1.Mental health-related presentations to a tertiary emergency department during the COVID-19 pandemic.
Elijah Gin LIM ; Ashley Ern Hui HOW ; Julian Zhong Hui LEE ; Sameera GANTI ; Eunizar OMAR
Singapore medical journal 2025;66(12):645-650
INTRODUCTION:
The coronavirus disease 2019 (COVID-19) pandemic has caused significant mental distress in populations globally. At the frontline of the pandemic, emergency departments (EDs) are the prime setting to observe the effects of the pandemic on the mental health of the population. We aimed to describe the trend of mental health-related ED attendances at an acute hospital in Singapore before and during the various stages of the COVID-19 pandemic.
METHODS:
This is a retrospective, descriptive study of patients who presented to the ED between 1 January 2019 and 31 December 2020. Patients diagnosed with mental health-related systematised nomenclature of medicine who visited the ED during this period were identified and were placed into mental health diagnosis categories for analysis. A comparison was made between patients who presented before the pandemic (2019) and during the pandemic (2020).
RESULTS:
During the study periods, we identified 1,421 patients, of whom 27 were excluded due to non-mental health-related diagnoses, leaving 1,394 patients for analysis. There was a 36.7% increase in mental health-related ED presentations from 2019 to 2020. The proportion of higher-acuity mental health-related ED attendances and number of suicide attempts also increased.
CONCLUSION
Our study described an increase in the proportion of high-acuity mental health-related ED attendances during the COVID-19 pandemic. Emergency physicians must be cognisant of the effects of the pandemic on mental health. Further research should be conducted to better equip the healthcare system for handling all aspects of the pandemic.
Humans
;
COVID-19/psychology*
;
Emergency Service, Hospital/statistics & numerical data*
;
Retrospective Studies
;
Singapore/epidemiology*
;
Male
;
Female
;
Adult
;
Middle Aged
;
Mental Disorders/diagnosis*
;
Mental Health
;
SARS-CoV-2
;
Tertiary Care Centers
;
Pandemics
;
Aged
;
Suicide, Attempted/statistics & numerical data*
;
Young Adult
;
Adolescent
2.iPARTY study: Increasing pre-exposure prophylaxis access and reach via telehealth for young men who have sex with men in Singapore 2022-2023.
Pei Hua LEE ; Justin Y LIM ; P Arun KUMAR ; Zhi Hui TAN ; Rayen Bing Hui TAN ; Chiaw Yee CHOY ; Rayner Kay Jin TAN ; Martin Tw CHIO ; Chen Seong WONG
Annals of the Academy of Medicine, Singapore 2025;54(3):160-169
INTRODUCTION:
Although pre-exposure prophylaxis (PrEP) has been available in Singapore since 2016, its uptake among gay, bisexual and other men-who-have-sex-with-men (GBMSM) is low. The iPARTY study was established to evaluate the acceptability and feasibility of PrEP and a PrEP teleconsultation service for young GBMSM aged 18 to 29 years.
METHOD:
A total of 53 young GBMSM were enrolled in the iPARTY study. They had a total of 5 in-person consultations and teleconsultations, at 12-week intervals. Laboratory tests and quarterly baseline surveys were performed to assess PrEP adherence, sexual behaviour, and incidence of human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs).
RESULTS:
Thirty-five participants completed the entire 12-month follow-up. Most participants had positive experiences with PrEP teleconsultations. There was a statistically significant fall in participants' aggregate Patient Health Questionnaire-9 scores throughout the study. Self-reported PrEP adherence decreased over the course of the study, denoting improved mental health. Although self-reported condom use for anal intercourse and participants' risk perception of HIV decreased after PrEP adoption, there was no statisti-cally significant increase in STI incidence.
CONCLUSION
This pilot project has shown that PrEP services provide an opportunity for YMSM to access sexual health testing, treatment and counselling, and may even have tangible benefits on the mental health of this population. Teleconsultation is shown to be a suitable platform for the delivery of such services. Collaborative initiatives are crucial to further enhance the affordability and accessibility of PrEP in Singapore, and to improve patient adherence.
