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Irizar P, Taylor H, Kapadia D, Pierce M, Bécares L, Goodwin L, Katikireddi SV, Nazroo J. The prevalence of common mental disorders across 18 ethnic groups in Britain during the COVID-19 pandemic: Evidence for Equality National Survey (EVENS). J Affect Disord 2024; 358:42-51. [PMID: 38705522 DOI: 10.1016/j.jad.2024.05.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 03/13/2024] [Accepted: 05/02/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND The COVID-19 pandemic negatively impacted mental health in the general population in Britain. Ethnic minority people suffered disproportionately, in terms of health and economic outcomes, which may contribute to poorer mental health. We compare the prevalence of depression and anxiety across 18 ethnic groups in Britain during the COVID-19 pandemic. METHODS Secondary analysis of cross-sectional data (February-November 2021) from 12,161 participants aged 18-60 years old (N with data on outcomes = 11,540 for depression & 11,825 for anxiety), obtained from the Evidence for Equality National Survey (EVENS). Data were weighted to account for selection bias and coverage bias. Weighted regression models examined ethnic differences in depression (Centre for Epidemiologic Studies Depression Scale) and anxiety (Generalised Anxiety Disorder-7). Effect modification analyses explored whether ethnic differences in outcomes were consistent within age and sex sub-groups. RESULTS Compared to White British people, greater odds of anxiety caseness (and greater anxiety symptoms) were observed for Arab (OR = 2.57; 95 % CI = 1.35-4.91), Mixed White and Black Caribbean (1.57; 1.07-2.30), any other Black (2.22, 1.28-3.87) and any other Mixed (1.58; 1.08-2.31) ethnic groups. Lower odds of depression caseness (and lower depressive symptoms) were identified for Chinese (0.63; 0.46-0.85), Black African (0.60; 0.46-0.79), and any other Asian (0.55; 0.42-0.72) ethnic groups. LIMITATIONS Cross-sectional data limits the opportunity to identify changes in ethnic inequalities in mental health over time. CONCLUSIONS We have identified certain ethnic groups who may require more targeted mental health support to ensure equitable recovery post-pandemic. Despite finding lower levels of depression for some ethnic groups, approximately one third of people within each ethnic group met criteria for depression.
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Affiliation(s)
- Patricia Irizar
- Department of Sociology, School of Social Sciences, University of Manchester, United Kingdom.
| | - Harry Taylor
- Department of Global Health & Social Medicine, King's College London, United Kingdom
| | - Dharmi Kapadia
- Department of Sociology, School of Social Sciences, University of Manchester, United Kingdom
| | - Matthias Pierce
- Division of Psychology and Mental Health, University of Manchester, United Kingdom
| | - Laia Bécares
- Department of Global Health & Social Medicine, King's College London, United Kingdom
| | - Laura Goodwin
- The Spectrum Centre for Mental Health Research, Lancaster University, United Kingdom
| | | | - James Nazroo
- Department of Sociology, School of Social Sciences, University of Manchester, United Kingdom
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2
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Hussey LJ, Kontopantelis E, Mok PLH, Ashcroft DM, Carr MJ, Garg S, Chew-Graham CA, Kapur N, Lovell K, Webb RT. Socio-demographic variation in diagnosis of and prescribing for common mental illnesses among children and young people during the COVID-19 pandemic: time series analysis of primary care electronic health records. J Child Psychol Psychiatry 2024. [PMID: 38877779 DOI: 10.1111/jcpp.14026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/10/2024] [Indexed: 06/16/2024]
Abstract
BACKGROUND The impact of the COVID-19 pandemic on the mental health of children and young people (CYP) has been widely reported. Primary care electronic health records were utilised to examine trends in the diagnosing, recording and treating of these common mental disorders by ethnicity and social deprivation in Greater Manchester, England. METHODS Time-series analyses conducted using Greater Manchester Care Record (GMCR) data examined all diagnosed episodes of anxiety disorders and depression and prescribing of anxiolytics and antidepressants among patients aged 6-24 years. The 41-month observation period was split into three epochs: Pre-pandemic (1/2019-2/2020); Pandemic Phase 1 (3/2020-6/2021); Pandemic Phase 2 (7/2021-5/2022). Rate ratios for all CYP specific to sex, age, ethnicity, and neighbourhood-level Indices of Multiple Deprivation (IMD) quintile were modelled using negative binomial regression. RESULTS Depression and anxiety disorder rates were highest in females, CYP aged 19-24, and White and 'Other' ethnic groups. During Pandemic Phase 1, rates for these diagnoses fell in all demographic subgroups and then rose to similar levels as those recorded pre-pandemic. In Pandemic Phase 2, rates in Black and Mixed-ethnicity females rose to a significantly greater degree (by 54% and 62%, respectively) than those in White females. Prescribing rates increased throughout the study period, with significantly greater rises observed in non-White females and males. The temporal trends were mostly homogeneous across deprivation quintiles. CONCLUSION The observed fluctuations in frequency of recorded common mental illness diagnoses likely reflect service accessibility and patients' differential propensities to consult as well as changing levels of distress and psychopathology in the population. However, psychotropic medication prescribing increased throughout the observation period, possibly indicating a sustained decline in mental health among CYP, and also clinicians' responses to problems presented. The comparatively greater increases in frequencies of diagnosis recording and medication prescribing among ethnic minority groups warrants further investigation.
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Affiliation(s)
- Louise Jane Hussey
- Division of Psychology and Mental Health, Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, UK
| | - Evan Kontopantelis
- Division of Informatics, Imaging and Data Sciences, University of Manchester, Manchester, UK
| | - Pearl L H Mok
- Division of Pharmacy and Optometry, School of Health Sciences, Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, UK
| | - Darren M Ashcroft
- Division of Pharmacy and Optometry, School of Health Sciences, Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, UK
| | - Matthew J Carr
- Division of Pharmacy and Optometry, Centre for Pharmacoepidemiology and Drug Safety, Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, UK
| | - Shruti Garg
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Carolyn A Chew-Graham
- School of Medicine, Faculty of Medicine and Health Sciences, Keele University, Keele, UK
| | - Nav Kapur
- Division of Psychology and Mental Health, Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, UK
| | - Karina Lovell
- Division of Nursing, Midwifery & Social Work, University of Manchester, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Roger T Webb
- Division of Psychology and Mental Health, Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, UK
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Maletta RM, Daly M, Goodwin L, Noonan R, Putra IGNE, Robinson E. Changes in the prevalence of perceived discrimination and associations with probable mental health problems in the UK from 2015 to 2020: A repeated cross-sectional analysis of the UK Household Longitudinal Study. SSM Popul Health 2024; 26:101667. [PMID: 38737142 PMCID: PMC11081791 DOI: 10.1016/j.ssmph.2024.101667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 03/28/2024] [Accepted: 04/01/2024] [Indexed: 05/14/2024] Open
Abstract
Background Significant social and political changes occurred in the UK between 2015 and 2020. Few studies have examined population level trends in experiencing discrimination and mental health problems during this period. Aims To determine prevalence trends in perceived discrimination and probable mental health problems amongst UK adults during 2015-2020. Method Repeated cross-sectional data from the UK Household Longitudinal Study was used to estimate nationally representative trends in perceived discrimination and probable mental health problems (GHQ-12; 4+ threshold) among adults between 2015/2016-2019/2020 (25,756 observations). Weighted logistic regression models with post-estimation margins commands determined changes between survey waves controlling for sociodemographic characteristics. Mediation models explored whether changes in perceived discrimination prevalence trends explained trends in probable mental health problems. Results From 2015/2016 to 2019/2020 perceived discrimination and probable mental health problems increased significantly by 6·1% (95% CI: 3·4-8·8, p <·001) and 4·5% (95% CI: 1·3-7·7, p = ·006), respectively. These changes did not tend to reliably differ by sociodemographic grouping. Increased prevalence of probable mental health problems from 2015/2016 to 2019/2020 was partially explained (15·2% of association mediated) by the increase in perceived discrimination observed during the same time period. Conclusions Amongst UK adults, the prevalence of perceived discrimination and probable mental health problems increased between 2015/2016 to 2019/2020. Increases in perceived discrimination partially explained increases in probable mental health problems. National measures designed to reduce both discrimination and mental health problems have potential to make substantial improvements to public health and should be prioritised in the UK.
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Affiliation(s)
| | - Michael Daly
- Department of Psychology, Maynooth University, Co. Kildare, Ireland
| | - Laura Goodwin
- Spectrum Centre for Mental Health Research, Division of Health Research, Lancaster University, Lancaster, UK
| | - Rob Noonan
- Faculty of Health and Wellbeing, University of Bolton, Bolton, UK
| | | | - Eric Robinson
- Department of Psychology, University of Liverpool, Liverpool, UK
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4
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Spinazzola E, Quattrone D, Quattrone A, Murray RM, Forti MD. The increased incidence of psychosis during the COVID-19 pandemic in South London: The role of heavy cannabis use. Psychiatry Res 2024; 336:115869. [PMID: 38583244 DOI: 10.1016/j.psychres.2024.115869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 03/21/2024] [Indexed: 04/09/2024]
Affiliation(s)
- Edoardo Spinazzola
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, United Kingdom; South London and Maudsley NHS Foundation Trust, United Kingdom.
| | - Diego Quattrone
- South London and Maudsley NHS Foundation Trust, United Kingdom; National Institute for Health and Care Research, Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, United Kingdom; Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience. King's College of London, London, United Kingdom
| | - Andrea Quattrone
- South London and Maudsley NHS Foundation Trust, United Kingdom; University of Porto, Institute of Biomedical Sciences Abel Salazar, Portugal
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, United Kingdom; South London and Maudsley NHS Foundation Trust, United Kingdom
| | - Marta Di Forti
- South London and Maudsley NHS Foundation Trust, United Kingdom; National Institute for Health and Care Research, Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, United Kingdom; Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience. King's College of London, London, United Kingdom
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5
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Kopasker D, Bronka P, Thomson RM, Khodygo V, Kromydas T, Meier P, Heppenstall A, Bambra C, Lomax N, Craig P, Richiardi M, Katikireddi SV. Evaluating the influence of taxation and social security policies on psychological distress: A microsimulation study of the UK during the COVID-19 economic crisis. Soc Sci Med 2024; 351:116953. [PMID: 38759385 DOI: 10.1016/j.socscimed.2024.116953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 05/01/2024] [Accepted: 05/07/2024] [Indexed: 05/19/2024]
Abstract
Economic determinants are important for population health, but actionable evidence of how policies can utilise these pathways remains scarce. This study employs a microsimulation framework to evaluate the effects of taxation and social security policies on population mental health. The UK economic crisis caused by the COVID-19 pandemic provides an informative context involving an economic shock accompanied by one of the strongest discretionary fiscal responses amongst OECD countries. The analytical setup involves a dynamic, stochastic, discrete-time microsimulation model (SimPaths) projecting changes in psychological distress given predicted economic outcomes from a static tax-benefit microsimulation model (UKMOD) based on different policy scenarios. We contrast projections of psychological distress for the working-age population from 2017 to 2025 given the observed policy environment against a counterfactual scenario where pre-crisis policies remained in place. Levels of psychological distress and potential cases of common mental disorders (CMDs) were assessed with the 12-item General Health Questionnaire (GHQ-12). The UK policy response to the economic crisis is estimated to have prevented a substantial fall (over 12 percentage points, %pt) in the employment rate in 2020 and 2021. In 2020, projected psychological distress increased substantially (CMD prevalence increase >10%pt) under both the observed and the counterfactual policy scenarios. Through economic pathways, the policy response is estimated to have prevented a further 3.4%pt [95%UI 2.8%pt, 4.0%pt] increase in the prevalence of CMDs, approximately 1.2 million cases. Beyond 2021, as employment levels rapidly recovered, psychological distress returned to the pre-pandemic trend. Sustained preventative effects on poverty are estimated, with projected levels 2.1%pt [95%UI 1.8%pt, 2.5%pt] lower in 2025 than in the absence of the observed policy response. The study shows that policies protecting employment during an economic crisis are effective in preventing short-term mental health losses and have lasting effects on poverty levels. This preventative effect has substantial public health benefits.
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Affiliation(s)
- Daniel Kopasker
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, UK.
| | - Patryk Bronka
- Centre for Microsimulation and Policy Analysis, University of Essex, UK
| | - Rachel M Thomson
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, UK
| | - Vladimir Khodygo
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, UK
| | | | - Petra Meier
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, UK
| | - Alison Heppenstall
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, UK; School of Political and Social Sciences, University of Glasgow, UK
| | - Clare Bambra
- Population Health Sciences Institute, Newcastle University, UK
| | - Nik Lomax
- School of Geography, University of Leeds, UK
| | - Peter Craig
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, UK
| | - Matteo Richiardi
- Centre for Microsimulation and Policy Analysis, University of Essex, UK
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6
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Beese F, Wachtler B, Grabka MM, Blume M, Kersjes C, Gutu R, Mauz E, Hoebel J. Socioeconomic inequalities in pandemic-induced psychosocial stress in different life domains among the working-age population. BMC Public Health 2024; 24:1421. [PMID: 38807100 PMCID: PMC11131271 DOI: 10.1186/s12889-024-18874-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 05/17/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND Psychosocial stress is considered a risk factor for physical and mental ill-health. Evidence on socioeconomic inequalities with regard to the psychosocial consequences of the COVID-19 pandemic in Germany is still limited. We aimed to investigate how pandemic-induced psychosocial stress (PIPS) in different life domains differed between socioeconomic groups. METHODS Data came from the German Corona-Monitoring nationwide study - wave 2 (RKI-SOEP-2, November 2021-February 2022). PIPS was assessed using 4-point Likert scales with reference to the following life domains: family, partnership, own financial situation, psychological well-being, leisure activity, social life and work/school situation. Responses were dichotomised into "not stressed/slightly stressed/rather stressed" (0) versus "highly stressed" (1). The sample was restricted to the working-age population in Germany (age = 18-67 years, n = 8,402). Prevalence estimates of high PIPS were calculated by sex, age, education and income. Adjusted prevalence ratios (PRs) were estimated using Poisson regression to investigate the association between education/income and PIPS; high education and income were the reference groups. RESULTS The highest stress levels were reported in the domains social life and leisure activity. Women and younger participants reported high stress levels more frequently. The highest inequalities were found regarding people's own financial situation, and PIPS was higher in low vs. high income groups (PR 5.54, 95% CI 3.61-8.52). Inequalities were also found regarding partnerships with higher PIPS in low vs. high education groups (PR 1.68, 95% CI 1.13-2.49) - and psychological well-being with higher PIPS in low vs. high income groups (PR 1.52, 95% CI 1.14-2.04). CONCLUSION Socioeconomic inequalities in PIPS were found for different life domains. Generally, psychosocial support and preventive interventions to help people cope with stress in a pandemic context should be target-group-specific, addressing the particular needs and circumstances of certain socioeconomic groups.
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Affiliation(s)
- Florian Beese
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
| | - Benjamin Wachtler
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Markus M Grabka
- Socio-Economic Panel, German Institute for Economic Research, Berlin, Germany
| | - Miriam Blume
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - Christina Kersjes
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Robert Gutu
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - Elvira Mauz
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Jens Hoebel
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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7
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Hernandez RG, Qu X, Volk H, Showell NN, Hoyo C, Ellison-Barnes A, Johnson SB. Pre-Pandemic Factors Associated with Pandemic Impact and Psychosocial Distress Among Mothers of Young Children. Acad Pediatr 2024:S1876-2859(24)00156-6. [PMID: 38759953 DOI: 10.1016/j.acap.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 05/07/2024] [Accepted: 05/12/2024] [Indexed: 05/19/2024]
Abstract
OBJECTIVE To describe COVID-19 pandemic impact among mothers of young children (0-8 yrs.) and assess pre-pandemic factors associated with greater pandemic impact and psychosocial distress. METHODS Mothers from three US birth cohorts (n=301, mean child age 2.4 years) reported on demographics and psychosocial distress (anxiety, perceived stress, financial stress) before the pandemic (2/2015-2/2020). During the pandemic (7/2020-6/2021), they completed a supplemental survey about the impact of the pandemic on their families (Coronavirus Impact Scale) and psychosocial distress. Multivariable linear and ordinal logistic regression were used to evaluate pre-pandemic factors associated with pandemic impact overall and by domain. RESULTS Compared to pre-pandemic reports, maternal anxiety symptoms increased by 9.4%, perceived stress increased by 13.3%, and financial stress increased by 41.7%, of which all were statistically significant changes. Participants reported the most severe pandemic impact in family routines (72.4%), experiences of stress (40.2%), and social support (38.6%). Mothers with some college or a 4-year degree experienced higher overall pandemic impact compared to mothers with the least and highest education. Pre-pandemic distress was not associated with pandemic impact however, mid-pandemic, all three distress measures were significantly positively associated with overall CIS, with the largest effect size noted for perceived stress (B=1.36, 95% CI: 0.90,1.82). CONCLUSIONS While, on average, mothers of young children experienced worsening psychosocial stress during the COVID-19 pandemic, pre-pandemic psychosocial stress alone was not prospectively associated with greater pandemic impact, suggesting that the COVID-19 pandemic may have both elaborated existing systemic social inequalities and created new burdens. WHAT'S NEW While mothers of young children experienced worsening psychosocial distress during the pandemic, pre-pandemic psychosocial distress alone was not associated with greater family pandemic impact. The pandemic may have both exacerbated existing systemic social inequalities and created new burdens.
