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Szanto K, Prigerson HG, Stahl ST. Is Social Connection the Solution for Reducing Widower Suicide in Late Life? Am J Geriatr Psychiatry 2024; 32:832-834. [PMID: 38448306 DOI: 10.1016/j.jagp.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 02/16/2024] [Indexed: 03/08/2024]
Affiliation(s)
- Katalin Szanto
- Department of Psychiatry (KS, STS), University of Pittsburgh School of Medicine, Pittsburgh, PA.
| | - Holly G Prigerson
- Cornell Center for Research on End-of-Life Care, Department of Radiology, Department of Medicine (HGP), Weill Cornell Medicine, NYC, NY
| | - Sarah T Stahl
- Department of Psychiatry (KS, STS), University of Pittsburgh School of Medicine, Pittsburgh, PA
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Hedna K, Sigström R, Johnell K, Waern M. Determinants of suicidal behavior in dementia: A Swedish national register-based study. Int Psychogeriatr 2024; 36:415-426. [PMID: 37642016 DOI: 10.1017/s1041610223000583] [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] [Indexed: 08/31/2023]
Abstract
OBJECTIVES To examine predictors of suicidal behavior (SB) in adults aged 75 years and above with dementia. DESIGN Longitudinal national register-based study. PARTICIPANTS AND SETTING Swedish residents aged ≥75 years with dementia identified in the Swedish Dementia Registry (SveDem) between 1 January 2007 and 31 December 2017 (N = 59 042) and followed until 31 December 2018. Data were linked with numerous national registers using personal identity numbers. MEASUREMENTS Outcomes were nonfatal self-harm and suicide. Fine and Gray regression models were used to investigate demographics, comorbidities, and psychoactive medications associated with fatal and nonfatal SB. RESULTS Suicidal behavior was observed in 160 persons after dementia diagnosis; 29 of these died by suicide. Adjusted sub-hazard ratio (aSHRs) for SB was increased in those who had a previous episode of self-harm (aSHR = 14.42; 95% confidence interval [CI] = 7.06-29.46), those with serious depression (aSHR = 4.33, 95%CI = 2.94-6.4), and in those born outside Sweden (aSHR = 1.53; 95% CI = 1.03-2.27). Use of hypnotics or anxiolytics was also associated with a higher risk of SB; use of antidepressants was not. Milder dementia and higher frailty score also increased risk of SB. Risk was decreased in those who received home care (aSHR = 0.52; 95%CI = 0.38-0.71) and in the oldest group (aSHR = 0.35; 95%CI = 0.25-0.49). CONCLUSION In addition to established targets for suicidal behavior prevention (improved identification and treatment of depression and previous self-harm), several new risk factors were suggested. There is a need for innovative public health strategies to meet the needs of older dementia patients with a foreign background. Home care may have a potential positive effect to prevent SB in people with dementia, but this needs to be further explored.
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Affiliation(s)
- Khedidja Hedna
- AgeCap Center, Department of Psychiatry and Neurochemistry, Gothenburg University, Gothenburg, Sweden
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Statistikkonsulterna Väst AB, Gothenburg, Sweden
| | - Robert Sigström
- AgeCap Center, Department of Psychiatry and Neurochemistry, Gothenburg University, Gothenburg, Sweden
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Department of Cognition and Old Age Psychiatry, Gothenburg, Sweden
| | - Kristina Johnell
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Margda Waern
- AgeCap Center, Department of Psychiatry and Neurochemistry, Gothenburg University, Gothenburg, Sweden
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Psychosis Clinic, Gothenburg, Sweden
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3
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Hynes DM, Niederhausen M, Chen JI, Shahoumian TA, Rowneki M, Hickok A, Shepherd-Banigan M, Hawkins EJ, Naylor J, Teo A, Govier DJ, Berry K, McCready H, Osborne TF, Wong E, Hebert PL, Smith VA, Bowling CB, Boyko EJ, Ioannou GN, Iwashyna TJ, Maciejewski ML, O'Hare AM, Viglianti EM, Bohnert ASB. Risk of Suicide-Related Outcomes After SARS-COV-2 Infection: Results from a Nationwide Observational Matched Cohort of US Veterans. J Gen Intern Med 2024; 39:626-635. [PMID: 37884839 PMCID: PMC10973286 DOI: 10.1007/s11606-023-08440-9] [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: 09/18/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND Negative mental health-related effects of SARS-COV-2 infection are increasingly evident. However, the impact on suicide-related outcomes is poorly understood, especially among populations at elevated risk. OBJECTIVE To determine risk of suicide attempts and other