Validating the Ontario Child Health Study Emotional Behavioural Scales-Brief Version (OCHS-EBS-B) in children with chronic physical illness.

BACKGROUND: A substantial proportion of children have a physical illness; these children commonly experience physical-mental comorbidity. To assess child mental health, brief scales that can be used in clinical and research settings are needed. This study assessed the validity and reliability of parent-reported Ontario Child Health Study Emotional Behavioural Scale-Brief Version (OCHS-EBS-B) scores. METHODS: Data come from a longitudinal study of children aged 2-16 years with a physical illness recruited from outpatient clinics at a pediatric hospital. Confirmatory factor analysis and McDonald's coefficient assessed the factor structure and internal consistency reliability of the OCHS-EBS-B, respectively. Point biserial correlations assessed agreement between the OCHS-EBS-B and Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID), a structured diagnostic interview. The Wilcoxon rank sum test compared OCHS-EBS-B scores between children with versus without physical-mental comorbidity (known-group validity). RESULTS: The three-factor structure of the OCHS-EBS-B was replicated in this sample of children with physical illness (χ2 = 196.23(272), p < 0.001; CFI = 0.98; TLI = 0.98; SRMR = 0.06; RMSEA [90% CI] = 0.034 [0.027, 0.044]). It had excellent internal consistency reliability (ω = 0.86-0.92) and was moderately correlated with the MINI-KID (baseline: rpb = 0.43-0.51; 6 months: rpb = 0.55-0.65). OCHS-EBS-B scores were significantly higher among children with versus without physical-mental comorbidity. CONCLUSIONS: Findings confirm psychometric evidence that the OCHS-EBS-B is a valid and reliable measure of mental health in children with chronic physical illness. Its brevity and robust psychometric properties make the OCHS-EBS-B a strong candidate for routine use in integrated pediatric physical and mental health services.

The effect of a single session of psychological first aid in the emergency department on PTSD and depressive symptoms three months post-intervention: results of a randomised controlled trial.

Background: Despite its popularity, evidence of the effectiveness of Psychological First Aid (PFA) is scarce.Objective: To assess whether PFA, compared to psychoeducation (PsyEd), an attention placebo control, reduces PTSD and depressive symptoms three months post-intervention.Methods: In two emergency departments, 166 recent-trauma adult survivors were randomised to a single session of PFA (n = 78) (active listening, breathing retraining, categorisation of needs, assisted referral to social networks, and PsyEd) or stand-alone PsyEd (n = 88). PTSD and depressive symptoms were assessed at baseline (T0), one (T1), and three months post-intervention (T2) with the PTSD Checklist (PCL-C at T0 and PCL-S at T1/T2) and the Beck Depression Inventory-II (BDI-II). Self-reported side effects, post-trauma increased alcohol/substance consumption and interpersonal conflicts, and use of psychotropics, psychotherapy, sick leave, and complementary/alternative medicine were also explored.Results: 86 participants (51.81% of those randomised) dropped out at T2. A significant proportion of participants in the PsyEd group also received PFA components (i.e. contamination). From T0 to T2, we did not find a significant advantage of PFA in reducing PTSD (p = .148) or depressive symptoms (p = .201). However, we found a significant dose-response effect between the number of delivered components, session duration, and PTSD symptom reduction. No significant difference in self-reported adverse effects was found. At T2, a smaller proportion of participants assigned to PFA reported increased consumption of alcohol/substances (OR = 0.09, p = .003), interpersonal conflicts (OR = 0.27, p = .014), and having used psychotropics (OR = 0.23, p = .013) or sick leave (OR = 0.11, p = .047).Conclusions: Three months post-intervention, we did not find evidence that PFA outperforms PsyEd in reducing PTSD or depressive symptoms. Contamination may have affected our results. PFA, nonetheless, appears to be promising in modifying some post-trauma behaviours. Further research is needed.

Psychological First Aid (PFA) is widely recommended early after trauma.We assessed PFA's effectiveness for decreasing PTSD symptoms and other problems 3 months post-trauma.We didn't find definitive evidence of PFA's effectiveness. Still, it seems to be a safe intervention.

