Prevalence and socio-economic determinants of growth and developmental delays among Iranian children aged under five years: A cross sectional study.

BACKGROUND: The main cause of growth and development delays remains unknown, but it can occur as an interaction between genetic, environmental, and socio-economic factors. OBJECTIVE: The aim of the study was to investigate the prevalence and social determinants of growth and developmental delays among children aged under five years in Qazvin, Iran. METHODS: A cross-sectional study was conducted between January 2019 to December 2020 with participation of 1800 mothers with children aged 4-60 months who were referred to comprehensive health centers in Qazvin city, Iran. Structural and intermediate social determinants of health were assessed including: parents and children socio-demographic characteristics, families' living and economic status, parents' behavioral factors, household food security, mother's general health, and perceived social support. Children's growth was assessed based on their anthropometric assessment and their development was assessed using their age-specific Ages and Stages Questionnaire. Data were analyzed using univariable and multivariable logistic regression models using SPSS software version 24 and Stata version 14. RESULTS: The prevalence of developmental problems in each domain were 4.28% for personal and social delay, 5.72% for gross motor delay, 6.5% for communication delay, 6.72% for fine motor delay, and 8% for problem-solving delay. The prevalence of weight growth delays was 13.56% and height growth delays was 4.66%. Communication, gross motor, and problem-solving delays were higher among children whose fathers' smoked cigarettes. Fine motor delays were lower among mothers with education status of high school diploma and university degree vs. the under diploma group. Personal and social delay was significantly higher among families with fair economic status and lower among children when their fathers were employed (vs. unemployed). Weight and height growth delays were higher among mothers who had experienced pregnancy complications and household food insecure families, respectively. CONCLUSION: There are different predictors of growth and developmental delay problems among Iranian children aged under five years including fathers' smoking, families' economic status, and household food insecurity as well as history of mothers' pregnancy complications. The present study's findings can be used to screen for at-risk of growth and developmental delays among children and could help in designing and implementation of timely interventions.

Burnout Mediates the Association between Workplace Bullying and Mental Health Problems of Health Practitioners in Cancer Units.

Background: Medical health practitioners, particularly those working in cancer units, are vulnerable to poor psychological outcomes. The present study was designed to examine the influence of workplace bullying on the mental health of medical and paramedical staff by testing workplace burnout as a mediating factor. Methods: Utilizing a cross-sectional survey, 220 Muslim medical staff officers from the cancer units of three hospitals in Lahore, Pakistan, were assessed for workplace bullying, mental health, and workplace burnout using the standardized psychometric measures (i.e., Negative Act Questionnaire; Depression, Anxiety, Stress Scale; and Maslach Burnout Inventory). Data were collected from 2019-2020. Results: Workplace bullying and workplace burnout were directly related to mental health problems, including depression, anxiety, and stress symptoms. Moreover, workplace burnout significantly mediated the paths between workplace bullying and mental health (i.e., depression, anxiety, and stress symptoms), suggesting that workplace burnout increases vulnerability to other mental health issues. Conclusion: A need for counseling and suitable management strategies to support medical staff working in cancer units is required.

Assessing intrinsic capacity in Taiwan: Initial psychometric properties of the Integrated Care for Older People Screening Tool for Taiwanese (ICOPES-TW).

BACKGROUND: The World Health Organization (WHO) proposed the concept of intrinsic capacity (comprising composite physical and mental capacity) which aligns with their concepts of healthy aging and functional ability. Consequently, the WHO promotes the Integrated Care for Older People (ICOPE) framework as guidance for geriatric care. Consequently, each government should have a screening tool corresponding to ICOPE framework to promote geriatric care. The present study examined the initial psychometric properties of the Taiwan version of ICOPE (i.e., ICOPES-TW). METHODS: Older people (n = 1235; mean age = 72.63 years; 634 females [51.3%]) were approached by well-trained interviewers for participation. A number of measures were administered including the ICOPES-TW, WHOQOL-AGE (assessing quality of life [QoL]), Clinical Frailty Scale (assessing frailty), Barthel Index (assessing basic activity of daily living [BADL]), and Lawton Instrumental Activities of Daily Living Scale (assessing instrumental activity of daily living [IADL]). RESULTS: The ICOPES-TW had a two-factor structure (body functionality [eigenvalue = 1.932] and life adaptation [eigenvalue = 1.170]) as indicated by the results of exploratory factor analysis. Internal consistency of the ICOPES-TW was low (Cronbach's α = 0.55 [entire ICOPES-TW], 0.45 (body functionality factor), and 0.52 (life adaptation factor). ICOPES-TW scores were significantly (i) positively correlated with age (r = 0.321), IADL (r = 0.313), and frailty (r = 0.601), and (ii) negatively correlated with QoL (r=-0.447), and BADL (r=-0.447), with all p-values < 0.001. CONCLUSION: The ICOPES-TW could be a useful screening tool for healthcare providers to quickly evaluate intrinsic capacity for Taiwanese older people given that it has moderate to strong associations with age, BADL, IADL, QoL, and frailty.

