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Bignardi G, Dalmaijer ES, Anwyl-Irvine AL, Smith TA, Siugzdaite R, Uh S, Astle DE. Longitudinal increases in childhood depression symptoms during the COVID-19 lockdown. Arch Dis Child 2021; 106:791-797. [PMID: 33298552 PMCID: PMC7733224 DOI: 10.1136/archdischild-2020-320372] [Citation(s) in RCA: 131] [Impact Index Per Article: 43.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/12/2020] [Accepted: 11/05/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE There has been widespread concern that so-called lockdown measures, including social distancing and school closures, could negatively impact children's mental health. However, there has been little direct evidence of any association due to the paucity of longitudinal studies reporting mental health before and during the lockdown. This present study provides the first longitudinal examination of changes in childhood mental health, a key component of an urgently needed evidence base that can inform policy and practice surrounding the continuing response to the COVID-19 pandemic. METHODS Mental health assessments on 168 children (aged 7.6-11.6 years) were taken before and during the UK lockdown (April-June 2020). Assessments included self-reports, caregiver reports, and teacher reports. Mean mental health scores before and during the UK lockdown were compared using mixed linear models. RESULTS A significant increase in depression symptoms during the UK lockdown was observed, as measured by the Revised Child Anxiety and Depression Scale (RCADS) short form. CIs suggest a medium-to-large effect size. There were no significant changes in the RCADS anxiety subscale and Strengths and Difficulties Questionnaire emotional problems subscale. CONCLUSIONS During the UK lockdown, children's depression symptoms have increased substantially, relative to before lockdown. The scale of this effect has direct relevance for the continuation of different elements of lockdown policy, such as complete or partial school closures. This early evidence for the direct impact of lockdown must now be combined with larger scale epidemiological studies that establish which children are most at risk and tracks their future recovery.
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Affiliation(s)
- Giacomo Bignardi
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Edwin S Dalmaijer
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | | | - Tess A Smith
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Roma Siugzdaite
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Stepheni Uh
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Duncan E Astle
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
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252
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Fernández-Sanlés A, Smith D, Clayton GL, Northstone K, Carter AR, Millard LAC, Borges MC, Timpson NJ, Tilling K, Griffith GJ, Lawlor DA. Bias from questionnaire invitation and response in COVID-19 research: an example using ALSPAC. Wellcome Open Res 2021; 6:184. [PMID: 35919505 PMCID: PMC9294498 DOI: 10.12688/wellcomeopenres.17041.1] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Longitudinal studies are crucial for identifying potential risk factors for infection with, and consequences of, COVID-19, but relationships can be biased if they are associated with invitation and response to data collection. We describe factors relating to questionnaire invitation and response in COVID-19 questionnaire data collection in a multigenerational birth cohort (the Avon Longitudinal Study of Parents and Children, ALSPAC). Methods: We analysed online questionnaires completed between the beginning of the pandemic and easing of the first UK lockdown by participants with valid email addresses who had not actively disengaged from the study. We assessed associations of pre-pandemic sociodemographic, behavioural, anthropometric and health-related factors with: i) being sent a questionnaire; ii) returning a questionnaire; and iii) item response (for specific questions). Analyses were conducted in three cohorts: the index children born in the early 1990s (now young adults; 41 variables assessed), their mothers (35 variables) and the mothers' partners (27 variables). Results: Of 14,849 young adults, 41% were sent a questionnaire, of whom 57% returned one. Item response was >95%. In this cohort, 78% of factors were associated with being sent a questionnaire, 56% with returning one, and, as an example of item response, 20% with keyworker status response. For instance, children from mothers educated to degree-level had greater odds of being sent a questionnaire (OR=5.59; 95% CI=4.87-6.41), returning one (OR=1.60; 95% CI=1.31-1.95), and responding to items (e.g., keyworker status OR=1.65; 95% CI=0.88-3.04), relative to children from mothers with fewer qualifications. Invitation and response rates and associations were similar in all cohorts. Conclusions: These results highlight the importance of considering potential biases due to non-response when using longitudinal studies in COVID-19 research and interpreting results. We recommend researchers report response rates and factors associated with invitation and response in all COVID-19 observational research studies, which can inform sensitivity analyses.
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Affiliation(s)
- Alba Fernández-Sanlés
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Daniel Smith
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Gemma L Clayton
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Kate Northstone
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Alice R Carter
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Louise AC Millard
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Maria Carolina Borges
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Nicholas John Timpson
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Kate Tilling
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Gareth J Griffith
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Deborah A Lawlor
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
- Bristol National Institute of Health Research (NIHR) Biomedical Research Centre, Bristol, UK
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253
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Fawns-Ritchie C, Altschul DM, Campbell A, Huggins C, Nangle C, Dawson R, Edwards R, Flaig R, Hartley L, Levein C, McCartney DL, Bell D, Douglas E, Deary IJ, Hayward C, Marioni RE, McIntosh AM, Sudlow C, Porteous DJ. CovidLife: a resource to understand mental health, well-being and behaviour during the COVID-19 pandemic in the UK. Wellcome Open Res 2021; 6:176. [PMID: 38406227 PMCID: PMC10884595 DOI: 10.12688/wellcomeopenres.16987.1] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2021] [Indexed: 02/27/2024] Open
Abstract
CovidLife is a longitudinal observational study designed to investigate the impact of the COVID-19 pandemic on mental health, well-being and behaviour in adults living in the UK. In total, 18,518 participants (mean age = 56.43, SD = 14.35) completed the first CovidLife questionnaire (CovidLife1) between April and June 2020. To date, participants have completed two follow-up assessments. CovidLife2 took place between July and August 2020 (n = 11,319), and CovidLife3 took place in February 2021 (n = 10,386). A range of social and psychological measures were administered at each wave including assessments of anxiety, depression, well-being, loneliness and isolation. Information on sociodemographic, health, and economic circumstances was also collected. Questions also assessed information on COVID-19 infections and symptoms, compliance to COVID-19 restrictions, and opinions on the UK and Scottish Governments' handling of the pandemic. CovidLife includes a subsample of 4,847 participants from the Generation Scotland cohort (N~24,000, collected 2006-2011); a well-characterised cohort of families in Scotland with pre-pandemic data on mental health, physical health, lifestyle, and socioeconomic factors, along with biochemical and genomic data derived from biological samples. These participants also consented to their study data being linked to Scottish health records. CovidLife and Generation Scotland data can be accessed and used by external researchers following approval from the Generation Scotland Access Committee. CovidLife can be used to investigate mental health, well-being and behaviour during COVID-19; how these vary according to sociodemographic, health and economic circumstances; and how these change over time. The Generation Scotland subsample with pre-pandemic data and linkage to health records can be used to investigate the predictors of health and well-being during COVID-19 and the future health consequences of the COVID-19 pandemic.
