Identifying the dominant personality profiles in medical students: Implications for their well-being and resilience

Purpos

Assessment of causal link between psychological factors and symptom exacerbation in inflammatory bowel disease: a systematic review utilising Bradford Hill criteria and meta-analysis of prospective cohort studies

BACKGROUND: Psychological stress is a prevalent factor in inflammatory bowel disease (IBD) with detrimental effects on patients' quality of life and possibly disease course. Although the aetiology of symptom exacerbation in IBD has been explored, determining any causation between psychological stress and symptom worsening remains challenging and requires a methodologically rigorous approach. AIM: The aim of this systematic review with meta-analysis was to determine a causal relationship between psychological stress and symptom exacerbation in IBD, subsequently utilising Bradford Hill's criteria (approach never used in this topic area before) to evaluate the likelihood of causal associations. METHODS: Medline, EMBASE, CINAHL and PsycInfo were searched for relevant studies up to July 20, 2019. Data extraction and quality appraisal were performed by two independent reviewers. Results of all retained papers were presented as a narrative synthesis. A random-effect meta-analysis was conducted on studies meeting the criteria for meta-analysis. Bradford Hill criteria were applied to assess the causality of the relationship between all psychological factors and symptom exacerbation. RESULTS: The searches yielded 2472 potential articles. Nineteen clinical prospective cohort studies were eligible for the narrative review with five suitable for the meta-analysis. Meta-analysis showed depression, anxiety and perceived stress did not have a statistically significant association with an increased risk of symptom exacerbation. Four of the Bradford Hill criteria were met which indicates that there is weak to moderate evidence of a causal association between all the psychological factors and disease activity. Inconsistent results and a dearth of studies using the same tools for measuring psychological factors suggest the need for more research to be done to facilitate more conclusive findings. CONCLUSIONS: This original review utilising Bradford Hill criteria in addition to meta-analysis to evaluate the causality of relationship between psychological factors and symptom exacerbation in IBD provides evidence that psychological factors have a weak to moderate causal involvement in IBD symptom exacerbation. However, when combining this finding with the outcomes of the meta-analysis, we can say that the results were inconclusive. Interventions to reduce the associated psychological impact should be part of the treatment plan for patients with IBD. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42012003143

How much cannabis is used in a joint in Australia? An experimental investigation into use by potency and frequency

Introduction Cannabis use is highly prevalent in Australia, yet current survey metrics measure tetrahydrocannabinol (THC) exposure with limited accuracy. Often survey items measure cannabis quantity by assuming specific modes of use (i.e., ‘how many joints do you use?’), which fail to capture variations in cannabis use and the diverse modes of use (e.g., joints, cones, spliffs). This study investigated how much cannabis is used in these modes of administration in an Australian sample. Methods Participants (N = 31, Mage = 25.77; 51% university students) completed the Roll a Joint Paradigm in which they rolled joints, spliffs and packed cones as they would typically, using oregano as ‘cannabis.’ Participants then prepared each again but with cannabis of higher or lower potency. Results The amount of cannabis used across different modes of administration was variable: joints (range 0.10–1.25 g), spliffs (range 0.12–1.21 g) and cones (range 0.03–0.41 g). Participants who used cannabis daily rolled three times the amount of cannabis into a joint. Discussion and Conclusions The amount of cannabis used in common modes of administration may be highly variable. Daily use may be associated using larger quantities of cannabis. Titration attempts based on potency were not proportional or consistent across modes of administration. The results indicate people may adjust the quantity of cannabis based on perceived potency, however, not proportional to THC concentration. Inconsistency in the amount of cannabis used based on potency and within different modes of administration may represent a problem for self-report metrics which ask participants to report cannabis use in joints

The prevalence of cannabis use disorders in people who use medicinal cannabis : A systematic review and meta-analysis

