Prevalence and Correlates of Individuals Screening Positive for Depression and Anxiety on the PHQ-4 in the German General Population: Findings from the Nationally Representative German Socio-Economic Panel (GSOEP)

[Fatigue after COVID-19 disease associated with depression and anxiety in insured persons from healthcare and social professions]

BACKGROUND

Fatigue is one of the most frequent symptoms in post-COVID syndrome (PCS) patients and describes a long-term feeling of tiredness and exhaustion. Frequently, it follows an infection or is a component of depressive symptoms. But fatigue itself is also a risk to mental health like other chronic conditions. The objective of this paper was to analyse the relationship between fatigue and depression/anxiety and the differences between PCS patients and fully recovered COVID-19 cases.

METHODS

In a longitudinal study with three measurement points, insured members of the Statutory Accident Insurance and Prevention in the Health and Welfare Service with a SARS-CoV‑2 infection in 2020 were asked about fatigue, depression/anxiety and persisting COVID-19 symptoms. To analyse the longitudinal effects of the two variables, a cross-lagged panel model was applied.

RESULTS

In the present sample (n = 860), a proportion of 68.7% to 75.1% of people was suffering from PCS. The results showed a model fit of R2 = 61.49% and all effects were significant, but the cross-lagged effects were not significantly different from each other. If stratified according to whether PCS symptoms were present, the cross-lagged effects weakened in both groups, while the effects of fatigue on depression and anxiety only remained in the group of those affected by PCS.

DISCUSSION

The results show a relationship in both directions between fatigue and depression/anxiety. PCS patients can benefit from psychotherapeutic treatment to tackle fatigue and prevent depression and anxiety.

Prevalence of Depression Among Women Using Hormonal Contraceptives in Mogadishu, Somalia: A Cross-Sectional Study

Background

Depression is a global health concern with significant consequences, especially for women. Hormonal changes and gender disparities contribute to its prevalence. Hormonal contraceptives are widely used among women of reproductive age, but some users report mood-related side effects.

Purpose

This study aims to investigate the relationship between hormonal contraceptive use and depression among women in Mogadishu, Somalia.

Methods

An analytical cross-sectional study was conducted at two hospitals in Mogadishu, targeting married women aged 15-49 using hormonal contraceptives. A sample size of 227 participants was determined, and data was collected using semi-structured questionnaires, including the Patient Health Questionnaire-9 (PHQ-9) to assess depression. The data were analyzed using SPSS version 25, including multivariate logistic regression.

Results

The prevalence of depression among participants was 33.5%, with significant associations observed between depression and occupation, income level, type of hormonal contraceptive used, and duration of contraceptive use. Housewives, individuals with lower income, users of oral pills and implant methods, as well as those with shorter durations of contraceptive use, constituted the high-risk groups for depression.

Conclusion

Depression poses a concern among women using hormonal contraceptives in Mogadishu, Somalia. Healthcare providers should educate women about potential side effects and consider individualized contraceptive recommendations. Mental health support initiatives and awareness campaigns should be introduced. Future research is recommended to further understand and address depression in this context.

Symptom patterns of comorbid depression and anxiety among older adults in China and their predictors

Comorbid depression and anxiety causes serious psychological and physiological damage for older people. This study aimed to identify heterogeneous classes of comorbid depression and anxiety (CDA) among older people in China and to ascertain predictors of latent class membership. Cross-sectional data of 10,919 cases were extracted from the Chinese Longitudinal Healthy Longevity Survey. Latent profile analysis (LPA) was used to identify symptom patterns of comorbid depression (measured by the 10-item Center for Epidemiologic Studies Depression Scale) and anxiety (measured by the Generalized Anxiety Disorder 7-item Scale). Multinomial logistic regressions following bivariate analyses were used to explore the relationship between the derived classes and individual- and social-level factors. Four patterns of CDA were identified: low symptoms of depression and anxiety (30.52%; n = 3333), mild depression only (53.26%; n = 5815), moderate depression and anxiety (13.82%; n = 1509), and severe depression and anxiety (2.40%; n = 262). Older people who are male, suffer from multimorbidity, and lack a healthy lifestyle are more likely to have problematic symptom profiles. While intimate relationships with partners and children significantly predicted CDA patterns, the effects of sibling relationships, daily life, and emotional support from the community were insignificant. LPA identified four distinct CDA patterns among a representative sample of older Chinese people. While restless sleep, lack of positive emotions, uselessness, and weak concentration are salient across all profiles, "difficult to relax" is prominent in profiles high in anxiety. In addition to individual-level variables, social-level factors, especially intimate relationships with partners and children rather than general links to siblings or the community, have unneglectable impacts on whether and to what extent older Chinese adults suffer from CDA in the cultural context of relationism, patriarchy, and filial piety.

