Internet addiction, depressive symptoms, and anxiety symptoms are associated with the risk of eating disorders among university students in Bangladesh.

The risk of developing an eating disorder among university students is higher than the general population in Bangladesh. Since psychiatric disorders (such as depression and anxiety) and addictive behaviors (e.g., internet addiction) predominantly exist among university students in the country, these may increase their vulnerability to developing an eating disorder. The association of internet addiction, depression, and anxiety with the risk of eating disorders among Bangladeshi university students is relatively unknown; therefore, this study investigates the association. This study was a cross-sectional design. Students (N = 700) from two public universities in Bangladesh completed the Patient Health Questionnaire (PHQ-9) scale, the Generalized Anxiety Disorder (GAD-7) tool, and Orman's Internet Addiction Survey (OIAS) to measure exposure variables. Eating Attitudes Test-26 (EAT-26) assessed the outcome variable. Multivariable logistic regression analysis showed that internet addiction [adjusted odds ratio (aOR) for moderate addiction = 2.15 and severe addiction = 3.95], depressive (aOR 3.04), and anxiety (aOR 2.06) symptoms were associated with an increased risk of eating disorder among study participants. Future longitudinal studies on university students are recommended to gain a better understanding about the causal factors of eating disorder to support intervention initiatives and strategies by public health practitioners and policy experts.

Prevalence and predictors of binge eating disorder symptoms among a sample of university students in Bangladesh: A cross-sectional survey.

Background and Aims: There is a dearth of information about binge eating disorder (BED) among Bangladeshi university students, who may be more susceptible to BED due to the rise in unhealthy lifestyles and food habits. Therefore, the purpose of this study was to assess the prevalence and associated factors of BED symptoms among Bangladeshi university students. Methods: Students (N = 525) from three public universities in Bangladesh participated in this cross-sectional study between November 2022 and March 2023. Face-to-face interviews were conducted using a structured paper-based questionnaire that included two validated survey tools; the binge eating disorder screener and the patient health questionnaire-9. To identify the factors associated with BED symptoms, multiple logistic regression analysis was conducted, with sociodemographic and behavioral information (e.g., age, sex, smoking status, etc.) considered as covariates. Results: The prevalence of BED symptoms among participants (mean age 21.28 years, 50.3% male and 49.7% female) was 20.6%. Male students had a 2.28 times higher likelihood of having BED symptoms compared to female counterparts (adjusted odds ratio [AOR] = 2.28; 95% CI: 1.33-3.89). Older students (AOR = 3.56, 95% CI: 1.80-7.05), students who were overweight or obese (AOR = 3.32, 95% CI: 1.87-5.89), and students reporting higher depressive symptoms (AOR = 2.69, 95% CI: 1.66-4.35) were at greater risk for developing BED compared to their respective counterparts. Conclusions: This study provides new insights into the prevalence of BED symptoms and its contributing factors among Bangladeshi students. Approximately 1-in-5 university students reported having BED symptoms. University students who are older, overweight, or obese, and who report depressive symptoms may be at greatest risk. Future longitudinal studies are needed to determine the causal factors underlying BED. Findings from this study can assist policymakers and public health professionals in developing effective and targeted strategies to mitigate the risks associated with BED among Bangladeshi university students.

Exposure to secondhand smoke is associated with poor sleep quality among non-smoking university students in Bangladesh: a cross-sectional survey.

