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Danzo S, Kuklinski MR, Sterling SA, Beck A, Braciszewski JM, Boggs J, Briney JS, Charvat-Aguilar N, Eisenberg N, Kaffl A, Kline-Simon A, Loree AM, Lyons VH, Morse EF, Morrison KM, Negusse R, Scheuer H. Anxiety, depression, and suicidal ideation among early adolescents during the COVID-19 pandemic. J Adolesc 2024; 96:1379-1387. [PMID: 38678440 PMCID: PMC11303115 DOI: 10.1002/jad.12333] [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: 10/21/2023] [Revised: 04/15/2024] [Accepted: 04/16/2024] [Indexed: 04/30/2024]
Abstract
BACKGROUND Anxiety and depression are among the most common and debilitating psychiatric disorders affecting youth, with both related to increased suicide risk. While rates of youth anxiety and depression were increasing before the COVID-19 pandemic, the pandemic further negatively impacted adolescent mental health. Unfortunately, few studies have examined prevalence of these concerns among early adolescents (ages 10-13) longitudinally during the pandemic. METHOD The current study examined self-reported anxiety and depression symptoms, and suicidal ideation amongst a general pediatrics population of 11- to 13-year-olds (n = 623) from March through September 2020 (early-pandemic) and approximately 7 months later (September 2020 through May 2021; mid-pandemic). Paired samples proportions were used to examine changes in prevalence of moderate to severe anxiety, depression, and suicidal ideation from early- to mid-pandemic. RESULTS Results highlight high initial rates and stability in anxiety and suicidal ideation, as well as a significant increase in depression (42.9% increase; p < .05) among the full sample during the COVID-19 pandemic. Prevalance of concerns were greatest for females and Hispanic youth during the early-pandemic, and generally highest for females and Medicaid insured youth at mid-pandemic. DISCUSSION Results extend recent research and underscore the need for continued monitoring of mental health concerns across development for youth who grew up during the COVID-19 pandemic; highlighting the need for sustainable, effective, and accessible early detection, prevention, and intervention strategies. Improving these services is critical to support youth who experienced pandemic-related stressors, and to prepare for supporting youth during future disruptive and isolating events.
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Affiliation(s)
- Sarah Danzo
- Department of Psychiatry and Behavioral Sciences, University of Washington
| | | | - Stacy A. Sterling
- Division of Research, Kaiser Permanente Northern California
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, California
| | - Arne Beck
- Institute for Health Research, Kaiser Permanente Colorado
| | | | - Jennifer Boggs
- Institute for Health Research, Kaiser Permanente Colorado
| | - John S. Briney
- Social Development Research Group, School of Social Work, University of Washington
| | | | - Nicole Eisenberg
- Social Development Research Group, School of Social Work, University of Washington
| | - Abnette Kaffl
- Division of Research, Kaiser Permanente Northern California
| | | | - Amy M. Loree
- Center for Health Policy and Health Services Research, Henry Ford Health
| | - Vivian H. Lyons
- Social Development Research Group, School of Social Work, University of Washington
- Allies in Healthier Systems for Health & Abundance in Youth, Department of Psychiatry & Behavioral Sciences, University of Washington
- Firearm Injury & Policy Research Program, University of Washington
| | - Erica F. Morse
- Institute for Health Research, Kaiser Permanente Colorado
| | - Kristi M. Morrison
- Social Development Research Group, School of Social Work, University of Washington
| | - Rahel Negusse
- Division of Research, Kaiser Permanente Northern California
| | - Hannah Scheuer
- Social Development Research Group, School of Social Work, University of Washington
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2
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Kabir S, Newnham EA, Dewan A, Kok KQX, Hamamura T. Climate hazards and psychological health among coastal communities in the Asia-Pacific region: a systematic review of quantitative and qualitative evidence. Health Psychol Rev 2024:1-19. [PMID: 39083637 DOI: 10.1080/17437199.2024.2383224] [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: 03/19/2023] [Accepted: 07/17/2024] [Indexed: 08/02/2024]
Abstract
This systematic review assesses the relationship between climate induced coastal hazards and psychological well-being of communities in the Asia-Pacific region. The review synthesises findings from 13 peer-reviewed articles published between 2007 and 2020, encompassing data from seven countries: Bangladesh, India, Indonesia, Philippines, Solomon Islands, Tuvalu, and Vietnam. Results reveals a robust negative association between exposure to coastal hazards and psychological outcomes, notably stress, depression, anxiety, and distress. Most of the studies (77%) corroborate negative impacts of coastal hazards on psychological health. Additionally, 69% of the reviewed articles suggest a correlation between coastal hazards and negative outcomes for community livelihoods and essential resources. The review highlights increased psychological vulnerability among marginalised subpopulations, such as economically disadvantaged communities, a trend supported by 92% of the examined articles. The findings indicates that factors such as environmental vulnerability, resource availability, community traits, and coping methods are important in determining whether a community can effectively handle coastal hazards or face increased psychological health risks. This research aligns with international health frameworks, including the World Health Organization's Health Emergency and Disaster Risk Management guidelines. However, a notable research gap emerges - the absence of studies that specifically explore psychological responses of communities to ongoing climate-related coastal hazards, such as sea-level rise. These findings emphasise an urgent need for targeted research to guide comprehensive, multidisciplinary policy interventions aimed at mitigating the psychological and socio-economic repercussions of climate-related coastal hazards.
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Affiliation(s)
- Sajjad Kabir
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Department of Psychology, Faculty of Earth and Life Sciences, Jagannath University, Dhaka, Bangladesh
| | - Elizabeth A Newnham
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Curtin enAble Institute, Perth, Australia
| | - Ashraf Dewan
- Earth and Planetary Sciences (EPS), Faculty of Science and Engineering, Curtin University, Perth, Australia
| | - Keegan Qi Xian Kok
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Takeshi Hamamura
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia
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3
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Lee H, Kim Y. Trajectories of quality of life among disaster victims: A national longitudinal study. Int Nurs Rev 2024. [PMID: 38953470 DOI: 10.1111/inr.13015] [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: 11/17/2023] [Accepted: 06/10/2024] [Indexed: 07/04/2024]
Abstract
AIM This study categorized quality-of-life trajectories among disaster victims in South Korea and identified the characteristics and predictors of each trajectory. BACKGROUND Disaster victims experience tremendous physical and mental distress, which has a long-term impact on their quality of life. METHODS We conducted a cross-sectional study using data obtained from the fourth Long-term Survey on the Change of Life of Disaster Victims conducted from 2017 to 2019. The study included 257 participants who experienced a typhoon, earthquake, or fire and completed the three-year follow-up. Latent transition analysis was used to identify the potential class of quality-of-life trajectories among disaster victims. Independent t tests, χ2 tests, and logistic regression were used to identify the predictors of quality-of-life trajectories. RESULTS Two latent quality-of-life classes were identified: persistent low-level and persistent high-level. Factors associated with the persistent high-level trajectory included higher education level, no injury/disease from the disaster, better subjective health status, higher social support, and lower social maladjustment. DISCUSSION Quality of life early after a disaster is maintained throughout subsequent years; early and active support following disasters is essential to promote its rapid improvement. CONCLUSION Targeted educational programs in disaster-prone areas are recommended to bolster resilience among individuals with lower education. Moreover, governmental and institutional efforts are needed to support victims who lack resources for disaster recovery. IMPLICATIONS FOR NURSING AND HEALTH POLICY There is a need to establish community-based social support systems and enhance nurses' disaster response capabilities to support vulnerable groups, with such interventions tailored to reflect disaster-affected victims' unique characteristics and needs, along with ongoing research and evaluation for continuous improvements to nursing practice and disaster response.
