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Jones BA, Cahill L, McDermott DT. Assessing Attitudes Toward Trans and Gender Diverse People: Adapting the 'Transgender Attitudes and Beliefs' Scale. JOURNAL OF HOMOSEXUALITY 2024; 71:2533-2544. [PMID: 37561420 DOI: 10.1080/00918369.2023.2245524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
This study aimed to update the gender-based terminology of a measure used to assess attitudes toward trans and gender diverse people (the Transgender Attitudes and Beliefs Scale; TABS) in order to reflect appropriate and inclusive language standards and conventions while maintaining the psychometric integrity of the tool. The updated TABS was administered to 247 heterosexual, cisgender adults in the UK. Participants also completed the original TABS as well as measure of self-esteem and social desirability to test construct validity. We demonstrate that after updating the language of the TABS to reflect best-practice, the psychometric properties of the TABS were unaffected.
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Affiliation(s)
- Bethany A Jones
- NTU Psychology, School of Social Sciences, Nottingham Trent University, Nottingham, UK
| | - Liam Cahill
- NTU Psychology, School of Social Sciences, Nottingham Trent University, Nottingham, UK
| | - Daragh T McDermott
- NTU Psychology, School of Social Sciences, Nottingham Trent University, Nottingham, UK
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Sarı E, Şencan Karakuş B, Demir E. Economic uncertainty and mental health: Global evidence, 1991 to 2019. SSM Popul Health 2024; 27:101691. [PMID: 38988726 PMCID: PMC11231563 DOI: 10.1016/j.ssmph.2024.101691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 06/11/2024] [Accepted: 06/12/2024] [Indexed: 07/12/2024] Open
Abstract
Mental health has deteriorated globally due to COVID-19, climate crisis, economic policies, and regional conflicts, requiring immediate attention. This study aims to comprehend the relationship between economic uncertainty and the prevalence of anxiety disorders, major depressive disorder, and eating disorders across various demographics and countries. Using robust fixed-effect models, we analyzed the relationship between economic uncertainty and mental disorders in 110 countries from 1991 to 2019. Our analysis also explored whether this association varies across genders and age groups. Our analysis indicates that economic uncertainty is associated with higher prevalence rates of anxiety and major depressive disorders, though no similar association is observed for eating disorders. In the subgroup analyses, while females have a significant association exclusively with anxiety disorders, males have associations with anxiety and major depressive disorders. The age-specific analyses show that economic uncertainty is associated with anxiety disorders for almost all age groups above 15 years, except for ages between 40 and 54. For major depressive disorders, this association becomes significant after the 40-44 age group. However, we see no significant association among age groups for eating disorders.
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Affiliation(s)
- Emre Sarı
- School of Business and Economics, UiT the Arctic University of Norway, Tromsø, Norway
- Division for Health and Social Sciences, NORCE Norwegian Research Centre, Oslo, Norway
| | - Buse Şencan Karakuş
- Division of Developmental Pediatrics, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkiye
| | - Ender Demir
- Department of Business Administration, School of Social Sciences, Reykjavik University, Reykjavik, Iceland
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Chen Q, Chen Y, Huang Y, Yang Q, He DY, Fang BJ, Ren Y, Liu J. Anxiety symptoms and risk factors in patients with SARS-cov-2 omicron variant in shanghai, China. Int J Psychiatry Med 2024:912174241264671. [PMID: 39041583 DOI: 10.1177/00912174241264671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/24/2024]
Abstract
OBJECTIVES The psychological effects of the COVID-19 pandemic may include anxiety. However, the association between demographic and physiological factors in COVID-19 associated anxiety symptoms is poorly understood. Therefore, the present cross-sectional study was conducted to examine anxiety symptoms and associated factors among patients with the SARS-CoV-2 omicron variant during quarantine in Shanghai. METHODS The study was conducted between April 16, 2022, and May 21, 2022, at Fangcang Shelter Hospital in Shanghai, China. Data were collected using an anonymous online questionnaire. Demographic characteristics, respiratory symptoms, vaccine dose, comorbidities (such as hypertension and diabetes), type of work, and mental health symptoms were evaluated. Logistic regression was used to investigate the relationship between anxiety symptoms and risk factors. Stratification analysis was performed to investigate potential interactions. RESULTS A total of 2132 patients with confirmed omicron variant SARS-CoV-2 infection were enrolled. The results showed that sex, age, type of work, respiratory symptoms, and comorbidities were positively associated with anxiety symptoms. Female gender (OR = 1.47, 95% CI = 1.11-1.94), nonmanual labor (OR = 1.62, 95% CI = 1.25-2.09), respiratory symptoms (OR = 3.19, 95% CI = 2.30-4.43), and other comorbidities (OR = 1.65, 95% = 1.09-2.50)were positively associated with anxiety symptoms. A significant interaction was observed between gender and nonmanual labor (OR = 1.54, 95% = 1.29-1.85), respiratory symptoms (OR = 2.06, 95% = 1.72-2.48), and comorbidities (OR = 1.57, 95% = 1.16-2.12), such that effects were stronger in women compared to men. There were also significant interactions between age group and nonmanual labor and respiratory symptoms in their association with anxiety symptoms. CONCLUSIONS Alleviation of respiratory symptoms, addressing comorbidities, and both psychological and psychopharmacological treatments may help reduce anxiety symptoms following infection with the SARS-CoV-2 omicron variant in mainland China.
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Affiliation(s)
- Qing Chen
- School of Public Health, Zunyi Medical University, Zunyi, China
- Key Laboratory of Maternal & Child Health and Exposure Science of Guizhou Higher Education Institutes, Zunyi, China
| | - Yong Chen
- Department of Classical Chinese Medicine, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, China
| | - Yi Huang
- Department of Classical Chinese Medicine, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, China
| | - Qinglin Yang
- School of Public Health, Zunyi Medical University, Zunyi, China
- Key Laboratory of Maternal & Child Health and Exposure Science of Guizhou Higher Education Institutes, Zunyi, China
| | - De-Ying He
- Department of Classical Chinese Medicine, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, China
| | - Bang-Jiang Fang
- Department of Emergency, Longhua Hospital Affiliated to Shanghai University of Chinese Medicine, Shanghai, China
| | - Yi Ren
- Department of Classical Chinese Medicine, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, China
| | - Jun Liu
- School of Public Health, Zunyi Medical University, Zunyi, China
- Key Laboratory of Maternal & Child Health and Exposure Science of Guizhou Higher Education Institutes, Zunyi, China
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Zhong W, Luo J, Zhang H. The therapeutic effectiveness of artificial intelligence-based chatbots in alleviation of depressive and anxiety symptoms in short-course treatments: A systematic review and meta-analysis. J Affect Disord 2024; 356:459-469. [PMID: 38631422 DOI: 10.1016/j.jad.2024.04.057] [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: 10/07/2023] [Revised: 04/10/2024] [Accepted: 04/14/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND The emergence of artificial intelligence-based chatbot has revolutionized the field of clinical psychology and psychotherapy, granting individuals unprecedented access to professional assistance, overcoming time constraints and geographical limitations with cost-effective convenience. However, despite its potential, there has been a noticeable gap in the literature regarding their effectiveness in addressing common mental health issues like depression and anxiety. This meta-analysis aims to evaluate the efficacy of AI-based chatbots in treating these conditions. METHODS A systematic search was executed across multiple databases, including PubMed, Cochrane Library, Web of Science, PsycINFO, and Embase on April 4th, 2024. The effect size of treatment efficacy was calculated using the standardized mean difference (Hedge's g). Quality assessment measures were implemented to ensure trial's quality. RESULTS In our analysis of 18 randomized controlled trials involving 3477 participants, we observed noteworthy improvements in depression (g = -0.26, 95 % CI = -0.34, -0.17) and anxiety (g = -0.19, 95 % CI = -0.29, -0.09) symptoms. The most significant benefits were evident after 8 weeks of treatment. However, at the three-month follow-up, no substantial effects were detected for either condition. LIMITATIONS Several limitations should be considered. These include the lack of diversity in the study populations, variations in chatbot design, and the use of different psychotherapeutic approaches. These factors may limit the generalizability of our findings. CONCLUSION This meta-analysis highlights the promising role of AI-based chatbot interventions in alleviating depressive and anxiety symptoms among adults. Our results indicate that these interventions can yield substantial improvements over a relatively brief treatment period.
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Affiliation(s)
- Wenjun Zhong
- Center for Studies of Education and Psychology of Ethnic Minorities in Southwest China, Southwest University, Chongqing, China
| | - Jianghua Luo
- Center for Studies of Education and Psychology of Ethnic Minorities in Southwest China, Southwest University, Chongqing, China.
| | - Hong Zhang
- Center for Psychological Health Education, Xinjiang University of Finance & Economics, Urumqi, Xinjiang, China
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5
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D'Aunno T, Neighbors CJ. Innovation in the Delivery of Behavioral Health Services. Annu Rev Public Health 2024; 45:507-525. [PMID: 37871139 DOI: 10.1146/annurev-publhealth-071521-024027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
Several factors motivate the need for innovation to improve the delivery of behavioral health services, including increased rates of mental health and substance use disorders, limited access to services, inconsistent use of evidence-based practices, and persistent racial and ethnic disparities. This narrative review identifies promising innovations that address these challenges, assesses empirical evidence for the effectiveness of these innovations and the extent to which they have been adopted and implemented, and suggests next steps for research. We review five categories of innovations: organizational models, including a range of novel locations for providing services and new ways of organizing services within and across sites; information and communication technologies; workforce; treatment technologies; and policy and regulatory changes. We conclude by discussing the need to strengthen and accelerate the contributions of implementation science to close the gap between the launch of innovative behavioral health services and their widespread use.
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Affiliation(s)
- Thomas D'Aunno
- Wagner Graduate School of Public Service, New York University, New York, NY, USA;
| | - Charles J Neighbors
- Department of Population Health, Grossman School of Medicine, New York University, New York, NY, USA
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Gruiskens JRJH, van Hoef LFM, Theunissen MM, Courtens AM, Gidding-Slok AHM, van Schayck OCP, van den Beuken-van Everdingen MMHJ. Recommendations for Improving Chronic Care in Times of a Pandemic Based on Patient Experiences. J Am Med Dir Assoc 2024; 25:623-632.e5. [PMID: 38000443 DOI: 10.1016/j.jamda.2023.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 08/24/2023] [Accepted: 10/14/2023] [Indexed: 11/26/2023]
Abstract
OBJECTIVES The COVID-19 pandemic had a profound and pervasive impact on the health of chronic care patients and disrupted care systems worldwide. Our research aimed to assess the impact of the pandemic on chronic care provision and provide recommendations for improving care provision, based on patient experiences. DESIGN Qualitative semi-structured interviews were held among patients with chronic obstructive pulmonary disease (COPD) or heart failure. SETTING AND PARTICIPANTS Using stratified sampling, 23 patients with COPD, heart failure, or both were recruited to participate in semi-structured interviews. In the summer of 2021, online interviews were conducted. METHODS An iterative process was adopted to analyze the data. Going back and forth through the data and our analytical structure, we first coded the data, and subsequently developed categories, themes, and aggregate dimensions. The data were synthesized in a data structure and a data table, which were analyzed using an interpretative approach. RESULTS We found 3 dimensions through which care might be improved: (1) proactive and adaptive health care organization and use of innovative technologies, (2) assistance in maintaining patient resilience and coping strategies, and (3) health care built on outreaching and person-centered care enabling identification of individual patient needs. Experiences of impaired accessibility to care, altered and unmet care demands and patient needs, and the negative impact of national containment strategies on patient resilience support the need for improvement in these dimensions. CONCLUSIONS AND IMPLICATIONS The in-depth insight gained on the impact of the pandemic on chronic care provision was used to propose recommendations for improving care, supported by not only the what and how but also the why developments require additional efforts made by policymakers and change agents, augmented by structural use and development of innovations. Health care organizations should be enabled to rapidly respond to changing internal and external environments, develop and implement innovations, and match care to patient needs.
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Affiliation(s)
- Jeroen R J H Gruiskens
- Department of Family Medicine, CAPHRI School of Public Health and Preventive Medicine, Maastricht University, Maastricht, The Netherlands.
| | - Liesbeth F M van Hoef
- Expertise Centre for Palliative Care, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Maurice M Theunissen
- Expertise Centre for Palliative Care, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Annemie M Courtens
- Expertise Centre for Palliative Care, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Annerika H M Gidding-Slok
- Department of Family Medicine, CAPHRI School of Public Health and Preventive Medicine, Maastricht University, Maastricht, The Netherlands
| | - Onno C P van Schayck
- Department of Family Medicine, CAPHRI School of Public Health and Preventive Medicine, Maastricht University, Maastricht, The Netherlands
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Ngamaba KH, Lombo LS, Makopa IK, Webber M, Liuta JM, Madinga JN, Mampunza SMM, Heap C. Mental health outcomes, literacy and service provision in low- and middle-income settings: a systematic review of the Democratic Republic of the Congo. NPJ MENTAL HEALTH RESEARCH 2024; 3:9. [PMID: 38609473 PMCID: PMC10956021 DOI: 10.1038/s44184-023-00051-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 12/20/2023] [Indexed: 04/14/2024]
Abstract
In the Democratic Republic of the Congo (DRC), the prevalence of mental health issues could be greater than in other low-income and middle-income countries because of major risk factors related to armed conflicts and poverty. Given that mental health is an essential component of health, it is surprising that no systematic evaluation of mental health in the DRC has yet been undertaken. This study aims to undertake the first systematic review of mental health literacy and service provision in the DRC, to bridge this gap and inform those who need to develop an evidence base. This could support policymakers in tackling the issues related to limited mental health systems and service provision in DRC. Following Cochrane and PRISMA guidelines, a systematic (Web of Science, Medline, Public Health, PsycINFO, and Google Scholar) search was conducted (January 2000 and August 2023). Combinations of key blocks of terms were used in the search such as DRC, war zone, mental health, post-traumatic stress disorder (PTSD), anxiety, depression, sexual violence, war trauma, resilience, mental health systems and service provision. We followed additional sources from reference lists of included studies. Screening was completed in two stages: title and abstract search, and full-text screening for relevance and quality. Overall, 50 studies were included in the review; the majority of studies (n = 31) were conducted in the Eastern region of the DRC, a region devastated by war and sexual violence. Different instruments were used to measure participants' mental health such as the Hopkins Symptoms Checklist (HSCL-25), The Harvard Trauma Questionnaire, Patient Health Questionnaire (PHQ-9); General Anxiety Disorder (GAD-7), and Positive and Negative Symptoms Scale (PANSS). Our study found that wartime sexual violence and extreme poverty are highly traumatic, and cause multiple, long-term mental health difficulties. We found that depression, anxiety, and PTSD were the most common problems in the DRC. Psychosocial interventions such as group therapy, family support, and socio-economic support were effective in reducing anxiety, depression, and PTSD symptoms. This systematic review calls attention to the need to support sexual violence survivors and many other Congolese people affected by traumatic events. This review also highlights the need for validating culturally appropriate measures, and the need for well-designed controlled intervention studies in low-income settings such as the DRC. Better public mental health systems and service provision could help to improve community cohesion, human resilience, and mental wellbeing. There is also an urgent need to address wider social issues such as poverty, stigma, and gender inequality in the DRC.
