1
|
Nöthling J, Gibbs A, Washington L, Gigaba SG, Willan S, Abrahams N, Jewkes R. Change in emotional distress, anxiety, depression and PTSD from pre- to post-flood exposure in women residing in low-income settings in South Africa. Arch Womens Ment Health 2024; 27:201-218. [PMID: 37989799 PMCID: PMC10933147 DOI: 10.1007/s00737-023-01384-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 10/15/2023] [Indexed: 11/23/2023]
Abstract
Floods are increasing in frequency and may increase the risk for experiencing emotional distress, anxiety, depression and PTSD. The aim of this study was to determine the extent of damage, loss, injury and death resulting from floods that occurred in and around the city of Durban, South Africa, in April 2022, and associated changes in mental health pre- to post-floods in a low-income setting. Seventy-three women between the ages of 18 and 45, residing in flood affected, low-income settings, were interviewed prior to the floods occurring. Mental health measures were repeated with 69 of the 73 women during the post-flood interview along with a questionnaire measuring flood-related exposures. Loss of infrastructure (lacked access to drinking water, electricity, fresh food, could not travel to work, had to stay in a shelter and could not get hold of friends or family) was a predictor of post-flood change in levels of emotional distress and anxiety. Higher levels of prior trauma exposure were associated with higher post-flood levels of emotional distress. Higher pre-flood food insecurity was also associated with higher post-flood anxiety. Women affected by poverty, food insecurity and a history of trauma are vulnerable to the additive adverse mental health effects of floods. Proactive approaches to diminishing the impact of floods on the livelihood of women is needed and post-flood relieve efforts may be more affective if they are enhanced by providing mental health support.
Collapse
Affiliation(s)
- J Nöthling
- Gender and Health Research Unit, South African Medical Research Council, Francie van Zijl DriveTygerberg, PO Box 19070, Cape Town, 7505, South Africa.
| | - A Gibbs
- Gender and Health Research Unit, South African Medical Research Council, Francie van Zijl DriveTygerberg, PO Box 19070, Cape Town, 7505, South Africa
- Department of Psychology, University of Exeter, Exeter, UK
- Centre for Rural Health, University of KwaZulu-Natal, Durban, South Africa
- Institute for Global Health, University College London, London, UK
| | | | - S G Gigaba
- Centre for Rural Health, University of KwaZulu-Natal, Durban, South Africa
| | - S Willan
- Gender and Health Research Unit, South African Medical Research Council, Francie van Zijl DriveTygerberg, PO Box 19070, Cape Town, 7505, South Africa
- The School of Applied Human Sciences (Psychology), University of KwaZulu-Natal, Durban, South Africa
| | - N Abrahams
- Gender and Health Research Unit, South African Medical Research Council, Francie van Zijl DriveTygerberg, PO Box 19070, Cape Town, 7505, South Africa
- School of Public Health and Family Medicine: Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - R Jewkes
- Gender and Health Research Unit, South African Medical Research Council, Francie van Zijl DriveTygerberg, PO Box 19070, Cape Town, 7505, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
2
|
Tiyuri A, Rasoulian M, Hajebi A, Naserbakht M, Shabani A, Hakim Shooshtari M, Rezapour A, Motevalian SA. Psychological impact of the Spring 2019 flood among adult population of Iran. Int J Soc Psychiatry 2023; 69:1916-1927. [PMID: 37329163 DOI: 10.1177/00207640231180824] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
BACKGROUND From March to April 2019, a flood occurred in several regions of Iran. The most affected provinces were Golestan, Lorestan, and Khuzestan. AIMS The present study aimed to determine the prevalence and determinants of psychological distress and depression among the affected adult population 6 months after the event. METHODS A cross-sectional household survey with face-to-face interview was carried out on a random sample of 1,671 adults aged above 15 years living in the flood-affected areas from August to September 2019. We applied GHQ-28 and PHQ-9 for the assessment of psychological distress and depression, respectively. RESULTS The prevalence of psychological distress and depression were 33.6% (95% CI [29.5, 37.7]) and 23.0% (95% CI [19.4, 26.7]), respectively. Determinants of psychological distress were a history of mental disorders (Adjusted odds ratio [AOR] = 4.7), primary (AOR = 2.9) or high school (AOR = 2.4) education (vs. university), no compensation received (AOR = 2.1), high damage to assets (AOR = 1.8), the house flooded more than 1 m (AOR = 1.8), female gender (AOR = 1.8), and limited access to health care services (AOR = 1.8). Determinants of depression were unemployment (AOR = 5.3) or being a housewife (AOR = 2.7), a history of mental disorders (AOR = 4.1), high damage to assets (AOR = 2.5), no compensation received (AOR = 2.0), the house flooded more than 1 m (AOR = 1.8), limited access to health care services (AOR = 1.8), and high wealth index (AOR = 1.7). CONCLUSION The results of this study revealed a high prevalence of psychological distress and depression in the flood-affected adult population. The high-risk group, particularly flood victims who had a history of mental disorders, and those exposed to severe damages of flood, should be prioritized for screening, and mental health services.