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Affiliation(s)
- Haeyoung Lee
- Red Cross College of Nursing, Chung-Ang University, Seoul, South Korea
| | - Yujeong Kim
- College of Nursing, Research Institute of Nursing Innovation, Kyungpook National University, Daegu, South Korea
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Rogers EM, Melde C, Williams J, Heinze J, McGarrell E. Adolescent Mental Health and Resilience Before and During the COVID-19 Pandemic. J Adolesc Health 2024; 75:43-50. [PMID: 38493399 DOI: 10.1016/j.jadohealth.2024.02.023] [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: 07/19/2023] [Revised: 02/15/2024] [Accepted: 02/15/2024] [Indexed: 03/18/2024]
Abstract
PURPOSE We aimed to assess levels of depression, anxiety, and resilience factors before and during the COVID-19 pandemic in a school sample of adolescents. We also aimed to examine the compensatory and protective effects of individual, family, and school resilience factors on adolescent mental health. METHODS We used fall 2019 and fall 2020 survey responses from a cluster randomized controlled trial implemented in 20 schools in a Midwestern county. The sample consisted of 3,085 responses from students in grades 5 and 6. Multilevel mixed-effects models with cluster robust standard errors were used to investigate the associations between exposure to the COVID-19 pandemic, mental health (anxiety, depression), and resilience factors (future orientation, family engagement, and having a caring school adult). RESULTS Anxiety, but not depression, was higher in fall 2020 compared to fall 2019. Family engagement increased during the pandemic, while future orientation of the student body was lower during that time and the prevalence of having a caring adult at school was unchanged. A positive future orientation was associated with lower levels of anxiety and depression, while having a caring school adult was associated with lower depression. Adolescents with less positive future orientations, low family engagement, and no caring school adults experienced the greatest increases in anxiety. DISCUSSION Positive future orientations, family engagement, and supportive nonparental adult relationships had compensatory and protective effects on adolescent mental health during the COVID-19 pandemic. Adding these measures to the inventory of modifiable resilience factors during natural disasters may promote healthy adaptation among adolescents.
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Affiliation(s)
- Ethan M Rogers
- Public Policy Center, University of Iowa, Iowa City, Iowa.
| | - Chris Melde
- School of Criminal Justice, Michigan State University, East Lansing, Michigan
| | - Jalena Williams
- School of Criminal Justice, Michigan State University, East Lansing, Michigan
| | - Justin Heinze
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Edmund McGarrell
- School of Criminal Justice, Michigan State University, East Lansing, Michigan
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5
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Conway F, Portela A, Filippi V, Chou D, Kovats S. Climate change, air pollution and maternal and newborn health: An overview of reviews of health outcomes. J Glob Health 2024; 14:04128. [PMID: 38785109 PMCID: PMC11117177 DOI: 10.7189/jogh.14.04128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024] Open
Abstract
Background Climate change represents a fundamental threat to human health, with pregnant women and newborns being more susceptible than other populations. In this review, we aimed to describe the current landscape of available epidemiological evidence on key climate risks on maternal and newborn health (MNH). Methods We sought to identify published systematic and scoping reviews investigating the impact of different climate hazards and air pollution on MNH outcomes. With this in mind, we developed a systematic search strategy based on the concepts of 'climate/air pollution hazards, 'maternal health,' and 'newborn health,' with restrictions to reviews published between 1 January 2010 and 6 February 2023, but without geographical or language restriction. Following full text screening and data extraction, we synthesised the results using narrative synthesis. Results We found 79 reviews investigating the effects of climate hazards on MNH, mainly focussing on outdoor air pollution (n = 47, 59%), heat (n = 24, 30%), and flood/storm disasters (n = 7, 9%). Most were published after 2015 (n = 60, 76%). These reviews had consistent findings regarding the positive association of exposure to heat and to air pollution with adverse birth outcomes, particularly preterm birth. We found limited evidence for impacts of climate-related food and water security on MNH and did not identify any reviews on climate-sensitive infectious diseases and MNH. Conclusions Climate change could undermine recent improvements in maternal and newborn health. Our review provides an overview of key climate risks to MNH. It could therefore be useful to the MNH community to better understand the MNH needs for each climate hazard and to strengthen discussions on evidence and research gaps and potential actions. Despite the lack of comprehensive evidence for some climate hazards and for many maternal, perinatal, and newborn outcomes, we observed repeated findings of the impact of heat and air pollutants on birth outcomes, particularly preterm birth. It is time for policy dialogue to follow to specifically design climate policy and actions to protect the needs of MNH.
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Affiliation(s)
- Francesca Conway
- World Health Organization, Department of Maternal, Newborn, Child and Adolescent Health and Ageing, Geneva, Switzerland
| | - Anayda Portela
- World Health Organization, Department of Maternal, Newborn, Child and Adolescent Health and Ageing, Geneva, Switzerland
| | - Veronique Filippi
- London School of Hygiene and Tropical Medicine, Faculty of Epidemiology and Population Health, London, United Kingdom
| | - Doris Chou
- UNDP/UNFPA/UNICEF/WHO/The World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Department of Sexual and Reproductive Health, Geneva, Switzerland
| | - Sari Kovats
- London School of Hygiene and Tropical Medicine, NIHR Health Protection Research Unit in Environmental Change and Health, London, United Kingdom
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Cerna-Turoff I, Casey JA, Keyes K, Rudolph KE, Malinsky D. Longitudinal patterns of natural hazard exposures and anxiety and depression symptoms among young adults in four low- and middle-income countries. Sci Rep 2024; 14:10538. [PMID: 38719874 PMCID: PMC11078992 DOI: 10.1038/s41598-024-60106-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 04/18/2024] [Indexed: 05/12/2024] Open
Abstract
We estimated the effect of community-level natural hazard exposure during prior developmental stages on later anxiety and depression symptoms among young adults and potential differences stratified by gender. We analyzed longitudinal data (2002-2020) on 5585 young adults between 19 and 26 years in Ethiopia, India, Peru, and Vietnam. A binary question identified community-level exposure, and psychometrically validated scales measured recent anxiety and depression symptoms. Young adults with three exposure histories ("time point 1," "time point 2," and "both time points") were contrasted with their unexposed peers. We applied a longitudinal targeted minimum loss-based estimator with an ensemble of machine learning algorithms for estimation. Young adults living in exposed communities did not exhibit substantially different anxiety or depression symptoms from their unexposed peers, except for young women in Ethiopia who exhibited less anxiety symptoms (average causal effect [ACE] estimate = - 8.86 [95% CI: - 17.04, - 0.68] anxiety score). In this study, singular and repeated natural hazard exposures generally were not associated with later anxiety and depression symptoms. Further examination is needed to understand how distal natural hazard exposures affect lifelong mental health, which aspects of natural hazards are most salient, how disaster relief may modify symptoms, and gendered, age-specific, and contextual differences.
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Affiliation(s)
- Ilan Cerna-Turoff
- Mailman School of Public Health, Department of Environmental Health Sciences, Columbia University, New York City, NY, USA.
