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Ramos-Ruiz JA, Pérez-Milena A, Noguera-Cuenca C, Ruiz-Díaz B. Social Experiences and Health Needs of Patients with Severe Mental Illness and their Caregivers during the first year of the COVID-19 pandemic in Spain. Eur J Gen Pract 2024; 30:2310088. [PMID: 38345069 PMCID: PMC10863535 DOI: 10.1080/13814788.2024.2310088] [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: 06/04/2023] [Accepted: 01/15/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND The strict isolation measures for the population imposed by the health authorities caused a prolonged disruption of informal social support networks. Both this new social situation and the decrease in accessibility to health care have generated new needs in people with severe mental illness (SMI) and their caregivers. OBJECTIVES This study provides insight into life experiences and health needs of a population with SMI during the first year of the COVID-19 pandemic in Spain. METHODS Qualitative design using semi-structured dyadic interviews, conducted from January through December 2022. A purposive sampling of patients with SMI and their caregivers was carried out through key informants in rural and urban localities in southern Spain. Verbatims were identified and classified by triangulation after the evaluation of the interview transcripts. The codes were defined through content analysis using the NVivo software. RESULTS Semi-structured dyadic interviews (21), identifying three main categories: 1. Social isolation: increased, causing greater personal vulnerability, exacerbation of psychiatric symptoms and exhaustion in caregivers. 2. Accessibility to Health Services: decreased with fewer face-to-face consultations, with difficulty in managing urgent situations and telephone attention in decompensated and disabled patients. 3. Continuity of healthcare: decreased with distrust in health professionals due to lack of communication between primary care and the hospital. CONCLUSION COVID-19 confinement exacerbated loneliness and worse health self-perception in SMI people. Greater formal social support was required. GPs role is key to avoiding delays in appointments and lack of coordination between primary and specialised care.
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Affiliation(s)
- Juan Andrés Ramos-Ruiz
- Multiprofessional Teaching Unit of Family and Community Care, Jaén North - Northeast, Andalusian Healthcare Service, Jaén,Spain
| | | | | | - Beatriz Ruiz-Díaz
- El Valle’ Primary Care Center, Andalusian Healthcare Service, Andalusia, Spain‘
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Schäfer SK, Supke M, Kausmann C, Schaubruch LM, Lieb K, Cohrdes C. A systematic review of individual, social, and societal resilience factors in response to societal challenges and crises. COMMUNICATIONS PSYCHOLOGY 2024; 2:92. [PMID: 39369098 DOI: 10.1038/s44271-024-00138-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 09/11/2024] [Indexed: 10/07/2024]
Abstract
Societal challenges put public mental health at risk and result in a growing interest in resilience as trajectories of good mental health during stressor exposure. Resilience factors represent multilevel psychosocial resources that increase the likelihood of resilient responses. This preregistered systematic review aims at summarizing evidence on the predictive value of individual, social and societal resilience factors for resilient responses to societal challenges and crises. Eligible studies examined the predictive value of resilience factors in stressor-exposed populations in high-income countries by means of multinomial regression models based on growth mixture modeling. Five databases were searched until August 2, 2023. Data synthesis employed a rating scheme to assess the incremental predictive value of resilience factors beyond sociodemographic variables and other resilience factors. An adapted version of the Newcastle-Ottawa Scale was used for risk of bias assessment. Fifty studies (sample sizes: 360-65,818 participants) with moderate study quality reported on various stressors (e.g., pandemics, natural disasters, terrorist attacks). Higher income, socioeconomic status and perceived social support, better emotion regulation and psychological flexibility were related to more resilient responses. The association between resilience factors and resilient responses was stronger in samples with younger mean age and a larger proportion of women. Most studies used non-representative convenience samples and effects were smaller when accounting for sociodemographic variables and other resilience factors. For many factors, findings were mixed, supporting the importance of the fit between resilience factors and situational demands. Research into social and societal resilience factors and multilevel resilience interventions is needed. Preregistration-ID: 10.17605/OSF.IO/GWJVA. Funding source: Robert Koch Institute (ID: LIR_2023_01).
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Affiliation(s)
- Sarah K Schäfer
- Leibniz Institute for Resilience Research, Mainz, Germany.
- Department of Clinical Psychology, Psychotherapy and Psychodiagnostics, Technische Universität, Braunschweig, Braunschweig, Germany.
| | - Max Supke
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Clinical Psychology, Psychotherapy and Psychodiagnostics, Technische Universität, Braunschweig, Braunschweig, Germany
| | - Corinna Kausmann
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | | | - Klaus Lieb
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of Johannes Gutenberg University, Mainz, Germany
| | - Caroline Cohrdes
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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Baum F, Schmitt J, Nagel O, Jacob J, Seifert M, Adorjan K, Tüscher O, Lieb K, Hölzel LP, Wiegand HF. Reductions in inpatient and outpatient mental health care in germany during the first year of the COVID-19 pandemic - What can we learn for a better crisis preparedness? Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01909-6. [PMID: 39356326 DOI: 10.1007/s00406-024-01909-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 09/11/2024] [Indexed: 10/03/2024]
Abstract
BACKGROUND During the COVID-19 pandemic, reports from several European mental health care systems hinted at important changes in utilization. So far, no study examined changes in utilization in the German mental health care inpatient and outpatient mental health care system comprehensively. METHODS This longitudinal observational study used claims data from two major German statutory health insurances, AOK PLUS and BKK, covering 162,905 inpatients and 2,131,186 outpatients with mental disorders nationwide. We analyzed changes in inpatient and outpatient mental health service utilization over the course of the first two lockdown phases (LDPs) of the pandemic in 2020 compared to a pre-COVID-19 reference period dating from March 2019 to February 2020 using a time series forecast model. RESULTS We observed significant decreases in the number of inpatient hospital admissions by 24-28% compared to the reference period. Day clinic admissions were even further reduced by 44-61%. Length of stay was significantly decreased for day clinic care but not for inpatient care. In the outpatient sector, the data showed a significant reduction in the number of incident outpatient diagnoses. CONCLUSION Indirect evidence regarding the consequences of the reductions in both the inpatient and outpatient sector of care described in this study is ambiguous and direct evidence on treatment outcomes and quality of trans-sectoral mental healthcare is sparse. In line with WHO and OECD we propose a comprehensive mental health system surveillance to prepare for a better oversight and thereby a better resilience during future global major disruptions.
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Affiliation(s)
- Fabian Baum
- Center for Evidence-Based Health Care (ZEGV), Faculty of Medicine Carl Gustav Carus, University Hospital Dresden, Technische Universität Dresden, Dresden, Germany.
| | - Jochen Schmitt
- Center for Evidence-Based Health Care (ZEGV), Faculty of Medicine Carl Gustav Carus, University Hospital Dresden, Technische Universität Dresden, Dresden, Germany
| | - Oliver Nagel
- InGef - Institute for Applied Health Research Berlin GmbH, Berlin, Germany
| | - Josephine Jacob
- InGef - Institute for Applied Health Research Berlin GmbH, Berlin, Germany
| | - Martin Seifert
- Center for Evidence-Based Health Care (ZEGV), Faculty of Medicine Carl Gustav Carus, University Hospital Dresden, Technische Universität Dresden, Dresden, Germany
| | - Kristina Adorjan
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany
- Department of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Oliver Tüscher
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg- University Mainz, Mainz, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, University Medicine Halle, Martin-Luther University Halle-Wittenberg, Halle, Germany
| | - Klaus Lieb
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg- University Mainz, Mainz, Germany
| | - Lars Peer Hölzel
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg- University Mainz, Mainz, Germany
- Oberberg Parkklinik Wiesbaden Schlangenbad, Schlangenbad, Germany
| | - Hauke Felix Wiegand
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg- University Mainz, Mainz, Germany
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Li G, Sun X, Gao T, Liang K, Wu M, Zhu Y, Gao X, Li P, Kong Y, Shu J. Analysis of risk factors and construction of a prediction model for posttraumatic stress disorder among Chinese college students during the COVID-19 pandemic. J Affect Disord 2024; 362:230-236. [PMID: 38969024 DOI: 10.1016/j.jad.2024.06.111] [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: 03/24/2024] [Revised: 05/31/2024] [Accepted: 06/25/2024] [Indexed: 07/07/2024]
Abstract
BACKGROUND To explore the risk factors of post-traumatic stress disorder (PTSD) among Chinese college students during the COVID-19 pandemic and the construction and validation of risk prediction models. METHODS A total of 10,705 university students were selected for the study. The questionnaire included the Generalized Anxiety Disorder 7 (GAD-7), Patient Health Questionnaire 9 (PHQ-9), PTSD Checklist for DSM-5 (PCL-5), and self-designed questionnaire. These assessments were conducted to facilitate the survey, construct the predictive model and validate the model's validity. RESULTS Sex, left-behind experience, poverty status, anxiety score, and depression score were identified as independent risk factors influencing psychological trauma among Chinese college students during the COVID-19 pandemic, while COVID-19 infection emerged as a protective factor against psychological trauma. A column chart was constructed to visualize the six independent risk factors derived from logistic regression analysis. The Hosmer-Lemeshow test results (χ2 = 13.021, P = 0.111) indicated that the risk prediction model fitted well. The receiver operating characteristic (ROC) curve showed an area under the curve (AUC) of 0.864 in the model group and 0.855 in the validation group. The calibration curves of the model closely resembled the ideal curve. Decision curve analysis (DCA) revealed that the model provided net benefit and demonstrated good clinical utility. LIMITATIONS The validation of the model is currently restricted to internal assessments. However, further confirmation through larger sample sizes, multicenter investigations, and prospective studies is necessary. CONCLUSIONS The model effectively predicted PTSD risk among Chinese college students during the COVID-19 pandemic, indicating strong clinical applicability.
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Affiliation(s)
- Guangjian Li
- Psychiatry and Psychology Department, Changzhou Dean Hospital, Changzhou, Jiangsu Province, China
| | - Xugui Sun
- Physical Education Teaching and Research Office, Wannan Medical College, Wuhu, Anhui Province, China
| | - Tingye Gao
- Psychiatry and Psychology Department, Changzhou Dean Hospital, Changzhou, Jiangsu Province, China.
| | - Kun Liang
- Graduate School, Wannan Medical College, Wuhu, Anhui Province, China
| | - Mengying Wu
- Pharmacy Department, The Second People's Hospital of Wuhu City, Wuhu, Anhui Province, China
| | - Yingzhi Zhu
- Psychiatry and Psychology Department, Changzhou Dean Hospital, Changzhou, Jiangsu Province, China
| | - Xin Gao
- Mental Health Education Center, ChangZhou Vocational Institute of Engineering, Changzhou, Jiangsu Province, China
| | - Peng Li
- Department of Student Affairs, ChangZhou Vocational Institute of Textile and Garment, Changzhou, Jiangsu Province, China
| | - Yaping Kong
- Psychiatry and Psychology Department, Changzhou Dean Hospital, Changzhou, Jiangsu Province, China
| | - Jingping Shu
- Psychiatry and Psychology Department, Changzhou Dean Hospital, Changzhou, Jiangsu Province, China.
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5
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Solmi M, Thompson T, Cortese S, Estradé A, Agorastos A, Radua J, Dragioti E, Vancampfort D, Thygesen LC, Aschauer H, Schlögelhofer M, Aschauer E, Schneeberger A, Huber CG, Hasler G, Conus P, Cuénod KQD, von Känel R, Arrondo G, Fusar-Poli P, Gorwood P, Llorca PM, Krebs MO, Scanferla E, Kishimoto T, Rabbani G, Skonieczna-Żydecka K, Brambilla P, Favaro A, Takamiya A, Zoccante L, Colizzi M, Bourgin J, Kamiński K, Moghadasin M, Seedat S, Matthews E, Wells J, Vassilopoulou E, Gadelha A, Su KP, Kwon JS, Kim M, Lee TY, Papsuev O, Manková D, Boscutti A, Gerunda C, Saccon D, Righi E, Monaco F, Croatto G, Cereda G, Demurtas J, Brondino N, Veronese N, Enrico P, Politi P, Ciappolino V, Pfennig A, Bechdolf A, Meyer-Lindenberg A, Kahl KG, Domschke K, Bauer M, Koutsouleris N, Winter S, Borgwardt S, Bitter I, Balazs J, Czobor P, Unoka Z, Mavridis D, Tsamakis K, Bozikas VP, Tunvirachaisakul C, Maes M, Rungnirundorn T, Supasitthumrong T, Haque A, Brunoni AR, Costardi CG, Schuch FB, Polanczyk G, Luiz JM, Fonseca L, Aparicio LV, Valvassori SS, Nordentoft M, Vendsborg P, Hoffmann SH, Sehli J, Sartorius N, Heuss S, Guinart D, Hamilton J, Kane J, Rubio J, Sand M, Koyanagi A, Solanes A, Andreu-Bernabeu A, Cáceres ASJ, Arango C, Díaz-Caneja CM, Hidalgo-Mazzei D, Vieta E, Gonzalez-Peñas J, Fortea L, Parellada M, Fullana MA, Verdolini N, Andrlíková E, Janků K, Millan MJ, Honciuc M, Moniuszko-Malinowska A, Łoniewski I, Samochowiec J, Kiszkiel Ł, Marlicz M, Sowa P, Marlicz W, Spies G, Stubbs B, Firth J, Sullivan S, Darcin AE, Aksu H, Dilbaz N, Noyan O, Kitazawa M, Kurokawa S, Tazawa Y, Anselmi A, Cracco C, Machado AI, Estrade N, De Leo D, Curtis J, Berk M, Carvalho AF, Ward P, Teasdale S, Rosenbaum S, Marx W, Horodnic AV, Oprea L, Alexinschi O, Ifteni P, Turliuc S, Ciuhodaru T, Bolos A, Matei V, Nieman DH, Sommer I, van Os J, van Amelsvoort T, Sun CF, Guu TW, Jiao C, Zhang J, Fan J, Zou L, Yu X, Chi X, de Timary P, van Winkel R, Ng B, Peña de León E, Arellano R, Roman R, Sanchez T, Movina L, Morgado P, Brissos S, Aizberg O, Mosina A, Krinitski D, Mugisha J, Sadeghi-Bahmani D, Sheybani F, Sadeghi M, Hadi S, Brand S, Errazuriz A, Crossley N, Ristic DI, López-Jaramillo C, Efthymiou D, Kuttichira P, Kallivayalil RA, Javed A, Afridi MI, James B, Seb-Akahomen OJ, Fiedorowicz J, Daskalakis J, Yatham LN, Yang L, Okasha T, Dahdouh A, Tiihonen J, Shin JI, Lee J, Mhalla A, Gaha L, Brahim T, Altynbekov K, Negay N, Nurmagambetova S, Jamei YA, Weiser M, Correll CU. Collaborative outcomes study on health and functioning during infection times (COH-FIT): Insights on modifiable and non-modifiable risk and protective factors for wellbeing and mental health during the COVID-19 pandemic from multivariable and network analyses. Eur Neuropsychopharmacol 2024; 90:1-15. [PMID: 39341043 DOI: 10.1016/j.euroneuro.2024.07.010] [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: 05/28/2024] [Revised: 07/17/2024] [Accepted: 07/21/2024] [Indexed: 09/30/2024]
Abstract
There is no multi-country/multi-language study testing a-priori multivariable associations between non-modifiable/modifiable factors and validated wellbeing/multidimensional mental health outcomes before/during the COVID-19 pandemic. Moreover, studies during COVID-19 pandemic generally do not report on representative/weighted non-probability samples. The Collaborative Outcomes study on Health and Functioning during Infection Times (COH-FIT) is a multi-country/multi-language survey conducting multivariable/LASSO-regularized regression models and network analyses to identify modifiable/non-modifiable factors associated with wellbeing (WHO-5)/composite psychopathology (P-score) change. It enrolled general population-representative/weighted-non-probability samples (26/04/2020-19/06/2022). Participants included 121,066 adults (age=42±15.9 years, females=64 %, representative sample=29 %) WHO-5/P-score worsened (SMD=0.53/SMD=0.74), especially initially during the pandemic. We identified 15 modifiable/nine non-modifiable risk and 13 modifiable/three non-modifiable protective factors for WHO-5, 16 modifiable/11 non-modifiable risk and 10 modifiable/six non-modifiable protective factors for P-score. The 12 shared risk/protective factors with highest centrality (network-analysis) were, for non-modifiable factors, country income, ethnicity, age, gender, education, mental disorder history, COVID-19-related restrictions, urbanicity, physical disorder history, household room numbers and green space, and socioeconomic status. For modifiable factors, we identified medications, learning, internet, pet-ownership, working and religion as coping strategies, plus pre-pandemic levels of stress, fear, TV, social media or reading time, and COVID-19 information. In multivariable models, for WHO-5, additional non-modifiable factors with |B|>1 were income loss, COVID-19 deaths. For modifiable factors we identified pre-pandemic levels of social functioning, hobbies, frustration and loneliness, and social interactions as coping strategy. For P-scores, additional non-modifiable/modifiable factors were income loss, pre-pandemic infection fear, and social interactions as coping strategy. COH-FIT identified vulnerable sub-populations and actionable individual/environmental factors to protect well-being/mental health during crisis times. Results inform public health policies, and clinical practice.