Psychometric properties of the arabic translation of the Physical Appearance Comparison Scale-Revised (PACS-R) in adults.

BACKGROUND: Physical comparison may be a factor in body dissatisfaction and related issues, like eating disorders and depression. The Physical Appearance Comparison Scale-Revised (PACS-R) is a scale developed to assess the frequency of physical comparison. Because there is no validated scale for body comparison in Arabic, this study aims to address this gap by validating the PACS-R in the Arabic language. METHODS: The PACS-R was translated to Arabic following a conventional forward-backward translation procedure, and was administered to a sample of 359 Lebanese adults along with The Depression Anxiety Stress Scale, and the Rosenberg self-esteem scale (RSES) for convergent validity. The factor structure was studied by confirmatory factor analysis (CFA), and composite reliability was assessed using McDonald's omega and Cronbach's alpha. RESULTS: Results suggested a one-factor structure of the Arabic PACS-R, with good internal consistency (McDonald's ω = 0.97 / Cronbach α = 0.97). Measurement invariance was established across sex groups, with no significant difference being reported between males and females in terms of PACS-R scores (15.42 ± 10.64 vs. 13.16 ± 11.88; t(357) = 1.84; p = .066). Finally, adequate convergent validity was tested and found to be adequate, with PACS-R scores found to be correlated negatively with self-esteem and positively with psychological distress. CONCLUSION: The present findings preliminarily establish the Arabic PACS-R as an effective instrument for researchers and practitioners aiming to explore the physical comparison among Arabic-speaking populations, thus contributing to research and clinical work in the Arabic community.

Detection of anxiety symptoms and disorders in older adults: a diagnostic accuracy systematic review.

BACKGROUND: Anxiety symptoms and disorders are common in older adults and often go undetected. A systematic review was completed to identify tools that can be used to detect anxiety symptoms and disorders in community-dwelling older adults. METHODS: MEDLINE, Embase and PsycINFO were searched using the search concepts anxiety, older adults and diagnostic accuracy in March 2023. Included articles assessed anxiety in community-dwelling older adults using an index anxiety tool and a gold standard form of anxiety assessment and reported resulting diagnostic accuracy outcomes. Estimates of pooled diagnostic accuracy outcomes were completed. RESULTS: Twenty-three anxiety tools were identified from the 32 included articles. Pooled diagnostic accuracy outcomes were estimated for the Geriatric Anxiety Inventory (GAI)-20 [n = 3, sensitivity = 0.89, 95% confidence interval (CI) = 0.70-0.97, specificity = 0.80, 95% CI = 0.67-0.89] to detect generalized anxiety disorder (GAD) and for the GAI-20 (n = 3, cut off ≥ 9, sensitivity = 0.74, 95% CI = 0.62-0.83, specificity = 0.96, 95% CI = 0.74-1.00), Beck Anxiety Inventory (n = 3, sensitivity = 0.70, 95% CI = 0.58-0.79, specificity = 0.60, 95% CI = 0.51-0.68) and Hospital Anxiety and Depression Scale (HADS-A) (n = 3, sensitivity = 0.78, 95% CI = 0.60-0.89, specificity = 0.76, 95% CI = 0.60-0.87) to detect anxiety disorders in clinical samples. CONCLUSION: The GAI-20 was the most studied tool and had adequate sensitivity while maintaining acceptable specificity when identifying GAD and anxiety disorders. The GAI-20, GAI-Short Form and HADS-A tools are supported for use in detecting anxiety in community-dwelling older adults. Brief, self-rated and easy-to-use tools may be the best options for anxiety detection in community-dwelling older adults given resource limitations. Clinicians may consider factors including patient comorbidities and anxiety prevalence when selecting a tool and cut off.

Relationship between plasma TNF-α levels and agitation symptoms in first episode patients with schizophrenia.