Confirmatory validation of the patient health questionnaire - 4 (PHQ-4) for gastrointestinal disorders: A large-scale cross-sectional survey

OBJECTIVE

Using the large Rome Foundation Global Epidemiology Survey dataset, the aim of this study was to evaluate the construct and convergent validity and internal consistency of the PHQ-4 across both gastrointestinal and non-gastrointestinal condition cohorts. Another aim was to provide descriptive information about the PHQ-4 including means, confidence intervals and percentage of caseness using a large representative sample.

METHODS

A cross-sectional survey was conducted in 26 countries. Confirmatory factor and internal consistency analyses were conducted across subsamples of patients with gastrointestinal conditions (i.e., disorders of gut-brain interaction [DGBI; any DGBI, individual DGBI, and DGBI region], gastroesophageal reflux disease (GERD), coeliac disease, diverticulitis, inflammatory bowel disease (IBD), cancer anywhere in the gastrointestinal tract, peptic ulcer) and those without a gastrointestinal condition. Convergent validity was also assessed via a series of Pearson's correlation coefficients with PROMIS (physical and mental quality of life), and PHQ-12 (somatisation).

RESULTS

Based on 54,127 participants (50.9% male; mean age 44.34 years) confirmatory factor analysis indicated acceptable to excellent model fits for the PHQ-4 across all subsamples and individual DGBI and DGBI region (Comparative Fit Index >0.950, Tucker-Lewis Index >0.950, Root Mean Squared Error of Approximation <0.05, and Standardised Root Mean Square Residual <0.05). The PHQ-4 was found to demonstrate convergent validity (Pearson's correlation coefficients >±0.4), and good internal consistency (Cronbach's α > 0.75).

CONCLUSIONS

This study provides evidence that the PHQ-4 is a valid and reliable tool for assessing mental health symptomology in both gastrointestinal and non-gastrointestinal cohorts.

Psychometric network analysis of the Patient Health Questionnaire-4 (PHQ-4) in Paraguayan general population

BACKGROUND

Depression and anxiety are two of the most prevalent and disabling mental disorders worldwide, both in the general population and in outpatient clinical settings.

OBJECTIVE

This study aimed to analyze the psychometric properties of the Patient Health Questionnaire-4 (PHQ-4) based on network analysis metrics.

METHODS

A total of 911 Paraguayans (23.71% women and 76.29% men; mean age 31.25 years, SD = 10.63), selected by non-probabilistic convenience sampling, participated in the study. Network analysis was used to evaluate the internal structure, reliability, and measurement invariance between men and women.

RESULTS

The results revealed that the PHQ-4 is a unidimensional measure through Exploratory Graph Analysis (EGA). Reliability, through structural consistency, identified that 100% of the time, only a single dimension was obtained, and all items remained stable, as they were always replicated within the empirical dimension. The unidimensional structure has shown evidence of configural invariance; therefore, the network structure functioned equally among the different sex groups.

CONCLUSION

The PHQ-4 presented optimal preliminary evidence of validity based on its internal structure, reliability, and invariance between sexes. Therefore, it may be useful as an accurate and brief measure of anxiety and depressive symptoms in the Paraguayan context.

Nightmare experiences and perceived ethnic discrimination amongst female university students in the United Arab Emirates: a cross-sectional study

Perceived ethnic discrimination is known to be associated with anxiety and depression, and in turn, anxiety and depression are known to be associated with nightmare frequency and distress. This elicits a question: is perceived ethnic discrimination associated with nightmare frequency and distress? In this study, 179 female university students from the United Arab Emirates were assessed to answer that question. Results showed that while anxiety and depression were related to nightmare experiences, perceived ethnic discrimination was a stronger predictor of nightmare experiences. We posit two explanations for this finding: one based on psychoanalytical insights, and the other based on the Disposition-Stress model with neurobiological correlates. No significant differences were found across ethnicity when it comes to nightmare experiences or perceived ethnic discrimination. This is an encouraging sign of optimal societal integration in the United Arab Emirates.

Integrative Nursing Interventions for Cancer-Related Symptoms in Oncology Inpatients: Results of a Descriptive Pilot Study

BACKGROUND

Integrative nursing (IN) is an essential component of integrative medicine and integrative oncology. IN includes a range of external naturopathic, integrative nursing interventions, such as compresses, embrocation, and foot/hand baths, aimed at alleviating symptoms and side effects of conventional treatment. The project IMPLEMENT-UKU ("Implementation of IN at the University Hospital Ulm") was accompanied by a descriptive pilot study on the use of IN interventions on cancer-related symptoms in oncology inpatients, the characterization of these patients and the evaluation of the impact.

METHODS

A single-arm study was conducted using a paper-based questionnaire administered before the IN interventions (t0) and 24 hours after the IN interventions (t1). Topics included sociodemographic data, symptoms, quality of life, health status, psychological burden, attitudes, and experience and satisfaction with the IN interventions. Analyses were descriptive using absolute and relative frequencies.

