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Dawson BD, Keller HE, Sawyer LM, Gorman S, Sabangan JA, McPartlin A, Payne S, Brown KJ, Li G, Sullivan DH. Evaluation of a Virtual Tai Chi Program for Older Veterans at Risk of Loneliness or Physical Deconditioning: A Quality Improvement Project. Geriatrics (Basel) 2024; 9:91. [PMID: 39051255 PMCID: PMC11270295 DOI: 10.3390/geriatrics9040091] [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: 05/07/2024] [Revised: 06/17/2024] [Accepted: 07/05/2024] [Indexed: 07/27/2024] Open
Abstract
This Quality Improvement project evaluated the implementation of a virtual Tai Chi program for older Veterans (OVs) at risk of loneliness and/or physical deconditioning. A 12-week Tai Chi course was conducted virtually at three Veterans Affairs sites using VA Video Connect (VVC). Changes in physical function based on the 30-Second Chair Stand (30CST) and loneliness based on the De Jong Gierveld Loneliness Scale (DJGS) were measured, as were the OVs' satisfaction and adherence. Of 109 OVs who enrolled, 74 completed the program with a mean attendance rate of 84%. Completers demonstrated a statistically significant improvement in the 30CST, and those who were moderately or severely lonely at baseline saw a statistically significant improvement in the DJGS. Course evaluations were generally very positive. Results suggest that a virtual Tai Chi program is an effective and very satisfying intervention for OVs at risk of loneliness or physical deconditioning.
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Affiliation(s)
- Bonnie D. Dawson
- Geriatric Research Education and Clinical Center, Central Arkansas Veterans Healthcare System, 2200 Fort Roots Drive, North Little Rock, AR 72114, USA; (H.E.K.); (L.M.S.); (D.H.S.)
| | - Hallie E. Keller
- Geriatric Research Education and Clinical Center, Central Arkansas Veterans Healthcare System, 2200 Fort Roots Drive, North Little Rock, AR 72114, USA; (H.E.K.); (L.M.S.); (D.H.S.)
| | - Linda M. Sawyer
- Geriatric Research Education and Clinical Center, Central Arkansas Veterans Healthcare System, 2200 Fort Roots Drive, North Little Rock, AR 72114, USA; (H.E.K.); (L.M.S.); (D.H.S.)
| | - Shannon Gorman
- VA Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA 94304, USA; (S.G.); (J.A.S.)
| | - Jerome A. Sabangan
- VA Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA 94304, USA; (S.G.); (J.A.S.)
| | - Adam McPartlin
- VA Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA 98108, USA; (A.M.); (S.P.); (K.J.B.); (G.L.)
| | - Sarah Payne
- VA Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA 98108, USA; (A.M.); (S.P.); (K.J.B.); (G.L.)
| | - Karl J. Brown
- VA Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA 98108, USA; (A.M.); (S.P.); (K.J.B.); (G.L.)
| | - Gail Li
- VA Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA 98108, USA; (A.M.); (S.P.); (K.J.B.); (G.L.)
| | - Dennis H. Sullivan
- Geriatric Research Education and Clinical Center, Central Arkansas Veterans Healthcare System, 2200 Fort Roots Drive, North Little Rock, AR 72114, USA; (H.E.K.); (L.M.S.); (D.H.S.)
- Donald W. Reynolds Department of Geriatrics, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR 72205, USA
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Serier KN, Zhao Z, Vogt D, Kehle-Forbes S, Smith BN, Mitchell KS. The impact of stress and well-being during the COVID-19 pandemic on mental health in U.S. veterans. Stress Health 2024; 40:e3357. [PMID: 38126682 DOI: 10.1002/smi.3357] [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: 05/11/2023] [Revised: 09/15/2023] [Accepted: 11/16/2023] [Indexed: 12/23/2023]
Abstract
The COVID-19 pandemic disrupted life around the globe and negatively impacted mental health (MH), including among military veterans. Building on previous research with U.S. veterans, the present study examined the association between a broad array of pandemic stressors and well-being on MH outcomes. A total of 372 veterans (51.3% women) from all service eras completed measures of posttraumatic stress disorder and depression during early (timepoint 1 [T1]) and peri-pandemic (timepoint 2 [T2]) periods. Pandemic-related stressors and well-being (satisfaction in life domains) were assessed at the peri-pandemic timepoint (T2). Logistic regression analyses were used to investigate associations between stressors and well-being with the likelihood of a probable MH diagnosis at T2 controlling for T1 MH status. More negative physical and MH impacts of the pandemic in addition to fewer positive consequences and lower satisfaction with paid work, finances, health, romantic relationships, and social life were associated with a higher likelihood of a probable T2 MH diagnosis. COVID infection was associated with lower odds of a probable T2 MH diagnosis. There were significant indirect effects, such that physical and MH impacts of the pandemic were associated with T2 MH via well-being. Overall, these findings highlight the role of stress and well-being on MH during a global pandemic. Interventions to address well-being may be important to address veteran MH during other periods of stress. Future research should examine the generalizability of study findings and further investigate factors that contribute to veterans' MH resilience during stressful life experiences.
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Affiliation(s)
- Kelsey N Serier
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Ziyu Zhao
- National Center for PTSD Women's Health Sciences Division, VA Boston Healthcare System, Boston, Massachusetts, USA
- Department of Psychological & Brain Sciences, Boston University, Boston, Massachusetts, USA
| | - Dawne Vogt
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
- National Center for PTSD Women's Health Sciences Division, VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Shannon Kehle-Forbes
- Minneapolis VA Healthcare System, Minneapolis, Minnesota, USA
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Brian N Smith
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
- National Center for PTSD Women's Health Sciences Division, VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Karen S Mitchell
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
- National Center for PTSD Women's Health Sciences Division, VA Boston Healthcare System, Boston, Massachusetts, USA
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Haller J. Herbal Cannabis and Depression: A Review of Findings Published over the Last Three Years. Pharmaceuticals (Basel) 2024; 17:689. [PMID: 38931356 PMCID: PMC11206863 DOI: 10.3390/ph17060689] [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: 04/24/2024] [Revised: 05/22/2024] [Accepted: 05/24/2024] [Indexed: 06/28/2024] Open
Abstract
Public perception contrasts scientific findings on the depression-related effects of cannabis. However, earlier studies were performed when cannabis was predominantly illegal, its production was mostly uncontrolled, and the idea of medical cannabis was incipient only. We hypothesized that recent changes in attitudes and legislations may have favorably affected research. In addition, publication bias against cannabis may have also decreased. To investigate this hypothesis, we conducted a review of research studies published over the last three years. We found 156 relevant research articles. In most cross-sectional studies, depression was higher in those who consumed cannabis than in those who did not. An increase in cannabis consumption was typically followed by an increase in depression, whereas withdrawal from cannabis ameliorated depression in most cases. Although medical cannabis reduced depression in most studies, none of these were placebo-controlled. In clinical studies published in the same period, the placebo also ameliorated depression and, in addition, the average effect size of the placebo was larger than the average effect size of medical cannabis. We also investigated the plausibility of the antidepressant effects of cannabis by reviewing molecular and pharmacological studies. Taken together, the reviewed findings do not support the antidepressant effects of herbal cannabis.
