Search Results (6,554)

Background/Objectives: To determine whether adolescent (T1) mental health, quality of life, and adjustment to celiac disease (CeD) are associated with college-age (T2) perceived physical and mental health and gluten-free diet (GFD) adherence. Methods: In 2015, adolescents with CeD (n = 101, T1) completed standardized surveys assessing mental health (CSI-4), quality of life (PedsQL), and adjustment to CeD (CDDUX). Five years later, participants ≥18 years self-reported GFD adherence and physical and mental health perception in college (n = 59, T2). Patients who were current or recent college students that provided complete data at both time points were analyzed (n = 43) using Kendall’s tau to test: concurrent associations among T2 perceived physical/mental health and GFD adherence; and prospective associations between T1 measures and T2 perceived outcomes. Results: Higher T1 CSI-4 and PedsQL scores were negatively correlated with T2 perceived physical health (τ = −0.31, p = 0.02 and τ = −0.28, p = 0.04, respectively). There was trending association between T1 PedsQL and T2 mental health perception (τ = -0.23, p = 0.06). T2 physical and mental health perception were positively correlated (τ = 0.41, p = 0.001). No significant associations emerged between T1 measures and T2 GFD adherence, nor between T2 health perception and GFD adherence, although T2 physical health perception positively trended with GFD adherence (p = 0.78). Conclusions: Adolescents with CeD reporting more depressive symptoms or lower quality of life feel less physically and mentally healthy when in college. In college, feeling physically healthy aligns with feeling mentally healthy, although neither clearly predicts GFD adherence. Early mental health screening in adolescents with CeD may support transitions to independent dietary management. Full article

Background: Evidence-based complex psychological interventions have been widely applied and appear promising in improving emotional and behavioral disturbances such as depression and sleep problems. However, the effectiveness of these complex psychological interventions, particularly in comparison to active control groups, has yet to be confirmed. Objectives: To explore the effects of a complex set of intervention strategies on depression and sleep quality, two randomized controlled trials with active control conditions were conducted. Method: A total of 97 college students with depressive symptoms were enrolled in study 1 (Intervention = 48; Active control = 49) and participated in the intervention for depression. A total of 110 college students with sleep problems (intervention = 54; active control = 56) participated in the intervention for sleep quality in study 2. College students in the intervention group received a combination intervention program of cognitive behavioral therapy, mindfulness exercises, and positive psychology for depression or sleep quality, while participants in the active control group read popular science articles about mental health. The intervention lasted two weeks. Depression, sleep quality, and related factors were measured before, during, and after the interventions. Results: Although both the intervention and active control conditions effectively reduced depression and sleep problems, the trend of change over time was consistent between both groups. Overall, the effects of the intervention group were not better than those of the active control group. Conclusions: The effects of short-term, multi-strategy interventions on depression and sleep quality in our study were not better than simply reading articles about mental health. These findings suggest that simply combining evidence-based components does not necessarily produce superior outcomes. Full article

Background: Chronotype refers to an individual’s preferred timing of activity and rest within a 24-h period, reflecting behavioral manifestations of the endogenous circadian rhythm. Variations in circadian timing may contribute to the temporal characteristics and pathophysiology of tension-type headache (TTH). TTH is the most common primary headache disorder and can have a significant impact on quality of life. While chronotype has been shown to influence pain perception, mood, and sleep quality in various chronic pain conditions, its relationship to TTH remains insufficiently explored. Aim: We aimed to determine the distribution of chronotypes among patients with TTH and to assess their associations with pain characteristics, depression, sleep quality, and quality of life. Methods: This cross-sectional study involved 77 adult patients diagnosed with TTH according to the International Classification of Headache Disorders (ICHD)-III criteria. Patients were recruited from the neurology outpatient clinic at SANKO University Hospital between June 2021 and June 2022. Data were collected using the Morningness–Eveningness Questionnaire (MEQ), the Visual Analogue Scale (VAS), the Hospital Anxiety and Depression Scale (HADS), the Pittsburgh Sleep Quality Index (PSQI), and the Short Form-36 (SF-36). Chronotypes were categorized as morning, intermediate, or evening. Group differences were analyzed using ANOVA, Kruskal–Wallis and linear regression models. Results: The mean age of the study sample was 29.0 [24.0–35.0] years. Fifty-five participants (71.4%) had an intermediate chronotype, 14 (18.2%) had a morning chronotype, and 8 (10.4%) had an evening chronotype. Those with an evening chronotype had a significantly lower BMI than those with an intermediate chronotype (p = 0.035) and lower scores on the SF-36 Role Limitations due to Physical Problems domain than those with a morning chronotype (p = 0.039). Chronotype (as assessed by the MEQ) was negatively correlated with sleep quality, with evening chronotypes showing poorer PSQI scores. No significant differences were found in VAS (pain intensity) and HADS (depression) scores among chronotypes. Linear regression analyses indicated that chronotype significantly predicted SF-36 Bodily Pain scores, whereas sex significantly predicted VAS pain intensity (p = 0.001). Conclusions: Evening chronotype is associated with poorer sleep quality and greater role limitations due to physical problemsin patients with TTH, which can potentially exacerbate the disabilities associated with headaches. Tailored interventions targeting chronotype and sleep may improve quality of life in this population. Full article

