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ObjectiveMethodResultsConclusionIn this study, we evaluated the psychometric properties of the Depression Anxiety Stress Scales 21 items (DASS-21) in a mild traumatic brain injury (mTBI) sample.Treatment-seeking adults (n = 347) were recruited from outpatient rehabilitation services in New Zealand. Dimensionality, reliability, person separation index, and differential item functioning (DIF) of the DASS-21 were examined using Rasch analysis.Initial analysis of the complete 21-item DASS showed poor overall fit due to problems with individual items. Fit to the Rasch model was excellent when treated as three composite scores. The stress subscale demonstrated adequate model fit, dimensionality and good reliability. For anxiety, fit was not good, reliability was unsatisfactory and DIF was evident on one item. When this item was removed, fit to the model was still inadequate as was reliability. DIF was also evident for depression, but when this item was removed, fit to the model was adequate.The DASS-21 is a psychometrically sound measure of distress and stress for adults seeking treatment following mTBI. Ordinal to interval score conversion tables are provided to increase the precision of measurement. When assessing depression in a mTBI population, a 6-item depression subscale is recommended. Caution is advised in using the DASS-21 anxiety subscale alone. [ABSTRACT FROM AUTHOR]

Background: Mental distress among retirees and older people is a severe public health challenge, and information on new risk groups is needed. This study aims to identify subgroups of old-age retirees with varying associations between low social support and mental distress by applying model-based recursive partitioning (MOB). Methods: We used the Helsinki Health Study follow-up survey data of old-age retired former municipal sector employees of the City of Helsinki, Finland. Phase 1 data were collected in 2000–2002, when all participants were employed, Phase 2 in 2007, Phase 3 in 2012, Phase 4 in 2017, and Phase 5 in 2022 (n = 4,466, 81% women). Social support and covariates were measured at each Phase 1–5 and the outcome, mental distress (Depression Anxiety Stress Scales [DASS-21]) was measured at a single occasion, during Phase 5. The three subscales and the common factor of general distress were analysed separately. An approach rooted in computational statistics was used to investigate risk factor heterogeneity in the association of low social support and mental distress. MOB combines decision trees with regression analysis to identify subgroups with the most significant heterogeneity among risk factors. Results: Median (IQR) general distress score from DASS-21 was 5.7 (3.0, 9.0), while Social Support Questionnaire number-score (SSQN) was 1.5 (1.15, 2.05). The primary effect modifier for the association between social support and general distress was education (p < 0.001). Those with high education had a different association of low social support and general distress than those with low or medium education. Additionally, the subgroup with low and medium education had a significant effect modification for age (p = 0.01). For the association between low social support and depressive symptoms, the moderating effect of education was dependent on gender, as men with medium–high education had the weakest association, while for women with medium–high education the association was strongest. Conclusions: Our results suggest that stratification by sociodemographic variables is justifiable when investigating risk factors of mental distress in old-age retirees. The incongruent association of low social support and depressive symptoms in men with medium–high education compared to women with medium–high education is a promising target for confirmatory research. [ABSTRACT FROM AUTHOR]

Background: Although the Depression Anxiety Stress Scales, Short Form (DASS-21) was developed for adults, its authors noted no compelling reasons to not use the measure with youth as young as 12 years. Despite increasingly widespread use with youth, psychometric evidence in support of its use with this population needs to be investigated to fully understand its utility. Objective: The goal of this paper was to conduct a systematic review to identify and appraise evidence for the psychometric properties of the Depression Anxiety Stress Scales, Short Form (DASS-21) when used with youth populations. Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this systematic review identified 18 studies that reported relevant information on the psychometrics of the DASS-21 with youth samples. Each article was coded for evidence of three indicators of particular importance to progress monitoring: reliability, validity, and sensitivity to change. Results: Studies have found varied factor structures (i.e., 1–4 factors) for the DASS-21 and validity evidence based on relations to other variables has been limited. As such, further research is needed to understand the utility of the depression, anxiety, and stress subscales. Furthermore, no information is currently available about the sensitivity to change of the measure. Conclusions: Most studies reporting psychometric properties in this review utilized the DASS-21 with mixed-gender groups of secondary school students, thus supporting its use with similar populations. Pending additional inquiry, however, both researchers and practitioners are encouraged to utilize the total score, for which stronger evidence of reliability and validity exist. [ABSTRACT FROM AUTHOR]

Breast cancer impacts the psychological well-being of women, leaving them at risk of developing depression, anxiety, and other stress-related disorders. The Depression Anxiety Stress Scales (DASS-21) is a widely used measure, although empirical evidence regarding its psychometric properties in the breast cancer population is limited. The purpose of this study was to conduct an exhaustive analysis of the psychometric properties of the DASS-21 in a sample of Spanish women diagnosed with breast cancer. Participants were 289 breast cancer patients who completed the DASS-21 and other questionnaires measuring life satisfaction, positive and negative affect, flourishing, perceived stress, and breast cancer-specific stressors. In terms of validity evidence based on the internal structure of the DASS-21, adequate fit indices were obtained for the model based on three first-order factors (depression, anxiety, stress) and one second-order factor (general psychological distress). Reliability coefficients (McDonald's omega) ranged from.84 to.95. Validity evidence based on relationships with other variables was also provided by moderate and strong correlations with well-being indicators and stress measures. The results support the use of the DASS-21 for measuring general psychological distress in the breast cancer context, where it may provide useful information for the design of psychological interventions with patients. [ABSTRACT FROM AUTHOR]

Background/aim: Physicians work under high levels of stress due to factors such as excessive workload, emotional factors, and economic variables. This leads to various health problems such as depression, burnout, fatigue, and hopelessness, resulting in decreased interest in a medical career and an increase in career choice regret. Materials and methods: The study included 300 volunteer resident physicians from Ankara University Medical Faculty Hospital. The data for the research were collected using a survey form prepared by reviewing the literature. The survey consisted of three parts, which questioned the physicians' sociodemographic characteristics and professional choices, including the Depression Anxiety Stress Scale-Short Form (DASS-21) items and the Decision Regret Scale. Results: Of the physicians, 216 (72.0%) chose the medical faculty due to personal preference. The percentage of those who were not regretful about their career choice was 14.3% (n = 43). Those not regretful about their career choice had fewer years in the profession than the others. According to the categorical assessment of the DASS-21, 73.7% (n = 221) of the physicians had depressive symptoms ranging from mild to severe, 78.7% (n = 236) had anxiety symptoms ranging from mild to severe, and 57.7% (n = 173) had stress symptoms ranging from mild to severe. Conclusion: Mental health problems such as depression, anxiety, and stress were common among the resident physicians independent of their sociodemographic characteristics, and this was also associated with the level of career regret. Improving working conditions and personal benefits, addressing economic and other issues for physicians, ensuring their well-being, preventing the development of mental health problems, and early screening and rehabilitation for those affected not only have personal benefits but also contribute positively to job satisfaction, strengthen the patient-physician relationship, and have a significant impact on healthcare services. [ABSTRACT FROM AUTHOR]