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Affiliation(s)
- Raquel G Hernandez
- Johns Hopkins All Children's Hospital, Institute for Clinical and Translational Research, St. Petersburg, FL; Johns Hopkins University School of Medicine, Department of Pediatrics, Baltimore, MD.
| | - Xueqi Qu
- Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, Baltimore, MD
| | - Heather Volk
- Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, Baltimore, MD
| | - Nakiya N Showell
- Johns Hopkins University School of Medicine, Department of Pediatrics, Baltimore, MD
| | - Cathrine Hoyo
- North Carolina State University, Center for Human Health and the Environment, Department of Biological Sciences, Raleigh, NC
| | | | - Sara B Johnson
- Johns Hopkins University School of Medicine, Department of Pediatrics, Baltimore, MD; Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, Baltimore, MD
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Wilhelmsen-Langeland A, Børtveit T, Jürgensen M, Søfteland E, Hystad SW, Kvale G. Concentrated transdiagnostic and cross-disciplinary micro-choice based group treatment for patients with depression and with anxiety leads to lasting improvements after 12 months: a pilot study. BMC Psychiatry 2024; 24:361. [PMID: 38745158 PMCID: PMC11094865 DOI: 10.1186/s12888-024-05786-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 04/24/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND A concentrated transdiagnostic and micro choice-based group treatment for patients with depression and anxiety has previously shown to yield significant reduction in symptoms and increased level of functioning from pre to 3-month follow-up. In the present study, we report the results after 12 months follow-up. METHODS This was a non-randomized clinical intervention pilot study, conducted in line with a published protocol. Sixty-seven consecutively referred patients, aged 19-47 (mean age 32.5, SD = 8.0) were included and completed treatment. All had a severity of their problems that entitled them to care in the specialist public mental health care. Self-reported age at onset of symptoms was 17.6 (SD = 7.9) years. Mean number of prior treatment courses was 3.5 (SD = 3.3; range 0-20). The main objective was to assess the treatment effectiveness by questionnaires measuring relevant symptoms at pre-treatment, 7 days-, 3 months-, 6 months- and at 12-months follow-up. RESULTS Validated measures of functional impairment (WSAS), depression (PHQ9), anxiety (GAD7), worry (PSWQ), fatigue (CFQ), insomnia (BIS) and illness perception (BIPQ) improved significantly (p < .0005) from before treatment to 12 months follow-up, yielding mostly large to extremely large effect sizes (0.89-3.68), whereas some moderate (0.60-0.76). After 12 months, 74% report an overall improvement in problems related to anxiety and depression. Utilization of specialist, public and private mental health care was reported as nonexistent or had decreased for 70% of the patients at 12-month follow up. CONCLUSIONS The concentrated, micro-choice based group treatment approach yielded a highly clinically significant reduction in a wide range of symptoms already one week after treatment, and the positive results persisted at 12-month follow-up. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05234281, first posted date 10/02/2022.
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Affiliation(s)
- Ane Wilhelmsen-Langeland
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.
- Helse i Hardanger, Øystese, Norway.
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway.
| | - Tore Børtveit
- Helse i Hardanger, Øystese, Norway
- Division of Mental Health and Addiction, Vestfold Hospital, Vestfold, Norway
| | - Marte Jürgensen
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Helse i Hardanger, Øystese, Norway
| | - Eirik Søfteland
- Helse i Hardanger, Øystese, Norway
- Department of Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | | | - Gerd Kvale
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Helse i Hardanger, Øystese, Norway
- Department of Clinical Psychology, University of Bergen, Bergen, Norway
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9
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Ou W, Xiao C, Dong Q, Chen Y, Ke C, Liu B, Liu J, Ju Y, Zhang Y. Risk factors associated with depression and anxiety among the Chinese general population after retracting the dynamic zero-COVID policy: A network analysis. J Affect Disord 2024; 349:77-85. [PMID: 38199391 DOI: 10.1016/j.jad.2024.01.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 01/01/2024] [Accepted: 01/03/2024] [Indexed: 01/12/2024]
Abstract
BACKGROUND Recent studies have evidenced the negative psychological consequences of the COVID-19 pandemic and sociodemographic vulnerability among the general population, while limited information was available on which factors make the greatest contribution to psychological distress when these factors were considered concurrently. Herein, we aimed to investigate the pathways that underlie psychological distress in the context of retracting dynamic zero-COVID policy. METHODS We employed the mixed graphical model to construct the network of depression (PHQ-9), anxiety (GAD-7), and pandemic-related factors in a general population sample (N = 1610). Then, we re-examined the network by adding sociodemographic variables to further explore the influence of sociodemographic factors. Additionally, we repeated the analyses in the second sample (N = 620) collected in the same period to assess the replicability. RESULTS The relationships between the pandemic factors and anxiety and depressive symptoms exhibited a tendency to decrease after adding demographic variables, and income became the most important node and shared edge weights with all anxiety and depressive symptoms. These findings were replicable with the second sample. No significant difference in the network properties was detected between the two samples. LIMITATIONS The cross-sectional design limits the ability to observe longitudinal changes in these risk factors and their relationship with psychological distress. CONCLUSIONS Income level, rather than the pandemic-related factors, acted as a vital role in the psychological distress of the general population, implying that livelihood issues may be the critical intervention targets for mental health during the post-pandemic period.
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Affiliation(s)
- Wenwen Ou
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Chuman Xiao
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Qiangli Dong
- Department of Psychiatry, Lanzhou University Second Hospital, Lanzhou 730000, Gansu, China
| | - Yafei Chen
- Xiangya Medical School, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China
| | - Chunxi Ke
- Xiangya Medical School, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China
| | - Bangshan Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Jin Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Yumeng Ju
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
| | - Yan Zhang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
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10
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Moreno-Agostino D, Woodhead C, Ploubidis GB, Das-Munshi J. A quantitative approach to the intersectional study of mental health inequalities during the COVID-19 pandemic in UK young adults. Soc Psychiatry Psychiatr Epidemiol 2024; 59:417-429. [PMID: 36692519 PMCID: PMC9872068 DOI: 10.1007/s00127-023-02424-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 01/12/2023] [Indexed: 01/25/2023]
Abstract
PURPOSE Mental health inequalities across social identities/positions during the COVID-19 pandemic have been mostly reported independently from each other or in a limited way (e.g., at the intersection between age and sex or gender). We aim to provide an inclusive socio-demographic mapping of different mental health measures in the population using quantitative methods that are consistent with an intersectional perspective. METHODS Data included 8,588 participants from two British cohorts (born in 1990 and 2000-2002, respectively), collected in February/March 2021 (during the third UK nationwide lockdown). Measures of anxiety and depressive symptomatology, loneliness, and life satisfaction were analysed using Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA) models. RESULTS We found evidence of large mental health inequalities across intersectional strata. Large proportions of those inequalities were accounted for by the additive effects of the variables used to define the intersections, with some of the largest gaps associated with sexual orientation (with sexual minority groups showing substantially worse outcomes). Additional inequalities were found by cohort/generation, birth sex, racial/ethnic groups, and socioeconomic position. Intersectional effects were observed mostly in intersections defined by combinations of privileged and marginalised social identities/positions (e.g., lower-than-expected life satisfaction in South Asian men in their thirties from a sexual minority and a disadvantaged childhood social class). CONCLUSION We found substantial inequalities largely cutting across intersectional strata defined by multiple co-constituting social identities/positions. The large gaps found by sexual orientation extend the existing evidence that sexual minority groups were disproportionately affected by the pandemic. Study implications and limitations are discussed.
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Affiliation(s)
- Darío Moreno-Agostino
- Centre for Longitudinal Studies, UCL Social Research Institute, University College London, 55-59 Gordon Square, London, WC1H 0NU, UK.
- ESRC Centre for Society and Mental Health, King's College London, Melbourne House, 44-46 Aldwych, London, WC2B 4LL, UK.
| | - Charlotte Woodhead
- ESRC Centre for Society and Mental Health, King's College London, Melbourne House, 44-46 Aldwych, London, WC2B 4LL, UK
- Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology & Neuroscience, 16 De Crespigny Park, London, SE5 8AF, UK
| | - George B Ploubidis
- Centre for Longitudinal Studies, UCL Social Research Institute, University College London, 55-59 Gordon Square, London, WC1H 0NU, UK
- ESRC Centre for Society and Mental Health, King's College London, Melbourne House, 44-46 Aldwych, London, WC2B 4LL, UK
| | - Jayati Das-Munshi
- ESRC Centre for Society and Mental Health, King's College London, Melbourne House, 44-46 Aldwych, London, WC2B 4LL, UK
- Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology & Neuroscience, 16 De Crespigny Park, London, SE5 8AF, UK
- South London and Maudsley NHS Trust, London, UK
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11
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Kendrick T, Dowrick C, Lewis G, Moore M, Leydon GM, Geraghty AW, Griffiths G, Zhu S, Yao GL, May C, Gabbay M, Dewar-Haggart R, Williams S, Bui L, Thompson N, Bridewell L, Trapasso E, Patel T, McCarthy M, Khan N, Page H, Corcoran E, Hahn JS, Bird M, Logan MX, Ching BCF, Tiwari R, Hunt A, Stuart B. Patient-reported outcome measures for monitoring primary care patients with depression: the PROMDEP cluster RCT and economic evaluation. Health Technol Assess 2024; 28:1-95. [PMID: 38551155 PMCID: PMC11017630 DOI: 10.3310/plrq4216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024] Open
Abstract
Background Guidelines on the management of depression recommend that practitioners use patient-reported outcome measures for the follow-up monitoring of symptoms, but there is a lack of evidence of benefit in terms of patient outcomes. Objective To test using the Patient Health Questionnaire-9 questionnaire as a patient-reported outcome measure for monitoring depression, training practitioners in interpreting scores and giving patients feedback. Design Parallel-group, cluster-randomised superiority trial; 1 : 1 allocation to intervention and control. Setting UK primary care (141 group general practices in England and Wales). Inclusion criteria Patients aged ≥ 18 years with a new episode of depressive disorder or symptoms, recruited mainly through medical record searches, plus opportunistically in consultations. Exclusions Current depression treatment, dementia, psychosis, substance misuse and risk of suicide. Intervention Administration of the Patient Health Questionnaire-9 questionnaire with patient feedback soon after diagnosis, and at follow-up 10-35 days later, compared with usual care. Primary outcome Beck Depression Inventory, 2nd edition, symptom scores at 12 weeks. Secondary outcomes Beck Depression Inventory, 2nd edition, scores at 26 weeks; antidepressant drug treatment and mental health service contacts; social functioning (Work and Social Adjustment Scale) and quality of life (EuroQol 5-Dimension, five-level) at 12 and 26 weeks; service use over 26 weeks to calculate NHS costs; patient satisfaction at 26 weeks (Medical Informant Satisfaction Scale); and adverse events. Sample size The original target sample of 676 patients recruited was reduced to 554 due to finding a significant correlation between baseline and follow-up values for the primary outcome measure. Randomisation Remote computerised randomisation with minimisation by recruiting university, small/large practice and urban/rural location. Blinding Blinding of participants was impossible given the open cluster design, but self-report outcome measures prevented observer bias. Analysis was blind to allocation. Analysis Linear mixed models were used, adjusted for baseline depression, baseline anxiety, sociodemographic factors, and clustering including practice as random effect. Quality of life and costs were analysed over 26 weeks. Qualitative interviews Practitioner and patient interviews were conducted to reflect on trial processes and use of the Patient Health Questionnaire-9 using the Normalization Process Theory framework. Results Three hundred and two patients were recruited in intervention arm practices and 227 patients were recruited in control practices. Primary outcome data were collected for 252 (83.4%) and 195 (85.9%), respectively. No significant difference in Beck Depression Inventory, 2nd edition, score was found at 12 weeks (adjusted mean difference -0.46, 95% confidence interval -2.16 to 1.26). Nor were significant differences found in Beck Depression Inventory, 2nd Edition, score at 26 weeks, social functioning, patient satisfaction or adverse events. EuroQol-5 Dimensions, five-level version, quality-of-life scores favoured the intervention arm at 26 weeks (adjusted mean difference 0.053, 95% confidence interval 0.013 to 0.093). However, quality-adjusted life-years over 26 weeks were not significantly greater (difference 0.0013, 95% confidence interval -0.0157 to 0.0182). Costs were lower in the intervention arm but, again, not significantly (-£163, 95% confidence interval -£349 to £28). Cost-effectiveness and cost-utility analyses, therefore, suggested that the intervention was dominant over usual care, but with considerable uncertainty around the point estimates. Patients valued using the Patient Health Questionnaire-9 to compare scores at baseline and follow-up, whereas practitioner views were more mixed, with some considering it too time-consuming. Conclusions We found no evidence of improved depression management or outcome at 12 weeks from using the Patient Health Questionnaire-9, but patients' quality of life was better at 26 weeks, perhaps because feedback of Patient Health Questionnaire-9 scores increased their awareness of improvement in their depression and reduced their anxiety. Further research in primary care should evaluate patient-reported outcome measures including anxiety symptoms, administered remotely, with algorithms delivering clear recommendations for changes in treatment. Study registration This study is registered as IRAS250225 and ISRCTN17299295. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 17/42/02) and is published in full in Health Technology Assessment; Vol. 28, No. 17. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Tony Kendrick
- School of Primary Care, Population Health and Medical Education, University of Southampton, Southampton, UK
| | - Christopher Dowrick
- Department of Primary Care and Mental Health, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Glyn Lewis
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - Michael Moore
- School of Primary Care, Population Health and Medical Education, University of Southampton, Southampton, UK
| | - Geraldine M Leydon
- School of Primary Care, Population Health and Medical Education, University of Southampton, Southampton, UK
| | - Adam Wa Geraghty
- School of Primary Care, Population Health and Medical Education, University of Southampton, Southampton, UK
| | - Gareth Griffiths
- Southampton Clinical Trials Unit, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Shihua Zhu
- School of Primary Care, Population Health and Medical Education, University of Southampton, Southampton, UK
| | - Guiqing Lily Yao
- Leicester Clinical Trials Unit, University of Leicester, Leicester, UK
| | - Carl May
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Mark Gabbay
- Department of Primary Care and Mental Health, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Rachel Dewar-Haggart
- School of Primary Care, Population Health and Medical Education, University of Southampton, Southampton, UK
| | - Samantha Williams
- School of Primary Care, Population Health and Medical Education, University of Southampton, Southampton, UK
| | - Lien Bui
- School of Primary Care, Population Health and Medical Education, University of Southampton, Southampton, UK
| | - Natalie Thompson
- School of Primary Care, Population Health and Medical Education, University of Southampton, Southampton, UK
| | - Lauren Bridewell
- School of Primary Care, Population Health and Medical Education, University of Southampton, Southampton, UK
| | - Emilia Trapasso
- Department of Primary Care and Mental Health, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Tasneem Patel
- Department of Primary Care and Mental Health, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Molly McCarthy
- Department of Primary Care and Mental Health, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Naila Khan
- Department of Primary Care and Mental Health, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Helen Page
- Department of Primary Care and Mental Health, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Emma Corcoran
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - Jane Sungmin Hahn
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - Molly Bird
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - Mekeda X Logan
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - Brian Chi Fung Ching
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - Riya Tiwari
- School of Primary Care, Population Health and Medical Education, University of Southampton, Southampton, UK
| | - Anna Hunt
- School of Primary Care, Population Health and Medical Education, University of Southampton, Southampton, UK
| | - Beth Stuart
- Centre for Evaluation and Methods, Wolfson Institute of Population Health, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
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12
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Schurr M, Junne F, Martus P, Paul G, Jürgensen JS, Allwang C, Binneböse M, Wallis H, Mikolajczyk R, Galante-Gottschalk A, Zipfel S, Ehehalt S, Giel KE. SARS-CoV-2 infection is associated with physical but not mental fatigue - Findings from a longitudinal controlled population-based study. J Psychosom Res 2024; 178:111598. [PMID: 38277895 DOI: 10.1016/j.jpsychores.2024.111598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 01/11/2024] [Accepted: 01/20/2024] [Indexed: 01/28/2024]
Abstract
OBJECTIVE Fatigue has been identified as the core symptom of long-Covid, however, putative pandemic-related influences remain largely unclear. We investigated trajectories of total, physical and mental fatigue and the factors associated with it in previously infected and non-infected individuals up to one year post- infection. METHODS We used data from a longitudinal cohort study of German adults with two samples: A representative probability sample and a sample of individuals with proven SARS-CoV-2 infection. Surveys were conducted in spring 2020(T1), autumn 2020(T2) and summer 2021(T3). Fatigue was assessed using the FAS, distinguishes between physical and mental fatigue. Depression, anxiety and stress were assessed using PHQ-4 and PSQ. RESULTS 1990 participants [mean age 47.2 (SD = 17.0), 30.5% previously infected] were included in the survey at T1 (n = 1118 at T2, n = 692 at T3). Total and physical fatigue, but not mental fatigue were significantly higher in the previously infected compared to the non-infected sample at T2, but this group difference disappeared at T3. We identified Covid-infection as a factor associated with transient total and physical fatigue at T2. Depression, anxiety and stress at T1 were associated with total, physical and mental fatigue at both follow-ups. CONCLUSIONS Our results highlight the importance of considering physical and mental fatigue as separate entities, while suggesting a greater relevance of the physical signs of fatigue in understanding long-Covid. The results further showed that baseline mental health symptoms were the most strongly associated with fatigue trajectories.
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Affiliation(s)
- Marisa Schurr
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany.
