Ramadan Fasting: Effect on Anxiety Using The DASS-42 Scoring System

@#Introduction: Ramadan fasting affects dietary propensity and mental health. As part of their courses, medical students encounter stressors such as examinations, college assignments, and others that can impact their mental health and contribute to conditions such as anxiety. Limited research has been conducted to date on the impact of Ramadan fasting on anxiety scores among college students. This study aimed to explore the impact of Ramadan fasting on anxiety using DASS-42 scoring system. Methods: A prospective cohort analytic study was conducted with a cross-sectional approach and a one-group pretest-posttest design. A total of 242 medical students were sampled and selected by consecutive sampling. The DASS-42 questionnaire was used to evaluate the respondents’ anxiety scores. Results: We found 99 respondents were experiencing anxiety while 143 were normal. The findings revealed that the anxiety scores fell during the pre- to post-Ramadan period for all respondents (p = 0.003), the respondents who had anxiety (p = 0,000), and the normal respondents (p = 0.001). Conclusion: The current study reports that Ramadan fasting was proven to reduce the anxiety scores of all students including those who experienced anxiety and normal subjects.

Psychological Distress and Its Association with Functional Disability Index Among Acne Patients Attending Dermatology Clinics in the Kuantan Tertiary Hospitals

@#Introduction: Acne is the most common skin disease among adolescents and has significant psychological distress. Our objective is to assess acne severity, functional disability, and its psychological distress among acne patients. Methods: A cross-sectional study was conducted from November 2021 to May 2022 among 163 acne patients attending Dermatology Clinics in the district of Kuantan, Pahang. The severity of acne was graded using the Comprehensive Acne Severity Scale (CASS). The functional disability index was measured using a Cardiff Acne Disability Index (CADI), while Depression, Anxiety and Stress Scale (DASS-21) questionnaires were used as a screening tool to detect the psychological distress of acne. Data were analysed using a Chi-square test, Fisher’s exact test and multiple logistic regression. Results: The mean age was 23 years, 60.1% were female, 94.5% were Malay, and 68.1% were unemployed. The severity of acne was more prominent in the mild (30.7%) and moderate (28.2%) categories. A total of 20.2%, 11.7%, and 4.9% of the respondents had anxiety, depression, and stress symptoms, respectively. Regarding the respondents’ functional disability, 40.5% had mild impairment, 38.0% had moderate impairment, and 13.5% had severe impairment. Acne severity was found to be significantly associated with the functional disability index (P<0.05). The functional disability index was also found to be significantly associated with depression (p=0.019) and anxiety symptoms (p=0.042). Conclusion: Clinical management of acne patients should include not only pharmacological treatment but also consideration of the disease’s functional disability status and psychological distress.

Physiological Response and Impact of COVID-19 Pandemic among Malaysian Citizens: A Cross-sectional Study

@#Introduction: Studies have shown that staying at home for prolonged periods of crisis can pose a significant challenge to individuals and affect their mental health. Hence, this study was conducted to identify the susceptible subgroups among Malaysian citizens that are prone to mental health problems during the lockdown period of the COVID-19 pandemic and its association with sociodemographic factors. Methods: The mental health status was assessed using the Depression, Anxiety, and Stress Scale -21 (DASS-21) questionnaire. The survey link was distributed online between October and December 2020. Results: Of 637 respondents, one-third experienced mild to extremely severe depression and anxiety (31.1% and 35.1%, respectively). Female respondents (odds ratio = 1.516, 95% confidence interval (CI) 1.057-2.172) were 1.5 times more likely to experience mild to severe depression than male respondents. Unmarried and divorced respondents were 2.1 times more prone to experience mild to severe depression than married respondents. A significant association was also found between employment status and age with depression symptoms among the respondents. For anxiety, a significant association was observed between the age group with mild to severe anxiety symptoms. Marital status, age, and employment status were socio-demographic factors significantly impacting stress levels. Conclusion: According to our findings, females, individuals aged 18-30 years old, students, unmarried and divorced respondents were more susceptible to mental health problems, suggesting that mental health support shall also be provided for these vulnerable groups during the COVID-19 crisis.

