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Engels A, Stein J, Riedel-Heller SG, Konnopka C, König HH. The development of suicide risk in people with severe mental disorders during the first year of the COVID-19 pandemic: a claims-based cohort study. Soc Psychiatry Psychiatr Epidemiol 2024; 59:1193-1200. [PMID: 37996604 PMCID: PMC11178617 DOI: 10.1007/s00127-023-02584-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 10/30/2023] [Indexed: 11/25/2023]
Abstract
PURPOSE In this study, we assess how the first and second waves of the COVID-19 pandemic influenced the suicide risk of patients with severe mental disorders in Germany. METHODS We analyzed German health insurance claims data to compare the suicide risk of patients with severe mental disorders before and during the pandemic. We included n = 690,845 patients between October 2019 and March 2020 and n = 693,457 patients the corresponding period of the previous year and applied entropy balancing to adjust for confounding covariates. Given that the cause of death was unknown, we defined potential suicides as deaths of patients with a history of intentional self-harm whose passing could not be explained by COVID-19. Potential suicides were tracked in both cohorts over one year and compared using logistic regression. RESULTS 128 potential suicides were identified in the period during and 101 before the pandemic. This corresponded to a significant increase in the risk for potential suicide of 27.4% compared to the control period (β = 0.24, z = 1.82, p < 0.05). CONCLUSION The noticeable increase in the risk for potential suicide for patients with severe pre-existing mental disorders emphasizes the call for additional efforts to prevent suicide and to help patients cope with their mental illness in the aftermath of the COVID-19 crisis.
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Affiliation(s)
- Alexander Engels
- Department of Health Economics and Health Services Research, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Building W37, 20246, Hamburg, Germany.
| | - Janine Stein
- Institute for Social Medicine, Occupational Medicine and Public Health, University Medical Center Leipzig, Leipzig, Germany
| | - Steffi G Riedel-Heller
- Institute for Social Medicine, Occupational Medicine and Public Health, University Medical Center Leipzig, Leipzig, Germany
| | - Claudia Konnopka
- Department of Health Economics and Health Services Research, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Building W37, 20246, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Building W37, 20246, Hamburg, Germany
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Ernst M, Brähler E, Beutel ME, Kruse J, Andreas S. Socially isolated, but not lonely in lockdown: Exploring the role of reflective functioning as a protective factor in the early days of the COVID-19 pandemic in Germany. J Affect Disord 2024; 362:201-208. [PMID: 38950870 DOI: 10.1016/j.jad.2024.06.109] [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: 01/01/2024] [Revised: 05/28/2024] [Accepted: 06/25/2024] [Indexed: 07/03/2024]
Abstract
INTRODUCTION Loneliness is a pressing public mental health issue. So far, there has been a paucity of investigations focused on the individual differences modulating this subjective feeling in the face of difficult circumstances, e.g., the COVID-19 pandemic. As such, the present study aimed to investigate the role of mentalization; given that the construct comprises reflection abilities that might be particularly relevant to the pandemic's interpersonal challenges. METHODS A survey representative of the German population was conducted from May to June 2020 (N = 2503). We examined mentalization, operationalized as reflective functioning (RF) and measured using the Mentalization Questionnaire (MZQ), both as a protective factor against loneliness on its own and as a moderator of the association of social isolation with loneliness. RESULTS Of the overall sample, 822 (32.8 %) individuals reported social isolation. Worse RF was moderately associated with higher levels of loneliness (r = 0.433, p < .001). A linear regression model (controlling for sociodemographic characteristics and general personality pathology) confirmed this positive association, but also indicated an interaction effect of RF and social isolation in the statistical prediction of loneliness. Stratified models showed that RF was a comparatively weaker statistical predictor of loneliness among the socially isolated. DISCUSSION This representative population study expanded our knowledge about the factors shaping loneliness in the population. RF emerged as a potentially modifiable protective influence. Further research needs to clarify the mechanisms through which it mitigates loneliness. LIMITATIONS The cross-sectional design does not give insight into the temporal association of RF and loneliness.
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Affiliation(s)
- Mareike Ernst
- Department of Clinical Psychology, Psychotherapy and Psychoanalysis, Institute of Psychology, University of Klagenfurt, Klagenfurt am Wörthersee, Austria.
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Johannes Kruse
- Department of Psychosomatic Medicine and Psychotherapy, Justus Liebig University Gießen, Gießen, Germany
| | - Sylke Andreas
- Department of Clinical Psychology, Psychotherapy and Psychoanalysis, Institute of Psychology, University of Klagenfurt, Klagenfurt am Wörthersee, Austria
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Liu T, Wang YH, Ng ZLY, Zhang W, Wong SMY, Wong GHY, Lum TYS. Comparison of networks of loneliness, depressive symptoms, and anxiety symptoms in at-risk community-dwelling older adults before and during COVID-19. Sci Rep 2024; 14:14737. [PMID: 38926445 PMCID: PMC11208589 DOI: 10.1038/s41598-024-65533-z] [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: 10/20/2023] [Accepted: 06/20/2024] [Indexed: 06/28/2024] Open
Abstract
Network analysis provides an innovative approach to examining symptom-to-symptom interactions in mental health, and adverse external conditions may change the network structures. This study compared the networks of common risk factors and mental health problems (loneliness, depressive symptoms, and anxiety symptoms) in community-dwelling older people before and during COVID-19. Older adults (aged ≥ 60) at risk for depression were recruited through non-governmental organizations. Loneliness, depressive symptoms and anxiety symptoms were measured using the three-item Loneliness Scale (UCLA-3), nine-item Patient Health Questionnaire (PHQ-9), and seven-item Generalized Anxiety Disorder Scale (GAD-7), respectively. Data from 2549 (before) and 3506 (during COVID-19) respondents were included using propensity score matching. Being restless (GAD-7-item5) was most central, indicated by Expected Influence, in both pre and during COVID-19 networks despite low severity (mean score). The network during COVID-19 had higher global strength and edge variability than the pre-pandemic network, suggesting easier symptom spread and potentially more complex symptom presentation. In addition, feeling isolated from others (UCLA-3-item3) had stronger connections with feeling worthless/guilty (PHQ-9-item6) and anticipatory anxiety (GAD-7-item7) during COVID-19 than before. These findings may enhance our knowledge of the symptom structure of common mental health problems and the impacts of the pandemic. Targeting central symptoms may offer novel preventive strategies for older people.
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Affiliation(s)
- Tianyin Liu
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China.
| | - Yun-Han Wang
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Zuna Loong Yee Ng
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Wen Zhang
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China
| | - Stephanie Ming Yin Wong
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Gloria Hoi-Yan Wong
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Terry Yat-Sang Lum
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
- Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong, China
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Hamdan-Mansour AM, Hamdan-Mansour RA, Allaham DM, Alrashidi M, Alhaiti A, Mansour LAH. Academic procrastination, loneliness, and academic anxiety as predictors of suicidality among university students. Int J Ment Health Nurs 2024. [PMID: 38797963 DOI: 10.1111/inm.13366] [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: 03/26/2024] [Revised: 05/06/2024] [Accepted: 05/14/2024] [Indexed: 05/29/2024]
Abstract
Suicide is a major public health concern, and university students are at higher risk of suicide than any other age group. The purpose of this study was to examine the prediction power of loneliness, academic anxiety, and academic procrastination on suicidality among university students. A cross-sectional, correlational design was used to recruit 403 university students using the electronic survey format in Jordan. Data were collected regarding loneliness, academic anxiety, academic procrastination, and suicidality. A two-step multiple hierarchical regression analysis was performed. Only 17.1% (n = 69) of students were at risk of suicide, low to moderate level of loneliness, moderate level and moderate to high level of academic procrastination of academic anxiety. The model that included the sociodemographic and the psychological factors was significant (F18,390 = 12.3, p < 0.001) where the total variance in suicidality was 37.3% (R2 = 0.373). Being a working student, being on psychotropic medication, romantic and family relationships domains of loneliness, and academic anxiety were found to be predictors of suicidality (p < 0.05). Suicide is a significant problem among university students. Mental health professionals and policymakers need to enhance the use and access to mental health services and seek psychological counselling to combat the increasingly observed phenomenon of suicide among young people.
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Affiliation(s)
| | | | | | | | - Ali Alhaiti
- Department of Nursing, College of Applied Sciences, Almaarefa University, Riyadh, Saudi Arabia
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Stockner M, Plattner B, Innamorati M, Hofer A, Burian I, Fronthaler M, Giupponi G, Huber M, Macina C, Perwanger V, Pycha R, Schaller G, Conca A. How Mental Health and Suicidality Changed during the COVID-19 Pandemic: A Longitudinal Study in the General and Psychiatric Population Illustrating Risk and Protective Factors. Behav Sci (Basel) 2024; 14:386. [PMID: 38785877 PMCID: PMC11117826 DOI: 10.3390/bs14050386] [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: 03/17/2024] [Revised: 04/20/2024] [Accepted: 04/28/2024] [Indexed: 05/25/2024] Open
Abstract
The COVID-19 pandemic has led to an increase in psychological distress in the general population, but contrasting results have been shown regarding its impact on psychological symptoms in clinical and non-clinical samples. Consequently, the aim of the present study was to compare in a longitudinal design (September-November 2020 and February-April 2021) the mental health outcomes of a clinical and a control sample and to determine the implications of various risk and protective factors in this regard. A total of 234 participants from the general population and 80 psychiatric patients took part in the present online study using the following measurements: the Brief Symptom Checklist (BSCL); Three-Item Loneliness Scale (TILS); Resilience Scale-13 (RS-13); and Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale-Non-Illness (FACIT-Sp Non-Illness). The results show an overall decrease in active suicidal ideation as well as "peace", a subscale of spiritual well-being, as well as increases in passive suicidal activation in the clinical sample, which did not change in the control sample. Psychological symptoms did not significantly change in either group. Significant group effects show an increase in resilience in the clinical sample. Resilience and peace turned out to be protective factors for negative mental health outcomes. However, loneliness, which interestingly increased only in the control sample, was shown to be an overall potential risk factor. Our results highlight the complex implications of the COVID-19 pandemic on the mental health outcomes of different groups in the population, demonstrating the necessity of further research, specifically regarding the risk of active and passive suicidal activation. Highlighted protective factors are discussed in regards to spirituality (i.e., peace), which is not strictly related to religion but rather personal spirituality related to the meaning of situations of one's life, as well as in terms of mental health interventions.
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Affiliation(s)
- Mara Stockner
- Faculty of Medicine and Psychology, Sapienza University of Rome, 00185 Rome, Italy;
| | - Barbara Plattner
- Department of Psychiatry, Sanitary Agency of South Tyrol, General Hospital of Bolzano, 39100 Bolzano, Italy; (B.P.); (A.C.)
| | - Marco Innamorati
- Department of Human Sciences, European University of Rome, 00163 Rome, Italy
| | - Alex Hofer
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Division of Psychiatry I, Medical University Innsbruck, 6020 Innsbruck, Austria
| | - Iuliia Burian
- Department of Psychiatry, General Hospital of Merano, Sanitary Agency of South Tyrol, 39012 Merano, Italy
| | - Martin Fronthaler
- Therapy Center Bad Bachgart, Sanitary Agency of South Tyrol, 39037 Rodengo, Italy
| | - Giancarlo Giupponi
- Department of Psychiatry, Sanitary Agency of South Tyrol, General Hospital of Bolzano, 39100 Bolzano, Italy; (B.P.); (A.C.)
| | - Markus Huber
- Department of Psychiatry, General Hospital of Brunico, Sanitary Agency of South Tyrol, 39031 Brunico, Italy
| | - Christian Macina
- Department of Psychiatry, General Hospital of Brunico, Sanitary Agency of South Tyrol, 39031 Brunico, Italy
| | - Verena Perwanger
- Department of Psychiatry, General Hospital of Merano, Sanitary Agency of South Tyrol, 39012 Merano, Italy
| | - Roger Pycha
- Department of Psychiatry, General Hospital of Bressanone, Sanitary Agency of South Tyrol, 39042 Bressanone, Italy
| | - Gerd Schaller
- Department of Psychiatry, General Hospital of Bressanone, Sanitary Agency of South Tyrol, 39042 Bressanone, Italy
| | - Andreas Conca
- Department of Psychiatry, Sanitary Agency of South Tyrol, General Hospital of Bolzano, 39100 Bolzano, Italy; (B.P.); (A.C.)
