Diminished well-being persists beyond the end of the COVID-19 lockdown

Burdens and resources of Austrian clinical psychologists: results of a qualitative study two years into the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic increased the mental health burden in the general population, enhancing the demands placed on mental healthcare professionals.

METHODS

This study aimed to assess the burdens and resources of clinical psychologists that emerged since the beginning of the pandemic. N = 172 Austrian clinical psychologists participated in a cross-sectional online survey between April and May 2022. The burdens and the sources of support that emerged during the pandemic were analyzed using qualitative content analysis.

RESULTS

Mental health-related issues were identified as the greatest burden, followed by work-related themes and restrictions imposed by the government to combat the spreading of the virus. The most important resources mentioned by the clinical psychologists were social contacts and recreational activities. Practising mindfulness and focusing on inner processes and work-related aspects were further important resources mentioned.

CONCLUSION

Overall, it seems that clinical psychologists have a high awareness of mental health-related problems related to the pandemic and use adaptive coping strategies to deal with them.

School students' burdens and resources after 2 years of COVID-19 in Austria: a qualitative study using content analysis

Introduction

The mental health of young people has been severely affected by the COVID-19 pandemic and the measures associated with it. Mental health symptoms increased across various domains during the pandemic and subjective wellbeing decreased.

Methods

This study examined the burdens and resources of Austrian school students (M = 16.63 years old) in the third year of the pandemic and compared them descriptively with the burdens and resources identified in a comparative study in 2021. A cross-sectional online survey with open-ended questions from April to May 2022 provided data that was analyzed using qualitative content analysis. A sub-sample of N = 214 was selected from the larger sample. This sub-sample is representative for the Austrian population aged 15-19 in terms of gender and migrant background.

Results

Analysis of the open-ended questions showed that concerns about the pandemic and the burdens of the measures were no longer on young people's minds at the time of the survey in 2022. On the other hand, stress at school was increasing and the opening of schools and the resumption of face-to-face teaching were challenging for respondents. While resuming social contacts and leisure activities was mentioned as a resource by many respondents, some also expressed a desire for more time off and a retreat into coping strategies such as sleeping more or avoiding problems.

Discussion

Our findings suggest that there is a need for low-threshold support from teachers and parents to help students catch up on missed lessons and to empathize with the mas they make the transition back to "old normal".

Understanding pandemic resilience: a mixed-methods exploration of burdens, resources, and determinants of good or poor well-being among Austrian psychotherapists

Introduction

The COVID-19 pandemic has exacerbated the mental health burden on the general population, resulting in increased demands on mental healthcare professionals, including psychotherapists. This cross-sectional study assessed the challenges and resources encountered by 513 psychotherapists based on an online survey conducted between April and May 2022.

Methods

Qualitative methods content analysis of written reports was employed to investigate the emerging challenges and sources of support during the pandemic. A comparative analysis of burdens, resources, sociodemographic factors and daily physical activity was conducted to discern patterns of good and poor well-being.

Results

The predominant burden identified was mental health-related issues, followed by global crises and government-imposed restrictions to mitigate virus transmission. Essential resources encompassed social connections, mindfulness, work satisfaction, and internal processes. Notably, psychotherapists demonstrating good well-being were older, more physically active, had a lower proportion of females, were employed in private practices rather than in institutionalized settings, had more years of professional experience and treated more patients weekly than their counterparts with poor well-being. Furthermore, they exhibited greater optimism, health focus, and satisfaction with their coping methods.

Discussion

These findings can help develop support systems, policies, and educational programs to better support mental health professionals during global crises and offer strategies for individual practitioners to maintain their well-being.

