bluuebunny/crossref_metadata_2025 huggingface dataset:
Positive effects from the introduction of fully subsidised nicotine replacement therapy in Ireland
Authors: Naughton P , Sheridan A , Murphy E , Blake M , Kavanagh P
Published: October 2024

Smoking remains a leading cause of preventable death in the Europe. Despite recent declines in prevalence, the adverse health and economic effects of smoking are felt disproportionately by disadvantaged groups. Nicotine replacement therapy (NRT) is well established as an effective smoking cessation aid; however, its financial cost may act as a barrier to uptake. In February 2023, eligibly for fully subsidised NRT was expanded to all users of smoking cessation services in Ireland. This study evaluated the impact of universal access to NRT on smoking cessation. This study utilised secondary analysis of routinely collected data from service users attending Irish smoking cessation services. Individuals were followed for twelve weeks. Changes in self-reported quit status and NRT use were analysed before (January 2021 - February 2023) and after (March 2023 - December 2023) the introduction of fully subsidised NRT. Logistic regression modelling identified factors associated with smoking cessation. The total number of participants was 19,717. There was higher uptake of NRT among service users who were eligible for free NRT (59% vs 40%, p < 0.001) and higher quit rates at four (41% vs 29%, p < 0.001) and twelve (29% vs 20%, p < 0.001) weeks. Logistic regression models demonstrated that NRT use was significantly associated with smoking cessation at four (aOR 1.88, 95%CI 1.47 - 2.41) and twelve (aOR 1.76, 95%CI 1.37 - 2.28) weeks. This study confirms the effectiveness of NRT in an Irish context and illustrates the benefits of universal access to this life saving medicine. Targeted interventions are required to intensify services offered to disadvantages groups if the ambitious objectives of Tobacco Endgame are to be achieved. These findings represent an urgent call to action for European policy makers to deliver equitable access to NRT across the continent. Such action can transform the public health landscape and help bring us closer to achieving a tobacco free Europe.

Key messages

• This study confirms the real-world effectiveness of NRT use as a smoking cessation aid.

• The removal of financial barriers is associated with increased NRT use and successful smoking cessation.
Impact of COVID-19 measures on psychosocial outcomes in Austria – a qualitative vignette study
Authors: Vorstandlechner M , Harlfinger J , Kien C , Ritschl V , Chapman A , Schneckenreither G , Zauner G , Gartlehner G , Popper N , Stamm T
Published: October 2024

During the COVID-19 pandemic, Austria implemented frequent and restrictive containment measures. We aimed to explore the perspectives of individuals affected by political and epidemiological decisions in Austria, particularly in Vienna and Lower Austria. A qualitative vignette-based study conducted from July to Oct 2023 utilized two hypothetical future pandemic scenarios to prompt in-depth discussions in semi-structured interviews with Austrian residents about their perspectives, either private or from the fields of healthcare, education, citizen representation, business, research, public health and politics. Interview data was analysed using a thematic analysis approach. To ensure results’ rigor and accuracy, we followed the COREQ guideline and included two citizen research partners. This project is funded by WWTF (Grant ID: LS22071). Preliminary thematic analysis from 28 interviewees (53.6% female) aged 19-77 (mean 53.0 years) shows that the negative effects of school closures was a major concern among participants. Despite diverging points of view on other topics, there was a broad consensus that school closures would have negative consequences, such as unstable educational modalities impairing young people’s individual development, decreasing psychosocial support in their peer groups, leading to long-term educational losses, not only for individuals but also for society as a whole, and having a negative impact on economic growth, social justice and innovation. The participants also described a lack of evidence for the necessity of the frequent school closures during the pandemic as had happened in Austria and suggested a different approach in a future pandemic. Further topics were the deterioration of mental health, incentives instead of mandatory measures, more transparent communication by authorities, agreement between experts and researchers, reducing uncertainties regarding pandemic management, compliance by the general public and democratic social cohesion.

Key messages

• Addressing the multi-faceted impact of a pandemic requires a comprehensive approach that considers mental health, social justice, communication and social cohesion alongside containment measures.

• This work represents a learning from the COVID-19 pandemic. From the conclusions of this study, recommendations can be derived to be better equipped in future pandemics.
Confronting the Global Crisis of Youth and Firearms in the Wake of Serbia’s First School Shooting
Authors: Sebek V , Opancina V , Yang Y T
Published: October 2024

Issue

School shootings reflect crucial systemic flaws, notably the ease of firearm access and training for children, despite rigorous firearm regulations.

Description

In May 2023, Serbia was rocked by its first school shooting in Belgrade, where a 13-year-old boy, armed with guns and Molotov cocktails, killed 9 and injured 6.His actions were amplified by his proficiency with firearms, a skill honed under his father’s guidance at shooting ranges. This tragic event ignited a nationwide debate on gun control. Our study seeks to attain an in-depth analysis on regulations on minimum age for firearm training in context of school shootings in Serbia and USA as countries with highest rates of civilian gun ownership globally.

