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Topical Collection "Social Determinants of Mental Health"

Editors

Dr. Emma Motrico
E-Mail Website
Collection Editor
Department of Psychology, Universidad Loyola Andalucía, 41014 Sevilla, Spain
Interests: psychosocial factors (social determinants) of mental health; prevention and promotion of mental health
Special Issues and Collections in MDPI journals
Dr. Maria Luisa Rodero-Cosano
E-Mail Website
Collection Editor
Quantitative Methods Department, Universidad Loyola Andalucía, 41704 Dos Hermanas- Sevilla, Spain
Interests: socioeconomic factors of mental health; epidemiology and spatial analysis in mental health; social determinants in health
Dr. Jose A. Salinas-Perez
E-Mail Website
Collection Editor
Quantitative Methods Department, Universidad Loyola Andalucía, Dos Hermanas- Sevilla, Spain
Interests: health geography; health service research; mental health; social determinants; spatial statistics
Dr. Sonia Conejo-Cerón
E-Mail Website
Collection Editor
(1) Biomedical Research Institute of Malaga (IBIMA), Málaga, Spain
(2) Prevention and Health Promotion Research Network (redIAPP), ISCIII, Spain
Interests: prevention of mental health diseases; promotion of mental health; risk factors; protective factors
Special Issues and Collections in MDPI journals
Dr. Nasser Bagheri
E-Mail Website
Collection Editor
Centre for Mental Health Research, Research School of Population Health, College of Health and Medicine, Australian National University, 63 Eggleston Rd, Acton, Canberra, ACT 2601, Australia
Interests: spatial analysis in chronic diseases; contextual analysis in healthcare ecosystems
Special Issues and Collections in MDPI journals
Dr. Giulio Castelpietra
E-Mail Website
Collection Editor
1. Region Friuli Venezia Giulia, Central Health Directorate, Outpatient and Inpatient Care Service, Riva Sauro 8, 34100 TRIESTE, Italy
2. Department of Medicine (DAME), University of Udine, via Colugna 50, 33100, Udine, Italy
3. Clinical Department of Medical, Surgical and Health Sciences, University of Trieste, Strada di Fiume, 447, 34100 Trieste, italy
Interests: suicide; psychopharmacoepidemiology; mental health service organization; mental health policy; classification of psychiatric interventions

Topical Collection Information

Dear Colleagues,

Mental disorders are one of the greatest public health problems of our time. Major depression, with a prevalence of 4.4% in the world population, is the most disabling disease while anxiety disorders, with a global prevalence of 3.6%, are in the sixth position. Researchers view mental disorders as having complex causes involving an interplay of biological, psychological and social factors.

The social determinants of mental health are the social and economic factors (such as socioeconomic status, education, neighborhood, employment, social support networks, health services) that influence people´s mental health. Interventions targeting social determinants are likely to exert small but, from a public health point of view, potentially important effects on population mental health. Therefore, the investigation of the social determinants that affect mental health is essential.

This Special Issue in the International Journal of Environmental Research and Public Health is devoted to recent findings on “Social Determinants of Mental Health” to make a substantial contribution to knowledge gaps in understanding  how social determinants influence mental health in many positive and negative ways.

A wide range of topics will be included in this issue, related, but not limited to, stress, living conditions, education, unemployment and job security, employment and working conditions, housing, social exclusion, mental health services, gender, race and disability.

We welcome the submission of Original Research Articles, Short Reports, Systematic Reviews and Meta-Analysis targeting any of these topics and beyond. We would be delighted to attract as high diversity and heterogeneity of submissions across geographies and jurisdictions as possible. Studies using innovative research methods to study these topics are most welcome.

Dr. Emma Motrico
Dr. María Luisa Rodero-Cosano
Dr. Jose A. Salinas-Perez
Dr. Sonia Conejo-Cerón
Dr. Nasser Bagheri
Dr. Giulio Castelpietra
Collection Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the collection website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2300 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • social determinants
  • mental health
  • psychosocial
  • socioeconomic factor
  • epidemiology and spatial analysis in mental health
  • health geography
  • health service research
  • risk factors
  • protective factors

Published Papers (40 papers)

