The impact of the initial COVID-19 outbreak on young adults' mental health: a longitudinal study of risk and resilience factors

Friendship buffering effects on mental health symptoms before and during the COVID-19 pandemic: A UK longitudinal study of young people with childhood adversity

Young people with childhood adversity (CA) were at increased risk to experience mental health problems during the COVID-19 pandemic. Pre-pandemic research identified high-quality friendship support as a protective factor that can buffer against the emergence of mental health problems in young people with CA. This longitudinal study investigated friendship buffering effects on mental health symptoms before and at three timepoints during the pandemic in 102 young people (aged 16-26) with low to moderate CA. Multilevel analyses revealed a continuous increase in depression symptoms following the outbreak. Friendship quality was perceived as elevated during lockdowns and returned to pre-pandemic baseline levels during reopening. A stress-sensitizing effect of CA on social functioning was evident, as social thinning occurred following the outbreak. Bivariate latent change score modeling revealed that before and during the pandemic, young people with greater friendship quality self-reported lower depression symptoms and vice versa. Furthermore, sequential mediation analysis showed that high-quality friendships before the pandemic buffered depression symptoms during the pandemic through reducing perceived stress. These findings highlight the importance of fostering stable and supportive friendships in young people with CA and suggest that through reducing stress perceptions high-quality friendships can mitigate mental health problems during times of multidimensional stress.

A psychologically interpretable artificial intelligence framework for the screening of loneliness, depression, and anxiety

Negative emotions such as loneliness, depression, and anxiety (LDA) are prevalent and pose significant challenges to emotional well-being. Traditional methods of assessing LDA, reliant on questionnaires, often face limitations because of participants' inability or potential bias. This study introduces emoLDAnet, an artificial intelligence (AI)-driven psychological framework that leverages video-recorded conversations to detect negative emotions through the analysis of facial expressions and physiological signals. We recruited 50 participants to undergo questionnaires and interviews, with their responses recorded on video. The emoLDAnet employs a combination of deep learning (e.g., VGG11) and machine learning (e.g., decision trees [DTs]) to identify emotional states. The emoLDAnet incorporates the OCC-PAD-LDA psychological transformation model, enhancing the interpretability of AI decisions by translating facial expressions into psychologically meaningful data. Results indicate that emoLDAnet achieves high detection rates for loneliness, depression, and anxiety, with F1-scores exceeding 80% and Kendall's correlation coefficients above 0.5, demonstrating strong agreement with traditional scales. The study underscores the importance of the OCC-PAD-LDA model in improving screening accuracy and the significant impact of machine learning classifiers on the framework's performance. The emoLDAnet has the potential to support large-scale emotional well-being early screening and contribute to the advancement of mental health care.

A systematic review of pre-pandemic resilience factors and mental health outcomes in adolescents and young adults during the COVID-19 pandemic

Adolescence and young adulthood are sensitive developmental periods to environmental influences. Investigating pre-emptive measures against stressors, such as those associated with the COVID-19 pandemic, on mental health is crucial. We aimed to synthesize evidence on pre-pandemic resilience factors shaping youth mental health outcomes during this period. For this pre-registered systematic review, we searched seven databases for longitudinal studies of youth populations affected by the COVID-19 pandemic, assessing a priori defined resilience factors at the individual, family, or community level before the pandemic. Studies required validated mental health or wellbeing measures collected both before and during the pandemic. Study quality was assessed using the corresponding NIH Quality Assessment Tool. From 4,419 unique records, 32 studies across 12 countries were included, using 46 distinct resilience measures. Due to the heterogeneity of study designs, we applied a narrative synthesis approach, finding that resilience factors were generally associated with better mental health outcomes both prior to and during the pandemic. However, most factors did not mitigate pandemic-related mental health effects. Nonetheless, family-level resilience factors emerged as promising under specific conditions. Study quality was generally fair, with concerns in resilience assessment and sampling quality. Future research should prioritize rigorous study designs and comprehensive resilience assessments.

Increased gastrointestinal bleeding-related mortality during the COVID-19 pandemic

Background

Despite its significant health burden, there is a lack of national-level temporal patterns in gastrointestinal bleeding (GIB) mortality.

Objectives

To comprehensively decipher the annual and monthly trend of GIB-related mortality in the United States.

Design

Cross-sectional study.

