Search Results (108)

Background: Fermented dairy foods, such as yogurt and cheese, contain bioactive components that differ from those in non-dairy foods, but their associations with depression and dementia risk in later life remain unclear. Methods: We analyzed data from the Sydney Memory and Ageing Study, a community-dwelling cohort of adults aged 70–90 years, to examine associations between dairy intake and depressive symptoms (Geriatric Depression Scale-15), psychological distress (Kessler-10), and incident depression (physician diagnosis or antidepressant use) and dementia (DSM-IV criteria). Intake of yogurt, cheese, and non-fermented milk was assessed at baseline using a validated food-frequency questionnaire. Longitudinal associations were examined using Fine–Gray competing-risks models that accounted for death; cross-sectional associations were also assessed. Results: Among 966 participants (mean age: 78.3; 55.5% women), compared with no consumption, higher yogurt intake (one standard serving) was significantly associated with lower depressive symptom scores (adjusted β: −0.37 and −0.39 for quartiles 3–4 (mean: 88.5–164 g/day), and so was low-fat cheese intake (mean: 13.2 g/day) (adjusted β: −0.35). Over a mean follow-up of 3.3 years, 120 incident cases of depression and 68 deaths occurred: higher yogurt intake and low-fat cheese consumption (versus non-consumption) were associated with lower risk of depression (adjusted subdistribution hazard ratios 0.41 [95% CI 0.19–0.88] and 0.40 [0.21–0.78], respectively). No significant associations were observed for psychological distress, cognition, or incident dementia (a mean follow-up of 5.2 years, 100 incident cases, and 153 deaths); no associations were observed for regular cheese or milk intake. Conclusions: These findings suggest a potential role for fermented dairy foods, particularly yogurt and low-fat cheese intake, but not non-fermented milk, in mental well-being in later life. Full article

Background: Sleep quality and mental health are important concerns for esports competitors. However, epidemiological data regarding sleep quality and psychological distress among high-level esports players remain limited. Objective: This study aimed to examine sleep quality and mental health status among high-level esports competitors in Japan and to identify factors associated with psychological distress. Methods: This cross-sectional study included 275 competitors (269 males, 3 females, and 3 who did not report sex) participating in the 2023 National Prefectural Esports Championship. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), psychological distress using the Kessler Psychological Distress Scale (K6), and depressive symptoms using the Patient Health Questionnaire-9 (PHQ-9). Multivariable logistic regression analyses were performed to identify associated factors. Results: The response rate was 61.8% (275/445). Poor sleep quality (PSQI > cut-off) was observed in 38.5% of competitors. Based on the K6, 24.4% reported psychological distress above the mild threshold, and 29.5% reported mild or greater depressive symptoms according to the PHQ-9. Overall mental health levels were comparable to those reported in previous studies of general populations. Nighttime esports training was significantly associated with psychological distress (adjusted odds ratio 3.80; 95% confidence interval 1.50–9.64; p = 0.005). Conclusions: More than one-third of Japanese esports competitors experience poor sleep quality, and approximately one-quarter report mild or greater psychological distress. Nighttime esports training may be an important factor associated with mental health among competitors. Further longitudinal studies are warranted to clarify temporal relationships and to examine whether reducing nighttime training is associated with improved mental health outcomes among esports competitors. Full article