Although secondhand smoke (SHS) exposure is predominant in Bangladesh, the adverse effect of SHS exposure on health-related behaviors, such as sleep quality, have remained an under-investigated area of the country's public health landscape. Therefore, the purpose of this study was to examine the association between SHS exposure and poor sleep quality among non-smoking university students in Bangladesh. A cross-sectional survey was carried out between May and September 2022. SHS exposure (main predictor variable) and other covariates (e.g., age, sex, etc.) were measured using a self-reported questionnaire and sleep quality (outcome variable) was measured via the Pittsburgh Sleep Quality Index. Multiple logistic regression models investigated the association between SHS exposure and poor sleep quality. The study included 390 students (mean age: 22 years, 53.8% male). Approximately 41.8% of the participants reported SHS exposure, and 50.5% had poor sleep quality. Students exposed to SHS were more likely to have poor sleep quality compared to their counterparts (AOR = 1.61; 95% CI 1.01, 2.58). Subgroup analysis revealed poor sleep quality was 2-times higher among male students exposed to SHS than those male students without SHS exposure (AOR = 2.03; 95% CI 1.05, 3.93). No association was found in female students. Findings from this study warrant increased awareness and public health initiatives on the implications of SHS on health behaviors, such as sleep quality, in non-smoking Bangladeshi university students.

Depression, anxiety, stress, and fear of COVID-19 among Bangladeshi medical students during the first wave of the pandemic: a mixed-methods study.

Aim: This study aims to investigate depression, anxiety, stress, and fear of the COVID-19 pandemic and the associated risk factors among Bangladeshi medical students. It also explored qualitative insights on mental health from medical students during the first wave of the pandemic. Methods: This mixed-methods study was conducted online in Bangladesh from June 2020 to September 2020. Participants were Bangladeshi medical students from the first year to the final year. The quantitative part included a structured online survey. One focus group discussion (FGD) was organized using the Zoom platform to collect qualitative insights from the students. To determine levels of stress, anxiety, and depression, the Bangla-validated version of the Depression, Anxiety, and Stress Scale 21 (DASS-21) was used. A 7-item and Bangla-validated Fear of COVID-19 Scale, also known as FCV-19S, was used to explore the COVID-19-specific fear of the students. A semi-structured topic guide was used for exploring the qualitative insights of medical students' perceptions of fear of COVID-19, mental health impacts during COVID-19, overall recommendations to support students, and the impact of the pandemic on the future of the medical curriculum. Results: The study reported that 51.20%, 59.40%, and 64% of the 406 respondents had moderate to severe stress, anxiety, and depressive symptoms, respectively, according to the DASS-21. The mean fear score for the COVID-19 scale was 19.4 (SD 6.4). Respondents with family members aged 50 years or older (B = 2.1; CI: 0.3-3.9) and those who had infected family members (B = 1.9; 95% CI: 0.1-3.7) exhibited a higher level of fear of COVID-19. Moreover, depression was associated with a history of having cancer among family members (AOR = 2.9, CI: 1.1-7.5), anxiety was strongly associated with having symptoms of COVID-19 (AOR = 2, CI: 1.3-3.2), and stress was associated with having symptoms of COVID-19 infection among family members (AOR = 1.9, CI: 1.3-3). Altered sleep was a potential risk factor for developing stress, anxiety, and depression symptoms. Manual thematic analysis of qualitative data generated four major themes, including the perception of fear of COVID-19, the perception of mental health impacts during COVID-19, the change in the medical curriculum along with the pandemic, and recommendations from the medical students to support the mental health concerns of medical students during public health crises like this pandemic. Qualitative findings showed that the participants experienced fear of their parents becoming infected by COVID-19, and this fear was more prominent in those who had their loved ones hospitalized. They were also stressed and anxious, with thoughts of death. Their fear also extended to their thoughts on academic progress and the effectiveness of online classes. Conclusion: A substantial proportion of medical students experienced mental health difficulties in Bangladesh. Appropriate interventions should be designed, and adequate support should be provided to the medical students to protect their mental health and wellbeing, considering their potential impact on the future health system in a low-resource setting like Bangladesh.

Contribution of socio-economic and demographic factors to maternal and child malnutrition in Bangladesh: Insights from a nationwide survey.

