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Paget S, Ostojic K, Goldsmith S, Nassar N, McIntyre S. Determinants of hospital-based health service utilisation in cerebral palsy: a systematic review. Arch Phys Med Rehabil 2021; 103:1628-1637. [PMID: 34968439 DOI: 10.1016/j.apmr.2021.12.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 10/25/2021] [Accepted: 12/01/2021] [Indexed: 11/02/2022]
Abstract
OBJECTIVE To systematically review and synthesize evidence of determinants associated with hospital-based health service utilisation among individuals with cerebral palsy (CP). DATA SOURCES Electronic databases MEDLINE, Embase, APA Psycinfo were searched from January 2000 to April 2020. STUDY SELECTION Observational studies were included that described people with CP, reported quantitative measures of hospital-based health service utilisation (inpatient, outpatient, emergency department), and based in high-income countries. We excluded studies that included only subsets of people with CP, or those that only reported therapy service utilisation. DATA EXTRACTION After initial screen, two reviewers reviewed full texts for inclusion and performed data extraction and risk of bias assessment using the Newcastle Ottawa scale. Determinants of health service utilisation were identified and categorised using the Andersen Behavioural Model. DATA SYNTHESIS Seventeen studies met inclusion criteria. Study quality was high. Twenty-six determinants were reported across eight Andersen Model characteristics. Individual predisposing factors such as sex showed no difference in health service utilisation; inpatient admissions decreased with increasing age during childhood and was lower in adults. Increased health service utilisation was associated with "individual need" including severe gross motor disability, epilepsy, developmental/ intellectual disability and gastrostomy-use across inpatient, outpatient and emergency department settings. There was little information reported on socio-demographic and health system contextual determinants. CONCLUSIONS CP health service utilisation was associated with age, severity and comorbidities. Improved understanding of determinants of health service utilisation can support health service access for people with CP.
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Affiliation(s)
- Simon Paget
- The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia; Kids Rehab, the Children's Hospital at Westmead, Westmead NSW Australia.
| | - Katarina Ostojic
- Cerebral Palsy Alliance, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, Australia
| | - Shona Goldsmith
- Cerebral Palsy Alliance, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, Australia
| | - Natasha Nassar
- Child Population and Translational Health, The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Sarah McIntyre
- Cerebral Palsy Alliance, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, Australia
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Tüzün H, Demirköse H, Özkan S, İlhan MN. Socioeconomic Factors Related to Prevalence, Severity, and Contact Coverage of Depression in Primary Health Care. PSYCHIAT CLIN PSYCH 2021; 31:457-467. [PMID: 38765649 PMCID: PMC11079699 DOI: 10.5152/pcp.2021.21051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 10/28/2021] [Indexed: 05/22/2024] Open
Abstract
Background We determine factors related to the prevalence, severity, and contact coverage of depression using the Patient Health Questionnaire-9. Methods This cross-sectional study included 1059 individuals who applied to primary health care in Ankara before the onset of pandemic restrictions. Contact coverage was evaluated to include mental health care users. Results The prevalence of depression was 22.9%. Individuals who were unemployed (OR: 3.832; 95% CI: 2.053-7.151), women (OR: 1.646; 95% CI: 1.158-2.340), those without social support (OR: 1.933; 95% CI: 1.219-3.065), those who did not receive formal education (OR: 2.631; 95 % CI: 1.312-5.275), lower-income group (OR: 1.528; 95% CI: 1.071-2.180), and unmarried or divorced (OR: 2.644; 95% CI: 1.324-5.281) were found to be at risk of developing depression. Based on the linear regression model including patients diagnosed with depression, individuals who were unemployed (standardized β: 0.190), women (standardized β: 0.075), those without social support (standardized β: 0.096), and those who were unmarried or single (standardized β: 0.147) had the highest scale scores. Contact coverage for depression was 31.0%. Contact coverage was more likely in the upper-income group (OR: 2.239, 95% CI: 1.173-4.273). Conclusion Although depression is common among primary health care applicants, contact coverage is low. Developing screening programs for depression in primary health care may help improve community mental health. Socioeconomic factors that contribute to the emergence, severity, and contact coverage of depression indicate health inequalities. The development and severity of depression are mostly due to unemployment, which suggests the importance of employment-enhancing policies.
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Affiliation(s)
- Hakan Tüzün
- Department of Public Health, Gazi University Medical Faculty, Ankara, Turkey
| | - Hacer Demirköse
- Department of Public Health, Gazi University Medical Faculty, Ankara, Turkey
| | - Seçil Özkan
- Department of Public Health, Gazi University Medical Faculty, Ankara, Turkey
| | - Mustafa Necmi İlhan
- Department of Public Health, Gazi University Medical Faculty, Ankara, Turkey
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103
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Estimating the global treatment rates for depression: A systematic review and meta-analysis. J Affect Disord 2021; 295:1234-1242. [PMID: 34665135 DOI: 10.1016/j.jad.2021.09.038] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 09/02/2021] [Accepted: 09/12/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Depression is considered a global crisis due to its high prevalence and associated disabilities. The burden posed by depression could be reduced by increasing access to timely treatment. Limited information is available on treatment rates of depression, particularly in low- and middle-income countries. This study aimed to estimate the treatment rates for depression in the general adult population by World Bank income classification. METHODS We searched PubMed, EMBASE, PsycINFO, and CINAHL, supplemented with hand-search of reference lists to identify community-based studies. The overall treatment rate for depression was estimated from studies that reported any treatment (behavioral or pharmacological treatments) in healthcare or informal non-healthcare settings. Data were pooled using a random-effects meta-analysis model. Subgroup analyses by income classification were completed. Meta-regression was conducted by study characteristics. The protocol was pre-registered at PROSPERO (CRD42020161683). RESULTS We included 65 studies comprising 1.1 million participants from 79 countries and territories. The global 12-month/lifetime pooled treatment rate was 34.8% (95% confidence interval: 29.9, 39.9%). The treatment rates were 48.3% (43.0, 53.6%) in high-income countries, 21.4% (15.1, 27.7%) in middle-income countries, and 16.8% (11.3, 23.0%) in low-income countries. Among the treated samples, 12-month minimally adequate treatment was estimated to be 40%. LIMITATION We reported a substantial level of between-study heterogeneity, which was partially explained by study characteristics in the meta-regression. CONCLUSION Globally, approximately one-third of people with depression receive treatment. Three in five treated people with depression did not receive minimally adequate treatment. Depression treatment rates are considerably lower in low-and middle-income countries.
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104
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Roxo L, Silva M, Perelman J. Gender gap in health service utilisation and outcomes of depression: A cross-country longitudinal analysis of European middle-aged and older adults. Prev Med 2021; 153:106847. [PMID: 34662596 DOI: 10.1016/j.ypmed.2021.106847] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 10/04/2021] [Accepted: 10/10/2021] [Indexed: 11/29/2022]
Abstract
Research has shown that health service utilisation for depression (HSUD) is less common among men than women. However, most evidence is cross-sectional, and there is limited information about gendered outcomes of depression. This cross-country study assesses gender differences in HSUD and in the persistence of depression by using cross-sectional and longitudinal data. We used data from the Survey of Health, Ageing and Retirement in Europe (SHARE), from 5428 participants between 50 and 80 from nine European countries, fulfilling criteria for depression in Wave 5 (assessed by the EURO-D depression scale). We modelled non-HSUD among all those depressed in Wave 5 ("cross-sectional data") and those not depressed in Wave 4 ("longitudinal data"), and the persistence of depression in Wave 6, as a function of gender. We used logistic regressions adjusted for age, marital status, country, education, financial strain, and severity of depression. Non-HSUD was more likely among depressed men than women in both cross-sectional (82.4% vs 73.2%, OR = 1.54, 99%CI = 1.54-1.55) and longitudinal analyses (94.4% vs 88.3%, OR = 2.27, 99%CI = 2.25-2.29). Gender differences were greater among low-educated participants and those with less pronounced financial strain. Among those with HSUD, men were more likely to remain depressed (62.3%, OR = 2.26, 99%CI = 2.22-2.30). Among those without HSUD, depression was more likely to persist among women (45.4%, OR = 0.79, 99%CI = 0.78-0.79). Results suggest that cross-sectional analyses underestimate men's disadvantage in HSUD. Interventions are needed to improve the demand for care and treatment adequacy among men, increasing their perception of need and their mental health literacy.
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Affiliation(s)
- Luis Roxo
- NOVA National School of Public Health, Universidade NOVA de Lisboa Avenida Padre Cruz, 1600-560 Lisboa, Portugal.
| | - Manuela Silva
- Comprehensive Health Research Centre (CHRC), Universidade NOVA de Lisboa Rua do Instituto Bacteriológico, n° 5, 1150-190 Lisboa, Portugal; Lisbon Institute of Global Mental Health Rua do Instituto Bacteriológico, n° 5, 1150-190 Lisboa, Portugal.
| | - Julian Perelman
- NOVA National School of Public Health, Universidade NOVA de Lisboa Avenida Padre Cruz, 1600-560 Lisboa, Portugal; Public Health Research Centre, NOVA National School of Public Health, Universidade NOVA de Lisboa Avenida Padre Cruz, 1600-560 Lisboa, Portugal.
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105
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Marzo RR, Aye SS, Naing TW, Mon Kyaw T, Win MT, Kyaw Soe HH, Soe M, Kyaw YW, Soe MM, Linn N. Factors associated with psychological distress among Myanmar residents during COVID-19 pandemic crises. J Public Health Res 2021; 10:jphr.2021.2279. [PMID: 34751532 PMCID: PMC9437481 DOI: 10.4081/jphr.2021.2279] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 09/26/2021] [Accepted: 10/21/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND COVID-19 pandemic reached a public health emergency status of international concern. The impacts and events associated with this were associated with adverse psychological impacts among the general public globally. This study aimed to determine the prevalence of psychological distress and to identify predictors associated with psychological distress due to the COVID-19 pandemic among the population in Myanmar. DESIGN AND METHODS A cross-sectional survey was conducted from March to April 2020 among adults, 18 years old and above, who reside in Myanmar through a structured questionnaire distributed in social media platforms. Univariate and Bivariate analyses were used to estimate the prevalence of COVID-19 Peritraumatic Distress Index (CPDI) symptoms and to test the associations between CPDI and the exposure variables. Logistic Regression Analysis was done to identify significant predictors of distress. RESULTS There were 530 participants in this study.37.4% of them did not have psychological distress,55.6% experienced mild to moderate psychological distress, and 7% experienced severe psychological distress due to COVID-19 pandemic. Simple and Multiple Logistic Regression Analyses were performed to determine the factors associated with psychological distress due to COVID-19. CONCLUSIONS It was shown that the self-employed group and age group older than 45 years old had more psychological distress than others. However, Buddhists and people from the capital city had less distress than other religions and districts. This study recommends the government to develop better strategies for self-employed groups, elders, and the poor for a support, relief, and resettlement of their ruined status.
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Affiliation(s)
- Roy Rillera Marzo
- Department of Community Medicine, International Medical School, Management and Science University, Kuala Lumpur.
| | - Soe Soe Aye
- Department of Pediatrics, Faculty of Medicine, Asia Metropolitan University, JalanLembah, Bandar Seri Alam, Masai, Johor.
| | - Thein Win Naing
- Department of Public Health, Faculty of Medicine, Asia Metropolitan University, JalanLembah, Bandar Seri Alam, Masai, Johor.
| | - Thin Mon Kyaw
- Department of Community Medicine, Faculty of Medicine, Asia Metropolitan University, JalanLembah, Bandar Seri Alam, Masai, Johor.
| | - Myat Thida Win
- Department of Internal Medicine, Faculty of Medicine, Asia Metropolitan University, JalanLembah, Bandar Seri Alam, Masai, Johor.
| | - Htoo Htoo Kyaw Soe
- Department of Community Medicine, Faculty of Medicine, Manipal University College Malaysia, Melaka.
| | - Minn Soe
- Department of Psychiatry, Faculty of Medicine, Nursing and Biomedical Sciences, Malaysian Allied Health Sciences Academy University (MAHSA),Bandar SaujanaPurta, Selangor.
| | - Ye Wint Kyaw
- Department of Pathology, Faculty of Medicine, Asia Metropolitan University, JalanLembah, Bandar Seri Alam, Masai, Johor.
| | - Maung Maung Soe
- Department of Surgery, Faculty of Medicine, Asia Metropolitan University, JalanLembah, Bandar Seri Alam, Masai, Johor.
| | - Nay Linn
- Department of Surgery, Faculty of Medicine, Asia Metropolitan University, JalanLembah, Bandar Seri Alam, Masai, Johor.
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Shah T, Shah Z, Yasmeen N, Ma ZR. Psychological impact of the COVID-19 pandemic on Chinese population: An online survey. World J Clin Cases 2021; 9:9500-9508. [PMID: 34877284 PMCID: PMC8610859 DOI: 10.12998/wjcc.v9.i31.9500] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 07/28/2021] [Accepted: 09/19/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The ongoing coronavirus disease 2019 (COVID-19) pandemic infiltrates every aspect of our life, including the psychological impact. China has experienced the first wave of this epidemic, and it is now affecting the global population.
AIM This study aimed to investigate the prevalence and associated factors of post-traumatic stress disorder (PTSD) among the general Chinese population.
METHODS A detailed questionnaire, comprising of 38 questions designed in both English and Chinese, was developed. The survey was conducted via WeChat, a multi-purpose messaging, social media, and mobile payment app, which is widely used by the Chinese population.
RESULTS In total, 1082 individuals from 31 provinces, autonomous regions, and municipalities participated in the survey by filling the questionnaires through the WeChat app. 97.8% of the participants had an Impact of Event-Scale-Revised (IES-R) total score above 20, which is an indicator of PTSD. The IES-R total and all the three subscales, including intrusion, avoidance, and hyperarousal, are significantly correlated with age. In addition, age, profession, marital status, and level of education are significantly correlated with the degree of PTSD symptoms.
CONCLUSION The COVID-19 epidemic has widely caused PTSD among the general Chinese population. These results bear important implications for regions struggling with the pandemic to implement effective interventions to cope with these mental health problems.