Urological cancers are associated with reduced quality of life and high psychological burden, yet affected patients receive less psychosocial support than other cancer groups. Electronic health literacy (eHL) may facilitate independent access to resources, but its role for psychological outcomes and quality of life in this group is unclear. This study examined associations between eHL, psychological symptoms, and quality of life during transition from inpatient to outpatient care. A prospective, single-centre observational study was conducted. Eligible inpatients (urological cancer, Distress Thermometer ≥5 and/or request for psycho-oncological support) received an initial psycho-oncology consultation and completed surveys during inpatient treatment (T1) and three months later (T2). Measures included socio-demographics, PO-BADO, eHL (eHEALS), distress, depression (PHQ-2), anxiety (GAD-2), and quality of life (EORTC QLQ-C30). Of 108 patients completing T1, 71 completed T2. After controlling for age, eHL was not significantly associated with distress, depression, anxiety, or quality of life. Age did not moderate these relationships. In this sample, eHL showed no significant associations with psychological outcomes or quality of life. However, higher age was linked to lower eHL, suggesting that older patients may face barriers to digital health engagement. Age-related differences in eHL should be considered when designing digital support services for urological cancer patients. Full article

This study evaluated the structural, convergent, and discriminant validity, invariance, and internal consistency of the Generalized Anxiety Disorder—7 (GAD-7), Patient Health Questionnaire—9 (PHQ-9), Somatic Symptom Scale—8 (SSS-8), and Satisfaction with Life Scale (SWLS) among 910 students at the National Autonomous University of Honduras. Mental health issues are common among university students, with anxiety, depression, and somatization often co-occurring from a transdiagnostic perspective. Life satisfaction, meanwhile, is recognized as a protective factor for mental well-being. In response to rising psychological distress among university students, reliable mental health screening tools are critical for early detection and intervention. Confirmatory factor analysis (CFA) supported the unidimensional structure of each scale, while multigroup CFA demonstrated gender invariance. Women reported higher anxiety, depression, and somatization scores, whereas men had higher life satisfaction. Internal consistency, measured by McDonald’s Omega (Ω) and composite reliability, was excellent for GAD-7 (Ω = 0.927), PHQ-9 (Ω = 0.919), and SSS-8 (Ω = 0.873). Convergent and discriminant validity were supported through significant correlations: GAD-7, PHQ-9, and SSS-8 were positively correlated with each other, and negatively correlated with SWLS. These findings confirm that the four scales are psychometrically sound instruments for evaluating mental health in Honduran university students. Full article

Objectives: Latinx Americans represent the largest ethnic minority group (nearly 19% of the U.S. population). Their behavioral health has received increasing attention as they exhibit elevated prevalence rates of anxiety (ANX), depression (DEP), and substance use disorders (SUDs). The National Latino and Asian American Study (NLAAS) is the first national population-based mental health study of Latinx Americans and is the most comprehensive resource for understanding their behavioral health. This systematic review aims to synthesize peer-reviewed publications using the NLAAS dataset to identify psychosocial determinants of the three key outcomes. Method: We followed PRISMA to search for English peer-reviewed articles published in EBSCO, Embase, PsycINFO, Web of Science, and PubMed. Inclusion criteria were as follows: (1) Latinx in the NLAAS database; (2) ANX, DEP, or SUD; (3) risk or protective factors; and (4) peer-reviewed publications in English. Search terms such as Latino, Latina, anxiety, depressive symptoms, substance abuse, and NLAAS were used to search for relevant articles. Two authors screened the articles independently and extracted data from each study. Results: Thirty-two studies published between 2007 and 2024 were included in our final review. Among them, 12 studies investigated ANX, and 17 studies examined DEP and SUD, respectively. Sixteen studies assessed protective factors. Ten articles assessed multiple key outcomes. All risk factors were grouped into three categories: Trauma and negative relationships (e.g., childhood maltreatment, negative family relationship, traumatic life experience), acculturation- and immigration-related factors (e.g., nativity, acculturation experience, English proficiency, discrimination), and sociodemographic and social participation factors (e.g., gender, education, income level). Protective factors such as family cohesion, religious activity, gender, and education were also identified. Conclusion: This first systematic review provided comprehensive NLAAS findings on multifaceted cultural, social, and intrapersonal factors that were either negatively or positively associated with three behavioral health outcomes within the U.S. Latinx population. Potential mechanisms by which risk and protective factors influence their mental health, as well as limitations of this review, were discussed. Findings of this review can inform culturally responsive prevention strategies and interventions to reduce behavioral health disparities and to improve mental health outcomes among Latinx Americans. Full article