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Affiliation(s)
- Chloe Fawns-Ritchie
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, EH4 2XU, UK
- Department of Psychology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
| | - Drew M. Altschul
- Department of Psychology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
| | - Archie Campbell
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, EH4 2XU, UK
- Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, EH16 4UX, UK
| | - Charlotte Huggins
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, EH4 2XU, UK
| | - Clifford Nangle
- Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, EH16 4UX, UK
| | - Rebecca Dawson
- Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, EH16 4UX, UK
| | - Rachel Edwards
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, EH4 2XU, UK
- MRC Human Genetics Unit, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, EH4 2XU, UK
| | - Robin Flaig
- Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, EH16 4UX, UK
| | - Louise Hartley
- Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, EH16 4UX, UK
| | - Christie Levein
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, EH4 2XU, UK
| | - Daniel L. McCartney
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, EH4 2XU, UK
| | - David Bell
- Division of Economics, Stirling Management School, University of Stirling, Stirling, FK9 4LA, UK
| | - Elaine Douglas
- Faculty of Social Sciences, University of Stirling, Stirling, FK9 4LA, UK
| | - Ian J. Deary
- Department of Psychology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
| | - Caroline Hayward
- MRC Human Genetics Unit, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, EH4 2XU, UK
| | - Riccardo E. Marioni
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, EH4 2XU, UK
| | - Andrew M. McIntosh
- Division of Psychiatry, University of Edinburgh, Edinburgh, EH10 5HF, UK
| | - Cathie Sudlow
- Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, EH16 4UX, UK
| | - David J. Porteous
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, EH4 2XU, UK
- Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, EH16 4UX, UK
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254
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Sideropoulos V, Dukes D, Hanley M, Palikara O, Rhodes S, Riby DM, Samson AC, Van Herwegen J. The Impact of COVID-19 on Anxiety and Worries for Families of Individuals with Special Education Needs and Disabilities in the UK. J Autism Dev Disord 2021; 52:2656-2669. [PMID: 34196890 PMCID: PMC8246131 DOI: 10.1007/s10803-021-05168-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2021] [Indexed: 12/01/2022]
Abstract
COVID-19 has affected people across the world. The current study examined anxiety and worries during the first UK national lockdown in March 2020. Parents (n = 402) reported on their own anxiety and worries as well as that of their son/daughter with Special Education Needs and Disabilities (SEND) and typically developing (TD) child (n = 186) at three time points. Although both groups showed increased anxiety across the three time points, levels of anxiety in the SEND group, but not the TD siblings, were predicted by awareness about COVID-19. In addition, worries differed between the groups showing that COVID-19 impacts the wellbeing of those with SEND differently to that of their TD siblings.
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Affiliation(s)
- V Sideropoulos
- Department of Psychology and Human Development, UCL, Institute of Education, University College London, London, UK
| | - D Dukes
- Institute of Special Education, University of Fribourg, Fribourg, Switzerland
- Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland
| | - M Hanley
- Department of Psychology, Centre for Developmental Disorders, Durham University, Durham, UK
| | - O Palikara
- Department for Education Studies, University of Warwick, Coventry, UK
| | - S Rhodes
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - D M Riby
- Department of Psychology, Centre for Developmental Disorders, Durham University, Durham, UK
| | - A C Samson
- Institute of Special Education, University of Fribourg, Fribourg, Switzerland
- Faculty of Psychology, Unidistance Suisse, Brig, Switzerland
| | - J Van Herwegen
- Department of Psychology and Human Development, UCL, Institute of Education, University College London, London, UK.
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255
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McGrath M, Duncan F, Dotsikas K, Baskin C, Crosby L, Gnani S, Hunter RM, Kaner E, Kirkbride JB, Lafortune L, Lee C, Oliver E, Osborn DP, Walters KR, Dykxhoorn J. Effectiveness of community interventions for protecting and promoting the mental health of working-age adults experiencing financial uncertainty: a systematic review. J Epidemiol Community Health 2021; 75:665-673. [PMID: 33931550 PMCID: PMC8223661 DOI: 10.1136/jech-2020-215574] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 03/01/2021] [Accepted: 03/23/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND The COVID-19 pandemic has created a period of global economic uncertainty. Financial strain, personal debt, recent job loss and housing insecurity are important risk factors for the mental health of working-age adults. Community interventions have the potential to attenuate the mental health impact of these stressors. We examined the effectiveness of community interventions for protecting and promoting the mental health of working-age adults in high-income countries during periods of financial insecurity. METHODS Eight electronic databases were systematically screened for experimental and observational studies published since 2000 measuring the effectiveness of community interventions on mental health outcomes. We included any non-clinical intervention that aimed to address the financial, employment, food or housing insecurity of participants. A review protocol was registered on the PROSPERO database (CRD42019156364) and results are reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS From 2326 studies screened, 15 met our inclusion criteria. Five categories of community intervention were identified: advice services colocated in healthcare settings; link worker social prescribing; telephone debt advice; food insecurity interventions; and active labour market programmes. In general, the evidence for effective and cost-effective community interventions delivered to individuals experiencing financial insecurity was lacking. From the small number of studies without a high risk of bias, there was some evidence that financial insecurity and associated mental health problems were amenable to change and differences by subpopulations were observed. CONCLUSION There is a need for well-controlled studies and trials to better understand effective ingredients and to identify those interventions warranting wider implementation.
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Affiliation(s)
- Michael McGrath
- Division of Psychiatry, University College London, London, UK
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Fiona Duncan
- Department of Sport and Exercise Sciences, Durham University, Durham, UK
| | - Kate Dotsikas
- Division of Psychiatry, University College London, London, UK
| | - Cleo Baskin
- Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Liam Crosby
- Department of Primary Care and Population Health, University College London, London, UK
| | - Shamini Gnani
- Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Rachael Maree Hunter
- Department of Primary Care and Population Health, University College London, London, UK
| | - Eileen Kaner
- Institute of Health and Society, Newcastle University, Newcastle, UK
| | | | | | - Caroline Lee
- Cambridge Public Health, University of Cambridge, Cambridge, UK
- Cambridge Institute for Sustainability Leadership, Cambridge, UK
| | - Emily Oliver
- Department of Sport and Exercise Sciences, Durham University, Durham, UK
| | - David P Osborn
- Division of Psychiatry, University College London, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
| | - Kate R Walters
- Department of Primary Care and Population Health, University College London, London, UK
| | - Jennifer Dykxhoorn
- Division of Psychiatry, University College London, London, UK
- Department of Primary Care and Population Health, University College London, London, UK
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256
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Smith D, Bowring C, Wells N, Crawford M, Timpson NJ, Northstone K. The Avon Longitudinal Study of Parents and Children - A resource for COVID-19 research: Questionnaire data capture November 2020 - March 2021. Wellcome Open Res 2021; 6:155. [PMID: 34796274 PMCID: PMC8591520 DOI: 10.12688/wellcomeopenres.16950.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2021] [Indexed: 09/13/2023] Open
Abstract
The Avon Longitudinal Study of Parents and Children (ALSPAC) is a prospective population-based cohort study which recruited pregnant women in 1990-1992 and has followed these women, their partners (Generation 0; G0) and their offspring (Generation 1; G1) ever since. The study has reacted rapidly and repeatedly to the coronavirus disease 2019 (COVID-19) pandemic, deploying online questionnaires throughout the pandemic. In November/December 2020, a fourth questionnaire was deployed asking about physical and mental health, lifestyle and behaviours, employment and finances. G0 participants were offered an online questionnaire between 17 th November 2020 and 7 th February 2021, while G1 participants were offered both online and paper questionnaires between 1 st December 2020 and 19 th March 2021. Of 15,844 invitations, 8,643 (55%) participants returned the questionnaire (3,101 original mothers [mean age 58.6 years], 1,172 original fathers/partners [mean age 61.5 years] and 4,370 offspring [mean age 28.4 years]). Of these 8,643 participants, 2,012 (23%) had not returned a previous COVID-19 questionnaire, while 3,575 (41%) had returned all three previous questionnaires. In this questionnaire, 300 participants (3.5%) reported a previous positive COVID-19 test, 110 (1.3%) had been told by a doctor they likely had COVID-19, and 759 (8.8%) suspected that they had had COVID-19. Based on self-reported symptoms, between October 2020 and February 2021 359 participants (4.2%) were predicted COVID-19 cases. COVID data is being complemented with linkage to health records and Public Health England pillar testing results as they become available. Data has been released as an update to the previous COVID-19 datasets. It comprises: 1) a standard dataset containing all participant responses to both questionnaires with key sociodemographic factors; and 2) as a composite release coordinating data from the existing resource, thus enabling bespoke research across all areas supported by the study. This data note describes the fourth questionnaire and the data obtained from it.