Introduction: Coronavirus disease 2019 (COVID-19) has an extremely high infection rate. This study aimed to investigate emotional states and COVID-19 infection of medical workers during the self-management strategy to COVID-19. Methodology: Questionnaires were collected via an online questionnaire platform from 20 December 2022 to 19 January 2023, including demographic characteristics, number of vaccine doses, COVID-19 test results, occupation, attendant situations of workers, clinical symptoms, disease duration, and the Depression, Anxiety and Stress Scale 21. Results: A total of 748 complete questionnaires were collected. The average age of participants was 33.61 ± 8.94 years, and 79.55% participants were female. The proportion of anxiety was significantly higher in the infection group (52.32%) than in the non-infection group (28.45%) (p < 0.001), as was the proportion of stress (41.47% vs. 31.90%, p = 0.046). Medical students (odds ratios (OR) 0.54, 95% confidence interval (CI) 0.31-0.93) and other staff (OR 0.63, 95% CI 0.40-0.98) had a lower risk for depression than doctors (p = 0.024), and attendant and infective situations of workers was the risk factor for depression (p = 0.007). Occupation (p = 0.029) and infected workers (p = 0.001) were related to anxiety. Infected attendant workers had a higher risk for stress (OR 1.97, 95% CI 1.12-3.48) than uninfected attendant workers (p = 0.019). Conclusions: Most medical workers infected with COVID-19 had emotional disorders during the COVID-19 pandemic. Attention and useful measures are suggested to support medical workers. [ABSTRACT FROM AUTHOR]

Nadia Tiara Putri,1 Faiznur Ridho,1,2 Indah Suasani Wahyuni3,4 1Oral Medicine Residency Program, Faculty of Dentistry, Universitas Padjadjaran, Bandung, West Java, Indonesia; 2Oral Health Polyclinic, Oral Medicine Division, Dr. Rivai Abdullah Central General Hospital, Palembang, South Sumatera, Indonesia; 3Oral Medicine Department, Faculty of Dentistry, Universitas Padjadjaran, Bandung, West Java, Indonesia; 4Clinical Research Unit, Dental Hospital, Universitas Padjadjaran, Bandung, West Java, IndonesiaCorrespondence: Nadia Tiara Putri, Email nadia21016@mail.unpad.ac.idIntroduction: The incidence of post-pandemic psychiatric disorders has increased globally in recent decades. Generalized anxiety disorder (GAD) is one of the psychiatric disorders that are partially associated with emotional factors. It can affect the quantity and quality of saliva, present as xerostomia, and trigger the emergence of the geographic tongue (GT).Purpose: This case report aims to discuss the management of xerostomia and geographic tongue in a patient with GAD.Case: A 26-year-old male patient complained of dry and sore mouth for one month after taking medication from the psychiatry department, was diagnosed with GAD, and had already consumed the antidepressant sertraline. Extraoral examination showed dry and exfoliative lips. Intraoral examination showed white plaque with depapilation on the dorsal tongue, frothy saliva, buccal mucosa and dorsal tongue sticking to the dental mirror. The unstimulated salivary flow rate was < 0.2 mL/min (sialometry method). The Depression, Anxiety, and Stress Scale-21 (DASS-21) questionnaire was used to estimate the psychological condition and showed an extremely severe level of anxiety (score = 13). The established oral diagnoses were GT with mild xerostomia and exfoliative cheilitis.Case Management: For two months, patients received hyaluronic acid gel and mouthwash, as well as a non-pharmacological approach to healthy lifestyle counseling. There was an improvement in xerostomia, and the GT became asymptomatic, with a reduction of DASS score in this patient.Conclusion: Improved psychological conditions will improve xerostomia, but the clinical appearance of the geographic tongue is more difficult to eliminate.Keywords: anxiety, DASS-21, geographic tongue, salivary flow rate, xerostomia

Abstract Background Mental distress among retirees and older people is a severe public health challenge, and information on new risk groups is needed. This study aims to identify subgroups of old-age retirees with varying associations between low social support and mental distress by applying model-based recursive partitioning (MOB). Methods We used the Helsinki Health Study follow-up survey data of old-age retired former municipal sector employees of the City of Helsinki, Finland. Phase 1 data were collected in 2000–2002, when all participants were employed, Phase 2 in 2007, Phase 3 in 2012, Phase 4 in 2017, and Phase 5 in 2022 (n = 4,466, 81% women). Social support and covariates were measured at each Phase 1–5 and the outcome, mental distress (Depression Anxiety Stress Scales [DASS-21]) was measured at a single occasion, during Phase 5. The three subscales and the common factor of general distress were analysed separately. An approach rooted in computational statistics was used to investigate risk factor heterogeneity in the association of low social support and mental distress. MOB combines decision trees with regression analysis to identify subgroups with the most significant heterogeneity among risk factors. Results Median (IQR) general distress score from DASS-21 was 5.7 (3.0, 9.0), while Social Support Questionnaire number-score (SSQN) was 1.5 (1.15, 2.05). The primary effect modifier for the association between social support and general distress was education (p

Abstract Breast cancer impacts the psychological well-being of women, leaving them at risk of developing depression, anxiety, and other stress-related disorders. The Depression Anxiety Stress Scales (DASS-21) is a widely used measure, although empirical evidence regarding its psychometric properties in the breast cancer population is limited. The purpose of this study was to conduct an exhaustive analysis of the psychometric properties of the DASS-21 in a sample of Spanish women diagnosed with breast cancer. Participants were 289 breast cancer patients who completed the DASS-21 and other questionnaires measuring life satisfaction, positive and negative affect, flourishing, perceived stress, and breast cancer-specific stressors. In terms of validity evidence based on the internal structure of the DASS-21, adequate fit indices were obtained for the model based on three first-order factors (depression, anxiety, stress) and one second-order factor (general psychological distress). Reliability coefficients (McDonald’s omega) ranged from .84 to .95. Validity evidence based on relationships with other variables was also provided by moderate and strong correlations with well-being indicators and stress measures. The results support the use of the DASS-21 for measuring general psychological distress in the breast cancer context, where it may provide useful information for the design of psychological interventions with patients.

Purpose: Pandemics usually have inequitable effects on the most vulnerable groups of society. Since the start of COVID-19, there has been a horrifying upsurge in cases of sexual and gender-based violence against women, globally. Consequently, frequent breaking news of sexual violence in media aggravated mental distress and worry among women. In this cross-sectional study, we investigated the impact of the rise in active circulation of news of sexual violence on the mental health of working women and students using the validated DASS-21 questionnaire. Methods: A total of 303 women with diverse socio-demographic backgrounds participated in the study. We performed a chi-square test to analyze the association of increase in media reporting with DASS-21total and sub-categories scores. Multivariate linear regression was performed on propensity score-matched subjects to identify psychosocial predictors of mental distress. Results: Increased self-reported worries in response to rise in media reports of sexual violence was found to be significant predictor of mental distress (p < 0.002). Moreover, highly significant correlation between the increase in media reports and scores of depression, anxiety, and stress was observed (p < 0.001). Conclusions: The rise in media reporting of sexual violence in the after math of COVID-19 was found to have a significant psychological impact on the mental health of Pakistani women. This is the first study of its kind on the subject and provides fundamental findings for shaping policy change on responsible media reporting of sexual violence. [ABSTRACT FROM AUTHOR]

Abstract Objective The objective of this study was to assess the validity, reliability, and factorial structure of the Bengali-translated Depression, Anxiety, and Stress Scale—21 (DASS-21) among Bangladeshi health professionals. Methods This study incorporated the cross-sectional study design, conducted among 312 health professionals from 28 health facilities in 18 districts across Bangladesh. The internal consistency and intraclass correlation coefficient of the DASS-21 was assessed. The confirmatory factor analyses was done to assess the fitness of different structural models of DASS-21. The concurrent validity was estimated by using the PHQ-9 and GAD-7 scales. Results In total, 258 healthcare professionals (82.7%) out of 312 completed the whole survey questionnaire and were included in the study. The internal consistency of the DASS-21 exhibited satisfactory internal consistency (α = 0.93) and ICC = 0.92). The conventional three-factor model appeared to best fit the Bengali-translated DASS-21 scale. The discriminant validity has been affirmed by strong evidence. The convergent validity of Bengali DASS-21 was confirmed by the PHQ-9 and GAD-7 scales. Conclusions This study found good validity, reliability, and suitability of the DASS-21 used among the Bangladeshi healthcare professionals. We warrant future research to explore the validity of this tool in other cohorts in Bangladesh.

