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Zhao S, Zhou J, Wang T. Evolving policies, enduring impacts: Cross-sectional surveys of mental health, risk-related perceptions, and coping behaviors throughout China's U-turn in its stringent zero-COVID policy. J Clin Psychol 2024; 80:1528-1551. [PMID: 38488659 DOI: 10.1002/jclp.23676] [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: 09/13/2023] [Revised: 02/21/2024] [Accepted: 02/26/2024] [Indexed: 06/12/2024]
Abstract
OBJECTIVE China's early encounter with COVID-19 and protracted prevention policies, presents an ideal case to study psychological changes during a prolonged and evolving crisis. This study aims to examine the shifts in mental health symptoms, risk-related perceptions, and associated coping behaviors within two large-scale samples of Chinese respondents, spanning from the pandemic's onset to the relaxation of the zero-COVID policy. Moreover, the study strives to identify protective factors that could potentially mitigate the pandemic's impact. METHODS Two online surveys were conducted during China's initial pandemic phase (February 25-28, 2020) and the relaxation of the zero-COVID policy (March 30-April 18, 2023). Participants' mental health indicators, risk-related perceptions, and coping behaviors were assessed using the Depression, Anxiety, and Stress Scale-21 Items, the 9-item Bergen Burnout Inventory, and other adopted scales. Multivariable linear models were employed to examine the enduring psychological impact of the pandemic and identify potential protective factors. RESULTS Analysis of two datasets comprising 1946 and 1878 participants from the onset and the remission of China's COVID-19 pandemic revealed an upward trend in various mental health indicators of Chinese respondents between 2020 and 2023. Similarly, risk-related perceptions, encompassing perceived severity, susceptibility, and self-efficacy, and risk-related information sharing witnessed an increase. Being female, single, residing in rural areas, having higher education, and lacking acquaintances with COVID-19 are protective factors against mental health risks. Additionally, being female, married, over 30, living in big cities, having higher education, and lacking personal or acquaintances' infection history are associated with engaging in protective behaviors and reduced information avoidance. CONCLUSION The study investigated the changes in mental health symptoms, risk-related perceptions, and coping behaviors of Chinese respondents between 2020 and 2023 and identified protective factors against the pandemic's impact, including demographic (gender, age), social (education, marital status, residence), and exposure (infection history) elements. Understanding these fluctuations and protective elements is crucial for policymakers, as it can inform the development of targeted strategies to alleviate negative psychological impacts while effectively managing future pandemics.
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Affiliation(s)
- Shuguang Zhao
- Research Center of Journalism and Social Development, School of Journalism and Communication, Renmin University of China, Beijing, China
| | - Jue Zhou
- New Era International Communication Research Institute, Renmin University of China, Beijing
| | - Ting Wang
- New Era International Communication Research Institute, Renmin University of China, Beijing
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Harrison S, Quigley MA, Fellmeth G, Stein A, Ayers S, Alderdice F. The impact of the Covid-19 pandemic on postnatal anxiety and posttraumatic stress: Analysis of two population-based national maternity surveys in England. J Affect Disord 2024; 356:122-136. [PMID: 38574867 DOI: 10.1016/j.jad.2024.04.003] [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: 10/16/2023] [Revised: 03/26/2024] [Accepted: 04/01/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Few studies have evaluated postnatal anxiety and posttraumatic stress (PTS) before and during the Covid-19 pandemic using comparable data across time. We used data from two national maternity surveys in England to explore the impact of the pandemic on prevalence and risk factors for postnatal anxiety and PTS. METHODS Analysis was conducted using population-based surveys carried out in 2018 (n = 4509) and 2020 (n = 4611). Weighted prevalence estimates for postnatal anxiety and PTS were compared across surveys. Adjusted risk ratios (aRR) were estimated for the association between risk factors and postnatal anxiety and PTS. FINDINGS Prevalence of postnatal anxiety increased from 13.7 % in 2018 to 15.1 % in 2020 (+1.4 %(95%CI:-0.4-3.1)). Prevalence of postnatal PTS increased from 9.7 % in 2018 to 11.5 % in 2020 (+1.8 %(95%CI:0.3-3.4)), due to an increase in PTS related to birth trauma from 2.5 % to 4.3 % (+1.8 %(95%CI:0.9-2.6); there was no increase in PTS related to non-birth trauma. Younger age (aRR = 1.31-1.51), being born in the UK (aRR = 1.29-1.59), long-term physical or mental health problem(s) (aRR = 1.27-1.94), and antenatal anxiety (aRR = 1.97-2.22) were associated with increased risk of postnatal anxiety and PTS before and during the pandemic, whereas higher satisfaction with birth (aRR = 0.92-0.94) and social support (aRR = 0.81-0.82) were associated with decreased risk. INTERPRETATION Prevalence of postnatal PTS was significantly higher during the pandemic, compared to before the pandemic, due to an increase in PTS related to birth trauma. Prevalence of postnatal anxiety was not significantly higher during the pandemic. Risk factors for postnatal anxiety and PTS were similar before and during the pandemic.
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Affiliation(s)
- S Harrison
- NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
| | - M A Quigley
- NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - G Fellmeth
- NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - A Stein
- NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK; Department of Psychiatry, Medical Sciences Division, University of Oxford, Oxford, UK; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; African Health Research Institute, Durban, KwaZulu-Natal, South Africa
| | - S Ayers
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, London, UK
| | - F Alderdice
- NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK; School of Nursing and Midwifery, Queens University Belfast, Belfast, UK
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Brinberg M, Jones SM, Birnbaum ML, Bodie GD, Ram N, Solomon DH. How are Conversations via an On-Demand Peer-To-Peer Emotional Well-Being App Associated with Emotional Improvement? HEALTH COMMUNICATION 2024:1-14. [PMID: 38836301 DOI: 10.1080/10410236.2024.2360178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
Non-clinical, on-demand peer-to-peer (PtP) support apps have become increasingly popular over the past several years. Although not as pervasive as general self-help apps, these PtP support apps are usually free and instantly connect individuals through live texting with a non-clinical volunteer who has been minimally trained to listen and offer support. To date, there is little empirical work that examines whether and how using an on-demand PtP support app improves emotional well-being. Applying regression and multilevel models to N = 1000+ PtP conversations, this study examined whether individuals experience emotional improvement following a conversation on a PtP support app (HearMe) and whether dyadic characteristics of the conversation - specifically, verbal and emotional synchrony - are associated with individuals' emotional improvement. We found that individuals reported emotional improvement following a conversation on the PtP support app and that verbal (but not emotional) synchrony was associated with the extent of individuals' emotional improvement. Our results suggest that online PtP support apps are a viable source of help. We discuss cautions and considerations when applying our findings to enhance the delivery of support provision on PtP apps.
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Affiliation(s)
| | | | - Michael L Birnbaum
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, NYC
- New York State Psychiatric Institute, Behavioral Health Services and Policy Research, NYC
| | - Graham D Bodie
- Department of Media & Communication, School of Journalism and New Media, University of Mississippi
| | - Nilam Ram
- Psychology and Communication, Stanford University
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Obsuth I, Madia JE, Murray AL, Thompson I, Daniels H. The impact of school exclusion in childhood on health and well-being outcomes in adulthood: Estimating causal effects using inverse probability of treatment weighting. BRITISH JOURNAL OF EDUCATIONAL PSYCHOLOGY 2024; 94:460-473. [PMID: 38155360 DOI: 10.1111/bjep.12656] [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: 02/02/2023] [Accepted: 12/08/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND Previous evidence has suggested a strong association between school exclusion and health outcomes. However, as health risks are themselves related to the risk of experiencing a school exclusion, it has been challenging to determine the extent to which school exclusion impacts later health outcomes, as opposed to reflecting a marker for pre-existing risks. AIM The aim of the current study was to address this challenge in estimating the medium-to-long-term impact of school exclusion of health and well-being outcomes. METHODS To this end, we used an inverse propensity weighting approach in the Next Steps data set (N = 6534, from wave 1, 2014, to wave 8, 2015). RESULTS We found that after weighting for propensity of treatment scores estimated based on a wide range of factors, including previous health indicators, there was a significant effect of school exclusion on a wide range of health and well-being outcomes. DISCUSSION These results provide some of the most robust evidence to date that school exclusion harms long-term health outcomes. CONCLUSION The findings suggest that policies should aim to reduce exclusion and ensure access to preventative health support for those who experience a school exclusion.
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Affiliation(s)
- Ingrid Obsuth
- Clinical and Health Psychology, University of Edinburgh, Edinburgh, UK
| | - Joan E Madia
- Department of Sociology, Nuffield College, University of Oxford, Oxford, UK
| | - Aja L Murray
- Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Ian Thompson
- Department of Education, University of Oxford, Oxford, UK
| | - Harry Daniels
- Department of Education, University of Oxford, Oxford, UK
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Zhang Z, Hu Y, Liu S, Feng X, Yang J, Cheng LJ, Ramazanu S, Wu XV. The effectiveness of e-mental health interventions on stress, anxiety, and depression among healthcare professionals: a systematic review and meta-analysis. Syst Rev 2024; 13:144. [PMID: 38816879 PMCID: PMC11138032 DOI: 10.1186/s13643-024-02565-6] [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: 08/30/2023] [Accepted: 05/17/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Many healthcare professionals are experiencing psychological distress. Electronic mental health (e-mental health) interventions are convenient and multifunctional. This review aimed to examine the effectiveness of e-mental health interventions in enhancing the well-being of healthcare professionals and to identify moderating factors. METHODS A comprehensive and systematic retrieval of randomized controlled trial (RCT) studies was conducted across eight databases. Population, intervention, comparison, and outcome (PICO) were used to define eligibility criteria. Stress, anxiety, and depression were included as the main outcomes. The overall effect was calculated based on the random effect model, and the effect size was presented using the standardized mean difference. The characteristics of the research design, intervention object, and intervention design were further selected as potential moderating factors for subgroup analysis. Meta-regression analyses were finally performed, incorporating intervention duration and sample size as independent variables. RESULTS A total of 20 studies were included in the systematic review, and 17 were included in the meta-analysis. A large effect on relieving stress and anxiety and a small-to-medium effect on reducing depression were observed. Subgroup analyses showed that features including mindfulness approaches, online courses, computer use, group interventions, and professional guidance were more favorable in the design of services. Meta-regression revealed that intervention duration only affected anxiety symptoms. Caution should be exercised, as some subgroups had fewer studies and higher heterogeneity. For the secondary outcomes, a large effect on emotional exhaustion and a small-to-medium effect on well-being were observed. CONCLUSION In general, e-mental health interventions significantly improve the psychological health of healthcare staff. Future high-quality, large-scale studies targeting healthcare professionals and specific intervention scenarios are warranted.
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Affiliation(s)
- Zemiao Zhang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yinhuan Hu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Sha Liu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiandong Feng
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jinhong Yang
- Xiangya School of Nursing, Central South University, Changsha, China
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Ling Jie Cheng
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Sheena Ramazanu
- School of Nursing and Health Studies, The Jockey Club Institute of Healthcare (IOH), Hong Kong Metropolitan University, Hong Kong, China
| | - Xi Vivien Wu
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Gallinella F, Trotta F, Fortinguerra F. Impact of COVID-19 pandemic on prescription of psychotropic medications in the Italian paediatric population during 2020. Ital J Pediatr 2024; 50:102. [PMID: 38764095 PMCID: PMC11103882 DOI: 10.1186/s13052-024-01670-5] [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: 01/19/2024] [Accepted: 05/04/2024] [Indexed: 05/21/2024] Open
Abstract
BACKGROUND There is a global perception that psychotropic utilization in children and adolescents is increasing, especially with the onset of COVID-19 pandemic. Available literature data on paediatric psychotropic medication prescriptions in Italy are limited to one or few regions and not updated. The aim of this study was to provide updated data on psychotropic prescriptions referred to the whole Italian paediatric population, as overall and by subgroups of medications and to evaluate if the COVID-19 pandemic during 2020 had an impact on prescription rates. METHODS A descriptive study on psychotropic drug utilization in children and adolescents (< 18 years) resident in all Italian regions during 2020 was performed. Patients registered in the Pharmaceutical Prescriptions database with at least one prescription/dispensing of a psychotropic medication (antipsychotics-N05A), (antidepressants-N06A) and (psychostimulants-N06BA) during the study period were considered. The indicators used were the prescription rate (number of prescriptions per 1000 children) and prevalence of use (proportion of the paediatric population with at least one prescription in the relevant year). RESULTS During the 2020 the prevalence of psychotropic drug use in the paediatric population was 0.3%, increased of 7.8% if compared to 2019. The same trend was observed for the prescription rate, which recorded an average of 28.2 per 1000 children with an increase of 11.6% if compared to previous year, representing the 0.6% of the overall drug use in this age group. The data showed a growing trend prescription by age, reaching the peak in adolescents aged 12-17 years old, with a prescription rate of 65 per 1000 children and a prevalence of 0.71%. Considering the subgroups of psychotropic medications, the highest prevalence of use was found for antipsychotic drugs, received by the 0.19% of the paediatric population during 2020. CONCLUSIONS Psychotropic drug utilization in children and adolescents has grown during 2020 in Italy and worldwide, raising alarms from health care clinicians and patient advocates about the increase of burden of mental diseases in paediatric population during the COVID-19 pandemic. A more systematic monitoring of the use of psychotropic medications should be implemented in all countries for collecting relevant information about children and adolescents taking psychotropic drugs, in order to address the present and the future of the mental health of the paediatric population.