2021

Jump to: 2020

Article
“We Thought We Were Prepared, but We Were Not”: Experiences from the Management of the Psychosocial Support Response during the COVID-19 Pandemic in Sweden. A Mixed-Methods Study
Int. J. Environ. Res. Public Health 2021, 18(17), 9079; https://doi.org/10.3390/ijerph18179079 - 28 Aug 2021
Viewed by 482
Abstract
This study aimed to describe experiences of managing mental health and psychosocial activities during the first six months of the COVID-19 pandemic in Sweden. A national survey was answered by a non-probability sample of 340 involved in the psychosocial response. The psychosocial response [...] Read more.
This study aimed to describe experiences of managing mental health and psychosocial activities during the first six months of the COVID-19 pandemic in Sweden. A national survey was answered by a non-probability sample of 340 involved in the psychosocial response. The psychosocial response operations met several challenges, mainly related to the diverse actors involved, lack of competence, and lack of preparations. Less than 20% of the participants had received specific training in the provision of psychosocial support during major incidents. The interventions used varied, and no large-scale interventions were used. The psychosocial response organizations were overwhelmed by the needs of health care staff and failed to meet the needs of patients and family members. An efficient and durable psychosocial response in a long-term crisis requires to be structured, planned and well-integrated into the overall pandemic response. All personnel involved need adequate and specific competence in evidence-based individual and large-scale interventions to provide psychosocial support in significant incidents. By increasing general awareness of mental wellbeing and psychosocial support amongst health professionals and their first-line managers, a more resilient health care system, both in everyday life and during major incidents and disasters, could be facilitated. Full article
Article
Estimation of Years Lived with Disability Using a Prevalence-Based Approach: Application to Major Psychiatric Disease in Korea
Int. J. Environ. Res. Public Health 2021, 18(17), 9056; https://doi.org/10.3390/ijerph18179056 - 27 Aug 2021
Viewed by 346
Abstract
To help develop policies concerning the prevention of psychiatric disease in Korea, we reviewed the literature on this topic in different countries and used a prevalence-based approach to estimate the years lived with disability (YLDs) in Korean patients with major psychiatric diseases. We [...] Read more.
To help develop policies concerning the prevention of psychiatric disease in Korea, we reviewed the literature on this topic in different countries and used a prevalence-based approach to estimate the years lived with disability (YLDs) in Korean patients with major psychiatric diseases. We calculated YLDs by extracting data on the number of patients with mild, moderate, and severe cases of schizophrenia, bipolar disorder, and major depressive disorder, as classified by International Statistical Classification of Disease (ICD) codes. YLDs were highest for patients with major depressive disorder (1190.6; 73.9%), schizophrenia (303.3; 18.8%) and bipolar disorder (117.9; 7.3%). Men had higher YLDs for schizophrenia, 2502 (20–24 years); bipolar disorder, 477 (40–44 years); and major depressive disorder, 2034 (75–79 years). Women had higher YLDs for schizophrenia, 484 (45–49 years); bipolar disorder, 214 (≥80 years); and major depressive disorder, 3541 (75–79 years). The prevalence-based approach and severity distribution is useful for estimating long-term psychiatric disease burden and YLDs. However, YLD-estimation studies must compensate for the shortcomings of the ICD-10 by referencing the Diagnostic and Statistical Manual of Mental Disorders 5th edition, as well as updating the disability weight score according to disease severity. Full article
Article
Socioeconomic Status, Mental Health, and Workplace Determinants among Working Adults in Hong Kong: A Latent Class Analysis
Int. J. Environ. Res. Public Health 2021, 18(15), 7894; https://doi.org/10.3390/ijerph18157894 - 26 Jul 2021
Viewed by 567
Abstract
This study provides insights on mental health correlates and work stress patterns in a representative sample of working adults in Hong Kong using an intersectional perspective. Using data from a cross-sectional, population-based telephone survey of 1007 working adults in Hong Kong, latent class [...] Read more.
This study provides insights on mental health correlates and work stress patterns in a representative sample of working adults in Hong Kong using an intersectional perspective. Using data from a cross-sectional, population-based telephone survey of 1007 working adults in Hong Kong, latent class analysis was conducted to identify socioeconomic classes within the sample. Three latent classes were identified, and they differed significantly in all the SES variables. Results suggested mental health to be the lowest in Class 1, the lowest income group. The three classes did not differ from their perceived level of job demand and control in work-related stress. Predictably, the highest income group perceived the lowest level of effort-reward imbalance. The lowest paid class was also reported perceiving the lowest level of relational justice. Different barriers to mental health services were also identified. Finally, cultural implications associated with work stress patterns, research, and practice implications are discussed. This study provides an empirical foundation for future studies to investigate patterns of job stress and mental health needs in a diverse population of working adults, with a particular focus on addressing the intersectional profiles of working adults and their needs in mental health services. Full article
Article
Teacher Teleworking during the COVID-19 Pandemic: Association between Work Hours, Work–Family Balance and Quality of Life
Int. J. Environ. Res. Public Health 2021, 18(14), 7566; https://doi.org/10.3390/ijerph18147566 - 16 Jul 2021
Viewed by 1104
Abstract
Background: Teachers worldwide had to reinvent their work routine according to teleworking during the COVID-19 pandemic, a work format that negatively impacts individuals’ physical and mental health. This study evaluates the association between work hours, work–family balance and quality of life (QoL) among [...] Read more.
Background: Teachers worldwide had to reinvent their work routine according to teleworking during the COVID-19 pandemic, a work format that negatively impacts individuals’ physical and mental health. This study evaluates the association between work hours, work–family balance and quality of life (QoL) among teachers during the Chilean health emergency of the COVID-19 pandemic. Teachers from across Chile were contacted via email and social media to answer an online survey. QoL was evaluated via the SF-36 questionnaire, work hours and work–family balance in the pandemic. A total of 336 teachers from across Chile participated in this study. Teachers had a low QoL score, associated with age (p < 0.05). Teachers who were ≤44 showed lower deterioration risks in the Physical Component Summary (OR: 0.54) than the ≥45-year-old age group; simultaneously, the younger group (≤44 years) had a greater risk (OR: 2.46) of deterioration in the Mental Component Summary than teachers over 45 years. A total of 78.7% of teachers reported having increased their work hours during the COVID-19 pandemic due to teleworking and 86% indicated negative effects on their work–family balance. Pandemic work hours and negative work–family balance increase the risk of reducing the Mental Component Summary (OR: 1.902; OR: 3.996, respectively). Teachers presented low median QoL scores, especially in the Mental Component Summary, suggesting that it would be beneficial to promote a better workload distribution for teachers in emergency contexts, considering the adverse effects of teleworking. Full article
Article
Quality of Life and Its Associations with Religiosity and Religious Coping among Outpatients with Psychosis in Singapore
Int. J. Environ. Res. Public Health 2021, 18(13), 7200; https://doi.org/10.3390/ijerph18137200 - 05 Jul 2021
Cited by 1 | Viewed by 714
Abstract
This cross-sectional study investigated the relationship of religiosity, the use of positive and negative religious coping methods, and quality of life (QOL) among 364 outpatients with psychosis in Singapore. Positive religious coping was significantly associated with better scores on physical (β = 0.51, [...] Read more.
This cross-sectional study investigated the relationship of religiosity, the use of positive and negative religious coping methods, and quality of life (QOL) among 364 outpatients with psychosis in Singapore. Positive religious coping was significantly associated with better scores on physical (β = 0.51, p = 0.02) and psychological (β = 0.64, p = 0.01) QOL domains in the regression model. Negative religious coping was related to worse QOL in all four domains: physical (β = −0.44, p = 0.03), psychological (β = −0.76, p < 0.01), social (β = −0.54, p = 0.03), and environment (β = −0.65, p < 0.01). Increased participation in organizational religious activities was positively associated with higher QOL for psychological (β = 2.47, p < 0.01), social relationships (β = 2.66, p = 0.01), and environment (β = 2.09, p = 0.01) domains. Interestingly, those with no religious affiliation were found with higher scores in the QOL domain for social relationships (β = 4.59, p = 0.02). Religious coping plays an important role for the QOL of outpatients with psychosis. Greater awareness of the importance of religion in this population may improve cultural competence in treatment. Individuals with psychosis may benefit from greater community support and collaboration between clinical and religious community-based organizations to improve social integration and QOL. Full article