Depression, Anxiety, and Stress Scale: Factor validation during the first COVID-19 lockdown in Mexico

Introduction: Globally, mental health problems have affected nearly 1 billion people and approximately 1 in 10 Mexicans. The detection and surveillance of depression, anxiety, and stress in Mexico requires more reliable and valid instruments. Objective: To determine the factor validity and internal consistency of the Depression, Anxiety, and Stress Scale-21 items (DASS-21) in a non-probabilistic national sample of Mexican adults. Method: Cross-sectional study by means of an online survey of 1 613 Mexican adults aged 18 years and older. The Spanish version of the DASS-21 was used, which evaluates the presence of depressive symptoms, anxiety, and stress. Factor validity was determined by comparing different confirmatory factor analysis models: one-dimensional, three factors (correlated and non-correlated), second order, and bifactor. Results: The application of the bifactor model to the DASS 21, supports its validity for identifying the presence of symptoms of depression, anxiety, and stress, as well as an altered general emotional state in a sample of Mexican adults. Conclusions: The DASS-21 is a theoretically robust instrument useful for research and clinical practice.

Introducción: A nivel global los problemas de salud mental han alcanzado a cerca de 1 billón de personas y aproximadamente a uno de cada diez mexicanos. La detección y vigilancia de depresión, ansiedad y estrés en México demandan instrumentos más confiables y válidos. Objetivo: Determinar la validez factorial y consistencia interna de la Escala de Depresión, Ansiedad y Estrés (DASS-21) en una muestra nacional no probabilística de adultos mexicanos. Método: Estudio transversal por medio de una encuesta en línea entre 1 613 adultos me-xicanos de 18 años o más. Se utilizó la versión en español del DASS-21 que evalúa la presencia de síntomas depresivos, ansiedad y estrés. La validez factorial se determinó mediante la comparación de distintos modelos del análisis factorial confirmatorio: unidimensional; tres factores (correlacionados y no), de segundo orden, y bifactor. Resultados: La aplicación del modelo bifactor al DASS-21 sustenta su validez para identificar la presencia de síntomas de depresión, ansiedad y estrés, así como de un estado general emocional alterado en una muestra de adultos mexicanos. Conclusiones: El DASS-21 es un instrumento teóricamente robusto útil para la investigación y la práctica clínica.

An assessment of mental health of Mexican and Colombian medical students during the COVID-19 pandemic / Una evaluación de la salud mental de estudiantes de medicina Mexicanos y Colombianos durante la pandemia de COVID-19

Abstract Introduction The COVID-19 pandemic caused the cessation of academic activities from the face-to-face format to confinement and virtual classes, in which little is studied about its effect on mental health. Objective Determine levels of depression, anxiety, and stress in medical students in Mexico and Colombia during the COVID-19 pandemic. Furthermore, depression, anxiety, and stress were compared by gender, education status, and country. Method A cross-sectional study was carried out with 426 medical students. Data was collected using an online survey containing the Depression, Anxiety, Stress Scale (DASS-21) questionnaire. Results Overall scores for depression, anxiety, and stress were 6.7 ± 1.2, 8.8 ± 1.2, and 5.6 ± 1.2, respectively. Females had significantly higher overall scores for depression (.24-fold increase), anxiety (.25-fold increase), and stress (.40-fold increase) than males (p ≤ .01). The risk for anxiety and stress by school year showed that basic years were associated with higher scores than advanced years (.25 and .38-fold increase, respectively). For females, starting medical school did show an increased risk of depression when compared to male students in their basic years (.38-fold increase). Lastly, students from Mexico had an increased risk for depression and anxiety (p ≤ .022 and p ≤ .004, respectively) but not for stress (p ≤ .402), when compared to students from Colombia. Discussion and conclusion Significant anxiety and depression were observed in medical students from Mexico and Colombia. Factors associated with an increased risk of depression and anxiety are students in their basic years as well as being female.