Results

Serbian regulations lack a definitive minimum age for firearm training at shooting ranges, mirroring a situation in the USA, where 17 states do not have child access prevention laws, and 43 states lack mandated safe storage requirements. A worrying trend is the escalation in mass shootings by individuals aged 21 or younger, deviating from the earlier trend of middle-aged perpetrators. This younger demographic often seeks fame, inspired by previous mass shooters, contributing to the rise in both deliberate and accidental shootings by young people.

Lessons

We need to consider the implementation of regulations on minimum age for children firearm training at shooting ranges, as well as stricter control of the ranges. This problem extends beyond national boundaries, reflecting a global issue. The accessibility of firearms to youth, coupled with their developmental susceptibility to impulsive and aggressive behavior, raises significant concerns.

Key messages

• To increase global awareness and stricter regulations on youth firearm access, emphasizing the stricter regulations on shooting ranges and the integration of firearm safety education into curricula.

• Firearm control and children safety is a collective international duty, crucial for addressing a concern that impacts public safety and youth welfare.
Childhood socioeconomic differences in type 2 diabetes: longitudinal results of The Maastricht study
Authors: Meisters R , Koster A , Albers J , Sezer B , de Galan B E , van Greevenbroek MMJ , Bosma H
Published: October 2024

Background

Type 2 diabetes mellitus (T2DM) is a common chronic disease that disproportionally affects disadvantaged groups. People with a low socioeconomic position (SEP) have an increased risk of developing T2DM. Knowing the potential influence of early life on T2DM risk later in life, this study aims to examine longitudinal associations between childhood SEP and type 2 diabetes, independent of adult SEP.

Methods

Longitudinal data was used from 6,727 participants of The Maastricht Study without T2DM at baseline (participants with prediabetes were included in the study sample). T2DM status was determined by a standardized oral glucose test. Sample mean (SD) age was 58.7 (8.7) years and 55.2% was female. Childhood SEP was determined by the highest level of completed education for father and mother and a measurement for childhood income inadequacy. Adult SEP was determined by the highest completed level of education, equivalent household income and occupational position. Incident T2DM was self-reported yearly. Associations were studied annually over a 12-year period (median (IQR) 8.2 (4.9) years) with Cox regression analyses.

Results

A total of 247 participants (3.7%) without T2DM at baseline reported incident T2DM. Incident T2DM was more common in people with low childhood SEP versus high childhood SEP (4.5% vs. 2.7%, p = 0.008) and for people with low adult SEP versus high adult SEP (5.2% vs. 2.1%, p < 0.001). The impact of parental education on incident T2DM is mitigated by adult SEP. Childhood income inadequacy did predict T2DM independently of adult SEP, with a HR of 1.22 (1.01, 1.45).

Conclusions

Socioeconomic inequalities in childhood and adulthood are both predictive for incident T2DM. Experiencing income inadequacy in childhood increases the risk of developing T2DM in later life, independent of adulthood SEP. More attention is needed for deprivation in childhood and its impact on T2DM.

Key messages

• People who have experienced income inadequacy as a child have a higher risk of developing T2DM in later life, independent of their adult SEP.

• More attention and research is needed for the impact of childhood poverty on developing T2DM in later life.
Sociodemographic predictors of the association between self-reported sleep duration and depression
Authors: Al Balushi M , Ahmad A , Al Balushi S , Javaid S , Al Maskari F , Abdulle A , Ali R
Published: October 2024

Background

This cross-sectional study is apart from one of the first and largest population-based prospective cohort studies in the UAE called the United Arab Emirates Healthy Future Study (UAEHFS). The aim of this study is to investigate the association between self-perceived sleep duration and self-perceived depression after adjustment for sociodemographic factors. Baseline line data from UAEHFS cohort participants were included in this cross-sectional study. Univariable and multivariable logistic regression models were fitted, with the binarized self-reported sleep hours as an outcome. The predictors were the self-reported PHQ-8, sociodemographic factors, and body mass index (BMI). Odds ratios with 95% confidence intervals (CI) were reported.

Results

Of 11,455 participants, 4,295 (37.5%) were included in the complete case analysis after omitting missing values. We applied a complete case analysis following omitting missing values. Participants’ median age was 32.0 years (Interquartile-Range: 24.0, 39.0). In total, 63.6% of the participants reported sleep duration of more than 7 hours. Statistically significant negative association was observed between the total PHQ-8 score and binarized self-reported sleep, OR = 0.961 (95% CI: 0.948, 0.974). For one unit increase in age and BMI, the odds ratio of reporting shorter sleep with OR of 0.979 (95% CI: 0.969, 0.990) and 0.987 (95% CI: 0.977, 0.998) respectively.

Conclusions

The study findings indicate a correlation between higher total PHQ-8 scores and an increased probability of individuals reporting shorter self-perceived sleep durations when considering some sociodemographic factors such as age, marital status and employment status. However, there was no difference between females and males in reporting self-perceived sleep duration among depressed individuals.