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Affiliation(s)
- Taif Shah
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming 650500, Yunnan Province, China
| | - Zahir Shah
- College of Veterinary Sciences, The University of Agriculture Peshawar, Peshawar 25120, KP, Pakistan
| | - Nafeesa Yasmeen
- College of Veterinary Medicine, South China Agricultural University, Guangzhou 510642, Guangdong Province, China
| | - Zhong-Ren Ma
- Biomedical Research Center, Northwest Minzu University Gansu China, Lanzhou 730030, Gansu Province, China
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107
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Heinig I, Wittchen HU, Knappe S. Help-Seeking Behavior and Treatment Barriers in Anxiety Disorders: Results from a Representative German Community Survey. Community Ment Health J 2021; 57:1505-1517. [PMID: 33471256 PMCID: PMC8531057 DOI: 10.1007/s10597-020-00767-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 12/23/2020] [Indexed: 11/24/2022]
Abstract
Although effective therapies exist, treatment rates of anxiety disorders (AD) are low, raising the question why affected individuals do not receive treatment. We provide data from the nationally representative German Health Interview and Examination Survey-2011 (DEGS1) on the help-seeking behavior and perceived treatment barriers of 650 subjects with Diagnostic and Statistical Manual of Mental Disorders' (DSM-IV AD). Only 26% of all cases with AD in the community reported having had contact with mental health services because of their anxiety problems in their lifetime. 16% were currently receiving professional help, most frequently by psychotherapists (8%), psychiatrists (5%) and general practitioners (5%). 40% of all cases never even considered seeking help and 31% reported barriers to treatment, such as self-reliance (18%) or beliefs that treatments were ineffective (9%), unavailable (8%) or too stigmatizing (7%). Measures to increase treatment rates should thus target individual as well as public attitudes and health literacy to increase awareness of and access to evidence-based interventions.
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Affiliation(s)
- Ingmar Heinig
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany.
| | - Hans-Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany.,Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität München, Nußbaumstr. 7, 80336, Munich, Germany
| | - Susanne Knappe
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
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108
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Mekonen T, Chan GCK, Connor J, Hall W, Hides L, Leung J. Treatment rates for alcohol use disorders: a systematic review and meta-analysis. Addiction 2021; 116:2617-2634. [PMID: 33245581 DOI: 10.1111/add.15357] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 10/11/2020] [Accepted: 11/25/2020] [Indexed: 01/05/2023]
Abstract
AIMS To estimate the treatment rate for alcohol use disorders (AUDs) in the general adult population. Treatment rates were also considered in relation to economic differences. METHODS Systematic review and meta-analysis. We searched PubMed, EMBASE, PsycINFO and CINAHL databases to identify studies that reported treatment rates for alcohol use disorders in the general population. Independent reviewers screened the articles based on predefined inclusion criteria. Data were extracted using a standardized data extraction form. We conducted quality assessments of the included studies. The overall treatment rates were estimated from studies that reported any treatment for AUDs from healthcare or informal non-healthcare settings (any treatment). We estimated the separate treatment rates for each diagnostic category as reported in the primary studies: AUD as a single disorder, alcohol abuse and alcohol dependence. Data were pooled using a random-effect model. RESULTS Thirty-two articles were included to estimate the treatment rates (percentage treated among the total number of people with AUDs). The pooled estimate of people with AUDs who received any treatment were 14.3% (95% CI: 9.3-20.3%) for alcohol abuse, 16.5% (95% CI: 12-21.5%) for alcohol dependence and 17.3% (95% CI: 12.8-22.3%) for AUD. A subgroup analysis by World Bank economic classification of countries found that the treatment rate for AUD was 9.3% (95% CI: 4.0-15.7%) in low and lower-middle-income countries. CONCLUSION Globally, approximately one in six people with AUDs receives treatment. Treatment rates for AUDs are generally low, with even lower rates in low and lower-middle-income countries.
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Affiliation(s)
- Tesfa Mekonen
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia.,Psychiatry Department, Bahir Dar University, Bahir Dar, Ethiopia
| | - Gary C K Chan
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, QLD, Australia
| | - Jason Connor
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, QLD, Australia.,Discipline of Psychiatry, The University of Queensland, Brisbane, QLD, Australia
| | - Wayne Hall
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, QLD, Australia.,Queensland Alliance for Environmental Health Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Leanne Hides
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia.,National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, QLD, Australia
| | - Janni Leung
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia.,National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, QLD, Australia.,National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
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109
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Maconick L, Sheridan Rains L, Jones R, Lloyd-Evans B, Johnson S. Investigating geographical variation in the use of mental health services by area of England: a cross-sectional ecological study. BMC Health Serv Res 2021; 21:951. [PMID: 34507575 PMCID: PMC8434730 DOI: 10.1186/s12913-021-06976-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 08/25/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND There is evidence of geographical variation in the use of mental health services in the UK and in international settings. It is important to understand whether this variation reflects differences in the prevalence of mental disorders, or if there is evidence of variation related to other factors, such as population socioeconomic status and access to primary care services. METHODS This is a cross-sectional ecological study using Public Health England data. The unit of analysis was the population served by clinical commissioning groups (CCGs), National Health Service (NHS) catchment areas. The analysis explored associations between area characteristics and the number of people in contact with mental health services using regression modelling. Explanatory variables included age, gender, prevalence of severe mental illness (SMI), prevalence of common mental disorder (CMD), index of multiple deprivation (IMD), unemployment, proportion of the population who are Black and Minority Ethnic (BAME), population density, access to and recovery in primary care psychological therapies. Unadjusted results are reported, as well as estimates adjusted for age, prevalence of CMD and prevalence of SMI. RESULTS The populations of 194 CCGs were included, clustered within 62 trusts (NHS providers of mental health services). The number of people in contact with mental health services showed wide variation by area (range from 1131 to 5205 per 100,000 population). Unemployment (adjusted IRR 1.11; 95% CI 1.05 to 1.17; p < 0.001) and deprivation (adjusted IRR 1.02 95% CI 1.01 to 1.04; p < 0.001) were associated with more people being in contact with mental health services. Areas with a higher proportion of the population who are BAME (IRR 0.95 95% CI 0.92 to 0.99 p = 0.007) had lower service use per 100,000 population. There was no evidence for association with access to primary care psychological therapies. CONCLUSIONS There is substantial variation in the use of mental health services by area of England. Social factors including deprivation, unemployment and population ethnicity continued to be associated with the outcome after controlling for the prevalence of mental illness. This suggests that there are factors that influence the local population use of mental health services in addition to the prevalence of mental disorder.
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Affiliation(s)
- Lucy Maconick
- Division of Psychiatry, University College London, 6th Floor Maple House, 149 Tottenham Court Road, London, W1T 7NF, United Kingdom
| | - Luke Sheridan Rains
- Division of Psychiatry, University College London, 6th Floor Maple House, 149 Tottenham Court Road, London, W1T 7NF, United Kingdom
| | - Rebecca Jones
- Division of Psychiatry, University College London, 6th Floor Maple House, 149 Tottenham Court Road, London, W1T 7NF, United Kingdom
| | - Brynmor Lloyd-Evans
- Division of Psychiatry, University College London, 6th Floor Maple House, 149 Tottenham Court Road, London, W1T 7NF, United Kingdom
| | - Sonia Johnson
- Division of Psychiatry, University College London, 6th Floor Maple House, 149 Tottenham Court Road, London, W1T 7NF, United Kingdom.
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110
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Kühne F, Heinze PE, Weck F. What do laypersons believe characterises a competent psychotherapist? COUNSELLING & PSYCHOTHERAPY RESEARCH 2021. [DOI: 10.1002/capr.12343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Franziska Kühne
- Clinical Psychology and Psychotherapy University of Potsdam Potsdam Germany
| | - Peter Eric Heinze
- Clinical Psychology and Psychotherapy University of Potsdam Potsdam Germany
| | - Florian Weck
- Clinical Psychology and Psychotherapy University of Potsdam Potsdam Germany
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111
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Seow LSE, Sambasivam R, Chang S, Subramaniam M, Lu HS, Assudani HA, Tan CYG, Vaingankar JA. A Qualitative Approach to Understanding the Holistic Experience of Psychotherapy Among Clients. Front Psychol 2021; 12:667303. [PMID: 34421720 PMCID: PMC8377233 DOI: 10.3389/fpsyg.2021.667303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 07/05/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The study of the experience of clients across multiple service encounters (or touchpoints) is important from the perspective of service research. Despite the availability of effective psychotherapies, there exists a significant gap in the optimal delivery of such interventions in the community. Therefore, the aim of this study was to explore the experience of psychotherapy among clients integrating the before-during-after service encounters using a qualitative approach. Methods: A total of 15 clients of outpatient psychotherapy were interviewed, and data saturation was reached. The topics included pathways and reasons to seeking psychotherapy, aspects of the therapy process that have been helpful or unhelpful, and perceived change after receiving psychotherapy. Information was analyzed using the inductive thematic analysis method. Emergent themes pertaining to pre-psychotherapy encounters were mapped onto major components that were identified in Andersen's Health Service Utilization Model. Results: Mental health stigma and the lack of understanding about psychotherapy were the predisposing factors that impeded service use while the preference for non-pharmacological intervention promoted its use. Enabling factors such as affordability and service availability were also of concern, along with perceived and evaluated needs. The attributes of therapists, application of techniques, and the resistance of the client were found to impact the therapeutic alliance. While the majority of the clients experienced positive change or had engaged in self-help strategies after receiving psychotherapy, some cited limited impact on the recovery of symptoms or problematic self-coping without the therapists. Conclusion: This study proposes to expand on Andersen's Behavioral Model by including therapy-related factors so as to provide a more holistic understanding of the use of psychotherapy among the clients. More importantly, the study identified several barriers to access and negative experiences or outcomes, which should be addressed to promote uptake of the psychotherapy intervention.
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Affiliation(s)
| | | | - Sherilyn Chang
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Huixian Sharon Lu
- Department of Psychology, Institute of Mental Health, Singapore, Singapore
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112
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Yıldırım N, Dayılar Candan H, İnan AH. Psychological Distress in Patients with COVID-19 During Hospitalization. Clin Nurs Res 2021; 31:376-384. [PMID: 34392731 DOI: 10.1177/10547738211040322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
To determine the changes in psychological distress levels of patients hospitalized with the diagnosis of COVID-19 and the characteristics of patients at risk. This longitudinal study included 76 patients. The psychological distress was evaluated using the Hospital Anxiety and Depression Scale thrice (on the 1st day of hospitalization and isolation (t0), sixth day (t1), and when the discharge decision was made). The prevalence of anxiety was 22.4%, 14.5%, and 9.2%, whereas the prevalence of depression was 36.8%, 42.1%, and 43.4% at t0, t1, and t2, respectively. The patients' anxiety level decreased, whereas the depression level increased during hospitalization (p < .001). Increasing age, a chronic physical disease, and at least one COVID-19-positive relative increased the risk of psychological distress (p < .05). The assessment and intervention of psychological distress should not be neglected in patients with COVID-19, particularly the group determined to be at a risk.
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113
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Fabian KE, Muanido A, Cumbe VFJ, Manaca N, Hicks L, Weiner BJ, Sherr K, Wagenaar BH. Optimizing treatment cascades for mental healthcare in Mozambique: preliminary effectiveness of the Systems Analysis and Improvement Approach for Mental Health (SAIA-MH). Health Policy Plan 2021; 35:1354-1363. [PMID: 33221835 DOI: 10.1093/heapol/czaa114] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2020] [Indexed: 11/13/2022] Open
Abstract
Substantial investments are being made to scale-up access to mental healthcare in low- and middle-income countries, but less attention has been paid to quality and performance of nascent public-sector mental healthcare systems. This study tested the initial effectiveness of an implementation strategy to optimize routine outpatient mental healthcare cascade performance in Mozambique [the Systems Analysis and Improvement Approach for Mental Health (SAIA-MH)]. This study employed a pre-post design from September 2018 to August 2019 across four Ministry of Health clinics among 810 patients and 3234 outpatient mental health visits. Effectiveness outcomes evaluated progression through the care cascade, including: (1) initial diagnosis and medication selection; (2) enrolling in follow-up care; (3) returning after initial consultation within 60 days; (4) returning for follow-up visits on time; (5) returning for follow-up visits adherent to medication and (6) achieving function improvement. Clustered generalized linear models evaluated odds of completing cascade steps pre- vs post-intervention. Facilities prioritized improvements focused on the follow-up cascade, with 62.5% (10 of 16) monthly system modifications targeting medication adherence. At baseline, only 4.2% of patient visits achieved function improvement; during the 6 months of SAIA-MH implementation, this improved to 13.1% of patient visits. Multilevel logistic regression found increased odds of returning on time and adherent [aOR = 1.53, 95% CI (1.21, 1.94), P = 0.0004] and returning on time, adherent and with function improvement [aOR = 3.68, 95% CI (2.57, 5.44), P < 0.0001] after SAIA-MH implementation. No significant differences were observed regarding other cascade steps. The SAIA-MH implementation strategy shows promise for rapidly and significantly improving mental healthcare cascade outcomes, including the ultimate goal of patient function improvement. Given poor baseline mental healthcare cascade performance, there is an urgent need for evidence-based implementation strategies to optimize the performance of mental healthcare cascades in low- and middle-income countries.
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Affiliation(s)
- Katrin E Fabian
- Department of Global Health, University of Washington, Seattle, WA, USA
| | | | - Vasco F J Cumbe
- Sofala Provincial Health Directorate, Department of Mental Health, Ministry of Health, Beira, Mozambique.,Faculty of Medicine, Eduardo Mondlane University, Mozambique
| | - Nelia Manaca
- Health Alliance International, Beira, Mozambique
| | | | - Bryan J Weiner
- Department of Global Health, University of Washington, Seattle, WA, USA.,Department of Health Services, University of Washington, Seattle, WA, USA
| | - Kenneth Sherr
- Department of Global Health, University of Washington, Seattle, WA, USA.,Health Alliance International, Seattle, WA, USA.,Department of Epidemiology, University of Washington, Seattle, WA, USA.,Department of Industrial & Systems Engineering, University of Washington, Seattle, WA, USA
| | - Bradley H Wagenaar
- Department of Global Health, University of Washington, Seattle, WA, USA.,Health Alliance International, Seattle, WA, USA.,Department of Epidemiology, University of Washington, Seattle, WA, USA
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114
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Shen Y, Yang X, Li G, Gao J, Liang Y. The change of gut microbiota in MDD patients under SSRIs treatment. Sci Rep 2021; 11:14918. [PMID: 34290352 PMCID: PMC8295378 DOI: 10.1038/s41598-021-94481-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 07/09/2021] [Indexed: 01/02/2023] Open
Abstract
The alterations in the gut microbiota have been reported to be correlated with the development of depression. The purpose of this study was to investigate the changes of intestinal microbiota in depressed patients after antidepressant treatment. We recruited 30 MDD patients (MDD group) and 30 healthy controls (control group). The MDD group received individualized treatment with escitalopram at a maximum dose of 20 mg/day. After depressive symptoms improved to a HAMD scale score > 50%, a fecal sample was collected again and used as the follow-up group. The differences of gut microbiota between patients and controls, the characteristics of gut microbiota under treatment and the potential differences in metabolic functions were thus investigated. The Firmicutes/Bacteroidetes ratio was significantly different within three groups, and the ratio of follow-up group was significantly lower than those of the other two groups. Alpha diversity was significantly higher in MDD group than those of the other groups, and the alpha diversity was not significantly different between control and follow-up groups. The beta diversity of some patients resembled participants in the control group. The metabolic function of gut microbiota after treatment was still different from that of the control group. This study suggests that the intestinal flora of depressed patients has a tendency to return to normal under escitalopram treatment.
