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      Differential network interactions between psychosocial factors, mental health, and health-related quality of life in women and men

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          Abstract

          Psychosocial factors affect mental health and health-related quality of life (HRQL) in a complex manner, yet gender differences in these interactions remain poorly understood. We investigated whether psychosocial factors such as social support and personal and work-related concerns impact mental health and HRQL differentially in women and men during the first year of the COVID-19 pandemic. Between June and October 2020, the first part of a COVID-19-specific program was conducted within the “Characteristics and Course of Heart Failure Stages A-B and Determinants of Progression (STAAB)” cohort study, a representative age- and gender-stratified sample of the general population of Würzburg, Germany. Using psychometric networks, we first established the complex relations between personal social support, personal and work-related concerns, and their interactions with anxiety, depression, and HRQL. Second, we tested for gender differences by comparing expected influence, edge weight differences, and stability of the networks. The network comparison revealed a significant difference in the overall network structure. The male ( N = 1370) but not the female network ( N = 1520) showed a positive link between work-related concern and anxiety. In both networks, anxiety was the most central variable. These findings provide further evidence that the complex interplay of psychosocial factors with mental health and HRQL decisively depends on gender. Our results are relevant for the development of gender-specific interventions to increase resilience in times of pandemic crisis.

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          Most cited references103

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          Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives

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            A brief measure for assessing generalized anxiety disorder: the GAD-7.

            Generalized anxiety disorder (GAD) is one of the most common mental disorders; however, there is no brief clinical measure for assessing GAD. The objective of this study was to develop a brief self-report scale to identify probable cases of GAD and evaluate its reliability and validity. A criterion-standard study was performed in 15 primary care clinics in the United States from November 2004 through June 2005. Of a total of 2740 adult patients completing a study questionnaire, 965 patients had a telephone interview with a mental health professional within 1 week. For criterion and construct validity, GAD self-report scale diagnoses were compared with independent diagnoses made by mental health professionals; functional status measures; disability days; and health care use. A 7-item anxiety scale (GAD-7) had good reliability, as well as criterion, construct, factorial, and procedural validity. A cut point was identified that optimized sensitivity (89%) and specificity (82%). Increasing scores on the scale were strongly associated with multiple domains of functional impairment (all 6 Medical Outcomes Study Short-Form General Health Survey scales and disability days). Although GAD and depression symptoms frequently co-occurred, factor analysis confirmed them as distinct dimensions. Moreover, GAD and depression symptoms had differing but independent effects on functional impairment and disability. There was good agreement between self-report and interviewer-administered versions of the scale. The GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research.
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              The PHQ-9: validity of a brief depression severity measure.

              While considerable attention has focused on improving the detection of depression, assessment of severity is also important in guiding treatment decisions. Therefore, we examined the validity of a brief, new measure of depression severity. The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. The PHQ-9 is the depression module, which scores each of the 9 DSM-IV criteria as "0" (not at all) to "3" (nearly every day). The PHQ-9 was completed by 6,000 patients in 8 primary care clinics and 7 obstetrics-gynecology clinics. Construct validity was assessed using the 20-item Short-Form General Health Survey, self-reported sick days and clinic visits, and symptom-related difficulty. Criterion validity was assessed against an independent structured mental health professional (MHP) interview in a sample of 580 patients. As PHQ-9 depression severity increased, there was a substantial decrease in functional status on all 6 SF-20 subscales. Also, symptom-related difficulty, sick days, and health care utilization increased. Using the MHP reinterview as the criterion standard, a PHQ-9 score > or =10 had a sensitivity of 88% and a specificity of 88% for major depression. PHQ-9 scores of 5, 10, 15, and 20 represented mild, moderate, moderately severe, and severe depression, respectively. Results were similar in the primary care and obstetrics-gynecology samples. In addition to making criteria-based diagnoses of depressive disorders, the PHQ-9 is also a reliable and valid measure of depression severity. These characteristics plus its brevity make the PHQ-9 a useful clinical and research tool.
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                Author and article information

                Contributors
                Weiss_M11@ukw.de
                Journal
                Sci Rep
                Sci Rep
                Scientific Reports
                Nature Publishing Group UK (London )
                2045-2322
                19 July 2023
                19 July 2023
                2023
                : 13
                : 11642
                Affiliations
                [1 ]GRID grid.411760.5, ISNI 0000 0001 1378 7891, Translational Social Neuroscience Unit, Department of Psychiatry, Psychosomatic and Psychotherapy, Center of Mental Health, , University Hospital Würzburg, ; Margarete-Höppel-Platz 1, 97080 Würzburg, Germany
                [2 ]GRID grid.8379.5, ISNI 0000 0001 1958 8658, Institute of Clinical Epidemiology and Biometry, , University of Würzburg, ; Würzburg, Germany
                [3 ]GRID grid.411760.5, ISNI 0000 0001 1378 7891, Comprehensive Heart Failure Center, , University Hospital Würzburg, ; Würzburg, Germany
                [4 ]GRID grid.411760.5, ISNI 0000 0001 1378 7891, Department of Internal Medicine I, , University Hospital Würzburg, ; Würzburg, Germany
                [5 ]GRID grid.411760.5, ISNI 0000 0001 1378 7891, Clinical Trial Center, , University Hospital Würzburg, ; Würzburg, Germany
                [6 ]GRID grid.411760.5, ISNI 0000 0001 1378 7891, Institute of Medical Data Science, , University Hospital Würzburg, ; Würzburg, Germany
                [7 ]GRID grid.8379.5, ISNI 0000 0001 1958 8658, Institute for Virology and Immunobiology, , University of Würzburg, ; Würzburg, Germany
                [8 ]GRID grid.8379.5, ISNI 0000 0001 1958 8658, Institute for Hygiene and Microbiology, , University of Würzburg, ; Würzburg, Germany
                [9 ]GRID grid.411760.5, ISNI 0000 0001 1378 7891, University Hospital Würzburg, ; Würzburg, Germany
                Article
                38525
                10.1038/s41598-023-38525-8
                10356800
                37468704
                f5021fb2-34a8-4091-97f4-62c5efdead29
                © The Author(s) 2023

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 10 October 2022
                : 10 July 2023
                Funding
                Funded by: Universitätsklinikum Würzburg (8913)
                Categories
                Article
                Custom metadata
                © Springer Nature Limited 2023

                Uncategorized
                human behaviour,quality of life,anxiety,depression
                Uncategorized
                human behaviour, quality of life, anxiety, depression

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