Key messages

• There is a correlation between higher total PHQ-8 scores and an increased probability of individuals reporting shorter self-perceived sleep durations.

• Our results can help contribute to the knowledge based on current and potential population mental health in the UAE and Gulf Region.
Poor psychosocial status and cardiovascular risk factors are associated with depression or anxiety
Authors: Peer N , Mashiane T , Hill J , Kengne A P
Published: October 2024

Background

Depression and anxiety are rising in South Africa but their associations with psychosocial and cardiovascular risk factors (CVRFs) remain under explored. This study determined the associations of depression and anxiety traits with poor psychosocial wellbeing, risky lifestyle behaviours and cardiometabolic diseases.

Methods

In a population-based cross-sectional study, data were collected via administered questionnaires, clinical examinations and biochemical assessments. Depression and anxiety traits were ascertained via the Patient Health Questionnaire-9 and Generalised Anxiety Disorder screening questions. Multivariable logistic regressions determined the associations with depression and anxiety traits; the basic model comprised sociodemographic factors, physical inactivity, tobacco smoking and alcohol misuse (CAGE ≥2). Psychosocial and cardiometabolic variables were entered individually in separate models.

Results

Among 678 participants, median age 52 years and mainly women (81%), prevalence of depression scores ≥10 were 14.2% (men:12.7%, women:14.6%, p = 0.498) and anxiety scores ≥10 were 10.2% (men:10.3%, women:10.2%). In the basic regression models, depression, but not anxiety, was associated with being separated, living as married/widowed vs. single (OR:2.01, 95%CI:1.02-3.94), and alcohol misuse (2.07, 1.13-3.78). Depression and anxiety were associated with decreasing social support (depression: 1.09, 1.04-1.12; anxiety: 1.09, 1.04-1.14), and increasing number of adverse life events. Hypertension (1.76, 1.07-2.90, p = 0.025), diabetes (1.98, 1.03-3.82, p = 0.041) and dyslipidaemia (1.97, 1.01-3.85, p = 0.048) were associated with depression but not anxiety.

Conclusions

The high burden and associations of depression and anxiety traits with poor psychosocial wellbeing suggest a need for holistic care approaches. The associations of depression traits with CVRFs warrant screening and care of depression in the presence of cardiometabolic diseases and alcohol misuse.

Key messages

• The high burden of depression and anxiety traits in South Africa is associated with poor social support and quality of life, and increasing adverse life events experienced.

• The associations of depression traits with hypertension, diabetes, dyslipidaemia, and alcohol misuse highlight the need for integrated management strategies.
Modification in Quality of Life and Health in Medical Students across Graduation
Authors: Szemik S , Kowalska M
Published: October 2024

Background

Medical students experience numerous demands during the education process, determining their quality of life (QoL) and health status. POLLEK study aims to identify and evaluate the quality of life by simultaneously assessing their determinants in Polish medical students during long-term observation. We have also examined the prevalence of chronic diseases, specifically focusing on overweight and obesity, and identified their risk factors.

Methods

The POLLEK is the follow-up cohort study conducted among medical students at the Medical University of Silesia in Katowice. Students were followed during two observation periods: in their first year of studies, the academic year 2021/2022 (T1), and in their second year, the academic year 2022/2023 (T2).

Results

The total number of participants in the first year of observation (T1) was 427 while in the second year (T2) was 335. We identified that the QoL score significantly decreased in their second year of studies mainly in the somatic and psychological domain. The determinants of QoL domains common to T1 and T2 remained self-declared health status, frequency of physical activity, and current financial situation. In the initial year of evaluation, 56 students (13.10%) were overweight or obese, and 52 (15.8%) in the second. Regardless of the academic year, the increased risk of being overweight or obese was significantly associated with dissatisfaction with personal health, financial deficiencies, and a diet abundant in animal products.

Conclusions

The QoL of medical students and selected indicators of their health status deteriorated during the observation period. Our findings suggest that medical schools should actively promote the activity needed to achieve a balance between schoolwork and the personal life of medical students from the beginning of university study.

Key messages

• Medical students experience numerous demands during the education process, determining their quality of life (QoL) and health status.

• Medical schools should actively promote the activity needed to achieve a balance between schoolwork and the personal life of medical students from the beginning of university study.
The UFair-Questionnaire: Perceived university fairness and its association with mental health
Authors: Soedel C A , Herr R M , Deyerl V M , Diehl K
Published: October 2024

Introduction

University students face different stressors that might jeopardise their mental health. Hitherto, mainly general stress perceptions were assessed, which appeared inappropriate to indicate stress directly linked to the university or for deriving specific preventative measures. The aim of this study was to adapt the concept of organisational justice to universities, develop and validate a corresponding questionnaire (UFair: University Fairness Questionnaire), and estimate its association with mental health.