self-directed violence (SDV) after SARS-COV-2 infection in a high-risk population. DESIGN We employed an observational design supported by comprehensive electronic health records from the Veterans Health Administration (VHA) to examine the association of SARS-COV-2 infection with suicide attempts and other SDV within one year of infection. Veterans with SARS-COV-2 infections were matched 1:5 with non-infected comparators each month. Three periods after index were evaluated: days 1-30, days 31-365, and days 1-365. PARTICIPANTS VHA patients infected with SARS-COV-2 between March 1, 2020 and March 31, 2021 and matched non-infected Veteran comparators. MAIN MEASURES Suicide attempt and other SDV events for the COVID-19 and non-infected comparator groups were analyzed using incidence rates per 100,000 person years and hazard ratios from Cox regressions modeling time from matched index date to first event. Subgroups were also examined. KEY RESULTS 198,938 veterans with SARS-COV-2 (COVID-19 group) and 992,036 comparators were included. Unadjusted one-year incidence per 100,000 for suicide attempt and other SDV was higher among the COVID-19 group: 355 vs 250 and 327 vs 235, respectively. The COVID-19 group had higher risk than comparators for suicide attempts: days 1-30 hazard ratio (HR) = 2.54 (CI:2.05, 3.15), days 31-365 HR = 1.30 (CI:1.19, 1.43) and days 1-365 HR = 1.41 (CI:1.30, 1.54), and for other SDV: days 1-30 HR = 1.94 (CI:1.51, 2.49), days 31-365 HR = 1.32 (CI:1.20, 1.45) and days 1-365 HR = 1.38 (CI:1.26, 1.51). CONCLUSIONS COVID-19 patients had higher risks of both suicide attempts and other forms of SDV compared to uninfected comparators, which persisted for at least one year after infection. Results support suicide risk screening of those infected with SARS-COV-2 to identify opportunities to prevent self-harm.
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Affiliation(s)
- Denise M Hynes
- Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System (HCS), Portland, OR, USA.
- College of Health, and Center for Quantitative Life Sciences, Oregon State University, Corvallis, OR, USA.
- School of Nursing, Oregon Health & Science University (OHSU), Portland, OR, USA.
| | - Meike Niederhausen
- Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System (HCS), Portland, OR, USA
- OHSU-Portland State University School of Public Health, OHSU, Portland, OR, USA
| | - Jason I Chen
- Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System (HCS), Portland, OR, USA
- Department of Psychiatry, OHSU, Portland, OR, USA
| | | | - Mazhgan Rowneki
- Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System (HCS), Portland, OR, USA
| | - Alex Hickok
- Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System (HCS), Portland, OR, USA
| | - Megan Shepherd-Banigan
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA HCS, Durham, NC, USA
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Eric J Hawkins
- Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound HCS, Seattle, WA, USA
- Center of Excellence in Substance Addiction Treatment and Education, VA Puget Sound HCS, Seattle, WA, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Jennifer Naylor
- School of Medicine, Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
- Education and Clinical Center, VISN 6 Mental Illness Research, Durham, NC, USA
- Durham VA HCS, Durham, NC, USA
| | - Alan Teo
- Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System (HCS), Portland, OR, USA
- Department of Psychiatry, OHSU, Portland, OR, USA
| | - Diana J Govier
- Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System (HCS), Portland, OR, USA
- OHSU-Portland State University School of Public Health, OHSU, Portland, OR, USA
| | - Kristin Berry
- Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound HCS, Seattle, WA, USA
| | - Holly McCready
- Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System (HCS), Portland, OR, USA
- Department of Psychiatry, OHSU, Portland, OR, USA
| | - Thomas F Osborne
- VA Palo Alto HCS, Palo Alto, CA, USA
- Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA
| | - Edwin Wong
- Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound HCS, Seattle, WA, USA
| | - Paul L Hebert
- Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound HCS, Seattle, WA, USA
| | - Valerie A Smith
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA HCS, Durham, NC, USA
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
- Department of Medicine, Duke University, Durham, NC, USA
| | - C Barrett Bowling
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA HCS, Durham, NC, USA
- Department of Medicine, Duke University, Durham, NC, USA
- Durham VA Geriatric Research Education and Clinical Center, Durham VA HCS, Durham, NC, USA