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Affiliation(s)
- Yang Shen
- National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health, Peking University, Haidian District, Huayuanbeilu 51, Beijing, 100191, China
| | - Xiao Yang
- School of Clinical Medicine, Henan University of Science and Technology, Luoyang, China
| | - Gaofei Li
- Department of Psychiatry, Beijing Hospital of Chinese Traditional and Western Medicine, Beijing, China
| | - Jiayu Gao
- School of Chemical Engineering and Pharmaceutics, Henan University of Science and Technology, No. 263, Kaiyuan Boulevard, Luolong District, Luoyang, 471023, Henan, China.
| | - Ying Liang
- National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health, Peking University, Haidian District, Huayuanbeilu 51, Beijing, 100191, China.
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115
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Greene MC, Huang TTK, Giusto A, Lovero KL, Stockton MA, Shelton RC, Dos Santos P, Saúte F, Wainberg ML. Leveraging Systems Science to Promote the Implementation and Sustainability of Mental Health and Psychosocial Interventions in Low- and Middle-Income Countries. Harv Rev Psychiatry 2021; 29:262-277. [PMID: 34241978 PMCID: PMC9162158 DOI: 10.1097/hrp.0000000000000306] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
ABSTRACT Advancements in global mental health implementation research have revealed promising strategies for improving access to evidence-based mental health care. These advancements have not translated, however, into a reduced prevalence of mental disorders. In this review we examine the relationships between determinants (i.e., barriers and facilitators) and outcomes of mental health services in low- and middle-income countries to identify opportunities for improving the population-level impact and sustainability of innovations in global mental health. We identified three key implementation and services outcomes that influenced the prevalence of mental disorders in the 56 included review articles: supply (access, implementation), demand (help seeking, utilization), and quality (effectiveness, quality of care) of mental health services. Determinants of these outcomes revealed seven themes: community stakeholder engagement; cultural relevance; stigma; human resource capacity; organization of services; governance, policy, and financing; and sociopolitical and community context. We developed a causal loop diagram to illustrate the relationships among these determinants and outcomes. The causal loop diagram revealed the central role of community stakeholder engagement in bridging implementation and patient outcomes, the importance of addressing stigma and social determinants of mental health, and the need to complement supply-side implementation strategies with approaches to equilibrate demand and improve the quality of services. Applying systems science methodologies to global mental health research presents an opportunity to examine the complex relationships among community and health system factors that influence implementation of evidence-based interventions in order to identify sustainable approaches to improve the population-level impact of mental health services in low- and middle-income countries.
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Affiliation(s)
- M Claire Greene
- From the Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health (Dr. Greene) and Department of Sociomedical Science (Dr. Shelton), Columbia University Mailman School of Public Health; Center for Systems and Community Design and Department of Health Policy and Management, City University of New York Graduate School of Public Health and Health Policy (Dr. Huang); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons & New York State Psychiatric Institute (Drs. Giusto, Lovero, Stockton, and Wainberg); Mental Health Department, Center for Applied Psychology and Psychometric Tests, Mozambique Ministry of Health (Dr. dos Santos); Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique (Dr. Saúte)
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116
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Van NHN, Thi Khanh Huyen N, Hue MT, Luong NT, Quoc Thanh P, Duc DM, Thi Thanh Mai V, Hong TT. Perceived Barriers to Mental Health Services among the Elderly in the Rural of Vietnam: A Cross Sectional Survey in 2019. Health Serv Insights 2021; 14:11786329211026035. [PMID: 34220203 PMCID: PMC8221696 DOI: 10.1177/11786329211026035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 05/28/2021] [Indexed: 11/15/2022] Open
Abstract
While the burden of neurological and mental disorders has been drastically increased in Vietnam, the current mental healthcare services do not meet the public demand. In order to determine perceived barriers to the use of mental health services, we conducted a cross-sectional study on 376 elderly people from a rural district in Hanoi, Vietnam. We found that depression may be an important indicator of the need for formal and informal community and home care mental health services. Barriers to mental healthcare access were categorized into 7 groups namely stigma, emotional concerns, participation restrictions, service satisfaction, time constraints, geographic and financial conditions, and availability of services. The most significant barriers are the limited availability of and accessibility to health professionals and services in rural areas. Our study highlights the urgent efforts that need to be made in order to enhance availability of mental healthcare services in rural areas of Vietnam.
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Affiliation(s)
| | | | - Mai Thi Hue
- Hanoi Medical University Campus in Thanh Hoa, Hanoi Medical University, Thanh Hoa, Vietnam
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117
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Fadila DES, Ibrahim FM, El-Gilany AH. Psychological distress among older adults during COVID-19 pandemic: Prevalence and associated factors. Geriatr Nurs 2021; 42:1077-1083. [PMID: 34265488 PMCID: PMC8231069 DOI: 10.1016/j.gerinurse.2021.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 06/09/2021] [Accepted: 06/11/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Doaa El Sayed Fadila
- Gerontological Nursing Department, Faculty of Nursing, Mansoura University, Egypt.
| | - Fatma Magdy Ibrahim
- Gerontological Nursing Department, Faculty of Nursing, Mansoura University, Egypt
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118
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Filiatreau LM, Ebasone PV, Dzudie A, Ajeh R, Pence B, Wainberg M, Nash D, Yotebieng M, Anastos K, Pefura-Yone E, Nsame D, Parcesepe AM. Correlates of self-reported history of mental health help-seeking: a cross-sectional study among individuals with symptoms of a mental or substance use disorder initiating care for HIV in Cameroon. BMC Psychiatry 2021; 21:293. [PMID: 34090367 PMCID: PMC8180128 DOI: 10.1186/s12888-021-03306-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 05/25/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Mental health and substance use disorders (MSDs) increase the risk of poor human immunodeficiency virus (HIV) care outcomes among people living with HIV (PLWH). Receipt of mental health care may improve these adverse outcomes. We aimed to identify correlates of prior mental health help-seeking among PLWH with symptoms of an MSD in Cameroon. METHODS We characterize prior mental health help-seeking from formal (mental health specialist/general medical provider) and informal (traditional healer/religious leader) sources among 161 people with symptoms of depression (Patient Health Questionnaire-9 scores> 9), anxiety (General Anxiety Disorder-7 scores> 9), probable post-traumatic stress disorder (PTSD Checklist for DSM-5 scores> 30), or possible alcohol use disorder (Alcohol Use Disorders Identification Test scores≥16) who were newly entering HIV care at three healthcare facilities in Cameroon between June 2019 and March 2020. Help-seeking was defined as ever speaking to a formal or informal source about emotional problems, sadness, or the way they were feeling or behaving. We estimated the association between sociodemographic and psychosocial measures and lifetime mental health help-seeking from each type of source using log-binomial regression. RESULTS Overall, 55.3% of 161 PLWH with MSD symptoms reported prior mental health help-seeking, with 24.2% and 46.0% seeking help from formal and informal sources, respectively. Religious leaders were the most common source of help (40.4%), followed by general medical professionals (22.4%), traditional healers (16.8%), and mental health specialists (7.4%). Individuals with higher depressive, anxiety, and trauma symptom severity scores were more likely to have sought help than those with lower scores. Individuals with possible alcohol use disorder were the least likely to have sought help. Prior help-seeking was more common among those reporting a higher number of lifetime traumatic events (prevalence ratio [PR]: 1.06; 95% confidence interval [CI]: 1.01, 1.11) and those with a history of emotional intimate partner violence (PR: 1.34; 95% CI: 1.01, 1.80). CONCLUSIONS Prior mental health help-seeking was associated with psychosocial stressors. Help-seeking from informal networks was more common than formal help-seeking. Training in the provision of evidence-based mental health support for informal networks could improve access to mental health care for PLWH with MSDs in Cameroon.
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Affiliation(s)
- Lindsey M. Filiatreau
- grid.10698.360000000122483208Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | | | - Anastase Dzudie
- Clinical Research Education Networking and Consultancy, Yaounde, Cameroon
| | - Rogers Ajeh
- Clinical Research Education Networking and Consultancy, Yaounde, Cameroon
| | - Brian Pence
- grid.10698.360000000122483208Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Milton Wainberg
- grid.413734.60000 0000 8499 1112Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, NY USA
| | - Denis Nash
- grid.212340.60000000122985718Institute of Implementation Science in Population Health, Graduate School of Public Health and Health Policy, City University of New York, New York, NY USA
| | - Marcel Yotebieng
- grid.251993.50000000121791997Department of Medicine, Albert Einstein College of Medicine, Bronx, NY USA
| | - Kathryn Anastos
- grid.251993.50000000121791997Departments of Medicine and Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY USA
| | | | - Denis Nsame
- Bamenda Regional Hospital, Bamenda, Cameroon
| | - Angela M. Parcesepe
- grid.10698.360000000122483208Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC USA ,grid.10698.360000000122483208Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
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119
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SoleimanvandiAzar N, Mohaqeqi Kamal SH, Sajjadi H, Malekafzali Ardakani H, Setareh Forouzan A, Karimi SE, Ghaedamini Harouni G. Outpatient health service utilization and associated factors: A cross-sectional population-based study in Tehran in 2019. Med J Islam Repub Iran 2021; 35:71. [PMID: 34290995 PMCID: PMC8285555 DOI: 10.47176/mjiri.35.71] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Indexed: 11/09/2022] Open
Abstract
Background: Health service utilization (HSU) is a significant health and political issue. Awareness of factors that affect HSU and the status of health service utilization can help health professionals improve their services. The aim of this study was to investigate the status of HSU and identify the factors affecting health service utilization among households residing in Tehran. Methods: The present cross-sectional study included 1200 residing households from different regions of Tehran, the capital of Iran. They were selected by a multi-stage cluster sampling method in accordance with the zoning of Tehran concerning socio-economic development. Interviews were conducted by trained individuals using a health service utilization questionnaire introduced by the World Health Organization, Zimet's social support questionnaire, and demographic checklist during winter 2018 and spring 2019. Simple and multiple logistic regression models were applied to analyze the data. In order to include the factors related to the status of outpatient health service utilization, a set of bivariate analyses was conducted, and then the factors with a p-value of ≤0.20 were included in the multiple models. Data were analyzed using Stata 12 software. Results: The results of the study indicated that the rate of outpatient HSU among households residing in Tehran was 63.61% (CI:60, 66.80). In addition, regarding the results of the study, asset index of family (OR=0.51, 95% CI: 0.28, 0.91), the level of awareness and knowledge of family members regarding health issues (OR=0.55, 95% CI: 0.34, 0.88) as well as the mother knowledge on health issues (OR=0.64, 95% CI: 0.45, 0.93), the level of social support (OR = 0.50, 95% CI: 0.37,0.68), family health expenditure (OR=1.20, 95% CI: 1.18, 4.06), having a member with a sort of disability in family (OR=1.66, 95% CI: 1.01, 2.77), and having an alcoholic member in family (OR=2.44, 95% CI: 1.27, 4.68) were factors associated with outpatient HSU among households. Considering the adjusted values of odds ratios, the prevalence of the HSU varied according to the area of residence. It should be noted that the variables included in the model explained 15% of the changes in the prevalence of HSU. Conclusion: According to the results of the study and in order to increase HSU in different classes, the level of social support, especially among women in the family due to their role in the general health of family members, should be enhanced. Also, policies should be adopted to increase the awareness, knowledge, and information of family members about health issues, lifestyle changes, nutrition, and health behaviors through social media.
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Affiliation(s)
- Neda SoleimanvandiAzar
- Department of Social Welfare Management, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Hossein Mohaqeqi Kamal
- Social Welfare Management Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Homeira Sajjadi
- Social Welfare Management Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Hossein Malekafzali Ardakani
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ameneh Setareh Forouzan
- Social Welfare Management Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Salah Eddin Karimi
- Social Determinants of Health Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
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Apolinário-Hagen J, Harrer M, Dederichs M, Fritsche L, Wopperer J, Wals F, Loerbroks A, Lehr D, Salewski C, Angerer P, Ebert DD. Exploring the influence of testimonial source on attitudes towards e-mental health interventions among university students: Four-group randomized controlled trial. PLoS One 2021; 16:e0252012. [PMID: 34038455 PMCID: PMC8153476 DOI: 10.1371/journal.pone.0252012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 05/09/2021] [Indexed: 11/18/2022] Open
Abstract
Electronic mental health services (eMHSs) offer additional options for the dissemination of psychological interventions for university students. Still, many university students are reluctant to use eMHSs. Narrative messages may help increase the awareness and acceptance of quality-approved programs. However, little is known about the usefulness of narrative messages to improve attitudes towards eMHSs. In this experiment, we thus aimed to explore in how far different ways of targeting information to students affect their attitudes towards eMHSs for stress prevention and therapy, and to identify potential determinants of attitude change. N = 451 students (Mean = 32.6 years, SD = 10.2, 75% female, 7% with eMHS experience) were randomly assigned to one of four study arms involving information designed to induce different levels of perceived similarity. While the active control condition only received general information (arm 1, “information only”, n = 116), the other experimental arms were additionally exposed to testimonials on specific eMHSs either addressing an unspecified audience (arm 2, n = 112), employees (arm 3, n = 115) or working university students (arm 4, n = 108). Two-way ANOVA revealed no impact of information on the alteration of attitudes towards eMHSs for stress coping (d = 0.20). Only a small effect of target-group specific testimonials on attitudes towards online therapies was identified at post-intervention (d = 0.29). Regression analyses demonstrated significant influences of source credibility and perceived similarity on attitudes for preventative eMHSs (ps<0.01), as well as a partial mediation effect of perceived similarity in favor of testimonials targeted to students (95% CI [0.22, 0.50]). Overall, this study indicated no meaningful impact of information on attitudes and limited evidence for benefits of tailored narrative messages. Since attitudes were already positive at baseline, further research with a representative student sample mimicking real-world decision scenarios is needed to gain an in-depth understanding of acceptance-facilitating message features that may contribute to promote the adoption of evidence-based eMHSs.