Collapse
Affiliation(s)
- Amir Tiyuri
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Rasoulian
- Mental Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
- Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Hajebi
- Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Research Center for Addiction and Risky Behaviors (ReCARB), Psychosocial Health Research Institute (PHRI), Iran University of Medical Sciences, Tehran, Iran
| | - Morteza Naserbakht
- Mental Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Amir Shabani
- Mental Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
- Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mitra Hakim Shooshtari
- Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Aziz Rezapour
- Health Management and Economics Research Center, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Abbas Motevalian
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
- Research Center for Addiction and Risky Behaviors (ReCARB), Psychosocial Health Research Institute (PHRI), Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
3
|
Thawonmas R, Hashizume M, Kim Y. Projections of Temperature-Related Suicide under Climate Change Scenarios in Japan. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:117012. [PMID: 37995154 PMCID: PMC10666824 DOI: 10.1289/ehp11246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 11/02/2023] [Accepted: 11/03/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND The impact of climate change on mental health largely remains to be evaluated. Although growing evidence has reported a short-term association between suicide and temperature, future projections of temperature-attributable suicide have not been thoroughly examined. OBJECTIVES We aimed to project the excess temperature-related suicide mortality in Japan under three climate change scenarios until the 2090s. METHODS Daily time series of mean temperature and the number of suicide deaths in 1973-2015 were collected for 47 prefectures in Japan. A two-stage time-stratified case-crossover analysis was used to estimate the temperature-suicide association. We obtained the modeled daily temperature series using five general circulation models under three climate change scenarios from the latest Coupled Model Intercomparison Project Phase 6 (CMIP6) Shared Socioeconomic Pathways scenarios (SSPs): SSP1-2.6, SSP2-4.5, and SSP5-8.5. We projected the excess temperature-related suicide mortality until 2099 for each scenario and evaluated the net relative changes compared with the 2010s. RESULTS During 1973-2015, there was a total of 1,049,592 suicides in Japan. Net increases in temperature-related excess suicide mortality were estimated under all scenarios. The net change in 2090-2099 compared with 2010-2019 was 1.3% [95% empirical confidence interval (eCI): 0.6, 2.4] for the intermediate-emission scenario (SSP2-4.5), 0.6% (95% eCI: 0.1, 1.6) for a low-emission scenario (SSP1-2.6), and 2.4% (95% eCI: 0.7, 3.9) for the extreme scenario (SSP5-8.5). The increases were greater the more extreme the scenarios were, with the highest increase under the most extreme scenario (SSP5-8.5). DISCUSSION This study indicates that Japan may experience a net increase in excess temperature-related suicide mortality, especially under the intermediate and extreme scenarios. The findings underscore the importance of mitigation policies. Further investigations of the future impacts of climate change on mental health including suicide are warranted. https://doi.org/10.1289/EHP11246.
Collapse
Affiliation(s)
- Ramita Thawonmas
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Masahiro Hashizume
- Department of Global Health Policy, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Yoonhee Kim
- Department of Global Environmental Health, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| |
Collapse
|
4
|
Woodland L, Ratwatte P, Phalkey R, Gillingham EL. Investigating the Health Impacts of Climate Change among People with Pre-Existing Mental Health Problems: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085563. [PMID: 37107845 PMCID: PMC10138675 DOI: 10.3390/ijerph20085563] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/02/2023] [Accepted: 03/14/2023] [Indexed: 05/11/2023]
Abstract
Climate change is the greatest threat to global public health, although the impacts on mental health are relatively understudied. Furthermore, there is a lack of consensus about the effects of climate change on individuals with pre-existing mental health problems. This review aimed to identify the health impacts of climate change on people with pre-existing mental health problems. The search was conducted across three databases; studies were included if they involved participants who had mental health problem(s) before a climate-driven event and reported on health outcomes post-event. A total of thirty-one studies met the full inclusion criteria. The study characteristics included 6 climate-driven events: heat events, floods, wildfires, wildfire and flood, hurricanes, and droughts, and 16 categories of pre-existing mental health problems, with depression, and non-specified mental health problems being the most common. The majority of the studies (90%, n = 28) suggest an association between the presence of pre-existing mental health problems and the likelihood of adverse health impacts (e.g., increased mortality risk, new symptom presentation, and an exacerbation of symptoms). To mitigate the exacerbation of health inequalities, people with pre-existing mental health problems should be included in adaption guidance and/or plans that mitigate the health impacts of climate change, future policy, reports, and frameworks.