The Impact of Cigarette Smoking, Water-Pipe Use on Hearing Loss/Hearing Impairment: A Cross-Sectional Study.

OBJECTIVE: The aim of the present study was to determine the association between cigarette smoking, waterpipe smoking, and co-morbidity diseases on hearing loss. METHODS: A cross-sectional study was conducted among 1015 patients [386 males (38%) and 629 females (62%)] who were aged are between 25 and 65 years. The study used clinical, physical examinations and Pure-Tone Audiometry (PTA) to assess hearing. Univariate and multivariate stepwise logistic regression analyses were used for the statistical analysis. RESULTS: Out of 1015 patients assessed, 199 were cigarette smokers with hearing loss (21.6%) and 111 waterpipe smokers with hearing loss (12%). There were statistically significant differences between cigarette smokers with hearing loss regarding (p<0.001), gender (p<0.001), BMI (p<0.001), hypertension (p<0.001), tinnitus (p<0.001), vertigo and/or dizziness (p<0.001), and migraine/headaches (p<0.001). Also there were statistically significant differences between waterpipe smokers with hearing loss, none smokers concerning age groups (p<0.001), BMI (p<0.001), using MP3 players (p=0.004), family history of hypertension (p=0.026), ATP III metabolic syndrome (p=0.010), IDF metabolic syndrome (p=0.012), tinnitus (p<0.001), vertigo/dizziness (p<0.001), and migraine/headaches (p=0.025). Multivariate stepwise logistic regression analysis indicated that tinnitus (p<0.001), dizziness (p<0.001), nausea (p=0.001), headaches and migraine (p<=0.003), fatigue (p=0.004), and vertigo (p=0.022) were considered as risk predictors risk hearing loss related cigarette smokers. Also, analysis revealed that tinnitus (p<0.001), nausea (p=0.001), headaches and migraines (p<0.001), Type 2 diabetes mellitus (p<0.001), and vertigo (p=0.021), were considered as risk predictors for hearing loss related waterpipe smokers. CONCLUSION: The present study suggests cigarette smoking and waterpipe smoking, life-style factors are possible risk factors for hearing loss among smoker participants.

The Global Distribution and Epidemiology of Psychoactive Substance Use and Injection Drug Use Among Street-Involved Children and Youth: A Meta-Analysis.

Background: Globally, street-involved children and youth (SICY) who work and live on/of the streets are at higher risk of increased psychoactive substances and injecting drug use. Objectives: The present study aimed to identify the prevalence, distribution, sociodemographic factors, and risk-taking behaviors associated with psychoactive substances and injecting drug use among SICY. Methods: Studies in English published from December 1 1985 to July 1 2022, were searched for on PubMed, Scopus, Cochrane, and Web of Science to identify primary studies on psychoactive substances and injecting drug use among SICY. The pooled-prevalence estimates were obtained using a robust fixed-effects model. Results: The most commonly reported life-time and current psychoactive substance was tobacco followed by cannabis, LSD/ecstasy, cocaine, methamphetamine, heroin and injection drug use. The results showed that life-time and current prevalence of methamphetamine and cannabis use, as well as life-time prevalence of cocaine, LSD/ecstasy, heroin, tobacco, and injecting drug use increased as age rose while current prevalence of cocaine and tobacco use decreased as age rose. SICY who were male, homeless, had parents who had died, had history of substance use among family members or best friends, had experienced violence, had casual sex partners, had a history of working in the sex trade, and had unprotected sex were all related to psychoactive substance use and injecting drug use. Conclusions: Research examining this population suffers from lack of studies, therefore, improving the knowledge for interventions aimed at reducing risk behaviors, particularly those related to the transmission of sexually transmitted infections such as HIV is of great importance.

