Predictors associated with the mental health of Japanese male registered nurses: focusing on environments with many female registered nurses and female patients’ refusal to accept nursing services from male registered nurses / Journal of Rural Medicine

Objective: To study the improvement of the mental health of Japanese male registered nurses, we investigated the predictors associated with the Japanese version of the 12-item General Health Questionnaire (GHQ-12). For those predictors, we focused on environments with many female registered nurses and female patients’ refusal to accept nursing services from male registered nurses.Materials and Methods: This study was conducted in 93 hospitals in the Aichi, Gifu, and Mie prefectures of Japan. The analyzed subjects were 1,216 full-time male registered nurses. The average age (standard deviation) was 34.5 (9.2) years. Multiple logistic regression analysis was conducted. A GHQ-12 score of ≤3 indicated good mental health, and a score of ≥4 indicated poor mental health. “Mental health” was a dependent variable. The independent variables were: “Age”, “Male registered nurses as important partners on the job”, “Female registered nurses’ good manners toward male registered nurses”, “Fairness regarding male registered nurses’ promotions”, and “Female patients’ refusal to accept nursing services from male registered nurses”.Results: There were 728 (59.9%) full-time male registered nurses with good mental health and 488 (40.1%) with poor mental health. The mental health of the male registered nurses who had negative feelings regarding, “Male registered nurses as important partners on the job” was significantly worse, and that of those who had negative feelings regarding, “Female registered nurses’ good manners toward male registered nurses” was also significantly worse.Conclusion: Female registered nurses must recognize that their attitudes toward male registered nurses influence the mental health of male registered nurses. Hospital managers should provide male registered nurses who cannot establish appropriate relations with female registered nurses with consultation opportunities. Such organizational action by managers is necessary.

Psychometric Properties And Factor Invariance For The General Health Questionnaire (Ghq-28): Study In Peruvian Population Exposed To The Covid-19 Pandemic

@#Large-scale epidemics are known to significantly disrupt the mental health and perceived well-being of most populations. In spite of the wide range of screening tools, there are not many reliable and widespread tools for the identification of psychological symptoms in non-clinical populations during a health crisis. Objective: The aim of this study was to conduct a psychometric analysis of the Goldberg's GHQ-28, through a sample of Peruvian adults by using a confirmatory factor analysis. Materials and Methods: 434 individuals have been examined, studying the goodness and structure of the Goldberg GHQ-28 questionnaire. Result: We found high reliability indicating optimal values (Cronbach α=0.829), also there are four correlated factors that show strict invariance among the 28 items. Confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) were used to examine the structure of the subscales. There are high levels of anxiety (X=1.01) and social dysfunction (X=1.21) in the assessed sampling. Conclusion: The factorial structure obtained in this study is similar to that originally described by the researchers involved in the original questionnaire. It is concluded that GHQ-28 is suitable to explore prevalence of psychopathologies in sanitary emergency contexts for general non-psychiatric population.

Validade fatorial do Questionário de Saúde Geral (QSG-28) / Factorial validity of the Goldberg General Health Questionnaire (GHQ-28) / Validez factorial del Cuestionario de Salud General (GHQ-28)

Conduzimos pesquisa com objetivo de avaliar a validade fatorial e a consistência interna do Questionário de Saúde Geral de Goldberg com 28 itens (QSG-28) no Brasil, comparando os ajustes de sua estrutura fatorial com quatro, três e cinco fatores. Realizamos procedimento de tradução reversa (inglês-português-inglês) do instrumento. Aplicamos o QSG-28 em 878 estudantes de duas faculdades de Belo Horizonte/MG. Desenvolvemos análise fatorial exploratória, Smallest Space Analysis e análise fatorial confirmatória (AFC). Na AFC, nenhum dos modelos apresentou bons ajustes. O modelo de três fatores do QSG-28 se mostrou mais adequado que os modelos de quatro e cinco fatores para a avaliação de estudantes universitários, ainda que o modelo de quatro fatores possa ser adotado. Concluímos que o instrumento se configura em uma alternativa para rastrear alterações na saúde mental em indivíduos não clínicos, podendo ser utilizado em estudos no campo do trabalho.(AU)

This study evaluated the factorial validity and internal consistence of the Brazilian version of the 28-item Goldberg General Health Questionnaire (QSG-28), comparing the four, three and five factor adjustments of its factorial structure. A reverse translation procedure (English-Portuguese-English) of the instrument was carried out. We applied the QSG-28 with 878 students from two colleges in Belo Horizonte/MG. Exploratory factorial analysis, Smallest Space Analysis and confirmatory factorial analysis (CFA) were performed. In the CFA, none of the models presented a good fit. The three-factor model of the QSG-28 was more appropriate than the four- and five-factor models for the evaluation of college students, although the four-factor model could be adopted. It was concluded that the instrument is an alternative for screening for changes in mental health in non-clinical individuals and can be used in occupational studies. (AU)