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Affiliation(s)
- Kayonda Hubert Ngamaba
- International Centre for Mental Health Social Research, Social Policy and Social Work, School for Business and Society, University of York, Heslington, York, YO10 5DD, UK.
| | - Laddy Sedzo Lombo
- Centre Spécialisé dans la Prise en charge Psychosociale en Santé Mentale (CSPEMRDC), Université Chrétienne de Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Israël Kenda Makopa
- Neuropsychiatre et Addictologue Centre Spécialisé dans la Prise en charge Psychosociale en Santé Mentale (CSPEMRDC), Université Chrétienne de Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Martin Webber
- International Centre for Mental Health Social Research, Social Policy and Social Work, School for Business and Society, University of York, Heslington, York, YO10 5DD, UK
| | - Jack M Liuta
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
| | - Joule Ntwan Madinga
- WHO Country Office DRC & Medical Parasitology and Epidemiology, Faculty of Medicine, University of Kikwit, Kikwit, Democratic Republic of Congo
| | - Samuel Ma Miezi Mampunza
- Faculte de Medicine University of Kinshasa & Université Protestante au Congo (UPC), Kinshasa, Democratic Republic of Congo
| | - Cheyann Heap
- International Centre for Mental Health Social Research, Social Policy and Social Work, School for Business and Society, University of York, Heslington, York, YO10 5DD, UK
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8
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Kerry MJ, Robin D, Albermann K, Dratva J. Measuring mental health action competencies in school teachers: internal and external validity evidence. Front Digit Health 2024; 6:1257392. [PMID: 38414714 PMCID: PMC10896949 DOI: 10.3389/fdgth.2024.1257392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 01/25/2024] [Indexed: 02/29/2024] Open
Abstract
Introduction Mental health literacy is receiving increasing research attention due to growing concerns for mental health globally. Among children, teachers have recently been recognized as playing a vital role in the recognition and reporting of potential mental health issues. Methods A nationally sampled cross-section of teachers was surveyed to examine the discriminant validity of the mental health literacy measure across levels of teaching. A survey collected a total of n = 369 teacher responses in Switzerland (Kindergarten = 76, Primary = 210, Secondary = 83). Item response theory (IRT) analyses were conducted. Results Inspection of psychometric properties indicated removal of two weak performing items. The 15-item measure exhibited a significant mean difference, such that class-responsibility function scored higher (M = 2.86, SD = .45) than non-responsible function (M = 2.68, SD = .45) teachers [t(309) = -2.20, p = .01]. It also exhibited a significant mean difference, such that more subjective experienced scored higher (M = 2.86, SD = .45) than less subjective experienced (M = 2.68, SD = .45) teachers [t(210) = -8.66, p < .01]. Discussion Hypotheses regarding age and role tenure were in the expected direction, but non-significant. The MHL measure for teachers demonstrated sound measurement properties supporting usage across teaching levels.
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Affiliation(s)
- Matthew J. Kerry
- Institute of Public Health, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Dominik Robin
- Institute of Public Health, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Kurt Albermann
- Centre of Social Paediatrics, Cantonal Hospital Winterthur, Winterthur, Switzerland
| | - Julia Dratva
- Institute of Public Health, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
- Medical Faculty, University of Basel, Basel, Switzerland
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Gichangi PB, Byrne ME, Thiongo MN, Waithaka M, Devoto B, Gummerson E, Wood SN, Anglewicz P, Decker MR. Impact of COVID-19 on the mental health of adolescents and youth in Nairobi, Kenya. Front Psychiatry 2024; 14:1209836. [PMID: 38389711 PMCID: PMC10881828 DOI: 10.3389/fpsyt.2023.1209836] [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: 04/21/2023] [Accepted: 08/07/2023] [Indexed: 02/24/2024] Open
Abstract
Objective To report on the mental health status of adolescents and youth in relation to the COVID-19 pandemic in Nairobi County, Kenya. Methodology This was a mixed-methods study with cross-sectional quantitative and qualitative components conducted in Nairobi County, Kenya from August to September 2020. The quantitative survey involved phone interviews of n = 1,217 adolescents and youth. Qualitative components included virtual focus group discussions (FGDs) with adolescents and youth (n = 64 unmarried youths aged 16-25 years, across 8 FGDs) and youth-serving stakeholders (n = 34, across 4 FGDs), key informant interviews (n = 12 higher-level stakeholders from Ministries of Health, Gender, and Education), and in-depth interviews with youth (n = 20) so as to examine the COVID-19 impact on mental health. Results Among the participants, 26.6% of young men and 30.0% of young women reported probable depressive symptoms, of whom 37.7% of young men and 38.9% of young women reported little interest or pleasure in doing various activities. Hopelessness and feeling down nearly every day was additionally reported by 10.7% of young women and 6.3% of young men. Further, about 8.8% of young men and 7.6% of young women reported they could not get the emotional help and support they may need from people in their life. Multivariable regression results showed an association between depressive symptoms and reduced working hours due to COVID-19 and increased intimate partner violence. Additionally, the results show that respondents with higher emotional help and support were less likely to report depressive symptoms. Qualitative results confirm the quantitative findings and exemplify the negative behavior arising from the impact of adherence to COVID-19 prevention measures. Conclusion Mental health issues were common among adolescents and youth and may have been augmented by isolation and economic hardships brought about by COVID-19 restrictions. There is a need for concerted efforts to support adolescents and young people to meet their mental health needs, while considering the unique variations by gender. There is need to urgently strengthen the mental health system in Kenya, including via integrating psychosocial support services in communities, schools, and healthcare services, to ensure adolescents and young persons are not left behind.
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Affiliation(s)
- Peter B Gichangi
- International Centre for Reproductive Health Kenya, Mombasa, Kenya
- Department of Environment and Health Sciences, Technical University of Mombasa, Mombasa, Kenya
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Meagan E Byrne
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Mary N Thiongo
- International Centre for Reproductive Health Kenya, Mombasa, Kenya
| | - Michael Waithaka
- International Centre for Reproductive Health Kenya, Mombasa, Kenya
| | - Bianca Devoto
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Elizabeth Gummerson
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Shannon N Wood
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Philip Anglewicz
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Michele R Decker
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
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10
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De Coninck D, Matthijs K, Van Bavel J, Luyten P. To be a freshman during the COVID-19 pandemic: A cross-lagged model of depression, mentalizing, and epistemic trust. Personal Ment Health 2024; 18:80-89. [PMID: 37960987 DOI: 10.1002/pmh.1598] [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: 03/09/2023] [Revised: 09/14/2023] [Accepted: 10/27/2023] [Indexed: 11/15/2023]
Abstract
Research has shown that severity of depression increased in freshmen during their first months at university due to increased social and academic pressures. Since the start of the COVID-19 pandemic, several cross-sectional studies have suggested that levels of depression in university students are higher than before the pandemic, but longitudinal data are largely lacking. This study investigated severity of depression and negative affect linked to the pandemic among freshmen during their first semester at a large university in Flanders, Belgium. We also investigated whether epistemic trust predicted severity of depression and pandemic-related negative affect and whether problems with reflective functioning (or mentalizing) mediated these relations. Participants in this two-wave prospective study were 289 first-year students of the Faculty of Psychology and Educational Sciences of a large Belgian university. We conducted paired samples t-tests and cross-panel analysis to answer the research question. The number of students at risk of clinical depression increased by 41% between T1 (early October 2020) and T2 (late December 2020). Epistemic mistrust at T1 was prospectively associated with an increase in the prevalence and severity of depression at T2. Problems with mentalizing and negative COVID-19-related affect were positively associated with severity of depression at T2 and mediated the association between epistemic mistrust and severity of depression at T2. The findings highlight the key role of epistemic trust in the development of depression among freshmen, with the COVID-19 pandemic presenting an additional source of uncertainty.
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Affiliation(s)
| | - Koen Matthijs
- Centre for Sociological Research, KU Leuven, Leuven, Belgium
| | - Jan Van Bavel
- Centre for Sociological Research, KU Leuven, Leuven, Belgium
| | - Patrick Luyten
- Psychoanalysis Unit, University College London, London, UK
- Clinical Psychology, KU Leuven, Leuven, Belgium
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11
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Sher L. Long COVID-19 and Suicide. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1458:51-57. [PMID: 39102189 DOI: 10.1007/978-3-031-61943-4_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/06/2024]
Abstract
Suicide is a significant public health problem around the world. More than 90% of individuals who die by suicide have a diagnosable psychiatric disorder, and most persons who attempt suicide also have a psychiatric illness. Depression, anxiety, posttraumatic symptoms, sleep disturbances, decreased energy, and cognitive abnormalities are the most frequently reported psychiatric symptoms of long COVID. All these conditions are associated with suicidal ideation and behavior. Therefore, individuals with long COVID may be at increased risk of suicide. Recent studies of patients with long COVID confirm that individuals with long COVID are at increased suicide risk. It is vital to educate clinicians taking care of long COVID individuals that patients with long COVID may be suicidal, that it is essential to screen patients with long COVID for suicidality, and if needed, suicide prevention interventions should be employed.
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Affiliation(s)
- Leo Sher
- James J. Peters VA Medical Center, 130 West Kingsbridge Road, New York, NY, 10468, USA.
- Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Columbia University College of Physicians and Surgeons, New York, NY, USA.
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Jagodics B, Szabó É. Is intergroup discrimination triggered by vaccination status? Exploring some social aspects of vaccinations during the COVID-19 pandemic. THE JOURNAL OF SOCIAL PSYCHOLOGY 2023; 163:826-840. [PMID: 35674409 DOI: 10.1080/00224545.2022.2085074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 05/17/2022] [Indexed: 10/18/2022]
Abstract
The pandemic has affected social relations in many ways, and even created new social groups through vaccination. The goal of this study was to explore whether intergroup discrimination regarding vaccination status can be observed in a resource allocation task. Participants (N = 818; Mage = 46.0 years) completed a resource allocation task. Results showed that the better-than-average effect was widespread among the participants as most of them perceived themselves more informed about the pandemic than others. The resource allocation task showed participants preferred to create maximum difference in favor of their group in intergroup situations, but decisions were fairer when targets' group membership was identical. Moreover, vaccinated people were more likely to use maximum difference strategies than non-vaccinated people. The results revealed that vaccination status changes the perception of intergroup situations, which may be important in planning future strategies to handle mass emergencies similar to the current pandemic.
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Park S, Cubillos L, Martinez-Camblor P, Bartels SM, Torrey WC, John DT, Cepeda M, Bell K, Castro S, Suárez-Obando F, Uribe-Restrepo JM, Gómez-Restrepo C, Marsch LA. Integrating Depression and Alcohol Use Care Into Primary Care in Low- and Middle-Income Countries: A Meta-Analysis. Psychiatr Serv 2023; 74:950-962. [PMID: 36852551 DOI: 10.1176/appi.ps.20220267] [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] [Indexed: 03/01/2023]
Abstract
OBJECTIVE Evaluation of the effectiveness of integration of depression and alcohol use disorder care into primary health care in low- and middle-income countries (LMICs) is limited. The authors aimed to quantify the effectiveness of integrating mental health care into primary care by examining depression and alcohol use disorder outcomes. The study updates a previous systematic review summarizing research on care integration in LMICs. METHODS Following PRISMA guidelines, the authors included studies from the previous review and studies published from 2017 to 2020 that included adults with alcohol use disorder or depression. Studies were evaluated for type of integration model with the typology developed previously. A meta-analysis using a random-effects model to assess effectiveness of integrated interventions was conducted. Meta-regression analyses to examine the impact of study characteristics on depression and alcohol use disorder outcomes were conducted. RESULTS In total, 49 new articles were identified, and 74 articles from the previous and current studies met inclusion criteria for the meta-analysis. Overall random effect sizes were 0.28 (95% CI=0.22-0.35) and 0.17 (95% CI=0.11-0.24) for studies targeting care integration for depression or for alcohol use disorder, respectively, into primary care in LMICs. High heterogeneity within and among studies was observed. No significant association was found between country income level and depression and alcohol use outcomes. However, differences in effect sizes between types of integration model were statistically significant (p<0.001). CONCLUSIONS Integration of mental health care into primary health care in LMICs was found to improve depression and alcohol use disorder outcomes. This evidence should be considered when designing interventions to improve mental health screening and treatment in LMICs.
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Affiliation(s)
- Sena Park
- Center for Technology and Behavioral Health (Park, Cubillos, Bartels, Torrey, John, Bell, Marsch), Department of Anesthesiology (Martinez-Camblor), Department of Psychiatry (Torrey, Marsch), Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; Department of Clinical Epidemiology and Biostatistics (Cepeda, Gómez-Restrepo), Department of Psychiatry and Mental Health (Castro, Suárez-Obando, Uribe-Restrepo, Gómez-Restrepo), Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Leonardo Cubillos
- Center for Technology and Behavioral Health (Park, Cubillos, Bartels, Torrey, John, Bell, Marsch), Department of Anesthesiology (Martinez-Camblor), Department of Psychiatry (Torrey, Marsch), Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; Department of Clinical Epidemiology and Biostatistics (Cepeda, Gómez-Restrepo), Department of Psychiatry and Mental Health (Castro, Suárez-Obando, Uribe-Restrepo, Gómez-Restrepo), Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Pablo Martinez-Camblor
- Center for Technology and Behavioral Health (Park, Cubillos, Bartels, Torrey, John, Bell, Marsch), Department of Anesthesiology (Martinez-Camblor), Department of Psychiatry (Torrey, Marsch), Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; Department of Clinical Epidemiology and Biostatistics (Cepeda, Gómez-Restrepo), Department of Psychiatry and Mental Health (Castro, Suárez-Obando, Uribe-Restrepo, Gómez-Restrepo), Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Sophia M Bartels
- Center for Technology and Behavioral Health (Park, Cubillos, Bartels, Torrey, John, Bell, Marsch), Department of Anesthesiology (Martinez-Camblor), Department of Psychiatry (Torrey, Marsch), Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; Department of Clinical Epidemiology and Biostatistics (Cepeda, Gómez-Restrepo), Department of Psychiatry and Mental Health (Castro, Suárez-Obando, Uribe-Restrepo, Gómez-Restrepo), Pontificia Universidad Javeriana, Bogotá, Colombia
| | - William C Torrey
- Center for Technology and Behavioral Health (Park, Cubillos, Bartels, Torrey, John, Bell, Marsch), Department of Anesthesiology (Martinez-Camblor), Department of Psychiatry (Torrey, Marsch), Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; Department of Clinical Epidemiology and Biostatistics (Cepeda, Gómez-Restrepo), Department of Psychiatry and Mental Health (Castro, Suárez-Obando, Uribe-Restrepo, Gómez-Restrepo), Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Deepak T John
- Center for Technology and Behavioral Health (Park, Cubillos, Bartels, Torrey, John, Bell, Marsch), Department of Anesthesiology (Martinez-Camblor), Department of Psychiatry (Torrey, Marsch), Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; Department of Clinical Epidemiology and Biostatistics (Cepeda, Gómez-Restrepo), Department of Psychiatry and Mental Health (Castro, Suárez-Obando, Uribe-Restrepo, Gómez-Restrepo), Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Magda Cepeda
- Center for Technology and Behavioral Health (Park, Cubillos, Bartels, Torrey, John, Bell, Marsch), Department of Anesthesiology (Martinez-Camblor), Department of Psychiatry (Torrey, Marsch), Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; Department of Clinical Epidemiology and Biostatistics (Cepeda, Gómez-Restrepo), Department of Psychiatry and Mental Health (Castro, Suárez-Obando, Uribe-Restrepo, Gómez-Restrepo), Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Kathleen Bell
- Center for Technology and Behavioral Health (Park, Cubillos, Bartels, Torrey, John, Bell, Marsch), Department of Anesthesiology (Martinez-Camblor), Department of Psychiatry (Torrey, Marsch), Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; Department of Clinical Epidemiology and Biostatistics (Cepeda, Gómez-Restrepo), Department of Psychiatry and Mental Health (Castro, Suárez-Obando, Uribe-Restrepo, Gómez-Restrepo), Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Sergio Castro
- Center for Technology and Behavioral Health (Park, Cubillos, Bartels, Torrey, John, Bell, Marsch), Department of Anesthesiology (Martinez-Camblor), Department of Psychiatry (Torrey, Marsch), Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; Department of Clinical Epidemiology and Biostatistics (Cepeda, Gómez-Restrepo), Department of Psychiatry and Mental Health (Castro, Suárez-Obando, Uribe-Restrepo, Gómez-Restrepo), Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Fernando Suárez-Obando
- Center for Technology and Behavioral Health (Park, Cubillos, Bartels, Torrey, John, Bell, Marsch), Department of Anesthesiology (Martinez-Camblor), Department of Psychiatry (Torrey, Marsch), Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; Department of Clinical Epidemiology and Biostatistics (Cepeda, Gómez-Restrepo), Department of Psychiatry and Mental Health (Castro, Suárez-Obando, Uribe-Restrepo, Gómez-Restrepo), Pontificia Universidad Javeriana, Bogotá, Colombia
| | - José Miguel Uribe-Restrepo
- Center for Technology and Behavioral Health (Park, Cubillos, Bartels, Torrey, John, Bell, Marsch), Department of Anesthesiology (Martinez-Camblor), Department of Psychiatry (Torrey, Marsch), Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; Department of Clinical Epidemiology and Biostatistics (Cepeda, Gómez-Restrepo), Department of Psychiatry and Mental Health (Castro, Suárez-Obando, Uribe-Restrepo, Gómez-Restrepo), Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Carlos Gómez-Restrepo
- Center for Technology and Behavioral Health (Park, Cubillos, Bartels, Torrey, John, Bell, Marsch), Department of Anesthesiology (Martinez-Camblor), Department of Psychiatry (Torrey, Marsch), Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; Department of Clinical Epidemiology and Biostatistics (Cepeda, Gómez-Restrepo), Department of Psychiatry and Mental Health (Castro, Suárez-Obando, Uribe-Restrepo, Gómez-Restrepo), Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Lisa A Marsch
- Center for Technology and Behavioral Health (Park, Cubillos, Bartels, Torrey, John, Bell, Marsch), Department of Anesthesiology (Martinez-Camblor), Department of Psychiatry (Torrey, Marsch), Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; Department of Clinical Epidemiology and Biostatistics (Cepeda, Gómez-Restrepo), Department of Psychiatry and Mental Health (Castro, Suárez-Obando, Uribe-Restrepo, Gómez-Restrepo), Pontificia Universidad Javeriana, Bogotá, Colombia
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14
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Moitra M, Owens S, Hailemariam M, Wilson KS, Mensa-Kwao A, Gonese G, Kamamia CK, White B, Young DM, Collins PY. Global Mental Health: Where We Are and Where We Are Going. Curr Psychiatry Rep 2023; 25:301-311. [PMID: 37256471 PMCID: PMC10230139 DOI: 10.1007/s11920-023-01426-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/15/2023] [Indexed: 06/01/2023]
Abstract
PURPOSE OF REVIEW To summarize recent findings in global mental health along several domains including socioeconomic determinants, inequities, funding, and inclusion in global mental health research and practice. RECENT FINDINGS Mental illness continues to disproportionately impact vulnerable populations and treatment coverage continues to be low globally. Advances in integrating mental health care and adopting task-shifting are accompanied by implementation challenges. The mental health impact of recent global events such as the COVID-19 pandemic, geo-political events, and environmental change is likely to persist and require coordinated care approaches for those in need of psychosocial support. Inequities also exist in funding for global mental health and there has been gradual progress in terms of building local capacity for mental health care programs and research. Lastly, there is an increasing effort to include people with lived experiences of mental health in research and policy shaping efforts. The field of global mental health will likely continue to be informed by evidence and perspectives originating increasingly from low- and middle-income countries along with ongoing global events and centering of relevant stakeholders.
