1.Syndrome differentiation and treatment of coronary heart disease combined with anxiety and depression from stages of phlegm, blood stasis, and toxic pathogen based on theory of "coexistence of diseases and depression syndromes".
Sen-Jie ZHONG ; Xiang GAO ; Lu-Xi WANG ; Jie CHEN ; Hui WU ; Jing LI ; Hong-Cheng FANG ; Shao-Xiang XIAN
China Journal of Chinese Materia Medica 2023;48(20):5675-5680
		                        		
		                        			
		                        			Depression syndromes(anxiety and depression), as typical psychological disorders, often coexist with and mutually influence coronary heart disease(CHD). They constitute a psycho-cardiology disease involving both the blood vessels of the heart and the spirit of the heart. Based on the theory of "coexistence of diseases and depression syndromes", it was proposed that CHD and depression syndromes coexisted independently and were causally related. The factors of depression syndromes go through the entire course of CHD and have different causal relationships at different stages, leading to a pathogenic process of "depression causing disease" or "disease causing depression". In the chronic latent period, phlegm predominates, with depression leading to the production of phlegm. Phlegm accumulation and Qi stagnation initiate a mutual damage process of psycho-cardiology, marking the onset of the disease. In the pathological development period, blood stasis becomes predominant. Depression leads to blood stasis, which further obstructs Qi circulation, accelerating disease progression. In the acute attack period, toxicity becomes crucial. Depression transforms into toxicity, damaging Qi and blood, disturbing the balance of the mind, and inducing a sudden and severe exacerbation of the disease. Based on this, the approach of treating phlegm and depression together, treating blood stasis and depression together, and treating toxicity and depression together by stages was established. Research has found that this approach can simultaneously improve organic damage and emotional disorders, and also has a regulating effect on micro-level syndrome indicators, achieving harmonization of psycho-cardiology in the treatment.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Medicine, Chinese Traditional
		                        			;
		                        		
		                        			Depression/diagnosis*
		                        			;
		                        		
		                        			Coronary Disease/diagnosis*
		                        			;
		                        		
		                        			Mucus
		                        			;
		                        		
		                        			Syndrome
		                        			;
		                        		
		                        			Anxiety
		                        			
		                        		
		                        	
2.Research advances in the correlation between chronic subjective tinnitus and anxiety state.
Xueyan WANG ; Yongde JIN ; Zhezhu CUI ; Changxu YU ; Yulian JIN ; Jun YANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(5):393-398
		                        		
		                        			
		                        			Tinnitus and anxiety disorder are common clinical symptoms. Comorbidity between tinnitus and anxiety state is increasing year by year. The relationship between tinnitus and anxiety state has always been a hot topic, and this paper reviews the literature on the relationship between chronic subjective tinnitus and anxiety state in recent years.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Tinnitus/diagnosis*
		                        			;
		                        		
		                        			Anxiety
		                        			;
		                        		
		                        			Anxiety Disorders/epidemiology*
		                        			;
		                        		
		                        			Comorbidity
		                        			
		                        		
		                        	
3.Clinical analysis of suspected COVID-19 patients with anxiety and depression.
Xin LI ; Tian DAI ; Hong WANG ; Junnian SHI ; Wei YUAN ; Jing LI ; Lijun CHEN ; Tianming ZHANG ; Shanshan ZHANG ; Yan KONG ; Ning YUE ; Hui SHI ; Yuping HE ; Huifang HU ; Furong LIU ; Caixia YANG
Journal of Zhejiang University. Medical sciences 2020;49(2):203-208
		                        		
		                        			OBJECTIVE:
		                        			To explore the risk factors of anxiety and depression in patients with suspected coronavirus disease 2019 (COVID-19) so as to achieve early intervention and better clinical prognosis.
		                        		
		                        			METHODS:
		                        			Seventy-six patients with suspected COVID-19 in fever isolation wards of Second Hospital of Lanzhou University were enrolled From January 31, 2020 to February 22, 2020. Their clinical baseline data were collected. The anxiety of patients was assessed by Hamilton Anxiety Scale, and the depression of patients was assessed by Hamilton Depression Scale. Multivariate Logistic regression analysis was performed to explore the risk factors of anxiety and depression in these patients.
		                        		