Effectiveness of Daily Mindfulness Meditation App Usage to Reduce Anxiety and Improve Well-Being During the COVID-19 Pandemic: A Randomized Controlled Trial

Introduction This study examined the effect of 10-minute daily meditation app usage for 30 days on adult anxiety and mental well-being during the first year of the COVID-19 pandemic. Methods Participants were randomized into intervention (10 minutes of daily usage of the Insight Timer app) or control groups. Participants completed surveys to assess anxiety and well-being pre- and post-study. Data were analyzed using t-tests, analysis of variance (ANOVA), or nonparametric equivalents. Results Pre-study results were comparable between groups. The pre- vs. post-study General Anxiety Disorder-7 (GAD-7) scores for anxiety decreased in the intervention group (n=18, median 5.5 vs. 3.0 (pre vs. post), p=0.0233, d=0.50), but not in the control group (n=28). The intervention group had a lower median GAD-7 score than the control group post-study (3.0 vs. 8.0, p=0.0223, d=0.35). Pre- vs. post-study mean 5-item World Health Organization Well-Being Index (WHO-5) scores were improved in both the control (11.6 vs. 12.9 (pre vs. post), p=0.0408, d=0.36) and intervention groups (12.0 vs. 16.3 (pre vs. post), p=0.0001, d=0.77), although it was higher in the intervention group (16.3 vs. 12.9, p=0.0056, d=0.88). Conclusion Ten minutes of daily meditation app usage for 30 days may reduce anxiety and improve well-being in adults during the COVID-19 pandemic.

An Assessment of Austrian School Students' Mental Health and Their Wish for Support: A Mixed Methods Approach

The mental health of school students has been severely impacted by the aftermath of the COVID-19 pandemic. The present study used a mixed methods approach to assess students' mental health and examine their wishes for support to improve their psychological well-being. We further investigated gender and age group differences in the amount of clinically relevant mental health problems and the roles that mental health and gender had on desired support. Between April and May 2022, a total of 616 Austrian students aged between 14 and 20 participated in a cross-sectional online survey (77.4% female; 19.8% male; 2.8% non-binary) assessing wishes for support regarding mental well-being and mental health indicators (depression: PHQ-9; anxiety: GAD-7; insomnia: ISI; stress: PSS-10; eating disorders: SCOFF; alcohol abuse: CAGE). A wish for support was expressed by 46.6% of the students. Qualitative content analysis revealed that the two most important categories of desired support types were "professional help" and "someone to talk to". The group of students with a wish for support in general significantly more often showed clinically relevant depression, anxiety, insomnia, eating disorders, or high stress symptoms. Students that wished for professional help significantly more often exceeded the cut-off for clinically relevant depression, anxiety, and high stress. Those who wished for someone to talk to significantly more often exceeded the cut-off for clinically relevant eating disorders. The results indicate a great need for support for young people's mental health problems and that this need is even more urgent for students.

Mental health in Austrian psychotherapists during the COVID-19 pandemic

Although the impact of the COVID-19 pandemic on mental health has been reported in different communities, little is known about the mental health of psychotherapists during the COVID-19 pandemic. This study aimed to assess mental health during the COVID-19 pandemic in Austrian psychotherapists and compare it with the general population. A total of n = 513 psychotherapists (80.5% women; mean age: 53.06 ± 9.94 years) took part in an online survey conducted from April to June 2022. At the same time, a representative sample (N = 1,031) of the Austrian general population was surveyed online. Indicators of mental health were mental wellbeing (WHO-5), depression (PHQ-2), anxiety (GAD-2), insomnia (ISI-2), and stress (PSS-10). The general population sample was matched according to age and gender with the psychotherapist's data using propensity scores, yielding a final sample of n = 513 (80.5% women; mean age: 52.33 ± 13.39 years). Psychotherapists showed lower odds for exceeding cut-offs for clinically relevant depressive, anxiety, insomnia and stress symptoms (0.34-0.58) compared to the general population. Further studies should elucidate the protective factors underlying these findings.

Health-Related Quality of Life and Mental Well-Being during the COVID-19 Pandemic in Five Countries: A One-Year Longitudinal Study

This study aimed to investigate socioeconomic and health-related determinants and recent life events and their relation to changes in health-related quality of life (HRQoL) and mental well-being during the first year of the COVID-19 pandemic. A web-based survey was administered repeatedly to participants from Greece, Italy, the Netherlands, the United Kingdom, and the United States. Primary outcome measures were HRQoL (measured by EQ-5D-5L) and mental well-being (measured by WHO-5). Linear regression analyses were performed to estimate the impact of determinants on HRQoL and well-being. In total, 6765 respondents completed the questionnaire at T1 (April-May 2020) and T2 (May-June 2021). Regarding results, 33% showed improved HRQoL at T2, whereas 31% deteriorated. In terms of mental well-being, 44% improved and 41% deteriorated. The greatest deterioration in HRQoL and mental well-being from T1 to T2 was observed with an increasing number of chronic conditions. The effect of negative life events on HRQoL and mental well-being was larger than the effect of positive life events. We conclude that slightly more respondents showed improved rather than deteriorated HRQoL and mental well-being, with some variation by outcome measure and country.

