The impact of subjective and objective social status on psychological distress among men and women in Japan

From around 1990s, social disparity issues and their effects on mental health have been gaining increasing attention in Japanese society. Findings from previous studies on socioeconomic status (SES) and mental health in Japan are inconsistent. Subjective Social Status (SSS) has been proposed and tested as a stronger predictor of mental health than measures such as education, income and occupation in the UK and US, but this has not been tested enough in countries with a different social and cultural background such as Japan. In the present study, a cross-sectional questionnaire survey was conducted in 2006 among a nationally representative community-based random sample of residents in Japan aged 20–74 years. A total of 1237 participants completed the questionnaire, with the overall response rate of 61.9%. After excluding 42 respondents, data from 1195 respondents (574 men and 621 women) were analyzed. SSS, household income, and education level of respondents were measured using single-item questions. Those with a K6 score of 5 or greater were defined as having psychological distress. A multiple logistic regression model was used to examine the effects of SSS, household income, and education on psychological distress. Among men, the prevalence of psychological distress, after adjusting for age and marital status, differed significantly across groups classified based on SSS, household income, and education. Among women, only SSS was significantly associated with psychological distress after adjusting for age and marital status. However, when all three variables were simultaneously entered into the model, SSS and household income were significantly associated with psychological distress, with the low SSS group having a higher odds ratio of psychological distress. In summary, SSS seems to be a stronger predictor of psychological distress among both men and women in the Japanese community than traditional measures of SES.     

Communication,support and psychosocial work environment affecting psychological distress among working women aged 20 to 39 years in Japan

When compared with their older counterparts, younger women are more likely to have depressive symptoms because they more often experience interrupted work history and a heavy childrearing burden. The purposes of the present study were 1) to investigate the possible association of psychosocial work environment with psychological distress and 2) to examine the way by which communication and support in the workplace affect to psychological distress among young women. We studied 198 women aged 20 to 39 yr in a cross-sectional study. The Kessler Scale-10 (K10 Scale) was used to examine psychological distress. In employees who experienced interpersonal conflict, those who had little or no conversations with their supervisor and/or co-workers had a significantly increased risk of psychological distress (OR, 4.2), and those who received little or no support from their supervisor and/or co-workers had a significantly increased risk of psychological distress (OR, 3.8) compared to those who had more frequent communication and received more support. Harmonious communication in the workplace can help prevent psychological distress among employees, which in turn may enable them to be satisfied with their work.     

Evaluation of psychological distress using the K6 in patients on chronic hemodialysis

Objective

The aim of this study was to evaluate psychological distress in patients on chronic hemodialysis.

Subjects and methods

A total of 72 patients on chronic hemodialysis were enrolled in this study. We evaluated psychological distress by using the K6 questionnaire, health-related quality of life (HRQOL) by using the EQ-5D questionnaire, and clinical parameters. Among the 72 patients, we also evaluated changes in K6 scores in 58 patients at 1-year follow-up.

Results

The mean K6 score was 3.7 ± 3.7 and 2 subjects (2.8 %) were defined as having psychological distress. K6 scores were significantly correlated with body fat percentage, albumin level, and EQ-5D scores in total subjects. K6 scores were also significantly and negatively correlated with EQ-5D scores in men and women. In the 1-year follow-up group, changes in K6 scores were weakly and negatively correlated with changes in EQ-5D scores.

Conclusion

Psychological distress was closely associated with HRQOL in patients on chronic hemodialysis. Coping strategies for psychological distress might be useful in improving HRQOL in patients on hemodialysis.     

The effect of pre-employment factors on job control, job strain and psychological distress: a 31-year longitudinal study

This study examined the role of pre-employment factors, such as maternal antenatal depression, low birth weight, childhood socioeconomic position, early adolescence health risk behaviours and academic performance, in the relationship between work characteristics (low job control and high job demands, or job strain) and psychological distress at age 31. The data of 2062 women and 2231 men was derived from the prospective unselected population-based Northern Finland 1966 Birth Cohort study. Results of linear regression models showed that being female, father's low socioeconomic position, and poor academic achievement in adolescence were linked to low control and high job strain jobs at age 31, and that low control and high job strain were associated with psychological distress at age 31. Although having lower school grades, high absence rate from school, and moderate alcohol consumption at age 14 were significant predictors of psychological distress at age 31, the associations between job control, job strain and psychological distress remained after controlling for these and other pre-employment effects. As such, pre-employment factors do seem to link people to risky work environments, which in turn seem to relate strongly to psychological distress. However, the relationship between pre-employment factors and later psychological distress in adulthood is not completely explained by job environment.     

