Background Sleep quality is an important determinant of health and well‐being. Nursing students may be particularly vulnerable to sleep‐related problems because of demanding academic and clinical responsibilities. This study assessed sleep quality and quality of life (QoL) among nursing students in Bangladesh and explored the association between individual Pittsburgh Sleep Quality Index (PSQI) items (sleep disturbances, sleep‐medication use, and daytime dysfunction) and QoL. Methods A cross‐sectional study was conducted among 345 nursing students at Ibn Sina Nursing Institute, Dhaka, Bangladesh, between January 2024 and April 2025. Participants were recruited using purposive sampling. Data were collected using a self‐administered Bengali questionnaire incorporating the PSQI and WHOQOL‐BREF. A PSQI score > 5 was defined as poor sleep quality. Descriptive statistics were used to summarize participant characteristics. Twelve item‐level associations with dichotomized QoL were examined as exploratory analyses using Pearson chi‐square tests, with exact tests, chi‐square tests for linear trend, and Holm‐adjusted p values to account for multiple comparisons. Statistical significance was set at p < 0.05 (adjusted p < 0.05 for item‐level inference). Results The participants had a mean age of 20.71 ± 1.663 years, and most were female and unmarried. Overall, 66.6% (95% CI 61.5–71.4) of participants had poor sleep quality, and 49.3% were classified as having poor QoL. Difficulty breathing comfortably was associated with QoL ( χ 2 = 14.50, df = 3, p = 0.002; Holm‐adjusted p = 0.028; trend p = 0.003) and remained significant after correction for multiple comparisons. Trouble staying awake during driving, eating, or socializing showed a nominal association ( χ 2 = 9.11, p = 0.03) that did not remain significant after correction (Holm‐adjusted p = 0.31) and showed no linear trend ( p = 0.21). No other item (nighttime awakenings, sleep‐onset difficulty, bathroom use, coughing or snoring, feeling too cold or hot, bad dreams, pain, sleep‐medication use, or difficulty maintaining enthusiasm) was significantly associated with QoL. Conclusion Poor sleep quality was common among nursing students. In this exploratory, unadjusted analysis, difficulty breathing comfortably was the only PSQI item that remained associated with QoL after multiplicity correction, no consistent dose–response pattern was observed, and the relationship between overall PSQI score and QoL domains was not examined; these findings are hypothesis‐generating and do not establish causation. Nursing institutions could consider sleep‐health education, early identification of persistent sleep problems, and appropriate student‐support services as potential implications for student well‐being.
Background Most studies linking sleep disturbances to depressive symptoms in youth have relied on aggregate sleep scores rather than subdomain‐specific measures, leaving the role of specific sleep disturbance subdomains in clinical populations poorly understood. Objective To examine whether specific subdomains of the Sleep Disturbance Scale for Children (SDSC) are differentially associated with depressive symptom severity in a clinical sample. Methods Cross‐sectional study of 52 children and adolescents (mean [SD] age, 15.05 [1.27] years; 86.5% female) diagnosed with major depressive disorder (MDD) at a public, referral‐based outpatient mental health clinic in Brazil. Associations between SDSC subdomains and CDI scores were examined using age‐ and sex‐adjusted logistic (CDI ≥ 17) and continuous CDI regression. Discrimination was explored using ROC analysis. Results Disorders of initiating and maintaining sleep (DIMS) showed the largest standardized difference between participants above and below the CDI threshold (Cohen ′ s d = 1.09, 95% CI 0.45–1.72). In a multivariable model including DIMS and sleep hyperhidrosis, only DIMS remained associated with CDI ≥ 17 (OR = 1.21, 95% CI 1.05–1.40). This pattern was consistent with CDI as a continuous outcome and after excluding the CDI sleep item. DIMS had the highest apparent AUC among individual sleep measures (0.828). Conclusions In this predominantly female sample of children and adolescents with MDD treated in a tertiary service, DIMS was the SDSC subdomain most consistently associated with depressive symptom severity.