		                        			RESULTS:
		                        			Female patients are more likely to have anxiety (=3.206, 95%: 1.073-9.583, <0.05) and depression (=9.111, 95%: 2.143-38.729, <0.01) than male patients; patients with known contact history of epidemic area and personnel in epidemic area are more likely to have depression (=3.267, 95%: 1.082-9.597, <0.05).
		                        		
		                        			CONCLUSIONS
		                        			During the isolation treatment of suspected COVID-19 patients, early psychological intervention should be carried out for the female patients with known contact history of epidemic area and personnel in epidemic area, and drug treatment should be given in advance if necessary.
		                        		
		                        		
		                        		
		                        			Anxiety
		                        			;
		                        		
		                        			diagnosis
		                        			;
		                        		
		                        			etiology
		                        			;
		                        		
		                        			therapy
		                        			;
		                        		
		                        			Betacoronavirus
		                        			;
		                        		
		                        			isolation & purification
		                        			;
		                        		
		                        			Coronavirus Infections
		                        			;
		                        		
		                        			complications
		                        			;
		                        		
		                        			diagnosis
		                        			;
		                        		
		                        			psychology
		                        			;
		                        		
		                        			Depression
		                        			;
		                        		
		                        			diagnosis
		                        			;
		                        		
		                        			etiology
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Logistic Models
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Pandemics
		                        			;
		                        		
		                        			Pneumonia, Viral
		                        			;
		                        		
		                        			complications
		                        			;
		                        		
		                        			diagnosis
		                        			;
		                        		
		                        			psychology
		                        			;
		                        		
		                        			Risk Factors
		                        			
		                        		
		                        	
4.Psychological status of the staff in a general hospital during the outbreak of coronavirus disease 2019 and its influential factors.
Furong JIANG ; Siyu LIU ; Nan ZHAO ; Yanhui XIE ; Shuhong WANG ; Xinbo OUYANG ; Feng GUO ; Zhicheng GONG ; Qiuhong ZHOU ; Jianling LI
Journal of Central South University(Medical Sciences) 2020;45(6):641-648
		                        		
		                        			OBJECTIVES:
		                        			To understand the psychological status of the staff in a general hospital during the coronavirus disease 2019 and its influential factors, and to provide references for the mental health services to hospital staff.
		                        		
		                        			METHODS:
		                        			Using star platform of questionnaire, the staff in the general hospital were investigated via Depression, Anxiety, Stress Scale (DASS-21), Social Support Rating Scale (SSRS) and Simplified Coping Style Questionnaire (SCSQ). The influential factors were discussed by descriptive analysis, rank sum test, single factor analysis, correlation analysis and multiple factors binary logistic regression analysis.
		                        		
		                        			RESULTS:
		                        			A total of 2 060 valid questionnaires were collected. The negative emotions of nurses and cleaners were the most obvious. The depression scores, anxiety scores and stress scores for nurses and cleaners were 5.06±7.47, 6.36±7.84, 9.75±8.65, and 6.72±8.84, 4.51±6.56, 9.69±9.56, respectively. Multivariate binary logistic regression analysis showed that staff types, education levels, job status, economic situation and concerns on the supplies of protective goods were the main influential factors for depression; staff types, contacting status with infected patients, economic situation, concerns on the supplies of protective goods, history of disease were the main influential factors for anxiety; contacting status with infected patients, economic situation, concerns on the supplies of protective goods were the main influential factors for stress.
		                        		
		                        			CONCLUSIONS
		                        			There are differences in psychological characteristics among different groups of staff in the general hospital under the outbreak. Thus psychological protection and intervention measures should be formulated according to different groups and work status.
		                        		
