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Published in: BMC Psychiatry 1/2020

Open Access 01-12-2020 | Burnout Syndrome | Research article

The role of social support and emotional exhaustion in the association between work-family conflict and anxiety symptoms among female medical staff: a moderated mediation model

Authors: Hui Zhang, Leiwen Tang, ZhiHong Ye, Ping Zou, Jing Shao, Man Wu, Qi Zhang, Guojin Qiao, Shaoyu Mu

Published in: BMC Psychiatry | Issue 1/2020

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Abstract

Background

Limited work has been done to explain how work-family conflict is related to anxiety symptoms and the roles of emotional exhaustion and social support may play.

Methods

Based on a sample of 764 female nurses and physicians, a model was tested in which emotional exhaustion served as a mediator and social support was regarded as a moderator between work-family conflict and anxiety symptoms.

Results

This current study supported a moderated mediation model where the relationship between work-family conflict and anxiety symptoms via emotional exhaustion was weakest for female medical staff who reported high levels of social support.

Conclusions

This study contribute to providing an understanding of how and when work-family conflict affects anxiety symptoms. The results implicate a wide range of interventions aimed at promoting mental wellbeing among female medical staff for policymakers and individuals.
Literature
1.
go back to reference Nomura K, Yamazaki Y, Gruppen LD, Horie S. The difficulty of professional continuation among female doctors in Japan: a qualitative study of alumnae of 13 medical schools in Japan. BMJ Open. 2015;5(3):e005845.PubMedPubMedCentralCrossRef Nomura K, Yamazaki Y, Gruppen LD, Horie S. The difficulty of professional continuation among female doctors in Japan: a qualitative study of alumnae of 13 medical schools in Japan. BMJ Open. 2015;5(3):e005845.PubMedPubMedCentralCrossRef
2.
go back to reference Petrie K, Crawford J, Baker STE, Dean K. Interventions to reduce symptoms of common mental disorders and suicidal ideation in physicians: a systematic review and meta-analysis. Lancet Psychiatry. 2019;6(3):225–34.PubMedCrossRef Petrie K, Crawford J, Baker STE, Dean K. Interventions to reduce symptoms of common mental disorders and suicidal ideation in physicians: a systematic review and meta-analysis. Lancet Psychiatry. 2019;6(3):225–34.PubMedCrossRef
4.
go back to reference Harvey SB, Modini M, Joyce S, Milligan-Saville JS, Tan L, Mykletun A, Bryant RA, Christensen H, Mitchell PB. Can work make you mentally ill? A systematic meta-review of work-related risk factors for common mental health problems. Occup Environ Med. 2017;74(4):301–10.PubMedCrossRef Harvey SB, Modini M, Joyce S, Milligan-Saville JS, Tan L, Mykletun A, Bryant RA, Christensen H, Mitchell PB. Can work make you mentally ill? A systematic meta-review of work-related risk factors for common mental health problems. Occup Environ Med. 2017;74(4):301–10.PubMedCrossRef
5.
go back to reference Greenhaus JH, Parasuraman S. Vocational and organizational behavior, 1985: a review ☆. J Vocat Behav. 1986;29(2):115–76.CrossRef Greenhaus JH, Parasuraman S. Vocational and organizational behavior, 1985: a review ☆. J Vocat Behav. 1986;29(2):115–76.CrossRef
6.
go back to reference Allen TD, Martin A. The work-family interface: a retrospective look at 20 years of research in JOHP. J Occup Health Psychol. 2017;22(3):259–72.PubMedCrossRef Allen TD, Martin A. The work-family interface: a retrospective look at 20 years of research in JOHP. J Occup Health Psychol. 2017;22(3):259–72.PubMedCrossRef
7.
go back to reference Mikol F, Franc C. Gender differences in the incomes of self-employed French physicians: the role of family structure. Health Policy. 2019;123(7):666–74.PubMedCrossRef Mikol F, Franc C. Gender differences in the incomes of self-employed French physicians: the role of family structure. Health Policy. 2019;123(7):666–74.PubMedCrossRef
