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Search Results (271)

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Keywords = chronic physical illness

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14 pages, 958 KiB  
Article
Adverse Childhood Experiences, Genetic Susceptibility, and the Risk of Osteoporosis: A Cohort Study
by Yanling Shu, Chao Tu, Yunyun Liu, Lulu Song, Youjie Wang and Mingyang Wu
Medicina 2025, 61(8), 1387; https://doi.org/10.3390/medicina61081387 - 30 Jul 2025
Viewed by 244
Abstract
Background and Objectives: Emerging evidence indicates that individuals exposed to adverse childhood experiences (ACEs) face elevated risks for various chronic illnesses. However, the association between ACEs and osteoporosis risk remains underexplored, particularly regarding potential modifications by genetic susceptibility. This prospective cohort study aims [...] Read more.
Background and Objectives: Emerging evidence indicates that individuals exposed to adverse childhood experiences (ACEs) face elevated risks for various chronic illnesses. However, the association between ACEs and osteoporosis risk remains underexplored, particularly regarding potential modifications by genetic susceptibility. This prospective cohort study aims to examine the relationship of ACEs with incident osteoporosis and investigate interactions with polygenic risk score (PRS). Materials and Methods: This study analyzed 124,789 UK Biobank participants initially free of osteoporosis. Cumulative ACE burden (emotional neglect, emotional abuse, physical neglect, physical abuse, sexual abuse) was ascertained through validated questionnaires. Multivariable-adjusted Cox proportional hazards models assessed osteoporosis risk during a median follow-up of 12.8 years. Moderation analysis examined genetic susceptibility interactions using a standardized PRS incorporating osteoporosis-related SNPs. Results: Among 2474 incident osteoporosis cases, cumulative ACEs showed dose–response associations with osteoporosis risk (adjusted hazard ratio [HR]per one-unit increase = 1.07, 95% confidence interval [CI] 1.04–1.11; high ACEs [≥3 types] vs. none: HR = 1.26, 1.10–1.43). Specifically, emotional neglect (HR = 1.14, 1.04–1.25), emotional abuse (HR = 1.14, 1.03–1.27), physical abuse (HR = 1.17, 1.05–1.30), and sexual abuse (HR = 1.15, 1.01–1.31) demonstrated comparable effect sizes. Sex-stratified analysis revealed stronger associations in women. Joint exposure to high ACEs/high PRS tripled osteoporosis risk (HR = 3.04, 2.46–3.76 vs. low ACEs/low PRS) although G × E interaction was nonsignificant (P-interaction = 0.10). Conclusions: These results suggest that ACEs conferred incremental osteoporosis risk independent of genetic predisposition. These findings support the inclusion of ACE screening in osteoporosis prevention strategies and highlight the need for targeted bone health interventions for youth exposed to ACEs. Full article
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8 pages, 192 KiB  
Article
Silent Struggles: Uncovering Mental Health Burdens in Adolescents with Inflammatory Bowel Disease and Juvenile Idiopathic Arthritis—A Retrospective Chart Review
by Kayla Beaudoin, Jaden Lo, Ethan Mewhinney, Kristen Bortolin, Tania Cellucci, Jenna Dowhaniuk, Liane Heale, Robert Issenman, Nikhil Pai, Mary Sherlock, Mary Zachos, Christina Grant, Karen Beattie, Katherine Prowse and Michelle Batthish
Children 2025, 12(8), 995; https://doi.org/10.3390/children12080995 - 29 Jul 2025
Viewed by 231
Abstract
Background/Objectives: Juvenile idiopathic arthritis (JIA) and inflammatory bowel disease (IBD) are chronic autoimmune conditions that impact the physical and psychological well-being of pediatric patients. While previous studies have shown a high prevalence of mental health challenges among youth with chronic conditions, the prevalence [...] Read more.
