Impact of a web-based personally tailored physical activity intervention on depression,anxiety, stress and quality of life: Secondary outcomes from a randomized controlled trial

BackgroundFew studies have investigated the impact of web-based physical activity interventions on mental health outcomes. Therefore, this study examined the impact of a web-based personally tailored physical activity intervention on depression, anxiety, stress and quality of life.Methods501 participants were randomised into either a control group or a pooled intervention condition who received a 3-month web-based personally tailored physical activity intervention. Previously, this intervention has demonstrated to improve self-reported physical activity, but not device-measured physical activity. At baseline, 3- and 9-months, depression, anxiety and stress were assessed using the DASS21, and quality of life was assessed using the SF-12V2. General linear mixed models examined differences between groups over time.ResultsMost participants (>80%) reported normal levels of depression, anxiety or stress. Relative to baseline levels, significant reductions of depression, anxiety, stress and the SF12 mental health component were observed in the pooled intervention group at 3 and 9 months. Relative to the control group, significant reductions were observed in the pooled intervention group for depression and stress (3-months only) and anxiety (3- and 9-months), but not quality of life.ConclusionA web-based physical activity intervention can result in positive mental health outcomes, even in the absence of device-measured physical activity improvements. However, these findings need to be confirmed in future studies.Trial registration numberACTRN12615000057583.     

But that's who I Am: The inability to enact physical activity identity is associated with depression and anxiety symptoms

There is strong evidence to suggest that physical activity reduces depression and anxiety symptoms, and recently there have been calls to consider the role of psychological determinants of physical activity behaviour as part of this effect. We investigated whether a person's physical activity identity moderated the impact of physical activity on depression and anxiety symptoms. Participants aged 19–33 years (N = 97; M = 21.8; 50.5% female, 44.3% Caucasian) self-reported their physical activity identity then wore activity monitors for six days. On the seventh day, participants self-reported their depression symptoms and anxiety symptoms. Multiple linear regression models were conducted to determine whether physical activity identity moderated the link of physical activity with prospective depression and anxiety symptoms. For people who had physical activity identity scores greater than 1.51 SD more than M, physical activity and depression symptoms were negatively associated. For people with a physical activity identity score greater than 0.52 SD more than M, physical activity and anxiety symptoms were negatively associated. For those with a strong physical activity identity, not being physically active was associated with more prospective depressive and anxiety symptoms although the effect sizes were small. It may be that there are negative mental health impacts of not being physical active for those with strong physical activity identities. Physical activity interventions targeting mental health outcomes may need to be tailored for a person's identity and provide support when people do not engage with the physical activity behaviour that they value as part of their identity standards.     

Physical activity and depression,anxiety, and self-esteem in children and youth: An umbrella systematic review

ProblemA 2011 review of reviews reported small to moderate associations between physical activity (PA) and depression, anxiety and self-esteem among children and youth (aged 5–17 years). Due to the increase in reviews examining PA and mental health outcomes in children and youth over the past decade, we conducted an umbrella review to determine the current state of the literature, including whether effects were moderated by dose and type of PA, age, sex, or severity of mental illness.MethodsWe systematically reviewed literature published from 2010 onwards from six online databases to identify and summarize findings from systematic reviews examining PA and depression, anxiety, and self-esteem outcomes in children and youth. We assessed review quality using the AMSTAR 2 critical appraisal tool.ResultsWe identified 26 reviews examining depression (n = 16), anxiety (n = 2), and self-esteem (n = 14). Half of the eligible reviews were considered to be of low or critically low quality (n = 13). PA had positive mental health outcomes for children and youth, specifically for reduction in depression/depressive symptoms and improvements in physical self-concept, a self-esteem sub-domain. Little research has examined PA and anxiety. The moderator analyses reviewed revealed stronger effects in populations with clinical diagnoses (e.g. depression) and for interventions consisting of regular, supervised, group-based aerobic exercise.ConclusionsPA appears to be an effective intervention for reducing depression/depressive symptoms and improving physical self-perceptions, although additional high-quality research and moderator analyses are needed to determine what type of PA interventions may result in better mental health outcomes for children and youth.     

