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Background: Health risk behaviours (e.g., harmful drinking and smoking) often cluster together and can be associated with poor mental health and stress. This study examined how health risk behaviours cluster together in individuals in a high stress occupation (UK Police Service), and the associations with mental health and job strain. Methods: Data was obtained from the Airwave Health Monitoring Study (25,234 male and 14,989 female police employees), which included measures of health risk behaviours (alcohol use, diet, smoking status, physical activity), poor mental health (depression, anxiety, post-traumatic stress disorder [PTSD]), and job strain (low, high, active, passive). Classes of health risk behaviours were identified using Latent Class Analysis (LCA) and the associations with mental health and job strain were analysed through multinomial logistic regressions. Results: For men and women, a 5-class solution was the best fit. Men and women with depression, anxiety, and/or PTSD (analysed as separate variables) had at least double the odds of being assigned to the "high health risk behaviours" class, compared to those with no mental health problem. Compared to those reporting low strain, men and women reporting high strain had increased odds of being assigned to the "low risk drinkers with other health risk behaviours" classes. Conclusions: These finding highlight the importance of holistic interventions which target co-occurring health risk behaviours, to prevent more adverse physical health consequences. Police employees with poor mental health are more likely to engage in multiple health risk behaviours, which suggests they may need additional support. However, as the data was cross-sectional, the temporal associations between the classes and mental health or job strain could not be determined. [ABSTRACT FROM AUTHOR]

Background: For a small minority of personnel, military service can have a negative impact on their mental health. Yet no studies have assessed how the mental health of UK veterans (who served during the recent operations in Afghanistan or Iraq) compares to non-veterans, to determine if they are at a disadvantage. We examine the prevalence of mental disorders and alcohol misuse in UK veterans compared to non-veterans. Methods: Veteran data were taken from the third phase of the King's Centre for Military Health Research cohort study (n = 2917). These data were compared with data on non-veterans taken from two large general population surveys: 2014 Adult Psychiatric Morbidity Survey (n = 5871) and wave 6 of the UK Household Longitudinal Study (UKHLS, n = 22 760). Results: We found that, overall, UK veterans who served at the time of recent military operations were more likely to report a significantly higher prevalence of common mental disorders (CMD) (23% v. 16%), post-traumatic stress disorder (PTSD) (8% v. 5%) and alcohol misuse (11% v. 6%) than non-veterans. Stratifying by gender showed that the negative impact of being a veteran on mental health and alcohol misuse was restricted to male veterans. Being ill or disabled was associated with a higher prevalence of CMD and PTSD for both veterans and non-veterans. Conclusion: Whilst the same sociodemographic groups within the veteran and non-veteran populations seemed to have an increased risk of mental health problems (e.g. those who were unemployed), male veterans, in particular, appear to be at a distinct disadvantage compared to those who have never served. [ABSTRACT FROM AUTHOR]

Background: Military families can experience unique stressors that may contribute towards poorer well-being among the spouses/partners of Service personnel. However, there is little UK research regarding mental health or alcohol consumption among this population. Objective: This study examined mental health outcomes (probable depression and post-traumatic stress disorder (PTSD)) and alcohol consumption among UK military spouses/partners compared to women in the general population. Associations with military and socio-demographic characteristics were examined. Method: Survey data from 405 female spouses/partners of current and former UK Service personnel participating in a study of military-connected children (2010–2012) was analysed. Comparisons to women in the general population were made using the 2007 Adult Psychiatric Morbidity Survey (n = 1594). Results: Compared to women from the general population, military spouses/partners were significantly more likely to meet criteria for probable depression (adj. OR 2.50 (95% CI 1.52–4.11)). There was no significant difference regarding probable PTSD. Spouses/partners were significantly more likely to meet criteria for hazardous alcohol consumption (adj. OR 2.55 (95% CI 1.87–3.47)) and more likely to report episodes of weekly, daily or almost daily binge-drinking (adj. OR 2.15 (95% CI 1.28–3.61)) than women in the general population. Binge-drinking was significantly higher among spouses/partners of Service personnel reporting family separations of more than 2 months in the last 2 years compared to those reporting no, or shorter, separations (adj. OR 1.88 (95% CI 1.08–3.27)). Conclusion: This is the first study to examine mental health and alcohol consumption among UK military spouses/partners. The significantly higher prevalence of probable depression, hazardous alcohol consumption, and binge-drinking compared to women in the general population suggests further research is needed into the drivers of poor mental health and alcohol consumption among this population and in identifying or developing prevention campaigns to reduce alcohol use and support their well-being. [ABSTRACT FROM AUTHOR]

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Latent class analysis methods provide an opportunity to progress research investigating the co-occurence of alcohol and mental health problems. These approaches allow us not only to understand how alcohol use patterns differ in individuals with and without a mental disorder, but to also define phenotypes based upon mental health and alcohol use symptoms. [ABSTRACT FROM PUBLISHER]

The article presents a study that explores adaptation in patients with advanced cancer. The study examines the factor structure of the Mental Adjustment to Cancer Scale and examines associations between types of coping and psychological outcomes. It reveals that patients with a desire for hastened death had lower acceptance and positivity, and patients with higher global quality of life reported a higher level.

