The mediating role of social support in the relationship between psychosocial problems and sleep patterns of adolescents with epilepsy.

AIM: This study was conducted to examine the mediating role of social support in the relationship between psychosocial problems of adolescents with epilepsy and their sleep patterns. METHODS: The data were collected with Adolescent Information Form, Strength and Difficulties Questionnaire, Sleep Disturbance Scale for Children and Multidimensional Scale of Perceived Social Support in this descriptive and correlational study. The mediating role of multidimensional social support that children with epilepsy received with the Process Macro program was examined in the relationship between their psychosocial problems and their sleep status. Process model 4 was used and analysis was made based on the Bootstrap method. RESULTS: As a result of the analysis, it was found that the participants had been diagnosed with epilepsy for a mean of 6.0 ± 1.61 years and had a mean of 3.1 ± 2.48 seizures per week. It was found that the sleep problems experienced by adolescents with epilepsy affected their psychosocial health and this effect was at the level of 84 % (ß = 0.933; p < 0.001). The effect of perceived social support on the dependent variable sleep disturbance in adolescents with epilepsy was found to be statistically significant (ß = -0.540; p < 0.001). It was determined that the Psychosocial Health Status score of adolescents diagnosed with epilepsy explained 87 % of the change in sleep disturbance experienced with perceived social support (p < 0.001). The effect of social support perceived by adolescents with epilepsy on sleep disturbance was found to be statistically significant. Perceived social support has no effect on the psychosocial problems they experience. CONCLUSIONS: It was found that social support was not a mediator in the relationship between psychosocial problems of adolescents with epilepsy and their sleep status.

Cumulative contextual risk, mothers' and fathers' parenting, and adolescents' psychosocial problems in Ghana.

Limited research exists on the association between cumulative risk factors and the psychosocial well-being of adolescents in low-income, culturally distinct settings. This study aimed to fill this gap by examining the impact of cumulative risk exposure on Ghanaian adolescents' psychosocial problems and exploring the mediating role of parenting. The study involved 212 adolescents (61% girls; average age = 13.38) who completed measures on cumulative risk, maternal and paternal warmth, behavioral control, anxiety, depression, overt aggression, and relational aggression. The results indicated that cumulative risk indirectly influenced adolescents' depression and overt aggression through paternal warmth. Furthermore, paternal behavioral control mediated the relationship between cumulative risk and adolescents' overt aggression. Findings highlight the importance of fathers' parenting in mediating cumulative risk effects.

Prevalence and determinants of postpartum depression among adolescent and adult mothers in Northwest Ethiopia.

Postpartum depression (PPD) is a common mental health issue in resource-limited settings that negatively affects the well-being of mothers and children. However, PPD often remains untreated, leading to long-term consequences for families. Therefore, we examined the prevalence and determinants of PPD among adolescent and adult mothers in northwest Ethiopia. Data were collected from 374 adolescent (10-19 years) and 760 adult (20-34 years) mothers 6 weeks after childbirth. Data were analyzed using binary and multiple logistic regression. Adolescent mothers had a significantly higher proportion of PPD (37.4%) than adult mothers (20.1%) and were more likely to report low self-esteem (13.1% vs. 8.2%) and low social support (28.3% vs. 23.3%). Factors associated with PPD differed between adolescent and adult mothers. Adolescent mothers with PPD were more likely to report household food insecurity, low self-esteem, low knowledge of postpartum complications, and working in agriculture or professional/technical occupations. For adult mothers, factors associated with PPD included distance to the nearest health facility, medium social support, inadequate dietary diversity, and food insecurity. Results suggest that targeted interventions by age group are needed to reduce the burden of PPD in Ethiopia.

The effect of drama on psychosocial problems and emotional states of hospitalized children with cancer.

