Search Results (1,426)

The COVID-19 pandemic precipitated unprecedented social isolation measures, profoundly disrupting daily life, educational routines, and mental health worldwide. University students, already susceptible to psychological distress, encountered intensified challenges under remote learning and prolonged confinement. This longitudinal study examined fluctuations in anxiety and mood among 102 Brazilian university students during the pandemic, distinguishing between those solely engaged in academic pursuits and those simultaneously balancing work and study. Data collected via the Brunel Mood Scale and State-Trait Anxiety Inventory in April and July 2021 revealed that students exclusively focused on studies exhibited significant increases in depressive symptoms, anger, confusion, and anxiety, alongside diminished vigor. Conversely, participants who combined work and study reported reduced tension, fatigue, confusion, and overall mood disturbance, coupled with heightened vigor across the same period. Notably, women demonstrated greater vulnerability to anxiety and mood fluctuations, with socioeconomic disparities particularly pronounced among females managing dual roles, who reported lower family income. These findings suggest that occupational engagement may serve as a protective factor against psychological distress during crises, underscoring the urgent need for tailored mental health interventions and institutional support to mitigate the enduring impacts of pandemic-related adversities on the student population. Full article

This study aims to provide a comprehensive overview of psychological distress among medical students in Spain, a growing concern given the high prevalence rates of anxiety, depression, and burnout reported across multiple medical schools and universities. To assess the scope and key characteristics of this phenomenon, a thorough literature search was conducted in the PubMed, ProQuest, and Web of Science (WoS) databases. Studies published between 2010 and 2024 in peer-reviewed scientific journals, written in English or Spanish, and specifically focused on medical students enrolled in Spanish universities were considered for inclusion. A total of 14 studies were analysed. The findings indicate that psychological distress often emerges early in medical training and tends to intensify as students progress academically. Female medical students are consistently more affected, as most of the studies reviewed indicate that they exhibit higher levels of depressive symptoms, trait anxiety, and perceived stress. Some research also suggests greater levels of burnout among female students compared to their male peers. Key contributing factors include academic overload and dissatisfaction, sleep deprivation, and the use of maladaptive coping strategies. Although awareness of the issue is increasing, available evidence suggests that institutional responses remain limited, and that only a small number of universities have implemented structured mental health programmes. Overall, the results underscore the urgent need for institutional reforms in Spanish medical education to safeguard students’ mental wellbeing. Key priorities include revising curricula, implementing structured emotional support programmes, and ensuring accessible services—requiring coordinated, long-term commitment across academic, healthcare, and policy sectors. Future research should explore longitudinal trends and the effectiveness of targeted interventions. Full article

Background/Objectives: Psychosocial (PS) factors and cognitive dysfunction (CD) in patients with atrial fibrillation (AF) may negatively impact treatment compliance. The PS profile covers multiple psychological and socio-economic factors, although research is mostly limited to depression, anxiety, and work stress. This study assessed the prevalence of a broad range of PS factors in patients with AF and their relationship with cognitive decline. Methods: We retrospectively analyzed data from patients referred to a cardiovascular rehabilitation clinic between March 2017 and April 2023 who underwent standardized assessments of PS factors, cognition, and quality of life. Results: Of the 798 included patients, 230 (28.8%) had AF, with a mean age of 68.07 years (SD 9.60 years). Six of nine PS factors were present in more than half of the overall sample. Compared to non-AF patients, those with AF showed significantly higher levels of social isolation, depression, and hostility, whereas low socioeconomic status, family and work-related stress, and other mental disorders were more frequent in the non-AF group. CD was present in 67.4% of the total cohort and was more prevalent in AF patients with a higher PS burden. Patients with permanent AF reported the poorest health status. Conclusions: Integrating assessments of PS factors and cognition in cardiac rehabilitation is feasible and supports a more comprehensive, patient-centred model of care in AF. Full article

