Search

Introduction: University psychological counselling services represent a frontline defence to detect, treat or refer students with a wide range of (clinical and non-clinical) difficulties. Nevertheless, only few studies describe their impact on academic self-efficacy and report follow-up data. Evidence on students' actual access to further psychological support in times of hardship is also scant and most needed. This study aimed to fill these gaps, exploring the stability of improvement in clinical conditions in a wide sample of university students and reporting post-intervention referrals to mental health services. Methods: In a longitudinal study, 218 students who accessed a psychological counselling service at the University of Milano-Bicocca between 2015 and 2019 completed an assessment at the beginning (T0), conclusion (T1) and 6 months after (T2) a brief cognitive behavioural intervention. The assessment included psychological symptoms, general distress, emotion dysregulation and academic self-efficacy. Information about students' choices to continue a psychological intervention in other services was also collected and contrasted with the counsellor's indication. Results: At follow-up, the improvement in academic self-efficacy remained stable, with more than 60% of the students maintaining a reliable clinical change, and nearly half of them reporting having accessed (or being willing to contact) a mental health service outside the university services. Conclusion: These findings highlight the key role of counselling services in addressing students' distress and academic performances in the long term and in building bridges with mental health services outside the university system for students who need longer and specialised treatment.

Psychological counselling represents sensitive frontline services for the detection and treatment of early signs of distress in students. This study aims to assess psychological distress in medical students at the beginning of their academic career and the access rate to a counselling service during medical school. Predictors of access to the service and the effectiveness of the service were also explored. Distress and emotional dysregulation were measured in three consecutive cohorts of first-year students (n = 385, 53% female). Students accessing the counselling service at any time during the 6 years of medical school all completed the same baseline measurements and a pre/post assessment of the intervention. Nearly one-third of first-year students reported levels of distress above the clinical cutoff. The access rate to the counselling service was 13.9%. Only 21% of the students with clinical levels of distress contacted the counselling service. Living alone and having high distress at the beginning of the medical course were the main predictors of access to the service. Students reported a significant reduction of distress and dysregulation after counselling interventions. More efforts are needed to develop effective tools for identifying and tracking medical students in psychological hardship and to increase their willingness to attend the counselling services.

The “Healthcare workers’ wellbeing [Benessere Operatori]” project is an exploratory longitudinal study assessing healthcare workers’ mental health at three different time points over a 14-month period during the COVID-19 pandemic. We collected socio-demographic and work-related information and assessed the perceived social support, coping strategies, and levels of depression, anxiety, insomnia, anger, burnout, and PTSD symptoms. In total, 325 Italian healthcare workers (i.e. physicians, nurses, other healthcare workers, and clerks) participated in the first initial survey and either the second or third subsequent survey. Participants reported subclinical levels of psychiatric symptoms that remained mostly unchanged across time, except for an increase in stress, depression, state anger, and emotional exhaustion symptoms. Despite subclinical levels, healthcare workers’ distress can adversely affect the quality of care, patient satisfaction, and medical error rates. Therefore, implementing interventions to improve healthcare workers’ wellbeing is required.

Background: The COVID-19 pandemic might affect mental health. Data from population-representative panel surveys with multiple waves including pre-COVID data investigating risk and protective factors are still rare. Methods: In a stratified random sample of the German household population (n=6,684), we conducted survey-weighted multiple linear regressions to determine the association of various psychological risk and protective factors assessed between 2015 and 2020 with changes in psychological distress (PD; measured via PHQ-4) from pre-pandemic (average of 2016 and 2019) to peri-pandemic (both 2020 and 2021) time points. Control analyses on PD change between two pre-pandemic time points (2016 and 2019) were conducted. Regularized regressions were computed to inform on which factors were statistically most influential in the multicollinear setting. Results: PHQ-4 scores in 2020 (M=2.45) and 2021 (M=2.21) were elevated compared to 2019 (M=1.79). Several risk factors (catastrophizing, neuroticism, asking for instrumental support) and protective factors (perceived stress recovery, positive reappraisal, optimism) were identified for the peri-pandemic outcomes. Control analyses revealed that in pre-pandemic times, neuroticism and optimism were predominantly related to PD changes. Regularized regression mostly confirmed the results and highlighted perceived stress recovery as most consistent influential protective factor across peri-pandemic outcomes. Conclusions: We identified several psychological risk and protective factors related to PD outcomes during the COVID-19 pandemic. Comparison to pre-pandemic data stress the relevance of longitudinal assessments to potentially reconcile contradictory findings. Implications and suggestions for targeted prevention and intervention programs during highly stressful times such as pandemics are discussed.