Methods

In total, 1,105 students (average age: 25.5 years [SD: 5.43]; female: 50.1%; university: 67.2%, university of applied sciences: 32.8%) were surveyed online. Perceived unfairness at the university was measured using the newly developed 20 item UFair Questionnaire. Mental health was measured using the Patient Health Questionnaire (PHQ-8, depression) and Maslach Burnout Inventory for Students (MBI-SS, burnout). Linear regression models estimated the adjusted (age, gender, type of university, lifestyle factors) relationship between perceived university injustice and mental health indicators.

Results

The UFair questionnaire showed good psychometric properties (Cronbach’s alpha = .960) and a unidimensional factor structure. There was a considerable association with depression (beta = .485; p < .001; R2 = .261) and burnout (beta = .481; p < .001; R2 = .250).

Conclusions

Perceived injustice represents not only a stressor at the workplace but also in the university setting, showing a considerable relationship with students’ mental health. University justice includes the perception of organisational aspects, the treatment of students, and consideration of the individual situation of students. The relevance of these aspects to the health of students should be recognised and taken into account by universities. The valid measurement by the UFair Questionnaire represents the basis for possible preventive approaches and interventions.

Key messages

• Organisational injustice exists not only in the workplace but also among students in the university setting.

• Perceived unfairness among students is associated with depression and burnout.
Dose-response associations between physical activity and mental health among USA adolescents
Authors: Fornaguera M , Dowda M , Pate R
Published: October 2024

Background

Adolescent mental health is a critical public health concern. Physical activity has been shown to reduce risk of negative mental health outcomes. However, in adolescents little is known about the dose-response nature of this relationship. This study aims to fill this gap by examining the association between varying levels of self-reported physical activity and the odds of reporting depressive symptoms and poor mental health, among US high school students.

Methods

This is a cross-sectional study using data from the 2021 Youth Risk Behavior Survey. Physical activity exposure was assessed as students’ self-reported weekly frequency of ≥ 60min moderate-to-vigorous physical activity (MVPA), as well as frequency of participation in muscle-strengthening activities, sports teams, and physical education (PE) classes. For the dose-response analysis three categories were created for each item. Depressive symptoms and poor mental health were measured using established survey items. Multivariate logistic regression risk models were used.

Results

A total of 8,015 high-school students were included. Depressive symptoms were reported by 43% of students, and 28% reported poor mental health. Moderate doses (1-4 days) of muscle-strengthening activities reduced the odds of depressive symptoms by 23% and the odds of poor mental health by 38% compared to low doses (0 days). Higher reductions were observed for higher doses (5-7 days). Similar results were observed for sports teams (1 vs 0 teams). Moderate doses (1-4 days) of MVPA ≥60min showed a significant reduction in the odds for poor mental health (38%) but not depressive symptoms compared to low doses (0 days). No effect was observed for any dose of PE attendance.

Conclusions

The findings suggest a dose-response pattern in the association between physical activity and mental health in adolescents. Any increase in physical activity levels among young adults would be valuable in preventing poor mental health.

Key messages

• A dose-response pattern was observed between self-reported mental health and physical activity exposure in adolescents.

• Moderate levels of physical activity significantly reduced the risk of self-reported poor mental health among adolescents.
Barriers and facilitators for implementing ABCs for Mental Wellbeing intervention model in Finland
Authors: Tamminen N , Vauhkonen T
Published: October 2024

Background

The ABCs for Mental Wellbeing study aims to improve mental health and wellbeing by adopting, implementing and evaluating a universal, community-based mental health promotion intervention model in Finland. The study gathers information and experiences of the implementation processes, identifies barriers and facilitators, and best practices for the implementation, and the feasibility and contextual adaptability of the intervention in different settings and specific target groups.

Methods

The implementation took place in four municipality community settings. In total, 40 participants attended the ABC activities. The study employs a mixed methods approach to look at the implementation processes: a quantitative survey before and after the implementation, and qualitative interviews with the employees implementing the model and the participants involved with the ABC activities.

Results

Based on qualitative analysis, the most identified facilitator is management support alongside the competencies of professionals. The observed effects of group activities aligned with the ABC model on mental wellbeing show that participants not only experienced the benefits of model-compliant activities on their mental wellbeing but also increased their awareness of factors influencing their mental wellbeing. The results of the quantitative analysis will be ready during the spring.

Conclusions

The study offers fresh insights into the obstacles and enablers affecting the implementation of a mental health promotion intervention model. The best practice strategies and guidelines identified are being shared both nationally and internationally and utilised to enhance future programme implementation and adaptation of these practices in various settings.

Key messages

• Best practice strategies and guidelines for successful implementation of mental health promotion identified.

