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Kneeland IJ, Biesen JN, Fink BC, Keeling LA, Lindsey L. The Association Between COVID-fear with Psychological Distress and Substance Use: the Moderating Effect of Treatment Engagement. J Behav Health Serv Res 2024:10.1007/s11414-024-09905-3. [PMID: 39187735 DOI: 10.1007/s11414-024-09905-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2024] [Indexed: 08/28/2024]
Abstract
The purpose of this brief report was to examine the association between COVID-fear with psychiatric symptoms severity and substance use risk in an outpatient population with co-occurring substance use and mental health disorders and whether these associations were moderated by treatment engagement, especially after providers had shifted from an in-person care model to a telehealth format. A total of 136 patients receiving outpatient treatment for comorbid substance use and mental health disorders completed self-report questionnaires on their psychiatric symptoms, substance use, and treatment engagement (i.e., frequency, length, and helpfulness of phone and video sessions with a mental health counselor, psychiatrist, or primary care provider) in the past month between November 2020 and March 2021. Results showed that COVID-fear was significantly associated with psychiatric symptom severity, but not substance use risk. Additionally, perceived helpfulness of phone counseling sessions moderated the associations between COVID-fear and global psychiatric symptom severity, such that COVID-fear and global psychiatric symptom severity were positively associated when perceived helpfulness was low, and not associated if perceived helpfulness was high. The present results highlight the importance of directly addressing fears specific to a national emergency, as well as for providers to build strong rapport with their clients.
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Affiliation(s)
| | - Judith N Biesen
- Department of Mental Health Law and Policy, University of South Florida, Tampa, FL, 33604, USA.
| | - Brandi C Fink
- Department of Psychiatry and Behavioral Science, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | | | - Larissa Lindsey
- Addictions and Substance Abuse Program, University of New Mexico Hospitals, Albuquerque, NM, USA
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2
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Yaphe S, Sundaresan L, Freedman JD, Weinberg SJ, Vaughn IA, Lamerato LE, Budzynska K. The Effect of COVID-19 on Mood Disorders in Urban and Suburban Detroit. AJPM FOCUS 2024; 3:100246. [PMID: 39034935 PMCID: PMC11260361 DOI: 10.1016/j.focus.2024.100246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 07/23/2024]
Abstract
Introduction The COVID-19 pandemic has increased the global experience of anxiety and depression owing to social isolation and government-mandated quarantine for transmission reduction. To date, literature surrounding the mental health effects of COVID-19 for the U.S. population is limited. Methods This is a retrospective study from a large metropolitan Detroit health system. Patient encounters between December 23, 2018 and June 22, 2021, with March 23, 2020 being the start of Michigan state-wide lockdown, were used to define pre- and post-COVID-19 encounters, respectively. The data were divided into Detroit and non-Detroit on the basis of patient ZIP code. All patients aged ≥13 years with a visit with a family medicine provider were included. Outcome variables included Patient Health Questionnaires-2 and -9 and General Anxiety Disorder-7 scores; diagnoses of depression, anxiety, adjustment, and grief disorders; antidepressant prescriptions; and behavioral health referrals. Logistic regression was used to determine the incidence of composite mood disorder, depression, and anxiety. Results A total of 20,970 individuals were included in this study: 10,613 in the Detroit subgroup and 10,357 in the non-Detroit subgroup. A total of 88.2% of the Detroit population were Black, and 70% were female. Logistic regression shows that the incidence of composite mood disorder decreased with increasing age (OR=0.787, 0.608, 0.422, and 0.392; p<0.001). Male sex is a protective factor (OR=0.646, p<0.001). Federal insurance is the only factor presenting a statistically significant increased risk (OR=1.395, p<0.001). There was no statistical difference between residing in urban and suburban areas in the incidence of composite mood disorder (OR=0.996, p=0.953). Conclusions This research demonstrates that residing in an urban setting did not increase the risk of developing a mental health disorder during the COVID-19 period.