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Affiliation(s)
- Marco Solmi
- University of Ottawa, Department of Psychiatry, Ontario, Canada; The Ottawa Hospital, Department of Mental Health, Ontario, Canada; Ottawa Hospital Research Institute (OHRI) Neurosciences Program, Ottawa Ontario, Canada; Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; Centre for Innovation in Mental Health-Developmental Lab, School of Psychology, University of Southampton, and NHS Trust, Southampton, United Kingdom; Charité Universitätsmedizin Berlin, Department of Child and Adolescent Psychiatry, Berlin, Germany
| | - Trevor Thompson
- Centre for Chronic Illness and Ageing, University of Greenwich, London, United Kingdom
| | - Samuele Cortese
- University of Southampton, Centre for Innovation in Mental Health, Southampton, United Kingdom
| | - Andrés Estradé
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; Universidad Católica, Department of Psychology, Montevideo, Uruguay
| | - Agorastos Agorastos
- Aristotle University of Thessaloniki, II. Dept. of Psychiatry, Division of Neurosciences, Medical School, Faculty of Health Sciences, Greece
| | - Joaquim Radua
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Imaging of Mood- and Anxiety-Related Disorders (IMARD), University of Barcelona, CIBERSAM, Instituto de Salud Carlos III, Barcelona, Spain; Karolinska Institutet, Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Stockholm, Sweden
| | - Elena Dragioti
- Linköping University, Pain and Rehabilitation Centre and Department of Health, Medicine and Caring Sciences, Linköping, Sweden; University of Ioannina, Research Laboratory Psychology of Patients, Families & Health Professionals, Department of Nursing, School of Health Sciences, Ioannina, Greece
| | - Davy Vancampfort
- Katholieke Universiteit Leuven (KU Leuven), Department of Rehabilitation Sciences, Leuven, Belgium
| | - Lau Caspar Thygesen
- National Institute of Public Health, University of Southern Denmark, Denmark
| | - Harald Aschauer
- BioPsyC - Biopsychosocial Corporation, Non-profit association for Research Funding Ltd., Vienna, Austria
| | - Monika Schlögelhofer
- BioPsyC - Biopsychosocial Corporation, Non-profit association for Research Funding Ltd., Vienna, Austria
| | - Elena Aschauer
- BioPsyC - Biopsychosocial Corporation, Non-profit association for Research Funding Ltd., Vienna, Austria
| | | | - Christian G Huber
- University of Basel, Universitäre Psychiatrische Kliniken Basel (UPK), Basel, Switzerland
| | - Gregor Hasler
- University of Fribourg, Fribourg Network of Mental Health (RFSM), Fribourg, Switzerland
| | - Philippe Conus
- University of Lausanne, Department of Psychiatry, Lausanne, Switzerland
| | - Kim Q Do Cuénod
- University of Lausanne, Department of Psychiatry, Lausanne, Switzerland
| | - Roland von Känel
- University of Zurich, University Hospital Zurich, Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, Switzerland
| | - Gonzalo Arrondo
- Karolinska Institutet, Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Stockholm, Sweden; University of Navarra, Mind-Brain Group, Institute for Culture and Society (ICS), Pamplona, Spain
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; OASIS service, South London and Maudsley NHS Foundation Trust, London, United Kingdom; University of Pavia, Department of Brain and Behavioral Sciences, Pavia, Italy
| | - Philip Gorwood
- Université Paris Cité, CMME, GHU Paris Psychiatrie et Neurosciences, Paris, France; Institute de Psychiatrie et Neuroscience de Paris, INSERM U1266, F-75014, Paris, France
| | - Pierre-Michel Llorca
- Université Clermont Auvergne, CHU Clermont-Ferrand, Service de Psychiatrie B, Clermont-Ferrand, France
| | - Marie-Odile Krebs
- Institute de Psychiatrie et Neuroscience de Paris, INSERM U1266, F-75014, Paris, France; Université de Paris, PEPIT, GHU Paris Psychiatrie et Neuroscience, Paris, France
| | - Elisabetta Scanferla
- Université Paris Cité, CMME, GHU Paris Psychiatrie et Neurosciences, Paris, France
| | - Taishiro Kishimoto
- Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan
| | - Golam Rabbani
- The National Foundation of Mental Health of Bangladesh, Bangladesh
| | | | - Paolo Brambilla
- University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, Milan, Italy
| | - Angela Favaro
- University of Padua, Neurosciences Department, Padua, Italy
| | - Akihiro Takamiya
- Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan
| | - Leonardo Zoccante
- UOC Infanzia, Adolescenza, Famiglia e Consultori, Districts 1 & 2 AULSS 9 Scaligera, Verona, Italy
| | - Marco Colizzi
- University of Udine, Department of Medicine (DAME), Unit of Psychiatry, Italy
| | - Julie Bourgin
- Service de Psychiatrie de l'enfant et de l'adolescent, GHNE, 91440 Bures Sur Yvette, France
| | - Karol Kamiński
- Medical University of Białystok, Department of Population Medicine and Lifestyle Diseases Prevention, Bialystok, Poland
| | - Maryam Moghadasin
- Kharazmi University, Department of Clinical Psychology, Faculty of Psychology and Education, Tehran, Iran
| | - Soraya Seedat
- South African Medical Research Council Unit on the Genomics of Brain Disorders, Stellenbosch University, Department of Psychiatry, Faculty of Medicine and Health Sciences, South Africa
| | - Evan Matthews
- South East Technological University, School of Health Science, Waterford, Ireland
| | - John Wells
- South East Technological University, School of Health Science, Waterford, Ireland
| | | | - Ary Gadelha
- Universidade Federal de São Paulo, Department of Psychiatry, São Paulo, Brazil
| | - Kuan-Pin Su
- An-Nan Hospital, China Medical University, Department of Psychiatry, Tainan, Taiwan; China Medical University Hospital, Mind-Body Interface Research Center, Taichung, Taiwan
| | - Jun Soo Kwon
- Seoul National University College of Medicine, Department of Psychiatry, Seoul, Republic of Korea
| | - Minah Kim
- Seoul National University Hospital, Department of Neuropsychiatry, Seoul, Republic of Korea
| | - Tae Young Lee
- Pusan National University Yangsan Hospital, Department of Psychiatry, Yangsan, Republic of Korea
| | - Oleg Papsuev
- University of Ottawa, Department of Psychiatry, Ontario, Canada; The Ottawa Hospital, Department of Mental Health, Ontario, Canada; Ottawa Hospital Research Institute (OHRI) Neurosciences Program, Ottawa Ontario, Canada
| | - Denisa Manková
- National Institute of Mental Health, Klecany, Czech Republic
| | | | | | - Diego Saccon
- AULSS4 Veneto Orientale, Addictions Department, Italy
| | - Elena Righi
- University of Modena and Reggio Emilia, Department of Biomedical, Metabolic and Neural Sciences, Modena, Italy
| | - Francesco Monaco
- ASL Salerno, Department of Mental Health, Salerno, Italy; European Biomedical Research Institute of Salerno (EBRIS), Salerno, Italy
| | | | - Guido Cereda
- University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy
| | - Jacopo Demurtas
- University of Modena and Reggio Emilia, Clinical and Experimental Medicine PhD Program, Modena, Italy
| | - Natascia Brondino
- University of Pavia, Department of Brain and Behavioral Sciences, Pavia, Italy
| | - Nicola Veronese
- University of Palermo, Department of Internal Medicine, Geriatrics Section, Palermo, Italy
| | - Paolo Enrico
- University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy
| | - Pierluigi Politi
- University of Pavia, Department of Brain and Behavioral Sciences, Pavia, Italy
| | - Valentina Ciappolino
- Unit of Psychiatry, Azienda Ospedaliero-Universitaria Ss. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Andrea Pfennig
- Technische Universität Dresden, University Hospital Carl Gustav Carus, Department of Psychiatry and Psychotherapy, Dresden, Germany
| | - Andreas Bechdolf
- Charité Universitätsmedizin Berlin, Department of Psychiatry and Psychotherapy, Berlin, Germany
| | | | - Kai G Kahl
- Hannover Medical School, Department of Psychiatry, Social Psychiatry and Psychotherapy, Germany
| | - Katharina Domschke
- University of Freiburg, Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Michael Bauer
- Technische Universität Dresden, University Hospital Carl Gustav Carus, Department of Psychiatry and Psychotherapy, Dresden, Germany
| | | | - Sibylle Winter
- Charité Universitätsmedizin Berlin, Department of Child and Adolescent Psychiatry, Berlin, Germany
| | - Stefan Borgwardt
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Istvan Bitter
- Semmelweis University, Department of Psychiatry and Psychotherapy, Budapest, Hungary
| | - Judit Balazs
- Eotvos Lorand University, Institute of Psychology, Budapest, Hungary; Bjørknes University College, Oslo, Norway
| | - Pál Czobor
- Semmelweis University, Department of Psychiatry and Psychotherapy, Budapest, Hungary
| | - Zsolt Unoka
- Semmelweis University, Department of Psychiatry and Psychotherapy, Budapest, Hungary
| | - Dimitris Mavridis
- University of Ioannina, Department of Primary Education, Ioannina, Greece
| | - Konstantinos Tsamakis
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - Vasilios P Bozikas
- Aristotle University of Thessaloniki, II. Dept. of Psychiatry, Division of Neurosciences, Medical School, Faculty of Health Sciences, Greece
| | | | - Michael Maes
- Chulalongkorn University, Department of Psychiatry, Thailand
| | | | | | - Ariful Haque
- The National Foundation of Mental Health of Bangladesh, Bangladesh
| | - Andre R Brunoni
- Faculdade de Medicina da Universidade de São Paulo, Departments of Internal Medicine and Psychiatry, São Paulo, Brazil; Instituto de Psiquiatria do Hospital das Clínicas da FMUSP, Brazil
| | | | - Felipe Barreto Schuch
- Universidade Federal de Santa Maria, Department of Sports Methods and Techniques, Santa Maria, RS, Brazil; Faculty of Health Sciences, Universidad Autónoma de Chile, Providencia, Chile; Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Guilherme Polanczyk
- Faculdade de Medicina da Universidade de São Paulo, Departments of Internal Medicine and Psychiatry, São Paulo, Brazil
| | - Jhoanne Merlyn Luiz
- Universidade do Extremo Sul Catarinense, Translational Psychiatry Laboratory, Graduate Program in Health Sciences, Criciúma, SC, Brazil
| | - Lais Fonseca
- Universidade Federal de São Paulo, Department of Psychiatry, São Paulo, Brazil
| | - Luana V Aparicio
- Faculdade de Medicina da Universidade de São Paulo, Departments of Internal Medicine and Psychiatry, São Paulo, Brazil
| | - Samira S Valvassori
- Universidade do Extremo Sul Catarinense, Translational Psychiatry Laboratory, Graduate Program in Health Sciences, Criciúma, SC, Brazil
| | | | | | - Sofie Have Hoffmann
- National Institute of Public Health, University of Southern Denmark, Denmark
| | - Jihed Sehli
- Le Jolimont Psychiatry and Psychotherapy, Fribourg, Switzerland
| | - Norman Sartorius
- Association for the Improvement of Mental Health Programmes (AMH), Switzerland
| | - Sabina Heuss
- FHNW University of Applied Sciences and Arts Northwestern Switzerland, Switzerland
| | - Daniel Guinart
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, USA; Institut de Salut Mental, Parc de Salut Mar, Barcelona, Spain; Hospital del Mar Research Institute, CIBERSAM, Barcelona, Spain
| | - Jane Hamilton
- University of Texas Health Science Center Houston, McGovern Medical School, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, USA
| | - John Kane
- The Zucker Hillside Hospital, Northwell Health, New York, USA; Feinstein Institutes for Medical Research, Center for Psychiatric Neuroscience, Manhasset, New York, USA
| | - Jose Rubio
- The Zucker Hillside Hospital, Northwell Health, New York, USA; Feinstein Institutes for Medical Research, Center for Psychiatric Neuroscience, Manhasset, New York, USA
| | | | - Ai Koyanagi
- Parc Sanitari Sant Joan de Deu, Barcelona, Spain
| | - Aleix Solanes
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Imaging of Mood- and Anxiety-Related Disorders (IMARD), University of Barcelona, CIBERSAM, Instituto de Salud Carlos III, Barcelona, Spain
| | - Alvaro Andreu-Bernabeu
- Hospital General Universitario Gregorio Marañón, Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health (IPS MARAÑÓN), IiSGM, CIBERSAM, Universidad Complutense, Madrid, Spain
| | - Antonia San José Cáceres
- Hospital General Universitario Gregorio Marañón, Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health (IPS MARAÑÓN), IiSGM, CIBERSAM, Universidad Complutense, Madrid, Spain
| | - Celso Arango
- Hospital General Universitario Gregorio Marañón, Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health (IPS MARAÑÓN), IiSGM, CIBERSAM, Universidad Complutense, Madrid, Spain
| | - Covadonga M Díaz-Caneja
- Hospital General Universitario Gregorio Marañón, Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health (IPS MARAÑÓN), IiSGM, CIBERSAM, Universidad Complutense, Madrid, Spain
| | | | - Eduard Vieta
- University of Barcelona, Hospital Clínic, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Javier Gonzalez-Peñas
- Hospital General Universitario Gregorio Marañón, Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health (IPS MARAÑÓN), IiSGM, CIBERSAM, Universidad Complutense, Madrid, Spain
| | - Lydia Fortea
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Imaging of Mood- and Anxiety-Related Disorders (IMARD), University of Barcelona, CIBERSAM, Instituto de Salud Carlos III, Barcelona, Spain
| | - Mara Parellada
- Hospital General Universitario Gregorio Marañón, Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health (IPS MARAÑÓN), IiSGM, CIBERSAM, Universidad Complutense, Madrid, Spain
| | - Miquel A Fullana
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Imaging of Mood- and Anxiety-Related Disorders (IMARD), University of Barcelona, CIBERSAM, Instituto de Salud Carlos III, Barcelona, Spain
| | - Norma Verdolini
- University of Barcelona, Hospital Clínic, IDIBAPS, CIBERSAM, Barcelona, Spain; Local Health Unit 1, Department of Mental Health, Mental Health Center of Perugia, Italy
| | - Eva Andrlíková
- National Institute of Mental Health, Klecany, Czech Republic
| | - Karolina Janků
- National Institute of Mental Health, Klecany, Czech Republic
| | - Mark J Millan
- Glasgow University, Institute of Neuroscience and Psychology, College of Medicine, Vet and Life Science, Glasgow, United Kingdom
| | - Mihaela Honciuc
- Université Clermont Auvergne, CHU Clermont-Ferrand, Service de Psychiatrie B, Clermont-Ferrand, France
| | | | - Igor Łoniewski
- Pomeranian Medical University in Szczecin, Department of Biochemical Sciences, Szczecin, Poland; Sanprobi Sp. z o.o. Sp. k, Poland
| | - Jerzy Samochowiec
- Pomeranian Medical University in Szczecin, Department of Psychiatry, Szczecin, Poland
| | - Łukasz Kiszkiel
- University of Białystok, Institute of Sociology, Society and Cognition Unit, Białystok, Poland
| | - Maria Marlicz
- Pomeranian Medical University in Szczecin, Department of Biochemical Sciences, Szczecin, Poland
| | - Paweł Sowa
- Medical University of Białystok, Department of Population Medicine and Lifestyle Diseases Prevention, Bialystok, Poland
| | - Wojciech Marlicz