Assessment of the Long-Term Mental Health Effects on Austrian Students after COVID-19 Restrictions

The mental health of adolescents has been severely affected by the COVID-19 pandemic. The aim of this study was to assess the mental health of Austrian adolescents in spring 2022, a time during which COVID-19-related restrictions had been significantly lifted. A total of N = 616 students aged between 14 and 20 participated in a cross-sectional survey between April and May 2022 (t2). The prevalence of clinically relevant symptoms was 73% among girls and 44% among boys for depression (PHQ-9 score ≥ 11), 57% in girls and 35% in boys for anxiety (GAD-7 score ≥ 11), 34% in girls and 21% in boys for sleeping problems (ISI score ≥ 15), and 95% in girls and 81% in boys for experiencing at least moderate stress (PSS-10 score ≥ 14). Frequent suicidal ideations were reported by 24% of girls and 12% of boys. These results were compared with the results from a cross-sectional study from February 2021 (t1). To account for differences in covariates between samples, data were propensity score matched before the analysis. Compared with t1, we found an increase among girls regarding clinically relevant symptoms of depression (OR = 1.78), anxiety (OR = 1.34), insomnia (OR = 1.63), and suicidal ideations (OR = 1.96; p < 0.05 for all measures). Significant correlations were found between smartphone use and mental health and physical activity and mental health for both genders. The results of this study indicated that even during the third year of the COVID-19 pandemic, the mental health of adolescents in Austria is still severely impaired.

Mental health burden of high school students, and suggestions for psychosocial support, 1.5 years into the COVID-19 pandemic in Austria

The COVID-19 pandemic and containment efforts seem to be particularly challenging for adolescents. This study assessed mental health in high school students 1.5 years after the pandemic began in Austria. A cross-sectional survey was carried out from September to November 2021. Well-being (WHO-5), depressive symptoms, anxiety symptoms and sleep quality were assessed. A total of 1505 adolescents participated (78% girls). The cut-offs for clinically relevant symptoms were exceeded by 62% girls and 38.1% boys for depression (PHQ-9 score ≥ 11), 49% girls and 29% boys for anxiety (GAD-7 score ≥ 11) and 28% girls and 17% boys for insomnia (ISI score ≥ 15). The prevalence of suicidal ideation (item 9 of the PHQ-9) within the last 2 weeks was 47% in girls and 32% in boys. These data collected in autumn 2021 (the start of the second semester of reopened schools; t2) were compared to data collected in February 2021 (one semester after remote schooling; t1). A matched pairs analysis according to age, gender, region, school type and migration background resulted in a total sample size of N = 2514 adolescents. Results showed small deteriorations in mental health (i.e., well-being, depression, insomnia, suicidal ideation) in girls at t2 compared to t1, and an increase in suicidal thoughts in boys (all p-values < 0.05). Qualitative data show that young people have a need for more psychological support, both professional and informal, as well as increased mental health literacy. Results suggest that mental health burden in adolescents remains high 1.5 years into the pandemic and highlight the need to implement timely psychological support.

The long-tail effect of the COVID-19 lockdown on Italians' quality of life, sleep and physical activity

From March 2020 to May 2021, several lockdown periods caused by the COVID-19 pandemic have limited people’s usual activities and mobility in Italy, as well as around the world. These unprecedented confinement measures dramatically modified citizens’ daily lifestyles and behaviours. However, with the advent of summer 2021 and thanks to the vaccination campaign that significantly prevents serious illness and death, and reduces the risk of contagion, all the Italian regions finally returned to regular behaviours and routines. Anyhow, it is unclear if there is a long-tail effect on people’s quality of life, sleep- and physical activity-related behaviours. Thanks to the dataset described in this paper, it will be possible to obtain accurate insights of the changes induced by the lockdown period in the Italians’ health that will permit to provide practical suggestions at local, regional, and state institutions and companies to improve infrastructures and services that could be beneficial to Italians’ well being.

