Association between Irregular Meal Timing and the Mental Health of Japanese Workers

Breakfast skipping and nighttime snacking have been identified as risk factors for obesity, diabetes, and cardiovascular diseases. However, the effects of irregularity of meal timing on health and daily quality of life are still unclear. In this study, a web-based self-administered questionnaire survey was conducted involving 4490 workers (73.3% males; average age = 47.4 ± 0.1 years) in Japan to investigate the association between meal habits, health, and social relationships. This study identified that irregular meal timing was correlated with higher neuroticism (one of the Big Five personality traits), lower physical activity levels, and higher productivity loss. Irregular meal timing was also associated with a higher incidence of sleep problems and lower subjective health conditions. Among health outcomes, a high correlation of irregular meal timing with mental health factors was observed. This study showed that irregularity of meal timing can be explained by unbalanced diets, frequent breakfast skipping, increased snacking frequency, and insufficient latency from the last meal to sleep onset. Finally, logistic regression analysis was conducted, and a significant contribution of meal timing irregularity to subjective mental health was found under adjustment for other confounding factors. These results suggest that irregular meal timing is a good marker of subjective mental health issues.

Prevalence of Mental Health Complaints Among Performing Arts Students Is Associated With COVID-19 Preventive Measures

The aim of this study was to investigate the effect of COVID-19 preventive measures on the mental health of performing arts students. In a prospective cohort study, performing arts students (N = 213) from Codarts Rotterdam, University of the Arts, were invited to monitor their health during one academic year (September 2019–May 2020). Every month, students completed items on mental health complaints, stress, and sleep quality. Chi-square tests and repeated-measures ANOVA with deviation contrasts were performed to investigate whether COVID-19 preventive measures were associated with changes in mental health complaints, stress scores, and sleep quality. During the COVID-19 lockdown, subjective mental health, Mental Health Inventory-5 (MHI-5), and items on loneliness were additionally completed by the respondents. A total of 98 students (46.0%) were included in the analyses. The 3-month prevalence of mental health complaints was significantly higher during the COVID-19 lockdown compared to the two pre-COVID-19 periods (p < 0.001). Mean stress scores were significantly lower for February (35.20) and March (36.41) when compared to the overall mean (40.38). Sleep quality scores (mean) were significantly higher for April (6.90), and May (6.89) when compared to overall mean (6.58). Furthermore, at least 75.5% of the participants dealt with moderate to very severe loneliness in all 3 months during the COVID-19 lockdown. During lockdown, performing arts students perceived less stress and their sleep quality increased. However, the prevalence of mental health complaints increased. Besides, 3 out 4 students dealt with moderate to very severe loneliness.

Impact of the COVID-19 Pandemic on the Psychological Distress of Medical Students in Japan: Cross-sectional Survey Study

Background The COVID-19 pandemic has negatively affected medical education. However, little data are available about medical students’ distress during the pandemic. Objective This study aimed to provide details on how medical students have been affected by the pandemic. Methods A cross-sectional study was conducted. A total of 717 medical students participated in the web-based survey. The survey included questions about how the participants’ mental status had changed from before to after the Japanese nationwide state of emergency (SOE). Results Out of 717 medical students, 473 (66.0%) participated in the study. In total, 29.8% (141/473) of the students reported concerns about the shift toward online education, mostly because they thought online education would be ineffective compared with in-person learning. The participants’ subjective mental health status significantly worsened after the SOE was lifted (P<.001). Those who had concerns about a shift toward online education had higher odds of having generalized anxiety and being depressed (odds ratio [OR] 1.97, 95% CI 1.19-3.28) as did those who said they would request food aid (OR 1.99, 95% CI 1.16-3.44) and mental health care resources (OR 3.56, 95% CI 2.07-6.15). Conclusions Given our findings, the sudden shift to online education might have overwhelmed medical students. Thus, we recommend that educators inform learners that online learning is not inferior to in-person learning, which could attenuate potential depression and anxiety.

