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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]

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.

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]

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]

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.

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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]

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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]

Background: The SARS-CoV-2 pandemic greatly impacted healthcare workers (HCWs) dedicated to COVID-19 patients. A cross-sectional investigation was conducted in a large European hospital to study the psychological distress of HCWs engaged in COVID-19 wards in the early phase of the pandemic. Methods: A questionnaire was sent to 1229 HCWs to collect the following information: i) sociodemographic data; ii) depression, anxiety, and stress scales (DASS-21); iii) event impact scale (IES-R); iv) perceived stress scale (PSS); and v) work interface analysis. Regardless of the outcome of the questionnaire, all subjects were offered psychological support voluntarily. Results: Approximately two-thirds of the workers reported no symptoms according to the DASS-21 scales, the corresponding figures for the IES-R and PSS scales being 36% and 43%, respectively. There were no differences in the levels of depression investigated through the different scales in the various occupational categories. Symptoms of anxiety, stress, and depression were more pronounced in women, whereas the highest stress levels were observed in the younger age groups. The highest scores were observed on the DAS-21 scales of anxiety and IES-R but not on the others. Only 51 workers, most with previous SARS-CoV-2 infection, sought clinical psychological counseling, and more than half received subsequent psychological support. Conclusions. Our results agree with most of the literature data that anxiety, depression, and stress are associated with gender (female), age (18-44 vs. over 55), and having cared for patients with COVID-19. [ABSTRACT FROM AUTHOR]

The Depression, Anxiety and Stress Scale (DASS-21) is one of the most used instruments to measure negative emotional states in different populations. Despite this, its dimensionality and consistency are still questioned, especially in less studied populations such as employees. The present study aimed to determine the DASS-21 dimensionality in a sample of service employees from a Chilean organization (N=1143), using a non-experimental design survey. Structural equation models were used to evaluate four models: unidimensional, oblique, second order, and bifactor. Results showed that all models had an adequate fit, although the ancillary bifactor measure supports the unidimensional structure of the DASS-21 in this samples of employees. We suggest further research on the conceptual and operational nature of this scale in the employee population. [ABSTRACT FROM AUTHOR]

Background. The negative effects of the COVID-19 pandemic on mental health are still present today and are the subject of international research. The present cross-sectional quantitative study aimed to assess depression, anxiety and stress as well as mental health and well-being among Hungarian adults. Material and methods. The online survey study consisted of two data collections: the first survey was conducted in the spring of 2022 with the participation of 482 adults, while the second survey was performed in the spring of 2023 with 1157 adults. The questionnaire contained questions on sociodemographic data, about subjective mental status and characteristics of mental health. Results. During the one year passed since the last pandemic wave, mitigation of the symptoms of depression and stress and the worsening of anxiety symptoms was observed among the Hungarian adult population. A slight improvement of emotional and psychological well-being but a mild deterioration of social well-being was experienced in the same timeframe in the year following the pandemic. Conclusions. Long-term monitoring of the population's mental status is justified, and the attention of professionals working in the field of mental health improvement is again directed to the necessity of prevention and intervention programs targeting vulnerable groups. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

The coronavirus disease (COVID-19) pandemic has extremely caused massive disruptions in the education sector, and this led to the adoption of full-distance learning modalities across different educational institutions worldwide. However, studies are still needed within the context of the Philippines in terms of the impact of the pandemic on university students in light of a gradual limited face-to-face transition. This study determined the Filipino college students' perceived impact of the COVID-19 pandemic and the prevalence of depression, anxiety, and stress symptomatology (DASS) among them. This cross-sectional study surveyed Filipino university students from a public higher education institution in the Philippines via convenience sampling. A total of 3,718 students participated in the study. Analysis showed that despite the respondents' level of DASS being roughly similar and normal, half of them is experiencing mild to extremely severe symptomatology. Further results indicated that there is a statistically significant difference in their DASS when grouped according to their gender and class level. The findings will be beneficial to multiple stakeholders in designing data-driven policies that would maximize the possibility of a safe resumption of limited, gradual, and eventually, full face-to-face modalities. [ABSTRACT FROM AUTHOR]

