Effects of mental health stigma on loneliness, social isolation, and relationships in young people with depression symptoms

Joint association of sleep duration and depression with new-onset hearing loss: a national cohort study

Background

Hearing loss, a global health burden, is closely associated with depression and sleep disorders. However, the combined effects of sleep duration and depression on hearing loss risk remain unclear.

Methods

Data from the China Health and Retirement Longitudinal Study (CHARLS) were analyzed, including 6,374 adults aged 45 and older. Cox proportional hazards models assessed the relationship between depression, sleep duration, and hearing loss. Mediation analysis explored the potential mediating roles of CESD-10 score and sleep duration on new-onset hearing loss. Subgroup analyses by age, sex, and BMI were also conducted.

Results

Over a 7-year follow-up, 1,422 participants developed hearing loss. Both short sleep duration and high CESD-10 scores were independently associated with increased risk of hearing loss. Participants with long sleep duration but depression had a hazards ratio (HR) of 1.59 (95% CI: 1.35, 1.87) for hearing loss. Mediation analysis showed that sleep duration mediated 10.1% of the association between CESD-10 score and hearing loss, while CESD-10 score mediated 70.8% of the relationship between sleep duration and hearing loss.

Conclusion

This study highlights the significant and interconnected roles of sleep duration and depression in the development of hearing loss. Interventions addressing both sleep and depression may offer more effective strategies for preventing and managing hearing loss.

Unseen Heroes: Exploring the Impact of Schizophrenia Caregiving on Families

BACKGROUND

Schizophrenia is a complex mental health disorder that not only affects the individual diagnosed but also has profound implications for their families and caregivers. This paper aims to shed light on the emotional, social and practical challenges faced by caregivers, as well as the coping mechanisms they employ to navigate the complexities of caregiving.

METHODS

Through semi-structured interviews with caregivers of patients with schizophrenia, thematic analysis was employed to uncover the initial reactions, dynamics, daily life impact and coping skills.

RESULTS

Thematic analysis of caregiver interviews reveals dominant themes including the emotional rollercoaster of caregiving, fostering fulfilling lives for loved ones with schizophrenia, the balancing act of caregiving responsibilities and the importance of social support networks.

CONCLUSION

Caregivers often experience a wide range of emotions, from love and empathy to frustration and helplessness, as they navigate the challenges of supporting their loved ones with schizophrenia. Additionally, caregivers may face stigma, social isolation and financial strain, further complicating their caregiving journey.

Research on the network structure and gender/age differences of psychological safety among urban residents: network analysis based on a large sample

BACKGROUND

Psychological safety as the key to mental health, not only affects individual happiness and quality of life but also relates to social stability and harmony. However, psychological safety is complex and multidimensional, with unclear internal structures and influencing factors and insufficient research on gender and age differences. Urban residents are living in an environment characterized by fast-paced, high-pressure, multicultural integration, and complex social relationships. Therefore, in-depth exploration of its core dimensions and network structure is crucial for formulating effective mental health strategies and enhancing residents' sense of psychological safety.

METHODS

A survey was conducted on 9,282 urban residents using the Psychological Safety Scale. Using R version 4.3.2 for network estimation, centrality estimation, accuracy and stability estimation, and network comparison.

RESULTS

The results found that the strength centrality index of the general sense of safety dimension is always the highest in the total network and networks of different genders and ages. The network comparison results show that there are significant gender and age differences in the dimensions/item networks of psychological safety. There are connections between trust and relaxation, excitement, and calmness in the dimension network of male samples, while there are no such connections in the dimension network of female samples. The general sense of safety and relaxation connection strength on the male dimension network is significantly stronger than that on the female dimension. In the dimension network of the youth sample, the strength of the connection between calmness and relaxation, trust and relaxation were significantly stronger than those of the middle-age sample, while the strength of the connection between relaxation and excitement was significantly weaker than that of the middle-age sample.

CONCLUSION

Researchers should fully consider gender and age factors and adopt more personalized and differentiated strategies for promoting individual psychological safety.

