The impact of COVID-19 lockdown stringency on loneliness in five European countries

Pediatric suicide attempts lagged during the COVID-19 pandemic: a European multicenter study

BACKGROUND

Elevated rates of suicidal behavior were reported during the COVID-19 pandemic. However, information is scarce on patients' profiles during this period. Studies evoke the potential adverse effects of the mandatory lockdown, but they remain relatively speculative.

METHODS

We monitored fluctuations in suicide attempts (SA) in six European countries. We gathered data, retrospectively for under 18-year-old SA episodes (1 January 2018 to 31 December 2021), through records of psychiatric emergency services. We collected clinical profiles individually. We extracted environmental indicators by month, as provided by Oxford COVID-19 Government Response Tracker (OxCGRT). We used the Pruned Exact Linear Time (PELT) method to identify breakpoints in SA episodes reported for each country, and logistic regressions to estimate changes in patients' characteristics after the breakpoints. Finally, we used a univariate and multivariate negative binomial model to assess the link between SA and OxCGRT indicators, accounting for the delay (lag) between the interventions and their impact on SA.

RESULTS

The study comprised 2,833 children and adolescents (mean age = 15.1 years (SD 1.6); M: F sex-ratio = 1:5.4). A significant increase in SA was found either 6 or 10 months after the beginning of the pandemic, varying by country. Patients were more likely to be girls (aOR = 1.77 [1.34; 2.34]) and used SA methods "other than self-poisoning" (aOR = 1.34 [1.05; 1.7]). In the multivariate model, an association was found between SA and the contact tracing indicator with an 11 months delay, and the number of COVID-19 deaths with a 3-months delay.

CONCLUSIONS

Findings confirmed a delayed increase in SA during the COVID-19 pandemic in children and adolescents as well as changes in patients' profiles. The duration and severity of the pandemic emerged as the strongest predictor in the rise of SA. If faced with a similar pandemic in the future, the gap between the onset of pandemic and the increase in suicide attempts presents an opportunity for prevention.

An Engineering Alternative to Lockdown During COVID-19 and Other Airborne Infectious Disease Pandemics: Feasibility Study

BACKGROUND

Now and in the future, airborne diseases such as COVID-19 could become uncontrollable and lead the world into lockdowns. Finding alternatives to lockdowns, which limit individual freedoms and cause enormous economic losses, is critical.

OBJECTIVE

The purpose of this study was to assess the feasibility of achieving a society or a nation that does not require lockdown during a pandemic due to airborne infectious diseases through the mass production and distribution of high-performance, low-cost, and comfortable powered air purifying respirators (PAPRs).

METHODS

The feasibility of a social system using PAPR as an alternative to lockdown was examined from the following perspectives: first, what PAPRs can do as an alternative to lockdown; second, how to operate a social system utilizing PAPR; third, directions of improvement of PAPR as an alternative to lockdown; and finally, balancing between efficiency of infection control and personal freedom through the use of Internet of Things (IoT).

RESULTS

PAPR was shown to be a possible alternative to lockdown through the reduction of airborne and droplet transmissions and through a temporary reduction of infection probability per contact. A social system in which individual constraints imposed by lockdown are replaced by PAPRs was proposed, and an example of its operation is presented in this paper. For example, the government determines the type and intensity of the lockdown and activates it. At that time, the government will also indicate how PAPR can be substituted for the different activity and movement restrictions imposed during a lockdown, for example, a curfew order may be replaced with the permission to go outside if wearing a PAPR. The following 7 points were raised as directions for improvement of PAPR as an alternative method to lockdown: flow optimization, precise differential pressure control, design improvement, maintenance method, variation development such as booth type, information terminal function, and performance evaluation method. In order to achieve the effectiveness and efficiency in controlling the spread of infection and the individual freedom at a high level in a social system that uses PAPRs as an alternative to lockdown, it was considered effective to develop a PAPR wearing rate network management system utilizing IoT.

CONCLUSIONS

This study shows that using PAPR with infection control ability and with less economic and social damage as an alternative to nationwide lockdown is possible during a pandemic due to airborne infectious diseases. Further, the efficiency of the government's infection control and each citizen's freedom can be balanced by using the PAPR wearing rate network management system utilizing an IoT system.

Interrogating the lack of diversity of thought in the pandemic response that led to mistakes - holistic evidence-based approach to deal with future pandemics

The COVID-19 pandemic, triggered by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), rapidly became a worldwide emergency. How it was managed garnered both commendation and vehement censure. This crisis profoundly affected healthcare, the economy, education, and public confidence in scientific endeavors. Our primary aim was to scrutinize the shortcomings in the pandemic management and to articulate a more effective strategy for handling prospective pandemics. We delved into the errors encountered in the COVID-19 response and posited a holistic, evidence-grounded approach for future pandemic mitigation.