Background The prevalence of cannabis use disorders (CUDs) in people who use cannabis recreationally has been estimated at 22%, yet there is a dearth of literature exploring CUDs among people who use medicinal cannabis. We aimed to systematically review the prevalence of CUDs in people who use medicinal cannabis. Methods In our systematic review and meta-analysis, we followed PRISMA guidelines and searched three databases (PsychInfo, Embase and PubMed) to identify studies examining the prevalence of CUDs in people who use medicinal cannabis. Meta-analyses were calculated on the prevalence of CUDs. Prevalence estimates were pooled across different prevalence periods using the DSM-IV and DSM-5. Results We conducted a systematic review of 14 eligible publications, assessing the prevalence of CUDs, providing data for 3681 participants from five different countries. The systematic review demonstrated that demographic factors, mental health disorders and the management of chronic pain with medicinal cannabis were associated with an elevated risk of CUDs. Meta-analyses were conducted on the prevalence of CUDs. For individuals using medicinal cannabis in the past 6–12 months, the prevalence of CUDs was 29% (95% CI: 21-38%) as per DSM-5 criteria. Similar prevalence was observed using DSM-IV (24%, CI: 14–38%) for the same period. When including all prevalence periods and using the DSM-5, the prevalence of CUDs in people who use medicinal cannabis was estimated at 25% (CI: 18-33%). Conclusions The prevalence of CUDs in people who use medicinal cannabis is substantial and comparable to people who use cannabis for recreational reasons, emphasizing the need for ongoing research to monitor the prevalence of CUDs in people who use medicinal cannabis

Patterns of social media use across age groups during the COVID-19 pandemic: a study across four countries

The aim of this study was to examine patterns of social media use across age groups in four countries (Norway, USA, UK, and Australia) two years after the COVID-19 pandemic outbreak, and whether types of use and time spent using social media was related to health worries. A cross-sectional online survey was completed by 1578 adult participants. The data were analysed with one-way analyses of variance and a linear regression analysis. Younger people spent more time on and were more likely to be passive users of social media than older people. Motives for social media use, and perceived effects of using social media, varied by participants’ age. Passive social media use and more time spent using social media were related to higher levels of health worries. Thus, an age perspective is relevant for understanding patterns of social media use, and different types of social media use appear to be differently related to health worries.publishedVersio

Patterns of social media use across age groups during the COVID-19 pandemic: a study across four countries

The aim of this study was to examine patterns of social media use across age groups in four countries (Norway, USA, UK, and Australia) two years after the COVID-19 pandemic outbreak, and whether types of use and time spent using social media was related to health worries. A cross- sectional online survey was completed by 1578 adult participants. The data were analysed with one-way analyses of variance and a linear regression analysis. Younger people spent more time on and were more likely to be passive users of social media than older people. Motives for social media use, and perceived effects of using social media, varied by participants’ age. Passive social media use and more time spent using social media were related to higher levels of health worries. Thus, an age perspective is relevant for understanding patterns of social media use, and different types of social media use appear to be differently related to health worries.publishedVersio

Loneliness and its associated factors nine months after the COVID-19 outbreak: a cross-national study

COVID-19 has been a global healthcare concern impacting multiple aspects of individual and community wellness. As one moves forward with different methods to reduce the infection and mortality rates, it is critical to continue to study the impact that national and local “social distancing” policies have on the daily lives of individuals. The aim of this study was to examine loneliness in relation to risk assessment, measures taken against risks, concerns, and social media use, while adjusting for sociodemographic variables. The cross-sectional study collected data from 3474 individuals from the USA, the UK, Norway, and Australia. Loneliness was measured with the de Jong Gierveld Loneliness Scale. Multiple linear regression was used in the analysis of associations between variables. The results showed that concerns about finances were more strongly associated with social loneliness, while concerns about the future was more strongly associated with emotional loneliness. Longer daily time spent on social media was associated with higher emotional loneliness. In conclusion, pandemic-related concerns seem to affect perceptions of loneliness. While social media can be used productively to maintain relationships, and thereby prevent loneliness, excessive use may be counterproductive.publishedVersio

Cross-National Study of Mental Health and Employment Status Nine Months Post Social Distancing Implementation Practices

This cross-national study examined the mental health between those individuals working and those not working nine months post initial COVID-19 social distancing implementation. Respondents (N = 3,474) were recruited through social media (e.g. Facebook, Twitter) and completed an online survey in October/November 2020. The respondents were from Norway, the UK, the USA and Australia. The mental health of those working and not working were analysed using t tests and socio-demographics were compared using one-way analysis of variance. Respondents who were working were significantly more likely to experience better mental health, were younger, report higher levels of education, and significantly less likely to worry about their own situation, health or financial situation than respondents who were not employed. Respondents who were retired reported better mental health than respondents who were not working for other reasons (laid off/dismissed, receiving benefits, studying, other). These findings raise the importance for social workers and other health service providers to monitor the overall mental health of individuals especially when social distancing protocols are in place and as countries begin to recover from the pandemic.publishedVersio