A longitudinal cohort study to explore the relationship between depression, anxiety and academic performance among Emirati university students

© 2020 The Author(s). Background: Many university students experience depression and anxiety, both of which have been shown to affect cognitive function. However, the impact of these emotional difficulties on academic performance is unclear. This study aims to determine the prevalence of depression and anxiety in university students in United Arab Emirates (UAE). It further seeks to explore the relationship between emotional difficulties and students\u27 academic performance. Methods: This longitudinal study recruited 404 students (aged 17-25 years) attending one UAE university (80.4% response rate). At baseline, participants completed a paper-based survey to assess socio-economic factors and academic performance, including most recent grade point average (GPA) and attendance warnings. PHQ-9 and GAD-7 scales were used to assess depressive and anxiety symptoms. At six-month follow-up, 134 participants (33.3%) provided details of their current GPA. Results: Over a third of students (34.2%; CIs 29.7-38.9%) screened for possible major depressive disorder (MDD; PHQ-9 ≥ 10) but less than a quarter (22.3%; CIs 18.2-26.3%) screened for possible generalized anxiety disorder (GAD; GAD-7 ≥ 10). The Possible MDD group had lower GPAs (p = 0.003) at baseline and were less satisfied with their studies (p = 0.015). The MDD group also had lower GPAs at follow-up (p = 0.035). The Possible GAD group had lower GPAs at baseline (p = 0.003) but did not differ at follow-up. The relationship between GAD group and GPA was moderated by gender with female students in the Possible GAD group having lower GPAs (p \u3c 0.001) than females in the Non-GAD group. Male students in the Possible GAD group had non-significantly higher GPA scores. Higher levels of both depression and anxiety symptoms scores were associated with lower GPAs at baseline. PHQ-9 scores, but not GAD-7 scores, independently predicted lower GPA scores at follow-up (p = 0.006). This relationship was no longer statistically significant after controlling for baseline GPA (p \u3c 0.09). Conclusion: This study confirms previous findings that around a third of university students are likely to be experiencing a depressive disorder at any one time. Furthermore, it provides important evidence regarding the negative impacts of emotional difficulties on students\u27 academic performance. The results support the need to consider the mental health of students who are struggling academically and highlight the importance of signposting those students to appropriate support, including evidence-based therapies

Computer and website-based interventions to improve common mental health problems in university students: a meta-analysis

Website-based and computer-delivered interventions could improve common mental health problems experienced by university students, as their help-seeking is limited. This review analysed RCT trials of these interventions to improve depression, anxiety and psychological well-being in university students. Studies aimed to trial computer-delivered/website-based interventions to improve symptoms of depression, anxiety, psychological distress and stress in university students. Seventeen trials of fourteen distinct interventions were identified – nine were CBT-based. Compared to inactive controls, interventions were supported in improving anxiety (SMD-0.56, CI -0.77 - -0.35, P=.05). Website-based and computer-delivered interventions can be effective in improving students’ mental health when compared to inactive controls, but caution is needed when compared to other conditions and methodological issues require consideration

“We don’t worry about diabetes that much”: A qualitative study exploring perceptions of physical activity among children with Type 1 Diabetes

Background: Despite the health benefits of physical activity, children across the population are insufficiently active. Physical activity is essential in the management of Type 1 Diabetes Mellitus (T1DM), therefore its promotion should be a priority, yet little research has explored the experience of physical activity from the viewpoint of children with this condition. This study sought to provide insight into how children with T1DM perceive and participate in physical activity to further the design of initiatives and clinical interventions that promote active lifestyles in this population. Methods: Researchers collected data through in-depth interviews with twelve children aged 9-11 years with T1DM in the UK. Interviews were recorded, transcribed verbatim and data were analysed using thematic analysis. Results: The overarching themes captured: children’s understanding of physical activity; children’s physical activity is motivated by friendship and social interaction; children’s physical activity is motivated by positive perceptions, fun and enjoyment; children describe how their family helps them to be active; school provides children with an opportunity to be active; children’s access to facilities and outdoor space encourages physical activity; children refer to personal mastery and competence in physical activity and; children perceive difficulties that make physical activity harder. Conclusions: This study is the first to distinguish children’s perceptions toward physical activity from other key stakeholders. Listening to children has identified what they believe is important, for example enjoyment and socialisation, which should be considered when developing strategies to promote physical activity in this population

