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Fan X, Ning K, Ma TSW, Aung Y, Tun HM, Thin Zaw PP, Flores FP, Chow MSC, Leung CMC, Lun P, Chang WC, Leung GM, Ni MY. Post-traumatic stress, depression, and anxiety during the 2021 Myanmar conflict: a nationwide population-based survey. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2024; 26:100396. [PMID: 38617087 PMCID: PMC11007429 DOI: 10.1016/j.lansea.2024.100396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 11/24/2023] [Accepted: 03/15/2024] [Indexed: 04/16/2024]
Abstract
Background The UN warns that Myanmar faces the 'triple crises' of mass conflict, uncontrolled COVID-19, and economic collapse. Therefore, we aimed to assess the population mental health burden, healthcare needs, and the associated risk factors in Myanmar. Methods We established a nationwide random sample and recruited 1038 adults via random digit dialling from July 3-Aug 9, 2021, during the ongoing conflict since Feb 1, 2021, and surge in SARS-CoV-2 infections. Probable post-traumatic stress disorder (PTSD) was assessed using the PTSD Checklist-Civilian Version. Probable depression and anxiety were assessed using the Patient Health Questionnaire-2 and the Generalized Anxiety Disorder-2. We calculated population attributable fractions for probable mental disorders using multivariable logistic regression models. Based on the mental health burden and healthcare-seeking patterns, we projected the need for mental health services. Findings During the 'triple crises', a third of adults in Myanmar (34.9%, 95% CI 32.0-37.7) reported a probable mental disorder. Prevalence of probable PTSD, depression, and anxiety were 8.1% (6.6-9.7), 14.3% (12.0-16.6), and 22.2% (19.7-24.7), respectively. We estimated that up to 79.9% (43.8-97.9) of probable PTSD was attributable to political stress. This corresponds to 2.1 million (1.1-3.2 million) fewer adults with probable PTSD if political stress was removed from the population. The mental health burden could translate into roughly 5.9 million adults seeking mental health services. Interpretation The mental health burden in Myanmar is substantial, and population mental health might only be restored when the three crises have ended. An accelerated peace process is critical to protecting Myanmar's population mental health. Funding This research was supported the Research Grants Council of the Hong Kong Special Administrative Region, China (Project No. HKU 17606122) and the Michele Tansella Award.
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Affiliation(s)
- Xiaoyan Fan
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Ke Ning
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Tiffany SW. Ma
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Yadanar Aung
- Institute for Population and Social Research, Mahidol University, Bangkok, Thailand
| | - Hein Min Tun
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Microbiota I-Center (MagIC), The Chinese University of Hong Kong, Hong Kong SAR, China
- Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- HKU-Pasteur Research Pole, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Phyu Phyu Thin Zaw
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Francis P. Flores
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Mathew SC. Chow
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Candi MC. Leung
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Phyllis Lun
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Wing Chung Chang
- Department of Psychiatry, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR, China
| | - Gabriel M. Leung
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- Laboratory of Data Discovery for Health (D4H), Hong Kong Science Park, Hong Kong SAR, China
| | - Michael Y. Ni
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR, China
- Urban Systems Institute, The University of Hong Kong, Hong Kong SAR, China
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Alon N, Macrynikola N, Jester DJ, Keshavan M, Reynolds CF, Saxena S, Thomas ML, Torous J, Jeste DV. Social determinants of mental health in major depressive disorder: Umbrella review of 26 meta-analyses and systematic reviews. Psychiatry Res 2024; 335:115854. [PMID: 38554496 DOI: 10.1016/j.psychres.2024.115854] [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: 02/11/2024] [Revised: 03/05/2024] [Accepted: 03/08/2024] [Indexed: 04/01/2024]
Abstract
There is a growing recognition of the impact of social determinants of mental health (SDoMHs) on people with, or at risk of, developing serious mental illnesses. Yet it is not known how associations of individual SDoMHs with risk for major depressive disorder (MDD) vary and roughly compare with one another. Following PRISMA guidelines, this umbrella review included 26 meta-analyses and systematic reviews that reported odds ratios, effect sizes, and/or pooled prevalence rates of MDD in samples with versus without specified SDoMHs. Childhood emotional, physical, or sexual abuse and neglect; intimate partner violence in females; and food insecurity were significantly associated with increased risk of MDD, with medium effect sizes. Natural disasters, terrorist acts, and military combat during deployment had small-size adverse effects, and homelessness, incarceration, and migration were associated with significantly elevated prevalence of MDD. Conversely, higher levels of parental care were significantly associated with reduced risk of MDD with medium effect sizes. Evidence supports the use of certain interventions at the individual and community level that can reduce the impact of these factors and promote health, although much more research is warranted in this area along with meaningful healthcare and societal policies to accomplish this goal.
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Affiliation(s)
- Noy Alon
- Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Psychiatry, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Natalia Macrynikola
- Department of Psychiatry, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Dylan J Jester
- Women's Operational Military Exposure Network Center of Excellence (WOMEN CoE), VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Matcheri Keshavan
- Department of Psychiatry, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | | | - Shekhar Saxena
- Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Michael L Thomas
- Department of Psychology, Colorado State University, Fort Collins, CO, USA
| | - John Torous
- Department of Psychiatry, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Dilip V Jeste
- Global Research Network on Social Determinants of Health, La Jolla, CA, USA.
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Ryan SC, Sugg MM, Runkle JD, Wertis L, Singh D, Green S. Short-term changes in mental health help-seeking behaviors following exposure to multiple social stressors and a natural disaster. Soc Sci Med 2024; 348:116843. [PMID: 38603916 PMCID: PMC11134597 DOI: 10.1016/j.socscimed.2024.116843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 02/23/2024] [Accepted: 03/26/2024] [Indexed: 04/13/2024]
Abstract
In 2020, unprecedented circumstances led to significant mental health consequences. Individuals faced mental health stressors that extended beyond the devastating impact of the COVID-19 pandemic, including widespread social unrest following the murder of George Floyd, an intense hurricane season in the Atlantic, and the politically divisive 2020 election. The objective of this analysis was to consider changes in help-seeking behavior following exposure to multiple social stressors and a natural disaster. Data from Crisis Text Line (CTL), a national text-based mental health crisis counseling service, was used to determine how help-seeking behavior changed in the wake of each event. Wilcoxon rank sum tests assessed changes in help-seeking behavior for each event in 2020 as compared to the same period in 2019. AutoRegressive Integrated Moving Average (ARIMA) models examined if changes in crisis conversation volumes following each event differed. Higher median conversation volumes noted for the COVID-19 pandemic (+1 to +5 conversations), Hurricane Laura (+1 to +7 conversations) and the 2020 Election (+1 to +26 conversations). ARIMA models show substantial increases in help-seeking behavior following the declaration of a national emergency for the COVID-19 pandemic (+4.3 to +38.2%) and following the 2020 election (+3 to +24.44%). Our analysis found that the mental health response following social stressors may be distinct from natural events, especially when natural disasters occur in the context of multiple social stressors. This analysis adds to the growing body of literature considering the mental health impact of exposure to multiple co-occurring societal stressors, like police violence and a global pandemic.
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Affiliation(s)
- Sophia C Ryan
- Department of Geography and Planning, Appalachian State University, Boone NC, 28607, USA.
| | - Margaret M Sugg
- Department of Geography and Planning, Appalachian State University, Boone NC, 28607, USA
| | - Jennifer D Runkle
- North Carolina Institute for Climate Studies, North Carolina State University, Raleigh NC, 27695, USA
| | - Luke Wertis
- Department of Geography and Planning, Appalachian State University, Boone NC, 28607, USA
| | - Devyani Singh
- Data Team, Crisis Text Line, New York City, New York, USA
| | - Shannon Green
- Data Team, Crisis Text Line, New York City, New York, USA
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Abdalla SM, Koya SF, Rosenberg SB, Stovall IB, Biermann O, Zeinali Z, Cohen GH, Ettman CK, Galea S. Pandemic stressors and mental health indicators in eight countries. Soc Psychiatry Psychiatr Epidemiol 2024; 59:585-598. [PMID: 37587229 DOI: 10.1007/s00127-023-02541-w] [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: 08/19/2022] [Accepted: 07/30/2023] [Indexed: 08/18/2023]
Abstract
PURPOSE The Covid-19 pandemic has exacted a significant physical, financial, social, and emotional toll on populations throughout the world. This study aimed to document the association between pandemic stressors and mental health during the pandemic across countries that differ in cultural, geographic, economic, and demographic factors. METHODS We administered an online survey randomly in Brazil, China, Germany, Egypt, India, Indonesia, Nigeria, and the United States from September 2020 to November 2020. This survey included questions on Covid-19-related stressors as well as the Patient Health Questionnaire-2 and the Primary Care PTSD Checklist to screen for depression and post-traumatic stress disorder (PTSD) symptoms, respectively. We performed bivariable and multivariable regression analyses to assess the prevalence and odds ratios of overall depression symptoms and probable PTSD and in relation to stressors across countries. RESULTS Among 8754 respondents, 28.9% (95% CI 27.5-30.0%) experienced depression symptoms, and 5.1% (95% CI 4.5-6.0%) experienced probable PTSD. The highest prevalence of depression symptoms was in Egypt (41.3%, 95% CI 37.6-45.0%) and lowest in the United States (24.9%, 95% CI 22.3-27.7%). The highest prevalence of probable PTSD was in Brazil (7.3%, 95% CI 5.6-9.4%) and the lowest in China (1.2%, 95% CI 0.7-2.0%). Overall, experiencing six or more Covid-19-related stressors was associated with both depression symptoms (OR 1.90, 95% CI 1.46-2.48) and probable PTSD (OR 13.8, 95% CI 9.66-19.6). CONCLUSION The association between pandemic related stressors and the burden of adverse mental health indicators early in the Covid-19 pandemic transcended geographic, economic, cultural, and demographic differences between countries. The short-term and long-term impacts of the pandemic on mental health should be incorporated in efforts to tackle the consequences of Covid-19.
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Affiliation(s)
- Salma M Abdalla
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, 02119, USA.