Impact of the COVID-19 Pandemic on the Psychological Distress of Medical Students in Japan: Cross-sectional Survey Study (Preprint)

BACKGROUND The COVID-19 pandemic has negatively affected medical education. However, little data are available about medical students’ distress during the pandemic. OBJECTIVE This study aimed to provide details on how medical students have been affected by the pandemic. METHODS A cross-sectional study was conducted. A total of 717 medical students participated in the web-based survey. The survey included questions about how the participants’ mental status had changed from before to after the Japanese nationwide state of emergency (SOE). RESULTS Out of 717 medical students, 473 (66.0%) participated in the study. In total, 29.8% (141/473) of the students reported concerns about the shift toward online education, mostly because they thought online education would be ineffective compared with in-person learning. The participants’ subjective mental health status significantly worsened after the SOE was lifted (<i>P</i>&lt;.001). Those who had concerns about a shift toward online education had higher odds of having generalized anxiety and being depressed (odds ratio [OR] 1.97, 95% CI 1.19-3.28) as did those who said they would request food aid (OR 1.99, 95% CI 1.16-3.44) and mental health care resources (OR 3.56, 95% CI 2.07-6.15). CONCLUSIONS Given our findings, the sudden shift to online education might have overwhelmed medical students. Thus, we recommend that educators inform learners that online learning is not inferior to in-person learning, which could attenuate potential depression and anxiety.

Subjective mental health and need for care among psychiatric outpatients during the COVID-19 pandemic: results from an outreach initiative in Sweden

ImportanceThe ongoing COVID-19 pandemic restricts access to care for psychiatric patients. The physical and mental well-being of patients with severe mental illness in the current circumstances is unknown.ObjectiveTo evaluate physical and mental well-being, subjective mental health, and need for updated psychiatric management plans in a sample of patients with severe mental illness during the early stages of the COVID-19 pandemic.DesignCross-sectional study of structured telephone assessments conducted between April 23 and June 30, 2020.SettingRegional psychiatric outpatient care centre in Stockholm, Sweden.ParticipantsPatients who had not been in contact with their psychiatric clinic between April 9 and April 23, 2020. A total of 1071 patients were contacted by phone.ExposuresOccurrence of respiratory symptoms, changes in psychiatric symptoms, and the need for updated psychiatric management plans, as determined by the telephone assessors. Subjective mental health rated 0-100 by patients.Main Outcomes and MeasuresSelf-rated physical, respiratory and psychiatric symptoms according to a semi-structured interview. Subjective mental health rated on a scale from 0-100.ResultsPatients (n = 1071) were on average 45 years old (SD = 16.9), of which 570 (53%) were female. Neurodevelopmental disorders, psychotic disorders, and bipolar disorder were the most common diagnostic categories. The majority of respondents reported no respiratory symptoms (86%), and few reported light (10%) or severe (4%) respiratory symptoms. Similarly, most patients reported no worsening in psychiatric symptoms (81%). For those who reported a worsening of psychiatric symptoms (19%), the psychiatric management plans that were already in place were deemed appropriate in most cases (16.5%), whereas 22 patients (2.5%) reported a worsening of psychiatric symptoms that warranted an earlier or immediate follow-up by their psychiatric clinic. Patients rated their subjective mental health on a 0-100 scale as 70.5 [95% CI 69 - 71.9] on average (n = 841). Response rates to the questions of the structured assessment varied from 79% - 82%.Conclusions and RelevanceThe majority of patients reported no respiratory symptoms, no change in psychiatric symptoms and a rather high subjective well-being. Patients in psychiatric care with a mental health care plan experienced stability in the management of their psychiatric symptoms and general well-being, and only a minority were in need of acute support during the early pandemic phase in Stockholm, Sweden.Key PointsQuestionWhat is the physical and mental health of patients with severe mental illness during the early phase of the COVID-19 pandemic?FindingsIn this cross-sectional study that included 1071 patients at a psychiatric outpatient clinic, the proportion of patients reporting respiratory symptoms were 4%. In addition, 19% of patients reported a worsening of psychiatric symptoms, with 2.5% needing an earlier follow-up than was planned.MeaningPatients with severe mental illness experienced stability in the management of their psychiatric symptoms during the early pandemic phase in Sweden.