RESULTS

During the 6-month study period out of 66 patients recommended for IN consultation by medical and nursing staff on 2 wards, 62 (93.9%) accepted the offer. Of those patients who received IN, 21 patients (33.9%) participated in the study. The number of IN interventions received per patient ranged from 1 to 3 during the 24-hour survey period. And a total of 36 IN interventions were performed: The most treated body region was the feet/legs (50.0%), followed by the back (25.0%), using oils such as solum oil (41.7%) and lavender oil (13.9%). Embrocation (77.8%) was the predominant type of IN intervention. For patients, the mean FACIT-F score was 29.2 ± 12.5. The mean PHQ-4 score was 3.0 ± 1.9. Regarding sleep quality in the last 4 weeks, 13 participants (61.9%) described it as rather or very poor. Satisfaction with the IN was high, with a large proportion of participants evaluating the IN interventions very positively.

CONCLUSION

The study's findings suggest that there is a great need for IN among oncology inpatients. These patients are open to and interested in IN interventions and evaluate them positively. IN provides a promising opportunity to provide non-pharmacological support to inpatients. The integration of IN in conventional oncology care settings may enhance patient-centered care and contribute to improved patient wellbeing.

Clinical Phenomenology of Fibromyalgia Syndrome in Male Patients: Same But Different

The majority of knowledge about fibromyalgia syndrome (FMS) derives from studies of female patients. Little is known about the clinical characteristics and treatment outcomes of male patients with FMS. In this retrospective cohort study with a prospective posttreatment follow-up, we investigated whether male patients with FMS differ from female patients in terms of 1) symptom burden, 2) psychological characteristics, and 3) clinical treatment response. We identified 263 male (4%) out of 5,541 patients with FMS completing a 3-week multimodal pain-treatment program. Male patients (51.3 ± 9.1 years) were age- and time-matched (1:4) with female patients (N = 1,052, 51.3 ± 9.0 years). Data on clinical characteristics, psychological comorbidities, and treatment responses were obtained from medical records and validated questionnaires. Levels of perceived pain, psychological comorbidity, and functional capacity were similar between genders, although male patients with FMS showed a higher prevalence of alcohol abuse. Compared to female patients, male patients experienced themselves less often as overly accommodating (Cohen's d = -.42) but more often as self-sacrificing (d = .26) or intrusive (d = .23). Regarding pain coping, male patients were less likely to utilize mental distraction, rest- and relaxation techniques, or counteractive activities (d = .18-.27). Male patients showed a slightly worse overall response rate than women (69% vs 77%), although differences between individual outcome measures were small (d < .2). Although male and female patients in our cohort were similar in clinical presentation and treatment response, the gender-specific differences in interpersonal problems and pain coping suggest consideration of these aspects in the treatment of male patients with FMS. PERSPECTIVE: Knowledge about fibromyalgia mostly derives from studies of female patients. Identifying and understanding gender-specific differences in fibromyalgia is an important roadmap in the treatment of this syndrome by focusing on specific gender aspects such as differences in interpersonal problems and pain coping mechanisms.

Generalised anxiety and panic symptoms in the German National Cohort (NAKO)

OBJECTIVES

Anxiety disorders (AD) are common in the general population, leading to high emotional distress and disability. The German National Cohort (NAKO) is a population-based mega-cohort study, examining participants in 16 German regions. The present study includes data of the first 101,667 participants and investigates the frequency and severity of generalised anxiety symptoms and panic attacks (PA).

METHODS

The Generalised Anxiety Disorder Symptoms Scale (GAD-7) and the first part of the Patient Health Questionnaire Panic Disorder (PHQ-PD) were filled out by NAKO participants (93,002). We examined the correlation of GAD-7 and PHQ-PD with demographic variables, stress (PHQ-Stress), depression (PHQ-9) and childhood trauma (CTS).

RESULTS

The total proportion of prior lifetime diagnoses of AD in the NAKO cohort reached 7.8%. Panic attacks were reported by 6.0% and possible/probable current GAD symptoms in 5.2% of the examined participants. Higher anxiety severity was associated with female sex, lower education level, German as a foreign language and younger age as well as high perceived stress and depression.

CONCLUSIONS

Clinically relevant GAD symptoms as well as panic attacks are frequent in the NAKO and are associated with sociodemographic factors, and high anxiety symptoms are accompanied by pronounced stress and depression levels.

Evaluating workforce well-being: an investigation of healthcare professionals' mental health and burnout symptoms at the Tokyo 2020 and Beijing 2022 Paralympic Games

OBJECTIVE

To explore the prevalence of symptoms of mental health conditions and burnout of healthcare professionals (HCPs) working during the Tokyo 2020 Paralympic Games and the Beijing 2022 Paralympic Winter Games.

METHODS

In this cross-sectional, observational study, HCPs working during the Tokyo 2020 and Beijing 2022 Paralympic Games were asked to complete an online, anonymous survey, which included demographic questions and questions regarding mental health symptoms including depression (Patient Health Questionnaire 9-item depression scale) and anxiety (Generalized Anxiety Disorder 7-item scale) as well as burnout (Maslach Burnout Inventory-Human Services Survey: depersonalisation, emotional exhaustion, personal accomplishment). Correlation coefficients (r) were calculated between demographic characteristics and mental health symptoms.

