Influence of stress, anxiety, and depression on sleep quality and academic performance of medical students in Fallujah University, Iraq.

BACKGROUND: There is a relation between sleep quality, mental health, and academic performance among medical students. Students who experience better sleep quality and have good mental health will exhibit higher academic performance compared to those who have reduced sleep quality and poor psychological health. OBJECTIVE: To assess the relation between mental health problems, sleep quality, and academic performance among medical students in the stage of clinical training at the University of Fallujah, Iraq. METHODS: In this cross-sectional study, a self-administered questionnaire was adopted that gathered three validated and previously used screening tools: The Pittsburgh Sleep Quality Index (PSQI), Depression Anxiety Stress Scale (DASS-21), and the AHELO Self-Assessment Questionnaire. RESULTS: The findings revealed a high prevalence of anxiety, 40% of the students reported experiencing mild to moderate anxiety, while 24.1% showed severe anxiety, 20.0% experienced mild depression, and 10.8% had moderate depression. There was a significant negative correlation between stress and academic performance (Pearson's r = -.333, p < .001), between depression and academic performance (Pearson's r = -.437, p < .001), and between anxiety and academic performance (Pearson's r = -.417, p < .001). CONCLUSION: Mental health problems are prevalent among medical students represented by the study sample, and are significantly correlated to the students' academic performance.

Assessment of adverse childhood experiences, undernutrition symptoms and gender among sample of medical students in Fallujah University - Iraq: A preliminary study.

BACKGROUND: Adverse childhood experiences is considered as major risk factor for several health problems and diseases during adulthood, such as hypertension, IHD, and eating disorders. The aim of current study was to measure the association between ACEs and malnutrition symptoms among sample of medical students in Fallujah University. METHODS: A convenience sample was used to recruit the participants; the data collection was carried out during December 2022. The questionnaire consisted from questions for demographical variables, questions for adverse childhood experiences and Short Nutritional Questionnaire was used for assessing the undernutrition symptoms among the subjects. RESULTS: Female subjects consisted 62.8% of the sample, 28.3% of the students had zero score of adverse childhood experience, 13% of the subjects had one score of ACEs and 45% of the participants had four or more of ACEs score. There was a statistically non- significant association between exposure to ACEs and undernutrition symptoms, p > .05. The logistic regression model revealed that female subjects had a risk of five folds for loss of appetite compare to male subjects (OR = 5.58, 95% CI [2.18, 14.31]). The females also had three folds for using nutritional supplement due to nutritional deficiencies compare to males (OR = 3.28, 95% CI [1.33, 8.1]). CONCLUSION: ACEs was not associated with undernutrition symptoms. Gender is significantly related with loss of appetite and using the nutritional supplement.

The relationship of childhood maltreatment to deviant behaviours among young Iraqi adults: A cross sectional study.

BACKGROUND: The exposure to stressful events during childhood may have prolonged effects and is associated with a higher risk of psychopathology during adulthood. OBJECTIVE: To assess the relationship between exposure to childhood maltreatment and the occurrence of deviant behaviours among Iraqi young adults. METHODS: A cross-sectional study was done from October 2018 to April 2019. A non -random convenient sample that consisted of young adults of age between 18 and 20 years. The childhood maltreatment was measured by Adverse Childhood Experiences Questionnaire, while the deviant behaviours were assessed by Deviant Behaviour Variety Scale. RESULTS: The participants were 401. There was a positive correlation between ACE score and deviant behaviours score. The male subjects had higher mean of deviant behaviour variety score compare to that of the female subjects. The linear regression model showed that exposure to physical abuse (ß = 0.180, p < 0.001), sexual abuse (ß = 0.138, p = 0.003) during the first 18 years of age significantly predicts the variety of deviant behaviours. CONCLUSION: Childhood maltreatment was associated with high risk for deviant behaviours among young Iraqi adults. The physical abuse was the main predictor for deviant behaviours in adulthood.

Traumatic events, post-traumatic stress disorders, and gender among Yazidi population after ISIS invasion: A post conflict study in Kurdistan - Iraq.

BACKGROUND: Traumatic experiences can lead to a range of mental health problems such as depression, anxiety and post-traumatic stress disorder. The prevalence of post-traumatic stress disorder depends on the cumulative exposure to traumatic stress. The Yazidis (Êzidî) are a Kurdish religious minority living in the north of Iraq, western Iran, eastern Turkey, and northern Syria. Islamic State of Iraq and Syria (ISIS) had sought to destroy the Yazidis population through killings; sexual slavery, enslavement, torture, degrading treatment, and forcible migration causing serious physical and mental disorders. The objectives of the study were to estimate the prevalence of traumatic events and post-traumatic stress disorder among Yazidi population in Yazidi community and to assess the association between post-traumatic stress disorder and gender. METHODS: A cross-sectional study was conducted during period from June to August 2019. The participants were chosen by a random sampling method from Chammshko camp in Zakho district that it's a city in Kurdistan region - Iraq. The questionnaire consisted of questions for demographical characteristics (e.g., gender, age, marital status, education, and job), and PTSD symptoms was assessed by using Harvard Trauma Questionnaire. RESULTS: The females consisted 54.7% of the subjects. The majority of the participants were married (54.1%) and 98 (54.1%) of them were uneducated. About 79% of the subjects had PTSD symptoms. There was a statistically significant association between gender and PTSD, the female subjects had higher mean of trauma and PTSD symptoms scores (17.84 ± 3.5), (117.34 ± 13.8) respectively compare to that of male subjects (15.95 ± 3.1), (104.61 ± 18.8) respectively (p < .001). CONCLUSION: High rate of PTSD among Yazidi population, Female subjects highly suffered from trauma and PTSD.