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Article
Positive Mental Health of Finnish People Living Alone: The Role of Circumstantial Factors and Leisure-Time Activities
Int. J. Environ. Res. Public Health 2021, 18(13), 6735; https://doi.org/10.3390/ijerph18136735 - 23 Jun 2021
Viewed by 549
Abstract
Living alone has become more common across Europe. Past research has consistently identified living alone as a risk factor for poor mental health while evidence on the positive dimension(s) of mental health has been scarce. Positive mental health has been associated with rather [...] Read more.
Living alone has become more common across Europe. Past research has consistently identified living alone as a risk factor for poor mental health while evidence on the positive dimension(s) of mental health has been scarce. Positive mental health has been associated with rather stable circumstantial factors, such as socio-economic characteristics and social relationships, and day-to-day activities in the form of leisure participation, in general populations. In this study, our objective was to assess these relationships among people living alone. We specified a structural equation model in a random sample of Finnish people living alone (n = 884), with the circumstantial factors as (exogenous) explanatory variables, participation in various leisure activities as mediators, and positive mental health as the outcome. In the model, more frequent engagement in several leisure-time activities, including being in contact with family/friends and physical activity in nature, were positively associated with positive mental health. The circumstantial factors that most strongly explained both leisure participation and positive mental health were the number of friends, being in a relationship, and having no limiting illnesses. In conclusion, among Finnish people living alone, social and functional factors appear to be more strongly associated with leisure participation and positive mental health than socio-economic factors. Full article
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Article
The Application of the Adult Self-Report and the Adult Behavior Checklist Form to Chinese Adults: Syndrome Structure, Inter-Informant Agreement, and Cultural Comparison
Int. J. Environ. Res. Public Health 2021, 18(12), 6352; https://doi.org/10.3390/ijerph18126352 - 11 Jun 2021
Cited by 1 | Viewed by 786
Abstract
Given the global public health burden of mental illness, there is a critical need for culturally validated psychopathology assessment tools that perform well in diverse societies. This study examines the psychometric properties of the Adult Self-Report (ASR) and Adult Behavioral Checklist (ABCL) from [...] Read more.
Given the global public health burden of mental illness, there is a critical need for culturally validated psychopathology assessment tools that perform well in diverse societies. This study examines the psychometric properties of the Adult Self-Report (ASR) and Adult Behavioral Checklist (ABCL) from the Achenbach System of Empirically Based Assessments in adults in China. Chinese adults (N = 1276) and their spouses completed the ASR and ABCL, respectively. We conducted confirmatory factor analysis on 99 ASR items and 93 ABCL items. Estimators of model fit confirmed that both measures demonstrated excellent fit (e.g., root mean square error of approximation = 0.016 and 0.018, respectively). Syndrome loadings on both measures were satisfactory but generally higher on the ASR. Neither gender nor education had significant effects, but there were informant x gender effects on most problem scales. Cross-informant agreement correlations between the ASR and ABCL were medium to large. Findings from this novel sample of Chinese adults are consistent with previous validation studies supporting the dimensionality, syndrome structure, gender differences, and inter-informant agreement of the ASR and ABCL. Our findings contribute to the cross-cultural understanding of mental health assessment and offer a psychometrically sound approach to measuring adult psychopathology in Chinese populations. Full article
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Article
Prevalence and Factors for Anxiety during the COVID-19 Pandemic among College Students in China
Int. J. Environ. Res. Public Health 2021, 18(9), 4974; https://doi.org/10.3390/ijerph18094974 - 07 May 2021
Viewed by 865
Abstract
Background: Knowledge of the impact of COVID-19 on the mental health of college students remains limited. Our aim is to investigate the prevalence of anxiety and explore the potential risk and protective factors of anxiety. Methods: A cross-sectional survey was adopted and a [...] Read more.
Background: Knowledge of the impact of COVID-19 on the mental health of college students remains limited. Our aim is to investigate the prevalence of anxiety and explore the potential risk and protective factors of anxiety. Methods: A cross-sectional survey was adopted and a total of 24,678 college students were included from Zhengzhou, Henan Province, China, during February, 2020. Anxiety was assessed by using the Generalized Anxiety Disorder tool (GAD-7). Multiple logistic regression models were established for exploring potential factors of anxiety. Results: The overall prevalence of anxiety was 7.3%. After adjusting for potential confounders, sex, place of residence, worried level, fear level, cognitive levels, and behavior status were found to be associated with anxiety (p < 0.05). Students with positive preventive behaviors showed a protective effect against the anxiety symptoms compared to those with negative preventive behaviors. In contrast to the high-cognition category, participants at a low cognitive level were 14.9% more likely to present anxiety symptoms. Conclusion: This large-scale study assessed the prevalence of anxiety and its potential influencing factors among college students. It suggests that the government could strengthen health education related to COVID-19 and supervise the performance of preventive behaviors to handle anxiety. Full article
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Editorial
Editors’ Comments on the Special Issue “Social Determinants of Mental Health”
Int. J. Environ. Res. Public Health 2021, 18(8), 3957; https://doi.org/10.3390/ijerph18083957 - 09 Apr 2021
Viewed by 868
Abstract
Mental disorders are one of the greatest public health concerns of our time, and they are affected by social factors. To reduce the considerable burden of mental disorders, more global and systematic knowledge of the social determinants of mental health is necessary. This [...] Read more.
Mental disorders are one of the greatest public health concerns of our time, and they are affected by social factors. To reduce the considerable burden of mental disorders, more global and systematic knowledge of the social determinants of mental health is necessary. This paper presents the results of the 27 studies included in the International Journal of Environmental Research and Public Health Special Issue, “Social Determinants of Mental Health”. The studies are grouped into four broad categories: social inclusion and mental health, young people’s mental health, mental health at work, and mental health service users. The results cover different countries, age populations, settings, and methodologies. Finally, the main findings on the relationship between social determinants and mental health are presented and summarized. Full article
Article
Impact of the COVID-19 Pandemic on Teacher Quality of Life: A Longitudinal Study from before and during the Health Crisis
Int. J. Environ. Res. Public Health 2021, 18(7), 3764; https://doi.org/10.3390/ijerph18073764 - 04 Apr 2021
Cited by 6 | Viewed by 2254
Abstract
Background: Prior to the COVID-19 pandemic, teachers were already reporting a low quality of life (QoL) perception, with a significant impact on mental and physical health due to various stress factors associated with work overload. The objective of this study was to evaluate [...] Read more.
Background: Prior to the COVID-19 pandemic, teachers were already reporting a low quality of life (QoL) perception, with a significant impact on mental and physical health due to various stress factors associated with work overload. The objective of this study was to evaluate the QoL impact on Chilean teachers before and during the COVID-19 pandemic. The analysis was performed following a longitudinal design on a sample of 63 Chilean teachers in pre-pandemic and COVID-19 pandemic timeframes. QoL perception, along with teachers’ sociodemographic data, was evaluated via the Short-Form 36 Health Survey (SF-36) questionnaire. Sociodemographic variables presented no significant variations in pre-pandemic and pandemic comparisons. QoL, however, showed a significant decrease during the pandemic compared to the pre-pandemic measurement (p < 0.01). In each gender, there were significant differences between pre-pandemic and pandemic timeframes, with a greater impact among women in the mental and physical component summary variables and seven of the eight QoL scales (p < 0.01). Between age categories, people under 45 presented significant differences (p < 0.05) between pre-pandemic and pandemic timeframes in all summary dimensions and measurements. In conclusion, Chilean teachers’ QoL perception has been affected by the COVID-19 pandemic. These findings could be related to work overload due to teleworking or feelings of uncertainty, loneliness, and fear that the pandemic and its associated confinements will worsen. Full article
Article
Psychological Responses According to Gender during the Early Stage of COVID-19 in Spain
Int. J. Environ. Res. Public Health 2021, 18(7), 3731; https://doi.org/10.3390/ijerph18073731 - 02 Apr 2021
Cited by 3 | Viewed by 904
Abstract