Background: Youth with chronic rheumatologic diseases undergo medical experiences that can lead to post-traumatic stress disorder (PTSD). Understudied in pediatric rheumatology, medical PTSD can be significantly distressing and impairing. Objective: This study explored the prevalence of medical PTSD symptoms in youth with chronic inflammatory arthritis and associated factors, including pain, disease activity, mental health history, and anxiety sensitivity. Methods: A cross-sectional study of 50 youth (ages 8–18) with juvenile idiopathic arthritis (JIA) and childhood-onset systemic lupus erythematous (cSLE) was conducted at a pediatric rheumatology clinic. Participants completed self-report measures assessing post-traumatic stress symptoms (CPSS-V), pain, anxiety sensitivity (CASI), pain-related self-efficacy (CSES), adverse childhood experiences (ACEs), and fibromyalgia symptoms (PSAT). Clinical data included diagnoses, disease activity, treatment history, and demographics. Results: Forty percent had trauma symptoms in the moderate or more severe range. The 14% likely meeting criteria for probable medical PTSD were older (median 17 vs. 15 years, p = 0.005), had higher pain scores (median 4 vs. 3, p = 0.008), more ACEs (median 3 vs. 1, p = 0.005), higher anxiety sensitivity scores (median 39 vs. 29, p = 0.008), and higher JIA disease activity scores (median cJADAS-10 11.5 vs. 7.5, p = 0.032). They were also more likely to report a history of depression (71 vs. 23%, p = 0.020). No associations were found with hospitalization or injected/IV medication use. Conclusions: Medical trauma symptoms are prevalent in youth with chronic inflammatory arthritis. Probable PTSD was associated with pain and psychological distress. These findings support the need for trauma-informed care in pediatric rheumatology. Full article

Background: Musculoskeletal disorders significantly affect healthcare professionals, particularly physiotherapists, due to the physical demands of their work. The link between physical ailments and psychological distress is especially prominent in clinical settings. Objectives: To assess the prevalence of work-related low back pain (LBP), stress, anxiety, and depression among physiotherapists in Saudi Arabia, and to identify associated local risk factors. Methods: A cross-sectional study using convenience sampling included 710 licensed physiotherapists across Saudi Arabia. Participants completed an online survey containing demographic data and the validated measures, including the Visual Analog Scale (VAS) for pain, the Oswestry Disability Index (ODI), and the Depression, Anxiety, and Stress Scale-21 (DASS-21) for psychological distress. Data were analysed using descriptive statistics, chi-square tests, correlation, and regression analyses. Results: Of 710 responses, 697 were valid; 378 physiotherapists reported work-related LBP. The mean pain intensity was 4.6 (SD = 1.6), with 54.2% experiencing moderate to severe disability. Mental health results showed 49.7% had depressive symptoms and 33.9% experienced some level of anxiety. Significant correlations were observed between disability and psychological distress (anxiety: r = 0.382; depression: r = 0.375; stress: r = 0.406; all p < 0.001). Regression analyses indicated psychological distress significantly predicted disability, with R² values ranging from 0.125 to 0.248, being higher among inpatient physiotherapists. Conclusions: This study reveals a high prevalence of LBP and psychological distress among Saudi physiotherapists, with stress being the strongest predictor of LBP severity. Integrated ergonomic and mental health interventions, including workplace wellness programs and psychological support, are recommended to reduce risks and promote a healthier, more sustainable physiotherapy workforce. Full article

Background/Objectives: Heart transplantation is a life-saving procedure for patients with end-stage heart failure, yet it involves significant psychological and emotional challenges throughout its various stages. International guidelines recommend a multi-professional approach to the care of these patients and a psycho-social assessment for listing. The recommendations focus on content aspects, but not on the psychometric measure to be administered to patients as part of the assessment. Therefore, the purpose of this study is to provide the preliminary results of administering the protocol used by our center, measuring coping strategies, cognitive functioning, quality of life, and psychological distress in a sample of patients who are candidates for and undergo cardiac transplantation, and to observe any variations after the procedure. Methods: We conducted a comprehensive psychological-clinical assessment involving 40 patients, focusing on psychosocial functioning, cognitive reserves, mental health, and coping strategies. Tools such as the Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT), Beck Depression Inventory-II (BDI-II), Montreal Cognitive Assessment (MoCA), General Anxiety Disorder 7 (GAD-7), and Medical Outcomes Survey Short Form 36 (SF-36) were employed to evaluate readiness for transplantation and post-transplant adaptation. Results: Results showed high levels of clinical anxiety (52.5%) and low perceived physical health (98%) before the transplant, while post-operative evaluations indicated reduced anxiety (13.51%) and depressive symptoms (10.81%), along with improved psychological well-being and reintegration into daily life. Conclusions: These results show improvement in physical and cognitive levels, accompanied by a state of enhanced psychological well-being after transplantation. A longitudinal psychological approach, from pre-transplant screening to post-discharge follow-up, is needed to address distress, improve coping mechanisms, and promote treatment adherence. This integrative strategy is critical to improving the quality of life and long-term outcomes for heart transplant recipients. Full article