- Department of Global Health, School of Public Health, Boston University, Boston, MA, USA.
| | - Shaffi Fazaludeen Koya
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, 02119, USA
| | - Samuel B Rosenberg
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, 02119, USA
| | - Isaac B Stovall
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, 02119, USA
| | - Olivia Biermann
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | | | - Gregory H Cohen
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, 02119, USA
| | | | - Sandro Galea
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, 02119, USA
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5
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Rosell J, Vergés A, Miranda-Castillo C. El papel del ocio y entretenimiento digital en la salud mental de personas mayores en contextos de crisis social: el caso del estallido social en Chile. Glob Health Promot 2024:17579759241232867. [PMID: 38517115 DOI: 10.1177/17579759241232867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Affiliation(s)
- Javiera Rosell
- Escuela de Psicología, Pontificia Universidad Católica de Chile, Santiago, Chile
- Millennium Institute for Care Research (MICARE), Santiago, Chile
- Oxford Institute of Population Ageing, University of Oxford, Oxford, Reino Unido
| | - Alvaro Vergés
- Universidad de los Andes, Chile, Escuela de Psicología, Las Condes, Santiago, Chile
- Núcleo Milenio para Mejorar la Salud Mental de Adolescentes y Jóvenes (Imhay), Chile
| | - Claudia Miranda-Castillo
- Millennium Institute for Care Research (MICARE), Santiago, Chile
- Facultad de Enfermería, Universidad Andrés Bello, Santiago, Chile
- Instituto Milenio para la Investigación en Depresión y Personalidad (MIDAP), Chile
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Otten D, Heller A, Schmidt P, Beutel ME, Brähler E. Gender differences in the prevalence of mental distress in East and West Germany over time: a hierarchical age-period-cohort analysis, 2006-2021. Soc Psychiatry Psychiatr Epidemiol 2024; 59:315-328. [PMID: 37041297 PMCID: PMC10089379 DOI: 10.1007/s00127-023-02479-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 03/30/2023] [Indexed: 04/13/2023]
Abstract
PURPOSE Mental distress has become a major public health concern. Temporal trends in psychological distress are complex and depend on numerous factors. In this study, we examined age-period-cohort effects for mental distress including gender and German region over a 15 years' time span. METHODS Data on mental distress from ten cross-sectional surveys of the general German population, covering the years from 2006 to 2021, was used. Hierarchical age-period-cohort analyses including gender and German region as predictors were performed to disentangle age, period, and cohort effects. The Patient Health Questionnaire-4 was used as a brief screener for mental distress. RESULTS We found significant period and cohort effects, with peek values for mental distress in the years 2017 and 2020 and for the oldest birth cohort (born before 1946). Age did not affect mental distress when cohort- and period effects as well as gender and German region were considered. An interaction effect for gender and the German region was found. Women in West Germany reported significantly higher mental distress compared to women in East Germany. Compared to men, women reported the highest prevalence in both regions. CONCLUSION Important political events as well as major crises can lead to an increase of mental distress in societies. Furthermore, an association between birth cohort and mental distress could be linked to socialization effects of that certain time, causing traumatic experiences or a specific coping style within this cohort group. Prevention and intervention strategies could benefit from acknowledging structural differences linked to period and cohort effects.
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Affiliation(s)
- Daniëlle Otten
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany.
| | - Ayline Heller
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Peter Schmidt
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
- Department of Psychiatry and Psychotherapy, Leipzig University Medical Center, Leipzig, Germany
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7
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Hamama-Raz Y, Leshem E, Ben-Ezra M. Differences in mental indicators and state-hope related to the level of engagement in social unrest: Israel 2023. Front Public Health 2024; 11:1284211. [PMID: 38249372 PMCID: PMC10796500 DOI: 10.3389/fpubh.2023.1284211] [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: 08/28/2023] [Accepted: 12/11/2023] [Indexed: 01/23/2024] Open
Abstract
Background This study examined the interplay between engagement in social unrest, mental indicators, state-hope and demographic variables. In addition, mental indicators and state-hope were compared in line with levels of engagement in social unrest. Methods In a cross-sectional study, conducted from March 23 to April 10, 2023, 2031 Israelis were recruited via a survey company. Participants completed self-report questionnaires to assess engagement in social unrest, anxiety, social unrest related distress, state-hope and demographic variables. Results Participants with higher engagement in social unrest, who opposed the law reform, were prone to higher levels of social unrest related distress, anxiety, and lower levels of state-hope compared to those not engaged in social unrest activities or those who supported the law reform. Conclusions Concerns regarding unmet mental health needs, during and following social unrest, regardless of the engagement level, should be actively addressed by mental health professionals and health policy makers.
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Duarte F, Jiménez-Molina Á. Exploring the impact of social protest on mental health: A study of the 2019 "Social Uprising" in Chile. Soc Sci Med 2024; 340:116392. [PMID: 38006846 DOI: 10.1016/j.socscimed.2023.116392] [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: 06/26/2023] [Revised: 10/30/2023] [Accepted: 11/02/2023] [Indexed: 11/27/2023]
Abstract
Socio-political conflicts, especially if accompanied by violent events, can affect the mental health of the population. This study aimed to estimate the causal effect of social protest-related violence on depressive symptoms during the 2019 social uprising in Chile. We collected population-representative data from a nationwide longitudinal survey (n = 2918), the fourth wave of which took place during the months of the social uprising in Chile (November 2019 and March 2020). Depressive symptoms were measured using the Patient Health Questionnaire-9, while violence related to social protest was measured as the perception of destruction at the neighbourhood level. To assess the casual relationship between destruction perception and depressive symptoms, we utilized an instrumental variable regression model. Our analysis controlled for relevant sociodemographic factors, participation in social protest, and history of mental health treatment. Results showed that perceived neighbourhood destruction during the 2019 social uprising significantly increased PHQ-9 score by 3.702 points, prevalence of moderate to severe depressive symptoms by 18.7%, and likelihood of having a Subthreshold or Major Depressive Episode by 15.2% (p < 0.01). The impact of perceived destruction on depressive symptoms varies by gender, with a significant effect found in men (an increase in depression indicators of 5.769 points, 26.8% and 23.0%, respectively, p < 0.05) but not in women. Stratified regression models by age demonstrate a positive association between the perception of neighbourhood destruction and depressive symptoms across all age groups, with a stronger effect observed among young adults. We found a casual effect of violence related to social protest on depressive symptoms. These findings have implications for the planning of social policies aimed at protecting the mental well-being of the population in times of increasing socio-political turmoil.
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Affiliation(s)
- Fabián Duarte
- Faculty of Economics and Business, Department of Economics, Universidad de Chile, Santiago, Chile.
| | - Álvaro Jiménez-Molina
- Faculty of Psychology, Universidad Diego Portales, Santiago, Chile; Faculty of Psychology and Humanities, Universidad San Sebastián, Santiago, Chile; Millennium Institute for Research in Depression and Personality (MIDAP), Santiago, Chile; Millennium Nucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago, Chile.
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Kemp CG, Mensa-Kwao A, Concepcion T, Hughsam M, Queen E, Sinha M, Collins PY. COVID-19, the COVID-19 response, and racial injustice: Associations with depressive and anxiety symptoms among US adults from April 2020 to March 2021. SSM - MENTAL HEALTH 2023; 3:100214. [PMID: 37124707 PMCID: PMC10122769 DOI: 10.1016/j.ssmmh.2023.100214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 03/20/2023] [Accepted: 04/21/2023] [Indexed: 05/02/2023] Open
Abstract
Background People in the United States have faced numerous large and intersecting threats to their mental health since the onset of the coronavirus disease pandemic. This study aimed to understand the unique relationships between these co-occurring threats - including the police killings of unarmed Black people and the fight for racial justice - and how they affect mental health symptoms among various demographic groups. Methods Data on population mental health, state-level COVID-19 incidence rates, cases of police-involved killings, and occurrences of racial justice protests were analyzed. The primary outcome was depression or anxiety symptoms. Regression models were used to estimate prospective associations between individual-, household-, and state-level exposures to hypothesized mental health threats and subsequent depression or anxiety symptoms. Results Data from 2,085,041 individual participants were included. Most were women (51.2%), and most were white, non-Hispanic (61.2%), with almost half (47.7%) reporting some loss of household income since March 13, 2020. Neither the killing of unarmed Black people by police, nor the above-average occurrence of Black Lives Matter (BLM) protests, were observed to be associated with anxiety or depressive symptoms in the overall population, though the BLM protests were associated with reduced depressive and anxiety symptoms among younger participants. State-level COVID-19 incidence risk was more strongly associated with depressive and anxiety symptoms among women, Black people, older people, and higher income people, compared to men, white people, younger people, and lower income people. Conclusion Our findings are relevant for anticipating and addressing the mental health consequences of social injustice and protest movements in the context of COVID-19 pandemic, as well as future pandemics. Promoting population mental health requires addressing underlying social and structural inequities and prioritizing the pursuit of social justice and health equity as a primary mental health intervention.
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Affiliation(s)
- Christopher G Kemp
- Johns Hopkins University, Department of International Health, Baltimore, MD, USA
| | | | - Tessa Concepcion
- University of Washington, Department of Global Health, Seattle, WA, USA
| | | | | | | | - Pamela Y Collins
- University of Washington, Department of Global Health, Seattle, WA, USA
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10
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Ma CF, Chien WT, Luo H, Bressington D, Chen EYH, Chan SKW. Impact of Severe Acute Respiratory Syndrome, Coronavirus Disease 2019, and Social Unrest on Adult Psychiatric Admissions in Hong Kong: A Comparative Population-Based Study. J Nerv Ment Dis 2023; 211:968-973. [PMID: 38015187 DOI: 10.1097/nmd.0000000000001607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
ABSTRACT In Hong Kong, two infectious disease outbreaks occurred in 2003 (SARS) and 2020 (COVID-19), and a large-scale social unrest happened in 2019. These were stressful societal events that influenced the mental well-being of the public. We aimed to explore the impact of these events on psychiatric admissions in Hong Kong. Socioeconomic and population-based psychiatric hospital admission data were retrieved from the government and Hospital Authority. Negative binomial time-series regression analysis was applied and we found overall significant reductions of psychiatric admissions during both the SARS and COVID-19 periods (-7.4% to -16.8%). Particularly, the admissions for unipolar disorders (-16.2% to -39.7%) and neuroses (-20.9% to -31.9%) were greatly reduced during the infection outbreaks. But an increase of admissions for schizophrenia (12.0%) was seen during the social unrest period. These findings support introducing early and targeted community mental health care strategies to the vulnerable people during the stressful societal events.
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Affiliation(s)
| | - Wai Tong Chien
- The Nethersole School of Nursing, The Chinese University of Hong Kong
| | - Hao Luo
- Department of Social Work and Social Administration, Faculty of Social Science, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Daniel Bressington
- College of Nursing and Midwifery, Charles Darwin University, Casuarina, Australia
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11
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Chan CKY, Wong PWC. Hong Kong veterinarians' encounters with client-related stress - a qualitative study. Front Vet Sci 2023; 10:1186715. [PMID: 38098999 PMCID: PMC10720360 DOI: 10.3389/fvets.2023.1186715] [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: 03/15/2023] [Accepted: 11/07/2023] [Indexed: 12/17/2023] Open
Abstract
Aims Limited research has explored the stressors experienced by veterinarians in East Asia. Metropolitan cities like Hong Kong may have overlooked factors that significantly contribute to veterinarians' stress. This paper examines how client-related stressors and contextual factors contribute to the stress levels of Hong Kong-based veterinarians. Methods Veterinarians from small domestic animal practices in Hong Kong were recruited using purposive and targeted snowball samplings until thematic saturation was achieved. Semi-structured in-depth interviews were conducted, audio-recorded, transcribed, coded, and analysed using reflexive thematic analysis with an interpretivist paradigm based on Heidegger's phenomenological approach. Results A total of 18 participating veterinarians described the expectations of and communication with the animal-health enthusiast (AHE) community, including clients, pet owners, and animal lovers, as their primary source of stress. Discrepant expectations and miscommunication between the AHE and veterinary communities, along with contextual factors, such as convenience in clinic switching, negative online reviews, and the relatively short history of the veterinary profession in the multilingual city, were identified as contributing factors to their stress. Recent socio-political events and the pandemic further intensified societal emotions, leading some clients to project frustrations onto perceived authority figures, including health professionals. Conclusion The study highlights that client-related stress extends beyond the health of animal patients, encompassing the expectations of the AHE community, which requires professional-level communication skills to build a mutually respectful three-party relationship. Besides, Hong Kong's unique contextual and historical factors subtly but chronically impact veterinary practices, which can be easily overlooked. Recognising these influences and how they interact is crucial for collaboration, within and beyond the profession, at the policy level to improve veterinary training and practices. Implications Our findings highlight the importance of expectation management and improving communication quality to foster healthy relationships among animals, the AHE community, and veterinary professionals. These efforts are believed to alleviate veterinarians' stress and enhance the well-being of all parties involved. We recommend incorporating effective communication and self-care discussions into the veterinary curriculum and advocating ongoing training for practising veterinarians. At the community level, encouraging open dialogues between animal caregivers and veterinary professionals can help address expectation discrepancies.