BACKGROUND AND PURPOSE: Hospitalization is a traumatic experience for children. Especially in the case of childhood cancers that require long-term hospitalization, children need psychosocial support. The study aimed to examine the effectiveness of drama in reducing psychosocial problems in hospitalized paediatric children diagnosed with cancer. METHODS: The study used a mixed method approach, combining both qualitative and quantitative methods with a single group. Drama sessions prepared according to the Tasks and Skills Model were used to support their psychosocial conditions. The Facial Expression Form, The Assessment Scale for Psychosocial Symptoms in Hospitalized Children, and the Drawing and Writing Technique were used before and after the drama sessions. RESULTS: This study differs from others in its use of drama intervention to reduce psychosocial problems in children undergoing cancer treatment. As a result of the study, it was found that there was a decrease in anxiety, hopelessness, anger-aggression and communication difficulties among psychosocial problems and a change in mood towards feeling happy. The study suggests that drama sessions were effective in relieving emotional distress in paediatric cancer patients. CONCLUSION: The study suggests that drama sessions were effective in relieving emotional distress in paediatric cancer patients. PRACTICE IMPLICATIONS: Applying drama to children undergoing long-term hospital treatment can help alleviate psychosocial problems by reducing stress, emotional suppression, and compensating for trauma.

The relationship between internet addiction, sleep quality, and psycho-social problems among secondary school students in Erbil, 2023-2024.

OBJECTIVE: This study aimed to show the association between internet addiction (IA), sleep quality, and psycho-social problems among secondary school students DESIGN: A cross-sectional, descriptive, and correlational study design was used. SAMPLE: A total of 557 students from four secondary schools in Erbil were selected using multistage cluster sampling MEASUREMENTS: The questionnaires of this research contained socio-demographic data, Internet Addiction Test (IAT), Pittsburgh Sleep Quality Index (PSQI), and Pediatric Symptom Checklist-Y (PSC-Y) questionnaire. RESULTS: Findings indicated that students displayed a mild IA, averaging a score of 42.9 ± 19.18. Furthermore, the average sleep quality (PSQI) score was 8.95 ± 2.75, indicating moderate sleep disturbance, and the average score for psycho-social problems was 27.78 ± 13.29. Importantly, there was a strong and positive association between IA and psycho-social issues, as shown by a correlation coefficient of 0.31 (p < .001). Sleep quality was correlated with IA and psychosocial issues (p < .001, correlation values: .23 and .27, respectively) CONCLUSIONS: The study highlights the urgent need for health policymakers and nursing managers in Erbil to develop targeted interventions, such as awareness campaigns and digital well-being programs in school curricula, to mitigate the interlinked issues of IA, sleep quality, and psycho-social problems among students.

Sex differences in Cannabis use disorder and associated psychosocial problems among US adults, 2012-2013.

While men show greater prevalence of cannabis use disorder (CUD) than women, whether cannabis use frequency drives this difference is unknown, and little is known about sex differences in problems associated with CUD. We therefore assessed the association of CUD with sex, adjusted for frequency of use, and compared the association of psychosocial and health-related problems with CUD between men and women. We included US adults age ≥ 18 who reported past-year cannabis use in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (n = 3701). Cannabis use frequency, DSM-5 CUD and problems (interpersonal, financial, legal, health-related) were assessed. Associations between psychosocial problems, sex and DSM-5 CUD were assessed using prevalence differences (PD) and 95% confidence intervals (CI) from logistic regression models, controlling for demographics and cannabis use frequency, and effect modification by sex was assessed. We found that the prevalence of CUD among men versus women was not significantly greater after adjusting for use frequency. Women had significantly higher prevalence of interpersonal, financial and health-related problems than men, adjusting for frequency of use. Women showed significantly greater association of CUD with interpersonal problems with a boss or co-workers (p < 0.05) and a neighbor, relative or friend (p < 0.05) compared to men. Lack of sex differences in CUD after adjusting for frequency of use suggests use frequency may be an important target of CUD prevention efforts. CUD showed stronger associations for interpersonal problems among women than men, suggesting the need for particular emphasis on treating interpersonal problems related to cannabis use among women.

Metabolic risk factors and psychosocial problems independently explain poor sleep quality and obstructive sleep apnea symptoms among adults in urban India.

