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Alarcão V, Candeias P, Stefanovska-Petkovska M, Neves J, Pintassilgo S, Machado FL, Santos O, Virgolino A, Santos RR, Heitor MJ, Costa A. Insights from the EQUALS4COVID19 study on migrant mental health in Portugal: a cross-sectional mixed-methods approach. BMC Public Health 2024; 24:2023. [PMID: 39075428 PMCID: PMC11285180 DOI: 10.1186/s12889-024-19563-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 07/23/2024] [Indexed: 07/31/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic and related disruptive consequences in the economic, health, and educational sectors have impacted people's lives, contributing to a context of increased economic and social vulnerability. The pandemic has revealed and accentuated social inequalities and discrimination based on racial or ethnic origin. This study aimed to contribute to the promotion of the mental health and well-being of migrant populations living in Portugal via the definition of an analytical framework and recommendations emerging from the EQUALS4COVID19 project. METHODS To gather information on the impact of the COVID-19 pandemic and resilience determinants among immigrants, a mixed-methods approach was implemented in 2022, combining a cross-sectional survey targeting immigrant adults in Portugal, focus groups with immigrants, focus groups with healthcare professionals, and in-depth individual interviews with stakeholders involved in the implementation of measures related to mental health and well-being during the pandemic. The analysis followed an integrated framework; quantitative data informed the script of qualitative data collection methods, and qualitative analysis informed the reinterpretation of quantitative data. RESULTS The survey with 604 Brazilian and Cape Verdean immigrants revealed that gender (being a woman) was associated with both psychological distress and depression-related symptomatology and that the perception of discrimination was a major risk factor for psychological suffering, while perceived social support and individuals' resilience characteristics were protective factors. Qualitative data provided deeper insights into these findings, revealing the ways mental health is affected by social structures, such as gender and ethnic hierarchies. Migrants tend to work in precarious jobs requiring physical presence, which, together with dense housing conditions, puts them at higher risk of infection. The deterioration of the economic conditions of the general population has also increased the perception of ethnic-racial discrimination, which was found to be related to the increase in insecurity and anxiety-related symptomatology among the migrant population. Newly arrived migrants, with reduced support networks, experienced a greater sense of insecurity as well as concern and anguish regarding relatives who live far away, in their home country. Migrant women reported greater family-related distress, including work-life balance problems. CONCLUSIONS Proposals to address mental health inequalities should be considered in the context of the necessary global changes both at the societal level and in the delivery of mental health services. Additionally, they should be considered with the active involvement of migrants, families, and communities in the design and delivery of mental health promotion and care processes.
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Affiliation(s)
- Violeta Alarcão
- Centro de Investigação e Estudos de Sociologia, Iscte - Instituto Universitário de Lisboa, Avenida das Forças Armadas, Lisboa, 1649-026, Portugal.
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal.
- Iscte - Instituto Universitário de Lisboa, Avenida das Forças Armadas, Lisboa, 1649-026, Portugal.
| | - Pedro Candeias
- Centro de Investigação e Estudos de Sociologia, Iscte - Instituto Universitário de Lisboa, Avenida das Forças Armadas, Lisboa, 1649-026, Portugal
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal
- Iscte - Instituto Universitário de Lisboa, Avenida das Forças Armadas, Lisboa, 1649-026, Portugal
| | - Miodraga Stefanovska-Petkovska
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal
| | - Júlia Neves
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal
| | - Sónia Pintassilgo
- Centro de Investigação e Estudos de Sociologia, Iscte - Instituto Universitário de Lisboa, Avenida das Forças Armadas, Lisboa, 1649-026, Portugal
- Iscte - Instituto Universitário de Lisboa, Avenida das Forças Armadas, Lisboa, 1649-026, Portugal
| | - Fernando Luís Machado
- Centro de Investigação e Estudos de Sociologia, Iscte - Instituto Universitário de Lisboa, Avenida das Forças Armadas, Lisboa, 1649-026, Portugal
- Iscte - Instituto Universitário de Lisboa, Avenida das Forças Armadas, Lisboa, 1649-026, Portugal
| | - Osvaldo Santos
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal
- Unbreakable Idea Research, Estrada Nacional 115, Sítio da Caniceira, nº 1, Casarão, Painho, 2550-426, Portugal
| | - Ana Virgolino
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal
| | - Ricardo R Santos
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal
| | - Maria João Heitor
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal
- Psychiatry and Mental Health Department, Hospital Beatriz Ângelo, Loures, Portugal
- Centro de Investigação Interdisciplinar em Saúde (CIIS), Faculdade de Medicina, Universidade Católica Portuguesa, Lisboa, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas - TERRA, Lisboa, Portugal
| | - Andreia Costa
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas - TERRA, Lisboa, Portugal
- Innovation and Development Centre of Lisbon (CIDNUR), Nursing Research, Nursing School of Lisbon, Lisbon, Portugal
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Herrmann K, Beese F, Wollgast L, Mauz E, Kersjes C, Hoebel J, Wachtler B. Temporal dynamics of socioeconomic inequalities in depressive and anxiety symptoms during the COVID-19 pandemic: a scoping review. Front Public Health 2024; 12:1397392. [PMID: 39022423 PMCID: PMC11252079 DOI: 10.3389/fpubh.2024.1397392] [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: 03/07/2024] [Accepted: 06/19/2024] [Indexed: 07/20/2024] Open
Abstract
Background The existence of socioeconomic inequalities in the prevalence of symptoms of depression and anxiety is widely acknowledged, and individuals from lower socioeconomic backgrounds tend to exhibit higher rates of symptoms. However, the direction in which the COVID-19 pandemic has influenced these disparities remains uncertain. We therefore aimed to systematically outline the available evidence on the temporal dynamics of socioeconomic inequalities in symptoms related to depression and anxiety during the COVID-19 pandemic across high-income countries. Methods A scoping review was conducted by searching the databases Embase, Scopus and PsycINFO. According to pre-defined eligibility criteria, two reviewers independently screened titles and abstracts as well as full texts of the compiled records. Data from the included studies were extracted using a standardised data-extraction form and analysed numerically and narratively. The scoping review followed the PRISMA-ScR guidelines. Results A total of 49 studies comprising 149 analyses of socioeconomic indicators in relation to symptoms of depression and anxiety were included. Despite heterogeneous study designs and results, there was a tendency of increasing (40.9%; n = 61) or persistent (38.2%; n = 57) inequality trends to the detriment of those in socially more disadvantaged positions. Increasing inequalities were most pronounced when income was used as a socioeconomic indicator. Groups with lower socioeconomic status appeared most vulnerable in the initial phase of the COVID-19 pandemic. Throughout the pandemic, dynamics were diverse, with persistent trends most frequently reported. Conclusion Overall, to the detriment of those with lower socioeconomic status, mental-health inequalities persisted or increased in most analyses. Continually monitoring socioeconomic inequalities over time is crucial, since this makes it possible to adapt prevention and intervention strategies to specific pandemic phases. Interventions targeting job security, income security and educational attainment could reduce mental-health inequalities. The results can contribute to preparedness plans for future pandemics and crises.
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Affiliation(s)
- Kiara Herrmann
- Institute of Public Health, Charité – University Medicine Berlin, Berlin, Germany
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Florian Beese
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Lina Wollgast
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Elvira Mauz
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Christina Kersjes
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Jens Hoebel
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Benjamin Wachtler
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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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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Savaglio M, O'Donnell R, Skouteris H. The impact of COVID-19 on community mental health: lessons learned from Tasmania, Australia. Aust J Prim Health 2024; 30:NULL. [PMID: 37731283 DOI: 10.1071/py23006] [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: 01/25/2023] [Accepted: 09/04/2023] [Indexed: 09/22/2023]
Abstract
BACKGROUND The COVID-19 pandemic had a significant impact on community mental health globally and widened pre-existing health and social inequities. Tasmania, Australia has one of the highest rates of mental ill health and socioeconomic disadvantage in the country. Whilst Tasmania experienced a delayed and reduced physical presence of COVID-19 compared to other states and territories, mental health impacts remain. It is necessary to understand such impacts to inform policy, practice, and recommendations to enhance the mental health service sector and prevent future mental health burden. This qualitative study aimed to explore expert mental health stakeholders' perspectives of the impact of COVID-19 on: (1) the mental health of people living in Tasmania, and (2) mental health services. METHOD Semi-structured interviews with 12 expert mental health stakeholders across Tasmania were conducted. This sample was well-positioned to comment on the impact of COVID-19 on community mental health and provide recommendations to enhance the sector. Interviews were thematically analysed. RESULTS Three subthemes exploring the COVID-19 impact on mental health were included: (1) anxiety, distress, and isolation; (2) varying presentations across age groups; and (3) increased complexity. Four key themes capturing the COVID-19 impact on mental health services were identified: (1) transition to telehealth; (2) increased service demand; (3) spotlight on service gaps; and (4) local workforce shortages. CONCLUSIONS The pandemic has highlighted existing gaps across the community mental health service sector, and exacerbated existing psychosocial/structural stressors resulting in increased presentations and complexity of mental illness among the community, particularly for youth. Existing treatment gaps and inequities in service access, engagement, and mental health outcomes will persist if not addressed. Recommendations have been provided to inform community mental health service planning, policy, design, access, and provision, and improve wellbeing.
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Affiliation(s)
- Melissa Savaglio
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic., Australia
| | - Renee O'Donnell
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic., Australia
| | - Helen Skouteris
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic., Australia; and Warwick Business School, University of Warwick, Coventry, UK
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Plummer N, Guardado R, Ngassa Y, Montalvo C, Kotoujian PJ, Siddiqi K, Senst T, Simon K, Acevedo A, Wurcel AG. Racial Differences in Self-Report of Mental Illness and Mental Illness Treatment in the Community: An Analysis of Jail Intake Data. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2023; 50:966-975. [PMID: 37733128 PMCID: PMC10543583 DOI: 10.1007/s10488-023-01297-4] [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] [Accepted: 08/19/2023] [Indexed: 09/22/2023]
Abstract
Jails and prisons in the United States house people with elevated rates of mental health and substance use disorders. The goal of this cross-sectional study was to evaluate the frequency of racial/ethnic differences in the self-report of mental illness and psychiatric medication use at jail entry. Our sample included individuals who had been incarcerated between 2016 and 2020 at the Middlesex Jail & House of Correction, located in Billerica, MA. We used data from the "Offender Management System," the administrative database used by the jail containing data on people who are incarcerated, and COREMR, the electronic medical record (EMR) used in the Middlesex Jail & House of Correction. We evaluated two primary outcomes (1) self-reported mental illness history and (2) self-reported use of psychiatric medication, with the primary indicator of interest as race/ethnicity. At intake, over half (57%) of the sample self-reported history of mental illness and 20% reported the use of psychiatric medications. Among people who self-reported a history of mental illness, Hispanic (AOR: 0.73, 95% CI: 0.60-0.90), Black (AOR: 0.52, 95% CI: 0.43-0.64), Asian/Pacific Islander (Non-Hispanic) people (AOR: 0.31, 95% CI: 0.13-0.74), and people from other racial/ethnic groups (AOR: 0.33, 95% CI: 0.11-0.93) all had decreased odds of reporting psychiatric medications. Mental illness was reported in about one-half of people who entered jail, but only 20% reported receiving medications in the community prior to incarceration. Our findings build on the existing literature on jail-based mental illness and show racial disparities in self-report of psychiatric medications in people who self-reported mental illness. The timing, frequency, and equity of mental health services in both the community and the jail setting deserves further research, investment, and improvement.