Depression and quality of life among Afghan healthcare workers: A cross-sectional survey study.

BACKGROUND: According to the World Health Organization, approximately 280 million individuals worldwide suffer from depression. One occupational group that is more prone to mental health issues is healthcare workers (HCWs). However, very little is known about the mental health of HCWs in Afghanistan. Therefore, the present study examined depression, quality of life (QOL), and related factors among Afghan HCWs. METHODS: A cross-sectional survey was administered in June 2022 among healthcare workers (N = 299) in the Herat province of Afghanistan. The survey examined depression, its risk factors and predictors among HCWs. RESULTS: Of the 299 participants, 73.6% of them reported depression symptoms. Low monthly income, working in a private hospital, and being a cigarette smoker were some of the main variables associated with depression symptoms among Afghan HCWs. Multiple regression analysis indicated that field of work (aOR = 3.774, p = 0.0048), monthly income (aOR = 0.746, p = 0.0088), job type (aOR = 8.970, p < 0.0001), cigarette smoking (aOR = 2.955, p = 0.0069), a bad event happening during the past month (aOR = 2.433, p = 0.0157), physical domain of quality of life (aOR = 0.966, p = 0.0186), and psychological domain of quality of life (aOR = 0.950, p = 0.0005) were significantly associated with depression symptoms. CONCLUSION: The prevalence of depression symptoms is high among healthcare workers in the Herat province of Afghanistan. One of the variables found to have a major impact on the prevalence of depression was their monthly income. Considering its impact on quality of life and the overall quality of healthcare services, the government should implement regular screening for depression, psychological counselling services, and psychiatric treatment for vulnerable healthcare workers.

Emergency Department Use, Hospitalization, and Their Sociodemographic Determinants among Patients with Substance-Related Disorders: A Worldwide Systematic Review and Meta-Analysis.

Background: Identifying the determinants of emergency department (ED) use and hospitalization among patients with substance-related disorders (SRD) can help inform healthcare services and case management regarding their unmet health needs and strategies to reduce their acute care. Objectives: The present study aimed to identify sociodemographic characteristics, type of used drug, and risky behaviors associated with ED use and hospitalization among patients with SRD. Methods: Studies in English published from January 1st, 1995 to April 30th, 2022 were searched from PubMed, Scopus, Cochrane Library, and Web of Science to identify primary studies on ED use and hospitalization among patients with SRD. Results: Of the 17,348 outputs found, a total of 39 studies met the eligibility criteria. Higher ED use and hospitalization among patients with SRD were associated with a history of homelessness (ED use: OR = 1.93, 95%CI = 1.32-2.83; hospitalization: OR = 1.53, 95%CI = 1.36-1.73) or of injection drug use (ED use: OR = 1.34, 95%CI = 1.13-1.59; hospitalization: OR = 1.42, 95%CI = 1.20-1.69). Being female (OR = 1.24, 95%CI = 1.14-1.35), using methamphetamine (OR = 1.99, 95%CI = 1.24-3.21) and tobacco (OR = 1.25, 95%CI = 1.11-1.42), having HIV (OR = 1.70, 95%CI = 1.47-1.96), a history of incarceration (OR = 1.90, 95%CI = 1.27-2.85) and injury (OR = 2.62, 95%CI = 1.08-6.35) increased ED use only, while having age over 30 years (OR = 1.40, 95%CI = 1.08-1.81) and using cocaine (OR = 1.60, 95%CI = 1.32-1.95) increased hospitalization only among patients with SRD. Conclusions: The finding outline the necessity of developing outreach program and primary care referral for patients with SRD. Establishing a harm reduction program, incorporating needle/syringe exchange programs, and safe injection training with the aim of declining ED use and hospitalization, is likely be another beneficial strategy for patients with SRD.

Changes of Health Outcomes, Healthy Behaviors, Generalized Trust, and Accessibility to Health Promotion Resources in Taiwan Before and During COVID-19 Pandemic: Comparing 2011 and 2021 Taiwan Social Change Survey (TSCS) Cohorts.