Motor Development Interventions for Preterm Infants: A Systematic Review and Meta-analysis

CONTEXTS Preterm infants are at an increased risk of neurodevelopmental delay. Some studies report positive intervention effects on motor outcomes, but it is currently unclear which motor activities are most effective in the short and longer term. OBJECTIVE The aim of the study was to identify interventions that improve the motor development of preterm infants. DATA SOURCES An a priori protocol was agreed upon. Seventeen electronic databases from 1980 to April 2015 and gray literature sources were searched. STUDY SELECTION Three reviewers screened the articles. DATA EXTRACTION The outcome of interest was motor skills assessment scores. All data collection and risk of bias assessments were agreed upon by the 3 reviewers. RESULTS Forty-two publications, which reported results from 36 trials (25 randomized controlled trials and 11 nonrandomized studies) with a total of 3484 infants, met the inclusion criteria. A meta-analysis was conducted by using standardized mean differences on 21 studies, with positive effects found at 3 months (mean 1.37; confidence interval 0.48-2.27), 6 months (0.34; 0.11-0.57), 12 months (0.73; 0.20-1.26), and 24 months (0.28; 0.07-0.49). At 3 months, there was a large and significant effect size for motor-specific interventions (2.00; 0.28-3.72) but not generic interventions (0.33; -0.03 to -0.69). Studies were not excluded on the basis of quality; therefore, heterogeneity was significant and the random-effects model was used. LIMITATIONS Incomplete or inconsistent reporting of outcome measures limited the data available for meta-analysis beyond 24 months. CONCLUSIONS A positive intervention effect on motor skills appears to be present up to 24 months' corrected age. There is some evidence at 3 months that interventions with specific motor components are most effective

Computer-delivered and web-based interventions to improve depression, anxiety, and psychological well-being of university students: a systematic review and meta-analysis

Background: Depression and anxiety are common mental health difficulties experienced by university students and can impair academic and social functioning. Students are limited in seeking help from professionals. As university students are highly connected to digital technologies, Web-based and computer-delivered interventions could be used to improve students’ mental health. The effectiveness of these intervention types requires investigation to identify whether these are viable prevention strategies for university students. Objective: The intent of the study was to systematically review and analyze trials of Web-based and computer-delivered interventions to improve depression, anxiety, psychological distress, and stress in university students. Methods: Several databases were searched using keywords relating to higher education students, mental health, and eHealth interventions. The eligibility criteria for studies included in the review were: (1) the study aimed to improve symptoms relating to depression, anxiety, psychological distress, and stress, (2) the study involved computer-delivered or Web-based interventions accessed via computer, laptop, or tablet, (3) the study was a randomized controlled trial, and (4) the study was trialed on higher education students. Trials were reviewed and outcome data analyzed through random effects meta-analyses for each outcome and each type of trial arm comparison. Cochrane Collaboration risk of bias tool was used to assess study quality. Results: A total of 17 trials were identified, in which seven were the same three interventions on separate samples; 14 reported sufficient information for meta-analysis. The majority (n=13) were website-delivered and nine interventions were based on cognitive behavioral therapy (CBT). A total of 1795 participants were randomized and 1480 analyzed. Risk of bias was considered moderate, as many publications did not sufficiently report their methods and seven explicitly conducted completers’ analyses. In comparison to the inactive control, sensitivity meta-analyses supported intervention in improving anxiety (pooled standardized mean difference [SMD] −0.56; 95% CI −0.77 to −0.35, P<.001), depression (pooled SMD −0.43; 95% CI −0.63 to −0.22, P<.001), and stress (pooled SMD −0.73; 95% CI −1.27 to −0.19, P=.008). In comparison to active controls, sensitivity analyses did not support either condition for anxiety (pooled SMD −0.18; 95% CI −0.98 to 0.62, P=.66) or depression (pooled SMD −0.28; 95% CI −0.75 to −0.20, P=.25). In contrast to a comparison intervention, neither condition was supported in sensitivity analyses for anxiety (pooled SMD −0.10; 95% CI −0.39 to 0.18, P=.48) or depression (pooled SMD −0.33; 95% CI −0.43 to 1.09, P=.40). Conclusions: The findings suggest Web-based and computer-delivered interventions can be effective in improving students’ depression, anxiety, and stress outcomes when compared to inactive controls, but some caution is needed when compared to other trial arms and methodological issues were noticeable. Interventions need to be trialed on more heterogeneous student samples and would benefit from user evaluation. Future trials should address methodological considerations to improve reporting of trial quality and address post-intervention skewed dat

