Search Results (2,495)

Hoarseness is a common voice symptom that can impair communication and lead to psychosocial difficulties. It has been hypothesized that chronic hoarseness may contribute to elevated social anxiety. This study aimed to assess the impact of hoarseness on quality of life and social anxiety in affected individuals. Thirty-eight patients with chronic hoarseness (voice disorders) and 40 matched healthy controls were evaluated in a prospective case-control study. Quality of life was measured using the WHOQOL-BREF questionnaire (Physical, Psychological, Social, and Environmental domains). Social anxiety was assessed with the Liebowitz Social Anxiety Scale (LSAS), and general anxiety and depression with the Hospital Anxiety and Depression Scale (HADS). Group scores were compared using appropriate statistical tests, and effect sizes with 95% confidence intervals were calculated. Patients with hoarseness had significantly lower Psychological Health and Social Relationships scores on the WHOQOL-BREF than controls (p < 0.01 for both; large effect sizes), indicating worse quality of life in these domains. Physical Health and Environmental domain scores did not differ between groups. The hoarseness group also showed higher social anxiety: LSAS total scores and Social Interaction subscale scores were significantly greater than those of controls (p < 0.01 and p < 0.05, respectively; moderate-to-large effects), whereas the Performance Anxiety subscale was similar between groups. By contrast, HADS anxiety and depression scores did not differ significantly between patients and controls. Notably, mean HADS scores in both groups fell in the mild (borderline) range rather than the normal range. Chronic hoarseness is associated with reduced quality of life in emotional and social domains and with increased social anxiety symptoms, but not with elevated general anxiety or depression. These findings underscore the need to address psychosocial factors, particularly social anxiety, in the clinical management of patients with voice disorders. Full article

In terms of occupational health and safety, psychosocial risks in the workplace can lead to temporary or permanent harm. Search and rescue workers assisting earthquake victims may develop PTSD due to the trauma they experience and witness. This study estimates the prevalence of PTSD among search and rescue workers involved in the February 6, 2023, earthquake in Türkiye. This study utilized the PTSD Checklist for DSM-5 (PCL-5) to assess 619 individuals. The results showed that the earthquake significantly affected post-traumatic stress symptoms across all demographic groups. Female participants (x̄ = 2.43) exhibited higher stress levels than male participants (x̄ = 2.24), showing an 8.48% difference. Participants with higher education levels (x̄ = 2.34) showed more stress than those with lower education (x̄ = 1.67). Individuals with over a decade of experience (x̄ = 3.28) experienced more distress compared to those with less than three years of experience (x̄ = 2.83). Participants under 30 (x̄ = 2.30) were more affected than those over 50 (x̄ = 2.25). Firsthand experience of the earthquake (x̄ = 2.49) resulted in greater distress compared to learning about it through communication channels (x̄ = 2.01). Concerning PTSD symptoms, 191 participants (30.86%) scored 33 or higher, which indicates clinically significant PTSD. Among the participants, 22 experienced severe to extremely severe symptoms, with 19 showing extremely severe symptoms on at least one subscale, 3 displaying extremely severe symptoms across all four subscales, and 9 demonstrating extremely severe symptoms in three subscales. Full article

Refugee mothers are at heightened risk of developing negative family dynamics due to traumatic experiences and unstable living conditions, often impacting their children in lasting ways. This partially mixed, explanatory mixed-methods pilot study examines the potential of Drama Therapy as a psychosocial intervention to reduce harmful parenting behaviors and strengthen parent–child relationships. The study engaged 20 refugee mothers who participated in a three-session intervention based on Emunah’s five-phase model. Data collection included pre-intervention demographic information, two standardized psychological scales—The Child–Parent Relationship Scale and the Parent Anger Scale—and post-intervention focus group discussions. The findings indicate that the Drama Therapy Intervention (DTI) helped reduce parental anger and improve emotional regulation, leading to more positive interactions with children and decreased conflict within the family. Focus group insights revealed that the mothers’ ongoing and past traumas significantly shaped their emotional responses and parenting styles. This pilot study highlights the importance of addressing maternal mental health in post-displacement contexts. Although one cannot draw causal inferences of efficacy in the absence of a control group, the findings provide preliminary evidence that Drama Therapy can be an effective tool for reducing parental maltreatment and improving family relationships among refugee populations. Full article