8.
go back to reference Sugawara N, Danjo K, Furukori H, Sato Y, Tomita T, Fujii A, Nakagami T, Kitaoka K, Yasuifurukori N. Work–family conflict as a mediator between occupational stress and psychological health among mental health nurses in Japan. Neuropsychiatric Dis Treat. 2017;13:779–84.CrossRef Sugawara N, Danjo K, Furukori H, Sato Y, Tomita T, Fujii A, Nakagami T, Kitaoka K, Yasuifurukori N. Work–family conflict as a mediator between occupational stress and psychological health among mental health nurses in Japan. Neuropsychiatric Dis Treat. 2017;13:779–84.CrossRef
9.
go back to reference Cigarán-Méndez M, Jiménez-Antona C, Parás-Bravo P, Fuensalida-Novo S, Rodríguez-Jiménez J, Fernández-de-las-Peñas C. Active trigger points are associated with anxiety and widespread pressure pain sensitivity in women, but not men, With Tension Type Headache. Pain Pract. 2019;19(5):522–9.PubMedCrossRef Cigarán-Méndez M, Jiménez-Antona C, Parás-Bravo P, Fuensalida-Novo S, Rodríguez-Jiménez J, Fernández-de-las-Peñas C. Active trigger points are associated with anxiety and widespread pressure pain sensitivity in women, but not men, With Tension Type Headache. Pain Pract. 2019;19(5):522–9.PubMedCrossRef
10.
go back to reference Carvalho VS, Chambel MJ. Perceived high-performance work systems and subjective well-being: work-to-family balance and well-being at work as mediators. J Career Dev. 2016;43(2):0894845315583113.CrossRef Carvalho VS, Chambel MJ. Perceived high-performance work systems and subjective well-being: work-to-family balance and well-being at work as mediators. J Career Dev. 2016;43(2):0894845315583113.CrossRef
11.
go back to reference Zhou S, Da S, Guo H, Zhang X. Work-family conflict and mental health among female employees: a sequential mediation model via negative affect and perceived stress. J Front Psychol. 2018;9:544.CrossRef Zhou S, Da S, Guo H, Zhang X. Work-family conflict and mental health among female employees: a sequential mediation model via negative affect and perceived stress. J Front Psychol. 2018;9:544.CrossRef
12.
go back to reference Guille C, Frank E, Zhao Z, Kalmbach DA, Nietert PJ, Mata DA, Sen S. Work-family conflict and the sex difference in depression among training physicians. JAMA Intern Med. 2017;177(12):1766–72.PubMedPubMedCentralCrossRef Guille C, Frank E, Zhao Z, Kalmbach DA, Nietert PJ, Mata DA, Sen S. Work-family conflict and the sex difference in depression among training physicians. JAMA Intern Med. 2017;177(12):1766–72.PubMedPubMedCentralCrossRef
13.
go back to reference Maslach C, Leiter MP. Understanding the burnout experience: recent research and its implications for psychiatry. World Psychiatry. 2016;15(2):103–11.PubMedPubMedCentralCrossRef Maslach C, Leiter MP. Understanding the burnout experience: recent research and its implications for psychiatry. World Psychiatry. 2016;15(2):103–11.PubMedPubMedCentralCrossRef
14.
15.
go back to reference Bogaert PV, Peremans L, Heusden DV, Verspuy M, Kureckova V, Cruys ZVD, Franck E. Predictors of burnout, work engagement and nurse reported job outcomes and quality of care: a mixed method study. BMC Nurs. 2017;16(1):5.PubMedPubMedCentralCrossRef Bogaert PV, Peremans L, Heusden DV, Verspuy M, Kureckova V, Cruys ZVD, Franck E. Predictors of burnout, work engagement and nurse reported job outcomes and quality of care: a mixed method study. BMC Nurs. 2017;16(1):5.PubMedPubMedCentralCrossRef
16.
go back to reference Aiken LH, Sermeus W, Van den Heede K, Sloane DM, Busse R, McKee M, Bruyneel L, Rafferty AM, Griffiths P, Moreno-Casbas MT. Patient safety, satisfaction, and quality of hospital care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United States. BMJ Open. 2012;344:e1717. Aiken LH, Sermeus W, Van den Heede K, Sloane DM, Busse R, McKee M, Bruyneel L, Rafferty AM, Griffiths P, Moreno-Casbas MT. Patient safety, satisfaction, and quality of hospital care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United States. BMJ Open. 2012;344:e1717.