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Affiliation(s)
| | - Paul W. C. Wong
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
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12
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Levi-Belz Y, Groweiss Y, Blank C. Moral injury and its mental health consequences among protesters: findings from Israel's civil protest against the government's judicial reform. Eur J Psychotraumatol 2023; 14:2283306. [PMID: 37994789 PMCID: PMC10993812 DOI: 10.1080/20008066.2023.2283306] [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: 09/22/2023] [Accepted: 11/02/2023] [Indexed: 11/24/2023] Open
Abstract
Background: Government actions and participating in protracted-duration protests against it affect protesters' mental health, leading to high distress levels, such as posttraumatic and depressive symptoms. Aside from exposure to violence and other issues, protest participation can pose unique challenges to the protesters as they may be exposed to potentially morally injurious events (PMIEs), such as the betrayal of leaders they once trusted. This study's primary objective was to examine the extent of psychological difficulties among civilians participating in long-duration protests in Israel. More specifically, the study aimed to understand the contribution of exposure to protest-related PMIEs to psychological difficulties such as posttraumatic and depressive symptoms.Method: Participants comprised 4036 Israelis who were actively involved in the unfolding civil protest movement against the government-led judicial overhaul between January 2023 and August 2023. The protesters completed validated self-report questionnaires that included measures of PMIE exposure, PTSD and depressive symptoms.Results: About half (44.3%) of the sample met the criteria for self-report diagnosis of major depression and 10.6% for PTSD. Most of the protesters indicated their exposure to at least one moral injury event, with 63.9% reporting exposure to PMIE-Betrayal. Protesters exposed to PMIEs reported significantly higher levels of both PTSD and depression than non-PMIE-exposed protesters. Hierarchical regression analyses revealed that, beyond demographics and protest-related characteristics such as exposure to violence, PMIE dimensions significantly contributed to both PTSD and depression levels.Conclusions: The findings highlight the mental burden of protesters during the civil protests against the judicial overhaul in Israel. More central to the present research, the findings highlight the critical contribution of PMIEs exposure to this burden. Clinicians treating protesters coping with depression and PTSD following the civil actions should attend to their exposure to PMIEs, which may relate to the deleterious psychological effects among protesters.
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Affiliation(s)
- Yossi Levi-Belz
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel
- Department of Behavioral Sciences, Ruppin Academic Center, Emek Hefer, Israel
| | - Yoav Groweiss
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel
| | - Carmel Blank
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel
- Department of Behavioral Sciences, Ruppin Academic Center, Emek Hefer, Israel
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13
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Daou L, Rached A, Jrad M, Naja W, Haddad R. Substance use disorder in the context of the economic crisis, covid-19 pandemic and social unrest: a cross-sectional study across Beirut (2020-2021). L'ENCEPHALE 2023:S0013-7006(23)00177-X. [PMID: 37985261 DOI: 10.1016/j.encep.2023.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 08/15/2023] [Accepted: 08/24/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND Substance use disorder (SUD) is related to the interplay of various factors. The primary objective of this study was to assess the variation in substance use (SU) among a set of Lebanese people undergoing treatment for SUD during the Lebanese economic crisis, COVID-19 pandemic, and Beirut Blast. METHODS A cross-sectional study including Lebanese adults previously diagnosed with and being treated for SUD at the Skoun center was conducted. Data collection was done using a paper-based Arabic questionnaire tackling the economic crisis, the Covid-19 pandemic, and the Beirut Blast, as well as the following scores: APGAR, PHQ-9, GAD-7 and PCL-6. Data were analyzed using SPSS version 25.0 with P value<0.05 considered significant. A bivariate analysis was conducted to study the association between the use of substances and study variables and scores. RESULTS The sample included 126 men and 10 women. Most participants had a stable consumption of illicit drugs (58.8%), alcohol (76.5%), prescription drugs (70.6%) and non-prescription drugs (89%). Additionally, most participants had concomitant mild or moderate depression (55.1%), mild or moderate anxiety (50.7%), and PTSD (61.8%). Factors found to significantly increase SU were economic distress, change in employment status, and decrease in working hours. PTSD was also identified as a risk factor for increased illicit drug and alcohol use. Furthermore, severe anxiety was found to be a risk factor for increased alcohol consumption. CONCLUSION Most participants were able to maintain a stable pattern of SU despite the quadruple crisis in Lebanon highlighting the important role played by Lebanese Non-Governmental Organizations (NGOs) and efforts employed to control SUD.
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Affiliation(s)
- Lea Daou
- Faculty of Medical Sciences, Lebanese University, Betchay, Mount Lebanon, Lebanon.
| | - Ahmad Rached
- Faculty of Medical Sciences, Lebanese University, Betchay, Mount Lebanon, Lebanon
| | - Manal Jrad
- Faculty of Medical Sciences, Lebanese University, Betchay, Mount Lebanon, Lebanon
| | - Wadih Naja
- Faculty of Medical Sciences, Lebanese University, Betchay, Mount Lebanon, Lebanon
| | - Ramzi Haddad
- Faculty of Medical Sciences, Lebanese University, Betchay, Mount Lebanon, Lebanon; Department of Psychiatry, Saint Joseph University, Beirut, Lebanon
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14
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Glushkova N, Ivankov A, Trenina V, Oshibayeva A, Kalmatayeva Z, Temirbekova Z, Mamyrbekova S, Davletov K, Khismetova Z, Kauysheva A, Auyezova A, Zhanaspayev M, Pivina L, Koshmaganbetova G, Nurbakyt A, Sarsenbayeva G, Sadibekova Z, Gazaliyeva M, Kulimbet M, Kalmatayeva D, Zhylkybekova A, Nurgaliyeva Z, Sultanbekov K, Semenov D, Izmailovich M, Tsigengagel O, Munir K. Post-conflict acute stress reactions in Kazakhstan in the aftermath of January 2022 unrests: A national survey. Heliyon 2023; 9:e21065. [PMID: 37964844 PMCID: PMC10641126 DOI: 10.1016/j.heliyon.2023.e21065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 10/12/2023] [Accepted: 10/13/2023] [Indexed: 11/16/2023] Open
Abstract
Background In January 2022 Kazakhstan experienced unprecedented nationwide protests that quickly turned to violent riots. Although the number of individuals affected physically by the disturbances were cited, the emotional toll of the events remains undetermined. The aim of this study was to evaluate the comparative rates of acute stress reactions in Kazakhstan in the aftermath of the unrests. Methods A cross-sectional, population-based online survey was conducted one month after the start of the disturbances. The study questionnaire were completed anonymously and included the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) and the General Anxiety Disorder-7 (GAD-7), as well as socio-demographic and event exposure information. Results Of the 7021 people who initially agreed to participate, 6510 were able to complete the full survey. For a cut-off of ≥3 on the PC-PTSD-5, 14.8 % of the study participants exhibited symptoms. With a cut-off of ≥4, this percentage reduced to 4.6 %. Participants from Almaty city and Almaty region who experienced the most extensive disturbances showed a doubled prevalence compared to the national level (30.0 % for a cut-off of ≥3, and 10.1 % for a cut-off of ≥4). At the national level, the prevalence of anxiety symptoms, defined as a score of ≥10 on the GAD-7, stood at 10.9 %. This prevalence decreased to 4.2 % when considering a cut-off of ≥15. Conclusion Health authorities of riot-affected areas ought to be aware of the population level mental health impact of the civil conflict and consider provision of targeted interventions to mitigate the long-term consequence of these lifespan disorders, while also seeking for the peaceful resolution of the ensuing conflicts.
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Affiliation(s)
- Natalya Glushkova
- Department of Epidemiology, Biostatistics and Evidence-Based Medicine, Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | | | - Varvara Trenina
- Department of Public Health, Semey Medical University, Semey, Kazakhstan
| | - Ainash Oshibayeva
- Rector Office, Khoja Akhmet Yassawi International Kazakh-Turkish University, Turkestan, Kazakhstan
| | - Zhanna Kalmatayeva
- Academic Office, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - Zhanar Temirbekova
- Rector Office, Khoja Akhmet Yassawi International Kazakh-Turkish University, Turkestan, Kazakhstan
| | - Saltanat Mamyrbekova
- Academic Office, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - Kairat Davletov
- Scientific Office, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - Zaituna Khismetova
- Department of Public Health, Semey Medical University, Semey, Kazakhstan
| | - Almagul Kauysheva
- Rector Office, Kazakhstan Medical University Higher School of Public Health, Almaty, Kazakhstan
| | - Ardak Auyezova
- Rector Office, Kazakhstan Medical University Higher School of Public Health, Almaty, Kazakhstan
| | - Marat Zhanaspayev
- Department of Traumatology, Semey Medical University, Semey, Kazakhstan
| | - Lyudmila Pivina
- Department of Internal Medicine, Semey Medical University, Semey, Kazakhstan
| | - Gulbakit Koshmaganbetova
- Department of Master's and Doctoral Studies, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Ardak Nurbakyt
- Department of Public Health, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - Gulzat Sarsenbayeva
- Department of Social Health Insurance and Public Health, South Kazakhstan Medical Academy, Shymkent, Kazakhstan
| | - Zhanat Sadibekova
- Department of Social Health Insurance and Public Health, South Kazakhstan Medical Academy, Shymkent, Kazakhstan
| | - Meruert Gazaliyeva
- Dean Office of the School of Medicine, Karaganda Medical University, Karaganda, Kazakhstan
| | - Mukhtar Kulimbet
- Department of Epidemiology, Biostatistics and Evidence-Based Medicine, Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Diana Kalmatayeva
- Department of General Psychology, Faculty of Philosophy and Political Science, Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Aliya Zhylkybekova
- Department of Master's and Doctoral Studies, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Zhansaya Nurgaliyeva
- Department of Epidemiology, Biostatistics and Evidence-Based Medicine, Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Kassymkhan Sultanbekov
- Department of Social Health Insurance and Public Health, South Kazakhstan Medical Academy, Shymkent, Kazakhstan
| | | | - Marina Izmailovich
- Department of Internal Diseases, Karaganda Medical University, Karaganda, Kazakhstan
| | - Oxana Tsigengagel
- Department of Public Health, Semey Medical University, Semey, Kazakhstan
| | - Kerim Munir
- Developmental Medicine Centre, Boston Children's Hospital and Departments of Psychiatry and Paediatrics, Harvard Medical School, Boston, USA
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Ma CF, Luo H, Leung SF, Wong GHY, Lam RPK, Bastiampillai T, Chen EYH, Chan SKW. Impact of community mental health services on the adult psychiatric admission through the emergency unit: a 20-year population-based study. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 39:100814. [PMID: 37927999 PMCID: PMC10625018 DOI: 10.1016/j.lanwpc.2023.100814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 04/17/2023] [Accepted: 05/22/2023] [Indexed: 11/07/2023]
Abstract
Background There is a lack of real-life population-based study examining the effect of community mental health services on psychiatric emergency admission. In Hong Kong, Integrated Community Center for Mental Wellness (ICCMW) and telecare service were introduced in 2009 and 2012, respectively. We examined the real-life impact of these services on psychiatric emergency admissions over 20 years. Methods Number of psychiatric emergency admissions between 2001 and 2020 was retrieved from the Hong Kong Clinical Data Analysis & Reporting System. We used an interrupted time series analysis to examine monthly psychiatric admission trend before and after service implementation, considering socioeconomic and environmental covariates. Findings A total of 108,492 psychiatric emergency admissions (47.8% males; 64.9% aged 18-44 years) were identified from the study period, of which 56,858, 12,506, 12,295, 11,791, and 15,051 were that for schizophrenia-spectrum disorders, bipolar affective disorders, unipolar mood disorders, neuroses, and substance use disorders. ICCMW introduction has an immediate effect on psychiatric emergency admission (adjusted estimate per 100,000: -10.576; 95% CI, -16.635 to -4.518, p < 0.001), particularly among adults aged 18-44 years (-8.543; 95% CI, -13.209 to -3.877, p < 0.001), females (-5.843; 95% CI, -9.647 to -2.039, p = 0.003), and with neuroses (-3.373; 95% CI, -5.187 to -1.560, p < 0.001), without a significant long-term effect. Unemployment, seasonality, and infectious disease outbreak were significant covariates. Interpretation ICCMW reduced psychiatric emergency admission, but no further reduction following full implementation. Community mental health services should be dynamically tailored for different populations and socioeconomic variations over time. Funding None.