BACKGROUND: Increasing evidence suggested that immune abnormalities involved in the pathophysiology of schizophrenia. However, the relationship between immunity and clinical features has not been clarified. The aim of this study was to measure the plasma levels of tumor necrosis factor alpha (TNF-α) and soluble TNF-α receptor 1 (sTNF-α R1) and to investigate their association with agitation in first episode patients with schizophrenia (FEPS). METHODS: The plasma TNF-α and sTNF-α R1 levels were measured using sandwich enzyme-linked immunosorbent assay (ELISA) in the FEPS with (n = 36) and without agitation (n = 49) symptoms, and healthy controls (HCs, n = 54). The psychopathology was assessed by the Positive and Negative Syndrome Scale (PANSS), and the agitation symptoms were evaluated by the PANSS excitatory component (PANSS-EC). RESULTS: The plasma TNF-α levels in patients with and without agitation symptoms were significantly higher than those in HCs. The patients with agitation had significantly higher plasma TNF-α levels compared to the patients without agitation. There were no significant differences in the sTNF-α R1 levels among the three groups. Furthermore, the plasma TNF-α levels were positively correlated with the PANSS total score, Positive and General psychopathological subscores, and PANSS-EC score in the FEPS, but the relationships were not found for the plasma sTNF-α R1 levels. CONCLUSIONS: These results suggested that TNF-α might play an important role in the onset and development of agitation symptoms of schizophrenia.

Prevalence of depressive and anxiety symptoms and perceived stress in hospitalised patients with COVID-19.

BACKGROUND: COVID-19 infection is associated with significant depressive and anxiety symptoms and stress. We examined the prevalences of depressive and anxiety symptoms and perceived stress among patients with COVID-19. METHODS: Clinically stable patients with COVID-19 aged 18 to 60 years who were admitted between April 2021 and September 2021 to the MES Medical College in Kerala, India were prospectively recruited. They were assessed using the Montgomery-Asberg Depression Rating Scale, the Hamilton Anxiety Scale, and the Perceived Stress Scale. RESULTS: Of 112 patients screened, 103 were included in the analysis. Depression scores were higher in patients of lower socio-economic status (p = 0.04), of unemployed (p = 0.01), and with longer hospital stays (p < 0.001). Anxiety scores were higher in patients aged 31 to 40 years (p = 0.04), of lower socio-economic status (p = 0.01), with a history of psychiatric illness (p = 0.006), and with a history of self-harm (p = 0.019). Perceived stress scores were higher in patients of lower socio-economic status (p = 0.02), with a history of psychiatric illness (p = 0.001), and with a history of self-harm (p = 0.022). CONCLUSION: Socio-economic status, employment status, a history of psychiatric illness, and duration of hospital stay are associated with depression, anxiety, and stress among patients with COVID-19.

Patients with schizophrenia in Morocco during the COVID-19 pandemic: a longitudinal observational study.