Loneliness in Middle-Aged and Older Adults: Effects of Social Environments

Loneliness is a common subjective condition that is associated with distress and negative outcomes for psychosocial functioning and well-being, and it is grounded in destructive or inadequate social functioning. Social interactions are considered one of the key factors determining loneliness, and similarly to social interactions, loneliness can occur in different domains. While a solid body of research is focused on loneliness as a general condition, there are few studies that investigate loneliness from a multidimensional perspective, particularly combining general and domain-specific loneliness. In the present study, we conceptualized loneliness as a complex phenomenon. We focused on the associations between different types of loneliness and the characteristics of social environments. The participants were 140 adults aged 45-73 (58.9% females). The methods involved the Multidimensional Inventory of Loneliness Experience, the Social and Emotional Loneliness Scale (SELSA-S), the "Sociotropy-Self-Sufficiency" Questionnaire, and the assessment of demographic characteristics (age and sex). To test our hypothesis, we applied regression path modeling. The results showed that general loneliness predicted both family and non-family loneliness. We also found that general loneliness increased experiences of social uncertainty, while non-family loneliness decreased positive relations with others. No age effects were found. An effect of sex was found for social uncertainty and positive relations with others.

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.

The mediating role of systemic inflammation in the association between bedroom light at night and new-onset depressive symptoms among Chinese young adults: A prospective cohort study

BACKGROUND

The detrimental effects of exposure to light at night (LAN) have received increasing attention. However, the effects of LAN exposure on depressive symptoms and underlying mechanism are less explored.

OBJECTIVES

To investigate the association between LAN exposure with new-onset and trajectories of depressive symptoms, and the potential mediating role of systemic inflammation.

METHODS

Baseline bedroom LAN exposure was monitored every minute for 2 consecutive nights using a portable illuminance meter. Fasting blood samples were collected at the 1-year follow-up to determine high sensitivity C-reactive protein (hs-CRP). Depressive symptoms were assessed at baseline, 1- and 2-year follow-up using the Mood and Feelings Questionnaire (MFQ).

RESULTS

At baseline, the mean age of the 347 participants was 18.7 ± 0.8 years, and 35.2 % were men. At 2-year follow-up, the new-onset depressive symptoms were 14.7 %. Compared with low-LANavg (average light intensity from bedtime to rising time) intensity group (LANavg < 3 lx), those with high-LANavg intensity (LANavg ≥ 3 lx) were associated with an 125 % increase in risk for depressive symptoms (HR = 2.25; 95 % CI: 1.27, 4.00); Compared with short-LAN5 (duration of nighttime light intensity ≥5 lx) duration group (LAN5 < 45 min), those with long-LAN5 duration (LAN5 ≥ 45 min) were associated with an 119 % increase in risk for depressive symptoms (HR = 2.19; 95 % CI: 1.18, 4.06). Participants were classified into 3 trajectory groups: consistently low, slow or rapid increase depressive symptoms; both intensity and duration of LAN exposure were associated with higher likelihood of slow or rapid increase depressive symptoms. Additionally, hs-CRP partially mediated the relationship between intensity (mediation proportion: 7.1 %) and duration (mediation proportion: 10.6 %) of LAN exposure with depressive symptoms.

CONCLUSION

Excessive bedroom LAN exposure is associated with increased risk of depressive symptoms among young adults, and systemic inflammation may be a partial mediator in the LAN-depressive symptoms association.

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.

Health-related quality of life of children and adolescents with sickle cell disease: An evolutionary concept analysis

The concept of Health-Related Quality of life (HRQOL) of children and adolescents with Sickle cell disease (SCD) is not clearly understood due to the lack of available studies. This review aimed to elucidate various attributes and related concepts of HRQOL in children and adolescents with SCD using Rodgers' et al. (2018) concept analysis framework. A systematic search was performed to identify studies reporting the attributes, antecedents, consequences, surrogate terms, and related concepts of HRQOL in children and adolescents with SCD. The review included 75 articles, including 70 quantitative, two mixed-methods, and three qualitative studies. These were categorized into attributes, antecedents, consequences, surrogate terms, related concepts, and an exemplar of HRQOL in children and adolescents with SCD. The review identified nine important attributes. It includes multidimensional and dynamic concepts, acknowledging the illness, maintaining emotional balance and self-control, coping with the disease, pain management, stigma and discrimination, treatment burden, palliative care and personal resilience. The antecedents were knowledge and attitude toward the disease, self-efficacy, social support, spirituality and spiritual well-being, disease severity, access to healthcare, environmental factors, and financial considerations. The consequences were independence in personal life, improved physical health outcomes, psychological well-being, family and caregiver well-being, improved family, social and peer relationships and social interactions, improved school performance, and improved overall HRQOL and long-term outcomes. This analysis provides an overview of HRQOL concepts related to children and adolescents with SCD, guiding further research into nursing care and clinical practice.