Resumen Introducción La pandemia de COVID-19 provocó el cese de las actividades académicas desde el formato presencial al confinamiento de las clases virtuales, de las que poco se ha estudiado sobre su efecto en la salud mental. Objetivo Determinar los niveles de depresión, ansiedad y estrés en estudiantes de medicina de México y Colombia durante la pandemia de COVID-19; además de comparar depresión, ansiedad y estrés por género, nivel educativo y país. Método Se realizó un estudio transversal con 426 estudiantes de medicina. Los datos se recopilaron mediante una encuesta en línea que contenía el cuestionario DASS-21. Resultados Las puntuaciones generales de depresión, ansiedad y estrés fueron 6.7 ± 1.2, 8.8 ± 1.2 y 5.6 ± 1.2, respectivamente. Las mujeres tuvieron puntajes generales significativamente más altos para depresión (.24-fold increase), ansiedad (.25-fold increase) y estrés (.40-fold increase). El riesgo de ansiedad y estrés por año escolar mostró que los años básicos se asociaron con puntajes más altos que los estudiantes en años los avanzados (.25 y .38-fold increase). Para las mujeres, cursar años básicos mostró un mayor riesgo de depresión en comparación con los estudiantes varones (.38-fold increase). Por último, los estudiantes mexicanos tuvieron un mayor riesgo de depresión y ansiedad (p ≤ .022 y p ≤ .004, respectivamente) pero no de estrés (p ≤ .402) en comparación con los estudiantes Colombianos. Discusión y conclusión Se observó ansiedad y depresión significativas en estudiantes de medicina mexicanos y colombianos. Los factores asociados a un mayor riesgo de depresión y ansiedad fueron; ser estudiante en años básicos además de ser mujer.

STUDY OF DEPRESSION, ANXIETY & STRESS AMONG FAMILY MEMBERS OF HOSPITALIZED COVID-19 PATIENTS IN A TERTIARY CARE HOSPITAL OF CENTRAL GUJARAT

Background: COVID-19 pandemic has caused mental health issues along with physical, social, and economic issues in both patients and their relatives.COVID-19-positive patients were hospitalized in isolation with no or limited access to relatives. These conditions may have contributed to signi?cant psychological distress in relatives and this study was designed to assess the same. To ?nd the prevalence of Depression, Anxiety, and Stress Objectives: among Relatives of hospitalized COVID-19 patients. A cross-sectional quantitative tertiary care hospital-based Methods: study was conducted after approval from Institutional Human Ethics Committee. Relatives of hospitalized COVID-19 patients were assessed by purposive sampling method using Semi-Structured Performa including socio-demographic details, illness- related details, and DASS-21 (Depression, Anxiety, and Stress scale-21) via a telephonic mode of interview. A total of Results: 200 relatives of COVID-19 positive turned negative patients were interviewed on the ?rst day of the COVID 19 negative report. Majority of participants were male,mean age 41 years,literate,married & having ?rst degree relation with the patient. The prevalence of Depression, Anxiety and Stress was 12%. On individual parameters, Depression, Anxiety and Stress was found 25%,21%,and 20% respectively. Female relatives were signi?cantly associated with depression (?2= 8.689,P=.003) & anxiety(?2= 5.790,P=.016) where as longer hospitalization was signi?cantly associated with anxiety(?2= 10.216,P=.006) and stress(?2= 8.936,P=.011). Relatives of COVID-19 patients had a signi?cant amount of psychological stress. Conclusions: Female gender of relatives and longer duration of hospitalization of patients were important predictors.

Mental Health of University Students in Northern Malaysia

Context/Background: Today, poor mental health is one of the most neglected diseases although it is one of the leading causes of disabilities in both developed and developing countries. This mental health issue be-comes a problem among university students too. This study was aimed to determine the prevalence and asso-ciated factors of depression, anxiety, and stress (DAS) among university students. Methodology: A cross-sectional study was carried out in a private university of northern Malaysia during 2020. A random sample of 161 students were included and DASS-21 was used to determine the prevalence of DAS. Multiple logistic regression analysis was performed to examine the associated factors. Results: The prevalence of DAS among students were 34.8%, 42.2%, and 33.5%, respectively. In contrast to years 2 and 4, the prevalence of all types of mental disorders were lower in years 1 and 3. The students’ living area, residence, academic year, and parental income were significantly associated with anxiety whereas the age group of the students and parent’s income did so for depression. The variables; age group, academic year and parent’s income were identified as significant determinants for the presence of stress among students. Conclusions: The significant extent of the mental health problems was detected among university students in Malaysia. Despite the small sample, this analysis indicates that opportunities exist to improve campus-based mental health education and psychological support among university students.