17.
go back to reference Yustina AI, Valerina T. Does work-family conflict affect the auditor's performance?: examining the mediating roles of emotional exhaustion and job satisfaction. Gadjah Mada Int J Bus. 2018;20(1):89.CrossRef Yustina AI, Valerina T. Does work-family conflict affect the auditor's performance?: examining the mediating roles of emotional exhaustion and job satisfaction. Gadjah Mada Int J Bus. 2018;20(1):89.CrossRef
18.
go back to reference Bakker AB, Demerouti E, Sanzvergel AI. Burnout and work engagement: the JD–R approach. Ann Review Organizational Psychol Organizational Behavior. 2014;1(1):389–411.CrossRef Bakker AB, Demerouti E, Sanzvergel AI. Burnout and work engagement: the JD–R approach. Ann Review Organizational Psychol Organizational Behavior. 2014;1(1):389–411.CrossRef
19.
go back to reference Dreher A, Theune M, Kersting C, Geiser F. Prevalence of burnout among German general practitioners: comparison of physicians working in solo and group practices. PLoS One. 2019;14(2):e0211223.PubMedPubMedCentralCrossRef Dreher A, Theune M, Kersting C, Geiser F. Prevalence of burnout among German general practitioners: comparison of physicians working in solo and group practices. PLoS One. 2019;14(2):e0211223.PubMedPubMedCentralCrossRef
20.
go back to reference Latkin CA, Knowlton AR. Social network assessments and interventions for health behavior change: a critical review. J Behavioral Med. 2015;41(3):90–7.CrossRef Latkin CA, Knowlton AR. Social network assessments and interventions for health behavior change: a critical review. J Behavioral Med. 2015;41(3):90–7.CrossRef
21.
go back to reference Cohen S, Wills T. Stress, social support, and the buffering hypothesis. Psychol Bull. 1985;98(2):310.PubMedCrossRef Cohen S, Wills T. Stress, social support, and the buffering hypothesis. Psychol Bull. 1985;98(2):310.PubMedCrossRef
22.
go back to reference Kornblith AB, Herndon JE 2nd, Zuckerman E, Viscoli CM, Horwitz RI, Cooper MR, Harris L, Tkaczuk KH, Perry MC, Budman D, et al. Social support as a buffer to the psychological impact of stressful life events in women with breast cancer. Cancer. 2001;91(2):443–54.PubMedCrossRef Kornblith AB, Herndon JE 2nd, Zuckerman E, Viscoli CM, Horwitz RI, Cooper MR, Harris L, Tkaczuk KH, Perry MC, Budman D, et al. Social support as a buffer to the psychological impact of stressful life events in women with breast cancer. Cancer. 2001;91(2):443–54.PubMedCrossRef
23.
go back to reference Lau Y, Wong DFK, Wang Y, Kwong DHK, Wang Y. The roles of social support in helping Chinese women with antenatal depressive and anxiety symptoms cope with perceived stress. Arch Psychiatr Nurs. 2014;28(5):305–13.PubMedCrossRef Lau Y, Wong DFK, Wang Y, Kwong DHK, Wang Y. The roles of social support in helping Chinese women with antenatal depressive and anxiety symptoms cope with perceived stress. Arch Psychiatr Nurs. 2014;28(5):305–13.PubMedCrossRef
24.
go back to reference Lin HS, Probst JC, Hsu YC. Depression among female psychiatric nurses in southern Taiwan: main and moderating effects of job stress, coping behaviour and social support. J Clin Nurs. 2010;19(15–16):2342–54.PubMedCrossRef Lin HS, Probst JC, Hsu YC. Depression among female psychiatric nurses in southern Taiwan: main and moderating effects of job stress, coping behaviour and social support. J Clin Nurs. 2010;19(15–16):2342–54.PubMedCrossRef
25.
go back to reference Maheri A, Sadeghi R, Shojaeizadeh D, Tol A, Yaseri M, Rohban A. Depression, anxiety, and perceived social support among adults with Beta-thalassemia major: cross-sectional study. Korean J Fam Med. 2018;39(2):101–7.PubMedPubMedCentralCrossRef Maheri A, Sadeghi R, Shojaeizadeh D, Tol A, Yaseri M, Rohban A. Depression, anxiety, and perceived social support among adults with Beta-thalassemia major: cross-sectional study. Korean J Fam Med. 2018;39(2):101–7.PubMedPubMedCentralCrossRef