Mental wellbeing and physical activity levels: A prospective cohort study

BackgroundAlthough much research has been devoted to examining the relationship between negative mental health states (e.g., depression) and physical activity, the literature is scarce in terms of associations between positive mental health states (e.g., mental wellbeing) and physical activity. The objective of this study was to examine the association between mental wellbeing measured in 2019 and physical activity measured in 2020 (including bi-directionality).MethodsData stem from a Danish nationally-representative panel of 5000 adults (aged 15+ years) conducted in 2019 and 2020, which was linked to register data. The SWEMWBS scale was used to assess mental wellbeing. The outcome was ≥150 min of physical activity per week (self-reported). Logistic regression models were performed, adjusting for covariates and physical activity at baseline.ResultsEach point increase in mental wellbeing in 2019 positively predicted ≥150 min of physical activity per week in 2020 (OR = 1.03, 95%CI 1.01–1.05). Compared to low mental wellbeing, moderate wellbeing was associated with higher odds (OR = 1.51, 95%CI 1.10–2.08) of engaging in ≥150 min of physical activity, while the odds among those with high mental wellbeing were even higher (OR = 1.93, 95%CI 1.37–2.72). The results reflected a dose-response pattern. Finally, the reverse pathway was noted as well, i.e., physical activity in 2019 positively predicted mental wellbeing in 2020.ConclusionsThe results show that favorable mental health status – beyond the absence of mental illness – positively predicts adherence to recommended physical activity levels in the following year. Initiatives to promote mental wellbeing may be instrumental as a means to protect and enhance general health by positively influencing engagement in physical activity. Conversely, increasing physical activity levels may protect against mental illness and further enhance population mental wellbeing.     

On campus physical activity programming for post-secondary student mental health: Examining effectiveness and acceptability

AimProviding effective support for students with mental health concerns is a priority on post-secondary campuses. Recreational programming including physical activity is an evidence-informed approach that can be used to support mental health and well-being. Yet, limited research has examined effective and acceptable strategies for using campus-based physical activity programs to support the mental health of post-secondary students. Using a mixed-methods approach, the current study addressed the acceptability and effectiveness of a physical activity program for student mental health.MethodsIn collaboration with on-campus mental health services, a 6-week one-on-one and individualized physical activity program tailored towards students seeking mental health support was implemented. A pretest-posttest design was used to test the effectiveness of the program and participants (N = 68; M_age = 22.96 years, SD = 3.42; 82% female) completed self-report questionnaires to assess changes in symptoms of psychological distress, depression, and anxiety. Semi-structured interviews (N = 11) with program participants were conducted to explore the acceptability of the program and were analyzed using thematic analysis.ResultsPaired samples t-tests demonstrated a significant reduction in anxiety symptoms, depression symptoms, and psychological distress pre-post program (ps < .05). The generated themes suggested that the program is an acceptable and effective holistic approach for improving mental health among students.ConclusionsThe results provide implications for implementing on-campus physical activity programs as a mental health and well-being intervention. Implications for further understanding principle program design and delivery strategies are discussed.     

Pain intensity is associated with both performance-based disability and self-reported disability in a sample of older adults attending primary health care centers

BackgroundOlder adults' function level can be used as a predictor of future detrimental events, such as disability, reliance on others, risk of institutionalization and likelihood of death. The assessment of function at the primary health care centers using self-reported and/or performance based measures is of prime importance.ObjectiveTo determine whether personal factors, pain, depression and physical activity are associated with self-reported and performance based disability for older adults aged ≥60 years attending primary health care centers, as measured by the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) and Short Physical Performance Battery (SPPB), respectively.MethodsParticipants (196 females and 55 males; mean age ± SD = 70.87 ± 7.76) had their pain, self-reported disability, performance, physical activity levels and depressive symptoms assessed. Regression analyses were performed with self-reported and performance-based disability as the dependent variable and age, sex, education, chronic conditions, depression, physical activity and pain characteristics as dependent variables.ResultsMean (SD) results for SPPB were 8.45 (2.86) and 20.06 (8.21) for WHODAS. Pain intensity, depression, pain frequency, number of chronic conditions and level of physical activity explained 44% of the self-reported disability variance. Pain intensity, age, level of physical activity, years of formal education and chronic conditions explained 37% of the performance variance. Pain intensity alone explained 27% and 18% of the self-reported and performance based disability, respectively.ConclusionFindings indicate that primary health care interventions should target pain intensity, depressive symptoms and physical activity as a means to preventing or decreasing both self-reported and performance based disability.     