Measurement(s)	Quality of Life • Overall Sleep Quality Rating • Physical Activity Measurement
Technology Type(s)	SF-36 • Overall Sleep Quality Rating • International Physical Activity Questionnaire (August 2002) Short Last 7 Days Self-Administered Format
Sample Characteristic - Organism	Homo sapiens
Sample Characteristic - Environment	questionnaire

COVID-19 lockdowns' effects on the quality of life, perceived health and well-being of healthy elderly individuals: A longitudinal comparison of pre-lockdown and lockdown states of well-being

PURPOSE

. The concept of lockdown in relation to COVID-19 is thought to have an indirect impact on the quality of life and well-being of the elderly due to its consequences on the physical, psychological, and cognitive health of individuals. However, previous published studies on this subject are limited in terms of methodological approach used, including the absence of pre-confinement status and the type of experimental design, which is often cross-sectional. The present study proposes a longitudinal design with pre-confinement measures. It assesses changes in quality of life, perceived health, and well-being by comparing the period before lockdown (T1 = December 2019), three months after the start of the first lockdown (T2 = June 2020), and during the second lockdown (T3 = January 2021) due to COVID-19.

MATERIALS AND METHODS

. This study is conducted with a group of 72 healthy elderly persons. They completed an electronic (online) survey assessing personal factors, activities, and participation as well as responding to the EuroQol-5D and Warwick-Edinburgh Mental Well-being Scale.

RESULTS

. A decrease in quality of life, perceived health and well-being was observed between T1 and T2 and between T1 and T3, but no difference was reported between the two lockdown periods. The variables associated with these changes included energy level, level of happiness, physical activity, change in medical condition, memory difficulties, level of perceived isolation and age.

CONCLUSION

. This study will help to target variables that may have a deleterious effect on older adults for consideration in future confinement settings and for preventive purposes.

Mental health in the Austrian general population during COVID-19: Cross-sectional study on the association with sociodemographic factors

INTRODUCTION

The impact of the Coronavirus disease (COVID-19) pandemic and the associated governmental restrictions on mental health have been reported in different countries. This cross-sectional study evaluated mental health during the COVID-19 pandemic in Austria and the association with sociodemographic factors (i.e., age, sex, education, income, employment status, partnership status, and migration background).

METHODS

A representative sample (N = 1,031) of the Austrian general population was surveyed online end of April 2022. Indicators of mental health were depression (PHQ-9), anxiety (GAD-7), insomnia (ISI), alcohol abuse (CAGE), eating disorders (SCOFF), and stress (PSS-10).

RESULTS

1,031 participants completed the online survey (50.3% women; mean age: 45.6 ± 17.23 years). Cut-offs for clinically relevant depression were exceeded by 28%. 16% scored above the cut-off for clinically relevant anxiety symptoms, 15% for clinical insomnia, 18% for alcohol abuse, 26% for eating disorders, and 65% for moderate to high stress. Comparisons with another cross-sectional representative Austrian sample recruited during the first weeks of the COVID-19 pandemic in Austria (April 2020) revealed increases in depression (from 21 to 28%) but no significant changes in anxiety, insomnia, and moderate to high stress. Multivariable logistic regression showed the strongest associations of mental health indicators with age, income, and sex. Increasing age and income were associated with lower odds of mental health symptoms. Being female compared to male increased the odds of depressive symptoms while decreasing the odds of alcohol abuse.

DISCUSSION

The COVID-19 crisis seems particularly stressful for younger adults (<35 years) and people with low income (<€2,000 net household income per month). Policymakers need to consider the high social and economic costs of lockdowns and think of optimal intervention methods for mental disorders among young and low-income individuals.