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Affiliation(s)
- Jennifer Apolinário-Hagen
- Faculty of Medicine, Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- * E-mail:
| | - Mathias Harrer
- Department of Clinical Psychology and Psychotherapy, Friedrich Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Melina Dederichs
- Faculty of Medicine, Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Lara Fritsche
- Faculty of Psychology, Department of Health Psychology, University of Hagen, Hagen, Germany
| | - Jeannette Wopperer
- Faculty of Psychology, Department of Health Psychology, University of Hagen, Hagen, Germany
| | - Frank Wals
- Faculty of Psychology, Department of Health Psychology, University of Hagen, Hagen, Germany
| | - Adrian Loerbroks
- Faculty of Medicine, Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Dirk Lehr
- Department of Health Psychology, Leuphana University Lueneburg, Lueneburg, Germany
| | - Christel Salewski
- Faculty of Psychology, Department of Health Psychology, University of Hagen, Hagen, Germany
| | - Peter Angerer
- Faculty of Medicine, Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - David Daniel Ebert
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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121
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Yang X, Yip BHK, Mak ADP, Zhang D, Lee EKP, Wong SYS. The Differential Effects of Social Media on Depressive Symptoms and Suicidal Ideation Among the Younger and Older Adult Population in Hong Kong During the COVID-19 Pandemic: Population-Based Cross-sectional Survey Study. JMIR Public Health Surveill 2021; 7:e24623. [PMID: 33835937 PMCID: PMC8153033 DOI: 10.2196/24623] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 11/27/2020] [Accepted: 04/02/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Social media has become a ubiquitous part of daily life during the COVID-19 pandemic isolation. However, the role of social media use in depression and suicidal ideation of the general public remains unclear. Related empirical studies were limited and reported inconsistent findings. Little is known about the potential underlying mechanisms that may illustrate the relationship between social media use and depression and suicidal ideation during the COVID-19 pandemic. OBJECTIVE This study tested the mediation effects of social loneliness and posttraumatic stress disorder (PTSD) symptoms on the relationship between social media use and depressive symptoms and suicidal ideation, as well as the moderation effect of age on the mediation models. METHODS We administered a population-based random telephone survey in May and June 2020, when infection control measures were being vigorously implemented in Hong Kong. A total of 1070 adults (658 social media users and 412 nonusers) completed the survey. Structural equation modeling (SEM) and multigroup SEM were conducted to test the mediation and moderation effects. RESULTS The weighted prevalence of probable depression was 11.6%; 1.6% had suicidal ideation in the past 2 weeks. Both moderated mediation models of depressive symptoms (χ262=335.3; P<.05; comparative fit index [CFI]=0.94; nonnormed fit index [NNFI]=0.92; root mean square error of approximation [RMSEA]=0.06) and suicidal ideation (χ234=50.8; P<.05; CFI=0.99; NNFI=0.99; RMSEA=0.02) showed acceptable model fit. There was a significantly negative direct effect of social media use on depressive symptoms among older people (β=-.07; P=.04) but not among younger people (β=.04; P=.55). The indirect effect via PTSD symptoms was significantly positive among both younger people (β=.09; P=.02) and older people (β=.10; P=.01). The indirect effect via social loneliness was significant among older people (β=-.01; P=.04) but not among younger people (β=.01; P=.31). The direct effect of social media use on suicidal ideation was not statistically significant in either age group (P>.05). The indirect effects via PTSD symptoms were statistically significant among younger people (β=.02; P=.04) and older people (β=.03; P=.01). Social loneliness was not a significant mediator between social media use and suicidal ideation among either age group (P>.05). CONCLUSIONS Social media may be a "double-edged sword" for psychosocial well-being during the COVID-19 pandemic, and its roles vary across age groups. The mediators identified in this study can be addressed by psychological interventions to prevent severe mental health problems during and after the COVID-19 pandemic.
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Affiliation(s)
- Xue Yang
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong.,The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, China
| | - Benjamin H K Yip
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Arthur D P Mak
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Dexing Zhang
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Eric K P Lee
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Samuel Y S Wong
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
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Sener H, Arikan I, Gündüz N, Gülekci Y. Detecting the Relationship between the Stress Levels and Perceived Burnout in Law-enforcement Officers during the COVID-19 Outbreak: A Cross-sectional Study. SOCIAL WORK IN PUBLIC HEALTH 2021; 36:486-495. [PMID: 33896405 DOI: 10.1080/19371918.2021.1915910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The present study aimed to determine the effect of burnout and stress levels on law enforcement officers' perceptions and behaviors to emphasize the need for adequate attention and care in these individuals during the COVID-19 outbreak. The research group of this cross-sectional study conducted in July-August 2020 was formed by the law enforcement officers. The Perceived Stress Scale (PSS), Burnout Measure-Short Version (BM-SV) and a personal data form prepared by the researchers were used in the study. Data were analyzed using the IBM SPSS Statistics 16.0 software package program. The PSS scores were higher and significant in the group whose working hours were not increased due to the COVID-19 pandemic and they thought that there was a decrease in crime rates and did not need psychological support (p ≤ .05). The PSS scores were higher and significant in the group who took the warnings about COVID-19 into consideration, were afraid of contracting the virus, did not care about the progress of the epidemic and used the mask correctly. Additionally, the BM-SV scores were higher and significant in the group who stated that they were not afraid of contracting the virus (p ≤.05). A comprehensive crisis prevention and intervention system including epidemiological monitoring/observing, screening, referral and targeted interventions should be established to reduce the perceived level of stress and burnout in law enforcement and prevent further mental health problems.
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Affiliation(s)
- Harun Sener
- Department of Forensic Sciences, Faculty of Engineering and Natural Sciences, Kütahya Health Sciences University, Kütahya, Turkey
| | - Inci Arikan
- Department of Public Health, Faculty of Medicine, Kütahya Health Sciences University, Kütahya, Turkey
| | - Nermin Gündüz
- Department of Psychiatry, Usküdar University, NP Istanbul Brain Hospital, Istanbul, Turkey
| | - Yakup Gülekci
- Department of Forensic Sciences, Faculty of Engineering and Natural Sciences, Kütahya Health Sciences University, Kütahya, Turkey
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Motrico E, Salinas-Perez JA, Rodero-Cosano ML, Conejo-Cerón S. Editors' Comments on the Special Issue "Social Determinants of Mental Health". INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18083957. [PMID: 33918698 PMCID: PMC8070115 DOI: 10.3390/ijerph18083957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 04/06/2021] [Indexed: 01/04/2023]
Abstract
Mental disorders are one of the greatest public health concerns of our time, and they are affected by social factors. To reduce the considerable burden of mental disorders, more global and systematic knowledge of the social determinants of mental health is necessary. This paper presents the results of the 27 studies included in the International Journal of Environmental Research and Public Health Special Issue, “Social Determinants of Mental Health”. The studies are grouped into four broad categories: social inclusion and mental health, young people’s mental health, mental health at work, and mental health service users. The results cover different countries, age populations, settings, and methodologies. Finally, the main findings on the relationship between social determinants and mental health are presented and summarized.
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Affiliation(s)
- Emma Motrico
- Department of Psychology, Universidad Loyola Andalucía, 41704 Sevilla, Spain
- Prevention and Health Promotion Research Network (redIAPP), 08007 Barcelona, Spain
- Correspondence: (E.M.); (J.A.S.-P.); (M.L.R.-C.); (S.C.-C.)
| | - Jose A. Salinas-Perez
- Department of Quantitative Methods, Universidad Loyola Andalucía, 41704 Sevilla, Spain
- Centre for Mental Health Research, Australian National University, Canberra, ACT 2601, Australia
- Correspondence: (E.M.); (J.A.S.-P.); (M.L.R.-C.); (S.C.-C.)
| | - Maria Luisa Rodero-Cosano
- Department of Quantitative Methods, Universidad Loyola Andalucía, 41704 Sevilla, Spain
- Correspondence: (E.M.); (J.A.S.-P.); (M.L.R.-C.); (S.C.-C.)
| | - Sonia Conejo-Cerón
- Prevention and Health Promotion Research Network (redIAPP), 08007 Barcelona, Spain
- Biomedical Research Institute of Malaga (IBIMA), 29009 Málaga, Spain
- Correspondence: (E.M.); (J.A.S.-P.); (M.L.R.-C.); (S.C.-C.)
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Suesse B, Lago L, Westley-Wise V, Cuenca J, Pai N. Predisposing, enabling and need factors associated with increased use and ongoing increased use of inpatient mental health care: A population-based longitudinal study. Aust N Z J Psychiatry 2021; 55:409-421. [PMID: 33287552 DOI: 10.1177/0004867420976848] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The study investigated factors associated with frequent (admissions), high (total length of stay) or heavy (frequent and high) hospital use, and with ongoing increased hospital use, for mental health conditions in a regional health district. METHODS A retrospective population-based study using longitudinal hospital, emergency department and community service use data for people admitted with a mental health condition between 1 January 2012 and 31 December 2016. Multivariate logistic regression models assessed the association of predisposing, enabling and need factors with increased, and ongoing increased, hospital use. RESULTS A total of 5,631 people had at least one mental health admission. Frequent admission was associated with not being married (odds ratio = 2.3, 95% confidence interval = [1.5, 3.3]), no private hospital insurance (odds ratio = 2.2, 95% confidence interval = [1.2, 3.8]), previous mental health service use (community, emergency department, lengthy admissions) and a history of a substance use disorder, childhood trauma, self-harm or chronic obstructive pulmonary disease. High and heavy hospital use was associated with marital status, hospital insurance, admission for schizophrenia, previous mental health service use and a history of self-harm. Ongoing frequent use was less likely among those aged 65 and older (odds ratio = 0.2, 95% confidence interval = [0.1, 1.0]) but more likely among those with a history of depression (odds ratio = 2.2, 95% confidence interval = [1.1, 4.4]). Ongoing high use was also associated with admissions for schizophrenia and a history of self-harm. CONCLUSION Interventions targeted at younger people hospitalised with schizophrenia, a history of depression or self-harm, particularly with evidence of social and or health disadvantage, should be considered to improve long-term consumer and health system outcomes. These data can support policymakers to better understand the context and need for improvements in stepped or staged care for people frequently using inpatient mental health care.
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Affiliation(s)
- Bianca Suesse
- Centre for Health Research Illawarra Shoalhaven Population (CHRISP), Australian Health Services Research Institute (AHSRI), Faculty of Business and Law, University of Wollongong (UOW), Wollongong, NSW, Australia
| | - Luise Lago
- Centre for Health Research Illawarra Shoalhaven Population (CHRISP), Australian Health Services Research Institute (AHSRI), Faculty of Business and Law, University of Wollongong (UOW), Wollongong, NSW, Australia
| | - Victoria Westley-Wise
- Centre for Health Research Illawarra Shoalhaven Population (CHRISP), Australian Health Services Research Institute (AHSRI), Faculty of Business and Law, University of Wollongong (UOW), Wollongong, NSW, Australia.,Integrated Care, Mental Health, Planning, Information and Performance Directorate, Illawarra Shoalhaven Local Health District (ISLHD), Wollongong, NSW, Australia
| | - Jose Cuenca
- Research Directorate, Illawarra Shoalhaven Local Health District (ISLHD), Wollongong, NSW, Australia
| | - Nagesh Pai
- Integrated Care, Mental Health, Planning, Information and Performance Directorate, Illawarra Shoalhaven Local Health District (ISLHD), Wollongong, NSW, Australia.,Faculty of Science, Medicine and Health, School of Medicine, University of Wollongong (UOW), Wollongong, NSW, Australia
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Muhorakeye O, Biracyaza E. Exploring Barriers to Mental Health Services Utilization at Kabutare District Hospital of Rwanda: Perspectives From Patients. Front Psychol 2021; 12:638377. [PMID: 33828506 PMCID: PMC8019821 DOI: 10.3389/fpsyg.2021.638377] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 02/16/2021] [Indexed: 11/13/2022] Open
Abstract
Barriers to mental health interventions globally remain a health concern; however, these are more prominent in low- and middle-income countries (LMICs). The barriers to accessibility include stigmatization, financial strain, acceptability, poor awareness, and sociocultural and religious influences. Exploring the barriers to the utilization of mental health services might contribute to mitigating them. Hence, this research aims to investigate these barriers to mental health service utilization in depth at the Kabutare District Hospital of the Southern Province of Rwanda. The qualitative approach was adopted with a cross-sectional study design. The participants were patients with mental illnesses seeking mental health services at the hospital. Ten interviews were conducted in the local language, recorded, and transcribed verbatim and translated by the researchers. Thematic analysis was applied to analyze the data collected. The results revealed that the most common barriers are fear of stigmatization, lack of awareness of mental health services, sociocultural scarcity, scarcity of financial support, and lack of geographical accessibility, which limit the patients to utilize mental health services. Furthermore, it was revealed that rural gossip networks and social visibility within the communities compounded the stigma and social exclusion for patients with mental health conditions. Stigmatization should be reduced among the community members for increasing their empathy. Then, the awareness of mental disorders needs to be improved. Further research in Rwanda on the factors associated with low compliance to mental health services with greater focus on the community level is recommended.
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Affiliation(s)
- Oliviette Muhorakeye
- Department of Clinical Psychology, School of Medicine and Pharmacy, University of Rwanda, Butare, Rwanda
| | - Emmanuel Biracyaza
- Department of Community Health, School of Public Health, University of Rwanda, Butare, Rwanda.,Sociotherapy Programme, Prison Fellowship Rwanda (PFR), Member of Prison Fellowship International, Kigali, Rwanda
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Rahmadiana M, Karyotaki E, Schulte M, Ebert DD, Passchier J, Cuijpers P, Berger T, van Ballegooijen W, Wimbarti S, Riper H. Transdiagnostic Internet Intervention for Indonesian University Students With Depression and Anxiety: Evaluation of Feasibility and Acceptability. JMIR Ment Health 2021; 8:e20036. [PMID: 33666553 PMCID: PMC7980121 DOI: 10.2196/20036] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 11/12/2020] [Accepted: 12/07/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND University students with depression and anxiety do not easily receive or seek treatment; therefore, internet-based interventions have been suggested to be a promising way to improve treatment accessibility and availability. However, it has not been examined whether a guided, culturally adapted, transdiagnostic, internet-based intervention is effective for treating symptoms of depression, anxiety, or both among university students in Indonesia. OBJECTIVE This study aims to investigate the feasibility (acceptability and satisfaction, usability, and uptake) of a guided, culturally adapted, transdiagnostic, internet-based intervention among university students with symptoms of depression, anxiety, or both in Indonesia. METHODS Students from Universitas Gadjah Mada, Yogyakarta, Indonesia, were screened for symptoms of depression, anxiety, or both, and filled online informed consent, demographic questionnaires, and a quality of life measure at pretreatment assessment (T0). Subsequently, the participants started the intervention. Seven weeks after T0, the primary outcomes of this feasibility study were analyzed at posttreatment assessment (T1) using the 8-item Client Satisfaction Questionnaire (CSQ-8) and the System Usability Scale (SUS). Mean and SDs for the CSQ-8 and SUS were calculated to examine feasibility. Within-group secondary outcomes (depression, anxiety, and quality of life) were inspected for outliers and normal distribution. Paired-sample t tests were used to investigate differences between time points of secondary outcomes. A mixed-method approach of quantitative and qualitative analyses was adopted. Both the primary and secondary outcomes were additionally explored with an individual semistructured interview and synthesized descriptively. RESULTS A total of 50 participants completed the intervention. We found a moderate to high level of satisfaction and acceptability, a slightly below-average level of desirable usability (≥70), and an adherence rate of 52% which was higher than expected given the novelty of the intervention. Results for the secondary outcomes indicated a decrease in depression and anxiety. For depression, the overall mean difference between the 2 time points for depression was 3.92 (95% CI 2.75-5.1; Hedges g 1.15; P<.001). For anxiety, the overall mean difference between the 2 time points was 3.34 (95% CI 2.06-4.61; Hedges g 1.02; P<.001). Further, a moderate effect in improving quality of life was found (g=0.50). Overall, participants were positive about the online intervention and ECoaches (online guidance), and they found the intervention to be culturally appropriate. CONCLUSIONS A culturally adapted, transdiagnostic, internet-based intervention appears to be acceptable and feasible for reducing symptoms of depression, anxiety, or both, and increasing quality of life in university students in Indonesia. Future studies should include a randomized controlled trial to assess the effectiveness of such interventions as they may supplement existing counseling services in universities, reduce the treatment costs, and maximize treatment accessibility in low-resourced settings. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1016/j.invent.2018.11.002.