Background: Malnutrition is a major global public health issue, especially for under five children and their mothers. Objective: This study examined the relationships between socio-economic and demographic characteristics and under- and over-nutrition in mothers and children of Bangladesh. Method: Using the Nationally representative Bangladesh Demographic and Health Survey (2017-18) data, we performed the multiple logistic regression analysis to assess the relationships between key outcome variables and predictors. The analysis included 8321 children aged 0-59 months and 7800 mothers aged 15-49 years. Findings: The prevalence of stunting, wasting, and overweight among children under five was 30.72%, 8.44%, and 2.21% respectively. About 2.74% of the children were both stunted and wasted, while 0.56% of the children were both stunted and overweight. The prevalence of underweight and overweight among mother was 14.09% and 26.35% respectively. Children who are stunted are significantly associated with the mother's BMI status, mothers' education, fathers' education, and wealth index, while children who are wasted are significantly associated with the mother's BMI status and the child's sex. A child's sex and birth order are significantly associated with children being overweight. Mother's age, mother's education, father's education, place of residence and wealth index are significant determinants for mothers being underweight, whereas mother's age, mother's occupation, father's education, father's occupation, place of residence and wealth index are significant determinants for mothers being overweight. Conclusion: In addition to essential nutrition interventions, it is vital to address the basic social-economic and demographic determinants.

Investigating problematic uses of Facebook and other Internet activities among university students in Bangladesh during the COVID-19 pandemic.

Problematic use of Internet (PUI) and problematic use of Facebook (PUF) has been linked to escalating behavioral health issues among university students and has increased during the COVID-19 pandemic. This study estimated the prevalence of and explored associated factors for PUI and PUF among Bangladeshi university students during the COVID-19 pandemic. A cross-sectional online survey was undertaken among 1101 Bangladeshi university students between November and December 2020. The Internet Addiction Test and Facebook Addiction Scale were used to assess PIU and PUF, respectively. A multiple linear regression analysis was performed to adjust for confounders. Among the participants, PUI and PUF were found in 39.3% and 37.1%, respectively. The multiple linear regression model indicated PUI was significantly associated with participants residing in a village, arts majors, those unsatisfied with their major, having mediocre parental relationships, failure in romantic relationships, physical comorbidities, longer use of the Internet, using the Internet for purposes other than education, using social media, and downloading movies/TV series. PUF was significantly associated with village residence, lower income, arts majors, failure in romantic relationships, longer use of the Internet, using the Internet for purposes other than education, and downloading movies/TV series. Both PUI and PUF have been prevalent among Bangladeshi university students during the COVID-19 pandemic. Longitudinal & exploratory studies are warranted in the future to identify causal factors for PUI and PUF and appropriate interventions should be designed quickly for this population.

Anxiety, depressive symptoms, sleep patterns & associated factors among Bangladeshi wage earners during the COVID-19 pandemic: a cross-sectional study.

The economic vulnerability imposed by the COVID-19 pandemic induces stress on mental health of wage earners in Bangladesh which is largely unexplored. This evidence gap was addressed in this study aiming to evaluate the mental health difficulties among Bangladeshi wage earners by assessing the associated factors influencing anxiety, depressive symptoms and sleep patterns. This cross-sectional study was conducted among 707 individual Bangladeshi wage earners in May 2020. The questionnaire included information about sleep duration, the Patient health questionnaire (PHQ-9), and the Generalized anxiety disorder (GAD-7) scales. The study revealed that anxiety and depressive symptoms were associated with male sex, higher educational status, service holder occupation and lower monthly income (p ≤ 0.01). Fear of COVID-19 when working outside during the pandemic situation was inextricably linked with anxiety (AOR = 2.08; 95% CI: 1.42-3.04) and depressive symptoms (AOR = 1.51; 95% CI = 1.04-2.20). Respondents who were responsible to financially support their family experienced significantly decreased duration of sleep (ß = -0.68; 95% CI: -1.18 to -0.20). The results of this study provided novel evidence on psychological difficulties among Bangladeshi wage earners which calls for an in-depth and longitudinal evaluation and immediate low-intensity psychosocial interventions.

Determinants of health care seeking behavior for childhood infectious diseases and malnutrition: A slum-based survey from Bangladesh.