Background: Current research has pointed out an increased risk of mental health problems during the COVID-19 pandemic in women compared to men, however the reason for this difference remains unclear. The aim of this research is to study early psychological responses to the [...] Read more.
Background: Current research has pointed out an increased risk of mental health problems during the COVID-19 pandemic in women compared to men, however the reason for this difference remains unclear. The aim of this research is to study early psychological responses to the pandemic in the Spanish general population, focusing on gender differences. Methods: Nine to 14 days after the declaration of a state of emergency an online survey was conducted assessing sociodemographic, health, behavioral and COVID-19-related variables. Mental health status was evaluated by the Depression, Anxiety and Stress Scale (DASS-21), the Impact of Event Scale-Revised (IES-R), and the Self-Care Scale (SCS). Results: The study included 3520 respondents: 2611 women and 909 men. Women scored significantly higher in DASS-21 and IES-R (p < 0.05) and were more likely to somatize, suffer from hypochondriasis, sleeping disturbances and claustrophobia (p < 0.05). Being a woman can be considered a risk factor for intrusive thoughts, avoidance mechanisms, stress and anxiety (Odd Ratio = 2.7/2.3/2.3/1.6). The risk of presenting posttraumatic symptoms and emotional distress was greater in women (Odd Ratio = 6.77/4.59). General linear models to predict IES-R and DASS-21 scores clarified which variables were gender specific, such as main concerns. Conclusions: This study provides evidence that at early stages of the pandemic, women mental health was more impacted and that both genders show different concerns. Gender perspective in secondary and tertiary prevention strategies must be taken into account when facing the distress associated with the pandemic. Full article
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Article
Neighborhood Environment, Internet Use and Mental Distress among Older Adults: The Case of Shanghai, China
by and
Int. J. Environ. Res. Public Health 2021, 18(7), 3616; https://doi.org/10.3390/ijerph18073616 - 31 Mar 2021
Viewed by 610
Abstract
As the Internet evolves in urban communities, its consequences on mental distress have drawn significant research attention. We examine the relationships of mental distress with neighborhood environment and Internet use among older adults, using data from a representative sample of 2036 adults aged [...] Read more.
As the Internet evolves in urban communities, its consequences on mental distress have drawn significant research attention. We examine the relationships of mental distress with neighborhood environment and Internet use among older adults, using data from a representative sample of 2036 adults aged older than 60 years in Shanghai, China. We assess mental health with a 10-item scale from the Symptom Checklist 90 and Internet use with a 4-item scale and obtain information of neighborhood environment from an online map platform. Results from multilevel models show that both neighborhood environment and Internet use are significantly related to mental distress. Moreover, a worse neighborhood environment may strengthen the correlation between Internet use and mental distress, indicating the strong moderating role of the neighborhood environment. Thus, promoting Internet use among elderly people might result in a reduction in the prevalence of mental distress in disadvantaged neighborhoods. Full article
Article
Stress, Anxiety and Depression among a Cohort of Health Sciences Undergraduate Students: The Prevalence and Risk Factors
Int. J. Environ. Res. Public Health 2021, 18(6), 3269; https://doi.org/10.3390/ijerph18063269 - 22 Mar 2021
Viewed by 1061
Abstract
Stress, anxiety, and depression (SAD) have a negative impact on the learning and academic performance of university students. Hence, this study aimed to determine the prevalence, as well as the risk factors associated with SAD among a cohort of students pursuing undergraduate degree [...] Read more.
Stress, anxiety, and depression (SAD) have a negative impact on the learning and academic performance of university students. Hence, this study aimed to determine the prevalence, as well as the risk factors associated with SAD among a cohort of students pursuing undergraduate degree courses in health sciences. This is part of the strategy in building a healthy nation. A questionnaire containing socio-demographic factors and the short version of Depression, Anxiety, and Stress Scale-21 (DASS-21) was used to assess the likelihood of psychological distress. Logistic regression analysis was conducted to determine the risk factors of SAD. In total, 449 students completed the questionnaire (93.9% response rate). Of these, 65% had stress, 85.1% had anxiety and 51.4% had depression. Most cases of stress (74.6%) and depression (66.2%) were of normal-to-mild level, while 74.6% of them showed moderate-to-extremely severe anxiety. There was a statistically significant association between stress score and the year of study. In the regression analysis, poor sleep quality and fatigue were risk factors of anxiety and depression, whereas low-grade fever and frequent headaches were risk factors for stress and anxiety. Stress, anxiety, and depression scores were significantly higher among students studying medical imaging. A substantial proportion of health science students are suffering from SAD. This study recommends screening and close monitoring of the above-mentioned predictors and the formulation of comprehensive intervention strategies for students with SAD. Full article
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Article
Latent Variables Quantifying Neighborhood Characteristics and Their Associations with Poor Mental Health
Int. J. Environ. Res. Public Health 2021, 18(3), 1202; https://doi.org/10.3390/ijerph18031202 - 29 Jan 2021
Cited by 1 | Viewed by 856
Abstract
Neighborhood characteristics can have profound impacts on resident mental health, but the wide variability in methodologies used across studies makes it difficult to reach a consensus as to the implications of these impacts. The aim of this study was to simplify the assessment [...] Read more.
Neighborhood characteristics can have profound impacts on resident mental health, but the wide variability in methodologies used across studies makes it difficult to reach a consensus as to the implications of these impacts. The aim of this study was to simplify the assessment of neighborhood influence on mental health. We used a factor analysis approach to reduce the multi-dimensional assessment of a neighborhood using census tracts and demographic data available from the American Community Survey (ACS). Multivariate quantitative characterization of the neighborhood was derived by performing a factor analysis on the 2011–2015 ACS data. The utility of the latent variables was examined by determining the association of these factors with poor mental health measures from the 500 Cities Project 2014–2015 data (2017 release). A five-factor model provided the best fit for the data. Each factor represents a complex multi-dimensional construct. However, based on heuristics and for simplicity we refer to them as (1) Affluence, (2) Singletons in Tract, (3) African Americans in Tract, (4) Seniors in Tract, and (5) Hispanics or Latinos in Tract. African Americans in Tract (with loadings showing larger numbers of people who are black, single moms, and unemployed along with fewer people who are white) and Affluence (with loadings showing higher income, education, and home value) were strongly associated with poor mental health (R2=0.67, R2=0.83). These findings demonstrate the utility of this factor model for future research focused on the relationship between neighborhood characteristics and resident mental health. Full article
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Article
Use of Mental Health Services for Patients Diagnosed with Major Depressive Disorders in Primary Care
Int. J. Environ. Res. Public Health 2021, 18(3), 885; https://doi.org/10.3390/ijerph18030885 - 20 Jan 2021
Cited by 1 | Viewed by 949
Abstract
Major depressive disorder (MDD) is one of the most disabling diseases worldwide, generating high use of health services. Previous studies have shown that Mental Health Services (MHS) use is associated with patient and Family Physician (FP) factors. The aim of this study was [...] Read more.
Major depressive disorder (MDD) is one of the most disabling diseases worldwide, generating high use of health services. Previous studies have shown that Mental Health Services (MHS) use is associated with patient and Family Physician (FP) factors. The aim of this study was to investigate MHS use in a naturalistic sample of MDD outpatients and the factors influencing use of services in specialized psychiatric care, to know the natural mental healthcare pathway. Non-randomized clinical trial including newly depressed Primary Care (PC) patients (n = 263) with a 12-month follow-up (from 2013 to 2015). Patient sociodemographic variables were assessed along with clinical variables (mental disorder diagnosis, severity of depression or anxiety, quality of life, disability, beliefs about illness and medication). FP (n = 53) variables were also evaluated. A multilevel logistic regression analysis was performed to assess factors associated with public or private MHS use. Subjects were clustered by FP. Having previously used MHS was associated with the use of MHS. The use of public MHS was associated with worse perception of quality of life. No other sociodemographic, clinical, nor FP variables were associated with the use of MHS. Patient self-perception is a factor that influences the use of services, in addition to having used them before. This is in line with Value-Based Healthcare, which propose to put the focus on the patient, who is the one who must define which health outcomes are relevant to him. Full article