		                        		
		                        		
		                        			Adaptation, Psychological
		                        			;
		                        		
		                        			Anxiety
		                        			;
		                        		
		                        			diagnosis
		                        			;
		                        		
		                        			Betacoronavirus
		                        			;
		                        		
		                        			China
		                        			;
		                        		
		                        			Coronavirus Infections
		                        			;
		                        		
		                        			psychology
		                        			;
		                        		
		                        			Cross-Sectional Studies
		                        			;
		                        		
		                        			Depression
		                        			;
		                        		
		                        			diagnosis
		                        			;
		                        		
		                        			Disease Outbreaks
		                        			;
		                        		
		                        			Hospitals, General
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Pandemics
		                        			;
		                        		
		                        			Personnel, Hospital
		                        			;
		                        		
		                        			psychology
		                        			;
		                        		
		                        			Pneumonia, Viral
		                        			;
		                        		
		                        			psychology
		                        			;
		                        		
		                        			Stress, Psychological
		                        			;
		                        		
		                        			Surveys and Questionnaires
		                        			
		                        		
		                        	
5.Mental health of front-line staff in prevention of coronavirus disease 2019.
Ziwei TENG ; Jing HUANG ; Yan QIU ; Yuxi TAN ; Qiuping ZHONG ; Hui TANG ; Haishan WU ; Ying WU ; Jindong CHEN
Journal of Central South University(Medical Sciences) 2020;45(6):613-619
		                        		
		                        			OBJECTIVES:
		                        			The coronavirus disease 2019 (COVID-19) pandemic is a global public health crisis, which elicits psychological problems in different population This study is to investigate the impact of COVID-19 on mental health in the front-line staff.
		                        		
		                        			METHODS:
		                        			Patient Health Questionnare-9 (PHQ-9), Self-Rating Anxiety Scale (SAS), and Fatigue Self-assessment Scale (FSAS) were used to assess the depression, anxiety, and fatigue in front-line staff.
		                        		
		                        			RESULTS:
		                        			The detection rates of depression, anxiety, and fatigue were 49.1%, 21.8%, and 76.0% among the front-line staff. The rates of depression, anxiety, and fatigue in community workers were higher than those in medical workers and other occupational staff (<0.01). The PHQ-9 of front-line staffs was negatively correlated with age, family income, family members' support, satisfaction of service objects, and sleep quality (all <0.01), while positively correlated with education level, fatigue, fear of pneumonia, and the duration of daily attention to the COVID-19 (all <0.01). SAS was negatively correlated with age, family income, family support, satisfaction of objects service, and sleep quality (all <0.01), while positively correlated with gender, fatigue, fear of pneumonia, and duration of daily attention to the COVID-19 (all <0.01).
		                        		
		                        			CONCLUSIONS
		                        			The front-line workers should manage work and rest time reasonably to adjust their negative mood and fatigue. The government and the society should pay more attention to the psychological state of the front-line staff, particularly for the staff working in the community or villages and towns in preventing the COVID-19 pandemic. Thus, front-line staff can be obtained mental intervention or be taken a rest from the high-intensive work.
		                        		
		                        		
		                        		
		                        			Anxiety
		                        			;
		                        		
		                        			diagnosis
		                        			;
		                        		
		                        			Betacoronavirus
		                        			;
		                        		
		                        			Coronavirus Infections
		                        			;
		                        		
		                        			prevention & control
		                        			;
		                        		
		                        			psychology
		                        			;
		                        		
		                        			Depression
		                        			;
		                        		
		                        			diagnosis
		                        			;
		                        		
		                        			Fatigue
		                        			;
		                        		
		                        			diagnosis
		                        			;
		                        		
		                        			Health Personnel
		                        			;
		                        		
		                        			psychology
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Mental Health
		                        			;
		                        		
		                        			Pandemics
		                        			;
		                        		
		                        			prevention & control
		                        			;
		                        		
		                        			Pneumonia, Viral
		                        			;
		                        		
		                        			prevention & control
		                        			;
		                        		
		                        			psychology
		                        			
		                        		
		                        	
6.Illness Experiences and Palliative Care Needs in Community Dwelling Persons with Cardiometabolic Diseases
EunSeok CHA ; JaeHwan LEE ; KangWook LEE ; Yujin HWANG
Korean Journal of Hospice and Palliative Care 2019;22(1):8-18
		                        		