| | - Joan A Casey
- Mailman School of Public Health, Department of Environmental Health Sciences, Columbia University, New York City, NY, USA
- School of Public Health, Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Katherine Keyes
- Mailman School of Public Health, Department of Epidemiology, Columbia University, New York City, NY, USA
| | - Kara E Rudolph
- Mailman School of Public Health, Department of Epidemiology, Columbia University, New York City, NY, USA
| | - Daniel Malinsky
- Mailman School of Public Health, Department of Biostatistics, Columbia University, New York City, NY, USA
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Donohoe-Bales A, O’Dean S, Smout S, Boyle J, Barrett E, Teesson M, Bower M. What set some young adults apart during the COVID-19 pandemic? Mental health trajectories, risk and protective factors in an Australian longitudinal study. Aust N Z J Psychiatry 2024; 58:435-445. [PMID: 38205782 PMCID: PMC11055410 DOI: 10.1177/00048674231223690] [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] [Indexed: 01/12/2024]
Abstract
OBJECTIVE Evidence suggests that young adults (aged 18-34) were disproportionately impacted by the COVID-19 pandemic, but little is known about their longer-term mental health changes beyond the early pandemic period. This article investigates heterogeneous trajectories of mental health among Australian young adults across 2 years of the pandemic and identifies a broad range of associated risk and protective factors. METHOD Young adults (N = 653, Mage = 27.8 years) from the longitudinal Alone Together Study were surveyed biannually between July 2020 and June 2022. Measures assessed anxiety (7-item Generalised Anxiety Disorder scale) and depression (9-item Patient Health Questionnaire) symptoms at Waves 1-4, as well as demographic, psychological, adversity and COVID-19 factors at baseline. RESULTS Four and three distinct trajectories of anxiety and depressive symptoms, respectively, were identified through growth mixture modelling. The proportion of participants in each anxiety trajectory were Asymptomatic (45.9%), Mild Stable (17.9%), Moderate-Severe Stable (31.1%) and Initially Severe/Recovering (5.1%). For depression, Mild Stable (58.3%), Moderate-Severe Stable (30.5%) and Reactive/Recovering (11.2%). Baseline factors associated with severe symptom trajectories included a lifetime mental health disorder, pre-pandemic stressful events, identifying as LGBTQIA+ and/or female, and experiencing one or more infection-control measures. Higher household income was protective. CONCLUSION Most young adults demonstrated stable trajectories of low or high symptoms during the pandemic, with smaller groups showing initially severe or reactive symptoms followed by marked improvements over time. Vulnerable subgroups (gender- or sexuality-diverse, those with prior adversity or pre-existing mental ill-health) may face ongoing impacts and require targeted psychosocial supports to assist their mental health recovery post-COVID-19 and in the event of future crises.
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Affiliation(s)
- Amarina Donohoe-Bales
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Siobhan O’Dean
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Scarlett Smout
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Julia Boyle
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Emma Barrett
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Marlee Bower
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
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8
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Allsopp K, Varese F, French P, Young E, White H, Chung P, Davey J, Hassan AA, Wright SA, Barrett A, Bhutani G, McGuirk K, Shields G, Huntley F, Jordan J, Rowlandson A, Sarsam M, Ten Cate H, Walker H, Watson R, Willbourn J, Hind D. A service mapping exercise of four health and social care staff mental health and wellbeing services, Resilience Hubs, to describe health service provision and interventions. BMC Health Serv Res 2024; 24:430. [PMID: 38575960 PMCID: PMC10996192 DOI: 10.1186/s12913-024-10835-1] [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: 09/15/2023] [Accepted: 03/06/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND NHS England funded 40 Mental Health and Wellbeing Hubs to support health and social care staff affected by the COVID-19 pandemic. We aimed to document variations in how national guidance was adapted to the local contexts of four Hubs in the North of England. METHODS We used a modified version of Price's (2019) service mapping methodology. Service level data were used to inform the analysis. A mapping template was adapted from a range of tools, including the European Service Mapping Schedule, and reviewed by Hub leads. Key data included service model; staffing; and interventions. Data were collected between March 2021 - March 2022 by site research assistants. Findings were accuracy-checked by Hub leads, and a logic model developed to theorise how the Hubs may effect change. RESULTS Hub goals and service models closely reflected guidance; offering: proactive outreach; team-based support; clinical assessment; onward referral, and rapid access to mental health support (in-house and external). Implementation reflected a service context of a client group with high mental health need, and high waiting times at external mental health services. Hubs were predominantly staffed by experienced clinicians, to manage these mental health presentations and organisational working. Formulation-based psychological assessment and the provision of direct therapy were not core functions of the NHS England model, however all Hubs incorporated these adaptations into their service models in response to local contexts, such as extensive waiting lists within external services, and/or client presentations falling between gaps in existing service provision. Finally, a standalone clinical records system was seen as important to reassure Hub users of confidentiality. Other more nuanced variation depended on localised contexts. CONCLUSION This study provides a map for setting up services, emphasising early understandings of how new services will integrate within existing systems. Local and regional contexts led to variation in service configuration. Whilst additional Hub functions are supported by available literature, further research is needed to determine whether these functions should comprise essential components of staff wellbeing services moving forward. Future research should also determine the comparative effectiveness of service components, and the limits of permissible variation. STUDY REGISTRATION researchregistry6303.
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Affiliation(s)
- Kate Allsopp
- Complex Trauma & Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Research and Innovation, 3rd Floor Rawnsley Building, Hathersage Road, Manchester, UK.
- School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Oxford Road, Manchester, UK.
| | - Filippo Varese
- Complex Trauma & Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Research and Innovation, 3rd Floor Rawnsley Building, Hathersage Road, Manchester, UK
- School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Oxford Road, Manchester, UK
| | - Paul French
- Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Brooks Building, Bonsall Street, Manchester, UK
- Pennine Care NHS Foundation Trust, Trust Headquarters, 225 Old Street, Ashton-Under-Lyne, Greater Manchester, UK
| | - Ellie Young
- Greater Manchester Resilience Hub, Pennine Care NHS Foundation Trust, Trust Headquarters, 225 Old Street, Ashton-Under-Lyne, Greater Manchester, UK
| | - Hannah White
- Complex Trauma & Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Research and Innovation, 3rd Floor Rawnsley Building, Hathersage Road, Manchester, UK
| | - Priscilla Chung
- Lancashire and South Cumbria Resilience Hub, Lancashire and South Cumbria NHS Foundation Trust, Sceptre Point, Sceptre Way, Walton Summit, Preston, UK
| | - Jessica Davey
- Humber and North Yorkshire Resilience Hub, Tees Esk and Wear Valleys NHS Foundation Trust, West Park Hospital, Edward Pease Way, Darlington, UK
| | - Alysha A Hassan
- Cheshire and Merseyside Resilience Hub, Mersey Care NHS Foundation Trust, V7 Building, Kings Business Park, Prescot, UK
| | - Sally-Anne Wright
- Lancashire and South Cumbria Resilience Hub, Lancashire and South Cumbria NHS Foundation Trust, Sceptre Point, Sceptre Way, Walton Summit, Preston, UK
| | - Alan Barrett
- Greater Manchester Resilience Hub, Pennine Care NHS Foundation Trust, Trust Headquarters, 225 Old Street, Ashton-Under-Lyne, Greater Manchester, UK
- School of Health Science, University of Salford, Mary Seacole Building, Frederick Road Campus, Broad St, Salford, UK
| | - Gita Bhutani
- School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Oxford Road, Manchester, UK
- Lancashire and South Cumbria Resilience Hub, Lancashire and South Cumbria NHS Foundation Trust, Sceptre Point, Sceptre Way, Walton Summit, Preston, UK
| | - Katherine McGuirk
- Greater Manchester Health and Social Care Partnership, 4th Floor, 3 Piccadilly Place, Manchester, UK
| | - Gemma Shields
- School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Oxford Road, Manchester, UK
| | - Fay Huntley
- Cheshire and Merseyside Resilience Hub, Mersey Care NHS Foundation Trust, V7 Building, Kings Business Park, Prescot, UK
- Doctorate of Clinical Psychology, School of Health in Social Science, Old Medical School, University of Edinburgh, Teviot Place, Room 2.2, Doorway 6, Edinburgh, UK
| | - Joanne Jordan
- Humber and North Yorkshire Resilience Hub, Tees Esk and Wear Valleys NHS Foundation Trust, West Park Hospital, Edward Pease Way, Darlington, UK
| | - Aleix Rowlandson
- School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Oxford Road, Manchester, UK
| | - May Sarsam
- Cheshire and Merseyside Resilience Hub, Mersey Care NHS Foundation Trust, V7 Building, Kings Business Park, Prescot, UK
| | - Hein Ten Cate
- Lancashire and South Cumbria Resilience Hub, Lancashire and South Cumbria NHS Foundation Trust, Sceptre Point, Sceptre Way, Walton Summit, Preston, UK
| | - Holly Walker
- Humber and North Yorkshire Resilience Hub, Tees Esk and Wear Valleys NHS Foundation Trust, West Park Hospital, Edward Pease Way, Darlington, UK
| | - Ruth Watson
- Greater Manchester Mental Health NHS Foundation Trust, Trust Headquarters, Bury New Road, Prestwich, Manchester, M25 3BL, UK
| | - Jenni Willbourn
- Greater Manchester Resilience Hub, Pennine Care NHS Foundation Trust, Trust Headquarters, 225 Old Street, Ashton-Under-Lyne, Greater Manchester, UK
| | - Daniel Hind
- School of Health and Related Research, The Innovation Centre, University of Sheffield, 217 Portobello, Sheffield, UK
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Kurt G, Erşahin M, Aker AT, Uygun E, Acartürk C. Mental health and support 1 year after the earthquakes in Türkiye. Lancet Psychiatry 2024; 11:245-246. [PMID: 38490757 DOI: 10.1016/s2215-0366(24)00059-2] [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: 02/13/2024] [Accepted: 02/14/2024] [Indexed: 03/17/2024]
Affiliation(s)
- Gulsah Kurt
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW 2052, Australia.