STUDY OBJECTIVES: To determine if metabolic risk factors are associated with poor sleep quality and obstructive sleep apnea-like symptoms (OSA symptoms) independent of psychosocial problems and demographic and lifestyle factors in older Indian adults. METHODOLOGY: We analyzed baseline data from adults (≥ 50 years) from a population-based cohort, the LoCARPoN study, in India. Variables were grouped as (a) demographic and lifestyle factors such as smoking, alcohol use, and physical activity; (b) psychosocial problems including symptoms of depression, anxiety, and perceived stress; and (c) metabolic risk factors including glycated hemoglobin, high-density lipoprotein, low-density lipoprotein, total cholesterol, body mass index, and hypertension. Variables were examined as predictors of poor sleep quality and OSA symptoms. Groups of variables were added stepwise to a logistic regression. Variance explained by nested models was quantified using McFadden's pseudo R2, and change was formally tested with the log-likelihood ratio test. RESULTS: Among 7505 adults, the prevalence of poor sleep quality was 16.9% (95% CI: 16.0, 17.7), and OSA symptoms were present in 7.0% (95% CI: 6.4, 7.6). Psychosocial problems had a strong independent association with both poor sleep quality (pseudo R2 increased from 0.10 to 0.15, p < 0.001) and more OSA symptoms (pseudo R2 increased from 0.08 to 0.10, p < 0.001). Metabolic risk factors had a modest independent association with sleep quality (pseudo R2 increased from 0.14 to 0.15, p < 0.01), but a strong association with OSA symptoms (pseudo R2 increased from 0.08 to 0.10, p < 0.001). CONCLUSION: Psychosocial and metabolic risk factors were independently associated with sleep quality and OSA symptoms. This fact implied that OSA symptoms may affect both mental health and physical health. Our findings have public health implications because the number and proportion of the elderly in India is increasing, while the prevalence of metabolic risk factors and psychosocial problems is high already. These facts have the potential to exacerbate not only the burden of sleep disorders and OSA symptoms but also associated cardiovascular and neurologic sequelae, further stretching the Indian health-care system.

Longitudinal changes in quality of life and psychosocial problems of primary school children in a deprived urban neighborhood over the course of a school-based integrated approach.

The municipality of Amsterdam implemented a 2-year school-based integrated approach in schools in a deprived neighborhood. The integrated approach targeted the domains of education, health and poverty and the children's school, neighborhood and home environment by involving various agencies and actors. In this study, changes in children's quality of life and psychosocial problems over the course of the integrated approach were examined and evaluated. A dynamic cohort design was used. At five measurement occasions (T1-T5) during 2 years, children from four consecutive grades in five schools filled out a questionnaire (total n = 614). In children between 7 and 13 years, quality of life was measured with the KIDSCREEN-10. In children between 9 and 13 years, psychosocial problems were measured with the Strengths and Difficulties Questionnaire. Generalized estimating equations were applied. Time, sex, age, socio-economic status, ethnic background, grade, and school were included as independent variables. Quality of life was higher from the first follow-up during the approach (T2) until the end of the approach (T4) compared to at the start of the approach (T1). At T5, several months after the approach ended, scores returned back to baseline. Likewise, a reduction in children's psychosocial problems was detected at the end of the approach (T4) compared to at the start of the approach (T1). However, both before and after that time point, no improvements were detected. This study shows that integrated approaches can be beneficial for children's quality of life and psychosocial health, but continued investments may be needed to maintain established improvements.Trial registration NTR6571 (NL6395), August 4 2017 retrospectively registered.

Psychosocial impact of structured transfer of adolescents with kidney transplants to adult services: An interventional national cohort study.

BACKGROUND: Pediatric kidney transplantation entails a well-timed transition from pediatric to adult medical care. We aimed to construct a structured transition protocol and evaluate its impact on transfer-related psychosocial problems in Slovenian patients with kidney transplants. METHODS: Individual transition-related perceptions of our patients and their parents were first assessed, and the gathered information was used to establish a country-specific transition protocol. Eleven kidney transplant patients qualified for actual transfer and were considered for further analysis. Comprehension and attitude towards transfer, coping strategies, personality resilience, behavioral, and emotional problems were assessed using questionnaires and established psychological tools before and after the completed transfer. The results were compared and analyzed. RESULTS: Ten of the eleven eligible patients were transferred to adult services between April 2020 and January 2021. The median age at enrollment was 19.7 years (range: 18.2-22.8 years). The most frequent concerns regarding upcoming health care were worse accessibility (50%), less supportive and less committed healthcare providers (40%), and deterioration of medical condition (10.0%). After the completed protocol-guided transfer, the patients declared to have no further concerns or worries. Before transfer, 28.9% of the patients' responses rated the amount and relevance of received information and counseling as "Adequate" or "Very adequate," whereas, after the transfer, the proportion of positive responses increased to 48.9%. Anxiety and withdrawn depressive symptoms were the predominant emotional problems before transfer. Their prevalence decreased after the completed transfer. CONCLUSIONS: Our results suggest that transfer-related anxieties and concerns can be significantly reduced by applying a structured transition protocol in transplant patients.