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Affiliation(s)
- Sean Yaphe
- Department of Family Medicine, Henry Ford Hospital, Detroit, Michigan
| | | | | | | | - Ivana A. Vaughn
- Department of Public Health Sciences, Henry Ford Health, Detroit, Michigan
- Henry Ford Health + Michigan State University Health Sciences, Detroit, Michigan
| | - Lois E. Lamerato
- Department of Public Health Sciences, Henry Ford Health, Detroit, Michigan
- Henry Ford Health + Michigan State University Health Sciences, Detroit, Michigan
| | - Katarzyna Budzynska
- Department of Family Medicine, Henry Ford Hospital, Detroit, Michigan
- Henry Ford Health + Michigan State University Health Sciences, Detroit, Michigan
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Alotaibi MR, Alsuwailem IA, Alsultan K, Alwasem KS, AlSaadi ZS, Assiri H, Layqah L, Almubrad J, Gammash N, Al-Qahtani R, Alaqeel M. The Impact of COVID-19 on Suicidal Behavior in King Abdulaziz Medical City in Saudi Arabia. Cureus 2024; 16:e62057. [PMID: 38989386 PMCID: PMC11235406 DOI: 10.7759/cureus.62057] [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] [Accepted: 06/10/2024] [Indexed: 07/12/2024] Open
Abstract
INTRODUCTION During the COVID-19 pandemic, there has been a global increase in mental health issues, including suicidal behaviors. This study focuses on assessing the impact of the pandemic on the prevalence and characteristics of suicidal behavior at King Abdulaziz Medical City in Riyadh, Saudi Arabia. METHODS A retrospective cohort study was conducted on 580 patients from January 2017 to December 2022, focusing on those aged 18 and above referred for suicide evaluation. Data were collected via chart reviews and analyzed using Statistical Product and Service Solutions (SPSS, version 25; IBM SPSS Statistics for Windows, Armonk, NY). RESULTS Our study reviewed 580 patient charts, with 555 (95.7%) meeting the inclusion criteria. The majority of participants were in the 18-29 age group (66.7%). We observed an increase in the number of cases undergoing suicide attempt assessment post COVID-19, with 296 incidents (53.3%) from March 2020 to December 2022 (about a year and eight months), compared to 259 incidents (46.7%) from January 2017 to March 2020 (over three years). A significant post-pandemic increase was noted in individuals with secondary education or higher (p = 0.004). No significant changes were found in other demographic variables or in the profiles of individuals with an intention to end life before and after the pandemic. CONCLUSION The study highlights the nuanced impact of the COVID-19 pandemic on suicidal behavior in Saudi Arabia, revealing an increased demand for suicide assessments, particularly among educated individuals. However, no corresponding increase was observed in the rate of high-intent suicidal cases or other significant variables. The findings underscore the complexity of factors influencing suicidal behavior during the pandemic and the need for targeted mental health interventions. Future research, ideally supported by a national database, is essential for a comprehensive understanding of suicidal behavior in Saudi Arabia.
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Affiliation(s)
| | | | - Khalid Alsultan
- Adult Mental Health, King Abdulaziz Medical City, Riyadh, SAU
| | | | - Ziad S AlSaadi
- Child and Adolescent Psychiatry, King Abdullah Specialist Children Hospital, Riyadh, SAU
| | - Hatim Assiri
- Adult Mental Health, King Abdulaziz Medical City, Riyadh, SAU
| | - Laila Layqah
- Research, King Abdullah International Medical Research Center, Riyadh, SAU
| | - Joharah Almubrad
- Psychiatry, Mental Health, Ministry of the National Guard Health Affairs, Riyadh, SAU
| | - Noura Gammash
- Psychiatry, Mental Health, Ministry of the National Guard Health Affairs, Riyadh, SAU
| | | | - Meshal Alaqeel
- Mental Health, Ministry of the National Guard Health Affairs, Riyadh, SAU
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4
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Ryan SC, Sugg MM, Runkle JD, Wertis L, Singh D, Green S. Short-term changes in mental health help-seeking behaviors following exposure to multiple social stressors and a natural disaster. Soc Sci Med 2024; 348:116843. [PMID: 38603916 PMCID: PMC11134597 DOI: 10.1016/j.socscimed.2024.116843] [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: 09/22/2023] [Revised: 02/23/2024] [Accepted: 03/26/2024] [Indexed: 04/13/2024]
Abstract
In 2020, unprecedented circumstances led to significant mental health consequences. Individuals faced mental health stressors that extended beyond the devastating impact of the COVID-19 pandemic, including widespread social unrest following the murder of George Floyd, an intense hurricane season in the Atlantic, and the politically divisive 2020 election. The objective of this analysis was to consider changes in help-seeking behavior following exposure to multiple social stressors and a natural disaster. Data from Crisis Text Line (CTL), a national text-based mental health crisis counseling service, was used to determine how help-seeking behavior changed in the wake of each event. Wilcoxon rank sum tests assessed changes in help-seeking behavior for each event in 2020 as compared to the same period in 2019. AutoRegressive Integrated Moving Average (ARIMA) models examined if changes in crisis conversation volumes following each event differed. Higher median conversation volumes noted for the COVID-19 pandemic (+1 to +5 conversations), Hurricane Laura (+1 to +7 conversations) and the 2020 Election (+1 to +26 conversations). ARIMA models show substantial increases in help-seeking behavior following the declaration of a national emergency for the COVID-19 pandemic (+4.3 to +38.2%) and following the 2020 election (+3 to +24.44%). Our analysis found that the mental health response following social stressors may be distinct from natural events, especially when natural disasters occur in the context of multiple social stressors. This analysis adds to the growing body of literature considering the mental health impact of exposure to multiple co-occurring societal stressors, like police violence and a global pandemic.