26.
go back to reference Yu-Qin G, Bo-Chen P, Wei S, Hui W, Jia-Na W, Lie W. Anxiety symptoms among Chinese nurses and the associated factors: a cross sectional study. BMC Psychiatry. 2012;12(1):141.CrossRef Yu-Qin G, Bo-Chen P, Wei S, Hui W, Jia-Na W, Lie W. Anxiety symptoms among Chinese nurses and the associated factors: a cross sectional study. BMC Psychiatry. 2012;12(1):141.CrossRef
27.
go back to reference Zhang H, Ye ZH, Tang L, et al. Anxiety symptoms and burnout among Chinese medical staff of intensive care unit: the moderating effect of social support[J]. BMC psychiatry, 2020;20:1-7. Zhang H, Ye ZH, Tang L, et al. Anxiety symptoms and burnout among Chinese medical staff of intensive care unit: the moderating effect of social support[J]. BMC psychiatry, 2020;20:1-7.
28.
go back to reference Huang HY, Wu KS, Wang ML, Tang PS. Moderating the effect of supervisor support on work-to-family conflict and burnout relationship. Stud Ethno-Med. 2015;9(2):263–78.CrossRef Huang HY, Wu KS, Wang ML, Tang PS. Moderating the effect of supervisor support on work-to-family conflict and burnout relationship. Stud Ethno-Med. 2015;9(2):263–78.CrossRef
29.
go back to reference Gattino S, De Piccoli N, Grosso MS, Miozzo S: Awareness of gender medicine among family doctors. A field investigation. J Prevention Intervention Community 2019:1–14. Gattino S, De Piccoli N, Grosso MS, Miozzo S: Awareness of gender medicine among family doctors. A field investigation. J Prevention Intervention Community 2019:1–14.
30.
go back to reference Bakker AB, Demerouti E. The job demands-resources model: state of the art. J Manag Psychol. 2007;22:309–28.CrossRef Bakker AB, Demerouti E. The job demands-resources model: state of the art. J Manag Psychol. 2007;22:309–28.CrossRef
31.
go back to reference Demerouti E, Bakker AB, Nachreiner F, Schaufeli WB. The job demands-resources model of burnout. J Appl Psychol. 2001;86(3):499.PubMedCrossRef Demerouti E, Bakker AB, Nachreiner F, Schaufeli WB. The job demands-resources model of burnout. J Appl Psychol. 2001;86(3):499.PubMedCrossRef
32.
go back to reference Schaufeli W. The job demands-resources model: a ‘how to’guide to increase work engagement and prevent burnout. Organ Dyn. 2017;46:120–32.CrossRef Schaufeli W. The job demands-resources model: a ‘how to’guide to increase work engagement and prevent burnout. Organ Dyn. 2017;46:120–32.CrossRef
33.
go back to reference Bakker AB, Van Emmerik H. P. VR: how job demands, resources, and burnout predict objective performance: a constructive replication. Anxiety Stress Coping. 2008;21(3):309–24.PubMedCrossRef Bakker AB, Van Emmerik H. P. VR: how job demands, resources, and burnout predict objective performance: a constructive replication. Anxiety Stress Coping. 2008;21(3):309–24.PubMedCrossRef
34.
go back to reference Santa Maria A, Wörfel F, Wolter C, Gusy B, Rotter M, Stark S, Kleiber D, Renneberg B. The role of job demands and job resources in the development of emotional exhaustion, depression, and anxiety among police officers. Police Q. 2018;21(1):109–34.CrossRef Santa Maria A, Wörfel F, Wolter C, Gusy B, Rotter M, Stark S, Kleiber D, Renneberg B. The role of job demands and job resources in the development of emotional exhaustion, depression, and anxiety among police officers. Police Q. 2018;21(1):109–34.CrossRef
35.
go back to reference Bakker AB, Demerouti E. Job demands–resources theory: taking stock and looking forward. J Occup Health Psychol. 2017;22(3):273.PubMedCrossRef Bakker AB, Demerouti E. Job demands–resources theory: taking stock and looking forward. J Occup Health Psychol. 2017;22(3):273.PubMedCrossRef
36.
37.