Public Perceptions Of COVID-19 Lockdown Policies In Europe: Socioeconomic Status And Trust Were Factors

During the COVID-19 pandemic, governments worldwide implemented nonpharmaceutical lockdown policies to mitigate the impact of the virus. The effectiveness of these policies depended on public support, and they came with serious consequences for the population. Given that people's perceptions can influence their support for lockdown policies, we aimed to elicit perceptions of policy stringency among people in Denmark, France, Germany, Italy, the Netherlands, Portugal, and the United Kingdom in early 2021 as part of the European Covid Survey. We examined the extent to which objective measures of policy stringency and other factors were associated with these perceptions, focusing on disadvantaged populations. We found that objective measures of stringency did not accurately capture the impact of lockdown policies on people. Moreover, we found that socioeconomically disadvantaged people perceived policies as stricter than did less disadvantaged people and that trust in information sources greatly influenced such perceptions. Our findings underscore the importance of understanding factors influencing policy perception to help policy makers develop more effective and equitable infection containment strategies.

Risk factors for loneliness: A literature review

RATIONALE

Increasingly, loneliness is being recognised as a serious problem with detrimental effects on health, as well as on social cohesion and community trust. To effectively tackle this complex issue, a clear understanding of the phenomenon and its main drivers is needed. Over years of scientific research on loneliness, many potential risk factors have emerged and been tested empirically.

OBJECTIVE

This narrative review of 109 studies provides a concise summary of empirical evidence on the main potential risk factors for loneliness and presents an additional section dedicated to the COVID-19 pandemic.

METHOD

Given the very large number of existing studies, emphasis is placed on recent meta-analyses and systematic literature reviews as well as longitudinal studies. Similarly, given the large number of possible risk factors for loneliness, which may differ based on the geographical and cultural context, this review focuses on studies from Europe and North America.

RESULTS

The results show that demographic factors often correlate with loneliness, but in many cases the link becomes negligible when controlling for other factors. Often, physical and mental health problems are found to be associated with loneliness, and so are some psychological factors, such as neuroticism or extroversion. Loneliness also depends on the environment in which one lives, and possibly the broader socio-economic and socio-cultural contexts. Nevertheless, the review shows that ultimately everything comes down to the quantity and quality of social relationships. In particular, marital status, living arrangements and the characteristics of one's personal social network are quite consistently found to be among the strongest predictors of loneliness. These main findings about the risk factors for loneliness remained valid also during the COVID-19 pandemic.

POLICY IMPLICATIONS

The findings of this review have implications for policy, as understanding who the most vulnerable groups are is key for designing targeted policy solutions that tackle loneliness.

Incidence rates of treated mental disorders before and during the COVID-19 pandemic-a nationwide study comparing trends in the period 2015 to 2021

BACKGROUND

There is a concern that exposure to psychosocial stressors during the COVID-19 pandemic may have led to a higher incidence of mental disorders. Thus, this study aimed to compare trends in incidence rates of depressive disorder, anxiety disorders, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and eating disorders in primary- and specialist health care before (2015-2019) and during the COVID-19 pandemic (2020-2021).

METHODS

We used aggregated population registry data to calculate incidence rates of mental disorders from primary- (The Norwegian Control and Payment of Health Reimbursements Registry (KUHR)) and specialist (The Norwegian Patient Registry (NPR)) health care. The analyses included all Norwegian residents aged 18-65 during the study period. Incident cases were defined as having no previous registration with the same mental disorder in KUHR (from 2006) or NPR (from 2008). We used linear prediction models and mean models to compare incidence rates and test trends before and during the pandemic.

RESULTS

During the pandemic, the incidence rates among women were higher or as predicted for OCD in specialist health care and for eating disorders in both primary- and specialist health care. These findings were strongest among women aged 18-24 years. Incidence rates for depression and phobia/OCD among both genders in primary health care and phobic anxiety disorders among both genders in specialist health care were lower or as predicted.

CONCLUSION

The COVID-19 pandemic may have led to more women needing treatment for OCD and eating disorders in the Norwegian population. The decreased incidence rates for some disorders might indicate that some individuals either avoided seeking help or had improved mental health during the pandemic.

The relationship between mindfulness and mental health among Chinese college students during the closed-loop management of the COVID-19 pandemic: A moderated mediation model

To prevent the spread of the COVID-19 epidemic on campus, universities in outbreak areas in China can implement closed-loop management.

OBJECTS

This study aimed to explore the relationship between mindfulness and mental health of college students under closed-loop management.

MEASURES

11,939 college students from a university in Changsha, China participated in the online survey during the closed-loop management period. The Chinese version of Perceived Stress Scale, the Emotion Regulation Questionnaire-Cognitive Reappraisal, the Mindful Attention Awareness Scale, the 7-item General Anxiety Disorder questionnaire, and the 9-item Patient Health Questionnaire were administered to the college students.

RESULTS

We found that mindfulness was negative association with mental health during the closed-loop management period. Perceived stress mediated the relationship between mindfulness and mental health. Cognitive reappraisal moderated the relationship between mindfulness and perceived stress. Specifically, when the level of mindfulness is the same, individuals with more cognitive reappraisal tend to experience a less perceived stress.

CONCLUSION

The results of this study are of great significance to improve the mental health of college students during closed-loop management period.