Prevalence and determinants of postpartum depression among adolescent and adult mothers in Northwest Ethiopia

Postpartum depression (PPD) is a common mental health issue in resource-limited settings that negatively affects the well-being of mothers and children. However, PPD often remains untreated, leading to long-term consequences for families. Therefore, we examined the prevalence and determinants of PPD among adolescent and adult mothers in northwest Ethiopia. Data were collected from 374 adolescent (10-19 years) and 760 adult (20-34 years) mothers 6 weeks after childbirth. Data were analyzed using binary and multiple logistic regression. Adolescent mothers had a significantly higher proportion of PPD (37.4%) than adult mothers (20.1%) and were more likely to report low self-esteem (13.1% vs. 8.2%) and low social support (28.3% vs. 23.3%). Factors associated with PPD differed between adolescent and adult mothers. Adolescent mothers with PPD were more likely to report household food insecurity, low self-esteem, low knowledge of postpartum complications, and working in agriculture or professional/technical occupations. For adult mothers, factors associated with PPD included distance to the nearest health facility, medium social support, inadequate dietary diversity, and food insecurity. Results suggest that targeted interventions by age group are needed to reduce the burden of PPD in Ethiopia.

Cumulative contextual risk, mothers' and fathers' parenting, and adolescents' psychosocial problems in Ghana

Limited research exists on the association between cumulative risk factors and the psychosocial well-being of adolescents in low-income, culturally distinct settings. This study aimed to fill this gap by examining the impact of cumulative risk exposure on Ghanaian adolescents' psychosocial problems and exploring the mediating role of parenting. The study involved 212 adolescents (61% girls; average age = 13.38) who completed measures on cumulative risk, maternal and paternal warmth, behavioral control, anxiety, depression, overt aggression, and relational aggression. The results indicated that cumulative risk indirectly influenced adolescents' depression and overt aggression through paternal warmth. Furthermore, paternal behavioral control mediated the relationship between cumulative risk and adolescents' overt aggression. Findings highlight the importance of fathers' parenting in mediating cumulative risk effects.

Socio-Cultural Discourses of Children Engaged in Child Labor in India: A Macro-Ethnographic Study

Background

Child labor is considered one of the main social problems that affect the community and has a physical and psychosocial impact on a child's health, growth, and development. The study aimed to describe the sociocultural discourses of children involved in child labor. A macroethnographic approach was used to collect the data from the selected community areas of Punjab, India.

Materials and Methods

A community-based qualitative study using purposive sampling was carried out among children engaged in child labor (n = 8). The data were gathered through in-depth or semi-structured interviews and non-participant observation under four phases: community context assessment, egocentric network analysis, validation, and dissemination of study findings. The guide for consolidated criteria for reporting qualitative research (COREQ) was followed. Ongoing analysis was conducted using Spradley's analysis approach to identify the themes.

Results

Thematic analysis resulted in the emergence of various themes related to child labor, namely, adaptability, money-centric attitude, sense of being underserved, social deprivation, work burden, reduced emotional expression, workaholism, abuse, family shoulder, family cohesion, and sense of industry. Apart from that, inhuman living and working conditions, as well as school deprivation among study subjects, were observed. Poverty emerged as the single most compelling factor for child labor in India.

Conclusion

The study concluded that child labor had a negative impact on children's overall development. An effective intervention to stop child labor is if vulnerable children are identified through primary healthcare, and a relationship of trust is built that allows for the provision of health care, education, support, and referral to additional services outside the health sector.

Attitudes of Non-psychiatric Doctors Toward the Management of Psychiatric Problems

INTRODUCTION

This research explores non-psychiatric doctors' attitudes toward managing psychiatric problems, recognizing the critical intersection between physical and emotional health. The study aims to understand the barriers and facilitators in addressing these challenges within a tertiary care hospital in Hyderabad, India. The prevalence of psychiatric disorders among general hospital inpatients and outpatients underscores the need for comprehensive care. However, various obstacles hinder effective management. The objectives are to describe and understand these attitudes and to investigate the reasons for non-referral in cases involving psychiatric concerns.

METHODS

A cross-sectional study was conducted from April to May 2023, involving 178 doctors from various specialties directly engaged in patient care. Participants completed a modified Doctors Attitudes Toward Collaborative Care for Mental Health (DACC-MH) questionnaire. This tool assessed their attitudes toward psychosocial and psychiatric problems, including their willingness to take responsibility for assessments and referrals. Data analysis utilized the IBM Statistical Package for the Social Sciences (SPSS) Version 22 (IBM Corp., Armonk, NY). Descriptive statistics and chi-square tests were used to assess differences in attitudes based on demographics and specialties.

RESULTS

The study revealed predominantly positive attitudes among non-psychiatric doctors. Most acknowledged the importance of addressing patients' emotional problems (97.8%) and recognizing psychological factors' role in physical illnesses (96.1%). However, variations existed in the willingness to take responsibility for psychological assessments, especially in outpatient settings. Attitudes toward psychiatric referrals were generally positive, though differences were noted based on gender and specialization. Female doctors were more inclined toward emotional care, while male doctors were more willing to prescribe psychotropic drugs (p < 0.0001) and refer patients to psychiatrists. Physicians were more favorable toward emotional care, shared responsibility for emotional difficulties, and routine assessment of psychological and social factors. In contrast, surgical specialists restricted themselves to physical assessments (p < 0.0001).

CONCLUSION

 This research underscores the need for targeted educational initiatives and awareness campaigns to address the challenges in integrating mental healthcare into general healthcare contexts. Tailored programs, interprofessional collaborations, and efforts to reduce stigma are essential for improving doctors' attitudes and practices in managing psychiatric problems. Enhancing the integration of mental health care can lead to better patient outcomes and overall healthcare quality. Healthcare institutions can strive for more comprehensive, patient-centered care by understanding and addressing these attitudes.

Identifying psychosocial problems, needs, and coping mechanisms of adolescent Syrian refugees in Jordan

Background

Refugees who have fled war zones are at a heightened risk of psychosocial problems that can impact their ability to function in day-to-day life and place a significant burden on the family structure. This study aimed to assess the psychosocial problems and needs and coping mechanisms of Adolescent Syrian refugees in Jordan.

Methods

Between October and December 2018, we conducted a qualitative study using semi-structured interviews with a sample of key and individual informants. Our sample included 20 primary healthcare professionals, 20 schoolteachers, 20 Syrian parents, and 20 adolescents aged 12-17 years. All interviews were transcribed verbatim, and we utilized thematic analysis to group, categorize, and analyze the original Arabic language transcripts. To ensure thorough analysis, we adopted a bottom-up inductive approach that covered the six-phase iterative process proposed by Braun and Clarke.

Results

The main psychosocial problems encountered by Syrian adolescents included stress, depression, loneliness, lack of a sense of security, isolation, aggressiveness, fear of war, and family disintegration. Almost all schoolteachers reported that they observed that Jordanian adolescents are more settled, self-confident, and financially stable relative to their Syrian peers. The Jordanian government and community were praised for their support, including education, recreational centers, health services, and awareness campaigns. Going to school, praying and reading the Holy Quran, listening to music, and talking to friends and engaging with them were reported as the main coping mechanisms. The majority of respondents said that more services are still needed for adolescents, including more places for entertainment, psychosocial support and psychological counseling, medical care, job creation, and providing health insurance.

Conclusion

Syrian refugees are aware of the psychological aspects of their situation, but they are not always able to access clinic-based humanitarian assistance for mental health and psychosocial support. Stakeholders must interact with refugees to learn about their needs and develop services that are appropriate for their culture.

Stigma Scale Adaptation and Validation for Measuring COVID-19 Stigma

BACKGROUND

The current coronavirus disease 2019 (COVID-19) pandemic has been found to be associated with increased psychosocial problems such as depression, anxiety, stress, and stigma. Many health-related stigma instruments that have been developed are condition-specific; these should be adapted and validated for generic use, across different health conditions. This study was conducted to measure stigma, stress, anxiety, and depression using the COVID-19 Stigma Scale-Modified (CSS-M), a modified version of the HIV Stigma Scale, among the Indian population.

METHODS

A weblink-based online survey was conducted using the adapted CSS-M, along with the Depression, Anxiety, and Stress Scale-21. Collected data were analyzed with correlation analysis, reliability analysis, exploratory factor analysis, and convergent and divergent validity.

RESULTS

With a sample size of 375, the modified scale for COVID-19 stigma showed internal consistency and a good inter-item correlation (Cronbach's alpha 0.821). Principal axis factoring with varimax rotation along with alternative parallel analysis established the two factorial structure and had valid composite reliability, discriminate validity, and partial convergent validity.

