International Journal of Environmental Research and Public Health

Research

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15 pages, 956 KiB

Open AccessArticle

Validation of Generalized Anxiety Disorder 6 (GAD-6)—A Modified Structure of Screening for Anxiety in the Adolescent French Population

by Anja Todorović, Cédric Baumann, Myriam Blanchin and Stéphanie Bourion-Bédès

Int. J. Environ. Res. Public Health 2023, 20(8), 5546; https://doi.org/10.3390/ijerph20085546 - 17 Apr 2023

Cited by 3 | Viewed by 2536

Abstract

Anxiety disorders remain underdiagnosed and undertreated, especially in child and adolescent populations. This study aimed to examine the construct validity of the Generalized Anxiety Disorder Scale 7 (GAD-7) in a sample of French adolescents by combining the Classical Test Theory (CTT) and the [...] Read more.

Anxiety disorders remain underdiagnosed and undertreated, especially in child and adolescent populations. This study aimed to examine the construct validity of the Generalized Anxiety Disorder Scale 7 (GAD-7) in a sample of French adolescents by combining the Classical Test Theory (CTT) and the Item Response Theory (IRT) and to assess the invariance of items. A total of 284 adolescents enrolled in school in the Lorraine region were randomly selected to participate in a cross-sectional study. A psychometric evaluation was performed using a combination of CTT and IRT analyses. The study of psychometric properties of GAD-7 revealed poor adequation to the sample population, and engendered the deletion of one item (#7) and the merger of two response modalities (#2 and #3). These modifications generated the new GAD-6 scale, which had a good internal consistency reliability (Cronbach α = 0.85; PSI = 0.83), acceptable goodness-of-fit indices (χ2 = 28.89, df = 9, P = 0.001; RMSEA (90% CI) = 0.088 [0.054; 0.125]; SRMR = 0.063; CFI = 0.857), and an acceptable convergent validity (r = –0.62). Only one item (#5) had a consistent Differential Item Functioning (DIF) by gender. This study evaluated the structure of the GAD-7 scale, which was essentially intended at discriminating adolescent patients with high levels of anxiety, and adapted it to a population of adolescents from the general population. The GAD-6 scale presents better psychometric properties in this general population than the original GAD-7 version. Full article

(This article belongs to the Special Issue Editorial Board Members' Collection Series: Prevention and Intervention in Mental Health)

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12 pages, 358 KiB

Open AccessArticle

Geographical Disparities and Settlement Factors and Mental Health of Refugees Living in Germany

by Julian Grabo and Gerard Leavey

Int. J. Environ. Res. Public Health 2023, 20(5), 4409; https://doi.org/10.3390/ijerph20054409 - 1 Mar 2023

Viewed by 2106

Abstract

(1) Background: Approximately half of all refugees living in Germany experience discrimination, which may negatively affect their mental health. Moreover, German refugees have experienced hostility, especially in eastern regions. (2) Aims: We examined the effect of perceived discrimination on refugees’ mental health in [...] Read more.

(1) Background: Approximately half of all refugees living in Germany experience discrimination, which may negatively affect their mental health. Moreover, German refugees have experienced hostility, especially in eastern regions. (2) Aims: We examined the effect of perceived discrimination on refugees’ mental health in Germany, with a particular focus on possible regional differences of refugee mental health and perceived discrimination. (3) Method: The data of 2075 refugees who arrived in Germany between 2013 and 2016, from a large-scale survey, was analysed using binary logistic regression. The refugee health screener, 13-item version, was used to assess psychological distress. All effects were investigated for the entire sample and both sexes independently. (4) Results: A third of refugees experienced discrimination which increased the risk of psychological distress (OR = 2.25 [1.80, 2.8]). Those living in eastern Germany were more than twice as likely to report experiences of discrimination, compared to their counterparts living in western Germany (OR = 2.52 [1.98, 3.21]). Differences were noted between males and females, and religious attendance. (5) Conclusions: Perceived discrimination is a risk factor for refugee mental health, particularly female refugees in eastern Germany. An east–west regional difference may be explained by socio-structural factors, rural placement, differential historical exposure to migrant populations, and a greater presence of right-wing and populist parties in eastern Germany. Full article