Collapse
Affiliation(s)
- Lisa Woodland
- Department of Psychological Medicine, King’s College London, London SE5 9RJ, UK
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, King’s College London, London SE5 9RJ, UK
- Correspondence:
| | - Priyanjali Ratwatte
- Climate Change and Health Unit, UK Health Security Agency, Chilton OX11 0RQ, UK
- Behavioural Science and Insights Unit, UK Health Security Agency, Porton Down, Salisbury SP4 0JG, UK
| | - Revati Phalkey
- Climate Change and Health Unit, UK Health Security Agency, Chilton OX11 0RQ, UK
| | - Emma L. Gillingham
- Climate Change and Health Unit, UK Health Security Agency, Chilton OX11 0RQ, UK
| |
Collapse
|
5
|
Adhikari K, Racine N, Hetherington E, McDonald S, Tough S. Women's Mental Health up to Eight Years after Childbirth and Associated Risk Factors: Longitudinal Findings from the All Our Families Cohort in Canada. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2023; 68:269-282. [PMID: 36947012 PMCID: PMC10037742 DOI: 10.1177/07067437221140387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE This study examined the prevalence of elevated maternal anxiety and/or depression symptoms up to eight years after childbirth and the association between role and relationship strains during parenting and mental health challenges from three to eight years after childbirth. METHODS This study used data from the All Our Families longitudinal pregnancy cohort. Role and relationship strain factors and anxiety and depression symptoms were measured at repeated time points from four months to eight years after childbirth. The proportion of women with elevated anxiety and/or depression was calculated at each available time point. Generalized estimating equation models were used to examine the association between role and relationship strain factors and anxiety and/or depression from three to eight years after childbirth. Predicted probability of having anxiety and/or depression was estimated across those with and without challenges with roles and relationships. The models were adjusted for known risk factors such as maternal income and perinatal anxiety and/or depression. RESULTS The prevalence of elevated anxiety and/or depression ranged from 18.8% (at four months) to 26.2% (at eight years). The adjusted odds ratio of anxiety and/or depression was 3.5 (95% CI = 2.9, 4.3) for those juggling family responsibilities and 2.4 (95% CI = 2.0, 3.0) for those with stressful partner relationship compared to their counterparts. Similarly, experiencing financial crunch and poor partner relationship were associated with increased mental health difficulties. Women without challenges in roles or relationships had a 23% lower predicted probability of anxiety and/or depression than those with the challenges. CONCLUSIONS Monitoring mothers for anxiety and depression beyond the postpartum period and strategies that address role and relationship challenges may be valuable to women at risk of anxiety and depression.
Collapse
Affiliation(s)
- Kamala Adhikari
- Provincial Population and Public Health, Alberta Health Services,
Edmonton, Alberta, Canada
- Department of Community Health Sciences, University of Calgary,
Calgary, Alberta, Canada
| | - Nicole Racine
- School of Psychology, University of Ottawa, Calgary, Alberta,
Canada
| | - Erin Hetherington
- Department of Epidemiology, Biostatistics & Occupational Health, McGill University, Montreal, Québec, Canada
| | - Sheila McDonald
- Provincial Population and Public Health, Alberta Health Services,
Edmonton, Alberta, Canada
- Department of Community Health Sciences, University of Calgary,
Calgary, Alberta, Canada
- Department of Pediatrics, University of Calgary, Calgary, Alberta,
Canada
| | - Suzanne Tough
- Department of Community Health Sciences, University of Calgary,
Calgary, Alberta, Canada
- Department of Pediatrics, University of Calgary, Calgary, Alberta,
Canada
| |
Collapse
|
6
|
Li Y, Ding X, Aierken A, Pan Y, Chen Y, Hu D. The role of community cohesion in elderly people during the COVID-19 epidemic: a cross-sectional study. JMIR Public Health Surveill 2023; 9:e45110. [PMID: 36921236 PMCID: PMC10148212 DOI: 10.2196/45110] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/25/2023] [Accepted: 03/14/2023] [Indexed: 03/17/2023] Open
Abstract
BACKGROUND Elderly people were regarded as the most impacted and most vulnerable social group during the COVID-19 epidemic. The community environment is vital for their health. The elderly people had to stay home during the implementation of the management and control of the COVID-19 epidemic. They lack resources and suffer from anxiety. Thus, determining environmental factors beneficial for their physical and mental health is very important. OBJECTIVE This study aims to assess the association between community cohesion and physical and mental health among elderly people and to identify the related community service and environmental factors that may promote community cohesion. METHODS This community-based cross-sectional study was designed during the COVID-19 epidemic. A multistage sampling method is applied to this study. A total of 2,036 participants aged ≥ 60 years were sampled from 27 locations in China. Data were collected through face-to-face interviews. The neighborhood cohesion instrument consisting of three-dimensional scales was used to assess community cohesion. Self-efficacy and life satisfaction, cognitive function and depression, and community service and environmental factors were also measured using standard instruments. Statistical analyses were restricted to 2,017 participants. Separate logistic regression analysis was conducted to assess the association