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Affiliation(s)
- Modhurima Moitra
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, 98195, USA.
| | - Shanise Owens
- Department of Public Health, Department of Obstetrics, Gynecology and Reproductive Biology, Charles Stewart Mott, Michigan State University, East Lansing, USA
| | - Maji Hailemariam
- Department of Global Health, University of Washington, Seattle, USA
| | - Katherine S Wilson
- Department of Health Systems and Population Health, University of Washington, Seattle, USA
| | - Augustina Mensa-Kwao
- Department of Health Systems and Population Health, University of Washington, Seattle, USA
| | - Gloria Gonese
- Department of Health Systems and Population Health, University of Washington, Seattle, USA
| | - Christine K Kamamia
- Department of Health Systems and Population Health, University of Washington, Seattle, USA
| | - Belinda White
- Department of Health Systems and Population Health, University of Washington, Seattle, USA
| | - Dorraine M Young
- Department of Health Systems and Population Health, University of Washington, Seattle, USA
| | - Pamela Y Collins
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, 98195, USA
- Department of Health Systems and Population Health, University of Washington, Seattle, USA
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15
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van der Schyff EL, Ridout B, Amon KL, Forsyth R, Campbell AJ. Providing Self-Led Mental Health Support Through an Artificial Intelligence-Powered Chat Bot (Leora) to Meet the Demand of Mental Health Care. J Med Internet Res 2023; 25:e46448. [PMID: 37335608 DOI: 10.2196/46448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 04/21/2023] [Accepted: 05/17/2023] [Indexed: 06/21/2023] Open
Abstract
Digital mental health services are becoming increasingly valuable for addressing the global public health burden of mental ill-health. There is significant demand for scalable and effective web-based mental health services. Artificial intelligence (AI) has the potential to improve mental health through the deployment of chatbots. These chatbots can provide round-the-clock support and triage individuals who are reluctant to access traditional health care due to stigma. The aim of this viewpoint paper is to consider the feasibility of AI-powered platforms to support mental well-being. The Leora model is considered a model with the potential to provide mental health support. Leora is a conversational agent that uses AI to engage in conversations with users about their mental health and provide support for minimal-to-mild symptoms of anxiety and depression. The tool is designed to be accessible, personalized, and discreet, offering strategies for promoting well-being and acting as a web-based self-care coach. Across all AI-powered mental health services, there are several challenges in the ethical development and deployment of AI in mental health treatment, including trust and transparency, bias and health inequity, and the potential for negative consequences. To ensure the effective and ethical use of AI in mental health care, researchers must carefully consider these challenges and engage with key stakeholders to provide high-quality mental health support. Validation of the Leora platform through rigorous user testing will be the next step in ensuring the model is effective.
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Affiliation(s)
- Emma L van der Schyff
- Cyberpsychology Research Group, Biomedical Informatics and Digital Health Theme, School of Medical Sciences, The University of Sydney, Sydney, Australia
| | - Brad Ridout
- Cyberpsychology Research Group, Biomedical Informatics and Digital Health Theme, School of Medical Sciences, The University of Sydney, Sydney, Australia
| | - Krestina L Amon
- Cyberpsychology Research Group, Biomedical Informatics and Digital Health Theme, School of Medical Sciences, The University of Sydney, Sydney, Australia
| | - Rowena Forsyth
- Cyberpsychology Research Group, Biomedical Informatics and Digital Health Theme, School of Medical Sciences, The University of Sydney, Sydney, Australia
| | - Andrew J Campbell
- Cyberpsychology Research Group, Biomedical Informatics and Digital Health Theme, School of Medical Sciences, The University of Sydney, Sydney, Australia
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16
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Maechling C, Yrondi A, Cambon A. Mobile health in the specific management of first-episode psychosis: a systematic literature review. Front Psychiatry 2023; 14:1137644. [PMID: 37377474 PMCID: PMC10291100 DOI: 10.3389/fpsyt.2023.1137644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 05/23/2023] [Indexed: 06/29/2023] Open
Abstract
Purpose The purpose of this systematic literature review is to assess the therapeutic efficacy of mobile health methods in the management of patients with first-episode psychosis (FEP). Method The participants are patients with FEP. The interventions are smartphone applications. The studies assess the preliminary efficacy of various types of application. Results One study found that monitoring symptoms minimized relapses, visits to A&E and hospital admissions, while one study showed a decrease in positive psychotic symptoms. One study found an improvement in anxiety symptoms and two studies noted an improvement in psychotic symptoms. One study demonstrated its efficacy in helping participants return to studying and employment and one study reported improved motivation. Conclusion The studies suggest that mobile applications have potential value in the management of young patients with FEP through the use of various assessment and intervention tools. This systematic review has several limitations due to the lack of randomized controlled studies available in the literature.
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Affiliation(s)
- Claire Maechling
- Pôle de Psychiatrie, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Antoine Yrondi
- Service de Psychiatrie et de Psychologie Médicale, Centre Expert Dépression Résistante Fonda Mental, CHU de Toulouse, Hôpital Purpan, ToNIC Toulouse NeuroImaging Centre, Université de Toulouse, INSERM, UPS, Toulouse, France
| | - Amandine Cambon
- Programme d'intervention précoce RePeps, réseau Transition, Clinique Aufrery, Toulouse, France
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17
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Barnett ML, Puffer ES, Ng LC, Jaguga F. Effective training practices for non-specialist providers to promote high-quality mental health intervention delivery: A narrative review with four case studies from Kenya, Ethiopia, and the United States. Glob Ment Health (Camb) 2023; 10:e26. [PMID: 37854408 PMCID: PMC10579690 DOI: 10.1017/gmh.2023.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 03/06/2023] [Accepted: 04/29/2023] [Indexed: 10/20/2023] Open
Abstract
Mental health needs and disparities are widespread and have been exacerbated by the COVID-19 pandemic, with the greatest burden being on marginalized individuals worldwide. The World Health Organization developed the Mental Health Gap Action Programme to address growing global mental health needs by promoting task sharing in the delivery of psychosocial and psychological interventions. However, little is known about the training needed for non-specialists to deliver these interventions with high levels of competence and fidelity. This article provides a brief conceptual overview of the evidence concerning the training of non-specialists carrying out task-sharing psychosocial and psychological interventions while utilizing illustrative case studies from Kenya, Ethiopia, and the United States to highlight findings from the literature. In this article, the authors discuss the importance of tailoring training to the skills and needs of the non-specialist providers and their roles in the delivery of an intervention. This narrative review with four case studies advocates for training that recognizes the expertise that non-specialist providers bring to intervention delivery, including how they promote culturally responsive care within their communities.
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Affiliation(s)
- Miya L. Barnett
- Department of Counseling, Clinical, and School Psychology, Gevirtz Graduate School of Education, University of California, Santa Barbara, Santa Barbara, CA, USA
| | - Eve S. Puffer
- Department of Psychology and Neuroscience, Global Health Institute, Duke University, Durham, NC, USA
| | - Lauren C. Ng
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Florence Jaguga
- Department of Mental Health, Moi Teaching and Referral Hospital, Eldoret, Kenya
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18
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Buckman JEJ, Stott J, Main N, Antonie DM, Singh S, Naqvi SA, Aguirre E, Wheatley J, Cirkovic M, Leibowitz J, Cape J, Pilling S, Saunders R. Understanding the psychological therapy treatment outcomes for young adults who are not in education, employment, or training (NEET), moderators of outcomes, and what might be done to improve them. Psychol Med 2023; 53:2808-2819. [PMID: 37449486 PMCID: PMC10235648 DOI: 10.1017/s0033291721004773] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 09/10/2021] [Accepted: 11/01/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND To determine: whether young adults (aged 18-24) not in education, employment or training (NEET) have different psychological treatment outcomes to other young adults; any socio-demographic or treatment-related moderators of differential outcomes; and whether service-level changes are associated with better outcomes for those who are NEET. METHODS A cohort was formed of 20 293 young adults treated with psychological therapies in eight Improving Access to Psychological Therapies services. Pre-treatment characteristics, outcomes, and moderators of differential outcomes were compared for those who were and were not NEET. Associations between outcomes and the following were assessed for those that were NEET: missing fewer sessions, attending more sessions, having a recorded diagnosis, and waiting fewer days between referral and starting treatment. RESULTS Those who were NEET had worse outcomes: odds ratio (OR) [95% confidence interval (CI)] for reliable recovery = 0.68 (0.63-0.74), for deterioration = 1.41 (1.25-1.60), and for attrition = 1.31 (1.19-1.43). Ethnic minority participants that were NEET had better outcomes than those that were White and NEET. Living in deprived areas was associated with worse outcomes. The intensity of treatment (high or low) did not moderate outcomes, but having more sessions was associated with improved outcomes for those that were NEET: odds (per one-session increase) of reliable recovery = 1.10 (1.08-1.12), deterioration = 0.94 (0.91-0.98), and attrition = 0.68 (0.66-0.71). CONCLUSIONS Earlier treatment, supporting those that are NEET to attend sessions, and in particular, offering them more sessions before ending treatment might be effective in improving clinical outcomes. Additional support when working with White young adults that are NEET and those in more deprived areas may also be important.
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Affiliation(s)
- Joshua E. J. Buckman
- Centre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational & Health Psychology, University College London, 1-19 Torrington Place, London WC1E 7HB, UK
- iCope – Camden & Islington NHS Foundation Trust, St Pancras Hospital, London NW1 0PE, UK
| | - Joshua Stott
- ADAPT lab, Research Department of Clinical, Educational and Health Psychology, University College London, Gower Street, London, UK
| | - Nicole Main
- Let's Talk IAPT – Barnet, Enfield & Haringey Psychological Therapies Service, Barnet, Enfield & Haringey Mental Health Trust, London, UK
| | - Daniela M. Antonie
- Newham Talking Therapies – East London NHS Foundation Trust, Vicarage Lane Health Centre, Stratford, London E15 4ES, UK
| | - Satwant Singh
- Waltham Forest Talking Therapies – North East London Foundation Trust, Thorne House, London E11 4HU, UK
| | - Syed A. Naqvi
- Barking & Dagenham and Havering IAPT Services – North East London Foundation Trust, Church Elm Lane Health Centre, Dagenham, Essex RM10 9RR, UK
| | - Elisa Aguirre
- Redbridge Talking Therapies Service, North East London NHS Foundation Trust, London, UK
| | - Jon Wheatley
- Talk Changes: City & Hackney IAPT Service, Homerton University Hospital NHS Foundation Trust, London, UK
| | - Mirko Cirkovic
- Talk Changes: City & Hackney IAPT Service, Homerton University Hospital NHS Foundation Trust, London, UK
| | - Judy Leibowitz
- iCope – Camden & Islington NHS Foundation Trust, St Pancras Hospital, London NW1 0PE, UK
| | - John Cape
- Centre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational & Health Psychology, University College London, 1-19 Torrington Place, London WC1E 7HB, UK
| | - Stephen Pilling
- Centre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational & Health Psychology, University College London, 1-19 Torrington Place, London WC1E 7HB, UK
| | - Rob Saunders
- Centre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational & Health Psychology, University College London, 1-19 Torrington Place, London WC1E 7HB, UK
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19
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Armijos A, Bonz AG, Brown FL, Charlet D, Cohen F, Greene MC, Hermosilla S, James LE, Le Roch K. Ensuring equity in mental health and psychosocial support during the COVID-19 pandemic and beyond. Confl Health 2023; 17:7. [PMID: 36804874 PMCID: PMC9938796 DOI: 10.1186/s13031-023-00500-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 01/16/2023] [Indexed: 02/21/2023] Open
Abstract
Populations affected by armed conflict and other humanitarian crises are at elevated risk for mental health problems. While the COVID-19 pandemic has had broadly deleterious effects on livelihoods, economic well-being, and population health worldwide, vulnerable groups have been disproportionately impacted by the pandemic. Providing mental health and psychosocial support (MHPSS) services during these times to vulnerable groups, especially in low- and middle-income countries and humanitarian settings, is essential. In an effort to comply with the public health response to the pandemic and mitigate COVID-19 transmission, significant implementation adaptations were made to service delivery during the pandemic. This short report describes several strategies to ensure that equity was central to these adaptations and public health responses, and provides recommendations for ensuring continuity of this progress post-pandemic. Examples and key lessons learned are given related to strategies to increase access to MHPSS services, improve meaningful stakeholder engagement, develop and support community networks, and implement community-based psychosocial support groups. They come from diverse settings of Bangladesh, Colombia, Ecuador, and Lebanon. The COVID-19 pandemic has highlighted the importance of preventing and treating MHPSS issues. It also has created opportunities for innovative programming to address overlooked problems, improve the quality of services provided, and increase focus on equity. It is vital that we use the momentum and attention generated around MHPSS services during the COVID-19 pandemic to continue to build and improve existing MHPSS services in more equitable ways for vulnerable populations.