This study aimed to explore the magnitude and determinants of health care seeking behaviors for common infectious disease and malnutrition among Bangladeshi under-five children living in slum areas. A cross-sectional study of 300 children-caregiver dyads was conducted in an urban slum of Bangladesh. Data were collected via a structured questionnaire with accompanying anthropometric assessments of children administered by research staff. Multiple logistic regression was employed to identify associated factors of health care seeking behaviors. Only 44.7% and 13.0% of respondents sought care for childhood infectious diseases and malnutrition, respectively. Being a male child, 2-5 years old, having ≤5 family members, monthly family income >125$, and living in close proximity to a health facility were found to be potential determinants of health care seeking behavior for childhood infectious diseases. Mother/caregivers with poor nutritional information knowledge and who had a child 2-5 years old reported engaging in less care seeking behaviors regarding their child's malnutrition compared to their counterparts. Caregivers of children under the age of 5 years old reported low participation in health care seeking behaviors in relation to childhood infectious disease and malnutrition. Families living in slums require additional support targeting health and nutritional educational programs.

Prevalence and associated factors of depression among Bangladeshi university students: A cross-sectional study.

Objective:  The study aimed to assess the prevalence of depression and its associated factors among university students in Bangladesh. Participants: A total of 403 undergraduate students from Patuakhali Science and Technology University, and Barisal University participated in the study. Method: A cross-sectional study was conducted using Beck's Depression Inventory (BDI). Result: The prevalence of depression (BDI ≥ 14) was 47.14%. Depression was 3.4 times (95% CI: 1.6-7.1), 3.8 times (95% CI: 1.7-8.6), and 3.9 times (95% CI: 1.5-8.9) higher among 2nd, 3rd, and 4th-year students, respectively than 1st-year students. Students with a history of stressful life events (aOR = 2.7, 95% CI: 1.7-4.4), suicidal attempts (aOR = 3.0, 95% CI: 1.2-7.9), and who received inadequate monthly allowance from their family (aOR = 0.53 95% CI: 0.3-0.9) were more likely to develop depressive symptoms. Conclusion: This study reports a high level of depression among university students which needs further discussion, exploration, and calls for designing appropriate interventions.

Association between Nutrition Literacy and Bangladeshi Adults' Healthy Eating Behaviors: Evidence from the Nutrition Literacy Study 2021.

This study investigated the association between healthy eating behaviors and nutrition literacy in a sample of Bangladeshi adults. A cross-sectional survey was conducted among 400 adults from two districts of Bangladesh (Dhaka and Chattogram). Data were generated by in-person interviews using a structured questionnaire. The Nutrition Literacy Scale and National Dietary Guidelines for Bangladesh were used to assess nutrition literacy and healthy eating behaviors, respectively. Multiple linear regression models were used to observe the association. The mean score for healthy eating behavior was 21.8 (SD = 4.8, Range: 5−33) on a scale of 34. A moderate positive correlation was found between nutrition literacy and healthy eating behavior of participants (r = 0.28, p < 0.001). The adjusted regression model showed that a 1 unit increase in nutrition literacy reflected an increase in the healthy eating behavior score of participants by 0.22 units (ß = 0.223, p < 0.001). Findings showed an association between nutrition literacy and eating behaviors in Bangladeshi adults. Future research could be carried out to establish a causal relationship that may help inform the necessity of educational interventions for Bangladeshi adults to assist with meeting national nutrition-related targets.

Food addiction, orthorexia nervosa and dietary diversity among Bangladeshi university students: a large online survey during the COVID-19 pandemic.