Abstract Background Comprehensive data has shown that adolescents often suffer from depression, anxiety, and low self-esteem, and are in a particularly fragile stage of psychological, physiological, and social development. Left-behind children in particular tend to have significantly higher, state anxiety and depression compared to non-left-behind children. The Depression, Anxiety, and Stress Scale (DASS-21) is an effective tool for evaluating depression, anxiety, and stress, and is used to measure levels of depression, anxiety, and stress in groups from a variety of backgrounds. The purpose of this study was to determine the effectiveness, reliability, and measurement invariance of the DASS-21 in Chinese left-behind children. Method The test and re-test method was used (N = 676), and the exploratory structural equation model (Mplus v.8.3) used to verify basic measurement models. For measurement invariance, the configural, weak, strong, and strict models were tested. The reliability of the DASS-21 was also tested using the collected data. Results Analysis results showed that the DASS-21 had a stable three-factor structure in the sample of left-behind children in China. The measurement invariance test showed that gender and time not only had strong invariance, but also strict invariance. The results of cross left and non-left invariance indicated a lack of strict invariance. Finally, the McDonald’s omega coefficient of the DASS-21 total scale was 0.864, and the internal consistency of each subscale was also good. Conclusions The DASS-21 is shown to be an effective and reliable tool for measuring depression, anxiety and stress in Chinese left-behind children.

Abstract Background Stress, depression and anxiety are prevalent mental health concerns that are getting worse every day in the context of rapidly expanding megacities, where a rising number of people live in slums. The purpose of this study is to evaluate the state of mental health and related variables underlying mental health issues among the impoverished population. Methodology A total of 384 slum residents from the Khulna division responded to our questionnaire, which included the DASS-21 and other pertinent questions. Using ordinal logistic regression, the significant factors were extracted. Results The Cronbach’s reliability coefficient for the DASS-21 scale lies between 0.79 and 0.89 which indicates the high reliability of the DASS-21 scales. According to the findings, roughly 72.7%, 84.1%, and 69% of participants slum dwellers experienced anxiety, depression, and anxiety problems respectively. The result of ordinal logistic regression shows, slum dwellers of female gender (B = 0.669*, 95% CI 0.141, 1.197), married (B = 1.506*, 95% CI 0.119, 2.893), having only one earning member in the family (B = 1.224*, 95% CI 0.526, 1.922), day laborers (B = 2.294*, 95% CI 1.115, 3.473), not being able to educate children due to financial problem (B = 0.558*, 95% CI 0.183, 0.932) were more likely to report high levels of anxiety, depression, and stress. Conclusion The study finds that a significant portion of people who live in slums struggle with mental health issues. It also points to the need for further support, intervention, and study on Khulna's slum inhabitants who are experiencing mental health issues. The authors anticipate that the results will spur policymakers and government representatives to enhance financing for slum dwellers and employ psychological intervention strategies, both of which will aid in achieving the Sustainable Development Goal.

Objective: The objective of this study was to assess the validity, reliability, and factorial structure of the Bengali-translated Depression, Anxiety, and Stress Scale—21 (DASS-21) among Bangladeshi health professionals. Methods: This study incorporated the cross-sectional study design, conducted among 312 health professionals from 28 health facilities in 18 districts across Bangladesh. The internal consistency and intraclass correlation coefficient of the DASS-21 was assessed. The confirmatory factor analyses was done to assess the fitness of different structural models of DASS-21. The concurrent validity was estimated by using the PHQ-9 and GAD-7 scales. Results: In total, 258 healthcare professionals (82.7%) out of 312 completed the whole survey questionnaire and were included in the study. The internal consistency of the DASS-21 exhibited satisfactory internal consistency (α = 0.93) and ICC = 0.92). The conventional three-factor model appeared to best fit the Bengali-translated DASS-21 scale. The discriminant validity has been affirmed by strong evidence. The convergent validity of Bengali DASS-21 was confirmed by the PHQ-9 and GAD-7 scales. Conclusions: This study found good validity, reliability, and suitability of the DASS-21 used among the Bangladeshi healthcare professionals. We warrant future research to explore the validity of this tool in other cohorts in Bangladesh. [ABSTRACT FROM AUTHOR]

Culturally appropriate tools are necessary to aid in objective screening for psychological symptoms among students in university settings. This study aimed to translate and validate the Depression Anxiety and Stress Scale‐21 (DASS‐21). The instrument underwent forward translation and was reviewed by representatives from the target population, field experts, and an external auditor. The translated version of the DASS‐21, together with the International Positive and Negative Affect Schedule Short Form (I‐PANAS‐SF), Patient Health Questionnaire (PHQ‐9), Generalized Anxiety Disorder‐7 (GAD‐7), Satisfaction with Life Scale (SWLS), was administered to 681 university students. Through confirmatory factor analysis, results supported the intercorrelated three‐factor model with correlated errors for the DASS‐21 Filipino. Results also demonstrated the criterion validity of the depression and anxiety subscales through significant correlations with PHQ‐9 and GAD‐7, respectively, and a stringent z‐score test to examine the difference between two dependent correlations with one variable in common. The convergent validity of all three subscales was established through significant correlations with I‐PANAS‐SF and SWLS. All DASS‐21 Filipino subscales which includes depression (α =.89), anxiety (α =.84), and stress (α =.85), showed high internal consistency. The current findings offer initial evidence on the structural validity of the DASS‐21 Filipino, which can be utilized as a tool to screen for depression, anxiety, and stress symptoms among Filipino speakers during a global health crisis. Implications for psychological assessment and school and clinical interventions are discussed. Practitioner Points: The original DASS‐21 was translated to Filipino to objectively measure depression, anxiety, and stress symptoms among university students in the Philippines.The DASS‐21 Filipino confirmed the correlated three‐factor structure of the original DASS‐21.The DASS‐21 Filipino also showed convergent and criterion validity and item reliability. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to investigate the status of health-related quality of life in Chinese patients with ankylosing spondylitis (AS) and to analyze factors associated with the Assessment of SpondyloArthritis international Society Health Index (ASAS-HI) in AS and its relationship with disease activity and psychological status. Methods: A cross-sectional study of 484 patients with AS attending 10 hospitals in China from March 2021 to September 2023 was recruited. The ASAS-HI assessed general health and functional status; the Depression Anxiety Stress Scales (DASS-21) assessed psychological disorders such as anxiety, depression, and stress; and the Functional Assessment of Chronic illness Therapy-Fatigue Scale (FACIT-F) assessed patients' fatigue symptoms; the Ankylosing Spondylitis Disease Activity Score-C-Reactive Protein (ASDAS-CRP), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), and Bath Ankylosing Spondylitis Measurement Index (BASMI) were used to assess patients' disease activity and functional impairment. The correlation between ASAS-HI and the ASDAS, poor psychological status, and fatigue symptoms was observed. Univariate and multivariate logistic regression analyses were used to explore the relevant influencing factors of ASAS-HI. Results: A total of 484 patients were included in this study of whom 162 were in poor health, 139 in moderate health, and 183 in good health. On univariate analysis, disease activity is an important factor affecting ASAS-HI. People with extremely high disease activity (ASDAS ≥ 3.5) had a 12 times elevated risk of having poor health status (OR = 12.53; P < 0.001). Other significant covariates included age ≥ 36 (OR = 1.58; P = 0.015), BMI ≥ 24 kg/m2 (OR = 2.93; P = 0.013), smoke (OR = 1.96; P = 0.002), BASFI (OR = 1.49; P < 0.001), BASMI (OR = 1.22; P < 0.001), fatigue (OR = 6.28; P < 0.001), and bad psychological conditions such as depression (OR = 10.86; P < 0.001), anxiety (OR = 3.88; P < 0.001), and stress (OR = 4.65; P < 0.001). The use of bMARDs is inversely associated with the appearance of adverse health status (OR = 0.54; P = 0.012). There was no significant relationship between HLA-B27 and sex. Multivariable logistic regression showed that higher disease activity (ASDAS ≥ 3.5) (OR = 5.14; P = 0.005), higher scores of BASMI (OR = 1.10; P = 0.009), self-reported depression (OR = 3.68; P = 0.007), and fatigue (OR = 2.76; P < 0.001) were factors associated with adverse health status. Conclusion: The health status of AS patients is related to age, BMI, smoking, disease activity, poor psychological status, and fatigue and is influenced by a combination of multiple factors such as emotional state, economic level, pain, and dysfunction. Therefore, clinicians should pay attention to the early assessment of ASAS-HI in order to improve the prognosis of the disease. Key Points •Ankylosing spondylitis (AS) is a chronic inflammatory autoimmune disease with a long course and heavy disease burden, which greatly affects patients' quality of life. Therefore, this study aims to evaluate the health status of ankylosing spondylitis in the Chinese population and its influencing factors. •This is a multi-center cross-sectional study in China, which can better reflect the overall situation of the Chinese population. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic started in the last week of December, 2019. An emergency was declared throughout the globe as the virus spread over 208 counties within a short amount of time. This pandemic had significant negative impacts on common men living in densely populated countries, including Pakistan. Hence, this research aimed to record people's perception of the 7th largest settlement in Pakistan, namely Hyderabad. This study mainly focused on socioeconomic and psychological parameters. The close-ended questionnaire was designed concerning the Depression, Anxiety, and Stress Scale (DASS-21). The DASS-21 is an optimal tool for recording the emotional values of depression, anxiety, and stress. A total of 400 questionnaires were filled out; they used a 5-point Likert scale. Significant socioeconomic issues were noted, such as lower household income, economic recession, job cuts, inaccessible Internet services during online teaching or working from home, etc. The primary challenges in the lockdown situation were Internet access (4.06) and anxiety (4.86) in the female population. There were higher levels of depression (N = 200), anxiety (N = 341), and stress (N = 125) in the local inhabitants. Other notable problems were illuminated, such as restrictions on social gatherings, electricity load shedding, and lower incomes. This study concludes that the degree of psychological problems varied according to the typology of gender. Based on study findings, this study recommends the prompt execution of policies considering possible future pandemics to restrain anxiety and depression in the female population. The local government is also advised to revitalize infrastructure to provide uninterrupted power supplies and Internet facilities. The income-generating channels should be open for lower-income households concerning future lockdowns. [ABSTRACT FROM AUTHOR]