| | - Merve Erşahin
- Department of Clinical Psychology, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - A Tamer Aker
- Trauma and Disaster Mental Health, Istanbul Bilgi University, Istanbul, Türkiye
| | - Ersin Uygun
- Trauma and Disaster Mental Health, Istanbul Bilgi University, Istanbul, Türkiye
| | - Ceren Acartürk
- Department of Psychology, Koc University, Istanbul, Türkiye
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Bonanno GA, Chen S, Bagrodia R, Galatzer-Levy IR. Resilience and Disaster: Flexible Adaptation in the Face of Uncertain Threat. Annu Rev Psychol 2024; 75:573-599. [PMID: 37566760 DOI: 10.1146/annurev-psych-011123-024224] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/13/2023]
Abstract
Disasters cause sweeping damage, hardship, and loss of life. In this article, we first consider the dominant psychological approach to disasters and its narrow focus on psychopathology (e.g., posttraumatic stress disorder). We then review research on a broader approach that has identified heterogeneous, highly replicable trajectories of outcome, the most common being stable mental health or resilience. We review trajectory research for different types of disasters, including the COVID-19 pandemic. Next, we consider correlates of the resilience trajectory and note their paradoxically limited ability to predict future resilient outcomes. Research using machine learning algorithms improved prediction but has not yet illuminated the mechanism behind resilient adaptation. To that end, we propose a more direct psychological explanation for resilience based on research on the motivational and mechanistic components of regulatory flexibility. Finally, we consider how future research might leverage new computational approaches to better capture regulatory flexibility in real time.
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Affiliation(s)
- George A Bonanno
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY, USA; , ,
| | - Shuquan Chen
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY, USA; , ,
| | - Rohini Bagrodia
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY, USA; , ,
| | - Isaac R Galatzer-Levy
- Department of Psychiatry, Grossman School of Medicine, New York University, New York, NY, USA;
- Google LLC, Mountain View, California
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Macleod E, Heffernan T, Greenwood LM, Walker I, Lane J, Stanley SK, Evans O, Calear AL, Cruwys T, Christensen BK, Kurz T, Lancsar E, Reynolds J, Rodney Harris R, Sutherland S. Predictors of individual mental health and psychological resilience after Australia's 2019-2020 bushfires. Aust N Z J Psychiatry 2024; 58:58-69. [PMID: 37264605 PMCID: PMC10756019 DOI: 10.1177/00048674231175618] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIMS We assessed the mental health effects of Australia's 2019-2020 bushfires 12-18 months later, predicting psychological distress and positive psychological outcomes from bushfire exposure and a range of demographic variables, and seeking insights to enhance disaster preparedness and resilience planning for different profiles of people. METHODS We surveyed 3083 bushfire-affected and non-affected Australian residents about their experiences of bushfire, COVID-19, psychological distress (depression, anxiety, stress, post-traumatic stress disorder) and positive psychological outcomes (resilient coping, wellbeing). RESULTS We found high rates of distress across all participants, exacerbated by severity of bushfire exposure. For people who were bushfire-affected, being older, having less financial stress, and having no or fewer pre-existing mental disorders predicted both lower distress and higher positive outcomes. Being male or having less income loss also predicted positive outcomes. Severity of exposure, higher education and higher COVID-19-related stressors predicted both higher distress and higher positive outcomes. Pre-existing physical health diagnosis and previous bushfire experience did not significantly predict distress or positive outcomes. RECOMMENDATIONS To promote disaster resilience, we recommend investment in mental health, particularly for younger adults and for those in rural and remote areas. We also recommend investment in mechanisms to protect against financial distress and the development of a broader definition of bushfire-related impacts than is currently used to capture brushfires' far-reaching effects.
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Affiliation(s)
- Emily Macleod
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
- Centre for Mental Health Research, The Australian National University, Canberra, ACT, Australia
| | - Timothy Heffernan
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
- School of Built Environment, University of New South Wales, Sydney, NSW, Australia
| | - Lisa-Marie Greenwood
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
| | - Iain Walker
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
- Melbourne Centre for Behaviour Change, The University of Melbourne, Parkville, VIC, Australia
| | - Jo Lane
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, ACT, Australia
| | - Samantha K Stanley
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
| | - Olivia Evans
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
| | - Alison L Calear
- Centre for Mental Health Research, The Australian National University, Canberra, ACT, Australia
| | - Tegan Cruwys
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
| | - Bruce K Christensen
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
| | - Tim Kurz
- School of Psychological Science, The University of Western Australia, Perth, WA, Australia
| | - Emily Lancsar
- Centre for Mental Health Research, The Australian National University, Canberra, ACT, Australia
| | - Julia Reynolds
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
| | - Rachael Rodney Harris
- Centre for Entrepreneurial Agri-Technology, The Australian National University, Canberra, ACT, Australia
| | - Stewart Sutherland
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
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12
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Öztürk HIB, Dönmezler S. Chronotype influences on posttraumatic stress disorder induced by the twin earthquakes in Turkey: A cross-sectional study among medical students. Chronobiol Int 2024; 41:10-16. [PMID: 38108143 DOI: 10.1080/07420528.2023.2294052] [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: 08/10/2023] [Accepted: 12/07/2023] [Indexed: 12/19/2023]
Abstract
This study aimed to investigate the correlation between chronotypes and posttraumatic stress disorder (PTSD) symptoms in medical students affected by earthquakes in Kahramanmaraş, Turkey, while elucidating if the PTSD manifestation varies among different chronotypes four months post-disaster. The study encompassed 193 medical students, subjected to the sociodemographic data form, the Morningness-Eveningness Questionnaire (MEQ) and the PTSD Checklist for DSM-5 (PCL-5). The results indicated that students identified as "evening types" reported significantly elevated PCL-5 scores (p < 0.001) relative to "morning" and "intermediate" types. According to PCL-5 scores, 43.5% of the participants exhibited PTSD, with a higher occurrence among the evening types. Multivariable linear regression analysis revealed that lower MEQ scores independently correlated with elevated PTSD symptoms (β = -0.1389 [95% CI = -0.273 - -0.0048], p = 0.042), suggesting the potential of eveningness as a risk factor for PTSD post-disaster. These findings could enhance our understanding of PTSD, aid the development of preventive strategies, and underscore the importance of considering chronotypes. Further expansive, population-based studies with a longitudinal design are necessary to better understand the relationship between PTSD and the circadian system.