Validity and reliability of a checklist for patients with Behçet's disease based on the International Classification of Functioning, Disability and Health.

In 2020, we reported the "BD-checklist 92" for patients with Behçet's disease (BD) based on the International Classification of Functioning, Disability and Health. The purpose of the present study was to evaluate the validity and reliability of this checklist. Questionnaires using the "BD-checklist 92" and the 36-item Short Form Survey (SF-36) were sent to ten affiliated institutions. In total, 174 patients answered the questionnaire (response rate, 32.7%). Criterion validity was evaluated using the correlation coefficient between the number of problem categories extracted from the "BD-checklist 92" and the scores of the eight subscales and two components of the SF-36. Construct validity was assessed based on the number of problem categories extracted as an external criterion for the number of manifestations experienced and specific lesions. The comparison was performed using the Mann-Whitney U test. Cronbach's alpha coefficient was used to evaluate reliability. The number of problem categories in the "Body functions and structures", "Activities and participation", and "Environmental factors" components correlated significantly with all dimensions of the SF-36 questionnaire (P < 0.05 each). Construct validity showed that the number of manifestations experienced in all components (P < 0.001 each) and specific lesions in "Body functions and structures" and "All categories" (P = 0.002 and 0.050, respectively) contributed to an increased number of problems associated with BD. Cronbach's alpha coefficient for the "BD-checklist 92" was 0.926. This study confirmed the validity and reliability of the "BD-checklist 92".

Vulnerability and resilience in children during the COVID-19 pandemic.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic is having a profound impact on the health and development of children worldwide. There is limited evidence on the impact of COVID-19 and its related school closures and disease-containment measures on the psychosocial wellbeing of children; little research has been done on the characteristics of vulnerable groups and factors that promote resilience. METHODS: We conducted a large-scale cross-sectional population study of Hong Kong families with children aged 2-12 years. Parents completed an online survey on family demographics, child psychosocial wellbeing, functioning and lifestyle habits, parent-child interactions, and parental stress during school closures due to COVID-19. We used simple and multiple linear regression analyses to explore factors associated with child psychosocial problems and parental stress during the pandemic. RESULTS: The study included 29,202 individual families; of which 12,163 had children aged 2-5 years and 17,029 had children aged 6-12 years. The risk of child psychosocial problems was higher in children with special educational needs, and/or acute or chronic disease, mothers with mental illness, single-parent families, and low-income families. Delayed bedtime and/or inadequate sleep or exercise duration, extended use of electronic devices were associated with significantly higher parental stress and more psychosocial problems among pre-schoolers. CONCLUSIONS: This study identifies vulnerable groups of children and highlights the importance of strengthening family coherence, adequate sleep and exercise, and responsible use of electronic devices in promoting psychosocial wellbeing during the COVID-19 pandemic.

Reactive attachment disorder and disinhibited social engagement disorder in adolescence: co-occurring psychopathology and psychosocial problems.