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Engels A, Stein J, Riedel-Heller SG, König HH, Konnopka C. Temporal and spatial changes in the provision of mental health care during the COVID-19 pandemic in Germany: a claims-based cohort study on patients with severe mental disorders. Soc Psychiatry Psychiatr Epidemiol 2024; 59:789-797. [PMID: 37831078 PMCID: PMC11087346 DOI: 10.1007/s00127-023-02571-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 09/28/2023] [Indexed: 10/14/2023]
Abstract
PURPOSE Major lockdowns were imposed in Germany from March until May 2020 and from December 2020 until May 2021. We studied the influence of these lockdowns, the strain on intensive care units and the strictness of COVID-19-related containment strategies on the utilization of mental health care among patients with severe mental disorders. METHODS We used health insurance claims data to identify n = 736,972 patients with severe mental disorders shortly before the pandemic and n = 735,816 patients a year earlier. We applied entropy balancing to adjust for baseline differences by district. For a 12-month follow-up, we modeled monthly changes in utilization through meta-analytic models using both the COVID-19 stringency index and intensive care unit cases per 100,000 inhabitants as predictors. Our outcomes were changes in psychiatric hospital days and time treated by outpatient psychiatrists. RESULTS Psychiatric hospital days declined by at least 7.7% in all calender month during the pandemic. Peak reduction rates were observed in April (- 27.9%), May (- 22.3%) 2020 and January 2021 (- 18.3%). Utilization changes were associated with the stringency index and the second lockdown. Time treated by psychiatrists was shorter in April (- 16.2%) and May (- 11.5%) 2020 and in January 2021 (- 10.5%), which was partially offset by higher utilization in June and September 2020. These utilization changes were associated with the stringency index and the strain on intensive care units during both lockdowns. CONCLUSION Hospitals did not maintain the level of utilization during the pandemic, while outpatient psychiatrists adapted more quickly, presumably due to digital and telemedical care.
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Affiliation(s)
- Alexander Engels
- Department of Health Economics and Health Services Research, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Building W37, 20246, Hamburg, Germany
| | - Janine Stein
- Institute for Social Medicine, Occupational Medicine and Public Health, University Medical Center Leipzig, Leipzig, Germany
| | - Steffi G Riedel-Heller
- Institute for Social Medicine, Occupational Medicine and Public Health, University Medical Center Leipzig, Leipzig, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Building W37, 20246, Hamburg, Germany
| | - Claudia Konnopka
- Department of Health Economics and Health Services Research, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Building W37, 20246, Hamburg, Germany.
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Hung WC, Wu CY, Lee MB, Chan CT, Chen CY. Loneliness and suicide risks in the general population before and during first-year COVID-19 in Taiwan. J Formos Med Assoc 2024; 123:510-516. [PMID: 38307799 DOI: 10.1016/j.jfma.2023.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 08/31/2023] [Accepted: 12/25/2023] [Indexed: 02/04/2024] Open
Abstract
PURPOSE Loneliness is a critical issue affecting the general population. Current evidence from national surveys of loneliness is scarce. The study aimed to examine the impact of COVID-19 pandemic on the prevalence of loneliness and its associating suicide risks in Taiwan. METHODS Four annual telephone interview surveys were performed by the Taiwan Suicide Prevention Center in 2015-2017 and 2020 during COVID outbreak. Each year the sample was randomly selected by stratifying the general public in different geographical areas and fulfilled a questionnaire collecting information including loneliness, psychological distress, and suicide risk assessment. All the data were analyzed using SPSS25 analysis. RESULTS A total of 8460 participants were recruited. The average prevalence of loneliness was 12.6 %. Feelings of loneliness was significantly correlated with psychological distress and most risk factors relating to suicide. The odds of loneliness for lifetime suicidal ideation, lifetime suicide attempt, and future suicide intent were 4.9, 5.1, and 9.2, respectively. During the COVID-19 period, loneliness and suicidality demonstrated a noteworthy decline trend, whereas "no one trustworthy to talk to" was the only item that showed significant increase under the pandemic and also impacted on loneliness. CONCLUSION Nearly one in ten Taiwanese people felt lonely before and during COVID-19. Loneliness was closely linked with various suicide risk factors such as lifetime suicide ideation and attempt or future intention. Although psychological distress and suicide risk were not increased during COVID-19, maintaining trustful relationships to seek support appeared to be critical to prevent the risks of loneliness or suicide.
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Affiliation(s)
- Wei-Chieh Hung
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Nursing, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
| | - Chia-Yi Wu
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan; Taiwanese Society of Suicidology & Taiwan Suicide Prevention Center, Taipei, Taiwan.
| | - Ming-Been Lee
- Taiwanese Society of Suicidology & Taiwan Suicide Prevention Center, Taipei, Taiwan; Department of Psychiatry, Shin Kong Wu Ho Su Memorial Hospital, Taipei, Taiwan.
| | - Chia-Ta Chan
- Taiwanese Society of Suicidology & Taiwan Suicide Prevention Center, Taipei, Taiwan; Department of Psychiatry, Shin Kong Wu Ho Su Memorial Hospital, Taipei, Taiwan.
| | - Chun-Ying Chen
- Taiwanese Society of Suicidology & Taiwan Suicide Prevention Center, Taipei, Taiwan.
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8
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Lee J, Wilson J, Oosterhoff B, Shook NJ. Self-quarantining, social distancing, and mental health during the COVID-19 pandemic: A multi wave, longitudinal investigation. PLoS One 2024; 19:e0298461. [PMID: 38408111 PMCID: PMC10896532 DOI: 10.1371/journal.pone.0298461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 01/24/2024] [Indexed: 02/28/2024] Open
Abstract
Social isolation and disconnectedness increase the risk of worse mental health, which might suggest that preventive health measures (i.e., self-quarantining, social distancing) negatively affect mental health. This longitudinal study examined relations of self-quarantining and social distancing with mental health during the COVID-19 pandemic. A U.S. national sample (N = 1,011) completed eight weekly online surveys from March 20, 2020 to May 17, 2020. Surveys assessed self-quarantining, social distancing, anxiety, and depression. Fixed-effect autoregressive cross-lagged models provided a good fit to the data, allowing for disaggregation of between-person and within-person effects. Significant between-person effects suggested those who engaged in more self-quarantining and social distancing had higher anxiety and depression compared to those who engaged in less social distancing and quarantining. Significant within-person effects indicated those who engaged in greater social distancing for a given week experienced higher anxiety and depression that week. However, there was no support for self-quarantining or social distancing as prospective predictors of mental health, or vice versa. Findings suggest a relationship between mental health and both self-quarantining and social distancing, but further longitudinal research is required to understand the prospective nature of this relationship and identify third variables that may explain these associations.
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Affiliation(s)
- Jerin Lee
- University of Connecticut, Storrs, CT, United States of America
| | - Jenna Wilson
- Brigham and Women's Hospital, Boston, MA, United States of America
| | - Benjamin Oosterhoff
- Meadows Mental Health Policy Institute, Dallas, TX, United States of America
| | - Natalie J Shook
- University of Connecticut, Storrs, CT, United States of America
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Lo HKY, Chan JKN, Wong CSM, Wong GHS, Lei JHC, So YK, Fung VSC, Chu RST, Ling R, Chung AKK, Lee KCK, Cheng CPW, Chan WC, Chang WC. Prevalence and correlates of suicidal ideation in the general public during the fifth wave of COVID-19 pandemic in Hong Kong. Front Psychiatry 2024; 14:1252600. [PMID: 38274415 PMCID: PMC10809397 DOI: 10.3389/fpsyt.2023.1252600] [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: 07/04/2023] [Accepted: 12/06/2023] [Indexed: 01/27/2024] Open
Abstract
Introduction Literature reveals increased suicidal ideation in the general population during pandemic. However, few COVID-19 studies comprehensively assessed factors associated with suicidal ideation, and mixed findings were observed. We aimed to examine prevalence and correlates of suicidal ideation in general public during the peak of fifth COVID-19 wave in Hong Kong based on a broad array of relevant measures. Methods This survey assessed 14,709 community-dwelling adults during March 15-April 3, 2022. Comprehensive assessment was administered including socio-demographics, pre-existing mental/physical morbidity, mental-health symptoms, resilience, loneliness, coping strategies, and pandemic-related factors. Presence of suicidal ideation was evaluated by ratings of item 9 on Patient-Health-Questionnaire-9. Results A total of 2,249 (15.3%) participants exhibited suicidal ideation. Multivariable-regression analysis found that being single and unemployed, pre-existing mental disorder, more severe depressive and anxiety symptoms, higher levels of loneliness and engagement in avoidant coping were significantly associated with suicidal ideation. Conversely, attaining tertiary educational level or above, greater resilience and adopting problem-focused coping were associated with lower likelihood of suicidal ideation. Although univariate-analyses revealed that a number of pandemic-related factors were linked to suicidal ideation, none remained significant in the multivariable model. Conclusion A significant proportion of people experienced suicidal ideation during the peak of fifth COVID-19 wave. Risk and protective factors identified would facilitate early identification of high-risk individuals and provision of targeted interventions to minimize suicidal ideation and risk of self-harm. Caution should be exercised due to study limitations of a cross-sectional design which precluded establishing causality among variables, and reliance on self-reported data.
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Affiliation(s)
- Heidi Ka Ying Lo
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Joe Kwun Nam Chan
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Corine Sau Man Wong
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Gabbie Hou Sem Wong
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Janet Hiu Ching Lei
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Yuen Kiu So
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Vivian Shi Cheng Fung
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Ryan Sai Ting Chu
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Rachel Ling
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Albert Kar Kin Chung
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Krystal Chi Kei Lee
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Calvin Pak Wing Cheng
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Wai Chi Chan
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Wing Chung Chang
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
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10
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So WWY, Fong TCT, Woo BPY, Yip PSF. Psychosocial and financial well-being mediated the effects of COVID-19 distress on suicidality: a serial mediation model among Hong Kong young adults. Soc Psychiatry Psychiatr Epidemiol 2024; 59:165-174. [PMID: 37270725 PMCID: PMC10239540 DOI: 10.1007/s00127-023-02501-4] [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: 12/20/2022] [Accepted: 05/24/2023] [Indexed: 06/05/2023]
Abstract
PURPOSE The COVID-19 pandemic has brought significant distress on not only the physical health but also mental health of individuals. The present study investigated the direct and indirect effects from COVID-19 distress to suicidality via psychosocial and financial well-being among young people. METHODS This cross-sectional survey recruited 1472 Hong Kong young people via random sampling in 2021. The respondents completed a phone survey on COVID-19 distress, the four-item Patient Health Questionnaire and items on social well-being, financial well-being, and suicidality. Structural equation modeling (SEM) was conducted to examine the direct and indirect effects of COVID-19 distress on suicidality via psychosocial and financial well-being. RESULTS The direct effect of COVID-19 distress on suicidality was not significant (β = 0.022, 95% CI - 0.097-0.156). The total indirect effect from COVID-19 distress to suicidality was significant and positive (αβγ = 0.150, 95% CI = 0.085-0.245) and accounted for 87% of the total effect (B = 0.172, 95% CI = 0.043-0.341). There were significant specific indirect effects via social well-being and psychological distress, and financial well-being and psychological distress. CONCLUSION The present findings support different pathways from COVID-19 distress to suicidality via functioning in different domains among young people in Hong Kong. Measures are needed to ameliorate the impact on their social and financial well-being to reduce their psychological distress and suicidality.
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Affiliation(s)
- Wendy Wing Yan So
- HKJC Centre for Suicide Research and Prevention, University of Hong Kong, 2/F, HKJC Building for Interdisciplinary Research, Pokfulam, Hong Kong
| | - Ted Chun Tat Fong
- Centre on Behavioral Health, The University of Hong Kong, Pokfulam, Hong Kong
| | - Bowie Po Yi Woo
- HKJC Centre for Suicide Research and Prevention, University of Hong Kong, 2/F, HKJC Building for Interdisciplinary Research, Pokfulam, Hong Kong
| | - Paul Siu Fai Yip
- HKJC Centre for Suicide Research and Prevention, University of Hong Kong, 2/F, HKJC Building for Interdisciplinary Research, Pokfulam, Hong Kong.
- Department of Social Work & Social Administration, University of Hong Kong, Pokfulam, Hong Kong.