go back to reference Wang Z, Chi Y. Chinese version of Zung's self-rating anxiety scale. Shanghai Psychiatry. 1984;2:73–4. Wang Z, Chi Y. Chinese version of Zung's self-rating anxiety scale. Shanghai Psychiatry. 1984;2:73–4.
38.
go back to reference Gong Y, Han T, Chen W, Dib HH, Yang G, Zhuang R, Chen Y, Tong X, Yin X, Lu Z. Prevalence of anxiety and depressive symptoms and related risk factors among physicians in China: a cross-sectional study. PLoS One. 2014;9(7):e103242.PubMedPubMedCentralCrossRef Gong Y, Han T, Chen W, Dib HH, Yang G, Zhuang R, Chen Y, Tong X, Yin X, Lu Z. Prevalence of anxiety and depressive symptoms and related risk factors among physicians in China: a cross-sectional study. PLoS One. 2014;9(7):e103242.PubMedPubMedCentralCrossRef
39.
go back to reference Xiao S. The theoretical basis and application of social support questionnaire. J Clin Psychol Med. 1994;4:98–100. Xiao S. The theoretical basis and application of social support questionnaire. J Clin Psychol Med. 1994;4:98–100.
40.
go back to reference Netemeyer RG, Boles JS, Mcmurrian R. Development and validation of work-family conflict and family-work conflict scales. J Appl Psychol. 1996;81(4):400–10.CrossRef Netemeyer RG, Boles JS, Mcmurrian R. Development and validation of work-family conflict and family-work conflict scales. J Appl Psychol. 1996;81(4):400–10.CrossRef
41.
go back to reference Li Y, Zhao N. Structure and measurement of work-family support and its moderation effect. Acta Psychol Sin. 2009;41:863–74. Li Y, Zhao N. Structure and measurement of work-family support and its moderation effect. Acta Psychol Sin. 2009;41:863–74.
42.
go back to reference Li Y, Li Y. Developing the diagnostic ctiterion of job burnout. Psychol Sci-Shanghai. 2006;29(1):148. Li Y, Li Y. Developing the diagnostic ctiterion of job burnout. Psychol Sci-Shanghai. 2006;29(1):148.
43.
go back to reference Hayes AF. Introduction to mediation, moderation, and conditional process analysis. J Educ Meas. 2013;51(3):335–7. Hayes AF. Introduction to mediation, moderation, and conditional process analysis. J Educ Meas. 2013;51(3):335–7.
44.
go back to reference Fritz MS, Taylor AB, Mackinnon DP. Explanation of two anomalous results in statistical mediation analysis. Multivar Behav Res. 2012;47(1):61–87.CrossRef Fritz MS, Taylor AB, Mackinnon DP. Explanation of two anomalous results in statistical mediation analysis. Multivar Behav Res. 2012;47(1):61–87.CrossRef
45.
go back to reference Hayes AF. An index and test of linear moderated mediation. Multivar Behav Res. 2015;50(1):1–22.CrossRef Hayes AF. An index and test of linear moderated mediation. Multivar Behav Res. 2015;50(1):1–22.CrossRef
46.
go back to reference Hayes AF, Rockwood NJ. Regression-based statistical mediation and moderation analysis in clinical research: observations, recommendations, and implementation. Behav Res Ther. 2017;98:39-57.CrossRef Hayes AF, Rockwood NJ. Regression-based statistical mediation and moderation analysis in clinical research: observations, recommendations, and implementation. Behav Res Ther. 2017;98:39-57.CrossRef
47.
go back to reference Ten Brummelhuis LL, Bakker AB. A resource perspective on the work–home interface: the work–home resources model. Am Psychol. 2012;67(7):545.PubMedCrossRef Ten Brummelhuis LL, Bakker AB. A resource perspective on the work–home interface: the work–home resources model. Am Psychol. 2012;67(7):545.PubMedCrossRef
48.
go back to reference Zurlo MC, Vallone F, Smith AP: Work–family conflict and psychophysical health conditions of nurses: Gender differences and moderating variables. Jpn J Nurs Sci 2020:e12324. Zurlo MC, Vallone F, Smith AP: Work–family conflict and psychophysical health conditions of nurses: Gender differences and moderating variables. Jpn J Nurs Sci 2020:e12324.
49.