Insufficient care is associated with most psychiatric disorders and psychosocial problems, and is part of the etiology of reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED). To minimize the risk of misdiagnosis, and aid treatment and care, clinicians need to know to which degree RAD and DSED co-occur with other psychopathology and psychosocial problems, a topic little researched in adolescence. In a national study of all adolescents (N = 381; 67% consent; 12-20 years old; 58% girls) in Norwegian residential youth care, the Child and Adolescent Psychiatric Assessment interview yielded information about psychiatric diagnoses and psychosocial problems categorized as present/absent, and the Child Behavior Check List questionnaire was applied for dimensional measures of psychopathology. Most adolescents with a RAD or DSED diagnosis had several cooccurring psychiatric disorders and psychosocial problems. Prevalence rates of both emotional and behavioral disorders were high in adolescent RAD and DSED, as were rates of suicidality, self-harm, victimization from bullying, contact with police, risky sexual behavior and alcohol or drug misuse. Although categorical measures of co-occurring disorders and psychosocial problems revealed few and weak associations with RAD and DSED, dimensional measures uncovered associations between both emotional and behavioral problems and RAD/DSED symptom loads, as well as DSED diagnosis. Given the high degree of comorbidity, adolescents with RAD or DSED-or symptoms thereof-should be assessed for co-occurring psychopathology and related psychosocial problems. Treatment plans should be adjusted accordingly.

Investigating the use of support in secondary school: the role of self-reliance and stigma towards help-seeking.

Purpose: Adolescents are the least likely to seek help for their mental health problems. School may be an important route to improve early recognition of adolescents with mental health problems in need for support, but little is known about the barriers to school support.Materials and methods: Data were collected in a longitudinal cohort study of Dutch adolescents (age 12-16) in secondary school (n = 956). We assessed the relation between level of psychosocial problems at the beginning of the school year (T1) and the support used in school at the end of that school year (T2), whether the willingness to talk to others (measured at T1) mediates this relation, and whether stigma towards help-seeking (T1) moderates this mediation.Results: Adolescents with more psychosocial problems were more likely to use support in school and were less willing to talk to others about their problems, but the willingness to talk to others was not a mediator. Stigma moderated the relationship between psychosocial problems and willingness to talk to others.Conclusions: Most adolescents with psychosocial problems get support in Dutch secondary school regardless of their willingness to talk to others about their problems. However, perceiving stigma towards help-seeking makes it less likely for someone to talk about their problems.

Examining Risk Factors of Health-Related Quality of Life Impairments Among Adolescents with Inflammatory Bowel Disease.

Inflammatory Bowel Disease (IBD) is a chronic, costly, and burdensome disease that is typically diagnosed during adolescence. Despite the use of effective treatments, rates of relapse and intestinal inflammation remain high and put patients at risk for long term physical and psychosocial health complications. Given the costs associated with IBD, it is critical to examine potential risk factors of poor health-related quality of life (HRQoL) among patients for the enhancement and further development of interventions. As such, the aim of the current study was to examine how sociodemographic and disease characteristics, psychosocial problems, and adherence behaviors impact HRQoL among a sample of youth with IBD. 107 adolescents with IBD and their caregiver completed self- and parent-report measures as part of a psychosocial screening service. Medical records were reviewed to obtain information regarding diagnosis, insurance, medication use, illness severity, and disease activity. Results revealed lower HRQoL scores among adolescents with more psychosocial problems (Est. = -3.08; p < .001), greater disease severity (Est. = -.40; p = .001), and those who identified as Black (Est. = -.38; p < .05). Greater disease severity (Est. = .13 p = .004), use of nonpublic insurance (Est. = .32 p = .004), and fewer psychosocial problems (Est. = -.13 p = .04) were associated with greater adherence behaviors. These findings suggest that implementing individually tailored, evidence-based psychological interventions focused on coping with psychosocial problems and symptoms may be important in enhancing adherence behaviors and HRQoL among adolescents with IBD.

Bullying patterns and their associations with child maltreatment and adolescent psychosocial problems.

Introduction: This study aimed 1) to identify underlying heterogeneous patterns of bully-victim; 2) to examine whether the different types of child maltreatment predict the patterns of bully-victim; and 3) to investigate the association between patterns of bully-victim and adolescent psychosocial problems (depression, trouble at school, and substance use). Methods: This study included a sample of 1139 (48.7% girls, 53.4% Black) drawn from the Fragile Families and Child Wellbeing Study. Children's self-reported bullying victimization at age 9 was used using the Panel Study of Income Dynamics Child Development Supplement III. Teacher's reported bullying perpetration at age 9 was used using Social Skills Rating System. Child maltreatment types were assessed at age 5 using the Parent-Child Conflict Tactics Scale Coding. At age 15, adolescent depression was measured using modified Center for Epidemiologic Studies Depression Scale; trouble at school was measured using modified Add Health In-School Questionnaire; and self-reported substance use was used. Results: Latent class analysis produced four classes: bully-victim (19.8%), victim (16.3%), no bully-victim (38.9%), and bully (24.9%). Individuals who have been neglected are more likely to be in the victim class compared to all other classes. Physical abuse to be at heightened risk of involvement in the bully-victim, compared to victim class. Additionally, individuals in the victim group are greater risk for depression, problems at school, and alcohol, as compared to those in the other classes. Conclusions: This study augments the knowledge base on bully/victim, child maltreatment, and behavioral health outcomes and elucidates several suggestions for research and policy.