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11
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Chen Z, Song X, Lee TMC, Zhang R. The robust reciprocal relationship between loneliness and depressive symptoms among the general population: Evidence from a quantitative analysis of 37 studies. J Affect Disord 2023; 343:119-128. [PMID: 37797753 DOI: 10.1016/j.jad.2023.09.035] [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: 04/10/2023] [Revised: 09/29/2023] [Accepted: 09/30/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND Loneliness has long been associated with depressive symptoms, but there is no evidence on the question of "which comes first". To help us to answer this question, this study conducted a meta-analysis using a cross-lagged formula to examine the reciprocal relations between loneliness and depressive symptoms, as well as potential moderators. METHODS The meta-analytic dataset consisted of 37 studies with sample sizes ranging from 52 to 5991. Effect sizes (including autoregressive effects and lagged coefficients) were included. We computed weighted mean effect sizes for the correlation effect and cross-lagged effect between loneliness and depressive symptoms. We also performed a meta-regression to investigate potential moderators. RESULTS The results showed that loneliness and depressive symptoms reciprocally predicted each other over time with similar effect sizes. There was no moderation of our overall effect size in either direction by time interval between measurements, the proportion of female participants, mean age of the sample, or type of measurement. LIMITATIONS Caution should be taken in drawing final conclusions about the relative strength of reciprocal effects between loneliness and depressive symptoms due to the potential influence of varied research focus in the included studies, which could affect the effect size. CONCLUSIONS These findings advance the study of the relationship between loneliness and depressive symptoms by providing evidence that the link between them is symmetrically reciprocal and robust, which may help clinicians to develop effective intervention methods.
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Affiliation(s)
- Zhijia Chen
- Cognitive control and Brain Healthy Laboratory, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Xiaoqi Song
- Cognitive control and Brain Healthy Laboratory, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Tatia M C Lee
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong; Laboratory of Neuropsychology and Human Neuroscience, The University of Hong Kong, Hong Kong; Center for Brain Science and Brain-Inspired Intelligence, Guangdong-Hong Kong-Macao Greater Bay Area, Guangzhou, China
| | - Ruibin Zhang
- Cognitive control and Brain Healthy Laboratory, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China; Center for Brain Science and Brain-Inspired Intelligence, Guangdong-Hong Kong-Macao Greater Bay Area, Guangzhou, China; Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
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12
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Hwang IT, Fu-Tsung Shaw F, Hsu WY, Liu GY, Kuan CI, Gunnell D, Chang SS. "I Can't See an End in Sight." How the COVID-19 Pandemic May Influence Suicide Risk. CRISIS 2023; 44:458-469. [PMID: 35983713 PMCID: PMC10658636 DOI: 10.1027/0227-5910/a000877] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 06/16/2022] [Accepted: 06/24/2022] [Indexed: 12/12/2022]
Abstract
Background: The COVID-19 pandemic and its consequences may affect population mental health and suicide risk. Aims: To explore the experiences among suicidal individuals who made calls to a suicide prevention hotline and to identify factors and psychological responses that may influence suicide risk. Method: We identified 60 eligible recorded calls to Taiwan's suicide prevention hotline (January 23, 2020-May 31, 2020) and analyzed the transcripts using a framework analysis. Results: We identified three themes: (a) effects of the COVID-19 pandemic on society (impacts on local economies, the fear of contagion, and disruptions caused by outbreak control measures); (b) stress experienced by callers, including increased challenges (financial burden, restricted freedom of movement, interpersonal conflicts, feelings of uncertainty, and education/career interruption) and reduced support (reduced access to health services and social support); and (c) the callers' psychological responses to stress, including anxiety, sleep disturbance, depression, loneliness, hopelessness, and entrapment, which may increase suicide risk. Limitations: Only the experiences among those who sought help by calling the hotline during the early months of the pandemic in 2020 were explored. Conclusion: Our findings revealed the potential process underlying the impact of the COVID-19 pandemic on suicide risk and have implications for prevention and intervention strategies.
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Affiliation(s)
- I-Ting Hwang
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Fortune Fu-Tsung Shaw
- Department of Counseling Psychology and Human Resource Development, National Chi Nan University, Nantou, Taiwan
| | - Wen-Yau Hsu
- Department of Psychology, National Chengchi University, Taipei, Taiwan
- Research Center for Mind, Brain and Learning, National Chengchi University, Taipei, Taiwan
| | - Guang-Yi Liu
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chen-I Kuan
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - David Gunnell
- Centre for Academic Mental Health, Population Health Sciences, University of Bristol, UK
- National Institute of Health and Care Research Biomedical Research Centre at the University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, UK
| | - Shu-Sen Chang
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
- Global Health Program, College of Public Health, National Taiwan University, Taipei, Taiwan
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
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13
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Du W, Jia YJ, Hu FH, Ge MW, Cheng YJ, Qu X, Chen HL. Prevalence of suicidal ideation and correlated risk factors during the COVID-19 pandemic: A meta-analysis of 113 studies from 31 countries. J Psychiatr Res 2023; 166:147-168. [PMID: 37774666 DOI: 10.1016/j.jpsychires.2023.07.040] [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: 03/25/2023] [Revised: 06/12/2023] [Accepted: 07/29/2023] [Indexed: 10/01/2023]
Abstract
The purpose of this study was to estimate the prevalence of suicidal ideation and correlated risk factors during the COVID-19 pandemic. Web of Science (WOS) and PubMed were searched according to a pre-set strategy. A total of 132 studies were identified, 104 of which were included in the meta-analysis. The prevalence of suicidal ideation was approximately 14.7% (95%CI: 12.5%, 16.8%, P < 0.01) in the general population, approximately 22.4% (95%CI: 17.1%, 27.8%, P < 0.01)in adolescents, approximately 21.0% (95%CI: 12.8%, 29.2%, P < 0.01) in psychiatric patients, approximately 20.6% (95%CI: 18.7%, 22.5%, P < 0.01)in university students, approximately 18.9% (95%CI: 8.3%, 29.5%, P < 0.01) in younger adults, approximately 10.6% (95%CI: 1.0%, 20.2%, P = 0.031) in COVID-19 patients and approximately 7.4% (95%CI: 4.3%, 10.5%, P < 0.01) in healthcare workers. The prevalence in North America was approximately 16.0% (95%CI: 13.6%-18.4%, P < 0.001), approximately 14.5% in Asia (95%CI: 9.5%-19.4%, P < 0.001), approximately 10.5% in Europe (95%CI: 8.5%-12.4%, P < 0.001), and approximately 20.5% in South America (95%CI: 19.5%-21.5%, P < 0.001). The following were risk factors which might be correlated with suicidal ideation: severe anxiety symptoms, mild to moderate depression, a strong feeling of loneliness/social isolation, poor sleep quality, having COVID-19-related experience, having quarantine or lockdown experience, being female, being single or divorced, having financial problems and having a history of suicidal ideation/attempt. This article reports the prevalence of suicidal ideation and discussing potential risk factors during the pandemic among general population and vulnerable groups. Early detection and follow-up were necessary for the noteworthy population.
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Affiliation(s)
- Wei Du
- Nantong University Medical School, PR China
| | - Yi Jie Jia
- Nantong University Medical School, PR China
| | | | | | | | - Xin Qu
- School of Medicine, Nantong University, Nantong, Jiangsu, PR China
| | - Hong Lin Chen
- School of Medicine, Nantong University, Nantong, Jiangsu, PR China.
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14
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Ribeiro-Alves M, Lucieri Costa G, Corrêa da Mota J, de Azevedo Cardoso T, Cerezer K, Martini T, Soriano de Sousa MU, Bastos FI, Balanzá-Martínez V, Kapczinski F, De Boni RB. Lifestyle changes during the COVID-19 pandemic in Brazil: results from three consecutive cross-sectional web surveys. BMJ Open 2023; 13:e070328. [PMID: 37423635 DOI: 10.1136/bmjopen-2022-070328] [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: 07/11/2023] Open
Abstract
OBJECTIVE The importance of a healthy lifestyle in preventing morbidity and mortality is well-established. The COVID-19 pandemic brought about significant lifestyle changes globally, but the extent of these changes in the Brazilian population remains unclear. The objective of this study was to evaluate changes in lifestyle among the Brazilian general population during the first year of the pandemic. DESIGN Three consecutive anonymous web surveys were carried out: survey 1 (S1)-April 2020, S2-August 2020 and S3-January 2021. SETTING Brazil. PARTICIPANTS The study included 19 257 (S1), 1590 (S2) and 859 (S3) participants from the general population, who were ≥18 years, of both sexes, with access to the internet, self-reporting living in Brazil and who agreed to participate after reading the informed consent. PRIMARY OUTCOME Lifestyle changes were assessed using the Short Multidimensional Instrument for Lifestyle Evaluation-Confinement (SMILE-C). The SMILE-C assesses lifestyle across multiple domains including diet, substance use, physical activity, stress management, restorative sleep, social support and environmental exposures. We used a combination of bootstrapping and linear fixed-effect modelling to estimate pairwise mean differences of SMILE-C scores overall and by domain between surveys. RESULTS In all the surveys, participants were mostly women and with a high education level. Mean SMILE-C scores were 186.4 (S1), 187.4 (S2) and 190.5 (S3), indicating a better lifestyle in S3 as compared with S1. The pairwise mean differences of the overall SMILE-C scores were statistically significant (p<0.001). We also observed a better lifestyle over time in all domains except for diet and social support. CONCLUSIONS Our findings indicate that individuals from a large middle-income country, such as Brazil, struggled to restore diet and social relationships after 1 year of the pandemic. These findings have implications for monitoring the long-term consequences of the pandemic, as well as future pandemics.
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Affiliation(s)
- Marcelo Ribeiro-Alves
- Laboratório de Pesquisa Clínica em DST-AIDS, Instituto Nacional de Infectologia Evandro Chagas (INI), Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Giovanna Lucieri Costa
- Escola de Medicina e Cirurgia, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Taiane de Azevedo Cardoso
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Keila Cerezer
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Thais Martini
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | | | | | - Flavio Kapczinski
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
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15
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Kuljancic D, Cvjetkovic Bosnjak M, Siladji D, Hinic D, Veskovic D, Janjic N, Ratkovic D, Zivanovic O, Vasic V, Sakic B. The Role of COVID-19-Associated Fear, Stress and Level of Social Support in Development of Suicidality in Patients Diagnosed with Affective and Stress-Induced Psychiatric Disorders during the COVID-19 Pandemic-A Comparative Analysis. Brain Sci 2023; 13:brainsci13050812. [PMID: 37239284 DOI: 10.3390/brainsci13050812] [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: 04/21/2023] [Revised: 05/11/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
Only a few studies seem to address suicidality as an effect of the COVID-19 pandemic in persons previously affected by psychiatric disorders. The relationship between fear and stress caused by the COVID-19 pandemic and the level of social support and suicidality in patients diagnosed with affective and stress-induced psychiatric disorders prior to the onset of the COVID-19 pandemic were investigated. This study was observational and involved 100 participants. The examined period was from April 2020 to April 2022. The Fear of COVID-19 Scale (FCV-19S), the Oslo Social Support Scale 3 (OSSS-3) and general psychiatric interviews were used to obtain data. A statistically significant relationship between the impact of COVID-19-related distress on the occurrence of suicidality and the year of the pandemic χ2(2, N = 100) = 8.347, p = 0.015 was observed. No statistically significant correlation was found between suicidal behavior, stress intensity, fear and the score on the social support scale (p > 0.05). Fear related to the COVID-19 pandemic can only be seen as a contributor to suicidality. Overall, social support does not always act protectively. Previously stressful experiences such as wars, poverty and natural disasters seem to play a significant role in the resilience to each new public health crisis.