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Affiliation(s)
| | - Annie G. Bonz
- grid.446747.20000 0001 2166 084XHIAS, 1300 Spring Street, Suite 500, Silver Spring, MD 20910 USA
| | - Felicity L. Brown
- grid.487424.90000 0004 0414 0756Research and Development Department, War Child Holland, Helmholtzstraat 61-G, 1098 LE Amsterdam, The Netherlands
| | - Danielle Charlet
- grid.281053.d0000 0004 0375 9266University Research Co., LLC, 5404 Wisconsin Ave Suite 800, Chevy Chase, MD 20815 USA
| | - Flora Cohen
- grid.4367.60000 0001 2355 7002Washington University in St. Louis, Brookings Dr, St. Louis, MO 63130 USA
| | - M. Claire Greene
- grid.21729.3f0000000419368729Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY 10032 USA
| | - Sabrina Hermosilla
- grid.214458.e0000000086837370University of Michigan, 400 4th St, Ann Arbor, MI 48103 USA
| | - Leah E. James
- grid.435215.40000 0004 0431 9086Heartland Alliance International, 208 S. LaSalle Street, Suite 1300, Chicago, IL 60604 USA
| | - Karine Le Roch
- grid.452229.a0000 0004 0643 9612Action contre la Faim, 14 Boulevard de Douaumont, 75017 Paris, France
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20
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Falgas-Bague I, Thembo T, Kaiser JL, Hamer DH, Scott NA, Ngoma T, Paul R, Juntunen A, Rockers PC, Fink G. Trends in maternal mental health during the COVID-19 pandemic-evidence from Zambia. PLoS One 2023; 18:e0281091. [PMID: 36735688 PMCID: PMC9897519 DOI: 10.1371/journal.pone.0281091] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 01/16/2023] [Indexed: 02/04/2023] Open
Abstract
The COVID-19 pandemic has increased social and emotional stressors globally, increasing mental health concerns and the risk of psychiatric illness worldwide. To date, relatively little is known about the impact of the pandemic on vulnerable groups such as women and children in low-resourced settings who generally have limited access to mental health care. We explore two rounds of data collected as part of an ongoing trial of early childhood development to assess mental health distress among mothers of children under 5-years-old living in two rural areas of Zambia during the COVID-19 pandemic. We examined the prevalence of mental health distress among a cohort of 1105 mothers using the World Health Organization's Self-Reporting Questionnaire (SRQ-20) before the onset of the COVID-19 pandemic in August 2019 and after the first two infection waves in October-November 2021. Our primary outcome was mental health distress, defined as SRQ-20 score above 7. We analyzed social, economic and family level characteristics as factors modifying to the COVID-19 induced changes in the mental health status. At baseline, 22.5% of women were in mental health distress. The odds of mental health distress among women increased marginally over the first two waves of the pandemic (aOR1.22, CI 0.99-1.49). Women under age 30, with lower educational background, with less than three children, and those living in Eastern Province (compared to Southern Province) of Zambia, were found to be at highest risk of mental health deterioration during the pandemic. Our findings suggest that the prevalence of mental health distress is high in this population and has further worsened during COVID-19 pandemic. Public health interventions targeting mothers' mental health in low resource settings may want to particularly focus on young mothers with limited educational attainment.
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Affiliation(s)
- Irene Falgas-Bague
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Medicine, Mongan Research Institute, Disparities Research Unit, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- * E-mail:
| | - Thandiwe Thembo
- Department of Psychiatry, University of Zambia, Lusaka, Zambia
| | - Jeanette L. Kaiser
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Davidson H. Hamer
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Nancy A. Scott
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Thandiwe Ngoma
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Ravi Paul
- Department of Psychiatry, University of Zambia, Lusaka, Zambia
| | - Allison Juntunen
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Peter C. Rockers
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Günther Fink
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
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21
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Nooraeen S, Bazargan-Hejazi S, Naserbakht M, Vahidi C, Shojaerad F, Mousavi SS, Malakouti SK. Impact of COVID-19 pandemic on relapse of individuals with severe mental illness and their caregiver's burden. Front Public Health 2023; 11:1086905. [PMID: 36817882 PMCID: PMC9929280 DOI: 10.3389/fpubh.2023.1086905] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 01/05/2023] [Indexed: 02/05/2023] Open
Abstract
Background The implementation of quarantine and social distancing measures to control the COVID-19 pandemic led to restrictions at the community level and most of in-person psychiatric services were discontinued. This situation could affect the psychopathology of the patients and the burden of their caregivers. The aim of this study was to investigate the effects of COVID-19 pandemic on people with severe mental illnesses (SMIs) and their caregivers' burden. Method The study sample consisted of 86 patients with severe mental illness and 86 caregivers. The mental status, relapse rate, and rehospitalization rate of the patients and the general health status and burden of caregivers were investigated in three waves, including before and 3 and 6 months after the COVID-19 pandemic. Results The relapse rate of the patients was 14%, 33.7%, and 43% (p = 0.000) and the rehospitalization rate was 4.7%, 7%, and 10.5% in waves 0, 1, and 2, respectively (p = 0.000). Most of the psychopathological scales increased in three waves (p = 0.000). The caregivers' burden and health condition worsened during the nine months of the study as well (p = 0.000). Conclusion The COVID-19 pandemic led to the exacerbation of symptoms and increased the relapse rate in people with SMIs. It also worsened the caregivers' condition. People with severe mental illnesses (SMIs) and their caregivers are one of the most vulnerable groups on which the COVID-19 pandemic had a marked negative effect.
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Affiliation(s)
- Sara Nooraeen
- Mental Health Research Center, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran
| | - Shahrzad Bazargan-Hejazi
- Department of Psychiatry, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States
| | - Morteza Naserbakht
- Mental Health Research Center, Psychosocial Health Research Institute, Tehran, Iran
| | - Camelia Vahidi
- Andisheh-Salamat-Ravan Mental Rehabilitation Center, Tehran, Iran
| | | | | | - Seyed Kazem Malakouti
- Mental Health Research Center, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran,*Correspondence: Seyed Kazem Malakouti ✉
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22
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Hayes J, Carvajal-Velez L, Hijazi Z, Ahs JW, Doraiswamy PM, El Azzouzi FA, Fox C, Herrman H, Gornitzka CP, Staglin B, Wolpert M. You Can't Manage What You Do Not Measure - Why Adolescent Mental Health Monitoring Matters. J Adolesc Health 2023; 72:S7-S8. [PMID: 36229393 DOI: 10.1016/j.jadohealth.2021.04.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 04/16/2021] [Indexed: 01/12/2023]
Affiliation(s)
- Joseph Hayes
- Division of Psychiatry, University College London, London, United Kingdom
| | - Liliana Carvajal-Velez
- Division of Data, Analytics, Planning and Monitoring, Data and Analytics Section, UNICEF, New York, New York; Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
| | | | - Jill Witney Ahs
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Department of Health Sciences, Swedish Red Cross University College, Huddinge, Sweden
| | - P Murali Doraiswamy
- Departments of Psychiatry and Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Fatima Azzahra El Azzouzi
- Equity & Inclusion Steering Committee, Global Shapers Community, Vancouver, British Columbia, Canada
| | - Cameron Fox
- Platform for Shaping the Future of Health & Healthcare, World Economic Forum, San Francisco, California
| | - Helen Herrman
- Orygen and Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | | | | | - Miranda Wolpert
- Research Programmes, Wellcome Trust, London, United Kingdom; Department of Clinical, Education and Health Psychology, University College London, London, United Kingdom
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23
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Psychological Distress Increases 30-Fold Among People with HIV in the First Year on ART in Nigeria-a Call for Integrated Mental Health Services. Int J Behav Med 2023; 30:38-48. [PMID: 35226343 PMCID: PMC8883753 DOI: 10.1007/s12529-022-10068-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Few studies have longitudinally assessed psychological distress among people with HIV (PWH) initiating ART in resource-limited settings. METHOD Baseline, 6-month, and 12-month psychological distress were measured in a Nigerian cohort newly initiating therapy; the relationship between baseline factors and psychological distress at 12 months was assessed; and the association between psychological distress at 12 months and care retention or immunologic failure was determined. RESULTS Among 563 patients, median age was 38 years (IQR: 33-46 years), 62% were female, and 51% were married. Psychological distress increased from 3% at baseline to 34% at 12 months. Age (aOR 1.28, 95% CI 1.06-1.56), female sex (aOR 2.89, 95% CI 1.93-4.33), lack of disclosure (aOR 4.32, 95% CI 2.48-7.51), and time on ART (6 months [aOR 6.91, 95% CI 3.14-15.18] and 12 months [aOR 32.63, 95% CI 16.54-64.36]) were associated with psychological distress while being married (OR 0.42, 95% CI 0.30-0.61) was associated with reduced odds. Tweve-month psychological distress was associated with increased risk of immunologic failure (aOR 2.22, 95% CI 1.31-3.82). CONCLUSION The risk of psychological distress increased 30-fold in the first year on therapy in PWH in Nigeria.
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24
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Sifat MS, Tasnim N, Stoebenau K, Green KM. A qualitative exploration of university student perspectives on mindfulness-based stress reduction exercises via smartphone app in Bangladesh. Int J Qual Stud Health Well-being 2022; 17:2113015. [PMID: 35980122 PMCID: PMC9397412 DOI: 10.1080/17482631.2022.2113015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose Mental health problems are proliferating, and access to mental health care is difficult due to barriers imposed by the COVID-19 pandemic in low-income countries such as Bangladesh. University students are susceptible to mental health concerns, given their unique stressors (i.e., academic pressure, new social environment). Mindfulness techniques can promote mental health , yet their acceptability has not been examined among Bangladeshi university students. These techniques can be used on a digital app, to decrease barriers to use.Qualitative methods were used to examine the acceptability of mindfulness among university students in Bangladesh. In-depth interviews (n = 12) were conducted to examine student reactions to linguistically (Bangla) and culturally adapted mindfulness exercises. Thematic analysis generated three themes (1) previous experience with mindfulness (2) positive responses to and (3) improvements to mindfulness exercises. Results The results showed favourable attitudes towards the mindfulness content; students expressed positive psychological and physiological reactions. Students welcomed the concept of using these exercises on an app and felt it could overcomepast barriers to help-seeking. Conclusions This evidence suggests the value of exploring the acceptability of an app with mindfulness exercises for mental health promotion through a larger-scale pilot study in university students in Bangladesh.
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Affiliation(s)
- Munjireen S. Sifat
- The University of Oklahoma Health Science Center, Health Promotion Research Center, Oklahoma City, Oklahoma, USA
| | - Naima Tasnim
- BRAC James P Grant School of Public Health, Dhaka, Bangladesh
| | - Kirsten Stoebenau
- Department of Behavioral and Community Health, University of Maryland School of Public Health, College Park, Maryland, USA
| | - Kerry M. Green
- Department of Behavioral and Community Health, University of Maryland School of Public Health, College Park, Maryland, USA
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25
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Luo Q, Huang L, Wu N. The relationship between internet use preference and loneliness among college students during COVID-19: The chain mediating effect of online social support and self-esteem. Front Psychol 2022; 13:1058944. [PMID: 36619083 PMCID: PMC9813670 DOI: 10.3389/fpsyg.2022.1058944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
The outbreak of COVID-19, especially the demands of social interaction and spatial distancing behavior, has led to a surge in Internet use, which has also led to an increase in loneliness. Therefore, we investigated the role of online social support and self-esteem in the relationship between Internet use preference and loneliness. In this study, 1053 college students were surveyed with a questionnaire based on the framework of Ecological System Theory, and a chain mediation model was established to clarify the mechanism between Internet use preference and loneliness. The results show that Internet use preference not only positively predicts loneliness, but also indirectly influences loneliness through the mediators of online social support and self-esteem, thereby impacting loneliness through the "online social support → self-esteem" chain. The results also indicate the need to pay attention to college students' mental health status during COVID-19. The advent of COVID-19 has impacted people's lifestyles and has changed the impact of the Internet on individual mental health. This study provides a new way to further understand college students' Internet use preferences, online social support, self-esteem, and loneliness status during COVID-19. It provides targeted interventions for college students' loneliness during COVID-19.
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Affiliation(s)
- Qing Luo
- Department of Psychology, School of Public Policy and Administration, Nanchang University, Nanchang, China,*Correspondence: Qing Luo,
| | - Lu Huang
- School of Marxism, Wuhan Business University, Wuhan, China
| | - Na Wu
- Department of Psychology, College of Education and Science, Hubei Normal University, Huangshi, China
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26
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Steidtmann D, McBride S, Mishkind M. Patient Experiences With Telemental Health During the COVID-19 Pandemic. J Patient Exp 2022; 9:23743735221145077. [PMID: 36545478 PMCID: PMC9761235 DOI: 10.1177/23743735221145077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Telemental health (TMH) was an effective and relatively well-accepted way of delivering mental health care prior to the COVID-19 pandemic and has become widely adopted through the pandemic. Although recent findings show telehealth remains relatively well accepted across health care broadly, little is known about how patient experiences of TMH may have changed through the pandemic as many sectors were virtualized. These findings describe patient experiences with TMH at an outpatient mental health clinic approximately 1 year after the clinic rapidly transitioned to full TMH due to COVID-19. Respondents are 137 adult patients. Most patients reported TMH to be extremely or very effective (85.0%) and better than anticipated (76.8%). Most patients (74.6%) were interested in continuing at least some visits by TMH after the pandemic. A small subset of patients who rated their relationship with their provider as better in-person than by TMH also reported a preference for most or all visits in-person. Results provide preliminary support that TMH remains a well-accepted option for many patients. Mental health clinics may best serve patients by offering a hybrid model of care that includes both TMH and in-person services.
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Affiliation(s)
- Dana Steidtmann
- Departments of Psychiatry and Family Medicine, Helen and Arthur
E. Johnson Depression Center, School of Medicine, University of Colorado
Anschutz Medical Campus, Aurora, CO, USA,Dana Steidtmann, Department of Psychiatry
and Family Medicine, Helen and Arthur E. Johnson Depression Center, School of
Medicine, University of Colorado Anschutz Medical Campus, MS F550, 1890 S. South
Revere Ct., Suite 5240, Aurora, CO 80045, USA.
| | - Samantha McBride
- Departments of Psychiatry and Family Medicine, Helen and Arthur
E. Johnson Depression Center, School of Medicine, University of Colorado
Anschutz Medical Campus, Aurora, CO, USA
| | - Matthew Mishkind
- Departments of Psychiatry and Family Medicine, Helen and Arthur
E. Johnson Depression Center, School of Medicine, University of Colorado
Anschutz Medical Campus, Aurora, CO, USA
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27
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Clemente-Suárez VJ, Bustamante-Sanchez Á, Tornero-Aguilera JF, Ruisoto P, Mielgo-Ayuso J. Inflammation in COVID-19 and the Effects of Non-Pharmacological Interventions during the Pandemic: A Review. Int J Mol Sci 2022; 23:ijms232415584. [PMID: 36555231 PMCID: PMC9779440 DOI: 10.3390/ijms232415584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/25/2022] [Accepted: 12/04/2022] [Indexed: 12/13/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused the coronavirus disease 2019 (COVID-19) pandemic that hit the health systems worldwide hard, causing a collapse of healthcare systems. One of the main problems of this new virus is the high inflammatory response it provokes, which is the cause of much of the symptoms. Different pharmacological approaches tried to stop the advance of the pandemic, but it seems that only vaccines are the solution. In this line, different nonpharmacological approaches have been made in order to improve symptomatology, contagion, and spread of COVID-19, the principal factors being the physical activity, nutrition, physiotherapy, psychology, and life patterns. The SARS-CoV-2 virus produces a disproportionate inflammatory response in the organism of the guest and causes complications in this that can end the life of the patient. It has been possible to see how different nonpharmacological interventions based on physical activity, nutritional, psychological, and physical therapy, and lifestyle changes can be functional tools to treat this inflammation. Thus, in the present review, we aim to provide an overview of the role of inflammation in COVID-19 and the nonpharmacological interventions related to it.