Stress levels in high-school students after a semester of home-schooling

There has been an increase in stress in adolescents since the beginning of the COVID-19 pandemic. Social distancing and home-schooling are just two of many stress factors for this age group. The aim of this study was to assess stress in high-school students after a semester of home-schooling. A cross-sectional online survey (February 3rd to 28th 2021) was performed, measuring stress with the Perceived Stress Scale (PSS-10) in Austria. In total, N = 2884 students (age: M = 16.47 (SD = 1.44); 70.4% females) completed the survey. Mean PSS-10 score was M = 23.50 (SD = 7.47) [females: M = 24.69 (SD = 6.80); males: M = 20.11 (SD = 7.93); p < 0.001]. 11.0% reported low stress (females: 7.2%; males 20.9%), 52.5% moderate stress (females: 51.5%; males: 57.3%), and 36.5% high stress (females: 41.3%; males 21.8%); p < 0.001. Around one-third of high-school students suffer from high stress level, females almost twice as often as males. Psychological support should particularly focus on stress and possibilities to reduce it.

Concerns and Support after One Year of COVID-19 in Austria: A Qualitative Study Using Content Analysis with 1505 Participants

The COVID-19 pandemic and subsequent governmental restrictions have had a major impact on the daily lives of Austrians and negatively affected their mental health. A representative sample of N = 1505 individuals was recruited via Qualtrics® to participate in an online survey between 23 December 2020 and 4 January 2021. A qualitative study design was used to determine the problem areas that emerged since the beginning of the pandemic (question 1), the factors that were the source of the greatest current concern (question 2), the biggest worries when thinking about the future (question 3), and what the most important source of support (question 4) during the pandemic was. The written responses were analyzed using conventional content analysis following a framework for qualitative research and reported in the form of descriptive statistics. Restrictions imposed by the government, sociopolitical developments, work- and health-related issues, and economic disruptions were identified as being the greatest concerns. Conversely, social contacts within and outside the family were the most important source of support, followed by recreational activities and distraction. Greater consideration should be given to psychosocial factors in future decisions to contain the pandemic. More detailed qualitative research, in particular, to collect the personal experience of more vulnerable groups such as young people, women, and the unemployed, is needed.

Psychotherapie auf Distanz in Österreich während COVID‑19. Zusammenfassung der bisher publizierten Ergebnisse von drei Onlinebefragungen

Die Donau-Universität Krems untersuchte in Kooperation mit dem Österreichischen Bundesverband für Psychotherapie mit drei Onlinebefragungen Psychotherapie auf Distanz in Österreich während der COVID-19-Pandemie. Dieser Artikel fasst die bisherigen bereits publizierten Ergebnisse dieser Befragungen zusammen. An der ersten Onlinebefragung, welche in den ersten Wochen des ersten coronabedingten Lockdowns in Österreich stattfand, beteiligten sich insgesamt 1547 Psychotherapeut*innen. Die Ergebnisse zeigen, dass Psychotherapeut*innen während des Lockdowns Psychotherapie im persönlichen Kontakt verstärkt durch Psychotherapie auf Distanz (Telefon oder Internet) ersetzten. Ein erhöhtes Stresserleben sowie jobbezogene Ängste waren v. a. bei Psychotherapeut*innen vorhanden, bei denen Psychotherapie die einzige Einnahmequelle darstellte. Die Erfahrungen mit Psychotherapie auf Distanz wurden als insgesamt positiver beschrieben als sie erwartet wurden. Nichtsdestotrotz wurde Psychotherapie auf Distanz als nicht vollständig vergleichbar mit Psychotherapie im persönlichen Kontakt angesehen. An einer zweiten Onlinebefragung nach dem ersten Lockdown (Sommer 2020) beteiligten sich 222 Psychotherapeut*innen aus Österreich. Ziel dieser Befragung war es den Wechsel des Behandlungsformats (persönlich zu digital oder digital zu persönlich) im Hinblick auf die Anwendung spezifischer therapeutischer Interventionen genauer zu untersuchen. Unter digital wurden verschiede Medien wie z. B. Sprachtelefonie, Videokonferenz, Chats und E‑Mail subsumiert. Zeitgleich mit der zweiten Befragung wurde eine dritte Onlinebefragung durchgeführt, an der 139 Patient*innen der 222 österreichischen Psychotherapeut*innen teilnahmen, um auch die Patient*innen-Perspektive beim Wechsel des Behandlungsformats zu untersuchen. Erste Ergebnisse zeigen, dass Psychotherapeut*innen und Patient*innen beim Wechsel des Behandlungsformats einen Unterschied hinsichtlich der angewandten therapeutischen Interventionen erlebten. So wurden die untersuchten therapeutischen Interventionen als typischer für die Therapie im direkten persönlichen Kontakt als für die Psychotherapie auf Distanz bewertet. Zudem veränderte sich die subjektive Bedeutung verschiedener Bereiche des Lebens während der Corona-Pandemie. Die bisherigen Auswertungen zeigen, dass die COVID-19 Pandemie einen deutlichen Impact auf die Psychotherapiepraxis in Österreich hat. Weitere quantitative und qualitative Auswertungen der Daten werden noch tiefergehende Erkenntnisse liefern.

