Perspectives in Psychiatric Care

Objectives. Cognitive functions in almost all domains are lower in patients with schizophrenia than those in healthy controls, with the severity of impairment differing between domains. Treatments are being developed to improve cognitive impairment in patients with schizophrenia. However, the pattern of cognitive impairment must be clarified to facilitate treatment. Therefore, this study aimed to classify the patterns of cognitive impairment in individuals and provide treatment suggestions. Methods. Patients with schizophrenia were recruited from two psychiatric hospitals in Japan. Demographic and psychopathological symptoms were assessed using the Positive and Negative Symptoms Scale for Schizophrenia and neurocognitive functions, using the CogHealth battery. The following domains were assessed: processing speed, visual attention, working memory, visual learning, and spatial attention. The scores were standardised and assigned as the same-aged average score. Hierarchical cluster analysis using Ward’s method was performed based on CogHealth scores. Subsequently, one-way analysis of variance (ANOVA) and Tukey’s multiple comparisons were performed to compare the variables in each cluster. Results. In total, 133 participants were classified into four clusters: Cluster 1 (n = 16), with severe cognitive impairment and psychiatric symptoms and the longest stay; Cluster 2 (n = 44), with moderate cognitive impairment and psychiatric symptoms; Cluster 3 (n = 42), with preserved cognitive function, except for spatial perception, and mild psychiatric symptoms; and Cluster 4 (n = 31), with only memory and spatial perception impairment and mild psychiatric symptoms. Implications. The clusters indicate that impairment may occur in all or selective domains. Selective domain impairments may be in spatial perception or in spatial perception and memory. Therefore, it is recommended that treatments for cognitive dysfunction are developed into four subsets considering an individual’s cognitive features.

The COVID-19 pandemic has inflicted physical harm and exacerbated a significant mental health crisis, warranting greater attention. This study investigated the prevalence of anxiety and depression among international medical students (IMSs) during the pandemic and explored its correlation with demographic factors. Participants completed a comprehensive questionnaire encompassing demographic details, the Zung self-rating anxiety scale, and the Zung self-rating depression scale. The findings revealed that 23.27% of IMSs reported anxiety, while 48.52% experienced symptoms of depression. Multivariate logistic regression analysis identified poor health conditions and limited access to the family as independent risk factors for anxiety. At the same time, depression was associated with both compromised health and notable financial burdens. This study provides crucial insights for policymakers, college administrators, and government authorities, urging proactive measures to support and manage the wellbeing of IMSs during pandemic situations.

Purpose. To examine the mediating role of positive psychological capital in the relationship between nursing students’ perceived social support and bullying behavior in nursing education. Design and Methods. In May 2021, a sample of 1196 nursing students majoring in nursing at a medical college was conveniently selected as the study population. A set of questionnaires, including a General Information Questionnaire, Perceived Social Support Scale (PSSS), Positive Psychological Capital Questionnaire (PPQ), and Bullying Behaviors in Nursing Education Scale (BBNE), were utilized to examine and analyze the relationships among the variables. Findings. The scores of nursing students’ PSSS, PPQ, and BBNE were 68.19 ± 11.90, 123.97 ± 18.74, and 13.31 ± 9.24, respectively. There was a negative correlation (r = −0.421, ) between perceived social support and bullying behaviors in nursing education among nursing students. Positive psychological capital partially mediated the relationship between perceived social support and bullying behaviors in nursing education, accounting for 19.88% of the total effect. Further analysis revealed that self-efficacy, resilience, optimism, and hope in positive psychological capital each played a partial mediating role in the impact of nursing students’ perceived social support on bullying behaviors in nursing education, with the ratio of indirect effect to total effect being 5.38%, 7.74%, 6.09%, and 5.34%, respectively. Practice Implications. The impact of perceived social support on bullying behaviors in nursing education is substantial among nursing students, and it can indirectly influence bullying behaviors through positive psychological capital. Nursing educators should pay attention to nursing students with lower levels of social support, and they can decrease the occurrence of bullying behaviors by enhancing social support and fostering higher levels of psychological capital.