RESULTS

In total, 256 HCPs (of 857 HCPs; 30%) completed the surveys. Twelve and eight per cent of HCP scores fell within the moderate to severe depression and moderate to severe anxiety categories, respectively. More than 30% reported moderate to high burnout (depersonalisation: 36%; emotional exhaustion: 36%; personal accomplishment: 58%). In addition, thoughts of self-harm and/or suicidality were reported by some HCPs (8%). Weak correlations were observed between age and depression (r=-0.13, p=0.046), anxiety (r=-0.16, p=0.010) and burnout (emotional exhaustion: r=-0.14, p=0.032; personal accomplishment: r=0.27, p<0.001).

CONCLUSION

Although most HCPs reported good mental health, this study suggests that a subset of HCPs experienced symptoms of depression, anxiety, burnout or thoughts of self-harm during the Tokyo 2020 and Beijing 2022 Paralympic Games. While the generalisability of these findings outside of COVID-19 restrictions should be tested, appropriate guidance and mental health support of HCPs leading up to the Paralympic Games should be prioritised.

Patients with endometriosis may experience worse clinical manifestations and therapeutic outcomes during COVID-19 in western China- a case series comparative analysis

BACKGROUND

Endometriosis is a crippling, ongoing, chronic inflammatory condition. The management of these patients has been impacted by the current COVID-19 pandemic, which is still controversial. This study compared the clinical therapy outcomes and psychological scores between before and during- the epidemic.

METHOD

The data of patients who were diagnosed with endometriosis in the Department of Gynecology, Chongqing Traditional Chinese Medicine Hospital from January 2018 to December 2022 were collected. The patients were divided into pre- and intra-COVID groups. The treatment results and psychological status of the two groups were compared.

RESULTS

A total of 1022 patients with endometriosis were enrolled, with a mean age of 33.16 ± 9.81 years and a BMI of 23.90 ± 3.04 kg/m², of which 434 cases (434/1022, 42.5%) were in the pre-COVID group and 588 cases (588/1022, 57.5%) in the intra-COVID group. Both groups were well balanced for age, BMI, history of abdominopelvic surgery, family relationships, education level, and duration between initial diagnosis and admission. Compared to the Pre-COVID group, the intra-COVID group had a higher proportion of patients with chronic pelvic pain (297/434, 68.4% vs. 447/588, 76.0%, p = 0.007) and dysmenorrhea (249/434, 62.8% vs. 402/588, 70.0%, p < 0.001), more patients requiring surgery (93/434, 21.4% vs. 178/588, 30.3%, p = 0.002) and longer hospital stays (5.82 ± 2.24 days vs. 7.71 ± 2.15 days, p < 0.001). A total of 830 questionnaires were completed. In the Intra-COVID group, PHQ-2 (2 (2, 3) vs. 3 (2,4), p < 0.001), GAD-2 (2 (1, 2) vs. 3 (2, 3), p < 0.001), PHQ-4 (4 (3, 5) vs. 5 (4, 7), EHP-5 (20.26 ± 6.05 vs. 28.08 ± 7.95, p < 0.001) scores were higher than that in the pre-COVID group, while BRS (3.0 (2.2, 4.0) vs. 2.4 (1.8, 3.8), p = 0.470) were not significantly different.

CONCLUSION

During the COVID-19 epidemic, patients with endometriosis may have reduced visits to the hospital, more severe related symptoms, longer length of hospital stays, and worse quality of life, with the possible cause being a disturbance in hormone levels through increased anxiety and depression. This provides a valid clinical basis for optimizing the management of patients with endometriosis and for early psychological intervention during the epidemic.

Welche Bedarfe haben Studierende hinsichtlich gesundheitsförderlicher Maßnahmen und welche sind ihnen bekannt? Eine Befragung an zwei Hochschulstandorten

Hintergrund

Viele Studierende in Deutschland sind von gesundheitlichen Beeinträchtigungen, darunter primär von Stress und psychischen Belastungen, betroffen. Die Prävalenz psychischer Störungen nimmt unter Studierenden kontinuierlich zu. Im Rahmen des Studentischen Gesundheitsmanagements an der Hochschule für Angewandte Wissenschaften Würzburg-Schweinfurt wurden Bedarfe und Wünsche zu Gesundheitsbereichen, die Studierende als relevant für ihr Studium betrachten, erfasst und das Wissen über vorhandene Gesundheitsangebote ermittelt.

Methoden

Im Mai 2022 wurde ein standardisierter Online-Fragebogen per E‑Mail an alle Studierenden der Hochschule Würzburg-Schweinfurt geschickt. Unterschiede zwischen den Hochschulstandorten sowie zwischen deutsch- und nicht-deutschmuttersprachigen Studierenden wurden über nonparametrische Verfahren ermittelt.