Background: Obesity is multifactorial, shaped by biological, behavioral, and psychosocial factors. Traditional sociodemographic and lifestyle influences are well studied, but psychological well-being, particularly life purpose, remains less explored. This study investigates associations between demographics, health behaviors, and life purpose and obesity prevalence, assessed through four validated adiposity indices in Spanish workers. Methods: This cross-sectional study included 93,077 workers (mean age: 43.8 ± 9.6 years; 54.1% men). Obesity was defined according to four measures: body mass index (BMI), waist-to-height ratio (WtHR), Clínica Universidad de Navarra Body Adiposity Estimator (CUN-BAE), and Metabolic Score for Visceral Fat (METS-VF). Sociodemographic, lifestyle (Mediterranean diet, physical activity, smoking), and psychological (Purpose in Life Test, PIL-10) variables were assessed. Logistic regression was used to evaluate associations with obesity risk. Results: Low life purpose was significantly associated with increased odds of obesity across all indices, particularly for CUN-BAE (OR = 4.58; 95% CI: 3.99–6.28) and BMI (OR = 5.45; 95% CI: 4.71–6.30). Traditional risk factors such as physical inactivity, poor adherence to the Mediterranean diet, older age, a lower social class, and smoking also demonstrated strong associations with higher adiposity levels. METS-VF showed the greatest sensitivity to male sex and unhealthy behaviors. Conclusions: This study identifies life purpose as an independent psychosocial determinant of obesity. Using multiple adiposity measures strengthens the findings, emphasizing psychological well-being in prevention. Longitudinal research is needed to confirm causality and develop interventions enhancing life purpose to improve cardiometabolic health. Given the cross-sectional design, causal inferences cannot be drawn and the directionality of associations remains uncertain. Full article

Background: Lifestyle behaviours, such as dietary patterns, sleep quality, perceived stress, and physical activity, are closely interconnected and play a critical role in maintaining health and well-being. Among school teachers, a profession marked by high psychosocial demands, the interplay between these factors warrants further exploration. Objective: This pilot study aimed to explore the associations between adherence to the Mediterranean Diet (MD), sleep quality, perceived stress, and physical activity levels among Portuguese primary and secondary school teachers. Methods: A cross-sectional study was conducted between April and December 2023. Participants completed validated self-reported instruments, including the MD Adherence Screener (MEDAS), the Pittsburgh Sleep Quality Index (PSQI), the Perceived Stress Scale (PSS-10), and the short form of the International Physical Activity Questionnaire (IPAQ-SF). Correlational analyses and multivariable linear regression models were applied to explore the relationships among the variables. Results: Among the 50 teachers, 32% demonstrated high adherence to the MD, 60% reported good sleep quality, 62% experienced moderate stress, and 44% engaged in high physical activity. Women were more likely to adhere strongly to the MD (p = 0.012). Higher MD adherence was positively associated with physical activity (ρ = 0.343; p = 0.015). A positive correlation was observed between perceived stress and poorer sleep quality (ρ = 0.346, p = 0.014), and a negative correlation between perceived stress and physical activity levels (ρ = −0.297, p = 0.036). Despite reporting good sleep quality, these participants had higher perceived stress scores (p = 0.015). In adjusted models, sleep quality was the only significant predictor of perceived stress (B = 0.708; p = 0.003), and vice versa (B = 0.267; p = 0.003), suggesting a bidirectional relationship. Conclusions: The findings highlight the interrelation between dietary pattern, sleep stress, and physical activity in a professional group vulnerable to lifestyle-related health challenges. Although the sample size limits generalisability, this study provides preliminary evidence supporting the need for integrated health promotion strategies targeting stress reduction and lifestyle optimisation among educators. Full article

Background: Children with disabilities face complex, systemic health access barriers rooted in societal, institutional, and structural inequities, requiring urgent global policy attention. Publications on access to health services for this population category have been found to have a significant growth in both quantity and content. The article aims to examine the structure and evolution of scientific literature in analyzing the healthcare system through the lens of inclusive services. Methods: We present the bibliometric profile of the global literature on access to health services for children with disabilities, the publication trends, the structure of research in this field concerning geographical distribution, methodological approaches, and interdisciplinary collaborations, and the core research topics, conceptual clusters, and future research directions in the field. The publications were screened from Web of Science databases, using PRISMA methodology. Finally, 1100 academic publications published between 1984 and 2025, obtained from a total of 432 different sources, the majority of which were peer-reviewed journals, were screened. Results: The calculated annual publication growth rate of 8.37% and the distinct upward trend observed, especially after 2015. The highest level was reached in 2023, with over 90 publications showing that the topic has become a focus of international academic interest. The USA (33.5%), the United Kingdom (15.7%), Australia (9.5%), and Canada (9.5%) stood out in publications, and there were strong collaborative networks among European nations (8.2%). Conclusions: Although high-income countries still appear to play a dominant role in research production, expanding international collaborations and distributing resources more equitably will contribute to the development of more inclusive solutions on a global scale. Temporal trends show an evolution toward diagnostic processes, family-centered approaches, and psychosocial dimensions. The results draw a clear picture of the current research landscape regarding access to health services for pediatric disability populations and identify potential directions for future research. Full article