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Affiliation(s)
| | - Süleyman Dönmezler
- School of Medicine, Department of Psychiatry, Sanko University, Gaziantep, Turkey
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13
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Woodward MJ, Griffith EL, Free BL, Bowen ME, Majeed R, Beyer MS, Beck JG. Do latent profiles of self-reported anxiety, depression, and PTSD map onto clinician ratings? An examination with intimate partner violence survivors. J Anxiety Disord 2024; 101:102806. [PMID: 38061324 DOI: 10.1016/j.janxdis.2023.102806] [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: 07/07/2023] [Revised: 11/10/2023] [Accepted: 12/01/2023] [Indexed: 01/17/2024]
Abstract
OBJECTIVE Studies exploring latent profiles of mental health in trauma survivors have largely relied on self-report, making it unclear whether these patterns correspond with clinician-assessed psychopathology. The purpose of the current study was to examine latent profiles of self-reported PTSD, depression, and anxiety in a sample of 387 women who had experienced intimate partner violence (IPV) and investigate whether profiles mapped onto clinician-rated measures of the same outcomes. METHOD Participants completed a series of semi-structured interviews and self-report measures assessing PTSD, depression, and anxiety. RESULTS Latent profile analyses revealed a 3-profile solution characterized by Low (22.48 %), Moderate (37.98 %), and High (39.53 %) self-reported symptomology. Clinician ratings were significant predictors of membership in the low vs. moderate vs. high symptomology profiles. However, normalized means showed discrepancies between self-report and clinician assessment regarding which issue was rated most severe. CONCLUSIONS Results suggest that while latent modeling approaches relying on self-report may adequately approximate common underlying patterns of psychopathology, they have limitations in identifying which disorders are most salient for clinical intervention.
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14
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Associations between media exposure and mental health among children and parents after the Great East Japan Earthquake. Eur J Psychotraumatol 2023; 14:2163127. [PMID: 37052091 PMCID: PMC9848268 DOI: 10.1080/20008066.2022.2163127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Background: Exposure to natural disaster media coverage is associated with mental health problems, but its long-term impacts are still unclear. Also, no study has analysed the psychological impact of exposure to natural disaster media coverage among children who are generally sensitive to threatening events.Objective: We aimed to examine how television images of victims after the 2011 Great East Japan Earthquake were associated with mental health among children and their parents.Methods: In 2012, questionnaires for sociodemographic factors were distributed to 2053 families. Parents who provided written consent were contacted in 2013 and invited to provide information on mental health problems (outcome) and retrospectively provide information on television watching at the time of the earthquake (exposure). We used data from 159 parents who completed the survey as the final sample. We used a dichotomous variable to evaluate exposure to media coverage. Multivariable regression was used to examine the association between exposure to television images of victims and mental health, adjusting for potential confounders. Bias-corrected and accelerated bootstrap confidence intervals (CIs) were used.Results: Exposure to television images of victims was significantly associated with worse psychopathology among children (β, 1.51; 95% CI, 0.07-2.96) and greater psychological distress among their parents (β, 1.49; 95% CI, 0.28-2.70). Child psychopathology and parental psychological distress were significantly correlated (r = 0.36, p < .001).Conclusions: Exposure to television images of disaster victims may produce long-term impacts on mental health among children and their parents. To reduce the likelihood of mental health problems associated with disasters, clinicians may recommend reducing exposure to television images of victims.
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15
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Cherbuin N, Bansal A, Dahlstrom JE, Carlisle H, Broom M, Nanan R, Sutherland S, Vardoulakis S, Phillips CB, Peek MJ, Christensen BK, Davis D, Nolan CJ. Bushfires and Mothers' Mental Health in Pregnancy and Recent Post-Partum. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 21:7. [PMID: 38276795 PMCID: PMC10815782 DOI: 10.3390/ijerph21010007] [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: 09/06/2023] [Revised: 11/21/2023] [Accepted: 12/08/2023] [Indexed: 01/27/2024]
Abstract
BACKGROUND The compounding effects of climate change catastrophes such as bushfires and pandemics impose significant burden on individuals, societies, and their economies. The enduring effects of such syndemics on mental health remain poorly understood, particularly for at-risk populations (e.g., pregnant women and newborns). The aim of this study was to investigate the impact of direct and indirect exposure to the 2019/20 Australian Capital Territory and South-Eastern New South Wales bushfires followed by COVID-19 on the mental health and wellbeing of pregnant women and mothers with newborn babies. METHODS All women who were pregnant, had given birth, or were within three months of conceiving during the 2019/2020 bushfires, lived within the catchment area, and provided consent were invited to participate. Those who consented were asked to complete three online surveys. Mental health was assessed with the DASS-21 and the WHO-5. Bushfire, smoke, and COVID-19 exposures were assessed by self-report. Cross-sectional associations between exposures and mental health measures were tested with hierarchical regression models. RESULTS Of the women who participated, and had minimum data (n = 919), most (>75%) reported at least one acute bushfire exposure and 63% reported severe smoke exposure. Compared to Australian norms, participants had higher depression (+12%), anxiety (+35%), and stress (+43%) scores. Women with greater exposure to bushfires/smoke but not COVID-19 had poorer scores on all mental health measures. CONCLUSIONS These findings provide novel evidence that the mental health of pregnant women and mothers of newborn babies is vulnerable to major climate catastrophes such as bushfires.
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Affiliation(s)
- Nicolas Cherbuin
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT 2601, Australia
| | - Amita Bansal
- School of Medicine and Psychology, Australian National University, Canberra, ACT 2601, Australia; (A.B.); (C.J.N.)
- John Curtin School of Medical Research, Australian National University, Canberra, ACT 2601, Australia
| | - Jane E. Dahlstrom
- School of Medicine and Psychology, Australian National University, Canberra, ACT 2601, Australia; (A.B.); (C.J.N.)
- John Curtin School of Medical Research, Australian National University, Canberra, ACT 2601, Australia
- The Canberra Hospital, Canberra Health Services, Garran, ACT 2605, Australia; (H.C.)
| | - Hazel Carlisle
- The Canberra Hospital, Canberra Health Services, Garran, ACT 2605, Australia; (H.C.)
| | - Margaret Broom
- The Canberra Hospital, Canberra Health Services, Garran, ACT 2605, Australia; (H.C.)
- School of Nursing and Midwifery, University of Canberra, Bruce, ACT 2617, Australia;
| | - Ralph Nanan
- Sydney Medical School and Charles Perkins Centre Nepean, University of Sydney, Penrith, NSW 2750, Australia;
| | - Stewart Sutherland
- School of Medicine and Psychology, Australian National University, Canberra, ACT 2601, Australia; (A.B.); (C.J.N.)
| | - Sotiris Vardoulakis
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT 2601, Australia
| | - Christine B. Phillips
- School of Medicine and Psychology, Australian National University, Canberra, ACT 2601, Australia; (A.B.); (C.J.N.)
| | - Michael J. Peek
- School of Medicine and Psychology, Australian National University, Canberra, ACT 2601, Australia; (A.B.); (C.J.N.)
| | - Bruce K. Christensen
- School of Medicine and Psychology, Australian National University, Canberra, ACT 2601, Australia; (A.B.); (C.J.N.)
| | - Deborah Davis
- School of Nursing and Midwifery, University of Canberra, Bruce, ACT 2617, Australia;
- Nursing and Midwifery Office, ACT Government Health Directorate, Phillip, ACT 2606, Australia
| | - Christopher J. Nolan
- School of Medicine and Psychology, Australian National University, Canberra, ACT 2601, Australia; (A.B.); (C.J.N.)
- John Curtin School of Medical Research, Australian National University, Canberra, ACT 2601, Australia
- The Canberra Hospital, Canberra Health Services, Garran, ACT 2605, Australia; (H.C.)
