The Prevalence of Caregiving among Young People.

With the increasing number of people with chronic diseases and disabilities, the number of family members as caregivers have also been growing. Despite the attention paid to caregiving in recent years, little is known about caregiving among young people, particularly its global prevalence. The lack of information has important implications for health policy and management, resulting in the inability to form appropriate evidence-based policies and managerial decision making. This study aims to derive an estimate of the prevalence of caregiving among young people through a systematic review of the current literature. The results of this study revealed a prevalence of caregiving among younger adolescents of between 1.1% (1.06-1.14%) and 12.0% (11.02-12.98%). However, the assessment of caregiving varies across studies, and all were conducted in developed countries. These results provide information on the burden of caregiving in young people and reveal the lack of global information, calling for more research on and attention to this specific population.

A Web-Based and Mobile Intervention Program Using a Spaced Education Approach for Workplace Mental Health Literacy: Cluster Randomized Controlled Trial.

Background: Workplace mental health is an important global health concern. objectives: This unblinded, phase-III, wait-listed cluster randomized controlled trial aimed to examine the effectiveness of a mobile health (mHealth) psychoeducation program using a spaced education approach on mental health literacy (MHL) in the workplace. The main interest of this paper was the immediate and 3-month medium-term effect of the program on the MHL of workers. The purposely built mHealth platform was also evaluated as a health-related app. Methods: The mHealth platform was designed using the principle of spaced education as a psychoeducation intervention program, with various modules of web-based and mobile materials presented to the participant in a progressive manner. Short quizzes at the end of each module ensured adequate learning, and successful completion qualified the learner to progress to the next level. The trial recruited 456 employees of specific industries with high levels of work-related stress. Participants who were nested in different offices or units were allocated into the intervention and wait-listed control groups using a block randomization process, with the office or unit as the cluster. A separate sample of 70 individual raters were used for the evaluation of the mHealth platform. The Australian National MHL and Stigma Survey and the Mobile Apps Rating Scale were completed through a web-based self-reported survey to assess MHL and evaluate the app. The trial and follow-up data were analyzed by a generalized linear latent and mixed model with adjustments for the clustering effect of work sites and repeated measures. Results: Of the 456 participants in the trial, 236 (51.8%) responded to the follow-up survey. Most MHL outcomes obtained significant results immediately after the intervention and across time. After adjusting for the clustering effect, the postintervention weighted mean scores were significantly higher in the intervention group than the control group for correct recognition of a mental health problem, help seeking, and stigmatization by 0.2 (SE 0.1; P=.003), 0.9 (SE 0.2; P<.001), and 1.8 (SE 0.4; P<.001), respectively. After adjusting for the clustering effect, significant differences across time were found in help-seeking intention (P=.01), stigmatization (P<.001), and social distancing (P<.001). The evaluation of the mHealth program resulted in average scores of the 4 major domains ranging from 3.8 to 4.2, with engagement having the lowest score. Conclusions: The mHealth psychoeducation intervention program using this platform had immediate and 3-month medium-term effects of retaining and improving MHL. The platform was evaluated to have satisfactory performance in terms of functionality, aesthetics, information content, and utility in enhancing MHL. It is anticipated that ongoing development in digital health will provide great benefits in improving the mental health of the global population.

The association between Long-COVID symptomology, perceived symptom burden and mental health in COVID-19 patients in Shijiazhuang, China: a population-based health survey.

