Clinical Practice and Epidemiology in Mental Health最新文献

{"title":"Assessment of eHealth Literacy in Healthcare Service Users: Construction and Validation of a Measurement Instrument.","authors":"Juan Morales, César Augusto Eguia","doi":"10.2174/0117450179393541250722062947","DOIUrl":"10.2174/0117450179393541250722062947","url":null,"abstract":"<p><strong>Introduction: </strong>eHealth literacy is influenced by Internet access and is associated with health status. The aim of this study was to develop and validate an instrument called eHealth-Much to measure eHealth literacy in users of healthcare services.</p><p><strong>Methods: </strong>An instrumental research design was used. Content validity was assessed by expert judgment and quantified using Aiken's V coefficient. A polychoric correlation matrix was used for the items. Sample adequacy was assessed through the Kaiser-Meyer-Olkin (KMO) index and Bartlett's test of sphericity before conducting exploratory factor analysis (EFA). The EFA was conducted using the Weighted Least Squares (WLS) extraction method with Oblimin rotation. Reliability was assessed using Cronbach's Alpha (α) and McDonald's Omega (ω) coefficients.</p><p><strong>Results: </strong>Twelve experts from five different countries participated in the content validation process, obtaining a V coefficient of 0.93 (95% CI: 0.79-0.97). A total of 1,068 health service users of both sexes participated in the construct validity testing. The median age was 32 years (IQR: 13, Q1: 26, Q3: 39; Min: 17, Max: 78). The KMO index was 0.92 (Bartlett's test, p < 0.001). The EFA suggested four factors labeled \"Digital Literacy\" (WLS1), \"Digital Self-Management\" (WLS4), \"Digital Skill\" (WLS3), and \"Scientific Empowerment\" (WLS2), which together explained 59.3% of the total variance. The reliability coefficients obtained were 0.86 for Cronbach's alpha and 0.90 for McDonald's omega. Percentile ranks and normative scores were also established for the sample.</p><p><strong>Discussion: </strong>The factorial structure obtained theoretically supports the multidimensionality of the construct, aligning with previous models of digital health literacy.</p><p><strong>Conclusion: </strong>The scale demonstrates adequate levels of validity and reliability. It may be considered a viable option for use in both primary care settings and hospital environments. Further studies are recommended to expand the psychometric analysis.</p>","PeriodicalId":35447,"journal":{"name":"Clinical Practice and Epidemiology in Mental Health","volume":"21 ","pages":"e17450179393541"},"PeriodicalIF":0.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Struggling with Self-Doubt: Impostor Phenomenon and Mental Health among Medical Students at Universitas Sumatera Utara Medan, Indonesia.","authors":"Ruhut Sion Simanjuntak, Rina Amelia, Elmeida Effendy, Yuki Yunanda","doi":"10.2174/0117450179397570250706100944","DOIUrl":"10.2174/0117450179397570250706100944","url":null,"abstract":"<p><strong>Introduction: </strong>Impostor Phenomenon (IP) is a common condition experienced by medical students and professionals who face high academic pressures and competitive environments, and is thought to be associated with other psychological conditions, such as anxiety, depression, and low self-esteem. Factors, such as gender and academic year, are also suspected to influence the development of IP experienced by individuals. This study aimed to analyze factors associated with IP among students at the Faculty of Medicine, Universitas Sumatera Utara.</p><p><strong>Methods: </strong>This analytical study employed a cross-sectional design. Variables assessed included gender, academic year, depression, anxiety, and self-esteem. Several questionnaires were used for data collection, such as CIPS, PHQ-9, GAD-7, and RSES questionnaires. Data analysis utilized Chi-square tests to investigate the relationship between each independent variable and Poisson regression tests to evaluate the correlation between all independent variables using the Statistical Package for the Social Sciences (SPSS Inc.).</p><p><strong>Results: </strong>A total of 347 students participated, revealing that 58.8% of medical students experienced IP, with a greater prevalence among females and the highest prevalence among second-year students. Data analysis revealed a significant association between IP and symptoms of depression (PR = 1.530; 95% CI = 1.229-1.904; P < 0.001), anxiety (PR = 1.317; 95% CI = 1.095-1.583, P = 0.003), and low self-esteem (PR = 1.237; 95% CI = 1.066-1.449; P = 0.008).</p><p><strong>Discussion: </strong>This study reinforces that psychological factors, including depression, anxiety, and low self-esteem, are strongly associated with the impostor phenomenon (IP) among medical students, while gender and academic year are not. The findings highlight the need for early mental health support to help students manage self-doubt and academic stress.