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany; Department of Psychosomatic Medicine and Psychotherapy, University Hospital Magdeburg, Magdeburg, Germany
| | - Peter Martus
- Institute for Clinical Epidemiology and applied Biostatistics, University Hospital Tuebingen, Tuebingen, Germany
| | - Gregor Paul
- Department of Gastroenterology, Hepatology, Pneumology and Infectious Diseases, Klinikum Stuttgart, Stuttgart, Germany; Department of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | | | - Christine Allwang
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Marius Binneböse
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Magdeburg, Magdeburg, Germany
| | - Hannah Wallis
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Magdeburg, Magdeburg, Germany
| | - Rafael Mikolajczyk
- Martin Luther University Halle-Wittenberg, Interdisciplinary Center for Health Sciences; Institute of Medical Epidemiology, Biometrics and Informatics, Halle (Saale), Germany
| | | | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany; German Center for Mental Health (DZPG), Germany
| | - Stefan Ehehalt
- Public Health Department, State Capital-City Stuttgart, Germany
| | - Katrin Elisabeth Giel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany; German Center for Mental Health (DZPG), Germany
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13
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Badinlou F, Rahimian F, Hedman-Lagerlöf M, Lundgren T, Abzhandadze T, Jansson-Fröjmark M. Trajectories of mental health outcomes following COVID-19 infection: a prospective longitudinal study. BMC Public Health 2024; 24:452. [PMID: 38350959 PMCID: PMC10863235 DOI: 10.1186/s12889-024-17997-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 02/05/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has triggered a global mental health crisis. Yet, we know little about the lasting effects of COVID-19 infection on mental health. This prospective longitudinal study aimed to investigate the trajectories of mental health changes in individuals infected with COVID-19 and to identify potential predictors that may influence these changes. METHODS A web-survey that targeted individuals that had been infected with COVID-19 was used at three time-points: T0 (baseline), T1 (six months), and T2 (twelve months). The survey included demographics, questions related to COVID-19 status, previous psychiatric diagnosis, post-COVID impairments, fatigue, and standardized measures of depression, anxiety, insomnia. Linear mixed models were used to examine changes in depression, anxiety, and insomnia over time and identify factors that impacted trajectories of mental health outcomes. RESULTS A total of 236 individuals completed assessments and was included in the longitudinal sample. The participants' age ranged between 19 and 81 years old (M = 48.71, SD = 10.74). The results revealed notable changes in mental health outcomes over time. The trajectory of depression showed significant improvement over time while the trends in anxiety and insomnia did not exhibit significant changes over time. Younger participants and individuals who experienced severe COVID-19 infection in the acute phase were identified as high-risk groups with worst mental ill-health. The main predictors of the changes in the mental health outcomes were fatigue and post-COVID impairments. CONCLUSIONS The findings of our study suggest that mental health outcomes following COVID-19 infection exhibit a dynamic pattern over time. The study provides valuable insights into the mental health trajectory following COVID-19 infection, emphasizing the need for ongoing assessment, support, and interventions tailored to the evolving mental health needs of this population.
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Affiliation(s)
- Farzaneh Badinlou
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute, and Stockholm Health Care Services, Region of Stockholm, Stockholm, Sweden.
- Medical Unit, Medical Psychology, Women's Health and Allied Health Professional Theme, Karolinska University Hospital, Stockholm, Sweden.
| | - Fatemeh Rahimian
- RISE Research Institutes of Sweden, Department of Computer Science, Stockholm, Sweden
| | - Maria Hedman-Lagerlöf
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute, and Stockholm Health Care Services, Region of Stockholm, Stockholm, Sweden
| | - Tobias Lundgren
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute, and Stockholm Health Care Services, Region of Stockholm, Stockholm, Sweden
| | - Tamar Abzhandadze
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
- Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Markus Jansson-Fröjmark
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute, and Stockholm Health Care Services, Region of Stockholm, Stockholm, Sweden
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14
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Scazufca M, Seward N. Addressing the threat of loneliness and depression in older adults. THE LANCET. HEALTHY LONGEVITY 2024; 5:e84-e85. [PMID: 38310897 DOI: 10.1016/s2666-7568(23)00267-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 12/07/2023] [Indexed: 02/06/2024] Open
Affiliation(s)
- Marcia Scazufca
- LIM-23, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil.
| | - Nadine Seward
- Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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15
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Gilbody S, Littlewood E, McMillan D, Atha L, Bailey D, Baird K, Brady S, Burke L, Chew-Graham CA, Coventry P, Crosland S, Fairhurst C, Henry A, Hollingsworth K, Newbronner E, Ryde E, Shearsmith L, Wang HI, Webster J, Woodhouse R, Clegg A, Dexter-Smith S, Gentry T, Hewitt C, Hill A, Lovell K, Sloan C, Traviss-Turner G, Pratt S, Ekers D. Behavioural activation to mitigate the psychological impacts of COVID-19 restrictions on older people in England and Wales (BASIL+): a pragmatic randomised controlled trial. THE LANCET. HEALTHY LONGEVITY 2024; 5:e97-e107. [PMID: 38310902 PMCID: PMC10834375 DOI: 10.1016/s2666-7568(23)00238-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 10/27/2023] [Accepted: 11/09/2023] [Indexed: 02/06/2024] Open
Abstract
BACKGROUND Older adults were more likely to be socially isolated during the COVID-19 pandemic, with increased risk of depression and loneliness. We aimed to investigate whether a behavioural activation intervention delivered via telephone could mitigate depression and loneliness in at-risk older people during the COVID-19 pandemic. METHODS BASIL+ (Behavioural Activation in Social Isolation) was a pragmatic randomised controlled trial conducted among patients recruited from general practices in England and Wales, and was designed to assess the effectiveness of behavioural activation in mitigating depression and loneliness among older people during the COVID-19 pandemic. Eligible participants were aged 65 years and older, socially isolated, with a score of 5 or higher on the Patient Health Questionnaire-9 (PHQ-9), and had multiple long-term conditions. Participants were allocated in a 1:1 ratio to the intervention (behavioural activation) or control groups by use of simple randomisation without stratification. Behavioural activation was delivered by telephone; participants were offered up to eight weekly sessions with trained BASIL+ Support Workers. Behavioural activation was adapted to maintain social connections and encourage socially reinforcing activities. Participants in the control group received usual care with existing COVID-19 wellbeing resources. The primary clinical outcome was self-reported depression severity, assessed by the PHQ-9, at 3 months. Outcomes were assessed masked to allocation and analysis was by treatment allocation. This trial is registered with the ISRCTN registry (ISRCTN63034289). FINDINGS Between Feb 8, 2021, and Feb 28, 2022, 449 eligible participants were identified and 435 from 26 general practices were recruited and randomly assigned (1:1) to the behavioural activation intervention (n=218) or to the control group (usual care with signposting; n=217). The mean age of participants was 75·7 years (SD 6·7); 270 (62·1%) of 435 participants were female, and 418 (96·1%) were White. Participants in the intervention group attended an average of 5·2 (SD 2·9) of eight remote behavioural activation sessions. The adjusted mean difference in PHQ-9 scores between the control and intervention groups at 3 months was -1·65 (95% CI -2·54 to -0·75, p=0·0003). No adverse events were reported that were attributable to the behavioural activation intervention. INTERPRETATION Behavioural activation is an effective and potentially scalable intervention that can reduce symptoms of depression and emotional loneliness in at-risk groups in the short term. The findings of this trial add to the range of strategies to improve the mental health of older adults with multiple long-term conditions. These results can be helpful to policy makers beyond the pandemic in reducing the global burden of depression and addressing the health impacts of loneliness, particularly in at-risk groups. FUNDING UK National Institute for Health and Care Research.
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Affiliation(s)
- Simon Gilbody
- Department of Health Sciences, University of York, York, UK; Hull York Medical School, University of York, York, UK.
| | - Elizabeth Littlewood
- Department of Health Sciences, University of York, York, UK; Tees, Esk and Wear Valleys NHS Foundation Trust, Research & Development, Flatts Lane Centre, Middlesbrough, UK
| | - Dean McMillan
- Department of Health Sciences, University of York, York, UK; Hull York Medical School, University of York, York, UK; Tees, Esk and Wear Valleys NHS Foundation Trust, Research & Development, Flatts Lane Centre, Middlesbrough, UK
| | - Lucy Atha
- Department of Health Sciences, University of York, York, UK
| | - Della Bailey
- Department of Health Sciences, University of York, York, UK
| | - Kalpita Baird
- Department of Health Sciences, University of York, York, UK
| | - Samantha Brady
- Department of Health Sciences, University of York, York, UK
| | - Lauren Burke
- Department of Health Sciences, University of York, York, UK
| | | | - Peter Coventry
- Department of Health Sciences, University of York, York, UK; York Environmental Sustainability Institute, University of York, York, UK
| | | | | | - Andrew Henry
- Department of Health Sciences, University of York, York, UK; Tees, Esk and Wear Valleys NHS Foundation Trust, Research & Development, Flatts Lane Centre, Middlesbrough, UK
| | - Kelly Hollingsworth
- Department of Health Sciences, University of York, York, UK; Tees, Esk and Wear Valleys NHS Foundation Trust, Research & Development, Flatts Lane Centre, Middlesbrough, UK
| | | | - Eloise Ryde
- Department of Health Sciences, University of York, York, UK; Tees, Esk and Wear Valleys NHS Foundation Trust, Research & Development, Flatts Lane Centre, Middlesbrough, UK
| | | | - Han-I Wang
- Department of Health Sciences, University of York, York, UK
| | | | | | - Andrew Clegg
- School of Medicine, University of Leeds, Leeds, UK
| | - Sarah Dexter-Smith
- Tees, Esk and Wear Valleys NHS Foundation Trust, Research & Development, Flatts Lane Centre, Middlesbrough, UK
| | | | | | - Andrew Hill
- School of Medicine, University of Leeds, Leeds, UK
| | - Karina Lovell
- Division of Nursing, Midwifery & Social Work, University of Manchester, Manchester, UK
| | - Claire Sloan
- Department of Health Sciences, University of York, York, UK
| | | | | | - David Ekers
- Department of Health Sciences, University of York, York, UK; Tees, Esk and Wear Valleys NHS Foundation Trust, Research & Development, Flatts Lane Centre, Middlesbrough, UK
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16
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Castro J, Gigase FAJ, Molenaar NM, Ibroçi E, Perez-Rodriguez MM, Lieb W, Janevic T, de Witte LD, Bergink V, Rommel AS. Increased postpartum anxiety symptoms after perinatal SARS-CoV-2 infection in a large, prospective pregnancy cohort in New York City. J Psychiatr Res 2024; 170:130-137. [PMID: 38134722 PMCID: PMC10905645 DOI: 10.1016/j.jpsychires.2023.12.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 11/15/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023]
Abstract
Numerous studies reported an increase of postpartum mood symptoms during the COVID-19 pandemic. Yet, the link between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and perinatal mental health is less well understood. We investigated the associations between prenatal SARS-CoV-2 infection and postpartum depressive and anxiety symptoms, including examinations of infection timing and pandemic timeline. We included 595 participants from Generation C, a prospective pregnancy cohort in New York City (2020-2022). Prenatal SARS-CoV-2 infection was determined via laboratory or medical diagnosis. Depression and anxiety symptoms were measured 4-12 weeks postpartum using the Edinburgh Postnatal Depression Scale (EPDS) and Generalized Anxiety Disorder questionnaire (GAD), respectively. Quantile regressions were conducted with prenatal SARS-CoV-2 infection as exposure and continuously measured EPDS and GAD scores as outcomes. We reran the analyses in those with COVID-19-like symptoms in the trimester during which infection occurred. 120 (20.1%) participants had prenatal SARS-CoV-2 infection. After adjusting for socio-demographic, obstetric and other maternal health factors, prenatal SARS-CoV-2 infection was associated with higher median postpartum anxiety scores (b = 0.55, 95% CI = 0.15; 0.96). Late gestation infection (b = 1.15, 95% CI = 0.22; 2.09) and symptomatic infection (b = 1.15, 95% CI = 0.12; 2.18) were also associated with higher median postpartum anxiety scores. No associations were found with depressive symptoms. The associations were not moderated by time since the start of the pandemic. This study suggests that prenatal SARS-CoV-2 infection increases the risk of postpartum anxiety symptoms among participants reporting median anxiety symptoms. Given that this association was not affected by pandemic timing and that SARS-CoV-2 transmission continues, individuals infected with SARS-CoV-2 during pregnancy should be monitored for postpartum anxiety symptoms.
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Affiliation(s)
- Juliana Castro
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
| | - Frederieke A J Gigase
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA; Department of Child and Adolescent Psychiatry, Erasmus Medical Center, Rotterdam, the Netherlands.
| | - Nina M Molenaar
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA; Department of Psychiatry, Erasmus Medical Center, Rotterdam, the Netherlands.
| | - Erona Ibroçi
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
| | | | - Whitney Lieb
- Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York City, NY, USA; Blavatnik Family Women's Health Research Institute, Icahn School of Medicine at Mount Sinai, New York City, NY, USA; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
| | - Teresa Janevic
- Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York City, NY, USA; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
| | - Lot D de Witte
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
| | - Veerle Bergink
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA; Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York City, NY, USA; Department of Psychiatry, Erasmus Medical Center, Rotterdam, the Netherlands.
| | - Anna-Sophie Rommel
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
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Nichols E, Petrosyan S, Khobragade P, Banerjee J, Angrisani M, Dey S, Bloom DE, Schaner S, Dey AB, Lee J. Trajectories and correlates of poor mental health in India over the course of the COVID-19 pandemic: a nationwide survey. BMJ Glob Health 2024; 9:e013365. [PMID: 38286516 PMCID: PMC10826618 DOI: 10.1136/bmjgh-2023-013365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 12/20/2023] [Indexed: 01/31/2024] Open
Abstract
INTRODUCTION The COVID-19 pandemic had large impacts on mental health; however, most existing evidence is focused on the initial lockdown period and high-income contexts. By assessing trajectories of mental health symptoms in India over 2 years, we aim to understand the effect of later time periods and pandemic characteristics on mental health in a lower-middle income context. METHODS We used data from the Real-Time Insights of COVID-19 in India cohort study (N=3709). We used covariate-adjusted linear regression models with generalised estimating equations to assess associations between mental health (Patient Health Questionnaire (PHQ-4) score; range 0-12) and pandemic periods as well as pandemic characteristics (COVID-19 cases and deaths, government stringency, self-reported financial impact, COVID-19 infection in the household) and explored effect modification by age, gender and rural/urban residence. RESULTS Mental health symptoms dropped immediately following the lockdown period but rose again during the delta and omicron waves. Associations between mental health and later pandemic stages were stronger for adults 45 years of age and older (p<0.001). PHQ-4 scores were significantly associated with all pandemic characteristics considered, including estimated COVID-19 deaths (PHQ-4 difference of 0.10 units; 95% CI 0.06 to 0.13), government stringency index (0.14 units; 95% CI 0.11 to 0.18), self-reported major financial impacts (1.20 units; 95% CI 1.09 to 1.32) and COVID-19 infection in the household (0.36 units; 95% CI 0.23 to 0.50). CONCLUSION While the lockdown period and associated financial stress had the largest mental health impacts on Indian adults, the effects of the pandemic on mental health persisted over time, especially among middle-aged and older adults. Results highlight the importance of investments in mental health supports and services to address the consequences of cyclical waves of infections and disease burden due to COVID-19 or other emerging pandemics.
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Affiliation(s)
- Emma Nichols
- Center for Economic and Social Research, University of Southern California, Los Angeles, California, USA
| | - Sarah Petrosyan
- Center for Economic and Social Research, University of Southern California, Los Angeles, California, USA
| | - Pranali Khobragade
- Center for Economic and Social Research, University of Southern California, Los Angeles, California, USA
| | - Joyita Banerjee
- Center for Economic and Social Research, University of Southern California, Los Angeles, California, USA
| | - Marco Angrisani
- Center for Economic and Social Research, University of Southern California, Los Angeles, California, USA
- Department of Economics, University of Southern California, Los Angeles, California, USA
| | - Sharmistha Dey
- All India Institute of Medical Sciences, New Delhi, India
| | - David E Bloom
- Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Simone Schaner
- Center for Economic and Social Research, University of Southern California, Los Angeles, California, USA
- Department of Economics, University of Southern California, Los Angeles, California, USA
| | - Aparajit B Dey
- Geriatric Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Jinkook Lee
- Center for Economic and Social Research, University of Southern California, Los Angeles, California, USA
- Department of Economics, University of Southern California, Los Angeles, California, USA
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18
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Kampe L, Hörz-Sagstetter S, Bohn J, Remmers C. How personality functioning relates to psychological distress and behavioral attitudes during the Covid-19 pandemic. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-023-01722-7. [PMID: 38183464 DOI: 10.1007/s00406-023-01722-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 11/04/2023] [Indexed: 01/08/2024]
Abstract
Functional aspects of personality are crucial for experiencing and handling emotional distress. With the outbreak of the Covid-19 virus and the subsequent installation of mitigation rules of social distancing, severe psycho-social challenges were posed upon people. Research has shown that individuals react differently to these challenges. This study aimed to investigate the role of dimensional aspects of personality during the Covid-19 pandemic. Specifically, we examined how personality functioning, defense mechanisms, and narcissism were related to psychological distress and cognitive and behavioral attitudes towards the rules of social distancing. In a non-clinical sample (N = 254), Level of Personality Functioning Scale, Inventory of Personality Organization, Defense Style Questionnaire, Pathological Narcissism Inventory, and three single questions regarding emotional distress and behavioral attitudes towards the pandemic were used. Structural equation models with reference and residual factors were calculated. Impairments in personality functioning and vulnerable narcissism showed significant positive relationships, adaptive defense mechanisms significant negative relationships with psychological distress during the pandemic. Residual factors for aggression and low moral values showed distinct negative relationships with psychological distress related to social distancing. Among individuals who chose to ignore the rules of social distancing, greater impairment in personality organization was found. Personality functioning may elucidate individual differences in psychological distress and compliance with the mitigation rules during the pandemic. Limitations of measures are carefully considered in all interpretations.