Background: Long-COVID (LC) refers to post-acute COVID-19 symptoms that can last for months or longer after the initial infection, affecting the physical health of infected patients. This study aims to investigate the association between the symptomology of LC and the mental health of patients in China. It also aims to examine the relationship between the perceived symptom burden and mental health of these patients. Methods: A population-based stratified cluster sample was recruited, using a standard sampling procedure, from a prefecture-level city in Northern China. Participants included patients who had tested positive for COVID-19 after December 2022. LC symptomology was assessed using a LC symptoms checklist where the perceived symptom burden was measured by the included 5-point Likert scales. Mental health of patients was measured using the Depression, Anxiety, and Stress Scale (DASS), the original Connor-Davidson Resilience Scale (CD-RISC), and the Duke-UNC Functional Social Support Questionnaire (DUFSS). Data were analysed using multiple linear regression models. Results: About 25% of respondents, experienced COVID symptoms lasting longer than two months that could only be explained by the infection. Post-exertional malaise (22.2%) and fatigue (21.2%) were the most common symptoms. After controlling for potential confounding variables, LC symptomology was significantly and positively associated with depression (t=2.09, p=0.037) and anxiety (t=4.51, p<0.001), but not stress. Perceived symptoms burden was also positively and significantly related to depression (ß=0.35, p<0.001), anxiety (ß=0.54, p<0.001), and stress (ß=0.35, p<0.001), suggesting a dose-response relationship between perceived symptom burden and mental ill health. Conclusion: This study highlights the importance of recognising the risk of LC, patients' perception of the symptom burden and its potential impact on mental health. Healthcare professionals should be aware of the complexity of psychological comorbidities among infected patients reporting prolonged symptoms, and be able to give advice regarding long-term management of the symptoms.

The effect of light therapy on sleep quality in cancer patients: a systematic review and meta-analysis of randomized controlled trials.

Background: Sleep problem is one of the major issues of cancer patients and may have detrimental effects on the ongoing treatment and recovery of patients. However, the evidence for the effect of light therapy on sleep problems in this population remained scarce. This study aimed to examine the effect of light therapy on self-reported and physiological measures of sleep quality of cancer patients. It also aimed to quantify the magnitude of the effect using a meta-analytical approach. Methods: Six databases were searched for randomized control trials (RCTs). The primary outcome was the sleep quality using the Pittsburgh sleep quality index (PSQI) measurement of self-reported scores, and the secondary outcomes included total sleep time and sleep efficiency measured by actigraphy. Meta-analyses were performed with the random effects model using the RevMan software. The standardized mean difference (SMD) of the PSQI scores and other measures with their 95% confidence intervals (CIs) were used for assessing the treatment effect (CRD42023370947). Results: Nine RCTs were identified and included in the study. Light therapy significantly improved the self-reported sleep quality with a reduction of the pooled PSQI score (SMD = -0.72; 95% CI: -1.24 to -0.21; p = 0.006). Regarding total sleep time (p = 0.72) and sleep efficiency (p = 0.47), no significant effects of light therapy were found. Conclusion: Light therapy could improve self-reported sleep quality in cancer patients. However, due to the heterogeneity and small sample size of the included trials, the results should be interpreted cautiously. Trials with better designs and larger sample sizes are suggested to be conducted for a more definitive conclusion.Systematic review registration:https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=370947.

Child and adolescent mental well-being intervention programme: A systematic review of randomised controlled trials.

Background: There has been an increasing awareness and recognition of mental well-being as one of the main outcome measures in national mental health policy and service provision in recent years. Many systemic reviews on intervention programmes for mental health or general well-being in young people have been conducted; however, these reviews were not mental well-being specific. Objective: This study aims to examine the effectiveness of child and adolescent mental well-being intervention programmes and to identify the approach of effective intervention by reviewing the available Randomised Controlled Trials. Methods: This systematic review study followed the PRISMA guidelines for systematic reviews ensuring a methodical and structured approach for the literature search and the subsequent review processes. The systematic literature search utilised major medical and health databases. Covidence, an online application for conducting systematic reviews, was used to assemble the titles, abstracts and full articles retrieved from the initial literature search. To examine the quality of the included trials for determining the strength of the evidence provided, the JBI Critical Appraisal Tool for Randomised Controlled Trial was used. Results: There were 34 studies identified after an extensive search of the literature following the PRISMA guidelines. Seven (7) fulfilled all selection criteria and provided information on the effect of an intervention programme on mental well-being in adolescence. Data were extracted and analysed systematically with key information summarised. The results suggested that two (2) programmes demonstrated significant intervention effects, but with a small effect size. The quality of these trials was also assessed using the JBI Critical Appraisal Tool for Randomised Controlled Trials and identified some methodological issues. Conclusion: In conclusion, activity-based and psychoeducation are shown to be potentially effective approaches for future programme development. More research on a well-designed programme is urgently needed, particularly in developing countries, to provide good evidence in supporting the mental health policy through the enhancement of mental well-being in young people.