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Affiliation(s)
- Narcissa Plummer
- Department of Population Health, Northeastern University, Boston, MA USA
| | - Rubeen Guardado
- Division of Geographic Medicine and Infectious Diseases, Department of Medicine, Tufts Medical Center, Boston, MA USA
| | - Yvane Ngassa
- Division of Geographic Medicine and Infectious Diseases, Department of Medicine, Tufts Medical Center, Boston, MA USA
| | - Cristina Montalvo
- Department of Psychiatry, Tufts Medical Center, Boston, MA USA
- Tufts University School of Medicine, Boston, MA USA
| | | | | | | | - Kevin Simon
- Harvard Medical School, Boston, MA USA
- Children’s Hospital, Boston, MA USA
| | - Andrea Acevedo
- Department of Community Health, Tufts University, Medford, MA USA
| | - Alysse G. Wurcel
- Division of Geographic Medicine and Infectious Diseases, Department of Medicine, Tufts Medical Center, Boston, MA USA
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Guillen-Burgos HF, Galvez-Florez JF, Moreno-Lopez S, Gonzalez I, Guillen M, Anaya JM. Factors associated with mental health outcomes after COVID-19: A 24-month follow-up longitudinal study. Gen Hosp Psychiatry 2023; 84:241-249. [PMID: 37690207 DOI: 10.1016/j.genhosppsych.2023.08.009] [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: 02/23/2023] [Revised: 08/26/2023] [Accepted: 08/29/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVE Investigate the proportion of mental health outcomes (MHOs) and associated factors in COVID-19 survivors during a 24-month follow-up period. METHOD An observational, prospective study was performed in a teaching hospital in Barranquilla, Colombia, from April 1, 2020, to August 30, 2022. A cohort of 1565 COVID-19 survivors was recruited after discharge from the emergency room (ER), inpatient floor (IF), and intensive care unit (ICU) services and followed for 24 -months. The clinical assessment included screening scales for symptoms of anxiety, depressive, post-traumatic stress disorder (PTSD), and insomnia. Sociodemographic and clinical factors were also collected to identify possible associated factors. Descriptive, bivariate and mixed random-effect linear models were performed. RESULTS A total of 1565 patients were included, of whom 785 (50.35%) were men. A large proportion of patients with mental symptoms were identified. After 24-months, the proportions of anxiety, depression, PTSD, and insomnia symptoms remained high at 16.55%, 21.79%, 35.27%, and 23.86%, respectively. Social factors, location of hospital stays, physical comorbidities, and the severity of COVID-19 were significantly associated with anxiety, depression, PTSD, and insomnia symptoms. CONCLUSIONS COVID-19's 2-year deleterious impacts on mental health, as well as the variables influencing these findings, have been documented. These results should aid in the development of public health initiatives to reduce morbidity rates in post-COVID-19 patients.
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Affiliation(s)
- Hernan F Guillen-Burgos
- Center for Clinical and Translational Research, Facultad de Ciencias de la Salud, Universidad Simón Bolívar, Barranquilla, Colombia; Center for Clinical and Translational Research, School of Medicine, Universidad El Bosque, Bogotá, Colombia; Department of Psychiatry and Mental Health, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia.
| | - Juan Francisco Galvez-Florez
- Center for Clinical and Translational Research, Facultad de Ciencias de la Salud, Universidad Simón Bolívar, Barranquilla, Colombia; Latin-American Society of Consultation - Liaison Psychiatry, Bogotá, Colombia
| | | | - Isabella Gonzalez
- Center for Clinical and Translational Research, Facultad de Ciencias de la Salud, Universidad Simón Bolívar, Barranquilla, Colombia; School of Medicine, Universidad del Rosario, Bogotá, Colombia
| | - Manuela Guillen
- Center for Clinical and Translational Research, Facultad de Ciencias de la Salud, Universidad Simón Bolívar, Barranquilla, Colombia; School of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Juan-Manuel Anaya
- Health Research and Innovation Center - Coosalud EPS, Cartagena, Colombia.
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Caqueo-Urízar A, Mena-Chamorro P, Henríquez D, Urzúa A, Irarrázaval M. The Effects of Social Determinants and Resilience on the Mental Health of Chilean Adolescents. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1213. [PMID: 37508710 PMCID: PMC10378294 DOI: 10.3390/children10071213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/04/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023]
Abstract
The aim of this research was to evaluate the effects of social determinants (i.e., gender, educational vulnerability, and socioeconomic status) and resilience on the mental health of Chilean adolescents in pre-, during, and post-COVID-19 pandemic contexts. The study included a group of 684 students, ranging in age from 12 to 18 years, who were attending educational institutions in the city of Arica. The Child and Adolescent Assessment System (SENA) was used to measure mental health problems, the Brief Resilience Scale for Children and Youth (CYRM-12) was used to measure resilience, and the Vulnerability Index of Educational Institutions was used to measure educational vulnerability. The results suggest increases in depressive, anxious, and social anxiety symptomatologies over time (wave by year, 2018, 2020, and 2021). In addition, multiple linear regression models showed predictive effects of the COVID-19 pandemic, gender, vulnerability index, socioeconomic status, and resilient behaviors on mental health problems. The worsening of mental health indicators over time requires the greater coordination and integration of mental health experts in the most vulnerable educational centers.
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Affiliation(s)
| | - Patricio Mena-Chamorro
- Centro de Justicia Educacional CJE, Pontificia Universidad Católica de Chile, Santiago 7820436, Chile
| | - Diego Henríquez
- Centro de Justicia Educacional CJE, Pontificia Universidad Católica de Chile, Santiago 7820436, Chile
| | - Alfonso Urzúa
- Escuela de Psicología, Universidad Católica del Norte, Antofagasta 1270709, Chile
| | - Matías Irarrázaval
- Department of Psychiatry, Faculty of Medicine, Clinical Hospital, Universidad de Chile, Santiago 8380453, Chile
- Millennium Institute for Research in Depression and Personality, MIDAP, Santiago 8380453, Chile
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Prabhakaran D, Day GS, Munipalli B, Rush BK, Pudalov L, Niazi SK, Brennan E, Powers HR, Durvasula R, Athreya A, Blackmon K. Neurophenotypes of COVID-19: Risk factors and recovery outcomes. Brain Behav Immun Health 2023; 30:100648. [PMID: 37293441 PMCID: PMC10239310 DOI: 10.1016/j.bbih.2023.100648] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 04/24/2023] [Accepted: 06/03/2023] [Indexed: 06/10/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) infection is associated with risk of persistent neurocognitive and neuropsychiatric complications. It is unclear whether the neuropsychological manifestations of COVID-19 present as a uniform syndrome or as distinct neurophenotypes with differing risk factors and recovery outcomes. We examined post-acute neuropsychological profiles following SARS-CoV-2 infection in 205 patients recruited from inpatient and outpatient populations, using an unsupervised machine learning cluster analysis, with objective and subjective measures as input features. This resulted in three distinct post-COVID clusters. In the largest cluster (69%), cognitive functions were within normal limits, although mild subjective attention and memory complaints were reported. Vaccination was associated with membership in this "normal cognition" phenotype. Cognitive impairment was present in the remaining 31% of the sample but clustered into two differentially impaired groups. In 16% of participants, memory deficits, slowed processing speed, and fatigue were predominant. Risk factors for membership in the "memory-speed impaired" neurophenotype included anosmia and more severe COVID-19 infection. In the remaining 15% of participants, executive dysfunction was predominant. Risk factors for membership in this milder "dysexecutive" neurophenotype included disease-nonspecific factors such as neighborhood deprivation and obesity. Recovery outcomes at 6-month follow-up differed across neurophenotypes, with the normal cognition group showing improvement in verbal memory and psychomotor speed, the dysexecutive group showing improvement in cognitive flexibility, and the memory-speed impaired group showing no objective improvement and relatively worse functional outcomes compared to the other two clusters. These results indicate that there are multiple post-acute neurophenotypes of COVID-19, with different etiological pathways and recovery outcomes. This information may inform phenotype-specific approaches to treatment.
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Affiliation(s)
- Divya Prabhakaran
- Mayo Clinic, Center for Individualized Medicine, Jacksonville, FL, USA
- University of California, San Diego, Radiation Medicine and Applied Sciences, San Diego, CA, USA
| | - Gregory S Day
- Mayo Clinic, Department of Neurology, Jacksonville, FL, USA
| | - Bala Munipalli
- Mayo Clinic, Department of General Internal Medicine, Jacksonville, FL, USA
| | - Beth K Rush
- Mayo Clinic, Department of Psychiatry and Psychology, Jacksonville, FL, USA
| | - Lauren Pudalov
- Mayo Clinic, Department of Psychiatry and Psychology, Jacksonville, FL, USA
| | - Shehzad K Niazi
- Mayo Clinic, Department of Psychiatry and Psychology, Jacksonville, FL, USA
| | - Emily Brennan
- Mayo Clinic, Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Jacksonville, FL, USA
| | - Harry R Powers
- Mayo Clinic, Division of Infectious Diseases, Jacksonville, FL, USA
| | - Ravi Durvasula
- Mayo Clinic, Division of Infectious Diseases, Jacksonville, FL, USA
| | - Arjun Athreya
- Mayo Clinic, Department of Molecular Pharmacology and Experimental Therapeutics, Rochester, MN, USA
- Mayo Clinic, Department of Psychiatry and Psychology, Rochester, MN, USA
| | - Karen Blackmon
- Mayo Clinic, Department of Psychiatry and Psychology, Jacksonville, FL, USA
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García MLN, Martínez PF, Bretón EF, Martínez Alfonso MM, Gil PS. Psychotropic consumption before and during COVID-19 in Asturias, Spain. BMC Public Health 2023; 23:494. [PMID: 36918825 PMCID: PMC10014411 DOI: 10.1186/s12889-023-15360-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 03/02/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Spain as multiple other countries has been experiencing an increasing and sustained trend in the use of psychotropic medications since the mid 90s. Recent studies show public health measures implemented to control SARS-Cov2, such as mobility restrictions and the shutdown of nonessential activities increased mental suffering, even contributing to a higher number of anxiety, depression and insomnia disorders that could lead to an increase in the consumption of psychotropics. The aims were: 1) Evaluate the temporal trend in psychotropic consumption by pharmacological subgroup, sex, and age group 2) Estimate the effect of the COVID-19 pandemic in the use of psychotropic drugs. METHODS We conducted a retrospective observational study, retrieving all prescriptions of anxiolytics, hypnotics and sedatives, and antidepressants dispensed in pharmacies of Asturias (Northern Spain) for Primary Care patients for the period 2018-2021. We presented the data expressed in Daily Defined Doses (DDDs) for 1000 persons/day (DHD). To estimate changes in DHDs by year and age group we conducted two multiple linear regressions (one for males and one for females) for every pharmacological subgroup studied. Changes were considered statistically significant when the regression coefficient was p < 0.05. We used the Software R 4.1.0. RESULTS For the studied period, the highest DHDs are for antidepressants, although all of the subgroups experienced an increase in consumption rates. Women consumed more psychotropic drugs than men. In 2021, 372 out of every 1000 women were taking daily 1 DDD of these drugs versus 184 out of every 1000 men. Consumption rates for all psychotropic drugs progressively increases with age. Conversely, the biggest increases in consumption were among the youngest age groups (0-14 and 15-29 years) for women, while for men there is more variability. The regression models suggest an upward trend in psychotropic consumption during all the period, especially remarkable from 2020, for both genders and all age groups. CONCLUSIONS - The consumption of psychotropic drugs has gradually increased over the last 4 years, with a significant boost starting in 2020 for both sexes, matching the start of the SARS-COV2 pandemic and the implementation of strict Public Health measures to contain it. - The increase observed on children and adolescents is a matter of concern.