</p><p><strong>Conclusion: </strong>The study highlights a high prevalence of IP among medical students, with a significant relationship between IP, depression, anxiety, and self-esteem.</p>","PeriodicalId":35447,"journal":{"name":"Clinical Practice and Epidemiology in Mental Health","volume":"21 ","pages":"e17450179397570"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Associated Factors of Benzodiazepine Use in Patients Attending a Community Mental Health Team in Scotland: A Cross-Sectional Survey.","authors":"Felix Kauye, Amanthi Wijesundara, Dalitso Mwandumba","doi":"10.2174/0117450179375369250623061653","DOIUrl":"10.2174/0117450179375369250623061653","url":null,"abstract":"<p><strong>Introduction: </strong>We aimed to assess the point prevalence and associated factors of Benzodiazepine (BZD) use in patients attending a Community Mental Health Team (CMHT) in Scotland.</p><p><strong>Methods: </strong>This cross-sectional survey included 412 patients from the outpatient medical caseload over a three-month period in 2021. Patient records were reviewed to identify whether they were prescribed BZDs. The analysis aimed to determine the point prevalence rate of BZD use and compare characteristics between patients on and not on BZDs.</p><p><strong>Results: </strong>The point prevalence rate was 16%. There were no significant sex differences (p=0.10) between patients on and not on BZDs. However, statistically significant differences were observed in relation to age (p=0.003), primary diagnosis (p=0.03), and the number of psychotropic medications (p= <0.001). Only the number of psychotropic medications varied significantly between long and short-term BZD use (p=0.005). Those on long-term BZD use of one year or longer had a higher number of psychotropic medications.</p><p><strong>Discussion: </strong>Monitoring and comparing the prevalence rates of BZD prescription by CMHTs is essential for reducing adverse effects associated with BZDs. Such concerns can influence clinical practice and may sometimes lead to conflicts between secondary and primary care clinicians. This study involved only one CMHT in Scotland and, therefore, may not be fully representative of all CMHTs across the country.</p><p><strong>Conclusion: </strong>A high number of psychotropic medications emerged as the only statistically significant factor associated with long-term BZD use. Consequently, diligent monitoring of BZD use is warranted in patients on a high number of psychotropic medications.</p>","PeriodicalId":35447,"journal":{"name":"Clinical Practice and Epidemiology in Mental Health","volume":"21 ","pages":"e17450179375369"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality from Alzheimer's Disease and Other Dementias in Ecuador during the Period 2012-2022.","authors":"Cristobal Espinoza, Maria Salinas, Alicia Morocho, Alex Morales, Byron Verdezoto","doi":"10.2174/0117450179376076250530074402","DOIUrl":"10.2174/0117450179376076250530074402","url":null,"abstract":"<p><strong>Introduction: </strong>Alzheimer's disease (AD) is a growing concern worldwide in healthcare. In Ecuador, the increasing life expectancy has raised the prevalence of age-related diseases, including dementias. The main objective of this study was to analyze the mortality from AD and other dementias in Ecuador from 2012 to 2022.</p><p><strong>Methodology: </strong>A retrospective, descriptive time series analysis was conducted on adult subjects with AD and other dementias across various geographic regions of Ecuador during the 2012-2022 period. A sample of 855,122 individuals registered in the databases of the National Institute of Statistics and Censuses (INEC) was analyzed.</p><p><strong>Results: </strong>Out of the total evaluated subjects, 4,836 deaths were due to AD (0.56%) and 1,317 deaths from other types of dementia (0.15%). For AD, the distribution of deaths by sex showed a predominant trend in women (n=3,008) within the group aged 65 years or older (n=4,749). For other dementias, women were also the main group (n=766), along with those aged 65 years and older (n=1,294). The national mortality rate showed an upward trend during this decade, increasing from 2.2 per 100,000 inhabitants in 2012 to 4.86 per 100,000 inhabitants in 2022.</p><p><strong>Discussion: </strong>This study reveals a worrying increase in mortality from Alzheimer's disease (AD) and other dementias in Ecuador between 2012 and 2022, especially among women, adults over 65 years of age, and residents of the Sierra region. Several factors that could negatively influence cognitive function were observed. These findings are consistent with global trends and suggest that biological, environmental, and social variables, such as aging, postmenopausal hormonal changes, chronic exposure to hypoxic altitude conditions, and unequal access to health services, could play a key role in this disease.