Assessment of psychological distress pattern & its correlates among people receiving COVID-19 vaccination during the COVID-19 pandemic: A cross-sectional study

Background & objectives: There is a possibility that vaccinated people may experience lesser psychological distress due to the sense of safety felt by them against getting the COVID-19 infection as compared to those who are not vaccinated. However, there is a paucity of research examining the mental health status of this important sub-group of population. Thus, the present study was aimed to examine the pattern of psychological distress and its correlates among people receiving COVID-19 vaccine. Methods: This cross-sectional study assessed individuals receiving COVID-19 vaccine at a tertiary care hospital. Psychological distress and COVID-19-related anxiety were assessed using the Depression Anxiety Stress Scale (DASS-21) and the COVID-19 Anxiety Scale-7, respectively. Results: The study comprised 728 individuals with a mean age of 44.8 yr. Moderate levels of depression, anxiety and stress were reported by about 50, six and 15 per cent of the participants, respectively, as assessed on DASS-21. Generalized linear model and quantile regression analyses revealed COVID-19-related anxiety, and being a healthcare worker or front-line worker as significant correlates of psychological distress. Interpretation & conclusions: About half of the study participants receiving COVID-19 vaccine reported moderate to severe symptoms of depression. Strategies focusing on alleviation of COVID-19-related fear and anxiety might be effective in improving the symptoms of psychological distress

Escala de Depressão, Ansiedade e Estresse (EDAE-21): propriedades psicométricas em gestantes brasileiras / Depression, Anxiety and Stress Scale (DASS-21): psychometric properties in brazilin pregnant women / Escala de Depresión, Ansiedad y Estrés (EDAE-21): propiedades psicométricas en mujeres embarazadas brasileñas

Apesar do crescente avanço no uso de instrumentos para a avaliação da saúde emocional nos períodos perinatal e puerperal, destaca-se que a maioria das ferramentas utilizadas não possui evidências psicométricas para a população de gestantes. A Escala de Depressão, Ansiedade e Estresse (EDAE-21) possibilita a mensuração simultânea de níveis de ansiedade, estresse e depressão. O estudo objetivou avaliar a consistência interna da EDAE-21, a validade convergente da escala em relação ao IDATE, à EEP e ao BDI-II, e a estabilidade das avaliações em um intervalo de até 12 semanas. Participaram da pesquisa 53 gestantes (primeira avaliação) e 35 gestantes (segunda avaliação). A escala apresentou índices de consistência interna, estabilidade e convergência adequados à população investigada. A EDAE-21 pode auxiliar profissionais e pesquisadores da saúde, proporcionando agilidade no diagnóstico de indicadores emocionais desfavoráveis em diferentes períodos gestacionais.

Despite the increasing progress in the use of instruments to assess emotional health in the perinatal and puerperal periods, it is emphasized that most of the tools used do not have psychometric evidence for the population of pregnant women. The Depression, Anxiety and Stress Scale (DASS-21) enables the measurement of anxiety, stress, and depression levels, simultaneously. The study aimed to assess the internal consistency of the DASS-21, the convergent validity of the scale in relation to the State-Trait Anxiety Inventory (STAI), the Beck Depression Inventory ­ second edition (BDI-II), and the Perceived Stress Scale (PSS) and the stability of the evaluations in a range of up to 12 weeks. Fifty-three (first evaluation) and 35 pregnant women (second evaluation) participated in the research. The scale showed adequate internal consistency, stability, and convergence rates for the investigated population. The DASS-21 can help practitioners and researchers of health, providing agility in the diagnosis of unfavorable emotional indicators in different gestational periods

A pesar del creciente progreso en el uso de instrumentos para evaluar la salud emocional en el período perinatal y puerperal, se destaca que la mayoría de las herramientas utilizadas no tienen evidencia psicométrica para mujeres embarazadas. La Escala de Depressión, Ansiedad y Estrés (EDAE-21) mide simultáneamente los niveles de ansiedad, estrés y depresión. El estudio evaluó la consistencia interna del EDAE-21, la validez convergente de la escala en relación con el STAI, el BDI-II y el EEP y la estabilidad de las evaluaciones en un intervalo de hasta 12 semanas. 53 mujeres embarazadas (primera evaluación) y 35 mujeres embarazadas (segunda evaluación) participaron en la investigación. La escala presentó valores de consistencia interna, estabilidad y convergencia adecuados para la población investigada. El EDAE-21 puede ayudar a los profesionales de la salud y a los investigadores, proporcionando agilidad en el diagnóstico de indicadores emocionales desfavorables en diferentes períodos de gestación.