The association of food security with psychological distress in New Zealand and any gender differences

Food security (access to safe, nutritious, affordable food) is intrinsically linked to feelings of stress or distress and it is strongly associated with socioeconomic factors. However, the impact of food insecurity on mental health, independent of confounding socioeconomic factors, is not clear. We investigated the association of food insecurity with psychological distress in New Zealand, controlling for socioeconomic factors. Secondarily, we examined the association in males and females. We used data from the Survey of Families, Income and Employment (SoFIE) (N = 18,955). Respondents were classified as food insecure if, in the last 12 months, they: used special food grants/banks, had to buy cheaper food to pay for other things, or went without fresh fruit and vegetables often. Psychological distress was measured using the Kessler-10 scale dichotomised at low (10-15) and moderate to high (16+). Logistic regression analyses were used to investigate the association of food insecurity with psychological distress using a staged modelling approach. Interaction models included an interaction between food security and gender, as well as interactions between gender and all other covariates (significant at p-value < 0.1). Models were repeated, stratified by gender. A strong relationship between food insecurity and psychological distress was found (crude odds ratio OR 3.4). Whilst substantially reduced, the association remained after adjusting for confounding demographic and socioeconomic variables (adjusted OR 1.8). In stratified models, food insecure females had slightly higher odds for psychological distress (fully adjusted OR 2.0) than males (fully adjusted OR 1.5). As such, an independent association of food insecurity with psychological distress was found in both males and females--slightly more so in females. However, we cannot rule out residual confounding as an explanation for the independent association and any apparent gender interaction.     

Influences of income and employment on psychological distress and depression treatment in Japanese adults

Objectives  

Psychological distress is a health issue of critical importance, especially in people of working age in developed countries, including Japan. This study examined the relationships of income and employment arrangement with psychological distress and treatment of depression in a national sample of Japanese adults.     

The Mediating and Moderating Effects of Workplace Social Capital on the Associations between Adverse Work Characteristics and Psychological Distress among Japanese Workers

Our current study investigated how workplace social capital (WSC) mediates and moderates the associations between adverse work characteristics and psychological distress among Japanese workers. We collected cross-sectional data (N=9,350) from a baseline survey of an occupational Japanese cohort study. We focused on individual WSC and considered job demands/control, effort/reward, and two types (i.e., procedural and interactional) of organizational justice as work-characteristic variables. We defined psychological distress as a score of ≥5 on the Kessler Psychological Distress Scale (K6 scale). Multivariate logistic regression analyses predicted a binary variable of psychological distress by individual WSC and adverse work characteristics, adjusting for individual-level covariates. Individual WSC mediated the associations between adverse work characteristics and psychological distress in almost all model specifications. Additionally, individual WSC moderated the associations of psychological distress with high job demands, high effort, and low interactional justice when we used a high WSC cutoff point. In contrast, individual WSC did not moderate such interactions with low job control, reward, or procedural justice. We concluded that individual WSC mediated the associations between adverse work characteristics and psychological distress among Japanese workers while selectively moderating their associations at high levels of WSC.     

Labor market integration,immigration experience,and psychological distress in a multi-ethnic sample of immigrants residing in Portugal

Objectives: This study aims at examining how factors relating to immigrants’ experience in the host country affect psychological distress (PD). Specifically, we analyzed the association among socio-economic status (SES), integration in the labor market, specific immigration experience characteristics, and PD in a multi-ethnic sample of immigrant individuals residing in Lisbon, Portugal.

Design: Using a sample (n?=?1375) consisting of all main immigrant groups residing in Portugal’s metropolitan area of Lisbon, we estimated multivariable linear regression models of PD regressed on selected sets of socio-economic independent variables. A psychological distress scale was constructed based on five items (feeling physically tired, feeling psychologically tired, feeling happy, feeling full of energy, and feeling lonely).