Adolescent
;
Adult
;
Humans
;
Male
;
Young Adult
;
Anti-HIV Agents/administration & dosage*
;
Feasibility Studies
;
Health Risk Behaviors
;
HIV Infections/psychology*
;
Incidence
;
Medication Adherence
;
Mental Health/statistics & numerical data*
;
Pilot Projects
;
Pre-Exposure Prophylaxis/statistics & numerical data*
;
Sexual and Gender Minorities/statistics & numerical data*
;
Sexually Transmitted Diseases/prevention & control*
;
Singapore/epidemiology*
;
Telemedicine/statistics & numerical data*
;
Homosexuality, Male/statistics & numerical data*
3.Associations between mental health and lifestyle changes during the COVID-19 pandemic in a general Japanese population: NIPPON DATA2010.
Naoki AONO ; Aya HIGASHIYAMA ; Harumitsu SUZUKI ; Akira FUJIYOSHI ; Makiko ABE ; Atsushi SATOH ; Hisatomi ARIMA ; Nobuo NISHI ; Aya KADOTA ; Takayoshi OHKUBO ; Tomonori OKAMURA ; Nagako OKUDA ; Akira OKAYAMA ; Katsuyuki MIURA
Environmental Health and Preventive Medicine 2025;30():28-28
BACKGROUND:
Deterioration in lifestyle associated with poor mental health could be an important concern during the coronavirus disease 2019 (COVID-19) pandemic. However, few studies have investigated the association between mental health status and lifestyle changes during the pandemic in nationwide Japanese general population.
METHODS:
This cross-sectional study was conducted using the data among 1,546 participants of the follow-up study of NIPPON DATA2010 in 2021. Recent mental status, as assessed using the Kessler 6 (K6) scale, and lifestyle changes compared to before the pandemic were determined using self-reported questionnaires. Some lifestyle changes such as decreased physical activity were defined as undesirable, whereas others such as decreased alcohol drinking were defined as desirable. The participants were divided into three groups based on the K6 scores: the K6<5, 5≤K6<9, and K6≥9 groups. The odds ratios (ORs) and 95% confidence intervals (CIs) of the K6 groups for each lifestyle change compared with that in the K6<5 group were estimated after adjusting for possible confounders.
RESULTS:
The ORs of the K6≥9 group for all undesirable lifestyle changes were significantly high, especially increased alcohol drinking (OR 4.64; 95% CI, 2.71-7.93), and decreased physical activity (OR 4.63; 95% CI, 3.29-6.52). Among the desirable changes, the OR of the 5≤K6<9 group was significantly high for increased eating home cooking.
CONCLUSIONS
Poor mental health showed a significant association with undesirable lifestyle changes, especially increased alcohol drinking and decreased physical activity, in a nationwide general Japanese population during the COVID-19 pandemic.
Humans
;
COVID-19/epidemiology*
;
Japan/epidemiology*
;
Male
;
Female
;
Mental Health/statistics & numerical data*
;
Middle Aged
;
Cross-Sectional Studies
;
Life Style
;
Adult
;
Aged
;
Exercise
;
Alcohol Drinking/epidemiology*
;
SARS-CoV-2
;
Pandemics
;
East Asian People
4.Environmental noise perception and risk of poor mental health in a region on the Mediterranean coast of Spain.
Andreu NOLASCO ; Jesús RABASCO ; Nayara TAMAYO-FONSECA ; Javier CASILLAS-CLOT ; Pamela PEREYRA-ZAMORA
Environmental Health and Preventive Medicine 2025;30():37-37
BACKGROUND:
Exposure to environmental noise may have a negative impact on a population's mental health. We estimated the prevalence of exposure perception to high environmental noise in the Valencian Community, a region on the Mediterranean coast of Spain, and analysed its association with poor mental health risk, adjusting for demographic, socioeconomic and health status variables.
