Anxiety, depression, and brain overwork in the general population of Mongolia.

In Mongolia, there is limited data on the prevalence and correlates of common mental health conditions. This study addresses this data gap by exploring anxiety, depression, and brain overwork. The aim of this study was to determine normative data on these conditions in the general population of Mongolia. This nationwide, population-based, cross-sectional study was conducted in 48 sampling centers across Mongolia in 2020. A total of 613 participants (190 men and 423 women) with a mean age of 41.8 ± 12.4 years were recruited. The participants completed the Hospital Anxiety and Depression Scale (HADS) and the Brain Overwork Scale (BOS-10). Vital signs, body measurements, and lifestyle determinants were also assessed. The prevalence of anxiety was 9.9%, depression was 4.9%, and brain overwork was 18.3% among the participants. Anxiety and depression were correlated with brain overwork symptoms. Brain overwork was associated with young age, unemployment, low income, and alcohol use. These findings suggest that anxiety, depression, and brain overwork are a significant problem in the general population of Mongolia. Further research is needed to develop effective interventions to reduce the prevalence and risk factors of anxiety, depression, and brain overwork.

Quality of life in the general population of Mongolia: Normative data on WHOQOL-BREF.

No data on the quality of life (QOL) of the general population are available for Mongolia. This study aimed to determine normative data on the World Health Organization Quality of Life-Brief Version (WHOQOL-BREF) in the general population of Mongolia. This nationwide, population-based, cross-sectional study was conducted in 48 sampling centers across Mongolia in 2020. We used the WHOQOL-BREF and the Hospital Anxiety and Depression Scale (HADS) in our study and evaluated their associations with vital signs, body measurements, and lifestyle determinants. A total of 714 participants (261 men and 453 women) with a mean (standard deviation) age of 40.7 (13.2) years were recruited. The mean scores of WHOQOL-BREF subscales were 61.5 for physical health, 73.5 for psychological health, 70.1 for social relationship, and 67.2 for environmental health domains. The prevalence of poor QOL was 16.9% among the participants. Participants living in an apartment in urban areas with high HADS scores had a low QOL. All domains of WHOQOL-BREF were inversely correlated with anxiety score (r = -0.353 - -0.206, p < 0.001) and depression scores (r = -0.335 - -0.156, p < 0.001). Physical health was predicted by residency location, anxiety, and depression (R2 = 0.200, p < 0.001); psychological health by anxiety and depression (R2 = 0.203, p < 0.001); social relationship by residency location, age group, anxiety and depression (R2 = 0.116, p < 0.001); and environmental health by employment, anxiety, and depression (R2 = 0.117, p < 0.001). This is the first report on normative data on the QOL in the general population of Mongolia. Physical health was low compared with that determined using international data. Poor QOL was observed among those with mental health issues living in the urban areas.

Anthropometric and Body Circumference Determinants for Hand Grip Strength: A Population-Based Mon-Timeline Study.

Background: Hand grip strength (HGS) is a tool for diagnosing sarcopenia. In this study, we examined some anthropometric and body circumference measurements as determinants for HGS. Methods: This cross-sectional study was conducted with participants (Mongolians, n = 1080, aged 18-70, mean age of 41.2 ± 13.9 years, 33.7% of men) from the "Mon-Timeline" cohort study. To measure HGS, a digital grip strength dynamometer was used. Results: Mean HGS in men was 40.1 ± 10.4 kg and in women was 24.5 ± 5.6 kg. Correlation analysis showed that the strongest correlation with HGS was height (r = 0.712, p < 0.001). Moreover, HGS was inversely correlated with age (r = -0.239, p < 0.001) and thigh circumference (r = -0.070, p < 0.01), while it was positively correlated with body weight (r = 0.309, p < 0.001), neck circumference (r = 0.427, p < 0.001), upper arm circumference (r = 0.108, p < 0.0001), lower arm circumference (r = 0.413, p < 0.0001), and calf circumference (r = 0.117, p < 0.0001). In the multivariate linear regression analysis (unstandardized B coefficient, 95% CI), age (-0.159, -0.188; -0.129), sex (-9.262, -10.459; -8.064), height (0.417, 0.357; 0.478), lower arm circumference (1.003, 0.736; 1.270), and calf circumference (-0.162, -0.309; -0.015) were significantly associated with HGS. Conclusions: When detecting sarcopenia using HGS, it is important to take into account variables such as body height and body circumference.

The Brain Overwork Scale: A Population-Based Cross-Sectional Study on the Psychometric Properties of a New 10-Item Scale to Assess Mental Distress in Mongolia.