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Affiliation(s)
| | - Francesco Trotta
- Italian Medicines Agency (AIFA), Via del Tritone, 181, Rome, 00187, Italy
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Simonsson O, Fisher SD. Mindfulness meditation use in Britain during the COVID-19 pandemic. PLoS One 2024; 19:e0303349. [PMID: 38739574 PMCID: PMC11090315 DOI: 10.1371/journal.pone.0303349] [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: 11/24/2022] [Accepted: 04/24/2024] [Indexed: 05/16/2024] Open
Abstract
OBJECTIVES The objectives of this study were to examine the prevalence and associations of mindfulness meditation use and also its perceived mental health effects during the COVID-19 pandemic. METHODS Using repeated cross-sectional data from broad online samples weighted to be representative of the adult population in Britain, we estimated the prevalence of mindfulness meditation use and employed logistic regression models to investigate sociodemographic and political associations of mindfulness meditation use and also its perceived mental health effects during the COVID-19 pandemic. RESULTS The findings suggest that 16 percent of adults in Britain had learnt to practice mindfulness in 2021. In covariate-adjusted regression models, having learnt to practice mindfulness was more common among young and middle-aged adults, residents in London, and respondents who voted for the Liberal Democrats. Among mindfulness meditation users who reported having practiced mindfulness during the COVID-19 pandemic, 60 percent reported that it positively affected their mental health and 24 percent reported that it negatively affected their mental health. Notably, 41 percent of respondents with children under 18 (versus 13 percent of those without minors) reported negative mental health effects. In covariate-adjusted regression models, negative mental health effects from mindfulness practice during the COVID-19 pandemic were not concentrated in any particular groups, except for respondents with children under 18. CONCLUSIONS Mindfulness meditation has become widespread in Britain, but the results in this study suggest that mindfulness meditation use may be concentrated in certain sociodemographic and political groups. The results also suggest that practicing mindfulness during the COVID-19 pandemic had positive mental health effects for a majority of users, but approximately one-quarter of users reported negative mental health effects. It is therefore important for future research to continue monitoring the prevalence of mindfulness meditation use in society and to investigate under what circumstances, for whom, and in what ways mindfulness-based practices may have negative effects on mental health.
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Affiliation(s)
- Otto Simonsson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
- Department of Sociology, University of Oxford, Oxford, United Kingdom
| | - Stephen D. Fisher
- Department of Sociology, University of Oxford, Oxford, United Kingdom
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Blake H, Hassard J, Dulal-Arthur T, Wishart M, Roper S, Bourke J, Belt V, Bartle C, Pahl N, Leka S, Thomson L. Typology of employers offering line manager training for mental health. Occup Med (Lond) 2024; 74:242-250. [PMID: 38722211 PMCID: PMC11080657 DOI: 10.1093/occmed/kqae025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Mental ill health has a high economic impact on society and employers. National and international policy advocates line manager (LM) training in mental health as a key intervention, but little is known about employer training provisions. AIMS To explore the prevalence and characteristics of organizations that offer LM training in mental health. METHODS Secondary analysis of existing longitudinal anonymised organizational-level survey data derived from computer-assisted telephone interview surveys collected in four waves (2020:1900 firms, 2021:1551, 2022:1904, 2023:1902) in England, before, during and after a global pandemic. RESULTS The proportion of organizations offering LM training in mental health increased pre- to post-pandemic (2020:50%, 2023:59%) but 41% do not currently provide it. Logistic regression confirmed that LM training is more likely to be offered by large-sized enterprises, organizations with a larger proportion of employees who are younger (aged 25-49), female, disabled and from ethnic minority communities. Sector patterns were inconsistent, but in 2023, organizations from the 'Hospitality' and 'Business Services' sectors were more likely to provide LM training than other sectors. CONCLUSIONS Continued efforts are needed to increase the proportion of employers offering LM training in mental health, particularly small- to medium-sized enterprises, and organizations with predominantly male, White and/or older workforces.
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Affiliation(s)
- H Blake
- School of Health Sciences, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK
| | - J Hassard
- Queen’s University Business School, Queen’s University Belfast, Belfast, Northern Ireland, UK
| | - T Dulal-Arthur
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - M Wishart
- Warwick University Business School, Warwick University, Coventry, UK
| | - S Roper
- Warwick University Business School, Warwick University, Coventry, UK
| | - J Bourke
- Cork University Business School, University College Cork, Cork, Ireland
| | - V Belt
- Warwick University Business School, Warwick University, Coventry, UK
| | - C Bartle
- School of Medicine, University of Nottingham, Nottingham, UK
| | - N Pahl
- Society of Occupational Medicine, London, UK
| | - S Leka
- Division of Health Research, Centre for Organisational Health & Well-being, Lancaster University, Lancaster, UK
| | - L Thomson
- School of Medicine, University of Nottingham, Nottingham, UK
- Institute of Mental Health, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
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Melianova E, Morris TT, Leckie G, Manley D. Local government spending and mental health: Untangling the impacts using a dynamic modelling approach. Soc Sci Med 2024; 348:116844. [PMID: 38615613 DOI: 10.1016/j.socscimed.2024.116844] [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: 09/06/2023] [Revised: 02/15/2024] [Accepted: 03/26/2024] [Indexed: 04/16/2024]
Abstract
This study investigated the impact of local government spending on mental health in England between 2013 and 2019. Guided by the "Health in All Policies" vision, which encourages the integration of health in all decision-making areas, we explored how healthcare and multiple nonmedical budgeting decisions related to population mental health. We used random curve general cross-lagged modelling to dynamically partition effects into the short-run (from t to t + 1) and long-run (from t to t + 2) impacts, account for unobserved area-level heterogeneity and reverse causality from health outcomes to financial investments, and comprehensive modelling of budget items as an interconnected system. Our findings revealed that spending in adult social care, healthcare, and law & order predicted long-term mental health gains (0.004-0.081 SDs increase for each additional 10% in expenditure). However, these sectors exhibited negative short-term impulses (0.012-0.077 SDs decrease for each additional 10% in expenditure), markedly offsetting the long-term gains. In turn, infrastructural and environmental spending related to short-run mental health gains (0.005-0.031 SDs increase for each additional 10% in expenditure), while the long-run effects were predominantly negative (0.005-0.028 SDs decrease for each additional 10% in expenditure). The frequent occurrence of short-run and long-run negative links suggested that government resources may not be effectively reaching the areas that are most in need. In the short-term, negative effects could also imply temporary disruptions to service delivery largely uncompensated by later mental health improvements. Nonetheless, some non-health spending policies, such as law & order and infrastructure, can be related to long-lasting positive mental health impacts.
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Affiliation(s)
| | - Tim T Morris
- Centre for Longitudinal Studies, Social Research Institute, University College London, UK.
| | - George Leckie
- Centre for Multilevel Modelling and School of Education, University of Bristol, UK.
| | - David Manley
- School of Geographical Sciences, University of Bristol, UK.
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Wiciak MT, Shazley O, Santhosh D. Reevaluating Sleep Quality During COVID-19 and Associations With Quarantine, Mental Health, Stress, and Screen Time in Young Adults: Results From a Cross-Sectional Online Survey. Am J Lifestyle Med 2024; 18:376-388. [PMID: 38737873 PMCID: PMC10265264 DOI: 10.1177/15598276231182621] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024] Open
Abstract
The COVID-19 pandemic affected individual sleep quality, especially with high-stress levels. We assessed sleep quality in young adults during COVID-19, and mental health, stress, and screen time (ST) use. An international cross-sectional study was conducted from September 2020 to January 2021. The surveys assessed sleep quality (PSQI), ST use, and mental health. 183 participants were eligible for analysis. The average global PSQI score was 7.29 (sd = 3.58, n = 99). Associations were found between global PSQI scores and Fear of COVID-19 (r (98) = .223, P = .027), anxiety scores (r (99) = -.541, P < .001), increased total stress scores (r (88) = .486, P < .001), and depression (r (97) = .628, P < .001). Those currently quarantining had statistically higher PSQI scores than those who quarantined in the past (F (2,175) = 3.397, P = .036), but not for those who did not quarantine. Differences were found between genders for global PSQI (F (4,94) = 2.865, P < .027) and poor vs good sleep (X2 (1,98) = 3.982, P = .046). There was also a relationship between ethnicity and poor vs good sleep quality (X2 (2,94) = 6.538, P = .038). We did not find associations between ST and sleep quality but found poor sleep quality significantly related to mental health during COVID-19. We found no direct evidence that quarantining itself results in poor sleep quality. Interventions need to maximize sleep quality in certain groups, like females and ethnic minorities.
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Affiliation(s)
- Michelle Teresa Wiciak
- Saint James School of Medicine, St Vincent and the Grenadines, 1181 Sandy Beach Drive, Arnos Vale 31201, British West Indies
| | - Omar Shazley
- Saint James School of Medicine, St Vincent and the Grenadines, 1181 Sandy Beach Drive, Arnos Vale 31201, British West Indies
| | - Daphne Santhosh
- Saint James School of Medicine, St Vincent and the Grenadines, 1181 Sandy Beach Drive, Arnos Vale 31201, British West Indies
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Donohoe-Bales A, O’Dean S, Smout S, Boyle J, Barrett E, Teesson M, Bower M. What set some young adults apart during the COVID-19 pandemic? Mental health trajectories, risk and protective factors in an Australian longitudinal study. Aust N Z J Psychiatry 2024; 58:435-445. [PMID: 38205782 PMCID: PMC11055410 DOI: 10.1177/00048674231223690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
OBJECTIVE Evidence suggests that young adults (aged 18-34) were disproportionately impacted by the COVID-19 pandemic, but little is known about their longer-term mental health changes beyond the early pandemic period. This article investigates heterogeneous trajectories of mental health among Australian young adults across 2 years of the pandemic and identifies a broad range of associated risk and protective factors. METHOD Young adults (N = 653, Mage = 27.8 years) from the longitudinal Alone Together Study were surveyed biannually between July 2020 and June 2022. Measures assessed anxiety (7-item Generalised Anxiety Disorder scale) and depression (9-item Patient Health Questionnaire) symptoms at Waves 1-4, as well as demographic, psychological, adversity and COVID-19 factors at baseline. RESULTS Four and three distinct trajectories of anxiety and depressive symptoms, respectively, were identified through growth mixture modelling. The proportion of participants in each anxiety trajectory were Asymptomatic (45.9%), Mild Stable (17.9%), Moderate-Severe Stable (31.1%) and Initially Severe/Recovering (5.1%). For depression, Mild Stable (58.3%), Moderate-Severe Stable (30.5%) and Reactive/Recovering (11.2%). Baseline factors associated with severe symptom trajectories included a lifetime mental health disorder, pre-pandemic stressful events, identifying as LGBTQIA+ and/or female, and experiencing one or more infection-control measures. Higher household income was protective. CONCLUSION Most young adults demonstrated stable trajectories of low or high symptoms during the pandemic, with smaller groups showing initially severe or reactive symptoms followed by marked improvements over time. Vulnerable subgroups (gender- or sexuality-diverse, those with prior adversity or pre-existing mental ill-health) may face ongoing impacts and require targeted psychosocial supports to assist their mental health recovery post-COVID-19 and in the event of future crises.
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Affiliation(s)
- Amarina Donohoe-Bales
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Siobhan O’Dean
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Scarlett Smout
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Julia Boyle
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Emma Barrett
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Marlee Bower
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
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12
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Zhao Y, Wang Y, Wei L, Ma Y, Chen Y, Zhang X. Self-Control, Openness, Personal Need for Structure and Compensatory Control Change: A Serial Mediation Investigation. Behav Sci (Basel) 2024; 14:352. [PMID: 38785843 PMCID: PMC11118860 DOI: 10.3390/bs14050352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 04/14/2024] [Accepted: 04/18/2024] [Indexed: 05/25/2024] Open
Abstract
In the aftermath of the COVID-19 pandemic, numerous studies have indicated that individuals are confronting a diminished sense of control. Compensatory control theory suggests that individuals strive to mitigate this loss by modifying their behavior. The present study aims to investigate the relationship between self-control and compensatory control change during the COVID-19 pandemic, as well as the mediating effects of openness and the personal need for structure. Participants completed an online questionnaire consisting of Personal Need for Structure Scale, Self-Control Scale, Openness Scale and Compensatory Control Change Scale. The results showed that the compensatory control change increased after the outbreak. Moreover, a serial mediation was found: openness and the personal need for structure partially mediated the relationship between self-control and compensatory control change. The results indicate that the COVID-19 pandemic has led to an increase in compensatory control behaviors, especially among those with pronounced self-control. High self-control individuals are found to exhibit greater openness, reducing their personal need for structure, in effect enhancing their compensatory control change. These findings highlight the critical role of self-control in sustaining a sense of control, which is vital for understanding psychological health management in the context of public health events.
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Affiliation(s)
- Yuan Zhao
- Beijing Key Laboratory of Applied Experimental Psychology, Faculty of Psychology, National Demonstration Center for Experimental Psychology Education, Beijing Normal University, Beijing 100875, China; (Y.Z.); (Y.W.); (Y.C.)
| | - Yuying Wang
- Beijing Key Laboratory of Applied Experimental Psychology, Faculty of Psychology, National Demonstration Center for Experimental Psychology Education, Beijing Normal University, Beijing 100875, China; (Y.Z.); (Y.W.); (Y.C.)
- Faculty of Psychology and Educational Sciences, KU Leuven, 3000 Leuven, Belgium
| | - Liuqing Wei
- Department of Psychology, Faculty of Education, Hubei University, Wuhan 430062, China;
| | - Yu Ma
- Center for Psychological Health, Ningxia Vocational Technical College of Industry and Commerce, Ningxia 750021, China;
| | - Yunyun Chen
- Beijing Key Laboratory of Applied Experimental Psychology, Faculty of Psychology, National Demonstration Center for Experimental Psychology Education, Beijing Normal University, Beijing 100875, China; (Y.Z.); (Y.W.); (Y.C.)
| | - Xuemin Zhang
- Beijing Key Laboratory of Applied Experimental Psychology, Faculty of Psychology, National Demonstration Center for Experimental Psychology Education, Beijing Normal University, Beijing 100875, China; (Y.Z.); (Y.W.); (Y.C.)
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China
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13
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Aymerich C, Pedruzo B, Salazar de Pablo G, Olazabal N, Catalan A, González-Torres MÁ. Number and nature of psychiatric emergency department visits in a tertiary hospital before, during, and after coronavirus pandemic. Front Psychiatry 2024; 15:1380401. [PMID: 38699456 PMCID: PMC11063275 DOI: 10.3389/fpsyt.2024.1380401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 04/01/2024] [Indexed: 05/05/2024] Open
Abstract
Introduction The COVID-19 pandemic has significantly impacted mental health globally, leading to a deterioration in the overall mental health of the population and changes across all healthcare levels, including emergency departments (ED). However, the evolution of the quantity and nature of psychiatric ED visits in the post-pandemic period remains uncertain. Aims To examine changes in the number and nature of psychiatric emergencies at a general hospital before, during, and after the COVID-19 pandemic. Materials and methods Psychiatric ED visits from a tertiary hospital in the Basque Country (Spain) between January 2019 and November 2023 were investigated. Electronical health registers detailing the number and nature of psychiatric care consultations were analyzed for the study timeframe. Three periods were then compared: pre-pandemic (from January 2019 to February 2020), pandemic (from March 2020 to January 2022), and post-pandemic (from February 2022 onwards). Results 16,969 psychiatric ED visits were recorded for the study period. The number of psychiatric ED visits remained stable from pre-pandemic (269.93 visits/month) to pandemic (264.48 visits/month) periods but experienced a significant rise during the post-pandemic period (330.00 visits/month; t=-6.42; p<0.001), which was not reflected in medical and traumatological visits. The proportion of visits for anxiety (Z=-2.97; p=0.003), suicidal ideation (Z=-5.48; p<0.001), and administrative and social consultations (Z=-5.69; p<0.001) increased over the course of the pandemic. In contrast, visits for schizophrenia and other psychotic disorders (Z=4.85; p<0.001), as well as unspecified behavioral alterations (Z=2.51; p=0.012), significantly decreased. Conclusion The COVID-19 pandemic and its aftermath have altered the patterns of urgent psychiatric care, characterized by a sharp increase of average monthly number of consultations and a shift in their nature. Future efforts should focus on characterizing this surge in demand and enhancing both emergency services and outpatient settings.