</p><p><strong>Conclusion: </strong>Mortality from Alzheimer's disease and other dementias in Ecuador showed a sustained increase between 2012 and 2022, reflecting a growing burden of these pathologies in the population and the urgent need to strengthen prevention, early diagnosis, and comprehensive treatment strategies. The disproportionate impact on women, adults over 65 years of age, and residents of the Sierra region suggests the involvement of various biological, environmental, and social determinants of health, which requires more rigorous surveillance and a differentiated approach for these particularly vulnerable populations.</p>","PeriodicalId":35447,"journal":{"name":"Clinical Practice and Epidemiology in Mental Health","volume":"21 ","pages":"e17450179376076"},"PeriodicalIF":0.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12272087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Effects of Multicomponent Training, Resistance Training and Walking on Affect and Enjoyment of Healthy Elderly Individuals: A Randomized Cross-sectional Study.","authors":"Leonardo Fernandes de Souza, Alberto Souza Sá Filho, Flávia Paes, Vicente Aprigliano, Pedro Augusto Inacio, Sergio Machado","doi":"10.2174/0117450179371185250521110952","DOIUrl":"10.2174/0117450179371185250521110952","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Physical exercise plays an essential role in muscle function and the emotional well-being of elderly people. These practices potentially contribute to the development of affective response and enjoyment, creating a social and relaxed environment that improves mood and promotes interpersonal connections. Although the affective responses derived from Resistance Training (RT) and Walking Training (WT) are understood, the behavior of these responses, and the enjoyment associated with Multicomponent Training (MCT) remains underexplored, making further investigation warranted.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The present study aimed to evaluate the acute effect of MCT, RT, and WT on affective responses and enjoyment in elderly women. Additionally, preference and tolerance were also assessed, as well as the established circumplex model of affect.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Fifteen older women familiar with MCT, RT, and WT participated in the study in 3 visits. The elderly were randomly allocated to a) MCT, b) RT, and c) WT sessions on alternate days. All participants underwent the three modalities, where a single session lasted a maximum of 40 minutes. Each individual answered the Feeling Scale (FS) and Felt Arousal Scale (FAS) immediately before (FS&lt;sub&gt;1&lt;/sub&gt; and FAS&lt;sub&gt;1&lt;/sub&gt;), during (FS&lt;sub&gt;2&lt;/sub&gt; and FAS&lt;sub&gt;2&lt;/sub&gt;), and immediately after (FS&lt;sub&gt;3&lt;/sub&gt; and FAS&lt;sub&gt;3&lt;/sub&gt;). At the end of each training session, individuals also answered the enjoyment scale (PACES) and preference/tolerance questionnaire (PRETIE - Q).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The Friedman test indicated differences only for FS in the face of RT (&lt;i&gt;p&lt;/i&gt; &lt;0.001) and WT (&lt;i&gt;p&lt;/i&gt; &lt;0.001), marking a reduction in affect. For MCT, no differences between the three measures performed were observed (&lt;i&gt;p&lt;/i&gt;=0.513). There were differences in the FS&lt;sub&gt;2&lt;/sub&gt; (&lt;i&gt;p&lt;/i&gt; = 0.021) and FS&lt;sub&gt;3&lt;/sub&gt; (&lt;i&gt;p&lt;/i&gt;=0.002) between RT or WT, with no differences for FS&lt;sub&gt;1&lt;/sub&gt; (&lt;i&gt;p&lt;/i&gt;=0.641). There were differences in the level of body arousal for RT (&lt;i&gt;p&lt;/i&gt; &lt;0.001), MCT (&lt;i&gt;p&lt;/i&gt; = 0.021), and WT (&lt;i&gt;p&lt;/i&gt; &lt;0.001). Differences were observed in FAS&lt;sub&gt;2&lt;/sub&gt; (&lt;i&gt;p&lt;/i&gt;=0.029) and FAS&lt;sub&gt;3&lt;/sub&gt; (&lt;i&gt;p&lt;/i&gt;=0.006) between groups, with no differences in FAS&lt;sub&gt;1&lt;/sub&gt; (&lt;i&gt;p&lt;/i&gt; = 0.314). PACES scale indicated differences between MCT and RT vs. WT (superior). There were no differences between groups for the PRETIE-Q scale for tolerance or preference. The circumplex model admits that the three exercises performed moved into positive domains.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;Different exercise alternatives are employed with the aim of overcoming barriers relating to adherence to exercise. From this perspective, the plurality of movement patterns and perceptions of pleasure are substantial. Thus, interventions with multimodal characteristics are incorporated as a response to such barriers. Interestingly, our findings on a population of elderly","PeriodicalId":35447,"journal":{"name":"Clinical Practice and Epidemiology in Mental Health","volume":"21 ","pages":"e17450179371185"},"PeriodicalIF":0.