Diabetes distress, whereby people with diabetes experience distressing psychological symptoms associated with living with their condition, is an emerging problem in India. Diabetes distress leads to self-care deficits, suboptimal glycaemic control (which can lead to increasing risks of complications) and impaired quality of life.

To determine the burden of diabetes distress and its associated factors in an Indian tertiary care centre in Trichy, Tamil Nadu, India, covering a population of 1.25 million.

This prospective observational study involved a structured questionnaire covering demographic and clinical details, which was given to patients. The Diabetes Distress Scale 17 (DDS-17) was used to assess diabetes distress levels. The DDS-17 also measures four subdomains: emotional burden, physician-related distress, regimen-related distress and diabetes-related interpersonal distress. Patients were divided into two groups based on their DDS-17 score: no diabetes distress (DDS-17 score <2) versus diabetes distress (DDS-17 score ≥2) and compared. Correlation analysis, chi-squared tests and t-tests were used, with P < 0.05 considered statistically significant.

Of 1019 respondents (mean age 56 years; 59.6% male, 40.4% female), diabetes distress was reported in 24.4% (n = 249). Factors significantly associated with higher DDS-17 scores were younger age (<45 years) (P < 0.0001), long-standing diabetes (>10 years) (P < 0.0001), and smoking and alcohol (P < 0.05). Significant protective factors for diabetes distress included working, daily exercise, no comorbidities and medical insurance cover (P < 0.05). Significant positive correlation between DDS-17 score and all four subdomains was observed (P < 0.0001).

Our findings highlight the need for routine psychological screening and holistic management strategies in diabetes care, to improve patient outcomes and quality of life.

Adults with mental illness have higher smoking prevalence and face greater financial burdens from smoking compared with the general population.

This study explores how individuals’ psychological distress and smoking status are jointly associated with household expenditure patterns in Australia.

Daily smokers and ex-smokers were compared using the Household, Income and Labour Dynamics in Australia Survey over three waves. Psychological distress was assessed with the Kessler Psychological Distress Scale (K10) and the mental health domain of Medical Outcomes Study Short-Form General Health Survey (SF-36 MHD). Household expenditure categories included alcohol, clothing, education, fuel, general insurance, medicines, health practitioners, groceries, meals eaten out, internet, utilities, public transport and rent. Regression models using the generalised estimating equation technique compared expenditure data, controlling for age, gender, household composition, socioeconomic position, education level and wave of data collection.

Smokers and ex-smokers showed significant differences in expenditure across K10 psychological distress levels. At low and moderate distress levels, smokers spent more on alcohol and rent and less on insurance, health practitioners, meals out and medicines. At high distress levels, only education expenditure was significantly lower for smokers. Across SF-36 MHD tertiles, smokers spent less on education, insurance and medicine, but more on alcohol, especially at lower and moderate distress levels.

Smoking cessation for those with moderate psychological distress may be associated with a reallocation of spending, benefiting both households and their local communities. Targeted interventions addressing smoking cessation and mental health are crucial for reducing financial and health inequities.

Although patients with lung cancer are at high risk of poor outcomes from COVID-19, little is known about the economic and psychosocial impact of the pandemic on this population. This study had 2 objectives: (1) to identify the prevalence of financial and social disruptions and other adverse COVID-19 experiences in socioeconomically diverse patients with lung cancer; and (2) to examine whether these experiences were associated with physical and psychological symptoms.

Patients with lung cancer (N = 191) were recruited from a cancer center in the midwestern U.S. from August 2021 to April 2022 to participate in a cross-sectional survey of COVID-19 experiences and symptoms. Path analyses tested associations between COVID-19 experiences and symptoms, adjusting for sociodemographic and medical covariates.

Prevalent COVID-19 experiences included disrupted interactions with family and friends (66.0%), inability to perform daily routines (38.5%), and financial difficulties (18.5%). Greater financial hardship and disruptions to daily activities and social interactions were associated with higher levels of all physical and psychological symptoms. Endorsing more COVID-19 experiences (e.g., job loss, death of loved ones) was only associated with greater anxiety. Despite prevalent hardships, mean levels of physical and psychological symptoms were within normal ranges, except for elevated fatigue.

Although adverse COVID-19 experiences were common and related to symptom burden, patients with lung cancer showed notable psychological resilience during the pandemic. Oncology clinicians should consider the impact of COVID-19 experiences when providing financial and support services.

Explore the relationship between the severity of psychological distress symptoms and COVID-19-related bereavement, along with various sociodemographic factors and smoking/substance use behaviors during the COVID-19 pandemic.