• The ABCs for Mental Wellbeing increased participants’ awareness of the factors influencing their mental wellbeing.
Multidimensional assessment and analysis of the mental health of teachers and police officers
Authors: Oláh C , Oláh Z , Orosz S , Baksa-Varga E , Oláh B , Horváth Á , Bánné Gál B , Papp M , Godzsák M , Szekér Z
Published: October 2024

Background

The years-long COVID-19 pandemic, the proximity of the Russian-Ukrainian war, high inflation, and the economic recession are significant stressors for the Hungarian people. Numerous domestic and international surveys are prepared every year, in which the most stressful professions are ranked. In recent years, based on Hungarian, American and European surveys, teachers and police officers have always been included in the 10 most stressful jobs. They also rank the most valued jobs and highest paid jobs every year. In this relation, police and teaching jobs never made it into the top 10, despite the fact that both professions are very important on a social level.

Methods

20 male and 20 female teachers and police officers completed a complex quality of life and psychological assessment using international tests with ethics approval. We measured pain syndromes, such as headache, neck and back pain, joint pain, assessed depression, anxiety, sleep quality, and gastrointestinal symptoms.

Results

For police officers and teachers, gender differences were not verified with regard to any parameter. None of the parameters differed significantly for male police officers and teachers. Many significant differences were confirmed between female police officers and female teachers, in all of them the results of the teachers were worse: depression (9,4±10,3 vs 2,9±4,3; p = 0.02) anxiety(43,3±12,2 vs 33±4,6; p = 0.01), sleep disorders(32,7±8,2 vs 24,3±7,8; p = 0.01), gastrointestinal complaints(24,7±9,4 vs 17,6±2,3; p = 0.01).

Conclusions

The sleep quality, depression and anxiety levels of female teachers are worse than those of female police officers who live at least as stressful a life. There is no difference between the mental and psychological state of male teachers and police officers. It is important to pay attention to the mental support of female teachers.

Key messages

• We consider the assessment of the mental state of police officers and teachers and the creation of primary prevention programs and a mental support network to be an important public health task.

• In particular, the mental state of female teachers should be monitored and supported.
Self-harming behaviours and social support among a sample of young men in Belfast, Northern Ireland
Authors: Morse A , Higgins K
Published: October 2024

Background

Psychiatric morbidity is substantially higher in Northern Ireland (NI) than in peer nations and men are disproportionately represented in suicide mortality data, particularly at early adulthood and middle age. To better scale interventions to reduce morbidity and mortality among young men, a mixed-methods study was conducted combining interviews and validated quantitative tools.

Methods

A non-random community sample of 30 working-class young men in Belfast aged 16-19 was recruited via organisations focused on job training, restorative justice, and youth work. Participants completed the Self-Harm Inventory and a semi-structured interview. Analyses were completed in NVivo and RStudio.

Results

The prevalence of self-harm was more than 8 times higher than for the general population of adolescents in NI, with 83.3% reporting ever engaging in self-harm. Only 2 of the 28 participants reported making a suicide attempt and most injuries were minor, suggesting nonsuicidal self-injury (NSSI) represented almost all injuries. Although the sample had a higher risk profile than the general population-with high levels of trauma, substance use, and socioeconomic deprivation-participants also endorsed strong social connections to friends, family, and community. While many expressed concerns about sharing their own emotional distress, almost all reported that disclosures are important to avert poor mental health and shared times when they or friends sought support.

Conclusions

Although there was a high prevalence of NSSI in the sample, the low prevalence of suicide attempts may be associated with the high levels of protective social connections reported by participants. Gender-based concerns regarding emotional support were common, but there was also strong endorsement for the importance of seeking support from trusted relationships. This suggests that there may be an appetite for male role models to provide education around the “bravery” of help-seeking.

Key messages

• Prevalence of nonsuicidal self-injury may be substantially more elevated in some populations of adolescent males.

• Gender-based concerns continue to act as a barrier to young men sharing their emotional distress with trusted individuals.
Evaluation of specific offers for mothers with mental stress
Authors: Scolik F , Ofner T , Sagerschnig S
Published: October 2024

Background

As part of the Austrian early intervention programme ‘Frühe Hilfen’, specific interventions (a psychotherapeutic short-term intervention and a therapeutic group) were implemented in some regions. An evaluation was carried out to gain general insights into the need for and benefits of psychosocial services as well as in-depth information on the benefits of the two selected services. The results of the project should also enable further conclusions/recommendations for appropriate services.

Methods

Mixed-methods approach: qualitative (focus groups, individual interviews, online surveys, participant observation) and quantitative (screening questionnaires) instruments involving a large number of relevant stakeholders and actors. Data analysis: content-structuring qualitative content analysis according to Kuckartz; descriptive analysis of the screening questionnaires.

Results

The analysis revealed a great need for specific psychosocial services for this target group as well as a high level of satisfaction with the psychosocial services utilised. However, all respondents pointed out barriers to the utilisation of psychosocial services. The evaluation results show that the two specific services make an important contribution to improving the well-being of mothers with mental health problems. Both services largely reach their target group well and, thanks to their focus, contribute to the well-being of mothers with mental health problems. The effectiveness of the service is underpinned by the fact that all participants perceive a reduction in mental stress and notice a reduction in stress during the screenings.