Background and Objective: This study aimed to explore the impact of physical activity on depression, anxiety, and stress among pregnant women in the Jazan region of Saudi Arabia. Materials and Methods: A descriptive cross-sectional study was conducted among pregnant women attending randomly selected prenatal clinics in primary healthcare hospitals in Jazan, Saudi Arabia. The calculated sample size was 350. Data were collected conveniently through a semi-structured questionnaire covering demographic details, pregnancy-related characteristics, physical activity assessed using the Pregnancy Physical Activity Questionnaire (PPAQ), and mental health parameters evaluated by the Depression, Anxiety, and Stress Scale-21 (DASS-21). The statistical analyses included descriptive statistics and Wilcoxon and Kruskal–Wallis rank sum tests, with significance levels set at p < 0.05. Results: The study involved 406 pregnant females. Nearly a third (31%) had a family history of depression, anxiety, or distress. The prevalence of depression, anxiety, and stress was 62.6%, 68.7%, and 38.4%, respectively. The mean sedentary, light, moderate, vigorous, and total energy expenditures were 1.512, 24.35, 22.32, 4.84, and 53.02 metabolic equivalent tasks/day. Anxious females exhibited higher light activity (median 24, p = 0.033), while stressed ones showed higher light (median 25, p = 0.039), moderate (median 20, p < 0.001), and vigorous activity (median 3, p < 0.001). A significant association was observed between total energy expenditure and stress levels (p < 0.001). Conclusions: This study underscores the importance of physical activity in managing depression, anxiety, and stress among pregnant women in Jazan, Saudi Arabia. The findings suggest a need for tailored interventions to promote physical activity to improve mental well-being during pregnancy. [ABSTRACT FROM AUTHOR]

Despite widespread evidence-based treatments for addressing internalizing concerns, many youth do not demonstrate reliable or clinically meaningful improvement. Regular progress monitoring, consisting of measurement and feedback, offers the opportunity to improve outcomes in real time. The 21-item Depression Anxiety and Stress Scales (DASS-21; Lovibond & Lovibond, 1995) has potential as a progress-monitoring tool for internalizing concerns in youth; however, limited psychometric data are available to support this use. The purpose of this study was to investigate the dependability of data obtained from the DASS-21 when completed by adolescents in a clinical setting. This study also aimed to understand the feasibility and utility of using the DASS-21 as a progress-monitoring tool from youth and clinicians' perspectives. Generalizability and dependability analyses were conducted to determine the number of ratings needed to obtain a dependable estimate of youth functioning within 1 week. Whereas two daily ratings were needed to dependably estimate total distress, results for the depression, anxiety, and stress subscales indicated that two to five data points would be needed over the course of the week. Finally, results demonstrate the usability of the DASS-21 from both youth and clinician perspectives when used in a progress-monitoring context. [ABSTRACT FROM AUTHOR]

Background: Comprehensive data has shown that adolescents often suffer from depression, anxiety, and low self-esteem, and are in a particularly fragile stage of psychological, physiological, and social development. Left-behind children in particular tend to have significantly higher, state anxiety and depression compared to non-left-behind children. The Depression, Anxiety, and Stress Scale (DASS-21) is an effective tool for evaluating depression, anxiety, and stress, and is used to measure levels of depression, anxiety, and stress in groups from a variety of backgrounds. The purpose of this study was to determine the effectiveness, reliability, and measurement invariance of the DASS-21 in Chinese left-behind children. Method: The test and re-test method was used (N = 676), and the exploratory structural equation model (Mplus v.8.3) used to verify basic measurement models. For measurement invariance, the configural, weak, strong, and strict models were tested. The reliability of the DASS-21 was also tested using the collected data. Results: Analysis results showed that the DASS-21 had a stable three-factor structure in the sample of left-behind children in China. The measurement invariance test showed that gender and time not only had strong invariance, but also strict invariance. The results of cross left and non-left invariance indicated a lack of strict invariance. Finally, the McDonald's omega coefficient of the DASS-21 total scale was 0.864, and the internal consistency of each subscale was also good. Conclusions: The DASS-21 is shown to be an effective and reliable tool for measuring depression, anxiety and stress in Chinese left-behind children. [ABSTRACT FROM AUTHOR]