(This article belongs to the Special Issue Editorial Board Members' Collection Series: Prevention and Intervention in Mental Health)

13 pages, 2797 KiB

Open AccessFeature PaperArticle

A Markov Chain Model for Mental Health Interventions

by David Claudio, Sally Moyce, Tyler Albano, Ekeoma Ibe, Nick Miller and Marshall O’Leary

Int. J. Environ. Res. Public Health 2023, 20(4), 3525; https://doi.org/10.3390/ijerph20043525 - 16 Feb 2023

Cited by 2 | Viewed by 2900

Abstract

Poor mental health affects nearly one billion people worldwide and can end in suicide if not treated. Unfortunately, stigma and a lack of mental healthcare providers are barriers to receiving needed care. We developed a Markov chain model to determine whether decreasing stigma [...] Read more.

Poor mental health affects nearly one billion people worldwide and can end in suicide if not treated. Unfortunately, stigma and a lack of mental healthcare providers are barriers to receiving needed care. We developed a Markov chain model to determine whether decreasing stigma or increasing available resources improves mental health outcomes. We mapped potential steps in the mental health care continuum with two discrete outcomes: getting better or committing suicide. Using a Markov chain model, we calculated probabilities of each outcome based on projected increases in seeking help or availability of professional resources. Modeling for a 12% increase in awareness of mental health concerns yielded a 0.39% reduction in suicide. A 12% increase in access to professional help yielded a 0.47% reduction in suicide rate. Our results show that expanding access to professional services has a higher impact on reducing suicide rates than creating awareness. Any intervention towards awareness or access positively impacts reducing suicide rates. However, increased access results in a higher reduction in suicide rates. We have made progress in increasing awareness. Awareness campaigns help to increase recognition of mental health needs. However, focusing efforts on increasing access to care may have a higher impact on reducing suicide rates. Full article

(This article belongs to the Special Issue Editorial Board Members' Collection Series: Prevention and Intervention in Mental Health)

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11 pages, 336 KiB

Open AccessArticle

Is (Disordered) Social Networking Sites Usage a Risk Factor for Dysfunctional Eating and Exercise Behavior?

by Lisa Mader, Kai W. Müller, Klaus Wölfling, Manfred E. Beutel and Lara Scherer

Int. J. Environ. Res. Public Health 2023, 20(4), 3484; https://doi.org/10.3390/ijerph20043484 - 16 Feb 2023

Cited by 4 | Viewed by 3077

Abstract

Background: Research over the past years has shown that exposure to thin and beauty ideals in the media can be associated with disordered eating and related variables. Nowadays, interactive media, such as social networking sites, have gained growing popularity and represent a major [...] Read more.

Background: Research over the past years has shown that exposure to thin and beauty ideals in the media can be associated with disordered eating and related variables. Nowadays, interactive media, such as social networking sites, have gained growing popularity and represent a major part of people’s lives. It is therefore crucial to investigate how far users might be negatively influenced by social networking sites regarding eating pathology or excessive exercise behavior and if there are particular links to social media use disorder. Methods: Data were collected by an online-survey encompassing questions on regular social networking site use, eating disorders, and excessive exercise behavior. Results: Analyses showed that disordered social networking sites use was significantly related to eating pathology and a poorer body image in men and women. The frequency of active or passive social networking sites usage however was not associated with exercise behavior. Conclusions: Our results confirm that disordered social networking sites use represents a risk factor for body image dissatisfaction and associated eating disorders. Full article

(This article belongs to the Special Issue Editorial Board Members' Collection Series: Prevention and Intervention in Mental Health)

11 pages, 688 KiB

Open AccessArticle

The Association between Nursing Skill Mix and Patient Outcomes in a Mental Health Setting: An Observational Feasibility Study

by Nompilo Moyo, Martin Jones, Shaun Dennis, Karan Sharma, Michael McKeown and Richard Gray

Int. J. Environ. Res. Public Health 2023, 20(3), 2715; https://doi.org/10.3390/ijerph20032715 - 3 Feb 2023

Cited by 1 | Viewed by 5150

Abstract

Higher levels of educational preparation for nurses are associated with lower mortality rates in both medical and surgical wards. In mental health inpatient wards, few studies have examined whether specialist mental health nurse training has any impact on patient outcomes. The aim of [...] Read more.