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Affiliation(s)
- Claudia Aymerich
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute, Organización Sanitaria Integrada (OSI) Bilbao-Basurto, Bilbao, Spain
- Centro de Investigación en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Neuroscience Department, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Borja Pedruzo
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute, Organización Sanitaria Integrada (OSI) Bilbao-Basurto, Bilbao, Spain
- Centro de Investigación en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Neuroscience Department, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Gonzalo Salazar de Pablo
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Child and Adolescent Mental Health Services, South London and Maudsley, NHS Foundation Trust, London, United Kingdom
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Nora Olazabal
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute, Organización Sanitaria Integrada (OSI) Bilbao-Basurto, Bilbao, Spain
- Neuroscience Department, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Ana Catalan
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute, Organización Sanitaria Integrada (OSI) Bilbao-Basurto, Bilbao, Spain
- Centro de Investigación en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Neuroscience Department, University of the Basque Country (UPV/EHU), Leioa, Spain
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Miguel Ángel González-Torres
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute, Organización Sanitaria Integrada (OSI) Bilbao-Basurto, Bilbao, Spain
- Centro de Investigación en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Neuroscience Department, University of the Basque Country (UPV/EHU), Leioa, Spain
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14
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Muraosa H, Shirata T, Saito Y, Noto K, Suzuki A. Comparison of dysfunctional attitudes, cognitive vulnerability to depression, before and during the COVID-19 pandemic in healthy participants. BMC Psychol 2024; 12:185. [PMID: 38570810 PMCID: PMC10993468 DOI: 10.1186/s40359-024-01674-0] [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: 12/25/2023] [Accepted: 03/19/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND During the COVID-19 pandemic, depression and suicide rates increased worldwide, and in Japan. Presumably, an increase of neuroticism-related personality traits mediates the relation linking the COVID-19 pandemic with depression and suicide. This study examined COVID-19 pandemic effects on dysfunctional attitudes, cognitive vulnerability to depression, in healthy participants. METHODS The study used Dysfunctional Attitude Scale (DAS) -24 data of three subscales (i.e., achievement, dependency, and self-control) obtained from 270 Japanese medical students during October 2017 - June 2022. Participants were divided into two groups: those for whom DAS-24 was assessed before the pandemic (phase 1 group, October 2017 - March 2020, n = 178) and those for whom DAS-24 was assessed during the pandemic (phase 2 group, April 2020 - June 2022, n = 92). RESULTS Total DAS-24 scores of the phase 2 group were significantly (p = 0.047) lower than those of the phase 1 group. Scores of the dependency subscale for the phase 2 group were significantly (p = 0.002) lower than those for the phase 1 group, but no significant difference was found in the scores of the achievement and self-control subscales. CONCLUSIONS These findings suggest that a decrease in DAS-24 scores, particularly of the dependency subscale, occurred during the COVID-19 pandemic. Possible mechanisms underlying these results are 1) individuals became less preoccupied with receiving evaluation, 2) individuals realized that self-cognition depending on the approval of others is unimportant, and 3) high levels of dysfunctional attitude were maladaptive for obtaining affective benefits via social interactions during the COVID-19 pandemic.
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Affiliation(s)
- Haruka Muraosa
- Department of Psychiatry, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata city, 990-9585, Japan
| | - Toshinori Shirata
- Department of Psychiatry, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata city, 990-9585, Japan.
| | - Yusuke Saito
- Department of Psychiatry, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata city, 990-9585, Japan
| | - Keisuke Noto
- Department of Psychiatry, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata city, 990-9585, Japan
| | - Akihito Suzuki
- Department of Psychiatry, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata city, 990-9585, Japan
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15
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Junger N, Hirsch O. Ethics of Nudging in the COVID-19 Crisis and the Necessary Return to the Principles of Shared Decision Making: A Critical Review. Cureus 2024; 16:e57960. [PMID: 38601812 PMCID: PMC11005480 DOI: 10.7759/cureus.57960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2024] [Indexed: 04/12/2024] Open
Abstract
Nudging, a controversial technique for modifying people's behavior in a predictable way, is claimed to preserve freedom of choice while simultaneously influencing it. Nudging had been largely confined to situations such as promoting healthy eating choices but has been employed in the coronavirus disease 2019 (COVID-19) crisis in a shift towards measures that involve significantly less choice, such as shoves and behavioral prods. Shared decision making (SDM), a method for direct involvement and autonomy, is an alternative approach to communicate risk. Predominantly peer-reviewed scientific publications from standard literature databases like PubMed, PsycInfo, and Psyndex were evaluated in a narrative review. The so-called fear nudges, as well as the dissemination of strongly emotionalizing or moralizing messages can lead to intense psycho-physical stress. The use of these nudges by specialized units during the COVID-19 pandemic generated a societal atmosphere of fear that precipitated a deterioration of the mental and physical health of the population. Major recommendations of the German COVID-19 Snapshot Monitoring (COSMO) study, which are based on elements of nudging and coercive measures, do not comply with ethical principles, basic psychological principles, or evidence-based data. SDM was misused in the COVID-19 crisis, which helped to achieve one-sided goals of governments. The emphasis on utilitarian thinking is criticized and the unethical behavior of decision makers is explained by both using the concept of moral disengagement and the maturity level of coping strategies. There should be a return to an open-ended, democratic, and pluralistic scientific debate without using nudges. It is therefore necessary to return to the origins of SDM.
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Affiliation(s)
- Nancy Junger
- Psychology, Independent Researcher, Tübingen, DEU
| | - Oliver Hirsch
- Psychology, FOM University of Applied Sciences, Siegen, DEU
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16
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Farangi MR, Naami A. A study of early multilingualism in Iran: The effects of mother tongue literacy, socio-economic status and foreground TV exposure. Acta Psychol (Amst) 2024; 243:104167. [PMID: 38306876 DOI: 10.1016/j.actpsy.2024.104167] [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: 09/18/2023] [Revised: 01/23/2024] [Accepted: 01/24/2024] [Indexed: 02/04/2024] Open
Abstract
This study investigated interactions among linguistics, social and political factors in a linguistically rich environment. For this purpose, two-hundred Iranian preschoolers (aged 5 to 6 years old) from four ethnic/linguistic groups (Arab, Kurd, Turk and Fars) were selected using multi-stage stratified sampling. All participants took part in an Elementary English language course and their exposure to foreground TV was recorded using media exposure portfolio. Maternal education and family income were considered as criteria for socio-economic status. Children's language proficiency was measured through Language Sample Analysis (LSA). The LSA components included total number of utterances produced, total number of words produced, total number of new words produced and mean length of utterances. Regression analysis, ANOVA and t-tests were used for data analyses. The results showed that bilingual children performed slightly better than multilingual children in LSA measures but this cannot be taken for granted. Moreover, socio-economic status and LSA measures were significantly related but TV exposure was not associated with the LSA measures. These results supported the arguments purported by minority language proponents on the importance of using children's mother tongue in educational curriculum.
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Affiliation(s)
| | - Amir Naami
- Applied linguistics, Shiraz University, Shiraz 71946-84636, Iran
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17
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Lee BHJ, Holleman A, Proeschold-Bell RJ. Stability and shifts in the combined positive and negative mental health of clergy: A longitudinal latent class and latent transition analysis study of united methodist pastors before and after the onset of COVID-19. Soc Sci Med 2024; 344:116651. [PMID: 38340387 DOI: 10.1016/j.socscimed.2024.116651] [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: 06/28/2023] [Revised: 12/27/2023] [Accepted: 02/02/2024] [Indexed: 02/12/2024]
Abstract
COVID-19 and its associated restrictions presented unprecedented challenges for those in the helping professions. In this study, we seek to understand how the mental health of those who belong to one specific helping profession - clergy - changed in the context of COVID-19. Using longitudinal data of a sample of United Methodist pastors from the North Carolina Clergy Health Initiative, we conduct both cross-sectional and person-centered analyses to investigate how the overall mental health of this occupational group changed, as well as how different subgroups of clergy fared within the context of the pandemic, depending on their well-being prior to the onset of COVID-19. We found that the mental health of pastors suffered within the context of the pandemic, but that individual changes in mental health differed based on what the combined positive and negative mental health patterns of clergy were prior to the pandemic, for which we used latent class analysis to identify as Flourishing, Distressed, Languishing, or Burdened but Fulfilled. Of these subgroups, having Flourishing pre-pandemic status was protective of mental health following the onset of COVID-19, whereas the other three subgroups' mental health statuses worsened. This study is the one of the first longitudinal studies of helping professionals which has tracked changes in mental health before and after the onset of COVID-19. Our findings demonstrate the utility of considering positive and negative mental health indicators together, and they point to certain groups that can be targeted with well-being resources during future periods of acute or abnormal stress.
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Affiliation(s)
- Bo-Hyeong Jane Lee
- Duke Global Health Institute and Center for Health Policy & Inequalities Research, 310 Trent Drive, Durham, NC, 27708, USA.
| | - Anna Holleman
- Department of Sociology and Duke Global Health Institute, 417 Chapel Drive, Durham, NC, 27708, USA.
| | - Rae Jean Proeschold-Bell
- Duke Global Health Institute and Center for Health Policy & Inequalities Research, 310 Trent Drive, Durham, NC, 27708, USA.
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18
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Sun HL, Zhang Q, Si TL, Bai W, Chen P, Lam MI, Lok KI, Su Z, Cheung T, Ungvari GS, Jackson T, Sha S, Xiang YT. Interactive changes in depression and loneliness symptoms prior to and during the COVID-19 pandemic: A longitudinal network analysis. Psychiatry Res 2024; 333:115744. [PMID: 38301287 DOI: 10.1016/j.psychres.2024.115744] [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: 07/19/2023] [Accepted: 01/15/2024] [Indexed: 02/03/2024]
Abstract
OBJECTIVES Depression and loneliness co-occur frequently. This study examined interactive changes between depression and loneliness among older adults prior to and during the COVID-19 pandemic from a longitudinal network perspective. METHODS This network study was based on data from three waves (2016-2017, 2018-2019, and 2020) of the English Longitudinal Study of Ageing (ELSA). Depression and loneliness were measured with the eight-item version of the Center for Epidemiologic Studies Depression Scale (CESD-8) and three item version of the University of California Los Angeles (UCLA) Loneliness Scale, respectively. A network model was constructed using an Ising Model while network differences were assessed using a Network Comparison Test. Central symptoms were identified via Expected Influence (EI). RESULTS A total of 4,293 older adults were included in this study. The prevalence and network of depression and loneliness did not change significantly between the baseline and pre-pandemic assessments but increased significantly from the pre-pandemic assessment to during COVID-19 assessment. The central symptom with the strongest increase from pre-pandemic to pandemic assessments was "Inability to get going" (CESD8) and the edge with the highest increase across depression-loneliness symptom communities was "Lack companionship" (UCLA1) - "Inability to get going" (CESD8). Finally, "Feeling depressed" (CESD1) and "Everything was an effort" (CESD2) were the most central symptoms over the three assessment periods. CONCLUSIONS The COVID-19 pandemic was associated with significant changes in the depression-loneliness network model. The most changed symptoms and edges could be treatment targets for reducing the risk of depression and loneliness in older adults.
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Affiliation(s)
- He-Li Sun
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
| | - Qinge Zhang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Tong Leong Si
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Wei Bai
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
| | - Pan Chen
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
| | - Mei Ieng Lam
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Kiang Wu Nursing College of Macau, Macau SAR, China
| | - Ka-In Lok
- Faculty of Health Sciences and Sports, Macao Polytechnic University, Macao SAR, China
| | - Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Gabor S Ungvari
- University of Notre Dame Australia, Fremantle, Australia; Division of Psychiatry, School of Medicine, University of Western Australia, Perth, Australia
| | - Todd Jackson
- Department of Psychology, University of Macau, Macao SAR, China
| | - Sha Sha
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China.