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Affiliation(s)
- Daniel Smith
- ALSPAC, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Claire Bowring
- ALSPAC, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Nicholas Wells
- ALSPAC, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Michael Crawford
- ALSPAC, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Nicholas John Timpson
- ALSPAC, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Kate Northstone
- ALSPAC, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
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257
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Ayuso-Mateos JL, Morillo D, Haro JM, Olaya B, Lara E, Miret M. Changes in depression and suicidal ideation under severe lockdown restrictions during the first wave of the COVID-19 pandemic in Spain: a longitudinal study in the general population. Epidemiol Psychiatr Sci 2021; 30:e49. [PMID: 34074355 PMCID: PMC8193203 DOI: 10.1017/s2045796021000408] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 05/24/2021] [Accepted: 05/25/2021] [Indexed: 12/12/2022] Open
Abstract
AIMS To assess whether there is a change in the prevalence of depression and suicidal ideation after the strict lockdown measures due to the first wave of the COVID-19 pandemic in Spain; and to assess which are the factors associated with the incidence of a depressive episode or suicidal ideation during the lockdown. METHODS Data from a longitudinal adult population-based cohort from the provinces of Madrid and Barcelona were analysed (n = 1103). Structured face-to-face home-based interviews (pre-pandemic) and telephone interviews were performed. Both depression and suicidal ideation were assessed through an adaptation of the Composite International Diagnostic Interview (CIDI 3.0). A variety of validated instruments and sociodemographic variables including age, sex, educational level, occupational status, home quietness, screen time, resilience, loneliness, social support, physical activity, disability, economic situation and COVID-19-related information were also considered. Population prevalence estimates and multivariable logistic regressions were computed. RESULTS Overall, prevalence rates of depression and suicidal ideation did not change significantly from before to after the COVID-19 outbreak. However, the rates of depression among individuals aged 50+ years showed a significant decrease compared to before the pandemic (from 8.48 to 6.41%; p = 0.01). Younger individuals (odds ratio (OR) = 0.97 per year older; 95% confidence interval (CI) = 0.95-0.99) and those feeling loneliness (OR = 1.96; 95% CI = 1.42-2.70) during the lockdown were at an increased risk of developing depression during the confinement. Resilience showed a protective effect against the risk of depression (OR = 0.46; 95% CI = 0.32-0.66) and suicidal ideation (OR = 0.33; 95% CI = 0.16-0.68), whereas individuals perceiving social support were at a lower risk of developing suicidal thoughts (OR = 0.35; 95% CI = 0.18-0.69). CONCLUSIONS Continuous reinforcement of mental health preventive and intervening measures during and in the aftermath of the crisis is of global importance, particularly among vulnerable groups who are experiencing the most distress. Future research should strive to evaluate the long-term effects of the COVID-19 crisis on mental health.
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Affiliation(s)
- J. L. Ayuso-Mateos
- Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
| | - D. Morillo
- Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
| | - J. M. Haro
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain
| | - B. Olaya
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain
| | - E. Lara
- Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
| | - M. Miret
- Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
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258
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Bhuiyan N, Puzia M, Stecher C, Huberty J. Associations Between Rural or Urban Status, Health Outcomes and Behaviors, and COVID-19 Perceptions Among Meditation App Users: Longitudinal Survey Study. JMIR Mhealth Uhealth 2021; 9:e26037. [PMID: 33900930 PMCID: PMC8158528 DOI: 10.2196/26037] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 02/27/2021] [Accepted: 04/20/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Rural and urban differences in health outcomes and behaviors have been well-documented, with significant rural health disparities frequently highlighted. Mobile health (mHealth) apps, such as meditation apps, are a novel method for improving health and behaviors. These apps may be a critical health promotion strategy during the COVID-19 pandemic and could potentially be used to address rural health disparities. However, limited research has assessed whether meditation app health outcomes are associated with rural and urban residence, and it is unclear whether disparities in health and behaviors between rural and urban populations would persist among meditation app users. OBJECTIVE We aimed to explore associations between rural or urban status, psychological outcomes, and physical activity among users of a mobile meditation app. We further aimed to explore associations between rural or urban status and perceived effects of COVID-19 on stress, mental health, and physical activity, and to explore changes in these outcomes in rural versus urban app users over time. METHODS This study was a secondary analysis of a national survey conducted among subscribers to the meditation app Calm. Eligible participants completed online baseline surveys from April to June 2020, and follow-up surveys from June to September 2020, assessing demographics, psychological outcomes, physical activity, and perceived effects of COVID-19 on stress, mental health, and physical activity. RESULTS Participants (N=8392) were mostly female (7041/8392, 83.9%), non-Hispanic (7855/8392, 93.6%), and White (7704/8392, 91.8%); had high socioeconomic status (income ≥US $100,000: 4389/8392, 52.3%; bachelor's degree or higher: 7251/8392, 86.4%); and resided in a metropolitan area core (rural-urban commuting area code 1: 7192/8392, 85.7%). Rural or urban status was not associated with baseline stress, depression, anxiety, pre-COVID-19 and current physical activity, or perceived effects of COVID-19 on stress, mental health, and physical activity. Repeated-measures models showed overall decreases in depression, anxiety, and perceived effects of COVID-19 on physical activity from baseline to follow-up, and no significant changes in stress or perceived effects of COVID-19 on stress and mental health over time. Models also showed no significant main effects of rural or urban status, COVID-19 statewide prevalence at baseline, or change in COVID-19 statewide prevalence. CONCLUSIONS We did not find associations between rural or urban status and psychological outcomes (ie, stress, depression, and anxiety), physical activity, or perceived effects of COVID-19 on stress, mental health, and physical activity. Rural or urban status does not appear to drive differences in outcomes among meditation app users, and the use of mHealth apps should continue to be explored as a health promotion strategy in both rural and urban populations. Furthermore, our results did not show negative cumulative effects of COVID-19 on psychological outcomes and physical activity among app users in our sample, the majority of whom were urban, White, female, and of high socioeconomic status. Further research is needed to investigate meditation app use as a health promotion strategy in rural and urban populations.