Purpose: The present study compared two nationally representative cohort datasets concerning Taiwan residents' healthy behaviors, subjective health outcomes, generalized trust, and accessibility to health promotion resources. Patients and Methods: The Taiwan Social Change Survey (TSCS) was conducted in two waves ten years apart: 2011 cohort (n = 1021; 48.4% males) and 2021 cohort (n = 1425; 47.4%) cohorts. Descriptive statistics were calculated to compare the two TSCS datasets. Then, multiple regression models were constructed with health outcome as the dependent variable, and demographics and other key components as independent variables. Results: The 2011 TSCS cohort showed higher prevalence for cigarette smoking (30.8% vs 25.2%; p=0.002), alcohol drinking (52.5% vs 24.3%; p<0.001), exercise habits (52.7% vs 48.0%; p=0.02), and better fruit and vegetable accessibility (Mean=3.91 vs 3.82; p=0.04). The 2021 TSCS cohort reported higher body mass index (Mean=24.20 vs 23.63; p<0.001), less residency in urban areas (22.4% vs 31.1%; p<0.001), better jogging accessibility (4.14 vs 4.05; p=0.006), higher generalized trust (2.26 vs 2.17; p=0.001), and greater internet usage (3.43 vs 2.89; p<0.001). The regression model showed that exercise habits (standardized coefficient=0.20 and 0.10; p<0.001) and generalized trust (standardized coefficient=0.11 and 0.11; p=0.004 and <0.001) were consistently associated with health outcomes in both cohorts. Additionally, internet use (standardized coefficient=-0.07; p=0.026) and alcohol drinking behaviors (standardized coefficient=-0.07; p=0.0022) were negatively associated with health outcomes in the 2021 cohort. Conclusion: The present study demonstrated the trends and changes over 10 years regarding multiple health-related components among Taiwan residents. The study's findings provide insight into education promotion programs to reduce unhealthy behaviors as well as enhancing generalized trust building and developing healthy behaviors for Taiwan residents.

Psychometric properties of the Slovenian version of Internet Disorder Scale-IDS-15.

BACKGROUND: Conceptualising internet addiction and assessing its symptoms has presented a significant challenge for researchers over the past 25 years. Recently, the Internet Disorder Scale (IDS-15), which is based on the criteria for Internet Gaming Disorder (IGD) from DSM-5, has emerged as a promising instrument to assess internet addiction. The main objective of the present study was to evaluate the psychometric properties of the Slovenian IDS-15. METHODS: The sample was recruited from the National Survey on the Use of Tobacco, Alcohol and Other Drugs that was conducted in 2018 on a nationally representative sample (N = 16,000; age range: 15-64 years; 62.4% response rate). The final sample comprised 9,161 participants, with 80.9% reporting having used the internet at least once a week (n = 7,413). A structured questionnaire was designed and internet addiction was assessed using the IDS-15. RESULTS: Confirmatory Factor Analysis showed acceptable fit to the proposed four-factor structure of the IDS-15. The reliability, and criterion, convergent and discriminant validity were also found to be adequate with a notable exception of the first item of the scale, as shown by its lower factor loading and higher variability. Additionally, latent profile analysis was used to distinguish between internet users with low (n = 3,818; 51.5%), medium (n = 3,111; 42.0%) and high (n = 484; 6.4%) addiction risk. Furthermore, the high-risk class was associated with higher IDS-15 factor scores, higher frequency of internet use in leisure time, and lower age of first internet use. CONCLUSIONS: The present study provides new insights about the strengths and shortcomings of the IDS-15. Moreover, the results provide an insight into the prevalence of internet addiction in Slovenia, as well as associations with other potential factors. The results serve as the basis for further analyses on internet addiction epidemiology, policymaking activities, and design for targeted public health interventions in Slovenia.

Are health promoting lifestyles associated with pain intensity and menstrual distress among Iranian adolescent girls?