Background: Stress, depression and anxiety are prevalent mental health concerns that are getting worse every day in the context of rapidly expanding megacities, where a rising number of people live in slums. The purpose of this study is to evaluate the state of mental health and related variables underlying mental health issues among the impoverished population. Methodology: A total of 384 slum residents from the Khulna division responded to our questionnaire, which included the DASS-21 and other pertinent questions. Using ordinal logistic regression, the significant factors were extracted. Results: The Cronbach's reliability coefficient for the DASS-21 scale lies between 0.79 and 0.89 which indicates the high reliability of the DASS-21 scales. According to the findings, roughly 72.7%, 84.1%, and 69% of participants slum dwellers experienced anxiety, depression, and anxiety problems respectively. The result of ordinal logistic regression shows, slum dwellers of female gender (B = 0.669*, 95% CI 0.141, 1.197), married (B = 1.506*, 95% CI 0.119, 2.893), having only one earning member in the family (B = 1.224*, 95% CI 0.526, 1.922), day laborers (B = 2.294*, 95% CI 1.115, 3.473), not being able to educate children due to financial problem (B = 0.558*, 95% CI 0.183, 0.932) were more likely to report high levels of anxiety, depression, and stress. Conclusion: The study finds that a significant portion of people who live in slums struggle with mental health issues. It also points to the need for further support, intervention, and study on Khulna's slum inhabitants who are experiencing mental health issues. The authors anticipate that the results will spur policymakers and government representatives to enhance financing for slum dwellers and employ psychological intervention strategies, both of which will aid in achieving the Sustainable Development Goal. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to investigate the presence of common psychological factors (i.e., stress, depression, anxiety) and their impact on the Oral health-related quality of life (OHRQoL) in patients diagnosed with four oral mucosal diseases (OMDs): recurrent aphthous ulcers (RAU), oral lichen planus (OLP), oral leukoplakia (OLK), and oral submucous fibrosis (OSF). Methods: A total of 229 patients with clinically diagnosed OMDs were enrolled in this study, consisting of 55 RAU, 68 OLK, 50 OLP, and 56 OSF patients. The patients were statistically analyzed for psychological problems and OHRQoL using the Visual Analog Scale (VAS)､ the 5-item Oral Health Impact Profile (OHIP-5) and the Depression Anxiety Stress Scale-21 (DASS-21) scales. Results: There were 229 valid questionnaires collected, consisting of 83 females and 146 males with a mean age of 45.24 (SD = 11.88) years. Multiple regressions between DASS-21 scores and OHIP-5 scores revealed generally negative impacts of psychological problems on OHRQoL, with depression on OLP (β = 0.47), OLK (β = 0.65) and OSF (β = 0.38), stress on RAU (β = 0.29), OLP (β = 0.72), OLK (β = 0.38) and OSF (β = 0.60), and anxiety on OLP (β = 0.33), OLK (β = 0.49) and OSF (β = 0.51). Conclusions: Psychological problems like depression, stress, and anxiety were found to be prevalent in OMDs patients and adversely affected their OHRQoL. The results support the biopsychosocial medical model in the treatment of OMDs patients. Clinical significance: The present study reinforced the crucial roles of psychological factors in impacting OMDs patients' OHRQoL. Therefore, it is necessary to monitor patients’ psychological status and OHRQoL using questionnaires like DASS-21 and OHIP-5. Followed by psychological interventions, the treatment is expected to be enhanced.

Copyright of Humanities & Educational Sciences Journal is the property of Humanities & Educational Sciences Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: This study aimed to evaluate the factor structure of the Depression Anxiety and Stress Scale (DASS‐21) among caregivers of young children in Southeastern Europe. Background: The DASS‐21 is a widely used measure in prevention and intervention research with families. Studies regarding the scale's psychometric properties among caregivers, particularly from non‐Western countries, are limited and additional research is required. Method: The DASS‐21 was administered to N = 835 primary caregivers from North Macedonia, the Republic of Moldova, and Romania. Competing models were tested with confirmatory factor analysis (CFA). Measurement invariance was assessed using multigroup CFA (MGCFA). Bifactor dimensionality and reliability indices were used to evaluate the validity of the composite and subscale scores. Results: A tripartite bifactor model with two specific factors (depression and anxiety) and one general factor (negative affectivity) represented the data well. This model showed cross‐country configural and partial metric invariance. Dimensionality and reliability indices supported a unidimensional interpretation of the measure, with the general negative affectivity factor accounting for a substantial share of the variance (82%) compared to the specific factors of depression (10%) and anxiety (8%). Conclusion: The tripartite model best represented the data. Configural and partial metric invariance were verified for this model. Dimensionality and reliability indices, however, indicate that the DASS‐21 functions best as a general measure of negative affectivity. Implications: Future intervention studies involving caregivers from Southeastern Europe should consider using the DASS‐21 as an overall measure of negative affectivity and utilize the composite score instead of the subscale scores. [ABSTRACT FROM AUTHOR]

Sleep is essential for overall health, yet various sleep disorders disrupt normal sleep patterns, affecting duration, quality, and timing. This pilot study investigate the impact of a food supplement (SPINOFF®) on both sleep quality and mental well-being in 41 participants (mean age: 45.3 years). Initial assessments revealed sleep disturbances (Pittsburgh Sleep Quality Index—PSQ—mean score: 8.2) and insomnia symptoms (Insomnia Severity Index—ISI— mean score: 12.7). Mental health assessments showed psychological distress (Dass-21 Depression mean score: 4.2, Anxiety mean score: 6.9, Stress mean score: 11.6, Total mean score: 22.7). This study assessed sleep continuity using Awakenings per Night (ApN) via a smartwatch (HELO HEALTH®) and conducted the study in two phases: baseline (T0) and after 30 days of treatment (T1) (Phase A). No placebo-control was used in this study. After 30 days (Phase B), 21 patients were selected for reassessment. Eleven continued treatment for another 30 days (T2), while ten discontinued. Following the intervention, we observed remarkable improvements in sleep quality and mental distress. The SPINOFF® supplement significantly reduced the PSQI scores (22.4%), indicating enhanced sleep quality. Additionally, there was a 19.6% decrease in ISI scores, demonstrating a reduction in insomnia symptoms. Moreover, overall psychological distress decreased by 19.5% signifying improved psychological well-being. In the second phase, participants who continued treatment experienced more substantial improvements, with a mean decrease of 0.8 points in PSQI scores (±0.9) and a mean decrease of 0.9 points in ISI scores. Our findings suggest that the SPINOFF® supplement has the potential to effectively address both sleep disturbances and psychological distress in our study population. [ABSTRACT FROM AUTHOR]

Background: As a prerequisite to start a medical practice in India, Foreign Medical graduates on returning have to sit for FMGE (Foreign Medical Graduate’s Exam), organized by NBE. The time and effort involved by the students with adjustments to various changes in educational and examination pattern may manifest as psychiatric morbidities while awaiting a positive outcome. Aim: To evaluate depression, anxiety, stress, and insomnia in Foreign Medical Graduate students and to understand the various factors associated with them. Materials and Methods: A total of 80 MBBS students appearing for FMGE were enrolled during the period of April 2023 to May 2023, after obtaining their written consent on the Google form to participate in this study. The participants answered a semi-structured proforma consisting of information about sociodemographic data, DASS-21 (depression, anxiety, and stress severity scale), ISI scale (insomnia severity index), and RSES (Rosenberg self-esteem scale). Results: In this study, 76.2%, 80%, 72.5%, and 78.8% of students were found to be suffering from depression, anxiety, stress, and insomnia, respectively. A significant statistical correlation was found between anxiety and the students appearing for July FMGE 2023. Stress and depression were associated with insecurities/comparisons faced by the participants due to peers clearing the examination before them. Low self-esteem was associated with 3 or more failed attempts for FMGE and the presence of other stressors preceding/concurrent while preparing for FMGE. Clinical insomnia was found to be statistically significant with depression, anxiety as well as stress in this study. Multiple regression analysis showed that stress and anxiety predicted depression while the young age of the student, low socioeconomic status, low self-esteem, stress, and depression predicted anxiety. Stress was found to be associated with anxiety, depression, and insomnia. Insomnia was corelated with having extension in the UG course and stress while low self-esteem was corelated with students who were attempting for the July 2023 examination and anxiety. Conclusion: The significantly high proportion of psychiatric morbidities among Foreign Medical Graduates is suggestive of the need for the necessary psychological aid and counseling as these foreign medical graduates can be viewed as an opportunity to correct India’s physician shortage.