Background/Objectives: We sought to determine the factors associated with Emergency Department (ED) healthcare workers (HCW) reluctance to seek, utilize, or take advantage of psychological support services during the pandemic. Methods: A 53-item survey, delivered via REDCap, was completed by ED staff in seven hospitals between 15 July 2020 and 24 August 2020. Results: 351 participants (28.7% response rate) completed the survey with 20.1% of respondents endorsing clinically significant psychiatric symptoms and 31.7% of participants endorsing burnout. 75% of those who endorsed significant emotional symptoms did not seek formal psychological support. Most of those (33/44) who did not seek support, despite anxiety and/or depression, reported experiencing practical barriers (access, cost, time, confidentiality) while emotional barriers (not wanting to acknowledge needing help; stigma; embarrassment) were endorsed by 22.7% (10/44). Conclusions: These findings offer several opportunities for intervention, including changes to workflow and culture in the ED which may address emotional barriers to self-care and pragmatic system changes that may help address practical barriers. Full article

Background/Objectives: Cancer-Related Cognitive Impairment (CRCI) is a frequent and significant complication in cancer patients, involving deficits in memory, attention, and executive functions. Its multifactorial origin includes effects of oncological treatments, psychological factors, and aging—particularly impacting older adults. Early detection through thorough cognitive and psychological evaluation is crucial to optimizing management and maintaining quality of life. Methods: This cross-sectional descriptive-correlational study employed a non-probabilistic convenience sampling technique to recruit cancer patients receiving chemotherapy at the Complejo Asistencial Universitario de Salamanca (Spain) between January 2023 and February 2025. Participants were assessed using validated instruments measuring cognitive function (CFRT), subjective memory failures (MFE-30), anxiety and depression (HADS), and sleep quality (PSQI). Statistical analyses included correlation tests, analysis of variance (ANOVA), and multivariable linear regression models to examine associations among cognitive, psychological, and sleep-related variables. Statistical analyses were performed using IBM SPSS Statistics version 29.0 (IBM Corp., Armonk, NY, USA). Results: Participants (mean age 63.18 years) showed a notable presence of subjective memory complaints and mild anxiety/depression symptoms. Cognitive performance correlated negatively with anxiety/depression (ρ = −0.146, p < 0.05) and sleep disturbances (ρ = −0.583, p < 0.001). Sleep quality worsened with increasing age (ρ = 0.583, p < 0.001), and age itself showed significant associations with cognitive decline and psychological symptoms. No significant link was found between anxiety/depression and sleep quality. Conclusions: Findings confirm CRCI as a multifactorial condition influenced by psychological distress, sleep quality, and aging. The study highlights the importance of early, multidimensional cognitive assessment, especially in older patients, to enable timely interventions. Integrating objective and subjective measures alongside emotional and sleep evaluations enhances understanding and management of CRCI, ultimately improving patient outcomes and quality of life. Full article

Background/Objectives: This study examined the prevalence of depression among older adults in Busan—the first metropolitan city in South Korea to become a super-aged society—and identified the social environmental factors associated with depression. Methods: Using data from the 2023 Korea Community Health Survey (KCHS), 5143 individuals aged 65 and older residing in Busan were analyzed. Depressive symptoms were measured using the PHQ-9, and social environmental factors—including unmet medical needs, satisfaction with the community environment, participation in social activities, and frequency of social contact—were derived from KCHS items. Descriptive statistics and logistic regression were performed using SPSS, version 29.0. Results: Participants’ mean age was 73.50 ± 0.11 years, and 54.4% were female. The average depression score was 2.85 ± 0.06, with 3.7% having moderate, 1.2% moderately severe, and 0.4% severe depression. Logistic regression revealed that low healthcare accessibility was significantly associated with higher odds of moderate-to-severe depression (OR = 2.54, 95% CI = 1.78–3.62). Conversely, higher satisfaction with community environment (OR = 0.80, 95% CI = 0.73–0.87) and greater participation in social activities (OR = 0.68, 95% CI = 0.53–0.87) were associated with lower odds of depression. Conclusions: Depression in older adults is a multidimensional phenomenon shaped by the complex interplay of individual, health-related, and socio-environmental factors. Region-specific, community-based programs that enhance living environments, expand social participation, improve healthcare access, and promote positive health perceptions are essential. These findings can inform integrated nursing and policy interventions that support healthy aging and enhance older adults’ well-being. Full article