Se llevó a cabo una investigación con el objetivo de evaluar la validez factorial y consistencia interna del Cuestionario de Salud General de Goldberg con 28 ítems (QSG-28) en Brasil, comparando los ajustes de su estructura factorial con cuatro, tres y cinco factores. El procedimiento de traducción inversa (Inglés-Portugués-Inglés) del instrumento fue realizado. El QSG-28 fue aplicado en 878 estudiantes de dos facultades de Belo Horizonte/MG. También se realizó un análisis factorial exploratorio, Smallest Space Analysis y análisis factorial confirmatorio (AFC). En el AFC, ninguno de los modelos presentó buenos ajustes. El modelo de tres factores del QSG-28 se mostró más adecuado que los modelos de cuatro y cinco factores para la evaluación de estudiantes universitarios, aunque el modelo de cuatro factores pueda ser utilizado en estudios en el campo del trabajo. Concluimos que el instrumento se configura en una alternativa para el seguimiento de alteraciones en la salud mental en individuos no clínicos, pudiendo ser utilizado en estudios en el ámbito del trabajo. (AU)

Study on the general mental health status and influencing factors of Chinese Medical Team members / 中华流行病学杂志

Objective@#To analyze the mental health status of the Chinese Medical Team (CMT) members and its influencing factors.@*Methods@#A total of 1 015 members of the CMT were recruited and surveyed by using a self-administered questionnaire and 12-item General Health Questionnaire (GHQ-12) from May 10 to June 10, 2018. Multivariable logistic regression models were used to identify risk factors for mental health problems.@*Results@#A total of 808 subjects completed the questionnaire and an estimated 25.9% of them were suspected to have mental health problems (GHQ-12≥3). Logistic model analysis indicated that family life (OR=1.928, 95%CI: 1.162-3.197), domestic work status (OR=2.069, 95%CI: 1.210-3.538), father’s health status (OR=1.703, 95%CI: 1.060-2.736), disease symptoms (OR=2.087, 95%CI: 1.363-3.194), captain (OR=1.996, 95%CI: 1.128-3.532), cultural differences (OR=2.439, 95%CI: 1.621-3.671) were the risk factors for mental health. Age (OR=0.736, 95%CI: 0.571-0.949), leisure activities (OR=0.654, 95%CI: 0.490-0.872) were the protective factors. Drinking habits (OR=7.439, 95%CI: 1.290- 42.900), loneliness (OR=4.094, 95%CI: 2.438-6.875), and respect from the hospital (OR=0.783, 95%CI: 0.610-1.004) were relative to mental health problems.@*Conclusion@#CMT members have certain mental health problems, especially young members and captains. Therefore, interventions should be implemented to improve the mental health of CMT members and to promote the development of foreign aid work.

The relationship between mental health and undergraduate student achievement:A study at Universiti Utara Malaysia / Jurnal Sains Kesihatan Malaysia

Mental health is an integral component to the formation of human capital performance. Human capital with high productivity is the key factor to the growth of a country. Thus, this study aims to investigate the relationship between the level of mental health of undergraduate students in Universiti Utara Malaysia (UUM) with their performance. Mental health was measured using the General Health Questionnaire 12-item (GHQ-12) and the performance was based on the Cumulative Grade Point Average (CGPA). A total of 316 undergraduate students at UUM had answered questionnaires that were distributed. The data were analysed descriptively and the effect of the level of mental health on performance was tested using probit model. Based on GHQ-12, 48% respondents were found to have a good mental health status. A total of 67.21% of the students who obtain CGPA 3.67 and above have a good level of health compared with only 36.08% for those with CGPA under 3.67. Based on the probit model, the level of mental health was found to be significant at 1% level in influencing the CGPA. These findings provide indication to policy makers of the importance of mental health in influencing the students’ performance. Mental health education programs should be implemented or enhanced to raise awareness of the importance of good mental health state among students in higher education institution.

The effects of armed conflict on health of children in Trincomalee, Sri Lanka / 国際保健医療

<p><b>Introduction</b></p><p>  In Sri Lanka, there was ethnic violence in the form of armed conflict that lasted 26 years from 1983 through 2009. The conflict between two ethnic groups were bogged down by terrorism or by foreign military intervention. It destroyed the life of inhabitants and it is thought to have inhibited the health and growth of children.</p><p>  A case study was conducted in Sri Lanka to establish the effects of the armed conflict on children’s health, soon after the conflict ended. The case study was aimed at using the result for planning health administration.</p><p><b>Methods </b></p><p>  400 participants aged 12 and above were selected from 10 schools of two out of 11 Divisional Secretariat Divisions in Trincomalee District in Sri Lanka. 10 schools were classified into two DS Divisions, severely devastated and less devastated. Each participant was assessed, using anthropometric techniques and questionnaires including GHQ-12.　Reliability of the questions was confirmed through back translation and the use of an English-Tamil questionnaire. The mean values of the anthropometric measurements, the mean values of score by factor analysis of GHQ-12 response, and various items of social environment were compared between the two regions. These different significances were tested using F-test, t-test and Chi-square test. </p><p><b>Results</b></p><p>  　In comparisons between two regions, body weight, height and BMI among participants in severely affected region were significantly lower. Additionally, susceptibility to infectious and endemic diseases in severely affected were significantly increased.</p><p>  Four characteristics of mental health were identified, but there was no significant difference about the state of depression between the two regions.</p><p><b>Conclusion </b></p><p>  Children in conflict zones are susceptible not only to malnutrition, but also infectious diseases caused by unhygienic living conditions. The application of simple anthropometric techniques and relevant knowledge and food distribution are important in evaluating and responding to these children’s health problems.</p>