| | - Edward J Boyko
- Seattle Epidemiologic Research Information Center, VA Puget Sound HCS, Seattle, WA, USA
| | - George N Ioannou
- Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound HCS, Seattle, WA, USA
- Division of Gastroenterology, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Theodore J Iwashyna
- Departments of Medicine and Health Policy and Management, Johns Hopkins University, Baltimore, MD, USA
- Center for Clinical Management Research, VA Ann Arbor HCS, Ann Arbor, MI, USA
| | - Matthew L Maciejewski
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA HCS, Durham, NC, USA
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Ann M O'Hare
- Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound HCS, Seattle, WA, USA
- Hospital and Specialty Medicine Service, VA Puget Sound HCS, Seattle, WA, USA
- University of Washington, Seattle, WA, USA
| | - Elizabeth M Viglianti
- Center for Clinical Management Research, VA Ann Arbor HCS, Ann Arbor, MI, USA
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Amy S-B Bohnert
- Center for Clinical Management Research, VA Ann Arbor HCS, Ann Arbor, MI, USA
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA
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Solomonov N. Improving social reward responsivity and social connectedness in psychotherapies for late-life depression: Engage & Connect as an example. Psychiatry Res 2023; 329:115469. [PMID: 37783093 PMCID: PMC10841452 DOI: 10.1016/j.psychres.2023.115469] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 08/23/2023] [Accepted: 09/06/2023] [Indexed: 10/04/2023]
Abstract
Psychotherapies are effective in reducing late-life depression. Yet, about half of patients remain depressed at treatment end. Advances in neuroscience can inform simplified interventions that target key brain networks impacted by depression. Behavioral activation therapies that increase social connectedness may improve social reward responsivity and alter abnormalities of the Positive Valence System (PVS). Engage & Connect is an example for a scalable and simple neuroscience-informed psychotherapy, aimed to improve PVS functions and social reward responsivity by increasing engagement in rewarding social activities. Interventions that improve social reward responsivity can be promising first-line treatments for late-life depression in the community.
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Affiliation(s)
- Nili Solomonov
- Weill Cornell Institute of Geriatric Psychiatry, Weill Cornell Medicine, New York, NY, USA.
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5
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Solomonov N, Green J, Quintana A, Lin J, Ognyanova K, Santillana M, Druckman JN, Baum MA, Lazer D, Gunning FM, Perlis RH. A 50-state survey study of thoughts of suicide and social isolation among older adults in the United States. J Affect Disord 2023; 334:43-49. [PMID: 37086804 PMCID: PMC10751855 DOI: 10.1016/j.jad.2023.04.038] [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: 01/02/2023] [Revised: 03/26/2023] [Accepted: 04/14/2023] [Indexed: 04/24/2023]
Abstract
BACKGROUND We aimed to characterize the prevalence of social disconnection and thoughts of suicide among older adults in the United States, and examine the association between them in a large naturalistic study. METHODS We analyzed data from 6 waves of a fifty-state non-probability survey among US adults conducted between February and December 2021. The internet-based survey collected the PHQ-9, as well as multiple measures of social connectedness. We applied multiple logistic regression to analyze the association between presence of thoughts of suicide and social disconnection. Exploratory analysis, using generalized random forests, examined heterogeneity of effects across sociodemographic groups. RESULTS Of 16,164 survey respondents age 65 and older, mean age was 70.9 (SD 5.0); the cohort was 61.4 % female and 29.6 % male; 2.0 % Asian, 6.7 % Black, 2.2 % Hispanic, and 86.8 % White. A total of 1144 (7.1 %) reported thoughts of suicide at least several days in the prior 2 week period. In models adjusted for sociodemographic features, households with 3 or more additional members (adjusted OR 1.73, 95 % CI 1.28-2.33) and lack of social supports, particularly emotional supports (adjusted OR 2.60, 95 % CI 2.09-3.23), were independently associated with greater likelihood of reporting such thoughts, as was greater reported loneliness (adjusted OR 1.75, 95 % CI 1.64-1.87). The effects of emotional support varied significantly across sociodemographic groups. CONCLUSIONS Thoughts of suicide are common among older adults in the US, and associated with lack of social support, but not with living alone. TRIAL REGISTRATION NA.