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Affiliation(s)
- Jozsef Haller
- Drug Research Institute, 1137 Budapest, Hungary;
- Department of Criminal Psychology, Faculty of Law Enforcement, Ludovika University of Public Service, 1083 Budapest, Hungary
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Manzo LL, Sarkar S, Nicholson NR, Sanft T, Poghosyan H. Prevalence and Correlates of Cannabis Use among U.S. Veterans during the Second Wave of the COVID-19 Pandemic. Mil Med 2024; 189:e1230-e1239. [PMID: 37715685 DOI: 10.1093/milmed/usad360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 08/09/2023] [Accepted: 08/31/2023] [Indexed: 09/18/2023] Open
Abstract
INTRODUCTION Military veterans are at increased risk of substance use disorders. Limited research is available about veterans' cannabis use (CU) during the coronavirus disease 2019 (COVID-19) pandemic. This study estimated the prevalence of past 30-day CU, investigated individual-level correlates of past 30-day CU, and evaluated the reasons (medical, recreational, or both) of past 30-day CU among U.S. Veterans during the second wave of the COVID-19 pandemic. MATERIALS AND METHODS We used population-based, cross-sectional data from the 2021 Behavioral Risk Factor Surveillance System Survey Marijuana Use model. The sample included nationally representative military veterans aged 18+ years (n = 11,167). The outcome was past 30-day CU. Individual-level demographic, socioeconomic, behavioral, and clinical correlates were examined. Analyses were weighted to account for the survey's complex design with results generalizable to nearly 2.9 million veterans. We conducted weighted descriptive statistics, prevalence estimates, and multivariable logistic regression analyses. RESULTS Out of 2.9 million veterans, 11.1% self-reported as non-Hispanic Black, 3.7% Hispanic, and 79.1% non-Hispanic White; 88.5% were men, and 72.8% were aged 50+ years. About 14.6% were current tobacco smokers, 4.7% were current e-cigarette users, 12.5% were binge alcohol drinkers, and 43.4% had three or more comorbid conditions. Overall, 8.5% reported CU in the past 30 days, of which 30.4% used it for medical reasons and 25.8% used it for nonmedical reasons. The prevalence of past 30-day CU decreased with age, education, and income level. Compared to their counterparts, the odds of past 30-day CU were greater among men, those living in urban areas, those with frequent mental distress, infrequent physical distress, and those who had at least one comorbid condition. Non-Hispanic Black veterans had 89% increased odds of past 30-day CU (adjusted odds ratio [AOR] =1.89, 95% confidence interval [CI], 1.19-3.0) compared with non-Hispanic White veterans. Current tobacco smokers had 3.54 (95% CI, 2.40-5.24) and former smokers had 1.78 (95% CI, 1.28-2.47) times higher odds of reporting past 30-day CU than never smokers. Current e-cigarette use (AOR = 3.37, 95% CI, 2.20-5.16) and binge drinking (AOR = 3.18, 95% CI, 2.29-4.41) were also statistically significantly associated with increased odds of past 30-day CU compared to no e-cigarette use and no binge drinking. CONCLUSIONS CU is prevalent among veterans, and certain subgroups are at higher risk of CU. Thus, identifying high-risk subgroups of veterans and adequately educating them about CU's benefits, risks, and safety is crucial.
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Affiliation(s)
- Laura L Manzo
- US Army, AMEDD Student Detachment, 187th Medical Battalion, Joint Base San Antonio, TX 78234, USA
- Yale School of Nursing, Orange, CT 06477, USA
| | | | | | - Tara Sanft
- Yale School of Medicine, New Haven, CT 06520, USA
| | - Hermine Poghosyan
- Yale School of Nursing, Orange, CT 06477, USA
- Cancer Outcomes, Public Policy, and Effectiveness Research Center (COPPER), Yale School of Medicine, New Haven, CT 06520, USA
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Falade-Nwulia O, Ward K, Wagner KD, Karimi-Sari H, Hsu J, Sulkowski M, Latkin C, Nwulia E. Loneliness and fearfulness are associated with non-fatal drug overdose among people who inject drugs. PLoS One 2024; 19:e0297209. [PMID: 38381763 PMCID: PMC10880973 DOI: 10.1371/journal.pone.0297209] [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: 08/04/2023] [Accepted: 12/29/2023] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND People who inject drugs (PWID) experience high rates of drug overdose death with the risk of mortality increasing after each non-fatal event. Racial differences exist in drug overdose rates, with higher rates among Black people who use drugs. Psychological factors may predict drug overdose. METHODS Cross-sectional data from a survey administered to PWID in Baltimore, MD enrolled in a social network-based intervention were analyzed. Linear regression methods with generalized estimating equations were used to analyze data from indexes and network members to assess for psychological factors significantly associated with self-reported number of lifetime drug overdoses. Factors associated with number of overdoses were assessed separately by race. RESULTS Among 111 PWID enrolled between January 2018 and January 2019, 25.2% were female, 65.7% were Black, 98.2% reported use of substances in addition to opioids, and the mean age was 49.0 ± 8.3 years. Seventy-five individuals (67.6%) had a history of any overdose with a mean of 5.0 ± 9.7 lifetime overdoses reported. Reports of feeling fearful (β = 9.74, P = 0.001) or feeling lonely all of the time (β = 5.62, P = 0.033) were independently associated with number of drug overdoses. In analyses disaggregated by race, only the most severe degree of fearfulness or loneliness was associated with overdose among Black participants, whereas among White participants, any degree of fearfulness or loneliness was associated with overdose. CONCLUSIONS In this study of PWID loneliness and fearfulness were significantly related to the number of reported overdose events. These factors could be targeted in future interventions.
