Anxiety during the COVID‐19 pandemic in prisoners who had high risks to suffer from mood disorders: A longitudinal study before and during the COVID‐19

The effects of the COVID-19 pandemic on the mental health of people with obesity

Obesity is a risk factor for anxiety and depression. Obesity is also a risk factor for severe COVID-19 disease and therefore may have contributed to adverse mental health outcomes in this vulnerable population during the COVID-19 pandemic. We compare the trajectory of mental health outcomes of people with obesity with normal-weight people before and during the COVID-19 pandemic using nationally representative individual-level longitudinal data from the National Health Interview Survey and Difference-in-Difference regressions. Our results indicate that severe anxiety increased by 2.75 (95% CI: 0.0056-0.0494; p-value 0.014) percentage points, representing a 31.3% relative increase, and anxiety-related prescription drug usage increased by 2.75 (95% CI: 0.0076-0.0473; p-value<0.01) percentage points, representing a 19.2% relative increase among people with obesity, compared to normal-weight people. We conclude that people with obesity experienced an increase in the incidence of severe anxiety and anxiety-related prescription drug usage during the COVID-19 pandemic, which was not observed among normal-weight individuals. Furthermore, women, less-educated, and rural residents with obesity disproportionately bore the burden of the pandemic.

Effects of the COVID-19 pandemic on people experiencing incarceration: a systematic review

OBJECTIVE

To assess the effect of the COVID-19 pandemic on people experiencing incarceration (PEI), focusing particularly on clinical outcomes compared with the general population.

DESIGN

Systematic review with narrative synthesis in accordance with the Centre for Reviews and Dissemination's good practice guidelines.

DATA SOURCES

Medline, Social Policy and Practice, Criminology Connection, ASSIA, EMBASE, SCOPUS, Web Of Science, CINAHL, Cochrane Library, Cochrane COVID-19 reviews, COVID-19 Evidence Reviews and L*OVE COVID-19 Evidence databases were searched up to 21 October 2022.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

We included studies presenting data specific to adults ≥18 years experiencing incarceration, with exposure to SARS-CoV-2 infection. All studies with a comparison group, regardless of study design and country were included. Studies with no comparison group data or not measuring clinical outcomes/health inequalities were excluded. Studies focussing on detained migrants, forensic hospitals, prison staff and those not in English were also excluded.

DATA EXTRACTION AND SYNTHESIS

Two reviewers extracted data and assessed risk of bias. Data underwent narrative synthesis using a framework analysis based on the objectives, for infection rates, testing, hospitalisation, mortality, vaccine uptake rates and mental health outcomes. There was no scope for meta-analysis, due to the heterogeneity of evidence available.

RESULTS

4516 references were exported from the databases and grey literature searched, of which 55 met the inclusion criteria. Most were from the USA and were retrospective analyses. Compared with the general population, PEI were usually found to have higher rates of SARS-CoV-2 infection and poorer clinical outcomes. Conflicting data were found regarding vaccine uptake and testing rates compared with the general population. The mental health of PEI declined during the pandemic. Certain subgroups were more adversely affected by the COVID-19 pandemic, such as ethnic minorities and older PEI.

CONCLUSION

PEI have poorer COVID-19 clinical outcomes than the general public, as shown by largely low-quality heterogenous evidence. Further high-quality research of continuing clinical outcomes and appropriate mitigating interventions is required to assess downstream effects of the pandemic on PEI. However, performing such research in the context of incarceration facilities is highly complex and potentially challenging. Prioritisation of resources for this vulnerable group should be a focus of national policy in the event of future pandemics.

PROSPERO REGISTRATION NUMBER

CRD42022296968.