Conclusions

Based on the evaluation results, it is generally recommended that low-threshold, free and needs-based services be established or expanded. In addition, there is a need for more educational and public relations work on psychosocial stress/diseases and more information on support services.

Key messages

• There is a great need for psychosocial support among mothers.

• The high level of satisfaction with the services evaluated indicates that more such services are needed to support families.
Trends and gender differentials in age-specific suicide mortality, 2004-2020, Cyprus
Authors: Middleton N , Karanikola M , Chatzittofis A
Published: October 2024

Background

Cyprus is rarely included in international studies of suicide trends and the only published national data is two decades old. In the context of the first National Strategy for Mental Health, this study assessed suicide trends in 2004-2020, spanning the 2008 global and 2012-2013 Cyprus financial recessions, but falling short of the COVID-19 pandemic due to delays in recording.

Methods

Suicide deaths were obtained from the Mortality Registry (ICD-10, including “undetermined”). Directly standardized rates were calculated for four gender/age groups. Annual change was estimated in Poisson regression models with interaction terms to assess differential trends over time periods.

Results

There were 560 deaths (4-times more in men, >80% classified as ‘violent’ in both genders). In men, the suicide rate doubled from 4-5 to 9-10 per 100000, with most of the increase prior to 2012, representing 9% annual change (Rate Ratio 1.09, 95% CI 1.03, 1.15; p = 0.002). From 2013, the trend reversed (effect modification p-value < 0.001) with 4% annual decrease (95% CI -9%, 1%). Declines were not uniform across age-groups; rates in males aged 45-64 continued to rise, surpassing the previously high rate in males 25-44. In women, rates presented a declining trajectory from 4-5 per 100000 to 2-3 over this period, widening the gender differential. M-to-F ratio was 5.33 (95% CI 3.46, 8.19) in 2017-2020 compared to 2.73 (1.88, 3.95) in 2004-2008. A shift to violent methods was observed, with hanging now ranking as most common in both females (1 in 3) and males (1 in 2).

Conclusions

While relatively lower compared to other European countries, the gender differential in suicide mortality has widened in Cyprus, with steep rises in all male age-groups up to 2012 and continuing rises in males 45-64, but declines in female rates over the same period. Further analysis of trends in relation to unemployment and other socio-economic indicators is warranted as well as continuous monitoring of trends.

Key messages

• After steep rises in suicide across all male age-groups up to 2012, against a declining trajectory in female rates, rates in males 45-64 continued to rise, further widening the gender differential.

• The age profiling and shift towards more violent methods in both genders should inform the first National Strategy for Mental Health, while continuous monitoring of trends is warranted.
Impact of retirement on physical activity in older adults: a longitudinal analysis from SHARE
Authors: Vigezzi G P , Bertuccio P , Mosconi G , Maggioni E , Vandoni M , Stenholm S , Odone A
Published: October 2024

Background

With ageing populations experiencing longer post-retirement years, understanding the influence of major life transitions on health behaviours such as physical activity (PA) is crucial. This study assesses how retirement affects PA levels by analysing longitudinal data from the Survey of Health, Ageing and Retirement in Europe (SHARE).

Methods

This analysis utilised longitudinal data from 2004 to 2020, categorising PA according to WHO guidelines adapted to individual-level data from successive waves of SHARE. The study examined the relative risks (RR) of being physically active, using generalised estimating equation models to compare periods before and after retirement.

Results

The cohort consisted of 8,998 individuals aged 50 and older who were employed at baseline and retired during the study period. Initially, 83.6% of participants were categorised as physically active. A noticeable decline in PA was observed post-retirement, with RR decreasing from 1.08 (95%CI 1.07-1.10) more than 10 years before retirement to 0.90 (95%CI 0.88-0.93) more than 10 years after retirement, compared to the year of retirement. Previously inactive individuals often increased their PA levels, peaking 3 to 4 years post-retirement (RR increased from 0.79, 95%CI 0.70-0.88, to 1.49, 95%CI 1.36-1.63), suggesting a temporary boost in moderate-intensity PA during the so-called “honeymoon phase”.

Conclusions

Retirement can serve as a window of opportunity for enhancing leisure-time PA, particularly among those previously inactive. Sustained increases in PA are less common, highlighting the need for targeted interventions to support continued engagement in PA among retirees. The variations in PA trends suggest that interventions should be tailored to individual characteristics such as age at retirement, previous job type, and educational background to maximise public health impact. This study underscores the challenges of ensuring long-term health benefits through PA.

Key messages

• Retirement significantly alters physical activity patterns, highlighting an opportunity for targeted health interventions.

• Longitudinal data reveals critical periods post-retirement that could benefit from public health strategies to maintain or increase physical activity among older adults.
Prevalence and social determinants of anxiety and depression among adults in Ghana systematic review
Authors: Awortwe V , Maharani F , Daivadanam M , Adjorlolo S , Olsson EMG , Rajabzadeh V , Woodford J
Published: October 2024

Background

Anxiety and depression are major public health concerns, yet their prevalence and social determinants contributing to mental health disparities remain underexplored. This review, to our knowledge, is the first of its kind, aiming to examine the prevalence of anxiety and depression symptoms and disorders among adults in Ghana, along with social determinants associated with their occurrence.