H.U.B city steps: methods and early findings from a community-based participatory research trial to reduce blood pressure among african americans

Background

Although lifestyle interventions targeting multiple lifestyle behaviors are more effective in preventing unhealthy weight gain and chronic diseases than intervening on a single behavior, few studies have compared individual and combined effects of diet and/or exercise interventions on health-related quality of life (HRQOL). In addition, the mechanisms of how these lifestyle interventions affect HRQOL are unknown. The primary aim of this study was to examine the individual and combined effects of dietary weight loss and/or exercise interventions on HRQOL and psychosocial factors (depression, anxiety, stress, social support). The secondary aim was to investigate predictors of changes in HRQOL.

Methods

This study was a randomized controlled trial. Overweight/obese postmenopausal women were randomly assigned to 12 months of dietary weight loss (n = 118), moderate-to-vigorous aerobic exercise (225 minutes/week, n = 117), combined diet and exercise (n = 117), or control (n = 87). Demographic, health and anthropometric information, aerobic fitness, HRQOL (SF-36), stress (Perceived Stress Scale), depression [Brief Symptom Inventory (BSI)-18], anxiety (BSI-18) and social support (Medical Outcome Study Social Support Survey) were assessed at baseline and 12 months. The 12-month changes in HRQOL and psychosocial factors were compared using analysis of covariance, adjusting for baseline scores. Multiple regression was used to assess predictors of changes in HRQOL.

Results

Twelve-month changes in HRQOL and psychosocial factors differed by intervention group. The combined diet + exercise group improved 4 aspects of HRQOL (physical functioning, role-physical, vitality, and mental health), and stress (p ≤ 0.01 vs. controls). The diet group increased vitality score (p < 0.01 vs. control), while HRQOL did not change differently in the exercise group compared with controls. However, regardless of intervention group, weight loss predicted increased physical functioning, role-physical, vitality, and mental health, while increased aerobic fitness predicted improved physical functioning. Positive changes in depression, stress, and social support were independently associated with increased HRQOL, after adjusting for changes in weight and aerobic fitness.

Conclusions

A combined diet and exercise intervention has positive effects on HRQOL and psychological health, which may be greater than that from exercise or diet alone. Improvements in weight, aerobic fitness and psychosocial factors may mediate intervention effects on HRQOL.     

Relationship between physical activity and general mental health

PurposeWe investigated the relationship between physical activity and mental health and determined the optimal amount of physical activity associated with better mental health.MethodSelf-reported data from a national random sample of 7674 adult respondents collected during the 2008 U.S. Health Information National Trends 2007 Survey (HINTS) were analyzed in 2012. Mental health was plotted against the number of hours of physical activity per week using a fractional 2-degree polynomial function. Demographic and physical health factors related to poorer mental health were examined. The optimal range of physical activity associated with poorer mental health was examined by age, gender, and physical health.ResultsA curvilinear association was observed between physical activity and general mental health. The optimal threshold volume for mental health benefits was of 2.5 to 7.5 h of weekly physical activity. The associations varied by gender, age, and physical health status. Individuals who engaged in the optimal amount of physical activity were more likely to have reported better mental health (odds ratio = 1.39, p = 0.006).ConclusionsThis study established a hyperbolic dose–response relationship between physical activity and general mental health, with an optimal range of 2.5 to 7.5 h of physical activity per week.     

Exploring the Association Between Physical Activity and Risk of Mental Health Disorders in Saudi Arabian Adults: Cross-sectional Study

