International Neuropsychiatric Disease Journal

A Systematic Review of Anxiety and Gender Differences among Employed Adults in the Workplace

Saba Khan — 2026-04-15

One of the most prevalent mental illnesses worldwide is anxiety, with a particularly high prevalence observed among working adults. Gender plays a vital role in the prevalence, manifestation, and effects of workplace-related anxiety, yet systematic studies that disaggregate findings by gender remain limited. This systematic review compares existing empirical evidence on gender disparities in anxiety among working adults (published between 2000 and 2025), focusing on prevalence rates, workplace-related risk factors, and the extent to which gender moderates or mediates these relationships. The selected quantitative observational studies were reviewed based on PRISMA 2020 guidelines and a PICOS-based eligibility framework, covering diverse occupational sectors and countries. Findings indicates that the anxiety was consistently higher among women, ranging approximately from 25% to 40% across included studies, compared to 20% to 35% among men. Significant workplace stressors associated with anxiety include shift work, high job demands and work–family conflict were constantly associated with augmented anxiety levels. In several studies, gender moderated or mediated the association between these stressors and anxiety due to both biological susceptibility and socio-cultural expectations. The overall risk of bias ranged from low to moderate. This review highlights the necessity of developing gender-sensitive workplace mental health policies, prioritizing at-risk groups, and conducting further research that considers gender as a dynamic variable. These findings have important implications for organizational leadership, HR policies, and global occupational health strategies.

Targeting Alzheimer’s Disease Through Physical Activity: A Systematic Review of Biological Mechanisms and Clinical Evidence

Saba Waheed — 2026-04-24

Background: Alzheimer’s disease (AD) is a progressive neurodegenerative disorder characterized by cognitive decline and memory impairment, representing a major global health challenge. With no definitive cure currently available, preventive strategies targeting modifiable risk factors have gained increasing attention. This study presents a systematic review of the role of physical activity in the prevention of Alzheimer’s disease, focusing on underlying biological mechanisms, epidemiological evidence, and exercise modalities.

Methodology: A structured literature search was conducted across major databases, including PubMed, Web of Science, and Google Scholar, covering studies published between 2020 and 2024. Eligible studies included observational studies, randomized controlled trials, and systematic reviews examining the relationship between physical activity and cognitive outcomes.

Results: Findings indicate that regular physical activity is associated with a reduced risk of Alzheimer’s disease and improved cognitive function. Mechanistically, exercise promotes neurogenesis, enhances brain-derived neurotrophic factor (BDNF) expression, improves cerebral blood flow, and reduces neuroinflammation and oxidative stress. Aerobic exercise, resistance training, and mind-body interventions all demonstrate beneficial effects, with combined exercise approaches showing the greatest impact.

Conclusion: In conclusion, physical activity represents a cost-effective, accessible, and non-pharmacological strategy for reducing Alzheimer’s disease risk. Future research should focus on standardising exercise protocols and establishing causal relationships through long-term randomised trials.

Equitable and Culturally Responsive Digital Rehabilitation Counseling in the United States: A Scoping Review of Policy Pathways

Cornelia Ifeoma Ejoh — 2026-05-25

Background: The COVID-19 pandemic accelerated the digital transformation of mental health and rehabilitation counseling services in the United States. This shift has expanded access to care, but it has also exposed persistent inequities that affect underserved populations.

Objective: This scoping review maps policy pathways for equitable and culturally responsive mental-health support within digital rehabilitation counseling, and quantifies the evidence base supporting reform.

Methods: Using the Arksey and O'Malley framework and the PRISMA Extension for Scoping Reviews (PRISMA-ScR), we identified, screened, and synthesized 88 sources published between 2020 and 2026 from PubMed, PsycINFO, Scopus, Google Scholar, and grey-literature repositories (WHO, FCC, HRSA, OECD, UNDP, NRHA). Descriptive statistics summarized source characteristics, a thematic coding matrix mapped eight policy-relevant themes, and a Pearson chi-square test examined associations between source type and thematic focus.