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Affiliation(s)
- Nishat Bhuiyan
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States
| | - Megan Puzia
- Behavioral Research and Analytics, LLC, Salt Lake City, UT, United States
| | - Chad Stecher
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States
| | - Jennifer Huberty
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States
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Thomas A, Danon L, Christensen H, Northstone K, Smith D, Nixon E, Trickey A, Hemani G, Sauchelli S, Finn A, Timpson N, Brooks-Pollock E. Limits of lockdown: characterising essential contacts during strict physical distancing. Wellcome Open Res 2021. [DOI: 10.12688/wellcomeopenres.16785.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Background: Coronavirus disease 2019 (COVID-19) has exposed health inequalities within countries and globally. The fundamental determining factor behind an individual’s risk of infection is the number of social contacts they make. In many countries, physical distancing measures have been implemented to control transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), reducing social contacts to a minimum. We characterise social contacts to understand the drivers and inequalities behind differential risks for aiding in planning SARS-CoV-2 mitigation programmes. Methods: We utilised an existing longitudinal birth cohort (n=6807) to explore social contact patterns and behaviours when strict physical distancing measures were in place during the UK’s first lockdown in March-May 2020. We used an online questionnaire to capture information on participant contact patterns, health, SARS-CoV-2 exposure, behaviours and impacts resulting from COVID-19. We quantified daily contacts and examined the association between covariates and numbers of daily total contacts using a negative binomial regression model. Results: A daily average of 3.7 [standard deviation = 10.6] total contacts outside the household were reported. Essential workers, specifically those in healthcare, had 4.5 times as many contacts as non-essential workers [incident rate ratio = 4.42 (95% CI: 3.88–5.04)], whilst essential workers in other sectors, mainly teaching and the police force had three times as many contacts [IRR = 2.84 (2.58–3.13)]. The number of individuals in a household, which largely reflects number of children, increases essential social contacts by 40%. Self-isolation effectively reduces numbers of contacts outside of the home, but not entirely. Conclusions: Contextualising contact patterns has highlighted the health inequalities exposed by COVID-19, as well as potential sources of infection risk and transmission. Together, these findings will aid the interpretation of epidemiological data and impact the design of effective control strategies for SARS-CoV-2, such as vaccination, testing and contact tracing.
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Mak HW, Fluharty M, Fancourt D. Predictors and Impact of Arts Engagement During the COVID-19 Pandemic: Analyses of Data From 19,384 Adults in the COVID-19 Social Study. Front Psychol 2021; 12:626263. [PMID: 33981269 PMCID: PMC8109242 DOI: 10.3389/fpsyg.2021.626263] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 03/26/2021] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES The global COVID-19 pandemic in 2020 heavily affected the arts and creative industries due to the instigation of lockdown measures in the United Kingdom and closure of venues. However, it also provided new opportunities for arts and cultural engagement through virtual activities and streamed performances. Yet it remains unclear (i) who was likely to engage with the arts at home during lockdown, (ii) how this engagement differed from patterns of arts engagement prior to COVID-19, and (iii) whether home-based arts engagement was related to people's ability to cope with their emotions during lockdown. This study was therefore designed to address these questions. METHODS We used data collected in late May from the United Kingdom COVID-19 Social Study run by University College London. Multivariate regressions were used for the analysis (N = 19,384). Identified factors included demographic factors, socio-economic position, psychosocial wellbeing and health conditions, adverse events/worries, and coping styles. RESULTS Four types of home-based arts engagement were identified during the COVID-19 pandemic: digital arts and writing, musical activities, crafts, and reading for pleasure. Our results show that the strongest predictors of the engagement were age, education attainment, social support, and emotion-focused or supportive coping styles. In particular, younger adults (aged 18-29), non-keyworkers, people with greater social support, people who had lost work, those who were worried about catching the virus, and those with an emotion-focused, problem-focused or supportive coping style were more likely to have increased arts engagement during lockdown. Arts activities were used as approach and avoidance strategies to help cope with emotions, as well as to help improve self-development. CONCLUSION Overall, our study suggests that while some people who engaged in the arts during the COVID-19 pandemic were those who typically engage under normal circumstances, the pandemic has also created new incentives and opportunities for others to engage virtually. Additionally, this study highlights the value of the arts as coping tools during stressful situations.
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Affiliation(s)
| | | | - Daisy Fancourt
- Department of Behavioural Science and Health, University College London, London, United Kingdom
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261
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Knolle F, Ronan L, Murray GK. The impact of the COVID-19 pandemic on mental health in the general population: a comparison between Germany and the UK. BMC Psychol 2021; 9:60. [PMID: 33892807 PMCID: PMC8064888 DOI: 10.1186/s40359-021-00565-y] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 04/14/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has led to dramatic social and economic changes in daily life. First studies report an impact on mental health of the general population showing increased levels of anxiety, stress and depression. In this study, we compared the impact of the pandemic on two culturally and economically similar European countries: the UK and Germany. METHODS Participants (UK = 241, German = 541) completed an online-survey assessing COVID-19 exposure, impact on financial situation and work, substance and media consumption, mental health using the Symptom-Check-List-27 (SCL-27) and the Schizotypal Personality Questionnaire. RESULTS We found distinct differences between the two countries. UK responders reported a stronger direct impact on health, financial situation and families. UK responders had higher clinical scores on the SCL-27, and higher prevalence. Interestingly, German responders were less hopeful for an end of the pandemic and more concerned about their life-stability. CONCLUSION As 25% of both German and UK responders reported a subjective worsening of the general psychological symptoms and 20-50% of German and UK responders reached the clinical cut-off for depressive and dysthymic symptoms as well as anxieties, it specifically shows the need for tailored intervention systems to support large proportions of the general public.
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Affiliation(s)
- Franziska Knolle
- grid.6936.a0000000123222966Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany ,grid.5335.00000000121885934Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Lisa Ronan
- grid.5335.00000000121885934Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Graham K. Murray
- grid.5335.00000000121885934Department of Psychiatry, University of Cambridge, Cambridge, UK ,grid.450563.10000 0004 0412 9303Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK ,grid.5335.00000000121885934Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
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Altschul D, Fawns-Ritchie C, Kwong A, Hartley L, Nangle C, Edwards R, Dawson R, Levein C, Campbell A, Flaig R, McIntosh A, Deary I, Marioni R, Hayward C, Sudlow C, Douglas E, Bell D, Porteous D. Face covering adherence is positively associated with better mental health and wellbeing: a longitudinal analysis of the CovidLife surveys. Wellcome Open Res 2021. [DOI: 10.12688/wellcomeopenres.16643.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Face masks or coverings are effective at reducing airborne infection rates, yet pandemic mitigation measures, including wearing face coverings, have been suggested to contribute to reductions in quality of life and poorer mental health. Complaints of inconvenience, discomfort, and other issues have been repeatedly and loudly voiced by critics, and adherence in many nations is not strong enough to suppress viral spread. We wished to see whether wearing face coverings is associated with mental health and wellbeing. Methods: We analysed survey 1 and 2 of the CovidLife study, a sample of more than 18,000 individuals living in the UK. The study asked a variety of questions about participants’ psychological, economic, and social lives while living under the coronavirus disease 2019 (COVID-19) pandemic in 2020. We measured individuals’ adherence to following guidance on wearing face coverings, as well as several mental health outcomes: depression, anxiety, wellbeing, life satisfaction, and loneliness. Results: We found no association between lower adherence to face covering guidelines and poorer mental health. The opposite appears to be true. Even after controlling for behavioural, social, and psychological confounds, including measures of pre-pandemic mental health, individuals who wore face coverings “most of the time” or “always” had better mental health and wellbeing than those who did not. Individuals who wore masks only “some of the time” or “never” tended to be male, lower income, and already had COVID-19 or COVID-19-like symptoms. Conclusions: These results suggest that wearing face coverings more often does not negatively impact mental health. Wearing a face covering more often is actually linked to better mental health and wellbeing. Implications are discussed and we highlight the potential pathways for addressing a lack of face covering that this study reveals.