Problematic Internet use is an emerging concern in adolescent mental health and is closely linked to psychological distress and emotional regulation. This cross-sectional study analyzed self-reported data from 1550 adolescents aged 11–19 years in South Tyrol, a linguistically and culturally diverse region in Northern Italy. Problematic Internet use was measured using the validated Generalized Problematic Internet Use Scale 2 (GPIUS-2), along with standardized instruments for depressive symptoms (PHQ-2) and anxiety (SCARED-GAD). Multivariable regression analysis revealed that depression and anxiety symptoms were the strongest independent predictors of higher GPIUS-2 scores. In contrast, demographic factors such as gender, family language, urbanization, migration background, and parental education were not significantly associated with PIU. Modest associations were observed between GPIUS-2 scores and both perceived economic burden and parental use of digital control tools. Perceived family support showed a small protective effect. These findings underscore the central role of emotional vulnerability in adolescent PIU and suggest that interventions should focus on supporting mental health and adaptive coping rather than solely targeting screen time or structural family characteristics. Full article

Background: Social media addiction is a growing concern among undergraduates, with nursing students particularly vulnerable as their stressful academic and clinical context may promote excessive use, impaired sleep, and higher depression risk. Therefore, we aimed to evaluate whether sleep disturbance mediates the association between problematic social media use and symptoms of depression among nursing students in Mexico. Methods: We conducted a multicenter, cross-sectional, analytical study using a random sample of 638 nursing students from three Mexican public universities. Between August and December 2024, participants completed validated scales for social media addiction, sleep quality, and depression. Counterfactual causal mediation analysis was performed using logistic regression with robust errors. Results: Sleep disturbance affected 51.7% of students, and 27.5% reported depression. Social media addiction showed a dose–response association with both outcomes. Mediation analysis revealed a total effect on depression (OR = 2.19; 95% CI = 1.45–3.30) and an indirect effect via sleep disturbance (OR = 1.22; 95% CI = 1.01–1.38), explaining 31.4% of the effect. Conclusions: Sleep disturbance partially mediates this association. Interventions addressing digital behavior and sleep hygiene may improve mental health in nursing students. Full article

In the US, research suggests that racial disparities exist in the prevalence of postpartum depression (PPD) and postnatal anxiety (PNA), with Black mothers experiencing PPD and PNA at a higher rate than their white counterparts. As a result, research that attempts to understand the antecedents of PPD and PNA in Black mothers may have value to the development of better interventions to reduce both in this subpopulation. Theory suggests that race-related stress (RRS) may be a contributing factor to PPD and PNA symptoms among Black mothers. RRS is defined as the stress associated with racism and discrimination encountered by Black women in their daily lives. In the current study, to test the relationship of RRS to PPD and PNA, we surveyed (N = 79) Black mothers who recently gave birth. The survey consisted of the Index of Race-Related Stress (IRRS), the Edinburgh Postnatal Depression Scale (EPDS), and the Postpartum Specific Anxiety Scale (PSAS-RSF), along with items capturing income, education, mental health status, and the number of children per mother. Income and mental health status, education, and the number of children per mother were used as covariates in a multivariate regression model with IRRS scores as the independent variable and EPDS and PSAS-RSF scores as twin dependent variables. These covariates were selected because of their established relationship with PPD and PNA. The data was analyzed using structural equation modeling. The results indicated that the model provided good fit to the data, (X² = 6.32, df = 9; p = 0.707; RMSEA = 0.00 [90% CI: 0.000, 0.097]; CFI: 1.0). Moreover, IRRS scores were significantly correlated with both PPD symptoms (β = 0.45; p < 0.001) and PNA symptoms (β = 0.3837, p < 0.001), respectively. Such results suggest that future research into the role race-related stress plays in the development of PPD symptoms and PNA symptoms may have value in the reduction in both among Black mothers. Full article