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Affiliation(s)
- Vicente Javier Clemente-Suárez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain
- Research Center in Applied Combat (CESCA), 45007 Toledo, Spain
- Correspondence:
| | | | - José Francisco Tornero-Aguilera
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain
- Research Center in Applied Combat (CESCA), 45007 Toledo, Spain
| | - Pablo Ruisoto
- Department of Health Sciences, Public University of Navarre, 31006 Pamplona, Spain
| | - Juan Mielgo-Ayuso
- Department of Health Sciences, Faculty of Health Sciences, University of Burgos, 09001 Burgos, Spain
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28
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Leung T, Okumu M, Kortenaar JL, Gittings L, Khan N, Hakiza R, Kibuuka Musoke D, Nakitende A, Katisi B, Kyambadde P, Khan T, Lester R, Mbuagbaw L. Mobile Health-Supported Virtual Reality and Group Problem Management Plus: Protocol for a Cluster Randomized Trial Among Urban Refugee and Displaced Youth in Kampala, Uganda (Tushirikiane4MH, Supporting Each Other for Mental Health). JMIR Res Protoc 2022; 11:e42342. [PMID: 36480274 PMCID: PMC9782374 DOI: 10.2196/42342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/20/2022] [Accepted: 10/28/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Although mental health challenges disproportionately affect people in humanitarian contexts, most refugee youth do not receive the mental health support needed. Uganda is the largest refugee-hosting nation in Africa, hosting over 1.58 million refugees in 2022, with more than 111,000 living in the city of Kampala. There is limited information about effective and feasible interventions to improve mental health outcomes and mental health literacy, and to reduce mental health stigma among urban refugee adolescents and youth in low- and middle-income countries (LMICs). Virtual reality (VR) is a promising approach to reduce stigma and improve mental health and coping, yet such interventions have not yet been tested in LMICs where most forcibly displaced people reside. Group Problem Management Plus (GPM+) is a scalable brief psychological transdiagnostic intervention for people experiencing a range of adversities, but has not been tested with adolescents and youth to date. Further, mobile health (mHealth) strategies have demonstrated promise in promoting mental health literacy. OBJECTIVE The aim of this study is to evaluate the feasibility and effectiveness of two youth-tailored mental health interventions (VR alone and VR combined with GMP+) in comparison with the standard of care in improving mental health outcomes among refugee and displaced youth aged 16-24 years in Kampala, Uganda. METHODS A three-arm cluster randomized controlled trial will be implemented across five informal settlements grouped into three sites, based on proximity, and randomized in a 1:1:1 design. Approximately 330 adolescents (110 per cluster) are enrolled and will be followed for approximately 16 weeks. Data will be collected at three time points: baseline enrollment, 8 weeks following enrollment, and 16 weeks after enrollment. Primary (depression) and secondary outcomes (mental health literacy, attitudes toward mental help-seeking, adaptive coping, mental health stigma, mental well-being, level of functioning) will be evaluated. RESULTS The study will be conducted in accordance with CONSORT (Consolidated Standards of Reporting Trials) guidelines. The study has received ethical approval from the University of Toronto (#40965; May 12, 2021), Mildmay Uganda Research Ethics Committee (MUREC-2021-41; June 24, 2021), and Uganda National Council for Science & Technology (SS1021ES; January 1, 2022). A qualitative formative phase was conducted using focus groups and in-depth, semistructured key informant interviews to understand contextual factors influencing mental well-being among urban refugee and displaced youth. Qualitative findings will inform the VR intervention, SMS text check-in messages, and the adaptation of GPM+. Intervention development was conducted in collaboration with refugee youth peer navigators. The trial launched in June 2022 and the final follow-up survey will be conducted in November 2022. CONCLUSIONS This study will contribute to the knowledge of youth-tailored mental health intervention strategies for urban refugee and displaced youth living in informal settlements in LMIC contexts. Findings will be shared in peer-reviewed publications, conference presentations, and with community dissemination. TRIAL REGISTRATION ClinicalTrials.gov NCT05187689; https://clinicaltrials.gov/ct2/show/NCT05187689. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/42342.
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Affiliation(s)
| | - Moses Okumu
- School of Social Work, University of Illinois, Urban-Champaign, IL, United States.,School of Social Sciences, Uganda Christian University, Mukono, Uganda
| | - Jean-Luc Kortenaar
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Lesley Gittings
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada.,School of Health Studies, Faculty of Health Sciences, Western University, London, ON, Canada.,Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
| | - Naimul Khan
- Electrical, Computer, and Biomedical Engineering, Toronto Metropolitan University, Toronto, ON, Canada
| | - Robert Hakiza
- Young African Refugees for Integral Development, Kampala, Uganda
| | | | | | - Brenda Katisi
- Young African Refugees for Integral Development, Kampala, Uganda
| | - Peter Kyambadde
- National AIDS and STI Control Programme, Ministry of Health, Kampala, Uganda.,Most At Risk Population Initiative, Mulago Hospital, Kampala, Uganda
| | - Torsum Khan
- Electrical, Computer, and Biomedical Engineering, Toronto Metropolitan University, Toronto, ON, Canada
| | - Richard Lester
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.,Department of Anesthesia, McMaster University, Hamilton, ON, Canada.,Department of Pediatrics, McMaster University, Hamilton, ON, Canada.,Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare, Hamilton, ON, Canada.,Centre for Development of Best Practices in Health, Yaoundé Central Hospital, Yaoundé, Cameroon.,Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town, South Africa
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29
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Gjoneska B, Potenza MN, Jones J, Sales CM, Hranov G, Demetrovics Z. Problematic use of the Internet in low- and middle-income countries before and during the COVID-19 pandemic: a scoping review. Curr Opin Behav Sci 2022; 48:101208. [PMID: 35919788 PMCID: PMC9334935 DOI: 10.1016/j.cobeha.2022.101208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
People from low- and middle-income countries (LMICs) represent large portions of the world population, often occupy less favorable living conditions, and typically suffer greater health risks, yet frequently receive little research and global health attention. The present study reviews emerging evidence on problematic use of the Internet (PUI) in LMICs prior/during the COVID-19 pandemic. Analyzed studies mainly focused on general properties of PUI in university students, problematic gaming in youth, or problematic use of social media in adults, registering higher prevalence estimates, as compared with earlier reports. Research mainly focused on initially affected regions and COVID-exposed populations. Overall, unfavorable circumstances, including poor social support, family relationships, and lifestyle tendencies/habits, may present potential risk for PUI in LMICs, likely exacerbated during the pandemic.
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Affiliation(s)
- Biljana Gjoneska
- Macedonian Academy of Sciences and Arts, Krste Misirkov 2, 1000 Skopje, North Macedonia
| | - Marc N Potenza
- Department of Psychiatry and Child Study Center, Yale University School of Medicine, New Haven, CT 06511, United States
- Department of Neuroscience and Wu Tsai Institute, Yale University, New Haven, CT 06510, United States
- Connecticut Mental Health Centre, New Haven, CT 06519, United States
- Connecticut Council on Problem Gambling, Wethersfield, CT 06109, United States
| | - Julia Jones
- Centre for Research in Public Health and Community Care, University of Hertfordshire, Hatfield AL10 9AB, United Kingdom
| | - Célia Md Sales
- Centre for Psychology, University of Porto, R. Alfredo Allen, 4200-135 Porto, Portugal
- Faculty of Psychology and Education Sciences, University of Porto, R. Alfredo Allen, 4200-135 Porto, Portugal
| | | | - Zsolt Demetrovics
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
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30
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Blukacz A, Cabieses B, Obach A, Madrid P, Carreño A, Pickett KE, Markkula N. "If I get sick here, I will never see my children again": The mental health of international migrants during the COVID-19 pandemic in Chile. PLoS One 2022; 17:e0277517. [PMID: 36445885 PMCID: PMC9707751 DOI: 10.1371/journal.pone.0277517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 10/28/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has had an impact on the mental health of international migrants globally. Chile has managed its response to the pandemic in an ongoing context of social unrest and combined regional migratory and humanitarian crisis. The country's population presents a high prevalence of common mental disorders and a high suicide rate, with limited access to mental healthcare. International migrants in Chile represent 8% of the total population, and although a socioeconomically heterogenous group, they face social vulnerability, a range of mental health stressors and additional barriers to access mental healthcare. This study describes the mental health outcomes, stressors, response, and coping strategies perceived by international migrants during the COVID-19 pandemic in Chile. METHODS AND FINDINGS A qualitative case study was carried out through individual online interviews to 30 international migrants living in Chile during the pandemic and 10 experts of the social and health care sectors. An inductive content analysis was carried out, a process during which the researchers sought to identify patterns and themes derived from the data. Participants experienced mainly negative mental health outcomes, including anxiety and depression symptomatology. Stressors included the virus itself, work, living and socioeconomic conditions, discrimination, fear for their family and distance caring. Institutional responses to address the mental health of international migrants during the pandemic in Chile were limited and participants relied mainly on individual coping strategies. CONCLUSIONS The pandemic can represent an important opportunity to strengthen mental health systems for the general population as well as for population groups experiencing social vulnerability, if the issues identified and the lessons learned are translated into action at national, regional, and international level. Promoting the mental health of international migrants means recognising migration as a social determinant of mental health and adopting a cross-cultural as well as a Human Rights approach.
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Affiliation(s)
- Alice Blukacz
- Facultad de Medicina Clínica Alemana, Instituto de Ciencias e Innovación en Medicina, Universidad del Desarrollo, Santiago, Chile
| | - Báltica Cabieses
- Facultad de Medicina Clínica Alemana, Instituto de Ciencias e Innovación en Medicina, Universidad del Desarrollo, Santiago, Chile
- * E-mail:
| | - Alexandra Obach
- Facultad de Medicina Clínica Alemana, Instituto de Ciencias e Innovación en Medicina, Universidad del Desarrollo, Santiago, Chile
| | - Paula Madrid
- Facultad de Medicina Clínica Alemana, Instituto de Ciencias e Innovación en Medicina, Universidad del Desarrollo, Santiago, Chile
| | - Alejandra Carreño
- Facultad de Medicina Clínica Alemana, Instituto de Ciencias e Innovación en Medicina, Universidad del Desarrollo, Santiago, Chile
| | - Kate E. Pickett
- Department of Health Sciences, University of York, York, United Kingdom
| | - Niina Markkula
- Faculty of Medicine, Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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31
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Alradhi MA, Moore J, Patte KA, O’Leary DD, Wade TJ. Adverse Childhood Experiences and COVID-19 Stress on Changes in Mental Health among Young Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12874. [PMID: 36232173 PMCID: PMC9566166 DOI: 10.3390/ijerph191912874] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/03/2022] [Accepted: 10/05/2022] [Indexed: 06/16/2023]
Abstract
The COVID-19 pandemic has been linked to poor mental health outcomes and may be particularly damaging for young adults who may be more affected by governmental pandemic responses such as mandatory school and work closures, online schooling, and social isolation. Exposure to Adverse Childhood Experiences (ACEs) has also been shown to have a significant impact on mental health among young adults. This prospective study examined whether young adults with higher ACE profiles were more vulnerable to COVID-19 stressors. Using pre-COVID-19 data from the Niagara Longitudinal Heart Study and a follow-up online survey during COVID-19, we examined 171 young adults and found that high COVID-19-related stress, especially emotional and relationship stress, led to a greater reduction in mental health among young adults with higher levels of ACEs. Findings indicate that young adults with high ACE profiles may benefit from resources and intervention programs directed at mental health in times of crisis, such as the COVID-19 pandemic.
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Affiliation(s)
- Meshari A. Alradhi
- Department of Health Sciences, Faculty of Applied Health Sciences, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON L2S 3A1, Canada
| | - Jessy Moore
- Department of Health Sciences, Faculty of Applied Health Sciences, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON L2S 3A1, Canada
| | - Karen A. Patte
- Department of Health Sciences, Faculty of Applied Health Sciences, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON L2S 3A1, Canada
| | - Deborah D. O’Leary
- Department of Health Sciences, Faculty of Applied Health Sciences, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON L2S 3A1, Canada
- Brock-Niagara Centre for Health and Well-Being, 130 Lockhart Dr, St. Catharines, ON L2T 1W5, Canada
| | - Terrance J. Wade
- Department of Health Sciences, Faculty of Applied Health Sciences, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON L2S 3A1, Canada
- Brock-Niagara Centre for Health and Well-Being, 130 Lockhart Dr, St. Catharines, ON L2T 1W5, Canada
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Steeg S, John A, Gunnell DJ, Kapur N, Dekel D, Schmidt L, Knipe D, Arensman E, Hawton K, Higgins JPT, Eyles E, Macleod-Hall C, McGuiness LA, Webb RT. The impact of the COVID-19 pandemic on presentations to health services following self-harm: systematic review. Br J Psychiatry 2022; 221:603-612. [PMID: 35816104 DOI: 10.1192/bjp.2022.79] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Evidence on the impact of the pandemic on healthcare presentations for self-harm has accumulated rapidly. However, existing reviews do not include studies published beyond 2020. AIMS To systematically review evidence on presentations to health services following self-harm during the COVID-19 pandemic. METHOD A comprehensive search of databases (WHO COVID-19 database; Medline; medRxiv; Scopus; PsyRxiv; SocArXiv; bioRxiv; COVID-19 Open Research Dataset, PubMed) was conducted. Studies published from 1 January 2020 to 7 September 2021 were included. Study quality was assessed with a critical appraisal tool. RESULTS Fifty-one studies were included: 57% (29/51) were rated as 'low' quality, 31% (16/51) as 'moderate' and 12% (6/51) as 'high-moderate'. Most evidence (84%, 43/51) was from high-income countries. A total of 47% (24/51) of studies reported reductions in presentation frequency, including all six rated as high-moderate quality, which reported reductions of 17-56%. Settings treating higher lethality self-harm were overrepresented among studies reporting increased demand. Two of the three higher-quality studies including study observation months from 2021 reported reductions in self-harm presentations. Evidence from 2021 suggests increased numbers of presentations among adolescents, particularly girls. CONCLUSIONS Sustained reductions in numbers of self-harm presentations were seen into the first half of 2021, although this evidence is based on a relatively small number of higher-quality studies. Evidence from low- and middle-income countries is lacking. Increased numbers of presentations among adolescents, particularly girls, into 2021 is concerning. Findings may reflect changes in thresholds for help-seeking, use of alternative sources of support and variable effects of the pandemic across groups.