Evaluation of Subjective and Objective Parameters of Stress in First Year Medical Students.

Introduction: Presence of stress among medical students is well known but there are very few studies that objectively prove it. This study aims to assess stresssubjectively and objectively in first year medical students by a) GHQ (General Health Questionnaire) scoring system b) measuring the biochemical parameters: serum cortisol and IgA(Immunoglobulin A). Materials and Methods: 75 students were included in the present study. Estimation of serum cortisol and Immunoglobulin A at the end of first month (time 1) and sixth month (time 2) were done by using autoanalyzers. GHQ scoring and assessment was also made at the end of the first month (time 1) and sixth month (time 2) of the first year. Results: GHQ scoring and serum cortisol for stress had significantly increased at time 2 when compared to time1. IgA levels were significantly decreased at time 2 when compared to time 1. All were found to be statistically significant. Conclusion: The study showed that first year medical course to be stressful by both subjective and objective parameters. It calls for measures to reduce stress in health professional’s education, in a process to improvise it.

Prevalência de transtornos mentais comuns em industriários da Bahia / Prevalence of common mental disorders among industry workers in Bahia, Brasil

Introdução: há poucos estudos relacionando transtornos mentais comuns e trabalhadores da indústria. Objetivo: estimar a prevalência dos transtornos mentais comuns (TMC) entre os industriários da Bahia e verificar a sua associação com a ocupação. Métodos: estudo transversal, envolvendo 41.639 trabalhadores de empresas cadastradas na Relação Anual de Informações Sociais (RAIS) e no Sistema de Gerenciamento de Risco à Saúde na Indústria, do Serviço Social da Indústria (SESI). Para mensurar os TMC usou-se o General Health Questionnaire 12 (GHQ12) e para análise dos grupos ocupacionais (GG), a Classificação Brasileira de Ocupações (CBO). Resultados: a prevalência de TMC na população foi de 11,6%. A associação dos TMC com os GG mostrou maior prevalência no GG4-trabalhadores de serviços administrativos (13,2%; RP=1,3; p<0,05). Após o ajuste pelas co-variáveis, os grupos GG1-dirigentes do poder público e de empresas (RP=2,4, p=0,00) e GG2-profissionais das ciências e das artes (RP=2,3, p=0,0) apresentaram as maiores prevalências em relação ao grupo de referência (GG3-técnicos de nível médio). Conclusão: o estudo permitiu traçar a distribuição dos TMC entre as ocupações dos industriários da Bahia, gerando informações que podem subsidiar a análise de variáveis sobre condições e organização do trabalho e a criação de estratégias que contribuam para a saúde mental dessa população. .

Background: there are few studies relating common mental disorders to industry workers. Objective: to estimate the prevalence of common mental disorders (CMD) among industry workers in Bahia, Brazil, and check association between disorders and occupations. Methods: a cross sectional study involving 41,639 workers from industries registered in the Brazilian Social Information Annual Report (RAIS) as well as in Management System on Health Risk in Industries from the Industry Social Service (SESI). To measure CMD we used the General Health Questionnaire GHQ-12, and to analyze occupational groups (GG), the Brazilian Classification of Occupations (CBO). Results: the CMD prevalence was 11.6%. The CMD association with GG showed the highest prevalence in GG4-administrative service workers (13.2%, PR=1.3, p<0.05). After adjustment for covariates, groups GG1- heads of public service and enterprises (RP=2.4, p=0.00) and GG2-science and art workers (RP=2.3, p=0.0), had the highest prevalence when compared to the reference group (GG3-technicians with secondary school level). Conclusion: the study allowed tracking CMD among industry workers' occupations in Bahia, generating information that may not only subsidize analysis on labor conditions and organization, but also develop strategies to improve industry workers' mental health. .

Study of psycho-social impairment in patients presenting with age related macular degeneration in a tertiary eye care hospital.

Background: Age Related Macular Degeneration (ARMD) is an eye condition affecting old age people causing severe vision loss. This study was carried out to assess the psycho-social impairment in the ARMD patients and compare it with the normal eye patients. Methods: A Two study groups were made: 1. ARMD patients. 2. Control group patients. Patients of both the groups were made to fill “The validated Gujarati version of: General Health Quality Questionnaire-28 (GHQ 28)”. Self-scoring was done according to 0-1-2-3 lower to higher disability respectively. Results: Prevalence GHQ Mean score of ARMD patients was 34.27 and that of normal eye patients was 24.66. 80.85% of ARMD patients and 26.73% of normal eye patients were psychosocially impaired. Conclusion: ARMD patients are psychosocially more impaired as compared to control group patients (p value <0.001, highly significant).