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Affiliation(s)
- Oluwaseun Falade-Nwulia
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Kathleen Ward
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
- School of Public Health, Drexel University, Philadelphia, PA, United States of America
| | - Karla D. Wagner
- School of Public Health, University of Nevada, Reno, NV, United States of America
| | - Hamidreza Karimi-Sari
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Jeffrey Hsu
- Department of Psychiatry and Behavioral Science, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Mark Sulkowski
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Carl Latkin
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Evaristus Nwulia
- Department of Psychiatry, Howard University, Washington, DC, United States of America
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Clingan SE, Cousins SJ, Lin C, Nguyen TE, Hser YI, Mooney LJ. Perceptions of COVID-19 risk during the pandemic: perspectives from people seeking medication for opioid use disorder. Ann Med 2023; 55:480-489. [PMID: 36692029 PMCID: PMC9879168 DOI: 10.1080/07853890.2023.2169342] [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: 07/09/2022] [Revised: 01/11/2023] [Accepted: 01/12/2023] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION The Coronavirus Disease 2019 (COVID-19) pandemic has had devastating consequences for persons with opioid use disorder (OUD). Yet, little is known about how people seeking treatment for OUD perceive the risks of COVID-19 and how their perception interplays with their health behaviours. METHODS In-depth interviews were conducted from September 2021 to March 2022 with 32 patients seeking medication treatment for OUD (MOUD) in Southern California. All interviews were conducted virtually and lasted between one and two hours. Interviews were recorded and transcribed verbatim. Two qualitative researchers independently conducted a content analysis of the transcripts to identify themes. RESULTS Three primary themes were identified: (1) perceptions and beliefs about COVID-19 susceptibility and severity; (2) perceptions of COVID-19 risk compared to substance use behaviours; and (3) vaccine hesitancy. Participants were mixed in their beliefs of susceptibility to contracting COVID-19 and the severity of the disease if contracted. Some participants reported taking precautions to mitigate their chances of acquiring COVID-19, and other participants reported that COVID was not a big concern as substance use took priority. For many of the participants, COVID-19 concerns were overshadowed by the risk of overdosing on substances and other risky substance use behaviour. Most of the participants (n = 23; 72%) had received at least one COVID-19 vaccine by the time of the interview, but over half (n = 19; 59%) expressed vaccine hesitancy. Vaccine hesitancy was driven by concerns about the unknown long-term side effects and potential interactions of the vaccine with MOUD. CONCLUSIONS Our study provides insight into COVID-19 prevention measures as well as vaccination perceptions and hesitancy among people who received treatment for OUD.Key messagesParticipants expressed diverse perceptions of the seriousness of COVID-19, with some taking precautions to mitigate their chances of acquiring COVID-19 and others perceiving that the risk of contracting COVID-19 was less than the risk of overdosing.Substance use, social isolation, vaccine hesitancy and COVID-19 risk behaviours should be studied as co-occurring phenomena that have potentially overlapping relationships that can influence behaviours that impact health and well-being.
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Affiliation(s)
- Sarah E. Clingan
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Sarah J. Cousins
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Community Health Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Chunqing Lin
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Tram E. Nguyen
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Community Health Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Yih-Ing Hser
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Larissa J. Mooney
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
- VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
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Mehra K, Rup J, Wiese JL, Watson TM, Bonato S, Rueda S. Changes in self-reported cannabis use during the COVID-19 pandemic: a scoping review. BMC Public Health 2023; 23:2139. [PMID: 37915021 PMCID: PMC10621278 DOI: 10.1186/s12889-023-17068-7] [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: 01/27/2023] [Accepted: 10/26/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic is affecting mental health and substance use (MHSU) issues worldwide. The purpose of this study was to characterize the literature on changes in cannabis use during the pandemic and the factors associated with such changes. METHODS We conducted a scoping review by searching peer-reviewed databases and grey literature from January 2020 to May 2022 using the Arksey and O'Malley Framework. Two independent reviewers screened a total of 4235 documents. We extracted data from 129 documents onto a data extraction form and collated results using content analytical techniques. RESULTS Nearly half (48%) of the studies reported an increase/initiation of cannabis use, while 36% studies reported no change, and 16% reported a decrease/cessation of cannabis use during the pandemic. Factors associated with increased cannabis use included socio-demographic factors (e.g., younger age), health related factors (e.g., increased symptom burden), MHSU factors (e.g., anxiety, depression), pandemic-specific reactions (e.g., stress, boredom, social isolation), cannabis-related factors (e.g., dependence), and policy-related factors (e.g., legalization of medical/recreational cannabis). CONCLUSION Public health emergencies like the COVID-19 pandemic have the potential to significantly impact cannabis use. The pandemic has placed urgency on improving coping mechanisms and supports that help populations adapt to major and sudden life changes. To better prepare health care systems for future pandemics, wide-reaching education on how pandemic-related change impacts cannabis use is needed.
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Affiliation(s)
- Kamna Mehra
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College Street, Toronto, ON, M5T 1R8, Canada
| | - Jennifer Rup
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College Street, Toronto, ON, M5T 1R8, Canada
| | - Jessica L Wiese
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College Street, Toronto, ON, M5T 1R8, Canada
| | - Tara Marie Watson
- Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1V7, Canada
| | - Sarah Bonato
- Library Services, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada
| | - Sergio Rueda
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada.
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College Street, Toronto, ON, M5T 1R8, Canada.
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, 250 College Street, Toronto, ON, M5T 1R8, Canada.
- Institute of Health Policy, Management and Evaluation, Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A1, Canada.