Background. Healthcare workers’ health can be influenced by physical, psychological, social, emotional, and work-related stress. MountainTherapy Activities (MTAs) are an integrated therapeutic approach that uses nature to enhance their well-being through group activities like hiking. This cross-sectional study examines well-being levels among Italian Departments of Mental Health workers who do or do not participate in MTAs. It hypothesizes that MTAs may reduce burnout, boost psychological resilience, and increase job satisfaction. Methods. The study involved 167 healthcare workers from 11 Italian Local Health Authorities, divided into MTA (who take part in MTA; n = 83) and non-MTA (who have never participated in MTA; n = 84) groups. They completed five validated questionnaires on psychological distress, burnout, resilience, job engagement, and psychological safety. Data were compared between groups, considering MTA frequency and well-being differences during MTAs versus workplace activities. Results. MTA participants scored higher in psychological well-being (t(117.282) = −1.721, p = 0.044) and general dysphoria (t(116.955) = −1.721, p = 0.042). Additionally, during MTAs, they showed greater job engagement (vigor: t(66) = −8.322, p < 0.001; devotion: t(66) = −4.500, p < 0.001; emotional involvement: t(66) = −8.322, p = 0.002) and psychological safety (general: t(66) = −5.819, p < 0.001; self-expression: t(66) = −5.609, p < 0.001) compared to other activities. Conclusions. MTAs can be considered a valid intervention for the promotion of the mental health of healthcare workers. Full article

Background: Adolescence is a key period of development characterized by emotional, cognitive, and social changes that impact positive mental health (PMH). While social support is a well-established protective factor, cognitive and emotional processes, such as cognitive fusion and regulation of distress, also play a critical role. Objective: This study aimed to examine the relationship among various cognitive (i.e., cognitive fusion), emotional (i.e., regulation of distress), and social determinants (i.e., social support) in adolescents’ PMH, as their interplay could reflect theoretical models highlighting how these factors jointly shape adolescents’ mental health. Methods. A cross-sectional study was conducted with 505 adolescents (aged 13–15 years) in Spain. Participants completed online questionnaires assessing sociodemographic variables, cognitive fusion, regulation of distress, PMH, and social support from friends. Descriptive statistics, correlation analyses, and mediation and moderated mediation models were conducted, adjusting for relevant covariates. Results: Cognitive fusion was negatively correlated with regulation of distress, PMH, and social support, whereas regulation of distress showed a positive association with both PMH and social support. Mediation analysis indicated that regulation of distress significantly mediated the relationship between cognitive fusion and PMH. Furthermore, peer support moderated this mediated relationship: higher levels of support mitigated the negative impact of regulation of distress on PMH. Sociodemographic analyses revealed that girls, non-national students, and those receiving educational support showed less favorable outcomes. Conclusions: Cognitive, emotional, and social variables jointly influence adolescents’ PMH. Emotional regulation serves as a mediator of cognitive fusion and PMH, while social support from peers mediates the impact of psychological distress. Targeted interventions should prioritize emotional regulation strategies and enhancing peer support, especially among more vulnerable groups. Full article