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Affiliation(s)
- Dusan Kuljancic
- Medical Faculty, University of Novi Sad, Hajduk Vejkova 3, 21000 Novi Sad, Serbia
- Clinic of Psychiatry, University Clinical Centre of Vojvodina, Hajduk Veljkova 4, 21000 Novi Sad, Serbia
| | - Mina Cvjetkovic Bosnjak
- Medical Faculty, University of Novi Sad, Hajduk Vejkova 3, 21000 Novi Sad, Serbia
- Clinic of Psychiatry, University Clinical Centre of Vojvodina, Hajduk Veljkova 4, 21000 Novi Sad, Serbia
| | - Djendji Siladji
- Medical Faculty, University of Novi Sad, Hajduk Vejkova 3, 21000 Novi Sad, Serbia
- Clinic of Psychiatry, University Clinical Centre of Vojvodina, Hajduk Veljkova 4, 21000 Novi Sad, Serbia
| | - Darko Hinic
- Faculty of Science, Department of Psychology, University of Kragujevac, Radoja Domanovića 12, 34000 Kragujevac, Serbia
| | - Dunja Veskovic
- Medical Faculty, University of Novi Sad, Hajduk Vejkova 3, 21000 Novi Sad, Serbia
- Clinic of Dermatology, University Clinical Centre of Vojvodina, Hajduk Veljkova 4, 21000 Novi Sad, Serbia
| | - Nebojsa Janjic
- Medical Faculty, University of Novi Sad, Hajduk Vejkova 3, 21000 Novi Sad, Serbia
- Clinic of Gastroenterology and Hepatology, University Clinical Centre of Vojvodina, Hajduk Veljkova 4, 21000 Novi Sad, Serbia
| | - Dragana Ratkovic
- Medical Faculty, University of Novi Sad, Hajduk Vejkova 3, 21000 Novi Sad, Serbia
- Clinic of Psychiatry, University Clinical Centre of Vojvodina, Hajduk Veljkova 4, 21000 Novi Sad, Serbia
| | - Olga Zivanovic
- Medical Faculty, University of Novi Sad, Hajduk Vejkova 3, 21000 Novi Sad, Serbia
- Clinic of Psychiatry, University Clinical Centre of Vojvodina, Hajduk Veljkova 4, 21000 Novi Sad, Serbia
| | - Vesna Vasic
- Medical Faculty, University of Novi Sad, Hajduk Vejkova 3, 21000 Novi Sad, Serbia
- Clinic of Psychiatry, University Clinical Centre of Vojvodina, Hajduk Veljkova 4, 21000 Novi Sad, Serbia
| | - Branislav Sakic
- Medical Faculty, University of Novi Sad, Hajduk Vejkova 3, 21000 Novi Sad, Serbia
- Clinic of Psychiatry, University Clinical Centre of Vojvodina, Hajduk Veljkova 4, 21000 Novi Sad, Serbia
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16
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Tachikawa H, Matsushima M, Midorikawa H, Aiba M, Okubo R, Tabuchi T. Impact of loneliness on suicidal ideation during the COVID-19 pandemic: findings from a cross-sectional online survey in Japan. BMJ Open 2023; 13:e063363. [PMID: 37188470 PMCID: PMC10186084 DOI: 10.1136/bmjopen-2022-063363] [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: 05/17/2023] Open
Abstract
OBJECTIVES We aim to reveal how loneliness relates to suicidal ideation following the onset of the COVID-19 pandemic. DESIGN Cross-sectional online survey. SETTING Community cohort study in Japan. PARTICIPANTS The second wave of a large web-based survey, Japan COVID-19 and Society Internet Survey, was conducted in February 2021, and we analysed the data of 6436 men and 5380 women who were aged 20-59 years. MAIN OUTCOME MEASURES The prevalence ratios (PRs) of suicidal ideation due to loneliness, depression, social isolation and decline in income during the pandemic and other sociodemographic and economic information were adjusted in the analysis. STATISTICAL METHODS Estimations were conducted by separating a male and female sample. The survey weight (inverse probability weighting) was applied for analyses, and a Poisson regression model was used with all the potential confounders adjected. RESULTS Overall, 15.1% of male and 16.3% of female participants were found to have had suicidal ideation during the COVID-19 pandemic. Among them, 23% of male and 20% of female participants experienced suicidal ideation for the first time. The results of the Poisson regression suggested that those who were feeling lonely had higher PRs for suicidal ideation (4.83 for men (95% CI, 3.87 to 6.16) and 6.19 for women (95% CI, 4.77 to 8.45)). The relationship between loneliness and suicidal ideation remained robust even after adjusting for depression, although there were declines in PRs. Additionally, the results showed that those who were lonely, and continued to feel lonely during the pandemic, had the highest PRs of suicidal ideation. CONCLUSION Loneliness had both direct and indirect effects on suicidal ideation mediated through depression. Those who felt lonelier during the pandemic had the highest risk of suicidal ideation. It is necessary to adopt national measures focused on providing psychological support to people who feel lonely to prevent them from taking their own lives.
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Affiliation(s)
- Hirokazu Tachikawa
- Department of Disaster and Community Psychiatry, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Midori Matsushima
- Faculty of Humanities and Social Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Haruhiko Midorikawa
- Department of Psychiatry, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
| | - Miyuki Aiba
- Faculty of Human Science, Toyo Gakuen University, Bunkyo-ku, Tokyo, Japan
| | - Ryo Okubo
- Department of Neuropsychiatry, National Hospital Organization Obihiro Hospital, Obihiro, Hokkaido, Japan
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
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17
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Christoffersen LA, Helenius D, Schwinn M, Erikstrup C, Hjalgrim H, Nissen J, Banasik K, Nielsen K, Kaspersen KA, Dinh KM, Bruun MT, Ostrowski SR, Sækmose S, Hansen TF, Werge T, Didriksen M, Pedersen OB. Experience of loneliness during the COVID-19 pandemic: a cross-sectional study of 50 968 adult Danes. BMJ Open 2023; 13:e064033. [PMID: 37185636 PMCID: PMC10151242 DOI: 10.1136/bmjopen-2022-064033] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/17/2023] Open
Abstract
OBJECTIVES To examine the level of loneliness experienced during the COVID-19 pandemic in Denmark and to identify associated behavioural patterns and demographic factors. DESIGN Cross-sectional cohort study. SETTING Includes Danish active and former blood donors. PARTICIPANTS A questionnaire was sent to 124 307 active and former blood donors, of these a total of 50 968 participants completed the study questionnaire (response rate=41%). PRIMARY AND SECONDARY OUTCOME MEASURES Subjective experience of loneliness was measured using the 3-item University of California, Los Angeles Loneliness Scale (UCLA-3). Besides the UCLA-3, the respondents answered items on sociodemographic and economic characteristics, items on precautionary measures taken to avoid COVID-19 infection as well as on COVID-19 anxiety. RESULTS The participants indicated their experienced level of loneliness both before and during the pandemic. Comparing the two reports yielded a mean increase in loneliness scores of 14.1% (p<0.001). Exploratory factor analysis identified the factor well-being, which comprised three questionnaire items related to emotional heath, physical health and happiness. A high score on the factor well-being was associated with reduced levels of loneliness (coefficient=-0.47, 95% CI -0.49 to -0.46)). Furthermore, women were more likely than men to have experienced increased levels of loneliness during the pandemic (coefficient=0.27, 95% CI 0.25 to 0.29). Furthermore, a negative correlation between higher age and change in loneliness score was observed. CONCLUSIONS The findings document an increase in the level of experienced loneliness during the COVID-19 pandemic, particularly affecting individuals with low well-being, women and younger individuals.
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Affiliation(s)
- Lea An Christoffersen
- Institute of Biological Psychiatry, Mental Health Services Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - Dorte Helenius
- Institute of Biological Psychiatry, Mental Health Services Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - Michael Schwinn
- Department of Clinical Immunology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Henrik Hjalgrim
- Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Janna Nissen
- Department of Clinical Immunology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Karina Banasik
- Novo Nordisk Foundation Center for Protein Research, University of Copenhagen, Copenhagen, Denmark
| | - Kaspar Nielsen
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
| | - Kathrine A Kaspersen
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
- Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, Aarhus, Denmark
| | - Khoa M Dinh
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Mie T Bruun
- Department of Clinical Immunology, Odense University Hospital, Odense, Denmark
| | - Sisse R Ostrowski
- Department of Clinical Immunology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Susanne Sækmose
- Department of Clinical Immunology, Zealand University Hospital, Køge, Denmark
| | - Thomas F Hansen
- Novo Nordisk Foundation Center for Protein Research, University of Copenhagen, Copenhagen, Denmark
- Department of Neurology, NeuroGenomic Group, Rigshospitalet, Glostrup, Denmark
| | - Thomas Werge
- Institute of Biological Psychiatry, Mental Health Services Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - Maria Didriksen
- Department of Clinical Immunology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Ole Birger Pedersen
- Department of Clinical Immunology, Zealand University Hospital, Køge, Denmark
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18
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Orsolini L, Longo G, Volpe U. The Mediatory Role of the Boredom and Loneliness Dimensions in the Development of Problematic Internet Use. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4446. [PMID: 36901452 PMCID: PMC10001960 DOI: 10.3390/ijerph20054446] [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: 01/01/2023] [Revised: 02/27/2023] [Accepted: 02/28/2023] [Indexed: 06/18/2023]
Abstract
In recent years, there has been a gradual digitalization of our society, resulting in intensified technology use for daily life activities, including the emergence of problematic Internet use (PIU). Few studies specifically addressed the boredom and loneliness dimensions in mediating the association between depression, anxiety, and stress levels and the onset of PIU. A nationwide population-based cross-sectional case-control study was carried out by recruiting a sample of Italian young people (aged 18-35). Only 1643 participants were selected for the analyses based on the age and the presence versus absence of PIU. Participants were mainly females (68.7%), with a mean age of 21.8 (SD = 1.7). Non-PIU individuals had significantly stable relationships (p = 0.012), siblings (p = 0.044) and lived with their family (p = 0.010), compared to PIU. PIU individuals displayed significantly higher depression, anxiety, and stress, as well as higher loneliness and boredom levels (all p < 0.001), compared to non-PIU. Depressive symptomatology predicted PIU and that their interaction is positively double mediated by boredom and loneliness (ß = 0.3829 (0.0245), 95%CI = 0.3349-0.4309). Our findings suggested that boredom and loneliness dimensions could act as mediators in the association between depressive symptomatology and the likelihood of PIU onset and maintenance.
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19
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Zhu S, Li X, Wong PWC. Risk and protective factors in suicidal behaviour among young people in Hong Kong: A comparison study between children and adolescents ✰. Psychiatry Res 2023; 321:115059. [PMID: 36796255 DOI: 10.1016/j.psychres.2023.115059] [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: 07/03/2022] [Revised: 01/05/2023] [Accepted: 01/14/2023] [Indexed: 02/05/2023]
Abstract
Suicide is the leading cause of death among young people worldwide. Few studies examined the factors of childhood suicidality and compared them with adolescent suicidality to meet their age-specific needs. We examined the similarities and differences in risk and protective factors of children and adolescent suicidality in Hong Kong. A school-based survey with 541 students in grades 4-6 and 3,061 students in grades 7-11 from 15 schools was conducted. We measured the demographic, familial, school, mental health, and psychological factors of suicidality. Hierarchical binary logistic regressions were performed to examine the association between correlates and child and youth suicidality, and the interaction effects of these factors and school-age groups. Approximately 17.51% and 7.84% of secondary school respondents and 15.76% and 8.17% of primary school respondents reported suicidal ideation and attempt, respectively. Common correlates for suicidal ideation were depression, bullying, loneliness, self-compassion, and growth mindset, while those for suicide attempt were depression and bullying. Secondary school respondents with higher life satisfaction reported less suicidal ideation, while primary school respondents with higher self-control reported fewer suicide attempts. In conclusion, we recommended recognizing the factors of suicidal ideation and attempt in children and adolescents to tailor preventive strategies in a culturally sensitive manner.
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Affiliation(s)
- Shimin Zhu
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Room GH348, Kowloon, Hong Kong; Mental Health Research Centre, The Hong Kong Polytechnic University, Hong Kong.
| | - Xiaomin Li
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Room GH348, Kowloon, Hong Kong
| | - Paul W C Wong
- Department of Social Work and Social Administration, The University of Hong Kong, Room 511, JC Teaching Tower, Centennial Campus, Pokfulam, Hong Kong.
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20
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Eib C, Bernhard-Oettel C. Entrepreneurial action and eudaimonic well-being in a crisis:
Insights from entrepreneurs in Sweden during the COVID-19
pandemic. ECONOMIC AND INDUSTRIAL DEMOCRACY 2023:0143831X231154753. [PMCID: PMC9950027 DOI: 10.1177/0143831x231154753] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
Based on transactional stress theory, this article provides an empirical glimpse into how entrepreneurs in Sweden have experienced the COVID-19 pandemic. The authors investigated the impact of two crisis-induced stressors (unpredictability, loneliness) on two aspects of entrepreneurial success (business and personal success) through the indirect effect of eudaimonic well-being. They examined the role of crisis-related entrepreneurial actions (applying for government financial support, engaging in online business activities). Results from a sample of entrepreneurs operating in Sweden in the summer of 2020 revealed that unpredictability and loneliness were negatively related to business and personal success via eudaimonic well-being. Results for the moderating effects of the crisis-related entrepreneurial actions revealed mixed findings. The results provide valuable insights into the mechanisms that tie entrepreneurial stressors and opportunities for action to eudaimonic well-being, and in turn, entrepreneurial success in the early days of the crisis caused by the pandemic.