between community cohesion and physical and mental health factors, as well as related community service and environmental factors, among elderly people. RESULTS The results showed that high levels of community cohesion were associated with good self-perceived health status and life satisfaction and high levels of self-efficacy and psychological resilience, and their odds ratios (ORs) were 1.27 (95% CI, 1.01-1.59) and 1.20 (95% CI, 1.15-1.27) and 1.09 (95% CI, 1.05-1.13) and 1.05 (95% CI, 1.03-1.06), respectively. The length of stay in the community and the level of physical activity were positively associated with community cohesion scores, whereas the educational level was negatively associated with the community cohesion scores (P < .05). Community cohesion was also associated with low level of depression and high level of cognitive function. The community cohesion was significantly associated with community services and environmental factors from four dimensions. High levels of community cohesion were associated with transportation service, rental of rehabilitation equipment, high levels of satisfaction for community doctors' technical level and community waste disposal, and their ORs were 3.14 (95% CI, 1.87-5.28), 3.62 (95% CI, 2.38-5.52), 1.37 (95% CI, 1.08-1.73), and 1.23 (95% CI, 1.01-1.50), respectively. CONCLUSIONS Community cohesion was associated with the physical and mental health of elderly people. Our research suggests that enhancing community services and environmental management may be an effective strategy to increase community cohesion during the epidemic period of major infectious diseases. CLINICALTRIAL
Collapse
Affiliation(s)
- Ying Li
- Zhejiang University, 866 Yu-hang-tang Road, HangZhou, CN
| | - XiWen Ding
- Zhejiang University, 866 Yu-hang-tang Road, HangZhou, CN
| | | | - YiYang Pan
- Zhejiang University, 866 Yu-hang-tang Road, HangZhou, CN
| | - Yuan Chen
- Zhejiang Provincial People's Hospital, HangZhou, CN
| | - DongBin Hu
- The Second Affiliated Hospital of Harbin Medical University, Harbin, CN
| |
Collapse
|
7
|
Cianconi P, Hanife B, Grillo F, Zhang K, Janiri L. Human Responses and Adaptation in a Changing Climate: A Framework Integrating Biological, Psychological, and Behavioural Aspects. Life (Basel) 2021; 11:895. [PMID: 34575043 PMCID: PMC8470032 DOI: 10.3390/life11090895] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/23/2021] [Accepted: 08/26/2021] [Indexed: 01/14/2023] Open
Abstract
Climate change is one of the biggest challenges of our times. Its impact on human populations is not yet completely understood. Many studies have focused on single aspects with contradictory observations. However, climate change is a complex phenomenon that cannot be adequately addressed from a single discipline's perspective. Hence, we propose a comprehensive conceptual framework on the relationships between climate change and human responses. This framework includes biological, psychological, and behavioural aspects and provides a multidisciplinary overview and critical information for focused interventions. The role of tipping points and regime shifts is explored, and a historical perspective is presented to describe the relationship between climate evolution and socio-cultural crisis. Vulnerability, resilience, and adaptation are analysed from an individual and a community point of view. Finally, emergent behaviours and mass effect phenomena are examined that account for mental maladjustment and conflicts.
Collapse
Affiliation(s)
- Paolo Cianconi
- Department of Neurosciences, Section of Psychiatry, Catholic University, 00168 Rome, Italy;
| | - Batul Hanife
- Provincial Agency for Health Services, Institute of the Autonomous Province of Trento, 380123 Trento, Italy;
| | - Francesco Grillo
- Department of History, Anthropology, Religions, Art History, Media and Performing Arts, Sapienza University of Rome, 00185 Rome, Italy;
| | - Kai Zhang
- Department of Environmental Health Sciences, School of Public Health, University at Albany–State University of New York, Rensselaer, NY 12144, USA;
| | - Luigi Janiri
- Department of Neurosciences, Section of Psychiatry, Catholic University, 00168 Rome, Italy;
| |
Collapse
|
8
|
How Do Non-Catastrophic Natural Disasters Impact Middle-Aged-to-Older Persons? Using Baseline Canadian Longitudinal Study on Aging Data to Explore Psychological Outcomes Associated with the 2013 Calgary Flood. Can J Aging 2021; 41:184-192. [PMID: 34431471 DOI: 10.1017/s0714980821000271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The objective of this study was to identify group-level health outcomes associated with the 2013 Calgary flood on Calgary participants (45-85 years of age) in the Canadian Longitudinal Study on Aging (CLSA). We compared baseline CLSA data collected on Calgary participants during the 6 months prior to and following the flood. Logistic regression models were created to explore whether select psychological outcomes were associated with the flood for participants categorized by evacuation status. Participants living in evacuated communities pre-flood had significantly lower levels of a diagnosed anxiety disorder than non-evacuated communities, which disappeared post-flood. Participants with higher household income were less likely to have post-traumatic stress disorder symptoms, worse self-rated mental health, and lower life satisfaction post-flood. Living alone reduced and female gender increased levels of perceived functional social support post-flood. Although natural disasters can shape research findings, the scope of the data being collected and the representativeness of impacted groups may challenge the ability to detect subtle impacts.