Against the backdrop of growing concerns over university students’ mental health worldwide, campus environments play a crucial role not only in shaping spatial experiences but also in influencing psychological well-being. However, the psychosocial mechanisms through which campus landscapes affect well-being remain insufficiently theorized. Drawing on survey data from 500 students across two Chinese universities, this study employs structural equation modeling (SEM) and interpretable machine learning techniques (XGBoost-SHAP) to systematically examine the interrelations among landscape perception, place attachment, perceived social acceptance, school belonging, and psychological well-being. The results reveal the following: (1) campus landscapes serve as the primary catalyst for fostering emotional identification (place attachment) and social connectedness (perceived social acceptance and school belonging), thereby indirectly influencing psychological well-being through these psychosocial pathways; (2) landscape perception emerges as the strongest predictor of well-being, followed by school belonging. Although behavioral variables such as the green space maintenance quality, visit frequency, and duration of stay contribute consistently, their predictive power remains comparatively limited; (3) significant nonlinear associations are observed between core variables and well-being. While the positive effects of landscape perception, place attachment, and school belonging exhibit diminishing returns beyond certain thresholds, high levels of perceived social acceptance continue to generate sustained improvements in well-being. This study advances environmental psychology by highlighting the central role of campus landscapes in promoting mental health and provides actionable strategies for campus planning. It advocates for the design of balanced, diverse, and socially engaging landscape environments to maximize psychological benefits. Full article

Background/Objectives: Pediatric acquired brain injury (ABI) often results in persistent challenges that extend beyond motor impairments, affecting quality of life (QoL), social participation, and engagement in physical activity. Given the complexity and chronicity of these outcomes, there is a pressing need for multidimensional interventions grounded in the International Classification of Functioning, Disability and Health (ICF). Sport-based exercise interventions, when developmentally adapted and tailored to individual interests, may promote intrinsic motivation, peer connection, and sustainable engagement—factors especially relevant in pediatric ABI populations, who often experience reduced physical activity and social isolation. However, standardized, replicable protocols specifically tailored to this population remain scarce. This study presents the protocol for a randomized controlled trial evaluating the effects of a 16-week sport-based intervention on QoL, social participation, physical activity engagement, and motor functioning tailored for adolescents with pediatric ABI. Methods: Participants will be randomly assigned to an intervention group or a control group receiving usual care. The intervention consists of one weekly 60-minute session, led by trained professionals in adapted physical activity and pediatric neurorehabilitation. It combines sport-based motor skill training, cooperative games, and group activities specifically tailored to each child’s developmental level, motor abilities, and preferences. Outcomes will be assessed at baseline and following the 16-week intervention period, focusing on QoL, participation, physical activity engagement, and motor functioning. Discussion: This study introduces a structured, child-centered model that bridges clinical rehabilitation and community-based sport. By integrating motor and psychosocial targets through a group sport-based intervention, it aims to enhance recovery across ICF domains. Findings may inform interdisciplinary practice and support the development of sustainable strategies to promote long-term engagement and well-being in adolescents with ABI. Full article

Objectives: Acute drug poisoning represents a significant public health issue among the pediatric population. The aim of this study was to evaluate the characteristics of drug poisoning in children and adolescents in the Vojvodina region from 2018 to 2023. Methods: In a retrospective observational study, 82 patients with confirmed drug poisoning were included, and data was collected regarding demographic characteristics, clinical manifestations, types of drugs involved, and the therapeutic interventions administered. The severity of poisonings was evaluated using the Poisoning Severity Score, and toxicological analysis was performed using gas chromatography–mass spectrometry. Results: The results indicated that poisonings were most prevalent in adolescent girls (72%), with 78% of cases resulting from intentional poisoning, while unintentional poisoning was more common in children. Benzodiazepines, antipsychotics, and analgesics were the primary drugs causing these poisoning incidents. The majority of patients (78%) experienced mild clinical symptoms, whereas 9% of pediatric patients suffered from severe poisoning, related to complications such as aspiration pneumonia and acute renal failure. Addressing pediatric drug poisoning in Vojvodina requires an increased focus on preventive strategies, including parental education and appropriate psychosocial support for the youth. Conclusions: Through collaborative efforts among healthcare providers, educators, and policymakers, prevention, treatment, and support mechanisms can be enhanced to combat this pressing public health challenge. Full article

