Aug 2026· Journal of Adolescent Health· 0 citations· 22 references
Medicine
Abstract
Purpose
Immigrant adolescents are exposed to multiple health risk factors. This study aimed to compare the burden of multimorbidity and psychological distress, along with associated exposure factors, among accompanied and unaccompanied immigrant adolescents seeking care in a hospital-based unit for vulnerable populations.
Methods
This monocentric observational cohort was undertaken in Marseille, France (2019-2024), and included 384 adolescents aged 10-17 years who had arrived within the previous 5 years. The Cumulative Illness Rating Scale assessed the multimorbidity, and the Protect questionnaire assessed the risk of psychological trauma as a major component of psychological distress.
Results
The mean Cumulative Illness Rating Scale was 3.98 (standard deviation: 2.64). Multimorbidity was common, with 35.4% of participants having impairment of ≥ 3 organ systems. The most frequent impairments involved the eye, ear, nose, throat or teeth (48.7%), musculoskeletal and integumentary systems (46.4%), and mental health conditions (25.3%). Multimorbidity was independently associated with chronic medical history before migration (adjusted OR = 1.40, p < .0005) and during migration (adjusted OR = 1.94, p = .005). The risk of psychological trauma was independently associated with unaccompanied immigrant adolescent status (adjusted OR = 4.27, p < .05) and physical morbidity burden (adjusted OR = 1.18, p < .05). Patients had less emergency department visits during and after care in this hospital-based unit.
Discussion
Immigrant adolescents seeking care experience a high burden of multimorbidity and psychological distress. This risk requires particular attention, especially for unaccompanied adolescents, despite the lack of a convenient screening tool. A comprehensive care pathway is needed to reduce health inequalities in this extremely vulnerable population.
Mental health disorders significantly contribute to the global burden of disease, both as non-communicable diseases (NCDs) and as risk factors for other health conditions. They represent a major public health concern in low- and middle-income countries (LMICs). This study aims to investigate associations between psychological distress, socioeconomic factors, and corruption-related factors among Iranian adults in urban settings using multilevel analysis. This cross-sectional analysis uses data from a survey conducted in 2025 among urban adults across all 31 provinces of Iran, employing a proportional, stratified cluster sampling design with probability proportional to size (PPS). Psychological distress among adults aged 18 years and above was assessed using the 12-item General Health Questionnaire (GHQ-12), with a binary threshold of ≥ 4. Multilevel logistic regression models were used to examine associations between psychological distress and socioeconomic factors, perceived corruption, and experience of paying bribes. Models adjusted for health status and included random effects at the province and county levels. Sensitivity analyses were conducted using alternative GHQ-12 thresholds (≥ 3 and ≥ 5) to assess the robustness of findings to the choice of cut-off. The proportion of participants scoring above the GHQ-12 threshold of ≥ 4 for psychological distress was 41.2% (mean = 3.46, SD = 3.54). Psychological distress showed clustering at both province and county levels. In the fully adjusted model, compared with married participants, single (OR = 1.32, 95% CI: 1.21–1.44) and divorced/separated participants (OR = 1.48, 95% CI: 1.26–1.74) reported higher odds of psychological distress, whereas widowed participants (OR = 1.18, 95% CI: 0.96–1.43) showed no statistically significant difference. Higher education (OR = 0.80, 95% CI: 0.72–0.89) and better subjective socioeconomic status (OR = 0.30, 95% CI: 0.25–0.37 for highest vs. lowest category) were associated with lower odds. Compared with unemployment, all employment categories were associated with lower odds of psychological distress (ORs = 0.65–0.70, all p < 0.001). Poorer health status showed a graded association with higher odds of distress (ORs = 1.30–1.70). After adjustment for socioeconomic and health factors, perceived corruption was weakly but positively associated with psychological distress (OR = 1.024, 95% CI: 1.019–1.028), and experience of paying bribes was associated with higher odds of psychological distress (OR = 1.38, 95% CI: 1.27–1.51). The findings indicate that participants’ psychological distress is associated with socioeconomic factors, perceived corruption, and experience of paying bribes, with variation across provinces and counties in urban Iran. These results underscore the relevance of socioeconomic disadvantage, corruption-related conditions in public services, and area-level contextual variation as important factors in understanding psychological well-being.