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Affiliation(s)
- Nili Solomonov
- Weill Cornell Institute of Geriatric Psychiatry, Weill Cornell Medicine, New York, NY, United States of America
| | - Jon Green
- Northeastern University, Boston, MA, United States of America
| | - Alexi Quintana
- Northeastern University, Boston, MA, United States of America
| | - Jennifer Lin
- Northwestern University, Evanston, IL, United States of America
| | | | - Mauricio Santillana
- Harvard Medical School, Boston, MA, United States of America; Boston Children's Hospital, Boston, MA, United States of America
| | | | - Matthew A Baum
- Massachusetts General Hospital, Boston, MA, United States of America
| | - David Lazer
- Northwestern University, Evanston, IL, United States of America
| | - Faith M Gunning
- Weill Cornell Institute of Geriatric Psychiatry, Weill Cornell Medicine, New York, NY, United States of America
| | - Roy H Perlis
- Harvard University, Cambridge, MA, United States of America; Harvard Medical School, Boston, MA, United States of America; Massachusetts General Hospital, Boston, MA, United States of America.
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6
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Jonson M, Sigström R, Van Orden KA, Fässberg MM, Skoog I, Waern M. Life-Weariness, Wish to Die, Active Suicidal Ideation, and All-Cause Mortality in Population-Based Samples of Older Adults. Am J Geriatr Psychiatry 2023; 31:267-276. [PMID: 36369206 DOI: 10.1016/j.jagp.2022.10.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/13/2022] [Accepted: 10/14/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVES To investigate potential differences in the strength of associations between different levels of passive and active suicidal ideation and all-cause mortality in older adults. DESIGN Prospective cohort study. SETTING Population-based samples of older adults in Gothenburg, Sweden. PARTICIPANTS Older adults aged 79 and above who participated in any wave of the Gothenburg H70 Birth Cohort Studies or the Prospective Population Study of Women between 1986 and 2015 (n = 2,438; 1,737 women, 701 men; mean age 86.6). MEASUREMENTS Most intense level of passive or active suicidal ideation during the past month: life-weariness, wish to die, or active suicidal ideation. The outcome was all-cause mortality over 3 years. RESULTS During follow-up, 672 participants (27.6%) died. After adjustments for sex, age, and year of examination, participants who reported a wish to die (HR 2.01; 95% CI 1.55-2.60) as the most intense level of ideation, but not participants who reported life-weariness (HR 1.40; 95% CI 0.88-2.21) or active suicidal ideation (HR 1.10; 95% CI 0.69-1.76) were at increased risk of all-cause mortality. Reporting a wish to die remained associated with mortality in a fully adjusted model, including somatic conditions, dementia, depression, and loneliness (HR 1.70; 95% CI 1.27-2.26). CONCLUSION In older adults, reporting a wish to die appears to be more strongly associated with all-cause mortality than either life-weariness or active suicidal ideation.
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Affiliation(s)
- Mattias Jonson
- Center for Ageing and Health (Age Cap), Department of Psychiatry and Neurochemistry (MJ, RS, MMF, IS,MW), Gothenburg University, Gothenburg, Sweden; Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, (MJ, RS, MMF,MW), University of Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Department of Affective Psychiatry, (MJ) Gothenburg, Sweden.