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Affiliation(s)
- Leonie Kampe
- Department of Psychological Diagnostics, International Psychoanalytic University Berlin, Stromstrasse 1, 10555, Berlin, Germany.
- Department of Clinical Psychology and Psychotherapy, Psychologische Hochschule Berlin, Berlin, Germany.
| | - Susanne Hörz-Sagstetter
- Department of Clinical Psychology and Psychotherapy, Psychologische Hochschule Berlin, Berlin, Germany
| | - Johannes Bohn
- Department of Education and Psychology, Division of Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany
| | - Carina Remmers
- Department of Psychology, Institute for Mental Health and Behavioral Medicine, HMU Health and Medical University, Potsdam, Germany
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Li R, Karukivi M, Lindblom J, Korja R, Karlsson L, Karlsson H, Nolvi S. Trajectories of COVID-19 pandemic-related depressive symptoms and potential predictors: the FinnBrain Birth Cohort Study. Soc Psychiatry Psychiatr Epidemiol 2024; 59:151-163. [PMID: 37668674 PMCID: PMC10799828 DOI: 10.1007/s00127-023-02559-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 08/21/2023] [Indexed: 09/06/2023]
Abstract
PURPOSE In the context of the COVID-19 pandemic, mental health problems have been reported, and parents of young children may be more vulnerable to psychological distress due to increased caregiving responsibilities. However, research on the heterogeneity of the longitudinal course of psychological symptoms during the pandemic and the predispositions linked with these courses is still scarce. This study aimed to identify differential trajectories of depressive symptoms among the parents of young children and investigate the role of temperament traits, alexithymia, and coping styles in the heterogeneity of the symptom trajectories. METHODS The sample consists of 844 parents from the FinnBrain Birth Cohort Study. Latent growth mixture modeling was utilized to identify trajectories of depressive symptoms from pre-pandemic between 2014 and 2019 (T0, the closest available measurement was used) to May/June 2020 (T1) and December 2020 (T2) during the pandemic. Multinomial logistic regression was used to examine temperament, alexithymia, and coping as predictors of symptom trajectories, controlling for various background factors. RESULTS Four trajectories of depressive symptoms were identified. Most parents experienced low and stable depressive symptoms. Negative affect, effortful control, alexithymia, emotion-diverting coping (self-distraction and venting), and avoidant coping (denial and behavioral disengagement) were predictors for subclinical stable depressive symptoms. Constructive coping (positive reframing, acceptance, and humor) protected the cohort parents from increasing or moderately high depressive symptoms. CONCLUSIONS The findings have implications for identifying vulnerable individuals with specific traits and strengthening of constructive coping strategies as possible foci in interventions for depression during global crises.
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Affiliation(s)
- Ru Li
- Department of Psychiatry, University of Turku and Turku University Hospital, Medisiina A, Kiinamyllynkatu 8-10, Turku, Finland.
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Turku, Finland.
| | - Max Karukivi
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Adolescent Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Jallu Lindblom
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Turku, Finland
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Riikka Korja
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
| | - Linnea Karlsson
- Department of Psychiatry, University of Turku and Turku University Hospital, Medisiina A, Kiinamyllynkatu 8-10, Turku, Finland
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Department of Pediatrics and Adolescent Medicine, University of Turku and Turku University Hospital, Turku, Finland
| | - Hasse Karlsson
- Department of Psychiatry, University of Turku and Turku University Hospital, Medisiina A, Kiinamyllynkatu 8-10, Turku, Finland
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Saara Nolvi
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Turku, Finland
- Turku Institute for Advanced Studies, University of Turku, Turku, Finland
- Department of Medical Psychology, Charité Universitätsmedizin, Berlin, Germany
- Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
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Fortes Cavalcanti de Macêdo P, Brito E, de Magalhães Cunha C, Ribas de Farias Costa P, da Purificação Nazaré Araújo M, Cardoso Martins P, Leila Portela de Santana M. Weight stigma is a predictor of disordered eating in Brazilian college students during the COVID-19 pandemic: A 16-month cohort follow-up. Appetite 2024; 192:107084. [PMID: 37875240 DOI: 10.1016/j.appet.2023.107084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/07/2023] [Accepted: 10/09/2023] [Indexed: 10/26/2023]
Abstract
This study examined the relationship between weight stigma and disordered eating behaviors in university students during the COVID-19 pandemic, considering individuals with and without overweight. A national sample of 738 college students completed an online questionnaire at three time points between July 2020 and December 2021, reporting their experiences of weight stigma, perceived increase in weight stigma during the pandemic, internalized weight stigma, and disordered eating behaviors. The findings showed that the trajectories of disordered eating behaviors varied depending on participants' anthropometric status. Among those with overweight, there was a decrease over time in binge eating, food restriction, and purging. Conversely, the non-overweight group experienced a slight increase in binge eating from T2 to T3. Using the Generalized Estimating Equations model, the study revealed that weight stigma predicted disordered eating behaviors in both weight spectrums during the pandemic. Experiences of weight stigma and the perceived increase in weight stigma significantly increased the likelihood of engaging in binge eating, food restriction, and purging among individuals with overweight. Furthermore, the internalization of weight stigma was longitudinally associated with all examined eating behaviors, regardless of anthropometric status. These findings highlight the importance of addressing weight stigma to prevent disordered eating in college students.
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Affiliation(s)
| | - Edleide Brito
- Statistics Department, Federal University of Bahia, Salvador, Brazil.
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21
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Wilson J, Demou E, Kromydas T. COVID-19 lockdowns and working women's mental health: Does motherhood and size of workplace matter? A comparative analysis using understanding society. Soc Sci Med 2024; 340:116418. [PMID: 37992613 PMCID: PMC7615337 DOI: 10.1016/j.socscimed.2023.116418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 10/10/2023] [Accepted: 11/09/2023] [Indexed: 11/24/2023]
Abstract
The COVID-19 pandemic had detrimental and unequal repercussions on mental health. To date there is little evidence exploring how motherhood and workplace size moderates this relationship for working women. This study aimed to estimate changes in working women's mental health at the start of each UK lockdown and estimate the effect of motherhood and workplace size on mental health. We used Understanding Society data from women in paid employment, who participated in at least: one pre-COVID-19 Wave (9 or 10/11) and one COVID-19 lockdown wave (Lockdown 1: April 2020, Lockdown 2: November 2020, Lockdown 3: January 2021). Primary outcome was probable psychological distress (i.e., score≥4 in the General Health Questionnaire-12 (GHQ-12)). In Model 1, exposure was motherhood (binary), interacting with a variable that split time in the pre-pandemic and lockdown periods. In Model 2, workplace size (Micro:1-24, Medium: 25-199, Large: More than 200 employees) was added as an exposure (3-way interaction) to investigate moderation effects. We fitted mixed-effects logistic regression models, adjusting for age, ethnicity, UK country of residence, cohabitation, educational qualifications, working hours, furlough, subjective financial difficulty and previous health condition. In the adjusted Model 1, pre-pandemic, odds of GHQ-12 caseness were lower for mothers compared to non-mothers (OR:0.89 95%CI:0.77,1.03). However post-pandemic compared to pre-pandemic, odds for mothers were higher than non-mothers, especially during lockdown 3 (Non-mothers: OR:1.93 95%CI:1.69,2.20; Mothers: OR:2.87 95%CI:2.36,3.49). In Model 2, workplace size did not modify the relationship. Pre-pandemic, there was no difference in the odds of GHQ-12 caseness by workplace size; however, the differences observed in Lockdown 3 between non-mothers and mothers, are mainly attributed to differences in medium-sized enterprises (Non-mothers: OR:1.95 95%CI:1.53,2.48; Mothers: OR:3.56 95%CI:2.54,4.99). Future policies should be designed to facilitate the working lives of mothers, but especially for medium-sized enterprises as extreme uncertainty appears to affect these employees more.
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Affiliation(s)
- Jessica Wilson
- College of Social Science, University of Glasgow, Glasgow, United Kingdom
| | - Evangelia Demou
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Theocharis Kromydas
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom.
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22
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Novotný JS, Gonzalez-Rivas JP, Kunzová Š, Skladaná M, Pospíšilová A, Polcrová A, Vassilaki M, Medina-Inojosa JR, Lopez-Jimenez F, Geda YE, Stokin GB. The long-term effects of consecutive COVID-19 waves on mental health. BJPsych Open 2023; 10:e15. [PMID: 38111960 PMCID: PMC10755548 DOI: 10.1192/bjo.2023.620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 10/29/2023] [Accepted: 11/03/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND Although several studies have documented the impact of the COVID-19 pandemic on mental health, the long-term effects remain unclear. AIMS To examine longitudinal changes in mental health before and during the consecutive COVID-19 waves in a well-established probability sample. METHOD An online survey was completed by the participants of the COVID-19 add-on study at four time points: pre-COVID-19 period (2014-2015, n = 1823), first COVID-19 wave (April to May 2020, n = 788), second COVID-19 wave (August to October 2020, n = 532) and third COVID-19 wave (March to April 2021, n = 383). Data were collected via a set of validated instruments, and analysed with latent growth models. RESULTS During the pandemic, we observed a significant increase in stress levels (standardised β = 0.473, P < 0.001) and depressive symptoms (standardised β = 1.284, P < 0.001). The rate of increase in depressive symptoms (std. covariance = 0.784, P = 0.014), but not in stress levels (std. covariance = 0.057, P = 0.743), was associated with the pre-pandemic mental health status of the participants. Further analysis showed that secondary stressors played a predominant role in the increase in mental health difficulties. The main secondary stressors were loneliness, negative emotionality associated with the perception of COVID-19 disease, lack of resilience, female gender and younger age. CONCLUSIONS The surge in stress levels and depressive symptoms persisted across all three consecutive COVID-19 waves. This persistence is attributable to the effects of secondary stressors, and particularly to the status of mental health before the COVID-19 pandemic. Our findings reveal mechanisms underlying the surge in mental health difficulties during the COVID-19 waves, with direct implications for strategies promoting mental health during pandemics.
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Affiliation(s)
- Jan Sebastian Novotný
- Institute for Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacký University Olomouc, Czech Republic
| | - Juan Pablo Gonzalez-Rivas
- International Clinical Research Centre, St. Anne's University Hospital Brno, Czech Republic; and Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, USA
| | - Šárka Kunzová
- International Clinical Research Centre, St. Anne's University Hospital Brno, Czech Republic
| | - Mária Skladaná
- International Clinical Research Centre, St. Anne's University Hospital Brno, Czech Republic; and Second Department of Internal Medicine, St. Anne's University Hospital Brno and Masaryk University, Brno, Czech Republic
| | - Anna Pospíšilová
- International Clinical Research Centre, St. Anne's University Hospital Brno, Czech Republic
| | - Anna Polcrová
- International Clinical Research Centre, St. Anne's University Hospital Brno, Czech Republic; and Research Centre for Toxic Compounds in the Environment (RECETOX), Masaryk University, Brno, Czech Republic
| | - Maria Vassilaki
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Jose Ramon Medina-Inojosa
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA; and Marriot Heart Disease Research Program, Mayo Clinic, Rochester, Minnesota, USA
| | - Francisco Lopez-Jimenez
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Yonas Endale Geda
- Department of Neurology, Barrow Neurological Institute, Phoenix, Arizona, USA; and Franke Global Neuroscience Education Center, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Gorazd Bernard Stokin
- Institute for Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacký University Olomouc, Czech Republic; and Department of Neurology, Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK
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23
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Elias A, Ben J. Pandemic Racism: Lessons on the Nature, Structures, and Trajectories of Racism During COVID-19. JOURNAL OF BIOETHICAL INQUIRY 2023; 20:617-623. [PMID: 37917295 PMCID: PMC10942924 DOI: 10.1007/s11673-023-10312-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 10/10/2023] [Indexed: 11/04/2023]
Abstract
The COVID-19 pandemic has been one of the most acute global crises in recent history, which profoundly impacted the world across many dimensions. During this period, racism manifested in ways specifically related to the pandemic, including xenophobic sentiments, racial attacks, discriminatory policies, and disparate outcomes across racial/ethnic groups. This paper examines some of the pressing questions about pandemic racism and inequity. We review what research has revealed about the nature and manifestations of racism, the entrenchment of structural racism, and trajectories of racism during COVID-19.
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Affiliation(s)
- A Elias
- Alfred Deakin Institute for Citizenship and Globalisation, Deakin University, 221 Burwood HWY, Burwood, Victoria, 3125, Australia.
| | - J Ben
- Alfred Deakin Institute for Citizenship and Globalisation, Deakin University, 221 Burwood HWY, Burwood, Victoria, 3125, Australia
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24
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Gouin J, de la Torre‐Luque A, Sánchez‐Carro Y, Geoffroy M, Essau C. Heterogeneity in the trajectories of psychological distress among late adolescents during the COVID-19 pandemic. JCPP ADVANCES 2023; 3:e12195. [PMID: 38054054 PMCID: PMC10694544 DOI: 10.1002/jcv2.12195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 07/28/2023] [Indexed: 12/07/2023] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has constrained opportunities in social, educational and professional domains, leading to developmental challenges for adolescents initiating their transition to adulthood. Meta-analysis indicated that there was a small increase in psychological distress during the first year of the COVID-19 pandemic. However, significant heterogeneity in the psychological response to the COVID-19 pandemic was noted. Developmental antecedents as well as social processes may account for such heterogeneity. The goal of this study was to characterize trajectories of psychological distress in late adolescence during the COVID-19 pandemic. Methods 5014 late adolescents born between 2000 and 2002 from the UK Millennium Cohort Study completed online self-reported assessments at three occasions during the first year of the COVID-19 pandemic (May 2020, September/October 2020 and February/March 2021). These surveys assessed psychological distress, loneliness, social support, family conflict, as well as other pandemic stressors. Information on developmental antecedents were obtained when cohort members were 17 years of age. Results Four distinct trajectories class were identified. Normative class (52.13%) experienced low and decreasing levels of psychological distress, while moderately increasing class (31.84%) experienced a small, but significant increase in distress over time and increasing class (8.75%) exhibited a larger increase in distress after the first wave of the pandemic. Inverted U-shaped class (7.29%) experienced elevated psychological distress during the first wave of the pandemic, followed by a decrease in distress in subsequent waves of the pandemic. Larger longitudinal increases in loneliness were noted among individuals in the elevated distress trajectory, compared to other trajectories. Pre-pandemic psychopathology was associated with elevated distress early in the pandemic. Conclusions The largest trajectory showed low and declining psychological distress, highlighting the resilience of the majority of late adolescents. However, a subgroup of adolescents experienced large increases in psychological distress, identifying a group of individuals more vulnerable to pandemic-related stress.
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Affiliation(s)
| | - Alejandro de la Torre‐Luque
- Department of Legal Medicine, Psychiatry and PathologyUniversidad Complutense de Madrid, CIBERSAM ISCIIIMadridSpain
| | - Yolanda Sánchez‐Carro
- Center for Biomedical Research in Mental Health (CIBERSAM)Carlos III Health InstituteMadridSpain
| | - Marie‐Claude Geoffroy
- Department of PsychiatryMcGill University and Douglas Mental Health University InstituteMontrealQuebecCanada
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Quattropani MC, Barbosa MLL, Lenzo V, Hope K, Toffle ME, Gafforelli LG, Sardella A, Islam-Zwart K. The psychological impact of the COVID-19 pandemic and the role of resilience: cross cultural differences between Brazil, Italy, and the United States. BMC Public Health 2023; 23:2278. [PMID: 37978480 PMCID: PMC10657012 DOI: 10.1186/s12889-023-16687-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 09/04/2023] [Indexed: 11/19/2023] Open
Abstract
OBJECTIVE Restrictive measures consequent to the COVID-19 pandemic have had a significant psychological impact on everyday life in the general population, even though differences between countries remain poorly investigated. The present study sought to examine the different psychological impacts and resilience of the pandemic among three of the most heavily hit countries: Brazil, Italy, and the United States. METHODS This cross-sectional study separately involved three national community populations, namely the Brazilian, the Italian, and the American population. Participants aged 18 years or older were recruited through a shared online survey. Participants self-completed the Connor-Davidson Resilience Scale (CD-RISC-10) and the Center for Epidemiological Studies-Depression Scale (CES-D); post-traumatic stress was additionally assessed using the Impact of Event Scale-Revised (IES-R). Three separate Analyses of Covariance (ANCOVA) were performed in order to investigate differences in the levels of resilience, post-traumatic stress, and depression among the three populations. RESULTS The study included in total 734 participants (mean age = 27.60 ± 11.69 years; 77% of females). Results of ANCOVA comparisons showed significant differences between the three groups in the variable measuring resilience, post-traumatic stress symptoms, and depression. As for resilience, results of post-hoc tests showed significant differences between the groups from Brazil and Italy and between the groups from Brazil and USA. As for the post-traumatic stress symptoms, results showed significant differences between the USA and Brazil groups and between the USA and Italy groups. As for the depression symptoms, results showed significant differences between the USA and Brazil groups. CONCLUSIONS Overall, these findings may help to increase understanding of the psychological impact of COVID-19 in Brazil, Italy, and the USA. Interventions to prevent mental disorders among general populations should take into account these findings.