CONCLUSION

We found that COVID-19 Stigma Scale-Modified is a valid measure to assess COVID-19-related stigma. The scale was found to be internally consistent with a good inter-item correlation, composite reliability, valid discriminate validity, and partial convergent validity. Specific COVID-related validated scales for stigma should be developed in the future.

The role of executive function deficits, delay aversion and emotion dysregulation in internet gaming disorder and social media disorder: Links to psychosocial outcomes

Background and aims

It has been argued that it is important to consider underlying mechanisms of mental health problems. Previous studies have shown that executive deficits, delay aversion, and emotion dysregulation are related to Internet Gaming Disorder (IGD) and Social Media Disorder (SMD). However, the present study is the first to investigate whether these neuropsychological deficits show additive effects or if they interact. The present study also investigated whether these deficits mediate the association between IGD/SMD and psychosocial outcomes.

Methods

The study involved 995 university students who completed a survey measuring IGD/SMD symptom severity, neuropsychological functions, and psychosocial outcomes. Both dimensional and categorical analyses were used to assess the associations between neuropsychological functions and IGD/SMD. Simple and multiple mediation analyses were conducted to examine if neuropsychological functioning mediates the association between IGD/SMD and psychosocial outcomes.

Results

All neuropsychological functions were significantly associated with both IGD and SMD symptom severity. However, only inhibition and emotion regulation, as well as delay aversion for SMD, remained significant when controlling for the overlap between different functions. Associations were significantly stronger for men compared to women for IGD. In the categorical analyses, individuals with IGD/SMD were more likely to have neuropsychological deficits (odds ratios between 3.33 and 8.81). Finally, all neuropsychological functions, except inhibition, were significant mediators in the link between IGD/SMD and psychosocial outcomes.

Discussion and conclusions

These results shed light on the neuropsychological underpinnings of IGD/SMD, which can be used to identify more homogenous subgroups and provide more individualized treatment options.

Identifying patients with psychosocial problems in general practice: A scoping review

Objective

We conducted a scoping review with the aim of comprehensively investigating what tools or methods have been examined in general practice research that capture a wide range of psychosocial problems (PSPs) and serve to identify patients and highlight their characteristics.

Methods

We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews and the Joanna Briggs Institute Reviewer's Manual on scoping reviews. A systematic search was conducted in four electronic databases (Medline [Ovid], Web of Science Core Collection, PsycInfo, Cochrane Library) for quantitative and qualitative studies in English, Spanish, French, and German with no time limit. The protocol was registered with Open Science Framework and published in BMJ Open.

Results

Of the 839 articles identified, 66 met the criteria for study eligibility, from which 61 instruments were identified. The publications were from 18 different countries, with most studies employing an observational design and including mostly adult patients. Among all instruments, 22 were reported as validated, which we present in this paper. Overall, quality criteria were reported differently, with studies generally providing little detail. Most of the instruments were used as paper and pencil questionnaires. We found considerable heterogeneity in the theoretical conceptualisation, definition, and measurement of PSPs, ranging from psychiatric case findings to specific social problems.

Discussion and conclusion

This review presents a number of tools and methods that have been studied and used in general practice research. Adapted and tailored to local circumstances, practice populations, and needs, they could be useful for identifying patients with PSPs in daily GP practice; however, this requires further research. Given the heterogeneity of studies and instruments, future research efforts should include both a more structured evaluation of instruments and the incorporation of consensus methods to move forward from instrument research to actual use in daily practice.

The longitudinal association between potential stressful life events and the risk of psychosocial problems in 3-year-old children

Background

Experiencing certain potentially stressful life events can impact psychosocial well-being among school-aged children and adolescents. This study aims to evaluate the association between life events occurring before age 2 and risk of psychosocial problems at 3 years of age.

Methods

All parents invited for the regular well-child visit when their child was 2 years of age by the preventive Youth Health Care in the Rotterdam-Rijnmond area, the Netherlands, were invited to participate in this study. In total 2,305 parents completed the baseline questionnaire at child age 2-years; 1,540 parents completed the questionnaire at child age 3-years. The baseline questionnaire included a life events assessment (12 items), and tension caused by the event (range 0-3). At child age 3-years the questionnaire included the Strengths and Difficulties Questionnaire (SDQ) to assess risk of psychosocial problems. Logistic regression models were applied.

Results

In the current study 48.5% of families experienced ≥1 life event before child age 2 years. Divorce and problems in the relationship between the parents received the highest perceived severity score [respectively 2.1 (SD = 0.8) and 2.0 (SD = 0.7)]. Children experiencing ≥1 event before the age of 2 years were at higher risk of psychosocial problems at 3 years of age, compared to children that had experienced no life event (1-2 events OR = 1.50, 95%CI: 1.09; 2.06, and >2 events OR = 2.55, 95%CI 1.64; 4.00, respectively). When life events caused high perceived levels of tension, there was also an association with an increased risk of psychosocial problems at age 3-years (OR = 2.03, 95%CI 1.43; 2.88).

Conclusions

Approximately half of children in our study experienced a potential stressful life event before the age of 2 years. Results suggest an association between experiencing a life event and risk of psychosocial problems at child age 3-years. These findings emphasize the need for child health care professionals to pay attention to life events taking place in the life of young children in order to provide appropriate support.

Study of myths and beliefs among the parents of a child with cleft lip and palate

Aim

The aim of the study was the identification of predictors of psychology and beliefs among parents of children affected by cleft lip and cleft palate.

Methods

The study included a sample of 157 parents of children having cleft lips and cleft palates. Parents were given a questionnaire related to their beliefs and reasons behind deformity.

Results

Out of 157 participants, 90 were fathers, and 67 were mothers. The children with deformities included 105 boys and 52 girls. The majority of parents (43) believed that the eclipse was one of the reasons for the deformity and the other was God's wrath for the mother's sins. The time of birth was considered a factor for cleft lip and palate by 27 parents. The study revealed that the self-esteem of fathers was higher than mothers and they were more concerned of being undesirably judged by others due to deformity of their children than the mothers.

Conclusion

It can be inferred that the parents of a child with cleft lip and palate differ in their psychosocial adjustments. Also, mothers experience more psychosocial problems than fathers. The superstitious beliefs still prevail in rural areas despite advanced medical facilities and awareness.

Selected Personality Traits and Employment as the Predictors of the Intensity of Psychosocial Problems Experienced by Chronically Ill Patients

BACKGROUND

This study sought to determine the effect of being employed or unemployed on the relationships between selected personal variables (acceptance of one's illness, self-efficacy, and self-actualization) and the intensity of psychosocial problems experienced by chronically ill persons (ChIP).

PARTICIPANTS AND PROCEDURES

The PCH-R Scale, the Generalized Self-Efficacy Scale, the Acceptance-of-Illness Scale, and the Self-Actualization Scale were used to collect information from 236 employed and unemployed ChIP.

RESULTS

Acceptance of illness and self-efficacy predicted the intensity of general psychosocial problems and problems in the personal, family, social, and occupational spheres in both employed and unemployed ChIP.

CONCLUSIONS

The results can significantly contribute to increasing the effectiveness of treatment and support offered to ChIP. Continued employment or reemployment after a period of intense therapy can protect them from a rapid degradation of their personal-and frequently, socio-economic-resources, which are necessary for them to be able to adapt to new challenges and maintain a good quality of life, despite experiencing a chronic illness.

Psychosocial Problems and Condomless Anal Sex among Transgender Women in Two Cities of China: Study Based on the Syndemic Framework

Studies examining the association between psychosocial problems and condomless anal sex (CAS) among transgender women (TGW) are rare. In this study, close attention was paid to the effect of co-occurring psychosocial problems on sexual risk behaviors. A cross-sectional study, including 247 TGW, was conducted in Kunming and Shenyang, China. The prevalence of condomless anal sex among TGW in the previous 6 months was 30.8%. Most of the psychosocial factors were associated with one another in bivariate logistic regression models. Low self-esteem (ORm = 2.99, 95% CI = 1.25-7.18), sexual compulsivity (ORm = 2.13, 95% CI = 1.13-4.00), and intimate partner violence (ORm = 2.21, 95% CI = 1.19-4.11) were discovered to be related to condomless anal sex in the multivariate regression model. No significant interactive effects of the syndemic factors on condomless anal sex were detected. More programmatic and effective HIV prevention interventions targeting psychosocial problems are required to reduce HIV infection within the population.