F. Alipour, H. Rafiey, Yahya Salimi et al.· BMC Psychology· 0 citations
The mental health of adolescents is a critical global public health priority. This large-scale, cross-sectional study investigated the prevalence of depression, anxiety, and stress, along with their key associated risk factors, among school-attending adolescents in South China.
An online anonymous survey utilizing the validated Depression Anxiety Stress Scales-21 (DASS-21) and the Mental Health Test (MHT) was administered to 23,856 students (mean age = 13.57 ± 1.94 years) from primary, middle, and high schools.
The results revealed concerning prevalence rates of mild-to-extreme symptoms: 27.9% for anxiety, 25.15% for depression, and 7.63% for stress. Severe study pressure (reported by 52%), loneliness (59%), and poor social relationships (50%) were identified as the predominant risk factors, with multivariate logistic regression confirming their significant associations with worse mental health outcomes (ORs ranging from 1.74 to 1.95).
This large-scale study quantifies high anxiety and depression prevalence among South Chinese adolescents, identifying study pressure, loneliness, social difficulties, and self-harm as key modifiable risk factors. This study calls for school-based mental health interventions and provides timely empirical evidence to promote student well-being.
Background Mental disorders pose a substantial global health burden. Complementary and Integrative Medicine (CIM) is widely used; however, data on CIM use in mental disorders are limited. The aim was to investigate CIM prevalence, usage patterns, disclosure, and perceived benefits among individuals with mental disorders in Germany. Methods A cross-sectional study was conducted among adults with psychiatric disorders in Germany between June 2023 and August 2024. Participants were recruited through a nationwide anonymous online survey and on-site surveys in randomly selected outpatient psychiatric, psychosomatic, and psychotherapeutic settings in Berlin and Brandenburg. The 33-item questionnaire assessed lifetime and current CIM use, diagnostic and sociodemographic characteristics, physician disclosure, recommendation sources, and perceived effectiveness. Associations were analysed using logistic regression. Results Seven hundred sixty-eight participants (mean age 43.2 years; 77.3% female) completed the questionnaire. Lifetime CIM use was 92.3, and 68.1% reported current use. The most commonly used approaches (lifetime use) were meditation (63.9%), yoga (60.8%), and dietary supplements (59.1%); positive experiences were highest for meditation (76.9%) and yoga (74.6%). Among CIM users, 60.9% informed their physician. Physician awareness was associated with more favourable CIM evaluations (adjusted OR 2.69, 95% CI 1.63–4.49). Recommendations were mainly based on self-directed research (59.9%) and friends’ advice (31.2%). Conclusion CIM use among individuals with mental disorders is highly prevalent and predominantly self-initiated. However, many patients do not disclose their CIM use to clinicians. Physician awareness of patients’ CIM use was associated with more positive patient-reported evaluations, suggesting that proactive enquiry and open communication about CIM use may facilitate safer and more coordinated care. Further clinical research is required to evaluate the effectiveness, safety, and potential interactions of commonly used CIM approaches in psychiatric care.
J. Siewert, Hannah Wackermann, K. Icke et al.· Frontiers in Medicine· 0 citations
Background: Mental health disorders, including depression, constitute a major global public health concern that can lead to significant morbidity as well as societal costs. Internally displaced people are at risk for depression. This study aimed to assess the prevalence of depressive symptoms among adults in Atbara, northern Sudan, and identify the key factors associated with depressive symptoms, including internal displacement. Methods: Using a stratified sampling technique, data were collected by trained research assistants through face-to-face interviews using a structured questionnaire. The Patient Health Questionnaire-9 (PHQ-9) was used to assess depressive symptoms. Multivariate binary analysis was performed. Results: Three hundred and seventy-three adults were enrolled in this study; 104 (27.9%) were males. Their median age was 42.0 years. Of the 373 adults, 81 (21.7%, 95.0% confidence interval = 17.5–25.9%) had depressive symptoms (PHQ-9 scores ≥ 8). The prevalence of depressive symptoms was significantly higher among displaced adults: 39 (28.1%) of the 139 displaced adults had depression, and 42 (17.9%) of the non-displaced adults had depression, p = 0.027. In multivariate binary analysis, being internally displaced was the only factor associated with depressive symptoms (adjusted odds ratio = 1.82, 95% confidence interval = 1.07–3.08); age, body mass index, sex, education, and marital status were not associated with depressive symptoms. Conclusions: One out of five adults in this region of Sudan had depressive symptoms, which was associated with internal displacement. More effort and further research are needed to explore possible interventions to improve mental health and livelihoods, especially among internally displaced people.