Abstract Background To estimate the determinants of anxiety and depression among university teachers in Lahore, Pakistan, during COVID-19. Methods A cross-sectional study was conducted by enrolling 668 teachers from the universities of Lahore, Pakistan. Data were collected using a questionnaire. Chi-square for significance and logistic regression for the association were used. Results Majorly, the university teachers, with an average age of 35.29 years, had regular jobs (72.8%), job experience of > 6 years (51.2%) and good self-reported health (55.4%). The majority of the teachers were working as lecturers (59.6%), lecturing in arts (33.5%) or general science (42.5%) departments, having MPhil (37.9%) or master (28.9%) degrees, and teaching via synchronous video (59.3%) mode. Anxiety and depression, severe and extremely severe, were higher among lecturers, MPhil or master degree holders, teachers lecturing arts and general science subjects, and in those on contract employment. Anxiety was significantly associated with academic departments; arts (OR;2.5, p = 0.001) and general science (OR;2.9, p = 0.001), poor health status (OR;4.4, p = 0.018), and contractual employment (OR;1.8, p = 0.003). Depression was associated with academic departments; arts (OR;2.7, p = 0.001) and general science (OR;2.5, p = 0.001), and health status (OR;2.3, p = 0.001). Conclusion Among university teachers, anxiety and depression, severe and extremely severe, were prevalent among lecturers having MPhil or master degrees, belonging to arts and general science departments, and among contract employees. Anxiety and depression were significantly associated with academic disciplines, lower cadre, and poor health status.

BACKGROUND: Smartphones have become an indispensable part of almost everyone’s life. India has now become the leading and second-largest Smartphone market in the world. It has been noted that the purpose of Smartphone usage has exceptionally changed over the past few years, especially among students, professionals, and the common man. Smartphones have now become essential and the need of the hour, and medical students are no exception. Smartphones can make “smart students smarter”! There are now 10,275 unique applications labeled under the “Medical” and “Healthcare and Fitness” categories. The common medical applications used are MedCalc, Drug Infusion, Flashcards, Encyclopedia, Merck Manual, Medscape, PubMed, Epocrates, MedlinePlus, Lab test applications, Medical Dictionary, Eponyms etc. Despite the advantages and needs of smartphones, they have proven to be a source of potential hazard to human health, not only physical but also mental, social, and emotional well-being. There is consistent evidence for co-morbidity (such as obesity, heart diseases, neck and back pain, etc.) between excessive smartphone use and other psychiatric disorders, such as depression, anxiety, obsessive and compulsive disorder (OCD), and attention deficit hyperactivity disorder (ADHD) similar to internet addiction. The significant association of this addiction with poorer sleep quality and higher perceived stress has been a cause for concern. Hence, further investigation to explore the association between smartphone addiction and mental health, this study was undertaken. MATERIALS AND METHODS: Our study was undertaken in Dr VMGMC, Solapur, from June to August 2022, after obtaining approval from the ethical committee, approval number 172/22. Total voluntary participation for the study was 600 (from first to final year), and accordingly convenient sample size was taken. RESULTS: We found that out of the total participants, 42% of the participants had an average screen time of 4–6 h daily. A very small percentage of participants (4%) spent less than two hours in front of a screen. Alarmingly, 65% of the participants had an average screen time of more than 4 hours, which puts them at risk for the negative health impacts of prolonged screen time. Around 12% of them had symptoms of mild stress, 10.3% for mild anxiety, and 15.6% for mild depression. 10.6% had symptoms of moderate stress, 23.3% for moderate anxiety, and 16% for moderate depression. A small proportion of undergraduates, that is, 5%, 16%, and 11.6%, had symptoms of severe and extremely severe stress, anxiety, and depression, respectively. CONCLUSION: The study participants did not feel a lot of stress, anxiety, or depression symptoms when smartphones were used judiciously and mostly for non-social purposes (such as studying, listening to music, or watching videos). This investigation led us to the conclusion that there are some positive effects of smartphones on mental health. However, those who spent an excessive amount of time on their smartphones for social contact, with an average screen time of 5 h, showed signs of mild to moderate sadness, moderate anxiety, and tension, demonstrating that social media had a negative impact on the mental health of medical undergraduates. Therefore, efforts should be made to inform medical students about how using a smartphone is harming their mental health.