Mental Health during the COVID-19 Lockdown over the Christmas Period in Austria and the Effects of Sociodemographic and Lifestyle Factors

Since the beginning of the COVID-19 pandemic a decline in mental health has been reported. This online study investigated mental health and well-being in Austria during a strict lockdown. In total, N = 1505 participants were recruited between 23 December 2020 and 4 January 2021 and levels of depression (PHQ-9), anxiety (GAD-7), sleep quality (ISI), well-being (WHO-5), quality of life (WHO-QOL) and stress (PSS-10) were measured. 26% scored above the cut-off for moderate depressive symptoms (PHQ-9 ≥ 10; ♀ = 32%; ♂ = 21%), 23% above the cut-off for moderate anxiety (GAF-7 ≥ 10; ♀ = 29%; ♂ = 17%) and 18% above the cut-off for moderate insomnia (ISI ≥ 15; ♀ = 21%; ♂ = 16%). Mean-scores for quality of life (psychological WHO-QOL) were 68.89, for well-being (WHO-5) 14.34, and for stress (PSS-10) 16.42. The youngest age group (18-24) was most burdened and showed significantly more mental health symptoms compared with the oldest age group (65+) in depressive symptoms (50% vs. 12%), anxiety symptoms (35% vs. 10%), and insomnia (25% vs. 11%, all p-values < 0.05). Mental health decreased compared to both the first lockdown earlier in 2020 and pre-pandemic data. Further analyses indicate these findings were especially apparent for the under 24-year-olds, women, single/separated people, low incomes and those who do not partake in any physical activity (all p-values < 0.05). We highlight the need for ongoing mental health support, particularly to the most burdened groups.

Comparing Mental Health During the COVID-19 Lockdown and 6 Months After the Lockdown in Austria: A Longitudinal Study

The novel coronavirus disease (COVID-19) has repeatedly been reported to impair mental health. This longitudinal study evaluated mental health at the emergence of the COVID-19 pandemic (t1) and 6 months later (t2) in Austria. Indicators of mental health were depression (PHQ-9), anxiety (GAD-7), sleep quality (ISI), perceived stress (PSS-10), as well as quality of life (WHO-QOL BREF) and well-being (WHO-5). In total, N = 437 individuals participated in both surveys (52.9% women). The number of participants with clinically relevant depressive, anxiety, or insomnia symptoms did not differ statistically significantly between t1 and t2 (p ≥ 0.48). The prevalence of moderate or severe (clinically relevant) (1) depressive symptoms changed from 18.3% to 19.7% (p = 0.48), (2) anxiety symptoms from 16.5 to 15.6% (p = 0.67), and insomnia from 14.6 to 15.6% (p = 0.69) from t1 to t2. Bonferroni-corrected t-tests showed that the stress level (PSS-10) decreased, and well-being (WHO-5) increased. However, effect sizes do not seem to be clinically relevant (Cohen's d < 0.2). Results suggest that detrimental health consequences of the COVID-19 pandemic persisted several months after its outbreak and the end of the lockdown measures, respectively. Regarding well-being and stress, there is a slight trend toward improvement.