PURPOSE: Maladaptive eating behaviors like food addiction (FA) are common among students, and orthorexia nervosa (ON) is being evaluated as a new condition among eating disorders (EDs). Moreover, dietary diversity (DD) is recognized as an important component of a healthy diet. Thus, the current study sought to examine the prevalence of ON and FA as well as the factors associated with ON, FA, and DD among university students in Bangladesh during the COVID-19 pandemic. METHODS: Four-thousand-and-seventy-six students were recruited and completed an online survey consisting of the Bratman Orthorexia test, the modified Yale Food Addiction Scale, and a questionnaire based on the Food and Agriculture Organizations' guidelines. Inferential statistics, bivariate and multivariable linear regression were used for analyzing data. RESULTS: ON and FA were observed in 1.7% and 7.5% of participants, respectively, with 43.8% exhibiting Health Fanatic eating attitude. The mean DD score was 5.96 (SD = 1.56). Students with ON consumed more legumes, nuts, seeds, and vegetables including dark green leafy vegetables whereas students with FA consumed more organ meats and eggs. Students who were older-aged, married, formerly smoked, had fitness goals, and had guilty feelings about violating food rules were more likely to have ON, whereas those who were female, were married, actively smoked, and were overweight and obese were more likely to have FA. CONCLUSIONS: The findings suggest that students from Bangladesh are at risk of FA, and less so for ON. These entities and low DD deserve more research attention in Bangladesh to increase awareness and ensure appropriate interventions.

Eating disorders, maladaptive eating behaviors, and low diversified diets are major public health issues amid the COVID-19 pandemic among university students. The current study aimed to address these issues by investigating Orthorexia Nervosa (ON), food addiction (FA), and dietary diversity. Four-thousand-and-seventy-six students completed an online questionnaire. It was found that being underweight was associated with ON. On the other hand, being overweight/obese was associated with having FA. Individuals who were former smokers and who had poor social interaction were significantly associated with having Orthorexia Nervosa. 1st-year university students are more likely to have FA compared to 5th-year/master's students. Active smokers were more likely to be food addicted. Students who had FA had less guilty feelings about violating food rules. Participants who had FA consumed more organ meats and eggs. Students who were from upper socio-economic status were more likely to have higher dietary diversity. Nutritional awareness programs focusing on DD and healthy eating habits should be implemented for students.

COVID-19 associated fear & anxiety among students: Findings from a large-scale online survey in Bangladesh.

Objective: The study aimed to assess anxiety and fear of COVID-19 among home-staying Bangladeshi students. Participants: A total of 3997 university students across Bangladesh participated in the study. Methods: A cross-sectional study was conducted using the generalized anxiety disorder scale and the fear of COVID-19 scale to measure anxiety and fear, respectively. Results: 40.11% of participants had anxiety. Fear of death by COVID-19 (ß1'=4.45; 95% CI: 3.99-4.90) and perceiving COVID-19-like symptoms as having COVID-19 (ß1'=2.47; 95% CI: 1.76-3.18) were associated with higher fear. Exposure to COVID-19 news on social media was a predictor of fear and anxiety. Furthermore, the severe educational loss was associated with fear (ß1'=2.88; 95% CI: 2.25-3.50) and anxiety (ß2'=1.91; 95% CI: 1.41 to 2.41). Physical exercise and recreational activities were protective factors for fear and anxiety. Conclusion: The study reports a higher level of psychological difficulties among students during the COVID-19 pandemic which needs further longitudinal exploration to design appropriate interventions.

Prevalence and factors associated with dietary supplement use among Bangladeshi public university students: A cross-sectional study.

INTRODUCTION: The usage of dietary supplement (DS) such as vitamins, minerals, and fish oil has expanded, but there is limited data on their use by sub-populations such as university students. The study was aimed to investigate the prevalence of DS use among Bangladeshi university students and its associated factors. METHODS: A cross-sectional survey of 390 students was conducted from two public universities from Barishal Division in Bangladesh using a structured questionnaire with 72 questions divided into five sections: sociodemographic, knowledge, opinions, and attitudes, types of DS, reasons and sources for using DS, and adverse reactions after taking DS. Descriptive statistics and logistic regression were utilized to estimate the results. RESULTS: Among all the students, 15.6% students were using DS where only 7.7% of them used DS according to physicians' recommendation. Additionally, students used DS for general health and well-being, weight gaining and as a source of energy for physical and sporting activities, etc. The use of DS was significantly associated with female sex (AOR = 5.44, 95% CI: 2.18-13.52), ≥25 years age (AOR = 0.08, 95% CI: 0.01-0.67), underweight (AOR = 5.86, 95% CI: 1.95-17.62), having major illness (AOR = 6.99, 95% CI: 1.98-24.70) and good knowledge of DS (AOR = 2.64, 95% CI: 1.23-5.64). CONCLUSION: This study provides new findings on DS use and its correlates in Bangladeshi students which may be used by the policymakers to improve DS usage among students. Adaptation of an appropriate program is recommended to educate students on proper and safer ways of using DS.

