Moderating Effect of Variables Associated with Positive Mental Health in a Mediation Model on Depression among College Students: Protocol for a Longitudinal Study.

BACKGROUND: Depression is significant mental health issue among university students and can decrease their ability to succeed academically. While various factors associated with mental health problems have been identified, researchers are increasingly exploring the role of positive mental health, such as character strengths and inner strengths, in relation to mental health problems. OBJECTIVE: This study aims to build upon previous research by examining the influence of positive mental health on the mediation model of depression among students enrolled at Chiang Mai University. METHOD/DESIGN: This study will employ an observational and longitudinal study that collects data from undergraduate students at Chiang Mai University during the 2023-2024 academic year. The primary outcome of this study will be depression. In the mediation models, insecure attachment and negative family climate will serve as predictors, while borderline personality symptoms will be the mediator. Positive mental health, including character strengths, inner strengths, and resilience, will be tested for moderation effects on the mediation models. Data will be collected at three intervals, with a three-month gap between each collection period. DISCUSSION AND CONCLUSION: This study will provide insights into the positive and negative mental health outcomes of university students in Chiang Mai. Through comprehensive analysis, this study intends to offer valuable insights into both positive and negative mental health outcomes among university students in Chiang Mai. Moreover, by employing a longitudinal approach, it aims to establish a more robust understanding of the causal relationships between positive mental health, predictors, mediators, and depression. The study's limitations will also be discussed.

Medical students' attitude towards psychiatry: a comparison of past and present.

Attitude to psychiatry influences motivation for medical students to successfully achieve in studying psychiatry. With a new generation of students, it would be interesting to investigate how attitudes have changed. This study aimed to compare the attitude of fifth-year medical students toward psychiatry in recent and in the past 24 years. Two samples of fifth-year medical students at Chiang Mai University completed the 30-item attitude to psychiatry (ATP-30); 118 students completed it in 1996, whereas 242 medical students completed it in 2019. Rasch analysis was employed for examining the differences between the total score and individual item scores between the two groups. The total score of ATP in the 2019 group was significantly higher than that in the 1996 group. After misfitting individuals and biased items were removed, only 15 items were valid and useful for a comparison. Of 15 items, 11 were found highly significantly different between two groups (p < 0.001). Negatively worded items, e.g., no strong evidence indicating effectiveness, became easier to score items (increased positive attitude) whereas some positively worded items, e.g., I would like to be a psychiatrist. Nine items, became more difficult (less positive attitude) comparing between 1996 and 2019. In a comparison between the two methods using the traditional t-test and Rasch analysis, only 5 of 30 items (16.7%) agreed with each other. The overall attitude to psychiatry was significantly higher at the present compared with that in the past. Most items did not differ between the two times. Further studies regarding improving the attitude scale using item response theory such as Rasch should be encouraged.

Experiences of Being Bullied and the Quality of Life of Transgender Women in Chiang Mai Province, Thailand.

Purpose: The objective of this study is to identify factors associated with depression and the quality of life of Thai transgender women (TGW) from Chiang Mai province, Thailand, who have experienced being bullied. Methods: We conducted the study on TGW ≥18 years of age in Chiang Mai province, Thailand, from May to November 2020. Data were collected using self-reporting questionnaires at the MPlus Chiang Mai foundation. Binary logistic regression analysis was used to examine the association between potential factors associated with depression and quality of life. Results: Of the 205 TGW individuals who participated in this study with a median age of 24 years, most were students (43.3%), and the most common type of bullying was verbal (30.9%). The prevalence of depression among the TGW participants was 30.1%, although most of the participants had a good overall quality of life (53.4%). The impacts of being physically bullied at primary or secondary school and experiencing cyberbullying at primary school were associated with a higher risk of depression. The impacts of being cyberbullied within the previous 6 months and physically bullied at primary or secondary school were associated with a fair quality of life. Conclusion: Our results show that many TGW had experienced bullying in their childhood and within the previous 6 months. Screening for experiences of having been bullied and psychological problems might be advantageous for the wellbeing of TGW, while counseling programs or psychotherapy should be provided for those who have experienced bullying to mitigate depression and improve their quality of life.

Escitalopram vs duloxetine in acute treatment of major depressive disorder: meta-analysis and systematic review.

BACKGROUND: Previous evidence indicated that efficacy of escitalopram (Esc) and duloxetine (Dul) was comparable in the treatment of major depressive disorder (MDD). Since such studies had small sample sizes, this study purposefully applied a systematic review to determine the efficacy, acceptability, and tolerability those antidepressants in treatment of MDD. PARTICIPANTS AND METHODS: The following primary databases were searched in July 2017: Scopus, PubMed, CINAHL, and Cochrane Controlled Trials Register. Any randomized controlled trials (RCTs) of Esc comparison with Dul in the treatment of MDD were included in this review. The primary efficacy of outcome was the pooled mean-changed scores of the rating scales for the standardized rating scales for depression. RESULTS: A total of 1,120 randomized subjects from 3 RCTs were collected for synthesis in the present meta-analysis. The mean-changed scores of the Hamilton Depression Rating Scale (HAMD) and Clinical Global Impression - Severity, overall response rate by the HAMD, and remission rate by the HAMD and Montgomery-Asberg Depression Rating Scale (MADRS) in the Esc- and Dul-treated groups showed no significant differences. However, the mean-changed score of the MARDS, mean-end scores of Clinical Global Impression - Improvement, and overall response by the MADRS in the Esc-treated group were greater than that of the Dul-treated group. Although the overall discontinuation rate had no significant differences between the 2 groups, the discontinuation rate due to adverse events in the Esc-treated group was greater than that of the Dul-treated group. LIMITATIONS: This review had limited eligible studies. CONCLUSION: This review indicated the efficacy in the acute treatment of Esc vs Dul varied relying on measurements across the studies. However, the tolerability of Esc was superior to Dul in acute MDD treatment. Therefore, selection between the 2 antidepressants may depend on the tolerability of MDD patients. Due to limited included studies in this review, more large-scale and well-defined RCTs in such patients should be carried out to determine these outcomes.