involving a consecutively selected sample (N=215) from Githurai, in Nairobi. A pre-tested questionnaire that captured data on socio-demographics, drinking patterns, type, reasons, initiator, and support system.

RESULTS

Of the respondents, those above 31 years, married, separated/divorced/widowed, of high education, earning above 50 USD, and from dysfunctional families consumed more alcohol. Low earners consumed (p < 0.05) unrecorded while high earners drank (p< 0.001) recorded alcohol. Adults from families with a drinking father and sibling consumed more alcohol (p=0.001). Single, low educational attainment/earners, and those in dysfunctional families (p <0.05) drank due to stress and reported alcohol-related problems. Young, unmarried, and casual laborers were introduced (p < 0.05) to alcohol by friends.

CONCLUSION

Socio-demographic, economic, familial, social interactions, and stress are associated with harmful alcohol use among adults from slums calling for interventions targeting these factors.

Prognostic and metastasis-related factors in colorectal neuroendocrine tumors: A cross-sectional study based on the Surveillance, Epidemiology and End Results

The incidence of colorectal neuroendocrine tumors (NETs) is gradually increasing with the increasing availability of colonoscopy and computed tomography. However, prognostic and metastatic factors for colorectal NETs are unknown. The aim of the present study was to identify clinicopathological prognostic and metastasis-related risk factors for colorectal NETs. Based on the Surveillance, Epidemiology and End Results (SEER) program, the data of 3,093 patients with colorectal NETs were included in the present study. χ² test, crosstabulation, Kaplan-Meier method, Cox proportional hazard regression model, nomogram and logistic regression analysis were used to evaluate the risk factors. Systemic analysis of data from 3,093 patients revealed that age (P<0.001), marital status (P<0.001), number of malignant tumors (P<0.001), histopathological grade (P<0.001) and clinical stage (P<0.001) were independent prognostic factors of cancer-specific survival (CSS). Among them, married patients exhibited longer CSS compared with unmarried patients (P<0.05). A nomogram based on these five factors with an area under the curve of 0.921 [95% confidence interval (CI), 0.908–0.934; P<0.001] was constructed. Age (P=0.010), primary tumor site (P<0.001), surgery (P<0.001), tumor size (P<0.001) and histopathological grade (P<0.001) were risk factors for distant metastasis of colorectal NETs. In conclusion, age, marital status, number of malignant tumors, histopathological grade and clinical stage may be independent prognostic factors for CSS of colorectal NETs, and the nomogram may have higher predictive efficiency compared with clinical stage. Age, primary tumor site, surgery, tumor size and histopathological grade may be risk factors for the distant metastasis of colorectal NETs.

Child marriage and psychological well-being in Niger and Ethiopia

Background

Despite an understanding of the circumstances of child marriage, including how it limits agency and erodes childhood support systems, not much is known about the relationship between child marriage and mental health of child brides, especially in the sub-Saharan African context. To address this gap, we use large-scale population-based data from ever-married women aged 18–45 in Niger (n = 2764) and Ethiopia (n = 4149) to examine the association of child marriage with overall psychological well-being and its sub-domains: depression, anxiety, positive well-being, vitality, self-control and general health. We complement this with qualitative data from Ethiopia to further contextualize the psychological well-being of child brides.

Methods

Multivariate linear regressions were conducted to estimate the association between child marriage and overall psychological well-being and its sub-domains. Thematic qualitative analysis was conducted to further understand the lives of child brides.

Results

Our regression analysis found significant negative associations between very early marriage (marriage at 15 years or earlier) and overall psychological well-being in both Niger and Ethiopia. With the exception of self-control, all sub-domains of psychological well-being – depression, anxiety, positive well-being, vitality and general health – were negatively associated with very early marriage. In addition, in the qualitative analysis, Ethiopian child brides reported suffering emotional distress and depression induced by the burden of handling marital responsibilities at an early age.

Conclusion

The study highlights that even in settings where child marriage is normative, marrying very early is associated with negative outcomes. Further research is needed to understand the mechanisms that make those married during early adolescence particularly vulnerable to psychological distress, so that programs can address those vulnerabilities.

Electronic supplementary material

The online version of this article (10.1186/s12889-019-7314-z) contains supplementary material, which is available to authorized users.