Background: Employee mental health has a significant impact on productivity at work. People who work in healthcare environments are known to be at an increased risk of developing mental health issues. Objective: To assess the psychological distress in housekeeping and sanitation workers of IHBAS hospital Methodology: A cross-sectional study was conducted on the housekeeping and sanitation workers of the IHBAS hospital, a tertiary care Neuropsychiatry hospital and Institute. The socio-demographic data of the workers was collected. Kessler Psychological Distress scale (K10) and the Depression Anxiety Stress Scale -21 (DASS-21) were used to assess psychological distress, depression, anxiety, and stress among workers. The data was entered and analysed in SPSS 21. Results: A total of 598 workers were screened, of which 50.7% were males and 49.3% were females .63.5% of the workers were in the age group of 31 to 50 years,24.4% were between 18-30 years of age and 12% were more than 50 years of age. The output of K10 scale for psychological distress showed that only 0.2% were likely to have a mild disorder. The analysis of DASS-21 yielded on depression subscale that 0.5% had mild depression, and 0.2% each had moderate and extremely severe depression. On the anxiety subscale, 0.5% had moderate anxiety, 0.2% each had mild and extremely severe anxiety and stress subscale yielded that 0.5% had mild stress, and 0.2% had moderate stress Conclusion: Even though the percentage of workers with mental health problems was very low based on screening with K10 and DASSS-21, it is still worthwhile to screen for and appropriately address mental health issues among hospital employees as part of the occupational health program

Given that there is limited evidence concerning the psychometric properties of DASS-21 when applied to primary school students, the present study undertook a comprehensive exploration of the psychometric evidence supporting the use of the DASS-21 within this demographic. The research comprised three studies. In Study 1, the basic psychometric properties of internal consistency and construct validity were examined. A total of 3138 primary school students from three provinces in mainland China participated. The internal reliability of the overall scale was 0.93, and for all the subscales, it was higher than 0.80. Construct validity was partially supported. Both exploratory and confirmatory factor analyses upheld the factorial validity of the original three-factor structure. While convergent validity was established, the results showed unsatisfactory discriminant validity. The bifactor model showed that DASS-21 raw scores predominantly indicated the general factor, evidenced by the high explained common variance and omega-hierarchical values. However, the contributions from the three specific factors were minimal, with their omega hierarchical values all below 0.15. In Study 2, a longitudinal design was adopted, tracking 1366 primary school students from Southwest China over a three-month interval. The results further confirmed that the DASS-21 exhibited scalar time-invariance. The latent mean analysis showed that there were no statistically significant differences in the latent means of depression, anxiety, and stress between Time 1 and Time 2. In Study 3, which included 364 college students and 483 enterprise workers, the results demonstrated that the DASS-21 had measurement invariance across different populations. The latent mean analysis further confirmed that, in terms of the latent mean of all three subscales, both college students and enterprise workers had significantly higher scores than primary school students. Overall, the findings indicated that the DASS-21 is a suitable tool for screening schoolchildren for general psychological distress, but it is not suitable for discerning distinct negative mood state disorders.