Background: Parenting styles are associated with various health outcomes among children, such as fruit and vegetable consumption, physical activity, and emotional well-being. Previous literature suggests that responsive parenting styles are associated with improved mental health outcomes. This study examines the association between an adult’s responsive parenting style and the psychosocial outcomes of emotion regulation and loneliness among children. Methods: Using data from the U.S. National Cancer Institute’s Family Life, Activity, Sun, Health, and Eating (FLASHE) cross-sectional survey, this secondary data analysis study seeks to understand how perceived parental responsiveness is associated with adolescents’ emotional health outcomes from the perspective of the adolescent. The sample consisted of 12- to 17-year-olds (n = ~1560), mostly female (50.2%) and non-Hispanic White (63.7%), with a mean age of 14.48 years (SD = 1.61). Results: Through multivariable regression, we found that perceived parental responsiveness negatively predicted adolescent emotion suppression (β = −0.29, p < 0.001), even after controlling for sex, age, race/ethnicity, parental marital status, parental education level, parent’s time spent at work, and the number of kids in the household (β = −0.29, p < 0.001). We also found that perceived parental responsiveness was the strongest predictor for adolescent loneliness (β = −0.27, p < 0.001), even when controlling for sex, age, race/ethnicity, parental marital status, parental education level, parent’s time spent at work, and the number of kids in the household (β = −0.28, p < 0.001). Conclusions: These results suggest that implementing interventions targeting parental responsiveness may be beneficial to improving adolescents’ emotional well-being. Full article

Identification of temporal relations among suicide mortality and economic/political implementations provides important information for not only planning suicide prevention but also socioeconomic/psychosocial measures. This cross-sectional observation study analyzed temporal fluctuations and causalities of suicide mortalities of working-age individuals, disaggregated by age/gender/social standing (employed/unemployed), in Japan from 2009 to 2024, using government databases, by joinpoint and vector-autoregressive analyses. Suicide mortality among total and employed females decreased until the COVID-19 pandemic outbreak but sharply increased, synchronized with the pandemic outbreak, before resuming a downward trend. Among males, the decreasing trends attenuated from 2016, followed by a transient increase in 2022. Unemployed males aged 40–69 exhibited four joinpoints: 2016 (decreasing–increasing), 2018 (increasing–decreasing), 2022 (decreasing–increasing), and 2023 (increasing–stable). In contrast, suicide mortality among unemployed females aged 40–69 sharply increased in 2022 and maintained the high level. Among individuals aged 30–39, suicide mortality reversed from decreasing to increasing in 2016 (males) and 2018 (unemployed females). Economic expansion was protective for employed individuals but had no significant effect on unemployed populations. The government management instability (AENROP) index was positively associated with suicide mortality among employed and unemployed males and employed females. Unemployed females aged 30–39 were sensitive to AENROP but not economic conditions, while those aged 40–69 were largely unaffected by either. Increasing employment of individuals with psychiatric disabilities was positively associated with suicide mortality among unemployed males (30–69) and females under 40. Positive impacts of the employment rates of individuals with psychiatric disabilities and unemployment enhanced from 2016 and 2022, respectively, whereas the impacts were inconstantly affected by political rather than economic factors. Suicide mortality among unemployed individuals has emerged as a critical public health concern in Japan, with rates more than doubling among males and tripling among females in the 2020s. These findings underscore the need for integrated suicide prevention policies that address both labor market vulnerabilities and psychosocial determinants. Full article

Background: Article 32 of the Italian Constitution guarantees the right to health for all citizens, including detainees. Prison populations face unique health challenges due to high-risk lifestyles, psychosocial stressors, and limited access to care. This study aimed to investigate the burden of chronic diseases and associated risk factors among male inmates in a central Italian prison. Methods: This cross-sectional study was conducted in accordance with STROBE guidelines at Giuseppe Pagliei Prison in Frosinone, Central Italy, from May 2022 to May 2023. A total of 477 adult male inmates underwent systematic clinical evaluations and medical record reviews. Demographic and health data were analyzed to determine the prevalence of chronic conditions and related risk factors. Results: Participants (mean age 47.3 ± 13.1 years; 69.6% Italian, 30.4% international, mainly Eastern European and African) presented on average 1.8 chronic conditions. The most frequent diagnoses were psychiatric disorders (19.9%), cardiovascular diseases (17.2%), and osteoarticular disorders (14.5%). Disease burden correlated with aging, unhealthy lifestyles, and incarceration-related stressors. Tobacco smoking was highly prevalent. Conclusions: Male inmates show a considerable and partly preventable burden of chronic disease. Broader policy measures, including alternative sentencing and community-based rehabilitation, may mitigate the health impact of imprisonment while ensuring public safety. Adequate prison healthcare remains a public health priority and a constitutional and human rights obligation. Full article