Computer and website-based interventions to improve common mental health problems in university students: a meta-analysis

Website-based and computer-delivered interventions could improve common mental health problems experienced by university students, as their help-seeking is limited. This review analysed RCT trials of these interventions to improve depression, anxiety and psychological well-being in university students. Studies aimed to trial computer-delivered/website-based interventions to improve symptoms of depression, anxiety, psychological distress and stress in university students. Seventeen trials of fourteen distinct interventions were identified – nine were CBT-based. Compared to inactive controls, interventions were supported in improving anxiety (SMD-0.56, CI -0.77 - -0.35, P=.05). Website-based and computer-delivered interventions can be effective in improving students’ mental health when compared to inactive controls, but caution is needed when compared to other conditions and methodological issues require consideration

Supporting students with Tourette syndrome in secondary school: a survey of staff views

Tourette syndrome is a neurological condition involving involuntary movements and sounds (tics) and is thought to affect as many as 1% of school aged children. Some young people with Tourette syndrome experience educational difficulties and social difficulties. Current clinical guidelines suggest educators can play an important role in maximising learning potential and reducing the negative impact of this condition on students’ social adjustment. Secondary school staff (N = 63) with responsibilities for special educational needs or disabilities completed a survey about support strategies for students with Tourette syndrome. Participants were first asked to suggest potentially helpful strategies and then rated how easily 17 recommended strategies could be implemented in school. The survey participants suggested a range of support strategies that were categorised as (1) promoting knowledge and understanding in school, (2) helping the student to cope with his/her tics, (3) supporting the student’s learning and (4) providing social and emotional support. All the recommended support strategies were rated as being easy to implement (or already in place) by the majority of respondents (e.g., increasing staff awareness and regular communication with home). The strategies that were identified as being least easy to implement were those requiring extra staff input (support from teaching assistants and individual/small group working). Additional challenges to providing support were also identified by the participants (e.g., getting input from outside agencies)

Quality of life of treatment-seeking transgender adults: A systematic review and meta-analysis

© 2018, The Author(s). The study aims to systematically extract and analyse data about Quality of Life (QoL) in the transgender population. A systematic literature search and meta-analysis were conducted using the MEDLINE, EMBASE, PubMed, and PsycINFO databases, up to July 2017. Only English language quantitative studies, in adults, which reported the means for validated QoL measures were included. Random-effect meta-analysis was adopted to pool data and estimate the 95% Confidence Intervals (CI). From 94 potentially relevant articles, 29 studies were included within the review and data extraction for meta-analysis was available in 14 studies. The majority of the studies were cross-sectional, lacked controls and displayed moderate risk of bias. Findings from the systematic review suggested that transgender people display poor QoL, independent of the domain investigated. Pooling across studies showed that transgender people report poorer mental health QoL compared to the general population (−0.78, 95% CI = −1.08 to −0.48, 14 studies). However, meta-analysis in a subgroup of studies looking at QoL in participants who were exclusively post-CHT found no difference in mental health QoL between groups (−0.42, 95% CI = −1.15 to 0.31; 7 studies). There was insufficient data for a pre-treatment subgroup. Evidence suggests that transgender people have lower QoL than the general population. Some evidence suggests that QoL improves post-treatment. Better quality studies that include clearly defined transgender populations, divided by stage of gender affirming treatment and with appropriate matched control groups are needed to draw firmer conclusions