Collapse
|
9
|
Racine N, Hetherington E, McArthur BA, McDonald S, Edwards S, Tough S, Madigan S. Maternal depressive and anxiety symptoms before and during the COVID-19 pandemic in Canada: a longitudinal analysis. Lancet Psychiatry 2021; 8:405-415. [PMID: 33773109 PMCID: PMC8824360 DOI: 10.1016/s2215-0366(21)00074-2] [Citation(s) in RCA: 126] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 02/12/2021] [Accepted: 02/15/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Parents have faced substantial social and economic challenges during the COVID-19 pandemic. Preliminary cross-sectional research has demonstrated increases in mental health problems in mothers during the COVID-19 pandemic compared with pre-pandemic estimates. We aimed to study an existing longitudinal cohort of mothers to assess changes in the prevalence of maternal depression and anxiety symptoms as a result of the COVID-19 pandemic over time and at the individual level. METHODS In this longitudinal observational study, women who took part in the All Our Families pregnancy cohort in Canada were invited to complete a COVID-19 impact survey between May 20 and July 15, 2020. Women who had not agreed to additional research, had discontinued, were lost to follow-up, or who were not contactable via email were excluded. Maternal depression and anxiety symptoms during the COVID-19 pandemic were compared with three previous estimates collected at 3, 5, and 8-year timepoints (between April, 2012, and October, 2019). Depression symptoms were assessed using the 10-item Center for Epidemiological Studies Depression scale and anxiety symptoms were assessed using the short form of the Spielberger State-Trait Anxiety Inventory. Repeated cross-sectional analyses were done to assess temporal trends and fixed-effects regression models were fitted to assess within-person change over time. FINDINGS Of the 3387 women included in the All Our Families study, 2445 women were eligible and were invited to participate in the COVID-19 impact study, of whom 1333 consented to participate, and 1301 were included in the longitudinal analysis. At the COVID-19 impact survey timepoint, a higher proportion of mothers had clinically significant depression (35·21%, 95% CI 32·48-38·04) and anxiety symptoms (31·39%, 28·76-34·15) than at all previous data collection timepoints. The mean depression score (8·31, 95% CI 7·97-8·65) and anxiety score (11·90, 11·66-12·13) at the COVID-19 pandemic timepoint were higher than previous data collection waves at the 3-year timepoint (mean depression score 5·05, 4·85-5·25; mean anxiety score 9·51, 9·35-9·66), 5-year timepoint (mean depression score 5·43, 5·20-5·66; mean anxiety score 9·49, 9·33-9·65), and 8-year timepoint (mean depression score 5·79, 5·55-6·02; mean anxiety score 10·26, 10·10-10·42). For the within-person comparisons, depression scores were a mean of 2·30 points (95% CI 1·95-2·65) higher and anxiety scores were a mean of 1·04 points (0·65-1·43) higher at the COVID-19 pandemic timepoint, after controlling for time trends. Larger increases in depression and anxiety symptoms were observed for women who had income disruptions, difficulty balancing home schooling with work responsibilities, and those with difficulty obtaining childcare. White mothers had greater increases in anxiety scores than non-white mothers and health-care workers had smaller increases in depressive symptoms than non-health-care workers. INTERPRETATION Compared with previous estimates, the prevalence of maternal depression and anxiety among mothers in a Canadian cohort increased during the COVID-19 pandemic. Financial support, childcare provision, and avoiding the closure of schools, might be key priorities for preventing future increases in maternal psychological distress. FUNDING Alberta Innovates Health Solutions Interdisciplinary Team, Canadian Institutes of Health Research, Alberta Innovates, and Alberta Children's Hospital Foundation.
Collapse
Affiliation(s)
- Nicole Racine
- Department of Psychology, Faculty of Arts, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Erin Hetherington
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Brae Anne McArthur
- Department of Psychology, Faculty of Arts, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Sheila McDonald
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Sarah Edwards
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Suzanne Tough
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Sheri Madigan
- Department of Psychology, Faculty of Arts, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
| |
Collapse
|
10
|
Hetherington E, Edwards SA, MacDonald SE, Racine N, Madigan S, McDonald S, Tough S. SARS-CoV-2 vaccination intentions among mothers of children aged 9 to 12 years: a survey of the All Our Families cohort. CMAJ Open 2021; 9:E548-E555. [PMID: 34021012 PMCID: PMC8177949 DOI: 10.9778/cmajo.20200302] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Acceptance of a vaccine against SARS-CoV-2 is critical to achieving high levels of immunization. The objectives of this study were to understand mothers' SARS-CoV-2 vaccine intentions to explore reasons for and against SARS-CoV-2 vaccination. METHODS Participants from the All Our Families pregnancy longitudinal cohort whose children had reached ages 9-12 years were invited in May-June 2020 to complete a survey on the impact of COVID-19. The survey covered topics about the impact of the pandemic and included 2 specific questions on mothers' intentions to vaccinate their child against SARS-CoV-2. Current responses were linked to previously collected data, including infant vaccine uptake. Multinomial regression models were run to estimate associations between demographic factors, past vaccination status and vaccination intention. Qualitative responses regarding factors affecting decision-making were analyzed thematically. RESULTS The response rate was 53.8% (1321/2455). A minority of children of participants had partial or no vaccinations at age 2 (n = 200, 15.1%). A total of 60.4% of mothers (n = 798) intended to vaccinate their children with the SARS-CoV-2 vaccine, 8.6% (n = 113) did not intend to vaccinate and 31.0% (n = 410) were unsure. Lower education, lower income and incomplete vaccination history were inversely associated with intention to vaccinate. Thematic analysis of qualitative responses showed 10 themes, including safety and efficacy, long-term effects and a rushed process. INTERPRETATION Within a cohort with historically high infant vaccination, a third of mothers remained unsure about vaccinating their children against SARS-CoV-2. Given the many uncertainties about future SARS-CoV-2 vaccines, clear communication regarding safety will be critical to ensuring vaccine uptake.