BACKGROUND: During the COVID-19 pandemic, social-distancing and confinement measures were implemented. These may affect the mental health of patients with mental disorders such as schizophrenia. This study examined the clinical course of patients with schizophrenia at a public hospital in Morocco during the COVID-19 pandemic. METHODS: This longitudinal observational study was conducted across three periods in 15 months: 1 April 2020 (start of strict home confinement) to 30 June 2020 (T1), 1 July 2020 to 31 January 2021 (corresponding to the Delta wave) [T2], and 1 February 2021 to 30 June 2021 (corresponding to the Omicron wave) [T3]. Patients aged 18 to 65 years with a diagnosis of schizophrenia or schizoaffective disorder (based on DSM 5) made before the pandemic who presented to the Faculty of Medicine and Pharmacy of Rabat were invited to participate. Psychotic symptomatology was evaluated using the Positive and Negative Syndrome Scale (PANSS). Severity and improvement of mental disorder were evaluated using the Clinical Global Impression (CGI)-Severity and -Improvement subscales. Depressive symptoms were assessed using the Calgary Depression Scale (CDS). Adherence to treatments was assessed using the Medication Adherence Rating Scale (MARS). All assessments were made by psychiatrists or residents face-to-face (for T1) or via telephone (for T2 and T3). RESULTS: Of 146 patients recruited, 83 men and 19 women (mean age, 39 years) completed all three assessments. The CGI-Severity score was higher at T2 than T1 and T3 (3.24 vs 3.04 vs 3.08, p = 0.041), and the MARS score was higher at T1 and T2 than T3 (6.80 vs 6.83 vs 6.35, p = 0.033). Patient age was negatively correlated with CDS scores for depressive symptoms at T1 (Spearman's rho = -0.239, p = 0.016) and at T2 (Spearman's rho = -0.231, p = 0.019). The MARS score for adherence was higher in female than male patients at T1 (p = 0.809), T2 (p = 0.353), and T3 (p = 0.004). Daily tobacco consumption was associated with the PANSS total score at T3 (p = 0.005), the CGI-Severity score at T3 (p = 0.021), and the MARS score at T3 (p = 0.002). Patients with a history of attempted suicide had higher CDS scores than those without such a history at T1 (p = 0.015) and T3 (p = 0.018) but not at T2 (p = 0.346). CONCLUSION: Home confinement during the COVID-19 pandemic had limited negative impact on the mental health of patients with schizophrenia in Morocco.

Factor analysis of the Chinese version of the Autism Spectrum Quotient 10 and its association with schizotypal traits in adolescents and young adults in Hong Kong.

BACKGROUND: There is evidence suggesting that autistic traits are associated with schizotypal traits. This study examined the factor structure of the Autism Spectrum Quotient 10 (AQ-10) and its associations with schizotypal traits (measured by the Schizotypal Personality Questionnaire-Brief [SPQ-B]) in a cohort of Chinese adolescents and young adults. METHODS: Invitation letters, stratified by locations and housing types, were randomly sent to individuals aged 15 to 24 years for participation. Assessments were made using face-to-face or online interviews. Autistic traits were assessed using the Chinese version of the AQ-10. Schizotypal personality traits were assessed using the Chinese version of the 22-item SPQ-B. RESULTS: In total, 395 male and 536 female participants (mean age, 19.93 years) were recruited between July 2020 and May 2021. Exploratory factor analysis of the AQ-10 yielded three factors (theory of mind, task switching, and attention deficits) explaining 55.11% of the total variance. Autistic traits were positively correlated with schizotypal traits of disorganised features (r = 0.21, p < 0.001), interpersonal relationship deficits (r = 0.19, p < 0.001), and cognitive-perceptual deficits (r = 0.11, p = 0.001). CONCLUSION: In Chinese adolescents and young adults, autistic traits, especially task switching and attention deficits (compared with theory of mind) are more closely correlated with schizotypal personality traits. Disentangling the overlapping and diametrical structure of autistic traits and schizotypal traits may help understand their aetiologies, assessment, and interventions.

Validity of the five-item mental health inventory for screening current mood and anxiety disorders in the general population.

OBJECTIVES: The Mental Health Inventory (MHI-5) is frequently used as a screener for mood and anxiety disorders. However, few population-based studies have validated it against a diagnostic instrument assessing disorders following current diagnostic criteria. METHODS: Within the third Netherlands Mental Health Survey and Incidence Study (NEMESIS-3), a representative population-based study of adults (N = 6194; age: 18-75 years), the MHI-5 was used to measure general mental ill-health in the past month. Presence of mood (major depressive disorder, persistent depressive disorder, or bipolar disorder) and anxiety disorders (panic disorder, agoraphobia, social phobia, or generalized anxiety disorder) in the past month was assessed with a slightly modified version of the Composite International Diagnostic Interview 3.0 per the Diagnostic and Statistical Manual of Mental disorders-5. RESULTS: The MHI-5 was good to excellent at distinguishing people with and without a mood disorder, an anxiety disorder, and any mood or anxiety disorder. The cut-off value associated with the highest sensitivity and highest specificity for mood disorder was ≤68, and ≤76 for an anxiety disorder or any mood or anxiety disorder. CONCLUSIONS: The MHI-5 can identify individuals at high risk of a current mood or anxiety disorder in the general population when diagnostic interviews are too time consuming.