Background/Objectives: Public healthcare workers face significant occupational stress during crisis situations, yet research on this particular population remains limited compared to other healthcare workers. The aim of this study was to investigate the impact of the COVID-19 pandemic on distress levels and the sense of coherence among public health workers by integrating psychological assessments with physiological markers of stress to identify protective factors against pandemic-related occupational stress. Methods: This longitudinal study was conducted at the Teaching Public Health Institute of Split and Dalmatia County from July 2021 to February 2022 at two time points: the latency phase (between COVID-19 waves) and hyperarousal phase (during an active wave). Fifty-four public health workers participated in the study. There were three questionnaires assessing psychological distress: Kessler Psychological Distress Scale, Impact of Events Scale—Revised and Sense of Coherence Scale-29. Salivary and blood samples were collected at both time points to measure cortisol levels, cortisol awakening response, and interleukin-6 concentrations. Results: The cortisol area under the curve with respect to ground (AUCg) was significantly elevated during the stress phase compared to the latency phase (234.8 vs. 201.8; p = 0.023), indicating heightened physiological stress responses. Epidemiologists demonstrated significantly lower sense of coherence scores compared to non-epidemiologists (117.9 ± 9.1 vs. 125.6 ± 10.5; p = 0.029). A lower sense of coherence was significantly associated with higher psychological distress and post-traumatic stress symptoms. Multiple linear regression analysis revealed that sense of coherence and interleukin-6 levels were significant independent predictors of cortisol changes. Conclusions: The findings demonstrate that public health workers experience measurable physiological stress responses during pandemic peaks, with sense of coherence emerging as a protective psychological factor. Interventions targeting sense of coherence and organizational support may possibly enhance resilience and reduce mental health morbidity in this vulnerable workforce during crisis situations. Full article

National parks are the core carriers for implementing the concept of “ecological protection first, public welfare for all”. This study used the fuzzy comprehensive evaluation method to evaluate the ecological experience resource quality of the Laohegou area in Giant Panda National Park of China. Based on the standardized psychological assessment scale and the Kessler Psychological Distress Scale, we have established an evaluation model for the psychological health benefits, quantifying the psychological health benefits of tourists in the ecological experience of national parks. At the same time, the relationship between the demographic characteristics, ecological experience characteristics, psychological health level, and psychological health benefits of visitors was analyzed. The ecological environment in Laohegou area is excellent (evaluated as “excellent” in multiple key indicators), with outstanding resource and value characteristics (evaluated as “good” in multiple indicators), and has the ability to provide high-quality public ecological experiences, which has significant benefits in promoting tourists’ mental health. The ecological experience within national parks could bring high psychological health benefits to visitors. The educational background, age, and income of visitors had a significant impact on the psychological health benefits of their ecological experience. Therefore, ecological experience products within national parks should be designed in layers based on age, income, and other factors, and spaces should be controlled at different levels. Full article

Background/Objectives: Scaling is central to non-surgical periodontal therapy; however, it is often perceived as uncomfortable, particularly in periodontitis. Psychological distress may amplify pain and reduce adherence. This comparative pilot study assessed whether ultrasonic technology influences patient-reported pain and psychoemotional status while quantifying the contribution of the periodontal condition and baseline psychological factors. Methods: A monocentric split-mouth design enrolled 42 adults (21 with stage I–III, grade B periodontitis; 21 periodontally healthy). Maxillary scaling was performed with Device nr.1 and mandibular scaling was performed with Device nr.2, and no anesthesia was used. Pain was measured immediately post-procedure using the Short-Form McGill Pain Questionnaire (SF-MPQ; sensory and affective subscales). Psychological status was assessed pre- and post-session with the Kessler Psychological Distress Scale (K10) and the Rosenberg Self-Esteem Scale (RSES). Construct validity was examined via exploratory factor analysis. The Mann–Whitney U, Wilcoxon signed-rank, Spearman’s ρ, and Cliff’s δ were applied (α = 0.05). Results: The overall pain was low. Between devices, sensory pain did not differ, whereas affective pain was modestly lower with the “No Pain” device (p = 0.017). Periodontitis was the dominant determinant of pain: higher sensory (U = 509.00, p = 0.0004; δ = 0.42) and affective scores (U = 290.00, p < 0.0001; δ = 0.67) occurred irrespective of device, while device-related effects were negligible (sensory δ = −0.03) to small (affective δ = 0.27). Somatic distress correlated with affective pain (ρ = 0.25, p = 0.023) and was borderline for sensory pain (ρ = 0.21, p = 0.060); emotional distress showed no significant associations. During the session, K10 scores decreased and RSES values increased, indicating immediate psychoemotional benefits. Conclusions: Pain perception during scaling is shaped primarily by periodontal status and psychological distress rather than by ultrasonic technology per se. Although the electronic module to dynamically adjust the power of the instrument technology may attenuate the affective component, standardized atraumatic techniques and routine psychosocial screening are likely to yield greater gains. The observed short-term improvements in distress and self-esteem support integrating patient-reported outcomes into individualized, patient-centered periodontal care. Full article