Methods

We analyzed the National Vital Statistic System database, which documents more than 99% of the annual deaths in the United States for GIB-related deaths from January 2010 to May 2023. Annual and monthly age-standardized mortality rates were estimated and categorized by age, sex, and bleeding site. Joinpoint regression was performed for trend analysis. Prediction modeling was conducted to determine the GIB-associated excess mortality.

Results

A total of 529,094 and 210,641 GIB-associated deaths occurred before and after 2020, respectively. Following a stably decreasing trend between 2010 and 2019, there was an excess mortality rate during the pandemic which peaked in 2021. The monthly mortality trend showed spikes corresponding to the outbreak of variants. Importantly, excess GIB-related mortality resolved in 2023, with the convergence of predicted and observed mortality rates. Subgroup analysis showed that young males (aged 19-44 years) were affected the most during the pandemic, with excess mortality rates of 35.80%, 52.77%, and 31.46% in 2020, 2021, and 2022, respectively. While the increasing trend of upper GIB was accentuated during the pandemic, lower GIB showed a reversal of the pre-pandemic decreasing trend.

Conclusion

Our findings demonstrate the trend of GIB-related mortality, underscoring an increased excess death during the pandemic followed by a resolution in 2023. We identify subpopulations vulnerable to the pandemic.

The unequal impacts of the COVID-19 pandemic on young adults' mental health. Predictors of vulnerability and resilience using longitudinal birth cohort data in the UK

INTRODUCTION

Previous studies have demonstrated deteriorations in young adult mental health during the COVID-19 pandemic, but evidence suggests heterogeneity in the mental health impacts of the pandemic. We sought to identify factors which may predict changes in psychological distress and wellbeing during the COVID-19 pandemic in UK young adults.

METHODS

A total of 2607 young adults from the Millennium Cohort Study were included. Psychological distress and mental wellbeing were measured using the Kessler-6 and Short Warwick-Edinburgh Mental Wellbeing Scale, respectively. Assessment occurred at three timepoints between the ages of 17-19: 2018/19 (pre-COVID Baseline), May 2020 (COVID Wave 1) and September/October 2020 (COVID Wave 2). Latent change score models were used to study change in distress and wellbeing across the study period, as well as the impact of sex, relative family poverty, parental education, preexisting mental health difficulties and perceived social support on these changes.

RESULTS

The latent change score models suggested both distress and wellbeing tended to increase across the study period. Being female and in relative poverty predicted greater increases in distress and/or poorer wellbeing. Higher levels of parental education and greater perceived social support were protective against increased distress and associated with improved wellbeing.

CONCLUSIONS

The impact of the COVID-19 pandemic on UK young adult mental health is complex. We provide further evidence for a distinction between symptoms of poor mental health and wellbeing. Research is urgently needed to assess the long-term impacts of the COVID-19 pandemic on the mental health and wellbeing of young people, particularly in more vulnerable groups.

Impact of the COVID-19 pandemic on young adults' mental health and beyond: a qualitative investigation nested within an ongoing general population cohort study

PURPOSE

Initial discussions about the COVID-19 pandemic often overlooked its impact on young adults. By employing a qualitative approach nested within an ongoing general population cohort study, we seek to fill a gap in the literature by providing insights into the longer-term impact on this demographic.

METHODS

Data collection involved the use of in-depth semi-structured interviews. Using a pre-determined sampling frame, we purposively recruited 30 participants based on age, gender, ethnicity, and deprivation from the Neuroscience in Psychiatry Network (NSPN). The NSPN cohort, established in 2012, consists of 2403 young people aged 14-24 at baseline, recruited from Greater London and Cambridgeshire. Interviews were conducted in Autumn 2022; data were analysed using the framework method.

RESULTS

Participants were on average 28 years old (SD = 3 years, range 24-34 years; 53.3% female). The sample comprised individuals from diverse ethnic backgrounds, with 40% from non-White ethnic groups. Many young adults reported profound personal growth and a stronger sense of resilience, a perception observed across varying levels of anxiety or depression. Nevertheless, we observed substantial disruptions to their personal and professional lives such as returning to their parents' homes, often deferring other life plans, lacking mental health support, and encountering significant career challenges.

CONCLUSION

Our findings highlight the complexity of pandemic impacts, demonstrating the need for supportive policies and further research to understand the circumstances under which genuine personal growth occurs, whether it is enduring or transient, and which factors influence it.

Study on anxiety, depression, and sleep conditions and their interrelations among vocational college students during the COVID-19 pandemic management normalization

Objective

This study investigates the sleep patterns among vocational college students and examines their association with anxiety and depression amidst the ongoing normalization of COVID-19 management strategies.