Background: The COVID-19 pandemic might affect mental health. Data from population-representative panel surveys with multiple waves including pre-COVID data investigating risk and protective factors are still rare. Methods: In a stratified random sample of the German household population (n=6,684), we conducted survey-weighted multiple linear regressions to determine the association of various psychological risk and protective factors assessed between 2015 and 2020 with changes in psychological distress (PD; measured via PHQ-4) from pre-pandemic (average of 2016 and 2019) to peri-pandemic (both 2020 and 2021) time points. Control analyses on PD change between two pre-pandemic time points (2016 and 2019) were conducted. Regularized regressions were computed to inform on which factors were statistically most influential in the multicollinear setting. Results: PHQ-4 scores in 2020 (M=2.45) and 2021 (M=2.21) were elevated compared to 2019 (M=1.79). Several risk factors (catastrophizing, neuroticism, asking for instrumental support) and protective factors (perceived stress recovery, positive reappraisal, optimism) were identified for the peri-pandemic outcomes. Control analyses revealed that in pre-pandemic times, neuroticism and optimism were predominantly related to PD changes. Regularized regression mostly confirmed the results and highlighted perceived stress recovery as most consistent influential protective factor across peri-pandemic outcomes. Conclusions: We identified several psychological risk and protective factors related to PD outcomes during the COVID-19 pandemic. Comparison to pre-pandemic data stress the relevance of longitudinal assessments to potentially reconcile contradictory findings. Implications and suggestions for targeted prevention and intervention programs during highly stressful times such as pandemics are discussed.

Background: The mental health of the Italian population declined at the onset of the COVID-19 pandemic. However, nationwide population prevalence estimates may not effectively reproduce the heterogeneity in distress responses to the pandemic. In particular, contextual determinants specific to COVID-19 pandemic need to be considered. We thus aimed to explore the association between local COVID-19 mortality rates and mental health response among the general population. Methods: We capitalised on data (N = 17,628) from a large, cross-sectional, national survey, the COMET study, run between March and May 2020. While psychological distress was measured by General Health Questionnaire–12 (GHQ-12), the Depression, Anxiety and Stress Scale-21 Items (DASS-21) was used to assess relevant domains. In addition, a Covid-19 mortality ratio was built to compare single regional mortality rates to the national estimate and official statistics were used to control for other area-level determinants. Results: Adjusted ordered regression analyses showed an association between mortality ratio and moderate (OR = 1.10, 95%CI 1.03–1.18) and severe (OR = 1.11, 95%CI 1.03–1.21) DASS-21 anxiety levels. No effects of mortality ratio on GHQ-12 scores and DASS-21 depression and stress levels, uniformly high across the country, were estimated. Conclusions: Although we could not find any association between regional COVID-19 mortality ratio and depression or psychological distress, anxiety levels were significantly increased among subjects from areas with the highest mortality rates. Local mortality rate seems a meaningful driver for anxiety among the general population. Considering the potentially long-lasting scenario, local public health authorities should provide neighbouring communities with preventive interventions reducing psychological isolation and anxiety levels.

We investigated whether, and to what extent, spiritual well-being was associated with psychological distress, traumatic response, and professional burnout in practitioners working in the Palestinian healthcare sector. Participants were 131 in-service healthcare workers employed in public and private health facilities in Gaza and the West Bank. Analysis of the statistical effects revealed that spiritual well-being was associated with psychological distress and burnout. On the contrary, it did not appear to be strongly associated with trauma symptoms. These findings point up the key role of spiritual well-being in the experience of healthcare professionals operating in contexts of low-intensity warfare.

Introduction: This study provides data on the rates, characteristics, and correlates of self-injury (SI) in an Italian nonclinical sample, a population previously unexamined within the SI literature. This study examined the associations between SI and defense mechanisms, as well as the differences between self-injurers (episodic and recurrent) and non self-injurers with regard to the severity and variety of their psychiatric symptoms and psychological distress. Materials and methods: Five hundred and seventy-eight university students (82.5% female; mean age = 22.3; S.D.=3.4) were administered a battery of self-report questionnaires, including the " Deliberate Self Harm Inventory" for SI, the Response Evaluation Measure-71 for defense mechanisms, and the " Symptom Checklist-90-Revised" for psychological distress and psychiatric symptoms. Results: One hundred and nineteen participants (20.6%) reported having engaged in SI at least once during their lifetime. Individuals with recurrent SI (SI ≥ 5) reported significantly higher levels of all psychiatric symptoms and many maladaptive defense mechanisms than individuals without SI. Results also provided evidence for differences between individuals with recurrent and episodic SI. Conclusion: Results suggest that recurrent self-injurers are distinguished from both episodic self-injurers and non self-injurers by their greater use of maladaptive defense mechanisms, rather than their lesser use of adaptive defenses. Further, results suggest that recurrent self-injurers differ from episodic self-injurers not in terms of the severity of their psychiatric symptoms, but the variety and number of these symptoms. © 2009 Elsevier Masson SAS.