Measuring psychological distress using the 12-item general health questionnaire and the six-item Kessler psychological distress scale. Psychometric comparison and equipercentile equating of the two scales.

OBJECTIVES: This study aimed to examine if the General Health Questionnaire (GHQ)-12 and Kessler 6 (K6) assess the same underlying construct and to develop a score conversion table for the two scales. METHODS: A random sample of 4303 people who completed both the GHQ-12 and K6 in 2021 were analyzed. Exploratory bifactor analysis evaluated if both scales measured the same construct, and Rasch analysis assessed item severities. The scales were transformed using Equipercentile equivalence for comparability and score conversion. Agreement was estimated with Cohen's Kappa coefficient, along with raw positive and negative agreement. RESULTS: We found that the two scales measure the same phenomenon to the extent that they can be made equivalent. Conversion tables between GHQ-12 and K6 are presented. Applying the commonly used cut-off of ≥3 on the GHQ-12 bi-modal scoring, we found that the best corresponding cut-off on the K6 would be ≥8. The prevalence of psychological distress was then 22% with GHQ-12% and 21% with K6. CONCLUSIONS: The GHQ-12 and K6 measure the same construct and corresponding cut-off scores on one scale were found for the other scale. This is valuable for longitudinal studies or time series where one scale has replaced the other scale.

Rethinking Unacceptable Thoughts: Validation of an Expanded Version of the Dimensional Obsessive-Compulsive Scale.

The Dimensional Obsessive-Compulsive Scale (DOCS) is widely used to measure obsessive-compulsive disorder (OCD) severity across four broad symptom dimensions (i.e., contamination, responsibility for harm, unacceptable thoughts, symmetry). Despite its proven utility, there is reason to suspect that the unacceptable thoughts subscale conflates different types of unacceptable thoughts that are meaningfully distinct from one another. In the current study, we first evaluated the psychometric properties of a newly developed DOCS violent and/or aggressive thoughts subscale. We then examined the factor structure, psychometric properties, and diagnostic sensitivity of a seven-factor version of the DOCS that includes the four original DOCS subscales and three more-specific versions of the unacceptable thoughts scale (i.e., sexually intrusive thoughts, violent and/or aggressive thoughts, and scrupulous or religious thoughts). The sample included 329 residential and intensive outpatients, the majority of which had a diagnosis of OCD (75.2%). The new unacceptable thoughts subscales demonstrated convergent and discriminant validity with unique associations between the subscales and depression, suicide, and perceived threat from emotions that were not present in the broader unacceptable thoughts subscale. The seven-factor version of the DOCS demonstrated slightly lower levels of diagnostic sensitivity than the original DOCS. Thus, the four-factor version of the DOCS is recommended for screening purposes. A score of 40 or higher on the seven-factor version of the DOCS best predicted a diagnosis of OCD. Overall, the three additional unacceptable thoughts subscales appear to be distinct factors that have potential value in research and clinical settings.

Depression in the Perinatal Period: Course and Outcome of Depression in the Period from the Last Trimester of Pregnancy to One Year after Delivery in Primiparous Mothers.