This study used 962 Missouri residents’ (age: mean 44.8, SD 16.7, range 18-86 years; 67% [641] female) responses in the context of COVID-19 during 2022. Severity of psychological distress was measured using combined responses from PHQ-8 and GAD-7 scales and classified as moderate to severe using a cutoff score of ≥15 in PHQ-8 or ≥10 in GAD-7 scale. Predictors were bereavement (yes/no), current smoking (yes/no), and any substance use and polysubstance use (≥2). Logistic regressions adjusted for age, highest educational level, and employment status.

Approximately 19% experienced loss due to COVID-19; 28% exhibited moderate to severe symptoms of psychological distress. Individuals who experienced COVID-19-related deaths were more likely to suffer from moderate to severe psychological distress symptoms (Adjusted Odds Ratios (AOR): 1.46; 95% CI:1.00, 2.12). Smoking (AOR:1.68; 95% CI: 1.20, 2.36) and polysubstance use (AOR: 2.44; 95% CI: 1.64, 3.65) also exhibited higher odds.

COVID-19 bereavement and smoking/substance use were linked to higher distress. Future research and strategies should integrate bereavement supports with substance-use screening/brief intervention in disaster mental-health services.

The awareness of climate change as a global environmental threat through media consumption and/or social interaction can have a psychological impact on people’s mental health. However, little is known about the association between climate change awareness-related psychological distress (CCARPD) and mental health in people with psychiatric diagnoses or subclinical symptoms.

A comprehensive and systematic literature search of the PubMed, Embase, Web of Science Core Collection, Scopus, and CENTRAL electronic databases (from inception to February 2025) was conducted, without language restriction, for articles assessing the association between CCARPD and the mental well-being of people in the general and psychiatric populations.

Twenty-eight thousand forty-seven reports were retrieved. Of these, 67 met the inclusion criteria (64 general and 3 psychiatric population studies). The overall correlation between CCARPD and mental health measurements (ranging from subclinical symptoms to clinical diagnoses of depression, anxiety, or stress) was positive and of weak-to-moderate strength. Nevertheless, higher psychological distress due to the awareness of climate change was found in those having more severe mental health problems.

Although most studies have found small-to-moderate correlations between CCARPD and mental health measurements, it can be distressing and damaging for those with more severe mental health problems. As CCARPD will increase globally as the climate crisis unfolds in the coming decades while the understanding of the connections between CCARPD and mental well-being is still at an early stage of development, more research will be of utmost relevance, particularly in psychiatric populations.

Psychological distress is one of the major public health challenges during the emerging adulthood period, which is a developmental stage characterized by major life transformations and instability. Emerging adults are more vulnerable to psychological distress as they frequently deal with different pressures about relationships, work, education and identity exploration. The rising prevalence of psychological distress can impair physical health and wellbeing along with the initiation of harmful behaviors such as substance use.

The study aims to explore the prevalence and associated factors of psychological distress among emerging adult students, comparing female and male participants.

Data were collected from 957 emerging adults in 12 institutions under Mangalore University in the Udupi district of Karnataka, India, pursuing bachelor’s degrees. Along with the sociodemographic pro forma, the Kessler Psychological Distress Scale (K10) was used to measure psychological distress, the World Health Organization’s Alcohol, Smoking and Substance Involvement Screening tool (WHO ASSIST version 3.0) was used to measure substance use, and the Adverse Childhood Experiences Scale was used to identify adverse childhood experiences. Univariate and multivariate regression analysis were employed to understand the determinants of psychological distress among participants.

Female participants reported a higher risk of experiencing psychological distress compared to male participants. Overall, 27.06% of participants experienced psychological distress, with 11.8% likely to have mild, 9.71% moderate and 5.53% severe mental disorders. While adverse childhood experiences were reported to be a major factor associated with psychological distress among both the groups (AOR 6.218, 95% CI (3.546, 10.901), p < 0.001, for female), (AOR 1.965, 95% CI (1.073, 3.601), p = 0.029, for male) substance use pattern during the COVID19 pandemic was also predicted higher psychological distress among male participants.

In the study setting, psychological distress was prevalent among emerging adults, with a higher incidence among females. Adverse childhood events and substance use further elevated vulnerability. These findings highlight the critical need for culturally relevant and gender-sensitive mental health interventions.

Irritable bowel syndrome (IBS) commonly co-occurs with psychological distress, including depression and anxiety, but the temporal and bidirectional nature of this relationship remains unclear. Dysregulation of the gut–brain–microbiota axis has been proposed as a shared mechanism.

We conducted two retrospective, population-based cohort studies using Taiwan’s National Health Insurance Research Database (2000–2015). Cohort 1 assessed the risk of incident IBS among patients with newly diagnosed depression or anxiety, while Cohort 2 evaluated the risk of subsequent depression or anxiety among patients with newly diagnosed IBS. Propensity score matching, multivariable Cox regression, and Fine–Gray competing risk models were applied.

