Children's screen time and psychosocial symptoms at 5 years of age - the role of parental factors.

BACKGROUND AND OBJECTIVES: Electronic media (e-media) has become a universal part of young children's daily lives. Previous studies have found an association between increased screen time and children's psychosocial symptoms. We investigated whether parents' psychological distress and parenting style dimensions explain the association between children's screen time and psychosocial symptoms. Moreover, we investigated whether parents' mental well-being and parenting style dimensions moderate this association. METHODS: We used data from the Finnish CHILD-SLEEP birth cohort study. Parents and the child were assessed when the child was 5 years old (N = 671). The measure of screen time included program viewing from TV and other devices. Child's psychosocial problems and parents' depression, stress and parenting style dimensions were assessed by self-reports. RESULTS: A high level of screen time in children was associated with attention and concentration difficulties, hyperactivity and impulsivity symptoms as well as internalizing and externalizing symptoms among 5-year-olds. For the most part, the associations remained significant despite controlling for parents' mental health, parenting style dimensions and multiple background factors, especially associations relating to attention and concentration difficulties and hyperactivity symptoms were robust. Maternal stress and depression moderated the association between children's screen time and psychosocial symptoms, indicating a more pronounced association among stressed or depressed mothers. CONCLUSION: There is an independent association between children's screen time and psychosocial symptoms which is especially pronounced among those children whose mothers had poorer mental well-being. In clinical practice, the length of screen time should be inquired already at a young age and parents should be offered guidance to reduce the possible ill effects of excessive screen time, as well as help with their own mental health problems.

Is cancer back?-psychological issues faced by survivors of breast cancer.

Breast cancer survival rates have shown notable improvements over the years thanks to advancements in detection, treatment modalities, and supportive care. However, survivors often encounter challenges when reintegrating into daily life and managing persistent physical and psychological concerns. This review article aims to delve into the multifaceted emotional complexities faced by survivors, encompassing a spectrum of issues from fear of recurrence to body image insecurities, thus emphasizing the imperative for comprehensive support. Articles were reviewed through searches of PubMed and through searches of the author's own file. We will examine not only the risk factors contributing to heightened psychological distress but also the periods of vulnerability and the most common unmet needs encountered by these individuals. Additionally, we will discuss various psychological interventions and strategies designed to promote resilience and enhance the quality of life post-diagnosis. Furthermore, we will underscore the pressing need for ongoing, specific research endeavors aimed at addressing the long-term psychological impacts of cancer recurrence on survivorship. By shedding light on these critical aspects, we aim not only to provide insight into the challenges faced by survivors but also to advocate for the importance of integrating comprehensive psychological support into survivorship care. Through this thorough exploration, we seek to empower both survivors and healthcare professionals alike, facilitating a deeper understanding of the complexities inherent in the breast cancer survivorship journey. Ultimately, our aim is to highlight the crucial aspects that must be considered by healthcare professionals in providing holistic care to breast cancer survivors.

The impact of mental health and psychological stressors on menstrual cycle modulation: exploring the influence of age and hormonal contraceptives.

Stress, infections, and psychological and social well-being can affect the reproductive system. Activation of the hypothalamic-pituitary-adrenal axis can disrupt ovarian cyclicity. Estrogens can modulate stress responsiveness and mood. Thus, understanding this interaction and how it modulates the menstrual cycle is crucial for women's reproductive health. PURPOSE: The objective of this study was to analyze the influence of a stressor, a period of the Covid-19 pandemic when there were no vaccines available yet, on the psychological state of women aged 18 to 45 years; as well as the influence of mental health on the menstrual cycle, considering the influence of age and hormonal contraceptives. METHOD: Online questionnaire using the Google Forms platform was used. RESULTS: There is a high prevalence of the onset of new psychosocial symptoms. Moreover, most women reported some type of change in their menstrual cycles. The women who were using hormonal contraceptives demonstrated a higher frequency of spotting and menstrual color alterations, while women without hormonal contraceptives demonstrated a higher frequency of cycle duration and menstrual odor alterations. Women without hormonal contraceptives were more susceptible to the development of psychosocial symptoms. Younger adult women were more affected by menstrual changes and psychosocial symptoms. Close to 90% of women who reported several psychosocial symptoms had changes in their menstrual cycles. CONCLUSION: These data suggest the impact of stressors, such as a period of the pandemic, on mental health and menstrual cycles, and younger adult women can be more susceptible. This reflects the relationship between mental and reproductive health.