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Affiliation(s)
- María Luisa Nicieza García
- Health Department, General Directorate of Health Policy and Planning, Asturias, Spain.
- Biostatistics and Epidemiology Platform, Health Research Institute of Asturias, Asturias, Spain.
| | | | - Eva Fernández Bretón
- Biostatistics and Epidemiology Platform, Health Research Institute of Asturias, Asturias, Spain
| | | | - Patricio Suárez Gil
- Biostatistics and Epidemiology Platform, Health Research Institute of Asturias, Asturias, Spain
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Wicks CL, Barton JL, Andrews L, Orbell S, Sandercock G, Wood CJ. The Impact of the Coronavirus Pandemic on the Contribution of Local Green Space and Nature Connection to Mental Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5083. [PMID: 36981991 PMCID: PMC10049389 DOI: 10.3390/ijerph20065083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/08/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Exposure to green space and feeling connected to the natural environment have independently been associated with improved mental health outcomes. During the coronavirus pandemic, people experienced restrictions on access to the outdoors, and health data indicated a decline in mental health in the UK general population. METHODS Data available from two independent surveys conducted prior to and during the pandemic enabled a naturally occurring comparison of mental health and its correlates prior to and during the pandemic. RESULTS Survey responses from 877 UK residents were included in the analyses. Independent t-tests revealed significant declines in mental health scores during the pandemic. After controlling for age and gender, greater nature connection significantly predicted lower depression and stress and improved well-being. Percentage of green space did not significantly predict any mental health outcomes. Further, time point (pre- or during COVID) and the interaction of time point with green space and nature connection did not significantly predict any of the outcome measures. The findings indicate that nature connection may play an important role in promoting mental health. Strategies to improve mental health and reduce mental illness should consider the role of nature connection and the use of interventions that involve direct interaction with natural environments.
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Affiliation(s)
- Claire L. Wicks
- School of Health and Social Care, University of Essex, Colchester CO4 3SQ, UK
| | - Jo L. Barton
- School of Sport, Rehabilitation and Exercise Science, University of Essex, Colchester CO4 3SQ, UK
| | - Leanne Andrews
- School of Health and Social Care, University of Essex, Colchester CO4 3SQ, UK
| | - Sheina Orbell
- Department of Psychology, University of Essex, Colchester CO4 3SQ, UK
| | - Gavin Sandercock
- School of Sport, Rehabilitation and Exercise Science, University of Essex, Colchester CO4 3SQ, UK
| | - Carly J. Wood
- School of Sport, Rehabilitation and Exercise Science, University of Essex, Colchester CO4 3SQ, UK
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11
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Thomas LE, Emich A, Weiss E, Zisman C, Foray K, Roberts DM, Page E, Ernst M. Examination of the COVID-19 Pandemic's Impact on Mental Health From Three Perspectives: Global, Social, and Individual. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2023; 18:513-526. [PMID: 36173751 PMCID: PMC10018233 DOI: 10.1177/17456916221078310] [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] [Indexed: 11/16/2022]
Abstract
The extent of the deleterious effects of the COVID-19 pandemic on mental health is recognized ubiquitously. However, these effects are subject to many modulatory factors from a plethora of domains of examination. It is important to understand the intersection of societal and individual levels for global stressors compared with local phenomena and physical-health outcomes. Here, we consider three perspectives: international/cultural, social, and individual. Both the enduring threat of COVID-19 infection and the protective measures to contain contagion have important consequences on individual mental health. These consequences, together with possible remedial interventions, are the focus of this article. We hope this work will stimulate more research and will suggest factors that need to be considered in the coordination of responses to a global threat, allowing for better preparation in the future.
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Affiliation(s)
- Lauren E. Thomas
- Section on the Neurobiology of Fear and Anxiety, National Institute of Mental Health, Bethesda, Maryland
| | - Abigail Emich
- Section on the Neurobiology of Fear and Anxiety, National Institute of Mental Health, Bethesda, Maryland
| | - Emily Weiss
- Section on the Neurobiology of Fear and Anxiety, National Institute of Mental Health, Bethesda, Maryland
| | - Corina Zisman
- Section on the Neurobiology of Fear and Anxiety, National Institute of Mental Health, Bethesda, Maryland
| | - Katherine Foray
- Section on the Neurobiology of Fear and Anxiety, National Institute of Mental Health, Bethesda, Maryland
| | - Deborah M. Roberts
- Section on the Neurobiology of Fear and Anxiety, National Institute of Mental Health, Bethesda, Maryland
| | - Emily Page
- Section on the Neurobiology of Fear and Anxiety, National Institute of Mental Health, Bethesda, Maryland
| | - Monique Ernst
- Section on the Neurobiology of Fear and Anxiety, National Institute of Mental Health, Bethesda, Maryland
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Prabhakaran D, Day GS, Munipalli B, Rush BK, Pudalov L, Niazi SK, Brennan E, Powers HR, Durvasula R, Athreya A, Blackmon K. Neurophenotypes of COVID-19: risk factors and recovery outcomes. RESEARCH SQUARE 2023:rs.3.rs-2363210. [PMID: 36597538 PMCID: PMC9810229 DOI: 10.21203/rs.3.rs-2363210/v2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Coronavirus disease 2019 (COVID-19) infection is associated with risk of persistent neurocognitive and neuropsychiatric complications, termed "long COVID". It is unclear whether the neuropsychological manifestations of COVID-19 present as a uniform syndrome or as distinct neurophenotypes with differing risk factors and recovery outcomes. We examined post-acute neuropsychological profiles following SARS-CoV-2 infection in 205 patients recruited from inpatient and outpatient populations, using an unsupervised machine learning cluster analysis, with objective and subjective measures as input features. This resulted in three distinct post-COVID clusters. In the largest cluster (69%), cognitive functions were within normal limits, although mild subjective attention and memory complaints were reported. Vaccination was associated with membership in this "normal cognition" phenotype. Cognitive impairment was present in the remaining 31% of the sample but clustered into two differentially impaired groups. In 16% of participants, memory deficits, slowed processing speed, and fatigue were predominant. Risk factors for membership in the "memory-speed impaired" neurophenotype included anosmia and more severe COVID-19 infection. In the remaining 15% of participants, executive dysfunction was predominant. Risk factors for membership in this milder "dysexecutive" neurophenotype included disease-nonspecific factors such as neighborhood deprivation and obesity. Recovery outcomes at 6-month follow-up differed across neurophenotypes, with the normal cognition group showing improvement in verbal memory and psychomotor speed, the dysexecutive group showing improvement in cognitive flexibility, and the memory-speed impaired group showing no objective improvement and relatively worse functional outcomes compared to the other two clusters. These results indicate that there are multiple post-acute neurophenotypes of long COVID, with different etiological pathways and recovery outcomes. This information may inform phenotype-specific approaches to treatment.
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13
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Prabhakaran D, Day G, Munipalli B, Rush B, Pudalov L, Niazi S, Brennan E, Powers H, Durvasula R, Athreya A, Blackmon K. Neurophenotypes of COVID-19: risk factors and recovery outcomes. RESEARCH SQUARE 2023:rs.3.rs-2363210. [PMID: 36597538 PMCID: PMC9810229 DOI: 10.21203/rs.3.rs-2363210/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Coronavirus disease 2019 (COVID-19) infection is associated with risk of persistent neurocognitive and neuropsychiatric complications, termed "long COVID". It is unclear whether the neuropsychological manifestations of COVID-19 present as a uniform syndrome or as distinct neurophenotypes with differing risk factors and recovery outcomes. We examined post-acute neuropsychological profiles following SARS-CoV-2 infection in 205 patients recruited from inpatient and outpatient populations, using an unsupervised machine learning cluster analysis, with objective and subjective measures as input features. This resulted in three distinct post-COVID clusters. In the largest cluster (69%), cognitive functions were within normal limits, although mild subjective attention and memory complaints were reported. Vaccination was associated with membership in this "normal cognition" phenotype. Cognitive impairment was present in the remaining 31% of the sample but clustered into two differentially impaired groups. In 16% of participants, memory deficits, slowed processing speed, and fatigue were predominant. Risk factors for membership in the "memory-speed impaired" neurophenotype included anosmia and more severe COVID-19 infection. In the remaining 15% of participants, executive dysfunction was predominant. Risk factors for membership in this milder "dysexecutive" neurophenotype included disease-nonspecific factors such as neighborhood deprivation and obesity. Recovery outcomes at 6-month follow-up differed across neurophenotypes, with the normal cognition group showing improvement in verbal memory and psychomotor speed, the dysexecutive group showing improvement in cognitive flexibility, and the memory-speed impaired group showing no objective improvement and relatively worse functional outcomes compared to the other two clusters. These results indicate that there are multiple post-acute neurophenotypes of long COVID, with different etiological pathways and recovery outcomes. This information may inform phenotype-specific approaches to treatment.