Ergebnisse

Stress und psychische Belastung sind gesundheitsgefährdende Probleme, mit denen sich die Befragten besonders häufig konfrontiert sehen. Studieren in Schweinfurt und Fremdsprachlichkeit stehen in Zusammenhang mit einer erhöhten Relevanz einiger Gesundheitsbereiche. Unterstützungsangebote wünschen sich die Befragten v. a. in den Bereichen Sport/Bewegung, psychische Belastung/Erkrankung und Stressreduktion. Die Studierenden haben mitunter kaum Kenntnis über vorhandene Angebote. Vor allem Studierende in Schweinfurt und internationale Studierende sind kaum informiert.

Schlussfolgerungen

Erstens sollten vorrangig Angebote zur Reduktion von Stress und psychischer Belastung an der Hochschule implementiert werden. Zweitens sollten zukünftig die gesundheitlichen Belange von Studierenden in Schweinfurt und internationalen Studierenden stärkere Beachtung finden. Drittens sollten alle Studierenden verstärkt über bereits bestehende Angebote informiert werden.

Anxiety and fear of COVID-19 in the UK general population: A cross-sectional study

There is still a generalized feeling of uncertainty in the population due to the coronavirus disease 2019 (COVID-19) pandemic, as restrictions on daily routines and social contact, accompanied by a large number of infections, negatively affect different areas of people's lives and, therefore, their mental health. The aim of the present study was to assess the presence of anxiety and fear of COVID-19 in the general UK population, using the Anxiety and Fear to COVID-19 Assessment Scale (Ansiedad y Miedo al COVID-19) (AMICO) scale. A descriptive, cross-sectional study based on a questionnaire was conducted in a sample of the UK general population in 2021. Socio-demographic and employment variables were included. The AMICO scale was included to measure fear and anxiety about COVID-19. The relationship between variables was studied with a categorical regression analysis. In general, participants regarded themselves as well-informed about the pandemic, although 62.6% had only received 1 dose of the vaccine. Regarding the AMICO scale the total score was 4.85 (out of 10; standard deviation 2.398). Women showed higher scores for the AMICO than men. The bivariate analysis revealed statistically significant differences in relation to self-confidence, amount of information received, and vaccination variables as related to the mean AMICO scores. An average level of anxiety and fear of COVID-19 is shown in the general UK population, which is lower than most of the studies that assessed the impact of the pandemic on the general population.

Prevalence and Determinants of Depressive and Anxiety Symptoms among Transgender People: Results of a Survey

OBJECTIVES

The aim was to investigate the prevalence of probable depression and probable anxiety and to investigate the determinants of depressive symptoms and anxiety symptoms among transgender people.

METHODS

In this "Transgender Survey" (n = 104) we included transgender people who had joined self-help groups to obtain and share information about the gender-affirming surgeries performed at the Division of Plastic, Reconstructive and Aesthetic Surgery at the University Medical Center Hamburg-Eppendorf. Data collection took place between April and October 2022. To measure probable depression, the patient health questionnaire-9 was used. The generalized anxiety disorder-7 was used to quantify probable anxiety.

RESULTS

The prevalence of probable depression was 33.3% and it was 29.6% for probable anxiety. Multiple linear regressions showed that both more depressive symptoms and anxiety symptoms were significantly associated with younger age (β = -0.16, p < 0.01; β = -0.14, p < 0.01), being unemployed (e.g., full-time employed compared to unemployment: β = -3.05, p < 0.05; β = -2.69, p < 0.05), worse self-rated health (β = -3.31, p < 0.001; β = -1.88, p < 0.05), and having at least one chronic disease (β = 3.71, p < 0.01; β = 2.61, p < 0.05).

CONCLUSIONS

Remarkably high prevalence rates were identified among transgender people. Furthermore, risk factors of poor mental health (e.g., unemployment or younger age) were identified-which can help to address transgender people at risk for poor mental health.

Related Factors with Depression and Anxiety in Mastectomized Women Breast Cancer Survivors

Breast cancer (BC) is the most common cancer diagnosis with the highest mortality rate worldwide. The aim of this study was to identify factors related to depression and anxiety in mastectomized women BC survivors. A cross-sectional study was conducted with a sample of 198 women diagnosed with BC aged 30-80 years in Mexico. Depression and anxiety were assessed using the 14-item Hospital Anxiety and Depression Scale (HADS). The results showed that 94.44% and 69.18% of the women scored more than eight points on HADS in the anxiety and depression subscales, respectively; 70.20% and 10.60% were identified as pathological. The following variables were analyzed: age, time elapsed since the start of treatment, received treatment at the time of the evaluation, type of surgery, family history, marital status and employment status. Time elapsed since surgery, having a partner, and employment showed significant results as factors associated to levels of depression and anxiety in these patients. In conclusion, it has been shown that BCSs under 50 years of age receiving some kind of treatment, without family history, without a partner, with a job, with more than secondary education and with more than 5 years since diagnosis could have higher rates of clinical depression. On the other hand, BCSs older than 50 years receiving some kind of treatment, without family history, without a partner, with a job, with more than secondary education and with more than 5 years since diagnosis, could have higher rates of clinical anxiety. In conclusion, the variables studied provide valuable information for the implementation of psychotherapy plans in healthcare systems to reduce the risk of depression and/or anxiety in women with BC who have undergone mastectomy.