The relation between psychosocial symptoms and parenting styles in hospitalized children.

OBJECTIVE: Hospitalization is a serious experience affecting emotional, physical and developmental needs of the children. The aim of this study was to examine the relationship between psychosocial symptoms and parenting styles in hospitalized children. DESIGN AND METHODS: The sample of this cross-sectional descriptive study consisted of parents of hospitalized children between the ages of 6-12 years. The data collection tools included 'Scale for Diagnosis of Psychosocial Symptom for Inpatient children (SDPSIC)' and 'Multidimensional Parenting Assessment Scale (MAPS)'. RESULTS: The highest scores for psychosocial symptoms belonged to anxiety (8.64 ± 2.03) and regressive behaviours (3.89 ± 1.59). The highest scores for parenting styles belonged to warmth (13.30 ± 1.98) and supportiveness (12.69 ± 2.33). Parenting styles were predictore of the hospitalized child's psychosocial symptoms and explained 23% of the variance in psychosocial symptoms. While a positive relation existed between lax control, hostility, physical control parenting styles and psychosocial symptoms like anxiety, regressive behaviours, communication difficulty; a negative relation occured between warmth, positive reinforcement styles and anger-aggression. CONCLUSIONS: Focusing to the processes associating parenting styles and parenting practices with child outcomes will make the understanding of psychosocial symptoms of the child in hospitalization process easier. PRACTICE IMPLICATIONS: Identification of psychosocial symptoms-related risk factors in hospitalized children will contribute to compliance of the child to disease and treatment as well.

Psychosocial symptoms associated with spiritual well-being in Latino patients and caregivers coping with advanced cancer.

PURPOSE: The objective of this study was to investigate the relationship among hopelessness, anxiety, and depression, with spiritual well-being in patients and family caregivers. METHODS: A cross-sectional survey was administered to patients (n = 57) and caregivers (n = 57) that incorporated assessments that measured spiritual well-being, depression, anxiety, hopelessness, quality of life, family relationship, burden, fatalism, religiosity, and distress. Logistic regression and cross-tabulation analyses were conducted to examine the relationship between hopelessness, anxiety, and depression, with spiritual well-being. Logistic regression was used to quantify the impact of spiritual well-being on anxiety, depression, and hopelessness. Additionally, cross-tabulations with chi-square tests were conducted to explore associations between severity of hopelessness and severity of anxiety and depression. RESULTS: Logistic regression analyses showed negative associations between spiritual well-being and mental health outcomes, although not all findings were statistically significant. Among caregivers, a significant negative relationship was observed for depression (B = - 0.161, p = 0.022). Hopelessness also exhibited a negative association with spiritual well-being among caregivers (B = - 0.099, p = 0.054) and patients (B = - .152, p = 0.038). Cross-tabulations highlighted significant associations in the severity of hopelessness symptoms with anxiety and depression levels among caregivers (p < .001). CONCLUSION: Results reveal a relationship among psychosocial symptoms among Latino patient-caregivers coping with cancer. By emphasizing spiritual well-being, hopelessness, and anxiety and involving family patients and caregivers in the treatment process as a unit of care. Also, it indicates the need to develop culturally tailored interventions that aim to provide valuable assistance to Latino patients and caregivers coping with cancer.

Irritability and its relationship with psychosocial symptoms and quality of life in adolescents with epilepsy receiving levetiracetam therapy: A case-control study.

BACKGROUND: Levetiracetam, a widely used anticonvulsant drug in children and adolescents, has been associated with irritability, psychosocial symptoms, and low quality of life, which are also influenced by other epilepsy variables. PURPOSE: The objective of this study was to investigate the level of treatment-related irritability in adolescents receiving levetiracetam, and to evaluate the relationship between irritability levels and psychosocial symptoms, and quality of life. METHODS: A cross-sectional, case-control study was conducted. Consecutive adolescent patients with epilepsy aged 11-17 years with partial or generalized seizures, treated with either levetiracetam or valproic acid for at least 6 months, and healthy controls were recruited. The Affective Reactivity Index parent report and self-report, Strengths and Difficulties Questionnaire, and Pediatric Quality of Life Inventory-Psychosocial subscale were utilized to assess irritability, psychosocial symptoms, and functioning. RESULTS: A total of 120 participants were analyzed; 33 patients in the LEV group, 45 patients in the VPA group, and 42 healthy controls. Both self and parent report irritability levels of the LEV group were found to be significantly higher than those of healthy controls. The irritability levels of the LEV and VPA groups were not statistically different, but still the LEV group had higher irritability levels on both scales. In the LEV group, irritability was positively correlated with behavioral, emotional, and attention/hyperactivity problems, and also negatively correlated with psychosocial quality of life. CONCLUSION: Adolescents with epilepsy using LEV have a high level of irritability and this is associated with some psychosocial symptoms and poor quality of life.