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Butler JM, Wang X, Riddoch M, Thorpe A, Stevens V, Scherer LD, Drews FA, Shoemaker H, Fagerlin A. Veterans and Nonveterans Coping With Stress During 4 Months of COVID-19. Ann Fam Med 2023; 21:508-516. [PMID: 38012035 PMCID: PMC10681693 DOI: 10.1370/afm.3046] [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: 05/23/2023] [Revised: 08/01/2023] [Accepted: 08/07/2023] [Indexed: 11/29/2023] Open
Abstract
PURPOSE Identifying how people have been coping with stress during the COVID-19 pandemic allows us to anticipate how the population may react to similar stressors over time. In this study, we assessed patterns of coping styles among veterans and nonveterans, and stability and change in these strategies at 3 time points during the pandemic. METHODS Using an online survey platform, we circulated a questionnaire at 3 time points during the period when COVID-19 vaccines became widely available (December 2-27, 2020; January 21-February 6, 2021; and March 8-23, 2021). The questionnaire asked participants about their extent of use of 11 coping strategies, and symptoms of anxiety and depression. RESULTS A total of 2,085 participants (50.8% veterans) completed the questionnaire at 1 or more time points and 930 participants (62.8% veterans) completed it at all 3 time points. Cluster analysis identified 3 distinct coping styles: adaptive, distressed, and disengaged. Compared with nonveterans, veterans more commonly had adaptive and disengaged coping styles, and less commonly had a distressed coping style. The majority of the cohort (71.3%) changed coping style at least once during the study period. Participants who used the same coping style across all 3 time points reported lower levels of anxiety and depression. CONCLUSIONS Our data demonstrate a need to better understand the dynamic nature of coping with pandemic-level stressors across time. We did not find patterns of change in coping styles, but our findings point to potential advantages of stability in coping style. It is possible that less adaptive styles that are more stable may be advantageous for mental health. This research has implications for supporting patients dealing with stress in family medicine.
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Affiliation(s)
- Jorie M Butler
- Department of Biomedical Informatics, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, Utah
- Informatics, Decision-Enhancement, and Analytic Sciences (IDEAS) Center of Innovation, VA Salt Lake City Health Care System, Salt Lake City, Utah
- Geriatrics Research, Education, and Clinical Center (GRECC), VA Salt Lake City Health Care System, Salt Lake City, Utah
| | - Xuechen Wang
- Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, Utah
| | - Marian Riddoch
- Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, Utah
| | - Alistair Thorpe
- Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, Utah
| | - Vanessa Stevens
- Informatics, Decision-Enhancement, and Analytic Sciences (IDEAS) Center of Innovation, VA Salt Lake City Health Care System, Salt Lake City, Utah
- Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, Utah
| | - Laura D Scherer
- University of Colorado School of Medicine, Aurora, Colorado
- VA Denver Center for Innovation, Denver, Colorado
| | - Frank A Drews
- Informatics, Decision-Enhancement, and Analytic Sciences (IDEAS) Center of Innovation, VA Salt Lake City Health Care System, Salt Lake City, Utah
- University of Utah College of Social and Behavioral Science, Salt Lake City, Utah
| | - Holly Shoemaker
- Informatics, Decision-Enhancement, and Analytic Sciences (IDEAS) Center of Innovation, VA Salt Lake City Health Care System, Salt Lake City, Utah
- Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, Utah
| | - Angela Fagerlin
- Informatics, Decision-Enhancement, and Analytic Sciences (IDEAS) Center of Innovation, VA Salt Lake City Health Care System, Salt Lake City, Utah
- Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, Utah
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Li S, Huang S, Hu S, Lai J. Psychological consequences among veterans during the COVID-19 pandemic: A scoping review. Psychiatry Res 2023; 324:115229. [PMID: 37121218 PMCID: PMC10131745 DOI: 10.1016/j.psychres.2023.115229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 04/09/2023] [Accepted: 04/25/2023] [Indexed: 05/02/2023]
Abstract
Although there is an increasing number of studies reporting the psychological impact of COVID-19 on the general population and healthcare workers, relatively less attention has been paid to the veterans. This study aimed to review the existing literature regarding the psychological consequences of COVID-19 on veterans. A systematic search was conducted on PubMed, Embase, and the Cochrane Library from inception to December 3, 2022. A total of twenty-three studies were included with moderate-quality of evidence. Veterans experienced more mental health problems than civilians. The prevalence rates of alcohol use, anxiety, depression, post-traumatic stress disorder, stress, loneliness, and suicide ideation significantly increased during the pandemic, ranging from 9.6% to 47.4%, 9.4% to 53.5%, 8.6% to 55.1%, 4.1% to 58.0%, 4.3% to 39.4%, 15.9% to 28.4%, and 7.8% to 22.0%, respectively. The main risk factors of negative consequences included pandemic-related stress, poor family relationships, lack of social support, financial problems, and preexisting mental disorders. In contrast, higher household income and greater community interaction and support appeared to be resilience factors. In conclusion, the COVID-19 pandemic has increased adverse mental health consequences among veterans. Tackling mental health issues due to the COVID-19 pandemic among veterans should be a priority.
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Affiliation(s)
- Shaoli Li
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; Department of Medical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Shu Huang
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Shaohua Hu
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; The Key Laboratory of Mental Disorders' Management in Zhejiang Province, Hangzhou 310003, China; Brain Research Institute of Zhejiang University, Hangzhou 310058, China; Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou 310003, China; Department of Neurobiology, NHC and CAMS Key Laboratory of Medical Neurobiology, School of Brain Science and Brian Medicine, and MOE Frontier Science Center for Brain Science and Brain-Machine Integration, Zhejiang University School of Medicine, Hangzhou 310003, China.
| | - Jianbo Lai
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; The Key Laboratory of Mental Disorders' Management in Zhejiang Province, Hangzhou 310003, China; Brain Research Institute of Zhejiang University, Hangzhou 310058, China; Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou 310003, China; Department of Neurobiology, NHC and CAMS Key Laboratory of Medical Neurobiology, School of Brain Science and Brian Medicine, and MOE Frontier Science Center for Brain Science and Brain-Machine Integration, Zhejiang University School of Medicine, Hangzhou 310003, China.