Well-Being and Romantic Relationships: A Systematic Review in Adolescence and Emerging Adulthood

Adolescence and emerging adulthood are both stages in which romantic relationships play a key role in development and can be a source of both well-being and negative outcomes. However, the limited number of studies prior to adulthood, along with the multiplicity of variables involved in the romantic context and the considerable ambiguity surrounding the construct of well-being, make it difficult to reach conclusions about the relationship between the two phenomena. This systematic review synthesizes the results produced into this topic over the last three decades. A total of 112 studies were included, following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines. On the one hand, these works revealed the terminological heterogeneity in research on well-being and the way the absence of symptoms of illness are commonly used to measure it, while on the other hand, they also showed that romantic relationships can be an important source of well-being for both adolescents and emerging adults. The findings underline the importance of providing a better definition of well-being, as well as to attribute greater value to the significance of romantic relationships. Devoting greater empirical, educational, and community efforts to romantic development in the stages leading up to adulthood are considered necessary actions in promoting the well-being of young people.

Assessing spousal support and health in an aging population: support and strain amidst changing social dynamics

This study examined the role of relationship quality on physical and psychological health among older adults. It included 2,298 adults aged 50 and older who participated in the Midlife in the US national longitudinal study of health and well-being. We assessed the effect of spousal support and strain on psychological and physical health, controlling for age, education, income, depression levels and prior health. Results indicated that spousal support and strain affected psychological health but not physical health. Despite prior research showing an association between marital quality and physical health, this study did not support the conceptualization that relationship quality measured by spousal support or strain has a direct effect on long-term health in this sample of older adults. This study does not preclude the presence of a mediated or moderated association between relationship quality and physical health. Higher levels of spousal support are associated with positive psychological health among adults over age 50 while spousal strain is associated with negative psychological health. This study supports the premise that relationship quality has an ongoing impact on the psychological health of mature adults, bolstering arguments to include psychological health screening and couples relationship education among health services provided to older adults.

[Perception of happiness associated to family life in Bogotá- Colombia]

OBJECTIVE

To demonstrate the association between happiness and family functionality in order to promote healthy family relationships and the biopsychosocial health of the people.

MATERIALS AND METHODS

Cross-sectional, descriptive study developed over a span of three years. A questionnaire was applied to 8 885 people from Bogotá selected by convenience sampling. The population was divided into those who said they were happy and those who said they felt sad at the time of the survey. Explanatory variables included sex, age, socioeconomic status, functionality (based on the family APGAR), family structure (members of the household), and support network. Odds ratios were obtained and the significant results were subjected to the regression process.

RESULTS

The logistic regression analysis of the odds ratios showed that the perception of happiness decreases with age (60 and over vs. 7 to 10 years; OR: 0.09, 95% CI: 0.03-0.26), that there is a stronger significant association with functionality (severe dysfunction vs. normal functionality; OR: 0.05, 95% CI: 0.03-0.08) than with family structure (extended vs. nuclear home; OR: 0.60, 95% CI: 0.37-0.96), and that happiness is related to support networks (low network vs. high network; OR: 0.52 95% CI: 0.31-0.88).

CONCLUSION

This research confirms the importance of the family in happiness perception, which is a sentiment considered as a health benchmark. Based on these results, strengthening family coexistence is essential to promote the health of people.

Establishment of Normative Self-Rated Health Status Data and Association between Ideal Life Expectancy and Social Wellness of General Population in Korea

PURPOSE

The purpose of this study was to establish normative data for holistic health parameters in the general Korean population and to investigate the factor associated with ideal life expectancy (ILE) among these holistic health parameters and sociodemographic variables.

METHODS

This study used a questionnaire to obtain self-reported physical, mental, social, spiritual, and general health status and then evaluated their association with ILE. A total of 1,241 individuals responded to the questionnaire, from which we established a multidimensional health status reference data set representing the Korean population. To explain factors associated with ILE, we stratified results by age and gender and performed multiple logistic regression of sociodemographic variables and multidimensional health status.

RESULTS

Women reported poor health status more frequently for all five health categories. The average ILE was 87.46 years versus 84.42 years of life expectancy in the general Korean population. Single marital status, higher income, and better social health were significantly associated with higher ILE.

CONCLUSION

ILE could be a good indicator reflecting social wellness in a certain society. Comprehensive social health promotion programs can improve individuals' attitudes toward life expectancy, especially for vulnerable groups.