METHODS:
Cross-sectional study based on a sample of 5.485 subjects, aged 15 or above, of the 2016 Valencian Community Health Survey. The risk of poor mental health was assessed via Goldberg's questionnaire, a highly standardized self-reported questionnaire designed to screen for general psychological distress in the general population. Noise perception were determined in the home environment based on individuals' responses to the Valencian Survey question about external noise problems. Sociodemographic variables, such as sex, age, level of education, or country of birth, and health variables, such as self-perceived health, or chronic diseases, were also considered. Logistic regression was used to estimate the Odds Ratios and confidence intervals of association between variables according to sex.
RESULTS:
The prevalence of poor mental health was 26.2% [n = 2665; 95% CI: 24.5-27.9] in men and 33.6% [n = 2820; 95% CI: 31.9-35.3] in women. A total of 7.8% [n = 5485; 95% CI: 6.8-8.8] presented exposure to high noise perception, with no differences according to sex. Being at risk of poor mental health was significantly associated (p < 0.05) with high noise perception after adjusting for the rest of the variables (OR: 2.16 [95% CI: 1.46-3.19] in men; 2.46 [95% CI: 1.72-3.50] in women).
CONCLUSIONS
Although the prevalence of exposure perception to high noise was not very high, population subgroups presenting high values were detected. High noise perception was related to the risk of poor mental health, regardless of other variables. Poor mental health risk was associated with exposure perception to high noise, other socioeconomic determinants, and health status. Improving noise exposure conditions could reduce the risk of poor mental health.
Humans
;
Spain/epidemiology*
;
Male
;
Female
;
Adult
;
Middle Aged
;
Noise/adverse effects*
;
Cross-Sectional Studies
;
Young Adult
;
Adolescent
;
Environmental Exposure/adverse effects*
;
Aged
;
Mental Health/statistics & numerical data*
;
Prevalence
;
Mental Disorders/epidemiology*
;
Risk Factors
5.Japanese medical researchers' perceptions of quantitative research evaluation metrics and their psychological well-being: a cross-sectional study.
Akira MINOURA ; Keisuke KUWAHARA ; Yuhei SHIMADA ; Hiroko FUKUSHIMA ; Makoto KONDO ; Takehiro SUGIYAMA
Environmental Health and Preventive Medicine 2025;30():74-74
BACKGROUND:
Supporting the mental health of researchers is essential to maintaining human resources and advancing science. This study investigated the association between Japanese medical researchers' perceptions of research evaluation processes and their psychological well-being.
METHODS:
We performed a web-based self-administered questionnaire survey. The questionnaires were distributed to each academic society through the Japanese Association of Medical Sciences from December 2022 to January 2023. These questionnaires targeted medical researchers. Exposure was the medical researchers' perceptions of quantitative indicators for evaluating medical research and researchers. The outcome was psychological well-being, measured using the Japanese version of the World Health Organization-Five Well-Being Index (WHO-5). Multivariable-adjusted logistic regressions were conducted to investigate the association between individual attitudes toward research evaluation and psychological well-being. Stratified analyses by research fields, i.e., clinical, basic, and social medicine, were also performed.
RESULTS:
A total of 3,139 valid responses were collected. After excluding 176 responses from research fields of other than clinical, basic, or social medicine, 2,963 researchers (2,185 male, 737 female, and 41 other) were analyzed. Prevalence of poor well-being (WHO-5 score <13) was 28.3% in the researchers. The highest number of medical researchers was in clinical medicine (n = 500) followed by basic medicine (n = 217) and social medicine (n = 121). Medical researchers who considered research funding slightly important/not important for researcher evaluation had poorer psychological well-being than those who considered it especially important (slightly important: adjusted odds ratio (aOR) 1.33, 95% confidence interval (CI) 1.03-1.71; not important: aOR 1.53, 95%CI 1.10-2.12). This tendency was stronger among basic medical researchers than clinical or social medical researchers. The research field significantly modified the relationship between research funding received and interaction with poor psychological well-being both additively (P = 0.030) and multiplicatively (P = 0.024).
