{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T05:42:43Z","timestamp":1780551763894,"version":"3.54.1"},"reference-count":61,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2024,6,27]],"date-time":"2024-06-27T00:00:00Z","timestamp":1719446400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diseases"],"abstract":"<jats:p>Unhealthy behaviors (UBs) can affect mental health. The most impactful of these are alcohol abuse, sedentary behavior, and sleep disturbances. Since these UBs are not well explored in medical residents, this study aims to overcome this gap, focusing on outcomes such as depression and anxiety. The Public Health Residents\u2019 Anonymous Survey in Italy (PHRASI) is a nationwide cross-sectional study based on an 88-item questionnaire. UBs were explored through validated questionnaires: the Alcohol Use Disorders Identification Test-c (AUDIT-C), the International Physical Activity Questionnaire (IPAQ), and the Insomnia Severity Index (ISI). Depressive symptoms and anxiety were detected by Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), respectively. Hierarchical cluster analysis described clusters using responses from the AUDIT-C, IPAQ, and ISI. A total of 375 participants were included in this study. Three distinct clusters (CL) were identified: CL1 was characterized by a moderate risk for alcohol abuse and high insomnia dissatisfaction, with a significantly higher frequency of depressive symptoms (46%, p &lt; 0.001) and anxiety (53%, p &lt; 0.001); CL2 had no risk for alcohol abuse, high sleep satisfaction, and better mental health profile, with the lowest prevalence of depressive symptoms (15%, p &lt; 0.001); CL3 had the highest risk of alcohol abuse, the highest rate of physical activity (40%, p = 0.013), and the lowest prevalence of anxiety (27%, p &lt; 0.001). Subjects belonging to CL1 required much more attention to prevent the worsening of mental outcomes. Interventions for promoting mental health should be addressed in all Public Health schools to create more sustainable working conditions.<\/jats:p>","DOI":"10.3390\/diseases12070134","type":"journal-article","created":{"date-parts":[[2024,6,27]],"date-time":"2024-06-27T04:19:26Z","timestamp":1719461966000},"page":"134","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Impacts of Unhealthy Behaviors on Mental Health among Public Health Residents: The PHRASI Study"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3848-981X","authenticated-orcid":false,"given":"Vincenza","family":"Gianfredi","sequence":"first","affiliation":[{"name":"Department of Biomedical Sciences for Health, University of Milan, via Pascal, 36, 20133 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7405-4904","authenticated-orcid":false,"given":"Lorenzo","family":"Stacchini","sequence":"additional","affiliation":[{"name":"Department of Health Science, University of Florence, 50121 Firenze, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4881-2185","authenticated-orcid":false,"given":"Giuseppa","family":"Minutolo","sequence":"additional","affiliation":[{"name":"Food Hygiene, Nutritional Surveillance and Prevention, Department of Prevention, Provincial Healthcare Authority of Palermo, 90129 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2599-4430","authenticated-orcid":false,"given":"Valentina","family":"De Nicol\u00f2","sequence":"additional","affiliation":[{"name":"Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nausicaa","family":"Berselli","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Campi, 287, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7416-218X","authenticated-orcid":false,"given":"Angela","family":"Ancona","sequence":"additional","affiliation":[{"name":"School of Public Health, Vita-Salute San Raffaele University, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6080-0219","authenticated-orcid":false,"given":"Alessandro","family":"Catalini","sequence":"additional","affiliation":[{"name":"UOC Igiene degli Alimenti e Nutrizione, Dipartimento di Prevenzione, AST Macerata, 62100 Macerata, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7310-2460","authenticated-orcid":false,"given":"Fabrizio","family":"Cedrone","sequence":"additional","affiliation":[{"name":"Hospital Management, Local Health Authority of Pescara, 65100 Pescara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1093\/eurpub\/11.3.294","article-title":"Patterns of Unhealthy Behaviour in Finland","volume":"11","author":"Laaksonen","year":"2001","journal-title":"Eur. 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