Background/Objectives: Juvenile idiopathic arthritis (JIA) and inflammatory bowel disease (IBD) are chronic autoimmune conditions that impact the physical and psychological well-being of pediatric patients. While previous studies have shown a high prevalence of mental health challenges among youth with chronic conditions, the prevalence of mental health issues in Canadian pediatric patients with JIA and IBD remains unclear. We aimed to estimate the prevalence of documented mental health disorders and related medication use of youth with JIA or IBD at a tertiary care centre. Methods: We conducted a retrospective chart review of youths aged 12–17 diagnosed with JIA or IBD at McMaster Children’s Hospital (MCH) to understand the prevalence of generalized anxiety disorder (GAD), separation anxiety disorder, social anxiety disorder (SAD), obsessive–compulsive disorders (OCD), eating disorders, major depressive disorder (MDD), adolescent adjustment disorder, suicide attempt/suicide ideation, self-harm behaviour, substance use disorder, and attention deficit disorders (ADD). Results: We reviewed 429 patient charts, including 303 patients with IBD and 126 with JIA. Our findings identified 90 IBD patients and 20 JIA patients who had one or more documented mental health conditions. Proportionately, there was a higher prevalence of mental health conditions among IBD patients (30%) compared to JIA patients (16%). The most frequently observed conditions in both IBD and JIA patients were GAD (63%, 50%), ADD (33%, 35%), and MDD (29%, 15%). Conclusions: These findings highlight the critical need for early mental health screening and integrated care approaches that address both medical and psychosocial needs in adolescents with chronic illnesses. Future research should incorporate prospective study designs, include diverse geographic and demographic populations, and explore targeted interventions to improve mental and physical health outcomes in this vulnerable group. Full article
(This article belongs to the Section Pediatric Mental Health)
17 pages, 360 KiB  
Article
High Antenatal Psychosocial Risk Among Pregnant Women in Bulgaria: Evidence to Support Routine Mental-Health Screening
by Elitsa Gyokova, Eleonora Hristova-Atanasova and Georgi Iskrov
J. Clin. Med. 2025, 14(14), 5158; https://doi.org/10.3390/jcm14145158 - 21 Jul 2025
Viewed by 343
Abstract
Background: Antenatal depression and anxiety contribute significantly to maternal morbidity and adverse pregnancy outcomes. However, structured screening and targeted interventions are largely absent from standard prenatal care in many Eastern European countries, including Bulgaria. This study examines the prevalence and psychosocial predictors of [...] Read more.
Background: Antenatal depression and anxiety contribute significantly to maternal morbidity and adverse pregnancy outcomes. However, structured screening and targeted interventions are largely absent from standard prenatal care in many Eastern European countries, including Bulgaria. This study examines the prevalence and psychosocial predictors of antenatal psychosocial risk using the validated Antenatal Risk Questionnaire–Revised (ANRQ-R) in a nationally underrepresented population. Methods: A cross-sectional survey was conducted among 216 third-trimester pregnant women in Bulgaria. Data on sociodemographic characteristics, health behaviours, and reproductive history were collected. Multivariate logistic regression identified predictors of elevated psychosocial risk. Results: A total of 65.7% of participants met the criteria for elevated psychosocial risk. Significant risk factors included passive smoking exposure during pregnancy (OR = 5.03, p < 0.001), physical activity prior to pregnancy (OR = 1.81, p = 0.004), and a family history of hereditary disease (OR = 42.67, p < 0.001). Protective factors were better self-rated current health (OR = 0.37, p = 0.004), the presence of chronic illness (OR = 0.42, p = 0.049), previous childbirth experience (OR = 0.11, p = 0.032), and residence in Northwestern Bulgaria (OR = 0.31, p = 0.028). Despite the high prevalence of psychosocial vulnerability, only 9.5% of affected women sought professional help. Conclusions: While our findings point to important unmet needs in antenatal mental health, further research is required before national screening policies can be implemented. Pilot programs, cultural validation of tools, and system-level readiness assessments should precede broad adoption. Full article
(This article belongs to the Section Mental Health)
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15 pages, 287 KiB  
Article
Injury, Risk and Training Habits Among Dog Agility Handlers: A Cross-Sectional Study
by Andrea Demeco, Laura Pinotti, Alessandro de Sire, Nicola Marotta, Antonello Salerno, Teresa Iona, Antonio Frizziero, Dalila Scaturro, Giulia Letizia Mauro, Umile Giuseppe Longo, Antonio Ammendolia and Cosimo Costantino
J. Funct. Morphol. Kinesiol. 2025, 10(3), 263; https://doi.org/10.3390/jfmk10030263 - 12 Jul 2025
Viewed by 1774
Abstract
Background: Dog agility is a rapidly growing sport involving a partnership between a dog and the handler, running through an obstacle course. Despite its increasing popularity and physical benefits, research on handler injuries remains limited. This study aimed to assess injury epidemiology [...] Read more.
