Various psychological, biological, and social factors make people vulnerable to mental health problems. These precursory factors as mental distress, are not sufficient alone for diagnosing a mental disorder but are recognised as risks to mental health. There has been no screening tool available in Mongolia that is adequately validated for mental health screening and neuropsychiatric functions of the brain. Therefore, we aimed to translate and validate the hospital anxiety and depression scale (HADS) to identify potential mental distress in healthy people. The HADS is reliable, valid, and practical for identifying the most common psychological disturbances. This nationwide comparative observational study for the validity of a self-reported measure was conducted between June and December 2020. One thousand ninety-four participants were randomly selected, aged 13-75, mean age was 37.7±13.7 years old, 60.9% were females, 63.9% were married. HADS total score was 13.0±5.7, HADS anxiety (HADS-A) score was 6.8±3.6, and HADS depression (HADS-D) score was 6.0±3.1 for the original two-factor model. The external reliability was good in the whole scale, and both subscales using the Intraclass Correlation Coefficient (0.872, 0.837, and 0.801 for the HADS-T, HADS-A, and HADS-D, respectively). Cronbach's alpha value was 0.776, 0.756, and 0.582, respectively, for the HADS-T, HADS-A, and HADS-D, indicating an acceptable internal consistency for the entire scale but marginal reliability for the HADS-D subscale. The reliability of both the two-factor and three-factor structures of the HADS was confirmed using confirmatory factor analysis with a satisfactory model fit on a separate sample. In conclusion, the Mongolian version of the HADS can be considered a valid and reliable measurement tool for various scientific and clinical practices in the general population.
Identifying mental distress is a complex task, particularly when individuals experience physical symptoms. Traditional self-report questionnaires that detect psychiatric symptoms using emotional words may not work for these individuals. Consequently, there is a need for a screening tool that can identify both the physical and mental symptoms of mental distress in individuals without a clinical diagnosis. Our study aimed to develop and validate a scale that measures mental distress by measuring the extent of brain overwork, which can be extrapolated as the burden of mental distress. In this population-based cross-sectional study, we recruited a total of 739 adults aged 16–65 years from 64 sampling centers of a cohort in Mongolia to validate a 10-item self-report questionnaire. Internal consistency was measured using McDonald’s ω coefficient. Test–retest reliability was analyzed using intraclass correlation coefficients. Construct and convergent validities were examined using principal component analysis (PCA) and confirmatory factor analysis (CFA). The Hospital Anxiety and Depression Scale (HADS) and the abbreviated version of World Health Organization Quality of Life (WHOQOL-BREF) were used to evaluate criterion validity. Among the participants, 70.9% were women, 22% held a bachelor’s degree or higher, 38.8% were employed, and 66% were married. The overall McDonald’s ω coefficient was 0.861, demonstrating evidence of excellent internal consistency. The total intraclass correlation coefficient of the test–retest analysis was 0.75, indicating moderate external reliability. PCA and CFA established a three-domain structure that provided an excellent fit to the data (RMSEA = 0.033, TLI = 0.984, CFI = 0.989, χ2 = 58, p = 0.003). This 10-item scale, the Brain Overwork Scale (BOS-10), determines mental distress in three dimensions: excessive thinking, hypersensitivity, and restless behavior. All the items had higher item-total correlations with their corresponding domain than they did with the other domains, and correlations between the domain scores had a range of 0.547–0.615. BOS-10 correlated with HADS, whereas it was inversely correlated with WHOQOL-BREF. In conclusion, the results suggest that BOS-10 is a valid and reliable instrument for assessing mental distress in the general population. The scale screens for mental distress that is characterized by subjective symptoms such as excessive thinking, hypersensitivity, and restless behavior. The current findings also demonstrate that the BOS-10 is quantitative, simple, and applicable for large group testing. This scale may be useful for identifying at-risk individuals who may require further evaluation and treatment for mental distress.
Communication via the sense of touch has long been perceived as an important aspect of human development, social comfort, and well-being. Human somatosensory system has in fact two tactile sub-modalities, one providing the well-recognized discriminative touch input to the brain, and the second–the affective or emotional input. C-tactile system is hypothesized to represent the neurobiological substrate for affective and rewarding properties of touch. Lower relationship quality is associated with lower resilience to stressors and can lead to increased vulnerability to mental health disorders. Based on the existing work, we know that social touch can increase well-being and lower state-anxiety. Our goal was to prove content validity for the Mongolian version with the factor structure of the original English version of the TEAQ. We translated, and adapted TEAQ for Mongolian language version. Original TEAQ-117 items were used in the pilot study. In the present study, enrolled 204 participants, age varied between 18 and 57 years (26.9±8.8), 57.8% were female. Validated TEAQ-57 items English version was used, and Exploratory factor analysis confirmed 55 items with 6 component structure. Confirmatory factor analysis demonstrated good consistency and homogeneity of the 6 factor structure of the TEAQ, and satisfactory model fit. Several subscales of the TEAQ revealed positive correlations on quality of life domains, in contrast negative correlations with anxiety and depression. In conclusion, analysed Mongolian version of the TEAQ-55 is a reliable and valid assessment tool of experiences and attitudes towards touch, and similar to component structure for different cultures (Validated British TEAQ-57, and TEAQ-37 RUS). We expected that Mongolian version of the TEAQ might be a helpful tool for screening mental health issues and researchers.