Reliability and Factor structure of the General Health Questionnaire-12 among university students

Introduction: The 12- item General Health Questionnaire (GHQ-12) has been translated into many languages and widely used in different settings and countries. Its reliability and psychometric properties were extensively studied in many population groups which suggested that it measures psychological distress in multidimensional construct. Objective: The objective of this study was to assess the reliability and factor structure of the Bahasa Malaysia version of the GHQ-12 among university students attending a health program at a Malaysian public university. Method: The cross sectional survey was conducted on 306 undergraduate students aged between 18 to 27 years old who visited the booth set up for mental health screening at a health program. The screening was conducted using a self-administered, validated Bahasa Malaysia version of GHQ-12 questionnaire. Results: Using exploratory factor analysis, the Bahasa Malaysia version of GHQ-12 was found to have a three factor structures namely depressive symptoms, self-esteem and perceived abilities which accounted for 58% of the item variance. The overall Cronbach’s alpha coefficient of the scale was found to be high (0.84) with each factor having acceptable inter-item consistency ranging from 0.61 to 0.82. Conclusion: The findings of the study show that the Bahasa Malaysia version GHQ-12 is reliable and has good structural characteristics. It can assess a few domains of the psychological status of university students. It also helps in providing more information on the domain which may become a focus target of intervention in the prevention of mental illness.

Agotamiento emocional y síntomas de malestar psíquico en alumnos de enfermería / Emotional exhaustion and symptoms of psychic distress in nursing students

Resumen:

Objetivos: estimar el nivel de agotamiento emocional y conocer el estado de malestar psicológico en una muestra de estudiantes de enfermería. Analizar la relación entre el agotamiento emocional y el estado de malestar psicológico percibido. Método: estudio descriptivo transversal. En una muestra de 113 estudiantes de enfermería de cuarto de grado se administraron dos cuestionarios validados: la escala del agotamiento emocional en la adaptación española del Inventario de Burnout de Maslach (MBI-GS), y la validación española del cuestionario de bienestar psicológico GHQ-12. Resultados: un 27,4% de la muestra experimentó niveles altos de agotamiento emocional. Se obtuvo una puntuación media de 9,43 (SD=7,26) en la escala de bienestar psicológico. El agotamiento emocional se asoció a la edad (r=0,252; p<0,01) y a una mayor frecuencia de malestar psíquico (r=0,494, p≤0,000). Ni el género ni el estado civil se asociaron al agotamiento emocional y al estado de bienestar psíquico.Conclusiones: un amplio porcentaje de la muestra reflejó altos niveles de agotamiento emocional, asociados a una mayor presencia de sintomatología psíquica. Por tanto, se requieren medidas a nivel formativo que permitan prevenir el desarrollo del síndrome de burnout y de sus consecuencias sobre el bienestar psicológico de los estudiantes.

Mental health issues in multiple sclerosis patients and healthy controls and their association with disease related factors.

Purpose: To investigate the mental health problems of multiple sclerosis (MS) patients, and the relationship between mental health, MS variables and disability status. Methods: The sample consisted of 80 participants, 40 MS patients and 40 Healthy Controls matched for gender, age and socioeconomic status. There were 30 (75%) women and 10 (25%) men, 27 (67.5%) Relapsing Remitting Multiple Sclerosis (RRMS) patients, 8 (20%), Secondary Progressive (SP) patients and 5 (12.5%) Primary Progressive (PP) patients in the MS group, 26 (65%) of those were on systemic treatment. The General Health Questionnaire-28 (GHQ-28) was used to screen for mental health issues. Disability status was assessed with the Expanded Disability Status Scale (EDSS). Mean comparisons were performed using Student’s t test while effect sizes were estimated by Cohen’s d coefficient. Percentage ratio differences were tested using chi-square tests, corrected by Fischer’s exact test for 1 df. Correlations were investigated using Pearson’s r coefficient. Results: MS patients exhibited significantly more mental health problems than the healthy controls. The effect size of the presence of positive MS diagnosis ranged from large to very large with respect to overall psychological distress as well as with respect to the following different dimensions of psychological distress: somatic symptoms, anxiety - insomnia, social dysfunction and severe depression. There were significantly more MS patients who could be diagnosed with mental health disorders (non psychotic disorders of axis I, DSM-IV-TR). Finally, no aspects of mental health impairment were significantly correlated with disease variables or disability status. Conclusions: Mental health problems in MS patients are evident and frequent. As they are independent of illness duration, medication or disability, special care should be taken in treating mental health problems in MS patients.