Remission of Persistent Negative Symptoms and Psychosocial Consequences by Combined Clozapine and Cariprazine Treatment in a Patient With Long-Standing Treatment-Resistant Schizoaffective Disorder.

This patient case report describes a 45-year old white unmarried man with disability pension due to schizoaffective disorder, diagnosed at the age of 24. He lives in an apartment and has housing support. Retrospectively, the patient displayed prodromal markers of a disorder within the schizophrenia spectrum many years before the onset of frank psychosis, indeed since childhood. Over the years several symptoms and signs across schizophrenia domains have been manifest: positive, negative, cognitive, and affective, among which the negative and affective symptoms and signs were the earliest to appear. While the positive, disorganized, and catatonic symptoms responded to treatment - when duly tested and complied with - the negative and affective symptoms have been notoriously difficult to handle. We now report on the successful introduction of cariprazine (CAR) to his ongoing clozapine (CLZ) medication, the result of which has been a near-complete remission of his persistent negative and psychosocial issues. We interpret this remarkable alleviation of the patient's disease - and concomitant improvement of his quality of life - in terms of neuroreceptor target complementarity between CLZ and CAR, with particular emphasis on the contributions from the D3 and D2 receptor partial agonist components of the latter agent.

Finnish children who experienced narcolepsy after receiving the Pandemrix vaccine during the 2009-2010 H1N1 pandemic demonstrated high level of psychosocial problems.

AIM: We assessed psychosocial burdens in children who developed narcolepsy after receiving the Pandemrix H1N1 vaccine during the 2009-2010 pandemic. Parental quality of life was also assessed. METHODS: This multicentre study covered four of the five Finnish University Hospital Districts, which dealt with about 90% of the paediatric narcolepsy cases after the Pandemrix vaccination. The medical records of children diagnosed from 2010 to 2014 were reviewed. The questionnaires included the Youth Self-Report (YSR), Children's Depression Inventory (CDI), the Child Behaviour Checklist (CBCL) and questions on parental resources, stress and quality of life. RESULTS: We obtained the medical records of 94 children who were aged 5-17 years at the time of their narcolepsy diagnosis and questionnaire data for 73 of those children. Most children had strong narcolepsy symptoms, and 25% had CDI scores that suggested depression. In addition, 41% had total CBCL problem scores above the clinically significant limit and 48% were anxious, withdrawn and had somatic complaints. Sleep latency was weakly associated with the CBCL total problem score. Half of the children needed psychiatric interventions and parental stress was common. CONCLUSION: Depression and behavioural problems were common in children with narcolepsy after the Pandemrix vaccination and their parents frequently reported feeling stressed.

Gender Differences in Psychosocial Outcomes of Hair Loss Resulting from Childhood Irradiation for Tinea Capitis.

Recent studies have linked hair loss due to childhood irradiation for tinea capitis, a fungal infection of the scalp, to adverse psychosocial and health outcomes in women. However, no study to date has examined gender differences in the outcomes of this type of hair loss. The current study aimed to investigate gender differences in health and psychosocial outcomes of hair loss resulting from childhood irradiation for tinea capitis, and to identify the risk factors associated with depression in both men and women. Medical records held at the archives of the Israel National Center for Compensation of Scalp Ringworm Victims were retrospectively reviewed for 217 women and 105 men who received maximum disability compensation due to severe hair loss resulting from irradiation for tinea capitis. We found that women were at increased risk of developing psychosocial symptoms, including depression. Gender emerged as a significant predictor of depression, distinct from other predictors, such as marital status, age at radiation, exposure to verbal and physical bullying, low self-esteem, social anxiety, and physical health problems. Thus, the psychosocial needs of patients, particularly female patients, who were irradiated for tinea capitis during childhood need to be taken into account by the healthcare professionals treating them.

Interventions for Loneliness Among Adult Cancer Survivors: A Systematic Review and Meta-Analysis.