Higher levels of educational preparation for nurses are associated with lower mortality rates in both medical and surgical wards. In mental health inpatient wards, few studies have examined whether specialist mental health nurse training has any impact on patient outcomes. The aim of this retrospective observational study was to establish the feasibility of extracting and linking nurse education and inpatient outcome data from hospital administrative sources to inform the design of future mental health nursing skill mix studies. Study participants were people experiencing mental ill-health and admitted to psychiatric inpatient care for at least 24 h. The exposure was the ratio of mental health nurses to comprehensive nurses for each patient for each day of their admission. The outcome was readmission for psychiatric inpatient care within 12 months of discharge from the index admission. Confounders were patient demographic (age, gender) and clinical characteristics (diagnosis, legal status, community follow-up). Forty-four patients included in the study were inpatients for a total of 595 days. The median hospital stay was 12 days (IQR = 7–17). In total, 11 (25%) patients were readmitted. In the readmitted and not readmitted groups, the median skill mix ratio was 5 (IQR = 5–7) and 5 (1–6), respectively. It was feasible to extract and code patient and nurse data from hospital databases and link them together. However, a substantial amount of manual post hoc recoding was required to enable us to calculate the exposure (mental health to comprehensive nurse ratio) in a precise way. It may be realistic to automate our methodology in an appropriately powered mental health nursing skill mix study. Australian and New Zealand clinical trial registry: ACTRN12619001337167p. Full article

(This article belongs to the Special Issue Editorial Board Members' Collection Series: Prevention and Intervention in Mental Health)

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8 pages, 343 KiB

Open AccessArticle

Cognitive and Mood Effect of Alpha-Lipoic Acid Supplementation in a Nonclinical Elder Sample: An Open-Label Pilot Study

by Gianpaolo Antonio Basile, Fiammetta Iannuzzo, Francesco Xerra, Giovanni Genovese, Gianluca Pandolfo, Clemente Cedro, Maria Rosaria Anna Muscatello and Antonio Bruno

Int. J. Environ. Res. Public Health 2023, 20(3), 2358; https://doi.org/10.3390/ijerph20032358 - 28 Jan 2023

Cited by 5 | Viewed by 3839

Abstract

Background: Memory disorders are common among elder people, and nonclinical cognitive decline is commonly experienced with age. Preclinical investigations have explored the possible role of alpha-lipoic acid (ALA), a known antioxidant compound abundant in vegetables and animal tissues, in reducing oxidative stress in [...] Read more.

Background: Memory disorders are common among elder people, and nonclinical cognitive decline is commonly experienced with age. Preclinical investigations have explored the possible role of alpha-lipoic acid (ALA), a known antioxidant compound abundant in vegetables and animal tissues, in reducing oxidative stress in the aging brain and preventing cognitive decline. However, clinical evidence is limited, and the few existing results are contrasting. In addition, while most of the existing trials have been focused on the effects of ALA administration in Alzheimer’s disease (AD) or other types of dementia, studies evaluating its effects on nonclinical elder population are still missing. Methods: In the present open-label, pilot study, fifteen elder patients (mean age: 84.5 ± 5.77) received ALA at a daily dose of 600 mg/day for 12 weeks. General cognitive function, executive function, and mood symptom assessment were carried out at baseline and at the endpoint. Results: Overall, ALA administration was generally well-tolerated (only one dropout due to gastrointestinal side effects). However, no statistically significant effects either on cognitive function, executive function, or mood were found. Conclusions: Despite several limitations, our study found no evidence of positive effects on cognition and mood after ALA administration in elder people without the diagnosis of AD or cognitive impairment. Further clinical trials are needed to better investigate ALA effectiveness on cognition and mood in elder subjects. Full article

(This article belongs to the Special Issue Editorial Board Members' Collection Series: Prevention and Intervention in Mental Health)

8 pages, 338 KiB

Open AccessArticle

Is Lethality Different between Males and Females? Clinical and Gender Differences in Inpatient Suicide Attempters

by Isabella Berardelli, Elena Rogante, Salvatore Sarubbi, Denise Erbuto, Mariarosaria Cifrodelli, Cristina Concolato, Massimo Pasquini, David Lester, Marco Innamorati and Maurizio Pompili

Int. J. Environ. Res. Public Health 2022, 19(20), 13309; https://doi.org/10.3390/ijerph192013309 - 15 Oct 2022

Cited by 11 | Viewed by 2331

Abstract

According to the gender paradox in suicidology, an important sex difference has been reported with a preponderance of females in nonfatal suicidal behavior and a preponderance of males in completed suicide. Furthermore, females and males present different risk factors for suicide. The present [...] Read more.