BackgroundThe relationship between physical activity and mental health, especially the symptoms of major depressive disorder (MDD) and generalized anxiety disorder (GAD), has received increasing attention in recent years.ObjectiveThe aim of this study was to explore the association between fulfilling the World Health Organization (WHO) global recommendations on physical activity and the risk and symptoms of MDD and GAD in the Saudi population.MethodsThis study was a secondary analysis of data from a large nationwide cross-sectional survey conducted via phone interviews in June and July 2020. In this study, a proportional quota sampling technique was used to obtain an equal distribution of participants, stratified by age and gender, across the 13 regions of Saudi Arabia. The main mental health screening tool used for the risk of MDD was the Patient Health Questionnaire-9 (PHQ-9). Risk of GAD was measured using the Generalized Anxiety Disorder-7 (GAD-7) scale. Participants self-reported whether they fulfill the WHO global recommendations on (1) moderate-intensity aerobic physical activity (MIPA) and (2) vigorous-intensity aerobic physical activity (VIPA). The results were then analyzed based on the following two categories: fulfilling the WHO global recommendations or not.ResultsThe data analysis included 8333 participants recruited in the main study between June and July 2020. The response rate was 81.45% (8333/10,231). Of them, 50.3% (4192/8333) were female, and the mean age was 36.5 years, with a median age of 36 years and a range from 18 to 90 years. The average total PHQ-9 score was 5.61, and the average total GAD-7 score was 4.18. For men, the average total PHQ-9 and GAD-7 scores were associated with fulfilling recommendations for MIPA; however, there were no associations for VIPA in both sexes. Fulfilling the WHO’s recommendations for MIPA was associated with considerably fewer depressive symptoms in six of the nine items in the PHQ-9. Moreover, fulfilling recommendations for MIPA was associated with considerably fewer anxiety symptoms in six of the seven items in the GAD-7. However, fulfilling recommendations for VIPA was significantly associated with more depressive symptoms in one of the PHQ-9 items (“Thoughts that you would be better off dead or thoughts of hurting yourself in some way;” P<.001).ConclusionsThis study has shown that fulfilling guidelines on MIPA is associated with less overall risk of MDD and GAD in males and fewer depressive and anxiety symptoms generally in a nonclinical population. In the general population, an increase in MIPA may improve well-being and general mental health.     

Do aerobic fitness and self-reported fitness in adolescence differently predict body image in young adulthood? An eight year follow-up study

AimTo study whether fitness level in adolescence predicts body image in young adulthood.MethodsLongitudinal study in which n = 385 participants were measured at age 15 and n = 201 at age 23. Fitness was assessed both objectively and subjectively. Body image was evaluated with the Offer Self- Image Questionnaire. Cross-lagged structural equation model was used to study whether fitness at age 15 predicted body image at age 23, covariates included sex, body mass index, physical activity, and socioeconomic status.ResultsAerobic fitness at age 15 was the strongest predictor (β = 0.372; p < 0.05) of body image at age 23. Baseline body image (β = 0.214; p < 0.05) had also a significant effect, but self-reported fitness and covariates did not relate to body image at follow-up. The structural model explained 22.1% of variability in body image at follow-up. During the eight-year study period both aerobic and self-reported fitness decreased but body image remained the same.ConclusionObjectively measured fitness in adolescence is an independent predictor of body image in young adulthood, whereas self-reported fitness is not. Strong fitness in adolescence is important for a healthy body image later in life.     

Investigating the effects of Physical Activity Counselling on depressive symptoms and physical activity in female undergraduate students with depression: A multiple baseline single-subject design

BackgroundDepression is one of the most common health problems faced by university students. Evidence supports that physical activity can significantly reduce the risk of depression, though activating this population remains challenging. One potential evidence-based strategy, to help people become more active, is Physical Activity Counselling (PAC). The current study examined the effects of a two-month PAC intervention on depressive symptoms and physical activity in female undergraduate students with depression.MethodsThe study followed a multiple baseline, single-subject design with five participants. There were four separate study phases: baseline, intervention, end point and follow-up. Physical activity was measured objectively using accelerometers and self-reported measures of depressive symptoms and physical activity were collected via online surveys.ResultsVisual analyses revealed that depressive symptoms decreased and self-reported physical activity increased from baseline throughout the duration of the study in all five participants. Statistical analyses supported these results. Cohen’s effect size estimates of grouped averages revealed that decreases in depressive symptoms and increases in self-reported physical activity from baseline throughout the duration of the study were large.ConclusionsThese results provide initial support for PAC as a potential method of increasing physical activity and reducing depressive symptoms in female undergraduate students with depression.     

The prevalence of common mental disorders among hospital physicians and their association with self-reported work ability: a cross-sectional study

ABSTRACT: BACKGROUND: We studied the prevalence of common mental disorders among Dutch hospital physicians and investigated whether the presence of a mental disorder was associated with insufficient self-reported work ability. METHODS: A questionnaire was sent to all (n=958) hospital physicians of one academic medical center, using validated scales to assess burnout, work-related fatigue, stress, posttraumatic stress disorder (PTSD), anxiety and depression. Furthermore, respondents were asked to rate their current work ability against the work ability in their own best period (adapted version of the first WAI item). The prevalence of each common mental disorder was calculated. In addition, odds ratios of reporting insufficient work ability for subjects with high complaint scores compared to patients with low complaint scores were calculated for each mental disorder. RESULTS: The response rate was 51%, and 423 questionnaires were eligible for analysis. The mental disorder prevalence rates were as follows: work-related fatigue 42%, depression 29%, anxiety 24%, posttraumatic stress complaints 15%, stress complaints 15% and burnout 6%. The mean score for self-reported work ability was 8.1 (range 0-10), and 4% of respondents rated their own work ability as insufficient. Physicians with high mental health complaints were 3.5- for fatigue, 5.6- for PTSD, 7.1- for anxiety, 9.5- for burnout, 10.8- for depression and 13.6-fold more likely to report their work ability as insufficient. CONCLUSIONS: The prevalence of common mental disorders among hospital physicians varied from 6% for burnout to 42% for work-related fatigue. Those physicians with high complaints had significantly 4- to 14 times increased odds of reporting their own work ability as insufficient. This work suggests that to ensure future workers health and patients safety occupational health services should plan appropriate intervention strategies.     