Problem identification: Loneliness is common after cancer, contributing to poor outcomes. Interventions to modify loneliness are needed. This systematic review describes the current literature regarding loneliness interventions in cancer survivors.Literature search: Databases including: Ovid/MEDLINE; The Cochrane Central Register of Controlled Trials (CENTRAL); Elsevier/Embase; Clarivate/Web of Science (Core Collection), EBSCO/PsycINFO, EBSCO/CINAHL were used to perform a systematic review of literature using PRISMA guidelines. Second, risk of bias, meta-analysis and a narrative synthesis approach was completed to synthesize findings from multiple studies.Data evaluation/synthesis: Six thousand five hundred three studies were initially evaluated; eight studies met inclusion criteria. Findings indicate a paucity of interventions, generally of lower quality. Interventions were feasible and acceptable; those interventions with cultural modifications were more likely to demonstrate effectiveness.Conclusions: There are limited interventions addressing loneliness in cancer survivors. Development and testing of culturally-relevant programs are warranted.Implications for psychosocial oncology: Current studies suggest the psychosocial symptom of loneliness is modifiable among adult cancer survivors. Few interventions have been tested and shown to be effectiveness in cancer survivors in the U.S. and none have been tailored for older adult survivors, by patient gender/sex and few for specific race/ethnic groups. Results from this systematic review: a narrative synthesis and meta-analysis can inform future interventions targeting loneliness in this growing, yet vulnerable, adult cancer survivor population.

Caring for People With Untreated Pectus Excavatum: An International Online Survey.

BACKGROUND: Pectus excavatum is a chest wall deformity with no known cause and no standardized guidelines for evaluation or management. There is a pressing need to characterize the symptoms that these individuals experience and to evaluate a potential mismatch between their expected and observed experiences with health care. We hypothesized that these individuals would feel that their health-care needs are not adequately met. METHODS: A total of 331 participants with untreated pectus excavatum from 47 countries recruited from the Pectus Awareness and Support Group completed a questionnaire about living with pectus excavatum. We focused on characterizing physical and psychosocial symptom frequency and whether these problems were discussed with providers during encounters related to pectus excavatum. RESULTS: A total of 46% and 31% of participants experience daily physical and psychosocial symptoms, respectively, but providers disproportionally focus on physical symptoms. Seventy-seven percent and 61% of participants thought their providers could do more to address their physical and psychosocial symptoms, respectively. Only 8% of participants were very satisfied after their most recent health-care visit about pectus excavatum. The overwhelming majority of participants have encountered providers that lacked basic knowledge about pectus. CONCLUSIONS: The results of this questionnaire expose a major discrepancy between expectations and delivery of care for people with pectus excavatum. These individuals should be routinely screened for both physical and psychosocial symptoms by general practitioners.

Psychosocial symptoms in very young children assessed for sexual abuse: A qualitative analysis from the ASAC study.

Child sexual abuse (CSA) is a worldwide problem with serious consequences. No recognizable symptom pattern for suspected CSA has yet been identified in very young children. We aim to investigate psychosocial symptoms in a sample of children with confirmed or strongly suspected CSA and the interpretations given to such symptoms by independent clinical experts. Secondly we examined whether experts were able to identify confirmed victims of severe CSA. A qualitative study including inductive content analysis of medical files and focus group discussions with independent experts on the interpretation of psychosocial symptoms was conducted. We included 125 children (76 boys, 60.8%, and 49 girls, 39.2%; median age 3.3 years; age range 0-11) who were involved in the Amsterdam sexual abuse case (ASAC) and had been examined for strongly suspected CSA. We identified four themes among the psychosocial symptoms: problems concerning emotions, behavior, toilet training, and development, whether or not associated with the daycare center or the perpetrator. Clinical experts identified signs of posttraumatic stress disorder (PTSD), regression in continence skills (not otherwise explained), and problems triggered by exposure to the perpetrator or the abuse location as concerning symptoms for CSA. Less concerning symptoms were designated as worrisome if they were numerous and there was no clear explanation for these symptoms. A clear symptom pattern was lacking and about half of the confirmed severe victims of CSA did not display any psychosocial problems. Therefore, it is difficult for experts to identify confirmed CSA victims. Thus, the assessment of suspected CSA should be over time and multidisciplinary.

Psychosocial problems in children of women entering substance use disorder treatment: A longitudinal study.