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19
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Thomson RM, Kopasker D, Bronka P, Richiardi M, Khodygo V, Baxter AJ, Igelström E, Pearce A, Leyland AH, Katikireddi SV. Short-term impacts of Universal Basic Income on population mental health inequalities in the UK: A microsimulation modelling study. PLoS Med 2024; 21:e1004358. [PMID: 38437214 PMCID: PMC10947674 DOI: 10.1371/journal.pmed.1004358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 03/18/2024] [Accepted: 02/05/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Population mental health in the United Kingdom (UK) has deteriorated, alongside worsening socioeconomic conditions, over the last decade. Policies such as Universal Basic Income (UBI) have been suggested as an alternative economic approach to improve population mental health and reduce health inequalities. UBI may improve mental health (MH), but to our knowledge, no studies have trialled or modelled UBI in whole populations. We aimed to estimate the short-term effects of introducing UBI on mental health in the UK working-age population. METHODS AND FINDINGS Adults aged 25 to 64 years were simulated across a 4-year period from 2022 to 2026 with the SimPaths microsimulation model, which models the effects of UK tax/benefit policies on mental health via income, poverty, and employment transitions. Data from the nationally representative UK Household Longitudinal Study were used to generate the simulated population (n = 25,000) and causal effect estimates. Three counterfactual UBI scenarios were modelled from 2023: "Partial" (value equivalent to existing benefits), "Full" (equivalent to the UK Minimum Income Standard), and "Full+" (retaining means-tested benefits for disability, housing, and childcare). Likely common mental disorder (CMD) was measured using the General Health Questionnaire (GHQ-12, score ≥4). Relative and slope indices of inequality were calculated, and outcomes stratified by gender, age, education, and household structure. Simulations were run 1,000 times to generate 95% uncertainty intervals (UIs). Sensitivity analyses relaxed SimPaths assumptions about reduced employment resulting from Full/Full+ UBI. Partial UBI had little impact on poverty, employment, or mental health. Full UBI scenarios practically eradicated poverty but decreased employment (for Full+ from 78.9% [95% UI 77.9, 79.9] to 74.1% [95% UI 72.6, 75.4]). Full+ UBI increased absolute CMD prevalence by 0.38% (percentage points; 95% UI 0.13, 0.69) in 2023, equivalent to 157,951 additional CMD cases (95% UI 54,036, 286,805); effects were largest for men (0.63% [95% UI 0.31, 1.01]) and those with children (0.64% [95% UI 0.18, 1.14]). In our sensitivity analysis assuming minimal UBI-related employment impacts, CMD prevalence instead fell by 0.27% (95% UI -0.49, -0.05), a reduction of 112,228 cases (95% UI 20,783, 203,673); effects were largest for women (-0.32% [95% UI -0.65, 0.00]), those without children (-0.40% [95% UI -0.68, -0.15]), and those with least education (-0.42% [95% UI -0.97, 0.15]). There was no effect on educational mental health inequalities in any scenario, and effects waned by 2026. The main limitations of our methods are the model's short time horizon and focus on pathways from UBI to mental health solely via income, poverty, and employment, as well as the inability to integrate macroeconomic consequences of UBI; future iterations of the model will address these limitations. CONCLUSIONS UBI has potential to improve short-term population mental health by reducing poverty, particularly for women, but impacts are highly dependent on whether individuals choose to remain in employment following its introduction. Future research modelling additional causal pathways between UBI and mental health would be beneficial.
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Affiliation(s)
- Rachel M. Thomson
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland, United Kingdom
| | - Daniel Kopasker
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland, United Kingdom
| | - Patryk Bronka
- Institute for Social and Economic Research, University of Essex, Essex, England, United Kingdom
| | - Matteo Richiardi
- Institute for Social and Economic Research, University of Essex, Essex, England, United Kingdom
| | - Vladimir Khodygo
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland, United Kingdom
| | - Andrew J. Baxter
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland, United Kingdom
| | - Erik Igelström
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland, United Kingdom
| | - Anna Pearce
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland, United Kingdom
| | - Alastair H. Leyland
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland, United Kingdom
| | - S. Vittal Katikireddi
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland, United Kingdom
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20
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Yin Z, Wang X, Lu X, Fu H. Hospital pharmacists' mental health during home isolation in the post-pandemic era of COVID-19: influencing factors, coping strategies, and the mediating effect of resilience. Front Public Health 2024; 12:1268638. [PMID: 38356948 PMCID: PMC10864583 DOI: 10.3389/fpubh.2024.1268638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 01/16/2024] [Indexed: 02/16/2024] Open
Abstract
Objective There is a notable research gap on the mental health challenges faced by hospital pharmacists in the post-pandemic era. Therefore, the present study aims to explore mental health status, influencing factors, coping strategies, and the mediating effect of resilience of home quarantine hospital pharmacists (HQHPs). Methods An embedded mixed-method study was conducted in Zhengzhou, a megalopolis in central China, from 20 October to 3 November 2022. For the qualitative study, semi-structured interviews and focus group discussions were conducted among HQHPs to understand their mental health state,the factors that affect their mental health, and the alleviating strategies they used. For the quantitative study, the Generalized Anxiety Disorder Scale (GAD-7) and the Chinese version of the Connor-Davidson Resilience Scale (CD-RISC-25) were used to explore the mental health level of HQHPs. Meanwhile, the mediating effect of resilience was explored and verified with the bootstrap method or the structural equation model. Results 20 HQHPs participated in the qualitative study. Two themes were identified in terms of the factors that influenced the HQHPs' mental health levels. The positive factors include optimism, family company, and connection with friends, while the negative factors include inadequate supplies, inadequate information, and other emergencies. 210 HQHPs participated in the quantitative study, with a median resilience score of 66 [55.75, 74] in the lowest score range and an anxiety score of 5 [2, 7] in the mild anxiety range. The correlation analysis showed that nine of the 10 influencing factors identified in qualitative research were positively correlated with CD-RISC-25 scores and negatively correlated with the GAD-7 score. The mediating effect of resilience on anxiety was significant (95% bootstrap CI [-1.818, -0.384], p<0.001; or 95% bootstrap CI [-1.174, -0.430], p<0.001). Conclusion Even in the post-epidemic era, hospital pharmacists face psychological challenges. They actively address these issues based on accumulated experience and a stabilized mindset. In this process, resilience plays a significant mediating role.
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Affiliation(s)
- Zhao Yin
- Institute for Hospital Management of Henan Province, Zhengzhou, China
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - XiangYu Wang
- Beijing Chaoyang Hospital, Party Committee Office, Beijing, China
| | - Xiaojing Lu
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Drug Clinical Comprehensive Evaluation Center, Zhengzhou, China
| | - Hang Fu
- Institute for Hospital Management of Henan Province, Zhengzhou, China
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21
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Wirkner J, Brakemeier EL. The crisis is over, long live the crisis: mental health in emerging adulthood during the course of the COVID-19 pandemic. Front Psychol 2024; 15:1283919. [PMID: 38356763 PMCID: PMC10864646 DOI: 10.3389/fpsyg.2024.1283919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 01/16/2024] [Indexed: 02/16/2024] Open
Abstract
Introduction As a multidimensional stressor, the COVID-19 pandemic posed a significant threat to mental health, with studies showing younger age groups to be particularly vulnerable. Thus, this study aimed to monitor mental health, potential risk/protective factors, and pandemic-related variables among young university students during the pandemic. Methods Students of the University of Greifswald (M age = 23.0 years, 73.9% female) participated in five cross-sectional online surveys in December 2020 (N = 1,127), March 2021 (N = 760), June/July 2021 (N = 531), December 2021 (N = 1,226), and December 2022 (N = 814). Sociodemographic data, depression and anxiety severity, loneliness, quality of life, coping strategies, resilience, self-esteem, and emotion regulation were measured. First, results from December 2020 were compared to pre-pandemic normative data. Second, the time course during the pandemic was analyzed. Third, linear models were calculated to examine the influence of risk and protective factures on depression and anxiety severity. Results Higher levels of depression, anxiety, and loneliness, as well as lower levels of self-esteem, physical and mental health, social relationships and well-being were found in December 2020 compared to pre-pandemic. Levels of depression and anxiety severity peaked in December 2022. Female sex, loneliness, and previous mental treatment showed associations with higher depression and anxiety severity, while higher self-esteem, resilience and use of reappraisal strategies appeared to act as protective factors. Discussion The study indicates the pandemic's detrimental impact on students' mental health and quality of life. Identified risk and protective factors provide guidance for tailored prevention and treatment, as well as the design of measures for future pandemics and other crisis.
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Affiliation(s)
| | - Eva-Lotta Brakemeier
- Department for Clinical Psychology and Psychotherapy, Institute for Psychology, University of Greifswald, Greifswald, Germany
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22
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Porter A, Franklin M, De Vocht F, d'Apice K, Curtin E, Albers P, Kidger J. Estimating the effectiveness of an enhanced 'Improving Access to Psychological Therapies' (IAPT) service addressing the wider determinants of mental health: a real-world evaluation. BMJ Open 2024; 14:e077220. [PMID: 38296286 PMCID: PMC10828880 DOI: 10.1136/bmjopen-2023-077220] [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: 06/30/2023] [Accepted: 12/22/2023] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Addressing the wider determinants of mental health alongside psychological therapy could improve mental health service outcomes and population mental health. OBJECTIVES To estimate the effectiveness of an enhanced 'Improving Access to Psychological Therapies' (IAPT) mental health service compared with traditional IAPT in England. Alongside traditional therapy treatment, the enhanced service included well-being support and community service links. DESIGN A real-world evaluation using IAPT's electronic health records. SETTING Three National Health Service IAPT services in England. PARTICIPANTS Data from 17 642 service users classified as having a case of depression and/or anxiety at baseline. INTERVENTION We compared the enhanced IAPT service (intervention) to an IAPT service in a different region providing traditional treatment only (geographical control), and the IAPT service with traditional treatment before additional support was introduced (historical control). PRIMARY OUTCOME MEASURES Patient Health Questionnaire-9 (PHQ-9) Depression Scale (score range: 0-27) and Generalised Anxiety Disorder-7 (GAD-7) Anxiety Scale (score range: 0-21); for both, lower scores indicate better mental health. Propensity scores were used to estimate inverse probability of treatment weights, subsequently used in mixed effects regression models. RESULTS Small improvements (mean, 95% CI) were observed for PHQ-9 (depression) (-0.21 to -0.32 to -0.09) and GAD-7 (anxiety) (-0.23 to -0.34 to -0.13) scores in the intervention group compared with the historical control. There was little evidence of statistically significant differences between intervention control and geographical control. CONCLUSIONS Embedding additional health and well-being (H&W) support into standard IAPT services may lead to improved mental health outcomes. However, the lack of improved outcomes compared with the geographical control may instead reflect a more general improvement to the intervention IAPT service. It is not clear from our findings whether an IAPT service with additional H&W support is clinically superior to traditional IAPT models.
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Affiliation(s)
- Alice Porter
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Matthew Franklin
- Health Economic and Decision Science, The University of Sheffield, Sheffield, UK
| | - Frank De Vocht
- Population Health Sciences, University of Bristol, Bristol, UK
- NIHR Applied Research Collaboration West (NIHR ARC West), Bristol, UK
| | - Katrina d'Apice
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Esther Curtin
- Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Patricia Albers
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Judi Kidger
- Population Health Sciences, University of Bristol, Bristol, UK
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23
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Nichols E, Petrosyan S, Khobragade P, Banerjee J, Angrisani M, Dey S, Bloom DE, Schaner S, Dey AB, Lee J. Trajectories and correlates of poor mental health in India over the course of the COVID-19 pandemic: a nationwide survey. BMJ Glob Health 2024; 9:e013365. [PMID: 38286516 PMCID: PMC10826618 DOI: 10.1136/bmjgh-2023-013365] [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: 07/09/2023] [Accepted: 12/20/2023] [Indexed: 01/31/2024] Open
Abstract
INTRODUCTION The COVID-19 pandemic had large impacts on mental health; however, most existing evidence is focused on the initial lockdown period and high-income contexts. By assessing trajectories of mental health symptoms in India over 2 years, we aim to understand the effect of later time periods and pandemic characteristics on mental health in a lower-middle income context. METHODS We used data from the Real-Time Insights of COVID-19 in India cohort study (N=3709). We used covariate-adjusted linear regression models with generalised estimating equations to assess associations between mental health (Patient Health Questionnaire (PHQ-4) score; range 0-12) and pandemic periods as well as pandemic characteristics (COVID-19 cases and deaths, government stringency, self-reported financial impact, COVID-19 infection in the household) and explored effect modification by age, gender and rural/urban residence. RESULTS Mental health symptoms dropped immediately following the lockdown period but rose again during the delta and omicron waves. Associations between mental health and later pandemic stages were stronger for adults 45 years of age and older (p<0.001). PHQ-4 scores were significantly associated with all pandemic characteristics considered, including estimated COVID-19 deaths (PHQ-4 difference of 0.10 units; 95% CI 0.06 to 0.13), government stringency index (0.14 units; 95% CI 0.11 to 0.18), self-reported major financial impacts (1.20 units; 95% CI 1.09 to 1.32) and COVID-19 infection in the household (0.36 units; 95% CI 0.23 to 0.50). CONCLUSION While the lockdown period and associated financial stress had the largest mental health impacts on Indian adults, the effects of the pandemic on mental health persisted over time, especially among middle-aged and older adults. Results highlight the importance of investments in mental health supports and services to address the consequences of cyclical waves of infections and disease burden due to COVID-19 or other emerging pandemics.
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Affiliation(s)
- Emma Nichols
- Center for Economic and Social Research, University of Southern California, Los Angeles, California, USA
| | - Sarah Petrosyan
- Center for Economic and Social Research, University of Southern California, Los Angeles, California, USA
| | - Pranali Khobragade
- Center for Economic and Social Research, University of Southern California, Los Angeles, California, USA
| | - Joyita Banerjee
- Center for Economic and Social Research, University of Southern California, Los Angeles, California, USA
| | - Marco Angrisani
- Center for Economic and Social Research, University of Southern California, Los Angeles, California, USA
- Department of Economics, University of Southern California, Los Angeles, California, USA
| | - Sharmistha Dey
- All India Institute of Medical Sciences, New Delhi, India
| | - David E Bloom
- Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Simone Schaner
- Center for Economic and Social Research, University of Southern California, Los Angeles, California, USA
- Department of Economics, University of Southern California, Los Angeles, California, USA
| | - Aparajit B Dey
- Geriatric Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Jinkook Lee
- Center for Economic and Social Research, University of Southern California, Los Angeles, California, USA
- Department of Economics, University of Southern California, Los Angeles, California, USA
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24
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Lossio-Ventura JA, Weger R, Lee AY, Guinee EP, Chung J, Atlas L, Linos E, Pereira F. A Comparison of ChatGPT and Fine-Tuned Open Pre-Trained Transformers (OPT) Against Widely Used Sentiment Analysis Tools: Sentiment Analysis of COVID-19 Survey Data. JMIR Ment Health 2024; 11:e50150. [PMID: 38271138 PMCID: PMC10813836 DOI: 10.2196/50150] [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: 06/21/2023] [Revised: 11/16/2023] [Accepted: 11/17/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Health care providers and health-related researchers face significant challenges when applying sentiment analysis tools to health-related free-text survey data. Most state-of-the-art applications were developed in domains such as social media, and their performance in the health care context remains relatively unknown. Moreover, existing studies indicate that these tools often lack accuracy and produce inconsistent results. OBJECTIVE This study aims to address the lack of comparative analysis on sentiment analysis tools applied to health-related free-text survey data in the context of COVID-19. The objective was to automatically predict sentence sentiment for 2 independent COVID-19 survey data sets from the National Institutes of Health and Stanford University. METHODS Gold standard labels were created for a subset of each data set using a panel of human raters. We compared 8 state-of-the-art sentiment analysis tools on both data sets to evaluate variability and disagreement across tools. In addition, few-shot learning was explored by fine-tuning Open Pre-Trained Transformers (OPT; a large language model [LLM] with publicly available weights) using a small annotated subset and zero-shot learning using ChatGPT (an LLM without available weights). RESULTS The comparison of sentiment analysis tools revealed high variability and disagreement across the evaluated tools when applied to health-related survey data. OPT and ChatGPT demonstrated superior performance, outperforming all other sentiment analysis tools. Moreover, ChatGPT outperformed OPT, exhibited higher accuracy by 6% and higher F-measure by 4% to 7%. CONCLUSIONS This study demonstrates the effectiveness of LLMs, particularly the few-shot learning and zero-shot learning approaches, in the sentiment analysis of health-related survey data. These results have implications for saving human labor and improving efficiency in sentiment analysis tasks, contributing to advancements in the field of automated sentiment analysis.