The 12-Item General Health Questionnaire as an Effective Mental Health Screening Tool for General Korean Adult Population

OBJECTIVE: The 12-item General Health Questionnaire (GHQ-12) has been used extensively in various settings across different cultures. This study was conducted to determine the thresholds associated with optimum sensitivity and specificity for the GHQ-12 in Korean adults. METHODS: Data was acquired from a sample of 6,510 Korean adults, ages 18 to 64 years old, who were selected from the 2005 Census (2,581 men and 3,929 women). Participants completed the GHQ-12 and the Korean Composite International Diagnostic Interview (K-CIDI). Receiver Operating Characteristic (ROC) curve analysis was conducted. RESULTS: The mean GHQ-12 score for the total sample was 1.63 (SD 1.98). The internal consistency of the GHQ-12 was good (Cronbach's alpha=0.72). Results from the ROC curve indicated that the GHQ-12 yielded greater accuracy when identifying mood and anxiety disorders than when identifying all mental disorders as a whole. The optimal threshold of the GHQ-12 was either 1/2 or 2/3 point depending on the disorder, but was mainly 2/3. CONCLUSION: The Korean version of the GHQ-12 could be used to screen for individuals at high risk of mental disorders, namely mood and anxiety disorders.

Factor Structure of the 12-Item General Health Questionnaire in the Korean General Adult Population / 신경정신의학

OBJECTIVES: The 12-item General Health Questionnaire (GHQ-12) has been used extensively in a variety of settings across countries. The objectives of this study were to test the factor structure and internal consistency of the GHQ-12 in the Korean general population and to test relationships among the scales, the Center for Epidemiologic Studies Depression Scale (CES-D) and the EuroQoL-5 Dimension Index (EQ-5D). METHODS: Data were acquired from a sample of 6,510 Koreans, aged 18 to 64 years old, who were randomly selected based on the 2005 census (2,581 men and 3,929 women). Participants completed the GHQ-12, the CES-D, and the EQ-5D. Exploratory factor analysis was performed for extraction of factor structures of the GHQ-12. Cronbach's alpha coefficient was used for assessment of internal consistency. Finally, correlation analysis was performed for assessment of the relationships among the three instruments. RESULTS: Results of principal axis factoring with oblique rotation solution showed that the GHQ-12 was a measure of psychological distress with a two-factor structure that jointly accounted for 38% of the variance. The internal consistency of the GHQ-12 was high (Cronbach's alpha=0.79). Concurrent validity indicated a significant positive correlation with the CES-D (r=0.68, p<0.01) and a significant negative correlation with the EQ-5D(r=-0.36, p<0.01). CONCLUSION: Findings of this study demonstrated that the Korean version of the GHQ-12 has a two-factor structure and is a reliable and valid instrument that can be used for measurement of psychological distress in Korean adults.

Acupuncture and moxibustion for patients / 全日本鍼灸学会雑誌

In this report, I trace the life of Prof. Hidetsurumaru Ishikawa who laid the foundation for the present successful development of acupuncture and moxibustion and pursued medical practice based on scientific evidence.<BR>Prof. Ishikawa was born in Toyama Prefecture. After graduation from Tokyo Imperial University, he moved to Kyoto Imperial University to work in Prof. Amaya’s laboratory.<BR>For 4 years starting from 1908, he studied in Europe, mainly under Prof. M. Verworn at Gottingen University, but also briefly visited Prof. I. Pavlov in Petersburg and Prof. E. Starling and Prof. C. Sherrington in England. He learned much about the newest science at that time, and these experiences served as a backbone for his later scientific research.<BR>After returning to Kyoto Imperial University as a professor of physiology, he developed the physiological sciences in Japan. Along with the progression of modern physiology, he came to recognize the need of a scientific approach to traditional medicine, especially acupuncture, as well as a psycho-physiological approach to analyzing human biological conditions. <BR>In the field of neurophysiology, he is famous for a sensational debate against Prof. Kato, who was one of his favorite disciples, about the conduction of electric impulses in anesthetized nerve cells:decrement or decrementless?<BR>After his retirement from Kyoto Imperial University in 1944, Prof. Ishikawa went to Tsu City as the head of Mie Prefectural Medical College, the predecessor of Mie University Faculty of Medicine and opened the department of acupuncture in the university hospital the following year. During the postwar occupation of Japan, the General Headquarters of the Allied Powers (GHQ) decided to prohibit Japanese traditional medicine, because at that time, the general condition of acupuncture and moxibustion therapy in Japan was far below Western standards.<BR>Learning of the prohibition order, Prof. Ishikawa visited the GHQ over and over again to explain with his own data the scientific basis of acupuncture and to demonstrate the benefits of acupuncture to the GHQ medical officers. Probably due to accumulated strain, in 1949 Prof. Ishikawa had a stroke during a faculty meeting and died about 2 weeks later. Prof. Ishikawa was succeeded by his apprentice, Prof. Kyugo Sasagawa of Kyoto University, who organized the Japan Society of Acupuncture. The first conference was held at Kyoto University in 1953, and the society has been continuously developing to its present successful status.