2020

Jump to: 2021

Article
Impact of the Great East Japan Earthquake on the Employment Status and Mental Health Conditions of Affected Coastal Communities
Int. J. Environ. Res. Public Health 2020, 17(21), 8130; https://doi.org/10.3390/ijerph17218130 - 03 Nov 2020
Cited by 1 | Viewed by 1002
Abstract
The Great East Japan Earthquake devasted the old community in coastal areas characterized by primary industry. The number of unemployed people increased from 150,000 to 190,000 after the earthquake. All of the adult residents of Shichigahama (18 years old or older), located in [...] Read more.
The Great East Japan Earthquake devasted the old community in coastal areas characterized by primary industry. The number of unemployed people increased from 150,000 to 190,000 after the earthquake. All of the adult residents of Shichigahama (18 years old or older), located in the coastal area of the Miyagi prefecture, whose houses were totally or majorly damaged, were recruited for a survey conducted in October 2011. All of the residents who responded with written informed consent were included in this study. Among 904 individuals who had a job before the Great East Japan Earthquake, 19% became unemployed. Concerning gender and age, 9% of young men, 34% of elderly men, 21% of young women, and 49% of elderly women became unemployed. Concerning the type of industry, 38%, 15%, and 16% of people who had belonged to the primary, secondary, and tertiary industries, respectively, before the disaster became unemployed. Those who became unemployed exhibited a significantly higher risk of insomnia compared to those who maintained jobs. The study pointed out the severe impact of the Great East Japan Earthquake on populations who had belonged to the primary industry, especially among elderly women, and its effect on sleep conditions. Full article
Article
Mental Health, Quality of Life and Violence Exposure in Low-Socioeconomic Status Children and Adolescents of Guatemala
Int. J. Environ. Res. Public Health 2020, 17(20), 7620; https://doi.org/10.3390/ijerph17207620 - 19 Oct 2020
Cited by 4 | Viewed by 1185
Abstract
Growing up in vulnerable conditions has an impact on children and adolescents’ mental health and well-being outcomes. However, this evidence has rarely been obtained in middle and low-income countries like Guatemala, where food insecurity and exposure to violence frequently threaten childhood development. The [...] Read more.
Growing up in vulnerable conditions has an impact on children and adolescents’ mental health and well-being outcomes. However, this evidence has rarely been obtained in middle and low-income countries like Guatemala, where food insecurity and exposure to violence frequently threaten childhood development. The aim of this study was to analyse the relations that sociodemographic and socioeconomic factors have with psychological adjustment of low-socioeconomic status (SES) Guatemalan children and adolescents, and how these relations were mediated by food insecurity and exposure to violence. A total of 185 participants (50.8% girls; aged between 6 to 17, M = 11.82, SD = 3.7) from three vulnerable schools located in rural and urban areas of Guatemala were assessed. The results indicated that exposure to violence significantly moderates the effect of sociodemographic and socioeconomic variables in measures of depression, anxiety and health-related quality of life. Adolescents more exposed to violence reported higher levels of depression and anxiety, as well as lower levels of health-related quality of life. In contrast, food insecurity did not seem to influence psychological adjustment outcomes in this low-SES sample. These findings highlight the relevance of exposure to violence for mental health and well-being, and is a factor that should be considered when designing public health policies to promote children and adolescents’ welfare. Full article
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Article
Are There Heterogeneous Impacts of National Income on Mental Health?
Int. J. Environ. Res. Public Health 2020, 17(20), 7530; https://doi.org/10.3390/ijerph17207530 - 16 Oct 2020
Cited by 2 | Viewed by 576
Abstract
Understanding heterogeneous impact and mechanisms between national income and mental health are crucial to develop prevention and intervention strategies. Based on panel data from 2007 to 2017, this study explores the heterogeneous impact of national income on different types of mental health. Then, [...] Read more.
Understanding heterogeneous impact and mechanisms between national income and mental health are crucial to develop prevention and intervention strategies. Based on panel data from 2007 to 2017, this study explores the heterogeneous impact of national income on different types of mental health. Then, it analyzes the heterogeneous impact among countries with different income levels. Furthermore, the heterogeneous moderating effects of national income on mental health mechanisms are elaborated and the findings reveal several key conclusions: firstly, national income exerts a heterogeneous impact on different types of mental health. Rising national income is conducive to increase people’s happiness and reduce their prevalence of anxiety disorders, but it increases the prevalence of depression disorders. Secondly, national income has a heterogeneous impact on different types of mental health among countries with different income levels. Furthermore, the heterogeneous influence mechanism of national income on mental health is mainly reflected in different types of mental health. Unemployment, social support and freedom can moderate the relationship between national income and depression, while social support, positive affect and negative affect can moderate the relationship between national income and anxiety. Finally, based on the conclusions of quantitative analysis, some important policy recommendations are proposed for policy makers. Full article
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Review
Work-Related Psychosocial Stress in Small and Medium-Sized Enterprises: An Integrative Review
Int. J. Environ. Res. Public Health 2020, 17(20), 7446; https://doi.org/10.3390/ijerph17207446 - 13 Oct 2020
Cited by 6 | Viewed by 1055
Abstract
Background: Work-related psychosocial stress can cause mental and physical illnesses resulting in high costs for the individual, the economy and society. Small and medium-sized enterprises (SMEs) employ the majority of the world’s workforce and often have fewer financial and human resources compared [...] Read more.
Background: Work-related psychosocial stress can cause mental and physical illnesses resulting in high costs for the individual, the economy and society. Small and medium-sized enterprises (SMEs) employ the majority of the world’s workforce and often have fewer financial and human resources compared to larger businesses. The aim of this review is to summarize current knowledge on work-related stress in SMEs according to well-established guidelines categorizing psychosocial factors at work. Methods: A systematic database search was carried out in PubMed, PsycINFO, PSYNDEX and Business Source Premiere from March to June 2019, updated in January 2020. Data of included studies were analyzed and mapped into five themes: “work content and task”, “organization of work”, “social relations”, “working environment” and “new forms of work”. Results: After full-text screening, 45 out of 116 studies were included for data extraction. Studies were very heterogeneous and of varying quality, mostly applying a cross-sectional study design. Psychosocial factors in SMEs have been researched with a focus on the work patterns “work organization” and “work content and task”. Conclusions: This review underlines the need for more and better quality research of psychosocial factors in SMEs, particularly in relation to ongoing and new challenges in the workplace, including stressors related to the process of digitalization or the development of safe working conditions during the emerge of new infectious diseases. Full article
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Article
What Is Rural Adversity, How Does It Affect Wellbeing and What Are the Implications for Action?
Int. J. Environ. Res. Public Health 2020, 17(19), 7205; https://doi.org/10.3390/ijerph17197205 - 01 Oct 2020
Cited by 5 | Viewed by 2566
Abstract
A growing body of literature recognises the profound impact of adversity on mental health outcomes for people living in rural and remote areas. With the cumulative effects of persistent drought, record-breaking bushfires, limited access to quality health services, the COVID-19 pandemic and ongoing [...] Read more.
A growing body of literature recognises the profound impact of adversity on mental health outcomes for people living in rural and remote areas. With the cumulative effects of persistent drought, record-breaking bushfires, limited access to quality health services, the COVID-19 pandemic and ongoing economic and social challenges, there is much to understand about the impact of adversity on mental health and wellbeing in rural populations. In this conceptual paper, we aim to review and adapt our existing understanding of rural adversity. We undertook a wide-ranging review of the literature, sought insights from multiple disciplines and critically developed our findings with an expert disciplinary group from across Australia. We propose that rural adversity be understood using a rural ecosystem lens to develop greater clarity around the dimensions and experiences of adversity, and to help identify the opportunities for interventions. We put forward a dynamic conceptual model of the impact of rural adversity on mental health and wellbeing, and close with a discussion of the implications for policy and practice. Whilst this paper has been written from an Australian perspective, it has implications for rural communities internationally. Full article
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Article
Work-Related Psychosocial Demands and Resources in General Practice Teams in Germany. A Team-Based Ethnography
Int. J. Environ. Res. Public Health 2020, 17(19), 7114; https://doi.org/10.3390/ijerph17197114 - 28 Sep 2020
Cited by 2 | Viewed by 835
Abstract
General practices are established microenterprises in Germany providing a variety of preventive and therapeutic health care services and procedures in a challenging working environment. For example, general practice teams are confronted increasingly with work-related demands, which have been associated with poor psychological and [...] Read more.
General practices are established microenterprises in Germany providing a variety of preventive and therapeutic health care services and procedures in a challenging working environment. For example, general practice teams are confronted increasingly with work-related demands, which have been associated with poor psychological and physical outcomes. It is therefore important to gain a better understanding of issues related to occupational health and safety for personnel working in the primary care setting. This study aims to gain an in-depth understanding of psychosocial demands and resources in the primary care setting. We applied an ethnographic design, comprising a combination of participating observations, individual interviews with general practitioners (GPs) (N = 6), and focus group discussion with practice assistants and administrative staff (N = 19) in five general practices in Germany. A grounded theory approach was applied to analyze all data. Our results identified psychosocial demands and resources exemplified mainly along two typical tasks in GP practices: the issuing of medical prescriptions and blood sampling. Main psychosocial demands included factors related to work content and tasks, organization of work, and the working environment. For example, daily routines across all practices were characterized by a very high work intensity including disturbances, interruptions, delegation, and the division of labor between GPs and practice staff. Work-related resources comprised the staff’s influence on aspects related to work organization and social support. The triangulation of methods and data formats allowed the disclosure of interconnectedness between these factors. Although work processes in general practices are complex and required to comply with legal regulations, there are opportunities for practice owners and practice teams to establish working procedures in ways that reduce psychosocial risks and strengthen work-related resources. Full article
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Article