Patients with cancer who present to emergency departments often experience significant anxiety because of acute physical symptoms and the psychological burden of their disease. This study is aimed at evaluating the effectiveness of Eye Movement Desensitization and Reprocessing (EMDR) in reducing anxiety among cancer patients presenting to emergency departments in hospitals in Shiraz. In this experimental pretest–posttest study with a control group, 42 cancer patients were selected through convenience sampling and randomly assigned to an experimental group (n=21) and a control group (n=21). The experimental group received the EMDR intervention, whereas the control group received no intervention. Anxiety levels were measured using a standardized questionnaire. Data were analyzed using independent and paired t-tests, the Mann–Whitney U test, the Wilcoxon test, and linear regression analysis. The two groups were comparable in demographic and clinical characteristics, including age, gender, marital status, educational level, cancer type, history of drug use, and hospitalization duration (p>0.05). Before the intervention, there was no significant difference in mean anxiety scores between the groups (p=0.337). After the intervention, anxiety decreased in both groups; however, the reduction was significantly greater in the experimental group than in the control group (p<0.001). Wilcoxon test results showed that all participants in the experimental group experienced a reduction in anxiety. Linear regression analysis indicated that the EMDR intervention independently and significantly reduced anxiety levels (p<0.001), and this effect remained stable after adjusting for baseline anxiety and other demographic and clinical variables. Baseline anxiety was a strong predictor of postintervention anxiety, whereas other variables showed no significant associations (p>0.05). Overall, the findings suggest that EMDR is an effective, brief, and practical complementary intervention for reducing anxiety in cancer patients in emergency medical settings.
Background The present study investigated perceptions of mental illness among psychiatric patients and their relatives attending ELKELAA Psychiatric Hospital in Morocco, using the Brief Illness Perception Questionnaire (BIPQ). The study included 1040 individuals across four groups: KARAMA beneficiary patients and their relatives, and nonbeneficiary patients and their relatives, defined by beneficiary status in the KARAMA operation, a social and medical initiative supporting psychiatric care. Results showed a mixed, dimension‐specific pattern rather than a uniformly more positive or negative illness representation. KARAMA beneficiaries and their relatives reported higher perceived consequences and illness timeline, whereas nonbeneficiaries reported markedly higher personal control and understanding, the two largest effects found. After adjustment for sociodemographic and clinical factors, KARAMA status remained an independent predictor of personal control and understanding but not of the global BIPQ score. Illness perceptions also diverged between patients and their relatives, suggesting that family members construct their own representations rather than simply mirroring patients′ views. These findings highlight the complexity of illness perceptions and point to a possible role of metacognitive functioning and cultural factors. However, these were not directly measured and remain hypotheses for future research. Overall, mental health services should account for the distinct, sometimes divergent, illness perceptions of patients and relatives rather than assuming a uniform effect of programs such as KARAMA. Future longitudinal research incorporating direct measures of metacognition and cultural beliefs is needed to clarify these mechanisms.
Background Social anxiety disorder (SAD) is associated with dysfunctions in face processing, a critical aspect of social interaction. However, there is a dearth of biomarkers that could facilitate precise diagnosis and targeted treatment. Aims This meta‐analysis seeks to investigate abnormalities in P1, N170, LPP, and N2pc during face processing in individuals with SAD. It also aims to examine the role of potential moderators. Methods A systematic review of the literature yielded 32 relevant studies, encompassing the aforementioned ERP components: P1 (21 studies), N170 (16 studies), LPP (11 studies), and N2pc (6 studies). We performed a random‐effects meta‐analysis to calculate Hedges′ g and assessed publication bias using the trim‐and‐fill method. Risk of bias was evaluated across five domains using an adapted Downs and Black checklist. Results Risk of bias was generally low, with some concerns regarding external validity. Primary analysis showed enhanced P1 ( g = 0.92) and LPP ( g = 1.07) amplitudes in SAD. However, the P1 effect became nonsignificant ( g = 0.20) after adjusting for publication bias, whereas the LPP enhancement remained robust. No significant differences were found for N170 or N2pc. Mixed‐model analysis indicated that P1 and N2pc exhibited the largest absolute effect sizes. No significant moderators (age, clinical status and task type) were identified. Conclusions The findings highlight the LPP as the most robust neural correlate of face processing deficits in SAD, reflecting impaired late‐stage attentional disengagement. Although P1 amplitudes appear enhanced, this effect is likely inflated by publication bias. Current evidence does not support consistent alterations in N170 or N2pc. LPP may serve as a promising potential biomarker for the clinical diagnosis and treatment monitoring of SAD.