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lifetime Prevalence of Recurrent and Persistent Depression: A Scoping Review of Epidemiological Studies.","authors":"Evgeny Kasyanov, Yana Yakovleva, Maria Khobeysh, Ekaterina Gerasimchuk, Galina Mazo","doi":"10.2174/0117450179372815250516102324","DOIUrl":"10.2174/0117450179372815250516102324","url":null,"abstract":"<p><strong>Background: </strong>Differing conceptualizations of recurrent and persistent depression in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD) lead to diagnostic inconsistencies. This scoping review analyzed epidemiological studies on the lifetime prevalence of recurrent and persistent depression in the general population.</p><p><strong>Methods: </strong>Following PRISMA-ScR guidelines, we searched MEDLINE and the Russian Science Citation Index without time or language restrictions. Inclusion criteria were original epidemiological studies of the general population reporting lifetime prevalence of recurrent or persistent depression, using DSM-III/IV/5 or ICD-9/10/11 criteria.</p><p><strong>Results: </strong>Only three studies on recurrent depression were identified - from Switzerland, the USA, and Hungary - showing a consistent lifetime prevalence of 10.3% to 10.5%. In contrast, major depressive disorder had a lifetime prevalence of 1.5 to 2.5 times higher in these studies. Dysthymia and persistent depression showed lifetime prevalences ranging from 1.1% to 6.4% and 1.6% to 18%, respectively. Women represented about two-thirds of cases of both recurrent and persistent depression.</p><p><strong>Conclusion: </strong>The underrepresentation of recurrent depression may stem from the DSM's dominant influence in psychiatric diagnostics. Our findings highlight the need for refined diagnostic criteria and more comprehensive epidemiological studies that separately identify recurrent and persistent depression.</p>","PeriodicalId":35447,"journal":{"name":"Clinical Practice and Epidemiology in Mental Health","volume":"21 ","pages":"e17450179372815"},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12272091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of a Playoff Match on Competitive Anxiety and Autonomic Regulation in Professional esports Players.","authors":"Sergio Machado, Leandro de Oliveira Sant'Ana, Luis Cid, Diogo S Teixeira, Antonio Egidio Nardi, Bruno Travassos, Diogo Monteiro","doi":"10.2174/0117450179293069250507074009","DOIUrl":"10.2174/0117450179293069250507074009","url":null,"abstract":"<p><strong>Introduction: </strong>A competition is considered a stressful situation since it causes physiological and emotional changes in the responses of athletes and consequently influences their performance. The aim of our study was to investigate competitive anxiety and heart rate variability (HRV) in professional eSports athletes, comparing the responses before and after matches based on whether they won or lost. We hypothesized that victorious players would display more favorable autonomic and anxiety-related responses after the matches compared to those who were defeated.</p><p><strong>Methods: </strong>We recruited fifty male esports players from 10 different Brazilian teams and carried out the experiment across two sessions. Initially, 24 hours before the game, players signed the informed consent form, and sample characterization, along with player familiarization with anxiety and HRV, was performed. Following this, the players recorded their anxiety levels and HRV at rest for 10 minutes, both 60 and 30 minutes prior to the game (baseline time points), as well as 10 minutes after the conclusion of the game.</p><p><strong>Results: </strong>Regarding anxiety, our results demonstrated that the victory group (VG) exhibited significantly lower scores for both cognitive and somatic anxiety in the post-game time point, coupled with increased scores for self-confidence when compared to the baseline (BL) and pre-game time points. In opposition, the defeated group (DG) displayed significantly elevated scores for cognitive and somatic anxiety during the post-game time point, accompanied by decreased self-confidence scores compared to the baseline and pre-game time points. Regarding heart rate variability (HRV), the victory group (VG) demonstrated a significant increase in SDNN, rMSSD, and HF measures, coupled with a significant decrease in the LF/HF ratio. Conversely, the defeated group (DG) exhibited a significant decrease in SDNN and rMSSD, along with a significant increase in the LF/HF ratio.</p><p><strong>Discussion: </strong>Our results revealed that VG exhibited better HRV responses, indicating greater parasympathetic activation. VG also showed lower levels of cognitive and somatic anxiety and higher levels of self-confidence in the post-game time. In contrast, DG demonstrated worse HRV responses, indicating greater sympathetic activation, along with higher levels of cognitive and somatic anxiety and lower levels of self-confidence in the same post-game period.</p><p><strong>Conclusion: </strong>In summary, the VG exhibited superior HRV responses in conjunction with lower levels of anxiety compared to the DG.</p>","PeriodicalId":35447,"journal":{"name":"Clinical Practice and Epidemiology in Mental Health","volume":"21 ","pages":"e17450179293069"},"PeriodicalIF":0.