The sustained accumulation of household debt may pose significant challenges to children’s mental health in China, particularly their depressive symptoms. However, limited research has examined this relationship. Using data from the 2020 and 2022 waves of the China Family Panel Studies, covering 805 respondents, we employed a pooled ordinary least squares (POLS) regression model to investigate the impact of household debt on children’s depressive symptoms. Our results show that higher household debt is associated with an increase in children’s depressive symptoms, primarily driven by housing debt and nonbank-sourced debt. These associations appear to operate through reduced parent–child intimacy and increased parent–child conflict. Notably, the adverse impacts are mitigated when fathers work longer hours to repay debt and when marital satisfaction is higher. Overall, our findings highlight important implications for enhancing child welfare and promoting family financial stability. Full article

Background: Women are disproportionately affected by depression and generalized anxiety disorder compared to men throughout their lives. Hormonal changes during the menstrual cycle, pregnancy, postpartum, and menopause are often associated with mood disturbances. Evidence suggests that modulating the gut microbiome through gut-targeted interventions may offer a novel therapeutic approach for various mental health conditions. Objective: This systematic review and meta-analysis aimed to synthesize evidence from randomized controlled trials (RCTs) on the efficacy of gut microbiome-targeted interventions in improving mental health symptoms in women during key hormonal transitions. Methods: A systematic search was conducted from inception to August 2025 across Embase, MEDLINE (PubMed), Web of Science, PsycINFO, CINAHL, Scopus, FSTA, CENTRAL, the WHO International Clinical Trials Registry Platform, and ClinicalTrials.gov. Two reviewers independently screened, extracted data, and assessed study quality. Methodological quality was evaluated using Cochrane’s risk-of-bias tool (RoB 2.0). Statistical analyses were performed with Comprehensive Meta-Analysis software (version 4). Results: Eleven RCTs were included, of which eight were used in the meta-analyses. Gut microbiome-targeted interventions significantly reduced depressive symptoms (Standardized Mean Difference (SMD) = −0.848; 95% Confidence Interval (CI): −1.470 to −0.226; p = 0.008) and anxiety symptoms (SMD = −0.997; 95% CI: −1.684 to −0.311; p = 0.004) versus controls. Heterogeneity was high (depression: Cochran’s Q = 87.1, I² = 92%, τ² = 0.729; anxiety: Q = 35.3, I² = 89%, τ² = 0.535), but sensitivity analyses confirmed robustness. Meta-regressions indicated that treatment duration was not a significant moderator (depression: p = 0.12; anxiety: p = 0.28). Conclusions: Gut-targeted interventions significantly reduced symptoms of both depression and anxiety, highlighting their potential as complementary therapeutic strategies for managing mood disorders in women across hormonal life stages. However, high heterogeneity limits the ability to determine optimal standardized clinical recommendations, highlighting the need for further research to guide clinical applications and inform individualized approaches to treatment. Full article

Background: Locus of control (LoC) may shape how older adults appraise aging, particularly in acute geriatric rehabilitation. Evidence linking internal/external LoC to domain-specific Views on Aging (VoA, containing Physical Loss, Social Loss, Personal Growth, Self-awareness/Gains) remains limited. Methods: We analyzed a cross-sectional cohort of patients aged 70 and above from an acute geriatric rehabilitation unit (N = 103) and contextualized findings with a 1:1 Mahalanobis-matched subsample from the German Ageing Survey. Internal and external LoC and covariates (age, sex, Barthel, cognitive function, depressive symptoms, health satisfaction) were standardized (z). Associations were estimated using (i) ordinary least squares (OLS) regression across eight LoC effects, as well as (ii) proportional-odds ordinal models (quartiles; logit link), as a complementary, distribution-robust approach. Results: For the Physical VoA domain, higher internal LoC related to more positive appraisals (OLS β = 0.133, 95% CI 0.043–0.223, p = 0.035; OR = 3.52), whereas higher external LoC related to less positive appraisals (β = −0.165, 95% CI −0.285 to −0.045, p = 0.035; OR = 0.274). Internal LoC also increased the odds of more positive Personal Growth (OR = 1.64, 95% CI 1.04–2.72), while effects on Social Loss (external LoC OR = 0.649, 95% CI 0.418–0.991) and Gains were smaller. Univariate Spearman correlations were directionally consistent. In the DEAS comparison, older patients showed greater endorsement of both physical losses and gains. Conclusions: In acute geriatric rehabilitation, internal control beliefs align with more positive views of physical aging and growth, whereas external control aligns with less positive physical (and modestly social) views. The results position LoC as a clinically relevant correlate of aging appraisals. Full article