Factors associated with household food insecurity and dietary diversity among day laborers amid the COVID-19 pandemic in Bangladesh.

BACKGROUNDS: Food insecurity and dietary diversity remain a public health concern in developing countries like Bangladesh which is exacerbated by the COVID-19 especially for day laborers' families in Bangladesh. This study aimed to determine factors associated with household food insecurity and household dietary diversity among day laborers during the COVID-19 pandemic in Bangladesh. METHODS: This cross-sectional study was conducted among 343 households of day laborers in Bangladesh using a semi-structured questionnaire. Household food security (HFS) and Household dietary diversity (HDD) scores were assessed using the HFS scale and household's 24-h recall of intake of 12 food groups, respectively. RESULTS: The overall mean scores of HFS and HDD were 26.80 (SD, 4.83) and 4.08 (SD, 1.15). Having household head aged > 40 years and monthly household income > 5000 Bangladeshi Taka (BDT) were positively associated with HDD scores. Having an education level above secondary, monthly household income > 5000 BDT, and having a refrigerator were associated with the higher HFS scores, whereas having family members > 5 was a potential determinant of lower HFS scores. Pandemic-induced work loss and food scarcity were also potential determinants of lower HFS and HDD scores. Approximately 94% of respondents reported their wages were reduced, and 76% were deprived of the same quantity of food as pre-pandemic periods. CONCLUSIONS: Lower socio-economic status and pandemic-induced work loss affect the HFS and HDD. Interventions with financial aid and complemented food distributions, particularly among the wage looser, may improve the HFS and HDD of day laborers.

The association between childhood trauma and the age of onset in drug-free bipolar depression.

OBJECTIVE: This study aimed to investigate the relationship between childhood trauma and clinical correlates in bipolar depression. METHODS: A total of 61 bipolar depression patients were enrolled and assessed based on the Childhood Trauma Questionnaire-Short Form (CTQ-SF), Patient Health Questionaire-15 (PHQ-15), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7) systems. RESULTS: The age of onset in bipolar depression patients with either trauma or abuse or neglect was significantly lower than in patients without these factors. There were statistically significant negative correlations between the age of onset and the number of different trauma types in bipolar depression patients. Multiple variable regression showed a significant association between the number of trauma types and the age of onset. Furthermore, there was a significant negative correlation between the age of onset with CTQ-SF total score (CTS), emotional abuse score and emotional neglect score, and physical neglect score. However, multiple variable regression analysis revealed that there was a significant association between emotional abuse score and the age of onset of bipolar depression patients. CONCLUSION: Our results suggest that childhood trauma may be associated with physical symptoms and the age of onset in bipolar depression patients.

Prevalence and correlates of diabetes distress and depressive symptoms among individuals with type-2 diabetes mellitus during Ramadan fasting: A cross-sectional study in Bangladesh amid the COVID-19.

AIMS: Psychological concerns relating to "diabetes distress" (DD) and depressive symptoms (DS) in individuals with type-2 diabetes mellitus (T2DM) may negatively impact adherence to medical treatments and overall mental health. Thus, this study was undertaken to investigate DS and DD in relation to fasting during the month of Ramadan. METHODS: A cross-sectional survey was conducted among 735 patients with T2DM in 2021. DD and DS were measured by the Problem Areas in Diabetes scale and Patient Health Questionnaire-9, respectively. Logistic regression and correlation analyses were executed. RESULTS: More than one-third of the participants (41.2%) had DD and DS (36.9%). DS was significantly higher in participants who did not fast (p = 0.027). Participants who had higher dietary diversity were less likely to have DD (p = 0.004) and DS (p = 0.001). Females (AOR = 1.89, 95% CI: 1.25-2.85) and those who lived alone (AOR = 1.89, 95% CI: 1.25-2.85) were more likely to have DS. Participants with diabetes-related complications were more likely to experience DS (AOR = 2.17; 95% CI: 1.5-3.13) and DD (AOR = 3.46; 95% CI: 2.42-4.95). DD was also associated with being younger (p = 0.003), having hypertension (p = 0.030), having heart disease (p = 0.012), and taking insulin (p = 0.010). CONCLUSIONS: Individuals with T2DM who were not fasting experienced more mental health concerns. Psychosocial support and other interventions from health professionals should be examined and empirical interventions should be implemented to promote the mental health and well-being of individuals with T2DM.