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Núñez-Cortés R, Cruz-Montecinos C, Torreblanca-Vargas S, Andersen LL, Tapia C, Ortega-Palavecinos M, López-Bueno R, Calatayud J, Pérez-Alenda S. Social determinants of health and physical activity are related to pain intensity and mental health in patients with carpal tunnel syndrome. Musculoskelet Sci Pract 2023; 63:102723. [PMID: 36740566 DOI: 10.1016/j.msksp.2023.102723] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 01/24/2023] [Accepted: 01/30/2023] [Indexed: 02/01/2023]
Abstract
BACKGROUND Carpal tunnel syndrome (CTS) is the most common peripheral neuropathy of the upper limb and a frequent cause of disability. OBJECTIVE To analyze the association between social determinants of health (SDH) and physical activity with pain intensity and mental health in patients with CTS. DESIGN A cross-sectional study was conducted in patients with CTS awaiting surgery in two public hospitals in Chile. METHODS The SDH collected included: employment status, educational level and monetary income. The level of physical activity was defined according to compliance with WHO recommendations. Outcome measures included: Pain intensity (Visual Analog Scale), Symptoms of anxiety and depression (Hospital Anxiety and Depression Scale), and catastrophic thinking (Pain Catastrophizing Scale). The adjusted regression coefficient (β) for the association between SDH and physical activity with each outcome was obtained using multivariable linear regression models controlling for age, sex, body mass index and symptom duration. RESULTS Eighty-six participants were included (mean age 50.9 ± 10 years, 94% women). A high level of physical activity was associated with a 12.41 mm decrease in pain intensity (β = -12.41, 95%CI: -23.87 to -0.95) and a 3.29 point decrease in depressive symptoms (β = -3.29, 95%CI: -5.52 to -1.06). In addition, being employed was associated with a 2.30 point decrease in anxiety symptoms (β = -2.30; 95%CI: -4.41 to -0.19) and a high educational level was associated with a 7.71 point decrease in catastrophizing (β = -7.71; 95%CI: -14.06 to -1.36). CONCLUSION Multidisciplinary care teams should be aware of the association between SDH and physical activity with physical and mental health.
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Affiliation(s)
- Rodrigo Núñez-Cortés
- Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain; Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile; Section of Clinical Research, Hospital Clínico La Florida, Santiago, Chile
| | - Carlos Cruz-Montecinos
- Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain; Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile; Section of Research, Innovation and Development in Kinesiology, Kinesiology Unit, San José Hospital, Santiago, Chile
| | | | | | - Claudio Tapia
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile
| | | | - Rubén López-Bueno
- National Research Centre for the Working Environment, Copenhagen, Denmark; Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Spain; Department of Physical Medicine and Nursing, University of Zaragoza, Zaragoza, Spain
| | - Joaquín Calatayud
- National Research Centre for the Working Environment, Copenhagen, Denmark; Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Spain.
| | - Sofía Pérez-Alenda
- Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain
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Rodríguez-Agudelo Y, Nava-Adán J, Paz-Rodríguez F, Abundes-Corona A, Flores-Rivera J, Corona T. Quality of life and mental health in multiple sclerosis patients during the COVID-19 Pandemic. Mult Scler Relat Disord 2023; 70:104487. [PMID: 36640561 PMCID: PMC9789892 DOI: 10.1016/j.msard.2022.104487] [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: 06/21/2022] [Revised: 11/16/2022] [Accepted: 12/22/2022] [Indexed: 12/26/2022]
Abstract
BACKGROUND The COVID-19 pandemic had a profound impact on mental health symptoms and quality of life (QoL) in the general population due to necessary public health restrictions such as social distancing. The psychosocial effect of the pandemic on vulnerable groups such as people living with Multiple Sclerosis (PwMS) has been scarcely explored in countries with additional socioeconomical burdens such as access to healthcare disparities METHODS: A questionnaire exploring sociodemographic variables, quality of life, mental health determinants and sleep quality was applied to 92 PwMS to explore changes prior and during the pandemic regarding these domains RESULTS: 58.8% of the subjects were female, median age was 37.1 (± 8.5) years and relapsing-remitting MS was the predominant clinical subtype (83.5%). Unemployment rate significantly increased during the pandemic (12.3% vs 27.8%; p= 0.001). Only 46.4% received medical follow-up care during the pandemic. QoL was affected predominantly due to limitations in instrumented activities of daily life (IADL). Neuropsychiatric symptoms, requiring healthcare during the pandemic, anxiety prior to the pandemic and restricted IADL were predictors of MS-related physical impact worsening, while decreased physical/emotional wellbeing selfcare, neuropsychiatric symptoms, bad sleep quality, anxiety prior to the pandemic and restricted non-instrumental ADL predicted aggravation of MS-related psychological impact measured by the MSIS-29. Curiously, specific items regarding anxiety were more prevalent prior to the pandemic (anxious mood; p=0.02, helplessness; p=0.01), sleep problems; p=0.001 and cardiovascular symptoms; p=0.001, nevertheless, stability was observed for most items. Importantly, 77.3% of PwMS reported at least one neuropsychiatric symptom CONCLUSION: The deleterious effects of the COVID-19 pandemic on psychosocial wellbeing in PwMS, QoL and mental health outcomes are frequently overseen in vulnerable populations such as PwMS. Albeit the limitations of this study, our results may help implement policies that prevent negative outcomes on psychosocial wellbeing due to public health measures (e.g., social distancing) in MS and other neurological diseases that inexorably need constant follow-up.
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Affiliation(s)
| | | | - Francisco Paz-Rodríguez
- Clinical Neuropsychology Laboratory, National Institute of Neurology and Neurosurgery, Mexico
| | - Arturo Abundes-Corona
- Clinical Neurodegenerative Diseases Laboratory, National Institute of Neurology and Neurosurgery
| | - José Flores-Rivera
- Clinical Neurodegenerative Diseases Laboratory, National Institute of Neurology and Neurosurgery
| | - Teresa Corona
- Faculty of Medicine, National Autonomous University of Mexico, Mexico; Clinical Neurodegenerative Diseases Laboratory, National Institute of Neurology and Neurosurgery.
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Sobierajski T, Surma S, Romańczyk M, Krzystanek M. The Global Pandemic as a Life-Changer? Medical, Psychological, or Self Help during COVID-19 Pandemic: A Cross-Sectional Representative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1092. [PMID: 36673848 PMCID: PMC9859610 DOI: 10.3390/ijerph20021092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/03/2023] [Accepted: 01/05/2023] [Indexed: 06/17/2023]
Abstract
The survey was conducted on a representative adult sample of Poles one year after the announcement of the global COVID-19 pandemic. The survey aimed to determine how the public in different social groups and age categories assessed the impact of the pandemic on their personal and professional lives, and where and to what extent respondents sought psychological and medical help to cope with the effects caused by the pandemic. The survey was conducted using the CAWI technique based on a questionnaire designed by an interdisciplinary team of experts. The study indicated that 61.9% of respondents declared that the COVID-19 pandemic did not bring any good, and had rather adverse effects on their lives, and 57.7% of respondents declared that the pandemic had not affected their professional lives. Nearly half of the respondents (45.0%) declared that although the pandemic forced them to change their personal lives, it did not work out for them. Due to the impact of the COVID-19 pandemic, every eighth respondent (12.3%) contacted a mental health specialist-a psychologist, or psychiatrist. Young people most often use psychological and medical help. Due to its representative nature, the survey can be used for in-depth qualitative analyses of the impact of the pandemic on people's mental health.
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Affiliation(s)
- Tomasz Sobierajski
- Faculty of Applied Social Sciences and Resocialization, University of Warsaw, 26/28 Krakowskie Przedmieście Str., 00-927 Warsaw, Poland
| | - Stanisław Surma
- Clinic of Psychiatric Rehabilitation, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 45/47 Ziołowa Str., 40-635 Katowice, Poland
| | - Monika Romańczyk
- Clinic of Psychiatric Rehabilitation, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 45/47 Ziołowa Str., 40-635 Katowice, Poland
| | - Marek Krzystanek
- Clinic of Psychiatric Rehabilitation, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 45/47 Ziołowa Str., 40-635 Katowice, Poland
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Mũrage A, Ngunjiri A, Oyekunle A, Smith J. Social determinants of mental health among older adolescent girls living in urban informal settlements in Kenya and Nigeria during the COVID-19 pandemic. Glob Public Health 2023; 18:2264946. [PMID: 37801724 DOI: 10.1080/17441692.2023.2264946] [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: 05/30/2023] [Accepted: 09/22/2023] [Indexed: 10/08/2023]
Abstract
The health burden due to mental health has historically been underestimated with focus on communicable diseases and deaths and little consideration of disability and comorbidity effects of poor mental health. Recent data show increasing trends of mental health disorders as a share of global health burdens and vulnerability of adolescents. This paper aims to explore social determinants of mental health as experienced by adolescent girls, drawing attention to gendered risks during the COVID-19 pandemic. Semi-structured interviews with twenty-two adolescent girls in urban informal settlements in Kenya and Nigeria reveal unique environmental, socio-cultural, economic and educational factors that threatened their mental wellbeing. The pandemic exacerbated these determinants. An equitable recovery will require a consideration of not only disproportional mental health outcomes, but also social determinants that contribute to these outcomes. As more than half of the urban population in sub-Saharan Africa reside in informal settlements, this study has implications for youth-focused mental health interventions in these and similar settings.
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18
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Tsujimoto KC, Cost KT, LaForge-MacKenzie K, Anagnostou E, Birken CS, Charach A, Monga S, Kelly E, Nicolson R, Georgiadis S, Lee N, Osokin K, Arnold P, Schachar R, Burton C, Crosbie J, Korczak DJ. School and learning contexts during the COVID-19 pandemic: Implications for child and youth mental health. CURRENT PSYCHOLOGY 2022; 42:1-17. [PMID: 36468159 PMCID: PMC9685153 DOI: 10.1007/s12144-022-03941-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2022] [Indexed: 11/25/2022]
Abstract
Despite significant disruption to school during the COVID-19 pandemic, research on the impact on children is sparse. This study examines in-person and virtual learning contexts and the impact of school format on mental health (MH). Children and adolescents were recruited from community and clinical settings. Parents and children completed prospective online surveys about school experiences (November 2020) and MH symptoms (February/March 2021), including school format and activities. Standardized measures of depression, anxiety, inattention, and hyperactivity were collected. Hierarchical regression analyses tested associations between school format and MH. Children (N = 1011; aged 6-18 years) attending school in-person (n = 549) engaged in high levels of participation in COVID-19 health measures and low levels of social learning activities. Learning online in high school was associated with greater MH symptoms (B = -2.22, CI[-4.32,-.12] to B = -8.18, CI[-15.59,-.77]). Children with no previous MH condition that attended school virtually experienced a similar magnitude of MH symptoms as those with previous MH conditions. However, children who attended school in a hybrid in-person format, with no previous MH condition, experienced less hyperactivity as same-age peers with prior MH problems (B = -8.08, CI[1.58,14.58]). Children's learning environments looked very different compared to before the pandemic. Removing children from school environments and limiting opportunities that support their MH, such as social learning activities, is problematic. Efforts to address the learning contexts to protect the mental health of children are needed.