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Affiliation(s)
- Metta Rahmadiana
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Eirini Karyotaki
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, Netherlands.,Department of Global Health and Social Medicine, Harvard Medical School, Harvard University, Boston, MA, United States
| | - Mieke Schulte
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - David Daniel Ebert
- Division of Online Health Training, Innovation Incubator, Leuphana University of Lueneburg, Lueneburg, Germany.,Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.,Department of Clinical Psychology and EMGO Institute for Health and Care Research, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Jan Passchier
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Thomas Berger
- Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
| | - Wouter van Ballegooijen
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, Netherlands.,Department of Psychiatry, Vrije Universiteit Medical Centre/GGZ inGeest, Amsterdam, Netherlands
| | - Supra Wimbarti
- Faculty of Psychology, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Heleen Riper
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, Netherlands.,Department of Psychiatry, Vrije Universiteit Medical Centre/GGZ inGeest, Amsterdam, Netherlands
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127
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Moayed MS, Vahedian-Azimi A, Mirmomeni G, Rahimi-Bashar F, Goharimoghadam K, Pourhoseingholi MA, Abbasi-Farajzadeh M, Hekmat M, Sathyapalan T, Guest PC, Sahebkar A. Survey of Immediate Psychological Distress Levels Among Healthcare Workers in the COVID-19 Epidemic: A Cross-Sectional Study. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1321:237-243. [PMID: 33656728 DOI: 10.1007/978-3-030-59261-5_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Abstract
AIM The outbreak of COVID-19 has laid unprecedented psychological stress on healthcare workers (HCWs). We aimed to assess the immediate psychological impact of COVID-19 epidemic on the HCWs at Baqiyatallah Hospital in Tehran, Iran. MATERIAL AND METHODS We conducted a cross-sectional survey of HCWs using questionnaires in February and March 2020 in Baqiyatallah Hospital, Tehran. We evaluated depression, stress, and anxiety levels using the DASS-21 questionnaire. Participants were selected by using census sampling. All statistical analyses were performed using R version 3.5.1. RESULTS The study population included 217 HCWs (111 male, 116 female) and the mean age of the study group was 39.6 years old. Approximately two-thirds of the HCWs stayed in the hospital for 2-3 weeks. The mean scores of depression and stress were at a "severe" level, while anxiety scores were at an "extremely severe" level. The prevalence of severe scores was 38.71%, 2.30%, and 48.97% for depression, anxiety, and stress, and the prevalence of extremely severe scores was 46.54%, 97.24%, and 4.98% depression, anxiety, and stress, respectively. In stress subscale, moderate stress was 47.46%. Female HCWs reported higher levels of depression compared with males. CONCLUSION In this study, HCWs reported experiencing severe and extremely severe psychological burdens. Timely interventions to promote mental health in HCWs exposed to patients with COVID-19 need to be immediately implemented, with female nurses requiring particular attention. This process could be facilitated via tests for molecular biomarkers in accessible body fluids, such as saliva, plasma, and serum.
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Affiliation(s)
- Malihe Sadat Moayed
- Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Amir Vahedian-Azimi
- Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran.
| | - Golshan Mirmomeni
- Hearing Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Farshid Rahimi-Bashar
- Anesthesia and Critical Care Department, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Keivan Goharimoghadam
- Internal Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohamad Amin Pourhoseingholi
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, ShahidBeheshti University of Medical Sciences, Tehran, Iran
| | | | - Mostafa Hekmat
- Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Thozhukat Sathyapalan
- Academic Diabetes, Endocrinology and Metabolism, Hull York Medical School, University of Hull, Hull, UK
| | - Paul C Guest
- Laboratory of Neuroproteomics, Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas (UNICAMP), Campinas, Brazil
| | - Amirhossein Sahebkar
- Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. .,Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran. .,Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland. .,Halal Research Center of IRI, FDA, Tehran, Iran.
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128
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Esponda GM, Ryan GK, Estrin GL, Usmani S, Lee L, Murphy J, Qureshi O, Endale T, Regan M, Eaton J, De Silva M. Lessons from a theory of change-driven evaluation of a global mental health funding portfolio. Int J Ment Health Syst 2021; 15:18. [PMID: 33640004 PMCID: PMC7913430 DOI: 10.1186/s13033-021-00442-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 02/15/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Given the underinvestment in global mental health to-date, it is important to consider how best to maximize the impact of existing investments. Theory of Change (ToC) is increasingly attracting the interest of funders seeking to evaluate their own impact. This is one of four papers investigating Grand Challenges Canada's (GCC's) first global mental health research funding portfolio (2012-2016) using a ToC-driven approach. METHODS A portfolio-level ToC map was developed through a collaborative process involving GCC grantees and other key stakeholders. Proposed ToC indicators were harmonised with GCC's pre-existing Results-based Management and Accountability Framework to produce a "Core Metrics Framework" of 23 indicators linked to 17 outcomes of the ToC map. For each indicator relevant to their project, the grantee was asked to set a target prior to the start of implementation, then report results at six-month intervals. We used the latest available dataset from all 56 projects in GCC's global mental health funding portfolio to produce a descriptive analysis of projects' characteristics and outcomes related to delivery. RESULTS 12,999 people were trained to provide services, the majority of whom were lay or other non-specialist health workers. Most projects exceeded their training targets for capacity-building, except for those training lay health workers. Of the 321,933 people screened by GCC-funded projects, 162,915 received treatment. Most projects focused on more than one disorder and exceeded all their targets for screening, diagnosis and treatment. Fewer people than intended were screened for common mental disorders and epilepsy (60% and 54%, respectively), but many more were diagnosed and treated than originally proposed (148% and 174%, respectively). In contrast, the three projects that focused on perinatal depression exceeded screening and diagnosis targets, but only treated 43% of their intended target. CONCLUSIONS Under- or over-achievement of targets may reflect operational challenges such as high staff turnover, or challenges in setting appropriate targets, for example due to insufficient epidemiological evidence. Differences in delivery outcomes when disaggregated by disorder suggest that these challenges are not universal. We caution implementers, funders and evaluators from taking a one-size-fits all approach and make several recommendations for how to facilitate more in-depth, multi-method evaluation of impact using portfolio-level ToC.
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Affiliation(s)
- G Miguel Esponda
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, Camberwell, London, SE5 8AB, UK.
- ESRC Centre for Society and Mental Health, King's College London, London, UK.
| | - G K Ryan
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - G Lockwood Estrin
- Centre for Brain and Cognitive Development, Department of Psychological Sciences, Birkbeck College, University of London, London, UK
| | - S Usmani
- Independent Researcher, Minneapolis, MN, USA
| | - L Lee
- Independent Researcher, London, UK
| | - J Murphy
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - O Qureshi
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - T Endale
- Department of Counselling and Clinical Psychology, Teachers College, Columbia University, New York, NY, USA
| | - M Regan
- Health Improvement Directorate, Public Health England, London, UK
| | - J Eaton
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
- CBM Global, Cambridge, UK
| | - M De Silva
- Department of Population Health, Wellcome Trust, London, UK
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Reinhold AK, Magaard JL, Brütt AL. Influence of established and subjectively perceived as well as evaluated individual characteristics on the utilization of mental health services among individuals with depressive disorders: protocol of a longitudinal study examining how to supplement the "behavioral model of health services use" and on need-congruent use of mental health services. BMC Psychiatry 2021; 21:68. [PMID: 33530953 PMCID: PMC7851814 DOI: 10.1186/s12888-021-03065-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 01/21/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Approximately one out of every three people in Germany who meets the diagnostic criteria for major depression has contact with mental health services. Therefore, according to treatment guidelines, two thirds of all individuals with depression are insufficiently treated. In the past, the subjective perspective of people who (do not) make use of mental health services has been neglected. Factors related to the use of health services are described in Andersen's Behavioral Model of Health Services Use (ABM). The aim of this study is to supplement operationalizations of subjectively perceived and evaluated individual characteristics in the ABM and to evaluate whether the supplemented model can better explain mental health services use in individuals with depression than established operationalizations. METHODS A representative telephone study with two measurement points will be conducted. In an explanatory mixed-methods design, qualitative interviews will be added to further interpret the quantitative data. A nationwide sample scoring 5 or more on the Patient Health Questionnaire (PHQ-9) will be recruited and interviewed via telephone at T0 and 12 months later (T1). Data on established and subjective characteristics as well as mental health service use will be collected. At T1, conducting a diagnostic interview (Composite International Diagnostic Interview, DIA-X-12/M-CIDI) enables the recording of 12-month diagnoses according to DSM-IV-TR criteria. Ideally, n = 768 datasets will be available and analyzed descriptively by means of regression analysis. Up to n = 32 persons who use or do not use depression-specific health services incongruent with their objective or subjective needs will be interviewed (face-to-face) to better explain their behavior. In addition, theories of non-need-based mental health service use are developed within the framework of the grounded theory-based analysis of the qualitative interviews. DISCUSSION The study intends to contribute to the theoretical foundation of health services research and to specify the characteristics described in the ABM. Thus, after completion of the study, a further sophisticated and empirically tested model will be available to explain mental health services. The identified modifiable influencing factors are relevant for the development of strategies to increase mental health service use in line with the objective and subjective needs of individuals with depression.
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Affiliation(s)
- Anna Katharina Reinhold
- Department of Health Services Research, Faculty of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Oldenburg, Germany.
| | - Julia Louise Magaard
- grid.13648.380000 0001 2180 3484Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Anna Levke Brütt
- grid.5560.60000 0001 1009 3608Department of Health Services Research, Faculty of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
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130
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Nagarajappa R, Mahapatra I, Satyarup D, Mohanty S. Validation and Assessment of COVID-19 Peritraumatic Distress Index among Indian Dental Professionals. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2021. [DOI: 10.1590/pboci.2021.112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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131
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Moayed MS, Vahedian-Azimi A, Mirmomeni G, Rahimi-Bashar F, Goharimoghadam K, Pourhoseingholi MA, Abbasi-Farajzadeh M, Babaei M, Sathyapalan T, Guest PC, Sahebkar A. A Survey of Psychological Distress Among the Community in the COVID-19 Epidemic: A Cross-Sectional Study. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1321:253-260. [PMID: 33656730 DOI: 10.1007/978-3-030-59261-5_22] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Aim The ongoing COVID-19 outbreak has not only had an impact on physical health but also on psychological health. The aim of this study was to measure the prevalence and severity of psychological distress in the community due to the COVID-19 pandemic. Methods This cross-sectional survey was conducted in February and March 2020 in Tehran, Iran. We analyzed demographic characteristics and assessed depression, anxiety, and stress levels in 241 people using convenience sampling and the DASS-21 questionnaire. All statistical analyses were performed using R. Results The study population included 241 community-dwelling participants, of whom 145 were women and 96 were males. The mean age was 49.16 ± 8.01 years. Approximately two-thirds of participants (n = 158) reported no history of comorbid illness. The mean scores of depression and stress were at a "severe" level, while anxiety levels were at an "extremely severe" level. The prevalence of severe and extremely severe depression readings was 51.45 and 38.17%, respectively. In the anxiety subscale, the prevalence of severe and extremely severe depression was 95.90 and 4.1%, and in the stress subscale the prevalence was 48.97 and 4.98%, respectively. Conclusion In this study, people reported experiencing severe and extremely severe psychological distress. Therefore, there is an urgent need to implement mental health intervention policies to cope with this ongoing challenge. We suggest that the incorporation of molecular biomarker tests into the algorithm could aid in assessment of patients and guide the most appropriate therapeutic response.
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Affiliation(s)
- Malihe Sadat Moayed
- Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Amir Vahedian-Azimi
- Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran.
| | - Golshan Mirmomeni
- Hearing Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Farshid Rahimi-Bashar
- Anesthesia and Critical Care Department, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Keivan Goharimoghadam
- Internal Medicine, Shariati hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohamad Amin Pourhoseingholi
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Mansour Babaei
- Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Thozhukat Sathyapalan
- Academic Diabetes, Endocrinology and Metabolism, Hull York Medical School, University of Hull, Hull, UK
| | - Paul C Guest
- Laboratory of Neuroproteomics, Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas (UNICAMP), Campinas, Brazil
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran. .,Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. .,Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland. .,Halal Research Center of IRI, FDA, Tehran, Iran.