IBS was associated with increased risks of depression (adjusted hazard ratio [aHR] = 1.55) and anxiety (aHR = 1.68). Conversely, depression and anxiety were associated with higher risks of developing IBS (aHR = 1.45 and 1.51, respectively). Associations were stronger among females and younger adults aged 18–39 years. Sleep disorders (SDs) showed the strongest modifying effect in both directions (sub-distribution HR ≈ 1.60). Results were consistent across sensitivity analyses.

This nationwide longitudinal study demonstrates a robust bidirectional association between IBS and psychological distress, supporting integrated screening and multidisciplinary care approaches targeting gut–brain interactions.

Societal pronatalist ideologies link womanhood to motherhood and create social pressures that often cause psychological distress when unmet. While previous research has documented the impact of these external pressures, much less is known about how women’s internal belief systems shape their responses to societal expectations. Recognising this gap, we examined the perspectives and concerns about motherhood and childlessness among child-free Greek women, their psychological distress and the potential mediating role of early maladaptive schemas (EMS) in this relationship. To provide context, we compared these findings with those of mothers, considering both their mental health and their assessments of similar issues after becoming parents.

We conducted an online, cross-sectional survey comparing child-free Greek women and mothers aged 30–50 years. Through custom-designed questionnaires, we evaluated concerns about motherhood and childlessness among child-free women, and we asked the mother group to assess the same aspects post-motherhood. Mental health was assessed using Depression, Anxiety and Stress Scale 21, while EMS were measured with the Young Schema Questionnaire. We used mediation analysis to examine whether EMS mediated the connection between pronatalist pressures and mental health outcomes.

The study included 1341 women, comprising 503 without children and 838 with children. Child-free women, who were predominantly involuntarily child-free, tended to be younger, more educated and had lower household incomes than mothers. They also reported more diverse sexual orientations, higher levels of depression and anxiety and elevated scores on EMS, which appear to exacerbate distress caused by societal pronatalist pressures. In contrast, mothers were typically older and more financially stable. Although they reported fulfilment from motherhood, they also faced challenges, including demanding caregiving responsibilities and financial or logistical barriers to having more children. Mothers’ psychological profiles were characterised by lower EMS scores and less overall distress.

This study revealed distinct demographic and psychological profile differences between child-free women and mothers. Our findings underscore that women’s mental health in the context of reproduction is shaped by a complex interaction of social pressures, psychological schemas and structural factors. Specifically, EMS – particularly in the domains of Emotional Deprivation, Mistrust/Abuse and Vulnerability to Harm – were identified as a key mechanism, mediating the relationship between pronatalist pressures and psychological distress. Furthermore, occupational disparities emerged as a significant stressor, affecting both child-free women in high-pressure careers and mothers who were home-makers.

Human papillomavirus (HPV) infection has a negative impact on quality of life (QoL) and sexual function, mainly owing to increased levels of anxiety and distress.

To examine the potentially moderating effects of general psychological health on the relationships between (a) HPV-related psychosocial burden and QoL and (b) HPV-related psychosocial burden and sexual function.

The HPV Impact Profile, Female Sexual Function Index, General Health Questionnaire-28 and Life Satisfaction Inventory questionnaires were completed by 151 women.

HPV-related psychosocial burden and general psychological health accounted for 23.2% of QoL variability. There was not strong evidence for a moderating effect of general psychological health on the relationship between HPV-related psychosocial burden and QoL. Higher HPV-related psychosocial burden predicted worse sexual function on average. However, HPV-related psychosocial burden accounted for only 4.1% of sexual function variability.

Higher HPV-related psychosocial burden is associated with lower QoL as well as worse sexual function. General psychological health predicts changes in QoL over and above HPV-related psychosocial burden; thus, a deep understanding of emerging mental health issues soon after diagnosis is crucial to improve counselling and enhance women’s mental empowerment to achieve a better psychological response.

Patients with a life-threatening illness and their family caregivers are often affected by biopsychosocial factors that contribute to suffering and burden-sharing and affect quality-of-life.

To compare anxiety and depression levels between patients with incurable cancer and caregivers, investigate the association between perceived burdensomeness and psychological outcomes over time, and evaluate factors associated with perceived burden.

Secondary analysis of a larger prospective, longitudinal study. Patients with incurable cancer and their family caregivers were interviewed every 3 months, from study enrollment to 12 months, to assess psychological factors. Anxiety and depression were measured with Hospital Anxiety and Depression Scale (HADS) and perceived of burden was assessed using distinct questions directed to patients and caregivers about feeling or perceiving caregiving as a burden. For the data analysis, generalized estimating equations were applied to assess the impact of patient and family caregiver related variables on HADS over time, considering anxiety and depression scores as binary variables.