Results: Most sources (84.1%, n = 74) were peer-reviewed journal articles, and 10.2% (n = 9) were institutional or governmental reports; the remainder were preprints, textbooks, or news commentaries. Ninety-six percent of dated sources appeared in 2022 or later, with a median publication year of 2025. The most frequently addressed themes were tele-rehabilitation and telehealth (27.3%), AI and digital mental health (20.5%), disability and rehabilitation (15.9%), and digital equity (14.8%). Source type and dominant theme were significantly associated (χ²(8) = 18.42, p = .018): institutional reports clustered around digital-equity and workforce issues, while peer-reviewed studies emphasized clinical and AI-related questions.

Conclusions: The evidence base for digital rehabilitation counseling is growing rapidly but remains unevenly distributed across equity-critical themes. Sustainable reform calls for coordinated investment in broadband infrastructure, multilingual and disability-inclusive platform design, culturally responsive workforce development, ethical AI governance, and inclusive workforce reintegration, anchored in a “human-in-the-loop” model of care.

Application of the Roy Adaptation Model in the Care of a Patient with Obsessive Compulsive Disorder

G. Aruna — 2026-05-26

The use of theoretical models in the nursing practice helps in developing and implementing excellent and wholistic nursing care for the patients. One of the commonly used theoretical models in nursing is the Roy Adaptation Model, which focuses on promoting an individual's adaptation to the changing environment. This article describes the use of the Roy Adaptation Model in the care of Ms X with Obsessive Compulsive Disorder. The four modes of the model, such as physiologic, self-concept, role function, and interdependence mode, were applied to assess the needs of the patient and the nursing process approach was used to provide comprehensive nursing care. Evaluation of data based on the four modes and nursing process was effective in improving the level of functioning in various modes.

Depression & Its Associated Factors: A Comparative Study of Rural and Urban Adult Out-Patients in Northwestern Nigeria

Aminu Ibrahim Shehu — 2026-04-21

Background: Depression has a substantial direct and indirect impact on physical illness among the general outpatients. This impact includes amplifying physical symptoms and worsening functional impairment, thereby increasing morbidity and mortality, decreasing patients’ adherence to treatment, increasing the cost of treatment, and reducing the health-related quality of life.

Aim: This study aimed to determine and compare the prevalence and factors associated with depression amongst rural and urban general outpatients.

Study Design: It was a descriptive comparative cross-sectional study.

Place and Duration of Study: The study was conducted in two general out-patients clinics located in urban and rural Kano, respectively, viz. Aminu Kano Teaching Hospital (AKTH) and Kumbotso Comprehensive Community Healthcare Clinic (KCCHC).

Methodology: A minimum sample size was calculated to be 50 per each group (Rural vs Urban) and 10 was added per each group to allow for attrition or non-response. A simple random sampling was employed to select 60 participants with depression. Patient Health Questionnaire 9(PHQ-9) was used to screen for depression, and was confirmed using Mini International Neuropsychiatric Inventory (MINI-5) among the participants. They were also assessed for social support using the Oslo-3-item Social Support Scale (OSS-3).

Results: A higher prevalence of depression was found among urban patients (53.6%) than their rural counterparts (33%). In the urban area, depression was associated with chronic medical illness, a family history of mental illness, lower social support and lower social status. In rural areas, depression was associated with being single; increased frequency of consultation visits, fewer years in formal education and having more than one physical illness.

Conclusion: Depression was more prevalent among urban outpatients than their rural counterparts. There is a need to incorporate regular screening of depression in the study areas, most notably among patients who are at high risk (Urban > rural) of depression based on the factors that were identified to be associated with depression in the study.