This narrative review examines the complex relationship between sleep changes during the menopausal transition and cardiometabolic risks. The most common complaint about sleep is increased awakenings during sleep. Other complaints include having trouble falling asleep, waking up too early, insufficient and non-restorative sleep, and overall poor quality. Sleep determined using objective methods also indicates that greater awakenings after sleep onset are associated with the period of menopausal transition. Polysomnography recordings suggest physiological hyperarousal during sleep. Changes in other sleep metrics, such as sleep latency and sleep duration, are less consistent, and some studies suggest they may not worsen during the menopausal transition. These sleep issues are influenced by multiple factors, such as hormonal fluctuations, vasomotor symptoms, and psychosocial factors, and evidence suggests that hypothalamic kisspeptin/neurokinin B/dynorphin (KNDy) neurons are key underlying mechanisms for these associations. The menopausal transition is also associated with increases in cardiometabolic risk factors, such as body fat, altered lipid profiles, blood pressure, and vascular health. Emerging evidence suggests that poor sleep health during this period is associated with increased cardiometabolic risks and adverse cardiovascular outcomes. Thus, addressing sleep disturbances is crucial for comprehensive healthcare during the menopausal transition to safeguard long-term cardiometabolic health. Future research is needed to investigate interventions that can improve sleep and their impact on cardiometabolic health in this population experiencing increases in cardiometabolic risk. Full article

Background/Objectives—The personalisation agenda—matching the correct psychological therapy to diverse and comorbid mental disorders—is an unanswered dilemma in the worldwide literature which has far reaching consequences for public health. This hypothesis article addresses the question: can a biomedical approach resolve the personalisation agenda? Methods—Narrative review drawing on clinical psychology, translational psychiatry, and biomedical science literature. Results—Diverse attempts to resolve the personalisation agenda have not yet succeeded. Randomised controlled trials are uniquely biased due to unwanted placebo effects; network meta-analysis cannot address adequately which psychological therapy to use; new methodologies have not yet produced data; and neuroscientific analysis cannot yet explain how trauma-based therapies work. However, a biomedical model which divides psychological therapy into low, medium and high intensity interventions can resolve the personalisation agenda. Conclusions—Combining low intensity (placebo), with medium intensity (cognitive behavioural techniques) and high intensity interventions (trauma-based therapies) are theoretically synergistic if combined with psychosocial treatments/exercise, and used in sequence in the correct order. A biomedical model based on recent advances in placebo studies and neuroplasticity can resolve the personalisation agenda, and improve outcomes for mental disorder. Full article

Suicide, a major contributor to global mortality rates, especially among young patients, remains insufficiently integrated into public health initiatives despite notable progress in identifying its determinants. The prediction of suicidal behavior remains complex, often relying on subjective assessments rather than objective biomarkers. Single nucleotide polymorphisms (SNPs) such as rs110402 (CRHR1 gene), rs3800373 (FKBP5 gene), and rs2289656 (NTRK2 gene) have been linked to physiological mechanisms involving stress response and activation of the hypothalamic–pituitary–adrenal (HPA) axis, which contributes to anxiety and stress regulation. This study aimed to assess stress-related gene polymorphisms in individuals with suicidal behavior compared to controls. According to our results, the presence of the A allele of rs2289656 was associated with a protective effect, while the GG genotype conferred a higher susceptibility to suicidal behaviors. Significant associations were observed between trauma and abuse history and the rs110402 polymorphism in CRHR1 gene, highlighting a protective role for the GG genotype and increased predisposition to stress-related psychiatric conditions and suicidal behavior for A allele carriers. No valid associations were found for rs3800373 in the FKBP5 gene, although suggestive trends related to depression and self-aggression were noted. Our findings underscore the need to identify reliable biomarkers associated with suicide risk, highlighting the importance of integrating hereditary and psychosocial data to better understand the underlying mechanisms and to support the development of effective early interventions. Full article