Depression, anxiety, and stress among the 1st year medical students in Kanchipuram District

Background: Medical education is a full-time commitment and responsibility of students that include academic assignments, activities, social behavior, support, and patient care. The health of students around the world is becoming a major concern as they are more prone to depression, stress. Aim and Objective: This study aims to assess the severity of depression, anxiety, and stress in the Ist year medical students. Materials and Methods: The DASS 42 questionnaire was used to study stress, depression, and anxiety. The DASS is a 42-point questionnaire containing three self-report scales designed to measure the negative emotional states of depression, anxiety, and stress. Results: It was found that 16%, 25%, and 27% of medical students were affected by mild symptoms of depression, anxiety, and stress. About 11%, 12%, and 4% of medical students with moderate depression, anxiety, and stress; 12%, 4%, and 3% of medical students with severe depression, anxiety, and stress; and 3%, 4%, and 1% of medical students suffered from extremely severe depression, anxiety, and stress. Conclusion: In our study, emotional distress is common medical students and attention, support, and personalized counseling are compulsory for the students.

Investigation of Intestinal Absorption Characteristics of Multi-index Components of Danggui Buxuetang Based on Drug Absorption Simulating System / 中国实验方剂学杂志

ObjectiveTo investigate the intestinal absorption characteristics of multi-index components in Danggui Buxuetang with drug absorption simulating system （DASS） established by everted intestinal sac model. MethodThe intestinal absorption solution at different time points after administration of Danggui Buxuetang was collected and detected by high performance liquid chromatography （HPLC）， acetonitrile （A）-0.2% glacial acetic acid solution （B） was used as the mobile phase for gradient elution （0-16 min， 15%-23%A； 16-20 min， 23%-28%A； 20-25 min， 28%-30%A； 25-30 min， 30%A； 30-35 min， 30%-65%A； 35-45 min， 65%-95%A）， the detection wavelength was 302 nm. HPLC fingerprint of intestinal absorption solution was established and the common peak was calibrated， and the relative cumulative absorption rate of each index component was calculated. The relative cumulative absorption curves of components were fitted with various mathematical models by DDSolver 1.0 to explore the absorption law of different components. ResultThe absorption process of C2 （calycosin-7-glucoside） and C6 in Danggui Buxuetang was in line with zero-order equation， C9 was best fitted by Weibull equation， and the remaining 7 components were in line with Makoid-Banakar equation. C1 with C2， C3， C5， C7 and C10， C2 with C5 and C7， C3 with C4， C5， C7 and C10， C4 with C6 and C10， C5 with C7， C6 with C10， C7 with C10， C8 with C9 were absorbed simultaneously during the absorption process. With the prolongation of time， the overall cumulative absorption rate of Danggui Buxuetang increased. At 120 min， the overall cumulative absorption rate of Danggui Buxuetang exceeded 38%， and reached 49.14% at 180 min. ConclusionTen ingredients in Danggui Buxuetang are absorbed in the jejunum， but absorption law of various components is different， which shows that the intestinal absorption of compound preparations of traditional Chinese medicine （TCM） has multiple characteristics. Intestinal absorption study of TCM compound preparations with chemical composition as the index can reveal some of its absorption law， but it is not complete.

A Study to Assess the Psycho-Social Implications of the COVID-19 Pandemic in India

Background: In response to the COVID-19 pandemic, the Indian Government called for a nation-wide quarantine or ‘Lockdown’ from 21st March 2020. While initially planned for 21days, satisfactory disease control was not achieved and cases continued to rise till November 2020. It is well established, that a Pandemic is associated with a decline in mental health of the population. This study was conducted in order to assess the prevalence, as well as to understand the causative factors for Depression, Anxiety and Stress in the population. Methodology: An online questionnaire including a consent form, semi-structured proforma, and the DASS- 21 was administered via various platforms. All subjects above 18 years of age, willing to give informed consent were included, while those with pre-existing psychiatric illness were excluded from the study. A total of 504 responses were thus analysed. Results: According to this study, 48.4% of the participants showed signs of psychiatric morbidity; younger age groups and females were more severely affected. Isolation and loneliness, fear of infection and death were reported as major causative factors. Conclusions: Thus, during a disease pandemic, another pandemic of mental illness may also be present. It is important to recognize and take measures to prevent such ill-effects of otherwise protective measures like quarantine.