A total of 190 patient-family caregiver dyads were included. Anxiety was more frequent among family caregivers than patients across all follow-up moments. No significant difference was found in mean depression scores. Feeling like a burden to their family (32.6%) was significantly associated with higher anxiety [odds ratio (OR) = 4.45] and depression scores (OR = 2.73). Poor health perception increased the likelihood of anxiety and depression for patients (OR = 11.00; OR = 38.81) and FC (OR = 2.73; OR = 4.30). Family caregivers demonstrated higher psychological distress, with active employment reducing anxiety (OR = 0.54) and depression (OR = 0.43).

The perceived burden experienced by patients with advanced cancer and their family caregivers over time were factors relevant in the disease process. The feeling of being a burden and poor health perception were key factors contributing to psychological distress, underlining the need for specific interventions in palliative care.

To investigate potential contributors to mental fatigue after aneurysmal subarachnoid hemorrhage (aSAH) and angiographically negative subarachnoid hemorrhage (anSAH), with a focus on information processing speed, attentional control, and psychological distress.

This observational study included 101 patients (70 aSAH, 31 anSAH) and 86 controls. Neuropsychological assessments and questionnaires were conducted five months post-SAH. Mental and physical fatigue were assessed with the Dutch Multifactor Fatigue Scale, information processing speed and attentional control with the Trail Making Test and Vienna Test System Reaction Time and Determination Test, and psychological distress with the Hospital Anxiety and Depression Scale.

Patients reported significantly higher mental and physical fatigue than controls (p < .001) and information processing speed and attentional control were significantly lower (p < .05), with no differences between aSAH and anSAH groups. Severe mental fatigue was present in 55.7% of patients with aSAH and 61.3% of patients with anSAH, significantly exceeding the prevalence of severe physical fatigue (p < .05). Higher mental fatigue correlated with worse attentional control in aSAH and with lower information processing speed in anSAH. Both mental and physical fatigue correlated with psychological distress, particularly after anSAH.

The factors related to mental fatigue appear to differ based on the type of SAH, potentially involving problems in information processing speed and attentional control, psychological distress, or both. This study emphasizes the need for individualized rehabilitation strategies addressing both cognitive and psychological factors in managing mental fatigue after SAH.

This study aimed to investigate the association between the experience of rescue activities in the 2024 Noto Peninsula earthquake and posttraumatic stress symptoms (PTSS) and psychological distress among medical rescue workers (MRWs).

MRWs were recruited from March 8 to March 31, 2024. Outcomes were psychological distress and PTSS. Independent variables were the experiences of rescue activities in the Noto Peninsula earthquake and peritraumatic distress assessed by the Peritraumatic Distress Inventory (PDI).

1085 MRWs completed all questions. Multiple linear regression analyses showed that experiences of being overwhelmed by the tragic situation in the disaster area (B = 0.61, p < 0.01), experience of disagreement and conflict among rescuers during rescue activities (B = 0.51, p < 0.01) and PDI (B = 0.33, p < 0.01) were significantly associated with psychological distress, and experience of disagreement and conflict among rescuers during rescue activities (B = 1.70, p < 0.01) and PDI (B = 0.65, p < 0.01) were significantly associated with PTSS.

This study showed factors associated with PTSS and psychological distress among MRWs during the Noto Peninsula earthquake, which was an important finding for future research on the mental health of MRWs.

Although workplace mental health screening is often implemented to aid early identification of mental health symptoms and facilitate access to treatment, supporting evidence is limited.

We aimed to evaluate the effect of independently conducted, confidential, online mental health screening, paired with automated tailored feedback recommending referral services, on help-seeking and psychological distress.

We conducted a cluster-randomised controlled trial with firefighters from an Australian fire and rescue service. Randomisation occurred by station (N = 264). Firefighters at stations allocated to the intervention group received tailored information detailing suitable mental health services based on their Kessler-6 psychological distress score (K6). The control group received generic feedback on services irrespective of K6 score. The primary outcome was help-seeking at 3-months post-intervention for those with at least moderate levels of psychological distress at baseline (K6 ≥14). The study was registered with Australian New Zealand Clinical Trials Registry (no. ANZCTR 12621001457831).

Of the 459 firefighters screened, 141 (30.72%) scored ≥14 on K6. Among this subgroup at 3 months, no differences were observed in rates of overall help-seeking between the intervention and control groups (P = 0.31). In contrast, levels of psychological distress remained high in the intervention group but declined in the control group (t[111] = 2.29, 95% CI: 0.24, 3.23, P = 0.024). The difference in psychological distress associated with workplace mental health screening equated to an effect size of −0.42 (95% CI: −0.04, −0.79).

Our findings suggest that independent, confidential online mental health screening, paired with tailored online feedback and information on available treatment, does not significantly increase help-seeking and may sustain psychological distress over time compared with receiving generic information. As such, it should not be implemented to promote help-seeking and reduce levels of psychological distress. These findings are relevant for workplaces, mental health researchers and practitioners alike, highlighting the potential risk and potential harm of mental health screening conducted in this way on individuals.