BackgroundThe aim of this study was to classify distinct subgroups of adolescents based on the severity levels of their mobile phone addiction and to investigate how these groups differed in terms of their psychosocial characteristics. We surveyed a total of 2,230 adolescents using three different questionnaires to assess the severity of their mobile phone addiction, stress, anxiety, depression, psychological resilience, and personality. Latent class analysis was employed to identify the subgroups, and we utilized Receiver Operating Characteristic (ROC) curves and multinomial logistic regression for statistical analysis. All data analyses were conducted using SPSS 26.0 and Mplus 8.5.MethodsWe classified the subjects into subgroups based on their mobile phone addiction severity, and the results revealed a clear pattern with a three-class model based on the likelihood level of mobile phone addiction (p 14, which corresponded to the maximum Youden index (Youden index = 0.751).ResultsThe latent classification process in this research confirmed the existence of three distinct mobile phone user groups. We also examined the psychosocial characteristics that varied in relation to the severity levels of addiction.ConclusionThis study provides valuable insights into the categorization of adolescents based on the severity of mobile phone addiction and sheds light on the psychosocial characteristics associated with different addiction levels. These findings are expected to enhance our understanding of mobile phone addiction traits and stimulate further research in this area.

Background: Psychological distress may worsen during cancer treatment and affect well-being. Information on the prevalence of distress and its associated variables in cancer patients undergoing chemotherapy in rural Bangladesh has not been thoroughly explored. To address this, we aimed to assess psychological distress and its associated factors in patients with cancer undergoing chemotherapy. Methods: This cross-sectional study was conducted at a tertiary care hospital in rural Bangladesh. Only adult patients with cancer who were receiving chemotherapy were enrolled in this study. The validated Depression Anxiety Stress Scale was used to assess psychological distress. Frequency and percentages were used in descriptive analysis, and logistic regression analysis was performed to investigate potential associated factors for depression, anxiety, and stress. Results: Participants comprised 415 patients with a mean age of 46.3 years. The prevalence of depression, anxiety, and stress was 61.5%, 55.4%, and 22.0%, respectively. In the multivariate logistic regression analysis, patients with more than five family members and smokeless tobacco users had a significant association with depression, anxiety, and stress. In contrast, participants aged >60 years had a protective association with depression. Conclusions: Our findings show that patients with cancer receiving chemotherapy experience a high prevalence of depression and anxiety and that the use of smokeless tobacco and having six or more family members are associated with psychological distress. These findings will aid health professionals and policymakers in establishing and implementing improved care programs to ensure the greater mental health of cancer survivors, particularly in resource-limited settings.

Background: Psychological distress may worsen during cancer treatment and affect well-being. Information on the prevalence of distress and its associated variables in cancer patients undergoing chemotherapy in rural Bangladesh has not been thoroughly explored. To address this, we aimed to assess psychological distress and its associated factors in patients with cancer undergoing chemotherapy. Methods: This cross-sectional study was conducted at a tertiary care hospital in rural Bangladesh. Only adult patients with cancer who were receiving chemotherapy were enrolled in this study. The validated Depression Anxiety Stress Scale was used to assess psychological distress. Frequency and percentages were used in descriptive analysis, and logistic regression analysis was performed to investigate potential associated factors for depression, anxiety, and stress. Results: Participants comprised 415 patients with a mean age of 46.3 years. The prevalence of depression, anxiety, and stress was 61.5%, 55.4%, and 22.0%, respectively. In the multivariate logistic regression analysis, patients with more than five family members and smokeless tobacco users had a significant association with depression, anxiety, and stress. In contrast, participants aged >60 years had a protective association with depression. Conclusions: Our findings show that patients with cancer receiving chemotherapy experience a high prevalence of depression and anxiety and that the use of smokeless tobacco and having six or more family members are associated with psychological distress. These findings will aid health professionals and policymakers in establishing and implementing improved care programs to ensure the greater mental health of cancer survivors, particularly in resource-limited settings. [ABSTRACT FROM AUTHOR]

Introduction: The objective of this study is to evaluate the quality of life (QoL), depression, anxiety, and stress, along with associated factors among individuals with diabetes in Saudi Arabia. Methods: This survey was conducted at King Abdulaziz University (KAU), Jeddah, Kingdom of Saudi Arabia (KSA). The assessment of depression, anxiety, and stress related to Type 2 Diabetes Mellitus (T2DM) was conducted using the DASS-21 questionnaire, while diabetes-related QoL was evaluated using the revised version of the diabetes QoL questionnaire (RV-DQoL13). Data were analyzed using SPSS-26. Results: A total of 251 subjects were included in the study (165 [65.7%] males and 86 [34.3%] females, mean age 50.1 ± 14.5 years). The individuals with DM had a mean value of QoL of 29.16 ± 9.23, with 46.9% having poor QoL. Furthermore, in dimensions of QoL, almost half of the individuals reported high worry about the disease (49.6%), followed by a high diabetes impact (46.6%) and low life satisfaction (42.9%). The prevalence of depression, anxiety, and stress was 49.4, 71.7, and 49.8%, respectively. A significant correlation was found between depression, anxiety, and stress and DASS-21 scores with QoL (p < 0.001). The regression analysis indicated an association of distinct factors with QoL like age above 41 years (p = 0.004), being married (p < 0.001), being divorced (p = 0.04), higher education (p = 0.007), regular medicine intake (p = 0.01), regular exercise (p = 0.03), lipid profile (p = 0.01), HbA1c (p < 0.001), and DASS-21 scores (p < 0.001). Poor QoL score (TQoL score > 27) was significantly associated with depression, anxiety, and stress (p < 0.001). The participants with higher monthly income, shorter disease duration, regular medicine use, and altered lipid profile, and older subjects had a lower chance of depression, anxiety, and stress. Conclusion: Approximately half of individuals with T2DM experienced poor QoL, while the prevalence rates for depression, anxiety, and stress were 49.4, 71.7, and 49.8%, respectively. Scores in the domains of impact, worry, and satisfaction were below optimal levels. Several factors were linked to QoL and depression, anxiety, and stress, and an association was observed between DASS-21 scores and QoL. [ABSTRACT FROM AUTHOR]

Introduction: Studies have shown that staying at home for prolonged periods of crisis can pose a significant challenge to individuals and affect their mental health. Hence, this study was conducted to identify the susceptible subgroups among Malaysian citizens that are prone to mental health problems during the lockdown period of the COVID-19 pandemic and its association with sociodemographic factors. Methods: The mental health status was assessed using the Depression, Anxiety, and Stress Scale -21 (DASS-21) questionnaire. The survey link was distributed online between October and December 2020. Results: Of 637 respondents, one-third experienced mild to extremely severe depression and anxiety (31.1% and 35.1%, respectively). Female respondents (odds ratio = 1.516, 95% confidence interval (CI) 1.057-2.172) were 1.5 times more likely to experience mild to severe depression than male respondents. Unmarried and divorced respondents were 2.1 times more prone to experience mild to severe depression than married respondents. A significant association was also found between employment status and age with depression symptoms among the respondents. For anxiety, a significant association was observed between the age group with mild to severe anxiety symptoms. Marital status, age, and employment status were socio-demographic factors significantly impacting stress levels. Conclusion: According to our findings, females, individuals aged 18-30 years old, students, unmarried and divorced respondents were more susceptible to mental health problems, suggesting that mental health support shall also be provided for these vulnerable groups during the COVID-19 crisis. [ABSTRACT FROM AUTHOR]