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Rauschenberg C, Schick A, Hirjak D, Seidler A, Paetzold I, Apfelbacher C, Riedel-Heller SG, Reininghaus U. Evidence Synthesis of Digital Interventions to Mitigate the Negative Impact of the COVID-19 Pandemic on Public Mental Health: Rapid Meta-review. J Med Internet Res 2021; 23:e23365. [PMID: 33606657 PMCID: PMC7951054 DOI: 10.2196/23365] [Citation(s) in RCA: 101] [Impact Index Per Article: 33.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 02/14/2021] [Accepted: 02/17/2021] [Indexed: 12/18/2022] Open
Abstract
Background Accumulating evidence suggests the COVID-19 pandemic has negative effects on public mental health. Digital interventions that have been developed and evaluated in recent years may be used to mitigate the negative consequences of the pandemic. However, evidence-based recommendations on the use of existing telemedicine and internet-based (eHealth) and app-based mobile health (mHealth) interventions are lacking. Objective The aim of this study was to investigate the theoretical and empirical base, user perspective, safety, effectiveness, and cost-effectiveness of digital interventions related to public mental health provision (ie, mental health promotion, prevention, and treatment of mental disorders) that may help to reduce the consequences of the COVID-19 pandemic. Methods A rapid meta-review was conducted. The MEDLINE, PsycINFO, and CENTRAL databases were searched on May 11, 2020. Study inclusion criteria were broad and considered systematic reviews and meta-analyses that investigated digital tools for health promotion, prevention, or treatment of mental health conditions and determinants likely affected by the COVID-19 pandemic. Results Overall, 815 peer-reviewed systematic reviews and meta-analyses were identified, of which 83 met the inclusion criteria. Our findings suggest that there is good evidence on the usability, safety, acceptance/satisfaction, and effectiveness of eHealth interventions. Evidence on mHealth apps is promising, especially if social components (eg, blended care) and strategies to promote adherence are incorporated. Although most digital interventions focus on the prevention or treatment of mental disorders, there is some evidence on mental health promotion. However, evidence on process quality, cost-effectiveness, and long-term effects is very limited. Conclusions There is evidence that digital interventions are particularly suited to mitigating psychosocial consequences at the population level. In times of physical distancing, quarantine, and restrictions on social contacts, decision makers should develop digital strategies for continued mental health care and invest time and efforts in the development and implementation of mental health promotion and prevention programs.
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Affiliation(s)
- Christian Rauschenberg
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Anita Schick
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Andreas Seidler
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Isabell Paetzold
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Christian Apfelbacher
- Institute of Social Medicine and Health Systems Research, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Ulrich Reininghaus
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.,ESRC Centre for Society and Mental Health, King´s College London, London, United Kingdom
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Rauschenberg C, Schick A, Goetzl C, Roehr S, Riedel-Heller SG, Koppe G, Durstewitz D, Krumm S, Reininghaus U. Social isolation, mental health, and use of digital interventions in youth during the COVID-19 pandemic: A nationally representative survey. Eur Psychiatry 2021; 64:e20. [PMID: 33686930 PMCID: PMC7985650 DOI: 10.1192/j.eurpsy.2021.17] [Citation(s) in RCA: 71] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background Public health measures to curb SARS-CoV-2 transmission rates may have negative psychosocial consequences in youth. Digital interventions may help to mitigate these effects. We investigated the associations between social isolation, COVID-19-related cognitive preoccupation, worries, and anxiety, objective social risk indicators, and psychological distress, as well as use of, and attitude toward, mobile health (mHealth) interventions in youth. Methods Data were collected as part of the “Mental Health And Innovation During COVID-19 Survey”—a cross-sectional panel study including a representative sample of individuals aged 16–25 years (N = 666; Mage = 21.3; assessment period: May 5, 2020 to May 16, 2020). Results Overall, 38% of youth met criteria for moderate or severe psychological distress. Social isolation worries and anxiety, and objective risk indicators were associated with psychological distress, with evidence of dose–response relationships for some of these associations. For instance, psychological distress was progressively more likely to occur as levels of social isolation increased (reporting “never” as reference group: “occasionally”: adjusted odds ratio [aOR] 9.1, 95% confidence interval [CI] 4.3–19.1, p < 0.001; “often”: aOR 22.2, CI 9.8–50.2, p < 0.001; “very often”: aOR 42.3, CI 14.1–126.8, p < 0.001). There was evidence that psychological distress, worries, and anxiety were associated with a positive attitude toward using mHealth interventions, whereas psychological distress, worries, and anxiety were associated with actual use. Conclusions Public health measures during pandemics may be associated with poor mental health outcomes in youth. Evidence-based digital interventions may help mitigate the negative psychosocial impact without risk of viral infection given there is an objective need and subjective demand.
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Affiliation(s)
- Christian Rauschenberg
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Anita Schick
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Christian Goetzl
- Department of Psychiatry II, University of Ulm and BKH Guenzburg, Ulm, Germany
| | - Susanne Roehr
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Georgia Koppe
- Department of Theoretical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Daniel Durstewitz
- Department of Theoretical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Silvia Krumm
- Department of Psychiatry II, University of Ulm and BKH Guenzburg, Ulm, Germany
| | - Ulrich Reininghaus
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.,ESRC Centre for Society and Mental Health, King's College London, London, United Kingdom
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Varga TV, Bu F, Dissing AS, Elsenburg LK, Bustamante JJH, Matta J, van Zon SK, Brouwer S, Bültmann U, Fancourt D, Hoeyer K, Goldberg M, Melchior M, Strandberg-Larsen K, Zins M, Clotworthy A, Rod NH. Loneliness, worries, anxiety, and precautionary behaviours in response to the COVID-19 pandemic: A longitudinal analysis of 200,000 Western and Northern Europeans. THE LANCET REGIONAL HEALTH. EUROPE 2021; 2:100020. [PMID: 33870246 PMCID: PMC8042675 DOI: 10.1016/j.lanepe.2020.100020] [Citation(s) in RCA: 131] [Impact Index Per Article: 43.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND In response to the COVID-19 pandemic, governments around the world instituted various public-health measures. Our project aimed to highlight the most significant similarities and differences in key mental-health indicators between four Western and Northern European countries, and identify the population subgroups with the poorest mental-health outcomes during the first months of the pandemic. METHODS We analysed time-series survey data of 205,084 individuals from seven studies from Denmark, France, the Netherlands, and the UK to assess the impact of the pandemic and associated lockdowns. All analyses focused on the initial lockdown phase (March-July 2020). The main outcomes were loneliness, anxiety, and COVID-19-related worries and precautionary behaviours. FINDINGS COVID-19-related worries were consistently high in each country but decreased during the gradual reopening phases. While only 7% of the respondents reported high levels of loneliness in the Netherlands, percentages were higher in the rest of the three countries (13-18%). In all four countries, younger individuals and individuals with a history of mental illness expressed the highest levels of loneliness. INTERPRETATION The pandemic and associated country lockdowns had a major impact on the mental health of populations, and certain subgroups should be closely followed to prevent negative long-term consequences. Younger individuals and individuals with a history of mental illness would benefit from tailored public-health interventions to prevent or counteract the negative effects of the pandemic. Individuals across Western and Northern Europe have thus far responded in psychologically similar ways despite differences in government approaches to the pandemic. FUNDING See the Funding section.