Background and Objectives: One of the most significant psychiatric problems in women is depression related to the perinatal period. Our study aims to determine the frequency and course of depressive symptomatology in the perinatal period with particular reference to objective rate and outcome of postpartum depression. Materials and Methods: One hundred and eighty-eight pregnant/postnatal women were included in a prospective, longitudinal, observational study during which the depressive symptomatology was estimated at the third trimester of pregnancy, and the first, sixth, and twelfth month' postpartum. All participants completed a semi-structured sociodemographic questionnaire constructed for research purposes, the Edinburgh Postnatal Depression Scale, Toronto Alexithymia Scale, Beck Anxiety Inventory, and The Mood Disorder Questionnaire at each time point. Postpartum depression diagnosis was confirmed by a trained and certified psychiatrist with long-standing experience. For a better understanding of the trajectory of depressive symptomatology and genuine postpartum depression, we classified depression into those with new-onset and those left over from the previous observation period. Results: In general, 48.9% of participants in the study were depressed at some point during the investigation. A total of 10.6% of women were depressed in the third trimester. The highest percentage of new-onset depression (25%) was in the first month after giving birth and was maintained for up to six months, after which the appearance was sporadic. Most of the postpartum depression resolved in the period from the first month to the sixth month after childbirth (20.7%). The episodes mainly had characteristics of unipolar depression. Conclusions: Our results imply that a new onset of depression is most intensive during the first six months, and after that, it is sporadic. Further studies are needed to explore whether all depressive symptomatology in the postnatal period is the same, or perhaps postpartum depression, classified in this way, has specific characteristics, etiology, and consequently different treatment and preventive options.

Comparison of cognitive performance in first-episode drug-naïve schizophrenia, bipolar II disorder, and major depressive disorder patients after treatment.

BACKGROUND: Cognitive impairment is a recognized fundamental deficit in individuals diagnosed with schizophrenia (SZ), bipolar II disorder (BD II), and major depressive disorder (MDD), among other psychiatric disorders. However, limited research has compared cognitive function among first-episode drug-naïve individuals with SZ, BD II, or MDD. METHODS: This study aimed to address this gap by assessing the cognitive performance of 235 participants (40 healthy controls, 58 SZ patients, 72 BD II patients, and 65 MDD patients) using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) before and after 12 weeks of treatment in SZ, BD II, and MDD patients. To clarify, the healthy controls only underwent RBANS testing at baseline, whereas the patient groups were assessed before and after treatment. The severity of symptoms in SZ patients was measured using the Positive and Negative Syndrome Scale (PANSS), and depression in BD II and MDD patients was assessed using the Hamilton Depression Scale-24 items (HAMD-24 items). RESULTS: Two hundred participants completed the 12-week treatment period, with 35 participants dropping out due to various reasons. This group included 49 SZ patients, 58 BD II patients, and 53 MDD patients. Among SZ patients, significant improvements in immediate and delayed memory were observed after 12 weeks of treatment compared to their initial scores. Similarly, BD II patients showed significant improvement in immediate and delayed memory following treatment. However, there were no significant differences in RBANS scores for MDD patients after 12 weeks of treatment. CONCLUSIONS: In conclusion, the findings of this study suggest that individuals with BD II and SZ may share similar deficits in cognitive domains. It is important to note that standardized clinical treatment may have varying degrees of effectiveness in improving cognitive function in patients with BD II and SZ, which could potentially alleviate cognitive dysfunction.

Clinical study of dance art therapy on hospitalized patients with chronic schizophrenia.

BACKGROUND: To explore the effect of dance art on the treatment of hospitalized patients with chronic schizophrenia. METHODS: In a prospective randomized controlled study conducted from June 2019 to June 2020, 120 patients from Shanghai Pudong New Area Mental Health Center were divided into intervention (n = 60) and control (n = 60) groups using a random number table. Control patients received standard drug treatment and nursing care, while the intervention group underwent dance art therapy sessions for 90 minutes twice weekly, in addition to standard care. Treatment outcomes after 6 and 12 weeks were measured using the positive and negative symptom scale (PANSS), Wisconsin Card Sorting Test (WCST), Montreal Cognitive Assessment Scale (MoCA), and body mass index (BMI). RESULTS: This study involved 120 male patients with chronic schizophrenia, aged 30 to 60 years. After 6 and 12 weeks, the intervention group showed a greater reduction in PANSS scores (intervention group: from 49.02 ±â€…2.53 to 37.02 ±â€…1.83, control group: from 49.08 ±â€…2.59 to 44.91 ±â€…2.35, P < .05). In the WCST, the intervention group exhibited a higher increase in classification completion and correct answers, and a greater decrease in errors (P < .05). MoCA scores improved significantly in the intervention group compared to the control group (P < .05). BMI decreased in both groups, with a more pronounced reduction in the intervention group (intervention group: from 26.47 ±â€…1.05 kg/m² to 22.87 ±â€…0.73 kg/m², control group: from 26.50 ±â€…1.03 kg/m² to 26.22 ±â€…0.80 kg/m², P < .05). CONCLUSION: Based on routine drug treatment and routine nursing care, dance art has a better clinical effect in treating hospitalized patients with chronic schizophrenia, which can improve cognitive function, alleviate clinical symptoms, and reduce BMI.