Introduction: Acne is the most common skin disease among adolescents and has significant psychological distress. Our objective is to assess acne severity, functional disability, and its psychological distress among acne patients. Methods: A cross-sectional study was conducted from November 2021 to May 2022 among 163 acne patients attending Dermatology Clinics in the district of Kuantan, Pahang. The severity of acne was graded using the Comprehensive Acne Severity Scale (CASS). The functional disability index was measured using a Cardiff Acne Disability Index (CADI), while Depression, Anxiety and Stress Scale (DASS-21) questionnaires were used as a screening tool to detect the psychological distress of acne. Data were analysed using a Chi-square test, Fisher's exact test and multiple logistic regression. Results: The mean age was 23 years, 60.1% were female, 94.5% were Malay, and 68.1% were unemployed. The severity of acne was more prominent in the mild (30.7%) and moderate (28.2%) categories. A total of 20.2%, 11.7%, and 4.9% of the respondents had anxiety, depression, and stress symptoms, respectively. Regarding the respondents' functional disability, 40.5% had mild impairment, 38.0% had moderate impairment, and 13.5% had severe impairment. Acne severity was found to be significantly associated with the functional disability index (P<0.05). The functional disability index was also found to be significantly associated with depression (p=0.019) and anxiety symptoms (p=0.042). Conclusion: Clinical management of acne patients should include not only pharmacological treatment but also consideration of the disease's functional disability status and psychological distress. [ABSTRACT FROM AUTHOR]

Copyright of Humanities & Educational Sciences Journal is the property of Humanities & Educational Sciences Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Emotional disorders are pervasive in the acquired brain injury (ABI) population, adversely affecting quality of life and rehabilitation. This study aimed to explore the unique associative effects of alexithymia as measured by the Perth Alexithymia Questionnaire (PAQ; i.e., difficulty identifying positive/negative feelings, difficulty describing positive/negative feelings, and externally orientated thinking), on emotional outcomes as measured by the Depression Anxiety Stress Scale-21 (DASS-21) and Mayo-Portland Adaptability Inventory (MPAI-4) Adjustment index, in 83 adults with ABI. The addition of alexithymia to hierarchical multiple regression models (controlling for demographic, injury-related, and functional outcome variables) yielded statistically significant changes in R2 for all emotional outcome measures (i.e., Depression, Anxiety, Stress, and Adjustment). Difficulty identifying negative feelings was found to be a significant unique predictor of Depression (β =.43 p = <.001), Anxiety (β =.40, p <.001), Stress (β =.49, p <.001), and Adjustment (β =.26, p =.001). Externally oriented thinking was found to be a significant unique predictor of Adjustment (β = -.15, p =.033). These findings strengthen the argument that alexithymia, especially difficulties identifying negative feelings, may be an important risk factor for psychological distress in ABI and should be considered during early rehabilitation. [ABSTRACT FROM AUTHOR]

Background: Migrant workers make up a third of the population of Saudi Arabia, approximately 13 million. Mental health disorders among this population are common, but very limited data exist currently. Aims: To assess the prevalence of moderate to severe symptoms of depression and stress among a sample of migrant workers in Saudi Arabia. To identify whether migrant-specific factors, such as occupation, nationality, duration of migration, and work characteristics, are associated with depressive and stress symptoms. Methods: A cross-sectional study of 2,123 migrants was conducted in Al Qassim, Saudi Arabia. Depressive and stress symptoms were assessed with the Depression, Anxiety, and Stress Scale (DASS-21). The outcomes were categorized into two levels (i.e. mild or no symptoms versus moderate to severe symptoms). Univariate and multivariate binary logistic regressions were used to assess the relationship with potential covariates. Results: The prevalence of moderate to severe depressive and stress symptoms was 7.3% and 3.6%, respectively. These did not vary by the duration of stay in the country or weekly work hours. However, there was substantial variance in the symptoms by participants' nationality and occupation. Participants from Bangladesh were 3.8 (95% CI [1.50, 9.62]) times more likely, and hospital cleaners were 6.5 (95% CI [2.12, 20.07]) times more likely to have depressive symptoms. Similarly, auto-repair workers were 6.3 times more likely to have symptoms of stress (95% CI [1.55, 25.90]). Conclusion: The prevalence of depressive and stress symptoms varied significantly depending on occupation and country of origin. It would behoove employers to screen for these mental health conditions and refer employees to the relevant healthcare services. Future studies could examine the feasibility of mental health screening programs among migrant employees. [ABSTRACT FROM AUTHOR]

Background: The escalating worldwide concerns for mental health, significantly amplified by the COVID-19 pandemic, necessitates understanding the impact on vulnerable populations, such as university students. This study aims to investigate the prevalence and implications of depression, anxiety, and stress among university students in the United Arab Emirates (UAE) using the Depression, Anxiety, and Stress Scale-21 Items (DASS-21). Methods: This study utilized convenience sampling to investigate the mental health of undergraduates in UAE universities using a bilingual DASS-21 questionnaire via Google Forms. Analysis was conducted using SPSS version 29.0, employing descriptive statistics, Chi-squared tests, Mann–Whitney tests, Kruskal–Wallis tests, and Multinomial Logistic Regression to analyze relationships between sociodemographic variables and mental health scores. Results: The study examined 332 students, with most female participants (81 %, n = 269) and individuals aged 18–20 (89.8 %, n = 298). It revealed higher mean DASS scores among females: Depression (M = 15.80, p = 0.030), Anxiety (M = 17.63, p

This cross-sectional study aimed to determine the prevalence of depression, anxiety, and stress among undergraduate dental students at Sofia Medical University and to investigate its associations with some demographic, educational and pandemic-related variables. A self-reported questionnaire that included the validated DASS-21 scale was administered to a group of 2nd, 3rd, 4th, and 5th year students (n=70, response rate 95.7%). Results indicated abnormal levels of depression, anxiety, and stress in 34.3%, 65.7% and 59.7% of the participants, respectively. A much larger proportion of females suffered from abnormal levels of anxiety (56.6%) as compared with males (9%), p=.003. Single students exhibited significantly higher level of depression (25.4%) than those having a partner (9%), p=.037. Third-year dental students demonstrated higher level of depression (19.4%) compared to 5th year students (1.5%), p=.007 as well as higher stress scores (25.4%) than 2nd year students (17.9%), p=.035. Academic performance (assessed by GPA in this study), dentistry as the first students’ choice when applying for MUS, financial responsibilities, and pandemic-related academic responses were not found significant factors for depression, anxiety, and stress (p>.05). These outcomes highlight the need to provide psychological support programs with special attention on susceptible groups. Dental students should implement preventive measures and adopt coping strategies to manage stress and reduce levels of anxiety and depression.

Since its inception, the coronavirus pandemic has caused serious social, economic, and health problems around the world. Seafarers have been identified as key workers in mitigating the negative impact of the coronavirus on global trade and ensuring the delivery of medical and hygiene supplies to regions in need. However, the complete closure policies implemented by certain countries have led to prolonged periods on board for seafarers with expired contracts and economic hardship for those unable to join new assignments. Seafarers who spend long periods on board a ship must deal with issues that may affect their psychological state. Therefore, it is important to identify the factors that cause seafarers to experience psychological distress and to develop relevant strategies to address them. The aim of this study was to determine the association between seafarers' fear of coronavirus disease-2019 (COVID-19) and psychological distress including symptoms of anxiety, depression, and stress. The questionnaire used the fear of COVID-19 Scale and the expression, Anxiety and Stress Scale), which have strong psychometric properties. Data were collected from 425 qualified seafarers working on international merchant ships and analyzed by structural equation modeling using AMOS-24. The results indicate that seafarers' fear of COVID-19 is positively associated with symptoms of anxiety and stress but not with depression. Maritime companies, sectoral organizations, and policymakers should collaborate to reduce these associations among seafarers. A unified management approach improved access to health services, and regular mental health assessments can be effective solutions.

