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Objectives This study aimed to compare the longitudinal change of the psychological distress of healthcare workers (HCWs) with non‐HCWs during the repeated outbreaks of the COVID‐19 in Japan. Methods The data were retrieved from the Employee Cohort Study in the Covid‐19 pandemic in Japan study. An online survey was conducted on March 2020 (T1), on May 2020 (T2), on August 2020 (T3), and on November 2020 (T4). Psychological distress was measured by the Brief Job Stress Questionnaire. A mixed‐model repeated‐measures ANOVA was conducted as an indicator of the group differences. Results A total sample of analysis was n = 996 (HCWs, n = 111; non‐HCWs, n = 885). HCWs consisted of physicians/nurses/midwives and other HCWs (eg, pharmacists, clinical laboratory technicians) in the clinical settings (n = 19; 17% and n = 61; 55%, respectively), and HCWs not working in the clinical settings (n = 31; 28%). Being HCWs were associated with a significant increase in psychological distress from T1 to T2, T3 and T4 (P = .001, P = .002, P < .001; respectively). Conclusions The mental health of HCWs deteriorated through the COVID‐19 outbreaks compared with non‐HCWs. HCWs are continuously the important targets to provide mental health support.

Objectives Gratitude intervention, which requires participants to engage regularly in brief activities designed to cultivate a sense of gratefulness, is known as one of the most effective positive psychological interventions. Although numerous meta‐analyses and systematic reviews have been conducted on gratitude intervention, no studies have focused on the working population. This study aimed to systematically summarize the effectiveness of gratitude interventions on workers' mental health and well‐being. Methods Systematic search was conducted in February 2021 using five databases. Eligible studies included randomized controlled trials implementing gratitude activities among healthy workers and measuring mental health or well‐being indicators and original articles or thesis in English. Results Nine out of 1957 articles met the inclusion criteria. Eight studies adopted gratitude list interventions, showing a significant improvement in perceived stress and depression; however, the effects on well‐being were inconsistent. Interventions with gratitude list four times or less did not report significant changes in any outcomes. Conclusions Most gratitude interventions incorporated a gratitude list, and some studies included gratitude activities as a part of the combined program. On the other hand, no studies focused on only behavioral gratitude expression among workers. Gratitude interventions might be effective in improving mental health, but their effects on well‐being remain unclear. The total number of gratitude lists and reflections might influence the effect on mental health and well‐being; however, due to the high heterogeneity of the studies, further studies are needed.

IntroductionWork engagement enhances nurses’ physical and mental health, well-being, job performance and satisfaction. This reduces turnover rates and improves patient care quality, making work engagement a crucial factor in the nursing workplace. However, no systematic review or meta-analysis has explored the effects of randomised controlled trial (RCT) interventions aimed at improving nurses’ work engagement. This study aimed to evaluate the effectiveness of these interventions, providing healthcare organisations with evidence-based recommendations for enhancing work engagement among nurses.Methods and analysisThis systematic review and meta-analysis will use the PICO criteria: (P) nurses, (I) psychosocial interventions, (C) no intervention or non-work engagement interventions and (O) work engagement as a primary outcome. Published studies will be searched by September 2025 using databases such as the Cochrane Central Register of Controlled Trials, PubMed (MEDLINE), Embase, CINAHL, PsycINFO, PsycARTICLES and the Japan Medical Abstracts Society. Eligible studies must use RCT designs, assess the impact of interventions on nurses’ work engagement and provide adequate data (sample sizes, means and SDs) to calculate effect sizes with 95% CIs. Publications must be written in English or Japanese as original articles. Two reviewers will independently select studies and assess the risk of bias. The methodological quality of the included studies will be evaluated using the Grading of Recommendation Assessment, Development and Evaluation approach. A meta-analysis will be conducted for statistical synthesis and publication bias will be assessed using Egger’s test and a visual funnel plot. Heterogeneity will be evaluated using Q statistics.Ethics and disseminationThis systematic review and meta-analysis are based on existing studies and do not require ethical approval. The findings will be shared through publications in peer-reviewed international journals and presentations at relevant conferences, symposia and seminars.PROSPERO registration numberCRD42024510479.