Mental Health and Psychosocial Problems of Medical Health Workers during the COVID-19 Epidemic in China.

OBJECTIVE: We explored whether medical health workers had more psychosocial problems than nonmedical health workers during the COVID-19 outbreak. METHODS: An online survey was run from February 19 to March 6, 2020; a total of 2,182 Chinese subjects participated. Mental health variables were assessed via the Insomnia Severity Index (ISI), the Symptom Check List-revised (SCL-90-R), and the Patient Health Questionnaire-4 (PHQ-4), which included a 2-item anxiety scale and a 2-item depression scale (PHQ-2). RESULTS: Compared with nonmedical health workers (n = 1,255), medical health workers (n = 927) had a higher prevalence of insomnia (38.4 vs. 30.5%, p < 0.01), anxiety (13.0 vs. 8.5%, p < 0.01), depression (12.2 vs. 9.5%; p< 0.04), somatization (1.6 vs. 0.4%; p < 0.01), and obsessive-compulsive symptoms (5.3 vs. 2.2%; p < 0.01). They also had higher total scores of ISI, GAD-2, PHQ-2, and SCL-90-R obsessive-compulsive symptoms (p ≤ 0.01). Among medical health workers, having organic disease was an independent factor for insomnia, anxiety, depression, somatization, and obsessive-compulsive symptoms (p < 0.05 or 0.01). Living in rural areas, being female, and being at risk of contact with COVID-19 patients were the most common risk factors for insomnia, anxiety, obsessive-compulsive symptoms, and depression (p < 0.01 or 0.05). Among nonmedical health workers, having organic disease was a risk factor for insomnia, depression, and obsessive-compulsive symptoms (p < 0.01 or 0.05). CONCLUSIONS: During the COVID-19 outbreak, medical health workers had psychosocial problems and risk factors for developing them. They were in need of attention and recovery programs.

Psychosocial difficulties identified by health care providers as they predict pain-related quality of life in children with cancer.

This study examined the predictive validity of the Psychosocial Care Checklist (PCCL), a psychosocial screener completed by a pediatric cancer health care provider (HCP), on child pain-related and nausea-related quality of life (QOL), and whether these associations are moderated by family psychosocial risk (Psychosocial Assessment Tool, PAT). Caregivers (N = 122) of children newly diagnosed with cancer and 62 HCPs (11 social workers, 17 nurses, 34 oncologists) at two Canadian sites participated. Near diagnosis (T1) and six months later (T2), caregivers reported on child QOL and family psychosocial risk, which was categorized as universal (typical distress), targeted (targetable distress), or clinical (severe distress). HCPs completed the PCCL at T1 and T2. HCP identification of more psychosocial problems in PCCL at T1 predicted reduced child pain-related (but not nausea-related) QOL at T2 among children with universal risk. The PCCL scores did not predict pain-related QOL in families with higher psychosocial needs (i.e., targeted and clinical). HCPs may have difficulty identifying psychosocial problems among families with high risk in a manner that predicts child's pain-related QOL. A hybrid model of psychosocial screening that includes both HCP and caregiver reports is recommended to best match family problems and interventions to improve QOL.

Identification of physical and psychosocial problems based on symptoms in patients with Behçet's disease.