		                        			
		                        			PURPOSE: This study was conducted to better understand the illness experiences and palliative care needs in community-dwelling persons with cardiometabolic diseases. METHODS: This qualitative descriptive study was conducted with 11 patients (and three family members) among 28 patients contacted. Interviews were led by the principal investigator in her office or at participants' home depending on their preference. All interviews were digitally recorded and transcribed by a research assistant. The interviews were analyzed by two independent researchers using a conventional method. RESULTS: Participants' ages ranged from 42 to 82 years (nine men and two women). Three themes were identified: (1) same disease, but different illness experiences; (2) I am in charge of my disease(s); (3) preparation for disease progression. Participants were informed of the name of their disease when they were diagnosed, but not provided with explanation of the diagnosis or meant or how to do self-care to delay the disease progression, which increased the feelings of uncertainty, hopelessness and anxiety. Taking medication was considered to be the primary treatment option and self-care a supplemental one. Advanced care plans were considered when they felt the progression of their disease(s) while refraining from sharing it with their family or health care professionals to save their concerns. All participants were willing to withhold life-sustaining treatment without making any preparation in writing. CONCLUSION: Education on self-care and advanced care planning should be provided to community-dwelling persons with cardiometabolic diseases. A patient-centered education program needs to be developed for this population.
		                        		
		                        		
		                        		
		                        			Anxiety
		                        			;
		                        		
		                        			Chronic Disease
		                        			;
		                        		
		                        			Delivery of Health Care
		                        			;
		                        		
		                        			Diagnosis
		                        			;
		                        		
		                        			Disease Progression
		                        			;
		                        		
		                        			Education
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Independent Living
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Methods
		                        			;
		                        		
		                        			Palliative Care
		                        			;
		                        		
		                        			Qualitative Research
		                        			;
		                        		
		                        			Research Personnel
		                        			;
		                        		
		                        			Self Care
		                        			;
		                        		
		                        			Uncertainty
		                        			;
		                        		
		                        			Writing
		                        			
		                        		
		                        	
7.Clinical Characteristics of NSSI and Predictors of Suicide Attempts in Clinically Depressed Korean Adolescents
Korean Journal of Psychosomatic Medicine 2019;27(1):69-76
		                        		
		                        			
		                        			OBJECTIVES: The purpose of this study was to examine the prevalence and clinical characteristics of nonsuicidal self-injury (NSSI), and its association with suicide attempts among clinically depressed adolescents in Korea. METHODS: In total, 113 depressed adolescents aged 12– 18 years in South Korea were enrolled in this study. We assessed sociodemographic and clinical characteristics including suicidality and non-suicidal self-injury (NSSI) using various self-reported scales and semi-structured interview for diagnosis of psychiatric disorders. Demographic and clinical characteristics of the subjects were compared between NSSI and non-NSSI groups. We examined significant predictors of suicide attempts using logistic regression analysis. RESULTS: Among 113 depressed participants, 48 (42.1%) adolescents were classified into the NSSI group. In the NSSI group, there were significantly more females, showed higher depression, higher state-anxiety, and more suicide ideation. The most predictive factors of suicide attempts were history of NSSI, observed suicide/NSSI behaviors of their family or friends, and total state anxiety score. CONCLUSIONS: NSSI is more common problem among clinically depressed adolescents and history of NSSI is a significant predictor of present suicide attempts. To include the assessment of NSSI for clinically depressed adolescent may be crucial for intervention programs for high risk adolescents of suicide in Korea.
		                        		
		                        		
		                        		
		                        			Adolescent
		                        			;
		                        		
		                        			Anxiety
		                        			;
		                        		
		                        			Depression
		                        			;
		                        		
		                        			Diagnosis
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Friends
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Korea
		                        			;
		                        		
		                        			Logistic Models
		                        			;
		                        		
		                        			Prevalence
		                        			;
		                        		
		                        			Suicide
		                        			;
		                        		
		                        			Weights and Measures
		                        			
		                        		
		                        	
8.Mediation Effect of Adaptation on the Quality of Life in Patients with Gastric Cancer Undergoing Gastrectomy: A Structure Equation Model
Asian Nursing Research 2019;13(1):38-46
		                        		