Psychosocial impact of structured transfer of adolescents with kidney transplants to adult services: An interventional national cohort study

BACKGROUND

Pediatric kidney transplantation entails a well-timed transition from pediatric to adult medical care. We aimed to construct a structured transition protocol and evaluate its impact on transfer-related psychosocial problems in Slovenian patients with kidney transplants.

METHODS

Individual transition-related perceptions of our patients and their parents were first assessed, and the gathered information was used to establish a country-specific transition protocol. Eleven kidney transplant patients qualified for actual transfer and were considered for further analysis. Comprehension and attitude towards transfer, coping strategies, personality resilience, behavioral, and emotional problems were assessed using questionnaires and established psychological tools before and after the completed transfer. The results were compared and analyzed.

RESULTS

Ten of the eleven eligible patients were transferred to adult services between April 2020 and January 2021. The median age at enrollment was 19.7 years (range: 18.2-22.8 years). The most frequent concerns regarding upcoming health care were worse accessibility (50%), less supportive and less committed healthcare providers (40%), and deterioration of medical condition (10.0%). After the completed protocol-guided transfer, the patients declared to have no further concerns or worries. Before transfer, 28.9% of the patients' responses rated the amount and relevance of received information and counseling as "Adequate" or "Very adequate," whereas, after the transfer, the proportion of positive responses increased to 48.9%. Anxiety and withdrawn depressive symptoms were the predominant emotional problems before transfer. Their prevalence decreased after the completed transfer.

CONCLUSIONS

Our results suggest that transfer-related anxieties and concerns can be significantly reduced by applying a structured transition protocol in transplant patients.

Drama Therapy for Children and Adolescents with Psychosocial Problems: A Systemic Review on Effects, Means, Therapeutic Attitude, and Supposed Mechanisms of Change

Drama therapy is applied to children and adolescents with psychosocial problems. Drama therapy is an experimental form of treatment which methodologically uses drama and theatre processes to achieve psychological growth. Although in clinical practice, drama therapy has been applied successfully, little is known about how and why drama therapy contributes to a decrease in psychosocial problems. A systematic narrative review was performed to obtain more insight into this issue. Eight databases were systematically searched. Ten out of 3742 studies were included, of which there were four random controlled trails, three non-controlled trials, and three pre-and post-test design studies. We identified the results, drama therapeutic means, attitude, and mechanism of change. Positive effects were found on overall psychosocial problems, internalizing and externalizing problems, social functioning, coping and regulation processes, social identity, and cognitive development. An adaptive approach was mentioned as the therapeutic attitude. The means established contribute to a dramatic reality, which triggers the mechanisms of change. These are processes that arise during treatment and which facilitate therapeutic change. We found ten supposed mechanisms of change to be frequently used in all studies. No direct relations were found between the results, drama therapeutic attitude, means, and mechanisms of change.

Investigating the use of support in secondary school: the role of self-reliance and stigma towards help-seeking

Purpose: Adolescents are the least likely to seek help for their mental health problems. School may be an important route to improve early recognition of adolescents with mental health problems in need for support, but little is known about the barriers to school support.Materials and methods: Data were collected in a longitudinal cohort study of Dutch adolescents (age 12-16) in secondary school (n = 956). We assessed the relation between level of psychosocial problems at the beginning of the school year (T1) and the support used in school at the end of that school year (T2), whether the willingness to talk to others (measured at T1) mediates this relation, and whether stigma towards help-seeking (T1) moderates this mediation.Results: Adolescents with more psychosocial problems were more likely to use support in school and were less willing to talk to others about their problems, but the willingness to talk to others was not a mediator. Stigma moderated the relationship between psychosocial problems and willingness to talk to others.Conclusions: Most adolescents with psychosocial problems get support in Dutch secondary school regardless of their willingness to talk to others about their problems. However, perceiving stigma towards help-seeking makes it less likely for someone to talk about their problems.

Psychosocial adaptation to precocious puberty: A nursing support program

PROBLEM

This study aimed to determine the effects of a nursing support program (NSP) based on the Roy Adaptation Model on the psychosocial adaptation of girls with precocious puberty and their mothers.

METHODS

This study adopted a pre-post design. It included 26 girls diagnosed with precocious puberty and their mothers. Data were collected using a Demographic Information Form; the Child Behavior Checklist for Ages 6-18; and the Depression, Anxiety, and Stress Scale. Participants were then enrolled in a NSP based on the Roy Adaptation Model. The same measures were administered at the end of the support program to the participants.

FINDINGS

It was determined that at the beginning of the program, approximately one-third of the mothers had depression, 15% anxiety, and approximately 20% experienced stress. Mothers' anxiety and stress levels and girls' anxiety/depression and total problem scores significantly decreased after the NSP.

CONCLUSIONS

The NSP designed for this study positively affected the psychosocial problems of girls with precocious puberty and their mothers.

Academic performance and psychosocial functioning in European schoolchildren: The role of cardiorespiratory fitness and weight status

BACKGROUND

Whether a high cardiorespiratory fitness (CRF) can attenuate the potential detrimental effect of childhood obesity on academic performance and particularly psychosocial functioning remains unclear.

OBJECTIVES

To analyse the academic performance/psychosocial functioning of schoolchildren attending to their CRF and weight status.

METHODS

470 schoolchildren (46% girls, 7 ± 0 years) from 20 schools in five European countries were categorized as (i) having overweight/obesity (n = 113) or normal weight (n = 357) attending to body mass index and (ii) 'fit' (n = 282) or 'unfit' (n = 188) based on 20-meter shuttle-run performance (CRF ≥ or <42 ml·kg^-1 ·min^-1 [boys] and 35 ml·kg^-1 ·min^-1 [girls], respectively). Academic performance and psychosocial functioning were assessed using the grades attained in school subjects and the Strengths and Difficulties Questionnaire (SDQ) for parents, respectively.

RESULTS

Independent of their weight status, fit children showed a greater academic performance and psychosocial functioning than their peers who were unfit and overweight/obese. In fit children, academic performance and psychosocial functioning did not differ between the two weight status categories (normal weight or overweight/obesity).

CONCLUSIONS

Children with a higher CRF show a greater performance achievement and psychosocial functioning regardless of their weight status, thereby supporting the 'fat but fit' paradox and reinforcing the importance of improving CRF in this population.

Association of screen exposure with psychosocial problems in primary school students

INTRODUCTION

This study aimed to investigate the current status of screen exposure and the factors related to screen exposure in primary school students and explore the relationship between screen exposure and psychosocial problems, which may provide evidence for the scientific use of electronic products and psychological interventions used in these children.

METHODS

The parents of 811 primary school students aged 6-12 years received a questionnaire survey in Beijing between January 13 and January 16, 2022. The demographic data and daily screen exposure time were collected, and the Strengths and Difficulties Questionnaire (SDQ) about their children was administered online.

RESULTS

In 793 students, the average daily screen exposure of <2 h and ≥2 h was noted in 75.0% and 25% of patients, respectively. The mobile phone was the main medium for screen exposure (40.9%). The family's economic level, parental relationship, and main supervisor were related to screen exposure time (χ ² = 44.8,14.5 and 12.4, P < 0.05). A low family economic level with a monthly income not meeting the basic living needs, poor parental relationship, and an elderly person responsible for supervision were related to increased screen exposure time. The abnormal emotional and behavioral symptoms, conduct problems, hyperactivity inattention, peer communication, prosocial behaviors, and a total difficulties score were found in 11.6%, 9.8%, 15.3%, 22.1%, 6.8%, and 13.4% of children, respectively. Excessive screen exposure was related to peer interaction and prosocial behaviors (χ ²= 12.18 and 7.76, P < 0.05). The children with excessive screen exposure were more likely to have abnormal peer interaction (χ ²= 12.09, P = 0.001) and prosocial behaviors (χ ²= 7.76, P = 0.005). Excessive screen exposure was a risk factor for peer interaction problems (P < 0.05).

DISCUSSION

In conclusion, the detection rate of excessive screen exposure is higher in primary school students, which is related to the family's economic level, parental relationship, and main supervisor. Excessive screen exposure is harmful to the psychosocial health of these children, which is characterized by abnormal peer intercommunion and prosocial behaviors. More attention should be paid to screen exposure time in primary school students.

Experiences of children (ages 6-12) during COVID-19 pandemic from mothers' perspectives

PURPOSE

This study evaluated the experiences of children between ages 6 and 12 based on their mothers' perspectives during the COVID-19 pandemic.

METHODS

Ten mothers living in Ankara, Turkey with children in the aforementioned age range, participated in this study. Data were collected through focus group interview with a qualitative phenomenological approach followed by thematic data analysis.