Identifying mental distress is a complex task, particularly when individuals experience physical symptoms. Traditional self-report questionnaires that detect psychiatric symptoms using emotional words may not work for these individuals. Consequently, there is a need for a screening tool that can identify both the physical and mental symptoms of mental distress in individuals without a clinical diagnosis. Our study aimed to develop and validate a scale that measures mental distress by measuring the extent of brain overwork, which can be extrapolated as the burden of mental distress. In this population-based cross-sectional study, we recruited a total of 739 adults aged 16-65 years from 64 sampling centers of a cohort in Mongolia to validate a 10-item self-report questionnaire. Internal consistency was measured using McDonald's ω coefficient. Test-retest reliability was analyzed using intraclass correlation coefficients. Construct and convergent validities were examined using principal component analysis (PCA) and confirmatory factor analysis (CFA). The Hospital Anxiety and Depression Scale (HADS) and the abbreviated version of World Health Organization Quality of Life (WHOQOL-BREF) were used to evaluate criterion validity. Among the participants, 70.9% were women, 22% held a bachelor's degree or higher, 38.8% were employed, and 66% were married. The overall McDonald's ω coefficient was 0.861, demonstrating evidence of excellent internal consistency. The total intraclass correlation coefficient of the test-retest analysis was 0.75, indicating moderate external reliability. PCA and CFA established a three-domain structure that provided an excellent fit to the data (RMSEA = 0.033, TLI = 0.984, CFI = 0.989, χ2 = 58, p = 0.003). This 10-item scale, the Brain Overwork Scale (BOS-10), determines mental distress in three dimensions: excessive thinking, hypersensitivity, and restless behavior. All the items had higher item-total correlations with their corresponding domain than they did with the other domains, and correlations between the domain scores had a range of 0.547-0.615. BOS-10 correlated with HADS, whereas it was inversely correlated with WHOQOL-BREF. In conclusion, the results suggest that BOS-10 is a valid and reliable instrument for assessing mental distress in the general population. The scale screens for mental distress that is characterized by subjective symptoms such as excessive thinking, hypersensitivity, and restless behavior. The current findings also demonstrate that the BOS-10 is quantitative, simple, and applicable for large group testing. This scale may be useful for identifying at-risk individuals who may require further evaluation and treatment for mental distress.

Validation of the abbreviated version of the World Health Organization Quality of Life in Mongolia: a population-based cross-sectional study among adults in Ulaanbaatar.

There is currently no validated tool to measure the quality of life (QOL) in the Mongolian language. This study aimed to validate the Mongolian version of the World Health Organization Quality of Life - Brief (WHOQOL-BREF) questionnaire for the general population of Mongolia. The subjects were 301 adults aged 18-65 years selected randomly by a computer from 30 centers in 8 districts of Ulaanbaatar, Mongolia, in 2020. Reliability was measured using Cronbach's α and intraclass correlation coefficients. Convergent, discriminant, and construct validities were examined using exploratory and confirmatory factor analyses for a four-domain factor structure. Among the participants, 56.1% were women, 32.9% held a bachelor's degree or higher, 48.8% were employed, and 61.8% were married. The overall Cronbach's α coefficient of the WHOQOL-BREF questionnaire was 0.804. Correlations between the component scores of the WHOQOL-BREF ranged from 0.581-0.822. All items showed higher item-total correlations with their corresponding domains than with other domains, except the mobility item from the physical domain. Discriminative validity was evident in physical and psychological domains. Exploratory and confirmatory factor analyses revealed a four-factorial structure consisting of 24 items that provided an acceptable fit to the data (RMSEA=0.084; CFI=0.860). In conclusion, the Mongolian version of the WHOQOL-BREF demonstrated evidence of good reliability and validity for assessing QOL in the general population of Mongolia. These findings indicate that it allows the comparison of QOL of adults in Mongolia with those in other countries.

Heart rate variability and tension-type headache: A population-based cross-sectional study.

Background: The relationship between tension-type headache (TTH) and autonomic functions is poorly understood, although TTH is one of the most prevalent disorders in the general population. The aim of this study was to investigate the direct and indirect effects of TTH on the autonomic functions measured by heart rate variability (HRV). Methods: This population-based cross-sectional study was carried out in the general population of Ulaanbaatar between July and September in 2020. After physical examination, trained researchers applied structured interviews to examine the remote history of TTH and mental distress, followed by a recording of HRV to detect autonomic activity. Psychological factors and the quality of life were measured using Hospital Anxiety Depression Scale (HADS), Pittsburgh Sleep Quality Index (PSQI), and the World Health Organization Quality of Life-Brief (WHOQOL-BREF). Binary logistic regression and GLM mediation model analysis were used to examine the effects of risk factors on the associations between TTH and autonomic functions. Results: Among participants (n = 217, mean age=41.8 ±â€¯11.5 years), a total of 117 (53.9%) participants had a remote history of TTH. The age and sex-adjusted prevalence was 43%. Groups did not differ statistically in the HRV indices. LF/HF (ratio of low-frequency to high frequency), the index of sympathovagal balance, was correlated with the HADS anxiety. TTH was associated with mental distress. Binary logistic regression analysis confirms the relationship suggesting that TTH was associated with increased likelihood of mental distress, and decreasing RMSSD (root mean square of the sum of the squares of differences between adjacent NN intervals) and pNN50 (NN50 divided by the total number of NN intervals) were the independent predictors of TTH. GLM mediation model indicated that the relationship between TTH and RMSSD was mediated by mental distress. Conclusions: The present study suggests that mental distress is a critical factor in the association between TTH and autonomic dysfunction. Additionally, our findings demonstrate the influence of age and gender on TTH. These results highlight the need to understand the mechanisms underlying pathophysiology to facilitate targeted and efficacious prevention and management approaches for TTH.