go back to reference Pas B, Peters P, Doorewaard H, Eisinga R, Lagro-Janssen T. Feminisation of the medical profession: a strategic HRM dilemma? The effects of family-friendly HR practices on female doctors' contracted working hours. Hum Resour Manag J. 2011;21(3):285–302.CrossRef Pas B, Peters P, Doorewaard H, Eisinga R, Lagro-Janssen T. Feminisation of the medical profession: a strategic HRM dilemma? The effects of family-friendly HR practices on female doctors' contracted working hours. Hum Resour Manag J. 2011;21(3):285–302.CrossRef
50.
go back to reference Chen J, Li J, Cao B, Wang F, Luo L, Xu J. Mediating effects of self-efficacy, coping, burnout, and social support between job stress and mental health among young Chinese nurses. J Adv Nurs. 2020;76(1):163–73.PubMedCrossRef Chen J, Li J, Cao B, Wang F, Luo L, Xu J. Mediating effects of self-efficacy, coping, burnout, and social support between job stress and mental health among young Chinese nurses. J Adv Nurs. 2020;76(1):163–73.PubMedCrossRef
51.
go back to reference Shu Y, Huang L. The study of the gender discrimination from the perspective of multimodal critical discourse analysis a case study of the image construction of a TV commercial Advertisemen. Int J Soc Sci Universities. 2019;2(2):126–34. Shu Y, Huang L. The study of the gender discrimination from the perspective of multimodal critical discourse analysis a case study of the image construction of a TV commercial Advertisemen. Int J Soc Sci Universities. 2019;2(2):126–34.
52.
go back to reference Du F. Dong X-y, Zhang Y: grandparent-provided childcare and labor force participation of mothers with preschool children in urban China. China Population Development Stud. 2019;2(4):347–68.CrossRef Du F. Dong X-y, Zhang Y: grandparent-provided childcare and labor force participation of mothers with preschool children in urban China. China Population Development Stud. 2019;2(4):347–68.CrossRef
53.
go back to reference Kaderli R, Muff B, Stefenelli U, Businger A. Female surgeons' mentoring experiences and success in an academic career in Switzerland. Swiss Med Wkly. 2011;141:w13233.PubMed Kaderli R, Muff B, Stefenelli U, Businger A. Female surgeons' mentoring experiences and success in an academic career in Switzerland. Swiss Med Wkly. 2011;141:w13233.PubMed
54.
go back to reference Minamizono S, Nomura K, Inoue Y, Hiraike H. Gender division of labor, burnout, and intention to leave work among young female nurses in Japan: a cross-sectional study. Int J Environ Res Public Health. 2019;16(22):2201.PubMedCentralCrossRef Minamizono S, Nomura K, Inoue Y, Hiraike H. Gender division of labor, burnout, and intention to leave work among young female nurses in Japan: a cross-sectional study. Int J Environ Res Public Health. 2019;16(22):2201.PubMedCentralCrossRef
55.
go back to reference Li A, Mccauley KD, Shaffer JA. The influence of leadership behavior on employee work-family outcomes: a review and research agenda. Hum Resour Manag Rev. 2017;27(3):S1053482217300190.CrossRef Li A, Mccauley KD, Shaffer JA. The influence of leadership behavior on employee work-family outcomes: a review and research agenda. Hum Resour Manag Rev. 2017;27(3):S1053482217300190.CrossRef
56.
go back to reference Bernerth JB, Aguinis H. A critical review and best-practice recommendations for control variable usage. Pers Psychol. 2016;69(1):229–83.CrossRef Bernerth JB, Aguinis H. A critical review and best-practice recommendations for control variable usage. Pers Psychol. 2016;69(1):229–83.CrossRef
Metadata
Title
The role of social support and emotional exhaustion in the association between work-family conflict and anxiety symptoms among female medical staff: a moderated mediation model
Authors
Hui Zhang
Leiwen Tang
ZhiHong Ye
Ping Zou
Jing Shao
Man Wu
Qi Zhang
Guojin Qiao
Shaoyu Mu
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2020
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-020-02673-2

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