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10
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Bonnet U, Specka M, Roser P, Scherbaum N. Cannabis use, abuse and dependence during the COVID-19 pandemic: a scoping review. J Neural Transm (Vienna) 2023; 130:7-18. [PMID: 36346483 PMCID: PMC9641691 DOI: 10.1007/s00702-022-02564-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 10/26/2022] [Indexed: 11/10/2022]
Abstract
The interaction between cannabis use or addiction and SARS-COV-2 infection rates and COVID-19 outcomes is obscure. As of 08/01/2022 among 57 evaluated epidemiological/clinical studies found in Pubmed-database, most evidence for how cannabis use patterns were influenced by the pandemic was given by two systematic reviews and 17 prospective studies, mostly involving adolescents. In this age group, cannabis use patterns have not changed markedly. For adults, several cross-sectional studies reported mixed results with cannabis use having increased, decreased or remained unchanged. Two cross-sectional studies demonstrated that the severity of adults´ cannabis dependence was either increased as a consequence of increasing cannabis use during the pandemic or not changed. Regarding the effect of cannabis use on COVID-19 outcomes, we found only five retrospective/cross-sectional studies. Accordingly, (i) cannabis use did not impact mild COVID-19 symptoms; (ii) cannabis using individuals experienced more COVID-19-related hospitalizations; (iii) cannabis using veterans were associated with reduced SARS-COV-2 infection rates; (iv) frequent cannabis use was significantly associated with COVID-19 mortality, and (v) cannabis dependents were at higher risk of COVID-19 breakthrough after vaccination. It should be outlined that the validity of these retrospective/cross-sectional studies (all self-reports or register/e-health-records) is rather low. Future prospective studies on the effects of cannabis use on SARS-COV-2 infection rates and COVID-19 outcomes are clearly required for conclusive risk-benefit assessments of the role of cannabis on users' health during the pandemic. Moreover, substance dependence (including cannabis) is associated with (often untreated) somatic comorbidity, which severity is a proven key risk factor for worse COVID-19 outcomes.
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Affiliation(s)
- Udo Bonnet
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Evangelisches Krankenhaus Castrop-Rauxel, Academic Teaching Hospital, University of Duisburg-Essen, Grutholzallee 21, 44577 Castrop-Rauxel, Germany ,Department of Psychiatry and Psychotherapy, Faculty of Medicine, LVR-Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Michael Specka
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, LVR-Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Patrik Roser
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, LVR-Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Norbert Scherbaum
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, LVR-Hospital Essen, University of Duisburg-Essen, Essen, Germany
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11
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Lennon JC, Hantke N, Mattek N, Wu CY, Dodge H, Wall R, Beattie Z, Kaye J, Silbert L. Mood and activity changes during the COVID-19 pandemic in rural and urban Veterans and their cohabitants. Clin Gerontol 2023; 46:759-766. [PMID: 36208222 PMCID: PMC10132474 DOI: 10.1080/07317115.2022.2130123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES We aimed to examine the impact of COVID-19 pandemic-related stay-at-home orders on weekly reports of mood and activity before and during COVID-19 in a sample of older Veterans and their cohabitants. METHODS Urban and rural Veterans and their cohabitants living in the Pacific Northwest ≥62 years old were enrolled as part of the Collaborative Aging Research Using Technology initiative (n = 100, age = 71.2 ± 6.5, 41% women). Participants reported frequency of social activities (e.g., travel away), physical illness, and mood (blue mood and loneliness) via weekly online health forms. RESULTS A total of 2,441 weekly online health forms (OHFs) were collected from 100 participants. During the COVID-19 pandemic, blue mood (OR = 4.4, p < .0001) and loneliness (OR = 7.2, p < .0001) were significantly higher than before the pandemic, and travel away from home was significantly lower (OR = 0.5, p < .0001). Prevalence of blue mood and loneliness were not associated with rurality. CONCLUSIONS The current study established that blue mood and loneliness were significantly more prevalent in older Veterans following COVID-19 stay-at-home orders regardless of rurality. CLINICAL IMPLICATIONS The COVID-19 pandemic associated health precautions, while necessary to curb acute health risks, have created a unique situation that places vulnerable populations at increased risk of low mood.
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Affiliation(s)
- Jack C. Lennon
- Division of Mental Health & Clinical Neurosciences, Veterans Affairs Portland Health Care System, Portland, OR USA
| | - Nathan Hantke
- Division of Mental Health & Clinical Neurosciences, Veterans Affairs Portland Health Care System, Portland, OR USA
- Department of Neurology, Oregon Health & Science University, Portland, OR USA
- NIA-Layton Aging & Alzheimer’s Disease Research Center, Portland, OR USA
| | - Nora Mattek
- Department of Neurology, Oregon Health & Science University, Portland, OR USA
- NIA-Layton Aging & Alzheimer’s Disease Research Center, Portland, OR USA
- Oregon Center for Aging & Technology (ORCATECH), Portland, OR USA
| | - Chao-Yi Wu
- Department of Neurology, Oregon Health & Science University, Portland, OR USA
- NIA-Layton Aging & Alzheimer’s Disease Research Center, Portland, OR USA
- Oregon Center for Aging & Technology (ORCATECH), Portland, OR USA
| | - Hiroko Dodge
- Department of Neurology, Oregon Health & Science University, Portland, OR USA
- NIA-Layton Aging & Alzheimer’s Disease Research Center, Portland, OR USA
- Oregon Center for Aging & Technology (ORCATECH), Portland, OR USA
| | - Rachel Wall
- Department of Neurology, Oregon Health & Science University, Portland, OR USA
- NIA-Layton Aging & Alzheimer’s Disease Research Center, Portland, OR USA
- Oregon Center for Aging & Technology (ORCATECH), Portland, OR USA
| | - Zachary Beattie
- Department of Neurology, Oregon Health & Science University, Portland, OR USA
- NIA-Layton Aging & Alzheimer’s Disease Research Center, Portland, OR USA
- Oregon Center for Aging & Technology (ORCATECH), Portland, OR USA
| | - Jeffrey Kaye
- Department of Neurology, Oregon Health & Science University, Portland, OR USA
- NIA-Layton Aging & Alzheimer’s Disease Research Center, Portland, OR USA
- Oregon Center for Aging & Technology (ORCATECH), Portland, OR USA
| | - Lisa Silbert
- Department of Neurology, Oregon Health & Science University, Portland, OR USA
- NIA-Layton Aging & Alzheimer’s Disease Research Center, Portland, OR USA
- Oregon Center for Aging & Technology (ORCATECH), Portland, OR USA
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12
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Sanders JS, Pillai RLI, Sturley R, Sillau S, Asato MR, Aravamuthan BR, Bonuck K, Cervenka MC, Hammond N, Siegel JF, Siasoco V, Margolis BA. Impact of the COVID-19 Pandemic on the Behavioral Health of People With Intellectual and Developmental Disabilities. Psychiatr Serv 2022; 73:1389-1392. [PMID: 35734865 DOI: 10.1176/appi.ps.202100524] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The authors examined how the COVID-19 pandemic affected the behavioral health of people with intellectual and developmental disabilities (IDD). METHODS A modified version of the Coronavirus Health Impact Survey-Adapted for Autism and Related Neurodevelopmental Conditions was sent to the authors' clinical networks and IDD-affiliated organizations from March to June 2021. RESULTS In total, 437 people with IDD or their caregivers responded to the survey. Diagnoses included intellectual disability (51%) and autism spectrum disorder (48%). More than half (52%) of respondents reported worsened mental health. Losing access to services correlated with declining mental health. Interventions suggested to improve behavioral health included more time with friends and family (68%), more time outdoors (61%), and access to community activities (59%). CONCLUSIONS COVID-19 affected the behavioral health of individuals with IDD. Survey results highlight the opportunity to leverage physical activity and pandemic-safe social supports as accessible means to mitigate gaps in services.