Obstructive sleep apnea (OSA) disrupts sleep. This study examined factors related to OSA severity. A cross-sectional, prospective, hospital-based study was conducted with 205 patients who underwent polysomnography (PSG). Demographic, anthropometric, clinical, PSG, and sleep quality assessment data were analyzed. Participants (N = 205) were classified into four groups based on apnea–hypopnea index (AHI); no OSA (AHI < 5/h; N = 14), mild (mOSA, 5 < AHI < 15/h; N = 50), moderate (modOSA, 15 < AHI < 30/h; N = 41), severe (sOSA, 30 < AHI < 60/h; N = 50), and very severe (vsOSA, AHI ≥ 60; N = 50). Men had more severe OSA than women (p < 0.001). Anthropometric characteristics differed with OSA severity (p < 0.001). OSA patients had decreased sleep quality and increased excessive daytime sleepiness (EDS). Body mass index (BMI), neck/waist circumference, and blood pressure (BP) differed between groups (p < 0.001). Patients with vsOSA had the highest Mallampati grades (p < 0.001). Multiple linear regression indicated that OSA severity was related to gender and sleep quality. PSG parameters (oxygen saturation, systolic BP, and arousal/respiratory arousal) were strongly related to OSA severity. In conclusion, about half of study-referred patients had severe/very severe OSA; these groups were predominantly obese men with high BP. OSA severity associated with high BP, BMI, waist circumference, and neck circumference.
Improving knowledge, attitudes, and practices toward COVID-19 is critical to control the infection rate of the pandemic successfully. Mongolia declared a state of emergency in January 2020 but no study was performed on public adherence to centralised measures and awareness of the pandemic in Mongolia. This study aimed to determine knowledge, attitudes, and practices (KAP) toward COVID-19 in the general population, especially regarding the extent to which KAP has contributed to the control measures before local COVID-19 outbreaks. The study was conducted between July and October 2020, when the pandemic was limited to internationally imported cases. We adapted a structured KAP questionnaire that was used to survey residents of Wuhan, China, during the initial outbreak of the pandemic. Participants aged between 13 and 65 years (n=1324, mean age=39.79±14.8), 73.2% were women, and 27.2% held a bachelor's degree or above. The results suggested that 81.9% of the participants had sufficient knowledge about the transmission, symptoms, treatment, and prevention of the disease. In the multiple linear regression, an increase in age and education contributed positively to a high knowledge score (p<0.05, p<0.001, respectively). The majority of the participants (96.2% - 96.5%) had compliance with the measures to control COVID-19 spread with good practices (82.4% - 93.1%) toward COVID-19 prevention. In the binary logistic regression analyses, the COVID-19 knowledge score was associated with a higher likelihood of optimistic attitudes and preventive practices (OR: 0.617 - 0.845). In conclusion, despite the sufficient knowledge toward the COVID-19 pandemic among the general population of Mongolia, a relatively low level of optimistic attitudes and appropriate practices compared to other populations may negatively impact preventing the outbreak in the society. Health education programs aimed at improving COVID-19 knowledge will be helpful to minimise local epidemic growth and the current government measures such as lockdowns, quarantines, and travel restrictions.
(1) Background: We hypothesized measuring the extent of brain overwork can extrapolate the burden of mental distress. This study aimed to develop a scale that measures mental distress and validate it in the general population. (2) Methods: In this population-based cross-sectional study, we recruited a total of 739 adults aged 16-65 years from 64 sampling centers of a clinical cohort across Mongolia to validate a 10-item self-report questionnaire. Internal consistency was measured using the McDonald’s ω. Test-retest reliability was analyzed using intraclass correlation coefficients. Construct and convergent validities were examined using the principal component analysis (PCA) and confirmatory factor analysis (CFA). Hospital Anxiety and Depression Scale (HADS) and the abbreviated version of the World Health Organization Quality of Life (WHOQOL-BREF) were used to evaluate the criterion validity. (3) Results: Among the participants, 70.9% were women, 22% held a bachelor's degree or higher, 38.8% were employed, and 66% were married. The overall McDonald’s ω coefficient was 0.861 demonstrating evidence of excellent internal consistency. The total intraclass correlation coefficient of the test-retest analysis was 0.75, indicating moderate external reliability. PCA and CFA established a three-domain structure that provided an excellent fit to the data (RMSEA=0.033, TLI=0.984, CFI=0.989, χ2=58, p=0.003). This 10-item scale, the Brain Overwork Scale (BOS-10), determines mental distress in three dimensions: Excessive Thinking, Hypersensitivity, and Restless Behavior. All items had higher item-total correlations with their corresponding domain than the other domains, and correlations between the domain scores ranged from 0.547–0.615. The BOS-10 correlated with the HADS, whereas it was inversely correlated with the WHOQOL-BREF. (4) Conclusions: The results suggest that the BOS-10 is a valid and reliable instrument for assessing mental distress in the general population. The current findings also demonstrate that the BOS-10 is quantitative, simple, and applicable for large-group testing.
Sleep is a vital component for maintaining good physical and mental health. When sleep is disordered, it can adversely affect an individual's mental and physical wellbeing. Although a variety of single specific disorder measurements are available for specialized clinicians use across the globe, to date, there are no proper screening instruments available for screening multiple sleep disorders at the primary care level. The purpose of this study is to determine the test-retest reliability of the sleep disorder screening questionnaire (SDSQ) for detecting multiple sleep disorders among the Mongolian population. A total of 366 university students were recruited for participation. SDSQ was administrated to all participants on two occasions two weeks apart. The test-retest reliability intra-class correlation (ICC) and Cronbach's alpha of the SDSQ were calculated. The sample consisted of 194 (53%) females, and 172 (47%) males, with a mean age of 21.6. Observed test-retest reliability was ranged from 0.53 to 0.81. The SDSQ was found to have excellent internal consistency with an alpha=0.950. The external validity of SDSQ revealed strong test-retest reliability in the current study population. The discriminant and convergent validity studies are required for the further improvement of the construct of the SDSQ.
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