Internet Addiction and Its Relationship to Gender, Depression and Anxiety Among Medical Students in Anbar Governorate-West of Iraq.

INTRODUCTION: The rapid increase of internet using was associated with a rise in internet addiction (IA) especially among adolescent and young adults that may associated with underlying psychological disorders. The aims of the study: a) to estimate the prevalence of internet addiction among medical students in Anbar governorate, b) to assess the effect of internet addiction on mental health by measuring the association of IA with depression and anxiety among the students. METHODS: A cross sectional study was carried out during the period from February to April 2019. A self-administered questionnaire was used which consisted from demographic questions, the Young Internet Addiction test to evaluate the internet addiction among the subjects and the Depression Anxiety stress scales (DASS) for assessing the depression and anxiety symptoms among the medical students. RESULTS: 47.5% of the subjects had mild internet addiction, proportion of moderate addiction among the participants was 23%. There was a significant association between internet addiction with depression and anxiety. The subjects with internet addiction had OR = 2.302 for depression development (P < 0.001), also the students with internet addiction had OR= 3.088 for anxiety development (p < 0.001). CONCLUSION: High rate of internet addiction among medical students in Anbar city- west of Iraq and there was significant association between internet addition and mental disorders of the subjects.

Adverse childhood experiences and their relationship to gender and depression among young adults in Iraq: a cross-sectional study.

BACKGROUND: Adverse childhood experiences (ACEs) are considered as universal public health problem that associate with mental disorders and risky behaviors during adulthood. The aims of the paper are to estimate the prevalence of Adverse childhood experiences (ACEs) among young adults in Iraq as well as to estimate the association between ACEs and depression. METHODS: A convenience sample of young adults of 18-20 years was chosen from centre and west of Iraq, mainly from universities. The adverse childhood experiences were measured by Adverse Childhood Experiences Questionnaire. A depression scale was derived from the Depression, Anxiety and Stress Scales (DASS). Statistical tests: chi square was used to measure the association between adverse childhood experiences and other variables like gender and depression. Odds ratios were computed to estimate the risk for depression. A P value of less than 0.05 was considered statistically significant. RESULTS: The total number of participants was 401, 38.9% of the subjects were men, while 61.1% were women. The mean age of the participants was 18.88 ± 0.745. The results revealed that the most common forms of ACEs among the subjects were physical neglect (19.8%) and emotional neglect (19.2%) followed by physical abuse (17.21%) while sexual abuse was 7.52%. There was statistically significant association between most forms of adverse childhood experiences especially emotional abuse, emotional neglect, physical abuse and physical neglect with depression. CONCLUSION: ACEs are not uncommon among young adults in Iraq and are associated with depression in adulthood. National programmes to support mental health rehabilitation might be necessary to reduce the effect of ACEs among Iraqi people, especially for adolescents and young adults.

Effect of adverse childhood experiences on physical health in adulthood: Results of a study conducted in Baghdad city.

BACKGROUND: Studies have revealed a powerful relationship between adverse childhood experiences (ACEs) and physical and mental health in adulthood. Literature documents the conversion of traumatic emotional experiences in childhood into organic disease later in life. OBJECTIVE: The aim was to estimate the effect of childhood experiences on the physical health of adults in Baghdad city. SUBJECTS AND METHODS: A cross-sectional study was conducted from January 2013 to January 2014. The study sample was drawn from Baghdad city. Multistage sampling techniques were used in choosing 13 primary health care centers and eight colleges of three universities in Baghdad. In addition, teachers of seven primary schools and two secondary schools were chosen by a convenient method. Childhood experiences were measured by applying a modified standardized ACEs-International Questionnaire form and with questions for bonding to family and parental monitoring. Physical health assessment was measured by a modified questionnaire derived from Health Appraisal Questionnaire of Centers for Disease Control and Prevention. The questionnaire includes questions on cerebrovascular diseases, diabetes mellitus, tumor, respiratory and gastrointestinal diseases. RESULTS: Logistic regression model showed that a higher level of bonding to family (fourth quartile) is expected to reduce the risk of chronic physical diseases by almost the half (odds ratio = 0.57) and exposure to a high level of household dysfunction and abuse (fourth quartile) is expected to increase the risk of chronic physical diseases by 81%. CONCLUSION: Childhood experiences play a major role in the determination of health outcomes in adulthood, and early prevention of ACEs. Encouraging strong family bonding can promote physical health in later life.