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Affiliation(s)
- Chak Fai Ma
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Hao Luo
- Department of Social Work and Social Administration, Faculty of Social Science, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Sau Fong Leung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Gloria Hoi Yan Wong
- Department of Social Work and Social Administration, Faculty of Social Science, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Rex Pui Kin Lam
- Emergency Medicine Unit, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Tarun Bastiampillai
- Department of Psychiatry, College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Eric Yu Hai Chen
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Sherry Kit Wa Chan
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong Special Administrative Region, China
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16
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Fenn N, Yang M, Pearson-Merkowitz S, Robbins M. Civic engagement and well-being among noncollege young adults: Investigating a mediation model. JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 51:2667-2685. [PMID: 36943410 PMCID: PMC10629573 DOI: 10.1002/jcop.23033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 02/08/2023] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
Young adults may benefit from civic engagement as a health promotion tool, as civic engagement is generally associated with positive well-being. However, more information is needed to examine civic engagement among lesser-educated young adults who are least likely to civically engage, and more likely to demonstrate mental health needs. We surveyed noncollege young adults (N = 621) to measure their civic engagement, meaning, civic efficacy, well-being, and sociodemographic factors. Using an a priori model, direct, indirect, and full effects path analyses were conducted across men and women, and then the entire sample. The full effects model best fit the data with mediation by civic efficacy and meaning (χ2 (2) = 0.59, p = 0.74; comparative fit index = 1.0; root mean square error of approximation = 0.00, 90% confidence interval [0.00-0.06]; R2 = 0.42). Types of engagement (civic, electoral, activism, and online) demonstrated differing relationships with well-being. Stakeholders should resource young adults with civic skills and coping strategies to address the many challenges that civic experiences often elicit.
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Affiliation(s)
- Natalie Fenn
- Department of Psychology, University of Rhode Island
- Department of Psychiatry & Human Behavior, Warren Alpert Medical School of Brown University
| | - Manshu Yang
- Department of Psychology, University of Rhode Island
| | | | - Mark Robbins
- Department of Psychology, University of Rhode Island
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Wong SMY, Chen EYH. Significance of timely responses to mental health crises during unprecedented societal and global changes using an agile, empathic and user-centred digital approach: lessons from the Hong Kong experience. BMJ Glob Health 2023; 8:e013540. [PMID: 37612035 PMCID: PMC10450124 DOI: 10.1136/bmjgh-2023-013540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 08/08/2023] [Indexed: 08/25/2023] Open
Affiliation(s)
- Stephanie Ming Yin Wong
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Hong Kong
| | - Eric Yu Hai Chen
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
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18
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Nooraeen S, Croarkin PE. Protest suicide: considerations for psychiatrists and psychologists. Front Psychiatry 2023; 14:1213420. [PMID: 37398601 PMCID: PMC10308011 DOI: 10.3389/fpsyt.2023.1213420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 05/25/2023] [Indexed: 07/04/2023] Open
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19
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Jacobi D, Ide T. Collective Violence against Health Workers in the Context of the COVID-19 Pandemic. NURSING REPORTS 2023; 13:902-912. [PMID: 37368346 DOI: 10.3390/nursrep13020079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 06/11/2023] [Accepted: 06/13/2023] [Indexed: 06/28/2023] Open
Abstract
Concerns about violence against nurses and other medical personnel have increased during the COVID-19 pandemic. However, as of yet, limited systematic knowledge of such violence is available. Addressing this gap, we analyse the geographical distribution of, motivations behind, and contexts of collective attacks against health workers in the context of the COVID-19 pandemic. To do so, we systematically recorded and coded attack events worldwide from 1 March 2020 to 31 December 2021. We identify high-risk countries, attack characteristics, and the socio-economic contexts in which attacks tend to occur. Our results show that opposition against public health measures (28.5%), fears of infection (22.3%), and supposed lack of care (20.6%) were the most common reasons for attacks. Most attacks occurred in facilities (often related to a supposed lack of care) or while health workers were on duty in a public place (often due to opposition to public health measures). However, 17.9% of all attacks took place in off-duty settings. Democratic countries with high vaccination rates and strong health systems were relatively safe for nurses and doctors. Distrust in the skills of health workers and the science underlying health interventions is a major driver of collective attack risks and should be addressed before it turns violent. This study was not registered.
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Affiliation(s)
- Davina Jacobi
- Discipline Area of Nursing, IUBH International University, 53604 Bad Honnef, Germany
| | - Tobias Ide
- Center of Biosecurity and OneHealth, Murdoch University, Murdoch, WA 6150, Australia
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20
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Das A, Bruckner TA. New York City's Stop, Question, and Frisk Policy and Psychiatric Emergencies among Black Americans. J Urban Health 2023; 100:255-268. [PMID: 36763179 PMCID: PMC10160307 DOI: 10.1007/s11524-022-00710-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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/23/2022] [Indexed: 02/11/2023]
Abstract
Under the Stop, Question, and Frisk (SQF) policy, New York City (NYC) police stopped Black Americans at more than twice the rate of non-Hispanic whites, after controlling for arrests and precinct differences. We examined whether police stops of Black Americans during SQF correspond positively with psychiatric emergency department (ED) visits among Black residents in NYC. We utilized as the exposure all police stops, stops including frisking, and stops including use of force among Black Americans in NYC between 2006 and 2015 from the New York City Police Department's New York City-Stop, Question, and Frisk database. We examined 938,356 outpatient psychiatric ED visits among Black Americans in NYC between 2006 and 2015 from the Statewide Emergency Department Database (SEDD). We applied Box-Jenkins time-series methods to control for monthly temporal patterns. Results indicate that all stops, frisking, and use of force of Black residents correspond with increased psychiatric ED visits among Black Americans in NYC (all stops-coef = 0.024, 95%CI = 0.006, 0.043; frisking-coef = 0.048, 95%CI = 0.015, 0.080; use of force-coef = 0.109, 95%CI = 0.028, 0.190). Our findings indicate that a one standard deviation increase in police stops equates to a 2.72% increase in psychiatric ED visits among Black residents in NYC. Use of force may have the greatest mental health consequences due to perceived threats of physical violence or bodily harm to other members of the targeted group. Racially biased and unconstitutional police encounters may have acute mental health implications for the broader Black community not directly involved in the encounter itself.
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Affiliation(s)
- Abhery Das
- Program in Public Health, University of California, 653 East Peltason Drive, Irvine, CA, 92617, USA.
| | - Tim A Bruckner
- Program in Public Health, University of California, 653 East Peltason Drive, Irvine, CA, 92617, USA
- Center for Population, Inequality, and Policy, University of California, Irvine, USA
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21
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Huggard L, Murphy R, O'Connor C, Nearchou F. The Social Determinants of Mental Illness: A Rapid Review of Systematic Reviews. Issues Ment Health Nurs 2023; 44:302-312. [PMID: 36972547 DOI: 10.1080/01612840.2023.2186124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
Previous research agendas have prioritised the role of biological determinants in mental illness aetiology. This is of particular concern, as endorsing biological determinants has been shown to promote negative attitudes towards people with mental illness. The aim of this review was to provide an overview of high-quality evidence of the social determinants of mental illness. A rapid review of systematic reviews was conducted. Five databases were searched: Embase, Medline, Academic Search Complete, CINAHL Plus, and PsycINFO. Systematic reviews or meta-analyses that described any social determinant of mental illness, were published in peer-review journals in English, and focussed on human participants were included. The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines were applied for the selection procedure. Thirty-seven systematic reviews were deemed eligible for review and narrative synthesis. Determinants identified included conflict, violence and maltreatment, life events and experiences, racism and discrimination, culture and migration, social interaction and support, structural policies and inequality, financial factors, employment factors, housing and living conditions, and demographic factors. We recommend that mental health nurses ensure adequate support be provided to those affected by the evidenced social determinants of mental illness.
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22
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The Indirect Effect of Sleep on the Association Between Protracted Social Stressors and Psychological Distress Among Hong Kong Young People. J Adolesc Health 2023; 72:788-795. [PMID: 36653260 PMCID: PMC9842456 DOI: 10.1016/j.jadohealth.2022.11.243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 11/22/2022] [Accepted: 11/22/2022] [Indexed: 01/19/2023]
Abstract
PURPOSE Hong Kong youth and young adults experienced unprecedented stress amid social unrest and the COVID-19 pandemic. Few studies have examined how these stressors were related to psychological distress among youth and young adults. This study assessed how psychological distress is associated with stress from social unrest, financial circumstances, and the COVID-19 pandemic, and whether poor sleep quality may explain these associations. METHODS Participants of a representative phone survey included 1,501 Hong Kong youth and young adults (Mage = 26.1 (4.0); 48.2% female). We examined the associations between psychological distress and three types of stress (social unrest, financial, and COVID-19 stress), and the indirect effect of poor sleep. RESULTS Eleven point nine percent, 4.1%, and 9.7% of respondents reported feeling very seriously distressed by social unrest, financial circumstances, and the COVID-19 pandemic, respectively. All three forms of stress were associated with poor sleep. The indirect effects of poor sleep on the association between all three forms of stress and psychological distress were identified. Moderated indirect effect analysis indicated that being female intensified the effect of COVID-19-related stress on psychological distress and that younger female youth and older male youth were more vulnerable to financial stress and social unrest stress (vs. older female youth and younger male youth). DISCUSSION Sleep may be one mechanism that accounts for the association between psychological distress and protracted stressors among Hong Kong youth and young adults. These results suggest the importance of prioritizing sleep improvement in mental health interventions during times of societal change.