Factor structure and reliability of the symptom measurement of post-stroke depression in the rehabilitation stage.

BACKGROUND: The incidence of Post Stroke Depression (PSD) in the Rehabilitation Stage is high, which can bring serious physical and psychological disorders to patients. However, there is still a lack of targeted tools for screening PSD in the rehabilitation stage. Therefore, the aim of this study was to evaluate the factor structure and reliability of a measurement instrument to screen for PSD in the rehabilitation stage. METHODS: A cross-sectional study was conducted on 780 hospitalized stroke patients who were within the rehabilitation stage from May to August 2020. Exploratory factor analysis (EFA) as well as first- and second-order confirmatory factor analysis (CFA) were performed to evaluate the factor structure of the newly developed Symptom Measurement of Post-Stroke Depression in the Rehabilitation Stage (SMPSD-RS). The reliability and validity of the SMPSD-RS were also verified using several statistical methods. RESULTS: EFA extracted a 24-item, five-factor (cognition, sleep, behavior, emotion, and obsession) model that can clinically explain the symptoms of PSD during the rehabilitation stage. A first-order CFA confirmed the EFA model with good model fit indices, and the second-order CFA further confirmed the five-factor structure model and showed acceptable model fit indices. Acceptable reliability and validity were also achieved by the corresponding indicators. CONCLUSION: The SMPSD-RS was proven to have a stable factor structure and was confirmed to be reliable and valid for assessing PSD symptoms in stroke patients during the rehabilitation stage.

Depression among inmates of Gandaki Province, Nepal: a cross-sectional study.

INTRODUCTION: Depression is a pervasive mental health condition that affects individuals across various demographic categories, including imprisoned adults. The prevalence of mental health problems among inmates worldwide is considerably higher than in the general population, and it is estimated that 11% of inmates have significant mental disorders, such as anxiety and depression. This study aimed to find out the prevalence of depression and factors associated with it among the prisoners of Gandaki Province, Nepal. METHODS: A descriptive cross-sectional study was conducted among the inmates in Gandaki Province, Nepal. Data were collected from 223 inmates, who were recruited through systematic random sampling from eight district-level prisons. The Beck Depression Inventory-II was used to measure depression, with the cumulated score dichotomized into depressed and not-depressed categories. Additionally, a structured questionnaire was employed to capture socio-demographic and imprisonment-related variables. Bivariate and multivariable logistic regressions were performed to examine the factors associated with depression. RESULTS: Findings revealed that 18.8% of the inmates exhibited symptoms of depression. Inmates with health problems [(adjusted odds ratio (aOR) = 2.39], suicide ideation during imprisonment (aOR = 4.37), and attempted suicide before imprisonment (aOR = 7.97) had a statistically significant relationship with depression. This study revealed a notable prevalence of depression among incarcerated individuals in the Gandaki Province of Nepal. CONCLUSION: The findings imply a crucial need for psychosocial and rehabilitative interventions to enhance inmates' mental health and overall well-being.

Anxiety, a significant risk factor for coronary artery disease: what is the best index.