Objectives: The COVID-19 pandemic increased psychological stress and decreased sleep quality, especially among young people. Aromatherapy alleviates psychological stress, and bergamot essential oil helps improve depression. This study aimed to verify whether bergamot essential oil use alleviates psychological stress due to the COVID-19 pandemic and improves sleep quality and morning wakefulness. Design: A placebo-controlled, randomized, open-label, two-arm, two-period crossover trial. Interventions: Each intervention period was 1 week, with a 1-week washout period between the two periods. Participants used a bergamot or placebo spray before bedtime and upon awakening in each period. Main outcome measures: The primary outcome measures were sleep quality and morning wakefulness, assessed using the Ogri-Shirakawa-Azumi sleep inventory MA version (OSA-MA). The secondary outcome measures were depression, anxiety, and stress, assessed using the Depression Anxiety Stress Scales-21 (DASS-21). Results: A total of 48 university students participated in the study. A significant improvement was observed in “sleepiness on rising,” “refreshing on rising,” and “sleep length” in the bergamot group. Additionally, a significant improvement was observed in depression, anxiety, and stress. Conclusion: Using bergamot essential oil before bedtime helps relax the mind and body and provides sound sleep. It also improves mood and wakefulness when used upon awakening. Using aromatic essential oils is expected to relieve psychological stress and improve sleep quality and morning wakefulness.

BackgroundSince February 2022, the nation of Ukraine has become entangled in an escalating conflict that erupted after coronavirus outbreak fostering a situation of indeterminacy and precariousness, which adversely affected several facets, especially psychological well-being. However, there is a lack of empirical evidence on the psychological well-being of Ukrainians during the Russo-Ukraine war, as well as their coping strategies in response to the war’s repercussions. Consequently, this investigation endeavors to explore the prevalence of symptoms associated with depression, anxiety, stress, and insomnia and to correlate these symptoms with Ukrainians’ effective coping mechanisms during the ongoing war.MethodsAn online survey was administered in Ukraine from June to August 2022 due to the ongoing Russo-Ukraine conflict. The survey employed a quota sampling technique, targeting 2,664 individuals (≥18 years). Out of the total sample, 1,833 valid responses were obtained, yielding a response rate of 68. 81%. Depression, anxiety, and stress were measured using the depression, anxiety, and stress scale-21 (DASS-21), while the Pittsburgh sleep quality index (PSQI) was utilized to evaluate insomnia symptoms. In addition, Brief-COPE was adopted to evaluate the coping mechanisms of the selected study participants.ResultsOf 1,833 Ukrainian adults, 60.5% had symptoms of stress; 62.4% of them reported symptoms of anxiety; and 58.2% reported symptoms of depression. Symptom criteria for insomnia were found in about 21.8% of the study sample. The factors of sex, living area, area occupied by Russian forces, and having older adults and children in the house were statistically significant with symptoms of depression, anxiety, stress, and insomnia. The productive coping strategies of self-distraction, using instrumental support, planning, and behavioral disengagement, were observed as statistically significant with four psychological constructs.ConclusionThe study outcomes highlight a substantial prevalence of symptoms related to depression, anxiety, stress, and insomnia attributed to the accumulated consequences of ongoing conflict and the COVID-19 outbreak. The aforementioned findings emphasize the imperative of providing healthcare services and facilitating effective coping strategies among Ukrainians amid the ongoing war.