This study investigated the feasibility and preliminary effects of enhanced midwifery care in reducing subclinical depression symptoms among women in ethnically diverse areas of the South Western Sydney Local Health District (SWSLHD). A pilot randomised controlled trial was conducted among pregnant women attending the Fairfield and/or Liverpool antenatal clinic with an Edinburgh Depression Scale (EDS) score of 10–12 (i.e., just below the generally accepted clinical cut-off score of 13 to indicate subclinical depressive symptoms) during the first antenatal visit (i.e., before 26 weeks gestation). Participants were randomly allocated to either the intervention group which received continuous and coordinated support from a dedicated Registered Midwife (RM) trained in counselling and linked with a multidisciplinary team, or the usual care group, which received standard maternity care from various providers without continuity or additional coordinated support. Primary outcomes included feasibility of recruitment, randomisation, intervention delivery and fidelity, and retention and follow-up. The secondary outcomes were improvement in depressive symptom severity assessed via EDS, psychological distress (Kessler’s psychological distress scale—K10), and parenting confidence (Karitane Parenting Confidence Scale (KPCS). Descriptive analyses were used to assess the feasibility outcomes, whereas mixed-effects models were used to examine the effects of treatment on secondary outcomes. Thirty-seven mothers were recruited into the study, of which eighteen were randomised to the intervention group and nineteen to the usual care group. The intervention was delivered with good fidelity, and remote adaptations during COVID-19 ensured both continuity of care and high retention at 6-month follow-up. Findings of the mixed-effects models showed significant within-group reduction in EDS scores over time, with scores at 8 weeks postpartum (T2) significantly lower than at baseline (T0; β = −2.77, SE = 1.36, p < 0.05) but no significant differences between the groups (β = −0.02, SE = 1.63, p = 0.992) or time-by-group interactions at any timepoint for EDS, K10, and KPCS. These findings demonstrate the feasibility of enhanced midwifery care in a “hard to reach” population of SWSLHD and highlight the need for adequately powered trials to determine its effectiveness on maternal mental health and parenting outcomes. Full article

Background: The psychosomatic effects of stress are risk factors for a range of dental and systemic diseases. This study used the massive Japanese national statistics database to clarify the association of psychological stress with subjective symptoms and conditions requiring hospital visits. Methods: Anonymized data from 93,690 respondents of the 2019 Japanese survey were provided for this study. From these data, those of 29,777 respondents aged 40–89 years were classified into stress groups based on their responses to the Kessler Psychological Distress Scale (K6). The response rates for symptoms and diseases were compared and analyzed using contingency tables and binomial logistic regression. Results: The items with the largest odds ratios in the univariate analysis were depression/other mental disease (7.60), followed by irritability (6.86) and health perception QOL (6.31). Among those with subjective symptoms, the proportion in the high-stress group was higher (15.1%), with a univariate odds ratio of 3.17. The results of the binomial logistic regression analysis, with subjective QOL as the dependent variable, were as follows: The explanatory variables with the highest adjusted odds ratios were stress group classification (3.14), followed by feeling physically tired (2.44) and sleep satisfaction (2.22). The stress group was associated with subjective symptoms, such as irritability and depression/other mental diseases, as well as with social factors, such as household structure and work hours. These results suggest the existence of specific symptoms, diseases, and environmental factors associated with high stress. Conclusions: The results suggest that stress may have a substantial impact on quality of life in later life. Therefore, healthcare measures for older adults should focus on the symptoms and diseases that tend to be associated with stress to mitigate their effects. Full article