Prevalence and Related Factors of Burnout among Healthcare Practitioners at Livingstone Central Hospital in Livingstone, Zambia

Evelyn Eselina Phiri — 2026-05-05

Burnout among healthcare practitioners is a critical issue affecting both the workforce and the quality of patient care. It is characterized by emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment, leading to decreased job satisfaction and increased turnover rates. This study aimed to assess the prevalence and related factors of burnout among healthcare practitioners at Livingstone Central Hospital in Zambia. A cross-sectional survey was conducted with 69 healthcare practitioners at Livingstone Central Hospital. The Maslach Burnout Inventory (MBI) was used to measure burnout across three dimensions: emotional exhaustion, depersonalization, and personal achievement. Socio-demographic and work-related factors were also collected. Descriptive statistics, correlation analysis, and multiple regression analysis were employed to examine the relationships between these factors and burnout. The findings revealed moderate levels of burnout. Emotional exhaustion averaged 18.2, with 16% reporting extreme fatigue. Depersonalization had a mean score of 9.8, while personal achievement was generally low, averaging 39.5, with about 61% of respondents reporting reduced accomplishment. Age, work experience, and professional role were significantly associated with burnout dimensions. Regression analysis showed that workplace comfort and functionality (β = -11.2, p < 0.001) and decision-making involvement (β = -7.5, p = 0.007) were strong protective factors, explaining about 45% of burnout variance (R² = 0.445). Organisational support for professional growth also had a significant impact, accounting for 46% of variance (R² = 0.461). Findings suggest that workplace comfort, involvement in decision-making, and organisational support for professional growth are strongly associated with lower burnout scores. These factors may serve as protective correlates rather than definitive solutions. The study underscores the need for targeted interventions and policies to support the well-being of healthcare workers and, consequently, improve the quality of patient care. The need for future research remains to solidify and expand the understanding on burnout.

Prevalence and Precursors of Compassion Fatigue among Healthcare Professionals at Levy Mwanawasa University Teaching Hospital in Lusaka, Zambia

Vongaishe Mashonganyika — 2026-05-05

The medical field is among the most demanding work fields, with healthcare providers being frequently exposed to traumatic injuries, heavy workloads, and intense emotional pressures. These conditions increase the risk of developing compassion fatigue, a syndrome of physical, emotional, and psychological exhaustion resulting from sustained exposure to patients’ trauma and suffering. Although compassion fatigue has gained recognition globally, limited literature exists in Africa, particularly in Zambia. This study investigated the precursors and prevalence of compassion fatigue among healthcare providers at Levy Mwanawasa University Teaching Hospital in Lusaka.

A descriptive cross-sectional quantitative design, was employed, using an online questionnaire completed by 232 healthcare professionals across 6 hospital departments.

Findings showed that 59.05% of the respondents identified excessive workload as primary precursor of compassion fatigue while 11.21% cited constant exhaustion. Exposure to wounds and patients suffering was noted among 8.19% of respondents respectively. Compassion fatigue prevalence was assessed using the Professional Quality of Life (ProQOL) scale, focusing on burnout as a key indicator. Results showed that 45.26% of the respondents experienced average burnout, 31.03% low burnout, and 23.71% high burnout. Coping mechanisms included adequate rest (70.60%), shared workload, recreational activities, family support and spiritual practices. These findings highlight the urgent need for institutional strategies to mitigate compassion fatigue and promote healthcare professional well-being.

School Psychologist Workforce Shortage and Its Impact on ASD Diagnosis and Intervention Access in Title I Schools