Lifetime and Twelve-Month Prevalence, Persistence, and Unmet Treatment Needs of Mood, Anxiety, and Substance Use Disorders in African American and U.S. versus Foreign-Born Caribbean Women
Int. J. Environ. Res. Public Health 2020, 17(19), 7007; https://doi.org/10.3390/ijerph17197007 - 25 Sep 2020
Cited by 2 | Viewed by 953
Abstract
There is growing diversity within the Black population in the U.S., but limited understanding of ethnic and nativity differences in the mental health treatment needs of Black women. This study examined differences in the prevalence of psychiatric disorders, their persistence, and unmet treatment [...] Read more.
There is growing diversity within the Black population in the U.S., but limited understanding of ethnic and nativity differences in the mental health treatment needs of Black women. This study examined differences in the prevalence of psychiatric disorders, their persistence, and unmet treatment needs among Black women in the U.S. Data were from the National Survey of American Life, a nationally representative survey that assessed lifetime and twelve-month mood, anxiety, and substance use disorders according to the Diagnostic and Statistical Manual of Mental Disorders 4th Edition (DSM-IV) criteria, and mental health service use among those meeting disorder criteria. One in three African American women met criteria for a lifetime disorder, compared to one in three Caribbean women born within the U.S. and one in five Caribbean women born outside the U.S. About half of African American women with a lifetime disorder had a persistent psychiatric disorder, compared to two in five Caribbean women born within the U.S. and two in three Caribbean women born outside the U.S. African Americans had more persisting dysthymia and panic disorder and less persisting social phobia compared to foreign-born Caribbean women. Of the three groups, Caribbean women born within the U.S. were most likely to seek mental health treatment during their lifetime. These results demonstrate, despite a lower prevalence of psychiatric disorders in Black women, that there is a great likelihood their disorders will be marked by persistence and underscores the need for culturally specific treatment approaches. As Black immigrants in the United States are increasing in number, adequate mental health services are needed. Full article
Article
The Prevalence of Depression, Anxiety and Stress and Their Associated Factors in College Students
Int. J. Environ. Res. Public Health 2020, 17(19), 7001; https://doi.org/10.3390/ijerph17197001 - 24 Sep 2020
Cited by 12 | Viewed by 3555
Abstract
Aim: To estimate the prevalence of symptoms of depression, anxiety, stress and associated factors in a population of college students. Method: Cross-sectional study of psychological distress measured through the Depression, Anxiety and Stress Scale (DASS-21) in a sample of 1074 college students. Results: [...] Read more.
Aim: To estimate the prevalence of symptoms of depression, anxiety, stress and associated factors in a population of college students. Method: Cross-sectional study of psychological distress measured through the Depression, Anxiety and Stress Scale (DASS-21) in a sample of 1074 college students. Results: We found a moderate prevalence of depression (18.4%), anxiety (23.6%) and stress (34.5%) symptoms in our study population. Being <21, having problematic Internet use behavior, smoking, presenting insomnia and having a low self-esteem were independently associated with symptoms of depression, anxiety and stress. Being a woman, living with their family, having a stable partner, consuming alcohol frequently and having poor nutritional habits were significantly associated with symptoms of stress; lacking a stable partner was significantly associated with depressive symptoms; and frequent consumption of alcohol was significantly associated with symptoms of anxiety. Conclusion: We found a moderate prevalence of depression, anxiety and stress symptoms in our population. Interventions aimed at promoting mental health among college students should be implemented. Full article
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Article
Elucidating Mental Health Disorders among Rohingya Refugees: A Malaysian Perspective
Int. J. Environ. Res. Public Health 2020, 17(18), 6730; https://doi.org/10.3390/ijerph17186730 - 15 Sep 2020
Cited by 3 | Viewed by 1053
Abstract
Mental health disorders (MHDs) among refugees has been recognized as a major public health issue. However, to date, there is limited evidence on the prevalence of MHDs among Rohingya refugees in Malaysia. This study aimed to examine the prevalence and associated factors of [...] Read more.
Mental health disorders (MHDs) among refugees has been recognized as a major public health issue. However, to date, there is limited evidence on the prevalence of MHDs among Rohingya refugees in Malaysia. This study aimed to examine the prevalence and associated factors of major depressive disorder (MDD), generalized anxiety disorder (GAD), and post-traumatic stress disorder (PTSD) among Rohingya refugees in Malaysia. A total of 220 refugees were randomly selected to participate in this cross-sectional study, conducted from June 2019 to November 2019. Perceived social support, religious orientation, food security, and sociodemographic characteristics were assessed as independent variables. The dependent variables assessed were MDD, GAD, and PTSD. The prevalence of GAD, PTSD, and MDD was reported at 92 (41.8%), 84 (38.2%), and 71 (32.3%). Several factors were significantly associated with MDD following multivariate analysis such as perceived low to moderate social support (AOR = 2.17; 95% CI 1.13, 4.19) and food insecurity (AOR = 2.77; 95% CI 1.19, 6.47). Exposure to violence (AOR = 38.46; 95% CI 16.27, 90.91) and food insecurity (AOR = 3.74; 95% CI 1.41, 9.91) were significantly associated with PTSD. Addressing these risk factors could be key in improving mental health outcomes among this vulnerable population. Full article
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Article
Hedonic and Utilitarian Performances as Determinants of Mental Health and Pro-Social Behaviors among Volunteer Tourists
Int. J. Environ. Res. Public Health 2020, 17(18), 6594; https://doi.org/10.3390/ijerph17186594 - 10 Sep 2020
Cited by 1 | Viewed by 772
Abstract
International volunteer tourism is an emerging and sustainable trend of the global tourism industry. In this study, we attempted to provide a clear comprehension of volunteer tourists’ mental health increase and pro-social intention formation. A survey method and quantitative approach were used. Our [...] Read more.
International volunteer tourism is an emerging and sustainable trend of the global tourism industry. In this study, we attempted to provide a clear comprehension of volunteer tourists’ mental health increase and pro-social intention formation. A survey method and quantitative approach were used. Our result from the structural analysis showed that hedonic and utilitarian performances, mental health, and volunteer tourism engagement had significant associations and that these relationships contributed to improving pro-social intention. In addition, results from the metric invariance assessment revealed that the volunteer tourism engagement and pro-social intention relation was under the significant influence of problem awareness and ascribed responsibility. Mental health and engagement acted as significant mediators. The comparative importance of volunteer tourism engagement was uncovered. Overall, our results provided a sufficient understanding of volunteer tourists’ pro-social decision-making process and behaviors. Full article
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Article
Does Believing in Fate Facilitate Active or Avoidant Coping? The Effects of Fate Control on Coping Strategies and Mental Well-Being
Int. J. Environ. Res. Public Health 2020, 17(17), 6383; https://doi.org/10.3390/ijerph17176383 - 02 Sep 2020
Cited by 3 | Viewed by 955
Abstract
The development of control-related constructs has involved different approaches over time, and yet internal and external locus of control are conceptualized as dichotomous factors influencing active versus avoidant coping strategies. While external control is associated with avoidance, a similar belief construct fate control, [...] Read more.
The development of control-related constructs has involved different approaches over time, and yet internal and external locus of control are conceptualized as dichotomous factors influencing active versus avoidant coping strategies. While external control is associated with avoidance, a similar belief construct fate control, which denotes that life events are pre-determined and influenced by external forces but predictable and alterable, challenges the assumption of incompatibility between fate and agency. To develop a dynamic model of control, we suggest that external control would affect avoidant coping, which in turn would affect psychological distress, whereas fate control would affect both active and avoidant coping when dealing with stress. The model was supported among Hong Kong Chinese using a cross-sectional approach in Study 1 (n = 251) and hypothetical stressful scenarios in Study 2 (n = 294). The moderating effect of perceived controllability was observed in coping behaviors using a diary approach in Study 3 (n = 188). Our findings offer an alternative perspective to the dichotomous view of control and provide implications for coping strategies and mental well-being. Full article
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Article
Living Conditions of Adolescents Who Have Attempted Suicide in Mexico
Int. J. Environ. Res. Public Health 2020, 17(16), 5990; https://doi.org/10.3390/ijerph17165990 - 18 Aug 2020
Cited by 1 | Viewed by 752
Abstract
Suicidal behavior represents a complex public health problem, with a rising number of suicide attempts registered among Mexican adolescents. We undertook a qualitative study in order to understand the living conditions of adolescents who had attempted to take their lives in five Mexican [...] Read more.
Suicidal behavior represents a complex public health problem, with a rising number of suicide attempts registered among Mexican adolescents. We undertook a qualitative study in order to understand the living conditions of adolescents who had attempted to take their lives in five Mexican states. We interviewed 37 adolescents who had engaged in suicide attempts in the year prior to our study. To code and analyze the information, we defined the following three categories of living conditions as social determinants of health for adolescents: poverty and vulnerability, education, and health care. To this end, we followed the methodology proposed by Taylor and Bogdan, and used Atlas.ti 7.5.18 software for analyses. Among our findings, we noted that poverty, manifested primarily as material deprivation, rendered the daily lives of our interviewees precarious, compromising even their basic needs. All the young people analyzed had either received medical, psychological, and/or psychiatric care as outpatients or had been hospitalized. School played a positive role in referring adolescents with suicidal behavior to health services; however, it also represented a high-risk environment. Our findings highlight the urgent need to implement a national intersectoral strategy as part of comprehensive public policy aimed at improving the health of adolescents in Mexico. Full article
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Article
Demographic, Social, and Economic Factors of Internalizing Problems in Referred and Non-Referred Adolescents
Int. J. Environ. Res. Public Health 2020, 17(14), 5195; https://doi.org/10.3390/ijerph17145195 - 18 Jul 2020
Cited by 1 | Viewed by 837
Abstract
Depressive symptoms and suicidal ideation are common internalizing problems during adolescence. Numerous studies have explored the role of certain demographic, social, and economic factors in their development in referred or non-referred adolescents, but not simultaneously in both groups. In this study, we examined [...] Read more.