Background. There was a remarkable downgrade in China’s COVID-19 response strategies in January 2023. The COVID-19 infection rate grew rapidly in the early stages following the management policy shift. This study attempted to explore the associations between SARS-CoV-2 infection and mental or physical health status in pregnant and postpartum women and the role of perceived health risks and family members’ SARS-CoV-2 infection status on these associations by capturing the impact of policy shifts in a short period of time. Methods. This cross-sectional study with a random sample from a convenience sample of hospitals was conducted in pregnant and postpartum women in January 2023. Standardized assessment tools were employed to assess anxiety, depressive and physical symptoms, and feelings of hopelessness. Hierarchical multiple logistic regressions were conducted to examine the mechanisms of associations of interests by including a range of sociodemographic factors, self-perceived health, SARS-CoV-2 infection status, and perceived health risks as covariates. Results. Of the 1,013 pregnant and postpartum women aged 32.0 ± 0.3 years, 58.2% (n = 590) were diagnosed with COVID-19, and 49.4% (n = 500) had family members who were infected with SARS-CoV-2. Nearly 98% of the included participants took measures to prevent SARS-CoV-2 infection. A COVID-19 diagnosis was positively associated with feelings of hopelessness (OR = 1.68, 95% CI: 1.20–2.35), probable anxiety (OR = 6.42, 95% CI: 2.18–24.61), possible depression (OR = 2.56, 95% CI: 1.07–6.70), and physical symptoms (OR = 6.28, 95% CI: 1.63–42.03) after adjusting for sociodemographic and health characteristics, while the associations presented no statistical significance when family members’ SARS-CoV-2 infection status and perceived health risks were introduced into the models. Conclusions. Our results suggested that pregnant and postpartum women may experience physical and mental health challenges when they or their family members contracted COVID-19 in the context of a considerable shift in COVID-19 management. Early detection of poor health status and its risk factors for vulnerable groups during shifts in health policy and administrative practice is very necessary, and health services, including easy access to psychosocial support and obstetric counselling, should be prioritized.

Aim. Midwives are prone to suboptimal health status (SHS), while there is a lack of unified measurement standard of SHS for them to early detect and prevent SHS. This study aimed to evaluate validity and reliability of Subhealth Measurement Scale V1.0 (SHMS V1.0) in midwives. Design and Methods. The cross-sectional study had 842 midwives from 46 midwifery institutions in southeastern China completing the SHMS V1.0 with 39 items. Internal consistency, test-retest reliability, and concurrent validity of SHMS V1.0 were assessed. Project analysis and confirmatory factor analysis (CFA) were performed to assess construct validity. Results. SHMS V1.0 had acceptable reliability with Cronbach’s alpha and a test-retest reliability coefficient of 0.908 and 0.804, respectively. The correlation coefficients between each item and corresponding dimension and those between dimension and corresponding subscale were all greater than 0.4. The CFA supported the structure of SHMS V1.0 with strong factor loadings and excellent fit indexes in the first-order and modified second-order factor model, illustrating that SHMS V1.0 had good construct validity among midwives. The concurrent validity for SHMS V1.0 showed large correlation with FS-14, but the social subscale showed medium correlations with fatigue, inferring that SHMS V1.0 can more comprehensively reflect SHS of midwives than FS-14, especially for social health symptoms. Practice Implications. SHMS V1.0 with excellent psychometric properties can accurately and reliably evaluate the SHS of midwives. These findings of our study provide an important measurement tool and inspiration for midwives to early detect and prevent SHS.

Purpose. This study aimed to examine the association between hedonic hunger and night-eating syndrome (NES) with difficulties in emotion regulation (DER) among young adults. Design and Methods. This cross-sectional, descriptive study was conducted on a voluntary basis at a private foundation university, involving a total of 1010 students enrolled in the 2020-2021 academic year. Data were collected through an online application of an information form, which assessed demographic characteristics, the Power of Food Scale (PFS), the Night-Eating Questionnaire (NEQ), and the Difficulties in Emotion Regulation Scale-Short Form (DERS-16). The data were analyzed using IBM SPSS26® software. Findings. Women made up 80.4% of the students in the study. The mean age was 21.58 ± 2.98 years, and the mean body mass index (BMI) was 22.06 ± 3.71 kg/m². The results indicated that 68.1% of the students reported hedonic hunger and 88.7% had NES. Moreover, DER was found to be more prevalent among women (1). In addition, the DERS-16 score increased by 6.5% () with each increase in age and by 6.8% () with each increase in BMI. Furthermore, the total PFS score increased by 32.5% (), and the total NEQ score increased by 22.4% (), corresponding to an increase in the total DERS-16 score. Practice Implications. These findings suggest that an increase in the difficulties experienced in emotion regulation is associated with higher levels of hedonic hunger and night-eating tendencies among young adults.