Background: Gastrointestinal (GI) cancer patients face a four-fold higher suicide risk than the general US population. This study explores psychosocial aspects of GI cancer patient experiences, assessing suicidal ideation and behavior, mental distress during treatment phases, and psychosocial factors on mental health. Methods: A two-phase mixed-methods approach involved a web-based survey and follow-up interviews. Quantitative data analysis validated mental health and suicidal ideation constructs, and correlation analyses were performed. The patient journey was charted from diagnosis to treatment. Results: Two hundred and two individuals participated, with 76 from the rural Appalachian region and 78 undergoing treatments. Quantitative analysis showed a higher prevalence of passive suicidal ideation than active planning. The post-treatment recovery period was the most emotionally challenging. Qualitative data emphasized emotional support and vulnerability to isolation. Care quality concerns included individualized treatment plans and better communication. Patients also needed clear, comprehensive information about treatment and side effects. The in-depth interview with four GI cancer patients revealed a healthcare system prioritizing expedient treatment over comprehensive care, lacking formal psychological support. AI emerged as a promising avenue for enhancing patient understanding and treatment options. Conclusions: Our research advocates for a patient-centric model of care, enhanced by technology and empathetic communication. Full article

Background/Objectives: Healthcare workers (HCW) have increased the risk of occupational stress injuries and adverse mental health outcomes, which were exacerbated during the COVID-19 pandemic. Understanding HCW psychological distress patterns and help-seeking behaviors can inform responsive resource development that may mitigate negative outcomes in future crises. This paper provides insights on monthly trends in HCW distress and support utilization at a large Canadian hospital over a 14-month period. Methods: As part of a hospital-wide wellness initiative during COVID-19, the STEADY program emailed monthly confidential wellness assessments to hospital staff from April 2020 to May 2021. The assessments included screens for burnout, anxiety, depression and posttraumatic stress, types of support accessed, and demographic information. Repeated cross-sectional data were summarized as monthly proportions and examined alongside longitudinal COVID-19 data. Results: A total of 2498 wellness assessments were submitted (M = ~168 monthly, range: 17–945). Overall, 67% of assessments had at least one positive screen for distress. Average positive screens were 44% for anxiety, 29% for depression, 31% for posttraumatic stress, and 53% for burnout. Despite high distress, most respondents used informal supports (e.g., family/friends), highlighting limited formal support use. Conclusions: HCWs experienced sustained high levels of psychological distress during the COVID-19 pandemic, with burnout remaining a predominant and persistent concern. The limited use of formal support services may indicate barriers to accessing these types of supports. Our findings underscore the need for accessible and acceptable mental health supports for HCW during prolonged crises. Full article

The global youth mental health crisis is increasingly intertwined with climate change, as young people experience heightened climate anxiety and ecological grief. This study examines the relationship between nature connectedness, climate worry, coping strategies, and mental health outcomes among Canadian university students. Drawing on Pihkala’s process model of eco-anxiety, we propose the Developing Ecological Consciousness Model, a three-act framework that traces young people’s journey from climate awareness to meaningful engagement. Using path analysis on two independent samples (N = 1825), we found that nature connectedness predicts increased climate worry, which in turn correlates with higher levels of depression and anxiety. However, meaning-focused coping emerged as a protective factor, mitigating these negative mental health impacts. Problem-focused coping alone was insufficient, highlighting the need for balanced strategies. The study underscores the dual role of nature connectedness—both as a source of climate distress and a foundation for resilience. These findings highlight the need for interventions that foster ecological consciousness while addressing the emotional toll of climate change, offering insights for policymakers, educators, and mental health practitioners working with youth in a warming world. Full article

Background/Objectives: Cognitive dysfunction is frequently observed in chronic migraine (CM) patients, but the contributing medical and psychological factors remain unclear. This study investigated associations between the cognitive reserve and medical, psychological, and lifestyle factors in individuals with CM. Methods: A retrospective review was conducted at a tertiary referral center in Taiwan. Cognitive function was evaluated via the mini-mental state examination (MMSE), while anxiety and depression were evaluated via the Beck Anxiety and Depression Inventories. Clinical variables included monthly headache days, headache intensity (numerical rating scale), migraine-related disability, and use of preventive medications. Multivariable linear regression analyses were performed to identify independent predictors of the cognitive reserve after adjusting for relevant covariates. Results: Among 50 participants (86.0% women; mean age 42.48 ± 13.47 years), six (12.0%) exhibited objective cognitive impairment (MMSE < cutoff). After a covariate adjustment, higher headache intensity was significantly associated with a lower cognitive reserve in anxiety and depression models. Patients with objective cognitive impairment reported significantly higher levels of pain, anxiety, and depression. Conclusions: The headache intensity, anxiety, and depression were significantly linked to a lower cognitive reserve in CM patients. These findings highlight the importance of incorporating routine psychological and cognitive assessments in CM care and suggest potential targets for integrative treatment strategies. Full article