Background: Dog agility is a rapidly growing sport involving a partnership between a dog and the handler, running through an obstacle course. Despite its increasing popularity and physical benefits, research on handler injuries remains limited. This study aimed to assess injury epidemiology of athletes practicing dog agility. Methods: This cross-sectional study was conducted using a comprehensive online survey consisting of 124 items, available in both English and Italian. The questionnaire was divided into four sections: Introduction collected demographic data and medical history; Materials and Methods focused on agility-related activities; Results explored injuries sustained in the past 12 months; Discussion examined training habits unrelated to agility. Results: Among 389 participants, the most represented age group ranged between 30 and 40 years old. Overall, 7% reported upper limb injuries, while 27% experienced at least one lower limb injury. Additionally, 20% of participants used medication, and 25% reported at least one chronic illness. On average, handlers trained twice per week and competed in two events per month. Lower limb injuries were predominantly muscular (49%) or ligamentous (14%) and most commonly occurred on grass pitches (56%). These injuries were more common in participants with a higher BMI, those using dynamic handling styles, and those competing at higher levels. Conclusions: This cross-sectional study highlighted the importance of identifying risk factors associated with dog agility handlers. Lower limb injuries were the most common, often associated with increased physical demands and handling styles involving intensive running and correlated with reduced physical fitness. Athletic conditioning, including structured warm-up and cool-down practices, might help decline injury risks. Full article
(This article belongs to the Section Kinesiology and Biomechanics)
18 pages, 312 KiB  
Review
Advancements in Family-Based Treatment of Adolescent Anorexia Nervosa: A Review of Access Barriers and Telehealth Solutions
by Ashlea Hambleton, Daniel Le Grange, Stephen Touyz and Sarah Maguire
Nutrients 2025, 17(13), 2160; https://doi.org/10.3390/nu17132160 - 28 Jun 2025
Viewed by 723
Abstract
Anorexia Nervosa (AN) is a psychiatric illness with serious medical and physiological implications. Anorexia Nervosa is characterised by significant disruptions in weight, growth and physical health resulting from disordered behaviours such as food restriction, purging and inappropriate exercise. The illness is associated with [...] Read more.
Anorexia Nervosa (AN) is a psychiatric illness with serious medical and physiological implications. Anorexia Nervosa is characterised by significant disruptions in weight, growth and physical health resulting from disordered behaviours such as food restriction, purging and inappropriate exercise. The illness is associated with substantial physical, psychological, social and economic burdens affecting all areas of functioning. Typically emerging in adolescence, AN can have a chronic course and high risk of mortality, with evidence suggesting that approximately 10% of individuals diagnosed with AN will die from medical complications or completed suicide. Whilst inpatient treatment reduces mortality risks through nutritional and weight restoration, outpatient treatment is the preferred level of intervention. In the case of adolescents, family-based treatment (FBT) is the recommended and most researched outpatient model for medically stable adolescents. However, access to FBT is limited, and there are several barriers that exist to receiving care from trained clinicians. This review provides a literature update on studies reporting the real-world access challenges for FBT, with particular attention paid to non-research settings. The review also highlights how digitally delivered treatment, specifically telehealth, has been used to increase access to FBT and examines the preliminary outcomes of telehealth-delivered FBT, which appear comparable to traditional in-person care. Despite these promising findings, provider, intervention and systemic factors have challenged the delivery of traditional in-person and telehealth FBT in real-world settings. Critical areas for future research include the need to understand the impact of potential confounders and what adaptions may be required to increase model feasibility in community settings, where access to specialist services is often limited and access challenges are most felt. Full article
(This article belongs to the Special Issue Focus on Eating Disorders of Adolescents and Children)
14 pages, 573 KiB  
Article
Stress and Coping in Teens with Chronic Physical Health Conditions: A Cross-Sectional Study
by Anne L. Ersig, Rachel Hawn, Niamh Nolan and Roger L. Brown
Children 2025, 12(7), 858; https://doi.org/10.3390/children12070858 - 28 Jun 2025
Viewed by 375
Abstract
Background/Objectives: Adolescents with chronic physical health conditions (CHCs) use specific coping strategies to respond to condition-related stressors. However, most studies of CHC-related stress and coping focus on a single condition. The objective of this study was to measure CHC-related stress and identify associated [...] Read more.