- Pomeranian Medical University in Szczecin, Department of Gastroenterology, Szczecin, Poland; The Centre for Digestive Diseases Endoklinika, Szczecin, Poland
| | - Georgina Spies
- South African Medical Research Council Unit on the Genomics of Brain Disorders, Stellenbosch University, Department of Psychiatry, Faculty of Medicine and Health Sciences, South Africa
| | | | - Joseph Firth
- University of Manchester, Division of Psychology and Mental Health, Manchester, United Kingdom
| | - Sarah Sullivan
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | | | - Hatice Aksu
- Adnan Menderes University Department of Child and Adolescent Psychiatry, Aydın, Turkey
| | - Nesrin Dilbaz
- Uskudar University, Department of Psychiatry and Psychology, Istanbul, Turkey
| | - Onur Noyan
- Uskudar University, Department of Psychiatry and Psychology, Istanbul, Turkey
| | - Momoko Kitazawa
- Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan
| | - Shunya Kurokawa
- Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan
| | - Yuki Tazawa
- Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan
| | | | - Cecilia Cracco
- Department of Psychology, Universidad Católica del Uruguay
| | | | | | - Diego De Leo
- Griffith University, South East Queensland, Australia
| | | | - Michael Berk
- Deakin University School of Medicine, Victoria, Australia
| | | | - Philip Ward
- UNSW Sydney, School of Psychiatry, Sydney, Australia
| | | | | | - Wolfgang Marx
- Deakin University School of Medicine, Victoria, Australia
| | | | - Liviu Oprea
- University of Medicine and Pharmacy Grigore T. Popa, Faculty of Medicine, Iasi, Romania
| | | | - Petru Ifteni
- Transilvania University of Brasov, Faculty of Medicine, Brasov, Romania
| | - Serban Turliuc
- University of Medicine and Pharmacy Grigore T. Popa, Faculty of Medicine, Iasi, Romania
| | | | - Alexandra Bolos
- University of Medicine and Pharmacy Grigore T. Popa, Faculty of Medicine, Iasi, Romania
| | - Valentin Matei
- Psychiatry Department, University of Medicine and Pharmacy "Carol Davila" Bucharest, "Prof. Dr. Alexandru Obregia" Psychiatric Hospital, Bucharest, Romania
| | - Dorien H Nieman
- Amsterdam University Medical Centers (location AMC), Department of Psychiatry, Amsterdam, the Netherlands
| | - Iris Sommer
- University Medical Center Groningen, Antoni Deusinglaan 2, room 117, Groningen, the Netherlands
| | - Jim van Os
- Utrecht University Medical Centre, Department of Psychiatry, Utrecht, the Netherlands
| | - Therese van Amelsvoort
- Maastricht University, Department of Psychiatry and Neuropsychology, Maastricht, the Netherlands
| | - Ching-Fang Sun
- China Medical University Hospital, Mind-Body Interface Research Center, Taichung, Taiwan; Department of Psychiatry and Behavioral Medicine, Carilion Clinic Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
| | - Ta-Wei Guu
- China Medical University Hospital, Mind-Body Interface Research Center, Taichung, Taiwan; King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom; China Medical University Beigang Hospital, Division of Psychiatry, Department of Internal Medicine, Taiwan
| | - Can Jiao
- Shenzhen University, School of Psychology, Shenzhen, China
| | - Jieting Zhang
- Shenzhen University, School of Psychology, Shenzhen, China
| | - Jialin Fan
- Shenzhen University, School of Psychology, Shenzhen, China
| | - Liye Zou
- Shenzhen University, School of Psychology, Shenzhen, China
| | - Xin Yu
- Peking University Institute of Mental Health, Department of Public Mental Health, Pekin, China
| | - Xinli Chi
- Shenzhen University, School of Psychology, Shenzhen, China
| | - Philippe de Timary
- UCLouvain, Institute of Neuroscience and Cliniques Universitaires Saint-Luc, Department of Adult Psychiatry, Brussels, Belgium; Cliniques Universitaires Saint-Luc, Department of Adult Psychiatry, Brussels, Belgium
| | - Ruud van Winkel
- Katholieke Universiteit Leuven (KU Leuven), Department of Neurosciences, Leuven, Belgium
| | | | | | | | | | | | - Larisa Movina
- Moscow Research Institute of Psychiatry, Moscow, Russia
| | - Pedro Morgado
- University of Minho, Life and Health Sciences Research Institute (ICVS), School of Medicine, Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Sofia Brissos
- Lisbon's Psychiatric Hospital Centre, Department of Psychiatry, Portugal
| | - Oleg Aizberg
- Belarusian Medical Academy of Postgraduate Education, Belarus
| | - Anna Mosina
- Clienia AG, Wetzikon Psychiatric Centre, Switzerland
| | | | - James Mugisha
- Kyambogo University, Department of Sociology and Social Administration, Kampala, Uganda
| | - Dena Sadeghi-Bahmani
- Stanford University, Department of Psychology, California, USA; Universitäre Psychiatrische Kliniken Basel (UPK), Center of Affective, Stress and Sleep Disorders (ZASS), Basel, Switzerland
| | - Farshad Sheybani
- Department of Psychiatry and Clinical Psychology, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Masoud Sadeghi
- Kermanshah University of Medical Sciences, Medical Biology Research Center, Kermanshah, Iran
| | | | - Serge Brand
- Universitäre Psychiatrische Kliniken Basel (UPK), Center of Affective, Stress and Sleep Disorders (ZASS), Basel, Switzerland; University of Basel, Department of Sport, Exercise, and Health, Division of Sport Science and Psychosocial Health, Basel, Switzerland; Kermanshah University of Medical Sciences, Substance Abuse Prevention Research Center, Kermanshah, Iran; Kermanshah University of Medical Sciences, Sleep Disorders Research Center, Kermanshah, Iran; Tehran University of Medical Sciences, School of Medicine, Tehran, Iran; Center for Disaster Psychiatry and Disaster Psychology, Psychiatric Clinics of the University of Basel, Basel, Switzerland
| | - Antonia Errazuriz
- Pontificia Universidad Católica de Chile, Department of Psychiatry, School of Medicine, Santiago, Chile
| | - Nicolas Crossley
- Pontificia Universidad Católica de Chile, Department of Psychiatry, School of Medicine, Santiago, Chile
| | | | | | | | | | | | - Afzal Javed
- Chairman, Pakistan Psychiatric Research Centre-Fountain House, Lahore, Pakistan
| | - Muhammad Iqbal Afridi
- Distinguished National Professor, Jinnah Sindh Medical University, Karachi, Pakistan; Adjunct Professor of Psychiatry, Baylor College of Medicine, Texas, USA
| | - Bawo James
- Tees Esk & Wear Valleys NHS Foundation Trust, UK
| | | | - Jess Fiedorowicz
- University of Ottawa, Department of Psychiatry, Ontario, Canada; The Ottawa Hospital, Department of Mental Health, Ontario, Canada; Ottawa Hospital Research Institute (OHRI) Neurosciences Program, Ottawa Ontario, Canada
| | - Jeff Daskalakis
- University of California San Diego, California, United States
| | | | - Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, Canada; Departments of Oncology and Community Health Sciences, University of Calgary, Calgary, Canada
| | - Tarek Okasha
- Okasha Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Aïcha Dahdouh
- Oran 1 University, Department of Psychiatry-Addictology, Oran, Algeria
| | - Jari Tiihonen
- Karolinska Institutet, Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Stockholm, Sweden; University of Eastern Finland, Department of Forensic Psychiatry, Niuvanniemi Hospital, Kuopio, Finland
| | - Jae Il Shin
- Yonsei University College of Medicine, Department of Pediatrics, Seoul, South Korea
| | - Jinhee Lee
- Yonsei University, Wonju College of Medicine, Department of Psychiatry, Wonju, South Korea
| | - Ahmed Mhalla
- University of Monastir, Faculty of Medicine of Monastir, Research Unit "Vulnerability to Mental Disorders" LR05ES10, Monastir, Tunisia
| | - Lotfi Gaha
- University of Monastir, Faculty of Medicine of Monastir, Research Unit "Vulnerability to Mental Disorders" LR05ES10, Monastir, Tunisia
| | - Takoua Brahim
- University of Monastir, Faculty of Medicine of Monastir, Research Unit "Vulnerability to Mental Disorders" LR05ES10, Monastir, Tunisia
| | - Kuanysh Altynbekov
- Republican Scientific and Practical Center of Mental Health, Almaty, Kazakhstan
| | - Nikolay Negay
- Republican Scientific and Practical Center of Mental Health, Almaty, Kazakhstan
| | | | | | | | - Christoph U Correll
- Charité Universitätsmedizin Berlin, Department of Child and Adolescent Psychiatry, Berlin, Germany; Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, USA; The Zucker Hillside Hospital, Northwell Health, New York, USA; Feinstein Institutes for Medical Research, Center for Psychiatric Neuroscience, Manhasset, New York, USA.
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6
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Schurr T, Frajo-Apor B, Pardeller S, Plattner B, Tutzer F, Schmit A, Conca A, Fronthaler M, Haring C, Holzner B, Huber M, Marksteiner J, Miller C, Perwanger V, Pycha R, Schmidt M, Sperner-Unterweger B, Hofer A. Overcoming times of crisis: unveiling coping strategies and mental health in a transnational general population sample during and after the COVID-19 pandemic. BMC Psychol 2024; 12:493. [PMID: 39300578 PMCID: PMC11412033 DOI: 10.1186/s40359-024-02001-3] [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: 05/29/2024] [Accepted: 09/12/2024] [Indexed: 09/22/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has had an unparalleled impact, precipitating not only direct threats to physical health but also widespread economic and psychological challenges. This study aims to explore the dynamics of coping behaviour and psychological distress (PD) across different phases of the pandemic within an adult general population sample, spanning Austria and Italy. METHODS An online questionnaire-based panel study was conducted between 2020 and 2023 including three measurements. We collected data on sociodemographic variables, coping responses (Brief COPE), and PD (Brief-Symptom-Checklist). Statistical analyses were conducted within a linear-mixed-model framework. Multiple imputation and sensitivity analysis were applied to validate the results obtained by complete case analysis. RESULTS The study follows 824 participants and reveals a marginal decrease in overall PD from the first to the second follow-up, particularly in clinically relevant phobic anxiety (35.6% and 34.5% to 25.4%). Most coping behaviours exhibited stable mean-levels with intra-individual variability across the study period. Maladaptive coping strategies were consistently linked to increased PD, whereas adaptive strategies were associated with decreased PD. CONCLUSION Our findings underscore the complex nature of coping behaviours and PD during and after the pandemic, suggesting that while mean-levels of PD and coping responses remained relatively stable, most coping strategies were subject to intra-individual change. Maladaptive strategies were associated with increased PD, pinpointing to the need for interventions that establish the foundation for adaptive coping mechanisms and promote their application. Further research should explore the reciprocal influences of mental health on coping behaviour, incorporating interventional designs to unravel the nuances of these relationships.
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Affiliation(s)
- Timo Schurr
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Division of Psychiatry I, Medical University Innsbruck, Anichstraße 35, Innsbruck, 6020, Austria.
| | - Beatrice Frajo-Apor
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Division of Psychiatry I, Medical University Innsbruck, Anichstraße 35, Innsbruck, 6020, Austria
| | - Silvia Pardeller
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Division of Psychiatry I, Medical University Innsbruck, Anichstraße 35, Innsbruck, 6020, Austria
| | - Barbara Plattner
- Department of Psychiatry, Sanitary Agency of South Tyrol, General Hospital of Bolzano, Bolzano, Italy
| | - Franziska Tutzer
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Division of Psychiatry I, Medical University Innsbruck, Anichstraße 35, Innsbruck, 6020, Austria
| | - Anna Schmit
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Division of Psychiatry I, Medical University Innsbruck, Anichstraße 35, Innsbruck, 6020, Austria
| | - Andreas Conca
- Department of Psychiatry, Sanitary Agency of South Tyrol, General Hospital of Bolzano, Bolzano, Italy
| | - Martin Fronthaler
- Sanitary Agency of South Tyrol, Therapy Center Bad Bachgart, Rodengo, Italy
| | - Christian Haring
- Department of Psychiatry and Psychotherapy B, State Hospital Hall in Tyrol, Hall in Tyrol, Austria
| | - Bernhard Holzner
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Division of Psychiatry I, Medical University Innsbruck, Anichstraße 35, Innsbruck, 6020, Austria
| | - Markus Huber
- Department of Psychiatry, Sanitary Agency of South Tyrol, General Hospital of Brunico, Brunico, Italy
| | - Josef Marksteiner
- Department of Psychiatry and Psychotherapy A, State Hospital Hall in Tyrol, Hall in Tyrol, Austria
| | - Carl Miller
- Department of Psychiatry, County Hospital Kufstein, Kufstein, Austria
| | - Verena Perwanger
- Department of Psychiatry, Sanitary Agency of South Tyrol, General Hospital of Merano, Merano, Italy
| | - Roger Pycha
- Department of Psychiatry, Sanitary Agency of South Tyrol, General Hospital of Bressanone, Bressanone, Italy
| | - Martin Schmidt
- Department of Psychiatry, County Hospital Lienz, Lienz, Austria
| | - Barbara Sperner-Unterweger
- Department of Psychiatry, Psychosomatics and Medical Psychology, Division of Psychiatry II, Medical University Innsbruck, PsychotherapyInnsbruck, Austria
| | - Alex Hofer
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Division of Psychiatry I, Medical University Innsbruck, Anichstraße 35, Innsbruck, 6020, Austria
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7
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Diel A, Schröter IC, Frewer AL, Jansen C, Robitzsch A, Gradl-Dietsch G, Teufel M, Bäuerle A. A systematic review and meta analysis on digital mental health interventions in inpatient settings. NPJ Digit Med 2024; 7:253. [PMID: 39289463 PMCID: PMC11408664 DOI: 10.1038/s41746-024-01252-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Accepted: 09/03/2024] [Indexed: 09/19/2024] Open
Abstract
E-mental health (EMH) interventions gain increasing importance in the treatment of mental health disorders. Their outpatient efficacy is well-established. However, research on EMH in inpatient settings remains sparse and lacks a meta-analytic synthesis. This paper presents a meta-analysis on the efficacy of EMH in inpatient settings. Searching multiple databases (PubMed, ScienceGov, PsycInfo, CENTRAL, references), 26 randomized controlled trial (RCT) EMH inpatient studies (n = 6112) with low or medium assessed risk of bias were included. A small significant total effect of EMH treatment was found (g = 0.3). The effect was significant both for blended interventions (g = 0.42) and post-treatment EMH-based aftercare (g = 0.29). EMH treatment yielded significant effects across different patient groups and types of therapy, and the effects remained stable post-treatment. The results show the efficacy of EMH treatment in inpatient settings. The meta-analysis is limited by the small number of included studies.