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Affiliation(s)
- Sarah Steeg
- Centre for Mental Health and Safety, Division of Psychology and Mental Health, University of Manchester, UK; and Manchester Academic Health Science Centre, UK
| | - Ann John
- Medical School, Swansea University, UK; and Public Health Wales NHS Trust, UK
| | - David J Gunnell
- Population Health Sciences, Bristol Medical School, University of Bristol, UK; and National Institute for Health Research Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, UK
| | - Nav Kapur
- Division of Psychology and Mental Health, University of Manchester, UK;NIHR Greater Manchester Patient Safety Translational Research Centre, UK; and Greater Manchester Mental Health NHS Foundation Trust, UK
| | - Dana Dekel
- Department of Population Psychiatry, Suicide and Informatics, Swansea University, UK
| | - Lena Schmidt
- Sciome LLC, North Carolina, USA; Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Duleeka Knipe
- Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Ella Arensman
- School of Public Health and National Suicide Research Foundation, University College Cork, Ireland; and Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Australia
| | - Keith Hawton
- Centre for Suicide Research, Department of Psychiatry, University of Oxford, UK; and Warneford Hospital, Oxford Health NHS Foundation Trust, UK
| | - Julian P T Higgins
- National Institute for Health Research Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, UK; National Institute for Health Research Applied Research Collaboration West, University Hospitals Bristol and Weston NHS Foundation Trust, UK; and Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Emily Eyles
- National Institute for Health Research Applied Research Collaboration West, University Hospitals Bristol and Weston NHS Foundation Trust, UK; and Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | | | - Luke A McGuiness
- Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Roger T Webb
- Division of Psychology and Mental Health, University of Manchester, UK; and NIHR Greater Manchester Patient Safety Translational Research Centre, UK
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Körbel K, Rosenow F, Maltseva M, Müller H, Schulz J, Tsalouchidou PE, Langenbruch L, Kovac S, Menzler K, Hamacher M, von Podewils F, Willems LM, Mann C, Strzelczyk A. Impact of COVID-19 pandemic on physical and mental health status and care of adults with epilepsy in Germany. Neurol Res Pract 2022; 4:44. [PMID: 36131301 PMCID: PMC9492304 DOI: 10.1186/s42466-022-00209-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 07/29/2022] [Indexed: 11/23/2022] Open
Abstract
Background To mitigate the potential consequences of the coronavirus disease 2019 (COVID-19) pandemic on public life, the German Federal Government and Ministry of Health enacted a strict lockdown protocol on March 16, 2020. This study aimed to evaluate the impact of the COVID-19 pandemic on physical and mental health status and the supply of medical care and medications for people with epilepsy (PWE) in Germany. Methods The Epi2020 study was a large, multicenter study focused on different healthcare aspects of adults with epilepsy. In addition to clinical and demographic characteristics, patients were asked to answer a questionnaire on the impact of the first wave of the COVID-19 pandemic between March and May 2020. Furthermore, the population-based number of epilepsy-related admissions in Hessen was evaluated for the January-June periods of 2017–2020 to detect pandemic-related changes. Results During the first wave of the pandemic, 41.6% of PWE reported a negative impact on their mental health, while only a minority reported worsening of their seizure situation. Mental and physical health were significantly more negatively affected in women than men with epilepsy and in PWE without regular employment. Moreover, difficulties in ensuring the supply of sanitary products (25.8%) and antiseizure medications (ASMs; 19.9%) affected PWE during the first lockdown; no significant difference regarding these impacts between men and women or between people with and without employment was observed. The number of epilepsy-related admissions decreased significantly during the first wave. Conclusions This analysis provides an overview of the general and medical care of epilepsy patients during the COVID-19 pandemic. PWE in our cohort frequently reported psychosocial distress during the first wave of the pandemic, with significant adverse effects on mental and physical health. Women and people without permanent jobs especially reported distress due to the pandemic. The COVID‐19 pandemic has added to the mental health burden and barriers to accessing medication and medical services, as self-reported by patients and verified in population-based data on hospital admissions. Trial registration German Clinical Trials Register (DRKS), DRKS00022024. Registered October 2, 2020, http://www.drks.de/DRKS00022024
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Apeti AE. Does trust in government improve Covid-19’s crisis management? SN SOCIAL SCIENCES 2022; 2:202. [PMID: 36158179 PMCID: PMC9489261 DOI: 10.1007/s43545-022-00505-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 08/31/2022] [Indexed: 11/29/2022]
Abstract
Countries have adopted several measures to control the spread of Covid-19. However, substantial differences remain in terms of performance in controlling the virus, potentially due to heterogeneity in citizen engagement with government measures. Although the literature documents the effects of trust in government on compliance with health restrictions related to the health crisis, little is said about the direct effect of trust in government on managing the Covid-19 crisis, defined as the number of cases and deaths. Drawing on this observation, this paper seeks to analyze the effect of pre–crisis ties, particularly trust in government, on crisis management, proxied by the number of Covid-19 cases and deaths per million population. We examine this question based on a sample of 41 countries for which data are available and using the Ordinary Least Squares (OLS) method. Results reveal that a high level of trust in government predicts better crisis management in terms of relatively low levels of cases and deaths. These results, which successfully pass a series of robustness tests, may vary according to level of contamination and increase with time. This paper, therefore, suggests that building trust between the public and the authorities, essentially governments and citizens, is essential for crisis management, taking the example of the Covid-19 pandemic.
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Affiliation(s)
- Ablam Estel Apeti
- Université Clermont Auvergne, CNRS, IRD, CERDI, 63000 Clermont-Ferrand, France
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35
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Mutyambizi-Mafunda V, Myers B, Sorsdahl K, Chanakira E, Lund C, Cleary S. Economic evaluation of psychological treatments for common mental disorders in low- and middle-income countries: a systematic review. Health Policy Plan 2022; 38:239-260. [PMID: 36005943 PMCID: PMC9923379 DOI: 10.1093/heapol/czac069] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 07/29/2022] [Accepted: 08/25/2022] [Indexed: 11/13/2022] Open
Abstract
Common mental disorders (CMDs) constitute a major public health and economic burden on low- and middle-income countries (LMICs). Systematic reviews of economic evaluations of psychological treatments for CMDs are limited. This systematic review examines methods, reports findings and appraises the quality of economic evaluations of psychological treatments for CMDs in LMICs. We searched a range of bibliographic databases (including PubMed, EconLit, APA-PsycINFO and Cochrane library) and the African Journals Online (AJoL) and Google Scholar platforms. We used a pre-populated template to extract data and the Drummond & Jefferson checklist for quality appraisal. We present results as a narrative synthesis. The review included 26 studies, mostly from Asia (12) and Africa (9). The majority were cost-effectiveness analyses (12), some were cost-utility analyses (5), with one cost-benefit analysis or combinations of economic evaluations (8). Most interventions were considered either cost-effective or potentially cost-effective (22), with 3 interventions being not cost-effective. Limitations were noted regarding appropriateness of conclusions drawn on cost-effectiveness, the use of cost-effectiveness thresholds and application of 'societal' incremental cost-effectiveness ratios to reflect value for money (VfM) of treatments. Non-specialist health workers (NSHWs) delivered most of the treatments (16) for low-cost delivery at scale, and costs should reflect the true opportunity cost of NSHWs' time to support the development of a sustainable cadre of health care providers. There is a 4-fold increase in economic evaluations of CMD psychological treatments in the last decade over the previous one. Yet, findings from this review highlight the need for better application of economic evaluation methodology to support resource allocation towards the World Health Organization recommended first-line treatments of CMDs. We suggest impact inventories to capture societal economic gains and propose a VfM assessment framework to guide researchers in evaluating cost-effectiveness.
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Affiliation(s)
- Vimbayi Mutyambizi-Mafunda
- *Corresponding author. Health Economics Unit, School of Public Health and Family Medicine, Health Sciences Faculty, University of Cape Town, Anzio Road, Observatory, Cape Town 7925, South Africa. E-mail:
| | - Bronwyn Myers
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Kent Street, Bentley, Perth, WA 6102, Australia,Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Francie van Zyl Drive, Tygerberg, Cape Town 7505, South Africa,Division of Addiction Psychiatry, Department of Psychiatry and Mental Health, 1st Floor, Neuroscience Institute, Groote Schuur Hospital, University of Cape Town, Observatory, Cape Town 7925, South Africa
| | - Katherine Sorsdahl
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, 46 Sawkins Road, Rondebosch, Cape Town 7700, South Africa
| | - Esther Chanakira
- School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Crick Lund
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, 46 Sawkins Road, Rondebosch, Cape Town 7700, South Africa,Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s Global Health Institute, King’s College London, De Crespigny Park, London, SE5 8AF, UK
| | - Susan Cleary
- Health Economics Unit, School of Public Health and Family Medicine, Health Sciences Faculty, University of Cape Town, Anzio Road, Observatory, Cape Town 7925, South Africa
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Leung CMC, Ho MK, Bharwani AA, Cogo-Moreira H, Wang Y, Chow MSC, Fan X, Galea S, Leung GM, Ni MY. Mental disorders following COVID-19 and other epidemics: a systematic review and meta-analysis. Transl Psychiatry 2022; 12:205. [PMID: 35581186 PMCID: PMC9110635 DOI: 10.1038/s41398-022-01946-6] [Citation(s) in RCA: 61] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 04/19/2022] [Accepted: 04/21/2022] [Indexed: 02/07/2023] Open
Abstract
COVID-19 has imposed a very substantial direct threat to the physical health of those infected, although the corollary impact on mental health may be even more burdensome. Here we focus on assessing the mental health impact of COVID-19 and of other epidemics in the community. We searched five electronic databases until December 9, 2020, for all peer-reviewed original studies reporting any prevalence or correlates of mental disorders in the general population following novel epidemics in English, Chinese or Portuguese. We synthesised prevalence estimates from probability samples during COVID-19 and past epidemics. The meta-analytical effect size was the prevalence of relevant outcomes, estimated via random-effects model. I2 statistics, Doi plots and the LFK index were used to examine heterogeneity and publication bias. This study is pre-registered with PROSPERO, CRD42020179105. We identified 255 eligible studies from 50 countries on: COVID-19 (n = 247 studies), severe acute respiratory syndrome (SARS; n = 5), Ebola virus disease (n = 2), and 1918 influenza (n = 1). During COVID-19, we estimated the point prevalence for probable anxiety (20.7%, 95% CI 12.9-29.7), probable depression (18.1%, 13.0-23.9), and psychological distress (13.0%, 0-34.1). Correlates for poorer mental health include female sex, lower income, pre-existing medical conditions, perceived risk of infection, exhibiting COVID-19-like symptoms, social media use, financial stress, and loneliness. Public trust in authorities, availability of accurate information, adoption of preventive measures and social support were associated with less morbidity. The mental health consequences of COVID-19 and other epidemics could be comparable to major disasters and armed conflicts. The considerable heterogeneity in our analysis indicates that more random samples are needed. Health-care professionals should be vigilant of the psychological toll of epidemics, including among those who have not been infected.
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Affiliation(s)
- Candi M. C. Leung
- grid.194645.b0000000121742757School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Special Administrative Region China
| | - Margaret K. Ho
- grid.194645.b0000000121742757School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Special Administrative Region China
| | - Alina A. Bharwani
- grid.194645.b0000000121742757School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Special Administrative Region China
| | - Hugo Cogo-Moreira
- grid.194645.b0000000121742757School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Special Administrative Region China ,grid.411249.b0000 0001 0514 7202Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Yishan Wang
- grid.194645.b0000000121742757School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Special Administrative Region China
| | - Mathew S. C. Chow
- grid.194645.b0000000121742757School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Special Administrative Region China
| | - Xiaoyan Fan
- grid.194645.b0000000121742757School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Special Administrative Region China
| | - Sandro Galea
- grid.189504.10000 0004 1936 7558School of Public Health, Boston University, Boston, MA USA
| | - Gabriel M. Leung
- grid.194645.b0000000121742757School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Special Administrative Region China ,grid.194645.b0000000121742757World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong, Special Administrative Region China
| | - Michael Y. Ni
- grid.194645.b0000000121742757School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Special Administrative Region China ,grid.194645.b0000000121742757The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, Special Administrative Region China ,grid.194645.b0000000121742757Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Hong Kong, Special Administrative Region China
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Bello UM, Kannan P, Chutiyami M, Salihu D, Cheong AMY, Miller T, Pun JW, Muhammad AS, Mahmud FA, Jalo HA, Ali MU, Kolo MA, Sulaiman SK, Lawan A, Bello IM, Gambo AA, Winser SJ. Prevalence of Anxiety and Depression Among the General Population in Africa During the COVID-19 Pandemic: A Systematic Review and Meta-Analysis. Front Public Health 2022; 10:814981. [PMID: 35655463 PMCID: PMC9152218 DOI: 10.3389/fpubh.2022.814981] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 04/04/2022] [Indexed: 12/23/2022] Open
Abstract
Background Medical and socio-economic uncertainties surrounding the COVID-19 pandemic have had a substantial impact on mental health. This study aimed to systematically review the existing literature reporting the prevalence of anxiety and depression among the general populace in Africa during the COVID-19 pandemic and examine associated risk factors. Methods A systematic search of the following databases African Journal Online, CINAHL, PubMed, Scopus, and Web of Science was conducted from database inception until 30th September 2021. Studies reporting the prevalence of anxiety and/or depression among the general populace in African settings were considered for inclusion. The methodological quality of included studies was assessed using the Agency for Healthcare Research and Quality (AHRQ). Meta-analyses on prevalence rates were conducted using Comprehensive Meta-analysis software. Results Seventy-eight primary studies (62,380 participants) were identified from 2,325 studies via electronic and manual searches. Pooled prevalence rates for anxiety (47%, 95% CI: 40-54%, I2 = 99.19%) and depression (48%, 95% CI: 39-57%, I2 = 99.45%) were reported across Africa during the COVID-19 pandemic. Sex (female) and history of existing medical/chronic conditions were identified as major risk factors for anxiety and depression. Conclusions The evidence put forth in this synthesis demonstrates the substantial impact of the pandemic on the pervasiveness of these psychological symptoms among the general population. Governments and stakeholders across continental Africa should therefore prioritize the allocation of available resources to institute educational programs and other intervention strategies for preventing and ameliorating universal distress and promoting psychological wellbeing. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021228023, PROSPERO CRD42021228023.
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Affiliation(s)
- Umar Muhammad Bello
- Centre for Eye and Vision Research Limited, Hong Kong, Hong Kong SAR, China
- Department of Physiotherapy, Yobe State University Teaching Hospital, Damaturu, Nigeria
| | - Priya Kannan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
| | - Muhammad Chutiyami
- School of Nursing, Institute of Health and Management, Sydney, NSW, Australia
| | - Dauda Salihu
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
| | - Allen M. Y. Cheong
- Centre for Eye and Vision Research Limited, Hong Kong, Hong Kong SAR, China
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
| | - Tiev Miller
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
| | - Joe Wing Pun
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
| | | | - Fatima Ado Mahmud
- Physiotherapy Department, Yobe State Specialist Hospital, Damaturu, Nigeria
| | | | - Mohammed Usman Ali
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
- Department of Rehabilitation Sciences, University of Maiduguri, Maiduguri, Nigeria
| | | | | | - Aliyu Lawan
- Department of Rehabilitation Sciences, University of Maiduguri, Maiduguri, Nigeria
- Department of Rehabilitation Science, Western University, London, ON, Canada
| | | | | | - Stanley John Winser
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
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Seruwagi G, Nakidde C, Lugada E, Ssematiko M, Ddamulira DP, Masaba A, Luswata B, Ochen EA, Okot B, Muhangi D, Lawoko S. Psychological distress and social support among conflict refugees in urban, semi-rural and rural settlements in Uganda: burden and associations. Confl Health 2022; 16:25. [PMID: 35551630 PMCID: PMC9096741 DOI: 10.1186/s13031-022-00451-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 04/10/2022] [Indexed: 11/10/2022] Open
Abstract
Background Recent research shows that psychological distress is on the rise globally as a result of the COVID-19 pandemic and restrictions imposed on populations to manage it. We studied the association between psychological distress and social support among conflict refugees in urban, semi-rural and rural settlements in Uganda during the COVID-19 pandemic.
Methods Cross-sectional survey data on psychological distress, social support, demographics, socio-economic and behavioral variables was gathered from 1014 adult refugees randomly sampled from urban, semi-rural and rural refugee settlements in Uganda, using two-staged cluster sampling. Data was analyzed in SPSS-version 22, and statistical significance was assumed at p < 0.05. Results Refugees resident in rural/semi-rural settlements exhibited higher levels of psychological distress [F(2, 1011) = 47.91; p < 0.001], higher availability of social interaction [F(2, 1011) = 82.24; p < 0.001], lower adequacy of social interaction [F(2, 1011) = 54.11; p < 0.001], higher availability of social attachment [F(2, 1011) = 47.95; p < 0.001], and lower adequacy of social attachment [F(2, 1011) = 50.54; p < 0.001] than peers in urban settlements. Adequacy of social interaction significantly explained variations in psychological distress levels overall and consistently across settlements, after controlling for plausible confounders. Additionally, adequacy of social attachment significantly explained variations in psychological distress levels among refugees in rural settlements, after controlling for plausible confounders. Conclusion There is a settlement-inequality (i.e. rural vs. urban) in psychological distress and social support among conflict refugees in Uganda. To address psychological distress, Mental Health and Psychosocial Support Services (MHPSS) should focus on strategies which strengthen the existing social networks among refugees. Variations in social support are a key predictor of distress which should guide tailored need-adapted interventions instead of duplicating similar and generic interventions across diverse refugee settlements.