According to the gender paradox in suicidology, an important sex difference has been reported with a preponderance of females in nonfatal suicidal behavior and a preponderance of males in completed suicide. Furthermore, females and males present different risk factors for suicide. The present study explored possible clinical differences between male and female psychiatric inpatients who had recently attempted suicide. The study included 177 adult inpatients hospitalized following a suicide attempt at the University Psychiatric Clinic, Sant’Andrea Hospital, Sapienza University of Rome. Clinical features assessed included psychiatric diagnosis, method and lethality of suicide attempts using the Risk/Rescue Rating Scale, the history of suicide attempts, age at onset of psychiatric illness, the presence of substance or alcohol use, and the length of stay. The results found that males and females differed in the method used for the suicide attempt, the scores for risk and rescue, and the length of hospitalization post-suicide attempt. In conclusion, identifying gender characteristics of patients at higher risk of suicide is important for implementing specific suicide prevention strategies and reducing the risk of future suicidal behavior in psychiatric inpatients. Full article

(This article belongs to the Special Issue Editorial Board Members' Collection Series: Prevention and Intervention in Mental Health)

Review

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21 pages, 447 KiB

Open AccessReview

The Risk for Schizophrenia–Bipolar Spectrum: Does the Apple Fall Close to the Tree? A Narrative Review

by Giulia Cattarinussi, Alessio A. Gugliotta and Fabio Sambataro

Int. J. Environ. Res. Public Health 2023, 20(15), 6540; https://doi.org/10.3390/ijerph20156540 - 7 Aug 2023

Cited by 2 | Viewed by 2008

Abstract

Schizophrenia (SCZ) and bipolar disorder (BD) are severe psychiatric disorders that share clinical features and several risk genes. Important information about their genetic underpinnings arises from intermediate phenotypes (IPs), quantifiable biological traits that are more prevalent in unaffected relatives (RELs) of patients compared [...] Read more.

Schizophrenia (SCZ) and bipolar disorder (BD) are severe psychiatric disorders that share clinical features and several risk genes. Important information about their genetic underpinnings arises from intermediate phenotypes (IPs), quantifiable biological traits that are more prevalent in unaffected relatives (RELs) of patients compared to the general population and co-segregate with the disorders. Within IPs, neuropsychological functions and neuroimaging measures have the potential to provide useful insight into the pathophysiology of SCZ and BD. In this context, the present narrative review provides a comprehensive overview of the available evidence on deficits in neuropsychological functions and neuroimaging alterations in unaffected relatives of SCZ (SCZ-RELs) and BD (BD-RELs). Overall, deficits in cognitive functions including intelligence, memory, attention, executive functions, and social cognition could be considered IPs for SCZ. Although the picture for cognitive alterations in BD-RELs is less defined, BD-RELs seem to present worse performances compared to controls in executive functioning, including adaptable thinking, planning, self-monitoring, self-control, and working memory. Among neuroimaging markers, SCZ-RELs appear to be characterized by structural and functional alterations in the cortico–striatal–thalamic network, while BD risk seems to be associated with abnormalities in the prefrontal, temporal, thalamic, and limbic regions. In conclusion, SCZ-RELs and BD-RELs present a pattern of cognitive and neuroimaging alterations that lie between patients and healthy individuals. Similar abnormalities in SCZ-RELs and BD-RELs may be the phenotypic expression of the shared genetic mechanisms underlying both disorders, while the specificities in neuropsychological and neuroimaging profiles may be associated with the differential symptom expression in the two disorders. Full article

(This article belongs to the Special Issue Editorial Board Members' Collection Series: Prevention and Intervention in Mental Health)

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