Background/Objectives: Adolescents with chronic physical health conditions (CHCs) use specific coping strategies to respond to condition-related stressors. However, most studies of CHC-related stress and coping focus on a single condition. The objective of this study was to measure CHC-related stress and identify associated coping strategies in adolescents with a variety of CHCs. A secondary objective was to examine the relationship between CHC-related stress, coping strategies, health-related quality of life, and perceived severity of chronic illness. Methods: Teens (n = 38, 68.42% female, mean age 17.9 years) with CHCs completed the Responses to Stress Questionnaire (RSQ) for CHC-related stress, the PedsQL to assess health-related quality of life, and the Perceptions of the Severity of Chronic Illness (PSCI) measure. The most frequently reported conditions were asthma, food allergies, and multiple conditions. We used fuzzy cluster analysis to identify two clusters, high stress and low stress, based on ratings of CHC-related stressors. Relationships between coping strategies and the PedsQL and PSCI, and between the PSCI and PedsQL, were assessed using Pearson partial correlations. Relationships between the PSCI, PedsQL, and coping strategies for the two clusters were assessed using adjusted mean differences. We adjusted for multiple comparisons by controlling the false discovery rate. Significance was set at p < 0.05. Results: Teens were most likely to use secondary control engagement coping and involuntary engagement to respond to CHC-related stressors. Teens in the two clusters differed on health-related quality of life but not coping strategies or perceived condition severity. CHC diagnosis category was associated with cluster membership. Conclusions: This exploratory study highlighted relationships among quality of life, coping strategies, and CHC diagnosis category that should be explored in future studies. Improved understanding of CHC-related stress and coping strategies in teens with CHCs could have an impact on their quality of life and well-being. Full article
(This article belongs to the Section Pediatric Mental Health)
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13 pages, 247 KiB  
Review
Supporting Migrant 2SLGBTQIA+ Unpaid Caregivers for Family Members Living with Chronic Illnesses
by Roya Haghiri-Vijeh, Robin Coatsworth-Puspoky, Harish Ramesh, Arvin Shakibai, Willian Roger Dullius and Marcus Allan
Healthcare 2025, 13(13), 1533; https://doi.org/10.3390/healthcare13131533 - 27 Jun 2025
Viewed by 1102
Abstract
The literature details the healthcare needs of migrant people living with chronic illnesses and the consequent economic, social, and healthcare needs of their caregivers. Similarly, some studies have underscored the social and healthcare needs of 2SLGBTQIA+ (two-spirit, lesbian, gay, bisexual, transgender, queer, and [...] Read more.
The literature details the healthcare needs of migrant people living with chronic illnesses and the consequent economic, social, and healthcare needs of their caregivers. Similarly, some studies have underscored the social and healthcare needs of 2SLGBTQIA+ (two-spirit, lesbian, gay, bisexual, transgender, queer, and intersex individuals, including diverse sexual and gender identities under the “+” symbol) adults living with chronic illnesses and their caregivers. This narrative review presents the context of migrant 2SLGBTQIA+ unpaid caregivers and how their intersecting identities influence their caregiving roles for family members with chronic illnesses. In this article, caregivers are defined as family members or chosen families who provide unpaid support that may last for three months or longer for people living with chronic illnesses. Most studies and policies overlook 2SLGBTQIA+ migrants who are also unpaid caregivers of individuals living with chronic illnesses, leaving them unsupported through discrimination at the intersection of racism, homophobia, transphobia, ageism, and ableism, forcing them to remain vulnerable to increased emotional and physical strain. There is a presence of pervasive systemic barriers, including a lack of training and education among social and healthcare providers, about the needs of migrant 2SLGBTQIA+ unpaid caregivers. Additional challenges stem from inadequate policies and insufficient targeted resources, particularly for caregivers from marginalized racial and ethnic backgrounds. The findings of this study highlight the necessity for a call to action to address these gaps and improve support systems for these highly marginalized communities. Full article
(This article belongs to the Special Issue Impact of Social Connections on Well-Being of Older Adults)
14 pages, 261 KiB  
Article
Level of Healthcare Facility and Psychosocial Factors Influence Perceived Self-Efficacy for Appropriate Use of Hydroxyurea: Experience from Caregivers of Children with Sickle Cell Disease in Tanzania
by Mwashungi Ally, Deodatus Kakoko, Tone Kristin Omsland, Calvin Swai, Emmy Metta, Kåre Moen, Elia John Mmbaga, Melkizedeck Leshabari, Mbonea Yonazi, Agnes Jonathan, Julie Makani and Emmanuel Balandya
Healthcare 2025, 13(13), 1500; https://doi.org/10.3390/healthcare13131500 - 24 Jun 2025
Viewed by 473
Abstract
Background: Sickle cell disease (SCD) is associated with high physical and psychosocial burden among patients and their families. Hydroxyurea (HU) improves health-related quality of life by preventing SCD complications. Despite its availability, HU is underutilised in Tanzania. Perceived self-efficacy for appropriate medication [...] Read more.