FINDINGS

Three categories were obtained relating to the pandemic, including negative effects, positive effects, and the resultant needs and expectations of parents.

CONCLUSION

The findings show that the pandemic has significantly affected children in psychological, social, developmental, and academic realms. Therefore, it is necessary to plan interventions with a multidisciplinary approach to increase children's physical and psychosocial health, minimizing children's level of negative influences.

Psychosocial health and its associated factors among Men who have sex with Men in India: A cross-sectional study

BACKGROUND AND AIM

MSM in India experience complex and multiple psychosocial challenges. The current study was conducted with an aim to assess the magnitude and predictors of psychosocial health-related problems including MSM registered in targeted intervention centers in Delhi.

METHODS

A cross-sectional study was conducted among 235 MSMs. Burden of psychosocial health issues among MSM including depression, anxiety, substance abuse, and partner violence was assessed using semistructured questionnaire. Chi-square test was used to study the association of sociodemographic characteristics and psychosocial issues among the study participants.

RESULTS

The prevalence of depression, anxiety, substance abuse, and partner violence was 45.1%, 37.8%, 27.6%, and 8%, respectively. Age (<24 years), education up to middle school, and being single had significant association with depression. Being sex worker as occupation had a significant association with anxiety and intimate partner violence.

CONCLUSIONS

The study reveals a significant burden of psychosocial problems and throws light toward broadening the spectrum of health assessment among this vulnerable group.

Prehospital Impact on Family Members of Road Traffic Accident

Background  Prehospital care is nonexistent in most rural and semiurban areas. The implementation of golden hour care is still unachieved. The psychosocial problems of family members who accompany the traumatic brain injury (TBI) survivors after road traffic accidents (RTA) are not given attention during prehospital care. Therefore, the current study was aimed to understand the prehospital psychosocial impact on family members.

Methodology  A cross-sectional study was conducted at the Emergency and Trauma Care Centre at National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru between July 2017 to April 2018. Forty-five ( n = 45) referred family members providing care for trauma survivors were purposively recruited in the study. Structured checklists were administered to measure the psychological reactions and psychosocial problems experienced by the family members during prehospital care. Data analysis was analyzed using the R software 3.0.1 version.

Results  TBI survivor's mean age was found to be 33 years (33.09 ± 13.20), of which males were 23 (51.1%) and females were 22 (48.9%), respectively. The result depicted first aid was provided by unskilled people after an average of 41 minutes (41 ± 30). The results further showed that family members had experienced agitation (100%), shock (82.2%), fatigue and headache (75.6%), depression (66.7%), feeling of hopelessness (55.6%) helplessness, and lack of support from family and financial constraints (48.9%) during prehospital care.

Conclusion  Psychosocial interventions need to be provided during prehospital care by trained medical and psychiatric social work professionals to address the need of family members during the crisis.

Examining Risk Factors of Health-Related Quality of Life Impairments Among Adolescents with Inflammatory Bowel Disease

Inflammatory Bowel Disease (IBD) is a chronic, costly, and burdensome disease that is typically diagnosed during adolescence. Despite the use of effective treatments, rates of relapse and intestinal inflammation remain high and put patients at risk for long term physical and psychosocial health complications. Given the costs associated with IBD, it is critical to examine potential risk factors of poor health-related quality of life (HRQoL) among patients for the enhancement and further development of interventions. As such, the aim of the current study was to examine how sociodemographic and disease characteristics, psychosocial problems, and adherence behaviors impact HRQoL among a sample of youth with IBD. 107 adolescents with IBD and their caregiver completed self- and parent-report measures as part of a psychosocial screening service. Medical records were reviewed to obtain information regarding diagnosis, insurance, medication use, illness severity, and disease activity. Results revealed lower HRQoL scores among adolescents with more psychosocial problems (Est. = -3.08; p < .001), greater disease severity (Est. = -.40; p = .001), and those who identified as Black (Est. = -.38; p < .05). Greater disease severity (Est. = .13 p = .004), use of nonpublic insurance (Est. = .32 p = .004), and fewer psychosocial problems (Est. = -.13 p = .04) were associated with greater adherence behaviors. These findings suggest that implementing individually tailored, evidence-based psychological interventions focused on coping with psychosocial problems and symptoms may be important in enhancing adherence behaviors and HRQoL among adolescents with IBD.

Tailor-Made Psychosocial Intervention for the Caregivers in Emergency and Trauma Care Center

Introduction  The caregiver's psychosocial problems are unnoticed in the emergency and trauma care center. Therefore, the study objective was to understand the impact of psychoeducation and psychosocial intervention on traumatic brain injury (TBI) caregivers during hospitalization. Methodology  The study adopted a descriptive research design. Sixty-three ( n = 63) consented caregivers were recruited by using a cross-sectional survey method. Two separate checklists were used to collect the psychosocial problems in emergency and trauma care as well as to know the satisfaction levels of caregivers after the intervention. R free 3.0.1 software was used to calculate the frequency and percentage. Results  The caregiver's mean age was 39 years (39.46 ± 16.22). The majority of the caregivers were males (45; 71.4%) working as daily wagers (42; 66.7%). Caregivers experienced psychosocial problems, that is, depression, anxiety, stress, unable to handle crisis, grief, lack of coping skills (57; 90.5%), emotional distress (57; 90.5%), financial constraints (45; 71.1%), and need for referral services (45; 71.1%). Tailor-made psychosocial interventions were provided to the caregivers. Conclusion  To conclude, there is a greater need to provide psychosocial intervention and train the caregivers to provide care for TBI survivors during hospitalization. There is a need to develop the uniform standard operating procedure for medical and psychiatric social workers in providing psychosocial care in emergency and trauma care setting.

Effects of COVID-19 on Mental Health and Anxiety of Adolescents Aged 13-16 Years: A Comparative Analysis of Longitudinal Data From China

Background: Adolescence is an important stage of psychological development, and the psychological and mental problems of many adults are affected by the COVID-19 epidemic. The aim of this study was to understand the psychological status of this group during the epidemic, and to determine the risk factors leading to psychological stress, as well as protective factors. Methods: An online survey was run on April 2, 2020. The participants were 254 adolescents aged 13-16 years from a junior high school in Jiangsu, China. The results were compared with the pre-epidemic data, which came from the psychological status survey routinely carried out by the school. Mental health variables were assessed via the Mental Health Test that included one validity subscale and eight content subscales. Results: The number of adolescents with poor mental health increased significantly from 12.3 to 24.2%. There was significant increase in learning anxiety (33.7 vs. 56.4%), sensitivity tendency (19.8 vs. 46%), somatic anxiety (13.9 vs. 40.7%) and phobia tendency (4.4 vs. 10.1%). During the epidemic, there were significant differences between adolescents with normal and poor mental health in family structure, personality, relationship with siblings, daily exercise time, and risk of family members coming in contact with COVID-19. Living in stem family, no siblings, and risk of contracting COVID-19 from family members were significant risk factors for teenagers with poor mental health. Risk of contracting COVID-19 from family members was the most influential risk factor for learning anxiety, self-blaming tendency, sensitivity tendency, and somatic anxiety. Exercising for ≥1 h per day was a significant protective factor for poor mental health. Conclusions: During the COVID-19 epidemic, adolescents aged 13-16 years have had psychosocial problems, especially learning anxiety, sensitivity tendency, somatic anxiety, and phobia tendency, as well as risk factors for developing them. Our study provides insights for potential interventions.

Art Therapy for Psychosocial Problems in Children and Adolescents: A Systematic Narrative Review on Art Therapeutic Means and Forms of Expression, Therapist Behavior, and Supposed Mechanisms of Change

Background: Art therapy (AT) is frequently offered to children and adolescents with psychosocial problems. AT is an experiential form of treatment in which the use of art materials, the process of creation in the presence and guidance of an art therapist, and the resulting artwork are assumed to contribute to the reduction of psychosocial problems. Although previous research reports positive effects, there is a lack of knowledge on which (combination of) art therapeutic components contribute to the reduction of psychosocial problems in children and adolescents. Method: A systematic narrative review was conducted to give an overview of AT interventions for children and adolescents with psychosocial problems. Fourteen databases and four electronic journals up to January 2020 were systematically searched. The applied means and forms of expression, therapist behavior, supposed mechanisms of change, and effects were extracted and coded. Results: Thirty-seven studies out of 1,299 studies met the inclusion criteria. This concerned 16 randomized controlled trials, eight controlled trials, and 13 single-group pre-post design studies. AT interventions for children and adolescents are characterized by a variety of materials/techniques, forms of structure such as giving topics or assignments, and the use of language. Three forms of therapist behavior were seen: non-directive, directive, and eclectic. All three forms of therapist behavior, in combination with a variety of means and forms of expression, showed significant effects on psychosocial problems. Conclusions: The results showed that the use of means and forms of expression and therapist behavior is applied flexibly. This suggests the responsiveness of AT, in which means and forms of expression and therapist behavior are applied to respond to the client's needs and circumstances, thereby giving positive results for psychosocial outcomes. For future studies, presenting detailed information on the potential beneficial effects of used therapeutic perspectives, means, art techniques, and therapist behavior is recommended to get a better insight into (un)successful art therapeutic elements.