Results: Variables associated with a decrease in PD are being a male (demographic), being satisfied with their income level (SES), living with the core family and having higher number of children (social isolation), planning to remain for longer periods of time in Portugal (migration project), and whether respondents considered themselves to be in good health condition (subjective health status). Study variables negatively associated with immigrants’ PD were job insecurity (labor market), and the perception that health professionals were not willing to understand immigrants during a clinical interaction.

Conclusion: The study findings emphasized the importance of labor market integration and access to good quality jobs for immigrants’ psychological well-being, as well as the existence of family ties in the host country, intention to reside long term in the host country, and high subjective (physical) health. Our research suggests the need to foster cross-national studies of immigrant populations in order to understand the social mechanisms that transverse all migrant groups and contribute to lower psychological well-being.     

High psychological distress among school-going adolescents in Afghanistan: prevalence and correlates from a national survey

ABSTRACT

The aim of this investigation was to assess the prevalence and correlates of psychological distress among adolescents Afghanistan. Cross-sectional 2014 ‘Global School-based Health Survey (GSHS)’ data included 2579 students that were representative of all students in Grades 7 to 11 in Afghanistan. The prevalence of single psychological distress was 28.4% and multiple psychological distress 27.7%. In adjusted multinomial logistic regression analysis, being female, ever cannabis and/or amphetamine use, bullying victimization and injury were associated with both single and multiple psychological distress. In addition, in unadjusted analysis, the experience of hunger, current tobacco use, secondary smoke, having been attacked, and truancy were positively and attending physical education classes was negatively associated with single and/or multiple psychological distress. High prevalence of psychological distress was observed and several risk factors identified that can facilitate intervention strategies.     

人工流产对女性心理状况影响的系统分析

目的:利用已发表文献,采用meta分析方法系统分析人工流产对女性心理状况的影响。方法:分别在PubMed采用abortion和mental health关键词组合检索英文文献;在CNKI、Sinomed、VIP等数据库,采用流产和心理健康关键词组合检索中文文献,限定为中文核心期刊(截止时间为2014年3月29日);检索所获文章的参考文献。结果:共获英文文献121篇(国外研究)、中文46篇;纳入英文12篇、中文7篇。根据异质性检验结果,分别采用随机和固定效应模型进行meta分析。据10个国外横断面研究,精神相关问题发生风险的合并OR_(流产者对比未流产者)及95%CI为1.74(1.58~1.90),P0.001;据2个国外队列研究,精神相关问题发生风险的合并RR_(流产者对比未流产者)及95%CI为1.33(1.17~1.51),PO.001。据中文文献结果,与常模相比,人工流产人群的症状自评量表(SCL-90)总均分较高,其标准均数差(SMD)及95%CI为:0.10(0.05~O.16),P0.001。结论:尽管因国内外研究设计不同而不能直接比较,但国内外人工流产者出现精神症状的风险均较未流产者高,因此,有必要进行适宜干预,降低该人群心理健康问题发生风险。     

Rural and urban variation in psychological distress among adults: results of the 2014–2015 Eastern Townships Population Health Survey (ETPHS)

ObjectiveA growing number of people live in urban areas. Urbanization has been associated with an increased prevalence of mental disorders, but which mechanisms cause this increase is unknown. Psychological distress is a good indicator of mental health. This study sought to examine the relationship between urbanization and distress among adults in the Eastern Townships (southern region of Quebec, Canada).MethodIn the 2014–2015 Eastern Townships Population Health Survey (N = 10,687 adults living in one of the 96 Eastern Townships communities), distress was measured with the K6 distress scale (≥ 7). Urbanization was estimated by the residential density of the community treated in quintiles. Logistic regression analyses were carried out with adjustments for individual and environmental characteristics.ResultsWomen, young people aged 18–24, single parents, those without diplomas, those without a job, those with < $20,000 in income, adults with two or more chronic physical illnesses, adults with bad perceived health, or those living in disadvantaged neighbourhoods exhibited more distress. The unadjusted estimate between density and distress is only significant for the fifth quintile when compared with the first quintile (OR 1.23; 95% CI: 1.06–1.42). The relationship is practically the same after controlling for individual characteristics but decreases considerably after controlling for environmental characteristics (lack of trees, social deprivation, intersection density, vegetation index, and land use mix).ConclusionThis study was the first to examine an association between urbanization and distress by considering individual and environmental characteristics. The latter seem to explain the relationship between these concepts.     