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clustering the Depression Prevalence in Indonesia Provinces through Natural Breaks Jenks Method.","authors":"Widya Saputri Agustin, Herlin Ari Prastika, Gading Kaila Kendrasti, Rohmatul Fajriyah, Vang Le-Quy","doi":"10.2174/0117450179375982250512114928","DOIUrl":"10.2174/0117450179375982250512114928","url":null,"abstract":"<p><strong>Introduction: </strong>Depression is a major public health issue worldwide, ranking fourth among global diseases in 2022 according to the WHO. In Indonesia, the 2018 Basic Health Research (Riskesdas) reported that over 12 million individuals aged 15 and above suffer from depression. Identifying regional disparities in depression prevalence is essential to guide targeted mental health policies and interventions.</p><p><strong>Methods: </strong>This study employed the Natural Breaks Jenks classification to cluster depression prevalence across Indonesian provinces using data from the 2023 Indonesia Health Survey. This method effectively grouped provinces based on natural data patterns, enabling the identification of regions with low, medium, high, and very high depression prevalence.</p><p><strong>Results: </strong>The analysis revealed significant regional disparities. Eighteen provinces, including Papua, Maluku, and several Sulawesi regions, were classified as having low depression prevalence. Eleven provinces, such as Aceh, Bali, and Kalimantan Timur, fell into the medium category. Six provinces-including DKI Jakarta, Banten, and Sumatera Selatan-exhibited high prevalence rates, possibly due to urbanization and socio-economic factors. Critically, Jawa Barat, Jawa Tengah, and Jawa Timur were identified as having very high depression prevalence, suggesting urgent needs for intervention.</p><p><strong>Discussion: </strong>These findings underscore the need for geographically targeted mental health strategies. Provinces with very high prevalence require prioritized attention for mental health services, infrastructure, and resource allocation. Understanding local socio-economic and cultural contexts will be crucial in reducing disparities and improving national mental health outcomes.</p><p><strong>Conclusion: </strong>These results indicate that Indonesia has a higher number of provinces with low depression prevalence compared to those with high prevalence. This suggests that while there are regions with lower rates of depression, there are still significant areas where mental health issues need more focused attention. Given this, the government should prioritize provinces with very high depression prevalence to improve mental health outcomes in those areas. By focusing on these regions, the government can better allocate resources, implement targeted interventions, and provide necessary mental health services. Addressing the mental health needs of provinces with high depression rates is essential for reducing overall national mental health disparities and ensuring equitable access to mental health support across Indonesia. Additionally, understanding the socio-economic and cultural factors that contribute to higher depression rates in these regions will be crucial in designing effective and sustainable mental health programs.</p>","PeriodicalId":35447,"journal":{"name":"Clinical Practice and Epidemiology in Mental Health","volume":"21 ","pages":"e17450179375982"},"PeriodicalIF":0.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12272090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of a Self-Report Measure of Existential Well-Being.","authors":"Angelo Picardi, Antonella Filastro","doi":"10.2174/0117450179366317250410071321","DOIUrl":"10.2174/0117450179366317250410071321","url":null,"abstract":"<p><strong>Background: </strong>Research in the field of existential psychotherapy has mainly relied on measures of spiritual well-being and existential quality of life, and has been hindered by the lack of instruments specifically assessing existential distress and wellbeing. Our aim was to develop a valid and reliable instrument to measure this dimension.</p><p><strong>Methods: </strong>First, we created a list comprising more than 200 items that address the main existential themes as described by the philosophical and clinical literature. Out of these, 84 were retained after pilot testing and exclusion of the items that showed unsatisfactory psychometric properties. A total of 411 non-clinical participants with a wide range of age groups and educational levels participated in the validation study with a cross-sectional design and a 4-week follow-up. They completed the new instrument, named the 'Existential Dimension Inventory' (EDIN), along with several criterion measures, such as the 15-item Dispositional Resilience Scale, the 18-item Personal Well-Being Scale, the Experiences in Close Relationships Questionnaire, the 18-item Brief Symptom Inventory, the Maudsley Obsessive-Compulsive Inventory, the Authenticity Scale, and the Temperament and Character Inventory. They also completed the EDIN for a second time after 4 weeks. After performing principal component analysis with orthogonal rotation, we estimated the internal consistency and test-retest stability of EDIN factorially derived scales. Convergent and discriminant validity were assessed by examining the correlations between EDIN total and subscale scores, and scores on the criterion measures.