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Affiliation(s)
| | - Rachel Weger
- School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Angela Y Lee
- Department of Communication, Stanford University, Stanford, CA, United States
| | - Emily P Guinee
- National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States
| | - Joyce Chung
- National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States
| | - Lauren Atlas
- National Center For Complementary and Alternative Medicine, National Institutes of Health, Bethesda, MD, United States
| | - Eleni Linos
- School of Medicine, Stanford University, Stanford, CA, United States
| | - Francisco Pereira
- National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States
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25
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Nikelski A, Trompetter EM, Boekholt M, Schumacher-Schönert F, Rädke A, Michalowsky B, Vollmar HC, Hoffmann W, Driessen M, Thyrian JR, Kreisel SH. [Everyday Life and Mental Health of Elderly with Cognitive Impairment During the Covid-19 Pandemic]. PSYCHIATRISCHE PRAXIS 2024. [PMID: 38272039 DOI: 10.1055/a-2230-2873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
OBJECTIVE The aim is to analyze pandemic-related effects on everyday life and psychosocial health in the understudied vulnerable group of cognitively impaired elderly people living at home. METHODS Structured telephone interviews in 2020 (n+=+141) and 2021 (n+=+107) were used to survey over-65s with cognitive impairment (MMSE Ø 23.4). The results from the 2021 survey presented here reflect experiences and attitudes, effects on daily life and health care, and psychosocial burdens and resources. Longitudinal analysis of selected indicators of burden is provided for n+=+66. RESULTS Even in the face of increasing concerns and moderate impacts on everyday life and health care, overall psychosocial health is proving to be good and largely stable over time. CONCLUSION Respondents have high levels of personal and social resources, and their coping with limitations is characterized by acceptance and willingness to adapt.
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Affiliation(s)
- Angela Nikelski
- Abteilung für Gerontopsychiatrie, Universitätsklinik für Psychiatrie und Psychotherapie, Evangelisches Klinikum Bethel gGmbH, Universitätsklinikum OWL der Universität Bielefeld, Bielefeld
| | - Eva M Trompetter
- Abteilung für Gerontopsychiatrie, Universitätsklinik für Psychiatrie und Psychotherapie, Evangelisches Klinikum Bethel gGmbH, Universitätsklinikum OWL der Universität Bielefeld, Bielefeld
| | - Melanie Boekholt
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), DZNE Rostock/Greifswald, Greifswald, Germany
| | - Fanny Schumacher-Schönert
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), DZNE Rostock/Greifswald, Greifswald, Germany
| | - Anika Rädke
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), DZNE Rostock/Greifswald, Greifswald, Germany
| | - Bernhard Michalowsky
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), DZNE Rostock/Greifswald, Greifswald, Germany
| | | | - Wolfgang Hoffmann
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), DZNE Rostock/Greifswald, Greifswald, Germany
- Institut für Community Medicine, Abteilung Versorgungsepidemiologie und Community Health, Universitätsmedizin Greifswald, Greifswald
| | - Martin Driessen
- Universitätsklinik für Psychiatrie und Psychotherapie, Evangelisches Klinikum Bethel gGmbH, Universitätsklinikum OWL der Universität Bielefeld
| | - Jochen René Thyrian
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), DZNE Rostock/Greifswald, Greifswald, Germany
- Institut für Community Medicine, Abteilung Versorgungsepidemiologie und Community Health, Universitätsmedizin Greifswald, Greifswald
| | - Stefan H Kreisel
- Abteilung für Gerontopsychiatrie, Universitätsklinik für Psychiatrie und Psychotherapie, Evangelisches Klinikum Bethel gGmbH, Universitätsklinikum OWL der Universität Bielefeld, Bielefeld
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26
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Yang Z, Huang J, Kwan MP, Liu D. The interplay among individuals' distress, daily activities, and perceptions of COVID-19 and neighborhood cohesion: A study using network analysis. PLoS One 2024; 19:e0293157. [PMID: 38236893 PMCID: PMC10796027 DOI: 10.1371/journal.pone.0293157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/05/2023] [Indexed: 01/22/2024] Open
Abstract
The reduction of social interactions through non-pharmaceutical interventions (NPIs) has been shown to effectively curb COVID-19 transmission. However, these control measures were often accompanied by changes in people's daily routines and constraints on their activity space, which could lead to mental distress (i.e., anxiety and depression). This study examined the interplay among individuals' anxiety, depression, daily activities, and perceptions of COVID-19 and neighborhood cohesion. Taking Hong Kong as an example, an online survey (N = 376) was conducted to collect data from participants between March 14 to May 11, 2022. The data include respondents' self-reported anxiety and depressive symptoms, daily activities (e.g., smartphone use), perceptions of COVID-19 (e.g., the possibility of infecting COVID-19), and perceptions of neighborhood cohesion. Using network analysis, we found that excessive smartphone use, life disturbance by COVID-19, and a community with people getting along well with each other were significant factors associated with participants' anxiety and depression. Using critical path analysis, we observed that NPIs reduced human mobility, led to delayed bedtime, and increased smartphone use, which were associated with participants' mental distress. We also found that NPIs and COVID-19 were associated with people's perceptions of infection and the severity of COVID-19 and human mobility flexibility, which may further lead to mental distress. Our results also demonstrated that people with high education levels were vulnerable. These results provided important insights for designing appropriate interventions without generating deleterious impacts on people's mental health in the future.
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Affiliation(s)
- Zhenchuan Yang
- Institute of Space and Earth Information Science, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Jianwei Huang
- Institute of Space and Earth Information Science, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Mei-Po Kwan
- Institute of Space and Earth Information Science, The Chinese University of Hong Kong, Shatin, Hong Kong, China
- Department of Geography and Resource Management, The Chinese University of Hong Kong, Shatin, Hong Kong, China
- Institute of Future Cities, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Dong Liu
- Institute of Space and Earth Information Science, The Chinese University of Hong Kong, Shatin, Hong Kong, China
- Institute of Future Cities, The Chinese University of Hong Kong, Shatin, Hong Kong, China
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27
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Békés V, Starrs CJ, Perry JC, Prout TA, Conversano C, Di Giuseppe M. Defense mechanisms are associated with mental health symptoms across six countries. RESEARCH IN PSYCHOTHERAPY (MILANO) 2023; 26:729. [PMID: 38226792 PMCID: PMC10849071 DOI: 10.4081/ripppo.2023.729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 11/15/2023] [Indexed: 01/17/2024]
Abstract
Defense mechanisms are adaptative processes that are related to mental health and psychological functioning and may play an important role in adaptation to distress, as well as in mental health interventions. The present study aimed to compare the use of defense mechanisms and their relationship to mental health symptoms across six countries. In a large-scale descriptive study, we collected data from community- based individuals (N=19,860) in the United States, Australia, Canada, Germany, Italy, and the United Kingdom about the use of defense mechanisms and experienced mental health symptoms during the early phase of the pandemic. We found that the use of defense mechanism categories was similar across countries. Moreover, lower defensive functioning, specifically, neurotic and immature defenses were related to experiencing higher distress across countries, whereas mature defenses were generally inversely related to symptoms. Furthermore, these findings were relatively similar across the six countries. Cross-cultural research on defense mechanisms and mental health has important clinical implications. Our results are consistent with the goal of promoting more adaptive defensive functioning to increase psychological well-being and mitigate the detrimental impact of situational stress.
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Affiliation(s)
- Vera Békés
- Yeshiva University, Ferkauf Graduate School of Psychology, New York, NY.
| | - Claire J Starrs
- University of Quebec in Montreal (UQAM), Department of Psychology, Montreal, QC.
| | - J Christopher Perry
- McGill University, Department of Psychiatry at the Insitute of Community & Family Psychiatry, Jewish General Hospital, Montreal, QC.
| | - Tracy A Prout
- Yeshiva University, Ferkauf Graduate School of Psychology, New York, NY.
| | - Ciro Conversano
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa.
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28
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Luo H, Luo D, Tang Q, Niu Z, Xu J, Li J. The combined impact of social networks and connectedness on anxiety, stress, and depression during COVID-19 quarantine: a retrospective observational study. Front Public Health 2023; 11:1298693. [PMID: 38169600 PMCID: PMC10758457 DOI: 10.3389/fpubh.2023.1298693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 12/01/2023] [Indexed: 01/05/2024] Open
Abstract
Introduction The COVID-19 pandemic and associated quarantine measures have precipitated a surge in mental health disorders, particularly depression and anxiety. Government policies and restrictions on physical activity have contributed to this phenomenon, as well as diminished subjective social connectedness and exacerbated objective social isolation. As two dimensions of social isolation, it is worth noting that subjectively perceived social connectedness serves as a protective factor for mental health, whereas the decline in the size of objectively evaluated social networks poses a significant risk. However, research investigating the combined influence of these two dimensions remains limited. Methods This study used an online survey to collect data to investigate the effects of objective social connectedness and objective social networks on anxiety, stress, and depression during COVID-19 quarantine. A total of 485 participants were analyzed using statistical methods, including paired t-test, Pearson correlation analysis, linear regression, cluster analysis, ANOVA, and moderated mediated. Results The study found that anxiety and depression scores increased during the quarantine, with age, education, and social connectedness scores associated with the increase. Pre-quarantine anxiety and depression levels were strongly correlated with mental health status during quarantine. Cluster analysis, respectively, revealed three clusters for those without increasing anxiety and depression scores. The study also found that objective social network influences the impact of subjective social connectedness on pre-quarantine mental health, which in turn affects anxiety and depression levels during quarantine. Conclusion The study identified that quarantine increased anxiety and depression, with age being protective, and education and subjective social connectedness as risk factors. The study also emphasizes the comprehensive impact of objective and subjective social isolation. Although individuals perceive the same degree of social connectedness, those with smaller social networks are more prone to developing symptoms of anxiety and depression, which are also more likely to worsen during quarantine.
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Affiliation(s)
| | | | | | | | - Jiajun Xu
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Jing Li
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
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29
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Botha F, Morris RW, Butterworth P, Glozier N. Generational differences in mental health trends in the twenty-first century. Proc Natl Acad Sci U S A 2023; 120:e2303781120. [PMID: 38011547 PMCID: PMC10710089 DOI: 10.1073/pnas.2303781120] [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: 03/06/2023] [Accepted: 09/27/2023] [Indexed: 11/29/2023] Open
Abstract
Given the observed deterioration in mental health among Australians over the past decade, this study investigates to what extent this differs in people born in different decades-i.e., possible birth cohort differences in the mental health of Australians. Using 20 y of data from a large, nationally representative panel survey (N = 27,572), we find strong evidence that cohort effects are driving the increase in population-level mental ill-health. Deteriorating mental health is particularly pronounced among people born in the 1990s and seen to a lesser extent among the 1980s cohort. There is little evidence that mental health is worsening with age for people born prior to the 1980s. The findings from this study highlight that it is the poorer mental health of Millennials that is driving the apparent deterioration in population-level mental health. Understanding the context and changes in society that have differentially affected younger people may inform efforts to ameliorate this trend and prevent it continuing for emerging cohorts.
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Affiliation(s)
- Ferdi Botha
- Australian Research Council Centre of Excellence for Children and Families over the Life Course, University of Queensland, Brisbane, QLD4068, Australia
- Melbourne Institute: Applied Economic & Social Research, The University of Melbourne, Melbourne, VIC3052, Australia
| | - Richard W. Morris
- Australian Research Council Centre of Excellence for Children and Families over the Life Course, University of Queensland, Brisbane, QLD4068, Australia
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW2006, Australia
| | - Peter Butterworth
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, ACT0200, Australia
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, VIC3125, Australia
| | - Nick Glozier
- Australian Research Council Centre of Excellence for Children and Families over the Life Course, University of Queensland, Brisbane, QLD4068, Australia
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW2006, Australia
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30
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Chen Z, Cong Z. Age Differences in Psychological Distress After Multiple Disaster Exposures: The Effect of Multidimensional Negative COVID-19 Impacts. Disaster Med Public Health Prep 2023; 17:e554. [PMID: 38044831 DOI: 10.1017/dmp.2023.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
OBJECTIVE This study examined how the multidimensional negative coronavirus disease (COVID-19) impacts contextualized the age differences in psychological distress following exposures to tornadoes and the COVID-19 pandemic. METHODS Data were from a 2-wave panel study conducted at T1 (October 2020-August 2021) and T2 (May-August 2022). Latent class analysis was conducted to explore the patterns of negative COVID-19 impacts based on a sample of 1134 at T1. Negative binomial regressions were performed to examine the age differences in psychological distress at T2, based on the working sample (N = 554), as well as the moderating effect of identified class membership, with baseline psychological distress controlled. RESULTS Three latent classes were identified: class 1 "low overall impacts," class 2 "moderate overall impacts with high emotional distress," and class 3 "severe overall impacts." Individuals ages 65 and over reported lower psychological distress at T2 relative to those ages 18-34 and 35-49. However, compared to people ages 18-34, 35-49, and 50-64, those ages 65 and over reported the greatest increases in T2 psychological distress if they had experienced moderate or severe overall COVID-19 impacts at T1. CONCLUSION There is a pressing need for mental health interventions that are tailored to multi-disaster scenarios and age-related differences in long-term disaster recovery.