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Affiliation(s)
- Sophia C Ryan
- Department of Geography and Planning, Appalachian State University, Boone NC, 28607, USA.
| | - Margaret M Sugg
- Department of Geography and Planning, Appalachian State University, Boone NC, 28607, USA
| | - Jennifer D Runkle
- North Carolina Institute for Climate Studies, North Carolina State University, Raleigh NC, 27695, USA
| | - Luke Wertis
- Department of Geography and Planning, Appalachian State University, Boone NC, 28607, USA
| | - Devyani Singh
- Data Team, Crisis Text Line, New York City, New York, USA
| | - Shannon Green
- Data Team, Crisis Text Line, New York City, New York, USA
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Veldhuis CB, Kreski NT, Usseglio J, Keyes KM. Are Cisgender Women and Transgender and Nonbinary People Drinking More During the COVID-19 Pandemic? It Depends. Alcohol Res 2023; 43:05. [PMID: 38170029 PMCID: PMC10760999 DOI: 10.35946/arcr.v43.1.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024] Open
Abstract
PURPOSE This narrative review of research conducted during the first 2 years of the COVID-19 pandemic examines whether alcohol use among cisgender women and transgender and nonbinary people increased during the pandemic. The overarching goal of the review is to inform intervention and prevention efforts to halt the narrowing of gender-related differences in alcohol use. SEARCH METHODS Eight databases (PubMed, APA PsycInfo, CINAHL, Embase, Scopus, Gender Studies Database, GenderWatch, and Web of Science) were searched for peer-reviewed literature, published between March 2020 and July 2022, that reported gender differences or findings specific to women, transgender or nonbinary people, and alcohol use during the pandemic. The search focused on studies conducted in the United States and excluded qualitative research. SEARCH RESULTS A total 4,132 records were identified, including 400 duplicates. Of the remaining 3,732 unique records for consideration in the review, 51 were ultimately included. Overall, most studies found increases in alcohol use as well as gender differences in alcohol use, with cisgender women experiencing the most serious consequences. The findings for transgender and nonbinary people were equivocal due to the dearth of research and because many studies aggregated across gender. DISCUSSION AND CONCLUSIONS Alcohol use by cisgender women seems to have increased during the pandemic; however, sizable limitations need to be considered, particularly the low number of studies on alcohol use during the pandemic that analyzed gender differences. This is of concern as gender differences in alcohol use had been narrowing before the pandemic; and this review suggests the gap has narrowed even further. Cisgender women and transgender and nonbinary people have experienced sizable stressors during the pandemic; thus, understanding the health and health behavior impacts of these stressors is critical to preventing the worsening of problematic alcohol use.
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Affiliation(s)
- Cindy B Veldhuis
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois
| | - Noah T Kreski
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - John Usseglio
- Augustus C. Long Health Sciences Library, Columbia Irving Medical Center, Columbia University, New York, New York
| | - Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
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Gonzalez HC, Nimri FM, Lu M, Zhou Y, Rupp LB, Trudeau S, Gordon SC. Alcohol-related hepatitis admissions decline in 2021 after a 2020 surge attributed to the COVID-19 pandemic. Hepatol Int 2023; 17:1637-1644. [PMID: 37505324 DOI: 10.1007/s12072-023-10569-y] [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: 02/22/2023] [Accepted: 07/07/2023] [Indexed: 07/29/2023]
Abstract
OBJECTIVE We previously investigated the impact of the COVID-19 pandemic on alcohol-related liver disease (ARLD), finding that admissions for alcoholic hepatitis (AH) increased by 50% in the summer of 2020 compared to the same period in 2016-2019. We have now expanded our analysis to consider full years' data and evaluate how rates changed in 2021. We also sought to identify factors associated with ICU admissions, need for dialysis, liver transplant evaluations, and death. METHODS Using retrospective data, we identified patients admitted to our four Detroit, Michigan area hospitals for acute ARLD for three periods pre-COVID (2016-February 2020), early COVID (June-December 2020), and late COVID (2021). Clustered logistic regression was performed to study rates of AH admissions across the three eras, where the patient was defined as the cluster and the analysis accounted for multiple encounters per cluster. A similar regression approach, univariate followed by multivariable analysis, was also used to study associations between patient characteristics and outcomes during hospitalization for AH. RESULTS AH-related admissions declined significantly from the early COVID to late COVID eras (OR 0.68, 95% CL 0.52, 0.88), returning to levels similar to that of the pre- COVID period (OR 1.18, 95% CL 0.96, 1.47). In multivariable analysis, baseline MELD score was associated with ICU admission, initiation of dialysis, transplant evaluation, and death while hospitalized for AH. Female patients were at almost twice the risk of death during admission compared to male patients (aOR 1.81, 95% CL 1.1, 2.98). Increasing age was associated with slightly lower odds of transplant (aOR 0.97, 95% CL 0.94, 1) and higher odds of death (aOR 1.03, 95% CL 1.01. 1.06). CONCLUSION After a spike in AH-related admissions during the first summer of the COVID-19 pandemic, rates declined significantly in 2021, returning to pre-pandemic levels.
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Affiliation(s)
- Humberto C Gonzalez
- Department of Gastroenterology and Hepatology, Henry Ford Health, Detroit, MI, USA.
- School of Medicine, Wayne State University, Detroit, MI, USA.