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23
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Ramadan R, Randell A, Lavoie S, Gao CX, Manrique PC, Anderson R, McDowell C, Zbukvic I. Empirical evidence for climate concerns, negative emotions and climate-related mental ill-health in young people: A scoping review. Early Interv Psychiatry 2023. [PMID: 36641809 DOI: 10.1111/eip.13374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 10/18/2022] [Accepted: 01/01/2023] [Indexed: 01/16/2023]
Abstract
BACKGROUND Climate change represents a serious threat to human health, including mental health, due to both the traumatizing effects of extreme climate events and the psychological effect of worry about climate change. OBJECTIVES This scoping review aims to search the literature for original research investigating mental health and climate-related negative emotions in young people. Findings will help to understand the current landscape, gaps in the literature, and provide recommendations for future youth mental health research and practice. METHODS A scoping review of the literature examining negative emotions associated with climate change in young people was undertaken. Studies published prior to March 2022 were included if they examined mental ill-health (e.g., symptoms of depression or anxiety) or negative emotions (e.g., distress, worry, concern) associated with the threat of climate change. RESULTS Of 3939 articles screened, 26 met the inclusion criteria. Together, studies show that young people are worried about climate change. Negative emotions about climate change were correlated with symptoms of mental ill-health. Studies also explored coping strategies young people use to manage their distress caused by climate change. DISCUSSION The limited literature in this area indicates a key gap in youth mental health research. While available evidence suggests that young people are concerned about climate change, more research is needed on the relationship between climate-related negative emotions and mental ill-health. Clinicians should assess for and address climate-related negative emotions in young people. Mental health leaders are urged to advocate for actions to mitigate the mental health impact of climate change.
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Affiliation(s)
- Reem Ramadan
- Orygen, Parkville, Victoria, Australia.,Orygen, North Western Mental Health, Melbourne Health, Parkville, Victoria, Australia
| | - Alicia Randell
- Orygen, Parkville, Victoria, Australia.,Headspace National Youth Mental Health Foundation, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Suzie Lavoie
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Caroline X Gao
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia.,Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Paula Cruz Manrique
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Rebekah Anderson
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Caitlin McDowell
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Isabel Zbukvic
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
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da Costa S, Páez D, Martí-González M, Díaz V, Bouchat P. Social movements and collective behavior: an integration of meta-analysis and systematic review of social psychology studies. Front Psychol 2023; 14:1096877. [PMID: 37151317 PMCID: PMC10162496 DOI: 10.3389/fpsyg.2023.1096877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 03/29/2023] [Indexed: 05/09/2023] Open
Abstract
Background The impact of social movements (SMs) and collective behavior (CB) supports the relevance of approaching this phenomenon from social psychology. Several systematic reviews (10) and meta-analyses (6) have been carried out in the 21st century, but there is a lack of integration. Aim This study seeks to review the patterns of CB and corroborate the psychosocial factors that explain participation in CB and SMs, as well as the long-term psychological effects of participating in them. Method A systematic search was carried out in the databases Web of Science, Scopus, ProQuest, ScienceDirect, Willey Online Library, EBSCO, and JSTOR for articles dated between 1969 and 2022. We searched for meta-analyses and systematic reviews that empirically evaluated social movements and collective behavior. Of the 494 initial records, after scanning and eligibility phases, 16 meta-analyses and systematic reviews were analyzed in the present work. Results The evidence reviewed shows that participation in collective gatherings and CB are common. A cross-cultural survey suggests that collective gatherings are mostly of a leisure type, to a lesser extent religious and sporting, and to an even lesser extent, demonstrations and large religious rites. World Value surveys found that one to three persons out of 10 participate in protests or CB related to SMs and four out of 10 movements achieved some kind of success. Studies challenged that CBs were characterized by unanimity of beliefs, identification and behavior, generalized excitement, as well as mass panic and riot after catastrophes. Only two out of 10 CB are violent. Meta-analysis and systematic reviews confirm that participation in CB and SMs was associated with (a) intergroup conflict and realistic threat (r = 0.30); (b) positive attitudes, expectations, or agreement with goals or collective motive (r = 0.44); (c) cognitive fraternal relative deprivation (r = 0.25); (d) collective efficacy (r = 0.36); (e) collective identity (r = 0.34); (f) emotions and affective relative deprivation (r = 0.35); (g) moral conviction and threat to moral (r = 0.29); and (h) disagreement with system justification belief (r = -0.26). Participation in successful CB and SMs provokes positive changes in emotions, social identity and social relationships, values and beliefs, and empowerment, as well as negative effects such as depression, stress, burnout, and disempowerment related to the failures of SMs. Conclusion Studies confirm the importance of explanatory factors for SMs, with data from various cultural regions. There is a lack of systematic studies of CB as well as meta-analyses and more culturally diverse studies of the effects of participation in them.
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Affiliation(s)
- Silvia da Costa
- Faculty of Social and Human Sciences, Department of Psychology and Sociology, University of Zaragoza, Teruel, Spain
- *Correspondence: Silvia da Costa
| | - Dario Páez
- Faculty of Psychology, Department of Social Psychology, University of Basque Country, San Sebastian, Spain
- Faculty of Education and Social Sciences, Andrés Bello University, Santiago, Chile
| | - Mariacarla Martí-González
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
- Department of Education, University of Cantabria, Santander, Spain
| | - Virginia Díaz
- Faculty of Psychology, Department of Social Psychology, University of Basque Country, San Sebastian, Spain
| | - Pierre Bouchat
- Laboratoire Perseus, University of Lorraine, Nancy, France
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León Rodríguez DA, Tobar Herrera MP, Fernández de Castro MOH, Aguilar Mejía OM. Empatía, redes sociales e indicadores de salud mental durante las crisis sociales en Colombia. UNIVERSITAS PSYCHOLOGICA 2022. [DOI: 10.11144/javeriana.upsy21.ersi] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Múltiples estudios sugieren que las crisis sociales exacerban los problemas de salud mental en la población. Sin embargo, el funcionamiento empático y la disponibilidad de información en redes sociales puede mediar su impacto. Colombia atravesó recientemente dos crisis sociales: la pandemia por COVID-19 y la huelga nacional del 2021. Se analizó la relación entre empatía, uso de redes sociales y salud mental durante estas crisis. 314 participantes respondieron en línea los cuestionarios Índice de Reactividad Interpersonal, Tiempo de uso de redes sociales, Escala de Estrés Traumático Secundario, Escala para el Trastorno de Ansiedad Generalizada GAD-7 y el Índice de Bienestar WHO-5. Los resultados indicaron mayor uso de redes durante las crisis; mayor reporte de ansiedad y de estrés traumático entre más tiempo de uso de redes; peores indicadores generales de bienestar y de salud mental entre mayor uso de redes; relación negativa entre salud mental y medidas de empatía y peores indicadores de salud mental en personas con un menor nivel educativo que más usaron redes y con índices altos de malestar personal y fantasía empática. En conclusión, las habilidades empáticas influyeron sobre la relación entre el uso de redes sociales y salud mental durante las dos crisis sociales.
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26
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Fakih A, El Baba M. The willingness to emigrate in six
MENA
countries: The role of
post‐revolutionary
stress. INTERNATIONAL MIGRATION 2022. [DOI: 10.1111/imig.13093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Ali Fakih
- Department of Economics Lebanese American University Beirut Lebanon
| | - Malak El Baba
- Department of Economics Lebanese American University Beirut Lebanon
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27
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Ayinde OO, Atere OP, Ibeawuchi U, Bello T, Ogunkoya A, Asafa O, Abdulmalik J. Aftermath of anti-police protests in Nigeria: Burden and predictors of psychiatric morbidity among protesters and non-protesters. Aust N Z J Psychiatry 2022; 56:1306-1319. [PMID: 34581195 DOI: 10.1177/00048674211049332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Anti-police (#EndSARS) protests took place in October 2020 across several Nigerian cities, resulting in deaths, injuries and loss of property, but the psychological sequelae of these protests have not been studied. METHOD In a cross-sectional online survey, we collected data on psychiatric morbidity and potential risk factors from 426 Nigerian social media users, who self-identified as participants or non-participants in a recent anti-police protest. RESULTS We found elevated rates of psychiatric morbidity, with worse outcomes for protesters compared to non-protesters (psychological distress [44.2% vs 29.8%], depression [26.0% vs 14.9%], anxiety [51.0% vs 29.8%], post-traumatic stress disorder [7.4% vs 1.8%], current substance use [11.2% vs 4.5%] and suicidal ideation [7.1% vs 4.4%], respectively). After adjusting for the effects of COVID-19 pandemic and previous mental health diagnosis, the predictors of poor mental health among non-protesters were being unmarried (odds ratio = 7.4, p = 0.01) and low resilience (odds ratio range = 4.1-5.4, p < 0.03) while for the protesters, the predictors were low resilience (odds ratio range = 2.9-4.7, p < 0.01), being from Northern Nigeria (odds ratio = 4.7, p < 0.01) or residing in Northern Nigeria (odds ratio = 2.8, p = 0.03), being under-/unemployed (odds ratio range = 2.1-2.5, p < 0.04), holding the view that the protest was caused by the state of the economy (odds ratio = 2.0, p = 0.01), belief that the protest had a direct negative impact on the protester (odds ratio = 2.3, p = 0.04) and willingness to participate in future protests (odds ratio = 4.13, p = 0.02). CONCLUSION We conclude that participating in the #EndSARS protest was associated with significant psychiatric morbidity. There is need to recognise and address the mental health sequelae of collective actions, and invest in programmes that build resilience and address socio-political determinants of mental health, especially with a focus on youth.
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Affiliation(s)
| | | | - Ugonna Ibeawuchi
- Department of Neuropsychiatry, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
| | - Toyin Bello
- WHO Collaborating Centre for Research and Training in Mental health, Neurosciences, and Substance abuse, Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | | | | | - Jibril Abdulmalik
- Department of Psychiatry, University College Hospital, Ibadan, Nigeria
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28
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Lai FTT, Chan VKY, Li TW, Li X, Hobfoll SE, Lee TMC, Hou WK. Disrupted daily routines mediate the socioeconomic gradient of depression amid public health crises: A repeated cross-sectional study. Aust N Z J Psychiatry 2022; 56:1320-1331. [PMID: 34677098 DOI: 10.1177/00048674211051271] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE There is a socioeconomic gradient to depression risks, with more pronounced inequality amid macroenvironmental potential traumatic events. Between mid-2019 and mid-2020, the Hong Kong population experienced drastic societal changes, including the escalating civil unrest and the COVID-19 pandemic. We examined the change of the socioeconomic gradient in depression and the potential intermediary role of daily routine disruptions. METHOD We conducted repeated territory-wide telephone surveys in July 2019 and July 2020 with 1112 and 2034 population-representative Cantonese-speaking Hong Kong citizens above 15 years old, respectively. Stratified by year, we examined the association between socioeconomic indicators (education attainment, household income, employment status and marital status) and probable depression (nine-item Patient Health Questionnaire [PHQ-9] ⩾ 10) using logistic regression. Differences in the socioeconomic gradient between 2019 and 2020 were tested. Finally, we performed a path analysis to test for the mediating role of daily routine disruptions. RESULTS Logistic regression showed that higher education attainment in 2019 and being married in 2020 were protective against probable depression. Interaction analysis showed that the inverse association of higher education attainment with probable depression attenuated in 2020 but that of being married increased. Path analysis showed that the mediated effects through daily routine disruptions accounted for 95.9% of the socioeconomic gradient of probable depression in 2020, compared with 13.1% in 2019. CONCLUSION From July 2019 to July 2020, the mediating role of daily routine disruptions in the socioeconomic gradient of depression in Hong Kong increased. It is thus implied that infection control measures should consider the relevant potential mental health impacts accordingly.