The Association Between Financial Hardship and Mental Health Difficulties Among Adult Wage Earners During the COVID-19 Pandemic in Bangladesh: Findings From a Cross-Sectional Analysis.

Background: The ongoing COVID-19 pandemic has created several challenges including financial burdens that may result in mental health conditions. This study was undertaken to gauge mental health difficulties during the COVID-19 pandemic and gain an insight into wage earners' mental health. Method: This cross-sectional study was conducted through an online survey. A t total of 707 individual Bangladeshi wage earners were enrolled between 20 and 30 May 2020. The questionnaire had sections on sociodemographic information, COVID-19 related questions, PHQ-9 and GAD-7 scales. STATA version 14.1 program was used to carry out all the analyses. Results: The study revealed that 58.6 and 55.9% of the respondents had moderate to severe anxiety and depressive symptoms, respectively. The total monthly income was <30,000 BDT (353.73USD) and displayed increased odds of suffering from depressive symptoms (OR = 4.12; 95% CI: 2.68-6.34) and anxiety (OR = 3.31; 95% CI: 2.17-5.03). Participants who did not receive salary income, had no income source during the pandemic, had financial problems, and inadequate food supply and were more likely to suffer from anxiety and depressive symptoms (p ≤ 0.01). Perceiving the upcoming financial crisis as a stressor was a potential risk factor for anxiety (OR = 1.91; 95% CI:1.32-2.77) and depressive symptoms (OR = 1.50; 95% CI:1.04-2.16). Limitations: The online survey method used in this study limits the generalizability of the findings and self-reported answers might include selection and social desirability bias as a community-based survey was not possible during the pandemic. Conclusion: Wage earners in a low resource setting like Bangladesh require mental health attention and financial consideration to deal with mental health difficulties.

Sex difference in the interrelationship between TNF-α and oxidative stress status in first-episode drug-naïve schizophrenia.

BACKGROUND: Increasing evidence indicates that dysregulated TNF-α and oxidative stress (OxS) contribute to the pathophysiology of schizophrenia. Additionally, previous evidence has demonstrated sex differences in many aspects of schizophrenia including clinical characteristics, cytokines, and OxS markers. However, to the best of our knowledge, there is no study investigating sex differences in the association between TNF-α, the OxS system, and their interaction with clinical symptoms in schizophrenia patients, especially in first-episode drug-naïve (FEDN) patients. METHODS: A total of 119 FEDN schizophrenia patients and 135 healthy controls were recruited for this study. Serum TNF-α, superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), catalase (CAT), and malondialdehyde (MDA) were measured. The Positive and Negative Syndrome Scale (PANSS) was applied to evaluate psychotic symptoms. Two-way ANOVA, partial correlation analysis, and multivariate regression analysis were performed. RESULTS: A sex difference in MDA levels was demonstrated only in healthy controls (F = 7.06, pBonferroni = 0.045) and not seen in patients. Furthermore, only male patients had higher MDA levels than male controls (F = 8.19, pBonferroni = 0.03). Additionally, sex differences were observed in the association of TNF-α and MDA levels with psychotic symptoms (all pBonferroni < 0.05). The interaction of TNF-α and MDA was only associated with general psychopathology symptom in male patients (B = - 0.07, p = 0.02). CONCLUSION: Our results demonstrate the sex difference in the relationship between TNF-α, MDA, and their interaction with psychopathological symptoms of patients with schizophrenia.