OBJECTIVE: The present study investigated the relationship between a health-promoting lifestyle and menstrual pain intensity and distress among adolescent girls in Qazvin. METHODS: A cross-sectional survey study using a two-stage sampling method was conducted. The participants (n = 986) were female high school students aged 14-19 years living in Qazvin. Random cluster sampling was used to recruit participants from schools and classes from each grade. An online survey was provided to all participants to complete. Data were collected using a Demographic and Menstrual Characteristics Checklist, the Visual Analogue Scale (VAS) to assess dysmenorrhea intensity, the Andresh Milsom Scale (AMS) to assess dysmenorrhea severity, the Moos Menstrual Distress Questionnaire (MMDS) to assess menstrual distress, and the Health-Promoting Lifestyle Profile (HPLP) to assess a health promoting lifestyle. Data were analyzed using an univariable linear regression model at a significance level of 0.05. RESULTS: The findings indicated that 421 participants (42.7%) experienced dysmenorrhea with a mean duration of 2.24 days (SD = 1.57) and a mean pain intensity of 4.62 on the VAS (SD = 2.87). The mean score on the menstrual distress on the MDDS was 13.55 (SD = 8.88) and the mean score on the HPLP was 2.55 (SD = 0.50). Based on the results of univariable linear regression, nutrition (ß=-0.18, p < 0.001) and exercise (ß=-0.17, p < 0.001) had the most significant effect on the severity of dysmenorrhea pain. Also, self-actualization (ß=-0.29, p < 0.001), stress management (ß=-0.25, p < 0.001) and nutrition (ß=-0.25, p < 0.001) had the most significant effect on menstrual distress. CONCLUSION: Based on these findings, it is suggested that (i) improving nutrition and exercise might reduce the severity of dysmenorrhea pain and (ii) improving self-actualization, stress management and nutrition might reduce the severity of menstrual distress. Overall, it seems that improving health-promoting lifestyle behaviors can help improve the severity of dysmenorrhea pain and menstrual distress among adolescent girls.

Prevalence of psychological distress among cancer patients in Southeast Asian countries: A systematic review.

Psychological distress (including depression and anxiety) is common in the first years of cancer diagnosis but can differ by country and region. The aim of the present paper was to review the prevalence of psychological distress among cancer patients in the Southeast Asia (SEA) region. A systematic literature search was carried out using several databases (i.e., PubMed, PsychARTICLES, Embase, CINAHI, Web of Sciences, Plus, Scopus, and AHMED). Papers originally published in English language were taken into consideration if they (i) were published from 2010 to 2021 and (ii) reported the prevalence of psychological distress among patients with different types of cancer. A total of 23 studies met the inclusion criteria. The most frequently employed psychometric instrument for anxiety and depression screening was the Hospital Anxiety and Depression Scale (HADS). The prevalence of anxiety (ranging from 7% to 88%) was wider than that of depression (ranging from 3% to 65.5%) among patients with different types of cancer and living in various countries in the SEA region. The overall prevalence rate of psychological distress among cancer patients from the SEA region was not fundamentally very different from that of general populations. These findings provide useful information for health professionals and cancer patients to understand the negative role of psychological distress in quality of life and health. The research findings demonstrate the importance of counselling for psychological distress among cancer patients as means of effectively resolving their psychological problems and ultimately improving the quality of oncology medical care. Clinical recommendations for cancer management should incorporate the early identification of (and therapy for) psychological distress, as well as their monitoring during treatment.

Disorders due to addictive behaviors: Further issues, debates, and controversies •.

Two recent papers in the Journal of Behavioral Addictions by Brand et al. (2022), and Sassover and Weinstein (2022) both make interesting additions to the place of behavioral addictions in the more general addictive behaviors field. This commentary discusses some of the further nuances in the debates surrounding whether problematic engagement in social networking, pornography, and buying/shopping should be considered as possible 'disorders due to addictive behaviors' in the ICD-11. Particular emphasis in this commentary is placed on social network use disorder and its delineation. While there is growing evidence that addictions to sex, pornography, social network sites, exercise, work, and buying/shopping may be genuine disorders among a minority of individuals, none of these behaviors is likely to be included in formal psychiatric manuals in the near future until there is more high-quality data on all research fronts (e.g., epidemiological, neurobiological, psychological, and clinical).

Comparison of Targeted and Routine Adolescent HIV Screening in a Pediatric Emergency Department.