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Affiliation(s)
- Alexander Diel
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
- Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, Essen, Germany.
| | - Isabel Carolin Schröter
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, Essen, Germany
| | - Anna-Lena Frewer
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, Essen, Germany
| | - Christoph Jansen
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, Essen, Germany
| | - Anita Robitzsch
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, Essen, Germany
| | - Gertraud Gradl-Dietsch
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Martin Teufel
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, Essen, Germany
| | - Alexander Bäuerle
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, Essen, Germany
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8
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Pietrzak P, Hanke W. The long COVID and its mental health manifestations - the review of literature. Int J Occup Med Environ Health 2024; 37:360-380. [PMID: 38912617 PMCID: PMC11424153 DOI: 10.13075/ijomeh.1896.02373] [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: 12/30/2023] [Accepted: 04/25/2024] [Indexed: 06/25/2024] Open
Abstract
This article aims to present the overview of the situation during the coronavirus disease 2019 (COVID-19) pandemic about issues concerning the prevalence of mental disorders such as depression, anxiety, rate of suicide attempts, and long COVID (LC) infections in the general population during COVID-19 pandemic. Analysis of the literature (in English, Polish and Spanish language) on topics related to COVID-19, mental disorders (suicide attempts, depression, anxiety) and LC infection published during the 4 years (2020-2023) was done using Pubmed and PubMed Central search engine. Keywords such as "COVID-19," "mental disorders," "long COVID infection," "depression," "anxiety," "suicide attempts" were used during the search. The conduct of this review/comment followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) protocol, which corresponds to a checklist of 27 items designed to facilitate the development and reporting of a robust protocol for systematic reviews or meta-analyses. Overall 35 studies were selected and analyzed in the review on topics: including among others LC (14 studies), suicide attempts (7 studies), mental disorders (depression, anxiety) (14 studies). The main issues raised in the articles were: higher risk of LC symptoms in women, fatigue and brain fog listed as frequently encountered patient's complaints together with anxiety, depression, loneliness, especially in younger age groups and in women. Issues regarding LC, mental disorders and suicide attempts requires further research as the results vary in different countries. Int J Occup Med Environ Health. 2024;37(3):360-80.
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Affiliation(s)
- Patrycja Pietrzak
- Medical University of Lodz, Department of Orthodontics, Łódź, Poland
| | - Wojciech Hanke
- Medical University of Lodz, Department of Informatics and Medical Statistics, Łódź, Poland
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9
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Fehr M, Köhler S, Roth-Sackenheim C, Geschke K, Tüscher O, Adorjan K, Lieb K, Hölzel LP, Wiegand HF. Outpatient mental health care during high incidence phases of the COVID-19 pandemic in Germany - changes in utilization, challenges and post-COVID care. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01886-w. [PMID: 39218918 DOI: 10.1007/s00406-024-01886-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 08/13/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND As only a few studies have examined the impact of the COVID-19 pandemic on the mental health outpatient system so far, the aim of the COVID Ψ Outpatient Survey was to gain insight from outpatient providers in Germany regarding changes in utilization; associated problems and challenges; telemedicine services; interactions with inpatient and nursing home services; and experiences with post-COVID syndromes. METHODS Between July and September 2021, we invited 351 randomly selected outpatient mental health specialists to take part in the online survey via e-mail. Additionally, we extended an invitation to professional associations to encourage their members to participate. N = 105 physicians of most regions of Germany took part in the survey. RESULTS Survey participants reported changes in utilization during the high incidence phases (HIP) of the pandemic using pre-formulated categories: For the first HIP in spring 2020, 31% of the survey participants reported a decrease > 20% and 5% an increase > 20% of patient contacts. For the third HIP in spring 2021, 4% reported a decrease > 20% of contacts, while 30% an increase > 20%. Participants chose "patient's fears of infection" and "providers protection measures" as reasons for decreases, and "pandemic related anxieties", "economic stressors", and "capacity reductions of the inpatient system" as reasons for increases of patient contact. Many providers introduced telemedicine services. A majority reported consultations for post-COVID syndromes already in spring 2021. CONCLUSIONS The survey hinted at changes in utilization, multiple problems but as well good-practice-solutions in the mental health outpatient system during the COVID-19 pandemic.
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Affiliation(s)
- Mandy Fehr
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Untere Zahlbacher Straße 8, 55131, Mainz, Germany
| | - Sabine Köhler
- Berufsverband Deutscher Nervenärzte, Berlin, Germany
- Berufsverband Deutscher Psychiater, Berlin, Germany
| | - Christa Roth-Sackenheim
- Berufsverband Deutscher Nervenärzte, Berlin, Germany
- Berufsverband Deutscher Psychiater, Berlin, Germany
| | - Katharina Geschke
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Untere Zahlbacher Straße 8, 55131, Mainz, Germany
| | - Oliver Tüscher
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Untere Zahlbacher Straße 8, 55131, Mainz, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Medicine Halle, Halle, Germany
| | - Kristina Adorjan
- Department of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilians University Munich, Munich, Germany
| | - Klaus Lieb
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Untere Zahlbacher Straße 8, 55131, Mainz, Germany
| | - Lars P Hölzel
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Untere Zahlbacher Straße 8, 55131, Mainz, Germany
- Oberberg Parkklinik Wiesbaden Schlangenbad, Schlangenbad, Germany
| | - Hauke F Wiegand
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Untere Zahlbacher Straße 8, 55131, Mainz, Germany.
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10
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Ye X, Wang X, Lin H. Global Research on Pandemics or Epidemics and Mental Health: A Natural Language Processing Study. J Epidemiol Glob Health 2024; 14:1268-1280. [PMID: 39117794 PMCID: PMC11442711 DOI: 10.1007/s44197-024-00284-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 08/02/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND The global research on pandemics or epidemics and mental health has been growing exponentially recently, which cannot be integrated through traditional systematic review. Our study aims to systematically synthesize the evidence using natural language processing (NLP) techniques. METHODS Multiple databases were searched using titles, abstracts, and keywords. We systematically identified relevant literature published prior to Dec 31, 2023, using NLP techniques such as text classification, topic modelling and geoparsing methods. Relevant articles were categorized by content, date, and geographic location, outputting evidence heat maps, geographical maps, and narrative synthesis of trends in related publications. RESULTS Our NLP analysis identified 77,915 studies in the area of pandemics or epidemics and mental health published before Dec 31, 2023. The Covid pandemic was the most common, followed by SARS and HIV/AIDS; Anxiety and stress were the most frequently studied mental health outcomes; Social support and healthcare were the most common way of coping. Geographically, the evidence base was dominated by studies from high-income countries, with scant evidence from low-income counties. Co-occurrence of pandemics or epidemics and fear, depression, stress was common. Anxiety was one of the three most common topics in all continents except North America. CONCLUSION Our findings suggest the importance and feasibility of using NLP to comprehensively map pandemics or epidemics and mental health in the age of big literature. The review identifies clear themes for future clinical and public health research, and is critical for designing evidence-based approaches to reduce the negative mental health impacts of pandemics or epidemics.
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Affiliation(s)
- Xin Ye
- Institute for Global Public Policy, Fudan University, 220 Handan Road, Yangpu District, Shanghai, 200433, China.
- LSE-Fudan Research Centre for Global Public Policy, Fudan University, 220 Handan Road, Yangpu District, Shanghai, 200433, China.
| | - Xinfeng Wang
- Institute for Global Public Policy, Fudan University, 220 Handan Road, Yangpu District, Shanghai, 200433, China
| | - Hugo Lin
- CentraleSupélec, Paris-Saclay University, Paris, 91192, France
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11
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Klokgieters SS, Ungar M, Penninx BWJH, Glas L, Rhebergen D, Kok AAL. How sustainable is resilience? A mixed-methods study on the COVID-19-pandemic as a challenge to resilience resources of older adults who previously recovered from depression. Aging Ment Health 2024; 28:1242-1251. [PMID: 38497375 DOI: 10.1080/13607863.2024.2326890] [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: 08/19/2023] [Accepted: 02/23/2024] [Indexed: 03/19/2024]
Abstract
OBJECTIVES Despite expanding knowledge about the internal and external resources that contribute to resilience among individuals who have experienced depression, the long-term accessibility and protectiveness of these resources across different stressors is unknown. We investigated whether and how the resilience resources of individuals who previously recovered from late-life depression remained protective during the COVID-19 pandemic. METHODS We used a sequential explanatory mixed methods design. Quantitative data were derived from two psychiatric case-control cohorts and included twelve repeated measures during the COVID-19 pandemic (n = 465, aged ≥ 60). Qualitative data included two sequential interviews held in 2020 (n = 25) and 2021 (n = 19). We used thematic analysis to determine the protective resources after depression and during the COVID-19 pandemic and linear mixed models to examine the effect of these resources on change in depressive symptoms during the COVID-19 pandemic. RESULTS While resources of 'Taking agency', 'Need for rest', 'Managing thought processes' and 'Learning from depression' remained accessible and protective during the pandemic, 'Social support' and 'Engaging in activities' did not. 'Negotiating with lockdown measures', 'changing social contact' and 'changing activities' were compensating strategies. Quantitative data confirmed the protectiveness of social contact, social cohesion, sense of mastery, physical activity, staying active and entertained and not following the media. CONCLUSION Many of the resources that previously helped to recover from depression also helped to maintain good mental health during the COVID-19 pandemic. Where accessibility and protectiveness declined, compensatory strategies or new resources were used. Hence, the sustainability of resilience is enabled through adaptation and compensation processes.
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Affiliation(s)
- Silvia S Klokgieters
- Department of Psychiatry, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Michael Ungar
- Resilience Research Centre, Dalhousie University, Halifax, NS, Canada
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Mental Health Program, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Lieneke Glas
- Department of Psychiatry, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Didi Rhebergen
- Department of Psychiatry, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Mental Health Institute GGz Centraal, Amersfoort, The Netherlands
| | - Almar A L Kok
- Department of Psychiatry, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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12
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Cruciani G, Liotti M, Lingiardi V. Motivations to become psychotherapists: beyond the concept of the wounded healer. RESEARCH IN PSYCHOTHERAPY (MILANO) 2024; 27:808. [PMID: 39221902 PMCID: PMC11417668 DOI: 10.4081/ripppo.2024.808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Accepted: 08/01/2024] [Indexed: 09/04/2024]
Abstract
Motivations to become psychotherapists have long been associated with the concept of the wounded healer, which posits that practitioners entering the field of mental health often do so as a result of their own personal struggles and challenges. Early difficulties and wounds are seen as a source of healers' capacity to comprehend and promote the processes of recovery, fostering a deeper connection between the healer and the person seeking support. Nevertheless, other factors not directly linked with early adversities have been posited to have an influence on the development of motivations towards pursuing a career in the psychological field. The present work aimed to review available empirical literature on the motivations to become psychotherapists, encompassing the concept of the wounded healer as well as other possible factors shaping practitioners' career choice. Three main domains of motivations have been addressed within the wounded healer framework: dysfunctional caregiving, negative personal experiences in the family of origin, and other early relational issues. Additionally, two other main domains, namely self-oriented and altruistic motivations, have been identified, and the concept of the healing healer was proposed to underline both the self-oriented healing process that a person may undergo while becoming a therapist, as well as the altruistic attitude in providing healing care towards others. Results were discussed addressing possible links between conscious and unconscious motivations to become therapists as well as in terms of clinical implications for practitioners in the field of clinical psychology.
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Affiliation(s)
| | - Marianna Liotti
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome.
| | - Vittorio Lingiardi
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome.
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13
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Wang JA, Wang HF, Cao B, Lei X, Long C. Cultural Dimensions Moderate the Association between Loneliness and Mental Health during Adolescence and Younger Adulthood: A Systematic Review and Meta-Analysis. J Youth Adolesc 2024; 53:1774-1819. [PMID: 38662185 DOI: 10.1007/s10964-024-01977-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Accepted: 03/22/2024] [Indexed: 04/26/2024]
Abstract
Cultural factors, such as country or continent, influence the relationship between loneliness and mental health. However, less is known about how cultural dimensions moderate this relationship during adolescence and younger adulthood, even if these dimensions manifest as country or continent differences. This study aims to examine the potential influence of Hofstede's cultural dimensions on this relationship using a three-level meta-analysis approach. A total of 292 studies with 291,946 participants aged 10 to 24 were included in this study. The results indicate that cultural dimensions, such as individualism vs. collectivism, indulgence vs. restraint, power distance, and long-term vs. short-term orientation, moderated the associations between loneliness and social anxiety, stress, Internet overuse, and negative affect. The association between loneliness and mental health was not moderated by cultural dimensions, such as masculinity and uncertainty avoidance. These findings suggest that culture's influence on the association between loneliness and mental health is based on a domain-specific mechanism.
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Affiliation(s)
- Jing-Ai Wang
- School of Psychology and Key Laboratory of Cognition and Personality of the Ministry of Education, Southwest University, Chongqing, 400715, China
| | - Hai-Fan Wang
- School of Psychology and Key Laboratory of Cognition and Personality of the Ministry of Education, Southwest University, Chongqing, 400715, China
| | - Bing Cao
- School of Psychology and Key Laboratory of Cognition and Personality of the Ministry of Education, Southwest University, Chongqing, 400715, China
| | - Xu Lei
- School of Psychology and Key Laboratory of Cognition and Personality of the Ministry of Education, Southwest University, Chongqing, 400715, China
| | - Changquan Long
- School of Psychology and Key Laboratory of Cognition and Personality of the Ministry of Education, Southwest University, Chongqing, 400715, China.
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14
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Alarcão V, Candeias P, Stefanovska-Petkovska M, Neves J, Pintassilgo S, Machado FL, Santos O, Virgolino A, Santos RR, Heitor MJ, Costa A. Insights from the EQUALS4COVID19 study on migrant mental health in Portugal: a cross-sectional mixed-methods approach. BMC Public Health 2024; 24:2023. [PMID: 39075428 PMCID: PMC11285180 DOI: 10.1186/s12889-024-19563-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 07/23/2024] [Indexed: 07/31/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic and related disruptive consequences in the economic, health, and educational sectors have impacted people's lives, contributing to a context of increased economic and social vulnerability. The pandemic has revealed and accentuated social inequalities and discrimination based on racial or ethnic origin. This study aimed to contribute to the promotion of the mental health and well-being of migrant populations living in Portugal via the definition of an analytical framework and recommendations emerging from the EQUALS4COVID19 project. METHODS To gather information on the impact of the COVID-19 pandemic and resilience determinants among immigrants, a mixed-methods approach was implemented in 2022, combining a cross-sectional survey targeting immigrant adults in Portugal, focus groups with immigrants, focus groups with healthcare professionals, and in-depth individual interviews with stakeholders involved in the implementation of measures related to mental health and well-being during the pandemic. The analysis followed an integrated framework; quantitative data informed the script of qualitative data collection methods, and qualitative analysis informed the reinterpretation of quantitative data. RESULTS The survey with 604 Brazilian and Cape Verdean immigrants revealed that gender (being a woman) was associated with both psychological distress and depression-related symptomatology and that the perception of discrimination was a major risk factor for psychological suffering, while perceived social support and individuals' resilience characteristics were protective factors. Qualitative data provided deeper insights into these findings, revealing the ways mental health is affected by social structures, such as gender and ethnic hierarchies. Migrants tend to work in precarious jobs requiring physical presence, which, together with dense housing conditions, puts them at higher risk of infection. The deterioration of the economic conditions of the general population has also increased the perception of ethnic-racial discrimination, which was found to be related to the increase in insecurity and anxiety-related symptomatology among the migrant population. Newly arrived migrants, with reduced support networks, experienced a greater sense of insecurity as well as concern and anguish regarding relatives who live far away, in their home country. Migrant women reported greater family-related distress, including work-life balance problems. CONCLUSIONS Proposals to address mental health inequalities should be considered in the context of the necessary global changes both at the societal level and in the delivery of mental health services. Additionally, they should be considered with the active involvement of migrants, families, and communities in the design and delivery of mental health promotion and care processes.