Prescribing behavior of antidepressants for depressive disorders: A systematic review.

Objective: Guidelines for the prescription of antidepressants for Depressive Disorders (DD) have been in place for a long time. However, there is a lack of systematic information on the prescribing behavior of antidepressants in evidence-based clinical practice in psychopharmacotherapy of depressive disorders. This may suggest a lack of implementation of clinical guidelines by clinicians. Existing literature mainly focuses on specific issues or medications. To provide general information on the prescribing behavior of antidepressants for depressive disorders, a systematic review of available studies since 2013 was conducted. Methods and materials: To ensure a structured and systematic approach for the literature search and subsequent review process, the PRISMA guidelines for systematic reviews were followed. Major medical and health and psychological databases were used for the literature search. These included Ebsco Host, OVID, PubMed, Science Direct, Scopus, and Web of Science. The online application "Covidence" was employed to manage the titles collected and the full articles retrieved from the initial literature search. Upon finalizing the list of selected studies, data extraction was then conducted using a build-in function of the Covidence platform with the required information pre-set on a template for data extraction. The extracted information was tabulated and summarized in a table. Results: Forty-one studies were identified after an extensive search of the literature following the PRISMA guidelines. Of these, 37 quantitative studies providing useful information were systematically reviewed and information extracted. There was a high level of heterogeneity among these studies with different foci or characteristics. Most studies were conducted in or utilized data obtained from hospital and primary healthcare settings. SSRIs were the most commonly prescribed type of antidepressant in the past decade, particularly among younger patients. Among these studies, antidepressants were mainly prescribed by psychiatrists with some by other physicians and general practitioners. This might reflect differences in legislation regarding professional requirements for prescribers or clinical practices. Conclusions: A few themes that would be considered important in terms of the effect of prescription behavior on depression, specifically children/adolescents, special target populations, and off-label prescription. The results highlighted the need for more studies on a community-based approach and the role of GPs in the treatment of DD.

Efficacy of a Workplace Intervention Program With Web-Based Online and Offline Modalities for Improving Workers' Mental Health.

Objective: This study aims to examine the efficacy of the Workplace Web-based blended psychoeducation mental health intervention program. Of particular interest is the short-term effect of the intervention on workplace burnout, stress, quality of life, and the mental health literacy of workers. Methods and Materials: The study focused on employees (n = 456) in specific industries with high levels of work-related stress, adopting a phase III wait-listed cluster randomized controlled trial. Work-related burnout was assessed by the Maslach Burnout Inventory (MBI) and stress was measured using the stress subscale of the Depression, Anxiety, and Stress scale (DASS). Quality of Life was evaluated by the European Quality of Life-5 Dimensions (EQ-5D-5L) and Mental Health Literacy was assessed using the Australian National Mental Health Literacy and Stigma Survey. Data were analyzed as a trial with intention-to-treat analysis and adjustment for the clustering effect of work sites. Results: Significant differences between intervention and control groups were found on all outcome measures except the self-rated quality of life. The intervention group displayed a significant reduction in the weighted mean score of about 1.0 units (s.e. = 0.4) on the stress scale (p = 0.015) and an increase in the weighted mean score of 1.9 units (s.e. = 0.9) in the professional accomplishment domain of the MBI (p = 0.035). Significant increases were found in the weighted mean scores in the intervention group for correct recognition of the mental problems, help-seeking, and stigmatization, in comparison to the control group who scored 0.2 (s.e. = 0.1), 0.9 (s.e. = 0.2), 1.8 (s.e. = 0.4), respectively. Conclusions: The results obtained from a comparison of the outcome measures between the intervention and control groups were statistically significant, indicating that the intervention group performed better on most measures. The study demonstrates that, in the short term. the on-and-offline modalities of the Web-based blended psychoeducation intervention program is efficacious in reducing workplace burnout and stress and promoting mental health literacy at the workplace.