Mental health circumstances among health care workers and general public under the pandemic situation of COVID-19 (HOME-COVID-19)

BACKGROUND

After the spread of the coronavirus disease 2019 (COVID-19) globally, upgraded quarantine and physical distancing strategy, strict infection measures, and government's strict lockdown have been abided to confront the spread of the COVID-19 in Thailand. During the COVID-19 pandemic, concerns about the mental health and psychosocial problems among health care workers and the general population are now arising. Yet, information on mental health and psychosocial problems among health care workers and the general population have not been comprehensively reported in Thailand. As such, we conduct a cross-sectional study, a national online survey to describe the short- and long-term consequences of the COVID-19 pandemic on mental health and psychosocial problems among health care workers and the general population in Thailand.

METHODS

This study is a repeated cross-sectional study, an open online voluntary national-based survey during the wave I (April 21-May 4, 2020) follow-up in the wave II (August 3-16, 2020), wave III (November 15-28, 2020), and a 1-year follow-up survey (wave IV: April 21-May 4, 2021) in Thailand. Health care workers at the hospitals and the adult general population will be invited to participate in the online survey via the SurveyMonkey that limits one-time participation per unique internet protocol address. The target sample size of at least 1182 health care workers and 1310 general populations will be required to complete the online survey for each wave of the survey. Sociodemographic characteristics and a set of measurement tools for mental and psychosocial problems for each subcohort including depression, anxiety, stress, resilient copings, neuroticism, perceived social support, wellbeing, somatic symptoms, insomnia, burnout (for healthcare workers), and public stigma toward COVID-19 infection (for the general population) will be collected. For all estimates of prevalence, we will weigh data for all wave analyses under the complex design of the survey. Subgroup analyses stratified by key characteristics will also be done to analyze the proportion differences. For the repeated cross-sectional survey, we will combine the data from the wave I to wave IV survey to analyze changes in the mental health status. We will perform multilevel logistic regression models with random intercepts to explore associations with individual-level and region-level/hospital-level predictors. We also plan to perform an ancillary systematic review and meta-analysis by incorporating data from our findings to all available evidence.

RESULTS

Our findings will provide information on the short- and long-term mental health status as well as the psychosocial responses to the COVID-19 outbreak in a national sample of health care workers and the general population in Thailand.

CONCLUSION

This prospective, nationally based, a repeated cross-sectional study will describe the mental health status and psychosocial problems among health care workers and the general population in Thailand during the COVID-19 pandemic.

ETHICS AND DISSEMINATION

Ethical approval for the study was obtained from the Faculty of Public Health and Faculty of Pharmacy, Chiang Mai University. The findings will be disseminated through public, scientific, and professional meetings, and publications in peer-reviewed journals.

THAI CLINICAL TRIALS REGISTRY (TCTR) REGISTRATION NUMBER

TCTR20200425001.

Psychosocial problems in women attending French, German and Spanish genetics clinics before and after targeted or multigene testing results: an observational prospective study

OBJECTIVES AND SETTING

Advances in multigene panel testing for cancer susceptibility has increased the complexity of counselling, requiring particular attention to counselees' psychosocial needs. Changes in psychosocial problems before and after genetic testing were prospectively compared between genetic test results in women tested for breast or ovarian cancer genetic susceptibility in French, German and Spanish clinics.

PARTICIPANTS AND MEASURES

Among 752 counselees consecutively approached, 646 (86%) were assessed after the initial genetic consultation (T1), including 510 (68%) affected with breast cancer, of which 460 (61%) were assessed again after receiving the test result (T2), using questionnaires addressing genetic-specific psychosocial problems (Psychosocial Aspects of Hereditary Cancer (PAHC)-six scales). Sociodemographic and clinical data were also collected.

RESULTS

Seventy-nine (17.2%), 19 (4.1%), 259 (56.3%), 44 (9.6%) and 59 (12.8%) women received a BRCA1/2, another high/moderate-risk pathogenic variant (PV), negative uninformative, true negative (TN) or variant of uncertain significance result (VUS), respectively. On multiple regression analyses, compared with women receiving another result, those with a VUS decreased more in psychosocial problems related to hereditary predisposition (eg, coping with the test result) (ß=-0.11, p<0.05) and familial/social issues (eg, risk communication) (ß=-0.13, p<0.05), almost independently from their problems before testing. Women with a PV presented no change in hereditary predisposition problems and, so as women with a TN result, a non-significant increase in familial/social issues. Other PAHC scales (ie, emotions, familial cancer, personal cancer and children-related issues) were not affected by genetic testing.

CONCLUSIONS

In women tested for breast or ovarian cancer genetic risk in European genetics clinics, psychosocial problems were mostly unaffected by genetic testing. Apart from women receiving a VUS result, those with another test result presented unchanged needs in counselling in particular about hereditary predisposition and familial/social issues.

Challenging care work: General practitioners' perspectives on caring for young adults with complex psychosocial problems

The international literature shows that primary care is well placed to address mental health problems in young people, but that primary care professionals experience a range of challenges in this regard. In Denmark, young adults who have complex psychosocial problems, and who are not in education or work, cause political and academic concern. They are also in regular contact with their general practitioners, the Danish municipalities and psychiatric services. However, little is known about general practitioners' perspectives on caring for this vulnerable group of patients. In this article, we investigate how general practitioners' care work is shaped by the bureaucratic management of care in a complex infrastructure network comprising the general practitioners, psychiatry, the municipalities and the young adults. The analysis is based on interviews and focus groups with general practitioners, psychiatric nurses and social workers. We employ Tronto's concept of care and the concept of boundary work as a theoretical framework. We argue that general practitioners strive to provide care, but they are challenged by the following: contested diagnostic interpretations and the bureaucratic significance of diagnoses for the provision of care from psychiatry and the municipalities, systemic issues with handling intertwined social and mental health problems, and the young adults' difficulties with accessing and receiving available care.

Preliminary Results From a Randomized Controlled Study for an App-Based Cognitive Behavioral Therapy Program for Depression and Anxiety in Cancer Patients

Cancer patients experience various psychological and social difficulties, the most common being depression and anxiety. The purpose of this study was to develop and evaluate the effectiveness of an app-based cognitive behavioral therapy program for depression and anxiety in cancer patients. For this purpose, 63 participants who met the inclusion criteria were randomly assigned to either a mobile-application-based cognitive behavioral therapy program (HARUToday), a simple information-provision mobile-application-based program (HARUCard), or a waitlist control group. Self-report questionnaires including the Beck Depression Inventory, State-Trait Anxiety Inventory, Health-Related Quality of Life Scale, Dysfunctional Attitude Scale, and two computer tasks including the dot-probe task and the Implicit Association Test, were administered before and after 66 days of intervention. The results showed that the Beck Depression Inventory and State-Trait Anxiety Inventory scores of the cognitive behavioral therapy program (HARUToday) group decreased significantly after the intervention compared to the attention control (HARUCard) and waitlist control groups. However, there were no significant changes in scores of the Health-Related Quality of Life Scale and Dysfunctional Attitude Scale, and the two computer tasks. Such results suggest that a mobile-application-based cognitive behavioral therapy program may be an effective intervention for alleviating depression and anxiety, but not the general quality of life of cancer patients. Taking into consideration that psychosocial problems may not the topmost priority for cancer patients who are facing a chronic and possibly mortal disease, a mobile-application cognitive behavioral therapy program may be a possible solution for the alleviation of depression and anxiety in cancer patients who have many restraints in terms of time and space.

Gender Differences in the Experience of Infertility Concerning Polish Couples: Preliminary Research

The World Health Organization (WHO) determines infertility as a disease of the reproductive system defined clinically by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse. Estimates indicate that the problem of infertility in the world is continuing to grow. The aim of the study was to compare approaches to disease in partners of both sexes diagnosed with infertility. The study was conducted among 61 couples treated for infertility using an original questionnaire developed by the authors. The Chi square independence test was used for statistical analysis. Both men and women responded to the diagnosis of infertility with negative emotions. Regardless of sex, sadness and anxiety were the dominant feelings associated with the diagnosis of infertility. Women believed in the success of the treatment to a greater extent than men. Mainly women attempted to talk openly about the problem of infertility, while men were more restrained in this respect. Women accepted the assisted reproductive technologies (ART) to a greater extent than men, but men would accept childlessness more often than women.