Comparison of stressful life events among family caregivers of cancer, mental retardation and schizophrenia patients leading to stress, anxiety and depression and its effect on quality of life

Background: Mental retardation (MR), schizophrenia and cancer are chronic disorders, requiring long term treatment along with family support. Principal caregiver is usually nonprofessional family person who play a pivotal role in supporting the patient medically, emotionally and financially which in turn affects their own health and quality of life. To identify stressful life events, level of anxiety, stress, depression and Quality of life in these family caregivers (FC), this study was planned.Methods: After gaining consent, the FC were assessed on Presumptive Stressful Life Events Scale (PSLE), Depression Anxiety Stress Scale (DASS) and WHO Quality of Life -Bref Scale (WHOQOL-Bref). Data so gained was analyzed by SPSS-21 and results were drawn.Results: 66 FC of cancer patients, 39 FC of MR patients and 53 FC of Schizophrenia patients were assessed. All three groups were found to be matched socio-demographically. On PSLE Mean of total stressful life events for cancer FC was 7±1.5, for MR 6.02±1.5 and for schizophrenia FC was 5.75±1.70 and this difference was statistically significant. Mean of total undesirable life events was 5.31±1.3, 4.33±1.34 and 3.86±1.46 respectively and this difference was also statistically significant. Similarly difference in mean stress score of total life events and for undesirable events was also statistically significant. On DASS scale no statistically significant difference was found within the groups. Quality of life was significantly low depicting high impact on physical health and social life of these care givers.Conclusions: Family Caregivers of cancer, mental retardation and schizophrenia groups are highly affected and there is urgent need to address these issues for early diagnosis and treatment.

Level of Depression, Anxiety, Stress, and Coping Strategies among Filipino Healthcare Workers (HCW) with Confirmed Covid-19 Infection using the Filipino-translated Depression Anxiety Stress Scale (DASS) 21 and Filipino Coping Strategies Scale in Perpetual Succour Hospital from March 2020 to September 2020: A One-Center Descriptive Study

@#INTRODUCTION: COVID 19 has become the most important public health issue today. It has the potential to significantly affect the mental health of frontline healthcare workers (HCW) putting them at a higher risk of developing psychological problems especially to those who acquired COVID19 infection. OBJECTIVES: To determine the level of depression, stress, anxiety and coping strategies among Filipino HCWs with confirmed COVID-19 infection and its association with demographic and clinical profiles. STUDY DESIGN: Single center Descriptive study materials and methods consisted of 114 Filipino HCW with COVID 19 infection. Data were collected utilizing the Filipino translation of DASS 21 and Filipino Coping Strategy scale. RESULTS: There was a significant increase of HCWs with moderate depression, anxiety, and stress. A large proportion of the HCWs were also severely depressed, severely anxious and severely stress. Majority of the COVID19 positive HCWs were nurses accounting to 35%. More likely, the occupation was significantly associated with their degree of depression and stress. Hypertension associated significantly with elevated stress while having diabetes was instrumental for the depression, anxiety and stress. Moreover, appreciation was more felt at the workplace, then at home. While discrimination was prevalent in the community, workplace and social media. Religiosity ranked the most sought coping strategy. CONCLUSION: The study has found that a large percentage of HCWs had moderate level and a notable portion of respondents had severe to extremely severe level in each of the psychological domains in which factors such as gender, occupation, comorbidities, area of assignment and disease severity have brought significant impact. Discrimination is prevalent in the community and surprisingly in the workplace. In contrast, appreciation was felt more at home and in the workplace. Religiosity was shown to be the top coping strategy among HCWs who tested positive.