Prevalence and correlates of depressive and anxiety symptoms among adults in Guangdong Province of China: A population-based study

AIMS

To examine the prevalence and health correlates of depressive and anxiety symptoms among adults living in Guangdong province of China with a large population and rapid urbanization.

METHODS

The Guangdong Sleep and Psychosomatic Health Survey was conducted from September to November in 2019, which was a population-based study with a representative sample of adults aged 18-85 years. Multistage stratified cluster sampling was used. A total of 13,768 inhabitants were included and face-to-face interviewed using standardized assessment tools. Depressive and anxiety symptoms were evaluated using the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder Scale (GAD-7), respectively.

RESULTS

The weighted prevalence rates of depressive and anxiety symptoms were 8.6% (95% confidence interval [CI]: 8.0%-9.3%) and 6.0% (95%CI, 5.4%-6.5%) respectively. People who have never married, irregular diet rhythm, hardly exercise, poorer sleep, alcohol consumption, chronic diseases and being unemployment and retirement were more likely to suffer depressive and anxiety symptoms. Moreover, the prevalence of depressive symptoms was significantly higher in those suffering from cardiovascular disease (Odds ratio[OR]:3.89, 95%CI: 1.77-8.54), chronic nephrosis (OR:3.89, 95%CI: 1.52-9.94), hyperlipidemia (OR:2.68, 95%CI: 1.57-4.59), anemia (OR:1.96, 95%CI: 1.33-2.89) and arthritis (OR:1.93, 95%CI: 1.17-3.16). The prevalence of anxiety symptoms was evidently greater within patients with cardiovascular disease (OR:3.15, 95%CI: 1.39-7.14), chronic nephrosis (OR: 2.89, 95%CI: 1.22-6.83), hyperlipidemia (OR:2.27, 95%CI: 1.20-4.29) and diabetes (OR:1.99, 95%CI: 1.15-3.44).

CONCLUSIONS

Depressive and anxiety symptoms are commonly found in patients with chronic diseases. Given these adverse outcomes on health, health professionals should pay more attention to depressive and anxiety problems in health care for high-risk population.

Predictors of Psychological Distress in Women with Endometriosis during the COVID-19 Pandemic

Background: Endometriosis is a multifaceted chronic pain condition that can have a negative impact on mental health. Patients suffering from chronic pain may face an additional psychological burden during adversity, such as the COVID-19 pandemic. The main aim of this research was to evaluate the prevalence of self-reported depression and anxiety, the influence of demographic, endometriosis-specific, pandemic-specific factors, and resilience on mental health outcomes of patients with endometriosis. Methods: An online survey was conducted through patient support groups of women suffering from endometriosis during the first wave of the COVID-19 pandemic. The PHQ-4 questionnaire, which combines two items of the Patient Health Questionnaire for Depression (PHQ-2) and two items from the Generalized Anxiety Disorder Scale (GAD-2) was used to assess self-reported mental health. The Brief Resilience Score (BRS) was employed to evaluate resilience. Independent risk and protective factors for mental health were investigated by multivariate logistic regression analyses. Results: The PHQ-4 questionnaire was completed by 274 respondents. More than 40% reached depression (PHQ-2) and anxiety (GAD-2) scores of ≥3, and more than 20% achieved PHQ-2 and GAD-2 scores of ≥5. High resilience was found to be a reliable and strong independent protector for the probability of developing adverse psychological outcomes: OR 0.295, p < 0.001 for developing generalized anxiety disorder (GAD-2 ≥ 3), and OR 0.467, p < 0.001 for having major depression (PHQ-2 ≥ 3). Conclusions: Pain-induced disability is an independent risk factor for developing major depression and anxiety, while resilience was identified as a potential protective parameter in terms of positive psychological outcomes in women with endometriosis. The results of this study may help to identify women at risk for adverse mental health outcomes and should encourage healthcare practitioners to establish strategies for the reduction of negative psychological and psychiatric impacts on patients with endometriosis.

The Mental and Physical Health of the Homeless

BACKGROUND

The health status of homeless individuals in Germany has been described incompletely. Mental and somatic illnesses seem to contribute to the high mortality in this cohort.

METHODS

In this national, multicenter, cross-sectional study, data were collected on the health of 651 homeless individuals in the metropolitan regions of Hamburg, Frankfurt, Leipzig, and Munich metropolitan regions. The lifetime prevalences of physician-diagnosed mental and somatic illnesses were determined with interviewbased questionnaires. Furthermore, clinical and laboratory examinations were carried out. Multivariable regressions were performed to identify determinants of health status and access to care.

