The referral trajectories for young people with depression in low-resource settings: A qualitative study from Ghana and Zimbabwe

Experiences of bullying can have significant psychological consequences, including an increased risk of social anxiety. This study aimed to examine changes in social anxiety following Virtual Reality Social Exposure (VRSE) among bullying victims. A one-group pretest–posttest design without a control group was employed with 12 participants. The intervention consisted of three gradual exposure sessions in virtual environments representing social situations. Social anxiety was measured before and after the intervention, and the data were analyzed using the Wilcoxon Signed-Rank Test. The results indicated a statistically significant decrease in social anxiety scores following the intervention (p = 0.002), with a reported effect size of 0.974. These findings suggest that VRSE may be a promising approach for reducing social anxiety among bullying victims. However, the absence of a control group and the small sample size limit conclusions regarding its effectiveness and safety. Further studies with larger samples, control groups, and systematic safety assessments are needed.

Abstract The COVID-19 pandemic created social disruptions, leading to high levels of mental health problems for adolescents. Interpersonal stressors, such as lack of familial support, peer victimization, and discrimination, may have further exacerbated teen mental health issues. Yet, the psychological impact of interpersonal stressors and their interactive effects with high levels of loneliness remains unknown. In this pre-registered study , conducted in November and December 2020 (approximately eight months into the COVID-19 pandemic), we used a diverse sample of adolescents from across 43 U.S. states with elevated depressive symptoms (n = 2,452, ages 13–16) to examine how familial support, peer victimization, and discrimination are concurrently associated with mental health outcomes. Results indicated that perceived discrimination was the strongest standardized correlate across continuous internalizing outcomes (depressive symptoms, anxiety symptoms, and hopelessness), whereas lack of familial support was the primary correlate of suicidal ideation; if youth reported a lack of familial support, they were over three times as likely to report suicidal ideation. Loneliness significantly moderated the cross-sectional links between lack of familial support and depressive symptoms, as well as perceived discrimination and hopelessness. Simple slope probing demonstrated a distress ceiling effect: interpersonal stressors were most strongly associated with elevated distress among youth reporting low baseline loneliness, whereas youth experiencing high loneliness exhibited consistently elevated distress regardless of stressor exposure. These findings underscore interpersonal stressors and loneliness as high-priority targets for youth prevention and intervention programs, particularly during periods of widespread social disruption.

Objective: The study aimed to evaluate the internalised stigma and self-esteem in adult outpatients with major depressive disorder (MDD) attending a psychiatric outpatient clinic in Iraq, and to explore the relationship between these variables. Methods: A cross-sectional correlational study among 120 adults with MDD who attended psychiatric outpatient clinics of Azadi Teaching Hospital in Kirkuk, Iraq. All participants filled out a sociodemographic and clinical questionnaire, the Internalised Stigma of Mental Illness Scale (ISMI), and the Rosenberg Self-Esteem Scale (RSES). Data were analysed using descriptive statistics, Pearson's correlation coefficient and simple linear regression. Results: The overall mean ISMI score was 2.90 (SD = 0.42), with the highest scores for stereotype endorsement (M = 3.16) and alienation (M = 3.14) and the lowest for stigma resistance (M = 2.19). The overall mean RSES score was 2.29 (SD = 0.38). There was a negative correlation between internalised stigma and self-esteem (r = −0.338, p < 0.001). Self-esteem was statistically associated with internalised stigma (β = −0.338, t = −3.897, p < 0.001), explaining 11.4% of the variance (R² = 0.114) in simple linear regression. Conclusions: In this single-centre sample of adults with MDD, internalised stigma and self-esteem were inversely related. Since the study is a cross-sectional design, the association observed cannot be considered a causal relationship. The results provide a basis for consideration of the psychosocial aspects of routine psychiatric care (stigma and self-esteem) and for further longitudinal and multicentre research to establish temporal relationships and to determine potentially modifiable factors.

University students who live away from their families may experience loneliness and depressive symptoms, while perceived social support may alter this relationship. This study examined the associations among loneliness, perceived social support, and depressive symptoms and tested whether perceived social support moderated the loneliness-depressive symptoms relationship. A cross-sectional quantitative design involved 396 university students living in boarding houses in Yogyakarta. Data were analyzed using Pearson correlations and moderated multiple regression. Perceived social support was negatively associated with depressive symptoms. Loneliness was also significantly associated with depressive symptoms, but the direction was negative and therefore did not support the proposed positive hypothesis. The interaction between loneliness and perceived social support was significant, indicating that the loneliness slope differed across levels of support. The findings highlight the relevance of perceived social support for student mental health while also showing that the unexpected loneliness pattern requires cautious interpretation and replication.

Stress arising from academic, professional and financial demands is common among students and young professionals, and the coping methods within easiest reach, such as listening to music, do not always suffice. This paper presents a survey-driven design for a virtual reality (VR) gadget that combines selectable immersive natural environments, environment-matched sound therapy and heart-rate biofeedback for short relaxation sessions. An online questionnaire completed by 24 respondents, mostly college students, supplies the user requirements. Among those who answer the relevant items, 65.2% report daily stress, 73.9% name academic or job pressure as the main cause, and 47.8% state that a busy schedule prevents regular yoga or meditation. Music is the most common coping method (63.6%). Asked about a 10–15 minute VR relaxation session described as free of side effects, 83.3% answer “yes, definitely” and 8.3% answer “maybe” if the price is under Rs. 5000. The findings yield design requirements, a system architecture, a session workflow and a protocol for comparing the gadget with guided breathing, meditation and relaxing music. That comparison is planned, not yet carried out: the prototype has not been tested with users, and the paper makes no claim of clinical effectiveness.