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Affiliation(s)
- Zhirui Chen
- Environmental Health Sciences, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Zhen Cong
- Environmental Health Sciences, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
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31
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Durmuş V. The prevalence of mental distress changes before and during the COVID-19 pandemic: a study on physicians in Turkey. J Ment Health 2023; 32:1096-1104. [PMID: 35506439 DOI: 10.1080/09638237.2022.2069704] [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: 05/27/2021] [Revised: 04/06/2022] [Accepted: 04/16/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND The emergence of the COVID-19 pandemic may adversely affect the physicians' mental health differently. AIMS This study aimed to investigate the degree of changes in mental distress in physicians through two cross-sectional studies before and during the COVID-19 pandemic and explore factors associated with the change of mental distress status of participants between two-time periods. METHODS This cross-sectional, web-based survey collected demographic data and mental health measurements with the 12-item General Health Questionnaire from 416 and 522 physicians before and during COVID-19, respectively. Mixed-effects ordinal logistic regression analyses were performed to assess the factors associated with the change of mental distress status. RESULTS During the outbreak, a total of 319 of the 522 participants reported a clinically significant level of mental distress compared with 123 of 416 participants before COVID-19. Higher levels of mental distress were observed in all socio-demographic groups during COVID-19 compared with before, with more than two-fold higher prevalence of mental health deterioration in general. CONCLUSIONS This study suggests a significant deterioration in mental health status after the occurrence of COVID-19 compared with before. The mental health of physicians working in all medical specialty groups, especially those in internal and surgical specialties, may require special attention.
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Affiliation(s)
- Veli Durmuş
- Institute of Health Sciences, Marmara University, Istanbul, Turkey
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Parsons CE, Purves KL, Davies MR, Mundy J, Bristow S, Eley TC, Breen G, Hirsch CR, Young KS. Seeking help for mental health during the COVID-19 pandemic: A longitudinal analysis of adults' experiences with digital technologies and services. PLOS DIGITAL HEALTH 2023; 2:e0000402. [PMID: 38055730 DOI: 10.1371/journal.pdig.0000402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 11/04/2023] [Indexed: 12/08/2023]
Abstract
The COVID-19 pandemic brought about dramatic changes in how patients access healthcare from its outset. Lockdown restrictions and remote working led to a proliferation of digital technologies and services, which also impacted mental health provisions. Against the backdrop of new and changing support services, along with an unprecedented emphasis on mental health, relatively little is known about how adults sought out and received support for their mental health during this period. With a sample of 27,574 adults assessed longitudinally online over 12 months of the pandemic in the UK, we analysed reports of help-seeking for mental health, as well as sources of treatment or support and the perceived helpfulness of treatments received. We observed that the proportions of participants who reported seeking help remained relatively consistent throughout the 12-month period (ranging from 12.6% to 17.0%). Online talking therapies were among the most frequently sought sources (15.3%), whereas online self-guided treatments were among the least frequently sought sources (5%). Telephone lines, both NHS and non-governmental, had marked treatment 'gaps'. These treatment gaps, where individuals sought treatment but did not receive it, were especially evident for men and older adults. Our findings underscore online talking therapies as being a widely-sought and helpful source of mental health support. This is important given the current global need for accessible treatment options.
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Affiliation(s)
- Christine E Parsons
- Department of Clinical Medicine, Interacting Minds Center, Aarhus University, Aarhus, Denmark
| | - Kirstin L Purves
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
- NIHR Maudsley Biomedical Research Centre, King's College London, United Kingdom
| | - Molly R Davies
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
- NIHR Maudsley Biomedical Research Centre, King's College London, United Kingdom
| | - Jessica Mundy
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Shannon Bristow
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
- NIHR Maudsley Biomedical Research Centre, King's College London, United Kingdom
| | - Thalia C Eley
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
- NIHR Maudsley Biomedical Research Centre, King's College London, United Kingdom
| | - Gerome Breen
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
- NIHR Maudsley Biomedical Research Centre, King's College London, United Kingdom
| | - Colette R Hirsch
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Katherine S Young
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
- NIHR Maudsley Biomedical Research Centre, King's College London, United Kingdom
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Bosma E, Feenstra V, van Oostrom SH. Anxiety among healthcare workers during the COVID-19 pandemic: a longitudinal study. Front Public Health 2023; 11:1236931. [PMID: 38098835 PMCID: PMC10720981 DOI: 10.3389/fpubh.2023.1236931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 11/06/2023] [Indexed: 12/17/2023] Open
Abstract
Background During the COVID-19 pandemic, many healthcare workers faced extreme working conditions and were at higher risk of infection with the coronavirus. These circumstances may have led to mental health problems, such as anxiety, among healthcare workers. Most studies that examined anxiety among healthcare workers during the COVID-19 pandemic were cross-sectional and focused on the first months of the pandemic only. Therefore, this study aimed to investigate the longitudinal association between working in healthcare and anxiety during a long-term period (i.e., 18 months) of the COVID-19 pandemic. Methods Data were used from online questionnaires of the Lifelines COVID-19 prospective cohort with 22 included time-points (March 2020-November 2021). In total, 2,750 healthcare workers and 9,335 non-healthcare workers were included. Anxiety was assessed with questions from the Mini-International Neuropsychiatric Interview, and an anxiety sum score (0-7) was calculated. Negative binomial generalized estimating equations (GEE), adjusted for demographic, work and health covariates, were used to examine the association between working in healthcare and anxiety. Results Anxiety sum scores over time during the COVID-19 pandemic were similar for healthcare workers and non-healthcare workers. No differences between the anxiety sum scores of healthcare workers and non-healthcare workers were found [incidence rate ratio (IRR) = 0.97, 95% CI = 0.91-1.04]. Conclusion This study did not find differences between healthcare workers and non-healthcare in perceived anxiety during the COVID-19 pandemic.
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Affiliation(s)
- Esmee Bosma
- Center for Prevention, Lifestyle and Health, Department Behavior and Health, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Verena Feenstra
- Center for Prevention, Lifestyle and Health, Department Behavior and Health, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Sandra H. van Oostrom
- Center for Prevention, Lifestyle and Health, Department Behavior and Health, National Institute for Public Health and the Environment, Bilthoven, Netherlands
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Wu Y, Wang L, Tao M, Cao H, Yuan H, Ye M, Chen X, Wang K, Zhu C. Changing trends in the global burden of mental disorders from 1990 to 2019 and predicted levels in 25 years. Epidemiol Psychiatr Sci 2023; 32:e63. [PMID: 37933540 PMCID: PMC10689059 DOI: 10.1017/s2045796023000756] [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: 03/06/2023] [Revised: 09/05/2023] [Accepted: 10/11/2023] [Indexed: 11/08/2023] Open
Abstract
AIMS The burden of mental disorders is increasing worldwide, thus, affecting society and healthcare systems. This study investigated the independent influences of age, period and cohort on the global prevalence of mental disorders from 1990 to 2019; compared them by sex; and predicted the future burden of mental disorders in the next 25 years. METHODS The age-specific and sex-specific incidence of mental disorders worldwide was analysed according to the general analysis strategy used in the Global Burden of Disease Study in 2019. The incidence and mortality trends of mental disorders from 1990 to 2019 were evaluated through joinpoint regression analysis. The influences of age, period and cohort on the incidence of mental disorders were evaluated with an age-period-cohort model. RESULTS From 1990 to 2019, the sex-specific age-standardized incidence and disability-adjusted life years (DALY) rate decreased slightly. Joinpoint regression analysis from 1990 to 2019 indicated four turning points in the male DALY rate and five turning points in the female DALY rate. In analysis of age effects, the relative risk (RR) of incidence and the DALY rate in mental disorders in men and women generally showed an inverted U-shaped pattern with increasing age. In analysis of period effects, the incidence of mental disorders increased gradually over time, and showed a sub-peak in 2004 (RR, 1.006 for males; 95% CI, 1.000-1.012; 1.002 for women, 0.997-1.008). Analysis of cohort effects showed that the incidence and DALY rate decreased in successive birth cohorts. The incidence of mental disorders is expected to decline slightly over the next 25 years, but the number of cases is expected to increase. CONCLUSIONS Although the age-standardized burden of mental disorders has declined in the past 30 years, the number of new cases and deaths of mental disorders worldwide has increased, and will continue to increase in the near future. Therefore, relevant policies should be used to promote the prevention and management of known risk factors and strengthen the understanding of risk profiles and incidence modes of mental disorders, to help guide future research on control and prevention strategies.
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Affiliation(s)
- Yang Wu
- Health Management Center, Yijishan Hospital of Wannan Medical College, Wuhu, 241001, China
| | - Lu Wang
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
- Collaborative Innovation Center for Neuropsychiatric Disorders and Mental Health, Hefei, China
| | - Mengjun Tao
- Health Management Center, Yijishan Hospital of Wannan Medical College, Wuhu, 241001, China
| | - Huiru Cao
- Department of Gastroenterology, Yijishan Hospital of Wannan Medical College, Wuhu, China
| | - Hui Yuan
- School of Public Health, Wannan Medical College, Wuhu, China
| | - Mingquan Ye
- School of Medical Information, Wannan Medical College, Wuhu, China
| | - Xingui Chen
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
- Collaborative Innovation Center for Neuropsychiatric Disorders and Mental Health, Hefei, China
| | - Kai Wang
- Department of Gastroenterology, Yijishan Hospital of Wannan Medical College, Wuhu, China
- School of Public Health, Wannan Medical College, Wuhu, China
- School of Medical Information, Wannan Medical College, Wuhu, China
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Chunyan Zhu
- Department of Gastroenterology, Yijishan Hospital of Wannan Medical College, Wuhu, China
- School of Public Health, Wannan Medical College, Wuhu, China
- School of Medical Information, Wannan Medical College, Wuhu, China
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
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Nguyen T, Zillich L, Cetin M, Hall ASM, Foo JC, Sirignano L, Frank J, Send TS, Gilles M, Rietschel M, Deuschle M, Witt SH, Streit F. Psychological, endocrine and polygenic predictors of emotional well-being during the COVID-19 pandemic in a longitudinal birth cohort. Stress 2023; 26:2234060. [PMID: 37519130 DOI: 10.1080/10253890.2023.2234060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 07/03/2023] [Indexed: 08/01/2023] Open
Abstract
The COVID-19 pandemic severely affected the lives of families and the well-being of both parents and their children. Various factors, including prenatal stress, dysregulated stress response systems, and genetics may have influenced how the stress caused by the pandemic impacted the well-being of different family members. The present work investigated if emotional well-being during the COVID-19 pandemic could be predicted by developmental stress-related and genetic factors. Emotional well-being of 7-10 year-old children (n = 263) and mothers (n = 241) (participants in a longitudinal German birth cohort (POSEIDON)) was assessed during the COVID-19 pandemic using the CRISIS questionnaire at two time periods (July 2020-October 2020; November 2020-February 2021). Associations of the children's and mothers' well-being with maternal perceived stress, of the children's well-being with their salivary and morning urine cortisol at 45 months, and polygenic risk scores (PRSs) for depression, schizophrenia, loneliness were investigated. Lower emotional well-being was observed in both children and mothers during compared to before the pandemic, with the children's but not the mothers' emotional well-being improving over the course of the pandemic. A positive association between the child and maternal emotional well-being was found. Prenatally assessed maternal perceived stress was associated with a lower well-being in children, but not in mothers. Cortisol measures and PRSs were not significantly associated with the children's emotional well-being. The present study confirms that emotional well-being of children and mothers are linked, and were negatively affected by the COVID-19 pandemic, with differences in development over time.
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Affiliation(s)
- Thao Nguyen
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Lea Zillich
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Metin Cetin
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Alisha S M Hall
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Jerome C Foo
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
- Institute for Psychopharmacology, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Lea Sirignano
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Josef Frank
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Tabea S Send
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Maria Gilles
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Michael Deuschle
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Stephanie H Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
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Miao R, Liu C, Zhang J, Jin H. Impact of the COVID-19 pandemic on the mental health of children and adolescents: A systematic review and meta-analysis of longitudinal studies. J Affect Disord 2023; 340:914-922. [PMID: 37598714 DOI: 10.1016/j.jad.2023.08.070] [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: 04/12/2023] [Revised: 08/13/2023] [Accepted: 08/14/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND Children's and adolescents' mental health has been affected since the onset of the coronavirus disease (COVID-19) pandemic, receiving global attention. We conducted a systematic review and meta-analysis of longitudinal studies to assess the extent of the mental health changes of children and adolescents in the aftermath of the pandemic. METHODS We searched PubMed, Embase, Web of Science, and PsycINFO to explore the pandemic's impact on children and adolescents' mental health; longitudinal studies were included. We used the random effects model to estimate the standardized mean differences (SMD) with 95 % confidence intervals (CI). RESULTS Twenty articles were included. Results showed that there was an increase in anxiety (SMD = 0.18, 95 % CI 0.05-0.32) and depressive symptoms (SMD = 0.22, 95 % CI 0.13-0.32) in children and adolescents after the pandemic. Anxiety and depressive symptoms noticeably increased from April to May 2020, subsequently decreased, but saw a small resurgence during the second wave of the pandemic. Anxiety change varied by region; highest in Asia (SMD = 0.38, 95 % CI 0.25-0.51). LIMITATIONS Heterogeneity was high in this study, with high variability in psychiatric symptoms among individuals. CONCLUSIONS This study on changes in children's and adolescents' mental health, anxiety and depression symptoms showed varying degrees of deterioration. Changes in symptoms were influenced by time and region and showed fluctuations.
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Affiliation(s)
- Ruishuai Miao
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, PR China; Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, PR China
| | - Chang Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, PR China; Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, PR China
| | - Jiarong Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, PR China; Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, PR China
| | - Hui Jin
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, PR China; Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, PR China.
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Lu L, Hannigan LJ, Brandlistuen RE, Nesvåg R, Trogstad L, Magnus P, Unnarsdóttir AB, Valdimarsdóttir UA, Andreassen OA, Ask H. Mental Distress Among Norwegian Adults During the COVID-19 Pandemic: Predictors in Initial Response and Subsequent Trajectories. Int J Public Health 2023; 68:1606164. [PMID: 38024210 PMCID: PMC10630161 DOI: 10.3389/ijph.2023.1606164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 10/11/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives: To identify factors associated with change in mental distress at the onset of the COVID-19 pandemic, relative to pre-pandemic levels, and with changes during the following 1.5 years. Methods: The prospective Norwegian Mother, Father and Child Cohort Study collected eight waves of data during the pandemic (March 2020-September 2021) in 105,972 adult participants used for this analyses. A piecewise latent growth model was fitted to identify initial level and longitudinal changes in mental distress. Results: Mental distress peaked at the beginning of the pandemic. Factors associated with initial increases were: medical conditions, living alone, history of psychiatric disorders, lower education, female sex, younger age, and obesity. Being quarantined or infected with SARS-CoV-2 were associated with increasing distress while being vaccinated was associated with reduced mental distress. Conclusion: Having a chronic disease and being quarantined or infected by the SARS-CoV-2 virus were associated with more mental distress during the pandemic. This knowledge is important for planning interventions to support individuals during future pandemics and other societal crises.