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Affiliation(s)
- Francisco Tsz Tsun Lai
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.,Laboratory of Data Discovery for Health (D²4H), Hong Kong Science and Technology Park, Hong Kong, China
| | - Vivien Kin Yi Chan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Tsz Wai Li
- Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong SAR, China
| | - Xue Li
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.,Laboratory of Data Discovery for Health (D²4H), Hong Kong Science and Technology Park, Hong Kong, China.,Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Stevan E Hobfoll
- STAR Consultants-STress, Anxiety and Resilience, Salt Lake City, UT, USA
| | - Tatia Mei-Chun Lee
- State Key Laboratory of Brain and Cognitive Sciences and Laboratory of Neuropsychology & Human Neuroscience, The University of Hong Kong, Hong Kong SAR, China
| | - Wai Kai Hou
- Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong SAR, China.,Department of Psychology, The Education University of Hong Kong, Hong Kong SAR, China
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29
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Lai DWL, Liu EHS, Yan ECW, Li JJ, Lee VWP. Exposure to socio-political unrest and wellbeing of older people in Hong Kong. BMC Geriatr 2022; 22:768. [PMID: 36151516 PMCID: PMC9502941 DOI: 10.1186/s12877-022-03433-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 09/02/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The social unrest in the second half of 2019 in Hong Kong came with conflicts, confrontations, and violence which affected almost everyone in the city. The destruction and disruption of the urban facilities have undoubtedly had a significant impact on the lives and mental well-being of the public, and the older people are even more vulnerable. This study examined the impacts of the social unrest on the wellbeing of older people, an area that was seldomly addressed in the public discourse and literature. METHODS Narrative interviews were conducted to capture older people's lived experiences and ways of making sense of the unrest in Hong Kong. A total of 63 participants aged 60 and above was recruited through personal networks of the research team, and referrals by participants who took part in the interviews. Qualitative semi-structure interviews was conducted one on one via telephone. RESULTS Thirty-three male and 30 female participants took part in the interview. The number of participants from different risk zones affected by political unrest was comparable. Three themes were generated. Participants experienced challenges during the social unrest, including disturbance to family and social life, reduced incomes which affect quality of life, and difficulties in socializing with friends and accessing medical services. The social unrest caused emotional disturbance, giving rise to feelings of panic, fear, insomnia, depression, annoyance, and anger. Participants reported different coping strategies, ranging from moving to other places, to avoiding going to risky areas and watching news. CONCLUSION Social unrest brings emotional distress to older people. In many cases, older people cope with challenges in different ways, whether active or passive. Social workers and other professionals should give more support to older people to encourage them to overcome their difficulties. The stakeholders' awareness of the problem and mental health promotion is required to alleviate the multiple layers of negative impacts.
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Affiliation(s)
- Daniel W L Lai
- Faculty of Social Sciences, Hong Kong Baptist University, Room 1325, 13/F Academic and Administration Building, Baptist University Road Campus, Kowloon Tong, Hong Kong, China.
| | - Emma H S Liu
- Faculty of Social Sciences, Hong Kong Baptist University, Room 1325, 13/F Academic and Administration Building, Baptist University Road Campus, Kowloon Tong, Hong Kong, China
| | - Elsie C W Yan
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hung How, Hong Kong, China
| | - Jessica J Li
- Department of Social Work, The Chinese University of Hong Kong, Ma Liu Shui, Hong Kong, China
| | - Vincent W P Lee
- Department of Social Work, Hong Kong Baptist University, Kowloon Tong, Hong Kong, China
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30
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Rabinowitz EP, Sayer MA, Samii MR, Straub EL, Kutash LA, Delahanty DL. The 50th anniversary of May 4, 1970 is associated with elevations of distress but no increase in mental health symptoms. Stress Health 2022; 38:556-567. [PMID: 34800065 DOI: 10.1002/smi.3117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 11/08/2021] [Accepted: 11/15/2021] [Indexed: 11/11/2022]
Abstract
Anniversaries of traumatic events are associated with increased symptoms of posttraumatic stress disorder (PTSD), depression, and anxiety, especially in individuals with prior mental health symptoms. However, research has largely focussed on 1-year anniversaries, and it is unclear whether symptom exacerbation persists for more distal, or milestone, anniversaries. Symptoms typically decrease over time after traumatic events, but major anniversaries may be associated with increases in mental health symptoms. During and 3 months after the 50th anniversary of the political protest violence at Kent State University on May 4, 1970, 115 individuals completed measures of PTSD, depression, anxiety, and anniversary-related stress. Participants reported greater stress (t(97) = 4.04 p ≤ .001) during the 50th anniversary compared to 3 months later, but there were no differences in total PTSD (t(114) = .65, p = .52) or depression/anxiety symptoms (all p's > .05). Even in higher-risk individuals (those who previously received mental health services), symptoms did not differ during versus after the anniversary. In general, long-term anniversaries may contribute to transient increases in distress but do not induce major changes in mental health symptoms.
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Affiliation(s)
- Emily P Rabinowitz
- Department of Psychological Sciences, Kent State University, Kent, Ohio, USA
| | - MacKenzie A Sayer
- Department of Psychological Sciences, Kent State University, Kent, Ohio, USA
| | - Marielle R Samii
- Department of Psychological Sciences, Kent State University, Kent, Ohio, USA
| | - Elizabeth L Straub
- Department of Psychological Sciences, Kent State University, Kent, Ohio, USA
| | - Lindsay A Kutash
- Department of Psychological Sciences, Kent State University, Kent, Ohio, USA
| | - Douglas L Delahanty
- Department of Psychological Sciences, Kent State University, Kent, Ohio, USA.,Northeast Ohio Medical University, Rootstown, Ohio, USA
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31
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Mohammed TF, Gin LE, Wiesenthal NJ, Cooper KM. The Experiences of Undergraduates with Depression in Online Science Learning Environments. CBE LIFE SCIENCES EDUCATION 2022; 21:ar18. [PMID: 35294254 PMCID: PMC9508907 DOI: 10.1187/cbe.21-09-0228] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Depression is one of the top mental health concerns among undergraduates and disproportionately affects students who are underrepresented in science. As such, understanding how emerging science learning environments, such as online science courses, affect students with depression is integral to creating a more inclusive scientific community. In this exploratory study, we interviewed 24 undergraduates with depression who were pursuing an online BS degree in biological sciences at a research-intensive institution. We assessed how students perceived depression affected their learning, and in turn, how online science courses affected their depression. Using a hybrid approach of deductive and inductive coding, we found that students reported depression negatively affected an array of cognitive domains when learning science online, including students' effort, focus, and time management. Students reported that the fast pace of online courses, the lack of needing to show up to a class in person, and difficulty developing relationships with other students commonly exacerbated their depression. Conversely, the flexibility of completing course work when and where students wanted, developing a relationship with the instructor, and the ease of having questions answered online positively affected students' depression. This study provides insight into ways to create inclusive online learning environments for students with depression.
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Affiliation(s)
| | - Logan E. Gin
- Research for Inclusive STEM Education Center, Arizona State University
| | | | - Katelyn M. Cooper
- Research for Inclusive STEM Education Center, Arizona State University
- *Address correspondence to: Katelyn M. Cooper ()
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32
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Leung CMC, Ho MK, Bharwani AA, Cogo-Moreira H, Wang Y, Chow MSC, Fan X, Galea S, Leung GM, Ni MY. Mental disorders following COVID-19 and other epidemics: a systematic review and meta-analysis. Transl Psychiatry 2022; 12:205. [PMID: 35581186 PMCID: PMC9110635 DOI: 10.1038/s41398-022-01946-6] [Citation(s) in RCA: 58] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 04/19/2022] [Accepted: 04/21/2022] [Indexed: 02/07/2023] Open
Abstract
COVID-19 has imposed a very substantial direct threat to the physical health of those infected, although the corollary impact on mental health may be even more burdensome. Here we focus on assessing the mental health impact of COVID-19 and of other epidemics in the community. We searched five electronic databases until December 9, 2020, for all peer-reviewed original studies reporting any prevalence or correlates of mental disorders in the general population following novel epidemics in English, Chinese or Portuguese. We synthesised prevalence estimates from probability samples during COVID-19 and past epidemics. The meta-analytical effect size was the prevalence of relevant outcomes, estimated via random-effects model. I2 statistics, Doi plots and the LFK index were used to examine heterogeneity and publication bias. This study is pre-registered with PROSPERO, CRD42020179105. We identified 255 eligible studies from 50 countries on: COVID-19 (n = 247 studies), severe acute respiratory syndrome (SARS; n = 5), Ebola virus disease (n = 2), and 1918 influenza (n = 1). During COVID-19, we estimated the point prevalence for probable anxiety (20.7%, 95% CI 12.9-29.7), probable depression (18.1%, 13.0-23.9), and psychological distress (13.0%, 0-34.1). Correlates for poorer mental health include female sex, lower income, pre-existing medical conditions, perceived risk of infection, exhibiting COVID-19-like symptoms, social media use, financial stress, and loneliness. Public trust in authorities, availability of accurate information, adoption of preventive measures and social support were associated with less morbidity. The mental health consequences of COVID-19 and other epidemics could be comparable to major disasters and armed conflicts. The considerable heterogeneity in our analysis indicates that more random samples are needed. Health-care professionals should be vigilant of the psychological toll of epidemics, including among those who have not been infected.
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Affiliation(s)
- Candi M. C. Leung
- grid.194645.b0000000121742757School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Special Administrative Region China
| | - Margaret K. Ho
- grid.194645.b0000000121742757School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Special Administrative Region China
| | - Alina A. Bharwani
- grid.194645.b0000000121742757School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Special Administrative Region China
| | - Hugo Cogo-Moreira
- grid.194645.b0000000121742757School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Special Administrative Region China ,grid.411249.b0000 0001 0514 7202Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Yishan Wang
- grid.194645.b0000000121742757School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Special Administrative Region China
| | - Mathew S. C. Chow
- grid.194645.b0000000121742757School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Special Administrative Region China
| | - Xiaoyan Fan
- grid.194645.b0000000121742757School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Special Administrative Region China
| | - Sandro Galea
- grid.189504.10000 0004 1936 7558School of Public Health, Boston University, Boston, MA USA
| | - Gabriel M. Leung
- grid.194645.b0000000121742757School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Special Administrative Region China ,grid.194645.b0000000121742757World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong, Special Administrative Region China
| | - Michael Y. Ni
- grid.194645.b0000000121742757School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Special Administrative Region China ,grid.194645.b0000000121742757The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, Special Administrative Region China ,grid.194645.b0000000121742757Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Hong Kong, Special Administrative Region China
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Wong SM, Hui CL, Suen YN, Wong CS, Chan SK, Lee EH, Chang WC, Chen EY. The impact of social unrest and pandemic on mental health of young people in Hong Kong: The transdiagnostic role of event-based rumination. Aust N Z J Psychiatry 2022; 56:376-384. [PMID: 34180248 DOI: 10.1177/00048674211025710] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Co-occurring population-level events, such as social unrest and coronavirus disease 2019, are observed in many societies today. Few studies have explored their combined mental health effects on young people. While self-focused rumination has been suggested to be a key mechanism underlying depression, the role of event-based rumination in mediating the impact of population stressors has yet to be elucidated. METHODS Data were collected from 6988 young people in a large-scale community online survey in Hong Kong. The survey assessed symptoms of post-traumatic stress disorder and depression, direct exposure to social unrest-related traumatic events, coronavirus disease 2019 pandemic-related events, personal stressful life events, event-based rumination and other individual risk factors. RESULTS High levels of comorbid post-traumatic stress disorder and depressive symptoms were observed. Logistic regression analysis revealed that probable post-traumatic stress disorder was associated with traumatic events (odds ratio = 1.73, 95% confidence interval = [1.64, 1.82]), pandemic-related events (odds ratio = 1.08, confidence interval = [1.01, 1.16]), stressful life events (odds ratio = 1.20, confidence interval = [1.21, 1.37]), high event-based rumination (odds ratio = 3.00, confidence interval = [2.58, 3.48]), lower resilience (odds ratio = 1.18, confidence interval = [1.15, 1.21]), higher smartphone reliance (odds ratio = 1.09, confidence interval = [1.05, 1.13]) and financial concerns (odds ratio = 1.25, confidence interval = [1.18, 1.33]). The odds for probable post-traumatic stress disorder was also significantly higher when two or more traumatic events were experienced (odds ratio = 4.03, confidence interval = [3.52, 4.62]). Factors associated with moderate-to-severe level depressive symptoms were similar. Event-based rumination significantly mediated between different types of external events (traumatic events, pandemic-related events, stressful life events) and both post-traumatic stress disorder and depressive symptoms. CONCLUSION These findings suggest that diverse types of stressful events during population-level crises could add to personal stressors to affect mental health outcomes in young people. Among other protective and risk factors, event-based rumination presented as a prominent transdiagnostic mediator for different symptom dimensions which may be a potentially important target for early risk detection and intervention.