Background/Objectives: Perinatal mental disorders are important health issues that affect both mothers and their children. The Mediterranean diet (MD) is one of the most well-recognized healthy dietary patterns worldwide. Recent evidence suggests that MD may prevent or reduce the risk of perinatal mental disorders. This study investigated the association between MD adherence during pregnancy and psychological distress in a large cohort of Japanese births. Methods: Data were obtained from 80,271 pregnant women who participated in the Japan Environment and Children’s Study. Adherence to the MD was assessed using three scoring methods: the Mediterranean Diet Score (MDS), relative Mediterranean Diet (rMED), and Mediterranean Diet Score for Pregnancy (PMDS). Psychological distress was defined as a score of ≥13 on the Kessler 6-item Psychological Distress Scale (K6). Modified Poisson regression models were used to estimate risk ratios (RRs) and 95% confidence intervals (CIs). Population attributable fractions (PAFs) were calculated to quantify the proportion of psychological distress attributable to low MD adherence. Results: The adjusted RR for psychological distress in the low PMDS group was 1.17 (95% CI: 1.07, 1.28) compared with the high PMDS group. The adjusted PAF for low PMDS was 10.43% (95% CI: 4.81, 16.06). No statistically significant associations were detected between psychological distress and the MDS or rMED scores. Conclusions: This study suggests that high adherence to MD based on the PMDS during pregnancy may reduce the risk of psychological distress in Japanese women. Therefore, promoting MD during pregnancy could be a potential strategy for preventing perinatal mental disorders. Full article

This article presents key findings and learnings from the Albury Project Mental Health Pilot, a six-month exploratory opportunity designed to extend the Community of Schools and Services (COSS) Model to proactively identify and support young people experiencing psychological distress in a regional Australian community. Working within the established COSS Model architecture and using population-level screening via the Australian Index of Adolescent Development (AIAD) survey, the pilot focused on a previously unreached and unsupported cohort of young people with high or very high scores on the Kessler Psychological Distress Scale (K10) who were not engaged with existing mental health services. The support involved brief, tiered interventions tailored to individual needs. Short-term outcomes demonstrated improvements in K10 scores for the majority of participants, with many moving out of the K10 at-risk range. Medium-term data further showed sustained improvements in psychological distress and personal wellbeing for a substantial proportion of the cohort. The pilot identified a ‘hidden cohort’ and demonstrated that low-resource, brief interventions are capable of achieving high-impact outcomes within the existing COSS Model collective impact framework. While short-term, these findings suggest the COSS Model’s adaptability and promise as a cost-efficient early intervention platform for youth mental health in broader community settings. Full article

Background: The interplay between QoL and psychological distress may differ cross-culturally. The purpose of this study was to investigate the relationship between quality of life (QoL) and psychological distress, among an Egyptian Christian background sample. Methods: Participants completed QoL and K-10 questionnaires. Descriptive statistics, correlation analysis, and partial correlation controlling for age were conducted to explore these relationships. Results: The sample had a mean age of 50.64 years (SD ± 9.6) and was slightly male dominated (57.1%). QoL scores ranged from 4.23 to 5.52 on a 7-point scale, with the highest scores in personal relationships and the lowest in community engagement. K-10 scores indicated low to moderate psychological distress, with feeling tired without reason scoring highest. A significant negative correlation was found between QoL and K-10 scores (r = −0.354, p < 0.001), suggesting higher QoL is associated with lower psychological distress. Material comforts and health showed the strongest negative correlations with K-10 scores. The relationship between QoL and psychological distress remained significant after controlling for age (r = −0.347, p < 0.01). Self-awareness and self-expression emerged as key factors positively correlated with overall QoL. Conclusions: Enhancing QoL, particularly in areas of material comfort, health, and personal growth, may effectively reduce psychological distress. Interventions should be culturally tailored to respect linguistic and religious backgrounds. Further research with more diverse samples and longitudinal designs is recommended to deepen understanding of these relationships. Full article