Mental health difficulties in students with suspected COVID-19 symptoms and students without suspected COVID-19 symptoms: A cross-sectional comparative study during the COVID-19 pandemic.

INTRODUCTION: Mental health problems are taking a heavy toll on students during the COVID-19 pandemic. The purpose of this study was to compare the level of anxiety symptoms, depressive symptoms, post-traumatic stress symptoms (PTSS), and fear of COVID-19 between students with suspected COVID-19 symptoms and students without any suspected symptoms during the pandemic in Bangladesh. METHODS: This cross-sectional comparative study was conducted online among Bangladeshi students from May to July 2020. Anxiety symptoms, depressive symptoms, PTSS, and fear of COVID-19 were assessed by using the Generalized Anxiety Disorder scale, Patient Health Questionnaire, the Impact of Event Scale, and Fear of COVID-19 Scale, respectively. College and University students were the participants of the study. RESULTS: Among 3777 students, 1259 had suspected COVID-19 symptoms and 2518 had no suspected COVID-19 symptoms. Students who experienced suspected COVID-19 symptoms had higher prevalence (moderate to severe) of depressive symptoms (61.15% vs. 47.62%), anxiety symptoms (44.96% vs. 36.97%), and PTSS (48.3% vs. 39.75%) compared to those who had no such symptoms. The study identified having suspected COVID-19 symptoms as a significant associated factor for anxiety symptoms (ß1' = 1.39; 95% CI: 1.03-1.74), depressive symptoms (ß1' = 1.88; 95% CI: 1.43-2.32), PTSS (ß1' = 3.66; 95% CI: 2.66-4.65), and fear of COVID-19 (ß1' = 0.48; 95% CI: 0.02 to 0.94). Students with suspected COVID-19 symptoms thought more that they would be better off dead, or of hurting themselves (P < 0.01) and felt more afraid as if something awful might happen (P < 0.01) than their counterparts. CONCLUSION: Mental health difficulties are more prevalent among students with suspected COVID-19 symptoms than the students without having such symptoms. This finding suggests that public health practitioners should deploy a rapid diagnostic system and consider psychological intervention in addition to clinical management for those who have COVID-19 like symptoms during the pandemic.

Fear and depressive symptoms amid COVID-19: A cross-sectional pilot study among adult population in Bangladesh.

BACKGROUND: Fear is a primary emotional reaction to the deadly coronavirus disease which might be an associated factor for developing depressive symptoms. This study aimed to assess the level and associated factors of fear and depression amid the COVID-19 pandemic among the adult population of Bangladesh. METHODS: After providing informed consent, 1050 participants completed the cross-sectional online survey tool. Depressive symptoms and fear were assessed through the PHQ-9 and validated fear of COVID-19 scale (FCV-19S), respectively. Linear regression analysis was performed to predict potential factors of fear and depression. RESULTS: The study finds that females had higher scores for fear of COVID-19 scale (ß1' = 1.81; 95% CI: 1.15 to 2.47) and Patient Health Questionnaire (ß2' = 1.92; 95% CI: 0.95 to 2.88) than their male counterpart. Respondents considering the virus to be extremely dangerous had higher scores for FCV-19S (ß1' = 1.55; 95% CI: 0.66 to 2.44) and PHQ-9 (ß2 = 1.59; 95% CI: 0.25 to 2.92). Similarly, respondents considering themselves unsafe and very worried about the virus had increased scores for both FCV-19S and PHQ-9. On other hand, people those were reluctant to use masks (ß1' = -1.58; 95% CI: -3.12 to -0.04) or seek doctors' advice (ß1' = -0.93; 95% CI: -1.83 to -0.02) if COVID-19 symptoms appear, had comparatively lower scores for FCV-19S. CONCLUSIONS: Fear of COVID-19 and depression were found to be associated with some specific knowledge, attitude & preparedness towards COVID-19 which should be adequately addressed in public health strategies to prevent the virus.