Background: Psychopathology could be brought on by an immune system disruption triggered by an infection. Psychiatric residual effects have been noted following prior coronavirus outbreaks. Method: This study is a cross‐sectional study that examined the psychopathological influence of the COVID‐19 pandemic among survivor students compared to students who have never been diagnosed as positive COVID‐19 patients (i.e., healthy students). Further, the study identified the relationship between sociodemographic profiles and mental health. To examine the significance of psychological health differences we used the DASS‐21, to measure depression, anxiety, and stress scales. There were seven questions to assess each dimension within the psychological scales. The respondents were selected randomly via online sources and completed the online self‐reporting questionnaire between August 23 and October 2, 2021. Results: A total of 750 students completed the online questionnaire, with 677 participants (90.27% of those originally surveyed) included in the final analysis of this study. The mean score of the stress scale for healthy students (M = 16.88, SD = 12.3, N = 537) demonstrated a significantly lower mean compared to COVID‐19 survival students (M = 21.7, SD = 11.01, N = 140), t(675) = −4.22, p < 0.001. The mean of the depression scale for healthy students (M = 16.18, SD = 11.94) demonstrated significantly lower mean compared to COVID‐19 survival students (M = 20.91, SD = 11. 90), t(675) = −4.18, p < 0.001. The mean of the anxiety scale for healthy students (M = 12.50, SD = 10.72) demonstrated significantly lower mean compared to COVID‐19 survival students (M = 19.43, SD = 11. 25), t(675) = −6.74, p < 0.001. Conclusion: University students who were infected with COVID‐19 had a traumatic experience, and thus developed psychological symptoms greater than students with no history of this infection. [ABSTRACT FROM AUTHOR]

Introduction: The mental health of South Asian women has been observed to be in regression lately, with sexual harassment as one of the major factors accounting for mental health deterioration, especially for women who leave their homes frequently for work and study. The COVID-19 pandemic not only augmented the mental health distress of the general female population but the rise in sexual violence against women is being consistently reported around the globe. Based on this background, we adopted a two-pronged strategy to assess whether working women and students aged 18-55 experienced a rise in sexual harassment in the 18 months after lifting the COVID-19 lockdowns. Secondly, using the well-validated psychometric test, DASS-21, we evaluated the psychiatric outcome of this change on the mental health of those women. Study design: The study was designed as a quantitative, cross-sectional surveybased research. Methodology: A total of 303 women participated in this study. Personal interviews through a specifically designed questionnaire and psychometric test DASS-21 were administered to assess the mental health state of working women and female students, aged between 18 and 55 years old. The mean age of the participants was 37 ± 2.8. The study population was further categorized into two main groups of limited and frequent interactions based on varying levels of the frequency of leaving home and interacting with male strangers in their daily routine. Data were analyzed and the correlation between limited/frequent interaction and DASS-21 total scores and sub-scores of depression, anxiety and stress, and other sociodemographic variables were investigated using the Chi-square test, whereas psychosocial predictors of mental distress were evaluated using multiple linear regression analysis after matching limited and frequent interaction groups using a 1:1 propensity score-matched pair method for sociodemographic covariates. Results: Overall, approximately 50% of our study population experienced changes in the behavior of male strangers that could be categorized as harassment in their daily life interactions, whereas 33.66% of participants experienced relatively more sexual harassment post-pandemic than before it. This observation was significantly correlated with the frequency of male interaction (X2 = 5.71, p < 0.01). Overall, 34% of our study population scored >60 on the DASS21-total score, whereas 29.04% scored >21 on the depression scale. Alarmingly, >40% of the women in the frequent interaction group scored in the extremely severe range of anxiety and depression. Moreover, in the regression analysis, out of all the factors analyzed, the extent of everyday interaction with male strangers, an increase in fear of sexual crimes, and a self-perceived increase in mental distress during the 18 months post-pandemic were found to be highly statistically significant predictors of mental distress not only for total DASS 21 but also for the sub-scales of depression, anxiety, and stress. Conclusion: In Pakistan, women experienced a rise in sexual harassment cases post-COVID-19. An increase in sexual harassment was found to be a predictor of negative mental health in the form of depression, anxiety, and stress. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

At a global level, COVID-19 was declared a pandemic by the WHO. During this crucial phase of the pandemic, people's lives went through a rollercoaster, with lower life expectancy and greater fear of losing loved ones. In a cross-sectional study of 202 female students, the state of depression, anxiety and stress due to the COVID-19 pandemic was examined using DASS-21. t-test and ANOVA test were used for statistical analysis. The result indicates that the girls had moderate to extremely severe cases of depression, anxiety and stress which were associated with socio-demographic background and COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

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 FROM AUTHOR]