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Affiliation(s)
- Tibor V. Varga
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Feifei Bu
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Agnete S. Dissing
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Leonie K. Elsenburg
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Joel J. Herranz Bustamante
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Paris, France
| | - Joane Matta
- Inserm, Population-based Epidemiological Cohorts Unit, UMS 011, 94800 Villejuif, France
| | - Sander K.R. van Zon
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Sandra Brouwer
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Ute Bültmann
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Daisy Fancourt
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Klaus Hoeyer
- Section for Health Services Research, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Marcel Goldberg
- Inserm, Population-based Epidemiological Cohorts Unit, UMS 011, 94800 Villejuif, France
| | - Maria Melchior
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Paris, France
| | | | - Marie Zins
- Inserm, Population-based Epidemiological Cohorts Unit, UMS 011, 94800 Villejuif, France
- Faculté de Médecine, Université de Paris, 75006 Paris
| | - Amy Clotworthy
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Naja H. Rod
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Carr MJ, Steeg S, Webb RT, Kapur N, Chew-Graham CA, Abel KM, Hope H, Pierce M, Ashcroft DM. Effects of the COVID-19 pandemic on primary care-recorded mental illness and self-harm episodes in the UK: a population-based cohort study. Lancet Public Health 2021; 6:e124-e135. [PMID: 33444560 PMCID: PMC7843955 DOI: 10.1016/s2468-2667(20)30288-7] [Citation(s) in RCA: 168] [Impact Index Per Article: 56.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 11/30/2020] [Accepted: 12/02/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND The COVID-19 pandemic has adversely affected population mental health. We aimed to assess temporal trends in primary care-recorded common mental illness, episodes of self-harm, psychotropic medication prescribing, and general practitioner (GP) referrals to mental health services during the COVID-19 emergency in the UK. METHODS We did a population-based cohort study using primary care electronic health records from general practices registered on the UK Clinical Practice Research Datalink (CPRD). We included patient records from Jan 1, 2010, to Sept 10, 2020, to establish long-term trends and patterns of seasonality, but focused primarily on the period January, 2019-September, 2020. We extracted data on clinical codes entered into patient records to estimate the incidence of depression and anxiety disorders, self-harm, prescriptions for antidepressants and benzodiazepines, and GP referrals to mental health services, and assessed event rates of all psychotropic prescriptions and self-harm. We used mean-dispersion negative binomial regression models to predict expected monthly incidence and overall event rates, which were then compared with observed rates to assess the percentage reduction in incidence and event rates after March, 2020. We also stratified analyses by sex, age group, and practice-level Index of Multiple Deprivation quintiles. FINDINGS We identified 14 210 507 patients from 1697 UK general practices registered in the CPRD databases. In April, 2020, compared with expected rates, the incidence of primary care-recorded depression had reduced by 43·0% (95% CI 38·3-47·4), anxiety disorders by 47·8% (44·3-51·2), and first antidepressant prescribing by 36·4% (33·9-38·8) in English general practices. Reductions in first diagnoses of depression and anxiety disorders were largest for adults of working age (18-44 and 45-64 years) and for patients registered at practices in more deprived areas. The incidence of self-harm was 37·6% (34·8-40·3%) lower than expected in April, 2020, and the reduction was greatest for women and individuals aged younger than 45 years. By September, 2020, rates of incident depression, anxiety disorder, and self-harm were similar to expected levels. In Northern Ireland, Scotland, and Wales, rates of incident depression and anxiety disorder remained around a third lower than expected to September, 2020. In April, 2020, the rate of referral to mental health services was less than a quarter of the expected rate for the time of year (75·3% reduction [74·0-76·4]). INTERPRETATION Consequences of the considerable reductions in primary care-recorded mental illness and self-harm could include more patients subsequently presenting with greater severity of mental illness and increasing incidence of non-fatal self-harm and suicide. Addressing the effects of future lockdowns and longer-term impacts of economic instability on mental health should be prioritised. FUNDING National Institute for Health Research and Medical Research Council.
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Affiliation(s)
- Matthew J Carr
- Centre for Pharmacoepidemiology and Drug Safety, University of Manchester, Manchester, UK; National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK; Manchester Academic Health Science Centre, Manchester, UK
| | - Sarah Steeg
- Centre for Mental Health and Safety, University of Manchester, Manchester, UK; Manchester Academic Health Science Centre, Manchester, UK.
| | - Roger T Webb
- National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK; Centre for Mental Health and Safety, University of Manchester, Manchester, UK; Manchester Academic Health Science Centre, Manchester, UK
| | - Nav Kapur
- National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK; Centre for Mental Health and Safety, University of Manchester, Manchester, UK; Manchester Academic Health Science Centre, Manchester, UK; Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | | | - Kathryn M Abel
- Centre for Women's Mental Health, University of Manchester, Manchester, UK; Manchester Academic Health Science Centre, Manchester, UK; Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Holly Hope
- Centre for Women's Mental Health, University of Manchester, Manchester, UK; Manchester Academic Health Science Centre, Manchester, UK
| | - Matthias Pierce
- Centre for Women's Mental Health, University of Manchester, Manchester, UK; Manchester Academic Health Science Centre, Manchester, UK
| | - Darren M Ashcroft
- Centre for Pharmacoepidemiology and Drug Safety, University of Manchester, Manchester, UK; National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK; Manchester Academic Health Science Centre, Manchester, UK
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Wyatt S, Mohammed MA, Fisher E, McConkey R, Spilsbury P. Impact of the SARS-CoV-2 pandemic and associated lockdown measures on attendances at emergency departments in English hospitals: A retrospective database study. LANCET REGIONAL HEALTH-EUROPE 2021; 2:100034. [PMID: 34173630 PMCID: PMC7837109 DOI: 10.1016/j.lanepe.2021.100034] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background The SARS-CoV-2 outbreak and associated lockdown measures have challenged healthcare. We examine how attendances to ED in England were impacted. Methods Interrupted time series regression (January 2019 to June 2020) of data from EDs in 41 English NHS Trusts was used to estimate the initial decrease in attendances and the rate of increase following an interruption from 11 March – 7 April 2020, which included the 23 March lockdown in England. Findings The SARS-CoV-2 interruption led to an initial 51.1% reduction (95% CI 46.3–55.9%) in ED attendances followed by a linear increase in attendances of 3.0% per week (95% CI 2.5–3.5%). Significantly larger initial reductions were seen in those aged 0–19 years (69.1%), Indian (64.9%), Pakistani (71.8%), Bangladeshi (75.3%), African (63.5%) and Chinese people (74.5%), self-conveying attendees (60.3%) and those presenting with contusions or abrasions (66.9%), muscle and tendon injuries (65.6%), and those with a diagnosis that was not classifiable (72.7%). Significantly smaller initial reductions were seen in those aged 65–74 years (42.6%), 75+ years (40.1%), those conveyed by ambulance (31.9%), and those presenting with the following conditions: central nervous system (44.9%), haematological (44.0%), cardiac (43.7%), gastrointestinal (43.4%), gynaecological (43.2%), psychiatric (40.4%), poisoning (39.7%), cerebro-vascular (39.0%), endocrinological (36.1%), other vascular (34.6%), and maxillo-facial (19.7%). No significant differences in the initial reduction of activity were seen in subgroups defined by sex, deprivation, urbanicity or acuity. Interpretation The SARS-CoV-2 outbreak and lockdown substantially reduced ED activity. The reduction varied by age groups, ethnicity, arrival mode and diagnostic group but not by sex, deprivation, urbanicity or acuity. Funding No funding to declare.