BACKGROUND: Coronary artery disease (CAD) is known as the leading cause of disability and death globally. Anxiety disorders are also recognized as common types of mental disorders that substantially impact global health. Iran ranks among the countries with a high incidence of CAD and anxiety disorders. Therefore, the present study aims to determine the potential association and epidemiological aspects of anxiety and CAD within the population of Mashhad, the second most popoulos city in Iran. METHODS: The present study is based on extracted data from the Mashhad stroke and heart atherosclerotic disorder (MASHAD) study which is a 10-year prospective cohort study intended to assess the effects of various CAD risk factors among Mashhad city residents. Anxiety scores were assessed at the baseline using Beck Anxiety Inventory and individuals were classified based on the BAI 4-factor structure model which included autonomic, cognitive, panic, and neuromotor components. Accordingly, the association between baseline anxiety scores and the BAI four-factor model with the risk of CAD events was analyzed using SPSS software version 21. RESULTS: Based on the results, 60.4% of the sample were female, and 5.6% were classified as having severe forms of anxiety. Moreover, severe anxiety was more prevalent in females. Results showed a 1.7% risk of CAD (p-value < 0.001) over 10 years with one unit increase in anxiety score. Based on the 4-factor model structure, we found that only panic disorder could significantly increase the risk of CAD by 1.1% over the 10-year follow-up (p-value < 0.001). CONCLUSION: Anxiety symptoms, particularly panic disorder, are independently and significantly associated with an increased overall risk of developing CAD over a 10-year period. Therefore, further studies are warranted to investigate the mechanisms through which anxiety may cause CAD, as well as possible interventions to mitigate these processes.

Validation of the German version of the 25-item hikikomori questionnaire 25.

OBJECTIVES: The 25-item Hikikomori Questionnaire (HQ-25) is an instrument developed to measure a condition characterized by extreme social withdrawal that was first described in Japan. This study aimed to translate the HQ-25 into German and validate the German version (HQ-25-G). METHODS: Translation was conducted according to established guidelines. Validation was based on data from a quota sample of individuals living in Germany, ranging from 18 to 74 years old (representing the distribution of age, sex and federal state, n = 5000). Data collection occurred during August and September 2023. We tested reliability, construct validity and concurrent validity. Moreover, HQ-25 scores for key sociodemographic group were reported. RESULTS: Internal reliability for the HQ-25-G was excellent (Cronbach's alpha = 0.93). We confirmed the original three-factor model. Moreover, higher hikikomori levels were significantly associated with more depressive symptoms (r = 0.50), more anxiety symptoms (r = 0.45), higher loneliness levels (r = 0.56), higher levels of objective social isolation (r = -0.47), higher levels of perceived social isolation (r = 0.59) and a higher preference for solitude (r = 0.45). CONCLUSIONS: In a large population-based sample (including younger adults, middle-aged adults and older adults), the HQ-25-G version proves to be a psychometrically robust instrument, which is useful for further exploring the phenomenon of hikikomori within the German-speaking population.

Screening for antenatal maternal depression: comparative performance of the Edinburgh Postnatal Depression Scale and Patient Health Questionnaire-9.

BACKGROUND: Maternal antenatal depression affects 21-28% of expectants globally and negatively impacts both maternal and child health in the short and long term. OBJECTIVE: To compare the psychometric properties and clinical utility of the Edinburgh Postnatal Depression Scale (EPDS) and the Patient Health Questionnaire (PHQ-9) in pregnant individuals. METHODS: In this cross-sectional study, 953 third-trimester pregnant Italian individuals completed both the EPDS and the PHQ-9. RESULTS: Both scales demonstrated good internal consistency (EPDS ω=0.83, PHQ-9 ω=0.80) and a moderate correlation between their scores (r=0.59). Concordance at recommended cut-off points (≥14 for both) was moderate (k=0.55). Factor analyses indicated a bifactor solution for the EPDS (dimensions: "depression" and "anxiety") and for the PHQ-9 (dimensions: "depression", "pregnancy symptoms", "somatic"). Benchmarks for clinical change were also established. CONCLUSIONS: The EPDS and PHQ-9 capture distinct aspects of perinatal depressive symptomatology. Clinically, these findings recommend using both scales in obstetric and gynaecologic settings to minimize false positives and negatives.

Factor structure and measurement invariance of the Depression anxiety stress scale (DASS-21) in Chinese left-behind and non-left-behind children: an exploratory structural equation modeling approach.

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.