OBJECTIVES: The aims of the study were (1) to compare targeted and routine HIV screening in a pediatric emergency department (PED) and (2) to compare provider documented HIV risk assessment with adolescent perception of HIV risk assessment conducted during the PED visit. METHODS: This prospective study ran concurrent to a PED routine HIV screening pilot. Adolescents could be tested for HIV by the PED provider per usual care (targeted testing); if not tested, they were approached for the routine screening pilot. A subset of adolescents completed a questionnaire on HIV risk. χ 2 analysis compared adolescents with targeted testing and routine screening. HIV-tested patients were asked if HIV risk was assessed; κ analysis compared this with documentation in the provider note. RESULTS: Over 4 months, 107 adolescents received targeted testing and 344 received routine screening. One 14-year-old patient tested positive by routine screening; this adolescent had 2 PED visits without targeted testing within 60 days. Compared with routine screening, adolescents with targeted testing were more likely female (82% vs 57%, P < 0.001), 16 years or older (71% vs 44%, P < 0.001), or had genitourinary/gynecologic concerns (48% vs 6%, P < 0.001). Adolescents with HIV risk factors were missed by targeted testing but received routine screening. Adolescents with documented HIV risk assessment were more likely to receive targeted testing. There was moderate agreement (κ = 0.61) between provider documentation and adolescent perception of HIV risk assessment. CONCLUSIONS: There are gaps in PED HIV risk assessment and testing, which may miss opportunities to diagnose adolescent HIV. Routine HIV screening addresses these gaps and expands adolescent HIV testing in the PED.

Prevalence of gaming addiction and its impact on sleep quality: A cross-sectional study from Pakistan.

Background: Gaming addiction has become a topic of increasing research interest worldwide but little research has been carried out in Pakistan. Aims: The present study assessed the prevalence of gaming addiction among a Pakistani sample of adults in the general population. It also explored the effects of online gaming addiction upon sleep quality. Method: A cross-sectional survey was carried out during a national lockdown due to the COVID-19 pandemic in Pakistan. Using a convenience sampling technique, an online survey comprising demographic information, the Game Addiction Scale (GAS), and the Pittsburgh Sleep Quality Index (PSQI) was completed by 618 participants (67.5% male) aged 18-56 years (M = 24.53 years, SD = ±5.016). Results: Out of 618 participants, 57.0% (n=352) played online games. Among gamers, 12.5% (n = 44) were classed as addicted to the gaming based on GAS scores. Compared to those not addicted to gaming, participants with gaming addiction had significantly poorer subjective sleep quality, higher sleep disturbance, lesser sleep duration, and higher daytime dysfunction. Gaming addiction was also more prevalent among males compared to females. Conclusion: Gaming addiction among the Pakistani general population is significantly associated with poor sleep quality. This problem needs to be addressed at both individual and societal levels to avoid adverse long-term health impacts.

Factor structure of ten psychoactive substance addictions and behavioural addictions.

Over the past two decades, many problematic/excessive behaviours have increasingly been conceptualized as addictions due to their similarity with more traditional psychoactive substance addictions. The primary aim of the present study was to simultaneously examine the factor structure of three psychoactive substance addictions (alcohol use, cigarette smoking, and substance use) and seven behavioural addictions (sex, social media use, shopping, exercise, online gambling, internet gaming, and internet use), using exploratory factor analysis (EFA; N = 481) and confirmatory factor analysis (CFA; N = 487). A total of 968 participants completed an online survey including ten psychometric scales assessing the ten different potentially addictive behaviours. EFA supported a two-factor solution, with different factors for the psychoactive substance and behavioural addictions (excluding exercise addiction). CFA supported the two-factor model in a separate sample. There was good support for the concurrent and discriminant validities of the CFA latent factors and the reliability of the behavioural latent factor in the two-factor CFA model. While there was support for the concurrent and discriminant validities of the psychoactive substance latent factor, there was insufficient support for its reliability. The taxonomic, theoretical, and clinical implications of the findings are discussed.

Prevalence and Factors Associated With Depression and Suicidal Ideation During the COVID-19 Pandemic Among University Students in Uganda: A Cross-Sectional Study.