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Affiliation(s)
- Gloria Seruwagi
- Makerere University School of Public Health, Kampala, Uganda. .,Department of Social Work and Social Administration, Centre for Health and Social Economic Improvement (CHASE-i), Makerere University, Kampala, Uganda.
| | - Catherine Nakidde
- Department of Social Work and Social Administration, Centre for Health and Social Economic Improvement (CHASE-i), Makerere University, Kampala, Uganda
| | - Eric Lugada
- Department of Social Work and Social Administration, Centre for Health and Social Economic Improvement (CHASE-i), Makerere University, Kampala, Uganda
| | - Maria Ssematiko
- Department of Social Work and Social Administration, Centre for Health and Social Economic Improvement (CHASE-i), Makerere University, Kampala, Uganda
| | | | | | - Brian Luswata
- Directorate of Governance and Regulation, Ministry of Health, Kampala, Uganda
| | - Eric A Ochen
- Department of Social Work and Social Administration, Centre for Health and Social Economic Improvement (CHASE-i), Makerere University, Kampala, Uganda
| | - Betty Okot
- Department of Social Work and Social Administration, Centre for Health and Social Economic Improvement (CHASE-i), Makerere University, Kampala, Uganda
| | - Denis Muhangi
- Department of Social Work and Social Administration, Centre for Health and Social Economic Improvement (CHASE-i), Makerere University, Kampala, Uganda
| | - Stephen Lawoko
- Department of Public Health Faculty of Medicine, Gulu University, Gulu, Uganda
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Sleep Quality, Insomnia, Anxiety, Fatigue, Stress, Memory and Active Coping during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19094940. [PMID: 35564337 PMCID: PMC9104759 DOI: 10.3390/ijerph19094940] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/15/2022] [Accepted: 04/17/2022] [Indexed: 01/09/2023]
Abstract
Background: The current study aimed to evaluate the impact of the coronavirus (COVID-19) pandemic on sleep quality, insomnia, anxiety, stress, fatigue and active coping in the United States. Methods: This was a cross-sectional study using a publicly available database taken from the Boston College COVID-19 Sleep and Well-Being Dataset. We have selected the most recent data that included information about sleep quality and other measures, including insomnia, anxiety, stress, fatigue and coping, collected between 22 February−8 March 2021. Results: A total of 476 subjects were included in the analysis. The mean (SD) age of the study population was 38.8 (17.8) years, and there were more females (85%) than males. The population had a mean (SD) score of the Pittsburgh Sleep Quality Index (PSQI) of 6 (3.2), with 65% having the prevalence of poor sleep quality (defined as PSQ ≥ 5; n = 311). The mean (SD) score for Insomnia Severity Index (ISI) was 6.9 (5.2), with 55 subjects (11.5%) having clinical insomnia (defined as ISI ≥ 15); of whom 9% had severe clinical insomnia. There were positive correlations between PSQI and ISI (r = 0.76, p < 0.001), PROMIS fatigue scale (r = 0.53, p < 0.001), Generalized Anxiety Disorder-7 (GAD-7) (r = 0.46, p < 0.001), and Perceived Stress Scale (PSS) (r = 0.44, p < 0.001). The PSQI was inversely correlated with the John Henryism Active Coping Scale (JHACS) and memory scale. In the multivariate regression model, JHACS, ISI, fatigue, PSS and GAD-7 were significant predictors of PSQI, and these variables accounted for 62% of the variance of PSQI, adjusted for age and gender. Conclusion: An important contribution to the literature is made by this research, which demonstrates the significant prevalence of poor sleep quality and its association with insomnia and other mental and physical well-being. It also underlines the need to prioritise policy and public health efforts to address sleep issues that have substantial health and economic effects for both individuals and the population at large.
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Tan Y, Wu Z, Qu X, Liu Y, Peng L, Ge Y, Li S, Du J, Tang Q, Wang J, Peng X, Liao J, Song M, Kang J. Influencing Factors of International Students’ Anxiety Under Online Learning During the COVID-19 Pandemic: A Cross-Sectional Study of 1,090 Chinese International Students. Front Psychol 2022; 13:860289. [PMID: 35496158 PMCID: PMC9046590 DOI: 10.3389/fpsyg.2022.860289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 03/28/2022] [Indexed: 12/12/2022] Open
Abstract
Objective We conducted the following cross-sectional study to comprehensively assess the anxiety among Chinese international students who studied online during the COVID-19 pandemic and its influencing factors. Methods Questionnaires were distributed through “Sojump,” and a total of 1,090 valid questionnaires were collected. The questionnaire was divided into two parts: general situation and anxiety assessment of students. The former used a self-made questionnaire, and the international general GAD-7 scale was used to measure anxiety. Chi-square test was used to analyze the differences between groups, and logistic regression analysis was performed for the factors with differences. Results Anxiety was found in 707 (64.9%) of 1,090 international students. Chi-square test and multivariate Logistic regression analysis showed that the incidence of anxiety was higher in the group under 22 years of age than in the group over 22 years of age (68% vs. 61%, p = 0.015; OR = 1.186, 95% CI 1.045–1.347, p = 0.008); International students living in big cities had a higher incidence of anxiety than those living in rural areas (67% vs. 60%, p = 0.022; OR = 1.419, 95%CI 1.038–1.859, p = 0.011); international students who socialized 3 times or less monthly had a higher incidence of anxiety than those who socialized more than 3 times per month (68% vs. 58%, p = 0.003; OR = 1.52, 95%CI 1.160–1.992, p = 0.002); international students who expected purely online teaching had a higher incidence of anxiety than those who expected purely offline teaching or dual-track teaching (72% vs. 64%, p = 0.037; OR = 1.525, 95%CI 1.069–2.177, p = 0.02); international students with a subjective score of online learning experience of 6 or less had a higher incidence of anxiety than those with subjective scores of more than 6 (70% vs. 60%, p = 0.001, OR = 1.25, 95%CI 1.099–1.422, p = 0.001). However, gender, emotional status, BMI, major of study, vaccination status, and degree type had no significant difference in the incidence of anxiety among international students who studied online during the COVID-19 pandemic. Conclusion During COVID-19, international students who were younger, came from big cities, had low social frequency, expected purely online teaching, and had poor experience of online classes were risk factors for anxiety during online classes.
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Affiliation(s)
- Yejun Tan
- Department of Rheumatology and Immunology, The Second Xiangya Hospital of Central South University, Changsha, China
- School of Mathematics, University of Minnesota Twin Cities, Minneapolis, MN, United States
| | - Zhijian Wu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha, China
| | | | - Yuzhuo Liu
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Lele Peng
- Department of Endocrinology, Wangwang Hospital of Hunan, Changsha, China
| | - Yan Ge
- Department of Rheumatology and Immunology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Shu Li
- Department of Rheumatology and Immunology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jinfeng Du
- Department of Rheumatology and Immunology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Qi Tang
- Department of Rheumatology and Immunology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jia Wang
- Department of Rheumatology and Immunology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Xiaofei Peng
- Department of Rheumatology and Immunology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jiafen Liao
- Department of Rheumatology and Immunology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Meiyan Song
- Department of Rheumatology and Immunology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jin Kang
- Department of Rheumatology and Immunology, The Second Xiangya Hospital of Central South University, Changsha, China
- *Correspondence: Jin Kang,
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Wu X, Xu L, Li P, Tang T, Huang C. Multipurpose Mobile Apps for Mental Health in Chinese App Stores: Content Analysis and Quality Evaluation. JMIR Mhealth Uhealth 2022; 10:e34054. [PMID: 34982717 PMCID: PMC8767465 DOI: 10.2196/34054] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 11/30/2021] [Indexed: 01/05/2023] Open
Abstract
Background Mental disorders impose varying degrees of burden on patients and their surroundings. However, people are reluctant to take the initiative to seek mental health services because of the uneven distribution of resources and stigmatization. Thus, mobile apps are considered an effective way to eliminate these obstacles and improve mental health awareness. Objective This study aims to evaluate the quality, function, privacy measures, and evidence-based and professional background of multipurpose mental health apps in Chinese commercial app stores. Methods A systematic search was conducted on iOS and Android platforms in China to identify multipurpose mental health apps. Two independent reviewers evaluated the identified mobile apps using the Mobile App Rating Scale (MARS). Each app was downloaded, and the general characteristics, privacy and security measures, development background, and functional characteristics of each app were evaluated. Results A total of 40 apps were analyzed, of which 35 (87.5%) were developed by companies and 33 (82.5%) provided links to access the privacy policy; 21 (52.5%) apps did not mention the involvement of relevant professionals or the guidance of a scientific basis in the app development process. The main built-in functions of these apps include psychological education (38/40, 95%), self-assessment (34/40, 85%), and counseling (33/40, 82.5%). The overall quality average MARS score of the 40 apps was 3.54 (SD 0.39), and the total score was between 2.96 and 4.30. The total MARS score was significantly positively correlated with the scores of each subscale (r=0.62-0.88, P<.001). However, the user score of the app market was not significantly correlated with the total MARS score (r=0.17, P=.33). Conclusions The quality of multipurpose mental health apps in China’s main app market is generally good. However, health professionals are less involved in the development of these apps, and the privacy protection policy of the apps also needs to be described in more detail. This study provides a reference for the development of multipurpose mental health apps.
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Affiliation(s)
- Xiaoqian Wu
- College of Medical Informatics, Chongqing Medical University, Chongqing, China
- Medical Data Science Academy, Chongqing Medical University, Chongqing, China
| | - Lin Xu
- College of Medical Informatics, Chongqing Medical University, Chongqing, China
- Medical Data Science Academy, Chongqing Medical University, Chongqing, China
| | - PengFei Li
- School of Public Health, Weifang Medical University, Weifang, China
| | - TingTing Tang
- The Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Cheng Huang
- College of Medical Informatics, Chongqing Medical University, Chongqing, China
- Medical Data Science Academy, Chongqing Medical University, Chongqing, China
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Choi E, Yoon EH, Park MH. Game-based digital therapeutics for children and adolescents: Their therapeutic effects on mental health problems, the sustainability of the therapeutic effects and the transfer of cognitive functions. Front Psychiatry 2022; 13:986687. [PMID: 36523871 PMCID: PMC9744939 DOI: 10.3389/fpsyt.2022.986687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 10/20/2022] [Indexed: 11/30/2022] Open
Abstract
Mental health problems in childhood and adolescence (e. g., attention deficits, problems in emotional understanding and subclinical levels of anxiety) are reported to develop further in adulthood and/or to increase the risk of developing mental health disorders in adulthood. Although it is important to provide treatment or prevention interventions for children and adolescents in order to reduce the risk of the further development of mental health problems, the pharmacological and behavioral treatments for this age group have limitations (e.g., limited access, unsustainable treatment effects and the lack of engagement in intervention). In order to overcome the limitations of conventional treatments, the use of digital technology, especially video games for this age group, is suggested. In order to be accepted as clinical interventions, objective evidence for the therapeutic effects of digital therapeutic that used video games to treat or prevent targeted mental health problems are required. Thus, this review aims to explore whether game-based digital therapeutics (DTx) for children and adolescents showed therapeutic effects on targeted mental health problems. As game-based DTx are suggested to show sustained therapeutic effects and the transfer of cognitive functions, it also reviews the maintenance of the therapeutic effects of DTx and the extent of the transfer of cognitive functions. Game-based DTx that are developed to treat or prevent mental health problems (e.g., attention deficit, depression) in children and adolescents are found to show therapeutic effects on targeted mental health problems despite the limitations (e.g., small sample size, limited investigation of the sustainability). This review would contribute to the understanding of whether there is objective evidence of the therapeutic effects of digital therapeutics using video games that deliver treatment or prevention interventions for mental health problems in children and adolescents.
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Affiliation(s)
- Eunhye Choi
- Department of Psychiatry, Eunpyeong St. Mary's Hospital, Catholic University of Korea, Seoul, South Korea
| | - Eun-Ha Yoon
- Department of Psychiatry, Eunpyeong St. Mary's Hospital, Catholic University of Korea, Seoul, South Korea
| | - Min-Hyeon Park
- Department of Psychiatry, Eunpyeong St. Mary's Hospital, Catholic University of Korea, Seoul, South Korea
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Shen N, Kassam I, Chen S, Ma C, Wang W, Boparai N, Jankowicz D, Strudwick G. Canadian perspectives of digital mental health supports: Findings from a national survey conducted during the COVID-19 pandemic. Digit Health 2022; 8:20552076221102253. [PMID: 35646379 PMCID: PMC9131389 DOI: 10.1177/20552076221102253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 05/05/2022] [Indexed: 11/16/2022] Open
Abstract
Objectives The impact of the COVID-19 pandemic on population mental health has highlighted the potential for digital mental health to support the needs of those requiring care. This study sought to understand the digital mental health experiences and priorities of Canadians affected by mental health conditions (i.e. seekers, patients, and care partners). Methods A national cross-sectional electronic survey of Canadians was administered through a market research firm's survey panel. Seekers, patients, and care partners were asked about their digital mental health experiences (e.g. uptake, barriers to access) and priorities. Survey responses were summarized using descriptive statistics. Results Overall, 1003 participants completed the survey. 70.2% of participants routinely use digital mental health supports to support themselves or those they care for; however, only 28.6% of participants are satisfied with the available digital mental health supports. Most participants (73.3%) have encountered some barriers when accessing digital mental health supports. Awareness of digital mental health supports was a top barrier identified by participants. The top digital mental health priorities consisted of digital mental health curation, navigation, and a digital mental health passport. Conclusions Most participants use digital mental health supports for themselves or others, however, many are unaware of digital mental health supports available. Efforts to improve navigating access to digital and in-person mental health services are seen as a top priority, highlighting the need to enable seekers, patients, and care partners to find the appropriate support and make decisions on how to best improve their mental health.
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Affiliation(s)
- Nelson Shen
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Iman Kassam
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Sheng Chen
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Clement Ma
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Wei Wang
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Navi Boparai
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Damian Jankowicz
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Gillian Strudwick
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
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Gjoneska B, Potenza MN, Jones J, Corazza O, Hall N, Sales CMD, Grünblatt E, Martinotti G, Burkauskas J, Werling AM, Walitza S, Zohar J, Menchón JM, Király O, Chamberlain SR, Fineberg NA, Demetrovics Z. Problematic use of the internet during the COVID-19 pandemic: Good practices and mental health recommendations. Compr Psychiatry 2022; 112:152279. [PMID: 34700188 PMCID: PMC8529894 DOI: 10.1016/j.comppsych.2021.152279] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 09/24/2021] [Accepted: 09/28/2021] [Indexed: 01/19/2023] Open
Abstract
With the onset of the COVID-19 pandemic and the accelerated spread of the SARS-CoV-2 virus came jurisdictional limitations on mobility of citizens and distinct alterations in their daily routines. Confined to their homes, many people increased their overall internet use, with problematic use of the internet (PUI) becoming a potential reason for increased mental health concerns. Our narrative review summarizes information on the extent of PUI during the pandemic, by focusing on three types: online gaming, gambling and pornography viewing. We conclude by providing guidance for mental health professionals and those affected by PUI (with an outline of immediate research priorities and best therapeutic approaches), as well as for the general public (with an overview of safe and preventative practices).
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Affiliation(s)
| | - Marc N Potenza
- Department of Psychiatry and Child Study Centre, Yale University School of Medicine, New Haven, CT, USA; Department of Neuroscience, Yale University, New Haven, CT, USA; Connecticut Mental Health Centre, New Haven, CT, USA; Connecticut Council on Problem Gambling, Wethersfield, CT, USA.
| | - Julia Jones
- Centre for Research in Public Health and Community Care, University of Hertfordshire, UK.
| | - Ornella Corazza
- Department of Clinical and Pharmaceutical Sciences, University of Hertfordshire, UK; Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Italy.
| | - Natalie Hall
- Centre for Health Services and Clinical Research, University of Hertfordshire, Hatfield, UK.
| | - Célia M D Sales
- Centre for Psychology, University of Porto, Portugal; Faculty of Psychology and Education Sciences, University of Porto, Portugal.
| | - Edna Grünblatt
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and the ETH Zurich, Zurich, Switzerland; Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland.
| | - Giovanni Martinotti
- Department of Clinical and Pharmaceutical Sciences, University of Hertfordshire, UK; Department of Neuroscience, Imaging, Clinical Sciences, University "Gabriele d'Annunzio", Chieti-Pescara, Italy.
| | - Julius Burkauskas
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Palanga, Lithuania.
| | - Anna Maria Werling
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland.