| | - Robert Sigström
- Center for Ageing and Health (Age Cap), Department of Psychiatry and Neurochemistry (MJ, RS, MMF, IS,MW), Gothenburg University, Gothenburg, Sweden; Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, (MJ, RS, MMF,MW), University of Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Department of Cognition and Old Age Psychiatry, (RS, IS), Gothenburg, Sweden
| | - Kimberly A Van Orden
- School of Medicine and Dentistry, (KAVO), University of Rochester Medical Center
| | - Madeleine Mellqvist Fässberg
- Center for Ageing and Health (Age Cap), Department of Psychiatry and Neurochemistry (MJ, RS, MMF, IS,MW), Gothenburg University, Gothenburg, Sweden; Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, (MJ, RS, MMF,MW), University of Gothenburg, Sweden
| | - Ingmar Skoog
- Center for Ageing and Health (Age Cap), Department of Psychiatry and Neurochemistry (MJ, RS, MMF, IS,MW), Gothenburg University, Gothenburg, Sweden; Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, (MJ, RS, MMF,MW), University of Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Department of Cognition and Old Age Psychiatry, (RS, IS), Gothenburg, Sweden
| | - Margda Waern
- Center for Ageing and Health (Age Cap), Department of Psychiatry and Neurochemistry (MJ, RS, MMF, IS,MW), Gothenburg University, Gothenburg, Sweden; Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, (MJ, RS, MMF,MW), University of Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Psychosis Department, (MW), Gothenburg, Sweden
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7
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Sher L, Challman KN, Smith EC, New AS, Perez-Rodriguez MM, McClure MM, Goodman M, Kahn RS, Hazlett EA. Clinical features of individuals with schizotypal personality disorder with and without suicidal ideation. Psychiatry Res 2023; 322:115132. [PMID: 36841053 DOI: 10.1016/j.psychres.2023.115132] [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: 12/13/2022] [Revised: 02/17/2023] [Accepted: 02/19/2023] [Indexed: 02/24/2023]
Abstract
This study compared demographic and clinical features in a sample of 384 participants: healthy controls (HC; n = 166) and individuals with schizotypal personality disorder (SPD) with (n = 50) and without (n = 168) suicidal ideation (SI) to examine specific risk factors for suicidality in SPD. Compared to the non-SI group, the SI group showed significantly greater severity of depression, aggression, impulsivity, affective lability, schizotypal features, poorer social adjustment, and had fewer social contacts. Individuals in the SI group were also more likely to have a history of a suicide attempt and comorbid borderline personality disorder in comparison to the non-SI group. Logistic regression analysis indicated that severity of depression and the number of social contacts drove the difference between the SI and non-SI groups. Compared with both SPD subgroups, the HC group was significantly less depressed, aggressive, impulsive, affectively labile, had fewer schizotypal features, was better socially adjusted, and had more social contacts. This study indicates that overall, the SI group is a more severely impaired group of individuals with SPD compared to the non-SI group. Better educating medical professionals about the diagnosis and management of SPD and its associations with suicidality is warranted.
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Affiliation(s)
- Leo Sher
- James J. Peters VA Medical Center, Bronx, NY, United States; Icahn School of Medicine at Mount Sinai, New York, NY, United States.
| | - Katelyn N Challman
- James J. Peters VA Medical Center, Bronx, NY, United States; Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Emma C Smith
- James J. Peters VA Medical Center, Bronx, NY, United States; Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Antonia S New
- James J. Peters VA Medical Center, Bronx, NY, United States; Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | | | | | - Marianne Goodman
- James J. Peters VA Medical Center, Bronx, NY, United States; Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - René S Kahn
- James J. Peters VA Medical Center, Bronx, NY, United States; Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Erin A Hazlett
- James J. Peters VA Medical Center, Bronx, NY, United States; Icahn School of Medicine at Mount Sinai, New York, NY, United States
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Psychosocial and Biological Outcomes of Immersive, Mindfulness-Based Treks in Nature for Groups of Young Adults and Caregivers Affected by Cancer: Results from a Single Arm Program Evaluation from 2016-2021. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312622. [PMID: 34886348 PMCID: PMC8657001 DOI: 10.3390/ijerph182312622] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/24/2021] [Accepted: 11/25/2021] [Indexed: 11/21/2022]
Abstract
The COVID-19 pandemic has left many individuals suffering from “connection deficit disorder” given changes to the way we work, go to school, socialize, and engage in daily activities. Young adults affected by cancer between the ages of 18–39 have known this connection deficit long before the pandemic. Being diagnosed and treated for cancer during this time can significantly disrupt engagement in important educational, career, social, and reproductive pursuits, and contribute to increased stress, anxiety, depression, and other negative outcomes. Experiencing meaningful connection—with nature, with peers who understand, and with oneself, may help assuage this adverse effect of disconnect. A single arm within-subjects program evaluation was conducted to examine outcomes following participation in immersive, multi-night, mindfulness-based treks in nature in a sample of young adults (n = 157) and caregivers (n = 50) affected by cancer from 2016–2021. Pre to post-trek changes included significant (p < 0.001) self-reported improvements in feeling connected to nature (d = 0.93–0.95), peers (d = 1.1–1.3), and oneself (d = 0.57–1.5); significant (p < 0.001) improvements on PROMIS Anxiety (d = 0.62–0.78), Depression (d = 0.87–0.89), and Sleep Disturbance (d = 0.37–0.48) short forms; and significant (p < 0.05) changes in pro-inflammatory biomarkers (d = 0.55–0.82). Connection-promoting experiences like this have the potential to improve health and wellbeing in this population and serve as a model for others.
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