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Affiliation(s)
- Kimberley C. Tsujimoto
- Department of Psychiatry, Hospital for Sick Children, 1145 Burton Wing, 555 University Ave, Toronto, ON M5G 1X8 Canada
| | - Katherine Tombeau Cost
- Department of Psychiatry, Hospital for Sick Children, 1145 Burton Wing, 555 University Ave, Toronto, ON M5G 1X8 Canada
| | - Kaitlyn LaForge-MacKenzie
- Department of Psychiatry, Hospital for Sick Children, 1145 Burton Wing, 555 University Ave, Toronto, ON M5G 1X8 Canada
| | - Evdokia Anagnostou
- Deprtment of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON Canada
- Holland Bloorview Research Institute, Toronto, ON Canada
| | - Catherine S. Birken
- Deprtment of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON Canada
- Division of Pediatric Medicine, Hospital for Sick Children, Toronto, ON Canada
| | - Alice Charach
- Department of Psychiatry, Hospital for Sick Children, 1145 Burton Wing, 555 University Ave, Toronto, ON M5G 1X8 Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON Canada
| | - Suneeta Monga
- Department of Psychiatry, Hospital for Sick Children, 1145 Burton Wing, 555 University Ave, Toronto, ON M5G 1X8 Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON Canada
| | - Elizabeth Kelly
- Departments of Psychology and Psychiatry, Queens University, Kingston, ON Canada
| | - Rob Nicolson
- Department of Child and Adolescent Psychiatry, University of Western Ontario, London, ON Canada
| | - Stelios Georgiadis
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON Canada
| | - Nicole Lee
- Toronto District School Board, Toronto, ON Canada
| | | | - Paul Arnold
- Department of Psychiatry, University of Calgary, AB Calgary, Canada
- Department Medical Genetics, University of Calgary, AB Calgary, Canada
| | - Russell Schachar
- Department of Psychiatry, Hospital for Sick Children, 1145 Burton Wing, 555 University Ave, Toronto, ON M5G 1X8 Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON Canada
| | - Christie Burton
- Department of Psychiatry, Hospital for Sick Children, 1145 Burton Wing, 555 University Ave, Toronto, ON M5G 1X8 Canada
| | - Jennifer Crosbie
- Department of Psychiatry, Hospital for Sick Children, 1145 Burton Wing, 555 University Ave, Toronto, ON M5G 1X8 Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON Canada
| | - Daphne J. Korczak
- Department of Psychiatry, Hospital for Sick Children, 1145 Burton Wing, 555 University Ave, Toronto, ON M5G 1X8 Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON Canada
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Xiao Y, Sharma MM, Thiruvalluru RK, Gimbrone C, Weissman MM, Olfson M, Keyes KM, Pathak J. Trends in psychiatric diagnoses by COVID-19 infection and hospitalization among patients with and without recent clinical psychiatric diagnoses in New York city from March 2020 to August 2021. Transl Psychiatry 2022; 12:492. [PMID: 36414624 PMCID: PMC9681844 DOI: 10.1038/s41398-022-02255-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 11/02/2022] [Accepted: 11/09/2022] [Indexed: 11/24/2022] Open
Abstract
Determining emerging trends of clinical psychiatric diagnoses among patients infected with the SARS-CoV-2 virus is important to understand post-acute sequelae of SARS-CoV-2 infection or long COVID. However, published reports accounting for pre-COVID psychiatric diagnoses have usually relied on self-report rather than clinical diagnoses. Using electronic health records (EHRs) among 2,358,318 patients from the New York City (NYC) metropolitan region, this time series study examined changes in clinical psychiatric diagnoses between March 2020 and August 2021 with month as the unit of analysis. We compared trends in patients with and without recent pre-COVID clinical psychiatric diagnoses noted in the EHRs up to 3 years before the first COVID-19 test. Patients with recent clinical psychiatric diagnoses, as compared to those without, had more subsequent anxiety disorders, mood disorders, and psychosis throughout the study period. Substance use disorders were greater between March and August 2020 among patients without any recent clinical psychiatric diagnoses than those with. COVID-19 positive patients (both hospitalized and non-hospitalized) had greater post-COVID psychiatric diagnoses than COVID-19 negative patients. Among patients with recent clinical psychiatric diagnoses, psychiatric diagnoses have decreased since January 2021, regardless of COVID-19 infection/hospitalization. However, among patients without recent clinical psychiatric diagnoses, new anxiety disorders, mood disorders, and psychosis diagnoses increased between February and August 2021 among all patients (COVID-19 positive and negative). The greatest increases were anxiety disorders (378.7%) and mood disorders (269.0%) among COVID-19 positive non-hospitalized patients. New clinical psychosis diagnoses increased by 242.5% among COVID-19 negative patients. This study is the first to delineate the impact of COVID-19 on different clinical psychiatric diagnoses by pre-COVID psychiatric diagnoses and COVID-19 infections and hospitalizations across NYC, one of the hardest-hit US cities in the early pandemic. Our findings suggest the need for tailoring treatment and policies to meet the needs of individuals with pre-COVID psychiatric diagnoses.
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Affiliation(s)
- Yunyu Xiao
- Department of Population Health Sciences, Weill Cornell Medicine, NewYork-Presbyterian, New York, NY, USA.
| | - Mohit M Sharma
- Department of Population Health Sciences, Weill Cornell Medicine, NewYork-Presbyterian, New York, NY, USA
| | - Rohith K Thiruvalluru
- Department of Population Health Sciences, Weill Cornell Medicine, NewYork-Presbyterian, New York, NY, USA
| | - Catherine Gimbrone
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Myrna M Weissman
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Division of Translational Epidemiology, New York State Psychiatric Institute, New York, NY, USA
| | - Mark Olfson
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Division of Translational Epidemiology, New York State Psychiatric Institute, New York, NY, USA
- Columbia University Irving Medical Center, New York, NY, USA
| | - Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Jyotishman Pathak
- Department of Population Health Sciences, Weill Cornell Medicine, NewYork-Presbyterian, New York, NY, USA
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20
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Zima BT, Edgcomb JB, Rodean J, Cochran SD, Harle CA, Pathak J, Tseng CH, Bussing R. Use of Acute Mental Health Care in U.S. Children's Hospitals Before and After Statewide COVID-19 School Closure Orders. Psychiatr Serv 2022; 73:1202-1209. [PMID: 35611510 PMCID: PMC9633407 DOI: 10.1176/appi.ps.202100582] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE This study aimed to examine changes in child emergency department (ED) discharges and hospitalizations for primary general medical (GM) and primary psychiatric disorders; prevalence of psychiatric disorders among acute care encounters; and change in acute mental health (MH) care encounters by disorder type and, within these categories, by child sociodemographic characteristics before and after statewide COVID-19–related school closure orders. METHODS This retrospective, cross-sectional cohort study used the Pediatric Health Information System database to assess percent changes in ED discharges and hospitalizations (N=2,658,474 total encounters) among children ages 3–17 years in 44 U.S. children’s hospitals in 2020 compared with 2019, by using matched data for 36- and 12-calendar-week intervals. RESULTS Decline in MH ED discharges accounted for about half of the decline in ED discharges and hospitalizations for primary GM disorders (−24.8% vs. −49.1%), and MH hospitalizations declined 3.4 times less (−8.0% vs. −26.8%) in 2020. Suicide attempt or self-injury and depressive disorders accounted for >50% of acute MH care encounters before and after the statewide school closures. The increase in both ED discharges and hospitalizations for suicide attempt or self-injury was 5.1 percentage points (p<0.001). By fall 2020, MH hospitalizations for suicide attempt or self-injury rose by 41.7%, with a 43.8% and 49.2% rise among adolescents and girls, respectively. CONCLUSIONS Suicide or self-injury and depressive disorders drove acute MH care encounters in 44 U.S. children’s hospitals after COVID-19–related school closures. Research is needed to identify continuing risk indicators (e.g., sociodemographic characteristics, psychiatric disorder types, and social determinants of health) of acute child MH care.