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and the ETH Zurich, Zurich, Switzerland; Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland.
| | - Joseph Zohar
- Sackler Medical School, Tel Aviv University, Chaim Sheba Medical Center Tel Hashomer, Tel Aviv, Israel.
| | - José M Menchón
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, University of Barcelona, Cibersam, Barcelona, Spain.
| | - Orsolya Király
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.
| | - Samuel R Chamberlain
- Department of Psychiatry, Faculty of Medicine, University of Southampton, Southampton, UK; Southern Health NHS Foundation Trust, Southampton, UK.
| | - Naomi A Fineberg
- University of Hertfordshire, Hatfield, UK; Hertfordshire Partnership University NHS Foundation Trust, Welwyn Garden City, Hertfordshire, UK; University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar.
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Bruhn L, Szabzon F, Abarca Brown C, Ravelli Cabrini D, Miranda E, Andrade LH. Suspension of social welfare services and mental health outcomes for women during the COVID-19 pandemic in a peripheral neighborhood in São Paulo, Brazil. Front Psychiatry 2022; 13:897276. [PMID: 36186890 PMCID: PMC9520081 DOI: 10.3389/fpsyt.2022.897276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 08/17/2022] [Indexed: 11/13/2022] Open
Abstract
During the COVID-19 pandemic, Brazilian urban peripheries have been severely affected both by the spread of the virus and by social, political, and economical dynamics, raising concerns about the psychological wellbeing and mental health of the population living in these areas. The pandemic broke out in a context of reduced public spending in social and health policies as well as in a process of erosion of social rights, fostering processes of exclusion and highlighting the association between austerity, the increase in poverty and inequality as well as in health and mental health problems indicators. This article presents the results of a qualitative participatory research that investigated subjective experiences in a peripheral neighborhood of São Paulo, Brazil, aiming to understand how contextual dynamics played a role in shaping mental health experiences during the COVID-19 pandemic. A multidisciplinary team of researchers worked closely with local volunteers trained to provide emotional support calls to neighbors of the community who signed up for the project. This article presents three ethnographic cases of women who had their routines strongly affected by the suspension of public and social protection services for the containment of the SARS-CoV-2 pandemic, leading to psychological suffering due to the increased demand of "domestic circuits of care". We argue that within a context of austerity, the pandemic was remarkably harsh in urban peripheries and, specifically, for women with caring responsibilities. In addition to highlighting the pervasive "social protection gap", the cases presented in this paper also reveals the unequal dynamics of the social reproduction work in several layers, which falls mainly on women's shoulders. The "crisis of care", proposed by gender and feminist scholars, can contribute to understanding the psychological outcomes of the COVID-19 pandemic for these women.
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Affiliation(s)
- Lenora Bruhn
- Nucleo de Epidemiologia Psiquiatrica, Instituto de Psiquiatria, Hospital das Clinicas da Universidade de São Paulo, São Paulo, Brazil
| | - Felipe Szabzon
- Nucleo de Epidemiologia Psiquiatrica, Instituto de Psiquiatria, Hospital das Clinicas da Universidade de São Paulo, São Paulo, Brazil
| | - Cristobal Abarca Brown
- Nucleo de Epidemiologia Psiquiatrica, Instituto de Psiquiatria, Hospital das Clinicas da Universidade de São Paulo, São Paulo, Brazil
| | - Daniela Ravelli Cabrini
- Nucleo de Epidemiologia Psiquiatrica, Instituto de Psiquiatria, Hospital das Clinicas da Universidade de São Paulo, São Paulo, Brazil
| | - Elisangela Miranda
- Nucleo de Epidemiologia Psiquiatrica, Instituto de Psiquiatria, Hospital das Clinicas da Universidade de São Paulo, São Paulo, Brazil
| | - Laura Helena Andrade
- Nucleo de Epidemiologia Psiquiatrica, Instituto de Psiquiatria, Hospital das Clinicas da Universidade de São Paulo, São Paulo, Brazil
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Donenberg G, Merrill KG, Atujuna M, Emerson E, Bray B, Bekker LG. Mental health outcomes of a pilot 2-arm randomized controlled trial of a HIV-prevention program for South African adolescent girls and young women and their female caregivers. BMC Public Health 2021; 21:2189. [PMID: 34847908 PMCID: PMC8630514 DOI: 10.1186/s12889-021-12010-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 10/06/2021] [Indexed: 11/16/2022] Open
Abstract
Background South African adolescent girls and young women (AGYW) report significant mental distress and sexual and reproductive health concerns. Mental health problems and trauma symptoms are consistently associated with sexual and reproductive health behavior. Despite their intersection, few interventions address them simultaneously or engage female caregivers (FC) as collaborators. This study presents findings from a pilot test of an empirically supported culturally adapted family-based HIV-prevention program, Informed Motivated Aware and Responsible Adolescents and Adults- South Africa (IMARA-SA), on AGYW anxiety, depression, and trauma. Methods Sixty 15–19-year-old AGYW (mean age = 17.1 years) and their FC from outside Cape Town were randomized to IMARA-SA or a health promotion control program. AGYW reported their anxiety using the GAD-7, depression using the PHQ-9, and trauma using the PC-PTSD-5 at baseline and follow-up (6–10 months post). Both interventions were delivered by Xhosa-speaking Black South African women in groups over 2 days for approximately 10 h. We examined intervention effects using zero-inflated negative binomial regression for anxiety, multinomial logistic regression for depression, and logistic regression for trauma. Results At baseline, groups did not differ in demographic characteristics but AGYW randomized to IMARA-SA had higher depression scores than controls (p = 0.04) and a greater proportion screened positive for PTSD (p = .07). Controlling for baseline mental health scores, AGYW who received IMARA-SA compared to controls had significantly fewer anxiety symptoms at follow-up (adjusted incidence rate ratio for count model = 0.54, 95% CI = 0.29–0.99, p = 0.05), were less likely to report at least one depressive symptom relative to no symptoms (relative risk ratio = 0.22, 95% CI = 0.05, 0.95, p = 0.04), and were less likely to report symptoms of PTSD relative to no symptoms, but this difference was not statistically significant. Conclusions Mental health is implicated in risky sexual behavior, and reducing emotional distress can mitigate exposure to poor sexual and reproductive health outcomes. This pilot study yielded promising findings for the mental health impact of IMARA-SA, justifying replication in a larger randomized trial. Trial registration ClinicalTrials.gov Number NCT04758390, accepted 17/02/2021.
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Affiliation(s)
- Geri Donenberg
- Center for Dissemination and Implementation Science, Department of Medicine, University of Illinois at Chicago, 818 S. Wolcott, Chicago, IL, 60612, USA.
| | - Katherine G Merrill
- Center for Dissemination and Implementation Science, Department of Medicine, University of Illinois at Chicago, 818 S. Wolcott, Chicago, IL, 60612, USA
| | | | - Erin Emerson
- Center for Dissemination and Implementation Science, Department of Medicine, University of Illinois at Chicago, 818 S. Wolcott, Chicago, IL, 60612, USA
| | - Bethany Bray
- Center for Dissemination and Implementation Science, Department of Medicine, University of Illinois at Chicago, 818 S. Wolcott, Chicago, IL, 60612, USA
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Zhang X, Zhang Y, Zhai J. Home Garden With Eco-Healing Functions Benefiting Mental Health and Biodiversity During and After the COVID-19 Pandemic: A Scoping Review. Front Public Health 2021; 9:740187. [PMID: 34869154 PMCID: PMC8632623 DOI: 10.3389/fpubh.2021.740187] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 10/11/2021] [Indexed: 12/24/2022] Open
Abstract
The COVID-19 pandemic has led to tremendous impacts on human lives and society, which are not only because of negative effects on people's mental health due to isolation policies and physical distance for mitigating the spread of SARS-CoV-2, but also because the incident post-acute sequelae of the coronavirus will cause mental disorders. A green environment is a health resource, which cannot only benefit human physical and mental health, but also increases biodiversity, contributes to flood mitigation, and cools urban areas. A home garden, as a kind of small green space, can provide ecosystem services with eco-healing functions in reducing mental stress during the isolation period of the COVID-19 pandemic through the garden itself and physical activities in it. Such an eco-healing approach within a mini-therapeutic landscape can also benefit biodiversity by enhancing plant diversity in residence and increasing biodiversity at a large scale. In this article, we propose a conceptual framework describing a home garden as "ecological medicine" with healing functions to improve mental health, as well as indirectly enhancing urban biodiversity. A home garden, as a mini-type of green landscape with biodiversity content, allows people to get close with nature so that it can promote comfortable and natural feelings during the pandemic. Furthermore, such an eco-healing home garden approach benefiting urban biodiversity can meet the challenges in maintaining environmental and mental health in post COVID-19 pandemic recovery, as well as preparing unknown next-surge risks with potential isolation regulations.
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Affiliation(s)
- Xindi Zhang
- Department of Landscape Architecture, Soochow University, Suzhou, China
| | - Yixin Zhang
- Department of Landscape Architecture, Soochow University, Suzhou, China
- Collaborative Innovation Center of Architecture and Urban Environment of Soochow University-Suzhou Yuanke; China-Portugal Belt and Road Cooperation Laboratory of Cultural Heritage Conservation Science, Research Center of Landscape Protection and Ecological Restoration, Soochow University, Suzhou, China
| | - Jun Zhai
- Department of Landscape Architecture, Soochow University, Suzhou, China
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Abraham A, Jithesh A, Doraiswamy S, Al-Khawaga N, Mamtani R, Cheema S. Telemental Health Use in the COVID-19 Pandemic: A Scoping Review and Evidence Gap Mapping. Front Psychiatry 2021; 12:748069. [PMID: 34819885 PMCID: PMC8606591 DOI: 10.3389/fpsyt.2021.748069] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 10/15/2021] [Indexed: 01/07/2023] Open
Abstract
Background: The COVID-19 pandemic has highlighted telemedicine use for mental illness (telemental health). Objective: In the scoping review, we describe the scope and domains of telemental health during the COVID-19 pandemic from the published literature and discuss associated challenges. Methods: PubMed, EMBASE, and the World Health Organization's Global COVID-19 Database were searched up to August 23, 2020 with no restrictions on study design, language, or geographical, following an a priori protocol (https://osf.io/4dxms/). Data were synthesized using descriptive statistics from the peer-reviewed literature and the National Quality Forum's (NQF) framework for telemental health. Sentiment analysis was also used to gauge patient and healthcare provider opinion toward telemental health. Results: After screening, we identified 196 articles, predominantly from high-income countries (36.22%). Most articles were classified as commentaries (51.53%) and discussed telemental health from a management standpoint (86.22%). Conditions commonly treated with telemental health were depression, anxiety, and eating disorders. Where data were available, most articles described telemental health in a home-based setting (use of telemental health at home by patients). Overall sentiment was neutral-to-positive for the individual domains of the NQF framework. Conclusions: Our findings suggest that there was a marked growth in the uptake of telemental health during the pandemic and that telemental health is effective, safe, and will remain in use for the foreseeable future. However, more needs to be done to better understand these findings. Greater investment into human and financial resources, and research should be made by governments, global funding agencies, academia, and other stakeholders, especially in low- and middle- income countries. Uniform guidelines for licensing and credentialing, payment and insurance, and standards of care need to be developed to ensure safe and optimal telemental health delivery. Telemental health education should be incorporated into health professions curricula globally. With rapidly advancing technology and increasing acceptance of interactive online platforms amongst patients and healthcare providers, telemental health can provide sustainable mental healthcare across patient populations. Systematic Review Registration: https://osf.io/4dxms/.
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Affiliation(s)
- Amit Abraham
- Institute for Population Health, Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar
| | - Anupama Jithesh
- Institute for Population Health, Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar
| | | | | | - Ravinder Mamtani
- Institute for Population Health, Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar
| | - Sohaila Cheema
- Institute for Population Health, Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar
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Abstract
The COVID-19 pandemic is affecting the health of people all around the world including mental health as social isolation which has been one of the best infection mitigation efforts is strongly associated with anxiety, depression, self-harm and suicide attempts. These feelings are consistent with past pandemics where there was loss of routine and sociability. Suicidality has been on the rise in the United States and it is within this context that the pandemic has struck. With the risk of suicide being increased, preventative measures need to be implemented at the universal, selective and indicated levels. Universal suicide prevention is needed for the population as a whole regardless of their risk of suicide. Selective prevention is for subgroups at an increased risk and lastly indicated prevention corresponds to people at a very high risk, for example those with recent suicide attempts. Telemedicine, informative and responsible media, as well as monetary help from governments, banks and other major institutions can all help with suicide prevention in these during the pandemic. These resources can broadly help the population at large, but more targeted approaches will be needed for high risk individuals including those with psychiatric diagnoses, COVID-19 survivors, frontline healthcare workers and the elderly. Additionally, those with recent suicide attempts should warrant even more attention.
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Schosser A, Senft B, Rauner M. The benefit of an ambulant psychiatric rehabilitation program in Vienna, Austria: an uncontrolled repeated measures study. CENTRAL EUROPEAN JOURNAL OF OPERATIONS RESEARCH 2021; 30:19-48. [PMID: 34658666 PMCID: PMC8501920 DOI: 10.1007/s10100-021-00773-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/09/2021] [Indexed: 06/13/2023]
Abstract
We investigated the benefit of a 6-week ambulant psychiatric rehabilitation program in an ambulant psychiatric rehabilitation clinic in Vienna, Austria, from January 2014 to December 2016 by an uncontrolled repeated measures study. The potential of this intervention program was assessed by effectiveness and cost measures using suitable statistical analyses. We compared the effectiveness and cost measures of this ambulant psychiatric rehabilitation program on patients for the period of up to 12 months after discharge to the period of 12 months before admission to the intervention program based on self-reported catamnesis questionnaires. For the program's effectiveness measures, we accounted for both psychological indices for measuring depression severity, symptom burden, and functioning to document the health improvement of patients and economy-related indices such as the number of sick leave days for patients. For the program's cost measures, both direct tangible treatment and medication costs and indirect tangible costs based on the productivity loss measured in non-working days of the patients were considered. The results significantly demonstrated that all psychological effectiveness measures for the patients highly improved by the 6-weeks rehabilitation program and remained rather stable 12 months after discharge. We found that costs for the 6-week ambulant psychiatric rehabilitation program could be easily covered within 12 months after discharge once a total societal cost perspective was considered. Even additional total cost savings of up to over 5000 Euro could be achieved which were highest for employed patients, followed by unemployed patients receiving rehabilitation allowance due to both their high direct medication and treatment costs as well as high indirect costs for productivity loss. The most important finding was that this treatment program was especially beneficial for rehabilitation patients in earlier stages of psychiatric diseases who were still employed, indicating the need for early intervention in mental disorder.
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Affiliation(s)
- Alexandra Schosser
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
- Zentren für seelische Gesundheit, BBRZ-Med, Schererstrasse 30, 1210 Vienna, Austria
- Faculty of Medicine, Sigmund Freud University, Freudplatz 3, 1020 Vienna, Austria
- Arbeitsgemeinschaft für Verhaltensmodifikation, Paris-Lodron-Straße 32, 5020 Salzburg, Austria Birgit Senf Vienna, Austria
| | - Birgit Senft
- Zentren für seelische Gesundheit, BBRZ-Med, Schererstrasse 30, 1210 Vienna, Austria
| | - Marion Rauner
- Faculty of
Business, Economics, and Statistics, Institute for Business Decisions and
Analytics, University of Vienna, Oskar-Morgenstern-Platz
1, 1090 Vienna, Austria
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