RESULTS

High prevalences of both mental and somatic illnesses were confirmed. Particularly, cardiovascular and metabolic diseases were highly prevalent. Evidence for possible unrecognized arterial hypertension and possible unrecognized hypercholesterolemia was found in 27.5% and 15.6% of homeless individuals, respec - tively. 23.1% of study participants reported having received a diagnosis of a mental illness. Evidence for a possible unrecognized mental illness was found in 69.7%. A history of immigration from another country to Germany was found to be an important determinant of the summed scores for mental, somatic, and possible unrecognized illness. Homeless individuals of non-German origin were more likely to be living without shelter (p = 0.03) and to lack health insurance (p < 0.001).

CONCLUSION

High prevalence rates for mental and somatic illnesses and limited access to mainstream medical care were found. Homeless individuals appear to receive inadequate care for mental illness. Healthcare programs for homeless individuals in Germany should pay particular attention to homeless migrants.

Prevalence and determinants of probable depression and anxiety during the COVID-19 pandemic in seven countries: Longitudinal evidence from the European COvid Survey (ECOS)

BACKGROUND

Our aim was to present data on the prevalence of probable depression and anxiety and to determine their correlates during the COVID-19 pandemic in seven European countries using a longitudinal approach.

METHODS

Longitudinal data (wave 4 in November 2020: n = 7,115; wave 5 in January 2021: n = 7,068; wave 6 in April 2021: n = 7,204) were taken from the European COvid Survey (ECOS), a representative sample of non-institutionalized inhabitants from Germany, United Kingdom, Denmark, Netherlands, France, Portugal and Italy aged 18+. Probable depression and anxiety were quantified using the established and validated PHQ-4 (2-item depression scale, PHQ-2 / 2-item anxiety scale, GAD-2).

RESULTS

In wave 4 (wave 5; wave 6), 26.6% (25.5%; 23.8%) of all respondents had probable depression and 25.7% (23.6%; 22.1%) had probable anxiety. Prevalence rates for probable depression and probable anxiety differed significantly between countries. Among all countries and waves, particularly high prevalence rates were found among individuals aged 18 to 29 years. Longitudinal analysis showed that the likelihood of probable depression was positively associated with increasing age, great income difficulties and lower health-related quality of life. The likelihood of probable anxiety was positively associated with income difficulties, and lower health-related quality of life.

LIMITATIONS

Screening tool was used to quantify the outcomes.

CONCLUSION

The magnitude of probable depression and anxiety during the COVID-19 pandemic in European countries was highlighted. Moreover, determining the factors associated with probable depression or anxiety (e.g., income difficulties, worse health-related quality of life) may assist in identifying individuals at increased risk.

Mental Health Symptoms and Associations with Tobacco Smoking, Dependence, Motivation, and Attempts to Quit: Findings from a Population Survey in Germany (DEBRA Study)

INTRODUCTION

This study aimed to estimate prevalence rates of mental health symptoms (anxiety, depression, and overall psychological distress) by tobacco smoking status, and associations between such symptoms and the level of dependence, motivation, and attempts to quit smoking in the German population.

METHODS

Cross-sectional analysis of data from six waves of a nationally representative household survey collected in 2018/19 (N = 11,937 respondents aged ≥18). Mental health symptoms were assessed with the Patient Health Questionnaire-4. Associations with smoking status, dependence, motivation to quit, and ≥1 past-year quit attempt (yes/no) were analysed with adjusted regression models among the total group, and among subgroups of current (n = 3,248) and past-year smokers (quit ≤12 months ago, n = 3,357).

RESULTS

Weighted prevalence rates of mental health symptoms among current, former, and never smokers were: 4.1%, 2.4%, 2.5% (anxiety), 5.4%, 4.7%, 4.0% (depression), and 3.1%, 2.5%, 2.4% (psychological distress). Current versus never smokers were more likely to report symptoms of anxiety and depression. Smokers with higher versus lower levels of dependence were more likely to report higher levels of all three mental health symptoms. Higher versus lower levels of overall psychological distress were associated with a higher motivation to quit smoking and, among past-year smokers, with higher odds of reporting a past-year quit attempt.

CONCLUSIONS

We found various relevant associations between mental health symptoms and smoking behaviour. Healthcare professionals need to be informed about these associations and trained to effectively support this vulnerable group in translating their motivation into abstinence.

The influence of patient-related factors on the frequency and duration of psycho-oncological sessions in a university cancer center

OBJECTIVE

The present study aimed at identifying factors that are associated with the frequency and duration of psycho-oncological sessions.

DESIGN

In a retrospective single-center study, data of all patients who made use of the psycho-oncological service (POS) at the University Hospital Erlangen from April 2017 - March 2018 were registered.

SAMPLE

Over the course of one year, N = 1601 patients made use of the POS.

METHODS

In the hospital's digital documentation system, relevant data such as frequency of sessions, duration of sessions, gender, age, family status, preexisting mental disorder, prior psychotherapy, cancer entity (type of cancer) and treatment modality were recorded. Socio-demographic and clinical parameters were analyzed to predict frequency and duration of the psycho-oncology sessions.