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Affiliation(s)
- Maria C Quattropani
- Department of Educational Sciences, University of Catania, Via Biblioteca 4, 95124, Catania, Italy
| | | | - Vittorio Lenzo
- Department of Educational Sciences, University of Catania, Via Biblioteca 4, 95124, Catania, Italy.
| | - Keely Hope
- School of Psychology, Professor, Eastern Washington University, 135 Martin Hall, Cheney, WA, 99004, USA
| | - Mary Ellen Toffle
- Department of Political and Juridical Sciences, University of Messina, Piazza XX Settembre, 4, 98122, Messina, Italy
| | | | - Alberto Sardella
- Department of Clinical and Experimental Medicine, University of Messina, Consolare Valeria St, 98125, Messina, Italy
| | - Kayleen Islam-Zwart
- School of Psychology, Professor, Eastern Washington University, 135 Martin Hall, Cheney, WA, 99004, USA
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Welsh VK, Mason KJ, Bailey J, Bajpai R, Jordan KP, Mallen CD, Burton C. Trends in consultations and prescribing for rheumatic and musculoskeletal diseases: an electronic primary care records study. Br J Gen Pract 2023; 73:e858-e866. [PMID: 37722859 PMCID: PMC10523337 DOI: 10.3399/bjgp.2022.0648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 05/15/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND Rheumatic and musculoskeletal diseases (RMDs) are common and generally managed in primary care through supported self-care, physiotherapy, analgesia, and specialist referral where indicated. The COVID-19 pandemic led to abrupt changes in primary care delivery, including moves to remote consulting, pauses on group-based self-care, and restricted referrals. AIM To describe how patterns of UK primary healthcare consultations and analgesic prescribing relating to RMDs changed during the COVID-19 pandemic. DESIGN AND SETTING Observational study using routinely collected national primary care electronic health record data from the Clinical Practice Research Datalink between 1 April 2017 and 1 October 2021. METHOD RMD and analgesic SNOMED-CT codes were derived through consensus and published work. Prevalent and incident RMD-related consultations were determined, and RMD consultations matched to prevalent and incident analgesia prescriptions. Joinpoint regression was used to describe trends over time. RESULTS Prevalent and incident RMD consultations steadily increased until March 2020 when a substantial drop occurred as pandemic- related restrictions were introduced; levels had not recovered to pre-pandemic highs by October 2021. While incident and prevalent analgesic prescribing also reduced around March 2020, the proportion of patients with an RMD consultation prescribed any analgesic increased from 27.72% in February 2020 to 38.15% in April 2020, with increases across all analgesic groups. A higher proportion of strong opioid prescriptions was seen in the most deprived areas. CONCLUSION Pandemic-associated restrictions led to fewer primary care consultations and relative increases in analgesic prescribing, including strong opioids, for RMDs in the UK. Policymakers must consider the impact of these changes in future healthcare resource planning.
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Affiliation(s)
- Victoria K Welsh
- Centre for Musculoskeletal Health Research, School of Medicine, Keele University, Keele
| | - Kayleigh J Mason
- Centre for Musculoskeletal Health Research, School of Medicine, Keele University, Keele
| | - James Bailey
- Centre for Musculoskeletal Health Research, School of Medicine, Keele University, Keele
| | - Ram Bajpai
- Centre for Musculoskeletal Health Research, School of Medicine, Keele University, Keele
| | - Kelvin P Jordan
- Centre for Musculoskeletal Health Research, School of Medicine, Keele University, Keele
| | - Christian D Mallen
- Centre for Musculoskeletal Health Research, School of Medicine, Keele University, Keele
| | - Claire Burton
- Centre for Musculoskeletal Health Research, School of Medicine, Keele University, Keele
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Song YX, Huang YC, Li YY, Bao YP, Zhou GD, Lu L, Shi J, Sun Y. Risk factors for poor progression of addictive internet use across different COVID-19 periods in China. Am J Addict 2023; 32:593-605. [PMID: 37615548 DOI: 10.1111/ajad.13464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 06/21/2023] [Accepted: 08/05/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Addictive behaviors are serious factors for mental health and usually increase during public crises. We identified the vulnerable characteristics for bad prognosis of addictive internet use across different periods of the coronavirus disease 2019 (COVID-19) pandemic. METHODS Self-reported questionnaires were delivered in three waves through jdh.com during the outbreak (n = 17,960), remission (n = 15,666), and dynamic zero (n = 12,158) periods of COVID-19 pandemic in China. Internet addiction degree was assessed using the Internet Addiction Test. The different progression groups were divided using a latent class growth model among 1679 longitudinal participants. Risk factors for bad progression were identified by two-step logistic regression. RESULTS A total of 40.16% of participants reported an increase in the addictive degree of internet use compared with prepandemic. Across different COVID-19 periods, the overall trend of addictive internet use was downward among general Chinese study participants (Mslope = -1.56). Childhood traumatic experiences, deterioration of physical health, depression, and anxiety during remission and dynamic periods were the main risk factors for the bad progression of pandemic-induced addictive internet use. DISCUSSION AND CONCLUSIONS Addictive internet use was remitted following relaxed control policies during the COVID-19 pandemic. Negative childhood experiences and bad mental status during the recovery period were harmful to coping with pandemic-related addictive internet use. SCIENTIFIC SIGNIFICANCE Our findings profiled the general trend of addictive internet use and the vulnerable characteristics of its bad progression across different periods of the first wave of COVID-19 pandemic in China. Our findings provide valuable insights for preventing the long-term adverse effects of negative public events on Internet addiction.
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Affiliation(s)
- Yi-Xuan Song
- National Institute on Drug Dependence, Peking University, Beijing, China
- Beijing Key Laboratory of Drug Dependence Research, Beijing, China
| | - Yu-Chen Huang
- National Institute on Drug Dependence, Peking University, Beijing, China
- Beijing Key Laboratory of Drug Dependence Research, Beijing, China
| | - Yang-Yang Li
- National Institute on Drug Dependence, Peking University, Beijing, China
| | - Yan-Ping Bao
- National Institute on Drug Dependence, Peking University, Beijing, China
- Beijing Key Laboratory of Drug Dependence Research, Beijing, China
| | - Guang-Dong Zhou
- Faculty of Psychology, Tianjin Normal University, Tianjin, China
| | - Lin Lu
- National Institute on Drug Dependence, Peking University, Beijing, China
- Beijing Key Laboratory of Drug Dependence Research, Beijing, China
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, Beijing, China
| | - Jie Shi
- National Institute on Drug Dependence, Peking University, Beijing, China
- Beijing Key Laboratory of Drug Dependence Research, Beijing, China
| | - Yan Sun
- National Institute on Drug Dependence, Peking University, Beijing, China
- Beijing Key Laboratory of Drug Dependence Research, Beijing, China
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Ferreira MJ, Sofia R, Carreno DF, Eisenbeck N, Cruz JFA. Positivity and coping as key to well-being and psychological adjustment during the pandemic of COVID-19: A follow-up study in Portugal. Appl Psychol Health Well Being 2023; 15:1750-1771. [PMID: 37321921 DOI: 10.1111/aphw.12462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 05/26/2023] [Indexed: 06/17/2023]
Abstract
This follow-up study aimed to analyze the protective role of positivity and coping strategies on the well-being and psychological distress levels reported during Portugal's first and third waves of COVID-19. The total sample consisted of 135 participants (82.0% women) with ages ranging from 20 to 72 years (M = 39.29, SD = 11.46). Results suggested a significant decrease in well-being levels but no changes in psychological distress were observed. Positivity was a strong and significant predictor of well-being and psychological distress during the pandemic crisis. Among the set of strategies used by individuals at the first wave, denial, self-blame, and self-distraction predicted a poorer adaptation with more significant mental health impairment, with self-blame standing out as the most harmful. This study highlighted the key role of positivity in adjusting to the current pandemic crisis and the lasting detrimental impact of specific coping strategies.
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Affiliation(s)
- Maria José Ferreira
- HEI-Lab: Digital Human-Environment Interaction Lab, Lisbon, Portugal
- Faculty of Psychology, Sports and Education, Lusófona University, Porto, Portugal
| | - Rui Sofia
- Center of Research, Education, Innovation and Intervention in Sport, Faculty of Sport, University of Porto, Porto, Portugal
- School of Sports and Leisure, Polytechnic Institute of Viana do Castelo, Viana do Castelo, Portugal
| | - David F Carreno
- Department of Psychology, University of Almeria, Almeria, Spain
| | - Nikolett Eisenbeck
- Department of Personality, Evaluation and Psychological Treatment, University of Seville, Seville, Spain
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Blackwell CK, Sherlock P, Jackson KL, Hofheimer JA, Cella D, Algermissen MA, Alshawabkeh AN, Avalos LA, Bastain T, Blair C, Enlow MB, Brennan PA, Breton C, Bush NR, Chandran A, Collazo S, Conradt E, Crowell SE, Deoni S, Elliott AJ, Frazier JA, Ganiban JM, Gold DR, Herbstman JB, Joseph C, Karagas MR, Lester B, Lasky-Su JA, Leve LD, LeWinn KZ, Mason WA, McGowan EC, McKee KS, Miller RL, Neiderhiser JM, O’Connor TG, Oken E, O’Shea TM, Pagliaccio D, Schmidt RJ, Singh AM, Stanford JB, Trasande L, Wright RJ, Duarte CS, Margolis AE. Development and psychometric validation of the Pandemic-Related Traumatic Stress Scale for children and adults. Psychol Assess 2023; 35:1054-1067. [PMID: 37902671 PMCID: PMC10773574 DOI: 10.1037/pas0001211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
To assess the public health impact of the COVID-19 pandemic on mental health, investigators from the National Institutes of Health Environmental influences on Child Health Outcomes (ECHO) research program developed the Pandemic-Related Traumatic Stress Scale (PTSS). Based on the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) acute stress disorder symptom criteria, the PTSS is designed for adolescent (13-21 years) and adult self-report and caregiver-report on 3-12-year-olds. To evaluate psychometric properties, we used PTSS data collected between April 2020 and August 2021 from non-pregnant adult caregivers (n = 11,483), pregnant/postpartum individuals (n = 1,656), adolescents (n = 1,795), and caregivers reporting on 3-12-year-olds (n = 2,896). We used Mokken scale analysis to examine unidimensionality and reliability, Pearson correlations to evaluate relationships with other relevant variables, and analyses of variance to identify regional, age, and sex differences. Mokken analysis resulted in a moderately strong, unidimensional scale that retained nine of the original 10 items. We detected small to moderate positive associations with depression, anxiety, and general stress, and negative associations with life satisfaction. Adult caregivers had the highest PTSS scores, followed by adolescents, pregnant/postpartum individuals, and children. Caregivers of younger children, females, and older youth had higher PTSS scores compared to caregivers of older children, males, and younger youth, respectively. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Courtney K. Blackwell
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine
| | - Phillip Sherlock
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine
| | - Kathryn L. Jackson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine
| | - Julie A. Hofheimer
- Department of Pediatrics, University of North Carolina School of Medicine
| | - David Cella
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine
| | | | - Akram N. Alshawabkeh
- Department of Civil and Environmental Engineering, College of Engineering, Northeastern University
| | - Lyndsay A. Avalos
- Kaiser Permanente North California, Division of Research, Oakland, California, United States
| | - Tracy Bastain
- Clinical Population and Public Health Sciences, Keck School of Medicine of the University of Southern California
| | - Clancy Blair
- New York University Grossman School of Medicine
- Department of Population Health, New York University Grossman School of Medicine
| | - Michelle Bosquet Enlow
- Boston Children’s Hospital, Boston, Massachusetts, United States
- Department of Psychiatry, Harvard Medical School
| | | | - Carrie Breton
- Clinical Population and Public Health Sciences, Keck School of Medicine of the University of Southern California
| | - Nicole R. Bush
- Department of Psychiatry, University of California, San Francisco
| | - Aruna Chandran
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health
| | - Shaina Collazo
- Icahn School of Medicine at Mount Sinai
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai
| | | | | | - Sean Deoni
- Bill and Melinda Gates Foundation, Seattle, Washington, United States
| | - Amy J. Elliott
- Avera Research Institute, Sioux Falls, South Dakota, United States
- Department of Pediatrics, University of South Dakota School of Medicine
| | - Jean A. Frazier
- Department of Psychiatry, University of Massachusetts Chan Medical School
| | - Jody M. Ganiban
- Department of Clinical/Developmental Psychology, George Washington University
| | - Diane R. Gold
- Department of Psychiatry, Harvard Medical School
- Department of Medicine, Harvard Medical School
- Harvard University T.H. Chan School of Public Health
- Department of Environmental Health, Harvard University T.H. Chan School of Public Health
- Brigham and Women’s Hospital, Boston, Massachusetts, United States
| | - Julie B. Herbstman
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health
| | | | | | - Barry Lester
- Women & Infants Hospital, Providence, Rhode Island, United States
- Department of Psychiatry and Human Behavior, Brown University
- Department of Pediatrics, Brown University
| | - Jessica A. Lasky-Su
- Department of Psychiatry, Harvard Medical School
- Department of Medicine, Harvard Medical School
- Brigham and Women’s Hospital, Boston, Massachusetts, United States
| | - Leslie D. Leve
- Department of Counseling Psychology and Human Services, University of Oregon College of Education
| | - Kaja Z. LeWinn
- Department of Psychiatry, University of California, San Francisco
| | - W. Alex Mason
- Department of Child, Youth, and Family Studies, College of Education and Human Sciences, University of Nebraska—Lincoln
| | - Elisabeth C. McGowan
- Women & Infants Hospital, Providence, Rhode Island, United States
- Department of Pediatrics, Brown University
| | - Kimberly S. McKee
- Department of Family Medicine, University of Michigan Medical School
| | - Rachel L. Miller
- Icahn School of Medicine at Mount Sinai
- Department of Medicine, Icahn School of Medicine at Mount Sinai
| | | | | | - Emily Oken
- Department of Psychiatry, Harvard Medical School
- Harvard University T.H. Chan School of Public Health
- Brigham and Women’s Hospital, Boston, Massachusetts, United States
- Department of Population Medicine, Harvard Medical School
- Department of Nutrition, Harvard University T.H. Chan School of Public Health
- Harvard Pilgrim Health Care Institute, Boston, Massachusetts, United States
| | - T. Michael O’Shea
- Department of Pediatrics, University of North Carolina School of Medicine
| | - David Pagliaccio
- Columbia University Irving Medical Center
- New York State Psychiatric Institute, New York, New York, United States
| | - Rebecca J. Schmidt
- Department of Public Health Services, University of California—Davis School of Medicine
| | - Anne Marie Singh
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health
| | - Joseph B. Stanford
- Department of Family and Preventative Medicine, University of Utah School of Medicine
| | - Leonardo Trasande
- New York University Grossman School of Medicine
- Department of Pediatrics, New York University Grossman School of Medicine
| | - Rosalind J. Wright
- Icahn School of Medicine at Mount Sinai
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai
| | - Cristiane S. Duarte
- Columbia University Irving Medical Center
- Department of Psychiatry, Columbia University
| | - Amy E. Margolis
- Columbia University Irving Medical Center
- Department of Psychiatry, Columbia University
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Hetlevik Ø, Wensaas KA, Baste V, Emberland KE, Özgümüs T, Håberg SE, Rortveit G. Prevalence and predictors of post-COVID-19 symptoms in general practice - a registry-based nationwide study. BMC Infect Dis 2023; 23:721. [PMID: 37880583 PMCID: PMC10599052 DOI: 10.1186/s12879-023-08727-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 10/18/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND With Norwegian national registry data, we assessed the prevalence of post-COVID-19 symptoms at least 3 months after confirmed infection, and whether sociodemographic factors and pre-pandemic health problems were risk factors for these symptoms. METHODS All persons with a positive SARS-CoV-2 PCR test from February 2020 to February 2021 (exposed) were compared to a group without a positive test (unexposed) matched on age, sex, and country of origin. We used Cox regression to estimate hazard ratios (HR) for 18 outcome symptoms commonly described as post-COVID-19 related, registered by GPs. We compared relative risks (RR) for fatigue, memory disturbance, or shortness of breath among exposed and unexposed using Poisson regression models, assessing sex, age, education, country of origin, and pre-pandemic presence of the same symptom and comorbidity as possible risk factors, with additional analyses to assess hospitalisation for COVID-19 as a risk factor among exposed. RESULTS The exposed group (N = 53 846) had a higher prevalence of most outcome symptoms compared to the unexposed (N = 485 757), with the highest risk for shortness of breath (HR 2.75; 95%CI 2.59-2.93), fatigue (2.08; 2.00-2.16) and memory disturbance (1.41;1.26-1.59). High HRs were also found for disturbance of smell/taste and hair loss, but frequencies were low. Concerning risk factors, sociodemographic factors were at large similarly associated with outcome symptoms in both groups. Registration of the outcome symptom before the pandemic increased the risk for fatigue, memory disturbance and shortness of breath after COVID-19, but these associations were weaker among exposed. Comorbidity was not associated with fatigue and shortness of breath in the COVID-19 group. For memory disturbance, the RR was slightly increased with the higher comorbidity score both among exposed and unexposed. CONCLUSION COVID-19 was associated with a range of symptoms lasting more than three months after the infection.