</p><p><strong>Results: </strong>Eight factors (interpreted as Mastery, Fear of loss and death, Authenticity, Serenity in relationships, Pressure of time, Openness to others, Worry about meaning in life, and Loneliness) that accounted for 53% of the total variance were extracted. All EDIN scales displayed high internal consistency and stability, and the pattern of correlations between EDIN scores and their relevant criterion measures was consistent with expectations. Also, the results supported discriminant validity with respect to emotional distress, psychiatric symptomatology, and temperament and character dimensions.</p><p><strong>Conclusion: </strong>These findings suggested that the EDIN may allow valid and reliable measurement of existential well-being. Many EDIN subscales cover themes identified by existential philosophers and therapists as key issues that human beings face in their everyday lives, which corroborates the relevance of the dimension of existential wellbeing as measured by the EDIN. Despite some limitations, this study supports the validity and reliability of the EDIN. It suggests that this instrument holds the promise of being a valuable tool for research, clinical, and training purposes.</p>","PeriodicalId":35447,"journal":{"name":"Clinical Practice and Epidemiology in Mental Health","volume":"21 ","pages":"e17450179366317"},"PeriodicalIF":0.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12272088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modifications of the Effect of Juvenile Idiopathic Arthritis (JIA) on Anxiety and Depression in Children and Adolescents: A Pseudo-longitudinal Study of 192,019 Children in the United States.","authors":"Kira Gor, Yu-Sheng Lee, Matthew Evan Sprong, Heaven Hollender, Junu Shrestha, Xueli Huang","doi":"10.2174/0117450179372640250324051404","DOIUrl":"10.2174/0117450179372640250324051404","url":null,"abstract":"<p><strong>Introduction: </strong>Juvenile Idiopathic Arthritis (JIA), among children and adolescents, is a heterogeneous condition and is a prevalent chronic rheumatological disease. Non-medical (<i>e.g.</i>, self-efficacy, social support, parental distress, and coping with pain), medical factors (<i>e.g.</i>, permanent damage to joints), and psychological factors (<i>e.g.</i>, depression and anxiety) can significantly impact the quality of life for individuals with JIA.</p><p><strong>Methods: </strong>This study aimed to investigate the effect modifiers of the associations of anxiety and depression in children with JIA. The National Survey of Children's Health database (2016-2021) was used for the current study. A total of 192,019 children were included in the analyses. An augmented backward elimination model selection method was used to identify predictors for depression and anxiety.</p><p><strong>Results: </strong>The period prevalence of JIA was 2.723 per 1,000. Sex was an effect modifier. Among boys, those who had JIA were 2.96 times (p<0.0001) more likely to have depression compared to non-JIA boys. On the other hand, the effects of JIA on anxiety were different across the insurance types. Among children with public insurance, children with JIA were 6.28 times (p <0.0001) more likely to have anxiety than those without JIA. Among children with JIA, those with public insurance were 5.23 times (p = 0.0005) more likely to have anxiety than those with private insurance.</p><p><strong>Discussion: </strong>This population-based study found that typical sex differences in depression were not observed in the JIA group and that children with JIA had higher rates of anxiety, particularly those with public insurance. These findings highlight the need for integrated care that addresses both physical and mental health.Collaborative models involving rheumatologists and mental health professionals may aid in early intervention. Limitations include the study's cross-sectional design, which did not establish a causal association, and a lack of analysis by the JIA subtype, which could have varying impacts on mental health outcomes.</p><p><strong>Conclusion: </strong>The findings highlight the importance of conducting comprehensive mental health assessments and developing personalized interventions tailored to the needs of JIA patients. The observed sex differences and the impact of insurance type on anxiety further emphasize the necessity of individualized care approaches.</p>","PeriodicalId":35447,"journal":{"name":"Clinical Practice and Epidemiology in Mental Health","volume":"21 ","pages":"e17450179372640"},"PeriodicalIF":0.0,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}