Direct and indirect effects of sociocultural influences on disordered eating among Malaysian male and female university students. A mediation analysis of psychological distress

In their short communication against satiety claims, Booth and Nouwen (2010) neglect dozens of well designed studies that show consistent relations between satiety, energy intake and body weight. Satiety, intake and weight are separate concepts, that need different claims and evidence to support them. Satiety can be measured reliably. A repeated higher satiety response to a specific food compared to an appropriate control food may be valuable to consumers who want to avoid hunger. This is good for society. The development of the psycho-biological knowledge to achieve this is good for science. The lawmaker should provide the frame of reference for trustworthy satiety claims. It is then up to the consumer to decide the value of these claims.     

Prevalence and factors related to psychological distress among ethnic minority adults in a semi-modern village in rural Vietnam: an evolutionary mismatch framework

Background and objectivesPsychological distress is one of the greatest health threats facing humanity and has been hypothesized to represent an evolutionary mismatch. This hypothesis can be tested in semi-traditional societies that are undergoing transitions to modern lifestyles. This study used an evolutionary medicine framework to examine the predictors of psychological distress symptomology in a semi-modern ethnic minority village in rural Vietnam that is transitioning into a developing economy.MethodologyA cross-sectional survey was conducted in Chieng Sai Village among White Thai ethnic minority adults aged 18–75. The DASS-21 scale was used to measure the prevalence of psychological distress symptoms (depression and stress), and a closed format questionnaire was used to collect data on independent variables within an evolutionary mismatch framework. Binary logistic regression analyses were used to determine associated factors of psychological distress symptomology.ResultsThe prevalence of psychological distress symptoms was 22% (depression = 16.9%, stress = 16.3%). Common features of modernity, such as low levels of exercise, boredom, and low income, showed positive associations with psychological distress, while lifestyle features that were more similar to those expected in the evolutionary past and that fulfill evolutionary adaptations, such as getting enough sleep, adequate physical exertion, and access to resources (earning a sufficient income), showed negative associations with psychological distress.Conclusions and implicationsThis study suggests that modern lifestyles might have generated evolutionary mismatches that are negatively impacting mental health in Chieng Sai Village. Further investigations on mental health in rural Vietnam are warrented. Future research should focus on determining the causal relationship between psychological distress and evolutionary mismatches. Evolutionary medicine approaches to understanding and preventing psychological distress are potential forces of insight to be considered in public health and educational policy.Lay summaryApproximately 22% of White Thai ethnic minority adults in the village of Cheing Sai reported psychological distress symptoms. I found that lifestyle factors prevalent in modern society had positive associations with psychological distress symptomology, while lifestyle factors that mimic aspects of the human evolutionary past, such as adequate physical exertion, had negative associations with psychological distress symptoms.     

The influence of social stigma and discriminatory experience on psychological distress and quality of life among rural-to-urban migrants in China

The global literature has revealed a potential negative impact of social stigma on both physical and mental health among stigmatized individuals; however, the mechanisms through which social stigma affects the individual’s quality of life and mental health are not well understood. This research simultaneously examines the relationships of several determinants and mediating factors of psychological distress and quality of life. Data were collected through a cross-sectional survey among 1006 adult (predominantly male) rural-to-urban migrants in 2004–2005 in Beijing, China. Participants reported on their perceived social stigma, discriminatory experiences in daily life, preparation for migration, discrepancy between expectation and reality, coping with stigma-related stress, psychological distress, and quality of life. Structural equation modeling was performed. We found that perceived social stigma and discriminatory experiences had direct negative effects on psychological distress and quality of life among rural-to-urban migrants. Expectation-reality discrepancy mediated the effects of perceived social stigma and discriminatory experiences on psychological distress and quality of life; coping mediated the effect of social stigma on quality of life. Psychological distress was associated with quality of life. Preparation prior to migration was positively related to coping skills, which were positively related to quality of life. We conclude that perceived social stigma and daily discriminatory experiences have a significant influence on psychological distress and quality of life among rural-to-urban migrants. Pre-migration training with a focus on establishment of effective coping skills and preparation of migration may be helpful to improve their quality of life and mental health.     