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Affiliation(s)
- Bonnie T Zima
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (UCLA), Los Angeles (Zima, Edgcomb); Children's Hospital Association, Lenexa, Kansas (Rodean); Fielding School of Public Health, UCLA, Los Angeles (Cochran); Department of Psychiatry, University of Florida, Gainesville (Harle, Bussing); Department of Healthcare Policy and Research, Weill Cornell Medicine, New York City (Pathak); Division of General Internal Medicine and Health Services Research, UCLA, Los Angeles (Tseng)
| | - Juliet Beni Edgcomb
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (UCLA), Los Angeles (Zima, Edgcomb); Children's Hospital Association, Lenexa, Kansas (Rodean); Fielding School of Public Health, UCLA, Los Angeles (Cochran); Department of Psychiatry, University of Florida, Gainesville (Harle, Bussing); Department of Healthcare Policy and Research, Weill Cornell Medicine, New York City (Pathak); Division of General Internal Medicine and Health Services Research, UCLA, Los Angeles (Tseng)
| | - Jonathan Rodean
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (UCLA), Los Angeles (Zima, Edgcomb); Children's Hospital Association, Lenexa, Kansas (Rodean); Fielding School of Public Health, UCLA, Los Angeles (Cochran); Department of Psychiatry, University of Florida, Gainesville (Harle, Bussing); Department of Healthcare Policy and Research, Weill Cornell Medicine, New York City (Pathak); Division of General Internal Medicine and Health Services Research, UCLA, Los Angeles (Tseng)
| | - Susan D Cochran
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (UCLA), Los Angeles (Zima, Edgcomb); Children's Hospital Association, Lenexa, Kansas (Rodean); Fielding School of Public Health, UCLA, Los Angeles (Cochran); Department of Psychiatry, University of Florida, Gainesville (Harle, Bussing); Department of Healthcare Policy and Research, Weill Cornell Medicine, New York City (Pathak); Division of General Internal Medicine and Health Services Research, UCLA, Los Angeles (Tseng)
| | - Christopher A Harle
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (UCLA), Los Angeles (Zima, Edgcomb); Children's Hospital Association, Lenexa, Kansas (Rodean); Fielding School of Public Health, UCLA, Los Angeles (Cochran); Department of Psychiatry, University of Florida, Gainesville (Harle, Bussing); Department of Healthcare Policy and Research, Weill Cornell Medicine, New York City (Pathak); Division of General Internal Medicine and Health Services Research, UCLA, Los Angeles (Tseng)
| | - Jyotishman Pathak
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (UCLA), Los Angeles (Zima, Edgcomb); Children's Hospital Association, Lenexa, Kansas (Rodean); Fielding School of Public Health, UCLA, Los Angeles (Cochran); Department of Psychiatry, University of Florida, Gainesville (Harle, Bussing); Department of Healthcare Policy and Research, Weill Cornell Medicine, New York City (Pathak); Division of General Internal Medicine and Health Services Research, UCLA, Los Angeles (Tseng)
| | - Chi-Hong Tseng
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (UCLA), Los Angeles (Zima, Edgcomb); Children's Hospital Association, Lenexa, Kansas (Rodean); Fielding School of Public Health, UCLA, Los Angeles (Cochran); Department of Psychiatry, University of Florida, Gainesville (Harle, Bussing); Department of Healthcare Policy and Research, Weill Cornell Medicine, New York City (Pathak); Division of General Internal Medicine and Health Services Research, UCLA, Los Angeles (Tseng)
| | - Regina Bussing
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (UCLA), Los Angeles (Zima, Edgcomb); Children's Hospital Association, Lenexa, Kansas (Rodean); Fielding School of Public Health, UCLA, Los Angeles (Cochran); Department of Psychiatry, University of Florida, Gainesville (Harle, Bussing); Department of Healthcare Policy and Research, Weill Cornell Medicine, New York City (Pathak); Division of General Internal Medicine and Health Services Research, UCLA, Los Angeles (Tseng)
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21
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Rotter M, Compton M, Samaranayake D, Ehntholt A, Baldwin E, Schaeffer L, Feeney S, Smith TE. The Social Determinants of Mental Health: A Descriptive Study of State Mental Health Agencies' Priorities. Community Ment Health J 2022; 58:1121-1129. [PMID: 35059936 PMCID: PMC8776369 DOI: 10.1007/s10597-021-00921-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 11/16/2021] [Indexed: 11/29/2022]
Abstract
Social determinants are receiving renewed attention as research demonstrates the effects of social factors on individuals' physical and mental health and elucidates the biological and psychological mechanisms underlying those effects. Through spheres of influence from policy and regulation development to direct service provision, state mental health agencies are in a unique position to lead primary and secondary prevention efforts aimed at addressing social determinants with both client-level and structural-level interventions. A survey of social determinants-related activity was sent to the Medical Directors of the state offices of mental health in all 50 states. The survey results suggest consensus among respondents as to the importance of addressing specific social determinants. However, few state mental health agencies have taken on a comprehensive and intentional approach to addressing social determinants as a unique area of activity. Specific activities are reviewed, and implications for future work is discussed.
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Affiliation(s)
- Merrill Rotter
- Bronx Psychiatric Center, NYS Office of Mental Health, Albert Einstein College of Medicine, 1500 Waters Place, Bronx, NY 10461 USA
| | - Michael Compton
- New York State Psychiatric Institute, Columbia University Vagelos College of Physicians and Surgeons, 1051 Riverside Drive, Unit 100, New York, NY 10032 USA
| | | | - Amy Ehntholt
- NYS Office of Mental Health, New York State Psychiatric Institute, 1051 Riverside Drive, Unit 100, New York, NY 10032 USA
| | - Emily Baldwin
- NYS Office of Mental Health, 44 Holland Avenue, Albany, NY 12229 USA
| | - Lynne Schaeffer
- NYS Office of Mental Health, 44 Holland Avenue, Albany, NY 12229 USA
| | - Suzanne Feeney
- NYS Office of Mental Health, 44 Holland Avenue, Albany, NY 12229 USA
| | - Thomas E. Smith
- New York State Psychiatric Institute, Columbia University Vagelos College of Physicians and Surgeons, 1051 Riverside Drive, Unit 100, New York, NY 10032 USA
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22
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Carr E, Oetzmann C, Davis K, Bergin-Cartwright G, Dorrington S, Lavelle G, Leightley D, Polling C, Stevelink SAM, Wickersham A, Vitiello V, Razavi R, Hotopf M. Trajectories of mental health among UK university staff and postgraduate students during the pandemic. Occup Environ Med 2022; 79:514-520. [PMID: 35307649 PMCID: PMC8960466 DOI: 10.1136/oemed-2021-108097] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 02/15/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVES The COVID-19 pandemic has disrupted the social and working lives of many. Past studies have highlighted worsening mental health during the pandemic, but often rely on small samples or infrequent follow-up. This study draws on fortnightly assessments from a large occupational cohort to describe differing trajectories of mental health between April 2020 and April 2021 and individual characteristics associated with these trajectory types. METHODS King's College London Coronavirus Health and Experiences of Colleagues at King's is an occupational cohort study at a large university in London, UK. Participants (n=2241) completed online questionnaires fortnightly between April 2020 and April 2021. Symptoms of anxiety and depression were assessed using Generalised Anxiety Disorder (GAD-7) and Patient Health Questionnaire (PHQ-9). RESULTS On average, participants reported low levels of anxiety and depression (GAD-7 and PHQ-9 scores of 0-9, consistent with 'none', 'minimal' or 'mild' symptoms) throughout the year, with symptoms highest in April 2020 and decreasing over the summer months when no lockdown measures were in place. However, we observed more severe and variable symptoms among subgroups of participants. Four trajectory types for anxiety and depression were identified: 'persistent high severity' (6%-7% of participants), 'varying symptoms, opposing national cases' (4%-8%), 'varying symptoms, consistent with national cases' (6%-11%) and 'persistent low severity' (74%-84%). Younger age, female gender, caring responsibilities and shielding were associated with higher severity trajectory types. CONCLUSIONS These data highlight differing individual responses to the pandemic and underscore the need to consider individual circumstances when assessing and treating mental health. Aggregate trends in anxiety and depression may hide greater variation and symptom severity among subgroups.
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Affiliation(s)
- Ewan Carr
- Department of Biostatistics and Health Informatics, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
| | - Carolin Oetzmann
- Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
| | - Katrina Davis
- Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
| | - Gabriella Bergin-Cartwright
- Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
| | - Sarah Dorrington
- Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
| | - Grace Lavelle
- Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
| | - Daniel Leightley
- Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
| | - Catherine Polling
- Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Sharon A M Stevelink
- Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
- King's Centre for Military Health Research, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Alice Wickersham
- Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
| | - Valentina Vitiello
- School of Biomedical Engineering & Imaging Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Reza Razavi
- School of Biomedical Engineering & Imaging Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Matthew Hotopf
- Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
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23
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Garg R, Muhammad SN, Cabassa LJ, McQueen A, Verdecias N, Greer R, Kreuter MW. Transportation and other social needs as markers of mental health conditions. JOURNAL OF TRANSPORT & HEALTH 2022; 25:101357. [PMID: 36407687 PMCID: PMC9667984 DOI: 10.1016/j.jth.2022.101357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Objective The study sought to determine whether reporting a history of depression, anxiety, PTSD, bipolar disorder, drug or alcohol use disorder, ADHD, schizophrenia, or current depressive symptoms was associated with requesting help for any of 12 social needs. Methods A community-based sample of 1,944 low-income adult smokers in Missouri who had called a telephone helpline for social needs were recruited between June 1, 2017 and November 15, 2020. Helpline data on callers' requests for assistance with utilities, housing, food, household goods, healthcare, transportation, adult care, financial assistance, employment, legal assistance, personal safety and childcare were merged with self-reported mental health data collected in a subsequent phone survey with the same callers. Using binary logistic regression, we examined which mental health conditions were associated with each social need. Results Reporting mental health conditions were associated with greater odds of requests for assistance with transportation, food, healthcare and personal safety. Of these, the strongest and most consistent associations were with transportation needs. In post-hoc analyses, most associations between transportation needs and mental health remained significant after adjusting for possible confounders. Conclusions Compared to participants who did not report histories of mental health conditions, those who reported mental health conditions were more likely to call 2-1-1 seeking transportation assistance. Community-based agencies providing transportation or mental health services could partner to provide linkages between services and increase capacity to address transportation and mental health needs.
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Affiliation(s)
- Rachel Garg
- Health Communication Research Laboratory, Brown School at Washington University in St. Louis, St. Louis, MO, United States
| | | | - Leopoldo J. Cabassa
- Center for Mental Health Services Research, Brown School at Washington University in St. Louis, St. Louis, MO, United States
| | - Amy McQueen
- Health Communication Research Laboratory, Brown School at Washington University in St. Louis, St. Louis, MO, United States
- Division of General Medical Sciences, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
| | - Niko Verdecias
- Health Communication Research Laboratory, Brown School at Washington University in St. Louis, St. Louis, MO, United States
| | - Regina Greer
- United Way of Greater St. Louis and 2-1-1 Missouri, St. Louis, MO, United States
| | - Matthew W. Kreuter
- Health Communication Research Laboratory, Brown School at Washington University in St. Louis, St. Louis, MO, United States
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24
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Xiao Y, Yip PSF, Pathak J, Mann JJ. Association of Social Determinants of Health and Vaccinations With Child Mental Health During the COVID-19 Pandemic in the US. JAMA Psychiatry 2022; 79:610-621. [PMID: 35475851 PMCID: PMC9047762 DOI: 10.1001/jamapsychiatry.2022.0818] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
IMPORTANCE The COVID-19 pandemic disproportionately affected mental health in socioeconomically disadvantaged children in the US. However, little is known about the relationship of preexisting and time-varying social determinants of health (SDoH) at individual and structural levels, vaccination eligibility/rates, and the racial and ethnic differences to trajectories of child mental health during the COVID-19 pandemic. OBJECTIVE To estimate the association of trajectories of child mental health to multilevel SDoH and vaccination eligibility/rates. DESIGN, SETTING, AND PARTICIPANTS This prospective longitudinal cohort study, conducted from May 16, 2020, to March 2, 2021, integrated structural-level, pandemic-related data with the Adolescent Brain Cognitive Development (ABCD) cohort data (release 4.0). The ABCD study recruited 11 878 children (baseline) and conducted 6 COVID-19 rapid response surveys across 21 US sites (in 17 states) from May 16, 2020, to March 2, 2021. EXPOSURES Preexisting individual (eg, household income) and structural (area deprivation) SDoH and time-varying individual (eg, food insecurity, unemployment) and structural (eg, social distancing, vaccination eligibility/rates) SDoH. MAIN OUTCOMES AND MEASURES Perceived Stress Scale, the National Institutes of Health-Toolbox emotion measures, and COVID-19-related worry. RESULTS The longitudinal sample included 8493 children (mean [SD] age, 9.93 [0.63] years; 5011 girls [47.89%]; 245 Asian [2.34%], 1213 Black [11.59%], 2029 Hispanic [19.39%], 5851 White [55.93%], and 1124 children of other/multiracial ethnicity [10.74%]). Trajectories of stress, sadness, and COVID-19-related worry decreased after adult vaccination rollout. Compared with younger children, boys, White children, or those living with married parents, those who reported greater perceived stress included older children aged 12 to 15 years (β = 0.26; 95% CI, 0.12-0.41; P < .001); girls (β = 0.75; 95% CI, 0.61-0.89; P < .001); Hispanic children (β = 0.24; 95% CI, 0.01-0.47; P = .04); children living with separated parents (β = 0.50; 95% CI, 0.03-0.96; P = .04); children experiencing disrupted medical health care access (β = 0.19; 95% CI, 0.01-0.36; P = .04); children living in economically deprived neighborhoods (β = 0.28; 95% CI, 0.05-0.51; P = .02); children living in areas with more full-time working-class adults who were unable to social distance (β = 1.35; 95% CI, 0.13-2.67; P = .04); and children living in states with fewer fully vaccinated adults (β = 0.59; 95% CI, 0.16-1.02; P = .007). COVID-19 pandemic-related worry was higher among Asian children (β = 0.22; 95% CI, 0.08-0.37; P = .003), Black children (β = 0.33; 95% CI, 0.22-0.43; P < .001), children of other/multiracial ethnicity (β = 0.17; 95% CI, 0.09-0.25; P < .001), and children with disrupted medical health care (β = 0.15; 95% CI, 0.09-0.21) and disrupted mental health treatment (β = 0.11; 95% CI, 0.06-0.16). Inability to afford food was associated with increased sadness (β = 1.50; 95% CI, 0.06-2.93; P = .04). States with later vaccination eligibility dates for all adults were associated with greater COVID-19-related worry (β = 0.16; 95% CI, 0.01-0.31; P = .03) and decreased positive affect (β = -1.78; 95% CI, -3.39 to -0.18; P = .03) among children. CONCLUSIONS AND RELEVANCE Results of this study suggest a disproportionately adverse association of the COVID-19 pandemic with child mental health among racial and ethnic minority groups, which may be improved by addressing modifiable individual (food insecurity, unemployment, health services, parental supervision) and structural (area deprivation, job protection, vaccination) SDoH.