Depressive symptoms and suicidal ideation are common internalizing problems during adolescence. Numerous studies have explored the role of certain demographic, social, and economic factors in their development in referred or non-referred adolescents, but not simultaneously in both groups. In this study, we examined the association between age, gender, parents’ educational level, and socioeconomic status (SES) and depressive symptoms and suicidal ideation in a referred group (n = 211) and a non-referred (n = 1401) group of adolescents. We also examined the moderating role that these factors play in the relationships between both internalizing problems. The results showed: higher levels of depressive symptoms and suicidal ideation in the referred group; an increase in both problems during early-to-middle adolescence in the non-referred group; an association between low SES and suicidal ideation in both groups; an association between low father’s education level and depressive symptoms in the non-referred group; and no gender differences in either of these two internalizing problems. The moderation analyses showed that age, in referred adolescents, and SES, in non-referred adolescents, moderated the relationship between depressive symptoms and suicidal ideation. This study contributes to the identification of groups of vulnerable adolescents that could constitute the target populations of preventive programs. Full article
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Article
Individual Health Budgets in Mental Health: Results of Its Implementation in the Friuli Venezia Giulia Region, Italy
Int. J. Environ. Res. Public Health 2020, 17(14), 5017; https://doi.org/10.3390/ijerph17145017 - 13 Jul 2020
Cited by 4 | Viewed by 724
Abstract
Background: Individual Health Budget (IHB) is an intervention for recovery in mental health services, providing personalized care for subjects with severe disorders and complex needs. Little is known on its effectiveness and on the criteria for its delivery. Methods: A total of 67 [...] Read more.
Background: Individual Health Budget (IHB) is an intervention for recovery in mental health services, providing personalized care for subjects with severe disorders and complex needs. Little is known on its effectiveness and on the criteria for its delivery. Methods: A total of 67 IHB beneficiaries and 61 comparators were recruited among service users of the Mental Health Department of the Trieste Healthcare Agency, Italy. Data included sociodemographic and clinical variables, type of IHB, and Health of the Nation Outcome Scale (HoNOS) scores. Results: A comparison between groups showed significant differences in several socioeconomic and clinical characteristics. Multivariate logistic regression showed that IHB was positively associated to the 20–49 age group, single status, unemployment, low family support, cohabitation with relatives or friends, diagnosis of personality disorder, and a higher number of hospitalizations. The IHB group was at a higher risk of severe problems related to aggressive or agitated behaviors (OR = 1.4), hallucinations and delusions (OR = 1.5), and impairment in everyday life activities (OR = 2.1). Conclusions: IHB was used in patients with severe clinical and social problems. More resources, however, may be aimed at the working and social axes. More research is needed to better assess clinical and social outcomes of IHB and to adjust their intensity in a longitudinal perspective in order to enhance cost-effectiveness. Full article
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Article
Finding the Hidden Risk Profiles of the United States Opioid Epidemic: Using a Person-Centered Approach on a National Dataset of Noninstitutionalized Adults Reporting Opioid Misuse
Int. J. Environ. Res. Public Health 2020, 17(12), 4321; https://doi.org/10.3390/ijerph17124321 - 17 Jun 2020
Cited by 2 | Viewed by 1081
Abstract
Opioid misuse can lead to use disorder and other adverse outcomes. Identifying sociodemographic risk profiles and understanding misuse patterns in combination with health indicators can inform prevention science and clinical practice. A latent class analysis of opioid misuse was conducted on noninstitutionalized United [...] Read more.
Opioid misuse can lead to use disorder and other adverse outcomes. Identifying sociodemographic risk profiles and understanding misuse patterns in combination with health indicators can inform prevention science and clinical practice. A latent class analysis of opioid misuse was conducted on noninstitutionalized United States civilians aged 18 and older that reported opioid dependence or abuse in the 2017 National Survey of Drug Use and Health (n = 476; weighted n = 2,018,922). Opioid misuse was based on heroin and/or prescription pain reliever use, and associated determinants of health and mental health indicators. Five misuse profiles were identified: (1) single heroin or prescription misuse with high-income; (2) female prescription pain reliever misuse with psychological distress and suicidality; (3) younger polyopioid misuse with the highest proportion of Hispanics and heroin use; (4) older polyopioid misuse with the highest proportion of non-Hispanic blacks and disability; and (5) older non-Hispanic white male exclusive dual heroin and/or prescription misuse (27%, 20%, 38%, 10%, and 5% of sample, respectively). The identified risk profiles can inform public health practice to develop interventions for acute and immediate response by providing etiological evidence and to inform prevention and intervention efforts along the continuum from opioid initiation to use disorder. Full article
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Review
Determinants of Suicidality in the European General Population: A Systematic Review and Meta-Analysis
Int. J. Environ. Res. Public Health 2020, 17(11), 4115; https://doi.org/10.3390/ijerph17114115 - 09 Jun 2020
Cited by 9 | Viewed by 1618
Abstract
Close to one million people commit suicide each year, with suicidal attempts being the main risk factor for suicide. The aim of this systematic review and meta-analysis is to achieve a greater understanding of suicidality in the general population of Europe by studying [...] Read more.
Close to one million people commit suicide each year, with suicidal attempts being the main risk factor for suicide. The aim of this systematic review and meta-analysis is to achieve a greater understanding of suicidality in the general population of Europe by studying associated factors and their statistical significance with suicidality, as well as the effect of the temporal moment in which suicidality is observed in a relationship. A search strategy was carried out in electronic databases: Proquest’s Psychology Database, Scopus, PsycINFO, Medline and Embase. Odds ratios (ORs), publication bias, influential studies on heterogeneity and analysis moderators were calculated. Twenty-six studies were included after meeting the inclusion criteria. Factors statistically associated with suicidality are female gender, age over 65 years, unemployment, low social support, adulthood adversity, childhood adversity, family history of mental disorder, any affective disorder, major depression, anxiety/stress/somatoform disorders, tobacco and substance use, any mental disorder and body mass index. As a limitation, a high heterogeneity between studies was found. Factors associated with suicidality in the general population are relevant for understanding the suicidal phenomenon. Full article
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Article
Social Capital as a Mediator through the Effect of Education on Depression and Obesity among the Elderly in China
Int. J. Environ. Res. Public Health 2020, 17(11), 3977; https://doi.org/10.3390/ijerph17113977 - 04 Jun 2020
Cited by 6 | Viewed by 1098
Abstract
Objectives: Global aging is an increasingly serious problem. The health problems faced by the elderly, such as depression and obesity, require serious consideration. Education, depression and obesity are inextricably linked; for the elderly, education is constant, and the factors which can mediate the [...] Read more.
Objectives: Global aging is an increasingly serious problem. The health problems faced by the elderly, such as depression and obesity, require serious consideration. Education, depression and obesity are inextricably linked; for the elderly, education is constant, and the factors which can mediate the relationship between education, depression and obesity are still being discussed by scholars. The mediating effect of social capital is rarely studied. The objective of this study was to assess the mediating role of cognitive social capital and structural social capital, as well as the effect of education on depression and obesity among the elderly using China Family Panel Studies (CFPS) data. Methods: In total, 4919 respondents were included in the final analysis. Education was measured by years of schooling. Trust and participation were used as measures of cognitive social capital and structural social capital. Depression symptoms and BMI were used as outcomes. Structural equation models were developed to examine the direct and indirect effect of social capital and education on health outcomes. Results: Education was negatively correlated with depression symptom (r = −0.15, p < 0.001), while education was positively correlated with BMI (r = 0.08, p < 0.001). Older adults with a higher education level have higher cognitive social capital (r = 0.11, p < 0.001) and structural social capital (r = 0.20, p < 0.001). Social capital plays a mediatory role. Older adults with higher social capital have a lower risk of depression (cognitive: r = −0.23, p < 0.001; structural: r = −0.03, p < 0.01) but a higher risk of obesity (cognitive: r = 0.06, p < 0.01; structural: r = 0.03, p < 0.01). For depression, the mediating function of cognitive social capital (a1b1= −0.025) is stronger than that of structural social capital (a2b2 = −0.006). While, for obesity, the effects of both cognitive and structural social capital are the same (a1c1 = a2c2 = 0.005). Conclusions: Social capital as a mediator through the effect of education on depression and obesity among the elderly in China. Meanwhile, using the positive effects of social capital to avoid negative effects should also be seriously considered. Full article
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Article
Assessing the Mental Health of Brazilian Students Involved in Risky Behaviors
Int. J. Environ. Res. Public Health 2020, 17(10), 3647; https://doi.org/10.3390/ijerph17103647 - 22 May 2020
Cited by 13 | Viewed by 1290
Abstract
Adolescence, which is the transition from childhood to adulthood, is marked by emotional sensitivity and inconsistency and may be affected by mental health problems. In order to fill the gap related to the risky behaviors in students in Brazil, our cross-sectional study aimed [...] Read more.
Adolescence, which is the transition from childhood to adulthood, is marked by emotional sensitivity and inconsistency and may be affected by mental health problems. In order to fill the gap related to the risky behaviors in students in Brazil, our cross-sectional study aimed to analyze the relationship between risky behaviors and indicators of mental health of Brazilian students. We used the data from the National School Health Survey to analyze the relationship between risk behaviors and three symptoms of mental health issues: feeling of being alone, number of close friends, and trouble sleeping due to worries. The sample consisted of 102,072 students in Brazil (48.3% boys and 51.7% girls), aged between 11 to 19 years. The risk behaviors evaluated were substance use, sedentary lifestyle, sexual behavior, and suffering violence and bullying. We have performed a multivariate analysis based on the Poisson regression model, and the measure of effect used was the prevalence ratio (PR) with confidence intervals (CI) of 95%. Our results showed that students with symptoms of mental health issues were involved in risky behaviors, including drug use and unsafe sex. Thus, mental illness outcomes may be associated with risky behaviors, or mental health may be impaired by them. Given these findings, in-school programs focused on improving mental health outcomes should be developed. Full article
Article
Development and Preliminary Validation of the Couples’ Stigma Scale to Assess Self-Stigma among the Partners of Persons with Autism Spectrum Disorder in Japan
Int. J. Environ. Res. Public Health 2020, 17(10), 3533; https://doi.org/10.3390/ijerph17103533 - 18 May 2020
Cited by 2 | Viewed by 1016
Abstract
Spouses of individuals with autism spectrum disorder (ASD) may struggle with self-stigma and may require attention and care; however, no scale exists to measure the stigma of spouses of persons with ASD. This study created and investigated the construct validity of the Couples [...] Read more.