Health Related Quality of Life in Common Variable Immunodeficiency

PURPOSE: To quantify the health related quality of life in primary immunodeficiency patients. MATERIALS AND METHODS: We used generic health status and general psychological health questionnaires to determine the range of issues that needed to be considered in examining the burden of common variable immunodeficiency (CVID). RESULTS: The health status of patients with CVID was lower than that observed in normal subjects. Overall, Role-Physical and General Health scales correlated with a poorer clinical status. Surprisingly, the duration of disease did not influence health status. Being female, older, General Health Questionnaire-positive and alexithymic proved to be major risk factors associated with a poor health status. Patients with chronic lung disease and chronic diarrhea had the lowest values on the Medical Outcome Study, Short Form SF-36 (SF-36) scales. Disease severity perception was associated with the General Health Questionnaire and alexithymia status. Limitations in daily activities as a result of lower physical health were the major problems facing common variable immunodeficiency patients. CONCLUSION: Our data underlined the importance of conducting a periodical health related quality of life assessment on patients with primary antibody deficiencies and, moreover, stressed the necessity of providing psychological support to at risk patients.

Estrutura fatorial do Questionário de Saúde Geral (QSG-12) em uma amostra de professores escolares / Factorial structure of General Health Questionnaire (GHQ-12) in a sample of school teachers

O Questionário de Saúde Geral (QSG-12) é um dos instrumentos mais utilizados na avaliação da saúde psicológica.Entretanto, não há consenso sobre sua estrutura fatorial. Este estudo objetiva investigar a estrutura fatorial do QSG-12.Participaram do estudo 517 professores de 57 escolas públicas e particulares, com idade média de 36,52 anos(DP=10,46), sendo 66,3% do sexo feminino. Análises fatoriais exploratórias (n=203) demonstraram a existência de doisfatores oblíquos, denominados Depressão e Autoeficácia. Foram comparados, por meio de análises fatoriaisconfirmatórias (n=304), os índices de ajuste do modelo exploratório e o modelo unidimensional. A solução bidimensionaldemonstrou melhor ajuste (c²/gl=2,43; AGFI=0,90; CFI=0,91; RMSEA=0,068; CAIC=297,98) em comparação àestrutura unifatorial. A consistência interna dos fatores Depressão e Autoeficácia variou de 0,82 a 0,80 e 0,66 a 0,63,respectivamente. São sugeridos estudos que comparem diferentes soluções fatoriais do instrumento em busca de umaestrutura fatorial generalizável do QSG-12.

The General Health Questionnaire (GHQ-12) is one of the most used instruments in psychological health assessment.However, there is no consensus about its factor structure. This study aimed to investigate the factor structure of GHQ-12.The study included 517 teachers from 57 public and private schools, averaging 36.5 years of age (DP=10.34), being66.3% women. Exploratory factor analysis (n=203) demonstrated the existence of two oblique factors, titled Depressionand Self-efficacy. Confirmatory factor analysis (n=314) compared the model fit indexes of the exploratory and singlefactormodels. The two-dimensional solution showed better fit indexes (c²/gl=2.43, AGFI=0.90, CFI=0.91,RMSEA=0.068, CAIC=297.98) compared to the single-factor structure. The internal consistence of the factorsDepression and Self-efficacy ranged from 0.82 to 0.80 and from 0.66 to 0.63, respectively. It is suggested further studiescomparing different factorial solutions of the instrument in the search for a generalizable GHQ-12 factor structure.

Actividad física durante el tiempo libre y su relación con algunos indicadores de salud mental en España / Leisure time physical activity and its relationships with some mental health indicators in Spain through the National Health Survey