- Transplant Hepatology, Henry Ford Health, 2799 West Grand Blvd, Detroit, MI, 48202, USA.
| | - Faisal M Nimri
- Department of Gastroenterology and Hepatology, Henry Ford Health, Detroit, MI, USA
| | - Mei Lu
- Department of Public Health Sciences, Henry Ford Health, Detroit, MI, USA
| | - Yueren Zhou
- Department of Public Health Sciences, Henry Ford Health, Detroit, MI, USA
| | - Loralee B Rupp
- Department of Health Policy and Health Systems Research, Henry Ford Health, Detroit, MI, USA
| | - Sheri Trudeau
- Department of Public Health Sciences, Henry Ford Health, Detroit, MI, USA
| | - Stuart C Gordon
- Department of Gastroenterology and Hepatology, Henry Ford Health, Detroit, MI, USA
- School of Medicine, Wayne State University, Detroit, MI, USA
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Ryan SC, Desjardins MR, Runkle JD, Wertis L, Sugg MM. Evaluating co-occurring space-time clusters of depression and suicide-related outcomes before and during the COVID-19 pandemic. Spat Spatiotemporal Epidemiol 2023; 47:100607. [PMID: 38042530 PMCID: PMC10693657 DOI: 10.1016/j.sste.2023.100607] [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: 11/14/2022] [Revised: 06/08/2023] [Accepted: 07/14/2023] [Indexed: 12/04/2023]
Abstract
Rapidly emerging research on the mental health consequences of the COVID-19 pandemic shows increasing patterns of psychological distress, including anxiety and depression, and self-harming behaviors, particularly during the early months of the pandemic. Yet, few studies have investigated the spatial and temporal changes in depressive disorders and suicidal behavior during the pandemic. The objective of this retrospective analysis was to evaluate geographic patterns of emergency department admissions for depression and suicidal behavior in North Carolina before (March 2017-February 2020) and during the COVID-19 pandemic (March 2020 - December 2021). Univariate cluster detection examined each outcome separately and multivariate cluster detection was used to examine the co-occurrence of depression and suicide-related outcomes in SatScan; the Rand index evaluated cluster overlap. Cluster analyses were adjusted for age, race, and sex. Findings suggest that the mental health burden of depression and suicide-related outcomes remained high in many communities throughout the pandemic. Rural communities exhibited a larger increase in the co-occurrence of depression and suicide-related ED visits during the pandemic period. Results showed the exacerbation of depression and suicide-related outcomes in select communities and emphasize the need for targeted and sustained mental health interventions throughout the many phases of the COVID-19 pandemic.
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Affiliation(s)
- Sophia C Ryan
- Department of Geography and Planning, Appalachian State University, Boone NC, 28607, USA.
| | - Michael R Desjardins
- Department of Epidemiology & Spatial Science for Public Health Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Jennifer D Runkle
- North Carolina Institute for Climate Studies, North Carolina State University, Raleigh NC, 27695, USA
| | - Luke Wertis
- Department of Geography and Planning, Appalachian State University, Boone NC, 28607, USA
| | - Margaret M Sugg
- Department of Geography and Planning, Appalachian State University, Boone NC, 28607, USA
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8
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Elsner A, Mergl R, Allgaier AK, Hegerl U. Suicide rates during and after the first COVID-19 lockdown in Germany in 2020. PLoS One 2023; 18:e0289136. [PMID: 37656723 PMCID: PMC10473467 DOI: 10.1371/journal.pone.0289136] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 07/11/2023] [Indexed: 09/03/2023] Open
Abstract
The impact of the COVID-19 pandemic and of measures implemented to curb the spread of the virus on suicidal behavior has been investigated in different regions of the world, but does not yet allow to draw conclusions for Germany. Especially lockdowns might have effects on suicide rates via impact on mental disorders, changes in the choice of suicide method, a decrease in help seeking behavior, or a deterioration in the quality of medical care for people with mental disorders. The following research questions were addressed: i) did suicide rates in Germany in 2020 change during lockdown and non-lockdown periods when compared to a ten-year baseline? ii) was there a change in the proportion of suicide methods during the lockdown compared to baseline? An interrupted time-series analysis based on a linear regression was used. For the comparisons of predicted and observed suicide rates, excess suicide mortality rates (ESMR) were chosen among others. Changes in the choice of method were analyzed by comparing the rates of different methods to those at baseline. Although the mean suicide rate in 2020 was not significantly different from baseline, the weekly analysis of suicide rates revealed a significant difference (χ2 = 64.16; df = 39; p = 0.007), with some weeks showing higher and others lower rates than previous years. The effects for separate weeks were attenuated to non-significance after correction for multiple testing. Suicide mortality during the first lockdown in 2020 was significantly lower than expected (ESMR = 0.933; 95% CI: 0.890; 0.985) whereas, in the post-lockdown period, the registered suicide mortality was not significantly different from the expected one (ESMR = 1.024; 95% CI: 0.997; 1.051). During lockdown, there was a significant increase of the percentage of the suicide method categories jumping and 'other methods' and a decrease of poisoning and lying in front of a moving object. Being able to determine whether the choice of more or less lethal methods during lockdown versus non-lockdown periods partly explains this finding would require a representative assessment of attempted suicides.