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Affiliation(s)
- Violeta Alarcão
- Centro de Investigação e Estudos de Sociologia, Iscte - Instituto Universitário de Lisboa, Avenida das Forças Armadas, Lisboa, 1649-026, Portugal.
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal.
- Iscte - Instituto Universitário de Lisboa, Avenida das Forças Armadas, Lisboa, 1649-026, Portugal.
| | - Pedro Candeias
- Centro de Investigação e Estudos de Sociologia, Iscte - Instituto Universitário de Lisboa, Avenida das Forças Armadas, Lisboa, 1649-026, Portugal
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal
- Iscte - Instituto Universitário de Lisboa, Avenida das Forças Armadas, Lisboa, 1649-026, Portugal
| | - Miodraga Stefanovska-Petkovska
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal
| | - Júlia Neves
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal
| | - Sónia Pintassilgo
- Centro de Investigação e Estudos de Sociologia, Iscte - Instituto Universitário de Lisboa, Avenida das Forças Armadas, Lisboa, 1649-026, Portugal
- Iscte - Instituto Universitário de Lisboa, Avenida das Forças Armadas, Lisboa, 1649-026, Portugal
| | - Fernando Luís Machado
- Centro de Investigação e Estudos de Sociologia, Iscte - Instituto Universitário de Lisboa, Avenida das Forças Armadas, Lisboa, 1649-026, Portugal
- Iscte - Instituto Universitário de Lisboa, Avenida das Forças Armadas, Lisboa, 1649-026, Portugal
| | - Osvaldo Santos
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal
- Unbreakable Idea Research, Estrada Nacional 115, Sítio da Caniceira, nº 1, Casarão, Painho, 2550-426, Portugal
| | - Ana Virgolino
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal
| | - Ricardo R Santos
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal
| | - Maria João Heitor
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal
- Psychiatry and Mental Health Department, Hospital Beatriz Ângelo, Loures, Portugal
- Centro de Investigação Interdisciplinar em Saúde (CIIS), Faculdade de Medicina, Universidade Católica Portuguesa, Lisboa, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas - TERRA, Lisboa, Portugal
| | - Andreia Costa
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas - TERRA, Lisboa, Portugal
- Innovation and Development Centre of Lisbon (CIDNUR), Nursing Research, Nursing School of Lisbon, Lisbon, Portugal
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15
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O’Shea J, James R, Nicholls D, Downs J, Hudson LD. Prevalence, severity and risk factors of psychiatric disorders amongst sexual and gender diverse young people during the COVID-19 pandemic: A systematic review. Clin Child Psychol Psychiatry 2024; 29:1213-1227. [PMID: 38290723 PMCID: PMC11188558 DOI: 10.1177/13591045241229751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
Before the COVID-19 pandemic, the prevalence and severity of psychiatric disorders among sexual and gender diverse (SGD) young people was greater than in their heterosexual/cisgender peers. We systematically reviewed literature examining the prevalence, severity, and risk factors for psychiatric disorders among SGD young people aged 25 and under during the pandemic. Four databases (MEDLINE, PsycInfo, Scopus and Web of Science) were searched. Eligibility criteria were studies assessing prevalence rates, mean symptomology scores and risk factors of psychiatric disorders using contemporaneous screening measures or diagnosis. Thirteen studies of mixed quality were identified. Most studies indicated SGD young people were at high risk of experiencing several psychiatric disorders including depressive and generalised anxiety disorder compared to the general population. This group also experienced more severe symptomology of various psychiatric disorders compared to their heterosexual/cisgender peers. Risk factors included those specific to the pandemic along with factors that led to greater risk before the pandemic. This systematic review has indicated evidence of heightened risk of psychiatric disorders among SGD young people during the COVID-19 pandemic. It is important for clinicians to acknowledge the needs of SGD young people, working with them to co-develop more inclusive care as they deal with the pandemic's fallout.
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Affiliation(s)
- Jonathan O’Shea
- Population, Policy and Practice Department, UCL GOS Institute of Child Health, UK
| | - Rachel James
- Population, Policy and Practice Department, UCL GOS Institute of Child Health, UK
| | - Dasha Nicholls
- Department of Brain Sciences, Imperial College London, UK
| | - James Downs
- Faculty of Eating Disorders, Royal College of Psychiatrists, UK
| | - Lee D Hudson
- Population, Policy and Practice Department, UCL GOS Institute of Child Health, UK
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16
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Hansen SJ, McLay J, Menkes DB. Eating Disorder and Other Psychiatric Hospitalizations in New Zealand During the COVID-19 Pandemic. Int J Eat Disord 2024. [PMID: 38946135 DOI: 10.1002/eat.24237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 05/14/2024] [Accepted: 05/14/2024] [Indexed: 07/02/2024]
Abstract
OBJECTIVE An unprecedented rise in eating disorder presentations has been documented in several countries during the COVID-19 pandemic. We explored this phenomenon by analyzing nationwide psychiatric admissions over 5 years, controlling for demographic variables. METHODS We retrospectively analyzed all hospitalizations in New Zealand with a primary psychiatric diagnosis from 2017 to 2021, using Poisson regression to calculate admission rates by diagnosis, before and during the pandemic. Using Fisher's exact test and Poisson modeling, national data were validated against a manually collected sample of eating disorder admissions. RESULTS Eating disorder admissions rose significantly during the pandemic (RR 1.48, p < 0.0001), while other diagnoses remained unchanged or decreased slightly. Anorexia nervosa in 10 to 19-year-old females drove increases, with persistent elevations noted in the 10-14 age group. Pandemic-associated increases were more striking for Māori (RR 2.55), the indigenous Polynesian population, compared with non-Māori (RR 1.43). CONCLUSIONS Eating disorder hospital presentations increased during the COVID-19 pandemic, while other psychiatric presentations to hospital remained relatively unchanged. Possible drivers include disrupted routines, barriers to healthcare access, altered social networks, and increased social media use. Clinical services require additional resources to manage the increased disease burden, especially in vulnerable pediatric and indigenous populations. Ongoing monitoring will be required to establish the time-course of pandemic-related clinical demand.
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Affiliation(s)
- Sara J Hansen
- Faculty of Medical and Health Sciences, Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
- Te Whatu Ora, Wellington, New Zealand
| | - Jessica McLay
- Department of Statistics, University of Auckland, Auckland, New Zealand
| | - David B Menkes
- Faculty of Medical and Health Sciences, Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
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Kenntemich L, von Hülsen L, Eggert L, Kriston L, Gallinat J, Schäfer I, Lotzin A. Trajectories of depressive and anxiety symptoms and associated risk factors during the COVID-19 pandemic in Germany: A longitudinal cohort study. J Affect Disord 2024; 355:136-146. [PMID: 38552918 DOI: 10.1016/j.jad.2024.03.131] [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: 11/22/2023] [Revised: 02/18/2024] [Accepted: 03/23/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND Most COVID-19-related mental health research focused on average levels of mental health parameters in the general population. However, considering heterogeneous groups and their long-term responses could deepen our understanding of mental health during community crises. This four-wave study aimed to (1) identify subgroups with different trajectories of depressive and anxiety symptoms in the German general population, and (2) investigate associated risk factors. METHODS We analyzed self-report data from N = 1257 German adults participating in a European cohort study, assessed in summer 2020 (T1), and at 6 (T2), 12 (T3), and 30 months (T4). Depressive and anxiety symptoms were measured using the PHQ-4. Sociodemographic, health-related, and pandemic-related variables were assessed at baseline. We applied growth mixture modeling to identify subgroups of symptom trajectories and conducted multinomial logistic regression to examine factors associated with class membership. RESULTS We identified six symptom trajectories: Low-stable (n = 971, 77.2 %), Continuous deterioration (n = 30, 2.4 %), Transient deterioration (n = 75, 6.0 %), Continuous improvement (n = 97, 7.7 %), Transient improvement (n = 38, 3.0 %) and Chronicity (n = 46, 3.7 %). Age, education, work status, mental health diagnoses, self-reported health, and pandemic-related news consumption were significantly associated with subgroup membership. LIMITATIONS The generalizability of the study is constrained by an unrepresentative sampling method, a notable dropout rate, and limited consideration of risk factors. CONCLUSION Most people experienced low symptoms or improvement during the pandemic, while others experienced chronic or transient symptoms. Specific risk factors were associated with these trajectories, revealing nuanced mental health dynamics.
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Affiliation(s)
- Laura Kenntemich
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg Eppendorf, Hamburg, Germany; Institute of Clinical Psychology and Psychotherapy, Department of Psychology, MSH Medical School Hamburg, Hamburg, Germany.
| | - Leonie von Hülsen
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Laura Eggert
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Levente Kriston
- Department of Medical Psychology, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Jürgen Gallinat
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Ingo Schäfer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Annett Lotzin
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg Eppendorf, Hamburg, Germany; Institute of Clinical Psychology and Psychotherapy, Department of Psychology, MSH Medical School Hamburg, Hamburg, Germany
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18
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Kurvits K, Toompere K, Jaanson P, Uusküla A. The COVID-19 pandemic and the use of benzodiazepines and benzodiazepine-related drugs in Estonia: an interrupted time-series analysis. Child Adolesc Psychiatry Ment Health 2024; 18:66. [PMID: 38845001 PMCID: PMC11157874 DOI: 10.1186/s13034-024-00757-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 05/24/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has posed challenges that worsened people's mental health. We explored the impact of the COVID-19 pandemic on the mental well-being of the population, as indicated by the prevalence rates of benzodiazepine and benzodiazepine-related drug (BDZ) use. METHODS This population-based, time-series analysis included all prescriptions of BDZs dispensed in Estonia between 2012 and 2021. The monthly prevalence rates of BDZ use were calculated. Autoregressive integrated moving average models with pulse and slope intervention functions tested for temporary and long-term changes in monthly prevalence rates after the onset of the COVID-19 pandemic. RESULTS Throughout the 10-year study period, a total of 5,528,911 BDZ prescriptions were dispensed to 397,436 individuals. A significant temporary increase in the overall prevalence rate of BDZ use in March 2020 (2.698 users per 1000, 95% CI 1.408-3.988) was observed, but there was no statistically significant long-term change. This temporary increase affected all the examined subgroups, except for new users, individuals aged 15-29 years, and prescribing specialists other than general practitioners and psychiatrists. The long-term increase in BDZ use was confined to females aged 15-29 years (0.056 users per 1000 per month, 95% CI 0.033-0.079), while no significant change was observed among males of the same age (0.009 users per 1000 per month, 95% CI - 0.017 to 0.035). Among females aged 15-29 years, a significant long-term increase in BDZ use was observed for anxiety disorders (0.017 users per 1000 per month, 95% CI 0.010-0.023), depressive disorders (0.021 users per 1000 per month, 95% CI 0.012-0.030), and other mental and behavioral disorders (0.020 users per 1000 per month, 95% CI 0.010-0.030), but not for sleep disorders (- 0.008 users per 1000 per month, 95% CI - 0.018-0.002). CONCLUSION The COVID-19 pandemic led to a short-term increase in BDZ use immediately after the pandemic was declared. In the long term, young females experienced a sustained increase in BDZ use. The prolonged effect on girls and young women suggests their greater vulnerability. These results underscore the need to effectively address the long-term effects of the pandemic among youth.
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Affiliation(s)
- Katrin Kurvits
- Institute of Family Medicine and Public Health, University of Tartu, 19 Ravila Street, 50411, Tartu, Estonia.
- State Agency of Medicines, Tartu, Estonia.
| | - Karolin Toompere
- Institute of Family Medicine and Public Health, University of Tartu, 19 Ravila Street, 50411, Tartu, Estonia
| | | | - Anneli Uusküla
- Institute of Family Medicine and Public Health, University of Tartu, 19 Ravila Street, 50411, Tartu, Estonia
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Herpertz J, Goltermann J, Gruber M, Blitz R, Taylor J, Brosch K, Stein F, Straube B, Meinert S, Kraus A, Leehr EJ, Repple J, Redlich R, Gutfleisch L, Besteher B, Ratzsch J, Winter A, Bonnekoh LM, Winter NR, Emden D, Kircher T, Nenadić I, Dannlowski U, Hahn T, Opel N. The impact of depression and childhood maltreatment experiences on psychological adaptation from lockdown to reopening period during the COVID-19 pandemic. Eur Neuropsychopharmacol 2024; 83:59-60. [PMID: 38677192 DOI: 10.1016/j.euroneuro.2024.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 04/04/2024] [Accepted: 04/08/2024] [Indexed: 04/29/2024]
Affiliation(s)
- Julian Herpertz
- Institute for Translational Psychiatry, University of Münster, Münster, Germany.