Spouses of individuals with autism spectrum disorder (ASD) may struggle with self-stigma and may require attention and care; however, no scale exists to measure the stigma of spouses of persons with ASD. This study created and investigated the construct validity of the Couples Stigma Scale. This scale consists of 14 items and it was designed based on prior literature, interviews, and the self-stigma theory to assess the self-stigma experienced by spouses of people with ASD. A survey was conducted with spouses of persons with ASD who participated in a self-help group. Responses were obtained from 259 people, of which 253 women were included in the analysis. Exploratory factor analysis was performed separately with two independent groups, indicating a four-factor structure, to determine structural validity. The factor loadings of the items constituting the four factors were 0.39 or greater. Regarding external validity, the correlation coefficient between the Couples Stigma Scale and the World Health Organization Quality of Life (WHOQOL) score was −0.341 (p < 0.001), and the domain correlation coefficient was significant for all relevant WHOQOL domains. Our results suggest that the Japanese version of the Couples Stigma Scale is a valid instrument for assessing self-stigma in the spouses of persons with ASD. Full article
Article
Does the Conversion of Household Registration Actually Improve the Happiness of Migrant Workers in China?
Int. J. Environ. Res. Public Health 2020, 17(8), 2661; https://doi.org/10.3390/ijerph17082661 - 13 Apr 2020
Cited by 1 | Viewed by 848
Abstract
Migrant workers are an important human resource for economic and social development. Considering the government’s goal of serving and improving people’s livelihoods, improving the happiness of migrant workers is necessary. This study investigates in-depth the impact of the conversion of household registration on [...] Read more.
Migrant workers are an important human resource for economic and social development. Considering the government’s goal of serving and improving people’s livelihoods, improving the happiness of migrant workers is necessary. This study investigates in-depth the impact of the conversion of household registration on migrant workers’ happiness, which is represented by a multi-dimensional comprehensive index based on the propensity matching score model and data from the China Migrants Dynamic Survey (CMDS) in 2017. Moreover, this study explores the different effects of conversion among the groups divided by the characteristics of migrant workers. The results show that from an overall perspective, although the conversion of household registration could improve the happiness of migrant workers, the degree of this improvement is minor. Further, the characteristics of the different groups, including age, educational background, contracted land, collective dividends, and income significantly affect the improvement of happiness. The conversion of household registration has obviously improved the happiness of migrant workers with low educational backgrounds, low income, and contracted land. Based on these findings, the government should take more targeted actions to improve the positive effects of household registration among different migrant worker groups due to the different characteristics in the process of household registration system reform. Full article
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Article
Effects of Psychotic Symptoms and Social Cognition on Job Retention in Patients with Schizophrenia in Korea
Int. J. Environ. Res. Public Health 2020, 17(8), 2628; https://doi.org/10.3390/ijerph17082628 - 11 Apr 2020
Cited by 1 | Viewed by 921
Abstract
This research examined the relationship between psychotic symptoms, social cognition, and job retention among people with schizophrenia in Korea. Participants (158 people with schizophrenia from 15 mental health institutions) were divided into two groups: those with a job retention period of less than [...] Read more.
This research examined the relationship between psychotic symptoms, social cognition, and job retention among people with schizophrenia in Korea. Participants (158 people with schizophrenia from 15 mental health institutions) were divided into two groups: those with a job retention period of less than six months (n = 75), and those with a job retention period of six months or more (n = 83). Participants completed a survey packet containing the Brief Psychiatric Rating Scale (BPRS), Global Assessment of Function (GAF) Scale, Interpersonal Relationship Functioning Assessment Scale, Basic Empathy Scale, Hinting Task, and Ambiguous Intention Hostility Questionnaire (AIHQ), and provided their job retention status. We used binomial logistic regression analysis to examine whether job retention was affected by participants’ demographic, clinical, and vocational characteristics, as well as the three components of social cognition, i.e., theory of mind, empathy, and attribution style. Results showed that theory of mind (ToM), attribution style, and psychotic symptoms explained 52.7% of the variance in job retention. A higher theory of mind means a higher ability to grasp the intentions of others. The higher theory of mind, the lesser attribution style, and the lesser psychotic symptoms were related to a longer period of job retention. Full article
Article
Associations among Employment Status, Health Behaviors, and Mental Health in a Representative Sample of South Koreans
Int. J. Environ. Res. Public Health 2020, 17(7), 2456; https://doi.org/10.3390/ijerph17072456 - 03 Apr 2020
Cited by 5 | Viewed by 1084
Abstract
The purpose of the present study was to compare the health behaviors, general health, and mental health of South Korean employees according to their employment status, and to examine how these associations vary across genders using the latest Korean National Examination Health and [...] Read more.
The purpose of the present study was to compare the health behaviors, general health, and mental health of South Korean employees according to their employment status, and to examine how these associations vary across genders using the latest Korean National Examination Health and Nutrition Survey data. Logistic regression analyses were performed using employment status—permanent job, temporary job, and unemployed—as predictor variables and health-related variables as the outcome variables. Results indicated that temporary workers and the unemployed have higher odds of poor mental health regardless of gender. On the other hand, only male permanent workers were found to have a higher risk of problematic drinking compared to precarious workers and the unemployed. Meanwhile, only women showed a higher risk of current smoking in the temporary job and unemployed groups compared with permanent employees. Regarding general health, women, not men, in the temporary job group reported poorer general health (i.e., low health-related quality of life and higher self-perceived poor health) than those in other groups. These findings suggest that the development and implementation of intervention services, as well as organizational actions, need to consider differential impacts of unfavorable employment status on health issues according to gender. Full article
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Article
New Evidences about Subjective Well-Being in Adolescence and Its Links with Neurocognitive Performance
Int. J. Environ. Res. Public Health 2020, 17(6), 1866; https://doi.org/10.3390/ijerph17061866 - 13 Mar 2020
Cited by 5 | Viewed by 1116
Abstract
The main purpose of the present work was to study the neurocognitive endophenotypes of adolescents at risk for low personal wellbeing. The sample included a total of 1588 adolescents from stratified random cluster sampling; derived from this sample, a group of high-risk ( [...] Read more.
The main purpose of the present work was to study the neurocognitive endophenotypes of adolescents at risk for low personal wellbeing. The sample included a total of 1588 adolescents from stratified random cluster sampling; derived from this sample, a group of high-risk (n = 84) and a control group (n = 84) were selected. The personal well-being index–school children (PWI–SC), the University of Pennsylvania computerized neuropsychological test battery for children (included 14 tasks assessing five neurobehavioral domains: executive functions, episodic memory, complex cognition, social cognition and sensorimotor speed), and the strengths and difficulties questionnaire (SDQ) were used. Adolescents with low personal wellbeing showed statistically significant impairments across the different neurocognitive domains. In particular, adolescents at risk showed lower accuracy scores on executive function and complex cognition and lower speed scores on episodic memory, complex cognition and social cognition scores. The results of the present study contribute relevant information about the nature of neurocognitive impairments associated with subjective wellbeing and allow implementing preventive treatments. Full article
Article
Community Integration of Persons with Mental Disorders Compared with the General Population
Int. J. Environ. Res. Public Health 2020, 17(5), 1596; https://doi.org/10.3390/ijerph17051596 - 02 Mar 2020
Cited by 3 | Viewed by 835
Abstract
Aims: Community integration is the catalyst for recovery that is provided by mental health services to persons with mental disorders. This study explores the impact of socio-demographic variables on the level of community integration in persons with mental disorders compared to the [...] Read more.
Aims: Community integration is the catalyst for recovery that is provided by mental health services to persons with mental disorders. This study explores the impact of socio-demographic variables on the level of community integration in persons with mental disorders compared to the general population living in the same communities and the difference in community integration level between the two groups. Methods: A total of 224 persons with mental disorders (M age = 45.0, SD = 12.84, male 51.8%, female 48.2%) in communities and 247 individuals (M age = 44.6, SD = 11.41, male 50.6%, female 49.4%) of the general population in the same communities participated in the evaluation of levels of physical, psychological, and social integration. The effects of socio-demographic variables on the three types of community integration on both groups were evaluated using multiple regression analyses. Differences in the three types of community integration between the two groups were tested using multivariate analysis of covariance (MANCOVA) by controlling for socio-demographic variables as covariates. Results: The effects of socio-demographic variables on the three types of community integration differed between the two groups. In addition, the two groups differed significantly in terms of social rather than physical or psychological integration when the level of community integration was compared while controlling socio-demographic variables. The results also show that persons with mental disorders had smaller social networks and fewer social contacts than the general population. Conclusions: Based on the findings, we recommended that service providers provide incentives for consumers to strengthen social relationships and social skills training in order to maintain relationships. Full article
Article
Religiosity and Mental Health: A Contribution to Understanding the Heterogeneity of Research Findings
Int. J. Environ. Res. Public Health 2020, 17(2), 494; https://doi.org/10.3390/ijerph17020494 - 13 Jan 2020
Cited by 6 | Viewed by 1224
Abstract
Most studies report positive associations between religiosity and spirituality and aspects of mental health, while a small proportion report mixed or fully negative associations. The aim of this study was to assess the associations of religiosity measured more specifically, with mental health in [...] Read more.
Most studies report positive associations between religiosity and spirituality and aspects of mental health, while a small proportion report mixed or fully negative associations. The aim of this study was to assess the associations of religiosity measured more specifically, with mental health in a secular environment, using a nationally representative sample of Czech adults (n = 1795). We measured religious affiliation, conversion experience, non-religious attitudes and the stability of these attitudes, mental health problems, and anxiety levels. Compared to stable non-religious respondents, unstable non-religious and converted respondents who perceived God as distant were more likely to experience anxiety in close relationships, and had higher risks of worse mental health. Our findings support the idea that the heterogeneity of findings in associations between religiosity/spirituality and mental health could be due to measurement problems and variation in the degree of secularity. A shift towards religiosity could be expected to be seen in a substantial part of non-religious respondents in problematic times. Full article
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