		                        			
		                        			PURPOSE: This study aimed to develop a model for estimating the quality of life mediated by adaptation to changes experienced after stomach cancer diagnosis and surgery in patients with gastrectomy and to verify the model based on the Cancer Survivor Adaptation Model by Naus et al. (2009) and literature reviews. METHODS: Data was collected from 297 gastric cancer patients who underwent a gastrectomy at an outpatient clinic of two university hospitals in Daegu city from May to August, 2016. The exogenous variableswere perceived gastrointestinal symptoms, self-efficacy, anxiety, social support, and spiritual well-being. The endogenous variableswere adaptation and quality of life, and adaptationwas themediating variable. For data analysis, structural equation modeling was performed using IBM SPSS 21.0 and AMOS 18.0. RESULTS: The fitness parameters of the final model showed a reasonable fit to the data. Based on R², the exogenous variables explained 73.9% of the quality of life of stomach cancer patients who underwent surgery, through the mediation of adaptation; adaptation alone explained 73.5% of quality of life. Adaptation of stomach cancer patients with gastrectomy was a factor that strongly influenced their quality of life. CONCLUSION: It is important for gastric cancer patients with gastrectomy to adapt well to changes after surgery in order to improve the quality of life. Nursing interventions to aid successful adaptation would ultimately exert positive influences and improve the patients' quality of life.
		                        		
		                        		
		                        		
		                        			Ambulatory Care Facilities
		                        			;
		                        		
		                        			Anxiety
		                        			;
		                        		
		                        			Daegu
		                        			;
		                        		
		                        			Diagnosis
		                        			;
		                        		
		                        			Gastrectomy
		                        			;
		                        		
		                        			Hospitals, University
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Negotiating
		                        			;
		                        		
		                        			Nursing
		                        			;
		                        		
		                        			Quality of Life
		                        			;
		                        		
		                        			Statistics as Topic
		                        			;
		                        		
		                        			Stomach Neoplasms
		                        			;
		                        		
		                        			Survivors
		                        			
		                        		
		                        	
9.Assessing for Mood and Anxiety Disorders in Parents of Clinically-Referred Children: Laying the Foundation for a Family-Based Approach to Mental Health in Singapore.
Sharon C SUNG ; Han Ying TNG ; Zi Jun WONG ; Yan Lin TAN ; Yi Ren TAN ; Siew Foong CHOONG ; Chee Hon CHIN ; Leong Yeok JANG ; Clare Hm KWAN ; Say How ONG ; James J HUDZIAK ; Michael J MEANEY ; Daniel Ss FUNG
Annals of the Academy of Medicine, Singapore 2019;48(2):55-62
		                        		
		                        			INTRODUCTION:
		                        			Family history of psychopathology is a risk factor for mood and anxiety disorders in children, but little is known about rates of parental psychopathology among treatment-seeking youth with affective disorders in the Asia Pacific region. This study examined patterns of emotional and behavioural problems in parents of clinically-referred youth in Singapore. We hypothesised that parents would have higher rates of affective disorders compared to the Singapore national prevalence rate of 12%.
		                        		
		                        			MATERIALS AND METHODS:
		                        			In this cross-sectional study, 47 families were recruited from affective disorders and community-based psychiatry programmes run by a tertiary child psychiatry clinic. All children had a confirmed primary clinical diagnosis of depression or an anxiety disorder. Parents completed the Mini International Neuropsychiatric Interview (MINI) to assess for lifetime mood and anxiety disorders. They also completed the Adult Self Report (ASR) and Adult Behavior Checklist (ABCL) to assess current internalising and externalising symptoms.
		                        		
		                        			RESULTS:
		                        			Consistent with our hypothesis, 38.5% of mothers and 10.5% of fathers reported a lifetime mood and anxiety disorder. Nearly 1/3 of mothers had clinical/subclinical scores on current internalising and externalising problems. A similar pattern was found for internalising problems among fathers, with a slightly lower rate of clinical/subclinical externalising problems.
		                        		