Impact of perimenopausal symptomatology on quality of life in Mongolian women.

This cross-sectional study focussed on perimenopausal Mongolian women and aimed to determine the quality of life (QOL) and risk factors in this population. We collected data on 392 women using a predesigned questionnaire and classified the participants according to menopausal status. We used The Menopause Rating Scale (MRS) and the World Health Organisation Quality of Life (WHOQOL)-BREF. Blood pressure (p = .003) and body mass index (p = .02) were significantly high, whereas sexual activity was significantly decreased in postmenopausal women (p = .001). In perimenopausal women, somatovegetative (p = .003) and psychological (p = .025) symptoms were significantly severe, and menopausal symptom severity was significantly higher (p = .017). Menopausal symptoms (p = .02) and monthly sexual activity (p = .005) significantly influenced overall QOL. Sexuality had a significantly negative effect on psychological health (p = .03). Age, occupation, menopausal stage and somatovegetative symptoms have significant effects on health-related QOL (p< .05). Our findings showed that menopausal symptoms and sexual activity significantly affect QOL in middle-aged Mongolian women.Impact StatementWhat is already known on this subject? Women experience physiological changes at the onset of menopause. However, as their oestrogen levels decline, many women also experience physical, psychological and somatovegetative symptoms. Postmenopausal health has been the main issue affecting middle-aged women, until recently. Here, we showed that menopausal transition is a turning point for middle-aged women and suggest that more attention should be paid to the health of perimenopausal women in Mongolia.What do the results of this study add? The study results showed that perimenopausal women had a higher prevalence of health-related problems than postmenopausal women, including weight gain, cardiovascular symptoms and vasomotor symptoms. The prevalence of genitourinary health problems increased with age.What are the implications of these findings for clinical practice and/or further research? General practitioners and gynaecologists in Mongolia should acquire a better understanding of the physiological changes that occur during menopause and pay greater attention to genitourinary issues as they affect general, health-related quality of life.

The Contributions of Food Groups to the Daily Caloric Intake in Mongolian Population: A Mon-Timeline Study.

(1) Background: The "Ger Recommendations" have been advised to promote a healthy diet in Mongolia. These recommendations emphasize the ratio of six macro-food components to ensure proper nutrition. In this study, the ratio of these six groups to the total daily caloric intake was determined. (2) Methods: This study was conducted as part of a study at the Clinical Cohort ("Mon-Timeline") of the Mongolian National University of Medical Science. A macro-community ratio was calculated using a 24-h dietary recall diary of a total of 498 people. (3) Results: The mean age of the study participants was 43.9 ± 12.9 years. Among them, 21.8% (n = 110) were male. Of the total calories, 44.7% were grains, 29.2% were meat and protein products, 9.3% were fats, 7.1% were dairy products, 6.6% were vegetables, and 3.1% were fruits. According to the ratio of the six groups in the Ger Recommendations, meat and grains exceeded the recommended amount, while fruits, milk, and vegetables were consumed less. It has been observed that the older a person ages, the closer they are to following these recommendations. In terms of gender, women consumed more fruit and milk than men. (4) Conclusions: The ratio of macronutrients in the daily caloric intake of Mongolians is inadequate. Therefore, knowledge about the "Ger Recommendations" needs to be studied in relation to people's healthy eating knowledge and attitudes. If necessary, the appropriate awareness needs to be increased to educate the public on proper eating habits.

Prevalence of restless leg syndrome in Mongolian adults: Mon-TimeLine study.

We conducted an epidemiologic study based on survey neuroscience screening for restless leg syndrome in the Mongolian to determine the prevalence of restless leg syndrome. We used baseline data from the Mon-TimeLine study, a multidisciplinary, prospective, population-based cohort study. The total number of participants (n = 1572) ranged from 18 to 65 years of age. We found the prevalence of restless leg syndrome to be 6.6% (n = 103), among which 4.1% (n = 16) were males and 7.3% (n = 87) were females. The peak prevalence age for both genders was 45-55, and we found a positive correlation with body mass index (P < 0.05). Most cases were mild (44.7%) or moderate (35.9%), but 18.4% and 1% of the cases were severe or very severe, respectively. The severe groups showed a positive association with chronic kidney disease, as well as with gastritis. In conclusion, the prevalence of restless leg syndrome in Mongolia approximates that in other countries.