Background: Sickle cell disease (SCD) is associated with high physical and psychosocial burden among patients and their families. Hydroxyurea (HU) improves health-related quality of life by preventing SCD complications. Despite its availability, HU is underutilised in Tanzania. Perceived self-efficacy for appropriate medication use influences medication usage among individuals with chronic illnesses. We studied factors associated with caregivers’ perceived self-efficacy for appropriate use of HU and its association with HU usage among children with SCD in Dar-es-Salaam. Methods: We conducted a cross-sectional study from May to August 2023. We enrolled 374 caregivers of children with SCD from two regional and two national hospitals. We adapted the self-efficacy for appropriate medication use scale, a multidimensional perceived social support scale, and a patient health questionnaire for assessment of self-efficacy, social support, and depressive symptoms, respectively. Results: Three-quarters of caregivers had high perceived self-efficacy scores for medication use. Attending national hospitals, high social support, and absence of depressive symptoms were positively associated with perceived self-efficacy (adjusted beta coefficient aβ 2.3, 95% CI 0.5–4.2; aβ 9, 95% CI 7.1–10.9; and aβ 5.3, 95% CI 2.8–7.8, respectively). Caregivers with high self-efficacy were 5.3 times more likely to give HU to their children compared with those with low self-efficacy (incidence rate ratio 5.3, 95% CI 3.3–8.3). Conclusions: Hospital levels and psychosocial factors influence caregivers’ perceived self-efficacy for appropriate HU use. We recommend targeted interventions to enhance psychosocial support among caregivers to increase caregivers’ perceived self-efficacy and HU utilization among children with SCD in Tanzania. Full article
17 pages, 294 KiB  
Review
The Many Faces of Child Abuse: How Clinical, Genetic and Epigenetic Correlates Help Us See the Full Picture
by Enrico Parano, Vito Pavone, Martino Ruggieri, Iside Castagnola, Giuseppe Ettore, Gaia Fusto, Roberta Rizzo and Piero Pavone
Children 2025, 12(6), 797; https://doi.org/10.3390/children12060797 - 18 Jun 2025
Cited by 1 | Viewed by 696
Abstract
Background/Objectives: Child abuse is a pervasive global issue with significant implications for the physical, emotional, and psychological well-being of victims. This review highlights the clinical, molecular, and therapeutic dimensions of child abuse, emphasizing its long-term impact and the need for interdisciplinary approaches. Early [...] Read more.
Background/Objectives: Child abuse is a pervasive global issue with significant implications for the physical, emotional, and psychological well-being of victims. This review highlights the clinical, molecular, and therapeutic dimensions of child abuse, emphasizing its long-term impact and the need for interdisciplinary approaches. Early exposure to abuse activates the hypothalamic-pituitary-adrenal (HPA) axis, leading to chronic cortisol release and subsequent neuroplastic changes in brain regions such as the hippocampus, amygdala, and prefrontal cortex. These molecular alterations, including epigenetic modifications and inflammatory responses, contribute to the heightened risk of psychiatric disorders and chronic illnesses in survivors. Clinically, child abuse presents with diverse manifestations ranging from physical injuries to psychological and developmental disorders, making timely diagnosis challenging. Methods: A multidisciplinary approach involving thorough clinical evaluation, detailed histories, and collaboration with child protection services is essential for accurate diagnosis and effective intervention. Results: Recent advances in molecular biology have identified biomarkers, such as stress-related hormones and epigenetic changes, which provide novel insights into the physiological impact of abuse and potential targets for therapeutic intervention. Current treatment strategies prioritize the child’s safety, psychological well-being, and prevention of further abuse. Trauma-focused cognitive behavioral therapy and family-centered interventions are pivotal in promoting recovery and resilience. Conclusions: Emerging research focuses on integrating molecular findings with clinical practice, utilizing digital health tools, and leveraging big data to develop predictive models and personalized treatments. Interdisciplinary collaboration remains crucial to translating research into policy and practice, ultimately aiming to mitigate the impact of child abuse and improve outcomes for survivors. Full article
(This article belongs to the Section Pediatric Mental Health)
32 pages, 392 KiB  
Article
Chronic Illnesses: Varied Health Patterns and Mental Health Challenges
by Ângela Leite
Healthcare 2025, 13(12), 1396; https://doi.org/10.3390/healthcare13121396 - 11 Jun 2025
Viewed by 1565
Abstract
Background/Objectives: Hypertension, diabetes, and cancer are three prevalent chronic conditions with distinct etiologies and significant global health impacts. This study aimed to explore the diverse impacts of different chronic illnesses on health behaviors and psychological well-being, with a focus on identifying and addressing [...] Read more.