Christopher Ugbong Akeke — 2026-05-12

This study examines how school psychologist workforce capacity influences the timeliness of Autism Spectrum Disorder (ASD) diagnosis and access to intervention services within Title I schools in the United States. Using secondary data obtained from the National Center for Education Statistics (NCES), including the Common Core of Data (CCD) and EDFacts databases, the study adopts a quantitative design to investigate the direct, indirect, and contextual effects of workforce capacity on ASD service delivery outcomes. Workforce capacity was operationalized using the student-to-psychologist ratio, while early identification, intervention access, and assessment capacity were measured using standardized proportional indicators derived from school-level reporting data. The analysis integrated multivariate linear regression, binary logistic regression, mediation analysis, and hierarchical linear modeling to evaluate the relationships among workforce capacity, assessment processes, and intervention access across Title I school contexts. The findings indicate that higher psychologist-to-student ratios significantly reduce early ASD identification rates (β = -0.000185, p < 0.001) and decrease the likelihood of access to intervention services (β = -0.00112, p < 0.001). Mediation analysis further demonstrates that assessment capacity partially mediates the relationship between workforce capacity and service access, while multilevel modeling reveals that the negative effects of workforce shortages are significantly amplified in high Title I contexts (\gamma = -0.000057, p = 0.002). The study concludes that workforce shortages and structural socioeconomic disadvantage jointly constrain ASD diagnostic and intervention pathways within underserved schools. The findings highlight the importance of strengthening workforce distribution, improving assessment infrastructure, enhancing inter-agency coordination, and expanding alternative service delivery models to improve equitable access to ASD-related services.

Predictive Analytics for Early Detection of Youth Mental Health Risks in Underserved Schools

Christopher Ugbong Akeke — 2026-05-19

Adolescent mental health issues are increasing, with many students reporting sadness and anxiety. Schools can help identify early warning signs, but limited resources often delay timely support, especially in underserved areas. This study explored predictive analytics as a school-centric approach for the early detection of youth mental health risks in underserved educational settings. Grounded in ecological and risk-and-resilience frameworks, the research synthesized existing predictive models and identified key indicators such as academic performance, bullying victimization, sleep disturbances, and substance use from publicly available youth survey and school policy datasets. A modular data architecture was proposed that integrates student-level behavioral and demographic variables with school-level contextual factors, including policy strength, counselor ratios, and climate indicators. Using synthetic data derived from publicly available youth survey and school-policy indicators, penalized logistic regression, random forest, and XGBoost models were evaluated, achieving moderate discriminatory power with AUC values ranging from 0.70 to 0.75. Fairness assessments highlighted trade-offs across racial groups, emphasizing the need for equitable deployment. Ethical, privacy, and implementation guidelines were developed to support feasible adoption in low-resource schools. Results demonstrated the value of leveraging routine school data for proactive risk stratification and targeted support. The study concludes that predictive analytics offers a practical pathway to address delayed identification of internalizing symptoms while balancing accuracy, equity, and feasibility. Recommendations include real-world piloting, explainable AI integration, and stakeholder collaboration to strengthen mental health support systems in underserved schools.

Prevalence and Antecedents of Postpartum Psychosis among Postnatal Mothers in Lusaka Zambia’s First level Hospitals

Choongo Mulungu — 2026-05-29

Background: Maternal mental health remains an under‑researched area in Zambia, with postpartum psychosis (PPP) representing the most severe but least documented psychiatric emergency among postnatal mothers. This study investigated the prevalence and antecedents of postpartum psychosis among postnatal mothers in Lusaka’s first‑level hospitals.

Methods: Guided by the Health Belief Model (HBM), the research adopted convergent parallel mixed methods research design cross-sectionally. The study population comprised 398 postnatal mothers above 2 weeks postpartum and attended to a questionnaire that integrated the Choongo Postpartum Psychosis Scale (CPPS-8) while qualitative insights came through interviews conducted on 22 family and healthcare workers.

Results: Results revealed that 23% of mothers screened positive for PPP, a prevalence substantially higher than global estimates of 1 – 2 per 1000. Key antecedents included substance use (38%), prior psychiatric history (32%), and family history of mental illness (12%). Substance use emerged as the strongest predictor (Estimate = 4.27, Wald χ² = 35.33, p < .001), with mothers engaging in alcohol or tobacco use being over three times more likely to screen positive. Regression analyses showed psychosocial and clinical factors explained up to 61% of variance in PPP screening outcomes, while demographic variables were weak predictors.

Conclusion: PPP, though rare, poses significant risks to maternal and infant wellbeing if undetected. PPP is a significant maternal health challenge in Zambia, shaped by psychosocial vulnerabilities and systemic gaps. Strengthening screening, training, and community sensitization is essential to safeguard maternal and infant wellbeing.