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Affiliation(s)
- Stephanie My Wong
- Department of Psychiatry, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Christy Lm Hui
- Department of Psychiatry, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Yi Nam Suen
- Department of Psychiatry, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Corine Sm Wong
- Department of Psychiatry, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Sherry Kw Chan
- Department of Psychiatry, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.,State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Pokfulam, Hong Kong
| | - Edwin Hm Lee
- Department of Psychiatry, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Wing Chung Chang
- Department of Psychiatry, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.,State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Pokfulam, Hong Kong
| | - Eric Yh Chen
- Department of Psychiatry, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.,State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Pokfulam, Hong Kong
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34
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Liu CH, Wong GTF, Hyun S, Hahm H“C. Concerns about the social climate, finances, and COVID-19 risk on depression and anxiety: An analysis on U.S. young adults across two waves. J Psychiatr Res 2022; 148:286-292. [PMID: 35189512 PMCID: PMC8828372 DOI: 10.1016/j.jpsychires.2022.01.048] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 01/15/2022] [Accepted: 01/26/2022] [Indexed: 12/16/2022]
Abstract
Concerns regarding contracting COVID-19 and finances may be risks to mental health during the COVID-19 pandemic. Social climate concerns may be another risk, given U.S. protests taking place during this period. We tested the hypothesis that concerns about COVID-19 risk, finances, and social climate would predict clinically significant levels of depression, anxiety, and comorbid depression and anxiety in young adults. A total of 782 U.S. young adults (18-30 years), initially recruited through convenience sampling (social media, email listservs), completed online surveys at Wave 1 (April-August 2020) and Wave 2 (September 2020-March 2021). The primary outcomes included scoring above the cut off for depressive (PHQ-8 ≥ 10) or anxiety symptoms (GAD ≥10). Approximately 41% reported depression and 47% reported anxiety at Wave 1; rates did not differ at Wave 2. Individuals with greater financial concerns were 14% more likely to score high on depressive symptoms; those with COVID-19 risk concerns and social climate concerns were 21% and 54% more likely, respectively, to score high on generalized anxiety. Those with social climate and financial concerns were 52% and 15% more likely, respectively, to score high on comorbid depressive and anxiety symptoms. Analyses controlled for Wave 1 symptoms. We provide evidence highlighting the roles of social climate and COVID-19 risk concerns on anxiety, and financial concerns on depression in young adults. Public health campaigns should acknowledge broader societal issues that have taken place as a source of mental health distress, beyond those driven by the pandemic (e.g., isolation and lockdowns).
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Affiliation(s)
- Cindy H. Liu
- Department of Newborn Medicine, Brigham and Women's Hospital, Boston, MA, USA,Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA,Corresponding author. Department of Newborn Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Ga Tin Finneas Wong
- Department of Newborn Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Sunah Hyun
- Department of Newborn Medicine, Brigham and Women's Hospital, Boston, MA, USA
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Karbownik MS, Mokros Ł, Kowalczyk E. Who Benefits from Fermented Food Consumption? A Comparative Analysis between Psychiatrically Ill and Psychiatrically Healthy Medical Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073861. [PMID: 35409544 PMCID: PMC8997937 DOI: 10.3390/ijerph19073861] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/19/2022] [Accepted: 03/21/2022] [Indexed: 12/18/2022]
Abstract
Probiotic therapies and fermented food diets hold promise for improving mental health. Although in this regard psychiatric patients appear to benefit more than healthy individuals, no research has been performed to directly evaluate this hypothesis. The present study examined a cohort of medical students facing a stressful event, and some of the students reported suffering from chronic psychiatric diseases. The amount of fermented food consumption was calculated with the use of seven-day dietary records, while depressive and anxiety symptoms were assessed with the use of the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7, respectively. In psychiatrically healthy medical students under psychological stress (n = 372), higher fermented food consumption was associated with more depressive and anxiety symptoms. In contrast, psychiatrically ill medical students (n = 25, 6.3% of all the participants) were found to present a negative association between the amount of fermented food consumed and the severity of depressive symptoms (adjusted β −0.52, 95% CI −0.85 to −0.19, p = 0.0042); however, this relationship was insignificant for anxiety symptoms (adjusted β −0.22, 95% CI −0.59 to 0.15, p = 0.22). A significant interaction was found between the consumption of fermented food and psychiatric diagnosis in predicting depressive symptoms (p = 0.0001), and a borderline significant interaction for anxiety symptoms (p = 0.053). In conclusion, psychiatrically ill people, but not healthy ones, may benefit from fermented food consumption in terms of alleviation of depressive symptoms. Our findings require cautious interpretation and further investigation.
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Affiliation(s)
- Michał Seweryn Karbownik
- Department of Pharmacology and Toxicology, Medical University of Lodz, Żeligowskiego 7/9, 90-752 Lodz, Poland;
- Correspondence: ; Tel.: +48-42-272-52-91
| | - Łukasz Mokros
- Department of Clinical Pharmacology, Medical University of Lodz, Kopcińskiego 22, 90-153 Lodz, Poland;
| | - Edward Kowalczyk
- Department of Pharmacology and Toxicology, Medical University of Lodz, Żeligowskiego 7/9, 90-752 Lodz, Poland;
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Chung EYH. Building and Testing of a Conceptual Model to Describe and Measure the Health of People as Affected by Post-traumatic Stress Disorder During Social Unrest: A Confirmatory Factor Analysis and Structural Equation Modeling. Front Public Health 2022; 10:838606. [PMID: 35356023 PMCID: PMC8959908 DOI: 10.3389/fpubh.2022.838606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 02/09/2022] [Indexed: 11/23/2022] Open
Abstract
Background Social unrest affects people's health and well-being. People's health-related needs during social unrest are concerns in both research and clinical practice. This study aimed to build and test a framework to describe and understand the health status and needs of people with post-traumatic stress disorder (PTSD) during social unrest. Methods This study was a cross-sectional survey. A total of 460 people who had experienced post-traumatic distress as a result of the social unrest in 2019 and 2020 were included. A conceptual model comprised four essential areas, namely posttraumatic distress symptoms, participation restrictions, perceived stigma and functional disability, was built from literature. Part 1 validated four instruments that evaluate and define the factor structure of these four areas, In Part II, structural equation modeling was used to test and validate a combined model. Results Factors underlying the four areas were defined. Analysis using structural equation modeling confirmed a best fit of the model. PTSD symptoms, perceived stigma and participation restriction during social unrest contributed significantly to functional disability; PTSD symptoms exerted a direct effect on participation restriction and perceived stigma; and the effect of PTSD symptoms on functional disability was mediated through its influence on perceived stigma during social unrest. Conclusions A community-based inclusive approach is essential to understand the holistic needs of people with PTSD during social unrest. To improve health and well-being in addition to evaluating mental health impacts, considering interactions with the rapid change and stressful social environment is essential.
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Stressful events as correlates of depressive and PTSD symptoms in Hong Kong women during social unrest and COVID-19 pandemic. J Affect Disord 2022; 300:263-268. [PMID: 34990624 PMCID: PMC9754668 DOI: 10.1016/j.jad.2022.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 12/28/2021] [Accepted: 01/01/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Stressors at the population level affect women more than men. The influence of prolonged stressors on mental disorders in women is yet unknown, especially when social movements and pandemics coexist. METHODS This study analysed data from an online mental health self-help service for women in Hong Kong between May and September 2020. We collected demographic data, PTSD symptoms, and exposure to social unrest-related traumatic events (TEs), pandemic-related traumatic events (PEs), and personal stressful life experiences (SLEs). Multiple logistic regression was performed to examine the links between TEs, PEs, and SLEs and PTSD. RESULTS The study found that 38.4% of 751 women had moderate-to-severe depressive symptoms and 23.8% had probable PTSD. The most common TEs, PEs, and SLEs were violence via media, major physical health concerns, and plans thwarted due to COVID-19, respectively. Younger age, less education, unemployment, and more stressors (individually or collectively, except for high TEs and PEs) were linked to increased odds of moderate-to-severe depressive symptoms. TEs and PEs increased the risk of probable PTSD only when SLEs were present. LIMITATION The non-random samplinging procedure reduced the generalisability to the entire women population. CONCLUSIONS Exposure to social conflicts and pandemics may increase depressive and PTSD symptoms in women. Developing mental health services for women should consider the impact of concurrent major events.
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Çelebi E, Adam-Troian J, Mahfud Y. Positive Links Between Exposure to Police Violence, PTSD, and Depression Symptoms Among Yellow Vests Protesters in France. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:2267-2288. [PMID: 32639923 DOI: 10.1177/0886260520935863] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Police violence during protests occurs worldwide with varying levels ranging from physical abuse to lethal use of force. Although prior research has investigated the health consequences of exposure to police violence (EPV), EPV's relationship with protesters' mental health has not yet been examined. Therefore, we designed a cross-sectional study which included measures of self-reported EPV, depression, and post-traumatic stress symptoms. The computerized survey was disseminated among a large sample of Yellow Vests protesters in France (N = 523; average protest attendance = 18). Overall, 49% of protesters displayed severe symptoms of depression and 15.5% met the criteria for provisory post-traumatic stress disorder (PTSD) diagnoses. Subsequent analyses revealed, as expected, positive associations between EPV, depression, and post-traumatic stress symptoms in our sample (.30 < d < .63). These were robust to adjustment on several potential confounds (e.g., physical injuries, demographics, political extremism) and similar when analyzing provisory diagnoses rates (1.65 < OR < 3.02). This study is the first to assess potentially detrimental effects of EPV on mental health during protests. Furthermore, prevalence rates for both provisory depression and PTSD diagnoses were comparable with those found among war-refugee populations. We call for further research on EPV among various protester samples and use longitudinal designs to investigate a potent risk factor for mental health issues among civilian populations.