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Affiliation(s)
- Anne Elsner
- German Depression Foundation, Leipzig, Germany
| | - Roland Mergl
- Universität der Bundeswehr München, Institute of Psychology, Neubiberg, Germany
| | | | - Ulrich Hegerl
- German Depression Foundation, Leipzig, Germany
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University Frankfurt (Distinguished Professorship funded by Dr. Senckenbergische Stiftung), Frankfurt am Main, Germany
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9
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Lawrence WR, Freedman ND, McGee-Avila JK, Berrington de González A, Chen Y, Emerson MA, Gee GC, Haozous EA, Haque AT, Inoue-Choi M, Jackson SS, Lord B, Nápoles AM, Pérez-Stable EJ, Vo JB, Williams F, Shiels MS. Trends in Mortality From Poisonings, Firearms, and All Other Injuries by Intent in the US, 1999-2020. JAMA Intern Med 2023; 183:849-856. [PMID: 37399025 PMCID: PMC10318548 DOI: 10.1001/jamainternmed.2023.2509] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 04/30/2023] [Indexed: 07/04/2023]
Abstract
Importance Although deaths due to external causes are a leading cause of mortality in the US, trends over time by intent and demographic characteristics remain poorly understood. Objective To examine national trends in mortality rates due to external causes from 1999 to 2020 by intent (homicide, suicide, unintentional, and undetermined) and demographic characteristics. External causes were defined as poisonings (eg, drug overdose), firearms, and all other injuries, including motor vehicle injuries and falls. Given the repercussions of the COVID-19 pandemic, US death rates for 2019 and 2020 were also compared. Design, Setting, and Participants Serial cross-sectional study using national death certificate data obtained from the National Center for Health Statistics and including all external causes of 3 813 894 deaths among individuals aged 20 years or older from January 1, 1999, to December 31, 2020. Data analysis was conducted from January 20, 2022, to February 5, 2023. Exposures Age, sex, and race and ethnicity. Main Outcomes and Measures Trends in age-standardized mortality rates and average annual percentage change (AAPC) in rates calculated by intent (suicide, homicide, unintentional, and undetermined), age, sex, and race and ethnicity for each external cause. Results Between 1999 and 2020, there were 3 813 894 deaths due to external causes in the US. From 1999 to 2020, poisoning death rates increased annually (AAPC, 7.0%; 95% CI, 5.4%-8.7%). From 2014 to 2020, poisoning death rates increased the most among men (APC, 10.8%; 95% CI, 7.7%-14.0%). During the study period, poisoning death rates increased in all the racial and ethnic groups examined; the most rapid increase was among American Indian and Alaska Native individuals (AAPC, 9.2%; 95% CI, 7.4%-10.9%). During the study period, death rates for unintentional poisoning had the most rapid rate of increase (AAPC, 8.1%; 95% CI, 7.4%-8.9%). From 1999 to 2020, firearm death rates increased (AAPC, 1.1%; 95% CI, 0.7%-1.5%). From 2013 to 2020, firearm mortality increased by an average of 4.7% annually (95% CI, 2.9%-6.5%) among individuals aged 20 to 39 years. From 2014 to 2020, mortality from firearm homicides increased by an average of 6.9% annually (95% CI, 3.5%-10.4%). From 2019 to 2020, mortality rates from external causes accelerated further, largely from increases in unintentional poisoning, and homicide due to firearms and all other injuries. Conclusions and Relevance Results of this cross-sectional study suggest that from 1999 to 2020, death rates due to poisonings, firearms, and all other injuries increased substantially in the US. The rapid increase in deaths due to unintentional poisonings and firearm homicides is a national emergency that requires urgent public health interventions at the local and national levels.
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Affiliation(s)
- Wayne R. Lawrence
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Neal D. Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Jennifer K. McGee-Avila
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Amy Berrington de González
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, United Kingdom
| | - Yingxi Chen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Marc A. Emerson
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill
| | - Gilbert C. Gee
- Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles, Los Angeles
| | - Emily A. Haozous
- Pacific Institute for Research and Evaluation, Albuquerque, New Mexico
| | - Anika T. Haque
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Maki Inoue-Choi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Sarah S. Jackson
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Brittany Lord
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Anna M. Nápoles
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland
| | - Eliseo J. Pérez-Stable
- Office of the Director, National Institute on Minority Health and Health Disparities, Bethesda, Maryland
| | - Jacqueline B. Vo
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland
| | - Meredith S. Shiels
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
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Yan Y, Hou J, Li Q, Yu NX. Suicide before and during the COVID-19 Pandemic: A Systematic Review with Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3346. [PMID: 36834037 PMCID: PMC9960664 DOI: 10.3390/ijerph20043346] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/09/2023] [Accepted: 02/11/2023] [Indexed: 06/01/2023]
Abstract
Synthesizing evidence to examine changes in suicide-related outcomes before and during the pandemic can inform suicide management during the COVID-19 crisis. We searched 13 databases as of December 2022 for studies reporting both the pre- and peri-pandemic prevalence of suicidal ideation, suicide attempts, or rate of death by suicide. A random-effects model was used to pool the ratio of peri- and pre-pandemic prevalence of suicidal ideation and attempt (Prevalence Ratio-PR) and rate of death by suicide (Rate Ratio; RR). We identified 51, 55, and 25 samples for suicidal ideation, attempt, and death by suicide. The prevalence of suicidal ideation increased significantly among non-clinical (PR = 1.142; 95% CI: 1.018-1.282; p = 0.024; k = 28) and clinical (PR = 1.134; 95% CI: 1.048-1.227; p = 0.002; k = 23) samples, and pooled estimates differed by population and study design. Suicide attempts were more prevalent during the pandemic among non-clinical (PR = 1.14; 95% CI: 1.053-1.233; p = 0.001; k = 30) and clinical (PR = 1.32; 95% CI: 1.17-1.489; p = 0.000; k = 25) participants. The pooled RR for death by suicide was 0.923 (95% CI: 0.84-1.01; p = 0.092; k = 25), indicating a nonsignificant downward trend. An upward trend of suicidal ideation and suicide attempts was observed during the COVID-19 pandemic, despite suicide rate remaining stable. Our findings suggest that timely prevention and intervention programs are highly needed for non-clinical adult population and clinical patients. Monitoring the real-time and long-run suicide risk as the pandemic evolves is warranted.