基层公共卫生防治人员身心健康与职业倦怠的关系研究

目的 分析基层公共卫生防治人员身心健康与职业倦怠的关系, 为该人群心理健康干预提供参考。
方法 随机抽取深圳市宝安区560名基层公共卫生防治人员作为对象, 实施问卷调查, 并对回收问卷的调查结果进行分析。
结果 基层公共卫生人员焦虑、抑郁、精神病性、呼吸系统及心血管系统的得分高于全国常模, 差异有统计学意义(P < 0.05);身心健康量表中的焦虑、抑郁、眼和耳、生殖及内分泌系统、心血管系统得分和情绪耗竭呈正相关, 焦虑、抑郁、精神病、消化系统得分和消极怠慢呈正相关, 抑郁、神经系统得分和专业低效能感呈正相关; 回归模型决定系数R2分别为0.985 6、0.964 8、0.958 9, 且整体回归效果均有统计学意义(P < 0.01)。
结论 身心健康和职业倦怠存在较强的相关性, 降低基层公共卫生防治人员的职业倦怠感, 提高该类人群的身心健康水平至关重要。
     

Associations Between Health Care Factors and Self-Reported Health Status Among Individuals with Diabetes: Results from a Community Assessment

To identify the influence of select health care variables on self-reported physical and mental health status of individuals with diabetes. Data from the 2006 Brazos Valley Health Status Assessment (BVHSA) were analyzed. Aspects of health care were defined through exploratory factor analysis. Structural equation modeling was used to create relationships between health care aspects, personal characteristics of the participants, and self-reported physical and mental health status of individuals with diabetes. The significant predictors of self-reported physical health status were the number of co-morbid chronic diseases (β = 0.27, P = .002), and medical system access (β = ?0.20, P = .035). The significant predictor of self-reported mental health status was the number of co-morbid chronic diseases (β = 0.35, P < .001). Self-reported physical (β = 0.27, P = .028) and mental (β = 0.29, P = .020) health status were both predictive of physician communication of mental health issues. Communication about mental health issues strongly relates to both self-reported physical and mental health status and should be an important part of physicians’ care for individuals with diabetes. Further, the nuances of medical system access for diabetes care should be further examined.     

Leisure-time physical activity, cardiorespiratory fitness and feelings of hopelessness in men

Background  

Leisure-time physical activity (LTPA) and cardiorespiratory fitness contribute to mental health. Hopelessness has been linked to impaired mental health, cardiovascular events and mortality. Previous studies have focused on physical exercise and depression. We examined the associations of LTPA and cardiorespiratory fitness with feelings of hopelessness.     

The Influence of Social Distancing Behaviors and Psychosocial Factors on Physical Activity During the COVID-19 Pandemic: Cross-sectional Survey Study