Factors Associated with Work-Related Burnout among Corporate Employees Amidst COVID-19 Pandemic.

Work-related burnout is common and has detrimental effects on employees in many industries. The current study aims to examine both environmental and personal factors that are associated with work-related burnout in a population of corporate employees who managed to retain their jobs amidst the global COVID-19 pandemic crisis. This cross-sectional survey served as the baseline data collection of a phase III wait-listed cluster randomised controlled trial (CRCT) of an intervention program on mental well-being at the workplace. Participants were recruited from six large-size corporations. Work-related burnout was assessed by the Maslach Burnout Inventory (MBI), and the Moos Work Environment Scale (WES) was used for evaluating the workers' perspective on the workplace. Information was also collected on demographics and health behaviours. Burnout in this sample was prevalent with 60% of participants rated at a moderate to a high level on emotional exhaustion. Results from the multiple linear regression analyses suggested that different factors were related to different components of burnout. For example, age, work involvement, co-worker cohesion, and work pressure were associated with emotional exhaustion and depersonalisation while others were related to professional accomplishment. The overall results suggested that the work environment is of influential importance to the burnout of employees. However, although the study was conducted during the peak of the COVID-19 pandemic, the factors identified as relating to workplace burnout do not differ much from those identified in a crisis time. Implications of the results were discussed.

Sleep Disorders in Early Childhood and the Development of Mental Health Problems in Adolescents: A Systematic Review of Longitudinal and Prospective Studies.

The association between sleep problems, particularly sleep disorders, and mental health has long been studied and recognized. However, the causal relationship between sleep disorders, particularly during early childhood, on mental health problems in adolescence are yet to be established. From a preventive perspective, it is important to understand the causality of mental health problems in adolescents so that intervention measures can be derived and implemented as early as possible for maximum effectiveness. To provide more precise information on the effect of early childhood sleep disorders on mental health problems during adolescence, a systematic review was conducted on longitudinal and prospective studies reported in the literature. Following the PRISMA guidelines with an extensive search of the literature 26 studies were identified. Seven of these identified studies satisfied all selection criteria with sufficient data on the effect of early childhood sleep disorders and mental health problems in adolescence. Information was extracted and analyzed systematically from each study and tabulated. The overall results obtained from these studies indicate a significant and possible causal relationship between early childhood sleep disorders and the development of mental health problems, such as anxiety, depression, and ADHD in adolescence. These results are discussed with regards to the theoretical and practical implications as well as preventive strategies.

Graded Exercise Testing Predicts Recovery Trajectory of Concussion in Children and Adolescents.

OBJECTIVE: To determine whether graded exercise testing can predict recovery trajectory of concussion in children and adolescents. DESIGN: Prospective study. SETTING: Children's Hospital, Westmead, Australia. PARTICIPANTS: One hundred thirty-nine children aged 12 to 16 years at 5 to 7 days after an acute concussive injury. INTERVENTION: Graded exercise testing on a treadmill at the subacute phase to assess symptom provocation and determine clinical recovery indicating readiness to commence a return to activity (RTA) protocol. Exercise time to symptom exacerbation and clinical recovery were measured. MAIN OUTCOME MEASURES: Standard concussion assessment and clinical testing (neurocognitive, vestibular/ocular, and balance) were conducted to determine major clinical drivers/indicators. RESULTS: Participants (mean age 12.4 ± 2.8 years, 73% male) had a confirmed sport-related concussion. The main clinical drivers identified on exercise testing were headache, balance, and vestibular dysfunction. Participants fell into 1 of 2 groups, exercise-tolerant (54%) and exercise-intolerant (46%). Exercise-tolerant patients showed mild clinical indicators, no symptom exacerbation during 10.3 ± 3.3 minutes of exercise, were safely transitioned to a RTA protocol, and recovered within 10 days. Exercise-intolerant patients had high clinical indicators, significant symptom exacerbation at 4.2 ± 1.6 minutes of exercise, and prolonged recovery of 45.6 days. No adverse effects from exercise were reported in either group. Combined use of provocative exercise and clinical testing was 93% predictive of outcome. CONCLUSIONS: Exercise testing during the subacute phase after a concussion can predict longer recovery. Exercise testing can identify a unique window where patients can be safely transitioned to activity, enabling clinicians to better inform patients and families, allocate resources and streamline care.