Background/Objectives: Hypertension, diabetes, and cancer are three prevalent chronic conditions with distinct etiologies and significant global health impacts. This study aimed to explore the diverse impacts of different chronic illnesses on health behaviors and psychological well-being, with a focus on identifying and addressing the unique challenges faced by individuals with hypertension, diabetes, and cancer. It was hypothesized that health behaviors and psychological well-being would differ significantly among individuals with hypertension, diabetes, and cancer, reflecting the distinct demands and psychosocial impacts of each condition. Methods: The database of Americans’ Changing Lives, Wave 6, including 767 participants, was used (56.1% hypertension, 20.8% diabetes, and 19.9% cancer cases). Variables concerning physical and mental health issues were chosen. Descriptive statistics summarized the data. Chi-squared and t-tests assessed associations and group differences, with effect sizes reported. Logistic regression examined predictors of hypertension, diabetes, and cancer. Sensitivity analyses excluded outliers. Results: Hypertensive individuals are more likely to show cognitive impairment and unhealthy behaviors, including poor self-rated health, higher BMI, lower physical activity, and altered alcohol use. Risk increases with age, widowhood, retirement, hospital admissions, and poor mental health, while more emergency room or doctor visits slightly reduce it. People with diabetes experience greater depressive symptoms, hopelessness, and financial stress. They also tend to have poorer self-rated health, higher BMI, and less physical activity. Risk is higher for separated individuals and lower for females. Psychological distress is a key factor, while age, employment, and healthcare use show minimal influence. Cancer is linked to chronic stress, poorer perceived health, and mental health challenges. Risk is higher among older adults and those who keep house. Poor self-rated health, high BMI, low fruit and vegetable intake, and psychological distress increase risk, but healthcare use is not a strong predictor. Conclusions: While different chronic illnesses present distinct challenges to health behaviors and psychological well-being, they also share common features-such as increased stress and lifestyle disruptions-underscoring the importance of both tailored and cross-cutting interventions to effectively support individuals across conditions. Full article
17 pages, 261 KiB  
Article
Anxiety in Portugal: Associated Factors in Adult Population from 2011 to 2021
by Ana Pedro Costa, Anabela Afonso, Irma da Silva Brito, Teresa Dionísio Mestre, Ana Matos Pires and Manuel José Lopes
J. Clin. Med. 2025, 14(12), 4100; https://doi.org/10.3390/jcm14124100 - 10 Jun 2025
Viewed by 421
Abstract
Background/Objectives: Anxiety disorders are the most prevalent mental illnesses worldwide and in Portugal, often resulting in chronicity and disability. The objective of this study is to evaluate the sociodemographic and health-related factors associated with anxiety in the Portuguese adult population. Methods: [...] Read more.
Background/Objectives: Anxiety disorders are the most prevalent mental illnesses worldwide and in Portugal, often resulting in chronicity and disability. The objective of this study is to evaluate the sociodemographic and health-related factors associated with anxiety in the Portuguese adult population. Methods: This study included participants aged 18 to 65 years from the nationwide, population-based EpiDoC cohort, who were followed from 2011 to 2021 (n = 2927). Anxiety was assessed using the Hospital Anxiety and Depression Scale (HADS). A mixed logistic regression analysis was performed using a prospective analytical approach. Two strategies were used to adjust the mixed models: (i) model with only complete observations (n = 1950) and (ii) model with imputation of the category “No” in missing self-reported diseases (n = 2554). Results: The proportion of anxiety symptoms decreased from 2011–2013 to 2021 (12.5% vs. 8.5%). Experienced anxiety symptoms were positively associated (OR > 1, p < 0.05) with being female; having a high school, 2nd and 3rd cycle (6–9 years of studies), or primary/no education; being unemployed; seeking the first job; and not working or being temporarily unable to work. Additionally, anxiety symptoms were positively associated (OR > 1, p < 0.05) with smoking daily, lack of physical exercise, and medication use. Digestive diseases, multimorbidity, and region were also positively associated (OR > 1, p < 0.05) with anxiety symptoms. Moreover, age was negatively associated (OR < 1, p < 0.05) with experiencing anxiety symptoms. Conclusions: Some determinants are modifiable and preventable through economic, social, and health policies. Measures to promote healthy lifestyles, like physical exercise, reduce substance abuse, prevent chronic diseases, increase employability, and increase schooling and health literacy, are necessary to reduce the anxiety rate in Portugal. Full article
(This article belongs to the Section Mental Health)
18 pages, 692 KiB  
Article
The Impact of COVID-19 on Mental Health and Healthcare in Youth with Chronic Physical Illness and Their Families
by Reese Parks, Chloe Bedard, Jennifer Yessis, Samantha B. Meyer and Mark A. Ferro
Psychiatry Int. 2025, 6(2), 66; https://doi.org/10.3390/psychiatryint6020066 - 5 Jun 2025
Viewed by 641
Abstract
The COVID-19 pandemic disproportionately impacted youth with chronic physical illness (CPI) and their caregivers. Emerging research aimed at understanding the impacts of the pandemic on this population is predominantly quantitative, lacking qualitative insights. This study used a qualitative approach to examine the experiences [...] Read more.