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Affiliation(s)
- Constanze Eib
- Department of Psychology, Uppsala University,
Sweden
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21
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Lewis KC, Roche MJ, Brown F, Tillman JG. Intolerance of aloneness as a prospective predictor of suicidal ideation during COVID-19. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2023; 11:100469. [PMID: 36618605 PMCID: PMC9811853 DOI: 10.1016/j.jadr.2023.100469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 09/26/2022] [Accepted: 01/03/2023] [Indexed: 01/06/2023] Open
Abstract
Background Social distancing has been essential in mitigating the spread of the SARS-CoV-2 virus. Evidence regarding the impact of reduced social contact on mental health during the pandemic has been mixed, however, with studies suggesting that enduring personality traits and affect regulation impairments may together increase risk for suicidal distress during periods of lockdown. The present study utilized experience sampling and longitudinal follow-up methods to evaluate intolerance of aloneness (IA) as a predictor of suicidal ideation (SI) during the pandemic. Methods A general adult sample (n = 184) recruited online completed an 8-week experience sampling protocol via smartphone between April and September 2020. A subset of n = 69 participants completed a follow-up assessment of SI six months after the initial study period. Results IA was associated with suicidal ideation both at baseline and prospectively during the experience sampling period. Individuals with greater IA were more likely to report SI in the short-term context of reduced daily in-person social contact. Higher IA at baseline furthermore prospectively predicted the occurrence of SI during the 6-month follow-up period. Limitations The sample was relatively homogenous in terms of demographic characteristics and excluded individuals with limited access to communication technology. While statistical models accounted for current mental health treatment status, other factors that were not assessed (such as adverse events or psychiatric symptoms in non-treatment-seeking subjects) may have contributed to the development of SI. Conclusions Findings enhance understanding of how personality-based factors may contribute to suicide risk during periods of social distancing, informing both clinical treatment, risk assessment, and public health intervention approaches.
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Affiliation(s)
- Katie C. Lewis
- Erikson Institute for Education and Research, Austen Riggs Center, 25 Main St, Stockbridge, MA, 01262, USA,Corresponding author at: Erikson Institute for Education, Research, and Advocacy, Austen Riggs Center, 25 Main Street, Stockbridge, MA 01262, USA
| | - Michael J. Roche
- Department of Psychology, West Chester University, 700 South High St, West Chester, PA, 19383, USA
| | - Fiona Brown
- Erikson Institute for Education and Research, Austen Riggs Center, 25 Main St, Stockbridge, MA, 01262, USA
| | - Jane G. Tillman
- Erikson Institute for Education and Research, Austen Riggs Center, 25 Main St, Stockbridge, MA, 01262, USA
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22
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Murayama H, Suda T, Nakamoto I, Shinozaki T, Tabuchi T. Changes in social isolation and loneliness prevalence during the COVID-19 pandemic in Japan: The JACSIS 2020-2021 study. Front Public Health 2023; 11:1094340. [PMID: 36875370 PMCID: PMC9978762 DOI: 10.3389/fpubh.2023.1094340] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 01/18/2023] [Indexed: 02/18/2023] Open
Abstract
Objective The recent coronavirus disease 2019 (COVID-19) outbreak has changed people's social connections with others and society. This study aimed to describe changes in the prevalence of social isolation and loneliness by demographic characteristics, socioeconomic status, health conditions, and outbreak situations in residential prefectures among Japanese people between the first year (2020) and the second year (2021) of the COVID-19 pandemic. Methods We used data from the Japan COVID-19 and Society Internet Survey (JACSIS) study, a large-scale web-based nationwide survey conducted with 53,657 participants aged 15-79 years in August-September 2020 and September-October 2021 (25,482 and 28,175 participants, respectively). Social isolation was defined as less than once a week in the total frequency of contact with family members or relatives who were living apart and friends/neighbors. Loneliness was assessed using the three-item University of California, Los Angeles (UCLA) Loneliness Scale (score range, 3-12). We used generalized estimating equations to estimate the prevalence of social isolation and loneliness in each year and the difference in prevalence between 2020 and 2021. Results The weighted proportion (95% confidence interval) of social isolation in the total sample was 27.4% (25.9, 28.9) in 2020 and 22.7% (21.9, 23.5) in 2021, representing a change of -4.7 percentage points (-6.3, -3.1). The weighted mean scores of the UCLA Loneliness Scale were 5.03 (4.86, 5.20) in 2020 and 5.86 (5.81, 5.91) in 2021, representing a change of 0.83 points (0.66, 1.00). The detailed trend changes for social isolation and loneliness were noted in the demographic subgroups of socioeconomic status, health conditions, and outbreak situation in the residential prefecture. Conclusion Social isolation decreased from the first to the second year of the COVID-19 pandemic, whereas loneliness increased. Assessing the COVID-19 pandemic's impact on social isolation and loneliness contributes to understanding who was particularly vulnerable during the pandemic.
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Affiliation(s)
- Hiroshi Murayama
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Takumi Suda
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.,Department of Global Health Research, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Isuzu Nakamoto
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.,Department of Gerontological and Home Healthcare Nursing, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | | | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
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23
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Does loneliness lie within? Personality functioning shapes loneliness and mental distress in a representative population sample. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2023. [DOI: 10.1016/j.jadr.2023.100486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
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24
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Pouquet M, Launay T, Rivière M, Chan-Chee C, Urbain F, Coulombel N, Bardoulat I, Pons R, Guerrisi C, Blanchon T, Hanslik T, Younes N. Trends and characteristics of attempted and completed suicides reported to general practitioners before vs during the COVID-19 pandemic in France: Data from a nationwide monitoring system, 2010-2022. PLoS One 2022; 17:e0278266. [PMID: 36520827 PMCID: PMC9754243 DOI: 10.1371/journal.pone.0278266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 11/12/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Most studies published to date have investigated the impact of the COVID-19 pandemic on suicidal acts using hospital data. Trends from primary care in a country such as France are crucial, as individuals may not consult hospital services after suicide attempts (SAs) but rather see their general practitioner (GP). OBJECTIVES We aimed to evaluate whether the incidence and characteristics of SAs and completed suicides (CSs) reported to French GPs were different during the COVID-19 pandemic than those of before. METHODS AND FINDINGS We conducted a retrospective observational study using data from a nationwide monitoring system, the French Sentinel Network (FSN). All SAs and CSs reported by GPs to the FSN from January 1, 2010, to March 10, 2022 were included. The annual incidence rates (IRs) and the characteristics of SAs and CSs during the pandemic (March 11, 2020, to March 10, 2022) were compared to those of before. In total, 687 SAs and 169 CSs were included. The IRs remained stable for SAs and CSs before and during the pandemic (overlap in confidence intervals). The mean IRs were 52 (95%CI = 44; 57) per 100,000 inhabitants for SAs during the pandemic versus 47 [36; 57] during the pre-pandemic period (p = 0.49), and 5 (95%CI = 2; 9) for CSs versus 11 [6; 16] (p = 0.30). During the pandemic, SA were slightly different from those before in terms of age and occupational status (young/students and older/retirees over-represented), history of consultation and expression of suicidal ideas to GP (more frequent), and CS in terms of occupational status (students over-represented) (p<0.05). CONCLUSION The COVID-19 pandemic had no major effect on the overall incidence of SAs and CSs reported to French GPs. However, more suicidal acts were reported among younger and older individuals. Suicidal patients and GPs have adapted by improving the expression of suicidal ideas.
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Affiliation(s)
- Marie Pouquet
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
- * E-mail:
| | - Titouan Launay
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
| | - Mathieu Rivière
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
| | | | - Frédéric Urbain
- Unité de Formation et de Recherche des Sciences de la Santé Simone-Veil, Université de Versailles Saint-Quentin-en-Yvelines, Versailles, France
| | | | | | - Romain Pons
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
| | - Caroline Guerrisi
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
| | - Thierry Blanchon
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
| | - Thomas Hanslik
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
- Unité de Formation et de Recherche des Sciences de la Santé Simone-Veil, Université de Versailles Saint-Quentin-en-Yvelines, Versailles, France
- Service de Médecine Interne, Hôpital Ambroise-Paré, Assistance Publique - Hôpitaux de Paris, Boulogne-Billancourt, France
| | - Nadia Younes
- Unité de Formation et de Recherche des Sciences de la Santé Simone-Veil, Université de Versailles Saint-Quentin-en-Yvelines, Versailles, France
- Université Versailles Saint Quentin, Université Paris Saclay, Team DevPsy, Villejuif, France
- Centre Hospitalier Versailles, Service Hospitalo-Universitaire de Psychiatrie de l’Adulte et d’Addictologie, Le Chesnay, France
- Université Versailles-Saint-Quentin-en-Yvelines, Versailles, France
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25
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Poor mental health is associated with loneliness and boredom during Covid-19-related restriction periods in patients with pre-existing depression. J Affect Disord 2022; 319:446-461. [PMID: 36184986 PMCID: PMC9482872 DOI: 10.1016/j.jad.2022.09.040] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 09/11/2022] [Accepted: 09/15/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND In 2020-2021, many European countries put in place temporary lockdown measures due to the increase in COVID-19 cases, although such measures have negative psychological effects. As pre-existing mental disorders are a risk factor of negative psychological consequences during pandemics, it is important to identify specific predictors of psychological distress caused by restrictive measures in patients with history of depressive episodes. The aims of this study were i) to determine whether depressive, anxious symptomatology and suicidal ideation (i.e. mental health outcomes) were influenced by stay-at-home orders, and ii) to identify the psychosocial dimensions that influenced these mental health outcomes in patients with pre-existing depression during/after COVID-19-related restrictions. METHODS This study concerned 296 psychiatric patients with history of depressive episode in the 2 years before the COVID-19 outbreak. Participants received a computerized form to self-measure depression, suicidal ideation, and anxiety (5 times during 2020-2021, two lockdown periods and three non- lockdown periods). Loneliness, boredom, habits, substance consumption, and access to psychiatric care also were self-reported. RESULTS Loneliness and boredom were independent risk factors of anxiety and depression, and their changes dynamically affected the psychological state. Suicidal ideation was mostly driven by depressive symptomatology. CONCLUSIONS Our results highlight the need to target these dimensions in the most vulnerable patients in order to prevent the psychological consequences of the repeated COVID-19-related restrictions.
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26
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Falla-Aliabadi S, Heydari A, Fatemi F, Yoshany N, Lotfi MH, Sarsangi A, Hanna F. Impact of social and cultural factors on incidence, transmission and control of Coronavirus disease in Iran: a qualitative study. BMC Public Health 2022; 22:2352. [PMID: 36522718 PMCID: PMC9753076 DOI: 10.1186/s12889-022-14805-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 12/05/2022] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION COVID-19 pandemic has had mixed reactions from nations, people and governments about ways to cope with, prevent and control the disease. The current study identifies social, cultural and policy factors affecting the incidence and control of Coronavirus disease in Iran. METHODS A qualitative study consists of content analysis as well as the views of 20 experienced and knowledgeable subjects specialized in social and cultural health management. The data were gathered using three semi-structured interviews and then continued by 17 semi-structured interviews. Data analysis was done using Graneheim approach. After each interview, the recorded audio files transcript and reviewed. Then codes extracted and divided to categories and sub-categories. RESULTS There are distinct social and cultural factors in coping with Coronavirus disease. These consisted of three categories of governance, individual and community related factors. A total of 17 subcategories and 215 primary codes that were extracted from the text of interviews as variables of the study and in relation to the research question. Ten subdomains of governance including vaccination, political issues, knowledge, support services, administrative services, transportation, health and treatment, culturalization, legislation and, managerial and financial policies impacted the spread and mitigation of the pandemic at various levels. CONCLUSION The management of pandemics requires a comprehensive capacity for identifying and determining social and cultural criteria. A healthy partnership between governments and the community may be required to remove unnecessary obstacles that hinder public health attempt to alleviate the risk. The obtained criteria and indicators from this study may be utilized by policy makers in an attempt to strengthen protocols for mitigating pandemics. Further studies may be warranted to confirm these findings.