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Affiliation(s)
- Yifei Yan
- Department of Social and Behavioural Sciences, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong SAR, China
| | - Jianhua Hou
- Department of Social and Behavioural Sciences, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong SAR, China
| | - Qing Li
- Department of Computing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Nancy Xiaonan Yu
- Department of Social and Behavioural Sciences, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong SAR, China
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11
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van Kessel R, Kyriopoulos I, Wong BLH, Mossialos E. The Effect of the COVID-19 Pandemic on Digital Health-Seeking Behavior: Big Data Interrupted Time-Series Analysis of Google Trends. J Med Internet Res 2023; 25:e42401. [PMID: 36603152 PMCID: PMC9848442 DOI: 10.2196/42401] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 11/20/2022] [Accepted: 01/05/2023] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Due to the emergency responses early in the COVID-19 pandemic, the use of digital health in health care increased abruptly. However, it remains unclear whether this introduction was sustained in the long term, especially with patients being able to decide between digital and traditional health services once the latter regained their functionality throughout the COVID-19 pandemic. OBJECTIVE We aim to understand how the public interest in digital health changed as proxy for digital health-seeking behavior and to what extent this change was sustainable over time. METHODS We used an interrupted time-series analysis of Google Trends data with break points on March 11, 2020 (declaration of COVID-19 as a pandemic by the World Health Organization), and December 20, 2020 (the announcement of the first COVID-19 vaccines). Nationally representative time-series data from February 2019 to August 2021 were extracted from Google Trends for 6 countries with English as their dominant language: Canada, the United States, the United Kingdom, New Zealand, Australia, and Ireland. We measured the changes in relative search volumes of the keywords online doctor, telehealth, online health, telemedicine, and health app. In doing so, we capture the prepandemic trend, the immediate change due to the announcement of COVID-19 being a pandemic, and the gradual change after the announcement. RESULTS Digital health search volumes immediately increased in all countries under study after the announcement of COVID-19 being a pandemic. There was some variation in what keywords were used per country. However, searches declined after this immediate spike, sometimes reverting to prepandemic levels. The announcement of COVID-19 vaccines did not consistently impact digital health search volumes in the countries under study. The exception is the search volume of health app, which was observed as either being stable or gradually increasing during the pandemic. CONCLUSIONS Our findings suggest that the increased public interest in digital health associated with the pandemic did not sustain, alluding to remaining structural barriers. Further building of digital health capacity and developing robust digital health governance frameworks remain crucial to facilitating sustainable digital health transformation.
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Affiliation(s)
- Robin van Kessel
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
- Department of International Health, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Ilias Kyriopoulos
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - Brian Li Han Wong
- Department of International Health, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
- Steering Committee, Digital Health Section, European Public Health Association, Utrecht, Netherlands
| | - Elias Mossialos
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
- Institute of Global Health Innovation, Imperial College London, London, United Kingdom
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12
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Xiao Y, Sharma MM, Thiruvalluru RK, Gimbrone C, Weissman MM, Olfson M, Keyes KM, Pathak J. Trends in psychiatric diagnoses by COVID-19 infection and hospitalization among patients with and without recent clinical psychiatric diagnoses in New York city from March 2020 to August 2021. Transl Psychiatry 2022; 12:492. [PMID: 36414624 PMCID: PMC9681844 DOI: 10.1038/s41398-022-02255-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 11/02/2022] [Accepted: 11/09/2022] [Indexed: 11/24/2022] Open
Abstract
Determining emerging trends of clinical psychiatric diagnoses among patients infected with the SARS-CoV-2 virus is important to understand post-acute sequelae of SARS-CoV-2 infection or long COVID. However, published reports accounting for pre-COVID psychiatric diagnoses have usually relied on self-report rather than clinical diagnoses. Using electronic health records (EHRs) among 2,358,318 patients from the New York City (NYC) metropolitan region, this time series study examined changes in clinical psychiatric diagnoses between March 2020 and August 2021 with month as the unit of analysis. We compared trends in patients with and without recent pre-COVID clinical psychiatric diagnoses noted in the EHRs up to 3 years before the first COVID-19 test. Patients with recent clinical psychiatric diagnoses, as compared to those without, had more subsequent anxiety disorders, mood disorders, and psychosis throughout the study period. Substance use disorders were greater between March and August 2020 among patients without any recent clinical psychiatric diagnoses than those with. COVID-19 positive patients (both hospitalized and non-hospitalized) had greater post-COVID psychiatric diagnoses than COVID-19 negative patients. Among patients with recent clinical psychiatric diagnoses, psychiatric diagnoses have decreased since January 2021, regardless of COVID-19 infection/hospitalization. However, among patients without recent clinical psychiatric diagnoses, new anxiety disorders, mood disorders, and psychosis diagnoses increased between February and August 2021 among all patients (COVID-19 positive and negative). The greatest increases were anxiety disorders (378.7%) and mood disorders (269.0%) among COVID-19 positive non-hospitalized patients. New clinical psychosis diagnoses increased by 242.5% among COVID-19 negative patients. This study is the first to delineate the impact of COVID-19 on different clinical psychiatric diagnoses by pre-COVID psychiatric diagnoses and COVID-19 infections and hospitalizations across NYC, one of the hardest-hit US cities in the early pandemic. Our findings suggest the need for tailoring treatment and policies to meet the needs of individuals with pre-COVID psychiatric diagnoses.