Delirium is a common mental health condition encountered in hospitals that increases mortality, hospital length of stay, and healthcare costs. Incarcerated individuals have higher rates of known risk factors for delirium, including mental and physical illness, psychological distress, and stigmatization and may be at increased risk of developing the condition. Despite this, there is a paucity of research in this specific area of psychiatry. We identified ethical concerns, feasibility with the electronic medical record, and stigmatization as reasons why adequate research into this population is limited. Nevertheless, we call on more dedicated research into delirium within the incarcerated population to enhance better care practices and advocate for these patients. Full article

Background: Psychological problems post-stroke can negatively impact stroke survivors. Although general psychological services exist (e.g., NHS Talking Therapies), access remains limited, particularly for individuals with post-stroke communication and cognitive impairments. Stroke service staff report low confidence in managing psychological distress. This study is the first to explore the barriers and facilitators to implementing a novel intervention package comprising a cross-service care pathway and staff training to enhance post-stroke psychological provision. Methods: Staff from stroke and mental health services in four UK regions, recruited through purposive sampling to ensure diversity of services and professional roles, participated in semi-structured interviews or focus groups, guided by the Theoretical Domains Framework (TDF), before and after implementation of the intervention package. Pre-implementation interviews/groups identified anticipated barriers and facilitators to implementation and training needs, informing the development of site-specific intervention packages; post-implementation interviews/groups explored experienced barriers, facilitators and perceptions of the intervention. Interviews underwent thematic analysis using the TDF. Results: Fifty-five staff participated pre-implementation and seventeen post-implementation, representing stroke (e.g., nurse, physiotherapist, consultant) and psychology (e.g., counsellor, psychological therapist) roles across acute, rehabilitation, community, and voluntary services. Challenges anticipated pre-implementation included: limited specialist post-stroke psychological support; low staff confidence; and fragmented service pathways. Post-implementation findings indicated increased staff knowledge and confidence, enhanced screening and referral processes, and stronger inter-service collaboration. Implementation success varied across sites (with some sites showing greater ownership and sustainability of the intervention) and across staff roles (with therapy staff more likely than nursing staff to have received training). Conclusions: Effective implementation of an intervention package to increase psychological provision post-stroke requires staff engagement at all levels across all services. Staff investment influenced ownership of the intervention package, beliefs about priorities and overall enhancement of service capability. Full article

Background: Medical education is considered one of the most academically and emotionally demanding training programs. Throughout their education, medical students are exposed to various factors that can lead to psychological distress, depression, and anxiety. The aim of this longitudinal study was to examine the changes in psychological distress, depression, anxiety levels and internet addiction among medical students throughout their six-year education and to identify the contributing factors. Methods: The study cohort consisted of 282 students who enrolled in the medical faculty in the 2017–2018 academic year. A questionnaire including sociodemographic characteristics, the General Health Questionnaire-12 (GHQ-12), Beck Depression Inventory (BDI), State–Trait Anxiety Inventory (STAI), and Young Internet Addiction Test (IAT) was administered to the students during the first week of their education. The same questionnaire was readministered at the end of the third and sixth years. Friedman’s variance analysis was used to compare measurement data across the three time points, while Cochran’s Q Test was employed for categorical variables. Results: The median scores of the GHQ-12, BDI, S-Anxiety, and IAT significantly increased from the first to the sixth year (p < 0.05). The prevalence of depressive symptoms, S-Anxiety, and risky internet use significantly increased from the first to the final year, particularly between the third and sixth years. According to logistic regression analysis based on sixth-year data, students whose fathers were university graduates, who had been diagnosed with COVID-19, and who were dissatisfied with their social lives were found to be at increased risk for psychological distress and depression. Students with high parental expectations were found to be at risk of depression and S-anxiety. Those dissatisfied with their occupational choice were at risk for both psychological distress and S-anxiety. Conclusions: It was found that the mental health of medical students deteriorated during their education, especially during the clinical years. Given that these students will be responsible for protecting and improving public health in the future, it is essential to prioritize their own mental well-being. Interventions aimed at preserving the mental health of medical students should be planned. Full article