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Affiliation(s)
- Saeed Falla-Aliabadi
- Department of Health in Emergencies and Disasters, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Accident Prevention and Crisis Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Ahad Heydari
- Department of Health in Disaster and Emergencies, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Farin Fatemi
- Social Determinant of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Nooshin Yoshany
- Department of Health education and Promotion, Social Determinants of Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Hasan Lotfi
- Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Alireza Sarsangi
- GIS and Remote Sensing Department, University of Tehran, Tehran, Iran
| | - Fahad Hanna
- Program of Public Health, Torrens University Australia, Melbourne, VIC Australia
- Higher Education College, Chisholm Institute, Dandenong, VIC Australia
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27
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Ornell F, Benzano D, Borelli WV, Narvaez JCDM, Moura HF, Passos IC, Sordi AO, Schuch JB, Kessler FHP, Scherer JN, von Diemen L. Differential impact on suicide mortality during the COVID-19 pandemic in Brazil. REVISTA BRASILEIRA DE PSIQUIATRIA (SAO PAULO, BRAZIL : 1999) 2022; 44:628-634. [PMID: 35839315 PMCID: PMC9851756 DOI: 10.47626/1516-4446-2022-2581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 03/12/2022] [Indexed: 02/01/2023]
Abstract
OBJECTIVES To compare suicide rates observed in Brazil after the onset of the COVID-19 pandemic with the estimated rate based on suicide deaths between 2010 and 2020, and identify sociodemographic variables associated with this outcome. METHODS Ecological time-series study. Data were obtained from Brazilian Unified Health System Department of Information Technology (DATASUS), with the structural break of the data set in March 2020. The number of actual suicides observed and the number of expected suicides if there were no COVID-19 pandemic were analyzed through bayesian structural time series modeling. RESULTS The overall incidence of suicides in Brazil remained stable after the start of the COVID-19 pandemic compared to what would be expected. However, there was a significant increase in suicide deaths among women (6.9%) and older adult (9.1%). Analysis by macro-regions of the country showed significant increases in suicide deaths in the Center-West (7.4%), Northeast (5.7%), and Southeast (10%). Stratified analyses revealed differences according to age, sex, education, and skin color. CONCLUSIONS Despite stability in the overall number of suicides, this phenomenon occurs heterogeneously among different population groups and regions of Brazil. Rates have increased in populations with a history of poor access to health, which may have been more severely impacted by the pandemic.
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Affiliation(s)
- Felipe Ornell
- Centro de Pesquisa em Álcool e Drogas, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil,Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Faculdade de Medicina, UFRGS, Porto Alegre, RS, Brazil,Correspondence: Felipe Ornell, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Centro de Pesquisa em Álcool e Drogas, Rua Ramiro Barcelos, 2350, Santa Cecilia, CEP 90410-004, Porto Alegre, RS, Brazil. E-mail:
| | - Daniela Benzano
- Centro de Pesquisa em Álcool e Drogas, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil,Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Faculdade de Medicina, UFRGS, Porto Alegre, RS, Brazil
| | | | | | - Helena Ferreira Moura
- Centro de Pesquisa em Álcool e Drogas, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil,Departamento de Clínica Médica, Faculdade de Medicina, Universidade de Brasília, Brasília, DF, Brazil
| | - Ives Cavalcante Passos
- Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Faculdade de Medicina, UFRGS, Porto Alegre, RS, Brazil
| | - Anne Orgler Sordi
- Centro de Pesquisa em Álcool e Drogas, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Jaqueline Bohrer Schuch
- Centro de Pesquisa em Álcool e Drogas, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil,Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Faculdade de Medicina, UFRGS, Porto Alegre, RS, Brazil
| | - Felix Henrique Paim Kessler
- Centro de Pesquisa em Álcool e Drogas, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil,Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Faculdade de Medicina, UFRGS, Porto Alegre, RS, Brazil
| | - Juliana Nichterwitz Scherer
- Centro de Pesquisa em Álcool e Drogas, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil,Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Faculdade de Medicina, UFRGS, Porto Alegre, RS, Brazil,Programa de Pós-Graduação em Saúde Coletiva, Universidade do Vale do Rio dos Sinos, São Leopoldo, RS, Brazil
| | - Lisia von Diemen
- Centro de Pesquisa em Álcool e Drogas, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil,Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Faculdade de Medicina, UFRGS, Porto Alegre, RS, Brazil
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Contribution of perceived loneliness to suicidal thoughts among French university students during the COVID-19 pandemic. Sci Rep 2022; 12:16833. [PMID: 36207381 PMCID: PMC9540057 DOI: 10.1038/s41598-022-21288-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 09/26/2022] [Indexed: 11/08/2022] Open
Abstract
Restrictive measures during the COVID-19 epidemic have led to increased levels of loneliness, especially among university students, although the influence on suicidal thoughts remains unclear. In this cross-sectional study of 1913 French university students, those with the highest level of loneliness had a fourfold increased risk of suicidal thoughts. Perceived loneliness should be incorporated into suicide risk assessment, and assistance in coping with loneliness should be considered as a means of reducing suicidal risk in vulnerable groups, like university students.
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29
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Nomura K, Yamazaki T, Maeda E, Hirayama J, Ono K, Fushimi M, Mishima K, Yamamoto F. Longitudinal survey of depressive symptoms among university students during the COVID-19 pandemic in Japan. Front Psychol 2022; 13:863300. [PMID: 36092090 PMCID: PMC9454255 DOI: 10.3389/fpsyg.2022.863300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 08/02/2022] [Indexed: 11/13/2022] Open
Abstract
While changes in response to the different stages of the pandemic remain unknown, this study investigated the longitudinal impact of the COVID-19 pandemic on depressive symptoms in Japanese university students and identified factors associated with new onset of depression and suicidal ideation. Two surveys were conducted at one university in Akita, Japan, during the first COVID-19 outbreak period (T1: May–June 2020) and 1 year later (T2: March–May 2021). Moderate depressive symptoms were defined as a Patient Health Questionnaire-9 score ≥ 10 and suicide-related ideation score ≥ 1 on question 9 of the questionnaire. Among 985 students who completed surveys in T1 and T2, participants with moderate depressive symptoms and suicide-related ideation increased from 11 to 17% and from 5.8 to 11.8%, respectively. Among 872 students at risk after excluding those with moderate depressive symptoms at T1, 103 students (11.8%) developed moderate depressive symptoms at T2. Among the 928 students at risk, after excluding those who had suicidal ideation at T1, 79 (8.5%) developed suicidal ideation. Multivariate logistic modeling revealed financial insecurity and academic performance as risk factors (ps < 0.01), while having someone to consult about worries was a coping factor for depressive symptoms and suicidal ideation (ps < 0.001). Our findings demonstrated that socioenvironmental factors may determine depressive symptoms of university students.
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Affiliation(s)
- Kyoko Nomura
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan
- *Correspondence: Kyoko Nomura,
| | - Teiichiro Yamazaki
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan
| | - Eri Maeda
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan
| | - Junko Hirayama
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan
| | - Kyoichi Ono
- Department of Cell Physiology, Akita University Graduate School of Medicine, Akita, Japan
| | | | - Kazuo Mishima
- Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan
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30
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Suicide Risk During COVID-19: Correlates of Peri-pandemic Suicidal Ideation Controlling for Pre-pandemic Ideation. Int J Cogn Ther 2022; 15:321-335. [PMID: 36000089 PMCID: PMC9389485 DOI: 10.1007/s41811-022-00140-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/29/2022] [Indexed: 11/21/2022]
Abstract
Suicide is a public health concern which warrants considerable attention, especially with the onset of the COVID-19 pandemic. The current study sought to examine the relationship between behavioral, psychological, and economic impacts of COVID-19 on suicidal ideation severity in a sample of 90 undergraduate students who completed a comprehensive survey on mental health in January 2020 and were re-assessed in April, June, and July of 2020. Multiple regression analyses showed that changes in experience of loneliness, loneliness due to social distancing, pandemic-related concerns, COVID contagion anxiety, and quarantining alone positively and significantly correlated with peri-pandemic suicidal ideation severity after accounting for pre-pandemic suicidal ideation and sexual orientation, while time spent talking to romantic partner and time spent talking to friends and family were negatively correlated. Findings provide insights into the psychological and behavioral effects of social distancing measures and the pandemic, but further research is needed to generalize findings.
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31
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Weziak-Bialowolska D, Bialowolski P, Lee MT, Chen Y, VanderWeele TJ, McNeely E. Prospective Associations Between Social Connectedness and Mental Health. Evidence From a Longitudinal Survey and Health Insurance Claims Data. Int J Public Health 2022; 67:1604710. [PMID: 35755953 PMCID: PMC9218058 DOI: 10.3389/ijph.2022.1604710] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 05/16/2022] [Indexed: 12/13/2022] Open
Abstract
Objectives: Evidence on social stimuli associated with mental health is based mostly on self-reported health measures. We aimed to examine prospective associations between social connectedness and clinical diagnosis of depression and of anxiety. Methods: Longitudinal observational data merged with health insurance data comprising medical information on diagnosis of depression and anxiety were used. 1,209 randomly sampled employees of a US employer provided data for the analysis. Robust Poisson regression models were used. Multiple imputation was conducted to handle missing data on covariates. Results: Better social connectedness was associated with lower risks of subsequently diagnosed depression and anxiety, over a one-year follow-up period. Reports of feeling lonely were associated with increased risks of depression and anxiety. Association between community-related social connectedness and subsequent diagnosis of depression, but not of anxiety, was found. The associations were independent of demographics, socioeconomic status, lifestyle, and work characteristics. They were also robust to unmeasured confounding, missing data patterns, and prior health conditions. Conclusion: Social connectedness may be an important factor for reducing risks of depression and anxiety. Loneliness should be perceived as a risk factor for depression and anxiety.
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Affiliation(s)
- Dorota Weziak-Bialowolska
- Department of Environmental Health, School of Public Health, Harvard University, Boston, MA, United States.,Institute for Quantitative Social Science, Harvard University, Cambridge, MA, United States.,Center for Evaluation and Analysis of Public Policies, Faculty of Philosophy, Jagiellonian University, Kraków, Poland
| | - Piotr Bialowolski
- Department of Environmental Health, School of Public Health, Harvard University, Boston, MA, United States.,Institute for Quantitative Social Science, Harvard University, Cambridge, MA, United States.,Department of Economics, Kozminski University, Warsaw, Poland
| | - Matthew T Lee
- Institute for Quantitative Social Science, Harvard University, Cambridge, MA, United States
| | - Ying Chen
- Institute for Quantitative Social Science, Harvard University, Cambridge, MA, United States.,Department of Epidemiology, School of Public Health, Harvard University, Boston, MA, United States
| | - Tyler J VanderWeele
- Institute for Quantitative Social Science, Harvard University, Cambridge, MA, United States.,Department of Epidemiology, School of Public Health, Harvard University, Boston, MA, United States
| | - Eileen McNeely
- Department of Environmental Health, School of Public Health, Harvard University, Boston, MA, United States
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Does social support prevent suicidal ideation in women and men? Gender-sensitive analyses of an important protective factor within prospective community cohorts. J Affect Disord 2022; 306:157-166. [PMID: 35304236 DOI: 10.1016/j.jad.2022.03.031] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 01/18/2022] [Accepted: 03/10/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Suicidal ideation and behavior constitute important public mental health issues. In this study, we examined whether social integration prevents suicidal ideation over time and whether gender modifies this association. METHODS Data from the Gutenberg Health Study (population-based representative community sample in midwest Germany) and the Study of Health in Pomerania (population-based cohort study in northeast Germany) were used. Participants reporting low social support were compared to those receiving middle or high social support. Within a longitudinal study design, we calculated multiple logistic regression models including interaction terms and relevant covariates to test whether gender modified the association of social support and suicidal ideation. RESULTS Suicidal ideation was present in 7.4% (N = 982) of the pooled cohorts' 13,290 participants. More women (8.6%, N = 565) than men (6.2%, N = 417) reported suicidal ideation. Middle or high social support was associated with a lower probability to report suicidal ideation five years later after controlling for sociodemographic factors, living situation, and cohort (OR = 0.42, 95%-CI = 0.34-0.52). Male gender was negatively related to suicidal ideation, but no statistically significant interaction of gender and social support was found (ratio of ORs = 1.00, 95%-CI = 0.73-1.35). LIMITATIONS The number of people reporting suicidal ideation in the SHIP study was small, especially for men. Suicidal ideation was measured using a single item. CONCLUSIONS Social support is an important protective factor in preventing suicidal ideation for both women and men. Future research should further clarify gender-specific effects of family variables in suicidal ideation and test similar predictive models of suicidal behavior.
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Liem A, Prawira B, Magdalena S, Siandita MJ, Hudiyana J. Predicting self-harm and suicide ideation during the COVID-19 pandemic in Indonesia: a nationwide survey report. BMC Psychiatry 2022; 22:304. [PMID: 35488326 PMCID: PMC9051849 DOI: 10.1186/s12888-022-03944-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 04/19/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND It is estimated that 77.0% of suicide cases occurred in low-and-middle-income countries (LMICs), which would increase because of the COVID-19 pandemic and socioeconomic inequity. However, there is lack of reports on this topic from LMICs, especially during the pandemic. Therefore, this nationwide study aimed to explore self-harm and suicide ideation and its predictive variables during the pandemic in Indonesia as a MIC with the highest COVID-19 fatality rate in Asia. METHODS Non-random sampling online survey was conducted nationwide between 25 May and 16 June 2021. The collected data were demographic variables (i.e. age group), loneliness from social isolation using The UCLA Loneliness Scale Six Items (ULS-6), and self-harm and suicide ideation using item 9 of The Patient Health Questionnaire-9 (PHQ-9). Predictive model was analyzed using hierarchical logistic regression. RESULTS A total of 5211 participants from all 34 provinces in Indonesia completed the survey. Among 39.3% of them reported self-harm and suicide ideation during the pandemic, which significantly correlated with loneliness. The predictive variables associated with the likelihood of self-harm and suicide ideation were age, residence, job, religion, sex-gender, sexual orientation, HIV status, disability status, and loneliness. The predictive model showed a significant goodness-of-fit to the observed data (x2 [ (15)] = 1803.46, p < .001), RN2 = .40. CONCLUSION Four out of 10 Indonesians experienced self-harm and suicide ideation during the COVID-19 pandemic, particularly people within the age range of 18-24, living in the Java Island, unemployed/student/retired and freelancer, women, members of minority and marginalized communities, and experience of loneliness during the pandemic.