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Affiliation(s)
- Jessica Solomon Sanders
- Department of Pediatrics (Sanders) and Department of Neurology (Sanders, Sillau), University of Colorado School of Medicine, Aurora; University of Massachusetts Chan Medical School-Baystate, Springfield (Pillai); Program in Humanistic Studies, Princeton University, Princeton, New Jersey (Sturley); Kennedy Krieger Institute (Asato) and Adult Epilepsy Diet Center (Cervenka), Johns Hopkins School of Medicine, Baltimore; Institute of Clinical and Translational Sciences, Washington University School of Medicine, St. Louis (Aravamuthan); Department of Pediatrics, Albert Einstein College of Medicine, New York City (Bonuck, Siegel, Siasoco); Department of Neurology, University of Kansas Medical Center, Kansas City (Hammond); Access: Supports for Living, Middletown, New York (Margolis)
| | - Rajapillai L I Pillai
- Department of Pediatrics (Sanders) and Department of Neurology (Sanders, Sillau), University of Colorado School of Medicine, Aurora; University of Massachusetts Chan Medical School-Baystate, Springfield (Pillai); Program in Humanistic Studies, Princeton University, Princeton, New Jersey (Sturley); Kennedy Krieger Institute (Asato) and Adult Epilepsy Diet Center (Cervenka), Johns Hopkins School of Medicine, Baltimore; Institute of Clinical and Translational Sciences, Washington University School of Medicine, St. Louis (Aravamuthan); Department of Pediatrics, Albert Einstein College of Medicine, New York City (Bonuck, Siegel, Siasoco); Department of Neurology, University of Kansas Medical Center, Kansas City (Hammond); Access: Supports for Living, Middletown, New York (Margolis)
| | - Rachel Sturley
- Department of Pediatrics (Sanders) and Department of Neurology (Sanders, Sillau), University of Colorado School of Medicine, Aurora; University of Massachusetts Chan Medical School-Baystate, Springfield (Pillai); Program in Humanistic Studies, Princeton University, Princeton, New Jersey (Sturley); Kennedy Krieger Institute (Asato) and Adult Epilepsy Diet Center (Cervenka), Johns Hopkins School of Medicine, Baltimore; Institute of Clinical and Translational Sciences, Washington University School of Medicine, St. Louis (Aravamuthan); Department of Pediatrics, Albert Einstein College of Medicine, New York City (Bonuck, Siegel, Siasoco); Department of Neurology, University of Kansas Medical Center, Kansas City (Hammond); Access: Supports for Living, Middletown, New York (Margolis)
| | - Stefan Sillau
- Department of Pediatrics (Sanders) and Department of Neurology (Sanders, Sillau), University of Colorado School of Medicine, Aurora; University of Massachusetts Chan Medical School-Baystate, Springfield (Pillai); Program in Humanistic Studies, Princeton University, Princeton, New Jersey (Sturley); Kennedy Krieger Institute (Asato) and Adult Epilepsy Diet Center (Cervenka), Johns Hopkins School of Medicine, Baltimore; Institute of Clinical and Translational Sciences, Washington University School of Medicine, St. Louis (Aravamuthan); Department of Pediatrics, Albert Einstein College of Medicine, New York City (Bonuck, Siegel, Siasoco); Department of Neurology, University of Kansas Medical Center, Kansas City (Hammond); Access: Supports for Living, Middletown, New York (Margolis)
| | - Miya R Asato
- Department of Pediatrics (Sanders) and Department of Neurology (Sanders, Sillau), University of Colorado School of Medicine, Aurora; University of Massachusetts Chan Medical School-Baystate, Springfield (Pillai); Program in Humanistic Studies, Princeton University, Princeton, New Jersey (Sturley); Kennedy Krieger Institute (Asato) and Adult Epilepsy Diet Center (Cervenka), Johns Hopkins School of Medicine, Baltimore; Institute of Clinical and Translational Sciences, Washington University School of Medicine, St. Louis (Aravamuthan); Department of Pediatrics, Albert Einstein College of Medicine, New York City (Bonuck, Siegel, Siasoco); Department of Neurology, University of Kansas Medical Center, Kansas City (Hammond); Access: Supports for Living, Middletown, New York (Margolis)
| | - Bhooma R Aravamuthan
- Department of Pediatrics (Sanders) and Department of Neurology (Sanders, Sillau), University of Colorado School of Medicine, Aurora; University of Massachusetts Chan Medical School-Baystate, Springfield (Pillai); Program in Humanistic Studies, Princeton University, Princeton, New Jersey (Sturley); Kennedy Krieger Institute (Asato) and Adult Epilepsy Diet Center (Cervenka), Johns Hopkins School of Medicine, Baltimore; Institute of Clinical and Translational Sciences, Washington University School of Medicine, St. Louis (Aravamuthan); Department of Pediatrics, Albert Einstein College of Medicine, New York City (Bonuck, Siegel, Siasoco); Department of Neurology, University of Kansas Medical Center, Kansas City (Hammond); Access: Supports for Living, Middletown, New York (Margolis)
| | - Karen Bonuck
- Department of Pediatrics (Sanders) and Department of Neurology (Sanders, Sillau), University of Colorado School of Medicine, Aurora; University of Massachusetts Chan Medical School-Baystate, Springfield (Pillai); Program in Humanistic Studies, Princeton University, Princeton, New Jersey (Sturley); Kennedy Krieger Institute (Asato) and Adult Epilepsy Diet Center (Cervenka), Johns Hopkins School of Medicine, Baltimore; Institute of Clinical and Translational Sciences, Washington University School of Medicine, St. Louis (Aravamuthan); Department of Pediatrics, Albert Einstein College of Medicine, New York City (Bonuck, Siegel, Siasoco); Department of Neurology, University of Kansas Medical Center, Kansas City (Hammond); Access: Supports for Living, Middletown, New York (Margolis)
| | - Mackenzie C Cervenka
- Department of Pediatrics (Sanders) and Department of Neurology (Sanders, Sillau), University of Colorado School of Medicine, Aurora; University of Massachusetts Chan Medical School-Baystate, Springfield (Pillai); Program in Humanistic Studies, Princeton University, Princeton, New Jersey (Sturley); Kennedy Krieger Institute (Asato) and Adult Epilepsy Diet Center (Cervenka), Johns Hopkins School of Medicine, Baltimore; Institute of Clinical and Translational Sciences, Washington University School of Medicine, St. Louis (Aravamuthan); Department of Pediatrics, Albert Einstein College of Medicine, New York City (Bonuck, Siegel, Siasoco); Department of Neurology, University of Kansas Medical Center, Kansas City (Hammond); Access: Supports for Living, Middletown, New York (Margolis)