Ferdows K. Kheiri, S. K. Noor, S. Alharthi et al.· Healthcare· 0 citations
ABSTRACT OBJECTIVE To assess the prevalence of multimorbidity in the Brazilian working-age population and analyze its determinants, with an emphasis on sociodemographic and behavioral aspects. METHODS A cross-sectional study was conducted using data from the 2019 National Survey of Health, involving employed individuals aged 18 years or older. The outcome was multimorbidity, characterized by the simultaneous presence of two or more chronic noncommunicable diseases, based on a list of 14 conditions. Poisson regression with robust variance was used to assess the association between sociodemographic variables, habits, behaviors, and health/service outcomes. RESULTS Among the 52,475 employed individuals, 22.6% (95%CI 21.9–23.2) had multimorbidity, which was more prevalent among: women; those aged 30 or older; those with lower levels of education; those who self-identified as white; and urban residents. Participation in public programs for physical activity, episodic heavy drinking, leisure-time screen time, self-rated health as fair/poor or very poor, a doctor’s visit in the past year, and having health insurance were also positively associated with multimorbidity. CONCLUSION The findings highlight the significant prevalence of multimorbidity among the working-age population in Brazil, with particular emphasis on social and behavioral determinants. These results reinforce the importance of health promotion strategies in multiple contexts, including workplaces, communities, and primary care settings.
Tamyres Araújo Andrade Donato, A. C. de Souza Andrade, Vanessa Moraes Bezerra· Revista de Saúde Pública· 0 citations
Introduction Mental health problems in young adults with hypertension are often underrecognized, despite their potential impact on quality of life and long-term outcomes. Evidence in younger populations remains limited, particularly in longitudinal and multicenter settings. Objective To examine the relationship between hypertension duration, mental health symptoms, and quality of life among young adults, as well as to explore psychosocial stressors identified through qualitative inquiry. Methods This multicenter longitudinal study recruited patients aged 18–45 years with hypertension from outpatient clinics across several Indonesian cities. Participants were assessed at baseline using the Depression Anxiety Stress Scale-21 (DASS-21) and the WHO Quality of Life-BREF (WHOQOL-BREF). Hypertension duration was recorded as a continuous variable. A subset of participants underwent semi-structured interviews to explore psychosocial stressors. Quantitative data were analyzed using correlation analysis, while qualitative data were analyzed thematically. Results A total of 791 participants were included in the study, with a mean age of 33 ± 10.14 years, and women slightly outnumbered men. This study found that a longer duration of hypertension was associated with worse overall quality of life (r = -0.45) and lower psychological well-being (r = -0.40). Notable correlations also emerged between hypertension duration and higher levels of anxiety (r = -0.42), depression (r = -0.38), and stress (r = -0.30), while socioeconomic and psychosocial stressors emerged as major contributing factors. Discussion This multicenter longitudinal study suggests a direct link between early-adulthood hypertension and subsequent psychological distress, particularly anxiety and depressive symptoms, as well as lower quality of life with aging. Recent findings underscore that hypertension in young individuals extends beyond cardiovascular risk and may also impose a substantial mental health burden. Evidence identifying socioeconomic and psychosocial stressors as key predisposing factors further strengthens the rationale for incorporating routine mental health screening and psychosocial interventions into standard hypertension management protocols, thereby enhancing patients’ quality of life and potentially improving long-term clinical outcomes. Conclusion In this multicenter longitudinal cohort, a longer duration of hypertension was associated with greater psychological distress and poorer quality of life among young adults. These findings support the integration of routine mental health screening into hypertension care.
E. Effendy, M. M. Amin, V. Camellia et al.· Clinical Practice and Epidem...· 0 citations
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