The purpose of this study was to use the International Classification of Functioning, Disability and Health (ICF) to identify physical and psychosocial problems associated with symptoms of Behçet's disease (BD) in Japanese patients. Thirty patients with BD were interviewed in a pilot study using the "ICF Checklist", and a team of medical experts selected categories related to physical and psychosocial aspects of BD. To identify specific physical and psychosocial problems of Japanese patients with BD, 100 new patients were interviewed using the selected categories. Among the 128 categories in the original ICF Checklist, 80 categories were identified as impaired, and another 12 ICF categories were added based on expert discussion of patients input. The number of problem categories was significantly greater in patients with BD with eye involvement and fatigue (eye involvement, 25.7 categories; fatigue, 25.2 categories; both P < 0.001). Specifically, patients with eye involvement had more difficulties with problems in daily life, such as writing (odds ratio 4.2), understanding such nonverbal messages as gestures and facial expressions (13.7), moving (5.7), walking in intense sunlight and bright light (17.6), and patients with fatigue had more difficulties with climate problems such as symptoms getting worse at the turn of the seasons or on cold days (2.5), compared to those without these symptoms. This study demonstrated that support focusing not only on physical symptoms but on other aspects of life as well is necessary for patients with BD, particularly patients with eye involvement and fatigue.

Psychosocial Syndemic of suicidal ideation: a cross-sectional study among sexually transmitted infection patients in Shanghai, China.

BACKGROUND: Patients with sexually transmitted infections (STIs) experience difficulties with stability and trust in long-term relationships and have poor mental health, factors that may lead to suicidal ideation. We sought to verify whether psychosocial health problems among patients with STIs were associated with these patients' suicidal ideation and to examine the syndemic effect of multiple psychosocial problems on suicidal ideation. METHODS: This was a cross-sectional study of 519 STI patients at the Shanghai Skin Disease Hospital. Demographic, psychosocial, and suicidal ideation information about the participants was collected by questionnaire. Logistic regressions were performed to detect the association between demographic variables and suicidal ideation, as well as each individual psychosocial variable and suicidal ideation, and to verify the syndemic effect of psychosocial factors. RESULTS: Of the participants, 25.0% (130/519) reported having suicidal ideation. In univariable analysis, low self-esteem, loneliness, depression, entrapment, defeat, and unsatisfied interpersonal needs were associated with suicidal ideation. Multivariable analysis found depression (odds ratio [OR]: 4.1; 95% confidence interval [CI]: 2.3-7.2) and entrapment (OR: 2.1; 95%CI: 1.1-4.1) each had a more significant relation with suicidal ideation than the other psychosocial problems examined. STI patients who experienced two or more psychosocial health problems had approximately fourfold odds of suicide ideation (adjusted OR [AOR]: 4.2; 95%CI: 2.6-6.8) compared with those in the non-syndemic group, especially in the high-level (five or more psychosocial problems) group (AOR: 7.0; 95%CI: 3.9-12.5). CONCLUSIONS: The study found the participants had a high rate of suicidal ideation and suffered from severe psychosocial problems. These results show a syndemic effect of psychosocial problems on increasing the odds of suicidal ideation. Our findings suggest an urgent need for efforts to prevent suicidal ideation among STI patients toward improving the social and health conditions of this population.

Matching Psychosocial Support Needs of Parents of a Child with a Chronic Illness to a Feasible Intervention.

OBJECTIVES: Parents of children with a chronic illness (CI) are at risk for psychosocial problems. The aim of this study was to refine an existing face-to-face intervention into an online psychosocial group intervention for parents by (1) exploring which themes are important, (2) determine what type of intervention parents would like and (3) assess parents' practical preferences. METHODS: Parents of children with a CI (0-18 years) were invited to complete an online questionnaire. To acquire more in-depth information, focus groups and telephone interviews were conducted. Descriptive statistics were used. RESULTS: 272 parents (mean age = 43.1 years, 85% female) participated. Three focus groups (15 parents) and seven telephone interviews were conducted. Most important themes were: the CI of the child, family functioning, taking care of yourself, relationships with others and practical support. Parents preferred a group with parents of children in the same age category. At first, parents preferred face-to-face contact. After an explanation and demonstration of an online intervention, parents became more positive about online support, mostly because they could participate from home. CONCLUSIONS FOR PRACTICE: Parents have a need for psychosocial support focusing on different themes. Professionals should explain and demonstrate an online intervention to parents. Based on these results, Op Koers Online for parents was developed. An RCT to assess feasibility and effectiveness of the intervention is currently running.