| | - Nancy Hammond
- Department of Pediatrics (Sanders) and Department of Neurology (Sanders, Sillau), University of Colorado School of Medicine, Aurora; University of Massachusetts Chan Medical School-Baystate, Springfield (Pillai); Program in Humanistic Studies, Princeton University, Princeton, New Jersey (Sturley); Kennedy Krieger Institute (Asato) and Adult Epilepsy Diet Center (Cervenka), Johns Hopkins School of Medicine, Baltimore; Institute of Clinical and Translational Sciences, Washington University School of Medicine, St. Louis (Aravamuthan); Department of Pediatrics, Albert Einstein College of Medicine, New York City (Bonuck, Siegel, Siasoco); Department of Neurology, University of Kansas Medical Center, Kansas City (Hammond); Access: Supports for Living, Middletown, New York (Margolis)
| | - Joanne F Siegel
- Department of Pediatrics (Sanders) and Department of Neurology (Sanders, Sillau), University of Colorado School of Medicine, Aurora; University of Massachusetts Chan Medical School-Baystate, Springfield (Pillai); Program in Humanistic Studies, Princeton University, Princeton, New Jersey (Sturley); Kennedy Krieger Institute (Asato) and Adult Epilepsy Diet Center (Cervenka), Johns Hopkins School of Medicine, Baltimore; Institute of Clinical and Translational Sciences, Washington University School of Medicine, St. Louis (Aravamuthan); Department of Pediatrics, Albert Einstein College of Medicine, New York City (Bonuck, Siegel, Siasoco); Department of Neurology, University of Kansas Medical Center, Kansas City (Hammond); Access: Supports for Living, Middletown, New York (Margolis)
| | - Vincent Siasoco
- Department of Pediatrics (Sanders) and Department of Neurology (Sanders, Sillau), University of Colorado School of Medicine, Aurora; University of Massachusetts Chan Medical School-Baystate, Springfield (Pillai); Program in Humanistic Studies, Princeton University, Princeton, New Jersey (Sturley); Kennedy Krieger Institute (Asato) and Adult Epilepsy Diet Center (Cervenka), Johns Hopkins School of Medicine, Baltimore; Institute of Clinical and Translational Sciences, Washington University School of Medicine, St. Louis (Aravamuthan); Department of Pediatrics, Albert Einstein College of Medicine, New York City (Bonuck, Siegel, Siasoco); Department of Neurology, University of Kansas Medical Center, Kansas City (Hammond); Access: Supports for Living, Middletown, New York (Margolis)
| | - Benjamin A Margolis
- Department of Pediatrics (Sanders) and Department of Neurology (Sanders, Sillau), University of Colorado School of Medicine, Aurora; University of Massachusetts Chan Medical School-Baystate, Springfield (Pillai); Program in Humanistic Studies, Princeton University, Princeton, New Jersey (Sturley); Kennedy Krieger Institute (Asato) and Adult Epilepsy Diet Center (Cervenka), Johns Hopkins School of Medicine, Baltimore; Institute of Clinical and Translational Sciences, Washington University School of Medicine, St. Louis (Aravamuthan); Department of Pediatrics, Albert Einstein College of Medicine, New York City (Bonuck, Siegel, Siasoco); Department of Neurology, University of Kansas Medical Center, Kansas City (Hammond); Access: Supports for Living, Middletown, New York (Margolis)
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13
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Krause-Parello CA, Flynn L, Hibler DA, Presciutti RE, Pratt BA, Walsh P, Garvin JT, Morse CY, Carter L, Moreno SJ. Social and Chronic Pain: Veterans Sharing a Path in Developing a Patient-Centered Response to the COVID-19 Pandemic. JOURNAL OF VETERANS STUDIES 2022. [DOI: 10.21061/jvs.v8i1.331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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14
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Reilly ED, Chamberlin ES, Duarte BA, Harris JI, Shirk SD, Kelly MM. The Impact of COVID-19 on Self-Reported Substance Use, Well-Being, and Functioning Among United States Veterans: A Cross-Sectional Study. Front Psychol 2022; 13:812247. [PMID: 35478735 PMCID: PMC9035845 DOI: 10.3389/fpsyg.2022.812247] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 03/14/2022] [Indexed: 12/24/2022] Open
Abstract
As the COVID-19 pandemic sweeps the globe, many veterans with substance use issues have faced the closure of treatment facilities, mandates to shelter in place, and social distancing measures. To better understand their pandemic experiences, substance use changes, and functioning, a survey was nationally administered to a sample of United States veterans reporting substance use issues during the pandemic. The purpose of this cross-sectional online survey for veterans (N = 409) was to report on COVID-19 experiences, safety behaviors, and infection experiences while also investigating the relationship among addictive behaviors, mental and physical health, and COVID-19 impact. Measures also assessed specific substance use concerns, pandemic-related loneliness, and functioning. Though few veterans reported personally receiving a confirmed COVID-19 medical diagnosis (10.5%), the impact of pandemic stressors was evident, with a majority reporting anxiety related to contracting COVID-19 (61.4%) or fear of a family member or close friend contracting COVID-19 (58.7%). Participants reported increased use of alcohol (45.3%), sedatives (36.6%), inhalants (35.7%), tobacco (35.0%), and cannabis (34.9%), attributed specifically to the pandemic. Regression analyses revealed that even when controlling for the contribution of problematic substance use issues, negative pandemic impacts and self-reported COVID-19 related loneliness were related to more impaired physical and mental health functioning during the pandemic. Findings from this sample of veterans with addiction issues add to the growing literature suggesting unique and adverse effects of COVID-19 stressors on functioning while also revealing specific pandemic impacts for this group.