Study of Incidence of Depression, Anxiety and Stress Among the First Year Medical Students in Government Medical College

To study the incidence of depression, anxiety and stress in first year MBBS students of governmentmedical college Jammu. Materials and Methods: the study was conducted on 120 first year MBBS studentsof Govt. Medical College Jammu after informed consent and ethical clearance. All of them were asked tofill DASS - 21 questionnaire without disclosing their identity. Only 118 students responded by filling up theform. The DASS - 21 questionnaire forms so obtained were analyzed, statistically and tabulated. Themean scores for depression was 6.66+5.82, (range-0.00-21), Anxiety was 5.16 ± 3.79 (range-0.00-19.00)and stress was 7.88±5.03 (range-0.00-21). The scores are more in male hostler and student less than 19years of age. Medical studies are highly demanding and cause stress, depression and anxiety to medicalstudents and so should be rescheduled and made student friendly

The Psychological Impact and Functional Disability of Patients With Acne Vulgaris in Hospital Serdang, Malaysia: A Cross Sectional Analysis

@#Introduction: Acne vulgaris is not only associated with physical morbidity, but also associated with significant psychosocial disturbances, such as depression and suicide. The objective of this study was to examine the functional disability and psychological impact of acne vulgaris. Methods: A cross-sectional study of 55 acne patients, aged more than 12, was conducted in the dermatology clinic of Serdang Hospital from January to March 2017. Data on demographics, clinical features, current treatment modalities were collected. Acne severity was graded using Comprehensive Acne Severity Scale (CASS), Cardiff Acne Disability Index (CADI) was used to assess functional disability, while DASS-21 was used to assess three related states of depression, anxiety and stress. Statistical analysis was done using SPSS software. A p value ≤ 0.05 considered significant. Results: The mean age was 23.2 (14-46), majority were females (39, 70.9%), Malays (44, 80%) and students (34, 61.8%). 53 (96.4%) subjects had almost clear (CASS = 1) to moderate (CASS = 3) acne severity. Majority had facial acne with or without truncal involvement, 53 (96.3%). The average age of disease onset was 17.8 (9-45). 45 (81.8%) patients found their acne mild to moderately disabling. 69.1%, 45.8% and 41.8% reported feeling anxious, depressed and stressed out. CADI was found to be significantly related with depression (p=0.012), anxiety (p= 0.015) and stress (p=0.001). Relationship between CASS with CADI (p=0.07), stress (p=0.09), anxiety (p=0.13) and depression (p=0.12) were insignificant. Conclusion: Although acne vulgaris is not hazardous, it is associated with psychosocial disturbances. Early and effective treatments are necessary, especially when dealing with facial lesions

Psychological morbidities amongst house officers in Sarawak General Hospital Kuching

@#Introduction: Psychological morbidities are common amongst healthcare professionals particularly among junior house officers (HO) who are in a transitional stage from being a medical student to a doctor. They undergo many stressors during this period and hence might suffer from higher psychological morbidities such as depression, anxiety and stress. Objectives: To determine the prevalence of depression, anxiety and stress among HO in Sarawak General Hospital (SGH), Kuching, Sarawak. The socialdemographic factors were also evaluated to identify the high-risk groups. Materials and methods: This is a descriptive cross-sectional study involving 227 house officers in SGH over a period of three months. The social-demographic data such as age, sex, marital status, current posting, duration of posting, place of graduate and state of origin were obtained from interviews with the respondents. The Depression, Anxiety and Stress scale (DASS) questionnaire was completed to assess the psychological morbidities. Results: HO were found to have high prevalence of psychiatric morbidities such as depression (42%), anxiety (50%) and stress (42.7%). Foreign graduates showed a significantly higher odds of depression (odds ratio, OR: 3.851; 95% confidence interval, 95%CI: 2.165, 6.851), anxiety (OR: 2.427; 95%CI: 1.394, 4.225) and stress (OR: 2.524; 95%CI: 1.439, 4.427) as compared to local graduates.. Further, non-Sarawakians were observed to have higher odds of developing anxiety (OR: 1.772; 95%CI: 1.022, 3.073) as compared to the Sarawakians. Conclusion: HO in SGH had high prevalence of depression, anxiety and stress. Therefore, psychiatric morbidities should be screened regularly amongst the HOs in Malaysia.