Methods

A search of nine electronic databases and seven grey literature sources was conducted up to September 25, 2023. Two reviewers independently screened and appraised the studies. Forty-six studies were included. Prevalence estimates were pooled using a random-effects model. Subgroup analysis and meta-regression explored potential moderators. A narrative synthesis explored social determinants associated with anxiety and depression.

Results

Preliminary results showed a high prevalence of anxiety (43.7%, 95% CI: 35.6-54.4%) and depression (37.8%, 95% CI; 32.5% to 46%), with regional variations. There were significant differences in the prevalence of anxiety and depression across chronic physical conditions and method of condition assessment. Meta-regression showed significant association between average age and anxiety prevalence. Social determinants associated with anxiety included being female, non-Christian, low income, self-employed, limited social support, and basic education, while that for depression included being young (< 25yr), low income, government employed, childhood physical and sexual abuse, gender-based violence and urban residence. Protective factors for both were male gender, strong social support and higher education.

Conclusions

Preliminary results indicate a high prevalence of anxiety and depression linked to social determinants. While methodological limitations exist (eg, study heterogeneity), findings highlight a need for evidence-based interventions targeting social determinants to reduce the burden of anxiety and depression among adults in Ghana.

Key messages

• Our review suggests addressing the social determinants of mental health, aligned with sustainable developmental goals, may reduce the burden of anxiety and depression.

• While Ghana is working towards improving mental health via its revised 12year Mental Health Policy launched in 2021, this review can facilitate planning and resource allocation for mental healthcare.
Suicide in young and middle-aged individuals: lessons from a psychosocial autopsy study
Authors: Balt E , Mérelle S , Eikelenboom M , Zeric A , Wiggers D , Gilissen R , Creemers D , Popma A
Published: October 2024

Background

Sociodemographic characteristics of suicides are available from Statistics Netherlands. To improve suicide prevention, it is not only necessary to know who dies but also why people die. A psychosocial autopsy was conducted in the Netherlands to investigate differences in psychosocial characteristics and precipitating factors of suicides of young (<30) and middle-aged (40-70) suicide decedents.

Methods

Data were collected from bereaved individuals. A questionnaire detailed sociodemographic and psychosocial characteristics of the decedents. We reconstructed the suicidal process in the months preceding the suicide in an interview. Findings from the questionnaire and interview were integrated. An independent expert committee formulated recommendations for suicide prevention.

Results

162 suicides were investigated. Young decedents showed high levels of substance use and academic pressure. Young adults with developmental disorders were vulnerable in the transition to adulthood. Young males reached out less to support and care. By contrast, suicides of young females were distinguished by comorbidity of psychiatric disorders, frequent suicidal behaviours, high levels of care use, wait lists and a loss of (treatment) perspective, harmful social media use and bullying. Work and financial problems were common in middle-aged decedents. Physical disability and pain were frequently mentioned for middle-aged females. Suicide in middle-aged males was characterized by financial distress, interpersonal conflicts such as divorce, high levels of binge drinking and addiction.

Conclusions

Our data provide a topology of the needs of individuals at risk for suicide. Suicide prevention strategies can be improved by better transition support and explicit suicide monitoring in young adults with a developmental disorder, active waitlist policies in mental healthcare, and improved collaboration between debt counsellors and mental care professionals based on shared accountability.

Key messages

• Bereaved individuals elucidated a wide range of psychosocial problems in suicide decedents.

• Suicide prevention should adhere to a needs-based approach.
Social inequalities in the mental well-being of adolescents in Barcelona (2016-2021)
Authors: Olivella-Cirici M , Vilagut G , Sánchez-Ledesma E , Serral G , Cortés-Albaladejo M , Pasarín M I , Alonso J , Pérez G
Published: October 2024