| | - Janik Goltermann
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Marius Gruber
- Institute for Translational Psychiatry, University of Münster, Münster, Germany; Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Rogério Blitz
- Department of Psychiatry and Psychotherapy, Jena University Hospital/Friedrich-Schiller-University Jena, Jena, Germany
| | - Jacob Taylor
- David A. Dunlap Department of Astronomy and Astrophysics, University of Toronto, Toronto, Canada
| | - Katharina Brosch
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg and University Hospital Marburg, UKGM, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany, Center for Mind, Brain and Behavior (CMBB), Hans-Meerwein-Str. 6, 35032 Marburg, Germany
| | - Frederike Stein
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg and University Hospital Marburg, UKGM, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany, Center for Mind, Brain and Behavior (CMBB), Hans-Meerwein-Str. 6, 35032 Marburg, Germany
| | - Benjamin Straube
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg and University Hospital Marburg, UKGM, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany, Center for Mind, Brain and Behavior (CMBB), Hans-Meerwein-Str. 6, 35032 Marburg, Germany
| | - Susanne Meinert
- Institute for Translational Psychiatry, University of Münster, Münster, Germany; Institute for Translational Neuroscience, University of Münster, Münster, Germany
| | - Anna Kraus
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Elisabeth J Leehr
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Jonathan Repple
- Institute for Translational Psychiatry, University of Münster, Münster, Germany; Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Ronny Redlich
- Institute for Translational Psychiatry, University of Münster, Münster, Germany; German Center for Mental Health (DZPG), Site Jena-Magdeburg-Halle, Germany; Center for Intervention and Research on adaptive and maladaptive brain Circuits underlying mental health (C-I-R-C), Jena-Magdeburg-Halle, Germany; Department of Psychology, University of Halle, Halle, Germany
| | - Lara Gutfleisch
- Department of Psychiatry and Psychotherapy, Jena University Hospital/Friedrich-Schiller-University Jena, Jena, Germany
| | - Bianca Besteher
- Department of Psychiatry and Psychotherapy, Jena University Hospital/Friedrich-Schiller-University Jena, Jena, Germany; German Center for Mental Health (DZPG), Site Jena-Magdeburg-Halle, Germany; Center for Intervention and Research on adaptive and maladaptive brain Circuits underlying mental health (C-I-R-C), Jena-Magdeburg-Halle, Germany
| | - Janette Ratzsch
- Department of Psychiatry and Psychotherapy, Jena University Hospital/Friedrich-Schiller-University Jena, Jena, Germany; German Center for Mental Health (DZPG), Site Jena-Magdeburg-Halle, Germany; Center for Intervention and Research on adaptive and maladaptive brain Circuits underlying mental health (C-I-R-C), Jena-Magdeburg-Halle, Germany
| | - Alexandra Winter
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Linda M Bonnekoh
- Institute for Translational Psychiatry, University of Münster, Münster, Germany; Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Münster, Münster, Germany
| | - Nils R Winter
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Daniel Emden
- Institute for Translational Psychiatry, University of Münster, Münster, Germany; Department of Psychiatry and Psychotherapy, Jena University Hospital/Friedrich-Schiller-University Jena, Jena, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg and University Hospital Marburg, UKGM, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany, Center for Mind, Brain and Behavior (CMBB), Hans-Meerwein-Str. 6, 35032 Marburg, Germany
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg and University Hospital Marburg, UKGM, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany, Center for Mind, Brain and Behavior (CMBB), Hans-Meerwein-Str. 6, 35032 Marburg, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Tim Hahn
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Nils Opel
- Institute for Translational Psychiatry, University of Münster, Münster, Germany; Department of Psychiatry and Psychotherapy, Jena University Hospital/Friedrich-Schiller-University Jena, Jena, Germany; German Center for Mental Health (DZPG), Site Jena-Magdeburg-Halle, Germany; Center for Intervention and Research on adaptive and maladaptive brain Circuits underlying mental health (C-I-R-C), Jena-Magdeburg-Halle, Germany
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20
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Serrano-Gimeno V, Diestre A, Agustin-Alcain M, Portella MJ, de Diego-Adeliño J, Tiana T, Cheddi N, Distefano A, Dominguez G, Arias M, Cardoner V, Puigdemont D, Perez V, Cardoner N. Non-fatal suicide behaviours across phases in the COVID-19 pandemic: a population-based study in a Catalan cohort. Lancet Psychiatry 2024; 11:348-358. [PMID: 38631785 DOI: 10.1016/s2215-0366(24)00065-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/20/2024] [Accepted: 02/26/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND The COVID-19 pandemic has been extensively discussed in the context of its effect on mental health. Although global suicide rates have remained stable during the pandemic, the specific effect on non-fatal suicide behaviours during and after the pandemic remains underexplored. This study aims to investigate patterns of non-fatal suicide behaviours before, during, and after the pandemic. METHODS In this cohort study, we used data from all hospitals in Catalonia, Spain, collected through the Catalan Suicide Risk Code, which is a specifically designed suicide attempt surveillance protocol, involving a face-to-face, in-depth psychiatric evaluation, after a Catalan resident presents any suicide risk behaviour in any public health-care setting. This evaluation centralises data from suicide registries across the territory. We included non-fatal suicide behaviours, meaning suicidal ideation or attempts that did not result in death, and excluded self-harm behaviours not judged to be linked with suicidal ideation. We considered three periods: the pre-confinement period (Jan 1, 2018, to the enforcement of the lockdown in Spain on March 14, 2020); the confinement period (March 14, 2020, to the end of lockdown on June 21, 2020); and the post-confinement period (June 21, 2020, to Dec 31, 2022). We used Bayesian structural time series models to assess the effect of pandemic phases on non-fatal suicide behaviours, and we ran stratified analyses by sex and age to identify distinct patterns among demographic cohorts. FINDINGS We obtained 26 482 records from Jan 1, 2018, to Dec 31, 2022. The mean age was 37·94 years (SD 18·07), and the sample included 17 584 (66·4%) women and 8898 (33·6%) men. Data on ethnicity were not collected. Temporal trends showed a mild increase in non-fatal suicide behaviours from Jan 1, 2018, to March 13, 2020; a reduction during the confinement period; and a subsequent rise after confinement. Bayesian models suggested a significant causal effect of lockdown easing, resulting in a 50·77% increase in non-fatal suicide behaviours (95% credible interval [CrI] 26·62-76·58; p<0·0001). Stratified analyses indicated that the easing of lockdown resulted in a significant increase in non-fatal suicide behaviours among women (25·92%; 6·71-44·72; p=0·011) and among individuals aged 18 years and younger (72·75%; 38·81-108·11; p<0·0001). INTERPRETATION This study provides a comprehensive examination of non-fatal suicide behaviours in Catalonia, Spain, emphasising the dynamics of different COVID-19 pandemic phases. The initial reduction during strict lockdown aligns with Joiner's Interpersonal Theory of Suicide, whereas the post-confinement rise reflects complex factors, including social isolation and economic challenges. Sex-specific and age-specific analyses underscore distinct vulnerabilities, emphasising the need for targeted preventive strategies. FUNDING Centro de Investigación Biomédica en Red de Salud Mental annual budget of G21, Agència de Gestió d'Ajuts Universitaris i de Recerca of the Generalitat de Catalunya. TRANSLATIONS For the Catalan and Spanish translations of the abstract see Supplementary Materials section.
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Affiliation(s)
- Víctor Serrano-Gimeno
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Sant Pau Mental Health Research Group, Institut de Recerca Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Alba Diestre
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Sant Pau Mental Health Research Group, Institut de Recerca Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | - Maria J Portella
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Sant Pau Mental Health Research Group, Institut de Recerca Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Javier de Diego-Adeliño
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Sant Pau Mental Health Research Group, Institut de Recerca Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Thaïs Tiana
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Sant Pau Mental Health Research Group, Institut de Recerca Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Nora Cheddi
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Sant Pau Mental Health Research Group, Institut de Recerca Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Alejandro Distefano
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Sant Pau Mental Health Research Group, Institut de Recerca Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Guillermo Dominguez
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Sant Pau Mental Health Research Group, Institut de Recerca Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | | | - Dolors Puigdemont
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Sant Pau Mental Health Research Group, Institut de Recerca Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Victor Perez
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Institut de Neuropsiquiatria i Addiccions, Parc de Salut Mar, Universitat Pompeu Fabra, Barcelona, Spain
| | - Narcís Cardoner
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Sant Pau Mental Health Research Group, Institut de Recerca Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
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21
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Marck CH, Ayton D, Steward T, Koay HF, Wiley JF, Taiaroa G, Walton CC, Weld-Blundell I, Greaves MD, Singh A. The workplace culture, mental health and wellbeing of early- and mid-career health academics: a cross-sectional analysis. BMC Public Health 2024; 24:1122. [PMID: 38654184 DOI: 10.1186/s12889-024-18556-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 03/21/2024] [Indexed: 04/25/2024] Open
Abstract
There are reports of poor working conditions for early and mid-career academics (EMCAs) in universities, however, empirical data using validated tools are scarce. We conducted an online, cross-sectional survey using validated tools to assess workplace satisfaction, exposure to workplace abuse, and mental health. Participants included employees of medical and health faculties of two of the largest Australian universities, surveyed between October 2020 and January 2021.Overall, 284 participants responded. Many reported job insecurity: half (50.7%) working on contracts with less than one remaining year. Workloads were considerable, with 89.5% of participants working overtime and 54.8% reporting burnout. Workplace abuse in the forms of bullying (46.6%), sexual harassment (25.3%), sexism (49.8%) and racism (22.5%) were commonly reported. Clinically significant symptoms of depression (28.0%), anxiety (21.7%) and suicidal ideation or self-harm (13.6%) were reported; with a higher prevalence among those working more overtime, and those exposed to workplace abuse. Priorities include providing a stable and safe workplace, increasing accountability and transparency in addressing workplace abuse, and supporting professional development.In summary, EMCAs in our study were commonly exposed to precarious employment conditions and workplace abuse. Our findings provide empirical evidence on where universities and funding bodies should direct resources and change organisational risk factors, to improve workplace culture.
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Affiliation(s)
- Claudia H Marck
- Disability and Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, 3010, Australia.
- The Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia.
| | - Darshini Ayton
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC, 3004, Australia
| | - Trevor Steward
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, 3010, Australia
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Hui-Fern Koay
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Joshua F Wiley
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, 18 Innovation Walk, Clayton, VIC, 3800, Australia
| | - George Taiaroa
- Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Parkville, VIC, 3010, Australia
- Victorian Infectious Diseases Reference Laboratory, The Royal Melbourne Hospital at The Peter Doherty Institute for Infection and Immunity, Parkville, VIC, 3010, Australia
| | - Courtney C Walton
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Isabelle Weld-Blundell
- Disability and Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Matthew D Greaves
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Ankur Singh
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, 3010, Australia
- Melbourne Dental School, University of Melbourne, Parkville, VIC, 3010, Australia
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22
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Luciano M, Carmassi C, Sampogna G, Bertelloni CA, Abbate-Daga G, Albert U, Castellini G, Della Rocca B, Fantasia S, Menchetti M, Pedrinelli V, Pompili M, Signorelli MS, Tosato S, Fiorillo A. Longitudinal trajectories of psychosocial functioning in patients with pre-existing mental disorders after one year of COVID-19 pandemic. J Psychiatr Res 2024; 172:200-209. [PMID: 38401365 DOI: 10.1016/j.jpsychires.2024.02.016] [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: 07/14/2023] [Revised: 01/09/2024] [Accepted: 02/07/2024] [Indexed: 02/26/2024]
Abstract
Aims of the present study were to prospectively assess psychosocial functioning trajectories during the COVID pandemic and the possible impact of sociodemographic variables, as well as of COVID-19 pandemic-related factors, on these trajectories, in a sample of patients with pre-existing severe mental disorders. Moreover, we aimed at identifying predictors of impairment in psychosocial functioning over a period of 9 months of COVID-19 pandemic. Patients were recruited during the 3rd wave of the COVID-19 pandemic (T0, March-April 2021) while strict containment measures were applied in Italy, and reassessed after 3 months (T1, June-July 2021), and after 6 months from T1 (T2- November-December 2021), during the 4th wave of COVID pandemic. A sample of 300 subject (out of the 527 subjects recruited at baseline) completed the T2 evaluation. Patients were assessed by: Work and Social Adjustment Scale (WSAS) for psychosocial functioning, Generalized Anxiety Disorder 7-Item (GAD-7) for anxiety symptoms, Patient Health Questionnaire-9 (PHQ-9) for depressive symptoms and the Impact of Events Scale-Revised, for post-traumatic symptoms. Cluster analyses identified 4 trajectories of functioning: the High, Stable Functioning group (N = 77), the Improvement Functioning group (N = 62), the Progressive Impairment group (N = 83) and the Persistent Severe Impairment group (N = 78) respectively. We found that predictors of higher WSAS score at T2 were higher WSAS score at T0 (B = 0.43, p < .001), PHQ scores at baseline >10 (B = 2.89, p < .05), while not living alone was found to be a protective factor (B = -2.5, p < .05). Results of the present study provides insights into the vulnerability of individuals with psychiatric disorders during times of crisis. Study findings can contribute to a better understanding of the specific needs of this population and inform interventions and support strategies.
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Affiliation(s)
- M Luciano
- Department of Psychiatry, University of Campania "Luigi Vanvitelli,", Naples, Italy.
| | - C Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - G Sampogna
- Department of Psychiatry, University of Campania "Luigi Vanvitelli,", Naples, Italy
| | - C A Bertelloni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - G Abbate-Daga
- Department of Neurosciences "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - U Albert
- Department of Medicine, Surgery and Health Sciences, University of Trieste and Department of Mental Health, Azienda Sanitaria Universitaria Giuliano Isontina - ASUGI, Trieste, Italy
| | - G Castellini
- Department of Health Sciences, University of Florence, Florence, Italy
| | - B Della Rocca
- Department of Psychiatry, University of Campania "Luigi Vanvitelli,", Naples, Italy
| | - S Fantasia
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - M Menchetti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - V Pedrinelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - M Pompili
- Department of Neuroscience, Mental Health and Sense Organs, University of Rome "La Sapienza", Rome, Italy
| | - M S Signorelli
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Catania, Italy
| | - S Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - A Fiorillo
- Department of Psychiatry, University of Campania "Luigi Vanvitelli,", Naples, Italy
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23
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Chai Y, Man KKC, Luo H, Torre CO, Wing YK, Hayes JF, Osborn DPJ, Chang WC, Lin X, Yin C, Chan EW, Lam ICH, Fortin S, Kern DM, Lee DY, Park RW, Jang JW, Li J, Seager S, Lau WCY, Wong ICK. Incidence of mental health diagnoses during the COVID-19 pandemic: a multinational network study. Epidemiol Psychiatr Sci 2024; 33:e9. [PMID: 38433286 PMCID: PMC10940053 DOI: 10.1017/s2045796024000088] [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: 10/08/2023] [Revised: 12/27/2023] [Accepted: 01/20/2024] [Indexed: 03/05/2024] Open
Abstract
AIMS Population-wide restrictions during the COVID-19 pandemic may create barriers to mental health diagnosis. This study aims to examine changes in the number of incident cases and the incidence rates of mental health diagnoses during the COVID-19 pandemic. METHODS By using electronic health records from France, Germany, Italy, South Korea and the UK and claims data from the US, this study conducted interrupted time-series analyses to compare the monthly incident cases and the incidence of depressive disorders, anxiety disorders, alcohol misuse or dependence, substance misuse or dependence, bipolar disorders, personality disorders and psychoses diagnoses before (January 2017 to February 2020) and after (April 2020 to the latest available date of each database [up to November 2021]) the introduction of COVID-related restrictions. RESULTS A total of 629,712,954 individuals were enrolled across nine databases. Following the introduction of restrictions, an immediate decline was observed in the number of incident cases of all mental health diagnoses in the US (rate ratios (RRs) ranged from 0.005 to 0.677) and in the incidence of all conditions in France, Germany, Italy and the US (RRs ranged from 0.002 to 0.422). In the UK, significant reductions were only observed in common mental illnesses. The number of incident cases and the incidence began to return to or exceed pre-pandemic levels in most countries from mid-2020 through 2021. CONCLUSIONS Healthcare providers should be prepared to deliver service adaptations to mitigate burdens directly or indirectly caused by delays in the diagnosis and treatment of mental health conditions.