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Affiliation(s)
- Yunyu Xiao
- Department of Population Health Sciences, Weill Cornell Medicine, New York–Presbyterian, New York
| | - Paul Siu-Fai Yip
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong,Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Jyotishman Pathak
- Department of Population Health Sciences, Weill Cornell Medicine, New York–Presbyterian, New York
| | - J. John Mann
- Department of Psychiatry, Columbia University Irving Medical Center, Columbia University, New York, New York,Department of Radiology, Columbia University Irving Medical Center, Columbia University, New York, New York,Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York
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25
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Markoulakis R, Da Silva A, Kodeeswaran S, Levitt A. Youth mental health and/or addiction concerns and service needs during the COVID-19 pandemic: a qualitative exploration of caregiver experiences and perspectives. Child Adolesc Psychiatry Ment Health 2022; 16:35. [PMID: 35538588 PMCID: PMC9088718 DOI: 10.1186/s13034-022-00471-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 04/14/2022] [Indexed: 11/24/2022] Open
Abstract
The COVID-19 pandemic has undoubtedly had a significant impact on youth mental health and/or addiction concerns and exacerbated pre-existing gaps in access to mental health and/or addiction care. Caregivers can support their youth in seeking and participating in care, however, their experiences in doing so in the pandemic and their perspectives of their youth's care needs are not well-understood. A descriptive qualitative study was conducted to better understand youth's and caregivers' experiences accessing care during the pandemic, from the caregivers' standpoint. Participants completed semi-structured qualitative interviews that focused on experiences seeking and accessing mental health and/or addiction services, with specific questions regarding their experiences accessing services during the pandemic. A total of 46 interviews were included in the thematic analysis of the data. Study findings highlight the impacts of the pandemic on everyday life, on youth mental health and/or addiction needs, on caregiver's experiences seeking and accessing services for their youth, and on service access, including perceptions of virtual care modalities. The discussion highlights the importance of focusing on factors that enable youth's participation in care, to ensure accessibility of appropriate and timely care that meets youth's and families' needs. Also highlighted is the frustration and despair experienced by caregivers seeking critical mental health and addictions supports for their youth during the pandemic, as well as the sense of isolation and of being left behind by the system. Identifying caregiver perspectives of youth mental health and addiction needs and service access during the COVID-19 pandemic provided important insights that can help inform approaches to youth mental health and addictions care during the pandemic and beyond.
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Affiliation(s)
- Roula Markoulakis
- Sunnybrook Research Institute, 1929 Bayview Avenue, Toronto, ON, M4G 3E8, Canada. .,Department of Occupational Science and Occupational Therapy, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1V7, Canada.
| | - Andreina Da Silva
- grid.17063.330000 0001 2157 2938Sunnybrook Research Institute, 1929 Bayview Avenue, Toronto, ON M4G 3E8 Canada
| | - Sugy Kodeeswaran
- grid.413104.30000 0000 9743 1587Family Navigation Project, Sunnybrook Health Sciences Centre, 1929 Bayview Avenue, Toronto, ON M4G 3E8 Canada
| | - Anthony Levitt
- grid.413104.30000 0000 9743 1587Family Navigation Project, Sunnybrook Health Sciences Centre, 1929 Bayview Avenue, Toronto, ON M4G 3E8 Canada ,grid.413104.30000 0000 9743 1587Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON M4N 3M5 Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, 250 College Street, Toronto, ON M5T 1R8 Canada
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26
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Raynor K, Panza L, Bentley R. Impact of COVID-19 shocks, precarity and mediating resources on the mental health of residents of share housing in Victoria, Australia: an analysis of data from a two-wave survey. BMJ Open 2022; 12:e058580. [PMID: 35418435 PMCID: PMC9013788 DOI: 10.1136/bmjopen-2021-058580] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES COVID-19 lockdown measures have challenged people's mental health, especially among economically vulnerable households. The objective of this study was to investigate the impact of exposure to COVID-19 shocks (defined as job loss, living cost pressures and changing housing conditions throughout the lockdown period) and double precarity (defined as precarity in housing and employment) on mental health outcomes for members of share households as well as the mediating effects of a range of resources. DESIGN We conducted a two-wave survey of occupants of share housing in June and October 2020 during a prolonged period of population lockdown. Research design involved fixed effects ordered logit regression models to assess the mental health consequences of baseline precarity and COVID-related shocks. SETTING Victoria, Australia. PARTICIPANTS We surveyed 293 occupants of share houses (mean age 34 SD 11.5, 56% female). Members of share houses (where individuals are unrelated adults and not in a romantic relationship) are more likely to be young, casually employed, visa-holders and low-income. OUTCOME MEASURES We measured household composition, housing and employment precarity, access to government support, household crowding, social networks and COVID-19 shocks. We used a self-reported measure of mental health. RESULTS Those exposed to COVID-19 shocks reported a 2.7 times higher odds of mental health deterioration (OR 2.7, 95% CI 1.53 to 4.85). People exposed to double precarity (precarity in both housing and employment) reported 2.4 times higher odds of mental health deterioration (OR 2.4, 95% CI 0.99 to 5.69). Housing inadequacy and lack of access to sufficient government payments explained 14.7% and 7% of the total effect of double precarity on mental health, respectively. CONCLUSIONS Results indicate that residents of group households characterised by pre-existing precarity were vulnerable to negative mental health effects during lockdown. Access to sufficient government payments and adequate housing buffered this negative effect.
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Affiliation(s)
- Katrina Raynor
- Faculty of Architecture Building and Planning, The University of Melbourne, Melbourne, Victoria, Australia
| | - Laura Panza
- Faculty of Business and Economics, University of Melbourne, Melbourne, Victoria, Australia
| | - Rebecca Bentley
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
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Kwok JOT, Yan RWK, Kwok CPC, Cheng GWH, Lin C, Wong BHC, Cheng ST, Lee ATC, Lam LCW. Common mental disorders during the COVID-19 pandemic in Hong Kong: Age-related differences and implications for dementia risk. Front Psychiatry 2022; 13:909162. [PMID: 36186878 PMCID: PMC9515428 DOI: 10.3389/fpsyt.2022.909162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 08/24/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has imposed a profound negative impact on the mental health and wellbeing of societies and individuals worldwide. Older adults may be more vulnerable to the mental health effects of the pandemic, either directly from the infection itself or indirectly through the preventive measures. However, the existing literature on mental health in the older age groups has not been consistent so far. The aim of this study was therefore to assess the prevalence of common mental disorders (CMD; including depression and anxiety disorders) given their association with dementia risk, and to further examine age-related differences between older (≥60 years old) and younger (18-59 years old) adult's psychological status during the COVID-19 pandemic. METHOD This was a secondary analysis of a cross-sectional survey-study conducted during the second wave of COVID-19 pandemic in Hong Kong. The survey was disseminated through different social media platforms to the general population and included sociodemographic questions, self-reported physical health, and previous encounter with SARS or COVID-19. CMD was the primary outcome and was assessed using the 6-item Kessler Scale. A total of 1030 adults fulfilled inclusion criteria. RESULTS The prevalence of CMD during the pandemic was 16.1%. Compared to younger adults, older adults were significantly less likely to have a CMD (unadjusted OR = 0.07, 95% CI = 0.02-0.30, p < 0.001), with 18.1% of younger adults having CMD compared to 1.6% in the older cohort. Age differences remained significant after controlling for sociodemographic factors, physical health, and previous encounter with SARS or COVID-19 (adjusted OR = 0.12, 95% CI = 0.02-0.57, p = 0.008). CONCLUSION Common mental disorders are highly prevalent during the COVID-19 pandemic in Hong Kong, though older adults appeared to be less affected mentally. Present findings highlight the urgent need to implement measures and strategies to mitigate the mental health problems, with particular attention to the younger cohort. Given their association with higher dementia risk, early detection and treatment of depression and anxiety disorders will be of critical importance in providing some relief to the already pressurized dementia burden in the longer term.