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Affiliation(s)
- Steven Wyatt
- The Strategy Unit, NHS Midlands and Lancashire Commissioning Support Unit, . Kingston House, 438-450 High Street, West Bromwich, West Midlands B70 9LD, UK
| | - Mohammed A Mohammed
- The Strategy Unit, NHS Midlands and Lancashire Commissioning Support Unit, West Bromwich, West Midlands UK.,Faculty of Health Studies, University of Bradford, Bradford, UK
| | | | | | - Peter Spilsbury
- The Strategy Unit, NHS Midlands and Lancashire Commissioning Support Unit, West Bromwich, West Midlands UK
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Luijten MAJ, van Muilekom MM, Teela L, Polderman TJC, Terwee CB, Zijlmans J, Klaufus L, Popma A, Oostrom KJ, van Oers HA, Haverman L. The impact of lockdown during the COVID-19 pandemic on mental and social health of children and adolescents. Qual Life Res 2021; 30:2795-2804. [PMID: 33991278 PMCID: PMC8122188 DOI: 10.1007/s11136-021-02861-x] [Citation(s) in RCA: 99] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE During the COVID-19 pandemic in the Netherlands, governmental regulations resulted in a lockdown for adults as well as children/adolescents. Schools were closed and contact with other people was limited. In this cross-sectional, population-based study, we aimed to investigate the mental/social health of children/adolescents during COVID-19 lockdown. METHODS Two representative samples of Dutch children/adolescents (8-18 years) before COVID-19 (2018, N = 2401) and during lockdown (April 2020, N = 844) were compared on the Patient-Reported Outcomes Measurement Information System (PROMIS) domains: global health, peer relationships, anxiety, depressive symptoms, anger, sleep-related impairment by linear mixed models and calculating relative risks (RR (95% CI)) for the proportion of severe scores. Variables associated with worse mental/social health during COVID-19 were explored through multivariable regression models. The impact of COVID-19 regulations on the daily life of children was qualitatively analyzed. RESULTS Participants reported worse PROMIS T-scores on all domains during COVID-19 lockdown compared to before (absolute mean difference range 2.1-7.1 (95% CI 1.3-7.9). During lockdown, more children reported severe Anxiety (RR = 1.95 (1.55-2.46) and Sleep-Related Impairment (RR = 1.89 (1.29-2.78) and fewer children reported poor Global Health (RR = 0.36 (0.20-0.65)). Associated factors with worse mental/social health were single-parent family, ≥ three children in the family, negative change in work situation of parents due to COVID-19 regulations, and a relative/friend infected with COVID-19. A large majority (> 90%) reported a negative impact of the COVID-19 regulations on daily life. CONCLUSION This study showed that governmental regulations regarding lockdown pose a serious mental/social health threat on children/adolescents that should be brought to the forefront of political decision-making and mental healthcare policy, intervention, and prevention.
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Affiliation(s)
- Michiel A. J. Luijten
- Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, G8-136, Meibergdreef 9, Postbox 22660, 1100 DD Amsterdam, The Netherlands ,Epidemiology and Data Science, Vrije Universiteit, Amsterdam UMC, Amsterdam, The Netherlands
| | - Maud M. van Muilekom
- Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, G8-136, Meibergdreef 9, Postbox 22660, 1100 DD Amsterdam, The Netherlands
| | - Lorynn Teela
- Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, G8-136, Meibergdreef 9, Postbox 22660, 1100 DD Amsterdam, The Netherlands
| | - Tinca J. C. Polderman
- Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Public Health, Vrije Universiteit Amsterdam, Amsterdam UMC, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Caroline B. Terwee
- Epidemiology and Data Science, Vrije Universiteit, Amsterdam UMC, Amsterdam, The Netherlands
| | - Josjan Zijlmans
- Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Public Health, Vrije Universiteit Amsterdam, Amsterdam UMC, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Leonie Klaufus
- Department of Public and Occupational Health, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands ,Department of Epidemiology, Health Promotion, and Health Care Innovation, Public Health Service Amsterdam, Amsterdam, The Netherlands
| | - Arne Popma
- Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, G8-136, Meibergdreef 9, Postbox 22660, 1100 DD Amsterdam, The Netherlands ,Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Public Health, Vrije Universiteit Amsterdam, Amsterdam UMC, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Kim J. Oostrom
- Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, G8-136, Meibergdreef 9, Postbox 22660, 1100 DD Amsterdam, The Netherlands
| | - Hedy A. van Oers
- Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, G8-136, Meibergdreef 9, Postbox 22660, 1100 DD Amsterdam, The Netherlands
| | - Lotte Haverman
- Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, G8-136, Meibergdreef 9, Postbox 22660, 1100 DD, Amsterdam, The Netherlands.
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270
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Zijlmans J, Teela L, van Ewijk H, Klip H, van der Mheen M, Ruisch H, Luijten MAJ, van Muilekom MM, Oostrom KJ, Buitelaar J, Hoekstra PJ, Lindauer R, Popma A, Staal W, Vermeiren R, van Oers HA, Haverman L, Polderman TJC. Mental and Social Health of Children and Adolescents With Pre-existing Mental or Somatic Problems During the COVID-19 Pandemic Lockdown. Front Psychiatry 2021; 12:692853. [PMID: 34305685 PMCID: PMC8295554 DOI: 10.3389/fpsyt.2021.692853] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 06/07/2021] [Indexed: 01/08/2023] Open
Abstract
Background: The COVID-19 lockdown increases psychological problems in children and adolescents from the general population. Here we investigate the mental and social health during the COVID-19 lockdown in children and adolescents with pre-existing mental or somatic problems. Methods: We included participants (8-18 years) from a psychiatric (N = 249) and pediatric (N = 90) sample, and compared them to a general population sample (N = 844). Measures were assessed during the first lockdown (April-May 2020) in the Netherlands. Main outcome measures were Patient-Reported Outcomes Measurement Information System (PROMIS®) domains: Global Health, Peer Relationships, Anxiety, Depressive Symptoms, Anger, and Sleep-Related Impairment, as reported by children and youth. Additionally, socio-demographic variables, COVID-19-related questions, changes in atmosphere at home from a parent and child perspective, and children's experiences of lockdown regulations were reported by parents. Results: On all measures except Global Health, the pediatric sample reported least problems. The psychiatric sample reported significantly more problems than the general population sample on all measures except for Anxiety and Peer Relationships. Having a COVID-19 affected friend/relative and a COVID-19 related change in parental work situation negatively moderated outcome, but not in the samples with pre-existing problems. All parents reported significant decreases in atmosphere at home, as did children from the general population. Conclusion: We observed significant differences in mental and social health between three child and adolescent samples during the COVID-19 pandemic lockdown and identified COVID-19-related factors influencing mental and social health.