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Affiliation(s)
- Li Lu
- Institute of Health Management and Policy, School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, China
- Norment Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
| | - Laurie J. Hannigan
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Ragnhild E. Brandlistuen
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
- The Norwegian Mother, Father and Child Cohort Study (MoBa), Norwegian Institute of Public Health, Oslo, Norway
| | - Ragnar Nesvåg
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
| | - Lill Trogstad
- Division of Infection Control, Norwegian Institute of Public Health, Oslo, Norway
| | - Per Magnus
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Anna Bára Unnarsdóttir
- Centre of Public Health Sciences, Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Unnur A. Valdimarsdóttir
- Centre of Public Health Sciences, Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
- Unit of Integrative Epidemiology, Department of Environmental Medicine (IMM), Karolinska Institutet, Stockholm, Sweden
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, United States
| | - Ole A. Andreassen
- Norment Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Norment Centre, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Helga Ask
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- Promenta Research Center, Department of Psychology, University of Oslo, Oslo, Norway
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Owens M, Bunce H. The effect of brief exposure to virtual nature on mental wellbeing in adolescents. Sci Rep 2023; 13:17769. [PMID: 37853074 PMCID: PMC10584913 DOI: 10.1038/s41598-023-44717-z] [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: 05/26/2023] [Accepted: 10/11/2023] [Indexed: 10/20/2023] Open
Abstract
Adolescence is a time of multiple transitions and a vulnerability period for mental health difficulties. There are many barriers to the treatment of mental health conditions which is one reason for developing alternatives to help improve efficacy in treatment and prevention. One approach is to use nature-based interventions (NBIs) to improve mental wellbeing. In this experimental proof-of-principle intervention study, we randomly allocated a sample of adolescents to brief exposure (6 min) to either a virtual woodland nature video or a busy train journey and tested the effect on mental wellbeing. Results showed beneficial effects in the nature condition on several self-reported outcomes including stress, relaxation, affect, mood, attention, nature connection and nature spirituality. The intervention was mainly acceptable and feasible to do suggesting that overall brief virtual nature interventions may have utility in a range of mental health contexts for adolescents including as self-help universal or targeted prevention strategies, adjunct to psychological therapy and as preparation for more intensive NBIs. Additionally, brief virtual nature interventions support accessibility for those who may be limited on time, unable to access real-life nature or who may be more biophobic.
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Affiliation(s)
- Matthew Owens
- Department of Psychology, The Mood Disorders Centre, University of Exeter, Exeter, EX4 4QQ, UK.
- The ROWAN Group, Exeter, UK.
| | - Hannah Bunce
- The ROWAN Group, Exeter, UK
- Somerset Foundation Trust NHS, Taunton, TA1 5DA, UK
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Vacchiano M, Politi E, Lueders A. The COVID-19 pandemic as an existential threat: Evidence on young people's psychological vulnerability using a Multifaceted Threat Scale. PLoS One 2023; 18:e0292894. [PMID: 37824537 PMCID: PMC10569596 DOI: 10.1371/journal.pone.0292894] [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: 05/15/2023] [Accepted: 10/01/2023] [Indexed: 10/14/2023] Open
Abstract
Research offers evidence that younger generations suffered the most psychologically from the COVID-19 crisis. In this article, we look at the onset of the pandemic to understand the reasons for this increased vulnerability. We use the COVID-19 Multifaceted Threat Scale to explore potential mechanisms underlying generational differences in psychological well-being. In a sample of 994 individuals (+18) obtained in the USA and India, we first assess levels of perceived psychological well-being across the generations. Thus, we measure cross-generational differences in the perceived levels of financial, relational, existential, health and lifestyle threats experienced by respondents seven months after the pandemic broke out. In accordance with earlier findings, the results confirm that people from Generation Z and Generation Y reported worse levels of psychological well-being than older adults. Our results suggest that the heightened existential threat, as reflected in a loss of meaning and feelings of being "trapped", mediate the association between younger generations and worse psychological well-being. No substantial intergenerational differences were found for other threat dimensions. The observed effects were consistent across both national contexts, hence stressing the importance of existential concerns as a mechanism underlying the psychological vulnerability of younger people in the historical contingencies of the COVID-19 pandemic.
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Affiliation(s)
- Mattia Vacchiano
- Department of Sociology, University of Geneva, Geneva, Switzerland
| | - Emanuele Politi
- Laboratory of Social Psychology, University of Lausanne, Lausanne, Switzerland
- Centre for Social and Cultural Psychology, KU Leuven, Leuven, Belgium
| | - Adrian Lueders
- Institute of Communication Science, University of Hohenheim, Stuttgart, Germany
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Pinfold V, Thompson R, Lewington A, Samuel G, Jayacodi S, Jones O, Vadgama A, Crawford A, Fischer LE, Dykxhoorn J, Kidger J, Oliver EJ, Duncan F. Public perspectives on inequality and mental health: A peer research study. Health Expect 2023; 27:e13868. [PMID: 37786331 PMCID: PMC10768865 DOI: 10.1111/hex.13868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/23/2023] [Accepted: 08/28/2023] [Indexed: 10/04/2023] Open
Abstract
INTRODUCTION Associations between structural inequalities and health are well established. However, there is limited work examining this link in relation to mental health, or that centres public perspectives. This study explores people's experience and sense-making of inequality in their daily lives, with particular consideration of impacts on mental health. METHODS We conducted a peer research study. Participants had to live in one of two London Boroughs and have an interest in inequalities and mental health. Using social media, newsletters, local organisations and our peer researchers' contacts, we recruited 30 participants who took photos representing their experience of inequality and discussed them during semi-structured interviews. Data were analysed using reflexive thematic analysis. RESULTS Three themes were identified in this study: (1) inequalities are unjust, multilayered and intertwined with mental health. Accounts demonstrated a deep understanding of inequalities and their link to mental health outcomes, describing inequalities as 'suffering' and 'not good for anyone'. Financial, housing, immigration and healthcare problems exacerbated poor mental health, with racism, gender-based violence and job loss also contributing factors for both poor mental health and experiences of inequality; (2) inequalities exclude and have far-reaching mental health consequences, impacting personal sense of belonging and perceived societal value and (3) moving forwards-addressing long-standing inequality and poor public mental health necessitated coping and resilience strategies that are often unacknowledged and undervalued by support systems. CONCLUSION Lived experience expertise was central in this study, creating an innovative methodological approach. To improve public mental health, we must address the everyday, painful structural inequalities experienced by many as commonplace and unfair. New policies and strategies must be found that involve communities, redistributing resources and power, building on a collective knowledge base, to coproduce actions combatting inequalities and improving population mental health. PATIENT OR PUBLIC CONTRIBUTION This study was peer-led, designed and carried out by researchers who had experiences of poor mental health. Six authors of the paper worked as peer researchers on this study.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Judi Kidger
- Population Health SciencesUniversity of BristolBristolUK
| | - Emily J. Oliver
- Population Health SciencesUniversity of NewcastleNewcastleUnited Kingdom
| | - Fiona Duncan
- Population Health SciencesUniversity of NewcastleNewcastleUnited Kingdom
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Cavallari JM, Garza JL, Charamut NR, Szarka C, Perry SD, Laguerre RA, Sanetti LMH, Dugan AG. Impact of work schedule characteristics on teacher mental health and burnout symptoms while remote working. Am J Ind Med 2023; 66:884-896. [PMID: 37563744 PMCID: PMC10947992 DOI: 10.1002/ajim.23522] [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: 04/25/2023] [Revised: 07/07/2023] [Accepted: 07/18/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND During the COVID-19 pandemic, teachers quickly shifted to remote teaching with many teachers experiencing increased work demands with limited resources, affecting both mental health and work. METHODS Within a cross-sectional study, we evaluated the relationship between one type of work demand, non-standard work schedule characteristics, and depressive and burnout symptoms in kindergarten through 8th grade U.S. teachers working remotely in May 2020. We further assessed the impact of COVID-19 and work resources. Work schedule characteristics were self-assessed across six domains on a 5-point frequency scale from always (1) to never (5). We used multilevel Poisson models to calculate prevalence ratios (PRs) and 95% confidence intervals (CIs). RESULTS In fully adjusted models, frequently working unexpectedly was associated with a higher prevalence of depressive symptoms (PR = 1.18, 95% CI = 1.07-1.31, p < 0.01), high emotional exhaustion (PR = 1.17, 95% CI = 1.05-1.30, p < 0.01), and high depersonalization (PR = 1.40, 95% CI = 1.02-1.92, p = 0.03). Remote work resources were significantly associated with a lower prevalence of depressive symptoms (PR = 0.88, 95% CI = 0.79-0.98, p = 0.02). There was a linear association between low coworker support and a low sense of personal accomplishment (PR = 0.68, 95% CI = 0.53-0.87, p < 0.01). CONCLUSIONS Frequently having to work unexpectedly while remote teaching was associated with symptoms of depression and burnout during the COVID-19 pandemic. Workplaces should support predictable working times to lessen the disruption caused by unexpected work to promote worker well-being.
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Affiliation(s)
- Jennifer M. Cavallari
- UConn School of Medicine, Department of Public Health Sciences, Farmington, CT USA
- UConn School of Medicine, Department of Medicine, Division of Occupational and Environmental Medicine, Farmington, CT USA
| | - Jennifer L. Garza
- UConn School of Medicine, Department of Medicine, Division of Occupational and Environmental Medicine, Farmington, CT USA
| | - Natalie R. Charamut
- University of Connecticut, Neag School of Education, Department of Educational Psychology, Storrs, CT USA
| | - Cheyenne Szarka
- University of Connecticut, Neag School of Education, Department of Educational Psychology, Storrs, CT USA
| | - Spencer D. Perry
- University of Connecticut, Neag School of Education, Department of Educational Psychology, Storrs, CT USA
| | - Rick A. Laguerre
- Montclair State University, Department of Psychology, Montclair, NJ USA
| | - Lisa M. H. Sanetti
- University of Connecticut, Neag School of Education, Department of Educational Psychology, Storrs, CT USA
| | - Alicia G. Dugan
- UConn School of Medicine, Department of Medicine, Division of Occupational and Environmental Medicine, Farmington, CT USA
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Bai W, Li JX, Wang YY, Zheng WY, Su Z, Cheung T, Jackson T, Xiang YT. The need to address mental health problems in the context of China's long-term 'dynamic-zero policy'. Psychol Med 2023; 53:6415-6416. [PMID: 36426598 DOI: 10.1017/s0033291722003725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Wei Bai
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Faculty of Health Sciences, Institute of Translational Medicine, University of Macau, Macao SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
| | - Jia-Xin Li
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
| | - Yue-Ying Wang
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
| | - Wan-Ying Zheng
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Faculty of Health Sciences, Institute of Translational Medicine, University of Macau, Macao SAR, China
| | - Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Todd Jackson
- Department of Psychology, University of Macau, Macao SAR, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Faculty of Health Sciences, Institute of Translational Medicine, University of Macau, Macao SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
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Morris SG, Kudrna L, Martin J. Mental health and life satisfaction among those advised to shield during the COVID-19 pandemic in the UK: a secondary analysis of the Understanding Society longitudinal study. Front Public Health 2023; 11:1235903. [PMID: 37829093 PMCID: PMC10566375 DOI: 10.3389/fpubh.2023.1235903] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 08/25/2023] [Indexed: 10/14/2023] Open
Abstract
Introduction During the COVID-19 pandemic in the UK, those considered most vulnerable to adverse outcomes from infection were designated "clinically extremely vulnerable" and advised to "shield." This involved prolonged confinement at home with strict limits on face-to-face contact, beyond national restrictions. Shielding ended in September 2021 and was considered likely to have harmed mental health and wellbeing. As the UK moved toward a new phase of "living with COVID-19" the mental health and wellbeing experiences of those advised to shield may have diverged from the general population. Methods This study is a secondary analysis of nine "COVID-19 Survey" waves of Understanding Society, a longitudinal study of UK participants covering April 2020 to September 2021 alongside pre-pandemic baseline data. The prevalence of clinically significant psychological distress (General Health Questionnaire 12) and low life satisfaction were examined at each wave for participants with longitudinal responses across all waves, stratified by receipt of shielding guidance (Received n = 410, Not received n = 6,878). Mixed effects regression modeling examined associations between shielding guidance receipt and mental health and life satisfaction when adjusting for potential confounders including age and sex, pre-pandemic mental health/life satisfaction, and loneliness. Results Those who received shielding guidance were more likely to experience poor mental health and low life satisfaction during the pandemic. However, this largely reflected differences in pre-pandemic baselines. Variation between waves broadly coincided with the changing burden of COVID-19 and associated restrictions, with similar patterns regardless of shielding guidance receipt. Regression modeling combining data across all waves indicated that receipt of shielding guidance did not independently predict adverse outcomes. However, poor pre-pandemic mental health and low life satisfaction, and frequent loneliness, as well as demographic factors including sex and age, consistently predicted adverse pandemic mental health and wellbeing. Discussion While those who received shielding guidance did on average experience poorer mental health and life satisfaction during the pandemic, this study suggests this largely reflects existing inequalities. Drawing on data throughout the shielding program, it addresses an existing evidence gap. These findings reinforce the importance of addressing existing mental health inequalities in the recovery from the current pandemic and for future preparedness.
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Affiliation(s)
- Simon George Morris
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
- Public Health Specialty Training Programme, NHS England - West Midlands, Birmingham, United Kingdom
| | - Laura Kudrna
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - James Martin
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
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Bahk YC, Jung D, Choi KH. Social distancing policy and mental health during COVID-19 pandemic: an 18-month longitudinal cohort study in South Korea. Front Psychol 2023; 14:1256240. [PMID: 37823072 PMCID: PMC10562579 DOI: 10.3389/fpsyg.2023.1256240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 09/08/2023] [Indexed: 10/13/2023] Open
Abstract
Background Despite the effectiveness of social distancing policies in preventing the spread of Coronavirus Disease 2019 (COVID-19), their impact on mental health remains a concern. Longitudinal studies investigating the psychological effects of social distancing are limited. Methods Longitudinal data on psychological variables were collected eight times between May 2020 and November 2021 through online surveys in South Korea. Results The participants in the study reported a worsening of depressive and anxiety symptoms, suicide risk, and psychological distress with increasing levels of social distancing. Specifically, during the third wave, when social distancing levels peaked, the highest levels of depression, anxiety, and psychological distress were observed, and the second-lowest levels of vitality were reported. Furthermore, psychological risk factors, such as depressive symptoms, anxiety symptoms, and suicidal risk, were closely associated with vitality levels in daily life. Discussions During the pandemic, although social distancing helped prevent the spread of COVID-19, it also led to increased depression, anxiety, suicide risk, psychological distress, and decreased vitality. Engagement at a personal level in fundamental daily activities is important to cope with psychological distress. Our results indicate that commitment to fundamental daily activities and following routines is an important protective factor against psychological distress, notwithstanding COVID-19.