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Affiliation(s)
- Øystein Hetlevik
- Department of Global Public Health and Primary Care, University of Bergen, Postbox 7804, Bergen, NO-5020, Norway.
| | - Knut-Arne Wensaas
- Research Unit for General Practice, NORCE Norwegian Research Centre, Bergen, Norway
| | - Valborg Baste
- National Centre for Emergency Primary Health Care, NORCE Norwegian Research Centre, Bergen, Norway
| | - Knut Erik Emberland
- Department of Global Public Health and Primary Care, University of Bergen, Postbox 7804, Bergen, NO-5020, Norway
| | - Türküler Özgümüs
- Department of Global Public Health and Primary Care, University of Bergen, Postbox 7804, Bergen, NO-5020, Norway
| | - Siri Eldevik Håberg
- Centre for Fertility and Health, The Norwegian Institute of Public Health, Oslo, Norway
| | - Guri Rortveit
- Department of Global Public Health and Primary Care, University of Bergen, Postbox 7804, Bergen, NO-5020, Norway
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31
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Gaynor N, Fitzgerald L. Mind-Wandering and Its Relationship With Psychological Wellbeing and Obsessive-Compulsive Symptomatology in the Context of Covid-19. Psychol Rep 2023:332941231203563. [PMID: 37787173 DOI: 10.1177/00332941231203563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
Mind-wandering (MW) as a research topic has received considerable attention over the last several decades. The recent differentiation between spontaneous and deliberate MW has suggested a particular effect of the former on psychopathology; in that increased spontaneous MW may precede mental illness. The present study sought to explore MW as a potential contributing factor to poor mental health in the context of the Covid-19 pandemic. More specifically, we sought to determine firstly, whether the effects of MW frequency, type and content on subjective psychological wellbeing was consistent with previous findings after controlling for the impacts of Covid-related stress. Secondly, previous research has demonstrated an effect of both Covid-stress and spontaneous MW on the experience of obsessive-compulsive symptomatology (OCS), and so the present study explored this relationship further by assessing whether Covid-stress mediated the relationship between spontaneous MW and OCS. Participants completed measures of MW, OCS and psychological wellbeing through an online questionnaire. The results indicated that increased spontaneous MW was indicative of both poorer subjective psychological wellbeing and OCS, with Covid-stress partially mediating the relationship between spontaneous MW and OCS. Our findings provide further support for the adverse effect of unintentional MW on psychological wellbeing, as well as for the differentiation between both forms of the cognitive phenomenon. Additionally, they provide an important insight into one of the factors that may have preceded poor mental health among the Irish population during Covid-19. Future research may build upon the present study by exploring similar relationships among clinical populations.
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Affiliation(s)
- Niamh Gaynor
- School of Psychology, Dublin City University, Dublin, Ireland
| | - Lisa Fitzgerald
- School of Psychology, Dublin City University, Dublin, Ireland
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van der Velden PG, Contino C, de Vroege L, Das M, Bosmans M, Zijlmans J. The prevalence of anxiety and depression symptoms (ADS), persistent and chronic ADS among the adult general population and specific subgroups before and during the COVID-19 pandemic until December 2021. J Affect Disord 2023; 338:393-401. [PMID: 37364654 PMCID: PMC10290740 DOI: 10.1016/j.jad.2023.06.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 05/28/2023] [Accepted: 06/20/2023] [Indexed: 06/28/2023]
Abstract
BACKGROUND It is unclear to what extent the prevalence of moderate and severe anxiety and depression symptoms (ADS) is higher during the first 20 months after the COVID-19 outbreak than before the outbreak. The same holds for persistent and chronic ADS among the adult general population and subgroups (such as employed, minorities, young adults, work disabled). METHODS Data were extracted from six surveys conducted with the Dutch longitudinal LISS panel, based on a traditional probability sample (N = 3493). Biographic characteristics and ADS (MHI-5 scores) were assessed in March-April 2019, November-December 2019, March-April 2020, November-December 2020, March-April 2021, and November-December 2021. Generalized estimating equations were conducted to examine differences in the prevalence of post-outbreak ADS, persistent and chronic ADS compared to the pre-outbreak prevalence in similar periods. The Benjamini-Hochberg correction for multiple testing was applied. RESULTS Among the general population chronic moderate ADS increased significantly but slightly in the period March-April 2020 to March-April 2021 compared to a similar period before the pandemic (11.9 % versus 10.9 %, Odds Ratio = 1.11). In the same period a somewhat larger significant increase in chronic moderate ADS was observed among 19-24 years old respondents (21.4 % versus 16.7 %, Odds Ratio = 1.35). After the Benjamini-Hochberg correction several other differences were no longer significant. LIMITATIONS No other mental health problems were assessed. CONCLUSIONS The Dutch general population and most of the assessed subgroups were relatively resilient given the limited increase or absence of increases in (persistent and chronic) ADS. However, young adults suffered from an increase of chronic ADS.
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Affiliation(s)
- Peter G van der Velden
- Centerdata, Tilburg, the Netherlands; TRANZO, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands.
| | | | - Lars de Vroege
- TRANZO, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands; GGz Breburg, Breda, the Netherlands
| | - Marcel Das
- Centerdata, Tilburg, the Netherlands; Tilburg School of Economics and Management, Tilburg University, Tilburg, the Netherlands
| | | | - Josjan Zijlmans
- Amsterdam University Medical Centres, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands; Department of Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Moreno-Agostino D, Fisher HL, Hatch SL, Morgan C, Ploubidis GB, Das-Munshi J. Generational, sex, and socioeconomic inequalities in mental and social wellbeing during the COVID-19 pandemic: prospective longitudinal observational study of five UK cohorts. Psychol Med 2023; 53:6403-6414. [PMID: 36345141 PMCID: PMC9874037 DOI: 10.1017/s0033291722003348] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 10/04/2022] [Accepted: 10/05/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Research suggests that there have been inequalities in the impact of the coronavirus disease 2019 (COVID-19) pandemic and related non-pharmaceutical interventions on population mental health. We explored generational, sex, and socioeconomic inequalities during the first year of the pandemic using nationally representative cohorts from the UK. METHODS We analysed data from 26772 participants from five longitudinal cohorts representing generations born between 1946 and 2000, collected in May 2020, September-October 2020, and February-March 2021 across all five cohorts. We used a multilevel growth curve modelling approach to investigate generational, sex, and socioeconomic differences in levels of anxiety and depressive symptomatology, loneliness, and life satisfaction (LS) over time. RESULTS Younger generations had worse levels of mental and social wellbeing throughout the first year of the pandemic. Whereas these generational inequalities narrowed between the first and last observation periods for LS [-0.33 (95% CI -0.51 to -0.15)], they became larger for anxiety [0.22 (0.10, 0.33)]. Generational inequalities in depression and loneliness did not change between the first and last observation periods, but initial depression levels of the youngest cohort were worse than expected if the generational inequalities had not accelerated. Women and those experiencing financial difficulties had worse initial mental and social wellbeing levels than men and those financially living comfortably, respectively, and these gaps did not substantially differ between the first and last observation periods. CONCLUSIONS By March 2021, mental and social wellbeing inequalities persisted in the UK adult population. Pre-existing generational inequalities may have been exacerbated with the pandemic onset. Policies aimed at protecting vulnerable groups are needed.
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Affiliation(s)
- Darío Moreno-Agostino
- Centre for Longitudinal Studies, UCL Social Research Institute, University College London, 55-59 Gordon Square, London WC1H 0NU, UK
- ESRC Centre for Society and Mental Health, King's College London, Melbourne House, 44-46 Aldwych, London WC2B 4LL, UK
| | - Helen L. Fisher
- ESRC Centre for Society and Mental Health, King's College London, Melbourne House, 44-46 Aldwych, London WC2B 4LL, UK
- King's College London, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, 16 De Crespigny Park, London SE5 8AF, UK
| | - Stephani L. Hatch
- ESRC Centre for Society and Mental Health, King's College London, Melbourne House, 44-46 Aldwych, London WC2B 4LL, UK
- Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology & Neuroscience, 16 De Crespigny Park, London SE5 8AF, UK
| | - Craig Morgan
- ESRC Centre for Society and Mental Health, King's College London, Melbourne House, 44-46 Aldwych, London WC2B 4LL, UK
- Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology & Neuroscience, 16 De Crespigny Park, London SE5 8AF, UK
| | - George B. Ploubidis
- Centre for Longitudinal Studies, UCL Social Research Institute, University College London, 55-59 Gordon Square, London WC1H 0NU, UK
- ESRC Centre for Society and Mental Health, King's College London, Melbourne House, 44-46 Aldwych, London WC2B 4LL, UK
| | - Jayati Das-Munshi
- ESRC Centre for Society and Mental Health, King's College London, Melbourne House, 44-46 Aldwych, London WC2B 4LL, UK
- Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology & Neuroscience, 16 De Crespigny Park, London SE5 8AF, UK
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Ziadni MS, Jaros S, Anderson SR, You DS, Darnall BD, Mackey SC. A Longitudinal Investigation of the Impact of COVID-19 on Patients With Chronic Pain. THE JOURNAL OF PAIN 2023; 24:1830-1842. [PMID: 37225065 PMCID: PMC10201913 DOI: 10.1016/j.jpain.2023.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 04/26/2023] [Accepted: 05/16/2023] [Indexed: 05/26/2023]
Abstract
The COVID-19 pandemic prompted unexpected changes in the healthcare system. This current longitudinal study had 2 aims: 1) describe the trajectory of pandemic-associated stressors and patient-reported health outcomes among patients receiving treatment at a tertiary pain clinic over 2 years (May 2020 to June 2022); and 2) identify vulnerable subgroups. We assessed changes in pandemic-associated stressors and patient-reported health outcome measures. The study sample included 1270 adult patients who were predominantly female (74.6%), White (66.2%), non-Hispanic (80.6%), married (66.1%), not on disability (71.2%), college-educated (59.45%), and not currently working (57.9%). We conducted linear mixed effect modeling to examine the main effect of time with controlling for a random intercept. Findings revealed a significant main effect of time for all pandemic-associated stressors except financial impact. Over time, patients reported increased proximity to COVID-19, but decreased pandemic-associated stressors. A significant improvement was also observed in pain intensity, pain catastrophizing, and PROMIS-pain interference, sleep, anxiety, anger, and depression scores. Demographic-based subgroup analyses for pandemic-associated stressors revealed that younger adults, Hispanics, Asians, and patients receiving disability compensation were vulnerable groups either during the initial visit or follow-up visits. We observed additional differential pandemic effects between groups based on participant sex, education level, and working status. In conclusion, despite unanticipated changes in pain care services during the pandemic, patients receiving pain treatments adjusted to pandemic-related stressors and improved their health status over time. As the current study observed differential pandemic impacts on patient subgroups, future studies should investigate and address the unmet needs of vulnerable subgroups. PERSPECTIVE: Over a 2-year timeframe, the pandemic did not adversely influence physical and mental health among treatment-seeking patients with chronic pain. Patients reported small but significant improvements across indices of physical and psychosocial health. Differential impacts emerged among groups based on ethnicity, age, disability status, gender, education level, and working status.
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Affiliation(s)
- Maisa S Ziadni
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford University, Palo Alto, California
| | - Sam Jaros
- Department of Epidemiology, Stanford University School of Medicine, Palo Alto, California
| | - Steven R Anderson
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford University, Palo Alto, California
| | - Dokyoung S You
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford University, Palo Alto, California
| | - Beth D Darnall
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford University, Palo Alto, California
| | - Sean C Mackey
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford University, Palo Alto, California
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35
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Nichols E, Petrosyan S, Khobragade P, Banerjee J, Angrisani M, Dey S, Bloom DE, Schaner S, Dey AB, Lee J. Trajectories and correlates of poor mental health in India over the course of the COVID-19 pandemic: a nation-wide survey. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.09.13.23295513. [PMID: 37745425 PMCID: PMC10516061 DOI: 10.1101/2023.09.13.23295513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Introduction The COVID-19 pandemic had large impacts on mental health; however, most existing evidence is focused on the initial lockdown period and high-income contexts. By assessing trajectories of mental health symptoms in India over two years, we aim to understand the effect of later time periods and pandemic characteristics on mental health in a lower-middle income context. Methods We used data from the Real-Time Insights of COVID-19 in India (RTI COVID-India) cohort study (N=3,662). We used covariate-adjusted linear regression models with generalized estimating equations to assess associations between mental health (PHQ-4 score) and pandemic periods as well as pandemic characteristics (COVID-19 cases and deaths, government stringency, self-reported financial impact, COVID-19 infection in the household) and explored effect modification by age, gender, and rural/urban residence. Results Mental health symptoms dropped immediately following the lockdown period but rose again during the delta and omicron waves. Associations between mental health and later pandemic stages were stronger for adults 45 years of age and older (p<0.001). PHQ-4 scores were significantly and independently associated with all pandemic characteristics considered, including estimated COVID-19 deaths (PHQ-4 difference of 0.041 SD units; 95% Confidence Interval 0.030 - 0.053), government stringency index (0.060 SD units; 0.048 - 0.072), self-reported major financial impacts (0.45 SD units; 0.41-0.49), and COVID-19 infection in the household (0.11 SD units; 0.07-0.16). Conclusion While the lockdown period and associated financial stress had the largest mental health impacts on Indian adults, the effects of the pandemic on mental health persisted over time, especially among middle-age and older adults. Results highlight the importance of investments in mental health supports and services to address the consequences of cyclical waves of infections and disease burden due to COVID-19 or other emerging pandemics.
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Affiliation(s)
- Emma Nichols
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA
| | - Sarah Petrosyan
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA
| | - Pranali Khobragade
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA
| | - Joyita Banerjee
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA
| | - Marco Angrisani
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA
- Department of Economics, University of Southern California, Los Angeles, CA, USA
| | - Sharmistha Dey
- All India Institute of Medical Sciences, New Delhi, India
| | - David E. Bloom
- Harvard School of Public Health, Boston, Massachusetts, USA
| | - Simone Schaner
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA
- Department of Economics, University of Southern California, Los Angeles, CA, USA
| | - AB Dey
- Venu Geriatric Institute, New Delhi, India
| | - Jinkook Lee
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA
- Department of Economics, University of Southern California, Los Angeles, CA, USA
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Kintrilis N, Blek N, Blek S, Olkiewicz A, Ladny JR, Szarpak L. Effect of the pandemic on prehospital management of patients with mental and behavioral disorders: a retrospective cohort study. Front Public Health 2023; 11:1174693. [PMID: 37780449 PMCID: PMC10535562 DOI: 10.3389/fpubh.2023.1174693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 08/24/2023] [Indexed: 10/03/2023] Open
Abstract
The novel severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection and the accompanying coronavirus disease (Covid-19) have shifted the priority of human and technical resources toward their handling, thus affecting the usual standards of care for populations diagnosed with other clinical entities. The phenomenon becomes even more apparent in patients with presenting symptoms of mental and behavioral disorders, a category already vulnerable and underrepresented in regard to its prehospital approach and management. For the purposes of the current retrospective cohort study, we used records of the Polish National Emergency Medical Service Command Support System for the time period between April 1, 2019 and April 30, 2021, the official register of medical interventions delivered in Poland by Emergency Medical Services (EMS). We aimed to examine the potential impact of the COVID-19 pandemic across the Masovian Voivodeship on individuals seeking medical care for mental and behavioral disorders pertaining in the "F" category of the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10). We examined the individuals' baseline characteristics, prehospital vital parameters and EMS processing times in a population of 59,651 adult patients (04/2019-03/2020, 28,089 patients, 04/2020-03/2021, 31,562 patients) handled by EMS teams. Compared to pre-COVID-19, EMS personnel handled fewer patients, but more patients required mental and behavioral care. Throughout the duration of the pandemic, all prehospital time periods were significantly delayed due to the increased time needed to prepare crew, vehicles, and technical equipment to ensure COVID-19 prevention and overcrowding in Emergency Departments (EDs).
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Affiliation(s)
- Nikolaos Kintrilis
- Infectious Disease Unit, General Military Hospital of Athens, Athens, Greece
| | - Natasza Blek
- Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy in Warsaw, Warsaw, Poland
- Department of Neurology, Wolski Hospital, Warsaw, Poland
| | - Sergiusz Blek
- Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland
| | | | - Jerzy Robert Ladny
- Department of Emergency Medicine, Bialystok Medical University, Białystok, Poland
| | - Lukasz Szarpak
- Henry J.N. Taub Department of Emergency Medicine, Baylor College of Medicine Houston, Houston, TX, United States
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Chong MK, Hickie IB, Cross SP, McKenna S, Varidel M, Capon W, Davenport TA, LaMonica HM, Sawrikar V, Guastella A, Naismith SL, Scott EM, Iorfino F. Digital Application of Clinical Staging to Support Stratification in Youth Mental Health Services: Validity and Reliability Study. JMIR Form Res 2023; 7:e45161. [PMID: 37682588 PMCID: PMC10517388 DOI: 10.2196/45161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 05/31/2023] [Accepted: 06/26/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND As the demand for youth mental health care continues to rise, managing wait times and reducing treatment delays are key challenges to delivering timely and quality care. Clinical staging is a heuristic model for youth mental health that can stratify care allocation according to individuals' risk of illness progression. The application of staging has been traditionally limited to trained clinicians yet leveraging digital technologies to apply clinical staging could increase the scalability and usability of this model in services. OBJECTIVE The aim of this study was to validate a digital algorithm to accurately differentiate young people at lower and higher risk of developing mental disorders. METHODS We conducted a study with a cohort comprising 131 young people, aged between 16 and 25 years, who presented to youth mental health services in Australia between November 2018 and March 2021. Expert psychiatrists independently assigned clinical stages (either stage 1a or stage 1b+), which were then compared to the digital algorithm's allocation based on a multidimensional self-report questionnaire. RESULTS Of the 131 participants, the mean age was 20.3 (SD 2.4) years, and 72% (94/131) of them were female. Ninety-one percent of clinical stage ratings were concordant between the digital algorithm and the experts' ratings, with a substantial interrater agreement (κ=0.67; P<.001). The algorithm demonstrated an accuracy of 91% (95% CI 86%-95%; P=.03), a sensitivity of 80%, a specificity of 93%, and an F1-score of 73%. Of the concordant ratings, 16 young people were allocated to stage 1a, while 103 were assigned to stage 1b+. Among the 12 discordant cases, the digital algorithm allocated a lower stage (stage 1a) to 8 participants compared to the experts. These individuals had significantly milder symptoms of depression (P<.001) and anxiety (P<.001) compared to those with concordant stage 1b+ ratings. CONCLUSIONS This novel digital algorithm is sufficiently robust to be used as an adjunctive decision support tool to stratify care and assist with demand management in youth mental health services. This work could transform care pathways and expedite care allocation for those in the early stages of common anxiety and depressive disorders. Between 11% and 27% of young people seeking care may benefit from low-intensity, self-directed, or brief interventions. Findings from this study suggest the possibility of redirecting clinical capacity to focus on individuals in stage 1b+ for further assessment and intervention.