Abstract Background In recognizing the need for a reliable and valid instrument to assess psychological distress among children and adolescents, the present study translated the newly developed Depression Anxiety Stress Scale for Youth (DASS-Y) into Chinese, while also comparing its psychometric properties with those of the well-established DASS-21 within a primary and middle school demographic. Methods Utilizing a combination of convenience sampling and purposive sampling, a cohort comprising 1,507 primary and 1,131 middle school students was recruited. Rasch analysis, confirmatory factor analysis (CFA), and structural equation modeling (SEM) were used in the data analysis. Results Significant differences were observed between the DASS-Y and the DASS-21, notably within the anxiety subscale. The proportions of individuals with clinical mood disorders identified by the two scales demonstrated a significant disparity. Both scales, following an adjustment of responses, exhibited satisfactory internal consistency and convergent validity, with the acceptance of a three-factor structure. Furthermore, the DASS-Y showed superior discriminant validity relative to the DASS-21, providing more compelling evidence regarding concurrent validity. Conclusion Overall, the Chinese version of the DASS-Y demonstrated superior robustness to the DASS-21 in terms of psychometric properties. The findings provide initial evidence for the psychometric properties of the DASS-Y from another culture.

The COVID-19 pandemic started in the last week of December, 2019. An emergency was declared throughout the globe as the virus spread over 208 counties within a short amount of time. This pandemic had significant negative impacts on common men living in densely populated countries, including Pakistan. Hence, this research aimed to record people’s perception of the 7th largest settlement in Pakistan, namely Hyderabad. This study mainly focused on socioeconomic and psychological parameters. The close-ended questionnaire was designed concerning the Depression, Anxiety, and Stress Scale (DASS-21). The DASS-21 is an optimal tool for recording the emotional values of depression, anxiety, and stress. A total of 400 questionnaires were filled out; they used a 5-point Likert scale. Significant socioeconomic issues were noted, such as lower household income, economic recession, job cuts, inaccessible Internet services during online teaching or working from home, etc. The primary challenges in the lockdown situation were Internet access (4.06) and anxiety (4.86) in the female population. There were higher levels of depression (N = 200), anxiety (N = 341), and stress (N = 125) in the local inhabitants. Other notable problems were illuminated, such as restrictions on social gatherings, electricity load shedding, and lower incomes. This study concludes that the degree of psychological problems varied according to the typology of gender. Based on study findings, this study recommends the prompt execution of policies considering possible future pandemics to restrain anxiety and depression in the female population. The local government is also advised to revitalize infrastructure to provide uninterrupted power supplies and Internet facilities. The income-generating channels should be open for lower-income households concerning future lockdowns.

Background: The COVID-19 pandemic has influenced almost every aspect of life, education being no exception. The sudden shift of teaching and learning using virtual methods was not an easy task. While medicine needs not just knowledge but also skills there were many questions regarding the efficacy of online classes. Aims: To study the impact of the sudden change of teaching method on the mental health of medical students using the DASS 21 questionnaires. Methods and Material: It was a cross-sectional study. This study was done among the 1st, 2nd and 3rd-year medical students over a period of 5 months. Pre-structured DASS-21 questionnaire was used to assess the mental health of these students. We have excluded all the students who already had a history of anxiety, stress, and depression before the corona virus pandemic. Results: Out of 122 students, 34 (27.9%) were males and 86 (70.5%) belonged to the age group 18-21 years. Depression, Anxiety and stress were more among the 1st MBBS students. Conclusions: Sudden changes in the mode of teaching are not easily accepted by the students. The transition should be well-planned.

The current study aims to investigate the psychometric properties of the Arabic DASS-21 questionnaire. A large-scale cross-sectional study of the Arabic adaptation of the DASS-21 scores. The participants (n= 1235) came from a variety of backgrounds. Overall, the reliability coefficient, Cronbach’s alpha, for the gross DASS- 21 score, was 0.94 (95% confidence interval CI between 0.93 and 0.94), indicative of excellent internal consistency. The three- factor model fitted acceptably for the full 21- item dataset. Nonetheless, some items were noted to load onto different factors to their original structure. Our study gives evidence of the excellent reliability, internal consistency, and convergent validity of the Arabic adaptation of DASS- 21. We also confirm the acceptability of the current three- factor composition for the DASS- 21 in its Arabic version. We may conclude that, in its current format, Arabic DASS- 21 can be used in many public and secondary health settings to detect depression, anxiety, and stress symptoms.

Background: The coronavirus disease 2019 (COVID-19) pandemic has impacted the mental health of the population globally with the increase in cases of depression, suicide, and self-harm. According to the World Health Organization, there has been an increase of 28% and 26% in major depressive disorders and anxiety, respectively, during 1 year of the COVID-19 pandemic. Only a few studies had been conducted in India assessing mental health, especially the post hoc effect of a pandemic. Therefore, the current study was conducted to estimate the prevalence of depression, anxiety, and stress in rural against urban populations as well as the contributing factors viz age, gender, socioeconomic class, change in occupation, and income. Materials and Methods: A community-based cross-sectional study was conducted from July 2021 to February 2022 among participants residing in the area covered by the Urban Health Training Centre (Ajmera, Pimpri, Pune) and Rural Health Training Centre (Alandi, Pune) of a medical college in Pune. One hundred fifty‑four participants (total of 308) above 18 years of age who were not diagnosed or under treatment for psychiatric illness were interviewed using the Depression Anxiety Stress Scale - 21 (DASS-21) to screen for anxiety, depression, and stress in each setting. Results: Overall prevalence of mental distress was 35.71% (n = 110). In the rural area, it was 29.2% (n = 45) as compared to 42.2% (n = 65). in the urban category. The prevalence of depression was significantly higher in urban areas (33.1%) compared to rural areas (19.4%), with an overall prevalence of 26.3%. The net prevalence of anxiety and stress was 35.7% and 15.6%, respectively, which were also higher in urban areas (Anxiety OR = 1.769, P = 0.018*; Stress OR = 2.262, P = 0.013). The upper middle class had the least psychological problems. Overall, 11% of participants had lost their jobs; 48.75% in rural and 37% of urban participants had a decrease in their income. Conclusion: The COVID-19 pandemic has resulted in an increased burden of mental illness. The prevalence of mental health problems is alarmingly high, especially in urban communities. To combat the global mental health pandemic, the interventions that mediate psychological distress must be quickly implemented. Due importance should be given to mental healthcare in the community. [ABSTRACT FROM AUTHOR]

Background: Health-care workers' psychological status is essential to Preventive control measures in a weak and unstable health system with poor infrastructural constraints. This study examines the psychological impact of the ongoing coronavirus disease 2019 (COVID-19) pandemic on the health-care providers working in primary health-care settings in Sudan. Materials and Methods: This is a health facility–based cross-sectional study conducted in primary health-care units in White Nile State, Sudan. The psychological impact of stress and anxiety was determined using the Depression Anxiety Stress Scale 21 (DASS-21). A self-administered questionnaire measured depression, anxiety, and stress. The population of this study included health professionals working in health centers, including physicians, nurses, technicians, pharmacists, and other support staff. Results: A total of 167 health professionals were systematically recruited. The mean anxiety score in the study population was 8.26 & 9.0 (corresponding to mild anxiety). Participants without anxiety constituted 26.35% (n = 44) of the participants. Women were significantly more likely to be affected than men (P = 0.0). Age (21–40 years), female nurses, and other health-care workers (anesthesiology, public health, health education, occupational health, psychiatry, etc.) could be strong predictors of psychological disorders (P-value of 0.0). Conclusion: This study provided evidence for primary health care at its preparatory levels, as they are the first line of protection against the COVID-19 pandemic. Addressing the high-risk population is a high priority in the preliminary phase. [ABSTRACT FROM AUTHOR]