Background: The COVID-19 pandemic has negatively impacted psychosocial well-being and mental health of students across the world. Although students are vulnerable to depression and suicidal ideation, few studies have been conducted in Uganda. This study aimed to determine the prevalence of depression and suicidal ideation, and associated factors among undergraduate university students in Uganda. Methods: A cross-sectional study was conducted among undergraduates [N = 540; 363 males; mean age = 23.3 (± 2.64) years] recruited from four universities using an online questionnaire that explored sociodemographic factors, depression, and other associated factors. The Patient Health Questionnaire (PHQ-9) was used to assess depression, and Item 9 was used to assess suicidal ideation in the past 2 weeks. Multivariable logistic regression analyses were performed to determine the factors associated with depression and suicidal ideation. Results: The prevalence of moderate to severe depression was 20% (n = 108) (cut-off: 10/27 based on the PHQ-9), and the prevalence of past-2-week suicidal ideation was 13.89% (n = 75) (cut-off: 1/3 based on the PHQ-9 Item 9). About half of the individuals who screened positive for depression had suicidal ideation. Factors associated with depression were: having relationship issues [adjusted odds ratio (aOR) = 1.79, 95% confidence interval (CI) = 1.13-2.81, p = 0.012], and having a history of sexual abuse (aOR = 2.06, 95% CI = 1.10-3.84, p = 0.023). Factors associated with reducing the risk of depression were: satisfaction with current academic performance (aOR = 0.50, 95% CI = 0.32-0.79, p = 0.003), and being in the fifth year of academic study (aOR = 0.16, 95% CI = 0.03-0.73, p = 0.018). Factors associated with suicidal ideation were: smoking cigarettes and/or marijuana (aOR = 4.83, 95% CI = 1.10-21.12, p = 0.037), and having financial tuition constraints (aOR = 1.85, 95% CI = 1.08-3.16, p = 0.024), However, satisfaction with current academic performance reduced the likelihood of suicidal ideation (aOR = 0.40, 95% CI = 0.23-0.70, p = 0.001). Conclusion: Approximately one-fifth of undergraduate university students were moderately to severely depressed, especially those who had relationship issues and those with a history of sexual abuse. Suicidal ideation was common among smokers and those having financial tuition constraints. Therefore, it is recommended that the university authorities implement measures to provide psychological support for the students with problems concerning financial tuition constraints, relationships, and sexual abuse. Also, all students with depression should be screened for suicidality.

FOXN3 and GDNF Polymorphisms as Common Genetic Factors of Substance Use and Addictive Behaviors.

Epidemiological and phenomenological studies suggest shared underpinnings between multiple addictive behaviors. The present genetic association study was conducted as part of the Psychological and Genetic Factors of Addictions study (n = 3003) and aimed to investigate genetic overlaps between different substance use, addictive, and other compulsive behaviors. Association analyses targeted 32 single-nucleotide polymorphisms, potentially addictive substances (alcohol, tobacco, cannabis, and other drugs), and potentially addictive or compulsive behaviors (internet use, gaming, social networking site use, gambling, exercise, hair-pulling, and eating). Analyses revealed 29 nominally significant associations, from which, nine survived an FDRbl correction. Four associations were observed between FOXN3 rs759364 and potentially addictive behaviors: rs759364 showed an association with the frequency of alcohol consumption and mean scores of scales assessing internet addiction, gaming disorder, and exercise addiction. Significant associations were found between GDNF rs1549250, rs2973033, CNR1 rs806380, DRD2/ANKK1 rs1800497 variants, and the "lifetime other drugs" variable. These suggested that genetic factors may contribute similarly to specific substance use and addictive behaviors. Specifically, FOXN3 rs759364 and GDNF rs1549250 and rs2973033 may constitute genetic risk factors for multiple addictive behaviors. Due to limitations (e.g., convenience sampling, lack of structured scales for substance use), further studies are needed. Functional correlates and mechanisms underlying these relationships should also be investigated.

Reciprocal Relationships Between Problematic Social Media Use, Problematic Gaming, and Psychological Distress Among University Students: A 9-Month Longitudinal Study.