Crises have the potential to affect mental well-being (MWB), especially at vital stages of personal development such as adolescence. The objective of this study was to investigate the 2016-21 trends of social inequalities in the MWB of adolescents in Barcelona, stratifying by sex. Sequential, cross-sectional study based on the FRESC survey, held by the ASPB, representative of 8th and 10th grade adolescents (13-16 years old) schooled in Barcelona, in 2016 (N = 2,154) and 2021 (N = 2,299). MWB was examined using the validated WEMWBS, scoring from 14 (lowest) to 70 (highest) MWB. A temporal trend analysis of inequalities in MWB was carried out using the student socioeconomic status (SES) (low/average/high), measured with the validated FAS. For each group, the effect size of the WEMWBS means was measured with Cohen’s D. Linear regressions were performed, adjusting for academic grade, student country of origin, type of school and school index of vulnerable students. Adjusted β coefficients (aβ) and their statistical significance (p<.05) were estimated. In 2016, boys had higher MWB mean scores than girls (54.0 vs 50.8) (p<.01). In 2021, sex differences persisted, but with lower scores (51.7 vs 47.0) (p<.01) and still with a moderate effect size (0.52 in 2021 vs 0.40 in 2016). In multivariate regression models, boys in low SES showed the greatest MWB decrease in 2016 (low vs high SES: aβ= -3.44; p<.01). A significant temporal trend 2016-2021 of MWB worsening was observed in all groups, except for boys in low SES. The greatest deterioration in MWB was observed in girls, similarly in different SES (low SES: aβ= -3.52; p<.01). Boys in low SES showed the worst MWB in 2016 whereas all SES categories of girls had a significant trend of deterioration in MWB (2016-21). The latter could be attributed, among other factors, to a differential effect of the COVID-19 pandemic. These results underline the importance of addressing inequalities in the MWB, particularly among adolescent girls.

Key messages

• This study reveals a deterioration in mental well-being temporal trends (2016-2021) among adolescents in Barcelona, especially in girls.

• Findings emphasize the need to address social inequalities for improving mental well-being outcomes in adolescent populations.
Barriers and facilitators to healthcare services of people with mental ill-health in Europe
Authors: Schäfer K , Wrzesińska M , Kostyła M , Mancebo Salas N , Gomez Trenado R , Radaios V , Gogos T , Gil-Salmeron A , Grabovac I
Published: October 2024

Background

People with mental ill-health (PMIH) have higher cancer mortality rates than the general population. Barriers to healthcare service access may be a contributing factor. The EU-funded CO-CAPTAIN project aims to reduce health inequalities by improving overall health and reducing cancer burden by adapting and implementing the Patient Navigation (PN) Model targeted at PMIH. This qualitative study explored healthcare system experiences of PMIH in Austria, Greece, Poland, and Spain.

Methods

Eighty-one participants (22-76 years old), including 34 PMIH, 10 caregivers, 14 care team members, 12 mental health organization representatives, and 11 service manager representatives, were recruited. Semi-structured interviews focused on awareness of cancer risk factors, healthcare system experiences, and perspectives on PN as an intervention. Interviews were transcribed verbatim and analyzed using thematic analysis.

Results

Three major themes emerged: (1) somatic health relevance and preventive services utilization and (2) barriers / (3) facilitators to preventive services access. Knowledge of cancer prevention services varied greatly. Participants were aware of associations between risky health behaviors and health. Burden of mental health problems and discrimination, insufficient access to information, and lack of service flexibility were noted as barriers. Considerations of individual circumstances, social support, and empowerment were named as facilitators.

Conclusions

Tailored interventions involving healthcare professionals and PMIH in development of supportive environments and health literacy have the potential of overcoming identified barriers to the use of healthcare services.

Key messages

• People experiencing mental ill-health are faced with significant structural barriers when accessing somatic health services.

• Understanding people’s needs in terms of access and utilization of health care allows us to define guidelines for future personalized healthcare solutions.
Self-esteem and illness perception in multiple sclerosis: Unveiling key factors for self-management
Authors: Mikula P , Timkova V , Szilasiova J , Nagyova I
Published: October 2024

Background

Multiple sclerosis (MS) is characterized by demyelination and variable symptomatology, and typically appears during young adulthood, making it a condition of considerable public health concern. Given its chronic nature, understanding of the illness perception plays a crucial role in long-term disease management. Our research aims to examine the factors affecting illness perception among people with MS.

Methods

The study sample consisted of 166 patients with MS (75.3% women; mean age: 40.9±11.3 years; mean disease duration: 11.6±7.1 years). People with MS underwent medical examination to assess their functional disability measured by Expanded Disability Status Scale (EDSS), and structured interview, during which data on age, sex, education, employment status, income and disease duration were obtained. Finally, they were asked to fill in the Brief Illness Perception Questionnaire (BIPQ), and the Rosenberg Self-esteem Scale (RSE). Data were analysed with multiple linear regression analysis.

Results

Our results showed an association between functional disability and illness perception (β = 0.22; p < 0.05). However, this association lost its significance upon adding self-esteem into the model (β=-0.53; p < 0.001), with overall explained variance in illness perception rising from 2.7% to 27.5%. No statistically significant contribution of other socio-demographic or clinical variables was observed.

Conclusions

Higher self-esteem in people with MS appears to be intricately connected to their illness perception. Given that the management of chronic conditions heavily relies on patients’ personal resources, healthcare providers could play a crucial role in fostering self-esteem. By encouraging the development of self-esteem, patients may come to view their illness as more manageable and less daunting, potentially leading to mitigation of negative consequences of functional disability. [Grant support: VEGA 1/0608/23]

Key messages

• Self-esteem may be stronger predictor of illness perception than functional disability in people with MS.

• MS patients may benefit from psychological support aimed at promoting self-esteem.