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Yan T, Zhizhong W, Jianzhong Z, Yubo Y, Jie L, Junjun Z, Guangtian L. Depressive and Anxiety Symptoms Among People Under Quarantine During the COVID-19 Epidemic in China: A Cross-Sectional Study. Front Psychiatry 2021; 12:566241. [PMID: 33658949 PMCID: PMC7917112 DOI: 10.3389/fpsyt.2021.566241] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 01/04/2021] [Indexed: 01/26/2023] Open
Abstract
Background: During the coronavirus disease 2019 (COVID-19) pandemic, quarantine as an effective public health measure has been widely used in China and elsewhere to slow down the spread, while high-risk psychological response populations remain under-reported. Objective: The aim of the study is to investigate the depressive and anxiety symptoms among the high-risk individuals quarantined during the COVID-19 pandemic in China. Methods: An online survey was conducted from February 29 to April 10, 2020, among individuals quarantined for at least 2 weeks due to the high-risk exposure. Chinese versions of the nine-item Patient Health Questionnaire (PHQ-9) with a seven-item Generalized Anxiety Disorder (GAD-7) were applied to assess depressive and anxiety symptoms, respectively. Compliance with quarantine and knowledge of COVID-19 was also assessed. An unconditional logistic regression model was performed to identify the correlators. Results: Of the 1,260 participants completing the full survey, 14.0% (95% CI: 12.2-16.1%), 7.1% (95% CI: 5.9-8.7%), and 6.3% (95% CI: 5.1-7.8%) had at least moderate symptoms of depression, anxiety, and a combination of depression and anxiety (CDA), respectively; 14.8% (95% CI: 13.0-16.9%) had at least one condition. Multivariate analysis showed that participants with an undergraduate or above degree were more likely to report depressive (OR = 2.98, 95% CI: 1.56-5.72) and anxiety symptoms (OR = 2.95, 95% CI: 1.14-7.63) than those with middle school education. Those who were unemployed (OR = 0.37, 95% CI: 0.21-0.65 for depression; OR = 0.31, 95% CI: 0.14-0.73 for anxiety), students (OR = 0.14, 95% CI: 0.04-0.48 for depression; OR = 0.11, 95% CI: 0.01-0.85 for anxiety), and more knowledgeable of COVID-19 (OR = 0.84, 95% CI: 0.73-0.96 for depression, OR = 0.82, 95% CI: 0.68-0.98 for anxiety) were less likely to report depressive and anxiety symptoms. Higher quarantine compliance correlated with lower risks of depressive (OR = 0.94, 95% CI: 0.91-0.96) and anxiety symptoms (OR = 0.95, 95% CI: 0.91-0.98). Conclusion: Individuals under quarantine during the COVID-19 pandemic suffered prevalent depressive and anxiety symptoms. Consequently, comprehensive interventional measures, including knowledge dissemination, timely virus tests, and strengthened communication, may minimize quarantine's adverse effects.
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Affiliation(s)
- Tong Yan
- Department of Social Medicine, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Wang Zhizhong
- Department of Epidemiology and Health Statistics, School of Public Health at Guangdong Medical University, DongGuan, China.,Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, China
| | - Zheng Jianzhong
- Department of Social Medicine, School of Public Health, Shanxi Medical University, Taiyuan, China.,Department of Preventive Medicine, Chang Zhi Medical College, Changzhi, China
| | - Ying Yubo
- Department of Social Medicine, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Liu Jie
- Department of Social Medicine, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Zhang Junjun
- Department of Social Medicine, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Liu Guangtian
- Department of Infectious Disease, The Fourth People Hospital of Ningxia, Yinchuan, China
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133
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Depression, Anxiety, and Stress Among Patients with COVID-19: A Cross-Sectional Study. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1321:229-236. [PMID: 33656727 DOI: 10.1007/978-3-030-59261-5_19] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
AIM Patients with confirmed COVID-19 infection can develop several psychological consequences. Epidemiological data on mental health and psychological disorder inpatients infected with COVID-19 pneumonia are not available in Iranian patients. The purpose of this study was to evaluate the anxiety, stress, and depression of patients with COVID-19. MATERIAL AND METHODS This cross-sectional survey was conducted in 2020. All confirmed patients with COVID-19 were included in the study by census sampling. Assessment of depression, stress, and anxiety was performed using the DASS-21 questionnaire. All statistical analyses were performed using R version 3.5.1. RESULTS The questionnaires were completed by 221 patients with COVID-19 infection (204 males, 17 females). The mean age was 45.90 ± 7.73 years. Our results indicated that the mean scores of depression and anxiety were at "extremely severe" levels, while stress levels were "severe." The prevalence of "extremely severe" symptoms of depression and anxiety was 54.29% and 97.29%, respectively. The prevalence of severe stress was 46.61%. CONCLUSION In this study, patients infected with COVID-19 reported severe and extremely severe experience psychological distress. Further studies should focus on the combined use of psychological and molecular biomarker testing to increase accuracy. Overall, the findings demonstrate the necessity of special intervention programs for the confirmed patients with emerging infectious disease COVID-19 to promote mental health needs.
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134
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Hamam AA, Milo S, Mor I, Shaked E, Eliav AS, Lahav Y. Peritraumatic reactions during the COVID-19 pandemic - The contribution of posttraumatic growth attributed to prior trauma. J Psychiatr Res 2021; 132:23-31. [PMID: 33038562 PMCID: PMC7525333 DOI: 10.1016/j.jpsychires.2020.09.029] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 09/22/2020] [Accepted: 09/25/2020] [Indexed: 01/22/2023]
Abstract
Trauma survivors who suffer from posttraumatic stress disorder (PTSD) symptoms may be particularly vulnerable when facing the COVID-19 pandemic. Yet trauma exposure may also lead to salutogenic outcomes, known as posttraumatic growth (PTG). Nevertheless, the implications of PTG attributed to prior trauma, for trauma survivors' adjustment when facing additional stressors, are unclear. Addressing this gap, 528 Israeli trauma survivors were assessed for PTG and PTSD symptoms attributed to prior trauma, as well as peritraumatic stress symptoms related to the pandemic, as part of an online survey. Analyses revealed that being younger, female, quarantined, negatively self-rating one's health status, and suffering from PTSD symptoms were associated with elevated peritraumatic stress symptoms. Furthermore, PTG attributed to prior trauma made a significant contribution in explaining elevated intrusion, avoidance, and hyperarousal symptoms. The present results point to the need for clinicians to take into account reports of PTG attributed to prior trauma when treating trauma survivors during the current pandemic.
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Affiliation(s)
- Asmaa Abu Hamam
- Department of Occupational Therapy, Sackler Faculty of Medicine, Tel Aviv University, Israel.
| | - Shai Milo
- Department of Occupational Therapy, Sackler Faculty of Medicine, Tel Aviv University, Israel.
| | - Inbar Mor
- Department of Occupational Therapy, Sackler Faculty of Medicine, Tel Aviv University, Israel.
| | - Elit Shaked
- Department of Occupational Therapy, Sackler Faculty of Medicine, Tel Aviv University, Israel.
| | - Ayala Sultana Eliav
- Department of Occupational Therapy, Sackler Faculty of Medicine, Tel Aviv University, Israel.
| | - Yael Lahav
- Department of Occupational Therapy, Sackler Faculty of Medicine, Tel Aviv University, Israel.
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135
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Gong J, Chen G, Qi Z, Zhong S, Su T, Pan Y, Wang J, Huang L, Wang Y. Psychological Effects of People Isolated in Hubei Due to COVID-19 Epidemic. Front Psychiatry 2021; 12:597894. [PMID: 34393837 PMCID: PMC8355422 DOI: 10.3389/fpsyt.2021.597894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 06/30/2021] [Indexed: 01/10/2023] Open
Abstract
The Coronavirus Disease 2019 (COVID-19) epidemic broke out from Wuhan in Hubei province, China, spread nationwide and then gradually developed into other countries in the world. The implementation of unprecedented strict isolation measures has affected many aspects of people's lives and posed a challenge to psychological health. To explore whether people isolated for 14 days due to having contact with COVID-19 patients had more psychosocial problems. We conducted an online survey from February 29 to March 10, 2020. Depression, anxiety, post-traumatic stress disorder (PTSD) symptoms, and coping style were assessed by the Patient Health Questionnaire-9 (PHQ-9), 7-item Generalized Anxiety Disorder Scale (GAD-7), Impact of Event Scale-Revised (IES-R), and Simplified Coping Style Questionnaire-20-Chinese Version. This study included 1,315 isolated respondents in Hubei province (58.5% located in Wuhan). 69.3% respondents isolated at home, 30.7% respondents isolated at centralized quarantined spot. Of all respondents, 66.8% reported depressive symptoms, 49.7% reported anxiety symptoms, 89.0% reported PTSD symptoms. The Cronbach α of the IES-R, PHQ-9, GAD-7, and total SCSQ-20 were 0.935, 0.847, 0.843, and 0.888, respectively. Persons who isolated at home were associated with a lower risk of PTSD, depressive and anxiety symptoms (P < 0.01). People who knew someone to have COVID-19 were associated with severe symptoms of PTSD symptoms (P = 0.001). As for coping style, higher level of passive coping style was associated with severe symptoms of PTSD, depression and anxiety (P < 0.001). Our findings identify that person isolated during the COVID-19 epidemic was associated with high proportion of depression, anxiety, and PTSD symptoms. Public health officials should be aware of and prepared to take necessary measures.
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Affiliation(s)
- Jiaying Gong
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China.,Department of Radiology, Six Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Guanmao Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China.,Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Zhangzhang Qi
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China.,Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Shuming Zhong
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Ting Su
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China.,Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Youling Pan
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China.,Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Jurong Wang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China.,Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Li Huang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China.,Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Ying Wang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China.,Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China
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136
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Pat-Horenczyk R, Bergman YS, Schiff M, Goldberg A, Cohen A, Leshem B, Jubran H, Worku-Mengisto W, Berkowitz R, Benbenishty R. COVID-19 related difficulties and perceived coping among university and college students: the moderating role of media-related exposure and stress. Eur J Psychotraumatol 2021; 12:1929029. [PMID: 34249243 PMCID: PMC8245071 DOI: 10.1080/20008198.2021.1929029] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: University and college students are not usually identified as a population at risk during the COVID-19 pandemic. Yet, there is growing evidence of their specific distress associated with facing multiple abrupt changes and the need for rapid adaptation to a variety of academic, social, and financial challenges. The extent of their exposure to COVID-19 media and the associated media-related stress may further impair students' perceived coping. Objective: This study assessed COVID-19-related functional difficulties and perceived coping among higher education students in Israel and explored the moderating role played by media coverage of the pandemic in inducing stress and exacerbating COVID-19-related difficulties in perceived coping among students. Method: Data was collected from 7,446 students from seven academic centres in Israel through online questionnaires about four to six weeks after the outbreak of the pandemic in Israel. Results: The findings showed positive associations between COVID-19-related difficulties, media exposure, media-related stress, and decreased levels of perceived coping with the pandemic. Moreover, media-related stress (but not the level of media exposure) moderated the relationship between COVID-19-related difficulties and perceived coping: the associations were significantly stronger for students reporting high media-related stress in comparison to individuals reporting low media-related stress. Conclusions: These results highlight the specific role of media-related stress and the need to distinguish this risk factor from the global impact of exposure to media coverage. The need for self-monitoring of the subjective level of stress associated with media exposure should be part of the psychoeducation efforts provided by public health authorities for promoting self-care during the COVID-19 pandemic.
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Affiliation(s)
- Ruth Pat-Horenczyk
- Paul Baerwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Yoav S Bergman
- Faculty of Social Work, Ashkelon Academic College, Ashqelon, Israel
| | - Miriam Schiff
- Paul Baerwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Alon Goldberg
- Department of Education, Tel Hai Academic College, Kiryat Shmona, Israel
| | - Ayala Cohen
- School of Social Work, Tel Hai College, Kiryat Shmona, Israel
| | - Becky Leshem
- School of Education, Achva Academic College, Ashqelon, Israel
| | - Hisham Jubran
- Faculty of Education, Beit Berl Academic College, Kfar Saba, Israel
| | | | - Ruth Berkowitz
- School of Social Work, University of Haifa, Haifa, Israel
| | - Rami Benbenishty
- Paul Baerwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem, Israel.,Department of Education, Andres Bello National University, Santiago, Chile
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137
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Chamaa F, Bahmad HF, Darwish B, Kobeissi JM, Hoballah M, Bou Nassif S, Ghandour Y, Saliba JP, Lawand N, Abou-Kheir W. PTSD in the COVID-19 Era. Curr Neuropharmacol 2021; 19:2164-2179. [PMID: 33441072 PMCID: PMC9185760 DOI: 10.2174/1570159x19666210113152954] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 12/31/2020] [Accepted: 01/13/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND In December 2019, Wuhan City in Hubei Province, China witnessed an outbreak of a novel type of coronavirus (COVID-19), named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The sharp rise in the number of infected cases and the surge spike in fatalities worldwide prompted the World Health Organization (WHO) to declare this rapid outbreak a global pandemic in March 2020. The economic, health, and social ramifications of COVID-19 induced fear and anxiety all over the world. OBJECTIVE The purpose of this review is to discuss how precautionary measures and restrictions imposed by governments, such as quarantines, lockdowns, and social distancing, have not only caused economic losses, but also a rise in mental health problems specifically post-traumatic stress disorder (PTSD). METHODS A deep comprehensive review of the relevant literature regarding the pandemic and its debilitating consequences on the psychological status of the public was performed. RESULTS This review illustrates that the pandemic had a traumatic impact on the psychological functioning of the public, particularly COVID-19 survivors, older adults, and healthcare workers, due to difficulties in coping with new realities and uncertainties. CONCLUSION In this review, we have discussed the psychological implications of this pandemic and we have provided an extensive background for understanding options regarding PTSD management in healthy individuals and those with preexisting conditions.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Nada Lawand
- Address correspondence to these authors at the Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Bliss Street, DTS Bldg, Room 116-B, PO Box 110236/41, Riad El Solh, Beirut 1107-2020, Beirut-Lebanon; Tel: 961-1-350000, Ext. 4778; Fax: 961-1-744464; E-mail: , Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut-Lebanon; Tel: 961-1-350000, Ext. 4816; Fax: 961-1-744464; E-mail:
| | - Wassim Abou-Kheir
- Address correspondence to these authors at the Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Bliss Street, DTS Bldg, Room 116-B, PO Box 110236/41, Riad El Solh, Beirut 1107-2020, Beirut-Lebanon; Tel: 961-1-350000, Ext. 4778; Fax: 961-1-744464; E-mail: , Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut-Lebanon; Tel: 961-1-350000, Ext. 4816; Fax: 961-1-744464; E-mail:
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138
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Packness A, Wehberg S, Hastrup LH, Simonsen E, Søndergaard J, Waldorff FB. Socioeconomic position and mental health care use before and after first redeemed antidepressant and time until subsequent contact to psychologist or psychiatrists: a nationwide Danish follow-up study. Soc Psychiatry Psychiatr Epidemiol 2021; 56:449-462. [PMID: 32642803 PMCID: PMC7904708 DOI: 10.1007/s00127-020-01908-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 06/30/2020] [Indexed: 01/20/2023]
Abstract
PURPOSE The purpose was to investigate inequalities in access to care among people with possible depression. METHOD In this nationwide register-based cohort study of 30,593 persons, we observed the association between socioeconomic position (SEP, education/income) and mental health care use (MHCU) four months before the date of first redeemed antidepressant (Index Date/ID) and 12 months afterwards-and time to contact to psychologist/psychiatrist (PP). Logistic, Poisson, and Cox regression models were used, adjusted for sex, age, cohabitation, and psychiatric comorbidity. RESULTS Before ID, high SEP was associated with less GP contact (general practitioner), higher odds ratios for GP-Mental Health Counseling (GP-MHC), psychologist contact, and admissions to hospital. This disparity decreased the following 12 months for GP-MHC but increased for contact to psychologist; same pattern was seen for rate of visits. However, the low-income group had more contact to private psychiatrist. For the 25,217 individuals with no MHCU before ID, higher educational level was associated with almost twice the rate of contact to PP the following 12 months; for the high-income group, the rate was 40% higher. 10% had contact to PP within 40 days after ID in the group with higher education; whereas, 10% of those with a short education would reach PP by day 120. High-income group had faster access as well. CONCLUSION Being in high SEP was positively associated with MHCU, before and after ID, and more rapid PP contact, most explicit when measured by education. Co-payment for psychologist may divert care towards private psychiatrist for low-income groups.