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Affiliation(s)
- Yong-Chun Bahk
- Department of Psychology, Korea University, Seoul, Republic of Korea
- KU Mind Health Institute, Korea University, Seoul, Republic of Korea
| | - Dawoon Jung
- Department of Psychology, Korea University, Seoul, Republic of Korea
| | - Kee-Hong Choi
- Department of Psychology, Korea University, Seoul, Republic of Korea
- KU Mind Health Institute, Korea University, Seoul, Republic of Korea
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Lindqvist Bagge AS, Lekander M, Olofsson Bagge R, Carlander A. Mental health, stress, and well-being measured before (2019) and during (2020) COVID-19: a Swedish socioeconomic population-based study. Psychol Health 2023:1-18. [PMID: 37728316 DOI: 10.1080/08870446.2023.2257747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 09/06/2023] [Indexed: 09/21/2023]
Abstract
OBJECTIVES Compare mental health, stress, and well-being in the Swedish population as measured before and during the COVID-19 pandemic. METHODS Repeated cross-sectional design using data measured before (Jan-2019; n = 2791) and during (Oct/Nov-2020; n = 2926) COVID-19 pandemic in Swedish population-representative cohorts. Following constructs were measured: anxiety (Beck Anxiety Inventory), depression (Beck Depression Inventory-II), stress (Perceived Stress Scale-10 items), health-related quality of life (HRQOL[Functional Assessment of Cancer Therapy-General Population]) and self-rated health (SRH) was assessed with a single-item question. RESULTS When adjusting for age, sex, education, and income there were significantly higher levels of anxiety (M̂ = 9.15 vs. 8.48, p < 0.01) and depression (M̂ = 3.64 vs. 3.30, p = 0.03), lower levels of stress (M̂ = 14.06 vs. 14.91, p < 0.001), but worsened HRQOL (M̂ = 76.40 vs. 77.92, p < 0.01) and SRH (M̂ = 6.91 vs. 7.20, p < 0.001), observed in 2020 compared to 2019. For the negative effects seen in anxiety, depression, HRQOL, and SRH, higher income and education had a protective effect. The decrease in stress was also correlated with higher income. CONCLUSIONS The COVID-19 pandemic led to a small but significant worsening in mental health and well-being in the general Swedish population, where higher socioeconomic status seemed to have a protective effect.
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Affiliation(s)
- Ann-Sophie Lindqvist Bagge
- Dept of Psychology, University of Gothenburg, Gothenburg, Sweden
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Mats Lekander
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
- Osher Center for Integrative Health and Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden
| | - Roger Olofsson Bagge
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
- Department of Surgery, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Anders Carlander
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
- SOM Institute, University of Gothenburg, Gothenburg, Sweden
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Nichols E, Petrosyan S, Khobragade P, Banerjee J, Angrisani M, Dey S, Bloom DE, Schaner S, Dey AB, Lee J. Trajectories and correlates of poor mental health in India over the course of the COVID-19 pandemic: a nation-wide survey. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.09.13.23295513. [PMID: 37745425 PMCID: PMC10516061 DOI: 10.1101/2023.09.13.23295513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Introduction The COVID-19 pandemic had large impacts on mental health; however, most existing evidence is focused on the initial lockdown period and high-income contexts. By assessing trajectories of mental health symptoms in India over two years, we aim to understand the effect of later time periods and pandemic characteristics on mental health in a lower-middle income context. Methods We used data from the Real-Time Insights of COVID-19 in India (RTI COVID-India) cohort study (N=3,662). We used covariate-adjusted linear regression models with generalized estimating equations to assess associations between mental health (PHQ-4 score) and pandemic periods as well as pandemic characteristics (COVID-19 cases and deaths, government stringency, self-reported financial impact, COVID-19 infection in the household) and explored effect modification by age, gender, and rural/urban residence. Results Mental health symptoms dropped immediately following the lockdown period but rose again during the delta and omicron waves. Associations between mental health and later pandemic stages were stronger for adults 45 years of age and older (p<0.001). PHQ-4 scores were significantly and independently associated with all pandemic characteristics considered, including estimated COVID-19 deaths (PHQ-4 difference of 0.041 SD units; 95% Confidence Interval 0.030 - 0.053), government stringency index (0.060 SD units; 0.048 - 0.072), self-reported major financial impacts (0.45 SD units; 0.41-0.49), and COVID-19 infection in the household (0.11 SD units; 0.07-0.16). Conclusion While the lockdown period and associated financial stress had the largest mental health impacts on Indian adults, the effects of the pandemic on mental health persisted over time, especially among middle-age and older adults. Results highlight the importance of investments in mental health supports and services to address the consequences of cyclical waves of infections and disease burden due to COVID-19 or other emerging pandemics.
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Affiliation(s)
- Emma Nichols
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA
| | - Sarah Petrosyan
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA
| | - Pranali Khobragade
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA
| | - Joyita Banerjee
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA
| | - Marco Angrisani
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA
- Department of Economics, University of Southern California, Los Angeles, CA, USA
| | - Sharmistha Dey
- All India Institute of Medical Sciences, New Delhi, India
| | - David E. Bloom
- Harvard School of Public Health, Boston, Massachusetts, USA
| | - Simone Schaner
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA
- Department of Economics, University of Southern California, Los Angeles, CA, USA
| | - AB Dey
- Venu Geriatric Institute, New Delhi, India
| | - Jinkook Lee
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA
- Department of Economics, University of Southern California, Los Angeles, CA, USA
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Yan X, Schneider JA, Modali L, Korban C, Tabidze I. Racial-ethnic, gender identity, and sexual orientation disparities in COVID-19-related social and health outcomes: A decomposition analysis. SSM Popul Health 2023; 23:101474. [PMID: 37560090 PMCID: PMC10407278 DOI: 10.1016/j.ssmph.2023.101474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/21/2023] [Accepted: 07/21/2023] [Indexed: 08/11/2023] Open
Abstract
Despite the growing literature on racial-ethnic disparities during the pandemic, less is known about the explanatory mechanisms of these disparities and inequalities across other axes, such as gender and sexual identities. We studied the levels and sources of racial-ethnic, gender identity, and sexual minority disparities in social (i.e., unmet resource needs) and health (i.e., hospitalization) outcomes among individuals diagnosed with COVID-19, hypothesizing differential age structure, underlying health, and work and living arrangements as contributors to inequalities. Using large-scale administrative data from Chicago and adjusting for covariates, we found substantial racial-ethnic and gender identity disparities in both outcomes, and weak evidence of sexual minority disparities in unmet needs. Subsequent decomposition analyses revealed that living in larger households, having a higher share of non-adult cases, and facing higher burdens of chronic illness, obesity, and unemployment each statistically significantly drove racial-ethnic disparities in unmet needs, but these together explained less than 15% of the disparities. Similarly, about 20% of the Black-White gap in hospitalization resulted from disparities in underlying health and unemployment, whereas a higher proportion of non-adult cases or higher unemployment rates respectively proved the only significant pathways to partially explain transgender individuals' disadvantages in unmet needs (12%) or hospitalization (6%). These findings highlight the importance of considering multiple dimensions of social differences in studying health disparities, the vulnerabilities of transgender and non-adult communities during the pandemic, and the valid yet quite limited roles of previously suggested sociodemographic factors in accounting for COVID-19-related categorical inequalities.
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Affiliation(s)
- Xuewen Yan
- Department of Sociology, Cornell University, Chicago Department of Public Health, USA
| | - John A. Schneider
- Departments of Medicine and Public Health Sciences, University of Chicago, Chicago Department of Public Health, USA
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Dunne S, Williams GP, Bradbury C, Keyes T, Lane AR, Yang K, Ellison A. Uncovering the social determinants of brain injury rehabilitation. J Health Psychol 2023; 28:956-969. [PMID: 37026570 PMCID: PMC10466963 DOI: 10.1177/13591053231166263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023] Open
Abstract
Social determinants of health (SDH), such as social isolation and loneliness, are often more frequently experienced in brain injury survivors. The paper explores the personal experiences of loneliness among brain injury survivors during lockdown to negate health inequalities and improve rehabilitation for this population in the future. Twenty-four brain injury survivors participated in semi-structured interviews and questionnaires relating to loneliness, resilience and wellbeing. Three themes (the experience of loneliness, loneliness during the pandemic and loneliness after the pandemic) explored survivors' experiences of loneliness generally post-brain injury, but also chronicle how these feelings developed in lockdown and survivors' feelings regarding society returning to 'normal'. Future interventions should focus on reframing survivors' beliefs regarding societal expectations and minimise the pressure they experience to keep up with their peers physically and emotionally. Additionally, we recommend creating accessible peer support options for all brain injury survivors as an important step for alleviating loneliness.
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Affiliation(s)
- Stephen Dunne
- Northumbria University, UK
- NIHR Applied Research Collaboration North-East and North Cumbria, UK
| | | | | | | | | | | | - Amanda Ellison
- NIHR Applied Research Collaboration North-East and North Cumbria, UK
- Durham University, UK
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Buechner H, Toparlak SM, Ostinelli EG, Shokraneh F, Nicholls-Mindlin J, Cipriani A, Geddes JR, Syed Sheriff R. Community interventions for anxiety and depression in adults and young people: A systematic review. Aust N Z J Psychiatry 2023; 57:1223-1242. [PMID: 36722407 PMCID: PMC10466972 DOI: 10.1177/00048674221150362] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Growing evidence suggests that community-based interventions may be effective for anxiety and depression. This study aimed to describe studies of community interventions delivered to adults and/or young people, either in person or online, evaluated in randomised controlled trials and provide an indication as to their effectiveness, acceptability, quality of data and where possible, mechanisms of action. We included interventions delivered at and/or by museums, art galleries, libraries, gardens, music groups/choirs and sports clubs. METHOD We developed and followed a preregistered protocol: PROSPERO CRD42020204471. Randomised controlled trials in adults and young people were identified in an extensive search with no date/time, language, document type and publication status limitations. Studies were selected according to predetermined eligibility criteria and data independently extracted and then assessed using Risk of Bias 1. The studies were deemed too heterogeneous for meta-analysis and were therefore reported using a narrative synthesis. RESULTS Our analysis included 31 studies, with 2898 participants. Community interventions most studied in randomised controlled trials were community music (12 studies, 1432 participants), community exercise (14 studies, 955 participants) and community gardens/gardening (6 studies, 335 participants). The majority of studies were from high-income countries - many were in specific populations (such as those with physical health problems) and were generally of low quality. Dropout rates across the included studies were low (1 participant on average per 100 participants). The inadequate description of interventions limited identification of potential mechanisms of action. DISCUSSION The uncertainty of the evidence allows only a weak recommendation in support of community interventions for anxiety and depression. The results suggest community engagement is a promising area for wide-reaching interventions to be implemented and evaluated, but more high-quality trials are needed, especially in young people and under-represented communities.
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Affiliation(s)
| | - Sureyya M Toparlak
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Edoardo G Ostinelli
- Oxford Precision Psychiatry Lab, NIHR Oxford Health Biomedical Research Centre, Oxford, UK
| | - Farhad Shokraneh
- Institute of Health Informatics, University College London, London, UK
| | | | - Andrea Cipriani
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - John R Geddes
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Rebecca Syed Sheriff
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
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Ayuso-Mateos JL, Morillo D, Haro JM, Olaya B, Lara E, Miret M. Changes on depression and suicidal ideation under severe lockdown restrictions during the first wave of the COVID-19 pandemic in Spain: a longitudinal study in the general population. Epidemiol Psychiatr Sci 2023; 32:e55. [PMID: 37655398 PMCID: PMC10539734 DOI: 10.1017/s2045796023000677] [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: 06/12/2023] [Accepted: 07/26/2023] [Indexed: 09/02/2023] Open
Abstract
AIMS To assess whether there is a change in the prevalence of depression and suicidal ideation after the strict lockdown measures due to the first wave of the COVID-19 pandemic in Spain, and to assess which are the factors associated with the incidence of a depressive episode or suicidal ideation during the lockdown. METHODS Data from a longitudinal adult population-based cohort from Madrid and Barcelona were analysed (n = 1103). Face-to-face home-based (pre-pandemic) and telephone interviews were performed. Depression and suicidal ideation were assessed through an adaptation of the Composite International Diagnostic Interview (CIDI 3.0). Population prevalence estimates and multivariable logistic regressions were computed. RESULTS Prevalence rates of depression changed significantly from before to after the COVID-19 outbreak (from 3.06% to 12.00%; p = 0.01) and per sex and age groups. Individuals reporting COVID-19 concerns (odds ratio [OR] = 3.11; 95% confidence interval [CI] = 1.45-6.69) and those feeling loneliness (OR = 1.99; 95% CI = 1.52-2.61) during the lockdown were at increased risk of developing depression during the confinement. Resilience showed a protective effect against the risk of depression (OR = 0.57; 95% CI = 0.39-0.83), while individuals perceiving social support during the confinement were at lower risk of developing suicidal thoughts (OR = 0.21; 95% CI = 0.09-0.46). Greater disability during the lockdown was also associated with the risk of suicidal ideation (OR = 2.77; 95% CI = 1.53-5.03). CONCLUSIONS Continuous reinforcement of mental health preventive and intervening measures is of global importance, particularly among vulnerable groups who are experiencing the most distress. Future research should strive to evaluate the long-term effects of the COVID-19 crisis on mental health.
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Affiliation(s)
- J. L. Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid, Spain
- Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
| | - D. Morillo
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid, Spain
- Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
| | - J. M. Haro
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid, Spain
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain
| | - B. Olaya
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid, Spain
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain
| | - E. Lara
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid, Spain
- Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
- Department of Personality, Evaluation and Clinical Psychology, Universidad Complutense de Madrid, Madrid, Spain
| | - M. Miret
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid, Spain
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