The COVID-19 pandemic disproportionately impacted youth with chronic physical illness (CPI) and their caregivers. Emerging research aimed at understanding the impacts of the pandemic on this population is predominantly quantitative, lacking qualitative insights. This study used a qualitative approach to examine the experiences of COVID-19 among youth with CPI and their families, exploring how the pandemic impacted their mental health and use of mental health services. Using a constructivist paradigm and a phenomenological approach, semi-structured interviews were conducted with youth with CPI (n = 8) and their primary caregiver (n = 13) between March 2021 and May 2021. Thematic analysis was used to identify three key themes: (1) mental health impact on youth, (2) caregiver mental health declines, and (3) variability in the experiences of mental healthcare. The findings highlight the heightened depression, anxiety, and stress among youth with CPI and their caregivers, exacerbated by loneliness, uncertainty, and social restrictions, while also revealing that virtual mental healthcare was perceived as less effective than in-person care, which was valued for its human connection, privacy, and comfort. These results emphasize the need for improved, comprehensive mental healthcare and the adoption of family-centred care models to strengthen caregiver–youth relationships and better integrate physical and mental healthcare to improve health outcomes for this population. Full article
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17 pages, 594 KiB  
Article
Psychological Well-Being and Life Satisfaction in Children and Adolescents with Chronic Illness: The Role of Depression, Nonproductive Thoughts, and Problematic Internet Use
by Karolina Eszter Kovács, Péter Boris and Beáta Erika Nagy
Children 2025, 12(5), 657; https://doi.org/10.3390/children12050657 - 21 May 2025
Viewed by 679
Abstract
Theoretical background: The study of psychological well-being in children and adolescents living with chronic illness is of particular relevance, as the physical and psychosocial aspects of the illness can have a significant impact on their quality of life. Previous research has highlighted that [...] Read more.
Theoretical background: The study of psychological well-being in children and adolescents living with chronic illness is of particular relevance, as the physical and psychosocial aspects of the illness can have a significant impact on their quality of life. Previous research has highlighted that depression, nonproductive thoughts and various aspects of problematic internet use may be related to life satisfaction and ways of coping with illness. This study aims to examine how depression, nonproductive thoughts, and problematic internet use interact with illness perception and burden to affect psychological well-being and life satisfaction. Methods: A cross-sectional study was conducted with 207 chronically ill children aged 10–18 years. The children, aged between 10 and 18 years old, attended regular check-ups in different specialities (gastroenterology, pulmonology, onco-haematology, and paediatric rehabilitation). A cross-sectional study was carried out using psychological instruments to measure life satisfaction (SWLS), nonproductive thoughts (NPG-K), problematic internet use (PIU-Q), illness perception (PRISM) and illness burden (PRISM-D, IIRS), and depression (BDI-R). Spearman rank correlation analysis was used to explore the associations between variables. Results: Life satisfaction was negatively related to nonproductive thoughts (r = −0.28, p < 0.001), internet obsession (r = −0.20, p < 0.01), and internet neglect (r = −0.20, p = 0.004). Conversely, a positive correlation was found with the PRISM (r = 0.14, p = 0.042), suggesting that less dominance of illness detection is associated with higher life satisfaction. Depression and nonproductive thoughts showed a strong positive relationship (r = 0.49, p < 0.001), and depression and problematic internet use also showed significant correlations for the obsession, neglect and control subscales (r = 0.23–0.29, all p < 0.001). Cluster analysis identified three psychological profiles: ‘positive fighters’, ‘avoidant sufferers’, and ‘negative observers’, distinguished by differences in depression, nonproductive thoughts, illness burden, and well-being. Conclusions: The results suggest that the quality of life of children and adolescents with chronic illness is significantly affected by mental health factors, particularly depression, nonproductive thoughts and problematic internet use. Illness perception and illness-related distress also play a key role in shaping life satisfaction and overall psychosocial well-being. These findings underscore the need for targeted psychological interventions in pediatric chronic care to enhance well-being and promote adaptive coping and suggest that psychological interventions and targeted psychosocial support can significantly improve these children’s quality of life. Further research is needed to explore intervention options and to develop optimal support strategies. Full article
(This article belongs to the Special Issue Mental Health of Children with Special Needs)
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22 pages, 2267 KiB  
Review
Health Impacts of Urban Environmental Parameters: A Review of Air Pollution, Heat, Noise, Green Spaces and Mobility
by Ainhoa Arriazu-Ramos, Jesús Miguel Santamaría, Aurora Monge-Barrio, Maira Bes-Rastrollo, Sonia Gutierrez Gabriel, Nuria Benito Frias and Ana Sánchez-Ostiz
Sustainability 2025, 17(10), 4336; https://doi.org/10.3390/su17104336 - 10 May 2025
Viewed by 1291
Abstract
This literature review examines the relationship between the urban environment and human health, focusing on five key parameters: air pollution, extreme temperatures, noise, green spaces, and urban mobility. A systematic review was conducted using indexed scientific databases (Scopus, Web of Science, and PubMed) [...] Read more.