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16
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Düken ME. Investigation of the Relationship Between Mental Health Status and Sleep Patterns of Children Who Experienced the Kahramanmaraş Earthquake: Data From the Earthquake Region. J Am Psychiatr Nurses Assoc 2023:10783903231211506. [PMID: 37994036 DOI: 10.1177/10783903231211506] [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] [Indexed: 11/24/2023]
Abstract
BACKGROUND The psychological conditions of children exposed to earthquakes, such as somatization, obsessive-compulsive, hostility, and paranoid thought, have not been adequately studied. AIM This study was conducted to examine the relationship between the mental states and sleep patterns of children who experienced the Kahramanmaraş earthquake. METHOD This is a descriptive, cross-sectional, and relational study that included 867 children from 11 provinces of Turkey affected by the earthquake that occurred in Kahramanmaraş on February 6th. The Child Follow-up Form, Mental Symptom Screening Scale, and Child Sleep Habits Scale were used to collect data. RESULTS The psychological symptoms (anxiety, depression, somatization, anger-hostility, obsessive-compulsive symptoms, interpersonal sensitivity, phobic anxiety, paranoid ideation, psychotic symptoms, and other issues) experienced by children after the earthquake explained 96.9% of their sleep disturbance. Some of the demographic characteristics, such as age, the status of experiencing loss in the earthquake, the survival status of their mother and father, the survival status of their siblings, the total number of losses after the earthquake, the total number of losses in the nuclear family, total hours spent under the rubble, the hours children waited for their father, mother, and siblings to come out of the rubble, accounted for 77.9% of the mental symptoms (SCL-90). CONCLUSIONS These results showed the importance of early recognition and treatment of sleep disturbances to prevent possible psychiatric disorders after children have been exposed to natural disasters. It is of great importance to evaluate the mental states of children after the earthquake and to apply appropriate psychiatric interventions.
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17
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Branje S. The impact of the COVID-19 pandemic on adolescent mental health across the world. Curr Opin Psychol 2023; 53:101665. [PMID: 37562339 DOI: 10.1016/j.copsyc.2023.101665] [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: 06/28/2023] [Revised: 07/12/2023] [Accepted: 07/14/2023] [Indexed: 08/12/2023]
Abstract
The global impact of the COVID-19 pandemic on adolescents has been substantial. The current review aimed to summarize the existing literature on the impact of the pandemic on mental health during adolescence, with a specific focus on longitudinal studies. The findings from these studies indicated that many adolescents experienced increased mental health problems, especially those who were already vulnerable prior to the pandemic. Several preexisting factors, such as socioeconomic background and gender, and pandemic-related factors, such as perceived stress and restrictive measures, were identified that contribute to interindividual differences in how adolescents were affected by the pandemic. However, it is crucial to interpret these changes in the context of the ongoing trend of increasing mental health problems among youth over the past decades.
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Affiliation(s)
- Susan Branje
- Faculty of Social and Behavioural Sciences, Utrecht University, the Netherlands.
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18
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Womersley JS, du Plessis M, Greene MC, van den Heuwel LL, Kinyanda E, Seedat S. Advances in the molecular neurobiology of posttraumatic stress disorder from global contexts: A systematic review of longitudinal studies. Glob Ment Health (Camb) 2023; 10:e62. [PMID: 37854422 PMCID: PMC10579657 DOI: 10.1017/gmh.2023.53] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/25/2023] [Accepted: 08/24/2023] [Indexed: 10/20/2023] Open
Abstract
Trauma exposure is prevalent globally and is a defining event for the development of posttraumatic stress disorder (PTSD), characterised by intrusive thoughts, avoidance behaviours, hypervigilance and negative alterations in cognition and mood. Exposure to trauma elicits a range of physiological responses which can interact with environmental factors to confer relative risk or resilience for PTSD. This systematic review summarises the findings of longitudinal studies examining biological correlates predictive of PTSD symptomology. Databases (Pubmed, Scopus and Web of Science) were systematically searched using relevant keywords for studies published between 1 January 2021 and 31 December 2022. English language studies were included if they were original research manuscripts or meta-analyses of cohort investigations that assessed longitudinal relationships between one or more molecular-level measures and either PTSD status or symptoms. Eighteen of the 1,042 records identified were included. Studies primarily included military veterans/personnel, individuals admitted to hospitals after acute traumatic injury, and women exposed to interpersonal violence or rape. Genomic, inflammation and endocrine measures were the most commonly assessed molecular markers and highlighted processes related to inflammation, stress responding, and learning and memory. Quality assessments were done using the Systematic Appraisal of Quality in Observational Research, and the majority of studies were rated as being of high quality, with the remainder of moderate quality. Studies were predominantly conducted in upper-income countries. Those performed in low- and middle-income countries were not broadly representative in terms of demographic, trauma type and geographic profiles, with three out of the four studies conducted assessing only female participants, rape exposure and South Africa, respectively. They also did not generate multimodal data or use machine learning or multilevel modelling, potentially reflecting greater resource limitations in LMICs. Research examining molecular contributions to PTSD does not adequately reflect the global burden of the disorder.
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Affiliation(s)
- Jacqueline S Womersley
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders Extramural Unit, Stellenbosch University, Cape Town, South Africa
| | - Morne du Plessis
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders Extramural Unit, Stellenbosch University, Cape Town, South Africa
| | - M Claire Greene
- Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Leigh L van den Heuwel
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders Extramural Unit, Stellenbosch University, Cape Town, South Africa
| | - Eugene Kinyanda
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- Department of Psychiatry, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Soraya Seedat
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders Extramural Unit, Stellenbosch University, Cape Town, South Africa
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19
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Newnham EA, Mergelsberg ELP, Tearne J, McEvoy P, Stanley S, Celenza A, Kavanagh H, Stevenson T, Mavaddat N, Demore G, Hood S. Mental Health Status, Risk and Protective Factors for Healthcare Staff Prior to the First Major COVID-19 Outbreak in Western Australia. Int J Public Health 2023; 68:1606102. [PMID: 37732330 PMCID: PMC10507727 DOI: 10.3389/ijph.2023.1606102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 08/16/2023] [Indexed: 09/22/2023] Open
Abstract
Objectives: Western Australia's unique public health response delayed the first wave of community COVID-19 transmission for 2 years. We aimed to determine the status of post-traumatic stress (PTSS), depressive, and anxiety symptoms among healthcare staff in major tertiary hospitals, together with associated risk and protective factors prior to the first substantial outbreak of COVID-19. Methods: A cross-sectional study was conducted with 431 healthcare staff immediately prior to the Western Australian border re-opening in 2022. Staff were recruited via notices in email newsletters, at four tertiary hospitals and a public mental health clinic in metropolitan Perth. Validated and original questionnaires were administered via Qualtrics. Results: Moderate levels of PTSS (22.3%), depression (21.9%), and anxiety (25.9%) were reported. Pathway analyses indicated that sleep difficulties, workplace stressors, and infectious disease training were associated with higher PTSS, depression and anxiety symptoms, and younger age was associated with higher levels of depression and anxiety. Nursing roles were associated with higher PTSS. Social support and workplace support were associated with lower levels of depression and anxiety but were not associated with PTSS. Conclusion: The findings illustrate high levels of resilience, but indicate a need for structural supports within the health system to foster staff mental health prior to the onset of emergencies.