Neuroimaging for precision medicine in psychiatry

Although the lifetime burden due to mental disorders is increasing, we lack tools for more precise diagnosing and treating prevalent and disabling disorders such as major depressive disorder. We lack strategies for selecting among available treatments or expediting access to new treatment options. This critical review concentrates on functional neuroimaging as a modality of measurement for precision psychiatry, focusing on major depressive and anxiety disorders. We begin by outlining evidence for the use of functional neuroimaging to stratify the heterogeneity of these disorders, based on underlying circuit dysfunction. We then review the current landscape of how functional neuroimaging-derived circuit predictors can predict treatment outcomes and clinical trajectories in depression and anxiety. Future directions for advancing clinically appliable neuroimaging measures are considered. We conclude by considering the opportunities and challenges of translating neuroimaging measures into practice. As an illustration, we highlight one approach for quantifying brain circuit function at an individual level, which could serve as a model for clinical translation.

Brain Circuit-Derived Biotypes for Treatment Selection in Mood Disorders: A Critical Review and Illustration of a Functional Neuroimaging Tool for Clinical Translation

Although the lifetime burden due to major depressive disorder is increasing, we lack tools for selecting the most effective treatments for each patient. One-third to one-half of patients with major depressive disorder do not respond to treatment, and we lack strategies for selecting among available treatments or expediting access to new treatment options. This critical review concentrates on functional neuroimaging as a modality of measurement for precision psychiatry. We begin by summarizing the current landscape of how functional neuroimaging-derived circuit predictors can forecast treatment outcomes in depression. Then, we outline the opportunities and challenges in integrating circuit predictors into clinical practice. We highlight one standardized and reproducible approach for quantifying brain circuit function at an individual level, which could serve as a model for clinical translation. We conclude by evaluating the prospects and practicality of employing neuroimaging tools, such as the one that we propose, in routine clinical practice.

Healthcare services access challenges and determinants among persons with disabilities in Bangladesh

Persons with disabilities in LMICs facing numerous challenges in accessing essential healthcare services. However, this understanding is lacking so far in LMICs and Bangladesh. This study aimed to explore the pattern and determinants of healthcare services access among persons with disabilities in Bangladesh. We analysed data from 4293 persons with disabilities extracted from the 2021 National Survey on Persons with Disabilities. The outcome variable was healthcare services access within three months of the survey, categorized as either "yes" or "no" based on perceived needs. Several individual, household, and community-level factors were considered as explanatory variables. We utilized a multilevel mixed-effect logistic regression model to explore the association of the outcome variable with explanatory variables. The analysis included stratification by age groups: 0-17 years and 18-95 years. One out of every four persons with disabilities in Bangladesh reported that they could not access healthcare services based on their needs within three months of the survey. The main reasons for not accessing services were healthcare costs (52.10%), followed by lack of family support (27.0%), and absence of healthcare facilities in their areas of residence (10.10%). Among those who did receive healthcare services, the majority reported accessing them from governmental hospitals (26.49%), followed by village practitioner (20.52%), and private healthcare centres (19.87%). There was a higher likelihood of accessing healthcare services among persons with disabilities residing in households with higher wealth quintiles and living in the Chattogram and Sylhet divisions. Unmarried or divorced/widowed/separated persons with disabilities reported lower likelihoods of accessing healthcare services. The findings of this study emphasize the need for policies and programs to ensure healthcare services for persons with disabilities in Bangladesh. This entails raising awareness about the importance of providing healthcare services for this demographic, as well as considering healthcare services as part of social safety net programs.

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

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

A modified persian version of the self-stigma of depression scale among the Iranian population: a methodological study in 2023

INTRODUCTION

This cross -sectional research evaluated the psychometric properties of the Self-Stigma of Depression Scale (SSDS) among Iranian people.