The Effectiveness of Web-Based Interventions Delivered to Children and Young People With Neurodevelopmental Disorders: Systematic Review and Meta-Analysis

Background: The prevalence of certain neurodevelopmental disorders, specifically autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD), has been increasing over the last four decades. Nonpharmacological interventions are available that can improve outcomes and reduce associated symptoms such as anxiety, but these are often difficult to access. Children and young people are using the internet and digital technology at higher rates than any other demographic, but although Web-based interventions have the potential to improve health outcomes in those with long-term conditions, no previous reviews have investigated the effectiveness of Web-based interventions delivered to children and young people with neurodevelopmental disorders.Objective: This study aimed to review the effectiveness of randomized controlled trials (RCTs) of Web-based interventions delivered to children and young people with neurodevelopmental disorders.Methods: Six databases and one trial register were searched in August and September 2018. RCTs were included if they were published in a peer-reviewed journal. Interventions were included if they (1) aimed to improve the diagnostic symptomology of the targeted neurodevelopmental disorder or associated psychological symptoms as measured by a valid and reliable outcome measure; (2) were delivered on the Web; (3) targeted a youth population (aged ≤18 years or reported a mean age of ≤18 years) with a diagnosis or suspected diagnosis of a neurodevelopmental disorder. Methodological quality was rated using the Joanna Briggs Institute Critical Appraisal Checklist for RCTs.Results: Of 5140 studies retrieved, 10 fulfilled the inclusion criteria. Half of the interventions were delivered to children and young people with ASDs with the other five targeting ADHD, tic disorder, dyscalculia, and specific learning disorder. In total, 6 of the 10 trials found that a Web-based intervention was effective in improving condition-specific outcomes or reducing comorbid psychological symptoms in children and young people. The 4 trials that failed to find an effect were all delivered by apps. The meta-analysis was conducted on five of the trials and did not show a significant effect, with a high level of heterogeneity detected (n=182 [33.4%, 182/545], 5 RCTs; pooled standardized mean difference=–0.39; 95% CI –0.98 to 0.20; Z=–1.29; P=.19 [I2=72%; P=.006]).Conclusions: Web-based interventions can be effective in reducing symptoms in children and young people with neurodevelopmental disorders; however, caution should be taken when interpreting these findings owing to methodological limitations, the minimal number of papers retrieved, and small samples of included studies. Overall, the number of studies was small and mainly limited to ASD, thus restricting the generalizability of the findings

Focus group or individual interviews for exploring children's health behaviour: the example of physical activity

Background: Children's health behaviours affect their current and future health. An appreciation of children’s perceptions regarding these behaviours can inform health promotion initiatives. Focus groups and individual interviews have increasingly been used to explore health-related issues with children although the rationale for choosing any one method is not often explained and despite considerable debate about their benefits and drawbacks these methods have rarely been compared directly. This study aimed toexplore the relative merits of the two approaches when collecting information from children about their perceptions of physical activity.Methods: Twelve children from Year 6 classes at one UK primary school were randomly allocated to an 'interview group' or a 'focus group' and asked questions about facilitators and barriers relating to their physical activity at school. Focus group interactions and interviews were recorded and transcribed verbatim. Qualitative data were analysed using exploratory thematic analysis and subsequently content analysis was undertaken to quantify differences between the groups.Results: Although both methods were suitable for collecting information from children about physical activity, children who were interviewed spoke on more occasions and offered more information about facilitators for physical activity. They also spoke more frequently about potentially important aspects of the school outdoor environment with regard to physical activity promotion. The focus group was more time efficient in this setting.Conclusion: Qualitative methods for exploring health behaviours may not be equivalent and need to be chosen carefully depending on the specific research problem and practical constraints within a project