		                        			CONCLUSION
		                        			Our findings are consistent with previous overseas studies showing elevated rates of affective disorders among parents - particularly mothers - of children seeking outpatient psychiatric care. Routine screening in this population may help to close the current treatment gap for adults with mood and anxiety disorders.
		                        		
		                        		
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Anxiety Disorders
		                        			;
		                        		
		                        			diagnosis
		                        			;
		                        		
		                        			epidemiology
		                        			;
		                        		
		                        			psychology
		                        			;
		                        		
		                        			Child
		                        			;
		                        		
		                        			Cross-Sectional Studies
		                        			;
		                        		
		                        			Family Health
		                        			;
		                        		
		                        			statistics & numerical data
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Mood Disorders
		                        			;
		                        		
		                        			diagnosis
		                        			;
		                        		
		                        			epidemiology
		                        			;
		                        		
		                        			psychology
		                        			;
		                        		
		                        			Parent-Child Relations
		                        			;
		                        		
		                        			Parenting
		                        			;
		                        		
		                        			psychology
		                        			;
		                        		
		                        			Parents
		                        			;
		                        		
		                        			psychology
		                        			;
		                        		
		                        			Psychiatric Status Rating Scales
		                        			;
		                        		
		                        			Psychopathology
		                        			;
		                        		
		                        			Singapore
		                        			;
		                        		
		                        			epidemiology
		                        			
		                        		
		                        	
10.Burden of Psychiatric Disorders among Pediatric and Young Adults with Inflammatory Bowel Disease: A Population-Based Analysis
Aravind THAVAMANI ; Krishna Kishore UMAPATHI ; Jasmine KHATANA ; Reema GULATI
Pediatric Gastroenterology, Hepatology & Nutrition 2019;22(6):527-535
		                        		
		                        			
		                        			PURPOSE: There is increasing prevalence of psychiatric disorders among inflammatory bowel Disease (IBD) population. Further, presence of psychiatric disorders has been shown as an independent predictor of quality of life among patients with IBD. We intended to explore the prevalence of various psychiatric disorders among pediatric and young adult population with IBD as a population-based analysis. METHODS: We did a retrospective case control analysis using a deidentified cloud-based database including health care data across 26 health care networks comprising of more than 360 hospitals across USA. Data collected across different hospitals were classified and stored according to Systematized Nomenclature of Medicine-Clinical Terms. We preidentified 10 psychiatric disorders and the queried the database for the presence of at least one of the ten psychiatric disorders among IBD patients between 5 and 24 years of age and compared with controls. RESULTS: Total of 11,316,450 patients in the age group between 5 and 24 years and the number of patients with a diagnosis of IBD, Crohn's disease or ulcerative colitis were 58,020. The prevalence of psychiatric disorders was 21.6% among IBD mainly comprising of depression and anxiety disorder. Multiple logistic regression analysis showed, IBD is 5 times more likely associated with psychiatric disorders than controls, p<0.001). We showed a steady increasing trend in the incidence of psychiatric disorders among IBD patients (2% in 2006 to 15% in 2017). CONCLUSION: Largest population-based analysis demonstrated an increased prevalence of psychiatric disorders among IBD patients. Our study emphasizes the need for psychological and mental health services to be incorporated as a part of the routine IBD clinic.
		                        		
		                        		
		                        		
		                        			Adjustment Disorders
		                        			;
		                        		
		                        			Anxiety
		                        			;
		                        		
		                        			Anxiety Disorders
		                        			;
		                        		
		                        			Case-Control Studies
		                        			;
		                        		
		                        			Colitis, Ulcerative
		                        			;
		                        		
		                        			Crohn Disease
		                        			;
		                        		
		                        			Delivery of Health Care
		                        			;
		                        		
		                        			Depression
		                        			;
		                        		
		                        			Diagnosis
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Incidence
		                        			;
		                        		
		                        			Inflammatory Bowel Diseases
		                        			;
		                        		
		                        			Logistic Models
		                        			;
		                        		
		                        			Mental Health Services
		                        			;
		                        		
		                        			Prevalence
		                        			;
		                        		
		                        			Quality of Life
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			Young Adult
		                        			
		                        		
		                        	
            
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