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Affiliation(s)
- Aake Packness
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark. .,Psychiatric Research Unit, Psychiatry Region Zealand, Fælledvej 6, 4200, Slagelse, Denmark.
| | - Sonja Wehberg
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Lene Halling Hastrup
- Psychiatric Research Unit, Psychiatry Region Zealand, Fælledvej 6, 4200 Slagelse, Denmark
| | - Erik Simonsen
- Psychiatric Research Unit, Psychiatry Region Zealand, Fælledvej 6, 4200 Slagelse, Denmark ,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jens Søndergaard
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Frans Boch Waldorff
- Section of General Practice and The Research Unit for General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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139
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Novotný JS, Gonzalez-Rivas JP, Kunzová Š, Skladaná M, Pospíšilová A, Polcrová A, Medina-Inojosa JR, Lopez-Jimenez F, Geda YE, Stokin GB. Risk Factors Underlying COVID-19 Lockdown-Induced Mental Distress. Front Psychiatry 2020; 11:603014. [PMID: 33424666 PMCID: PMC7793642 DOI: 10.3389/fpsyt.2020.603014] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 11/30/2020] [Indexed: 12/11/2022] Open
Abstract
Recent reports suggest that the COVID-19 lockdown resulted in changes in mental health, however, potential age-related changes and risk factors remain unknown. We measured COVID-19 lockdown-induced stress levels and the severity of depressive symptoms prior to and during the COVID-19 lockdown in different age groups and then searched for potential risk factors in a well-characterized general population-based sample. A total of 715 participants were tested for mental distress and related risk factors at two time-points, baseline testing prior to COVID-19 and follow-up testing during COVID-19, using a battery of validated psychological tests including the Perceived Stress Scale and the Patient Health Questionnaire. Longitudinal measurements revealed that the prevalence of moderate to high stress and the severity of depressive symptoms increased 1.4- and 5.5-fold, respectively, during the COVID-19 lockdown. This surge in mental distress was more severe in women, but was present in all age groups with the older age group exhibiting, cross-sectionally, the lowest levels of mental distress prior to and during the lockdown. Illness perception, personality characteristics such as a feeling of loneliness, and several lifestyle components were found to be associated with a significant increase in mental distress. The observed changes in mental health and the identified potential risk factors underlying these changes provide critical data justifying timely and public emergency-tailored preventive, diagnostic, and therapeutic mental health interventions, which should be integrated into future public health policies globally.
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Affiliation(s)
- Jan Sebastian Novotný
- Translational Neuroscience and Aging Program, Centre for Translational Medicine, International Clinical Research Centre, St. Anne's University Hospital, Brno, Czechia
| | - Juan Pablo Gonzalez-Rivas
- Kardiovize Study, International Clinical Research Centre, St. Anne's University Hospital, Brno, Czechia
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Harvard University, Boston, MA, United States
| | - Šárka Kunzová
- Kardiovize Study, International Clinical Research Centre, St. Anne's University Hospital, Brno, Czechia
| | - Mária Skladaná
- Kardiovize Study, International Clinical Research Centre, St. Anne's University Hospital, Brno, Czechia
| | - Anna Pospíšilová
- Kardiovize Study, International Clinical Research Centre, St. Anne's University Hospital, Brno, Czechia
| | - Anna Polcrová
- Kardiovize Study, International Clinical Research Centre, St. Anne's University Hospital, Brno, Czechia
| | - Jose Ramon Medina-Inojosa
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States
| | - Francisco Lopez-Jimenez
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States
| | - Yonas Endale Geda
- Department of Neurology, Barrow Neurological Institute, Phoenix, AZ, United States
| | - Gorazd Bernard Stokin
- Translational Neuroscience and Aging Program, Centre for Translational Medicine, International Clinical Research Centre, St. Anne's University Hospital, Brno, Czechia
- Translational Neuroscience and Aging Program, Mayo Clinic, Rochester, MN, United States
- Division of Neurology, University Medical Centre, Ljubljana, Slovenia
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140
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Measures of depression and incident type 2 diabetes in a community sample. Ann Epidemiol 2020; 55:4-9. [PMID: 33285259 DOI: 10.1016/j.annepidem.2020.11.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 11/23/2020] [Accepted: 11/30/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE The purpose of this study was to estimate associations between distinct measures of depression and incident type 2 diabetes. METHODS Our sample consisted of 30,360 community-dwelling adults aged 40 to 69 in Canada. Depression was defined as elevated depressive symptoms using the Patient Health Questionnaire 9, diagnoses of depression in administrative data, or antidepressant use from a medication inventory. Type 2 diabetes was ascertained in administrative data over up to 7 years of follow-up. Cox proportional hazards models were used to estimate associations between different measures of depression and incident diabetes. RESULTS In separate models, elevated depressive symptoms were associated with a 17% increased risk of type 2 diabetes (hazard ratio (HR) 1.17, 95% confidence interval (CI) 1.02-1.34), diagnoses of depression were associated with a 20% increased risk (HR 1.20, 95% CI 0.94-1.52), and antidepressant use was associated with a 19% increased risk (HR 1.19, 95% CI 1.01-1.41). When examining combinations of measures in the same model, depressive symptoms paired with antidepressant use and depressive symptoms paired with diagnoses of depression were associated with the highest risk of type 2 diabetes. CONCLUSIONS Various measures of depression and combinations of measures can be used to identify older adults at higher risk of type 2 diabetes in research and public health.
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141
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Psychological distress related to COVID-19 - The contribution of continuous traumatic stress. J Affect Disord 2020; 277:129-137. [PMID: 32818776 PMCID: PMC7416772 DOI: 10.1016/j.jad.2020.07.141] [Citation(s) in RCA: 104] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 07/28/2020] [Accepted: 07/31/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVE The novel coronavirus (COVID-19) is a substantial stressor that could eventuate in psychological distress. Evidence suggests that individuals previously exposed to traumatic events, and particularly to continuous traumatic stress (CTS), might be more vulnerable to distress when facing additional stressors. This study aimed to investigate these suppositions in the context of the ongoing shelling of Israel from the Israel-Gaza border, which continues even amidst the COVID-19 crisis. METHOD An online survey was conducted among Israel's general population. The sample included 976 participants. Seven-hundred-and-ninety-three participants had been exposed to traumatic events, with 255 participants reporting CTS. Trauma exposure, COVID-19-related stressors, and psychological distress related to COVID-19 (anxiety, depression, and peritraumatic stress symptoms) were assessed. RESULTS Most participants reported experiencing at least one psychiatric symptom related to COVID-19. Being younger, female, not in a relationship, having a below-average income, being diagnosed with the disease, living alone during the outbreak, having a close other in a high-risk group, and negatively self-rating one's health status were associated with elevated distress. Individuals who had been exposed to trauma, and to CTS in particular, had elevated anxiety, depression, and peritraumatic stress symptoms compared to individuals without such a history or to survivors of non-ongoing traumatic events. CTS moderated the relations between PTSD symptoms, anxiety symptoms, and peritraumatic stress symptoms, with significantly stronger relations found among individuals exposed to CTS. LIMITATIONS This study relied on convenience sampling. CONCLUSIONS Trauma survivors, and particularly traumatized individuals exposed to CTS, seem at risk for psychological distress related to COVID-19.
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142
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Dagnino P, Anguita V, Escobar K, Cifuentes S. Psychological Effects of Social Isolation Due to Quarantine in Chile: An Exploratory Study. Front Psychiatry 2020; 11:591142. [PMID: 33312141 PMCID: PMC7704437 DOI: 10.3389/fpsyt.2020.591142] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 10/19/2020] [Indexed: 12/13/2022] Open
Abstract
As we all know, COVID-19 has impacted the entire world. Quarantine disrupts people's lives, with high levels of stress and negative psychological impacts. Studies carried out mostly in the Far East, Europe, or the United States have started to provide evidence on survivors, frontline healthcare workers, and parents. The present study is the first survey to be carried out in Latin America (in Santiago, the capital of Chile). It aims to (a) explore the perceived psychological impact and future concerns; (b) evaluate vulnerability factors; (c) describe the perceived psychological impacts on participants whose psychological help and actual online psychotherapy was interrupted; and (d) explore the future need for psychological help. Procedure: An online survey was carried out (the first 2 weeks of lockdown in Santiago), which included sociodemographic data, perceived psychological impact, future concerns, and questions about psychological support. Participants: A total of 3,919 subjects answered, mostly women (80%). Results: The main perceived psychological impacts were concern (67%) and anxiety (60%). Future concerns were: general health (55.3%), employment (53.1%), and finances (49.8%). Younger participants had a greater perceived psychological impact (p's < 0.01) and concerns about employment, finances, mental health, stigma, and general health (p's < 0.001). Women reported more perceived psychological impact than men (p's < 0.05). Men reported mainly boredom (χ2 = 11.82, gl = 1, p < 0.001). Dependent employees experienced more boredom, anxiety, distress, sleep problems, an inability to relax, and a lack of concentration than the self-employed (p's < 0.05). While the latter reported future concerns about employment and finances (p's < 0.001), dependent employees reported them on their general and mental health (p's < 0.001). Regarding psychological support, 22% of participants were receiving it before lockdown. They showed more perceived psychological impact than those who were not (p's < 0.01), and 7% of them had online psychotherapy, reporting excellent (32.1%) or odd but working (65.2%) results. Finally, of the total sample, almost half of the participants (43.8%) felt they would need emotional support after this pandemic, and these are the ones that also showed higher perceived psychological impact (p's < 0.001). This study confirms the presence of perceived negative emotional impact and concerns about the future. Also, there are vulnerable groups, such as women, younger people, the self-employed, and people with psychological processes that were interrupted.
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Affiliation(s)
- Paula Dagnino
- Faculty of Psychology, Universidad Alberto Hurtado, Santiago, Chile
- Center for the Research on Psychotherapy—CIPSI, Santiago, Chile
- Millennium Institute for Research on Depression and Personality—MIDAP, Santiago, Chile
| | - Verónica Anguita
- Ethics Committee of Research With Human Beings, Universidad Alberto Hurtado, Santiago, Chile
- Bioethics Department, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Katherine Escobar
- Faculty of Psychology, Universidad Alberto Hurtado, Santiago, Chile
- Center for the Research on Psychotherapy—CIPSI, Santiago, Chile
| | - Sofía Cifuentes
- Faculty of Psychology, Universidad Alberto Hurtado, Santiago, Chile
- Center for the Research on Psychotherapy—CIPSI, Santiago, Chile
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143
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Unmet mental health needs in the general population: perspectives of Belgian health and social care professionals. Int J Equity Health 2020; 19:169. [PMID: 32993667 PMCID: PMC7526210 DOI: 10.1186/s12939-020-01287-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 09/23/2020] [Indexed: 11/21/2022] Open
Abstract
Background An unmet mental health need exists when someone has a mental health problem but doesn’t receive formal care, or when the care received is insufficient or inadequate. Epidemiological research has identified both structural and attitudinal barriers to care which lead to unmet mental health needs, but reviewed literature has shown gaps in qualitative research on unmet mental health needs. This study aimed to explore unmet mental health needs in the general population from the perspective of professionals working with vulnerable groups. Methods Four focus group discussions and two interviews with 34 participants were conducted from October 2019 to January 2020. Participants’ professional backgrounds encompassed social work, mental health care and primary care in one rural and one urban primary care zone in Antwerp, Belgium. A topic guide was used to prompt discussions about which groups have high unmet mental health needs and why. Transcripts were coded using thematic analysis. Results Five themes emerged, which are subdivided in several subthemes: (1) socio-demographic determinants and disorder characteristics associated with unmet mental health needs; (2) demand-side barriers; (3) supply-side barriers; (4) consequences of unmet mental health needs; and (5) suggested improvements for meeting unmet mental health needs. Conclusions Findings of epidemiological research were largely corroborated. Some additional groups with high unmet needs were identified. Professionals argued that they are often confronted with cases which are too complex for regular psychiatric care and highlighted the problem of care avoidance. Important system-level factors include waiting times of subsidized services and cost of non-subsidized services. Feelings of burden and powerlessness are common among professionals who are often confronted with unmet needs. Professionals discussed future directions for an equitable mental health care provision, which should be accessible and targeted at those in the greatest need. Further research is needed to include the patients’ perspective of unmet mental health needs.
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144
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Sfendla A, Hadrya F. Factors Associated with Psychological Distress and Physical Activity During the COVID-19 Pandemic. Health Secur 2020; 18:444-453. [PMID: 32946286 DOI: 10.1089/hs.2020.0062] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
In Morocco, as in many countries, COVID-19 spread nationwide causing a public health emergency. Strict quarantine measures implemented as a result of the pandemic have disrupted many aspects of people's lives, triggering psychological distress. A total of 256 participants were recruited through a convenience sample. Data were collected through snowball sampling, an assessment of distress symptoms using the Brief Symptoms Inventory, and an assessment of leisure-time physical activity using the Godin-Shephard Leisure-Time Physical Activity Questionnaire. Bivariate and multivariate analyses were performed. Significant changes in paranoid ideation (z = -2.45, P = .01) and interpersonal sensitivity (z = -2.01, P = .04) dimensions were noted between those who were and those who were not authorized to leave their homes during quarantine. Similarly, for physical activity, significant changes in depression (z = -2.15, P = .03), anxiety (z = -2.13, P = .03), interpersonal sensitivity (z = -1.95, P = .05), and somatization (z = -2.11, P = .03) were reported among the insufficiently active group compared with the more physically active group. From multiple regression analysis, variables correlated with general distress were type of quarantine, gender, age, education level, chronic disease, and smoking (R2 = .80). With some variables, leisure-time physical activity domains appeared to be associated only with interpersonal sensitivity and somatization. Having to leave one's home during the outbreak was linked to distress, especially symptoms like suspiciousness, hostility, fearful thoughts of losing autonomy, and feelings of inadequacy, uneasiness, and discomfort during interpersonal interactions. Individuals who were moderately or sufficiently active physically reported less psychological distress.