CONCLUSIONS
The discrepancy between medical researchers' attitudes toward research evaluation and the current state of research evaluation in their research community may worsen their psychological well-being. The influence of this discrepancy differs among clinical, basic, and social medicine. Appropriate evaluation of medical research and researchers in each field can facilitate improving their psychological well-being via the resolution of this discrepancy.
Humans
;
Japan
;
Female
;
Male
;
Cross-Sectional Studies
;
Adult
;
Research Personnel/statistics & numerical data*
;
Middle Aged
;
Biomedical Research
;
Surveys and Questionnaires
;
Mental Health
;
Psychological Well-Being
;
East Asian People
6.Cross-century process of mental health surveys in China.
Junjie HUANG ; Zhaorui LIU ; Tingting ZHANG ; Yueqin HUANG
Journal of Peking University(Health Sciences) 2025;57(5):868-874
The epidemiological research on mental health in China has undergone decades of development, transitioning from multi-regional surveys to nationally representative studies. In 1982, Academician Shen Yucun led a team to complete the first national survey in 12 regions, revealing a point prevalence rate of 10.54‰. In 1993, the point prevalence rate in the second national survey in 7 regions rose to 11.18‰. In 2002, the Composite International Diagnostic Interview (CIDI)-3.0 and Diagnostic and Statistical Manual of Mental Disorders, Fouth Edition (DSM-Ⅳ) standards were first applied in the surveys in urban Beijing and Shanghai to achieve international standards, but the representativeness of urban samples was limited. Subsequent regional studies contributed methodological insights toward a nationally representative survey. From 2013 to 2015, a research team led by Professor Huang Yueqin, in collaboration with 43 institutions, completed the China Mental Health Survey (CMHS), covering 32 552 community adults in 157 counties/districts in 31 provinces/autonomous. This study represents the first nationally representative epidemiological survey of mental disorders in China. The main results showed that the lifetime prevalence of mental disorders among adults in Chinese communities with depressive disorders was 16.6%, including 7.4% for mood disorders and 7.6% for anxiety disorders. Only 9.5% of patients with depressive disorders received treatment, and the full treatment rate was as low as 0.5%. Further surveys based on the CMHS framework in regions such as Ningxia, Urumqi, and Inner Mongolia confirmed the high risk of disease among rural women in western China and the widespread phenomenon of inadequate treatment. The results of CMHS methodology was transformed into the national Guidelines and Technical Standards for Epidemiological Investigation of Community Mental Disorders (2015 Edition) and software copyright, and the main data had been published in The Lancet Psychiatry. It has been used to guide the formulation of policies such as the Healthy China Action (2019-2030). CMHS establishing a complete process from scientific investigation to policy translation, filling the data gap at the national level, providing a replicable paradigm for the world, especially for developing countries, and marking a new stage of evidence-based decision-making in China's mental health epidemiological research.
China/epidemiology*
;
Humans
;
Mental Disorders/epidemiology*
;
Health Surveys/history*
;
Mental Health/statistics & numerical data*
;
Prevalence
;
Adult
;
Female
;
Male
8.Classes of childhood adversities and their associations to the mental health of college undergraduates: a nationwide cross-sectional study.
Peigang WANG ; Mohammedhamid Osman KELIFA ; Bin YU ; Yinmei YANG
Environmental Health and Preventive Medicine 2021;26(1):73-73
BACKGROUND:
Childhood adversities pose deleterious consequences on health and well-being, but limited studies explore whether unique patterns of adverse childhood experiences (ACEs) impact the mental health of emerging adults and the mediating role of current stressful events (CSEs). This study examined classes of ACEs and how they relate to CSEs, psychological distress, and subjective well-being among Eritrean College undergraduates.
METHODS:
Cross-sectional data on ACEs, CSEs, symptoms of psychological distress, and subjective well-being were collected from a national sample of college students (N = 507). We identified ACE patterns using latent class analysis and further examined whether CSEs mediated the effects of ACE classes on psychological distress and subjective well-being.