Collapse
Affiliation(s)
- Erin Hetherington
- Department of Obstetrics and Gynaecology (Hetherington), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Epidemiology, Biostatistics and Occupational Health (Hetherington), McGill University, Montréal, Que.; Department of Community Health Sciences (Edwards, Tough), Cumming School of Medicine, University of Calgary; Department of Pediatrics (MacDonald, McDonald, Tough), Cumming School of Medicine, University of Calgary; Faculty of Nursing (MacDonald), University of Alberta; Department of Psychology (Racine, Madigan, Tough), University of Calgary; Alberta Children's Hospital Research Institute (Racine, Madigan), Calgary, Alta.
| | - Sarah A Edwards
- Department of Obstetrics and Gynaecology (Hetherington), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Epidemiology, Biostatistics and Occupational Health (Hetherington), McGill University, Montréal, Que.; Department of Community Health Sciences (Edwards, Tough), Cumming School of Medicine, University of Calgary; Department of Pediatrics (MacDonald, McDonald, Tough), Cumming School of Medicine, University of Calgary; Faculty of Nursing (MacDonald), University of Alberta; Department of Psychology (Racine, Madigan, Tough), University of Calgary; Alberta Children's Hospital Research Institute (Racine, Madigan), Calgary, Alta
| | - Shannon E MacDonald
- Department of Obstetrics and Gynaecology (Hetherington), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Epidemiology, Biostatistics and Occupational Health (Hetherington), McGill University, Montréal, Que.; Department of Community Health Sciences (Edwards, Tough), Cumming School of Medicine, University of Calgary; Department of Pediatrics (MacDonald, McDonald, Tough), Cumming School of Medicine, University of Calgary; Faculty of Nursing (MacDonald), University of Alberta; Department of Psychology (Racine, Madigan, Tough), University of Calgary; Alberta Children's Hospital Research Institute (Racine, Madigan), Calgary, Alta
| | - Nicole Racine
- Department of Obstetrics and Gynaecology (Hetherington), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Epidemiology, Biostatistics and Occupational Health (Hetherington), McGill University, Montréal, Que.; Department of Community Health Sciences (Edwards, Tough), Cumming School of Medicine, University of Calgary; Department of Pediatrics (MacDonald, McDonald, Tough), Cumming School of Medicine, University of Calgary; Faculty of Nursing (MacDonald), University of Alberta; Department of Psychology (Racine, Madigan, Tough), University of Calgary; Alberta Children's Hospital Research Institute (Racine, Madigan), Calgary, Alta
| | - Sheri Madigan
- Department of Obstetrics and Gynaecology (Hetherington), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Epidemiology, Biostatistics and Occupational Health (Hetherington), McGill University, Montréal, Que.; Department of Community Health Sciences (Edwards, Tough), Cumming School of Medicine, University of Calgary; Department of Pediatrics (MacDonald, McDonald, Tough), Cumming School of Medicine, University of Calgary; Faculty of Nursing (MacDonald), University of Alberta; Department of Psychology (Racine, Madigan, Tough), University of Calgary; Alberta Children's Hospital Research Institute (Racine, Madigan), Calgary, Alta
| | - Sheila McDonald
- Department of Obstetrics and Gynaecology (Hetherington), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Epidemiology, Biostatistics and Occupational Health (Hetherington), McGill University, Montréal, Que.; Department of Community Health Sciences (Edwards, Tough), Cumming School of Medicine, University of Calgary; Department of Pediatrics (MacDonald, McDonald, Tough), Cumming School of Medicine, University of Calgary; Faculty of Nursing (MacDonald), University of Alberta; Department of Psychology (Racine, Madigan, Tough), University of Calgary; Alberta Children's Hospital Research Institute (Racine, Madigan), Calgary, Alta
| | - Suzanne Tough
- Department of Obstetrics and Gynaecology (Hetherington), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Epidemiology, Biostatistics and Occupational Health (Hetherington), McGill University, Montréal, Que.; Department of Community Health Sciences (Edwards, Tough), Cumming School of Medicine, University of Calgary; Department of Pediatrics (MacDonald, McDonald, Tough), Cumming School of Medicine, University of Calgary; Faculty of Nursing (MacDonald), University of Alberta; Department of Psychology (Racine, Madigan, Tough), University of Calgary; Alberta Children's Hospital Research Institute (Racine, Madigan), Calgary, Alta