Background: The causal relationships between two specific types of problematic use in internet-related activities [i.e., problematic social media use (PSMU) and problematic gaming (PG)] and psychological distress remain controversial. The present study investigated the temporal relationships between PSMU, PG, and psychological distress (i.e., anxiety, depression) in university students. Methods: Hong Kong and Taiwan university students [N = 645; nmale = 266; mean = 20.95 years (SD = 5.63)] were recruited for a survey study, with follow-ups at 3, 6, and 9 months after baseline assessment. The Bergen Social Media Addiction Scale, Internet Gaming Disorder Scale-Short Form, and the Hospital Anxiety and Depression Scale were used to assess studied variables. Demographics including age, physical characteristics (i.e., height, weight, and body mass index), and cigarette use were compared between participants who completed all the follow-ups and those who dropped out. Random intercept cross-lagged models were constructed to understand the reciprocal relationships between PSMU, PG, and psychological distress. Results: No significant differences were found in age, physical characteristics, and cigarette use between participants who completed all the follow-ups and those who dropped out. Findings indicated that a high level of PSMU significantly increased the level of anxiety and a high level of anxiety significantly increased the level of PSMU. A high level of PSMU significantly increased the level of depression but the level of depression did not significantly affect the level of PSMU. A high level of PG significantly increased the level of anxiety, but the level of anxiety did not significantly affect the level of PG. A high level of depression significantly increased the level of PG, but the level of depression did not significantly affect the level of PG. Conclusion: The patterns of the causal relationship between PIU and psychological distress variables differ. A reciprocal relationship was only found between the level of PSMU and the level of anxiety. Moreover, the longitudinal design found no differences in the waves in terms of gaming by the participants.

Problem Gambling in Early Adulthood: a Population-Based Study.

The aims of this study were to investigate stability of problem gambling between 20 and 24 years of age, and the antecedents and consequences of problem gambling at age 20 years. Young adult participants in the Avon Longitudinal Study of Parents and Children (ALSPAC) completed computer-administered gambling surveys on paper, or online. Responses to the Problem Gambling Severity Index (PGSI) were complete for 2624 participants at 20 years, and 1921 participants at 24 years. Responses were categorized into 'non-problem' (71-78%), 'low-risk gambling' (16-21%), 'moderate-risk gambling' (4-5.5%), and 'problem gambling' (1-1.5%). The overall frequency of moderate-risk/problem gambling varied little between age 20 and 24 years, and scratch cards, online betting and gambling were the most frequent activities. Problem gamblers at age 20 years had a history of hyperactivity and conduct problems in adolescence, high sensation seeking, and an external locus of control. They were more likely to have mothers who had problems with gambling, reported less parental supervision, and higher social media usage. Moderate-risk/problem gambling at age 20 years was associated with regular cigarette smoking, high levels of illicit drug use, and problematic use of alcohol at age 24 years. A significant minority of young adults (mainly males) showed problem gambling behaviours which appeared to be established by the age of 20 years and were associated with other potentially addictive behaviours.

Applying the DSM-5 Criteria for Gambling Disorder to Online Gambling Account-Based Tracking Data: An Empirical Study Utilizing Cluster Analysis.

The emergence of online gambling has raised concerns about potential gambling-related harm, and various measures have been implemented in order to minimise harm such as identifying and/or predicting potential markers of harm. The present study explored how the nine DSM-5 criteria for gambling disorder can be operationalised in terms of actual online gambling behaviour using account-based gambling tracking data. The authors were given access to an anonymised sample of 982 gamblers registered with an online gambling operator. The data collected for these gamblers consisted of their first three months' gambling activity. The data points included customer service contacts, number of hours spent gambling, number of active days, deposit amounts and frequency, the number of times a responsible gambling tool (such as deposit limit) were removed by the gamblers themselves, number of cancelled withdrawals, number of third-party requests, number of registered credit cards, and frequency of requesting bonuses through customer service (i.e., the number of instances of 'bonus begging'). Using these metrics, most of the DSM-5 criteria for gambling disorder can be operationalized (at least to some extent) using actual transaction data. These metrics were then applied to a sample of online gamblers, and through cluster analysis four types of online gambler based on these metrics (non-problem gamblers, at-risk gamblers, financially vulnerable gamblers, and emotionally vulnerable gamblers) were identified. The present study is the first to examine the application of the DSM-5 criteria of gambling disorder to actual gambling behaviour using online gambling transaction data and suggests ways that gambling operators could identify problem gamblers online without the need for self-report diagnostic screening instruments.