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Affiliation(s)
- Yi Chai
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong
| | - Kenneth K. C. Man
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
- Research Department of Practice and Policy, UCL School of Pharmacy, London, UK
- Laboratory of Data Discovery for Health (D4H), Hong Kong Science Park, Hong Kong
| | - Hao Luo
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
- Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong
| | - Carmen Olga Torre
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
- Real World Data Sciences, Roche, Welwyn Garden City, UK
- School of Science and Engineering, University of Groningen, Groningen, The Netherlands
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Joseph F. Hayes
- Division of Psychiatry, University College London, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
| | - David P. J. Osborn
- Division of Psychiatry, University College London, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
| | - Wing Chung Chang
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong
| | - Xiaoyu Lin
- Real-World Solutions, IQVIA, Durham, NC, USA
| | - Can Yin
- Real-World Solutions, IQVIA, Durham, NC, USA
| | - Esther W. Chan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
- Laboratory of Data Discovery for Health (D4H), Hong Kong Science Park, Hong Kong
- The University of Hong Kong Shenzhen Institute of Research and Innovation, Shenzhen, Guangdong, China
| | - Ivan C. H. Lam
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Stephen Fortin
- Observation Health Data Analytics, Janssen Research & Development, Titusville, NJ, USA
| | - David M. Kern
- Department of Epidemiology, Janssen Research & Development, Titusville, NJ, USA
| | - Dong Yun Lee
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, South Korea
| | - Rae Woong Park
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, South Korea
| | - Jae-Won Jang
- Department of Neurology, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, South Korea
| | - Jing Li
- Real-World Solutions, IQVIA, Durham, NC, USA
| | | | - Wallis C. Y. Lau
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
- Research Department of Practice and Policy, UCL School of Pharmacy, London, UK
- Laboratory of Data Discovery for Health (D4H), Hong Kong Science Park, Hong Kong
| | - Ian C. K. Wong
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
- Research Department of Practice and Policy, UCL School of Pharmacy, London, UK
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24
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Olfson M, McClellan C, Zuvekas SH, Wall M, Blanco C. Trends in Psychological Distress and Outpatient Mental Health Care of Adults During the COVID-19 Era. Ann Intern Med 2024; 177:353-362. [PMID: 38316009 DOI: 10.7326/m23-2824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND In addition to the physical disease burden of the COVID-19 pandemic, concern exists over its adverse mental health effects. OBJECTIVE To characterize trends in psychological distress and outpatient mental health care among U.S. adults from 2018 to 2021 and to describe patterns of in-person, telephone, and video outpatient mental health care. DESIGN Cross-sectional nationally representative survey of noninstitutionalized adults. SETTING United States. PARTICIPANTS Adults included in the Medical Expenditure Panel Survey Household Component, 2018 to 2021 (n = 86 658). MEASUREMENTS Psychological distress was measured with the Kessler-6 scale (range of 0 to 24, with higher scores indicating more severe distress), with a score of 13 or higher defined as serious psychological distress, 1 to 12 as less serious distress, and 0 as no distress. Outpatient mental health care use was measured via computer-assisted personal interviews. RESULTS Between 2018 and 2021, the rate of serious psychological distress among adults increased from 3.5% to 4.2%. Although the rate of outpatient mental health care increased from 11.2% to 12.4% overall, the rate decreased from 46.5% to 40.4% among adults with serious psychological distress. When age, sex, and distress were controlled for, a significant increase in outpatient mental health care was observed for young adults (aged 18 to 44 years) but not middle-aged (aged 45 to 64 years) and older (aged >65 years) adults and for employed adults but not unemployed adults. In 2021, 33.4% of mental health outpatients received at least 1 video visit, including a disproportionate percentage of young, college-educated, higher-income, employed, and urban adults. LIMITATION Information about outpatient mental health service modality (in-person, video, telephone) was first fully available in the 2021 survey. CONCLUSION These trends and patterns underscore the persistent challenges of connecting older adults, unemployed persons, and seriously distressed adults to outpatient mental health care and the difficulties faced by older, less educated, lower-income, unemployed, and rural patients in accessing outpatient mental health care via video. PRIMARY FUNDING SOURCE None.
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Affiliation(s)
- Mark Olfson
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University and New York State Psychiatric Institute, New York, New York (M.O., M.W.)
| | - Chandler McClellan
- Agency for Healthcare Research and Quality, Rockville, Maryland (C.M., S.H.Z.)
| | - Samuel H Zuvekas
- Agency for Healthcare Research and Quality, Rockville, Maryland (C.M., S.H.Z.)
| | - Melanie Wall
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University and New York State Psychiatric Institute, New York, New York (M.O., M.W.)
| | - Carlos Blanco
- National Institute on Drug Abuse, Bethesda, Maryland (C.B.)
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25
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Poštuvan V, Krohne N, Lavrič M, Gomboc V, De Leo D, Rojs L. A Lonelier World after COVID-19: Longitudinal Population-Based Study of Well-Being, Emotional and Social Loneliness, and Suicidal Behaviour in Slovenia. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:312. [PMID: 38399599 PMCID: PMC10890292 DOI: 10.3390/medicina60020312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 01/26/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024]
Abstract
Background and Objectives: The impact of coronavirus disease 2019 (COVID-19) goes beyond the consequences of the infectious disease, especially as the measures taken to prevent the spread of the virus have had a very profound impact on people's social relationships and everyday lives. Several studies have investigated these effects, but there is a lack of longitudinal studies in Central Europe. Objective: The aim of our study was to observe changes in well-being, loneliness, and suicidal behaviour before, during, and after the COVID-19 pandemic using the same population-based cohort. Materials and Methods: A representative sample of 440 participants completed online questionnaires at four time points: 2019 (wave 0), 2021 (wave 1), 2022 (wave 2), and 2023 (wave 3). Results: The results show significant changes in the levels of well-being and loneliness over these periods. In particular, both social and emotional loneliness increased during the pandemic, while emotional loneliness increased to a greater extent without further decreases. Well-being appeared to increase after pandemic-related restrictions diminished but decreased again one year later. No significant changes concerning suicidal ideation were observed. Conclusions: Our study suggests that the COVID-19 pandemic changed the way in which people perceive their well-being and especially their relationships with others. From the data, we can conclude that people's worldview is now lonelier than before the pandemic.
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Affiliation(s)
- Vita Poštuvan
- Slovene Centre for Suicide Research, Andrej Marušič Institute, University of Primorska, 6000 Koper, Slovenia; (N.K.); (M.L.); (V.G.); (D.D.L.); (L.R.)
- Department of Psychology, Faculty of Mathematics, Natural Sciences and Information Technologies, University of Primorska, 6000 Koper, Slovenia
| | - Nina Krohne
- Slovene Centre for Suicide Research, Andrej Marušič Institute, University of Primorska, 6000 Koper, Slovenia; (N.K.); (M.L.); (V.G.); (D.D.L.); (L.R.)
- Department of Psychology, Faculty of Mathematics, Natural Sciences and Information Technologies, University of Primorska, 6000 Koper, Slovenia
| | - Meta Lavrič
- Slovene Centre for Suicide Research, Andrej Marušič Institute, University of Primorska, 6000 Koper, Slovenia; (N.K.); (M.L.); (V.G.); (D.D.L.); (L.R.)
- Department of Psychology, Faculty of Mathematics, Natural Sciences and Information Technologies, University of Primorska, 6000 Koper, Slovenia
| | - Vanja Gomboc
- Slovene Centre for Suicide Research, Andrej Marušič Institute, University of Primorska, 6000 Koper, Slovenia; (N.K.); (M.L.); (V.G.); (D.D.L.); (L.R.)
- Department of Psychology, Faculty of Mathematics, Natural Sciences and Information Technologies, University of Primorska, 6000 Koper, Slovenia
| | - Diego De Leo
- Slovene Centre for Suicide Research, Andrej Marušič Institute, University of Primorska, 6000 Koper, Slovenia; (N.K.); (M.L.); (V.G.); (D.D.L.); (L.R.)
- Department of Psychology, Faculty of Mathematics, Natural Sciences and Information Technologies, University of Primorska, 6000 Koper, Slovenia
| | - Lucia Rojs
- Slovene Centre for Suicide Research, Andrej Marušič Institute, University of Primorska, 6000 Koper, Slovenia; (N.K.); (M.L.); (V.G.); (D.D.L.); (L.R.)
- Department of Psychology, Faculty of Mathematics, Natural Sciences and Information Technologies, University of Primorska, 6000 Koper, Slovenia
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van Rijn L, Metz MJ, van der Velden PR, Mathijsen P, Swildens WE, Schellekens AFA, Cahn W, Milota MM, Zinkstok JR. 'I am proud of how I handled it'. Exploring the impact of the COVID-19 pandemic and related restrictions on well-being of adults with severe mental illness using qualitative methods. Health Expect 2024; 27:e13983. [PMID: 38348759 PMCID: PMC10862174 DOI: 10.1111/hex.13983] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 01/10/2024] [Accepted: 01/24/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic and related restrictions globally impacted mental health, particularly for those with pre-existing severe mental illness (SMI). This qualitative study examined how adults with SMI perceived the effects of the COVID-19 pandemic and related restrictions in the Netherlands, focusing on their personal recovery, well-being and daily life, including an exploration of factors influencing these effects. METHODS Semi-structured interviews were conducted, audio-recorded and transcribed verbatim. Reflexive thematic analysis was applied. Purposive sampling was used to ensure diversity of individuals with SMI (i.e., age, gender, diagnosis, cultural background and mental healthcare institution). RESULTS Twenty participants (median age: 45 years [SD: 12, 8]; 11 females) were interviewed between May and July 2023. Findings revealed a wide range of experiences: while some individuals reported a negative impact on their existing psychiatric symptoms, others described adaptability, resilience and even positive effects of COVID-19 restrictions on their mental health and well-being. Factors influencing the heterogeneic perceptions of the COVID-19 pandemic and related restrictions include the availability of trusted social relationships and enduring interactions with health professionals. CONCLUSION Personalised support, both socially and professionally, is crucial for addressing fears, building resilience, reducing isolation and encouraging positive coping strategies for individuals with SMI during external crises. In this project, a participatory research approach that integrated the lived experience perspective helped uncover the unique perceptions of people with SMI with regard to the pandemic and related restrictions. PATIENT OR PUBLIC CONTRIBUTION The study used a participatory action research approach, with experts-by-experience involved in every stage of the project as part of the research team. This included engagement with the funding application process, recruitment strategies for interviews, developing the interview guide, piloting the interview, interpreting findings, and knowledge dissemination activities.
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Affiliation(s)
- L. van Rijn
- Department of PsychiatryRadboud University Medical Center, Donders Institute For Brain, Cognition, and BehaviorNijmegenThe Netherlands
- Department of Psychiatry, Brain CenterUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - M. J. Metz
- GGz BreburgInstitute for Mental Health CareBredaThe Netherlands
- Tranzo Scientific Center for Care and WellbeingTilburg UniversityTilburgThe Netherlands
| | | | - P. Mathijsen
- GGz BreburgInstitute for Mental Health CareBredaThe Netherlands
| | - W. E. Swildens
- Altrecht, Institute for Mental Health CareUtrechtThe Netherlands
- Inholland University of Applied ScienceAmsterdamThe Netherlands
| | - A. F. A. Schellekens
- Department of PsychiatryRadboud University Medical Center, Donders Institute For Brain, Cognition, and BehaviorNijmegenThe Netherlands
| | - W. Cahn
- Department of Psychiatry, Brain CenterUniversity Medical Center UtrechtUtrechtThe Netherlands
- Altrecht, Institute for Mental Health CareUtrechtThe Netherlands
| | - M. M. Milota
- Julius Center for Health Sciences and Primary CareUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - J. R. Zinkstok
- Department of PsychiatryRadboud University Medical Center, Donders Institute For Brain, Cognition, and BehaviorNijmegenThe Netherlands
- Department of Psychiatry, Brain CenterUniversity Medical Center UtrechtUtrechtThe Netherlands
- Karakter Child and Adolescent Mental Health CareNijmegenThe Netherlands
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da Conceição V, Mesquita E, Gusmão R. Effects of a stigma reduction intervention on help-seeking behaviors in university students: A 2019-2021 randomized controlled trial. Psychiatry Res 2024; 331:115673. [PMID: 38113809 DOI: 10.1016/j.psychres.2023.115673] [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: 09/25/2023] [Revised: 12/05/2023] [Accepted: 12/06/2023] [Indexed: 12/21/2023]
Abstract
INTRODUCTION Stigma is one of the most frequently identified help-seeking barriers, but there is a lack of research on the effects of stigma reduction interventions on actual mental health help-seeking behaviors during crucial academic years. This research explores the effects of stigma on university students' mental health care help-seeking behaviors before and during the pandemic. METHODS A randomized control trial spanned from 2019 to 2021 at the University of Porto, along five evaluation moments, with students into one control group and two intervention groups-the interventions aimed to reduce depression stigma. RESULTS Among the 702 participants (mean age 18.87, 59.4 % female), the intervention groups significantly increased help-seeking behaviors. In 2020, the intervention groups, having reduced stigma, continued to demonstrate to be more prompt to seek mental health help. In 2021, 22 months, the effects of the intervention on help-seeking were no longer significant; however, participants in the intervention groups showed less severe symptomatology. CONCLUSION Stigma reduction interventions have a pronounced effect on enhancing help-seeking behaviors among university students, even during times of crisis. This study advocates for prioritizing stigma reduction in academic settings, highlighting its value in promoting mental health access during crucial academic and life challenges.
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Affiliation(s)
- Virgínia da Conceição
- EPIUnit - Institute of Public Health, University of Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal.
| | - Edgar Mesquita
- EPIUnit - Institute of Public Health, University of Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - Ricardo Gusmão
- EPIUnit - Institute of Public Health, University of Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal; Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Portugal
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Haukka E, Gluschkoff K, Kalliolahti E, Lanki T, Jussila JJ, Halonen JI, Oksanen T, Salo P, Ervasti J. Changes in active commuting and changes in health: Within- and between-individual analyses among 16 881 Finnish public sector employees. Prev Med 2023; 177:107744. [PMID: 37871670 DOI: 10.1016/j.ypmed.2023.107744] [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: 06/29/2023] [Revised: 09/15/2023] [Accepted: 10/20/2023] [Indexed: 10/25/2023]
Abstract
BACKGROUND Active commuting, such as walking or cycling to work, can be beneficial for health. However, because within-individual studies on the association between change in active commuting and change in health are scarce, the previous results may have been biased due to unmeasured confounding. Additionally, prior studies have often lacked information about commuting distance. METHODS We used two waves (2020, T1 and 2022, T2) of self-report data from the Finnish Public Sector study (N = 16,881; 80% female) to examine the within- and between associations (in a hybrid model) between active commuting and health. Exposure was measured by actively commuted kilometers per week, that is, by multiplying the number of walking or cycling days per week with the daily commuting distance. The primary outcome, self-rated health, was measured at T1 and T2. The secondary outcomes, psychological distress, and sleep problems were measured only at T2 and were therefore analyzed only in a between-individual design. RESULTS After adjustment for potential time-varying confounders such as socioeconomic factors, body mass index, and health behaviors, an increase equivalent to 10 additional active commuting kilometers per week was associated with a small improvement in self-rated health (within-individual unstandardized beta = 0.01, 95% CI 0.01-0.02; between-individual unstandardized beta = 0.03, 95% CI 0.02-0.04). No associations were observed between changes in active commuting and psychological distress or sleep problems. CONCLUSIONS An increase in active commuting may promote self-rated health. However, increase of tens of additional kilometers in commuting every day may be required to produce even a small effect on health.
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Affiliation(s)
- Eija Haukka
- Finnish Institute of Occupational Health, Helsinki, Finland.
| | - Kia Gluschkoff
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Essi Kalliolahti
- Finnish Institute of Occupational Health, Helsinki, Finland; University of Eastern Finland, Institute of Public Health and Clinical Nutrition, Kuopio, Finland
| | - Timo Lanki
- University of Eastern Finland, Institute of Public Health and Clinical Nutrition, Kuopio, Finland; Finnish Institute for Health and Welfare, Department of Health Security, Helsinki, Finland; University of Eastern Finland, Department of Environmental and Biological Sciences, Kuopio, Finland
| | - Juuso J Jussila
- University of Eastern Finland, Institute of Public Health and Clinical Nutrition, Kuopio, Finland; Finnish Institute for Health and Welfare, Department of Health Security, Helsinki, Finland
| | - Jaana I Halonen
- Finnish Institute for Health and Welfare, Department of Health Security, Helsinki, Finland
| | - Tuula Oksanen
- University of Eastern Finland, Institute of Public Health and Clinical Nutrition, Kuopio, Finland
| | - Paula Salo
- University of Turku, Department of Psychology and Speech-Language Pathology, Turku, Finland
| | - Jenni Ervasti
- Finnish Institute of Occupational Health, Helsinki, Finland
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29
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Hilbrands LB. The COVID-19 pandemic and mental health outcomes in CKD patients. Nephrol Dial Transplant 2023; 38:2673-2674. [PMID: 37563085 DOI: 10.1093/ndt/gfad177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Indexed: 08/12/2023] Open
Affiliation(s)
- Luuk B Hilbrands
- Department of Nephrology, Radboud University Medical Center, Nijmegen, The Netherlands
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Spinazzola E, Meyer Z, Gray ZI, Azlan A, Wratten C, Rayat M, Hiscott L, Kyriakou L, Cottrell D, Pritchard M, Pinto da Costa M, Quattrone A, Stewart R, Di Forti M, Murray RM, Quattrone D. The effect of the COVID-19 pandemic on the treated incidence of psychotic disorders in South London. Psychiatry Res 2023; 329:115483. [PMID: 37783096 DOI: 10.1016/j.psychres.2023.115483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 09/12/2023] [Accepted: 09/13/2023] [Indexed: 10/04/2023]
Abstract
Evidence on the impact of the COVID-19 pandemic on psychotic disorders is so far scarce. We conducted an incidence study to ascertain rates of first-episode psychosis (FEP) before and during the COVID-19 pandemic in South London. We screened clinical records of individuals living in the London boroughs of Southwark and Lambeth who were referred to the early intervention services before (from 1/3/2019 to 28/2/2020) and during (from 1/3/2020 to 28/2/2021) the COVID-19 pandemic. We used the Office for National Statistics to determine the population at risk. We computed crude and sex-age standardised FEP incidence per 100,000 person-years. We used Poisson regression to calculate the incidence rate ratio (IRR) across the COVID-19 pandemic. A total of 321 incident cases of FEP were identified during the COVID-19 pandemic, accounting for a crude rate of 69.8 (95% CI 62.1-77.4) per 100,000 person-years. The crude rate for the year before was 47.5 (95% CI 41.2-53.8). The incidence variation between the two years accounted for an adjusted IRR of 1.45 (95% CI 1.22-1.72). The pandemic was accompanied by a 45% spike in the rates of first-episode psychosis. This finding should inform public health research and demonstrate the need for adequate resources for secondary care.