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Affiliation(s)
- Andrian Liem
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Selangor, Malaysia.
| | | | | | | | - Joevarian Hudiyana
- grid.9581.50000000120191471Faculty of Psychology, Universitas Indonesia, Depok, Jawa Barat Indonesia
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Akdeniz S, Gültekin Ahçı Z. The role of cognitive flexibility and hope in the relationship between loneliness and psychological adjustment: a moderated mediation model. EDUCATIONAL AND DEVELOPMENTAL PSYCHOLOGIST 2022. [DOI: 10.1080/20590776.2022.2050460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- Seher Akdeniz
- Faculty of Social and Humanity Science, Psychology Department, KTO Karatay University, Konya, Turkey
| | - Zeynep Gültekin Ahçı
- Faculty of Social and Humanity Science, Psychology Department, KTO Karatay University, Konya, Turkey
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de Moraes F, de Baumont A, Dreher CB, Gauer G, Manfro GG. Psychiatric outcomes and overall functioning in healthcare students during the first wave of the COVID-19 pandemic: a cross-sectional study. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2022; 45:e20210416. [PMID: 35259292 PMCID: PMC10416255 DOI: 10.47626/2237-6089-2021-0416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 02/28/2022] [Indexed: 11/20/2022]
Abstract
INTRODUCTION There is evidence that the coronavirus disease 2019 (COVID-19) pandemic impacted students on health care courses, including evidence of associations between anxiety or depression and inadequate coping mechanisms or unhealthy habits. However, little is known about possible predictors of mental health or psychiatric symptoms in Brazilian health care students during this period. OBJECTIVE To evaluate possible factors associated with anxiety and depressive symptoms, used to measure psychiatric outcomes, and quality of life, used as a parameter of overall functionality, in Brazilian students on health care courses during the COVID-19 pandemic. METHODS A cross-sectional study was conducted with Brazilian students on health care courses from May to December 2020. Participants were recruited through social media and answered a 71-item open online questionnaire exploring demographic characteristics and personal behavior during the pandemic, anxiety, depression, and quality of life. We searched for variables potentially associated with psychiatric symptoms and mental health in these individuals using Poisson regression models. RESULTS Multivariate models showed depression and anxiety were associated with poor quality of life and medication abuse was associated with greater anxiety and poor quality of life. Psychotherapy was an effective coping strategy for anxiety and meditation or mindfulness practice and physical activity improved the students' quality of life. CONCLUSIONS Our study presents important information about the factors associated with psychological impacts of the COVID-19 pandemic and strategies for coping with them that should be helpful to reflect on and for designing appropriate interventions.
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Affiliation(s)
- Flávia de Moraes
- Programa de Transtornos de AnsiedadeHospital de Clínicas de Porto AlegreUniversidade Federal do Rio Grande do SulPorto AlegreRSBrazil Programa de Transtornos de Ansiedade, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
- Faculdade de PsicologiaUFRGSPorto AlegreRSBrazil Faculdade de Psicologia, UFRGS, Porto Alegre, RS, Brazil.
| | - Angelica de Baumont
- Programa de Transtornos de AnsiedadeHospital de Clínicas de Porto AlegreUniversidade Federal do Rio Grande do SulPorto AlegreRSBrazil Programa de Transtornos de Ansiedade, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
- Programa de Pós-Graduação em Psiquiatria e Ciências do ComportamentoUFRGSPorto AlegreRSBrazil Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, UFRGS, Porto Alegre, RS, Brazil.
| | - Carolina Blaya Dreher
- Programa de Transtornos de AnsiedadeHospital de Clínicas de Porto AlegreUniversidade Federal do Rio Grande do SulPorto AlegreRSBrazil Programa de Transtornos de Ansiedade, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
- Programa de Pós-Graduação em Psiquiatria e Ciências do ComportamentoUFRGSPorto AlegreRSBrazil Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, UFRGS, Porto Alegre, RS, Brazil.
| | - Gustavo Gauer
- Programa de Pós-Graduação em PsicologiaUFRGSPorto AlegreRSBrazil Programa de Pós-Graduação em Psicologia, UFRGS, Porto Alegre, RS, Brazil.
| | - Gisele Gus Manfro
- Programa de Transtornos de AnsiedadeHospital de Clínicas de Porto AlegreUniversidade Federal do Rio Grande do SulPorto AlegreRSBrazil Programa de Transtornos de Ansiedade, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
- Programa de Pós-Graduação em Psiquiatria e Ciências do ComportamentoUFRGSPorto AlegreRSBrazil Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, UFRGS, Porto Alegre, RS, Brazil.
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Wu CY, Lee MB, Huong PTT, Chan CT, Chen CY, Liao SC. The impact of COVID-19 stressors on psychological distress and suicidality in a nationwide community survey in Taiwan. Sci Rep 2022; 12:2696. [PMID: 35177670 PMCID: PMC8854558 DOI: 10.1038/s41598-022-06511-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 01/28/2022] [Indexed: 12/18/2022] Open
Abstract
COVID-19 stressors and psychological stress response are important correlates of suicide risks under the COVID-19 pandemic. This study aimed to investigate the prevalence of COVID-19 stress, its impact on mental health and associated risk factors among the general population during the outbreak of COVID-19 in July 2020 throughout Taiwan. A nationwide population-based survey was conducted using a computer-assisted telephone interview system with a stratified, proportional randomization method for the survey. The questionnaire comprised demographic variables, psychological distress assessed by the five-item Brief Symptom Rating Scale and independent psychosocial variables including COVID-19 stressors, loneliness, suicidality, and health-related self-efficacy. In total, 2094 respondents completed the survey (female 51%). The COVID-19 stress was experienced among 45.4% of the participants, with the most prevalent stressors related to daily life and job/financial concerns. Higher levels of suicidality, loneliness, and a lower level of self-efficacy had significantly higher odds of having COVID-19 stress. The structural equation model revealed that COVID-19 stress was moderately associated with psychological distress and mediated by other psychosocial risk factors. The findings call for more attention on strategies of stress management and mental health promotion for the public to prevent larger scales of psychological consequences in future waves of the COVID-19 pandemic.
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Affiliation(s)
- Chia-Yi Wu
- School of Nursing, National Taiwan University College of Medicine, Taipei, Taiwan.
- Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan.
- Taiwanese Society of Suicidology & Taiwan Suicide Prevention Center, Taipei, Taiwan.
- School of Nursing, National Taiwan University College of Medicine, 1, Jen-Ai Road Section 1, Taipei, 10051, Taiwan.
| | - Ming-Been Lee
- Taiwanese Society of Suicidology & Taiwan Suicide Prevention Center, Taipei, Taiwan
- Department of Psychiatry, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
- Department of Psychiatry, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Pham Thi Thu Huong
- School of Nursing, National Taiwan University College of Medicine, Taipei, Taiwan
- Faculty of Nursing and Midwifery, Hanoi Medical University, Hanoi, Vietnam
- National Institute of Mental Health, Bach Mai Hospital, Hanoi, Vietnam
| | - Chia-Ta Chan
- Taiwanese Society of Suicidology & Taiwan Suicide Prevention Center, Taipei, Taiwan
- Department of Psychiatry, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Chun-Yin Chen
- Taiwanese Society of Suicidology & Taiwan Suicide Prevention Center, Taipei, Taiwan
| | - Shih-Cheng Liao
- Taiwanese Society of Suicidology & Taiwan Suicide Prevention Center, Taipei, Taiwan
- Department of Psychiatry, National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
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Wang Y, Warmenhoven H, Feng Y, Wilson A, Guo D, Chen R. The relationship between childhood trauma and suicidal ideation, the mediating role of identification of all humanity, indifference and loneliness. J Affect Disord 2022; 299:658-665. [PMID: 34942226 DOI: 10.1016/j.jad.2021.12.052] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/27/2021] [Accepted: 12/18/2021] [Indexed: 01/25/2023]
Abstract
BACKGROUND Research shows that childhood trauma has a detrimental impact on an individual's health, including suicidal ideation. In order to intervene with suicidal ideation, it is necessary to study the impact of childhood trauma on emotional and social functioning. This study explored the relationship between childhood trauma and suicidal ideation from the perspectives of indifference, identification with all humanity, and loneliness. METHODS A total number of 8,452 college students completed the study. Childhood trauma was measured by the short form of Childhood Trauma Questionnaire (CTQ-SF). The Identification With All Humanity scale (IWAH) was used to measure individual's ability to identify or not identify with humanity. For indifference, we used the Inventory of Callous-Unemotional Traits, and Loneliness was assessed by the Loneliness Scale. The relationship of indifference, identification with all humanity, and loneliness were explored to further understand the relationship between childhood trauma and suicidal ideation's correlations, regression analysis, and path analysis were employed for data analysis. RESULTS Childhood trauma was positively correlated with indifference, loneliness, and suicidal ideation, and negatively correlated with identification with all humanity (r = -0.140∼0.335, p < .001). Suicidal ideation was positively correlated with indifference and loneliness, and negatively correlated with identification with all humanity (r = -0.082∼0.260, p < .001). The results indicated that childhood trauma leads to indifference, which increases loneliness, and results in suicidal ideation (β = 0.073∼0.335, p < 0.001). If an individual with childhood trauma were to gain more recognition from social groups, this would reduce their loneliness and suicidal ideation (β = -0.125∼0.228, p < 0.001). DISCUSSION Individuals with childhood trauma were more likely to display apathy, including non-emotional behavior. This makes individuals lonelier and may increase suicidal ideation. However, if individuals are further recognized by others and social groups within their environment it is possible to intervene in this process.
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Affiliation(s)
- Yuanyuan Wang
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, and China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China; Division of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, United Kingdom.
| | - Helmut Warmenhoven
- Division of Humanities and Social Sciences, Beijing Normal University-Hong Kong Baptist University United International College, Zhuhai, China
| | - Yi Feng
- Mental Health Center, Central University of Finance and Economics, Beijing, China; Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Amanda Wilson
- Division of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, United Kingdom
| | - Dandan Guo
- Department of Clinical Psychology, The Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, China
| | - Runsen Chen
- Vanke School of Public Health, Tsinghua University, Beijing, China.
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Mann F, Wang J, Pearce E, Ma R, Schlief M, Lloyd-Evans B, Ikhtabi S, Johnson S. Loneliness and the onset of new mental health problems in the general population. Soc Psychiatry Psychiatr Epidemiol 2022; 57:2161-2178. [PMID: 35583561 PMCID: PMC9636084 DOI: 10.1007/s00127-022-02261-7] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 02/18/2022] [Indexed: 12/27/2022]
Abstract
PURPOSE Loneliness is associated with poor health including premature mortality. There are cross-sectional associations with depression, anxiety, psychosis, and other mental health outcomes. However, it is not known whether loneliness is causally linked with the new onset of mental health problems in the general population. Longitudinal studies are key to understanding this relationship. We synthesized evidence from longitudinal studies investigating the relationship between loneliness and new onset of mental health problems, in the general population. METHOD We systematically searched six electronic databases, unpublished sources, and hand-searched references, up to August 2021. We conducted a meta-analysis of eight independent cohorts and narrative synthesis of the remaining studies. RESULTS We included 32 studies, of which the majority focused on depression. Our narrative synthesis found most studies show loneliness at baseline which is associated with the subsequent new onset of depression. The few studies on anxiety and self-harm also showed a positive association. Our meta-analysis found a pooled adjusted odds ratio of 2.33 (95% CI 1.62-3.34) for risk of new onset depression in adults who were often lonely compared with people who were not often lonely. This should be interpreted with caution given evidence of heterogeneity. CONCLUSION Loneliness is a public mental health issue. There is growing evidence it is associated with the onset of depression and other common mental health problems. Future studies should explore its impact across the age range and in more diverse populations, look beyond depression, and explore the mechanisms involved with a view to better informing appropriate interventions.