Prevalence Of Stress And Its Associated Factors Among Medical Students In Sabah, Malaysia Borneo

@#Stress is accepted as the accumulation of unpleasant state of physical, mental and emotion on a person. Medical education has been known as one of the most stressful academic curriculum. Hence, medical students may subjected to multiple psychological changes and challenges throughout the years of medical education. The aim of this study was to determine the prevalence of stress and its associated factors among medical students. This cross sectional study was conducted from April to May 2018 in medical school in Sabah. It involved 396 medical students through universal sampling. Self-administered questionnaires were used as an instrument for data collection. The questionnaires included were Sociodemographic Questionnaire, Depression, Anxiety and Stress Scales 21 (DASS-21) and Medical Student Stressors Questionnaire (MSSQ). Bivariate analysis (Chi Square test, Fisher’s Exact Test, Independent T test and Man-Whitney U test) were used to analyse the association. The response rate was 90.2%. The prevalence of stress among medical students were 33.3%. Significant associated factors include financial support inadequacy (p=0.010) and all categories of medical student stressors. The mean score of the academic related stressors was found to be at 2.117 (±0.758) which was the highest mean score among medical student stressors assessed by MSSQ. The result of this study can be used as a basis for implementation of preventive measures such as provision of comprehensive, integrated and responsive mental health care services in university-based settings.@*@#

Epidemiology of stress among Nursing Undergraduate Students

Background: Stress is a double-edged sword that can either invigorate or decrease the student’s performance. Longer the duration of stress poorer the performance. Nursing students may develop feeling of inadequacy regarding the activities required during professional education which may lead to stress Aims & Objectives: To study the level of stress among undergraduate nursing students of Lucknow city and to determine the risk factors causing stress. Material & Methods: A cross-sectional study was conducted among 380 B.Sc. (Nursing) Students enrolled in government and private colleges of Lucknow city using semi-structured questionnaire and DASS 42 scale Results: 60 percent and 62 percent of total nursing student from government college and private nursing respectively were stressed. There was no statistical difference (p= 0.17) between median stress score of two colleges. Predictor for stress was gender (odds ratio =3.41) Conclusion: The study showed high level of stress among the nursing students from government college and private college. Risk factors which were responsible for stress among students were gender, sharing of room, educational expenses, academic performance, mobile phone and harassment in college.

Self-reported symptoms of depression, anxiety and stress among patients with Rheumatoid Arthritis in a Malaysian rheumatology centre - prevalence and correlates

Objective: To determine the prevalence, correlates andindependent predictors of self-reported depression, anxietyand stress in Rheumatoid arthritis (RA) patients in Hospital Melaka.Methods: This was a cross-sectional survey usingconvenient sampling of 192 RA patients who attended theRheumatology Clinic outpatient appointment, HospitalMelaka from June 2013 to December 2013. Depression,Anxiety and Stress Scale (DASS21) questionnaire was usedto evaluate symptoms of depression, anxiety and stress. RAdisease activity was assessed using the DAS28-ESRformula. Functional status was assessed via the HealthAssessment Questionnaire Disability Index (HAQ-DI).Results: Out of 189 completed questionnaires, 46%(n=86)patients reported psychological distress symptoms, and25%(n=48) experienced more than one negative emotionalstates. The prevalence of depression, anxiety and stressamong our patients were 23.3%(n=44), 42.3%(n=80) and20.1%(n=38) respectively. There were significant positivecorrelations (p<0.05) between these psychologicalsymptoms with disease activity, number of tender joints,general health, pain and HAQ score. Age was inverselycorrelated with depression, anxiety and stress. Highernumber of swollen joints correlated positively withdepression but not with anxiety and stress. HAQ was theonly independent predictor for depression (Odds Ratio[OR]=2.07; 95%CI: 1.19 to 3.61) and anxiety (OR=1.81;95%CI: 1.1 to 3.0) whilst pain was found to be independentpredictor for stress (OR=1.04; 95%CI: 1.0 to 1.1).Conclusion: The incidence of depression and anxiety in ourMalaysian sample of RA patient was comparable to thatobserved in Caucasian populations. Functional status wasan independent predictor of depression and anxiety,whereas pain was an independent predictor of stress.