The article discusses a study in palliative care exploring factors associated with non-remission of depression. The study helps in determining whether specific psychiatric or psychological intervention is required. Results reveal that patients with low social support from family on referral require additional psychosocial care in the treatment of depression. Also discussed are the clinical implications for palliative care.

Abstract: Context: Representations of illness have been studied in several populations, but research is limited in palliative care. Objectives: To describe illness representations in a population with advanced disease receiving palliative care and to examine the relationship between illness perceptions, adaptive coping, and depression. Methods: A cross-sectional survey of 301 consecutive eligible patients recruited from a palliative care service in south London, U.K. Measures used included the Brief Illness Perception Questionnaire (Brief IPQ), the Mental Adjustment to Cancer (MAC) Scale, and the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire-9. Results: Scores were not normally distributed for most questions on the Brief IPQ. The correlations found between items on the Brief IPQ were understandable in the context of advanced disease. MAC helplessness-hopelessness and fighting spirit were highly correlated with items on the Brief IPQ in opposite directions. The Brief IPQ domains of consequences, identity, concern, personal control, and emotion were associated with depression, a relationship that was not explained by adaptive coping. Seven causal attribution themes were identified: don’t know, personal responsibility, exposure, pathological process, intrinsic personal factors, chance, fate or luck, and other. Both lung cancer diagnosis and gender were found to be independently associated with personal responsibility attribution. None of the attribution themes were associated with the presence of depression. Conclusion: Assessment of illness perceptions in palliative care is likely to yield important information about risk of depression and will help clinicians to personalize management of advanced disease. [Copyright &y& Elsevier]

The COVID-19 pandemic negatively impacted mental health in the general population in Britain. Ethnic minority people suffered disproportionately, in terms of health and economic outcomes, which may contribute to poorer mental health. We compare the prevalence of depression and anxiety across 18 ethnic groups in Britain during the COVID-19 pandemic. Secondary analysis of cross-sectional data (February–November 2021) from 12,161 participants aged 18–60 years old (N with data on outcomes = 11,540 for depression & 11,825 for anxiety), obtained from the Evidence for Equality National Survey (EVENS). Data were weighted to account for selection bias and coverage bias. Weighted regression models examined ethnic differences in depression (Centre for Epidemiologic Studies Depression Scale) and anxiety (Generalised Anxiety Disorder-7). Effect modification analyses explored whether ethnic differences in outcomes were consistent within age and sex sub-groups. Compared to White British people, greater odds of anxiety caseness (and greater anxiety symptoms) were observed for Arab (OR = 2.57; 95 % CI = 1.35–4.91), Mixed White and Black Caribbean (1.57; 1.07–2.30), any other Black (2.22, 1.28–3.87) and any other Mixed (1.58; 1.08–2.31) ethnic groups. Lower odds of depression caseness (and lower depressive symptoms) were identified for Chinese (0.63; 0.46–0.85), Black African (0.60; 0.46–0.79), and any other Asian (0.55; 0.42–0.72) ethnic groups. Cross-sectional data limits the opportunity to identify changes in ethnic inequalities in mental health over time. We have identified certain ethnic groups who may require more targeted mental health support to ensure equitable recovery post-pandemic. Despite finding lower levels of depression for some ethnic groups, approximately one third of people within each ethnic group met criteria for depression. • Cross-sectional analysis of the largest UK survey of ethnic minority people • Ethnic differences in depression and anxiety were compared against White British. • Arab and any other Black people had more than double the odds of reporting anxiety. • Mixed White and Black Caribbean and any other Mixed people also had greater odds. • Lower levels of depression observed for some ethnic minority groups. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: The Primary Care Evaluation of Mental Disorders Patient Health Questionnaire (PRIME-MD PHQ-9) is a common screening tool designed to facilitate detection of depression according to DSM-IV criteria. However, the factor structure of the PHQ-9 within the palliative care population has not been evaluated. Methods: 300 participants completed the PHQ-9 within one week of referral to a palliative care service. Participants completed the PHQ-9 again four weeks later (n=213). Confirmatory factor analysis (CFA) and multiple-group CFA were undertaken to test the factor structure of the PHQ-9 and evaluate model invariance over time. Results: A two-factor model comprising somatic and cognitive–affective latent factors provided the best fit to the data. Multiple-group CFA suggested model invariance over time. Structural equation modelling revealed that follow-up (time 2) cognitive–affective and somatic symptoms were predicted by their baseline (time 1) factors. Conclusions: The PHQ-9 measures two stable depression factors (cognitive–affective and somatic) within the palliative care population. Studies are now required to examine the trajectories of these symptoms over time in relation to clinical intervention and events. [Copyright &y& Elsevier]