Objectives: This longitudinal study examined the associations of workplace loneliness with job turnover at 6-month follow-up among Japanese full-time employees.Methods: This study employed a 6-month prospective design as part of the Employee Cohort Study in Japan. Data from wave 15 (February 2024; baseline, T1) and wave 16 (August 2024; follow-up, T2) were used. Only participants who were employed at baseline and completed the follow-up survey were included in the analysis. Workplace loneliness at T1 was measured using 3 scales: the Loneliness at Work Scale (LAWS), a single-item workplace loneliness scale, and a 3-item scale developed by modifying the short UCLA (University College, Los Angeles) Loneliness Scale for workplace loneliness. Job turnover at T2 was defined based on responses indicating either leaving a job or moving to a different company within the preceding 6 months. Multivariable logistic regression analysis assessed the association between workplace loneliness and job turnover, adjusting for sociodemographic variables.Results: In total, 706 employees who were employed at baseline were included in the analysis. Observed turnover at follow-up was n = 47 (6.7%). Participants who experienced turnover had significantly higher baseline scores for LAWS and the 3-item scale (P = .044 and P = .012, respectively). In the multivariable logistic regression, all 3 workplace loneliness scales demonstrated similar and significant associations with turnover at follow-up.Conclusions: Workplace loneliness leads to job turnover. Further research is needed to address the generalization and explore mechanisms of the present findings.

The aim of this study was to investigate the long-term impact of being bullied at school on current psychological distress and work engagement in adulthood among Japanese workers. We hypothesized that workers who had been bullied at school could have higher psychological distress and lower work engagement compared to those who had not been bullied. We used data from the Japanese Study on Stratification, Health, Income, and Neighborhood (J-SHINE) project, conducted from July 2010 to February 2011 in Japan. This survey randomly selected the local residents around a metropolitan area in Japan. Of 13,920 adults originally selected, 4,317 people participated this survey, and the total response rate was 31%. The self-administered questionnaires assessed current psychological distress (K6), work engagement (UWES), the experiences of being bullied in elementary or junior high school and other covariates. Statistical analyses were conducted only for workers. Hierarchical multiple regression analyses were conducted to determine associations between experiences of being bullied at school and psychological distress/work engagement, with six steps. Statistical analysis was conducted for 3,111 workers. The number of respondents who reported being bullied in elementary or junior high school was 1,318 (42%). We found that the experience of being bullied at school was significantly associated with high psychological distress in adulthood (β = .079, p = < .0001); however, the work engagement scores of respondents who were bullied were significantly higher than for people who were not bullied at school (β = .068, p = < .0001), after adjusting all covariates. Being bullied at school was positively associated with both psychological distress and work engagement in a sample of workers. Being bullied at school may be a predisposing factor for psychological distress, as previously reported. The higher levels of work engagement among people who experienced being bullied at school may be because some of them might have overcome the experience to gain more psychological resilience.

Digital health technology has been widely applied to mental health interventions worldwide. Using digital phenotyping to identify an individual’s mental health status has become particularly important. However, many technologies other than digital phenotyping are expected to become more prevalent in the future. The systematization of these technologies is necessary to accurately identify trends in mental health interventions. However, no consensus on the technical classification of digital health technologies for mental health interventions has emerged. Thus, we conducted a review of systematic review articles on the application of digital health technologies in mental health while attempting to systematize the technology using the Delphi method. To identify technologies used in digital phenotyping and other digital technologies, we included 4 systematic review articles that met the inclusion criteria, and an additional 8 review articles, using a snowballing approach, were incorporated into the comprehensive review. Based on the review results, experts from various disciplines participated in the Delphi process and agreed on the following 11 technical categories for mental health interventions: heart rate estimation, exercise or physical activity, sleep estimation, contactless heart rate/pulse wave estimation, voice and emotion analysis, self-care/cognitive behavioral therapy/mindfulness, dietary management, psychological safety, communication robots, avatar/metaverse devices, and brain wave devices. The categories we defined intentionally included technologies that are expected to become widely used in the future. Therefore, we believe these 11 categories are socially implementable and useful for mental health interventions.