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Affiliation(s)
- Farhana Mann
- Division of Psychiatry, University College London, Wing B, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK.
| | - Jingyi Wang
- School of Public Health Shanghai, Fudan University, Shanghai, China
| | - Eiluned Pearce
- Division of Psychiatry, University College London, Wing B, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Ruimin Ma
- Department of Psychological Medicine, Kings College London, London, UK
| | - Merle Schlief
- Division of Psychiatry, University College London, Wing B, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Brynmor Lloyd-Evans
- Division of Psychiatry, University College London, Wing B, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Sarah Ikhtabi
- Division of Psychiatry, University College London, Wing B, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Sonia Johnson
- Division of Psychiatry, University College London, Wing B, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
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Efstathiou V, Stefanou MI, Siafakas N, Makris M, Tsivgoulis G, Zoumpourlis V, Spandidos DA, Smyrnis N, Rizos E. Suicidality and COVID-19: Suicidal ideation, suicidal behaviors and completed suicides amidst the COVID-19 pandemic (Review). Exp Ther Med 2022; 23:107. [PMID: 34976149 PMCID: PMC8674972 DOI: 10.3892/etm.2021.11030] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 11/22/2021] [Indexed: 12/14/2022] Open
Abstract
Since the outbreak of the coronavirus 2019 (COVID-19) pandemic, there has been widespread concern that social isolation, financial stress, depression, limited or variable access to health care services and other pandemic-related stressors may contribute to an increase in suicidal behaviors. In patients who have recovered from COVID-19, an increased risk of developing suicidal behaviors may be noted, while post-COVID syndrome comprises another potential risk factor contributing to increased suicidal behaviors. Despite the initial alarming predictions for an increase in suicide rates due to the COVID-19 pandemic, the majority of published studies to date suggest that experienced difficulties and distress do not inevitably translate into an increased number of suicide-related deaths, at least not in the short-term. Nevertheless, the long-term mental health effects of the COVID-19 pandemic have yet to be unfolded and are likely to remain for a long period of time. Suicide prevention and measures aiming at promoting well-being and mitigating the effects of COVID-19 on mental health, particularly among vulnerable groups, should thus be a priority for healthcare professionals and policymakers amidst the evolving COVID-19 pandemic.
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Affiliation(s)
- Vasiliki Efstathiou
- Second Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, ‘Attikon’ University General Hospital, Athens 12462, Greece
| | - Maria-Ioanna Stefanou
- Second Department of Neurology, Medical School, National and Kapodistrian University of Athens, ‘Attikon’ University General Hospital, Athens 12462, Greece
| | - Nikolaos Siafakas
- Clinical Microbiology Laboratory, Medical School, National and Kapodistrian University of Athens, ‘Attikon’ University General Hospital, Athens 12462, Greece
| | - Michael Makris
- Allergy Unit, Medical School, National and Kapodistrian University of Athens, ‘Attikon’ University General Hospital, Athens 12462, Greece
| | - Georgios Tsivgoulis
- Second Department of Neurology, Medical School, National and Kapodistrian University of Athens, ‘Attikon’ University General Hospital, Athens 12462, Greece
- Department of Neurology, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Vassilios Zoumpourlis
- Biomedical Applications Unit, Institute of Chemical Biology, National Hellenic Research Foundation (NHRF), Athens 11635, Greece
| | - Demetrios A. Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, Heraklion 71003, Greece
| | - Nikolaos Smyrnis
- Second Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, ‘Attikon’ University General Hospital, Athens 12462, Greece
| | - Emmanouil Rizos
- Second Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, ‘Attikon’ University General Hospital, Athens 12462, Greece
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Razali S, Saw JA, Hashim NA, Raduan NJN, Tukhvatullina D, Smirnova D, Fountoulakis KN. Suicidal behaviour amid first wave of COVID-19 pandemic in Malaysia: Data from the COVID-19 mental health international (COMET-G) study. Front Psychiatry 2022; 13:998888. [PMID: 36329914 PMCID: PMC9622798 DOI: 10.3389/fpsyt.2022.998888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 09/12/2022] [Indexed: 12/04/2022] Open
Abstract
During the COVID-19 pandemic, numerous social and life changes were implemented to curb the spread of the disease. The effect of lockdown and isolation predisposes the general population to various psychological health concerns. The existing determinants of suicidal behaviour were further added with social isolation, financial stress, depression, and other pandemic-related stressors. Hence, our study aimed to investigate suicidal behaviour and the associated factors among Malaysians during the COVID-19 pandemic. It is a cross-sectional online questionnaire survey that used convenient sampling, where the survey was disseminated to the public via Google Forms through social media during the first wave of the COVID-19 pandemic in Malaysia. This study is also part of a large international COVID-19 mental health international study for the general population (COMET-G). This research revealed concerns about issues related to suicidal behaviours during the beginning of the COVID-19 pandemic. Suicidal behaviours were associated with depression, sex, marital status, educational level, employment type, residential area, number of people living together, number of children, and family dynamics. The pandemic effects from psychological, social, and economic perspectives will definitely take more time for recovery. Future prevention and protection are needed especially for the highly at-risk group on top of the general population in any future unforeseen circumstances of the pandemic.
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Affiliation(s)
- Salmi Razali
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia.,Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA (UiTM), Sungai Buloh, Selangor, Malaysia.,Maternofetal and Embryo Research Group (MatE), Universiti Teknologi MARA (UiTM), Sungai Buloh, Selangor, Malaysia
| | - Jo Anne Saw
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Nurul Azreen Hashim
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Nor Jannah Nasution Raduan
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Dina Tukhvatullina
- Centre for Global Public Health, Institute of Population Health Sciences, Queen Mary University of London, London, United Kingdom
| | - Daria Smirnova
- International Centre for Education and Research in Neuropsychiatry (ICERN), Samara State Medical University, Samara, Russia.,Department of Psychiatry, Narcology, Psychotherapy and Clinical Psychology, Samara State Medical University, Samara, Russia
| | - Konstantinos N Fountoulakis
- 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki Greece, Thessaloniki, Greece
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Ishikawa H, Kato M, Kiuchi T. Declines in health literacy and health-related quality of life during the COVID-19 pandemic: a longitudinal study of the Japanese general population. BMC Public Health 2021; 21:2180. [PMID: 34837972 PMCID: PMC8627295 DOI: 10.1186/s12889-021-12092-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 10/25/2021] [Indexed: 12/23/2022] Open
Abstract
Background During the coronavirus disease 2019 (COVID-19) pandemic, the importance of health literacy (HL) was addressed by public health researchers. We longitudinally examined the changes in general HL and health-related quality of life (HRQOL) between immediately before the COVID-19 outbreak and 1 year later, and how general HL before the outbreak was related to changes in HRQOL in the Japanese general population. Methods Among the Japanese residents aged 20–79 years who participated in our previous study in 2017, 826 were followed-up via self-administered questionnaires in January 2020 and February 2021, for the purposes of this study. The HRQOL was measured using the SF-8, a short version of the SF-36 Health Survey, and general HL was measured using the short form of the European Health Literacy Survey Questionnaire (HL-SF12) in the 2020 and 2021 surveys. Results The physical and mental dimensions of HRQOL as well as general HL declined significantly from immediately before the COVID-19 outbreak to 1 year later (p = .010, p < .001 and p < .001, respectively). The decline in HRQOL, especially the mental dimension, was more significant among women. A lower economic status was also related to a greater decline in HRQOL (p = .026 for the physical dimension and p = .012 for the mental dimension). Higher general HL before the COVID-19 outbreak was associated with a lesser decline in HRQOL in both the physical and mental dimensions (p = .040 and p < .001, respectively) after controlling for possible confounding variables such as gender and economic status. Conclusions Healthcare support is crucial for vulnerable populations during and after the pandemic. General HL may be important for attenuating the decline in HRQOL, by enabling effective use of health information and adaptive behaviors toward health threats. Further studies are needed to better understand the association between HL and HRQOL.
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Affiliation(s)
- Hirono Ishikawa
- Graduate School of Public Health, Teikyo University, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan.
| | - Mio Kato
- Graduate School of Public Health, Teikyo University, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan
| | - Takahiro Kiuchi
- Department of Health Communication, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
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Gender-specific associations of loneliness and suicidal ideation in a representative population sample: Young, lonely men are particularly at risk. J Affect Disord 2021; 294:63-70. [PMID: 34274789 DOI: 10.1016/j.jad.2021.06.085] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 06/28/2021] [Accepted: 06/30/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Loneliness has been related to negative physical and mental health outcomes including suicidal ideation (SI). However, it is not clear whether loneliness is equally important for SI in women and men and in individuals of all age groups. METHODS Participants were a representative population sample (N=2,450) comprising the entire adult age range (18-95 years). Participants filled out established questionnaires (UCLA Three-Item Loneliness Scale, Beck Scale for Suicide Ideation, Patient Health Questionnaire-4). We tested a multiple linear regression model of SI (controlling for income, living alone, and mental distress) with interaction terms (loneliness x gender, loneliness x age, gender x age, loneliness x gender x age). We also investigated women and men separately. RESULTS Women and men did not differ regarding mean levels of SI, but women reported more loneliness. Loneliness was related to SI regardless of participants' gender (β=.410; p<.001). Gender-specific analyses showed that the association of loneliness and SI was especially strong among younger men (loneliness x age within the male sample: β=-.149; p=.014). Living in a shared household was negatively associated with SI in men (β=-.072; p=.019), but not in women. LIMITATIONS The cross-sectional study design does not allow for interpretations regarding the direction of effects. CONCLUSIONS Besides similarities, the study indicated gender-specific potential risk- and protective factors, i.e. age and living together with others. Young men who report loneliness could be at particularly high risk for suicidal ideation. Gender- and age-specific approaches can contribute to a more precise identification of vulnerable groups in the population.
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Heinze N, Hussain SF, Castle CL, Godier-McBard LR, Kempapidis T, Gomes RSM. The Long-Term Impact of the COVID-19 Pandemic on Loneliness in People Living With Disability and Visual Impairment. Front Public Health 2021; 9:738304. [PMID: 34568266 PMCID: PMC8458570 DOI: 10.3389/fpubh.2021.738304] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 07/30/2021] [Indexed: 12/28/2022] Open
Abstract
Background: There has been growing concern about the impact of restrictions put in place to contain the coronavirus pandemic on loneliness, particularly in individuals with disabilities. This study explored the longitudinal impact of the pandemic on loneliness in these individuals, with a focus on those living with visual impairment (VI). Methods: An online survey was conducted in April-2020 and repeated in March 2021 to explore current life circumstances, health-related behaviours, sleep (Pittsburgh Sleep Quality Index) and social well-being, including state anxiety (State-Trait Anxiety Index) and loneliness (UCLA Loneliness scale). A convenience sample of 602 participants completed the first survey. Participants who agreed to be re-contacted were invited to take part in the follow-up survey. Results: Data is presented for the 160 participants who completed both timepoints. At both timepoints, median loneliness was significantly higher in participants with disabilities and those with VI than in participants with no disabilities. While there was no significant change in loneliness in any of the three subgroups, participants with VI experienced the largest increase in median loneliness. Loneliness was associated with having a mental health condition and higher levels of state anxiety at both timepoints. Conclusions: Individuals with disabilities such as VI experienced consistently higher levels of loneliness than those with no disabilities throughout the pandemic. While loneliness remained relatively stable in individuals with no disabilities, it increased, albeit to a non-significant level, in those with disabilities and particularly those with VI. Interventions designed to alleviate loneliness may benefit from addressing state anxiety.
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Affiliation(s)
- Nikki Heinze
- Research and Innovation, Blind Veterans UK, London, United Kingdom
- BRAVO VICTOR, Research, London, United Kingdom
| | - Syeda F. Hussain
- Research and Innovation, Blind Veterans UK, London, United Kingdom
- BRAVO VICTOR, Research, London, United Kingdom
| | - Claire L. Castle
- Research and Innovation, Blind Veterans UK, London, United Kingdom
- BRAVO VICTOR, Research, London, United Kingdom
| | - Lauren R. Godier-McBard
- Veterans and Families Institute for Military Social Research, Anglia Ruskin University, Chelmsford, United Kingdom
| | - Theofilos Kempapidis
- Research and Innovation, Blind Veterans UK, London, United Kingdom
- BRAVO VICTOR, Research, London, United Kingdom
| | - Renata S. M. Gomes
- Research and Innovation, Blind Veterans UK, London, United Kingdom
- BRAVO VICTOR, Research, London, United Kingdom
- Northern Hub for Veterans and Military Families Research, Department of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
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