The mental health of young adults is a widespread and growing concern in many communities, impacting social sustainability. At the same time, there is growing evidence of the value that nature can provide towards improving health and wellbeing. However, there is little research on the scale of the monetized value of relevant wellbeing benefits from nature exposure. Nature prescribing draws on the growing base of evidence about nature and its health and wellbeing connections, with medical practitioners and/or allied health workers providing a prescription to selected patients to participate in a program that offers interventions intended to improve participant health and/or wellbeing, using a nature setting. This paper is the first to undertake a cost–benefit analysis of nature prescribing, involving a program aimed to improve the wellbeing of young adults with mild to moderate mental illness in regional/rural Victoria, Australia. The evaluation demonstrates that a curated, group-based nature exposure program can yield significant improvement in levels of life satisfaction and mental health in this cohort. Paired sample comparisons and multiple regression analyses suggest that the program produced an increase in mean participant life satisfaction scores of ~0.7 units, measured using Personal Wellbeing Index scores. A project benefit–cost ratio of over four resulted from this. Mental health, as measured by Kessler scale scores, also showed solid improvement, and loneliness was reduced. The unique contributions of nature and of the group-based delivery mode to the measured benefits were not identifiable but the combined effect was evident, improving participants’ likelihood of social inclusion, a major social sustainability goal. Furthermore, the solid program benefit–cost ratios indicate an economically sustainable program, which uses an environmental platform (nature) for its delivery. This links all three triple bottom line sustainability outcomes to this program. Topping up group-based nature exposure, after completion of the six-session, two-hours-per-session program, was important for many participants to sustain benefit levels. Participants emphasized the importance of the program being delivered by trained professionals. Achieving involvement of a suitably sized project comparison or control group through the 8-month program evaluation period to follow-up proved challenging, which somewhat weakens the power of the evaluation findings. Full article

Background: The nation’s defense relies on a cadre of young individuals with strong physical and mental health. The study aimed to identify health behavior-related correlates of physical and mental health in future conscripts. Methods: This cross-sectional study comprised 676 male school students with an average age of 18.48 (1.15) years. The measures of weekly physical activity, nutrition (Kidmed questionnaire), psychological well-being (WHO-5 Well-Being Index), psychological distress (Kessler scale), cardiorespiratory fitness (20 m Shuttle Run test), weight, and height for calculation of body mass index were taken. Results: Among potential conscripts (17–19-year-old males), 22% have poor cardiorespiratory fitness. More than a quarter of young males have poor psychological well-being. Better cardiorespiratory fitness is related to more recommendations-adherent nutrition (Std β = 0.133 [0.03–0.14], p < 0.05). Engagement in sports is related to better cardiorespiratory fitness (Std β = 0.202 [0.10–0.30], p < 0.05). Higher psychological distress is associated with more time spent passively (Std β = 0.145 [0.12–0.34], p < 0.01); better psychological well-being is associated with more adherent nutrition (Std β = 0.172 [0.14–0.34], p < 0.0001), more hours accumulated in moderate-to-vigorous physical activity (Std β = 0.150 [0.30–1.10], p < 0.01), and less time spent passively (Std β = −0.131 [−0.34–−0.11]). Conclusions: Potential conscripts’ physical fitness and mental health are related to better health behaviors. Behavior change practices and policies applied at school could benefit potential conscripts and youth in general in terms of their physical and mental health. Full article