BackgroundThe COVID-19 pandemic has arguably facilitated a shift toward increased sedentariness and reduced physical activity. Moreover, there is mounting evidence that mental health has also declined during the pandemic. However, it remains unknown to what extent social distancing (SD) behaviors and mental health have affected the physical activity levels of the general population.ObjectiveThe purpose of this study was to determine the influence of SD behaviors and prevailing mental health on the odds of being physically active during the early COVID-19 pandemic response.MethodsA total of 4819 adults (2474/4819, 51.3%, female) from the US population with a median age of 46 (IQR 35-59) completed an online survey during the early pandemic response (April-June 2020). The survey included questions on adherence to 11 SD behaviors, and validated questionnaires which assessed self-reported physical activity, depression, anxiety, and mental well-being. Respondents were categorized into 2 physical activity groups: inactive (0-599 metabolic equivalent of task [MET]-minutes/week) and active (≥600 MET-minutes/week). A logistic generalized additive model (GAM) was used to determine which SD factors and mental health outcomes were associated with physical activity level.ResultsThe GAM analysis revealed that wearing a facemask in public (odds ratio [OR] 1.46, 95% CI 1.14-1.79; P=.003), limiting the use of public transport (OR 1.47, 95% CI 1.19-1.83; P=.001), and restricting travel outside the house (OR 1.56, 95% CI 1.19-2.05; P=.002) were SD behaviors associated with higher odds of being more physically active. Conversely, avoiding physical activity outside the house was associated with higher odds of being inactive (OR 0.52, 95% CI 0.46-0.63; P<.001). Leaving the house more frequently, and a higher mental well-being were associated with increasing odds of being physically active (P<.001). Engaging with a moderate number of SD behaviors (3-7 total) was positively associated with physical activity, whereas a very high SD vigilance (ie, engaging with ≥10 total behaviors) decreased the odds of being active during the early pandemic response.ConclusionsBased on the findings of our study, we suggest that future public health messaging of SD guidelines should include (1) a clear portrayal of the benefits of regular exercise on mental health; and (2) a specific focus on how to be physically active outdoors in a COVID-safe manner.     

Knowing is not doing: The relationship between health behaviour knowledge and actual health behaviours in people with serious mental illness

ObjectivesLow levels of physical activity and poor dietary habits are common in people with serious mental illness and contribute to the poorer overall health and early mortality observed in this population. This paper examines the relationships between health behaviour knowledge and self-reported health behaviours in people with serious mental illness.MethodsWe examined the health behaviour knowledge, level of physical activity, consumption of fruits and vegetables and attitudes towards saturated fat intake in 21 community-based mental health consumers in a regional city in Queensland, Australia. Relationships between dichotomous variables of health behaviour knowledge, physical activity levels, daily fruit and vegetable intake, and attitude towards saturated fat intake were examined using Phi coefficients and point biserial relationships respectively.ResultsThe mean score for health behaviour knowledge was 10.2 out of a possible maximum score of 14 points. No statistically significant relationships were observed between the dichotomous variables of health behaviour knowledge and level of physical activity, consumption of fruits and vegetables or attitudes towards saturated fat intake. A weak statistically significant relationship was observed between raw health knowledge score and the number of daily serves of vegetable.ConclusionsThe lack of significant relationships between health behaviour knowledge and self-reported health behaviours is supported by health behaviour theory which proposes that knowledge alone is insufficient to elicit behaviour. In this regard, people with serious mental illness may not be dissimilar to the general population.     

The Use of Generic Patient-Reported Outcome Measures in Emergency Department Surveys: Discriminant Validity Evidence for the Veterans RAND 12-Item Health Survey and the EQ-5D

ObjectivesThis study aimed to compare discriminant validity evidence of 2 generic patient-reported outcome measures (PROMs), the Veterans RAND 12-Item Health Survey (VR-12) and level 5 of EQ-5D (EQ-5D-5L), for use in emergency departments (EDs).MethodsData were obtained via a cross-sectional survey of 5876 patients in British Columbia (Canada) who completed a questionnaire after visiting an ED in 2018. We compared the extent to which the VR-12 and the EQ-5D-5L distinguished among groups of ED patients with different levels of comorbidity burden and self-reported physical and mental or emotional health status. Multivariable logistic regression was used to evaluate the ability of the 2 PROMs to identify patients presenting with a mental health (MH) condition.ResultsAll the measures produced small effect sizes (ESs) for discriminating comorbidity levels (R² range: 0.00 [VR-12 mental component summary {MCS}] to 0.10 [VR-12 physical component summary score]). The EQ-5D visual analog scale offered the largest ES for discriminating self-reported physical health (R² = 0.48), whereas the MCS, the VR-12 MH domain, and the EQ-5D-5L anxiety/depression dimension had the largest ESs for discriminating self-reported mental or emotional health (R² = 0.42, 0.40, and 0.38, respectively). The MCS produced a medium ES (R² = 0.42) along with the VR-12 utility score (R² = 0.27) compared with the EQ-5D-5L index (R² = 0.19). Having a MH condition was predominantly identified by the MCS (Pratt index = 0.56).ConclusionsThe VR-12 PROM provides a more comprehensive measurement of MH than the EQ-5D-5L, which is important to inform healthcare service needs for patients who present in EDs with MH challenges.