Measuring psychological distress in older Aboriginal and Torres Strait Islanders Australians: a comparison of the K‐10 and K‐5

Objectives: To assess the cross‐cultural validity of two Kessler psychological distress scales (K‐10 and K‐5) by examining their measurement properties among older Aboriginal and Torres Strait Islanders and comparing them to those in non‐Aboriginal individuals from NSW Australia. Methods: Self‐reported questionnaire data from the 45 and Up Study for 1,631 Aboriginal and 231,774 non‐Aboriginal people were used to examine the factor structure, convergent validity, internal consistency and levels of missing data of K‐10 and K‐5. Results: We found excellent agreement in classification of distress of Aboriginal participants by K‐10 and K‐5 (weighted kappa=0.87), high internal consistency (Cronbach's alpha K‐10: 0.93, K‐5: 0.88), and factor structures consistent with those for the total Australian population. Convergent validity was evidenced by a strong graded relationship between the level of distress and the odds of: problems with daily activities due to emotional problems; current treatment for depression or anxiety; and poor quality of life. Conclusions and implications: K‐10 and K‐5 scales are promising tools for measuring psychological distress among Aboriginal and Torres Strait Islanders aged 45 and over in research and clinical settings.     

The psychological effect of orphanhood in a matured HIV epidemic: An analysis of young people in Mukono,Uganda

As the HIV pandemic progresses, the number of orphans is expected to rise. Uganda is one of the countries that has been most impacted by the pandemic. A few studies have explored the effects of orphanhood on psychological well-being; however, most of these studies have not explored potential pathways through which orphanhood could affect psychological well-being. Using a school-based sample, this study sought to examine the differences in depressive symptoms and hopelessness between orphans and non-orphans in Mukono District, Uganda. The study also explored the potential mediating role of the family environment. The study included 1500 young people from 10 randomly selected schools in Mukono Town Council. Data on school characteristics also were collected from the head teachers or their designees. Linear regression methods were used for multivariate models. We found that orphanhood was associated with psychological ill health among the males. Male double and male maternal orphans had a significantly higher level of hopelessness than their non-orphaned counterparts. Male double orphans also had more depressive symptoms, but this association was mediated by the family environment. No differences were noted between orphaned and non-orphaned females. The cause and timing of parental death was important only among the males, and loss of a parent to HIV was associated with worse psychological outcomes among the males and not the females. Lower parent/guardian connectedness, having a chronically ill adult in the household and ill treatment in residence were associated with a higher level of depression, especially among the males. The data show that the effect of orphanhood on psychological outcomes may vary by gender and type of outcome. This study also suggests an attenuated effect of orphanhood on psychological well-being among school-going youth. Programs seeking to improve psychological well-being among youth must pay attention to the family situations of these youth.     

The association between smoking status and hospital length of stay: evidence from a hospital-based cohort

Objectives: Smoking is recognized as one of the main preventable causes of mortality and morbidity that imposes a high financial burden on healthcare systems and society. This study aimed to examine the association between smoking status and hospital length of stay (LOS) among patients with lung cancer (LC), chronic obstructive pulmonary disease (COPD) and ischemic heart diseases (IHD) in Iran in 2014.

Methods: A total of 1271 patients (415 LC patients, 427 COPD patients and 429 IHD patients) were included in the study. Data on age, sex, insurance status and LOS was extracted from the patients’ medical records and smoking status was obtained from the patients using telephone survey. The LOS among current smokers, former smokers, and nonsmokers was compared using a zero-truncated poisson regression. Analysis was done using STATA v.12.

Results: The mean LOS for current smokers, former smokers and nonsmokers was 9.4±8.4, 7.3 ±5.3 and 6.02±5.05 days, respectively. The unadjusted and adjusted probabilities of LOS for current smokers and former smokers were 56% and 21% and 48% and 15% higher, respectively, than when compared with the nonsmoker category.

Conclusion: The study demonstrated longer LOS for the current and former smokers, contributing to the drain on large hospital resources in Iran. The results of the study provide useful information for health-policy makers that contribute to the planning and designing of smoking cessation interventions in this area.