Methods

In the period of January to February 2022, a comprehensive survey was conducted involving a random sample of 3,300 students. By employing face-to-face interviews, data on general demographics, along with levels of anxiety, depression, and sleep quality, were meticulously gathered and analyzed.

Results

Out of the 3,049 questionnaires deemed valid for analysis, the prevalence rates for anxiety, depression, and insomnia were found to be 9.7, 14.1, and 81.9%, respectively. Through regression analysis, several factors were identified as significant predictors of insomnia: female gender, a self-perceived average or poor family economic status over the last year, moderate psychological stress due to the pandemic and its associated restrictions, extended daily screen time during the pandemic, absence of a routine physical exercise regime, significant disruption or alteration of daily life routines due to the pandemic, presence of anxiety and depression symptoms during the pandemic, and only partial restoration of normal life routines post-pandemic control measures (p < 0.001, p < 0.005, or p < 0.050). A strong correlation was observed among the symptoms of anxiety, depression, and insomnia (all p < 0.001). The correlation between stress and depression, depression and insomnia, and anxiety and insomnia were 0.824, 0.714, 0.620, respectively, (all p < 0.001).

Conclusion

Given the substantial impact of abrupt or prolonged crisis events, it is imperative to develop and implement specific intervention strategies aimed at safeguarding the psychological well-being of college students.

Mental well-being and sleep quality among vocational college students in Sichuan, China during standardized COVID-19 management measures

Purpose

This research investigated the impact of the COVID-19 pandemic on the mental well-being and sleep quality of students in higher vocational colleges in Sichuan, China, identifying key factors influencing their psychological health during this period.

Methods

Between January and February 2022, a comprehensive survey was conducted among students from several higher vocational colleges in Sichuan, utilizing a randomized selection approach to involve 3,300 participants. Data were collected through direct interviews executed by skilled interviewers.

Results

Out of 3,049 valid responses, a significant number reported experiencing symptoms of poor mental health, anxiety, depression, and insomnia, with prevalence rates of 21.2%, 9.7%, 14.1%, and 81.9%, respectively. Factors contributing positively to mental health and sleep included a higher family economic status, reduced stress from the pandemic, and decreased online activity. Conversely, lack of physical activity post-pandemic, disruptions to education and employment, and deteriorating relationships emerged as negative influencers. Interestingly, a lack of pre-pandemic mental health knowledge acted as a protective factor against insomnia.

Conclusion

The ongoing management of COVID-19 has notably influenced the psychological and sleep health of vocational college students, driven by economic, emotional, lifestyle, and educational factors. The findings underscore the necessity for targeted interventions to address these challenges effectively.

What set some young adults apart during the COVID-19 pandemic? Mental health trajectories, risk and protective factors in an Australian longitudinal study

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.

Factors Affecting Well-Being in Korean Young Adults Facing Material Deprivation: Testing the Reserve Capacity Model

Based on the reserve capacity model, the current study aims to explore the effect of material deprivation on well-being in Korean young adults using path analysis to investigate the mediating effects of loneliness, relationship satisfaction, perceived social support, and depression. Data from 2,041 young adults in the 2021 Youth Socio-Economic Reality Survey were included in a secondary analysis. According to the constructed path model, material deprivation, relationship satisfaction, perceived social support, and depression had significant direct effects on well-being. The indirect effect of material deprivation on well-being was statistically significant and sequentially mediated by loneliness, relationship satisfaction, and depression. Findings suggest the multidimensional effects of material deprivation on the mental health and well-being of Korean young adults through loneliness and relationship satisfaction-representing intrapersonal and interpersonal reserves, respectively. Policy support and multidimensional practical programs are needed to help materially deprived young adults build and maintain relationships and avoid feelings of loneliness and social isolation. [Journal of Psychosocial Nursing and Mental Health Services, 62(3), 29-38.].

Biomarker-Guided Tailored Therapy in Major Depression

This chapter provides a comprehensive examination of a broad range of biomarkers used for the diagnosis and prediction of treatment outcomes in major depressive disorder (MDD). Genetic, epigenetic, serum, cerebrospinal fluid (CSF), and neuroimaging biomarkers are analyzed in depth, as well as the integration of new technologies such as digital phenotyping and machine learning. The intricate interplay between biological and psychological elements is emphasized as essential for tailoring MDD management strategies. In addition, the evolving link between psychotherapy and biomarkers is explored to uncover potential associations that shed light on treatment response. This analysis underscores the importance of individualized approaches in the treatment of MDD that integrate advanced biological insights into clinical practice to improve patient outcomes.