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Affiliation(s)
- Erin D. Reilly
- Mental Illness Research, Education, and Clinical Center (MIRECC), VA Bedford Healthcare System, Bedford, MA, United States
- The Department of Psychiatry and Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
- *Correspondence: Erin D. Reilly,
| | - Elizabeth S. Chamberlin
- Mental Illness Research, Education, and Clinical Center (MIRECC), VA Bedford Healthcare System, Bedford, MA, United States
| | | | - J. Irene Harris
- Mental Illness Research, Education, and Clinical Center (MIRECC), VA Bedford Healthcare System, Bedford, MA, United States
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Steven D. Shirk
- Mental Illness Research, Education, and Clinical Center (MIRECC), VA Bedford Healthcare System, Bedford, MA, United States
- The Department of Psychiatry and Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Megan M. Kelly
- Mental Illness Research, Education, and Clinical Center (MIRECC), VA Bedford Healthcare System, Bedford, MA, United States
- The Department of Psychiatry and Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
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15
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Marchand WR, Joubert K, Smith J, Nazarenko E, Klinger W, Sheppard S, Hoopes KH. A Pilot Observational Study of Implementing an Equine-A ssisted Services Program Within a VA Medical Center Residential Substance Use Disorder Treatment Program. Mil Med 2022; 188:usac028. [PMID: 35231128 DOI: 10.1093/milmed/usac028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/14/2021] [Accepted: 01/27/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION The aim of this observational pilot study was to assess the safety, feasibility, preliminary outcomes, and predictors of participant response as a result of implementing an equine-assisted intervention within a residential substance abuse treatment program at a large Veterans Administration medical center. A secondary aim was to evaluate psychological instruments for use in future, more rigorous studies. The overarching goal was to complete the necessary work to prepare for a large randomized controlled trial of this intervention for Veterans with addictive disorders. MATERIALS AND METHODS Participants were 33 Veterans, 29 males and 4 females, who participated in one 4-hour session of combined equine-assisted learning and equine-assisted psychotherapy during an admission to a residential substance abuse treatment program. Preintervention and postintervention instruments were utilized to assess changes in affect, anxiety, and craving. Demographic and diagnostic variables were evaluated for the potential to predict outcomes. RESULTS The intervention was safe and feasible to utilize as there were no adverse outcomes to patients, staff, or equines. The State-Trait Anxiety Inventory, Craving Experience Questionnaire, and Positive and Negative Affect Scale revealed preliminary findings of significant preintervention to postintervention decreases in anxiety, negative affect, and craving, as well as increased positive affect. Lastly, the presence or absence of a history of suicide attempts and/or suicidal ideation were predictive of some postintervention scores. CONCLUSION While more rigorous studies are needed, these results indicate that the intervention evaluated in this study is safe and feasible to utilize for Veterans admitted to a residential substance abuse treatment program. Furthermore, preliminary outcomes suggest that this intervention, and perhaps other equine-assisted interventions, has the potential to be beneficial to Veterans with addictive disorders as well as those at risk of suicide. The psychological instruments used in this intervention appear to be appropriate for use in future investigations. Additionally, more rigorous studies are warranted, and this work provides the necessary first steps needed to proceed with those investigations.
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Affiliation(s)
- William R Marchand
- VISN 19 Whole Health Flagship Site, VA Salt Lake City Health Care System, Salt Lake City, UT 84148, USA
- Department of Psychiatry, University of Utah, Salt Lake City, UT 84108, USA
- Department of Animal, Dairy and Veterinary Sciences, Utah State University, Logan, UT 84322, USA
| | - Katryna Joubert
- Mental Health Service, VA Salt Lake City Health Care System, Salt Lake City, UT 84148, USA
| | - Judy Smith
- Department of Animal, Dairy and Veterinary Sciences, Utah State University, Logan, UT 84322, USA
| | - Elena Nazarenko
- VISN 19 Whole Health Flagship Site, VA Salt Lake City Health Care System, Salt Lake City, UT 84148, USA
| | - William Klinger
- Mental Health Service, VA Salt Lake City Health Care System, Salt Lake City, UT 84148, USA
| | - Stephen Sheppard
- Mental Health Service, VA Salt Lake City Health Care System, Salt Lake City, UT 84148, USA
| | - Karl H Hoopes
- Department of Animal, Dairy and Veterinary Sciences, Utah State University, Logan, UT 84322, USA
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