| |
Collapse
|
11
|
|
12
|
Hrabok M, Delorme A, Agyapong VIO. Threats to Mental Health and Well-Being Associated with Climate Change. J Anxiety Disord 2020; 76:102295. [PMID: 32896782 DOI: 10.1016/j.janxdis.2020.102295] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 08/02/2020] [Accepted: 08/10/2020] [Indexed: 01/16/2023]
Abstract
Climate change is a contributor to extreme weather events and natural disasters. The mental health effects of climate change are multifaceted, with post-traumatic stress disorder and depression predominant. This paper aims to describe the impact of climate change on mental health conditions, including risk and protective factors related to the expression of mental health conditions post-disaster, as well as a discussion of our local experience with a devastating wildfire to our region within Canada. The risk of the development of mental health conditions post-disaster is not equally distributed; research has consistently demonstrated that specific risk factors (e.g., gender, socioeconomic status and education, pre-existing mental health symptomatology), are associated with increased vulnerability to mental health conditions following natural disasters. There are multiple strategies that must be undertaken by communities to enhance adjustment and coping post-disaster, including improved access to care, inter-agency cooperation, enhanced community resiliency, and adequate preparation.
Collapse
Affiliation(s)
- Marianne Hrabok
- Dission of Community Psychiatry, Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Aaron Delorme
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Vincent I O Agyapong
- Dission of Community Psychiatry, Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
| |
Collapse
|
13
|
Agyapong VIO, Hrabok M, Vuong W, Gusnowski A, Shalaby R, Mrklas K, Li D, Urichuk L, Snaterse M, Surood S, Cao B, Li XM, Greiner R, Greenshaw AJ. Closing the Psychological Treatment Gap During the COVID-19 Pandemic With a Supportive Text Messaging Program: Protocol for Implementation and Evaluation. JMIR Res Protoc 2020; 9:e19292. [PMID: 32501805 PMCID: PMC7309448 DOI: 10.2196/19292] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 05/15/2020] [Accepted: 06/04/2020] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Coronavirus disease (COVID-19) has spread globally with far-reaching, significant, and unprecedented impacts on health and everyday life. Threats to mental health, psychological safety, and well-being are now emerging, increasing the impact of this virus on world health. Providing support for these challenges is difficult because of the high number of people requiring support in the context of a need to maintain physical distancing. This protocol describes the use of SMS text messaging (Text4Hope) as a convenient, cost-effective, and accessible population-level mental health intervention. This program is evidence-based, with prior research supporting good outcomes and high user satisfaction. OBJECTIVE The project goal is to implement a program of daily supportive SMS text messaging (Text4Hope) to reduce distress related to the COVID-19 crisis, initially among Canadians. The prevalence of stress, anxiety, and depressive symptoms; the demographic correlates of the same; and the outcomes of the Text4Hope intervention in mitigating distress will be evaluated. METHODS Self-administered anonymous online questionnaires will be used to assess stress (Perceived Stress Scale), anxiety (Generalized Anxiety Disorder-7 scale [GAD-7]), and depressive symptoms (Patient Health Questionnaire-9 [PHQ-9]). Data will be collected at baseline (onset of SMS text messaging), the program midpoint (6 weeks), and the program endpoint (12 weeks). RESULTS Data analysis will include parametric and nonparametric techniques, focusing on primary outcomes (ie, stress, anxiety, and depressive symptoms) and metrics of use, including the number of subscribers and user satisfaction. Given the large size of the data set, machine learning and data mining methods will also be used. CONCLUSIONS This COVID-19 project will provide key information regarding prevalence rates of stress, anxiety, and depressive symptoms during the pandemic; demographic correlates of distress; and outcome data related to this scalable population-level intervention. Information from this study will be valuable for practitioners and useful for informing policy and decision making regarding psychological interventions during the pandemic. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/19292.