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Affiliation(s)
- Min K Chong
- Brain and Mind Centre, University of Sydney, Camperdown, Australia
| | - Ian B Hickie
- Brain and Mind Centre, University of Sydney, Camperdown, Australia
| | | | - Sarah McKenna
- Brain and Mind Centre, University of Sydney, Camperdown, Australia
| | - Mathew Varidel
- Brain and Mind Centre, University of Sydney, Camperdown, Australia
| | - William Capon
- Brain and Mind Centre, University of Sydney, Camperdown, Australia
| | - Tracey A Davenport
- Design and Strategy Division, Australian Digital Health Agency, Sydney, Australia
| | - Haley M LaMonica
- Brain and Mind Centre, University of Sydney, Camperdown, Australia
| | - Vilas Sawrikar
- School of Health and Social Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Adam Guastella
- Brain and Mind Centre, University of Sydney, Camperdown, Australia
- Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Sharon L Naismith
- Brain and Mind Centre, University of Sydney, Camperdown, Australia
- Healthy Brain Ageing Program, University of Sydney, Sydney, Australia
| | - Elizabeth M Scott
- Brain and Mind Centre, University of Sydney, Camperdown, Australia
- St Vincent's and Mater Clinical School, The University of Notre Dame, Sydney, Australia
| | - Frank Iorfino
- Brain and Mind Centre, University of Sydney, Camperdown, Australia
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Tan Dat N, Mitsui N, Asakura S, Fujii Y, Toyoshima K, Kusumi I. Relationship between self-esteem and suicidal ideation before and during COVID-19 in a non-clinical sample: mediating effects of psychological distress and hopelessness. Front Psychiatry 2023; 14:1240715. [PMID: 37743986 PMCID: PMC10512949 DOI: 10.3389/fpsyt.2023.1240715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 08/21/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction Several studies have highlighted the impact of the novel coronavirus disease (COVID-19) pandemic on suicide. Accordingly, investigating the risk factors of suicide during this crisis is important. Based on the escape theory of suicide, the current study examined the serial mediating roles of psychological distress and hopelessness in the relationship between self-esteem and suicidal ideation. It also aimed to explore whether or not the COVID-19 pandemic changed the mediation effect in any way. Methods Data were collected from 645 university students before and during the pandemic. The study employed mediation and multi-group analyses to test the hypotheses. Results The results demonstrated that individuals with low self-esteem reported high psychological distress, which further lead to hopelessness and eventually heightened suicidal ideation. Multi-group analysis revealed that psychological distress exerted a greater impact on suicidal ideation during COVID-19. Discussion The finding suggested that self-esteem, hopelessness, and psychological distress could help elucidate the development of suicidal ideation. Clinicians may target these factors in suicide prevention programs, particularly in the settings of the COVID-19 pandemic or future crisis.
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Affiliation(s)
- Nguyen Tan Dat
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Nobuyuki Mitsui
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Satoshi Asakura
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
- Health Care Center of Hokkaido University, Sapporo, Japan
| | - Yutaka Fujii
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
- Health Care Center of Hokkaido University, Sapporo, Japan
| | - Kuniyoshi Toyoshima
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Ichiro Kusumi
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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Schäfer SK, Lindner S, Kunzler AM, Meerpohl JJ, Lieb K. The mental health impact of the COVID-19 pandemic on older adults: a systematic review and meta-analysis. Age Ageing 2023; 52:afad170. [PMID: 37725975 DOI: 10.1093/ageing/afad170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Early in the COVID-19 pandemic, many experts pointed to potential adverse mental health effects for older adults. By contrast, many studies in young to middle-aged adults found older age to be associated with reduced mental burden. However, a systematic review on older adults is missing. OBJECTIVES To comprehensively assess the pandemic's mental health impact on older adults. DATA SOURCES We searched nine databases from December 2019 to April 2022. STUDY SELECTION We included longitudinal and repeated cross-sectional studies assessing pre- and/or peri-pandemic mental distress and/or positive mental health indicators (e.g. wellbeing) on at least two occasions. DATA SYNTHESIS We identified 108 studies comprising 102,136 participants (≥60 years). After removal of outliers, there was a small increase in mental distress from pre-to-peri-pandemic assessments, standardised mean difference (SMD) = 0.10, 95% confidence interval (CI) [0.01, 0.18]. Furthermore, a small peri-pandemic decrease in anxiety symptoms was observed, whereas other symptoms remained unchanged. For positive mental health indicators, wellbeing and quality of life showed an initial decrease, whereas overall positive mental health increased during the pandemic, SMD = 0.08, 95% CI [0.01, 0.15]. Being female was related to larger peri-pandemic increases in mental distress. CONCLUSIONS Based on many studies, this review demonstrated small decreases in mental health during early stages of the pandemic in older adults, with evidence for later recovery. These findings are similar to those for younger adults and correct earlier claims that older adults are at particular risk for negative mental health consequences. The results ask for further research into resilience and adaptation processes in older adults.
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Affiliation(s)
- Sarah K Schäfer
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Clinical Psychology, Psychotherapy and Diagnostics, Technische Universität Braunschweig, Braunschweig, Germany
| | - Saskia Lindner
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Angela M Kunzler
- Leibniz Institute for Resilience Research, Mainz, Germany
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Jörg J Meerpohl
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Klaus Lieb
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Sullivan EC, James E, Henderson LM, McCall C, Cairney SA. The influence of emotion regulation strategies and sleep quality on depression and anxiety. Cortex 2023; 166:286-305. [PMID: 37451185 DOI: 10.1016/j.cortex.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 05/19/2023] [Accepted: 06/06/2023] [Indexed: 07/18/2023]
Abstract
Chronic stress is a major risk factor for a number of mental health disorders, including depression and pathological anxiety. Adaptive cognitive emotion regulation (CER) strategies (i.e. positively-focused thought processes) can help to prevent psychiatric disturbance when enduring unpleasant and stressful experiences, but little is known about the inter-individual factors that govern their success. Sleep plays an important role in mental health, and may moderate the effectiveness of adaptive CER strategies by maintaining the executive functions on which they rely. In this study, we carried out a secondary analysis of self-reported mental health and sleep data acquired during a protracted and naturally-occurring stressor - the COVID-19 pandemic - to firstly test the hypothesis that adaptive CER strategy use is associated with positive mental health outcomes and secondly, that the benefits of adaptive CER strategy use for mental health are contingent on high-quality sleep. Using established self-report tools, participants estimated their depression (N = 551) and anxiety (N = 590)2 levels, sleep quality and tendency to engage in adaptive and maladaptive CER strategies during the Spring and Autumn of 2020. Using a linear mixed modelling approach, we found that greater use of adaptive CER strategies and higher sleep quality were independently associated with lower self-reported depression and anxiety. However, adaptive CER strategy use was not a significant predictor of self-reported anxiety when accounting for sleep quality in our final model. The positive influence of adaptive CER strategy use on depression was observed at different levels of sleep quality. These findings highlight the importance of adaptive CER strategy use and good sleep quality in promoting resilience to depression and anxiety when experiencing chronic stress.
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Affiliation(s)
- Emma C Sullivan
- Department of Psychology, University of York, York, YO10 5DD, United Kingdom.
| | - Emma James
- Department of Experimental Psychology, University of Oxford, Woodstock Road, Oxford, OX2 6GG, United Kingdom
| | - Lisa-Marie Henderson
- Department of Psychology, University of York, York, YO10 5DD, United Kingdom; York Biomedical Research Institute, University of York, York, YO10 5DD, United Kingdom
| | - Cade McCall
- Department of Psychology, University of York, York, YO10 5DD, United Kingdom
| | - Scott A Cairney
- Department of Psychology, University of York, York, YO10 5DD, United Kingdom; York Biomedical Research Institute, University of York, York, YO10 5DD, United Kingdom
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van den Boom W, Marra E, van der Vliet N, Elberse J, van Dijken S, van Dijk M, Euser S, Derks M, Leurs M, Albers C, Sanderman R, de Bruin M. General Mental Health, Loneliness, and Life Satisfaction in the Context of COVID-19 Policies: A 2-Year Cohort Study in the Netherlands, April 2020-January 2022. Public Health Rep 2023; 138:812-821. [PMID: 37408335 PMCID: PMC10323514 DOI: 10.1177/00333549231176000] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2023] Open
Abstract
OBJECTIVE Although the COVID-19 pandemic has affected mental health, understanding who has been affected most and why is incomplete. We sought to understand changes in mental health in the context of transmission numbers and pandemic (social) restrictions and whether changes in mental health varied among population groups. METHODS We analyzed data from 92 062 people (aged ≥16 years and able to read Dutch) who participated in the Corona Behavioral Unit cohort study at the National Institute for Public Health and the Environment, the Netherlands, from April 17, 2020, through January 25, 2022. Participants self-reported mental well-being through multiple rounds of surveys. We used a multivariable linear mixed-effects model to analyze loneliness, general mental health, and life satisfaction. RESULTS As strictness of pandemic prevention measures and social restrictions increased, people's feelings of loneliness increased and mental health and life satisfaction decreased. As restrictions were relaxed, loneliness decreased and general mental health improved. Younger people (aged 16-24 y) versus older people (aged ≥40 y), people with low (vs high) education levels, and people living alone (vs living together) were more likely to have negative well-being outcomes. We observed that trajectories over time differed considerably only by age, with participants aged 16-24 years affected substantially more than participants aged ≥40 years by pandemic social restrictions. These patterns were consistent across multiple waves of SARS-CoV-2 infection. CONCLUSIONS Our findings suggest that the social restrictions imposed by the Dutch government during the study period were associated with reduced mental well-being, especially among younger people. However, people appeared resilient as they recovered during periods when restrictions were relaxed. Monitoring and supporting well-being, in particular to reduce loneliness, may help younger people during periods of intense social restrictions.
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Affiliation(s)
- Wijnand van den Boom
- Corona Behavioral Unit, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Elske Marra
- Corona Behavioral Unit, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
- Centre for Environmental Safety and Security, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Nina van der Vliet
- Corona Behavioral Unit, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
- Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
| | - Janneke Elberse
- Corona Behavioral Unit, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
- Centre for Environmental Safety and Security, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | | | - Mart van Dijk
- Corona Behavioral Unit, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Saskia Euser
- Corona Behavioral Unit, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Mare Derks
- Corona Behavioral Unit, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Mariken Leurs
- Corona Behavioral Unit, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Casper Albers
- Heymans Institute for Psychological Research, University of Groningen, Groningen, the Netherlands
| | - Robbert Sanderman
- University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
- Department of Psychology, Health and Technology, University of Twente, Enschede, the Netherlands
| | - Marijn de Bruin
- Corona Behavioral Unit, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
- Institute of Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, the Netherlands
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Taxiarchi VP, Senior M, Ashcroft DM, Carr MJ, Hope H, Hotopf M, Kontopantelis E, McManus S, Patalay P, Steeg S, Webb RT, Abel KM, Pierce M. Changes to healthcare utilisation and symptoms for common mental health problems over the first 21 months of the COVID-19 pandemic: parallel analyses of electronic health records and survey data in England. THE LANCET REGIONAL HEALTH. EUROPE 2023; 32:100697. [PMID: 37671125 PMCID: PMC10477036 DOI: 10.1016/j.lanepe.2023.100697] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 07/04/2023] [Accepted: 07/07/2023] [Indexed: 09/07/2023]
Abstract
Background Few studies have investigated the effect of the COVID-19 pandemic on mental health beyond 2020. This study quantifies changes to healthcare utilisation and symptoms for common mental health problems over the pandemic's first 21 months. Methods Parallel cohort studies using primary care database and survey data for adults (≥16 years) in England from January 2015 to December 2021: 16,551,842 from the Clinical Practice Research Datalink (CPRD) and 40,699 from the UK Household Longitudinal Survey (UKHLS). Interrupted time-series models estimated changes in monthly prevalence of presentations and prescribed medications for anxiety and depression (CPRD); and self-reported psychological distress (UKHLS). The pandemic period was divided into five phases: 1st Wave (April-May 2020); post-1st Wave (June-September 2020); 2nd Wave (October 2020-February 2021); post 2nd Wave (March-May 2021); 3rd Wave (June-December 2021). Findings Primary care presentations for depression or anxiety dropped during the first wave (4.6 fewer monthly appointments per 1000 patients, 4.4-4.8) and remained lower than expected throughout follow-up. Self-reported psychological distress exceeded expected levels during the first (Prevalence Ratio = 1.378, 95% CI 1.289-1.459) and second waves (PR = 1.285, 1.189-1.377), returning towards expected levels during the third wave (PR = 1.038, 0.929-1.154). Increases in psychological distress and declines in presentations were greater for women. The decrease in primary care presentations for depression and anxiety exceeded that for physical health conditions (rheumatoid arthritis, diabetes, urinary tract infections). Anxiety and depression prescriptions returned to pre-pandemic levels during the second wave due to increased repeat prescriptions. Interpretation Despite periods of distress during the pandemic, we did not find an enduring effect on common mental health problems. The fall in primary care presentations for anxiety or depression suggests changing healthcare utilisation for mental distress and a potential treatment gap. Funding National Institute for Health and Care Research (NIHR).
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Affiliation(s)
- Vicky P. Taxiarchi
- Faculty of Biology, Medicine and Health, Division of Psychology and Mental Health, Centre for Women’s Mental Health, University of Manchester, Manchester, UK
| | - Morwenna Senior
- Faculty of Biology, Medicine and Health, Division of Psychology and Mental Health, Centre for Women’s Mental Health, University of Manchester, Manchester, UK
| | - Darren M. Ashcroft
- Faculty of Biology, Medicine and Health, Division of Pharmacy and Optometry, The University of Manchester, Manchester, UK
- National Institute for Health and Care Research (NIHR) Greater Manchester Patient Safety Research Collaboration (GM PSRC), University of Manchester, UK
| | - Matthew J. Carr
- Faculty of Biology, Medicine and Health, Division of Pharmacy and Optometry, The University of Manchester, Manchester, UK
- National Institute for Health and Care Research (NIHR) Greater Manchester Patient Safety Research Collaboration (GM PSRC), University of Manchester, UK
| | - Holly Hope
- Faculty of Biology, Medicine and Health, Division of Psychology and Mental Health, Centre for Women’s Mental Health, University of Manchester, Manchester, UK
| | - Matthew Hotopf
- Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King’s College London, London, UK
| | - Evangelos Kontopantelis
- Faculty of Biology, Medicine and Health, Division of Informatics, Imaging and Data Sciences, The University of Manchester, Manchester, UK
| | - Sally McManus
- Violence and Society Centre, City, University of London, London EC1V 0HB, UK
| | - Praveetha Patalay
- Centre for Longitudinal Studies and MRC Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Sarah Steeg
- Division of Psychology & Mental Health, Centre for Mental Health and Safety, The University of Manchester, Manchester, UK
- NIHR School for Primary Care Research, UK
| | - Roger T. Webb
- National Institute for Health and Care Research (NIHR) Greater Manchester Patient Safety Research Collaboration (GM PSRC), University of Manchester, UK
- Division of Psychology & Mental Health, Centre for Mental Health and Safety, The University of Manchester, Manchester, UK
| | - Kathryn M. Abel
- Faculty of Biology, Medicine and Health, Division of Psychology and Mental Health, Centre for Women’s Mental Health, University of Manchester, Manchester, UK
| | - Matthias Pierce
- Faculty of Biology, Medicine and Health, Division of Psychology and Mental Health, Centre for Women’s Mental Health, University of Manchester, Manchester, UK
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Schröder D, Müllenmeister C, Heinemann S, Hummers E, Klawonn F, Vahldiek K, Dopfer-Jablonka A, Steffens S, Mikuteit M, Niewolik J, Overbeck TR, Kallusky J, Königs G, Heesen G, Schmachtenberg T, Müller F. Social participation during the COVID-19 pandemic in persons with a high risk for a severe course of COVID-19 - results of a longitudinal, multi-center observational study in Germany. Health Psychol Behav Med 2023; 11:2249534. [PMID: 37645515 PMCID: PMC10461510 DOI: 10.1080/21642850.2023.2249534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 08/11/2023] [Indexed: 08/31/2023] Open
Abstract
Objective The COVID-19 pandemic has affected how people go about their daily lives, often in various and substantial ways. This study aims to prospectively evaluate the changes in social participation during the COVID-19 pandemic in persons with a high risk for a severe COVID-19 course in Germany. Methods A paper-pencil-based survey was conducted starting at March 2021. Participants filled out questionnaires at four time points based on their COVID-19 vaccination status: before COVID-19 vaccination, one month, six months and twelve months after COVID-19 vaccination. Social participation measures included the Pandemic Social Participation Questionnaire (PSP-Q) and the Index for measuring participation restrictions (IMET). Repeated measures ANOVA and paired t-test were used to test for changes between time-points. Repeated measures correlation was used to assess the relationship between social participation and local COVID-19 incidences. Results Data from 245 participants was analyzed before and one month after COVID-19 vaccination. In addition, data from 156 participants was analyzed at time points one, six and twelve months after COVID-19. PSP-Q and IMET scores changed significantly after participants received a COVID-19 vaccination. Between one month and twelve months after vaccination, social participation improved significantly measured by PSP-Q. Social participation was negatively correlated with regional COVID-19 incidences before and after COVID-19 vaccination. Social participation was positively correlated with COVID-19 incidences between one month and twelve months after COVID-19 vaccination. Conclusions Social participation improved in persons with a high risk for a severe COVID-19 course during the pandemic. The local COVID-19 incidence showed a negative association with social participation only until the fall of 2021 when it was used as the sole metric to regulate COVID-19 protective measures. Although our data describes the trends in social participation, further studies are needed to identify the influencing factors for the observed increase in social participation.