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Affiliation(s)
- Edoardo Spinazzola
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience. King's College of London, London, United Kingdom
| | - Zeryab Meyer
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience. King's College of London, London, United Kingdom
| | - Zoë Isabella Gray
- Avon and Wiltshire Mental Health Partnership NHS Trust, United Kingdom
| | - Aryn Azlan
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience. King's College of London, London, United Kingdom
| | - Camille Wratten
- South West London and Saint George's Mental Health NHS Trust, United Kingdom
| | - Mandeep Rayat
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience. King's College of London, London, United Kingdom
| | - Lauren Hiscott
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience. King's College of London, London, United Kingdom
| | - Loui Kyriakou
- Hertfordshire Partnership University NHS Foundation Trust, United Kingdom
| | | | - Megan Pritchard
- South London and Maudsley NHS Foundation Trust, United Kingdom
| | - Mariana Pinto da Costa
- South London and Maudsley NHS Foundation Trust, United Kingdom; University of Porto, Institute of Biomedical Sciences Abel Salazar, Porto, Portugal; Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience. King's College of London, London, United Kingdom
| | - Andrea Quattrone
- South London and Maudsley NHS Foundation Trust, United Kingdom; University of Porto, Institute of Biomedical Sciences Abel Salazar, Porto, Portugal
| | - Robert Stewart
- South London and Maudsley NHS Foundation Trust, United Kingdom; Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience. King's College of London, London, United Kingdom; National Institute for Health and Care Research, Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, United Kingdom
| | - Marta Di Forti
- South London and Maudsley NHS Foundation Trust, United Kingdom; National Institute for Health and Care Research, Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, United Kingdom; Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience. King's College of London, London, United Kingdom
| | - Robin MacGregor Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience. King's College of London, London, United Kingdom; South London and Maudsley NHS Foundation Trust, United Kingdom; National Institute for Health and Care Research, Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, United Kingdom
| | - Diego Quattrone
- South London and Maudsley NHS Foundation Trust, United Kingdom; National Institute for Health and Care Research, Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, United Kingdom; Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience. King's College of London, London, United Kingdom.
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31
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Arias-de la Torre J, Vilagut G, Ronaldson A, Bakolis I, Dregan A, Martín V, Martinez-Alés G, Molina AJ, Serrano-Blanco A, Valderas JM, Viana MC, Alonso J. Prevalence and variability of depressive symptoms in Europe: update using representative data from the second and third waves of the European Health Interview Survey (EHIS-2 and EHIS-3). Lancet Public Health 2023; 8:e889-e898. [PMID: 37898521 DOI: 10.1016/s2468-2667(23)00220-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 09/13/2023] [Accepted: 09/15/2023] [Indexed: 10/30/2023]
Abstract
BACKGROUND Assessing the prevalence of clinically relevant depressive symptoms and their possible variation by country and over time could be a valuable resource to inform the development of public health policies and preventive resources to reduce mental health burden. We aimed to assess cross-national differences in the point prevalence of clinically relevant depressive symptoms in Europe in 2018-20, and to evaluate point prevalence differences between countries and over time between 2013-15 and 2018-20. METHODS In this population-based study, data from participants in the second and third waves of the European Health Interview Survey (EHIS-2 from 2013 to 2015 and EHIS-3 from 2018 to 2020) from 30 European countries were used (n=542 580). From the total sample, 283 692 participants belonging to EHIS-3 were included in the study (52·4% women and 47·5% men). The non-response in EHIS-3 ranged by country, from 12% to 78%. Point prevalence of clinically relevant depressive symptoms was evaluated using a cutoff score of 10 or more for the 8-item version of the Patient Health Questionnaire. Crude prevalence ratios and adjusted prevalence ratios (aPRs) were obtained to assess differences in the prevalence between countries and over time within countries. FINDINGS The point prevalence of clinically relevant depressive symptoms in Europe in 2018-20 was 6·54% (95% CI 6·34-6·73), ranging across countries from 1·85% (1·53-2·17) in Greece to 10·72% (10·04-11·40) in Sweden. Compared with the other European countries, those with the lowest aPRs were Greece, Serbia, and Cyprus and those with the highest aPRs were Belgium, Slovenia, and Croatia. A small but significant increase in the prevalence between EHIS-2 and EHIS-3 was observed (aPR 1·11 [1·07-1·14]). A wide variability over time in the point prevalence within countries was observed, ranging from an aPR of 0·63 (0·54-0·74) in Hungary to 1·88 (1·53-2·31) in Slovenia. INTERPRETATION This study, based on large and representative datasets and a valid and reliable screening tool for the assessment of depression, indicates that the point prevalence of clinically relevant depressive symptoms in Europe from 2013 to 2020 remains relatively stable, with wide variability between countries. These findings could be considered a baseline for monitoring the prevalence of clinically relevant depressive symptoms in Europe, and could inform policy for the development of preventive strategies for depression both at a country and European level. FUNDING Center for Biomedical Research in Epidemiology and Public Health Network and AGAUR.
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Affiliation(s)
- Jorge Arias-de la Torre
- Care in Long Term Conditions Research Division, King's College London, London, UK; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain; Institute of Biomedicine, Universidad de León, León, Spain.
| | - Gemma Vilagut
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain; Health Services Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Amy Ronaldson
- Instiute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ioannis Bakolis
- Instiute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Alex Dregan
- Instiute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Vicente Martín
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain; Institute of Biomedicine, Universidad de León, León, Spain
| | - Gonzalo Martinez-Alés
- CAUSALab, Harvard T H Chan School of Public Health, Boston, MA, USA; La Paz Research Institute, Madrid, Spain; Network Center for Biomedical Research in Mental Health, Madrid, Spain
| | - Antonio J Molina
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain; Institute of Biomedicine, Universidad de León, León, Spain
| | - Antoni Serrano-Blanco
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain; Institut de Recerca Sant Joan de Déu, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - Jose M Valderas
- Department of Medicine, National University of Singapore, Singapore; Department of Family Medicine, National University Health System, Singapore; Centre for Research in Health Systems Performance, National University Health System, Singapore
| | - Maria Carmen Viana
- Department of Social Medicine Post-Graduate Program in Public Health, Health Sciences Center, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Jordi Alonso
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain; Health Services Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain; Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain
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Schäfer SK, Fritz J, Sopp MR, Kunzler AM, von Boros L, Tüscher O, Göritz AS, Lieb K, Michael T. Interrelations of resilience factors and their incremental impact for mental health: insights from network modeling using a prospective study across seven timepoints. Transl Psychiatry 2023; 13:328. [PMID: 37872216 PMCID: PMC10593776 DOI: 10.1038/s41398-023-02603-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 09/15/2023] [Accepted: 09/20/2023] [Indexed: 10/25/2023] Open
Abstract
Resilience can be viewed as trajectory of stable good mental health or the quick recovery of mental health during or after stressor exposure. Resilience factors (RFs) are psychological resources that buffer the potentially negative effects of stress on mental health. A problem of resilience research is the large number of conceptually overlapping RFs complicating their understanding. The current study sheds light on the interrelations of RFs in the face of the COVID-19 pandemic as a use case for major disruptions. The non-preregistered prospective study assessed a sample of 1275 German-speaking people from February 2020 to March 2021 at seven timepoints. We measured coping, hardiness, control beliefs, optimism, self-efficacy, sense of coherence (SOC), sense of mastery, social support and dispositional resilience as RFs in February 2020, and mental health (i.e., psychopathological symptoms, COVID-19-related rumination, stress-related growth) at all timepoints. Analyses used partial correlation network models and latent growth mixture modeling (LGMM). Pre-pandemic RFs were strongly interrelated, with SOC being the most central node. The strongest associations emerged between coping using emotional support and social support, SOC and sense of mastery, and dispositional resilience and self-efficacy. SOC and active coping were negatively linked. When we examined RFs as predictors of mental health trajectories, SOC was the strongest predictor of psychopathological symptoms and rumination, while trajectories of stress-related growth were predicted by optimism. Subsequent network analyses, including individual intercepts and slopes from LGMM, showed that RFs had small to moderate associations with intercepts but were unrelated to slopes. Our findings provide evidence for SOC playing an important role in mental distress and suggest further examining SOC's incremental validity. However, our results also propose that RFs might be more important for stable levels of mental health than for adaptation processes over time. The differential associations for negative and positive outcomes support the use of multidimensional outcomes in resilience research.
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Affiliation(s)
- Sarah K Schäfer
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Clinical Psychology and Psychotherapy, Saarland University, Saarbrücken, Germany
- Department of Clinical Psychology, Psychotherapy and Psychodiagnostics, Technische Universität Braunschweig, Braunschweig, Germany
| | - Jessica Fritz
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
- Department of Clinical Psychology, Philipps-University Marburg, Marburg, Germany
| | - M Roxanne Sopp
- Department of Clinical Psychology and Psychotherapy, Saarland University, Saarbrücken, Germany
| | - Angela M Kunzler
- Leibniz Institute for Resilience Research, Mainz, Germany
- Institute for Evidence in Medicine, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Lisa von Boros
- Leibniz Institute for Resilience Research, Mainz, Germany
| | - Oliver Tüscher
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of Johannes Gutenberg University, Mainz, Germany
- Institute for Molecular Biology, Mainz, Germany
| | - Anja S Göritz
- Behavioral Health Technology, Augsburg University, Augsburg, Germany
| | - Klaus Lieb
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of Johannes Gutenberg University, Mainz, Germany
| | - Tanja Michael
- Department of Clinical Psychology and Psychotherapy, Saarland University, Saarbrücken, Germany.
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Schäfer SK, Lindner S, Kunzler AM, Meerpohl JJ, Lieb K. The mental health impact of the COVID-19 pandemic on older adults: a systematic review and meta-analysis. Age Ageing 2023; 52:afad170. [PMID: 37725975 DOI: 10.1093/ageing/afad170] [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: 02/09/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Early in the COVID-19 pandemic, many experts pointed to potential adverse mental health effects for older adults. By contrast, many studies in young to middle-aged adults found older age to be associated with reduced mental burden. However, a systematic review on older adults is missing. OBJECTIVES To comprehensively assess the pandemic's mental health impact on older adults. DATA SOURCES We searched nine databases from December 2019 to April 2022. STUDY SELECTION We included longitudinal and repeated cross-sectional studies assessing pre- and/or peri-pandemic mental distress and/or positive mental health indicators (e.g. wellbeing) on at least two occasions. DATA SYNTHESIS We identified 108 studies comprising 102,136 participants (≥60 years). After removal of outliers, there was a small increase in mental distress from pre-to-peri-pandemic assessments, standardised mean difference (SMD) = 0.10, 95% confidence interval (CI) [0.01, 0.18]. Furthermore, a small peri-pandemic decrease in anxiety symptoms was observed, whereas other symptoms remained unchanged. For positive mental health indicators, wellbeing and quality of life showed an initial decrease, whereas overall positive mental health increased during the pandemic, SMD = 0.08, 95% CI [0.01, 0.15]. Being female was related to larger peri-pandemic increases in mental distress. CONCLUSIONS Based on many studies, this review demonstrated small decreases in mental health during early stages of the pandemic in older adults, with evidence for later recovery. These findings are similar to those for younger adults and correct earlier claims that older adults are at particular risk for negative mental health consequences. The results ask for further research into resilience and adaptation processes in older adults.
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Affiliation(s)
- Sarah K Schäfer
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Clinical Psychology, Psychotherapy and Diagnostics, Technische Universität Braunschweig, Braunschweig, Germany
| | - Saskia Lindner
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Angela M Kunzler
- Leibniz Institute for Resilience Research, Mainz, Germany
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Jörg J Meerpohl
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Klaus Lieb
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Dregan A, Armstrong D. Shifts in patterns of mental health burden during the COVID-19 pandemic. THE LANCET REGIONAL HEALTH. EUROPE 2023; 32:100711. [PMID: 37671128 PMCID: PMC10477034 DOI: 10.1016/j.lanepe.2023.100711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 07/24/2023] [Indexed: 09/07/2023]
Affiliation(s)
- Alex Dregan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, UK
| | - David Armstrong
- School of Life Course and Population Sciences, King’s College London, London, UK
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Sousa RD, Henriques AR, Caldas de Almeida J, Canhão H, Rodrigues AM. Unraveling Depressive Symptomatology and Risk Factors in a Changing World. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6575. [PMID: 37623161 PMCID: PMC10454694 DOI: 10.3390/ijerph20166575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 07/21/2023] [Accepted: 07/25/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND This study aimed to examine the prevalence and factors associated with symptoms of depression during the third wave of the COVID-19 pandemic. METHODS A representative sample of Portuguese adults was included in this populational survey, conducted between 25 March and 31 July 2021, with participants completing a structured questionnaire via phone interview. The symptoms of depression were measured using the Portuguese version of the Hospital Anxiety and Depression Scale (HADS). Multivariate logistic regression analyses were used to examine the association between sociodemographic, health, and lifestyle factors and depression levels (normal, mild, or moderate/severe). RESULTS The estimated prevalence of depression symptoms among participants was 24%. Participants who were women, were in older age groups, had multimorbidity, lived in isolated Portuguese regions such as islands and Alentejo, and were retired or unemployed more frequently reported depression symptoms. Economic hardship was also found to be associated with an increased frequency of mild or moderate-to-severe depression. In contrast, higher levels of education, regular alcohol intake, and regular exercise were associated with a lower frequency of depression symptoms. CONCLUSIONS These findings highlight that during the third wave of the COVID-19 pandemic, a high proportion of Portuguese adults reported depression symptoms, particularly the COVID-19-vulnerable strata such seniors, patients with multimorbidity, and people in economic hardship. On the other hand, citizens who performed regular physical exercise reported lower depressive symptomology. Our work contributes to improving the planning of mental health promotion after the COVID-19 pandemic and future emergencies.
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Affiliation(s)
- Rute Dinis Sousa
- CHRC, NOVA Medical School, Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, 1169-056 Lisboa, Portugal; (A.R.H.); (J.C.d.A.); (H.C.); (A.M.R.)
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