FINDINGS

Regression analyses revealed that among POS users, women, younger patients, patients with a longer hospital stay and those with a preexisting mental disorder attended significantly more sessions than other patients (p < .001). Patients with skin cancer had significantly fewer POS sessions than those with a hematological diagnosis. Also, patients who had undergone surgery had significantly fewer sessions than patients with pharmacological treatment. Younger age and a longer hospital stay significantly predicted longer sessions (p < .001). In the regression model, patients with brain tumors and lung cancer had significantly longer sessions than patients with skin cancer.

IMPLICATIONS

With the identification of specific risk groups that require more and longer sessions, we can provide the basis for more patient-tailored intervention approaches and better scheduling according to the patients' needs. However, our results also suggest that the frequency and duration of POS sessions also depend on illness- and treatment-related criteria, e.g. the length of the hospital stay.

The Prevalence and Correlates of Probable Major Depressive Disorder and Probable Generalized Anxiety Disorder during the COVID-19 Pandemic. Results of a Nationally Representative Survey in Germany

The aim was to clarify the prevalence and correlates of probable major depressive disorder and probable generalized anxiety disorder in the general adult population during the COVID-19 pandemic. Data were derived from a nationally representative survey (August and September 2021). In total, n = 3075 individuals took part. To quantify probable generalized anxiety disorder, the established Generalized Anxiety Disorder-7 (GAD-7; cutoff of 10) was used. Moreover, the Patient Health Questionnaire-9 (PHQ-9; cutoff of 10) was used to quantify probable major depressive disorder. The prevalence of probable major depressive disorder was 20.0% and the prevalence of probable generalized anxiety disorder was 13.4%. Particularly high prevalence rates were observed for younger individuals, individuals with migration background and individuals with at least one chronic disease. The likelihood of probable major depressive disorder was positively associated with younger age, being unmarried, having a migration background, smoking, daily alcohol intake, the presence of chronic diseases and lower self-rated health. Similarly, the likelihood of probable generalized anxiety disorder was positively associated with younger age, being unmarried, smoking, the presence of chronic diseases and lower self-rated health. In conclusion, the magnitude of probable major depressive disorder and probable generalized anxiety disorder in Germany in late summer of 2021 was highlighted. Identifying the correlates of them may help to tackle individuals at higher risk.

Investigating Binge-Watching Adverse Mental Health Outcomes During Covid-19 Pandemic: Moderating Role of Screen Time for Web Series Using Online Streaming

Background and Purpose

Watching multiple episodes using streaming services, such as Netflix, Hulu, and Youku, has become widespread in recent years. While much attention has been paid to binge-watching, there is, however, a dearth of research on binge-watching and its adverse psychological effects during the COVID-19 pandemic. To the best of our knowledge, less attention has been paid to understanding the multiple influences of binge-watching on binge-watchers during the COVID-19 pandemic. Most of the past studies on this topic mainly underscored the individual's motivations for binge-watching. Also, past studies were limited and inconclusive as they mostly espoused only the underpinning adverse effects of binge-watching without looking into the association between binge-watching and screen time for web series through online streaming services during the COVID-19 pandemic. Therefore, this study sought to fill this gap by probing the association between binge-watching and psychological aftereffects.

Participants and Methods

The study employed a cross-sectional research design vis-à-vis the survey method. A sample of 1089 adult respondents was collected through an online administrated questionnaire.

Results

The findings of this study demonstrated that extensive binge-watching is an antecedent of stress, loneliness, insomnia, depression and anxiety. Furthermore, it was found that screen time on binge-watching could intensify these adverse effects of binge-watching. Interestingly, the moderating effect of screen time on binge-watching was found to be insignificant for stress and loneliness.

Conclusion

The findings of this study suggest that binge-watching correlates with psychological and mental health symptoms including stress, loneliness, insomnia, depression and anxiety. Hence, this study suggests that consumption of web series through online streaming services related literacy interventions are imperative to help the audience become critical about online streaming content and its comparison to the real social world.

[Use of Health Care by Homeless Individuals: Results of the Hamburg Survey of Homeless Individuals]

OBJECTIVE

There is a lack of studies focusing on the use of health care facilities by homeless people. The aim of this study was to survey health care use by the homeless.

METHODS

Data were taken from the Hamburg survey of homeless individuals (n=150, mean age:12,5 years; SD: 12,5 years). Assessment covered details of health insurance status, use of ambulatory and hospital care, medication use, and reasons for not accessing health services.

RESULTS

In total, 61,2% of the homeless individuals had health insurance. About two thirds of homeless individuals (65,9%) had accessed some sort of medical services in the past 12 months. The key reason for not making use of health services was the absence of any need for treatment (74,6%). In sum, 39,8% of homeless individuals had made at least one hospital visit in the past 12 months. About one third (34,2%) had used mobile support services (mainly a mobile doctor's office). In total, 37,7% of homeless individuals took medications regularly, with 'prices too high' (63,6%) being the key reason for difficulties in access to medications. Almost one half of homeless individuals (47,0%) had not made a visit to a physician in the past three months.

CONCLUSION

Additional efforts are required to improve access to health care by homeless individuals. Future research in this area is therefore necessary.