RESULTS:
86.4% of the sample experienced at least one ACE. Collective violence, domestic violence, and physical abuse were the most common ACEs. Three subgroups, low ACEs (66.3%), household violence (19.1%), and multiple ACEs (14.6%) were identified. We found that relative to low ACEs, household violence (β = 0.142, 95% CI 0.046, 0.248) and multiple ACEs (β = 0.501, 95% CI 0.357, 0.666) indirectly influenced psychological distress through CSEs, and CSEs mediated the relationships between household violence (β = -0.096, 95% CI -0.176, -0.033), multiple ACEs (β = -0.338, 95% CI -0.498, -0.210), and subjective well-being. However, there were nonsignificant relative direct effects of ACE patterns on both psychological distress and subjective well-being.
CONCLUSIONS
Experiencing multiple ACEs and household violence in conjunction with CSEs significantly predict psychological distress and subjective well-being. Contextual interventions for the early identification of ACEs and the management of CSEs may play a crucial role in the prevention of mental health problems.
Adolescent
;
Adult
;
Adverse Childhood Experiences/statistics & numerical data*
;
Cross-Sectional Studies
;
Female
;
Health Status
;
Humans
;
Latent Class Analysis
;
Male
;
Mental Health/statistics & numerical data*
;
Models, Psychological
;
Prevalence
;
Stress, Psychological/psychology*
;
Students/statistics & numerical data*
;
Universities
;
Young Adult
10.Associations between screen time, physical activity, and depressive symptoms during the 2019 coronavirus disease (COVID-19) outbreak among Chinese college students.
Yi ZHANG ; Xiaoyan WU ; Shuman TAO ; Shiyue LI ; Le MA ; Yizhen YU ; Guilong SUN ; Tingting LI ; Fangbiao TAO
Environmental Health and Preventive Medicine 2021;26(1):107-107
BACKGROUND:
The 2019 novel coronavirus disease (COVID-19) emerges in China, which spreads rapidly and becomes a public health emergency of international concern. Chinese government has promptly taken quarantine measures to block the transmission of the COVID-19, which may cause deleterious consequences on everyone's behaviors and psychological health. Few studies have examined the associations between behavioral and mental health in different endemic areas. This study aimed to describe screen time (ST), physical activity (PA), and depressive symptoms, as well as their associations among Chinese college students according to different epidemic areas.
METHODS:
The study design is cross-sectional using online survey, from 4 to 12 February 2020, 14,789 college students accomplished this online study, participants who did not complete the questionnaire were excluded, and finally this study included 11,787 college students from China.
RESULTS:
The average age of participants was 20.51 ± 1.88 years. 57.1% of the college students were male. In total, 25.9% of college students reported depression symptoms. ST > 4 h/day was positively correlated with depressive symptoms (β = 0.48, 95%CI 0.37-0.59). COVID-19ST > 1 h/day was positively correlated with depressive symptoms (β = 0.54, 95%CI 0.43-0.65), compared with COVID-19ST ≤ 0.5 h/day. Compared with PA ≥ 3 day/week, PA < 3 day/week was positively associated with depression symptoms (β = 0.01, 95%CI 0.008-0.012). Compared with low ST and high PA, there was an interaction association between high ST and low PA on depression (β = 0.31, 95%CI 0.26-0.36). Compared with low COVID-19ST and high PA, there was an interaction association between high COVID-19ST and low PA on depression (β = 0.37, 95%CI 0.32-0.43). There were also current residence areas differences.
CONCLUSIONS
Our findings identified that high ST or low PA was positively associated with depressive symptoms independently, and there was also an interactive effect between ST and PA on depressive symptoms.
Adult
;
COVID-19/psychology*
;
China/epidemiology*
;
Cross-Sectional Studies
;
Depression/etiology*
;
Exercise
;
Female
;
Humans
;
Male
;
Mental Health/statistics & numerical data*
;
Screen Time
;
Students/psychology*
;
Time Factors
;
Universities
;
Young Adult

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