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Affiliation(s)
- Anis Sfendla
- Anis Sfendla, PhD, is a Professor, Higher Institute of Nursing Professions and Health Techniques, Errachidia, and a Member, Abdelmalek Essaâdi University, Tetouan; and Fatine Hadrya, PhD, is a Professor, Unit of Epidemiology and Biomedical Sciences, High Institute of Health Sciences, Hassan 1st University, Settat, and a Member, Laboratory of Genetics and Biometry, Faculty of Sciences, Ibn Tofail University, Kenitra; all in Morocco
| | - Fatine Hadrya
- Anis Sfendla, PhD, is a Professor, Higher Institute of Nursing Professions and Health Techniques, Errachidia, and a Member, Abdelmalek Essaâdi University, Tetouan; and Fatine Hadrya, PhD, is a Professor, Unit of Epidemiology and Biomedical Sciences, High Institute of Health Sciences, Hassan 1st University, Settat, and a Member, Laboratory of Genetics and Biometry, Faculty of Sciences, Ibn Tofail University, Kenitra; all in Morocco
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145
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Listabarth S, Vyssoki B, Glahn A, Gmeiner A, Pruckner N, Vyssoki S, Wippel A, Waldhoer T, König D. The effect of sex on suicide risk during and after psychiatric inpatient care in 12 countries-An ecological study. Eur Psychiatry 2020; 63:e85. [PMID: 32892754 PMCID: PMC7576527 DOI: 10.1192/j.eurpsy.2020.83] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Suicide risk in patients is markedly elevated during psychiatric inpatient care, as well as after discharge. However, it is unclear whether, and to what extent, this increased suicide risk varies between sex. Thus, the aim of this study was to analyze sex differences for suicides during and after psychiatric hospitalization in various countries. METHODS National suicide mortality rates and inpatient-related suicide rates (three intervals: during psychiatric inpatient treatment, 1 month, and 1 year after discharge) from 12 countries for 2000-2016 were analyzed, and a logistic model was used to quantify the effect of sex. RESULTS Persons admitted to or discharged from psychiatric inpatient care exhibited significantly increased rates of suicide compared to those in the general population. Furthermore, increase of suicide risk was significantly higher for females than for males for all investigated time intervals (inpatient suicide odds ratio [OR] 1.85; suicide within 1 month after discharge-OR 1.94; suicide within 1 year after discharge-OR 2.04). CONCLUSION Analysis confirmed the time during and after psychiatric inpatient care to be significantly associated with an elevated risk for suicide. Further, a significant sex effect was observed, with females in this population being at a proportionally higher risk for suicide during psychiatric inpatient treatment as well as the year following discharge. Our study implicates that more effective suicide preventive measures during inpatient stay, focusing on female patients, are needed.
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Affiliation(s)
- Stephan Listabarth
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Benjamin Vyssoki
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Alexander Glahn
- Department for Psychiatry, Social Psychiatry and Psychotherapy, Medical University of Hannover, Hannover, Germany
| | - Andrea Gmeiner
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Nathalie Pruckner
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Sandra Vyssoki
- Department of Health Sciences, St. Pölten University of Applied Sciences, Sankt Pölten, Austria
| | - Andreas Wippel
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Thomas Waldhoer
- Center for Public Health, Department of Epidemiology, Medical University of Vienna, Vienna, Austria
| | - Daniel König
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
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146
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Chen X, Gao H, Zou Y, Lin F. Changes in psychological wellbeing, attitude and information-seeking behaviour among people at the epicentre of the COVID-19 pandemic: a panel survey of residents in Hubei province, China. Epidemiol Infect 2020; 148:e201. [PMID: 32873358 PMCID: PMC7487750 DOI: 10.1017/s0950268820002009] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 08/27/2020] [Accepted: 08/28/2020] [Indexed: 12/25/2022] Open
Abstract
While most research focuses on the clinical treatment of COVID-19, fewer studies have investigated individuals' responses towards this novel infectious disease. This study aims to report the temporal changes in individuals' psychological wellbeing, perceived discrimination, sociopolitical perceptions and information-seeking behaviours among the general public in Hubei, China. Data were obtained from a two-wave survey of 1902 respondents aged 18-80 in Hubei province during the peak and mitigation stages of the outbreak. The results showed that the prevalence of psychological distress dropped from over 75% to around 15% throughout the study period, but perceived discrimination remained stable. Female, middle-aged, well-educated respondents and those employed in government/public institutions/state-owned enterprises tended to report more distress. While respondents' attention on COVID-19 information kept high and stable, their sources of information diversified across different sociodemographic groups. Over time, people obtained more social support from neighbourhoods than from their friends and relatives or non-government organisations. Over 80% of respondents were satisfied with the performance of the central government, which was notably higher than their ratings on the local government and neighbourhood/village committees. The findings of this research are informative for formulating effective intervention strategies to tackle various psychosocial problems during COVID-19.
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Affiliation(s)
- Xi Chen
- Department of Media and Communication, City University of Hong Kong, Kowloon, Hong Kong
| | - Haiyan Gao
- Institute of Sociology, Chinese Academy of Social Sciences, Beijing, China
| | - Yuchun Zou
- Institute of Sociology, Chinese Academy of Social Sciences, Beijing, China
| | - Fen Lin
- Department of Media and Communication, City University of Hong Kong, Kowloon, Hong Kong
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147
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Nurmela KS, Heikkinen VH, Ylinen AM, Uitti JA, Virtanen PJ. Healthcare attendance styles among long-term unemployed people with substance-related and mood disorders. Public Health 2020; 186:211-216. [PMID: 32861086 DOI: 10.1016/j.puhe.2020.07.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 06/16/2020] [Accepted: 07/19/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND Both increased and decreased health service usage and unmet care needs are more prevalent among unemployed people than in the general population. STUDY DESIGN This study investigates the associations of substance-related and mood disorders among long-term unemployed people with styles of healthcare attendance in Finland. METHODS The study material consisted of the health register information on 498 long-term unemployed people in a project screening for work disabilities. The data were analysed by mixed methods: qualitative typological analysis was applied to identify differential healthcare attendance styles, and the associations of the obtained styles with mental health disorders were analysed quantitatively by multinomial logistic regression. RESULTS Three styles, characterized as smooth, faltering and marginalized, were identified. Compared with participants with the smooth attendance style without mental disorders, those with the faltering style had tenfold relative risk for substance-related disorder and fourfold relative risk for mood disorder. Those with the marginalized style had fivefold relative risk for substance-related disorder and twofold relative risk for mood disorder. Adjusting for background characteristics did not alter the statistical significance of substance-related disorder. In the case of mood disorders, the statistical significance persisted throughout the adjustments in the faltering style. CONCLUSION Dysfunctional use of health services is more common among people with substance-related or mood disorders, who are at risk of drifting towards long-term unemployment and work disabilities. The early detection of those with faltering or marginalized healthcare attendance style may prevent prolonged unemployment, enable rehabilitation measures and reduce the risk of disability pensions.
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Affiliation(s)
- K S Nurmela
- Faculty of Social Sciences, Health Sciences, Tampere University, Tampere, Finland; Mental Health and Substance Abuse Services, City of Tampere, Finland.
| | - V H Heikkinen
- Department of Neurosciences and Rehabilitation, Tampere University Hospital, Tampere, Finland
| | - A M Ylinen
- Department of Neurosciences and Rehabilitation, Tampere University Hospital, Tampere, Finland
| | - J A Uitti
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Clinic of Occupational Medicine, Tampere University Hospital, Tampere, Finland; Finnish Institute of Occupational Health, Tampere, Finland
| | - P J Virtanen
- Faculty of Social Sciences, Health Sciences, Tampere University, Tampere, Finland; Faculty of Medicine, Department of Public Health, Uppsala University, Uppsala, Sweden
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148
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Aragonès E, Sánchez-Iriso E, López-Cortacans G, Tomé-Pires C, Rambla C, Sánchez-Rodríguez E. Cost-effectiveness of a collaborative care program for managing major depression and chronic musculoskeletal pain in primary care: Economic evaluation alongside a randomized controlled trial. J Psychosom Res 2020; 135:110167. [PMID: 32554105 DOI: 10.1016/j.jpsychores.2020.110167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 05/26/2020] [Accepted: 06/04/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND We designed a collaborative care program for the integrated management of chronic musculoskeletal pain and depression, which frequently coexist in primary care patients. The aim of this study was to evaluate the cost-effectiveness of this program compared with care as usual. METHODS We performed a cost-effectiveness analysis alongside a randomized clinical trial. Results were monitored over a 12-month period. The primary outcome was the incremental cost-effectiveness ratio (ICER). We performed cost-effectiveness analyses from the perspectives of the healthcare system and society using an intention-to-treat approach with imputation of missing values. RESULTS We evaluated 328 patients (167 in the intervention group and 161 in the control group) with chronic musculoskeletal pain and major depression at baseline. From the healthcare system perspective, the mean incremental cost was €234 (p = .17) and the mean incremental effectiveness was 0.009 QALYs (p = .66), resulting in an ICER of €23,989/QALY. Costs from the societal perspective were €235 (p = .16), yielding an ICER of €24,102/QALY. These estimates were associated with a high degree of uncertainty illustrated on the cost-effectiveness plane. CONCLUSIONS Contrary to our expectations, the collaborative care program had no significant effects on health status, and although the additional costs of implementing the program compared with care as usual were not high, we were unable to demonstrate a favorable cost-effectiveness ratio, largely due to the high degree of uncertainty surrounding the estimates.
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Affiliation(s)
- Enric Aragonès
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain; Atenció Primària Camp de Tarragona, Institut Català de la Salut, Tarragona, Spain.
| | - Eduardo Sánchez-Iriso
- Department of Economics, Public University of Navarra, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Germán López-Cortacans
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain; Atenció Primària Camp de Tarragona, Institut Català de la Salut, Tarragona, Spain
| | - Catarina Tomé-Pires
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain; ISCTE-Lisbon University Institute (ISCTE-IUL), Center for Social Research and Intervention (CIS-IUL), Lisbon, Portugal
| | - Concepción Rambla
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain; Atenció Primària Camp de Tarragona, Institut Català de la Salut, Tarragona, Spain
| | - Elisabet Sánchez-Rodríguez
- Unit for the Study and Treatment of Pain - ALGOS, Research Center for Behavior Assessment (CRAMC), Department of Psychology, Universitat Rovira i Virgili, Tarragona, Spain; Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Tarragona, Spain
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149
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Fugger G, Waldhör T, Hinterbuchinger B, Pruckner N, König D, Gmeiner A, Vyssoki S, Vyssoki B, Fellinger M. Pattern of inpatient care for depression: an analysis of 232,289 admissions. BMC Psychiatry 2020; 20:375. [PMID: 32677945 PMCID: PMC7364660 DOI: 10.1186/s12888-020-02781-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Accepted: 07/08/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The prevalence of major depressive disorder (MDD) in women is up to 50% higher as compared to men. However, little is known about discrepancies in health care utilization between depressed female and male patients. Consequently, the aim of the present study was to elucidate gender differences regarding the frequency of hospital admissions and the length of inpatient treatment for MDD across the lifespan. METHODS This nationwide, registry-based study analyzed all inpatient admissions in psychiatric hospitals due to recurrent/non-recurrent MDD episodes according to ICD-10 (moderate (F32/33.1), severe (F32/33.2), severe with psychotic features (F32/33.3)) in Austria across 14 years. We calculated weekly admission rates per 100,000 patients by directly age-standardized rates. RESULTS Across 232,289 admissions (63.2% female) the population based admission rates in MDD were significantly higher in women (p < 0.001). Female to male ratios across subgroups were 1.65 (F32/33.1), 1.58 (F32/33.2), 1.73 (F32/33.3), and peaked around 65 years (ratio ≥ 2 for all subgroups). Length of hospital stay for women was significantly longer in all depression subtypes (p < 0.001). CONCLUSIONS Elevated rates of inpatient treatment in women cannot solely be explained by a higher MDD prevalence and are dependent on age and type of depressive episode. Irrespective of the type and severity of the mood episode, women exhibit longer hospitalisation times.
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Affiliation(s)
- Gernot Fugger
- grid.22937.3d0000 0000 9259 8492Clinical Division of General Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Thomas Waldhör
- grid.22937.3d0000 0000 9259 8492Centre for Public Health, Department of Epidemiology, Medical University of Vienna, Vienna, Austria
| | - Barbara Hinterbuchinger
- grid.22937.3d0000 0000 9259 8492Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Wien, Austria
| | - Nathalie Pruckner
- grid.22937.3d0000 0000 9259 8492Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Wien, Austria
| | - Daniel König
- grid.22937.3d0000 0000 9259 8492Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Wien, Austria
| | - Andrea Gmeiner
- grid.22937.3d0000 0000 9259 8492Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Wien, Austria
| | - Sandra Vyssoki
- grid.434096.c0000 0001 2190 9211St. Pölten University of Applied Sciences, Sankt Pölten, Austria
| | - Benjamin Vyssoki
- grid.22937.3d0000 0000 9259 8492Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Wien, Austria
| | - Matthäus Fellinger
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Wien, Austria.
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150
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Elovanio M, Hakulinen C, Pulkki-Råback L, Aalto AM, Virtanen M, Partonen T, Suvisaari J. General Health Questionnaire (GHQ-12), Beck Depression Inventory (BDI-6), and Mental Health Index (MHI-5): psychometric and predictive properties in a Finnish population-based sample. Psychiatry Res 2020; 289:112973. [PMID: 32413708 DOI: 10.1016/j.psychres.2020.112973] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 03/17/2020] [Accepted: 03/29/2020] [Indexed: 01/04/2023]
Abstract
The short versions of the General Health Questionnaire (GHQ-12), Beck's Depression Inventory (BDI-6), and Mental Health Index (MHI-5) are all valid and reliable measures of general psychological distress, depressive symptoms, and anxiety. We tested the psychometric properties of the scales, their overlap, and their ability to predict mental health service use using both regression and machine learning (ML, random forest) approaches. Data were from the population-based FinHealth-2017 Study of adults (N = 4270) with data on all of the evaluated instruments. Constructive validity, internal consistency, invariance, and optimal cut-off points in predicting mental health services were tested. Constructive validity was acceptable and all instruments measured their own distinct phenomenon. Some of the item scoring in BDI-6 was not optimal, and the sensitivity and specificity of all scales were relatively weak in predicting service use. Small gender differences emerged in optimal cut-off points. ML did not improve model predictions. GHQ-12, BDI-6, and MHI-5 may be interpreted to measure different constructs of psychological health symptoms, but are not particularly useful predictors of service use.
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Affiliation(s)
- Marko Elovanio
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland; National Institute for Health and Welfare, Finland.
| | - Christian Hakulinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | - Laura Pulkki-Råback
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | | | - Marianna Virtanen
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland
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