Collapse
Affiliation(s)
- Vincent Israel Opoku Agyapong
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.,Addiction and Mental Health, Alberta Health Services, Edmonton, AB, Canada
| | - Marianne Hrabok
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.,Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Wesley Vuong
- Addiction and Mental Health, Alberta Health Services, Edmonton, AB, Canada
| | - April Gusnowski
- Addiction and Mental Health, Alberta Health Services, Edmonton, AB, Canada
| | - Reham Shalaby
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Kelly Mrklas
- Strategic Clinical Networks, System Innovation and Programs, Alberta Health Services, Calgary, AB, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Daniel Li
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.,Addiction and Mental Health, Alberta Health Services, Edmonton, AB, Canada
| | - Liana Urichuk
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.,Addiction and Mental Health, Alberta Health Services, Edmonton, AB, Canada
| | - Mark Snaterse
- Addiction and Mental Health, Alberta Health Services, Edmonton, AB, Canada
| | - Shireen Surood
- Addiction and Mental Health, Alberta Health Services, Edmonton, AB, Canada
| | - Bo Cao
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Xin-Min Li
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Russ Greiner
- Department of Computing Science, Faculty of Science, University of Alberta, Edmonton, AB, Canada
| | - Andrew James Greenshaw
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.,APEC Digital Hub for Mental Health, Edmonton, AB, Canada
| |
Collapse
|
14
|
Lowe SR, Bonumwezi JL, Valdespino-Hayden Z, Galea S. Posttraumatic Stress and Depression in the Aftermath of Environmental Disasters: A Review of Quantitative Studies Published in 2018. Curr Environ Health Rep 2020; 6:344-360. [PMID: 31487033 DOI: 10.1007/s40572-019-00245-5] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE OF REVIEW As interest in the mental health consequences of environmental disasters increases, this review aimed to summarize peer-reviewed studies published in 2018 on posttraumatic stress disorder (PTSD) and depression symptoms after such events. RECENT FINDINGS Notable trends in the past year of research included studies focusing on vulnerable populations (e.g., persons with preexisting physical health conditions), assessing the cumulative impact of exposure to multiple disasters, exploring pathway leading to PTSD and depression symptoms, and evaluating the effectiveness of post-disaster interventions. Over 100 articles were identified, focused on 40 disasters that occurred between 1982 and 2017. Prevalence estimates ranged from 0 to 70.51% for PTSD and 1.9 to 59.5% for depression. Consistent predictors of adverse outcomes included female gender, socioeconomic disadvantage, high disaster exposure, and low psychosocial resources. Further research that expands upon recent advances in the literature is critical given the large proportion of the world's population exposed to disasters and the increasing incidence of such events.
Collapse
Affiliation(s)
- Sarah R Lowe
- Department of Social and Behavioral Sciences, Yale School of Public Health, 60 College St., New Haven, CT, 06510, USA.
| | | | | | - Sandro Galea
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| |
Collapse
|
15
|
Cianconi P, Betrò S, Janiri L. The Impact of Climate Change on Mental Health: A Systematic Descriptive Review. Front Psychiatry 2020; 11:74. [PMID: 32210846 PMCID: PMC7068211 DOI: 10.3389/fpsyt.2020.00074] [Citation(s) in RCA: 263] [Impact Index Per Article: 65.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 01/28/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Climate change is one of the great challenges of our time. The consequences of climate change on exposed biological subjects, as well as on vulnerable societies, are a concern for the entire scientific community. Rising temperatures, heat waves, floods, tornadoes, hurricanes, droughts, fires, loss of forest, and glaciers, along with disappearance of rivers and desertification, can directly and indirectly cause human pathologies that are physical and mental. However, there is a clear lack in psychiatric studies on mental disorders linked to climate change. METHODS Literature available on PubMed, EMBASE, and Cochrane library until end of June 2019 were reviewed. The total number of articles and association reports was 445. From these, 163 were selected. We looked for the association between classical psychiatric disorders such as anxiety schizophrenia, mood disorder and depression, suicide, aggressive behaviors, despair for the loss of usual landscape, and phenomena related to climate change and extreme weather. Review of literature was then divided into specific areas: the course of change in mental health, temperature, water, air pollution, drought, as well as the exposure of certain groups and critical psychological adaptations. RESULTS Climate change has an impact on a large part of the population, in different geographical areas and with different types of threats to public health. However, the delay in studies on climate change and mental health consequences is an important aspect. Lack of literature is perhaps due to the complexity and novelty of this issue. It has been shown that climate change acts on mental health with different timing. The phenomenology of the effects of climate change differs greatly-some mental disorders are common and others more specific in relation to atypical climatic conditions. Moreover, climate change also affects different population groups who are directly exposed and more vulnerable in their geographical conditions, as well as a lack of access to resources, information, and protection. Perhaps it is also worth underlining that in some papers the connection between climatic events and mental disorders was described through the introduction of new terms, coined only recently: ecoanxiety, ecoguilt, ecopsychology, ecological grief, solastalgia, biospheric concern, etc. CONCLUSIONS The effects of climate change can be direct or indirect, short-term or long-term. Acute events can act through mechanisms similar to that of traumatic stress, leading to well-understood psychopathological patterns. In addition, the consequences of exposure to extreme or prolonged weather-related events can also be delayed, encompassing disorders such as posttraumatic stress, or even transmitted to later generations.
Collapse
Affiliation(s)
- Paolo Cianconi
- Department of Neurosciences, Institute of Psychiatry, Catholic University, Rome, Italy
| | | | - Luigi Janiri
- Department of Neurosciences, Institute of Psychiatry, Catholic University, Rome, Italy
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| |
Collapse
|