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Affiliation(s)
- Josjan Zijlmans
- Department of Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam Public Health, Amsterdam, Netherlands
| | - Lorynn Teela
- Emma Children's Hospital, Amsterdam University Medical Center, Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, University of Amsterdam, Amsterdam, Netherlands
| | - Hanneke van Ewijk
- Curium-Leiden University Medical Center, Leiden University Medical Center, Leiden, Netherlands
| | - Helen Klip
- Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, Netherlands
| | - Malindi van der Mheen
- Department of Child and Adolescent Psychiatry, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands.,Levvel, Academic Center for Child and Adolescent Psychiatry, Amsterdam, Netherlands
| | - Hyun Ruisch
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Michiel A J Luijten
- Emma Children's Hospital, Amsterdam University Medical Center, Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, University of Amsterdam, Amsterdam, Netherlands.,Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Epidemiology and Data Science, Amsterdam Public Health, Amsterdam, Netherlands
| | - Maud M van Muilekom
- Emma Children's Hospital, Amsterdam University Medical Center, Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, University of Amsterdam, Amsterdam, Netherlands
| | - Kim J Oostrom
- Emma Children's Hospital, Amsterdam University Medical Center, Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, University of Amsterdam, Amsterdam, Netherlands
| | - Jan Buitelaar
- Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, Netherlands.,Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboudumc, Nijmegen, Netherlands
| | - Pieter J Hoekstra
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Ramón Lindauer
- Department of Child and Adolescent Psychiatry, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands.,Levvel, Academic Center for Child and Adolescent Psychiatry, Amsterdam, Netherlands
| | - Arne Popma
- Department of Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam Public Health, Amsterdam, Netherlands.,Levvel, Academic Center for Child and Adolescent Psychiatry, Amsterdam, Netherlands
| | - Wouter Staal
- Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, Netherlands
| | - Robert Vermeiren
- Curium-Leiden University Medical Center, Leiden University Medical Center, Leiden, Netherlands
| | - Hedy A van Oers
- Emma Children's Hospital, Amsterdam University Medical Center, Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, University of Amsterdam, Amsterdam, Netherlands
| | - Lotte Haverman
- Emma Children's Hospital, Amsterdam University Medical Center, Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, University of Amsterdam, Amsterdam, Netherlands
| | - Tinca J C Polderman
- Department of Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam Public Health, Amsterdam, Netherlands.,Curium-Leiden University Medical Center, Leiden University Medical Center, Leiden, Netherlands.,Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, Netherlands.,Department of Child and Adolescent Psychiatry, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands.,Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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271
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Livingston JD, Youssef GJ, Francis LM, Greenwood CJ, Olsson CA, Macdonald JA. Hidden in Plain Sight? Men's Coping Patterns and Psychological Distress Before and During the COVID-19 Pandemic. Front Psychiatry 2021; 12:772942. [PMID: 35069282 PMCID: PMC8766713 DOI: 10.3389/fpsyt.2021.772942] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 11/22/2021] [Indexed: 11/16/2022] Open
Abstract
Individuals cope with stress using multiple strategies, yet studies of coping profiles are rare. We draw data from a longitudinal study of Australian men (n = 272; 30-37 years), assessed before (T1) and during (T2) a nation-wide COVID-19 lockdown. We aimed to: (1) identify men's multi-strategy coping profiles before and during the pandemic; (2) assess cross-sectional (T1-T1, T2-T2) and prospective (T1-T2) associations between profiles and symptoms of psychological distress (stress, anxiety, depression, and anger); and (3) examine relationships between coping profiles and appraisals of pandemic-related stressors and options for coping. In latent profile analyses of 14 coping strategies, three profiles emerged that were largely consistent across T1 and T2: (1) Relaxed Copers (low use of all strategies), (2) Approach Copers, and (3) Dual Copers (high avoidant and moderate-high approach-oriented strategies). Compared to Relaxed and Approach Copers, men who were Dual Copers had elevated psychological distress cross-sectionally before (T1) and during (T2) the pandemic, but not prospectively. Post hoc analyses suggested this was because many men changed coping profiles in the context of the pandemic. Men with stable (T1-T2) or new (T2 only) Dual Coping profiles experienced greater psychological distress and more negative appraisals of pandemic stressors and options for coping. In sum, at the sample level, the composition of men's coping profiles and associations with mental health risk were relatively stable over time and contexts; however, many men appeared to respond to pandemic conditions by changing coping profile groups, with mostly positive mental health outcomes. Of concern were men who adopted more avoidant strategies (e.g., denial, self-distraction, disengagement, substance use, and self-blame) under pandemic conditions. These Dual Coper men also engaged in commonly observable approach-oriented behaviours (e.g., planning, active coping, humour, seeking practical social support) that may mask their vulnerability to mental health risk. Our findings highlight the clinical importance of enquiring about escalating or frequent avoidant coping even in the presence of more active and interactive approach-oriented behaviours.
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Affiliation(s)
- Julianne D Livingston
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - George J Youssef
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Lauren M Francis
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Christopher J Greenwood
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Parkville, VIC, Australia
| | - Craig A Olsson
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Parkville, VIC, Australia
| | - Jacqui A Macdonald
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Parkville, VIC, Australia
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272
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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: 40] [Impact Index Per Article: 10.0] [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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273
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Lamb D, Greenberg N, Stevelink SAM, Wessely S. Mixed signals about the mental health of the NHS workforce. Lancet Psychiatry 2020; 7:1009-1011. [PMID: 32891218 PMCID: PMC7470862 DOI: 10.1016/s2215-0366(20)30379-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 08/13/2020] [Indexed: 02/08/2023]
Affiliation(s)
- Danielle Lamb
- NIHR ARC North Thames, Department of Applied Health Research, University College London, London, WC1E 7HB, UK.
| | - Neil Greenberg
- Health Protection Research Unit, King's College London, London, UK; King's College London, London, UK
| | - Sharon A M Stevelink
- Weston Education Centre and Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Simon Wessely
- Department of Psychological Medicine, King's College London, London, UK
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274
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Gray NS, O'Connor C, Knowles J, Pink J, Simkiss NJ, Williams SD, Snowden RJ. The Influence of the COVID-19 Pandemic on Mental Well-Being and Psychological Distress: Impact Upon a Single Country. Front Psychiatry 2020; 11:594115. [PMID: 33262714 PMCID: PMC7686842 DOI: 10.3389/fpsyt.2020.594115] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 10/14/2020] [Indexed: 01/01/2023] Open
Abstract
The COVID-19 pandemic is likely to have affected the psychological well-being and mental health of many people. Data on prevalence rates of mental health problems are needed for mental health service planning. Psychological well-being and prevalence of clinically significant mental distress were measured in a large sample from Wales 11-16 weeks into lockdown and compared to population-based data collected in 2019 before the COVID-19 pandemic. Data were collected using an online survey disseminated across Wales and open to adults (age 16+) from 9th June to 13th July 2020. Psychological well-being was indexed via the Warwick-Edinburgh Mental Well-being Scale, and psychological distress was indexed via the K10. Data from 12,989 people who took part in this study were compared to that from April 2018 - March 2019, gathered by the National Survey for Wales (N = 11,922). Well-being showed a large decrease from 2019 levels. Clinically significant psychological distress was found in around 50% of the population (men = 47.4%, women = 58.6%), with around 20% showing "severe" effects (men = 17.0%, women = 20.9%): a 3-4-fold increase in prevalence. Most affected were young people, women, and those in deprived areas. By June-July 2020 the COVID-19 pandemic had dramatic effects on the mental health of people living in Wales (and by implication those in the UK and beyond). The effects are larger than previous reports. This probably reflects that the current data were taken deeper into the lockdown period than previous evaluations. Mental health services need to prepare for this wave of mental health problems with an emphasis on younger adults, women, and in areas of greater deprivation.
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Affiliation(s)
- Nicola S. Gray
- Department of Psychology, Swansea University, Swansea, & Swansea Bay University Health Board, Swansea, United Kingdom
| | - Chris O'Connor
- Aneurin Bevan University Health Board, Newport, United Kingdom
| | - James Knowles
- Department of Psychology, Swansea University, Swansea, United Kingdom
| | - Jennifer Pink
- Department of Psychology, Swansea University, Swansea, United Kingdom
| | - Nicola J. Simkiss
- Department of Psychology, Swansea University, Swansea, United Kingdom
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