Economic and psychosocial problems experienced by pediatric with cancer patients and their families during the treatment and follow-up process

Aim:

To identify the psychosocial and economic problems of the pediatric patients with cancer who were treated at the Dr. Sami Ulus Obstetrics and Gynecology and Child Health and Diseases Training and Research Hospital’s Pediatric Oncology Department and their relatives during this process.

Material and Methods:

We interviewed a total of 100 patients who were treated at Dr. Sami Ulus Obstetrics and Gynecology and Child Health and Diseases Hospital’s Pediatric Oncology Department between 1996 and 2015, and were now followed up without treatment and their relatives using survey questions on the psychosocial and economic problems they experienced.

Results:

Most of patients were from provinces outside Ankara. The average monthly income was below the level that would meet the family needs in 80% of the families and only 16% had extra income. Additional economic support had been received by 93% of the families in the patient group. Twenty-five families (25%) had been forced to sell property during the treatment. Forty-nine (49%) families had borrowed money from acquaintances and relatives or had taken out a bank loan. Serious psychological problems were experienced during and after the treatment by 46% of the mothers; 41% of the families had used religious procedures more commonly during the treatment period to cope with the psychological problems. Education was subject to a 1–2 year pause in 83% of the patients.

Conclusion:

Childhood-age patients with cancer and their families experience significant psychosocial and economic problems during and after the treatment process. Providing medical treatment and psychosocial support in harmony is an important factor that increases the success of cancer treatment. The patient and the family will require psychosocial support mechanisms throughout life, starting from the moment they face the disease. Developing national social support programs and legal regulations to form a basis for such programs are required in our country.

Maladaptive Daydreaming Is Associated With Intensified Psychosocial Problems Experienced by Female Survivors of Childhood Sexual Abuse

We measured maladaptive daydreaming (MD) and psychosocial indices among 194 participants, aged 18-56  years: 99 female survivors of childhood sexual abuse (CSA) and 95 control respondents with no reported history of sexual abuse. Our data show that survivors of CSA scored higher on MD compared to controls. Survivors of CSA with probable MD scored higher on psychological distress, social phobia, and social isolation compared to survivors of CSA without suspected MD, implying that MD might exacerbate the psychosocial problems linked with CSA. MD psychological screening of female survivors of CSA and the development of a treatment module for MD could improve the quality of clinical services provided to survivors.

"Every part of me has changed"-shared lived experiences of adolescents living with cancer in Zambia

This study explored experiences of adolescents living with cancer, focusing on physical and psychosocial problems. Semi-structured interviews were carried out on 18 adolescents aged between 12 and 18 years. Transcripts were analyzed using thematic analysis. Results showed that the adolescents faced a lot of physical, psychological, and social problems due to cancer diagnosis, treatment, and care. In order to improve their well-being and quality of life, psychosocial interventions should be incorporated in biomedical interventions that adolescents with cancer receive. This study proposes cost-effective interventions that can be implemented in resource-restricted sub-Saharan countries like Zambia.

Are procrastinators psychologically healthy? Association between psychosocial problems and procrastination among college students in Shanghai, China: a syndemic approach

Procrastination has been closely linked to psychosocial health problems, such as depression and anxiety, among college students. However, few studies have focused on the magnifying effects of multiple psychosocial health problems on procrastination. We conducted a cross-sectional study by convenience sampling among 509 college students in Shanghai, China. Logistic regressions were performed to assess the relationship between psychosocial variables and procrastination and to verify the syndemic effect of psychosocial factors. Univariate analyses revealed that self-esteem, depression, and loneliness were associated with procrastination. In multivariate analyses, self-esteem and depression remained significant. College students with four psychosocial problems were approximately 2.5 times more vulnerable to procrastination compared with non-syndemic (have no more than one problem) students. The study indicates that college students with more psychosocial health problems exhibit severer procrastination, which in turn suggests that psychosocial syndemic theory can be applied to procrastination.

Overview of psychosocial problems in individuals with stoma: A review of literature

This literature review was conducted to summarise empirical evidence relating to psychosocial health following ostomy surgery during hospitalisation and after discharge. Both qualitative and quantitative studies were searched from 2000 to 2017 using PubMed, CINAHL, Ebrary, Elsevier, Science Direct, and Scopus. Twenty-seven articles were included that examined the patient's psychosocial health following colostomy or ileostomy surgery. Among the 27 included studies, 11 adopted qualitative research methods and 16 used quantitative designs. Most of the studies were conducted to determine psychosocial problems and emotions of the individuals, their adaptation to the stoma, and their quality of life. Most of the psychosocial problems identified in these studies were poor body image perception and self-respect, depression, sexual problems, and lower psychosocial adaptation. This literature review has illustrated the patient's psychosocial health following stoma surgery. Further studies exploring the effect of psychosocial interventions could be planned.

Sleep Disturbances, Psychosocial Difficulties, and Health Risk Behavior in 16,781 Dutch Adolescents

OBJECTIVE

To investigate the prevalence of adolescent sleep disturbances and their relation to psychosocial difficulties and health risk behaviors with the use of data from a province-wide health survey (n = 16,781).

METHODS

Psychosocial difficulties were measured with the Strength and Difficulties Questionnaire. Additional assessments included self-reported sleep disturbances, suicidality, and health risk behaviors including current use of tobacco, alcohol, and drugs, physical inactivity, and compulsive use of multimedia. We used multilevel analyses to investigate the relationhips, including differences, between boys and girls, as well as the mediating role of emotional problems.

RESULTS

Just under 20% of adolescents reported sleep disturbances in the previous month. These sleep disturbances were associated with psychosocial problems (odds ratio [OR], 6.42; P < .001), suicidality (OR, 3.90-4.14; P < .001), and all health risk behaviors (OR, 1.62-2.66; P < .001), but not with physical inactivity. We found moderation by gender for the relations between sleep and suicide attempts (OR, 0.38; P < .002) and between sleep and cannabis use (OR, 0.52; P = .002), indicating attenuated relationships in girls compared with boys. Emotional problems partially mediated the relationships between sleep disturbances and multimedia use.

CONCLUSIONS

This study reiterates the high prevalence of sleep disturbances during adolescence. These sleep disturbances were strongly related to psychosocial problems and a wide range of health risk behaviors. Although the direction of causality cannot be inferred, this study emphasizes the need for awareness of impaired sleep in adolescents. Moreover, the gender differences in associated suicide attempts and cannabis use call for further research into tailored intervention strategies.

Clinical Characteristics and Burden of Illness in Pediatric Patients with Narcolepsy

BACKGROUND

Narcolepsy is a chronic and lifelong neurologic disorder with onset commonly occurring in childhood or adolescence, and affecting approximately 0.025% to 0.05% of the general population. The primary symptom is excessive daytime sleepiness, which is accompanied by cataplexy in 70% of patients. Other common symptoms include sleep paralysis, hallucinations upon falling asleep or waking, and disrupted nocturnal sleep. Narcolepsy is associated with a considerable burden of illness (BOI), which has been well characterized in adults, and is exacerbated by delays in symptom recognition, diagnosis, and intervention.

METHODS

This review describes the specific characteristics and BOI of pediatric narcolepsy, using a wide range of published research data.

RESULTS

Pediatric narcolepsy presents distinct challenges in diagnosis and management. Narcolepsy symptoms often initially manifest differently in children and adolescents versus adults, which may pose diagnostic dilemmas. Children often respond to sleepiness with irritability, hyperactivity, and poor attention, which may be misinterpreted as misbehavior or neurocognitive sequelae of other conditions. Pediatric cataplexy symptoms may include subtle and unusual facial expressions or choreic-like movements, which are not observed in adults. Insufficient sleep and circadian rhythm disorders presenting with excessive daytime sleepiness are common in adolescents, potentially confounding narcolepsy diagnosis. Pediatric narcolepsy is also associated with comorbidities including rapid weight gain, precocious puberty, and attention deficit hyperactivity disorder, and increased risk for deficits in social functioning, depression, and anxiety. School performance is also typically impaired, requiring special education services.

CONCLUSIONS

Thus, the discrete BOI of pediatric narcolepsy underscores the need for prompt and accurate diagnosis, and appropriate treatment of this disorder.