Introduction An active lifestyle, characterized by a regular pattern of leisure time physical activity along the lifespan, improves cognitive functioning and mental health. To join in sports activities or exercise programs is associated with a better quality of life, and people who engage in these activities show not only a better physical fitness, but a better psychological and emotional wellbeing. An active lifestyle provides an apparent protective effect against the incidence of disorders such as anxiety or depression. However, in this regard, the dose-response in terms of what type, amount, duration and intensity of physical activity is necessary for achieving improvements has not been well established in studies with large samples. Objetives The aim of this study is to provide evidence that, from a descriptive point of view, shows the association between different indicators of mental health in the Spanish adult population and leisure time physical activity practice, also assessing the level of this leisure time physical activity. Methods Data were obtained from the last Spanish National Health Survey, a cross-sectional study conducted by the Ministry of Health and Social Policy Institute for Health Information-Spain, between June 2006 and June 2007. The sample was representative of the Spanish adult population. Persons over 16 years took part in this study, being the reference population available in the last official census (January 1, 2006). A total of 29 478 persons (11 645 men and 1 7 833 women, older than 1 6 years) were interviewed using the National Health Survey Questionnaire 2006. It was designed as multistage sampling, stratified cluster in which the first units were census tracts distributed by population size; the second stage units are the main family dwellings, and the last unit was selected as a person over 1 6 years from each dwelling. The census tracts studied were selected within each stratum with proportional probability to size with the goal of this whole procedure would lead to self-weighting samples in each stratum, and households and individuals were selected by a random procedure, taking into account sampling quotas for age and sex. The sampling error for a confidence interval was 95.5% ± 0.6%. To minimize seasonal biases in the study, in terms of morbidity and lifestyle, the questionnaire was administered in four phases over the year: each stage involved 15 days, and the reference period of each variable explored comprised two weeks one year from the day of data collection. The gathering of information was conducted by trained interviewers. Leisure time physical activity pattern was obtained through this questionnaire by the question: «Usually, do you engage in any leisure time physical activity such as walking, sports, gymnastics ...?¼ This question could be answered «yes¼ or «no¼. Those who responded affirmatively were asked to describe the amount of physical activity in the last two weeks, in bouts of 20 or more minutes, in response to three levels of physical activity: light (<3.0 times resting energy expenditure), moderate (3.0 to 5.9 times resting energy expenditure) or vigorous (>6.0 times resting energy expenditure), providing the interviewer at least five examples of each level of activity. People who reported any amount of leisure time physical activity were classified into three groups based on the recommendations of physical activity practice for adults from the American Heart Association: insufficiently active (people who engage in some kind of physical activity, but do not meet the minimum recommendation to maintain health), moderately active (150 or more minutes of moderate physical activity, weekly) and vigorously active (60 or more minutes of vigorous physical activity, weekly). To assess mental health, we used a subjective mental health index obtained through a 12 items questionnaire (General Health Questionnaire, GHQ-12) designed for diagnosing psychiatric disorders, widely used in international literature and validated for Spanish adult population. The score ranges from 0 to 1 2 points, from the better mental health to the worse mental health. To facilitate statistical comparison, individuals are grouped into percentiles, containing the 95th percentile for people with worse mental health. Other variables included in this study were: age group, gender, perceived health status, history of depression or mental illness throughout life, depression or mental illness in the last 12 months, diagnosed depression, anxiety or other mental disorders at some time, psychiatrist attendance in the last 12 months, and finally, use of antidepressants, anxiolytics or other mental drugs for the past 12 months. We used a multinomial logistic regression to model the association between variables and calculating the odds ratio (OR) and confidence interval 95% (CI) to determine the degree of association between leisure time physical activity and mental-health related factors, taking into account gender and age group. Also, the association between the level of practice and mental health-related factors as studied in both sexes. The statistical treatment of data was performed trough the SPSS statistical package software (15.0 version). Results Leisure time physical activity is associated with a higher prevalence of perceived good or very good health status, and with a better assessment on the GHQ scale of subjective mental health (50th percentile). In terms of levels of practice, it seems that any amount of leisure time physical activity was associated with a higher probability of showing better perceived health status (p<0.001) and good GHQ index (p<0.001 ) in both sexes, although the degree of association grows proportionally to the level of practice of physical activity achieved. In both sexes, vigorous activity level is strongly associated with the studied variables, showing that there are more positive indicators of mental well-being in more vigorously active subjects, being the only exception psychiatrist attendance for females. For men, there is an association at this level of vigorous physical activity with a smaller number of psychiatrist attendance (p<0.05), but this association is less than the relationship with other variables, in which there is a higher significance level (p<0.001). For the lower levels of physical activity, the relationship of practice with these variables is not significant on many occasions. Sometimes, there is no difference between those classified as insufficiently actives (not reaching the minimum) and those who have a pattern of physical activity considered as moderate, and even the differences are in favour of those individuals insufficiently active. Such is the case of the use of medication for mental health in men or psychiatrist attendance in the case of women, less probable in insufficiently active group than in the other two groups (moderate and vigorous leisure time physical activity). Conclusion Practicing a physical activity during leisure time is associated with a lower prevalence of negative mental health indicators.