BACKGROUND: While parental substance use disorder (SUD) has been recognized as a risk factor for child outcomes, past research seldom focused specifically on children whose mothers suffer from alcohol and drug use disorders. Are these children at risk for elevated psychosocial problems, and would such risk be reduced if maternal substance use was reduced? AIMS: Children of substance-abusing mothers (COSAM, N=130) were compared to a demographically matched comparison sample, and examined soon after their mothers entered SUD treatment and in the 18months after treatment entry. We expected to observe elevated symptomatology among COSAM at baseline assessment, followed by a decreasing trend after maternal treatment in general, and remission in particular. RESULTS: Children's psychosocial problems were assessed through maternal reports on the Pediatric Symptom Checklist. Soon after their mothers entered SUD treatment, COSAM exhibited significantly greater overall and clinical-level psychosocial problems than the children from the matched comparison sample. However, at the end of the 18-months study period, these two groups no longer differed in terms of problems. Results from the longitudinal growth models revealed reductions in COSAM's overall and clinical-level problems following their mothers' SUD treatment. However, these reductions were similar for all COSAM, regardless of whether their mothers relapsed or remitted. CONCLUSION: Psychosocial problems were significantly reduced in COSAM following maternal SUD treatment, such that COSAM did not significantly differ from children from the matched comparison sample by the end of the 18-month study period.

Quality of life and psychosocial issues are important outcome measures in eczema treatment.

BACKGROUND: Atopic eczema (AE) is a common relapsing inflammatory skin disease in children associated with chronicity and poor quality of life. Many children also display depressive, anxiety and stress symptoms. AIM: To investigate the prevalence of depressive, anxiety and stress symptoms, and if these symptoms are associated with disease severity, quality of life and skin biophysiology in childhood AE. METHODS: Psychological symptoms, eczema severity, quality of life and biophysical skin condition of consecutive adolescents at the pediatric dermatology clinic of a teaching hospital were evaluated with the validated Chinese versions of Depressive, Anxiety, Stress Scales (DASS-42), Beck Depression Inventory (BDI-13), Nottingham Eczema Severity Score (NESS), Children's Dermatology Life Quality Index (CDLQI), transepidermal water loss (TEWL) and stratum corneum skin hydration (SH), respectively. RESULTS: AE patients (n=120) had lower SH, higher TEWL, worse CDLQI and reported higher overall, depressive and stress symptom scores, personal history of atopy, current topical corticosteroid usage and food avoidance than non-AE patients (n=26). Depressive, anxiety and stress symptoms were reported in 21%, 33% and 23% of AE patients, respectively. Multivariate analyses showed that these symptoms were significantly correlated with a poor quality of life (partial correlations of 0.40-0.49; p<0.001). Male patients had more severe disease (higher NESS, p=0.036) and DASS-depressive symptoms (multivariate OR=3.2, p=0.034) than females. Patients who reported current topical steroid usage generally practiced food avoidance (p=0.047), had poor quality of life (p=0.043) but less DASS-depression (multivariate OR=0.354, p=0.043). Only 6% of the 120 AE patients reported prior psychology consultation. CONCLUSIONS: Quality of life impairments correlate with disease severity, aberrant skin biophysiology, depression, anxiety and stress symptoms in adolescents with AE. Physicians caring for these patients must evaluate the different but inter-correlated medical, biophysiological and pertinent psychosocial domains. These significant correlations imply that a holistic approach should encompass psychotherapy, behavioral therapy and coping strategies in conjunction with dermatologic therapy.

Psychosocial and somatic outcomes of sleep problems in children: a 4-year follow-up study.

BACKGROUND: Inadequate sleep in children relates to medical and psychosocial problems. However, not much is known about the effects of sleep problems persisting from pre-school to school age on somatic and psychosocial symptoms. OBJECTIVES: To examine the associations between sleep disturbances and psychosocial symptoms, somatic complaints, medical problems at school age. METHODS: This was a population-based 4-year follow-up study of sleep problems in Finnish children (n = 470). Parents filled in Sleep Disturbance Scale for Children during pre-school and school years. Children were categorized into four groups: no sleep problems, sleep problems only at pre-school or only at school age, and persistent sleep problems. At follow-up the parents filled in Child Behavior Checklist and a background questionnaire. RESULTS: The children with persistent sleep problems (9%) had a 16-fold risk of having psychosocial symptoms on subclinical/clinical range compared with the children without sleep problems. The psychosocial symptoms that were related strongest to prolonged sleep problems were aggression, social and attention problems, and anxious/depressed mood. Also, somatic complaints (ninefold risk) and medical problems (P < 0.001) were typical for children with persistent sleep problems. CONCLUSIONS: Persistent sleep problems in children associate with high levels of psychosocial, somatic and medical problems. In paediatric health care more attention should be paid to recognizing, monitoring of the persistence and treatment of sleep problems before school transition period.