Psychosocial Problems, Indoor Air-Related Symptoms, and Perceived Indoor Air Quality among Students in Schools without Indoor Air Problems: A Longitudinal Study

The effect of students' psychosocial problems on their reporting of indoor air quality (subjective IAQ) and indoor air-related (IA-related) symptoms has not been studied in schools in a longitudinal setting. Therefore, we analyzed whether changes in students' psychosocial problems (socioemotional difficulties and perceived teacher⁻student relations) between the beginning of seventh grade (age 12⁻13 years) and the end of ninth grade (15⁻16 years) predicted subjective IAQ and IA-related symptoms at the end of ninth grade. In order to explore the independent effect of psychosocial factors, we focused only on students in schools without observed indoor air problems. The analysis was of longitudinal data (N = 986 students) using latent change modelling. Increased socioemotional difficulties were related to more IA-related symptoms (standardized beta = 0.20) and deteriorated subjective IAQ (standardized beta = 0.20). Increased problems in teacher⁻student relations were related to deteriorated subjective IAQ (standardized beta = 0.21). Although students' psychosocial problems explained only 9⁻13% of the total variances, our findings support the notion that psychosocial factors also need to be taken into account in the evaluation of IAQ and the prevalence of IA-related symptoms in schools.

Characteristics of adult smokers presenting to a mind-body medicine clinic

Mind-body interventions can improve vulnerabilities that underlie smoking behavior. The characteristics of smokers who use mind-body medicine have not been explored, preventing the development of targeted interventions. Patients ( N = 593) presenting to a mind-body medicine clinic completed self-report measures. Patients were 67 percent never smokers, 27 percent former smokers, and 6 percent current smokers. Current smokers were younger; more likely to be single, unemployed, or on disability; and report greater depression symptoms, greater pain, and lower social support ( ps < .05).Current smokers who use mind-body medicine have unique psychosocial needs that should be targeted in mind-body smoking cessation interventions.

A Cross-Sectional Study of the Psychosocial Problems Following Abortion

BACKGROUND

Twenty percent of pregnant women undergo an abortion. Reviews of previous studies on the effects of abortion on mental health have been inconclusive. Little research has been carried out in this direction in our country.

AIMS

This study aims to study the psychological effects of abortions and the associated sociodemographic and other parameters.

SETTING AND DESIGN

It is a cross-sectional study, conducted in five different government hospitals of Hyderabad.

MATERIALS AND METHODS

After identifying the participants, an interview was conducted. First, sociodemographic and other parameters were collected by an interviewer. Then, another interviewer conducted the interview using diagnostic tools (Impact of Events Scale-Revised [IES-R] and Goldberg Health Questionnaire-12 [GHQ-12]). Analysis was carried out using SPSS software.

RESULTS

Sixty cases of spontaneous abortion, 31 therapeutic and 9 elective abortions, were collected. Overall, on GHQ-12, 57% women had no distress, 11% had typical distress, while 14% had more than typical distress, 15% had psychological distress, and 3% of them had severe distress. On IES-R, 16% women had little or no symptoms of posttraumatic stress disorder PTSD, 57% had several symptoms, while 27% of them were likely to have PTSD.

CONCLUSIONS

Women who underwent elective abortion showed less distress than the other types. Those that underwent a late abortion were more likely to suffer from psychological distress than those having an early one. The medical history was a significant factor in determining the mental health outcome of the women who underwent abortion.

Social work interventions in Sweden for patients newly diagnosed with type 1 or type 2 diabetes

We evaluated psychosocial work with patients in ordinary clinical practice who were newly diagnosed with type 1 or type 2 diabetes and experienced psychosocial problems at disease onset. We examined types of psychosocial problems, causes of these problems, psychosocial interventions, extent of achievement of psychosocial treatment goals, and whether the patients felt they benefited from the treatment. Eighty-nine working-age (18-65-year-old) Swedish adults newly diagnosed with diabetes were included. Each was interviewed and responded to questionnaires at the beginning and end of the study period. Thirty-four (38%) received psychosocial treatment as needed over 2 years. A psychosocial treatment plan with a defined goal was developed for each. Interventions included counseling, problem-focused support, social information, and advice. The treatment process was documented. Eighteen patients had type 1, and 16 had type 2 diabetes. One-third had emotional problems directly caused by receiving a diagnosis. Several of them had crisis reactions. The rest had problems primarily caused by their life situations. Those with psychosocial problems caused by receiving a diagnosis achieved treatment goals more frequently than the others. Distinguishing the cause of the psychosocial problems of newly diagnosed patients may help ensure that social work resources in health care are used as effectively as possible.

ADVERSE CHILDHOOD EXPERIENCES AMONG YOUTH AGING OUT OF FOSTER CARE: A LATENT CLASS ANALYSIS

Research has demonstrated that youth who age out, or emancipate, from foster care face deleterious outcomes across a variety of domains in early adulthood. This article builds on this knowledge base by investigating the role of adverse childhood experience accumulation and composition on these outcomes. A latent class analysis was performed to identify three subgroups: Complex Adversity, Environmental Adversity, and Lower Adversity. Differences are found amongst the classes in terms of young adult outcomes in terms of socio-economic outcomes, psychosocial problems, and criminal behaviors. The results indicate that not only does the accumulation of adversity matter, but so does the composition of the adversity. These results have implications for policymakers, the numerous service providers and systems that interact with foster youth, and for future research.

Rehabilitation needs and participation restriction in patients with cognitive disorder in the chronic phase of traumatic brain injury

The purpose of this study was to clarify psychosocial factors/problems, social participation, quality of life (QOL), and rehabilitation needs in chronic-phase traumatic brain injury (TBI) patients with cognitive disorder discharged from the level-1 trauma center (L1-TC), and to inspect the effects of rehabilitation intervention to these subjects.A mixed-method research (cross-sectional and qualitative study) was conducted at an outpatient rehabilitation department.Inclusion criteria of subjects were transfer to the L1-TC due to TBI; acute-stage rehabilitation treatment received in the L1-TC from November 2006 to October 2011; age of ≥18 and <70 years at the time of injury; a score of 0-3 on the Modified Rankin Scale at discharge and that of 4-5 due to physical or severe aggressive behavioral comorbid disorders. Study details were sent, via mail, to 84 suitable candidates, of whom 36 replied. Thirty-one subjects (median age: 33.4 years; male: 17; and average time since injury: 48.1 months), who had consented to study participation, were participated. Cognitive function, social participation, QOL, psychosocial factors/problems, rehabilitation needs, and chronic-phase rehabilitation outcomes were evaluated using the Wechsler Adult Intelligence Scale, Third Edition, the Wechsler Memory Scale-Revised, the Zung Self-Rating Depression Scale, the Sydney Psychosocial Reintegration Scale, Version 2, and the Short Form 36, Version 2, qualitative analysis of semistructured interviews, etc.Participants were classified into achieved-social-participation (n = 11; employed: 8), difficult-social-participation (n = 12; unemployed: 8), and no-cognitive-dysfunction groups (n = 8; no social participation restriction). Relative to the achieved-social-participation group, the difficult-social-participation group showed greater injury and cognitive dysfunction and lower Sydney Psychosocial Reintegration Scale and Short Form 36 role/social component summary scores (64.9/49.1 vs 44.3/30.4, respectively, P < 0.05). Linear regression analysis showed that the social participation status was greatly affected by the later cognitive disorders and psychosocial factors/problems not by the severity of TBI. No changes were observed in these scores following chronic-phase rehabilitation intervention.Chronic-phase TBI with cognitive disorder led to rehabilitation needs, and improvement of subjects' psychosocial problems and QOL was difficult.

Attention-deficit/hyperactivity disorder casts a long shadow: findings from a population-based study of adult women with self-reported ADHD

BACKGROUND

To develop a sociodemographic and health profile of women with self-reported attention deficit/hyperactivity disorder (ADHD) in comparison to women without.

METHODS

Chi-square tests and logistic regression analyses were conducted on data from the nationally representative Canadian Community Health Survey-Mental Health (2012) comparing 107 women aged 20 to 39 years (inclusive) with ADHD to 3801 without ADHD. Depression, generalized anxiety disorder and substance abuse were measured using the WHO-CIDI.

RESULTS

Women with ADHD had triple the prevalence of insomnia, chronic pain, suicidal ideation, childhood sexual abuse and generalized anxiety disorder and double the prevalence of substance abuse, current smoking, depressive disorders, severe poverty and childhood physical abuse in comparison with women without ADHD (all P < 0.001). Even after adjustments for age, race, education and income, women with ADHD had substantially higher odds of a wide range of problems.