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Affiliation(s)
- Yunyu Xiao
- Department of Population Health Sciences, Weill Cornell Medicine, NewYork-Presbyterian, New York, NY, USA.
| | - Mohit M Sharma
- Department of Population Health Sciences, Weill Cornell Medicine, NewYork-Presbyterian, New York, NY, USA
| | - Rohith K Thiruvalluru
- Department of Population Health Sciences, Weill Cornell Medicine, NewYork-Presbyterian, New York, NY, USA
| | - Catherine Gimbrone
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Myrna M Weissman
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Division of Translational Epidemiology, New York State Psychiatric Institute, New York, NY, USA
| | - Mark Olfson
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Division of Translational Epidemiology, New York State Psychiatric Institute, New York, NY, USA
- Columbia University Irving Medical Center, New York, NY, USA
| | - Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Jyotishman Pathak
- Department of Population Health Sciences, Weill Cornell Medicine, NewYork-Presbyterian, New York, NY, USA
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13
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Webb RT, John A, Knipe D, Bojanić L, Dekel D, Eyles E, Marchant A, Mughal F, Pirkis J, Schmidt L, Gunnell D. Has the COVID-19 pandemic influenced suicide rates differentially according to socioeconomic indices and ethnicity? More evidence is needed globally. Epidemiol Psychiatr Sci 2022; 31:e72. [PMID: 36217667 PMCID: PMC9579839 DOI: 10.1017/s2045796022000543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 09/11/2022] [Indexed: 11/29/2022] Open
Abstract
The COVID-19 pandemic has harmed many people's mental health globally. Whilst the evidence generated thus far from high-income countries regarding the pandemic's impact on suicide rates is generally reassuring, we know little about its influence on this outcome in lower- and middle-income countries or among marginalised and disadvantaged people. There are some signals for concern regarding the pandemic's potentially unequal impact on suicide rates, with some of the affected demographic subgroups and regions being at elevated risk before the pandemic began. However, the evidence-base for this topic is currently sparse, and studies conducted to date have generally not taken account of pre-pandemic temporal trends. The collection of accurate, complete and comparable data on suicide rate trends in ethnic minority and low-income groups should be prioritised. The vulnerability of low-income groups will likely be exacerbated further by the current energy supply and cost-of-living crises in many countries. It is therefore crucial that reassuring messaging highlighting the stability of suicide rates during the pandemic does not lead to complacency among policymakers.
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Affiliation(s)
- Roger T. Webb
- Division of Psychology and Mental Health, The University of Manchester, Manchester, UK
- National Institute for Health and Care Research Greater Manchester Patient Safety Translational Research Centre (NIHR GM PSTRC), Manchester, UK
| | - Ann John
- Swansea University Medical School, Swansea University, Swansea, UK
- Public Health Wales, Cardiff, UK
| | - Duleeka Knipe
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Lana Bojanić
- Division of Psychology and Mental Health, The University of Manchester, Manchester, UK
| | | | - Emily Eyles
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Amanda Marchant
- Swansea University Medical School, Swansea University, Swansea, UK
| | | | - Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Lena Schmidt
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Sciome LLC, Research Triangle Park, Durham, NC, USA
| | - David Gunnell
- National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- National Institute for Health and Care Research Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK
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14
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Gonzalez HC, Rupp LB, Trudeau S, Gordon SC. Response to: 'No impact of Covid-19 pandemic on decompensation of alcoholic liver disease: Results from a single Center in Milan'. Liver Int 2022; 42:1910-1911. [PMID: 35670429 PMCID: PMC9348101 DOI: 10.1111/liv.15333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 06/04/2022] [Indexed: 02/13/2023]
Affiliation(s)
- Humberto C. Gonzalez
- Department of Gastroenterology and HepatologyHenry Ford Health SystemDetroitMichiganUSA,School of MedicineWayne State UniversityDetroitMichiganUSA
| | - Loralee B. Rupp
- Department of Health Policy and Health Systems ResearchHenry Ford Health SystemDetroitMichiganUSA
| | - Sheri Trudeau
- Department of Public Health SciencesHenry Ford Health SystemDetroitMichiganUSA
| | - Stuart C. Gordon
- Department of Gastroenterology and HepatologyHenry Ford Health SystemDetroitMichiganUSA,School of MedicineWayne State UniversityDetroitMichiganUSA
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15
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Brown KG, Chen CY, Dong D, Lake KJ, Butelman ER. Has the United States Reached a Plateau in Overdoses Caused by Synthetic Opioids After the Onset of the COVID-19 Pandemic? Examination of Centers for Disease Control and Prevention Data to November 2021. Front Psychiatry 2022; 13:947603. [PMID: 35873233 PMCID: PMC9300908 DOI: 10.3389/fpsyt.2022.947603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 06/17/2022] [Indexed: 11/23/2022] Open
Abstract