The Roles of Parent-and-Child Mental Health and Parental Internet Addiction in Adolescent Internet Addiction: Does a Parent-and-Child Gender Match Matter?

Objective: This study aimed to investigate the relationship between parental mental health, particularly depression, and Internet addiction (IA) among adolescents taking into consideration adolescent mental health and parental IA as possible mediating factors. Of particular interest was the effect of parent-and-child gender match on these relationships. Materials and Methods: This was a population-based parent-and-child dyad health survey utilizing a random sampling technique. Adolescent IA was measured by the Internet Addiction Test (IAT) designed by Young. The mental health status of the parents was assessed using the Depression, Anxiety, Stress Scale (DASS). Data were analyzed using Structural Equation Model (SEM) techniques with stratification by parent-and-child gender match. Results: One thousand ninety-eight (n = 1,098) parent-and-child dyads were recruited, and useful information was obtained. The mean IAT score was 28.6 (SD = 9.9) for parents and 41.7 (SD = 12.4) for adolescents. Results of the SEM suggested that the effect of parental depression on adolescent IA was mediated through adolescent mental health mainly through adolescent stress (regression weight = 0.33, p < 0.001) and less so through adolescent depression (regression weight = 0.19, p < 0.001) or parental IA (regression weight = 0.13, p < 0.001). Further analysis revealed that these mediating relationships are more significantly manifested in the father-and-son and mother-and-daughter dyads. Conclusions: Result suggested that the relationship between parental mental health and adolescent IA is complex and that adolescent mental health and parental IA also play important roles as mediating factors. These results have direct implications on the treatment and prevention of IA among young people.

The factor structure of the Center for Epidemiological Study - Depression Scale in people with multiple sclerosis.

Background: Depression is common in multiple sclerosis (MS); however, its assessment is complicated by biological processes. In this context it is important to consider the performance of depression screening measures including that their factor structure is consistent with expectation.  This study sought to identify the factor structure of the Center for Epidemiological Study - Depression Scale (CES-D) in people with MS (PwMS). Methods: Participants (N = 493) were those who had consented to take part in a large three-phase longitudinal study of depression in PwMS. CES-D questionnaires completed at phase 1 of the study were utilised. An error in the questionnaire meant it was most appropriate to consider data for 19 of the 20 CES-D questionnaire items. The data was split into two samples by a random selection process to create an exploratory, model development sample and a validation sample. The first sample was subject to confirmatory factor analysis. Following examination of model fit and specification errors, the original model was modified. The revised model was tested in the confirmation sample to assess reproducibility. Results: The analysis results supported the original four factor solution for the CES-D, that is: Depressed Affect, Positive Affect, Somatic Complaints/Activity Inhibition, and Interpersonal Difficulties. Conclusions: The CES-D appears to have a coherent structure with which to examine depression in PwMS.

Protocol for a phase III wait-listed cluster randomised controlled trial of an intervention for mental well-being through enhancing mental health literacy and improving work friendliness in Hong Kong.

BACKGROUND: Mental health has long been recognised as a major global health issue. Some work-related characteristics have been identified to be associated with common mental health problems, and thus the workplace is an important venue for the prevention of mental health problems and promoting mental wellness. Burnout is one of the important aspects of workplace organisational stressors and, in recent years, the lack of mental health literacy has also been identified as a fundamental issue. Studies have demonstrated that an improvement in mental health literacy is an effective measure for enhancing mental well-being. It would be prudent to combine an organisation-directed component and the enhancement of mental health literacy in an intervention programme. This trial will examine the novel approach of an intervention aiming to provide an evidence-based prevention programme. METHODS: This study utilised a wait-listed cluster randomised control trial design. Using branch offices as the primary sampling units, employees from three large companies in different industries will be recruited. Upon enrolment and after the baseline assessment of the outcome measures, participants nested in the branch offices will be allocated to the intervention or wait-listed arms. The intervention programme comprises of two main elements: an organisation-directed component and individual-directed psychoeducation training. This intervention will be delivered by a senior social worker well-versed in workplace issues over a period of 3 months. The trial will determine whether an integrated workplace mental health literacy and well-being programme is effective in increasing the mental health literacy scores and reducing burnout and stress scores, as measured by standardised and validated scales. DISCUSSION: If the trial results are in line with the hypothesis that supports the efficacy of the intervention programme, this will provide an evidence-based approach for an effective workplace mental well-being intervention programme that could not only enhance the understanding of mental health issues, but also reduce work-related burnout and stress as well as increase workers' quality of life. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12619000464167. Registered prospectively on 20 March 2019.