METHODS

This methodological study was conducted among 881 people in 2023, Iran. The method of proportional stratified sampling was used to select participants. To evaluate the validity, face, content, construct, convergent, and discriminant were evaluated. The reliability of SSDS was assessed with the McDonald's omega coefficient, Cronbach α coefficient, and test- retest (Intraclass Correlation Coefficient).

RESULTS

In confirmatory factor analysis, the factor loading of all items of SSDS was more than 0.5, and two items had low factor loading. After deleted these items, goodness of fit indexes (such as GFI = 0.945, RMSEA = 0.067, AGFI = 0.917, CFI = 0.941, RFI = 0.905) confirmed the final model with 14 items and four factors of social inadequacy (3 items), help-seeking inhibition (4 questions), self-blame (3 questions), and shame (4 questions). In the reliability phase, for all items of SSDS, Cronbach α coefficient was 0.850, the McDonald omega coefficient was 0.853, and the intraclass correlation coefficient was 0.903.

CONCLUSION

The Persian form of SSDS was approved with 14 items and four factors: social inadequacy, help-seeking inhibition, self-blame, and shame. This tool can be used to check the status of self-stigmatization of depression in different groups.

Loneliness in the Daily Lives of People With Mood and Psychotic Disorders

BACKGROUND AND HYPOTHESIS

Loneliness, the subjective experience of feeling alone, is associated with physical and psychological impairments. While there is an extensive literature linking loneliness to psychopathology, limited work has examined loneliness in daily life in those with serious mental illness. We hypothesized that trait and momentary loneliness would be transdiagnostic and relate to symptoms and measures of daily functioning.

STUDY DESIGN

The current study utilized ecological momentary assessment and passive sensing to examine loneliness in those with schizophrenia (N = 59), bipolar disorder (N = 61), unipolar depression (N = 60), remitted unipolar depression (N = 51), and nonclinical comparisons (N = 82) to examine relationships of both trait and momentary loneliness to symptoms and social functioning in daily life.

STUDY RESULTS

Findings suggest that both trait and momentary loneliness are higher in those with psychopathology (F(4,284) = 28.00, P < .001, ηp2 = 0.27), and that loneliness significantly relates to social functioning beyond negative symptoms and depression (β = -0.44, t = 6.40, P < .001). Furthermore, passive sensing measures showed that greater movement (β = -0.56, t = -3.29, P = .02) and phone calls (β = -0.22, t = 12.79, P = .04), but not text messaging, were specifically related to decreased loneliness in daily life. Individuals higher in trait loneliness show stronger relationships between momentary loneliness and social context and emotions in everyday life.

CONCLUSIONS

These findings provide further evidence pointing to the importance of loneliness transdiagnostically and its strong relation to social functioning. Furthermore, we show that passive sensing technology can be used to measure behaviors related to loneliness in daily life that may point to potential treatment implications or early detection markers of loneliness.

The moderating role of stigma in the relationship between depression and resilience: results of a cross-sectional study in university students

Background/objective

Depression is a growing concern in university students and resilience has shown to play a protective role. The impact of stigma is still under-explored, with reference to its moderating role between depression and resilience. The present study investigate such a relationship among Italian university students.

Methods

A cross-sectional design was applied in a simple of 1,912 students to examine the interrelationships between depression (Patient Health Questionnaire-9), resilience (Nicholson McBride Resilience questionnaire), and stigma (Stigma-9). Correlation, predictor, and moderation analyses were applied in RStudio.

Results

A negative correlation was found between depressive symptoms and resilience (r = -0.455, p < 0.001). A positive correlation was found between depressive symptoms and stigma (r = 0.207, p < 0.001). Lower levels of resilience and higher levels of stigma were significant predictors of depressive symptoms [F(df, n) = 190.8(3, 1884), p < 0.001, R2 = 0.236]. The moderation analysis showed a weakening of resilience protective effect against depression as stigma levels increase [F(df,n) = 186.7(3,1908), p < 0.001, R2 = 0.226].

Conclusion

Stigma influences the relationship between depression and resilience. Anti-stigma interventions and programs empowering resilience, should be implemented in university settings to protect students from depression.