Addressing the Increasing Mental Health Distress and Mental Illness Among Young Adults in the United States

ABSTRACT

Recent surveys show rising numbers of young people who report anxiety and depression. Although much attention has focused on mental health of adolescent youth, less attention has been paid to young people as they transition into adulthood. Multiple factors may have contributed to this steady increase: greater exposure to social media, information, and distressing news via personal electronic devices; increased concerns regarding social determinants of health and climate change; and changing social norms due to increased mental health literacy and reduced stigma. The COVID-19 pandemic may have temporarily exacerbated symptoms and impacted treatment availability. Strategies to mitigate causal factors for depression and anxiety in young adults may include education and skills training for cognitive, behavioral, and social coping strategies, as well as healthier use of technology and social media. Policies must support the availability of health insurance and treatment, and clinicians can adapt interventions to encompass the specific concerns and needs of young adults.

Interrelations of resilience factors and their incremental impact for mental health: insights from network modeling using a prospective study across seven timepoints

Resilience can be viewed as trajectory of stable good mental health or the quick recovery of mental health during or after stressor exposure. Resilience factors (RFs) are psychological resources that buffer the potentially negative effects of stress on mental health. A problem of resilience research is the large number of conceptually overlapping RFs complicating their understanding. The current study sheds light on the interrelations of RFs in the face of the COVID-19 pandemic as a use case for major disruptions. The non-preregistered prospective study assessed a sample of 1275 German-speaking people from February 2020 to March 2021 at seven timepoints. We measured coping, hardiness, control beliefs, optimism, self-efficacy, sense of coherence (SOC), sense of mastery, social support and dispositional resilience as RFs in February 2020, and mental health (i.e., psychopathological symptoms, COVID-19-related rumination, stress-related growth) at all timepoints. Analyses used partial correlation network models and latent growth mixture modeling (LGMM). Pre-pandemic RFs were strongly interrelated, with SOC being the most central node. The strongest associations emerged between coping using emotional support and social support, SOC and sense of mastery, and dispositional resilience and self-efficacy. SOC and active coping were negatively linked. When we examined RFs as predictors of mental health trajectories, SOC was the strongest predictor of psychopathological symptoms and rumination, while trajectories of stress-related growth were predicted by optimism. Subsequent network analyses, including individual intercepts and slopes from LGMM, showed that RFs had small to moderate associations with intercepts but were unrelated to slopes. Our findings provide evidence for SOC playing an important role in mental distress and suggest further examining SOC's incremental validity. However, our results also propose that RFs might be more important for stable levels of mental health than for adaptation processes over time. The differential associations for negative and positive outcomes support the use of multidimensional outcomes in resilience research.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSION

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

Exploring the psychometric properties of the Intellectual Disability versions of the Short Warwick-Edinburgh Mental Wellbeing Scale and Kidscreen10, self-reported by adolescents with intellectual disability

BACKGROUND

There are no validated self-report measures that can be used to assess health and wellbeing in adolescents with intellectual disability (ID).

METHOD

The aim of this study was to explore the psychometric properties of two newly adapted self-report health-related quality of life (HRQoL) and mental wellbeing measures: the Intellectual Disability versions of the Short Warwick-Edinburgh Mental Wellbeing Scale (ID-SWEMWBS) and Kidscreen10 (ID-Kidscreen10). For this, we used data from a sample of 427 adolescents (aged 11-19) with ID recruited from special school settings.

RESULTS

Confirmatory factor analysis (CFA) was conducted to validate the factor structure of both measures. Internal consistency was assessed using Cronbach's alpha and test-retest reliability was analysed using intra-class correlation coefficients. The internal consistency measured using Cronbach's alpha was found to be in the range of 0.70-0.78, test-retest reliabilities were expressed using intra-class correlation coefficients that were found to be high for both measures (ID-SWEMWBS, 0.758; ID-Kidscreen10, 0.723), and the CFA supported the unidimensional structure of both measures.

CONCLUSIONS

The results of this study indicate that the ID-SWEMWBS and ID-Kidscreen10 have very good psychometric properties and can be used as self-report measures to assess HRQoL and mental wellbeing in adolescents with ID.