Socio-educational Impact and Psychological Distress of Medical Students amid the COVID-19 Pandemic: A Japanese Cross-Sectional Survey

The COVID-19 pandemic has negatively affected medical education. However, few data are available about medical students’ distress during the pandemic. This study aimed to provide details on how medical students had been affected by the pandemic. In this cross-sectional study, 717 medical students participated in the web-based survey. The questions included how their mental status had changed before and after the Japanese nationwide state of emergency (SOE). 65.9% (473/717) participated in the study. 29.8% (141/473) reported concerns about the shift toward online education, mostly because they thought online education could have been ineffective compared with in-person learning. Participants’ subjective mental health status significantly worsened after the SOE was lifted (p <.001). Those who had concerns about a shift toward online education had higher odds of having generalized anxiety and being depressed (OR 1.97, 95% CI 1.19 – 3.28), as did those who requested food aid and mental health care resources (OR 1.99, 95% CI 1.16 – 3.44; OR 3.56, 95% CI 2.07 – 6.15, respectively). Given our findings, the sudden shift to online education might have overwhelmed medical students. Thus, we recommend educators to inform learners that online learning is non-inferior to in-person learning, which could attenuate potential depression and anxiety.

Relationship between types of activity and subjective well-being in older adults living alone: Secondary analysis of the 2014 survey of attitudes towards older people living alone

Objective: In the contemporary aging society, subjective well-being is an important determinant of quality of life for older adults living alone. Although the association between improved health and subjective well-being in this population is well documented, the types of activities associated with subjective well-being are unclear.Methods: This study assessed the relationship between subjective well-being and activity types among older adults living alone based on a secondary analysis of the 2014 Survey of Attitudes Towards Older People Living Alone data. We conducted a Poisson regression analysis to determine the association between activity and subjective well-being.Results: After adjustment for age, sex, subjective physical health, subjective mental health, and income, higher levels of subjective well-being were significantly associated with spending time with family, meeting friends, playing with pets, eating, hiking, traveling, and watching sports.Conclusion: Going out and interactive activities, as well as individual activities outside the home, are associated with higher levels of subjective well-being. Promoting these activities has the potential to increase the subjective well-being of older adults.

Subjective mental health, incidence of depressive symptoms in later life, and the role of epigenetics: results from two longitudinal cohort studies

The role of self-perceived general health in predicting morbidity and mortality among older people is established. The predictive value of self-perceived mental health and of its possible biological underpinnings for future depressive symptoms is unexplored. This study aimed to assess the role of mental health-related quality of life (HRQOL) and of its epigenetic markers in predicting depressive symptoms among older people without lifetime history of depression. Data were based on a subgroup (n = 1 492) of participants of the longitudinal ESTHER study. An epigenome-wide association study (EWAS) of mental HRQOL was conducted using DNA from baseline whole blood samples and logistic regression analyses were performed to assess the predictive value of methylation beta values of EWAS identified CpGs for incidence of depressive symptoms in later life. The methylation analyses were replicated in the independent KORA cohort (n = 890) and a meta-analysis of the two studies was conducted. Results of the meta-analysis showed that participants with beta values of cg27115863 within quartile 1 (Q1) had nearly a two-fold increased risk of developing depressive symptoms compared to participants with beta values within Q4 (ORQ1vsQ4 = 1.80; CI 1.25–2.61). In the ESTHER study the predictive value of subjective mental health for future depressive symptoms was also assessed and for 10-unit increase in mental HRQOL scores the odds for incident depressive symptoms were reduced by 54% (OR 0.46; CI 0.40–0.54). These findings suggest that subjective mental health and hypomethylation at cg27115863 are predictive of depressive symptoms, possibly through the activation of inflammatory signaling pathway.