Background Overdoses caused by synthetic mu-opioid receptor (MOR) agonists such as fentanyl are causing increasing mortality in the United States. The COVID-19 pandemic continues to have complex effects on public health, including opioid use disorders (OUD). It is unclear whether recent increases in mortality caused by synthetic opioids have reached a plateau (i.e., a stable period), after the onset of the COVID-19 pandemic. Method This study examined provisional overdose mortality data from the Centers for Disease Control and Prevention, for synthetic opioids excluding methadone (code T40.4; monthly data available from 39 States, plus New York City and Washington DC), for June 2019-November 2021. Data were first examined as crude mortality rates. The presence of a maximum plateau was analyzed for the last 4 months of available data. For authorities in which a plateau in mortality was detected, sigmoidal Boltzmann equations were used to model parameters of this phenomenon (e.g., level of the plateau). Results At the end of the study period, all but one authority (New Hampshire) reported increases in mortality rates for synthetic opioids, compared to the baseline month of June 2019 (range: 111-745% of baseline). A plateau was observed over the last 4 months of the study period (Aug 2021-Nov 2021) in 29 of the authorities. Ten other authorities had not reached a stable plateau at the end of the study period. For the authorities where a plateau was detected, a sigmoidal Boltzmann model revealed a fitted maximum of 262% rise in mortality over the study period, from the baseline month. The midpoint in the rise in mortality was fitted in September 2020. After separation of data into census regions, the highest plateau was observed in the West region, followed by South, Midwest, and Northeast (fitted plateau values were 409, 262, 204, and 149% of baseline, respectively). Discussion There were increases in overdose mortality due to synthetic opioids across most states, ranging considerably in magnitude. A plateau in overdose mortality was detected at the end of the study period in most of these authorities. The reasons for these plateaus should be explored, in order to develop optimized public health interventions.
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Affiliation(s)
| | | | | | | | - Eduardo R. Butelman
- Laboratory on the Biology of Addictive Diseases, The Rockefeller University, New York, NY, United States
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16
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Sawamura D, Ito A, Miyaguchi H, Nakamura H, Ishioka T. Different Impacts of COVID-19 on Quality of Therapy, Psychological Condition, and Work Life Among Occupational Therapists in Physical and Mental Health Fields. Front Public Health 2022; 10:887069. [PMID: 35719669 PMCID: PMC9204004 DOI: 10.3389/fpubh.2022.887069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 05/04/2022] [Indexed: 11/28/2022] Open
Abstract
Background The negative impacts of the coronavirus disease 2019 (COVID-19) pandemic have worsened the quality of therapy, psychological condition, and work life of second-line healthcare workers and occupational therapists (OTs). However, no study has investigated whether the impact of COVID-19 varies among OTs working in different fields. This study aimed to investigate the differences on the impact of COVID-19 between OTs in the physical and mental health fields. Methods A cross-sectional online survey was conducted in Japan between January 20 and January 25, 2021. A total of 4,418 registered OTs who were members of the Japanese Association of Occupational Therapists volunteered for this study. After screening using the exclusion criteria, 1,383 participants were classified into two groups based on their field (mental health and physical health), and their quality of therapy, psychological condition, and work life were analyzed. Results OTs in the mental health field showed a greater decrease in therapy quality and increase in workload and a lower rate of decrease in working hours than those in the physical health field. In the multinomial logistic regression analysis, decreased and increased therapy quality and decreased therapy quality were significantly associated with depression in the physical health field, and decreased therapy quality was associated with insomnia in the mental health field. Furthermore, insomnia and anxiety were commonly associated with increased workload and working hours, respectively, in both fields, whereas anxiety and depression were associated with increased workload only in the physical health field. Conclusions These results demonstrate that COVID-19 differently impacted quality of treatment, workload, work time, and psychological condition in the physical and mental health fields; moreover, the relationships among these are different in these two fields. These results highlight the importance of investigating the field-specific negative impacts of COVID-19 on OTs and may provide helpful information for devising tailored and effective prevention and intervention strategies to address these challenges.
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Affiliation(s)
- Daisuke Sawamura
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
- *Correspondence: Daisuke Sawamura
| | - Ayahito Ito
- Research Institute for Future Design, Kochi University of Technology, Kochi, Japan
- Ayahito Ito
| | - Hideki Miyaguchi
- Department of Human Behavior Science of Occupational Therapy, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Haruki Nakamura
- Japanese Association of Occupational Therapists, Tokyo, Japan
| | - Toshiyuki Ishioka
- Department of Occupational Therapy, Saitama Prefectural University, Koshigaya, Japan
- Toshiyuki Ishioka
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