CONCLUSION

Our results suggest that women with ADHD are particularly vulnerable to early adversities, health and mental health problems.

Psychiatric Symptoms and Psychosocial Problems in Patients with Breast Cancer

Cancer is a physical disease and also one of the leading clinical manifestations where psychosocial problems are prevalent. Psychosocial problems that these patients may have in the long run include anxiety, uneasiness, mourning, helplessness, fatigue, impairment of concentration, sleep disorders, mental and cognitive reservation, sexual dysfunction, infertility, psychological distress, and psychiatric disorders. Psychosocial problems have a nature of underpinning the emergence of psychological troubles. The prevalence of psychological disorders in patients with cancer range from 29% to 47%. Psychiatric disorders that are likely to be seen are severe stress disorder, adjustment disorder, depressive disorder, and other neurotic disorders. It is considered by the present author that in the event of breast cancer, potential psychiatric disorders may affect prognosis of the disease, adherance to and success of therapy, social and societal functioning, and survival rate. This paper aims to review the psychiatric symptoms and diseases that may develop in patients with breast cancer, which is one of the most frequent types of a globally common disease; i.e., cancer, as well as the impact of psychiatric symptoms on the treatment of disease.

Children with bronchial asthma assessed for psychosocial problems in a teaching hospital in Nigeria

BACKGROUND

Paediatric bronchial asthma causes respiratory related mortality and morbidity globally and elevates the risk of psychological and social problems (psychosocial problems); which may result in poorer asthma control. The rate of and associated factors for psychosocial problems among our asthmatic children was assessed in this study.

METHODS

Seventy five (75) children aged 7 to 14 years with bronchial asthma who were attending clinics at the University of Ilorin Teaching Hospital, Ilorin, Nigeria, were assessed with Child behaviour questionnaire and a semi-structured questionnaire.

RESULTS

Probable psychological morbidity was present in 25% of the children. The most frequently reported social impairments associated with the disease were: interference with play (60%), domestic work (49%), fear of dying anytime (29%) and feeling of being a burden on the family (25%). Psychological morbidity was significantly associated with lower maternal education (p=0.020) and occupation (p=0.038), polygamy (p=0.012), fathers having more than 5 children (p=0.027) and mothers having inadequate spousal support (p=0.012). Inadequate spousal support and lower maternal occupational level were the significant predictors of morbidity following logistic regression.

CONCLUSION

Routine psychosocial assessment and care for children with asthma needs to be introduced into our clinics to help protect them and their families from avoidable suffering.

Stepping Stones Triple P: the importance of putting the findings into context--a response to Tellegen and Sofronoff

Recently, we reported the findings of a randomized controlled trial on the effectiveness of Stepping Stones Triple P (SSTP) compared to Care as Usual (CAU), in BMC Medicine. The study involved parents of 209 children with Borderline to Mild Intellectual Disability (BMID), included following a school-based assessment of psychosocial problems. We found that SSTP had some short-term advantages over CAU, i.e., a reduction of parenting stress and of teacher-reported psychosocial problems, but no long-term advantages, at 6 months after the intervention. Tellegen and Sofronoff criticized that we included a limited amount of studies on the effectiveness of SSTP, and that the interpretation of our findings was inadequate. Regarding available evidence, we confined our summary to published high-quality RCTs regarding individual SSTP on level 4--our RCT concerned that type of SSTP. Consequently, many studies were excluded but in a very adequate way. Regarding interpretation, Tellegen and Sofronoff criticized that we compared SSTP with CAU, but seem to be unware that this is consonant with current guidelines. Moreover, they noted that 49% of the parents who started SSTP followed less than half of the intended number of sessions. However, our findings on those who completed SSTP showed no more advantages of SSTP in the long term than CAU. We therefore stick to our conclusion that SSTP has some advantages in the short term compared to CAU, but not in the long term. The major burden of psychosocial problems in children with BMID prompts for further improvements. Please see related articles: http://www.biomedcentral.com/1741-7015/12/191 and http://www.biomedcentral.com/1741-7015/13/25.

Withdrawal from mental and psychosocial care during pregnancy

Psychopathology, psychosocial problems and substance use (PPS) commonly occur in pregnant women, and can have a negative impact on the course of pregnancy and the healthy development of the child. As PPS often remains undetected and untreated during pregnancy, we developed and implemented a four-step screen-and-treat protocol in routine obstetric care, with: (i) screening including triage and subsequent confirmation, (ii) indication assessment, (iii) transfer towards care and (iv) utilization of care. Adherence to the protocol and risk factors associated with dropout were examined for 236 Dutch pregnant women in a deprived urban area. Seventy-nine percent of women accepted the screening, 21% dropped out during triage, 15% during confirmation, 3% during transfer and 8% thereafter. Provided reasons for dropout were lack of time and lack of perceived benefit. In particular, smokers, multiparous women, and women of non-Western ethnicity dropout on the way towards mental and psychosocial care. For a successful implementation of the protocol in the future, with improved adherence of pregnant women to the protocol, education of women on PPS risks, motivational skills and compulsory treatment are worth investigation.

What can we learn from a failed trial: insight into non-participation in a chat-based intervention trial for adolescents with psychosocial problems

BACKGROUND

Psychosocial problems are highly prevalent among Dutch adolescents. We have conducted a trial to test whether offering chat-based consultations could be of added value within the context of Dutch Youth Health Care. This trial was ended prematurely because of recruitment issues. The aim of this study is to learn from this failed trial and to provide more insight into non-participation. Sources of data were non-participation forms, oral clarification, patient records, telephone interviews with adolescents that declined to participate, and a questionnaire-based process evaluation among nurses.

RESULTS

Non-participation appears to be a multi-factorial problem. Of those 290 adolescents eligible to participate, the majority (n = 165, 57%) declined to do so. Two-third of those (n = 109) also refused usual care, which might be indicative of not wanting help and/or experiencing problems and the validity of the assessment instrument. The other one-third (n = 56) did enrol in usual care and indicated other reasons for non-participation, such as a preference for face-to-face consultations, the extensive information that was provided, and not liking the idea of being randomized.

CONCLUSIONS

This study shows that even if a trial fails, we can learn about the challenges of recruiting adolescents in intervention trials.

TRIAL REGISTRATION

NL37668.068.11/METC11-3-077.

The effectiveness of Stepping Stones Triple P parenting support in parents of children with borderline to mild intellectual disability and psychosocial problems: a randomized controlled trial

BACKGROUND

Children with borderline to mild intellectual disability (BMID) have been shown to be at increased risk for psychosocial problems. The presence of these psychosocial problems leads to parenting stress. Stepping Stones Triple P (SSTP) is a parenting support program to support parents with children with BMID and psychosocial problems. The aim of this study was to evaluate the effectiveness of SSTP compared to Care as Usual (CAU) in reducing psychosocial problems in children with BMID.

METHOD

We conducted a randomized controlled trial in the Northern provinces of the Netherlands. Parents of children aged 5 to 12 with borderline (IQ 70 to 85) or mild (IQ 70 to 50) ID and psychosocial problems were invited. Psychosocial problems were identified using the Strengths and Difficulties Questionnaire (SDQ) parent report (≥14). Measurements were assessed before the intervention (T0), immediately after the intervention (T1) and after a follow-up of six months (T2). SSTP takes 8 to 10 individual sessions of 40-90 minutes, provided over 10 to 12 weeks. CAU concerned any service, except SSTP. Primary outcomes were the child's psychosocial problems (SDQ parent and teacher forms and the Eyberg Child Behavior Inventory, ECBI). Secondary outcomes were parenting stress (Parenting Stress Index, PSI) and parenting skills (Alabama Parenting Questionnaire, APQ).

RESULTS

In total 209 parents of children aged 5 to 12 with BMID were allocated blindly to either SSTP (n =111) or CAU (n =98). In the intention to treat analyses, SSTP achieved no significantly better effect than CAU for the SDQ parent report, the ECBI and the APQ on the short- and long- term. In the short term, SSTP was significantly more effective than CAU for the SDQ teacher report (B = -2.25, 95% CI -3.79 to -0.71) and the PSI (B = -7.06, 95% CI -12.11 to -2.01). For both SDQ teacher report and PSI, there was no statistically significant effect in the long term. Dropout from SSTP was considerable (49%), with the effects being solely found in the adherent SSTP subgroup.

CONCLUSIONS

SSTP had some short-term advantages over CAU, but not in the longer term.

TRIAL REGISTRATION

Dutch Trial Register NTR2624. Registered 26 November 2010.