Background: Chronic pain significantly impacts quality of life and may lead to physical and psychological dysfunction. Although various tools have been developed to assess pain-related conditions, many are composed of time-consuming multi-item questionnaires, limiting practicality in clinical settings. The Multidimensional Evaluation Scale for Patient Impression of Change (MPIC) was developed as a simple, retrospective tool to assess multiple domains targeted in interdisciplinary pain management. This study evaluated the reliability and validity of the Japanese MPIC in patients with chronic non-cancer pain. Methods: We recruited 101 participants from the Interdisciplinary Pain Center at Keio University Hospital between August 2022 and September 2024. Pretreatment measures included pain intensity, disability, catastrophizing, self-efficacy, psychological distress, and sleep quality. Baseline assessments encompassed pain intensity, disability, catastrophizing, self-efficacy, psychological distress, and sleep quality. Psychological distress was evaluated using the Hospital Anxiety and Depression Scale (HADS) for the initial cohort of 35 participants and the Kessler Psychological Distress Scale (K6) for the subsequent 66 participants. Following the intervention, participants completed the MPIC, in addition to reassessments of pain intensity, disability, catastrophizing, self-efficacy, psychological distress (HADS or K6), and sleep quality. Retesting the MPIC was performed in a small subgroup of 20 participants for test–retest reliability analysis. Confirmatory factor analysis (CFA), average variance extracted (AVE), Pearson’s correlations with pain-related measures, Cronbach’s alpha, and intraclass correlation coefficients (ICC) were used to assess construct validity, convergent validity, criterion validity, internal consistency, and reliability. Results: CFA indicated marginal fit (CFI = 0.86, RMSEA = 0.23, SRMR = 0.06), with factor loadings from 0.49 to 0.91. AVE supported convergent validity (0.58). Internal consistency was excellent (Cronbach’s alpha = 0.93), and ICC was moderate (0.52). MPIC domains correlated significantly with changes in pain intensity, disability, catastrophizing, self-efficacy, sleep, and psychological distress (p < 0.05), supporting criterion validity. Conclusions: The Japanese MPIC provides preliminary evidence of validity and reliability, with acceptable internal consistency, marginal structural fit, and moderate test–retest reliability. These findings suggest that the MPIC may serve as a concise retrospective instrument for assessing multidimensional treatment outcomes within interdisciplinary pain management programs for chronic non-cancer pain. Full article

Purpose: This paper examines the differences between transgender persons who self-identify as bisexual (n = 4129) and those who self-identify as pansexual (n = 5056) when it comes to experiencing anti-transgender harassment, discrimination, and violence, serious psychological distress, and suicidal ideation. Methods: Data from the 2015 U.S. National Transgender Survey were used to evaluate the differences between bisexual and pansexual persons in a sample of transgender Americans aged 18 or older. The Kessler-6 scale assessed psychological distress, and a dichotomous measure of past-year suicidal ideation was used. A 20-item scale assessed the extent to which people experienced anti-transgender harassment, discrimination, and violence. Multivariate analysis and structural equation analysis were used to analyze the data. Results: Compared to their bisexual counterparts, pansexual persons experienced more anti-transgender harassment, discrimination, and violence, were more likely to experience serious psychological distress, and were more likely to report suicidal ideation. A structural equation analysis revealed that the bisexual–pansexual distinction is important when understanding transgender persons’ likelihood of experiencing suicidal ideation. It operates indirectly through its direct impact on the number of anti-transgender experiences incurred. Conclusions: Pansexual individuals fare more poorly than their bisexual counterparts on measures of anti-transgender experiences, serious psychological distress, and suicidal ideation. The bisexual–pansexual distinction is a meaningful one when trying to understand the transgender persons’ odds of thinking about dying by suicide. Full article

Background/Objectives: This predictive research aimed to examine the influences of gender, perceived patients’ ability to perform activities of daily living, perceived impact of behavioral and psychological symptoms of dementia (BPSD), perceived caregiver burden, and perceived social support on the psychological distress of family caregivers of persons with dementia. Methods: The sample consists of 172 family caregivers of persons with dementia who received services at the outpatient department of a hospital in Bangkok and met the inclusion criteria. The research tools used in this study included a demographic questionnaire, the Kessler Psychological Distress Scale, the Barthel Activities of Daily Living Index, a Thai tool for assessing behavioral and psychological symptoms of dementia, the Thai Burden Interview for Caregivers of Patients with Chronic Illness, and Social Support Scale. The data were analyzed using descriptive statistics and multiple regression analysis. Results: The research findings revealed that 26.2% of the sample experienced psychological distress. Multiple regression analysis indicated that gender, perceived patients’ ability to perform activities of daily living, perceived impact of BPSD, perceived caregiver burden, and perceived social support could jointly explain 66.3% of the variance of psychological stress of family caregivers of persons with dementia (R² = 0.663, F = 65.303, p < 0.001). The factors that significantly influenced psychological distress in family caregivers of dementia were perceived caregiver burden (β = 0.693, p < 0.001) and perceived impact of BPSD (β = 0.164, p < 0.01). Conclusions: The findings from this study can serve as a basis for developing strategies to reduce or prevent psychological distress in family caregivers of persons with dementia. Full article