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Affiliation(s)
- Jessie O T Kwok
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Rachel W K Yan
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Charlotte P C Kwok
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Gabriel W H Cheng
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Cuichan Lin
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Brian H C Wong
- Department of Psychiatry, Tai Po Hospital, Hong Kong, Hong Kong SAR, China
| | - Sheung Tak Cheng
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Allen T C Lee
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Linda C W Lam
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Zima BT, Devaskar SU, Patel M, Raphael J, Pursley D, Keller D, Cheng T, Javier J, Lee L. Imperative to accelerate research aligning real-time clinical demand with mental health supply. Pediatr Res 2022; 92:917-920. [PMID: 36104514 PMCID: PMC9472179 DOI: 10.1038/s41390-022-02246-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 06/29/2022] [Accepted: 07/19/2022] [Indexed: 11/25/2022]
Affiliation(s)
- Bonnie T. Zima
- grid.19006.3e0000 0000 9632 6718Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA USA ,grid.19006.3e0000 0000 9632 6718Department of Pediatrics, University of California at Los Angeles, Los Angeles, CA USA ,Pediatric Policy Council, Washington, DC USA
| | - Sherin U. Devaskar
- grid.19006.3e0000 0000 9632 6718Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA USA ,grid.19006.3e0000 0000 9632 6718Department of Pediatrics, University of California at Los Angeles, Los Angeles, CA USA ,Pediatric Policy Council, Washington, DC USA
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29
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Pandey K, Thurman M, Johnson SD, Acharya A, Johnston M, Klug EA, Olwenyi OA, Rajaiah R, Byrareddy SN. Mental Health Issues During and After COVID-19 Vaccine Era. Brain Res Bull 2021; 176:161-173. [PMID: 34487856 PMCID: PMC8414813 DOI: 10.1016/j.brainresbull.2021.08.012] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/01/2021] [Accepted: 08/27/2021] [Indexed: 02/07/2023]
Abstract
The COVID-19 pandemic has persisted for more than a year, and post-COVID-19 sequelae of neurological complications, including direct and indirect effects on the central nervous system (CNS), have been recognized. There is a plethora of evidence for neurological, cognitive, and emotional deficits in COVID-19 patients. Acute neurological symptoms like neuroinflammation, cognitive impairment, loss of smell, and brain stroke are common direct effects among SARS-CoV-2 infected individuals. Work-associated stress, lockdowns, social distancing, and quarantine in response to contain SARS-CoV-2 have also affected the mental health of large populations, regardless of age. Public health emergencies have affected individuals and communities, resulting in emotional reactions and unhealthy behaviors. Although vaccines have been widely distributed and administered among large populations, vaccine hesitancy still exists and may be due to apprehension about vaccine efficacy, preliminary trials, and associated side effects. This review highlights the impact of COVID-19 on the CNS by outlining direct and indirect effects and factors contributing to the decline in people's mental health throughout the COVID-19 pandemic both during and after vaccine administration. Furthermore, we also discuss reasons for vaccine hesitancy and why some groups of people are deprived of vaccines. Finally, we touched upon the social determinants of mental health and their impact on disadvantaged populations during times of crisis which may help policymakers set up some action plans to mitigate the COVID-19 mental health turmoil during this ongoing pandemic.
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Affiliation(s)
- Kabita Pandey
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE, USA; Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Michellie Thurman
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE, USA
| | - Samuel D Johnson
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE, USA; Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Arpan Acharya
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE, USA
| | - Morgan Johnston
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE, USA
| | - Elizabeth A Klug
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE, USA; Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Omalla A Olwenyi
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE, USA; Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Rajesh Rajaiah
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE, USA
| | - Siddappa N Byrareddy
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE, USA; Department of Genetics, Cell Biology, and Anatomy, University of Nebraska Medical Center, Omaha, NE, USA; Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, NE, USA.
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Fink-Samnick E. The Social Determinants of Mental Health: Assessment, Intervention, and Wholistic Health Equity: Part 2. Prof Case Manag 2021; 26:224-241. [PMID: 34397650 DOI: 10.1097/ncm.0000000000000518] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Ellen Fink-Samnick
- Ellen Fink-Samnick, MSW, ACSW, LCSW, CCM, CCTP, CMHIMP, CRP, DBH-C, is an award-winning industry thought leader who empowers the healthcare interprofessional workforce. She is a sought-out professional speaker, author, and educator for her innovative content and vibrant presence. Ellen is an international national expert on the social determinants of health and mental health, workplace bullying, professional ethics, professional case management practice, and Wholistic Case Management. Her recent books include The Essential Guide to Interprofessional Ethics for Healthcare Case Management, The Social Determinants of Health: Case Management's Next Frontier, and End of Life for Case Management , all through HCPro. The Social Determinants of Mental Health: Case Management's Essential Guide will be published through Blue Bayou Press/HCP2HCP in November 2021. Along with several academic teaching appointments, Ellen is a doctoral in behavioral health (DBH) candidate at Cummings Graduate Institute for Behavioral Health Studies. View more on her LinkedIn profile
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Lee ATC, Cheng GWH, Lin C, Wong BHC, Lam LCW. Do people with mental health problems have lower adherence to precautionary measures in COVID-19 pandemic? A cross-sectional observational study in Hong Kong. BMJ Open 2021; 11:e046658. [PMID: 34385242 PMCID: PMC8361707 DOI: 10.1136/bmjopen-2020-046658] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES Mental health problems are prevalent during the COVID-19 pandemic, but their effect on adherence to precautionary measures is not well understood. Given that psychological morbidities are associated with lower treatment adherence, and that precautionary measures are important in containing the spread of COVID-19, this study aims to determine if people with mental health problems have lower adherence to precautionary measures against COVID-19. DESIGN We conducted a cross-sectional territory-wide online survey between 17 June and 31 July 2020 during the COVID-19 pandemic. Clinically significant mental health problems, adherence to precautionary behaviours, and confounding factors such as sociodemographic factors and self-reported physical health were assessed. SETTING The link to the questionnaire was disseminated to the general population in all 18 districts of Hong Kong using various social media platforms. PARTICIPANTS 1036 individuals completed the survey. Of them, 1030 met the inclusion criteria of being adult Hong Kong residents. PRIMARY OUTCOME Adherence to precautionary measures against COVID-19, including wearing face mask, frequent handwashing, household disinfection, social distancing, minimising unnecessary travel, and stocking up on food and daily essentials. RESULTS Of the 1030 participants, 166 (16.1%) had clinically significant mental health problems. Interestingly, they were more likely to stock up on food and daily essentials during the pandemic (7 (4.2%) vs 15 (1.7%), p=0.04; unadjusted OR=2.49, 95% CI=1.00 to 6.21, p<0.05) and had a lesser tendency to stop social distancing even if the pandemic subsides (86 (51.8%) vs 513 (59.4%), p=0.07; unadjusted OR=0.74, 95% CI=0.53 to 1.03, p=0.07). The latter association remained significant after adjusting for the confounding factors (adjusted OR=0.68, 95% CI=0.48 to 0.96, p=0.03). CONCLUSIONS Contrary to our hypothesis, people who are mentally unwell might go beyond the recommended precautionary measures. Our findings highlight the need to identify mental health problems and provide care and support for those who might go too far with precautionary measures. TRIAL REGISTRATION NUMBER ChiCTR 2000033936.
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Affiliation(s)
- Allen T C Lee
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, People's Republic of China
| | - Gabriel W H Cheng
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, People's Republic of China
| | - Cuichan Lin
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, People's Republic of China
| | - Brian H C Wong
- Department of Psychiatry, Tai Po Hospital, Hong Kong, SAR, People's Republic of China
| | - Linda Chiu Wa Lam
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, People's Republic of China
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32
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Swartz HA. Connectivity and COVID-19. Am J Psychother 2021; 74:101-102. [PMID: 34521213 DOI: 10.1176/appi.psychotherapy.20210038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Holly A Swartz
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh
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Campo-Arias A, De Mendieta CT. Social determinants of mental health and the COVID-19 pandemic in low-income and middle-income countries. LANCET GLOBAL HEALTH 2021; 9:e1029-e1030. [PMID: 34175004 PMCID: PMC8443023 DOI: 10.1016/s2214-109x(21)00253-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 05/17/2021] [Indexed: 12/20/2022]
Affiliation(s)
- Adalberto Campo-Arias
- Programa de Medicina, Facultad de Ciencias de la Salud, Universidad del Magdalena, Santa Marta 470004, Colombia.
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Menculini G, Bernardini F, Attademo L, Balducci PM, Sciarma T, Moretti P, Tortorella A. The Influence of the Urban Environment on Mental Health during the COVID-19 Pandemic: Focus on Air Pollution and Migration-A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3920. [PMID: 33917942 PMCID: PMC8068323 DOI: 10.3390/ijerph18083920] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/27/2021] [Accepted: 03/29/2021] [Indexed: 12/14/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic caused a crisis worldwide, due to both its public health impact and socio-economic consequences. Mental health was consistently affected by the pandemic, with the emergence of newly diagnosed psychiatric disorders and the exacerbation of pre-existing ones. Urban areas were particularly affected by the virus spread. In this review, we analyze how the urban environment may influence mental health during the COVID-19 pandemic, considering two factors that profoundly characterize urbanization: air pollution and migration. Air pollution serves as a possibly risk factor for higher viral spread and infection severity in the context of urban areas and it has also been demonstrated to play a role in the development of serious mental illnesses and their relapses. The urban environment also represents a complex social context where minorities such as migrants may live in poor hygienic conditions and lack access to adequate mental health care. A global rethinking of the urban environment is thus required to reduce the impact of these factors on mental health. This should include actions aimed at reducing air pollution and combating climate change, promoting at the same time a more inclusive society in a sustainable development perspective.
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Affiliation(s)
- Giulia Menculini
- Department of Psychiatry, University of Perugia, 06132 Perugia, Italy; (G.M.); (P.M.B.); (T.S.); (P.M.)
| | - Francesco Bernardini
- CSM 24 ore Area delle Dolomiti Friulane, Department of Mental Health, AsFO Friuli Occidentale, 33170 Pordenone, Italy;
- Planetary Health Lab, Old Medical School, University of Edinburgh, Edinburgh EH8 9AG, UK;
| | - Luigi Attademo
- Planetary Health Lab, Old Medical School, University of Edinburgh, Edinburgh EH8 9AG, UK;
- SPDC Potenza, Department of Mental Health, ASP Basilicata, Italian National Health Service, 85100 Potenza, Italy
| | - Pierfrancesco Maria Balducci
- Department of Psychiatry, University of Perugia, 06132 Perugia, Italy; (G.M.); (P.M.B.); (T.S.); (P.M.)
- CSM Terni, Department of Mental Health, 05100 Terni, Italy
| | - Tiziana Sciarma
- Department of Psychiatry, University of Perugia, 06132 Perugia, Italy; (G.M.); (P.M.B.); (T.S.); (P.M.)
| | - Patrizia Moretti
- Department of Psychiatry, University of Perugia, 06132 Perugia, Italy; (G.M.); (P.M.B.); (T.S.); (P.M.)
| | - Alfonso Tortorella
- Department of Psychiatry, University of Perugia, 06132 Perugia, Italy; (G.M.); (P.M.B.); (T.S.); (P.M.)
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36
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Swartz H. Importance and application of interpersonal psychotherapy during the COVID-19 pandemic. HEART AND MIND 2021. [DOI: 10.4103/hm.hm_55_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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