Introducción La práctica de actividad física a lo largo de la vida favorece el mantenimiento de las funciones cognitivas y se asocia habitualmente a una mejor salud mental. Invertir tiempo en realizar deporte o hacer ejercicio físico se asocia con una mejor calidad de vida en las personas que realizan regularmente estas actividades, y participar en programas de ejercicio físico dirigidos puede mejorar diferentes dimensiones del bienestar psicológico y emocional. Un estilo de vida activo otorga un aparente efecto protector ante la incidencia de trastornos como la ansiedad o la depresión; no obstante, la relación dosis-respuesta en términos de qué tipo, cantidad, duración e intensidad de la actividad física es necesaria para lograr mejorías en este sentido, no ha sido muy bien establecida en estudios con grandes muestras, y aún menos en los que se describa la relación con la actividad física durante el tiempo libre. Objetivo El objetivo del presente trabajo es aportar datos que desde un punto de vista descriptivo permitan contrastar la asociación entre diferentes indicadores de salud mental en la población española y la práctica de actividad física durante el tiempo libre, valorando también el nivel de actividad física realizado habitualmente. Métodos Los datos empleados en este artículo forman parte de un estudio transversal llevado a cabo por el Ministerio de Sanidad y Política Social-Instituto de Información Sanitaria de España, comenzado en el año 2006. La muestra estaba compuesta por sujetos mayores de 16 años, siendo la población de referencia el último censo oficial disponible. Fue entrevistado un total de 29 478 personas (11 645 hombres y 1 7 833 mujeres mayores de 1 6 años) con el Cuestionario Nacional de Salud del año 2006. Se evaluó la práctica de actividad física durante el tiempo libre y el nivel de práctica, de acuerdo a las recomendaciones existentes para mantener la salud, y se obtuvo un índice de salud mental por medio de un cuestionario de 12 ítems (General Health Questionnaire, GHQ-12), además de otras variables relacionadas con la salud mental. Resultados Se puede observar tanto en hombres como en mujeres de los diferentes grupos de edad, que realizar actividad física se asocia con una mejor valoración en la escala GHQ-1 2. En función del nivel de práctica, cualquier cantidad de ejercicio físico durante el tiempo libre se relaciona con una mayor probabilidad de mostrar mejor estado de salud percibida (p<0,001) y mejor puntuación en el cuestionario GHQ-12 (p<0,001) en ambos sexos, aunque el grado de asociación estimado (OR) crece proporcionalmente al nivel de práctica de actividad física alcanzado. Conclusiones Practicar actividad física durante el tiempo libre se asocia con una menor prevalencia de indicadores negativos de salud mental. Por medio de los diferentes indicadores estudiados se observa una mejor salud mental en las personas de ambos sexos que realizan práctica de actividad física vigorosa.

The validity of two malay versions of the general health questionnaire (GHQ) in detecting distressed medical students

Objective: To compare the sensitivity, specificity and reliability between the Malay GHQ-30 and the Malay GHQ-12 in detecting distressed medical students. This study determined which version is more sensitive, specific and reliable in detecting distressed medical students. Methods: Three validated instruments, the Malay version GHQ-30, the Malay version GHQ-12 and the Malay version Beck Depression Inventory-II (BDI-II), were administered to a total of 187 medical students. Distress diagnoses were made based on the Malay version BDI-II. ROC curve analysis was applied to determine the sensitivity and specificity of the both GHQs by testing against the BDI-II. Reliability analysis (Cronbach’s alpha) was applied to test internal consistency of the GHQ. The analysis was done using SPSS version 12. Results: 141 (75.4%) medical students participated in this study. The GHQ-30 sensitivity and specificity at cut-off point of 6 was 87.5% and 80.6% respectively with positive predictive value (PPV) of 70% as well as area under ROC curve was 0.93. The GHQ-12 sensitivity and specificity at cut-off point of 4 was 81.3% and 75.3% respectively with PPV of 62.9% as well as area under ROC curve was 0.82 The Cronbach’s alpha value of the GHQ-30 and GHQ-12 was 0.93 and 0.85 respectively. The Kappa value for the GHQ- 12 and GHQ-30 was 0.65 (p < 0.001). Conclusion: This study showed the Malay GHQ-30 had better ability to discriminate between distressed and non-distressed medical students compared to the Malay GHQ-12. The shorter version was found to be as reliable as the long version GHQ-30 in detecting distressed medical students. The optimum threshold score for the GHQ-30 and GHQ-12 to detect distressed medical students were 6 and 4 respectively. The GHQ-12 and GHQ-30 showed a good level of agreement in detecting distressed medical students.

The sensitivity, specificity and reliability of the malay version 12-items general health questionnaire (GHQ-12) in detecting distress medical students

Objective: To determine the sensitivity, specificity and internal consistency of the Malay version GHQ-12 among medical student population. This study determined the appropriate GHQ-12 score to detect distressed medical students. Methods: The Malay version of GHQ-12 was derived based on two sources which were the original version GHQ-12 and the validated Malay version 30-items GHQ. The GHQ-12 and the Malay version Beck Depression Inventory-II (BDI-II) were administered to a total of 141 medical students. Distress diagnoses were made based on the Malay version BDI-II. ROC curve analysis was applied to determine the sensitivity and specificity of the GHQ-12 by testing against the BDI-II. Reliability analysis (Cronbach’s alpha and item total correlation) was applied to test internal consistency of the GHQ-12. The analysis was done using SPSS version 12.Results: The GHQ-12 sensitivity and specificity at cut-off point of 3/4 was 81.3% and 75.3% respectively with positive predictive value (PPV) of 62.9% as well as area under ROC curve more than 0.7. The Cronbach’s alpha value of the GHQ-12 was 0.85.Conclusion: This study showed the Malay version GHQ-12 is a valid and reliable screening tool in detecting distressed medical students. The GHQ-12 score equal to or more than 4 was considered as significant distress.