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Affiliation(s)
- Dominik Schröder
- Department of General Practice, University Medical Center, Göttingen, Germany
| | | | - Stephanie Heinemann
- Department of General Practice, University Medical Center, Göttingen, Germany
- Department of Geriatrics, University Medical Center Göttingen, Göttingen, Germany
| | - Eva Hummers
- Department of General Practice, University Medical Center, Göttingen, Germany
| | - Frank Klawonn
- Department of Computer Science, Ostfalia University of Applied Sciences, Wolfenbuettel, Germany
- Biostatistics Group, Helmholtz Centre for Infecwetion Research, Braunschweig, Germany
| | - Kai Vahldiek
- Department of Computer Science, Ostfalia University of Applied Sciences, Wolfenbuettel, Germany
| | - Alexandra Dopfer-Jablonka
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
- German Center for Infection Research (DZIF), Partner site Hannover-Braunschweig, Brunswick, Germany
| | - Sandra Steffens
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | - Marie Mikuteit
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | - Jacqueline Niewolik
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | - Tobias R. Overbeck
- Department of Hematology and Medical Oncology, University Medical Center Göttingen, Göttingen, Germany
| | - Jonathan Kallusky
- Department of Hematology and Medical Oncology, University Medical Center Göttingen, Göttingen, Germany
| | - Gloria Königs
- Department of General Practice, University Medical Center, Göttingen, Germany
| | - Gloria Heesen
- Department of General Practice, University Medical Center, Göttingen, Germany
| | - Tim Schmachtenberg
- Department of General Practice, University Medical Center, Göttingen, Germany
| | - Frank Müller
- Department of General Practice, University Medical Center, Göttingen, Germany
- Department of Family Medicine, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
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Schnettler B, Lobos G, Orellana L, Adasme-Berríos C, Lapo M, Beroíza K. Profiles of older adults according to their life and food-related life satisfaction during the COVID-19 pandemic: the importance of the social environment. Front Public Health 2023; 11:1165256. [PMID: 37663848 PMCID: PMC10470648 DOI: 10.3389/fpubh.2023.1165256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 07/20/2023] [Indexed: 09/05/2023] Open
Abstract
Introduction Older adults are a highly heterogeneous population, as individuals of the same age can show considerable variations in personal characteristics and living conditions. Risk and protective factors for older adults' subjective wellbeing during the COVID-19 pandemic can be explored by examining how life satisfaction, food-related life satisfaction, and associated variables coexist among these individuals. On this basis, this study aimed to identify older adult profiles based on their levels of life and food-related life satisfaction; to characterize these profiles by diet quality, social support, financial wellbeing, and sociodemographic characteristics; and to identify variables associated with higher life and food-related life satisfaction. Methods The sample included 1,371 institutionalized and non-institutionalized individuals over the age of 60, from four cities in Chile. Participants answered a survey, either online or face to face, with questions about life and food-related life satisfaction, perceived social support from family, friends, and others, food quality, financial wellbeing/distress, sociodemographic characteristics, and prior COVID-19 infection. Results Using a latent profile analysis, we identified three profiles of older adults: Profile 1: Unsatisfied with their life, somewhat satisfied with their food-related life (5.40%); Profile 2: Somewhat satisfied with their life, satisfied with their food-related life (65.06%); Profile 3: Extremely satisfied with their life and food-related life (29.54%). Profiles differed by residence (institutionalized vs. independent), age, marital status, social support, financial wellbeing, COVID-19 infection, and city of residence. Discussion The patterns of association between life and food-related satisfaction and related variables indicate conditions of vulnerability and protection related to living conditions, the social dimensions of food consumption, and social support. These results underscore the need for identifying groups of older adults based on diverse characteristics and conditions outside of chronological age.
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Affiliation(s)
- Berta Schnettler
- Facultad de Ciencias Agropecuarias y Medioambiente, Universidad de La Frontera, Temuco, Chile
- Scientific and Technological Bioresource Nucleus (BIOREN-UFRO), Universidad de La Frontera, Temuco, Chile
- Centro de Excelencia en Psicología Económica y del Consumo, Universidad de La Frontera, Temuco, Chile
- Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
| | - Germán Lobos
- Facultad de Economía y Negocios, Universidad de Talca, Talca, Chile
| | - Ligia Orellana
- Centro de Excelencia en Psicología Económica y del Consumo, Universidad de La Frontera, Temuco, Chile
- Núcleo de Ciencias Sociales y Humanidades, Universidad de La Frontera, Temuco, Chile
- Departamento de Psicología, Universidad de La Frontera, Temuco, Chile
| | | | - María Lapo
- Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
| | - Katherine Beroíza
- Centro de Excelencia en Psicología Económica y del Consumo, Universidad de La Frontera, Temuco, Chile
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Miller AL, Bhattacharyya M, Bhattacharyya R, Frankhauser F, Miller LE. Determinants of life dissatisfaction among adults in the United States: A cross-sectional analysis of the National Health Interview Survey. Medicine (Baltimore) 2023; 102:e34488. [PMID: 37565865 PMCID: PMC10419356 DOI: 10.1097/md.0000000000034488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 06/22/2023] [Indexed: 08/12/2023] Open
Abstract
The number of Americans who report dissatisfaction with their quality of life has increased over the past several decades. This study investigated social- and health-related determinants of life dissatisfaction among adults in the United States (US). We conducted a cross-sectional observational study using data from the 2021 National Health Interview Survey, a nationally representative sample of adults in the US. We analyzed the association between self-reported life dissatisfaction and independent variables including demographics, family-level information, health status and conditions, functioning and disability, health insurance coverage, chronic pain, occupational variables, socioeconomic indicators, health-related behaviors, and psychological distress indicators. Survey multivariable logistic regression was used to determine the association among social- and health-related determinants and life dissatisfaction. The relative importance of each variable in the final model was determined using Shapley Additive Explanations values (0-100% scale). Among the 253.2 million civilian noninstitutionalized adults, 12.2 million (4.8%) reported life dissatisfaction. Recent psychological distress, unmarried status, poor general health, lack of social/emotional support, and lower food security were independently associated with life dissatisfaction (all P < .001). The relative importance of these variables in predicting life dissatisfaction was 39.3% for recent psychological distress, 22.2% for unmarried status, 18.3% for poor general health, 13.4% for lack of social/emotional support, and 6.9% for lower food security. Additionally, racial inequities were identified in the prevalence of these factors. Life dissatisfaction among adults in the US is associated with social- and health-related factors that are more prevalent in racial minority groups. The study findings suggest that resource prioritization should be targeted towards individuals with these factors, with particular emphasis on racial minority groups. This study aligns with US health policy initiatives and the results may help policymakers address the underlying factors contributing to life dissatisfaction among the US population.
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Affiliation(s)
- Anna L. Miller
- Department of Biostatistics, Miller Scientific, Johnson City, TN
| | | | | | - Frederick Frankhauser
- Department of Pharmaceutical Business and Administrative Sciences, Massachusetts College of Pharmacy and Health Sciences, Boston, MA
| | - Larry E. Miller
- Department of Biostatistics, Miller Scientific, Johnson City, TN
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Lo Destro C, Costa A. Effects of Locomotion Regulatory Mode on COVID-19 Anxiety: The Mediating Role of Resilience. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6533. [PMID: 37569073 PMCID: PMC10418419 DOI: 10.3390/ijerph20156533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 07/25/2023] [Accepted: 08/04/2023] [Indexed: 08/13/2023]
Abstract
The COVID-19 pandemic has exerted a significant impact on mental health globally. The uncertainty, fear, and stress associated with this crisis have contributed to a heightened prevalence of anxiety, depression, and various other mental health disorders. In this scenario, the present study aimed at investigating the relationship between locomotion regulatory mode, resilience, and COVID-19 anxiety. It is worth noting that previous extensive research has established a significant correlation between high levels of locomotion and diverse positive psychological conditions, such as optimism, reduced hopelessness, and a positive effect. A total of 243 participants completed measures of locomotion regulatory mode, resilience, and COVID-19 anxiety. In line with our hypotheses, individuals' locomotion regulatory mode was negatively, although non-significatively, associated with COVID-19 anxiety. Furthermore, resilience was found to mediate the relationship between the locomotion regulatory mode and COVID-19 anxiety, indicating that individuals displaying high locomotion may be better equipped to cope with the stress and uncertainty of the COVID-19 pandemic due to their greater levels of resilience. Taken together, these findings highlight the importance of considering both locomotion and resilience in managing anxiety related to COVID-19, and suggest that interventions aimed at enhancing resilience may be particularly beneficial for individuals with a low locomotion regulatory mode.
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Fiorini Bincoletto A, Zanini L, Spitoni GF, Lingiardi V. Negative and positive ageism in an Italian sample: how ageist beliefs relate to epistemic trust, psychological distress, and well-being. RESEARCH IN PSYCHOTHERAPY (MILANO) 2023; 26:676. [PMID: 37503673 PMCID: PMC10483480 DOI: 10.4081/ripppo.2023.676] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 05/04/2023] [Indexed: 07/29/2023]
Abstract
Ageism is a social issue of growing concern; ageist beliefs can shape the individual and collective experience of aging. The present study aimed to explore positive and negative ageism in young adults (YA) (18-30 years) and adults (AD) (31-60 years) and their relationship with epistemic trust, psychological distress, and psychological well-being. 301 Italian adult participants completed an online survey that included the following self-report questionnaires: attitudes towards older people scale, epistemic trust, mistrust and credulity questionnaire, depression anxiety stress scale-21, and Warwick-Edinburgh mental wellbeing scale. Negative ageism was significantly higher in YA compared to AD; on the contrary, AD presented more positive ageism than YA. When considering the entire sample, negative ageism was correlated with various dimensions of psychological distress and epistemic trust. A mediation model revealed that epistemic mistrust fully mediated the relationship between age and negative ageism, suggesting that changes in ageist beliefs that seem to occur with age are mediated by a mistrustful epistemic stance. Future research should focus on further exploring the link between epistemic trust, mental health, and holding ageist beliefs. The results are also discussed in terms of their implications for the treatment of older patients.
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Affiliation(s)
| | - Ludovica Zanini
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome.
| | - Grazia Fernanda Spitoni
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome.
| | - Vittorio Lingiardi
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome.
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White LL, Goldberg SR, Spencer Feigelson H, Burnett-Hartman AN. Depression, anxiety, & loneliness among cancer survivors during the COVID-19 pandemic. J Psychosoc Oncol 2023; 42:242-255. [PMID: 37486169 DOI: 10.1080/07347332.2023.2238192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
PURPOSE To assess the impact of the COVID-19 pandemic on depression, anxiety, and loneliness between those with and without a history of cancer. DESIGN This prospective observational study used a quantitative approach. PARTICIPANTS Adult members of the Kaiser Permanente Research Bank (N = 104,640). METHODS Participants completed a series of surveys from May to December 2020. The difference in score of depression, anxiety, and loneliness were estimated using linear mixed regression. FINDINGS Among cancer survivors, 21% and 19% met the thresholds for increased risk of depression and anxiety. Among cancer survivors, younger age groups and females reported increased depression, anxiety, and loneliness scores. CONCLUSIONS This study highlights the continued necessity of addressing mental health needs and social support in cancer survivors during and after a public health emergency. IMPLICATIONS FOR PSYCHOSOCIAL PROVIDERS Cancer survivors may need particular resources after cancer treatment to strengthen resilience and improve quality of life.
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Affiliation(s)
- Larissa Lee White
- Institute for Health Research, Kaiser Permanente Colorado, Aurora, Colorado, USA
| | - Shauna R Goldberg
- Institute for Health Research, Kaiser Permanente Colorado, Aurora, Colorado, USA
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Rodrigues F, Morouço P, Santos T. Testing the Associations between Coping, Mental Health, and Satisfaction with Life in Portuguese Workers. Eur J Investig Health Psychol Educ 2023; 13:1245-1256. [PMID: 37504483 PMCID: PMC10378365 DOI: 10.3390/ejihpe13070092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/06/2023] [Accepted: 07/09/2023] [Indexed: 07/29/2023] Open
Abstract
The present study aimed to explore the relationships between coping strategies, symptoms of depression, anxiety, and stress, and satisfaction with life among Portuguese workers. A sample of 402 participants (207 male, 195 female), ranging in age from 18 to 70 years (M = 32.90, SD = 11.75), was included in the study. Participants reported varying levels of work experience, ranging from 1 to 45 years (M = 10.62, SD = 4.07). The sample encompassed diverse occupations, including arts and design (n = 28), engineering (n = 23), marketing (n = 27), administration (n = 50), transportation and logistics (n = 57), clerks (n = 63), lawyers (n = 21), factory workers (n = 20), accountant and finance (n = 41), journalism (n = 27), health care (n = 29), and others (n = 16). To examine the associations between each determinant and satisfaction with life, hierarchical multiple regression analyses were conducted. Two models were tested, with predictors entered in blocks based on theoretical and empirical considerations. The second model accounted for 52.4% of the variance in satisfaction with life (F (14, 384) = 3.884, p < 0.001, R2 = 0.27, adjusted R2 = 0.24). Depressive symptoms and stress consistently exhibited a significant association (p < 0.05) with satisfaction with life across all tested models. In terms of coping mechanisms, instrumental support reinterpretation, disengagement, and humor demonstrated a significant association with satisfaction with life (p < 0.05). The findings suggest that employing adaptive coping strategies may help mitigate symptoms of mental distress and enhance satisfaction with life. By understanding the relationships between coping strategies, mental health symptoms, and satisfaction with life, interventions can be developed to promote well-being and improve overall quality of life among Portuguese workers.
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Affiliation(s)
- Filipe Rodrigues
- ESECS-Polytechnic of Leiria, 2411-901 Leiria, Portugal
- Life Quality Research Centre (CIEQV), 2040-413 Leiria, Portugal
| | - Pedro Morouço
- ESECS-Polytechnic of Leiria, 2411-901 Leiria, Portugal
- Center for Innovative Care and Health Technology (CiTechcare), 2410-541 Leiria, Portugal
| | - Tiago Santos
- National School of Public Health (ENSP-UNOVA), NOVA University Lisbon, 1600-560 Lisbon, Portugal
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Samraj JR, Wright DJ, McMurtrie H. Age and adult attachment style predict psychological distress in the Singapore general population during COVID-19. PSYCHOL HEALTH MED 2023; 28:2212-2224. [PMID: 37278229 DOI: 10.1080/13548506.2023.2216466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 05/16/2023] [Indexed: 06/07/2023]
Abstract
To date, there is increasing evidence to suggest that age and adult attachment styles, such as secure, anxious and avoidant attachment are predictive or protective for psychological distress. The study aimed to investigate the extent to which age and adult attachment style, measured by the Attachment Style Questionnaire, predicted psychological distress, measured by the Kessler 10 Psychological Distress Scale, in the Singapore general population during COVID-19. Ninety-nine residents of Singapore (44 females, 52 males, 3 prefer not to state their gender) aged between 18 and 66 completed an online survey, which collected information on age, adult attachment styles and levels of psychological distress. Multiple regression analysis was performed to study the influence of predictive factors on psychological distress. The study identified 20.2%, 13.1% and 14.1% of participants reporting psychological distress at the mild, moderate and severe levels, respectively. The study also reported that age and psychological distress were negatively correlated, and that psychological distress was negatively correlated with both anxious and avoidant attachment styles. It was concluded that age and adult attachment style significantly predicted psychological distress in the Singapore general population during COVID-19. Further studies exploring other variables and risk factors are required to further consolidate these results. At the global level, these findings may help countries predict residents' reactions to future outbreaks and help them prepare strategies and approaches to address these situations.
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Affiliation(s)
- Juliet R Samraj
- Department of Psychology, Manchester Metropolitan University, Manchester, UK
| | - David J Wright
- Department of Psychology, Manchester Metropolitan University, Manchester, UK
| | - Hazel McMurtrie
- Department of Psychology, Manchester Metropolitan University, Manchester, UK
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