Basic Psychological Needs Satisfaction and Frustration, Stress, and Sports Injury Among University Athletes: A Four-Wave Prospective Survey.

The prevalence of sports injury among athletes is rather high, suggesting the need to better understand the causes of sports injury, including the risk factors, for preventive purposes. Grounded in basic psychological needs theory (BPNT) and the Model of Stress and Athletic Injury, the aim of this four-wave prospective survey study was to investigate the relationships among basic psychological needs satisfaction and frustration, stress responses, and sports injury. Study variables, including basic psychological need satisfaction/frustration, and perceived stress, were measured using a survey from 112 university athletes at the 1st, 2nd, and 3rd months of the study. Sports injury was assessed using a self-report form at the 2nd, 3rd, and 4th months of study. Results of the Bayesian multilevel analysis showed that basic psychological need satisfaction negatively predicted sports injuries, whereas stress was a positive predictor. In addition, basic psychological need satisfaction had an indirect effect on injury occurrence via stress. However, basic psychological need frustration did not predict sports injury. BPNT is a viable model to provide additional explanations to psychological risk factors of injury. Intervention programs may be formulated based on the evidence obtained on the model.

Predictors of mental health literacy in older people.

OBJECTIVES: Older adults exhibit poorer mental health literacy than younger adults, including less accuracy at identifying symptoms of mental disorders, and endorsing fewer sources of treatment for a mental disorder. The current study's intention was to determine if the executive component of cognition is associated with mental health literacy in older adults, when controlling for other established predictors (sex, age, education, and proximity to someone with a mental disorder). METHOD: The sample included 85 cognitively healthy adults aged 60 and over. Participants completed the Mini-Addenbrooke's Cognitive Examination III, the Trail Making Test, a Phonemic Verbal Fluency Test, and the Mental Health Literacy Scale. RESULTS: A multiple regression indicated that age and mental health proximity significantly and uniquely predicted total mental health literacy (Age: ß = -0.22, t = -2.04, p < 0.05; Proximity: ß = 0.31, t = 2.78, p < 0.01). Older age predicted poorer PTSD mental health literacy (ß = -0.31, t = -2.90, p < 0.01). CONCLUSION: In neurologically healthy older adults, level of executive function did not contribute to mental health literacy. Older adults in closer proximity to someone with a mental disorder were more likely to have better mental health literacy, a finding that has the potential to inform mental health education and promotion strategies in this population.

Application of the Social Network Analysis to Better Comprehend Relationships in Qualitative Health Data.

OBJECTIVE: To explore social network analysis (SNA) as an additional approach to elucidate quantifiable insight from qualitative health-related textual data. METHODS: Key concepts gained from thematic analyses of a set of qualitative health data obtained from an implementation study was analysed using the Excel Add-on module NodeXL. RESULTS: Our results show that SNA provided useful visualisation and quantifiable information of the relationship between key concepts obtained from the thematic analysis. DISCUSSION: SNA is a useful technique for exploring and analysing qualitative data, particularly when the research interest is in complex relationships that may exist among a large number of qualitative variables. In addition to providing a way to visualise the relationship between concepts, SNA provides metric measures that can be further analysed quantitatively. CONCLUSION: The SNA approach allows researchers to explore deeper relationships that may exist among various variables and enable researchers to derive potentially a fuller and more complete appreciation and comprehension of health-related data.