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Affiliation(s)
- Elizabeth A. Newnham
- School of Population Health, Curtin University, Perth, WA, Australia
- Curtin enAble Institute, Perth, WA, Australia
- François-Xavier Bagnoud Center for Health and Human Rights, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | | | - Jessica Tearne
- Department of Clinical Psychology and Clinical Neuropsychology, Fiona Stanley Hospital, Perth, WA, Australia
- State Major Trauma Unit, Royal Perth Hospital, Perth, WA, Australia
| | - Peter McEvoy
- School of Population Health, Curtin University, Perth, WA, Australia
- Curtin enAble Institute, Perth, WA, Australia
- Centre for Clinical Interventions, North Metropolitan Health Service, Perth, WA, Australia
| | - Susanne Stanley
- Division of Psychiatry, School of Medicine, The University of Western Australia, Perth, WA, Australia
| | - Antonio Celenza
- Emergency Medicine, School of Medicine, University of Western Australia, Perth, WA, Australia
- Emergency Department, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Hyranthi Kavanagh
- Department of Clinical Psychology and Clinical Neuropsychology, Fiona Stanley Hospital, Perth, WA, Australia
| | - Teresa Stevenson
- Peel and Rockingham Kwinana Mental Health Service, Rockingham, WA, Australia
| | - Nahal Mavaddat
- Discipline of General Practice, School of Medicine, University of Western Australia, Perth, WA, Australia
| | - Gavin Demore
- Emergency Medicine, School of Medicine, University of Western Australia, Perth, WA, Australia
- Western Australia Country Health Service, Perth, WA, Australia
| | - Sean Hood
- Division of Psychiatry, School of Medicine, The University of Western Australia, Perth, WA, Australia
- Sir Charles Gairdner Hospital Mental Health Unit, North Metropolitan Health Service Mental Health, Public Health and Dental Services (MHPHDS), Perth, WA, Australia
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20
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Godara M, Rademacher J, Hecht M, Silveira S, Voelkle MC, Singer T. Heterogeneous Mental Health Responses to the COVID-19 Pandemic in Germany: An Examination of Long-Term Trajectories, Risk Factors, and Vulnerable Groups. Healthcare (Basel) 2023; 11:healthcare11091305. [PMID: 37174848 PMCID: PMC10177770 DOI: 10.3390/healthcare11091305] [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: 02/24/2023] [Revised: 04/21/2023] [Accepted: 04/29/2023] [Indexed: 05/15/2023] Open
Abstract
Abundant studies have examined mental health in the early periods of the COVID-19 pandemic. However, empirical work examining the mental health impact of the pandemic's subsequent phases remains limited. In the present study, we investigated how mental vulnerability and resilience evolved over the various phases of the pandemic in 2020 and 2021 in Germany. Data were collected (n = 3522) across seven measurement occasions using validated and self-generated measures of vulnerability and resilience. We found evidence for an immediate increase in vulnerability during the first lockdown in Germany, a trend towards recovery when lockdown measures were eased, and an increase in vulnerability with each passing month of the second lockdown. Four different latent trajectories of resilience-vulnerability emerged, with the majority of participants displaying a rather resilient trajectory, but nearly 30% of the sample fell into the more vulnerable groups. Females, younger individuals, those with a history of psychiatric disorders, lower income groups, and those with high trait vulnerability and low trait social belonging were more likely to exhibit trajectories associated with poorer mental well-being. Our findings indicate that resilience-vulnerability responses in Germany during the COVID-19 pandemic may have been more complex than previously thought, identifying risk groups that could benefit from greater support.
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Affiliation(s)
- Malvika Godara
- Social Neuroscience Lab, Max Planck Society, 10557 Berlin, Germany
| | | | - Martin Hecht
- Department of Psychology, Helmut Schmidt University, 22043 Hamburg, Germany
| | - Sarita Silveira
- Social Neuroscience Lab, Max Planck Society, 10557 Berlin, Germany
| | - Manuel C Voelkle
- Institute of Psychology, Humboldt University of Berlin, 10117 Berlin, Germany
| | - Tania Singer
- Social Neuroscience Lab, Max Planck Society, 10557 Berlin, Germany
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21
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Smith CL, Campbell TCH, Gao CX, Lane TJ, Maybery D, Berger E, Brown D, Ikin JF, McFarlane A, Abramson MJ, Carroll M. Sociodemographic circumstances, health, and life experience shape posttraumatic distress trajectories among individuals exposed to smoke during a large-scale coal mine fire. J Trauma Stress 2023; 36:465-473. [PMID: 37005219 DOI: 10.1002/jts.22923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 11/29/2022] [Accepted: 12/29/2022] [Indexed: 04/04/2023]
Abstract
The 2014 Hazelwood coal mine fire in the Latrobe Valley, Australia, distributed toxic smoke into surrounding communities over 45 days. This study investigated risk and protective factors associated with four trajectories of posttraumatic distress (resilient, recovery, delayed-onset, chronic) among exposed adults. Participants (N = 709) completed surveys in 2016-2017 and 2019-2020 assessing mine fire-related particulate matter (PM2.5 ) exposure; sociodemographic, physical, and mental health variables; and exposure to other traumatic and recent stressful events. Mine fire-related posttraumatic distress was measured using the IES-R; trajectories were determined according to established clinical significance thresholds. Relative risk ratios (RRRs) were generated from multivariate multinomial regressions. The resilient trajectory was most common (77.0%). The chronic trajectory (8.5%) was associated with loneliness, RRR = 2.59, 95% CI [1.30, 5.16], and physical health diagnoses, RRR = 2.31, 95% CI [1.32, 4.02]. The delayed-onset trajectory (9.1%) was associated with multiple recent stressful events, RRR = 2.51, 95% CI [1.37, 4.59]; mental health diagnoses, RRR = 2.30, 95% CI [1.25, 4.24]; loneliness, RRR = 2.05, 95% CI [1.09, 3.88]; and male gender, RRR = 2.01, 95% CI [1.18, 3.44]. Socioeconomic advantage protected against chronic, RRR = 0.68, 95% CI [0.53, 0.86], and delayed-onset trajectory membership, RRR = 0.68, 95% CI [0.50, 0.94]; social support protected against chronic trajectory membership, RRR = 0.67, 95% CI [0.49, 0.92]. PM2.5 exposure did not determine trajectory. These findings enhance understanding of longer-term posttraumatic responses to large-scale smoke events and can inform mental health initiatives within at-risk communities.
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Affiliation(s)
- Catherine L Smith
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | | | - Caroline X Gao
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Orygen, Centre for Youth Mental Health, University of Melbourne, Parkville, Australia
| | - Tyler J Lane
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Darryl Maybery
- Monash Rural Health, Monash University, Warragul, Australia
| | - Emily Berger
- School of Educational Psychology and Counselling, Faculty of Education, Monash University, Clayton, Australia
| | - David Brown
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Jillian F Ikin
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | | | - Michael J Abramson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Matthew Carroll
- Monash Rural Health Churchill, Monash University, Churchill, Australia
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22
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Fischer SH, Landis RK, Acosta JD, Faherty LJ. Changes in Poison Center Calls for Intentional Exposure During Public Health Emergencies: COVID-19 and Winter Storm Uri in Dallas County, Texas. Disaster Med Public Health Prep 2023; 17:e361. [PMID: 36942743 DOI: 10.1017/dmp.2023.6] [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: 03/23/2023]
Abstract
OBJECTIVE This study aimed to: (1) explore changes in the volume of calls to poison control centers (PCs) for intentional exposures (IEs) in Dallas County, Texas, overall and by gender and age, and (2) examine the association between 2 different public health emergencies (PHEs) and changes in IE call volume. METHODS PCs categorize calls they receive by intentionality of the exposure, based on information from the caller. We analyzed data on PC calls categorized as intentional in Dallas County, Texas, from March 2019 - April 2021. This period includes the COVID-19 pandemic declaration (March 2020), a surge in COVID-19 cases (July 2020), and Winter Storm Uri (February 2021). Changes in IE call volume (overall and by age and gender), were explored, and interrupted time series analysis was used to examine call volume changes after PHE onset. RESULTS The summer surge in COVID-19 cases was associated with 1.9 additional IE calls/day (95% CI 0.7 to 3.1), in the context of a baseline unadjusted mean of 6.2 calls per day (unadjusted) before November 3, 2020. Neither the pandemic declaration nor Winter Storm Uri was significantly associated with changes in call volume. Women, on average, made 1.2 more calls per day compared to men during the study period. IE calls for youth increased after the pandemic declaration, closing the longstanding gap between adults and youth by early 2021. CONCLUSIONS Changes in IE call volume in Dallas County varied by gender and age. Calls increased during the local COVID-19 surge. Population-level behavioral health may be associated with local crisis severity.