Approximately 1 out of 5 pregnant women develops depression. Internet-based cognitive behavioral therapy (iCBT) is an effective way to treat not only depression but also mild depressive symptoms or subthreshold depression. While numerous iCBT programs have been developed and tested through randomized controlled trials for various mental health conditions and specific populations, research on their effectiveness and application in the real world remains limited. This study aimed to examine the effectiveness of a previously developed iCBT program implemented in an existing app for improving depressive symptoms among pregnant women in a real-world setting. The previously developed iCBT program for preventing perinatal depression was already implemented in an existing app called Luna Luna Baby by MTI Ltd. The app aims to provide information to pregnant women about pregnancy and babies, and potential users can download it from the Japanese version of the Apple App Store or Google Play Store without any fee. The program does not require any additional fees. The log data stored on the app identified iCBT program users and nonusers, allowing us to conduct this retrospective cohort study. Data from September 2022 to September 2024 were extracted from the app after anonymous processing. The primary outcome was the score on the self-reported Edinburgh Postnatal Depression Scale (EPDS), which participants answer by themselves on the app. The exposure group was defined as completers of all 6 modules of the iCBT program. The nonexposure group was defined as users who did not use any module of the program and matched the baseline characteristics of the exposure group. The change in EPDS score before and after using the program was compared using effect sizes, and repeated 2-way ANOVA was conducted to test the difference between the exposure and nonexposure groups. Data from 119 women who completed the iCBT program and 448 pair-matched controls were selected. The average EPDS scores at baseline were 7.24 (SD 5.30) in the exposure group and 7.25 (SD 5.18) in the nonexposure group. After using the iCBT program, the group mean EPDS scores changed by -0.69 (SD 4.92) and +0.99 (SD 5.56) over time in the exposure and nonexposure groups, respectively (Cohen d=0.31, 95% CI 0.11-0.51). The repeated 2-way ANOVA showed statistical significance in the interaction terms between the groups and the measurement time points (P=.04). The previously developed iCBT program showed a significant effect with a modest effect size on decreasing depressive symptoms among pregnant women in a real-world setting. Future research should attempt to minimize dropouts and increase participation in the program.

There are growing concerns on stress among nurses in low- and middle-income countries (LMICs) in South-East Asia. It is important to improve mental health among nurses in these countries. The objective of this study was to examine the efficacy of two types of newly developed smartphone-based stress management programs in improving depressive and anxiety symptoms among hospital nurses in Vietnam. This study was a three-arm (including two intervention groups and one control group) randomized trial. Participants were recruited from nurses in a large general hospital in Hanoi, Vietnam. Two types (free-choice and fixed sequential order) of smartphone-based stress management programs were developed. Participants were randomly allocated to Program A (a free-choice, multimodule stress management), Program B (a fixed-order, internet cognitive behavioral therapy, iCBT), or a control group (treatment as usual). The depressive and anxiety symptoms were measured by using the Depression Anxiety and Stress Scales at baseline, 3-, and 7-month follow-up surveys. 951 participants were randomly allocated to each of the three groups. Program B showed a statistically significant effect on improving depressive symptoms at 3-month (p = 0.048), but not at 7-month (p = 0.92); Cohen’s d was − 0.18 (95% CI − 0.34 to − 0.02) and 0.03 (95% CI − 1.00 to 1.05), respectively. Program A failed to show a significant intervention effect on any of the outcomes at 3- or 7-month follow-up (p > 0.05). Despite the small effect size, the present fixed-order iCBT program seems effective in improving depression of hospital nurses in Vietnam. A public health impact of the intervention can be scalable, when considering its accessibility and minimal cost. Trial registration number: The study protocol is registered at the UMIN Clinical Trials Registry (UMINCTR; ID = UMIN000033139). Registered date of the protocol is 1st Jul. 2018. https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000037796