This literature review examines the relationship between the urban environment and human health, focusing on five key parameters: air pollution, extreme temperatures, noise, green spaces, and urban mobility. A systematic review was conducted using indexed scientific databases (Scopus, Web of Science, and PubMed) and technical reports, following predefined search terms and exclusion criteria. A total of 131 publications were selected and analyzed. The study highlights the negative health effects of air pollution, heat, and noise—particularly on the respiratory, cardiovascular, nervous, and reproductive systems—especially in vulnerable populations including older adults, children, pregnant women, individuals with chronic illnesses, and those living in socioeconomically disadvantaged areas. In contrast, green spaces and sustainable mobility have shown beneficial impacts, including improvements in mental health, increased physical activity, and indirect benefits as they contribute to reducing air pollution, urban heat, and noise. Among all parameters, air pollution emerges as the most extensively studied and regulated, while significant research gaps persist in the fields of urban mobility and noise pollution. Furthermore, regulatory development remains limited across all parameters analyzed, highlighting the need for more comprehensive and consistent policy frameworks. Based on the evidence, three key urban strategies are proposed: renaturalizing cities, promoting sustainable mobility, and implementing data-driven management and educational tools. These actions are essential to create healthier, more resilient, and sustainable urban environments. Full article
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Article
Cardio-Respiratory Fitness and Fatigue in Post-COVID-19 Syndrome—A Three-Year Update
by Radostina Cherneva, Zheyna Cherneva, Vania Youroukova, Tanya Kadiyska, Dinko Valev, Ebru Myuyun Hayrula-Manaf and Vanyo Mitev
Biomedicines 2025, 13(5), 1097; https://doi.org/10.3390/biomedicines13051097 - 30 Apr 2025
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Abstract
Background: Post-COVID-19 syndrome (PCS) is defined as the persistence of symptoms 3 months after acute SARS-CoV-2 infection. The long-term prevalence and clinical progression of PCS has not been established. Our aim was to investigate the symptoms in PCS patients, explore the degree of [...] Read more.
Background: Post-COVID-19 syndrome (PCS) is defined as the persistence of symptoms 3 months after acute SARS-CoV-2 infection. The long-term prevalence and clinical progression of PCS has not been established. Our aim was to investigate the symptoms in PCS patients, explore the degree of physical activity, according to the fatigue severity score, and analyze its association with basic cardio-pulmonary exercise testing (CPET) parameters. Methods: A total of 192 subjects with history of SARSCoV-2 infection were included. They filled in the Chronic Fatigue Syndrome Questionnaire (CFSQ) and were divided into symptomatic and asymptomatic groups. Forty-seven had persistent post-COVID complaints—reduced physical capacity, fatigue, dyspnea, sleep disturbances, muscle pain. CPET was performed and the pathophysiological parameters in the different fatigue severity groups were compared. Results: Subjects with persistent long-term PCS were divided into two groups—mild (20) and moderate–severe (27), depending on the CFSQ score; forty-eight PCS subjects without complaints served as a control group. The average period between the acute illness and the study was 1028 ± 214 days. Subjects with moderate–severe PCS had more symptoms during CPET (73.6% vs. 24.8% vs. 17.4%), as compared to mild/asymptomatic. The rate of perceived effort was subjective and did not correspond to the workload, heart, or breathing rate in the symptomatic group. These subjects were unable to reach the anaerobic threshold, compared to mild/asymptomatic subjects (51.8% vs. 25%, vs. 12.5%). Patients with moderate–severe PCS showed lower peak VO2 (24.13 ± 6.1 mL/min/kg vs. 26.73 ± 5.9 mL/min/kg, vs. 27.01 ± 6.3 mL/min/kg), as compared to mild/asymptomatic subjects. Conclusions: Long-term PCS is still present in up to 24% of the general population, more than thirty months after the acute episode. It is characterized by increased perception of symptom burden and diminished aerobic metabolism. A third of the long-term PCS exhibit lower cardio-respiratory fitness, independently from the severity of the symptoms. Full article
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