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Affiliation(s)
| | | | | | - Laura J Faherty
- RAND Corporation, Boston, MA
- Department of Pediatrics, Maine Medical Center, Portland, ME
- Department of Pediatrics, Tufts University School of Medicine, Boston, MA
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23
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Schäfer SK, Sopp MR, Fuchs A, Kotzur M, Maahs L, Michael T. The relationship between sense of coherence and mental health problems from childhood to young adulthood: A meta-analysis. J Affect Disord 2023; 325:804-816. [PMID: 36638967 DOI: 10.1016/j.jad.2022.12.106] [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: 12/21/2021] [Revised: 10/07/2022] [Accepted: 12/23/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Sense of coherence (SOC) as the key component of the salutogenesis framework is negatively correlated with mental health problems in adults but also in children and adolescents. Since SOC is conceptualized to develop and stabilize from childhood to young adulthood, these life phases are of critical importance for the salutogenesis concept. Individual studies examining SOC's link with mental health at younger ages yielded heterogeneous effect size estimates. Thus, the present meta-analysis is the first to quantify the current state of evidence on the association between SOC and mental health problems. METHODS The random-effects multi-level meta-analysis followed PRISMA guidelines and was based on 57 studies (70 samples) comprising 41,013 participants. Weighted mean age of participants was 15.46 years and 50.4 % were female. RESULTS The mean correlation (r) between SOC and overall mental health problems was M(r) = -0.46, 95 % CI [-0.53, -0.39]. However, there was substantial heterogeneity between studies, while differences between symptom types were smaller. Subsequent moderator analyses showed that higher sample age was associated with more negative relationships and higher internal consistencies of SOC measures. Moreover, internalizing symptoms, depressive symptoms, and feelings of loneliness showed a stronger negative association with SOC than psychosomatic symptoms. LIMITATIONS Our findings on age-related differences were based on (repeated) cross-sectional data and require replication in longitudinal studies. CONCLUSIONS Results yielded a negative association between SOC and mental health problems with increasing magnitude from childhood to young adulthood. Thus, SOC-fostering interventions may help to buffer negative effects of stress and improve resilience starting from early ages.
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Affiliation(s)
- Sarah K Schäfer
- Department of Clinical Psychology and Psychotherapy, Saarland University, Building A1 3, D-66123 Saarbruecken, Germany; Leibniz Institute for Resilience Research, Wallstrasse 7, D-55122 Mainz, Germany..
| | - M Roxanne Sopp
- Department of Clinical Psychology and Psychotherapy, Saarland University, Building A1 3, D-66123 Saarbruecken, Germany
| | - Alicia Fuchs
- Department of Clinical Psychology and Psychotherapy, Saarland University, Building A1 3, D-66123 Saarbruecken, Germany
| | - Maren Kotzur
- Department of Clinical Psychology and Psychotherapy, Saarland University, Building A1 3, D-66123 Saarbruecken, Germany
| | - Lisann Maahs
- Department of Clinical Psychology and Psychotherapy, Saarland University, Building A1 3, D-66123 Saarbruecken, Germany
| | - Tanja Michael
- Department of Clinical Psychology and Psychotherapy, Saarland University, Building A1 3, D-66123 Saarbruecken, Germany
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24
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Fattori A, Comotti A, Mazzaracca S, Consonni D, Bordini L, Colombo E, Brambilla P, Bonzini M. Long-Term Trajectory and Risk Factors of Healthcare Workers' Mental Health during COVID-19 Pandemic: A 24 Month Longitudinal Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4586. [PMID: 36901597 PMCID: PMC10002366 DOI: 10.3390/ijerph20054586] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/28/2023] [Accepted: 03/02/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Research has shown the substantial impact of the COVID-19 pandemic on healthcare workers' (HCWs) mental health, however, it mostly relies on data collected during the early stages of COVID-19. The aim of this study is to assess the long-term trajectory of HCWs' mental health and the associated risk factors. METHODS a longitudinal cohort study was carried out in an Italian hospital. At Time 1 (July 2020-July 2021), 990 HCWs took part in the study and completed the General Health Questionnaire (GHQ-12), the Impact of Event Scale (IES-R), and the General Anxiety Disorder (GAD-7)questionnaire. McNemar's test measured changes in symptoms' trajectories, and random effects models evaluated risk factors associated with scores above the cut-off. RESULTS 310 HCWs participated to the follow-up evaluation (Time 2; July 2021-July 2022). At Time 2, scores above cut-offs were significantly lower (p < 0.001) than at Time 1 for all scales (23% vs. 48% for GHQ-12; 11% vs. 25% for IES-R; 15% vs. 23% for GAD-7). Risk factors for psychological impairment were being a nurse (IES-R: OR 4.72, 95% CI 1.71-13.0; GAD-7: OR 2.82, 95% CI 1.44-7.17), a health assistant (IES-R: OR 6.76, 95% CI 1.30-35.1), or having had an infected family member (GHQ-12: OR 1.95, 95% CI 1.01-3.83). Compared to Time 1, gender and experience in COVID-19 units lost significance with psychological symptoms. CONCLUSIONS data over more than 24 months from the pandemic onset showed improvement of HCWs' mental health; our findings suggested the need to tailor and prioritize preventive actions towards healthcare workforce.
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Affiliation(s)
- Alice Fattori
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Anna Comotti
- Occupational Medicine Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Sara Mazzaracca
- Occupational Medicine Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Dario Consonni
- Occupational Medicine Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Lorenzo Bordini
- Occupational Medicine Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Elisa Colombo
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Department of Pathophysiology and Trasplantation, University of Milan, 20122 Milan, Italy
| | - Matteo Bonzini
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
- Occupational Medicine Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
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25
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Foster S, Estévez-Lamorte N, Walitza S, Mohler-Kuo M. The Impact of the COVID-19 Pandemic on Young Adults' Mental Health in Switzerland: A Longitudinal Cohort Study from 2018 to 2021. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2598. [PMID: 36767967 PMCID: PMC9915161 DOI: 10.3390/ijerph20032598] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 01/23/2023] [Accepted: 01/28/2023] [Indexed: 06/18/2023]
Abstract
Most of the studies that examine the effect of the COVID-19 pandemic on mental health have been restricted to pandemic mental health data alone. The aim of the current study was to estimate the pandemic's effect on young Swiss adults' mental health by comparing pandemic to pre-pandemic mental health. Longitudinal data of 1175 young Swiss adults who participated in the S-YESMH study in 2018 and were followed-up in 2020 and 2021 were analyzed. The study outcomes were self-reported symptoms of depression, generalized anxiety disorder (GAD), attention-deficit/hyperactivity disorder (ADHD), thoughts about death or self-harm, and risky single-occasion drinking (RSOD). Generalized estimation equations, logistic regression and statistical mediation analysis were used to analyze the data. Evidence was found of increased depression, GAD, and ADHD among young women and increased depression among young men, resulting from the COVID-19 pandemic. Uncertainty about the future predicted young women's depression and anxiety in 2021. COVID-19 stress in 2021 fully mediated the effect of COVID-19 stress in 2020 on depression and GAD in 2021. Young Swiss women's and men's mental health appears to have been adversely affected by the COVID-19 pandemic, especially during the second pandemic year. Uncertainty about the future and stress becoming chronic in 2021 likely explain some of the adverse effects.
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Affiliation(s)
- Simon Foster
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, 8032 Zurich, Switzerland
| | - Natalia Estévez-Lamorte
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, 8032 Zurich, Switzerland
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, 1004 Lausanne, Switzerland
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, 8032 Zurich, Switzerland
| | - Meichun Mohler-Kuo
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, 8032 Zurich, Switzerland
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, 1004 Lausanne, Switzerland
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