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Yip PSF, Pinkney E. Social media and suicide in social movements: a case study in Hong Kong. JOURNAL OF COMPUTATIONAL SOCIAL SCIENCE 2022; 5:1023-1040. [PMID: 35252621 PMCID: PMC8886558 DOI: 10.1007/s42001-022-00159-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 02/01/2022] [Indexed: 06/14/2023]
Abstract
Research has indicated that excessive and sensationalized suicide reporting can lead to copycat suicides, especially when deaths involve well-known people. Little is known, however, about the impact of the reporting of suspected protestor suicide deaths during social unrest, particularly in an age of social media. In June 2019, the most substantial social unrest in Hong Kong since its handover in 1997 was triggered by the proposed Anti-Extradition Law Amendment Bill (Anti-ELAB). The social unrest subsided when Hong Kong and many parts of the world were hit by Covid-19 and very strict quarantine measures were imposed on crowd gatherings in Hong Kong at the end of January 2020. A number of reported suicides and deaths of undetermined cause took place during this 8-month period that received considerable attention. To better understand the possible effects of these highly publicized deaths, we examined media reports of suspected suicide cases before, during and after the protest period, as well as topics of suicide-related threads and their replies in social media forums. We found no clear evidence of increased rates of suicide as a result of these incidents, or during the protest period; however, it is suggested that certain narratives and attention surrounding the suspected suicides and undetermined deaths may have contributed to collective emotions such as sadness and anxiety. Some implications for misinformation (intentionally or un-intentionally) and mitigation of suicide risk during social unrest are discussed.
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Affiliation(s)
- Paul S. F. Yip
- Centre for Suicide Research and Prevention, The University of Hong Kong, Pokfulam, Hong Kong
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong
| | - Edward Pinkney
- Centre for Suicide Research and Prevention, The University of Hong Kong, Pokfulam, Hong Kong
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Pilar M, Jost E, Walsh-Bailey C, Powell BJ, Mazzucca S, Eyler A, Purtle J, Allen P, Brownson RC. Quantitative measures used in empirical evaluations of mental health policy implementation: A systematic review. IMPLEMENTATION RESEARCH AND PRACTICE 2022; 3:26334895221141116. [PMID: 37091091 PMCID: PMC9924289 DOI: 10.1177/26334895221141116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background Mental health is a critical component of wellness. Public policies present an opportunity for large-scale mental health impact, but policy implementation is complex and can vary significantly across contexts, making it crucial to evaluate implementation. The objective of this study was to (1) identify quantitative measurement tools used to evaluate the implementation of public mental health policies; (2) describe implementation determinants and outcomes assessed in the measures; and (3) assess the pragmatic and psychometric quality of identified measures. Method Guided by the Consolidated Framework for Implementation Research, Policy Implementation Determinants Framework, and Implementation Outcomes Framework, we conducted a systematic review of peer-reviewed journal articles published in 1995-2020. Data extracted included study characteristics, measure development and testing, implementation determinants and outcomes, and measure quality using the Psychometric and Pragmatic Evidence Rating Scale. Results We identified 34 tools from 25 articles, which were designed for mental health policies or used to evaluate constructs that impact implementation. Many measures lacked information regarding measurement development and testing. The most assessed implementation determinants were readiness for implementation, which encompassed training (n = 20, 57%) and other resources (n = 12, 34%), actor relationships/networks (n = 15, 43%), and organizational culture and climate (n = 11, 31%). Fidelity was the most prevalent implementation outcome (n = 9, 26%), followed by penetration (n = 8, 23%) and acceptability (n = 7, 20%). Apart from internal consistency and sample norms, psychometric properties were frequently unreported. Most measures were accessible and brief, though minimal information was provided regarding interpreting scores, handling missing data, or training needed to administer tools. Conclusions This work contributes to the nascent field of policy-focused implementation science by providing an overview of existing measurement tools used to evaluate mental health policy implementation and recommendations for measure development and refinement. To advance this field, more valid, reliable, and pragmatic measures are needed to evaluate policy implementation and close the policy-to-practice gap. Plain Language Summary Mental health is a critical component of wellness, and public policies present an opportunity to improve mental health on a large scale. Policy implementation is complex because it involves action by multiple entities at several levels of society. Policy implementation is also challenging because it can be impacted by many factors, such as political will, stakeholder relationships, and resources available for implementation. Because of these factors, implementation can vary between locations, such as states or countries. It is crucial to evaluate policy implementation, thus we conducted a systematic review to identify and evaluate the quality of measurement tools used in mental health policy implementation studies. Our search and screening procedures resulted in 34 measurement tools. We rated their quality to determine if these tools were practical to use and would yield consistent (i.e., reliable) and accurate (i.e., valid) data. These tools most frequently assessed whether implementing organizations complied with policy mandates and whether organizations had the training and other resources required to implement a policy. Though many were relatively brief and available at little-to-no cost, these findings highlight that more reliable, valid, and practical measurement tools are needed to assess and inform mental health policy implementation. Findings from this review can guide future efforts to select or develop policy implementation measures.
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Affiliation(s)
- Meagan Pilar
- Prevention Research Center, Brown School, Washington University in St.
Louis, St. Louis, MO, USA
- Department of Infectious Diseases, Washington University School of Medicine,
Washington University in St. Louis, St. Louis, MO, USA
| | - Eliot Jost
- Prevention Research Center, Brown School, Washington University in St.
Louis, St. Louis, MO, USA
| | - Callie Walsh-Bailey
- Prevention Research Center, Brown School, Washington University in St.
Louis, St. Louis, MO, USA
| | - Byron J. Powell
- Center for Mental Health Services Research, Brown School, Washington University in St.
Louis, St. Louis, MO, USA
- Division of Infectious Diseases, John T. Milliken Department of
Medicine, Washington University School of Medicine, Washington University in St.
Louis, St. Louis, MO, USA
| | - Stephanie Mazzucca
- Prevention Research Center, Brown School, Washington University in St.
Louis, St. Louis, MO, USA
| | - Amy Eyler
- Prevention Research Center, Brown School, Washington University in St.
Louis, St. Louis, MO, USA
| | - Jonathan Purtle
- Department of Public Health Policy & Management, New York
University School of Global Public Health, Global Center for Implementation Science, New York University, New York, NY, USA
| | - Peg Allen
- Prevention Research Center, Brown School, Washington University in St.
Louis, St. Louis, MO, USA
| | - Ross C. Brownson
- Prevention Research Center, Brown School, Washington University in St.
Louis, St. Louis, MO, USA
- Department of Surgery (Division of Public Health Sciences) and Alvin
J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St.
Louis, St. Louis, MO, USA
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Racial disparities in psychological distress in post-apartheid South Africa: results from the SANHANES-1 survey. Soc Psychiatry Psychiatr Epidemiol 2022; 57:843-857. [PMID: 34617128 PMCID: PMC8494453 DOI: 10.1007/s00127-021-02175-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 08/30/2021] [Indexed: 11/05/2022]
Abstract
PURPOSE South Africa has long endured a high prevalence of mental disorders at the national level, and its unique social and historical context could be a contributor to an increased risk of mental health problems. Our current understanding is limited regarding the relative importance of various social determinants to mental health challenges in South Africa, and how existing racial inequities may be explained by these determinants. METHODS This study attempted to elucidate potential social determinants of mental health in South Africa using data from the nationally representative South African National Health and Nutrition Examination Survey (SANHANES-1). The main outcome of interest was psychological distress, measured with the Kessler-10 scale. Hierarchical linear regression models included covariates for demographic and socioeconomic factors, count of traumatic events, and a series of stress-related constructs. Analyses were conducted on two populations: the entire sample (n = 15,981), and the African subpopulation (n = 10,723). RESULTS Regression models on the entire sample indicated racial disparities in psychological distress, with Africans experiencing higher distress than White and Coloured individuals. Results within the African sub-population indicated geo-spatial disparities, with Africans in formal urban settings experiencing higher psychological distress than those living in formal and informal rural locales. Across both samples, results indicated a cumulative association between count of stressors and traumatic events and distress. CONCLUSION We found racial disparities across several mental health-related domains. Africans had greater exposure to traumatic events, social stressors, and psychological distress. This research is a necessary foundation for public health interventions and policy change to effectively reduce inequities in psychological distress.
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Mohammed TF, Nadile EM, Busch CA, Brister D, Brownell SE, Claiborne CT, Edwards BA, Wolf JG, Lunt C, Tran M, Vargas C, Walker KM, Warkina TD, Witt ML, Zheng Y, Cooper KM. Aspects of Large-Enrollment Online College Science Courses That Exacerbate and Alleviate Student Anxiety. CBE LIFE SCIENCES EDUCATION 2021; 20:ar69. [PMID: 34806910 PMCID: PMC8715781 DOI: 10.1187/cbe.21-05-0132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 08/27/2021] [Accepted: 10/01/2021] [Indexed: 05/06/2023]
Abstract
Anxiety is the top mental health concern for undergraduates. While researchers have identified ways that in-person science courses can affect anxiety, little is known about how online science courses affect anxiety. In this study, 2111 undergraduates at a large research-intensive institution completed survey questions about their anxiety in large-enrollment online science courses. Specifically, we assessed students' anxiety in the context of online science courses and asked what aspects of online science courses increase and decrease their anxiety. Students also identified what instructors can do to lessen anxiety in online classrooms. We used open coding and logistic regression to analyze student responses. More than 50% of students reported at least moderate anxiety in the context of online college science courses. Students commonly reported that the potential for personal technology issues (69.8%) and proctored exams (68.0%) increased their anxiety, while being able to access content at a later time (79.0%) and attending class from where they want (74.2%) decreased their anxiety. The most common ways that students suggested that instructors could decrease student anxiety is to increase test-taking flexibility (25.0%) and be understanding (23.1%). This study provides insight into how instructors can create more inclusive online learning environments for students with anxiety.
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Affiliation(s)
| | | | - Carly A. Busch
- Biology Education Research Course, School of Life Sciences
| | | | - Sara E. Brownell
- Research for Inclusive STEM Education Center, Arizona State University, Tempe, AZ 85281
| | | | | | | | - Curtis Lunt
- Biology Education Research Course, School of Life Sciences
| | - Missy Tran
- Biology Education Research Course, School of Life Sciences
| | - Cindy Vargas
- Biology Education Research Course, School of Life Sciences
| | - Kobe M. Walker
- Biology Education Research Course, School of Life Sciences
| | | | | | - Yi Zheng
- Mary Lou Fulton Teachers College, Arizona State University, Tempe, AZ 85281
| | - Katelyn M. Cooper
- Research for Inclusive STEM Education Center, Arizona State University, Tempe, AZ 85281
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Li AWY, Chak WH, Yuen KSL. Snapshot of a social movement: Mental health and protest classes in Hong Kong. J Affect Disord 2021; 295:883-892. [PMID: 34706459 DOI: 10.1016/j.jad.2021.08.111] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 07/27/2021] [Accepted: 08/28/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Popular protests have broken out worldwide, particularly in the last few years. In 2019, numerous demonstrations against an extradition bill occurred in Hong Kong until pandemic restrictions were imposed. The policing response relied heavily on methods such as batons, tear gas and rubber bullets. Given the relevance for other geographical contexts, the current study investigated the mental health impacts on protest participants and spillover to community members. METHODS Surveys were disseminated on social media in August and October 2019 to collect demographics, political views, protest participation, exposure to (protest-related) potentially traumatic events (PTEs) and mental health symptoms. A latent class analysis (LCA) was conducted using demographic data and inter-class differences in PTEs and mental health symptoms were examined. RESULTS There were 37,541 (59.8% female) and 40,703 (50.0% female) responses in August and October. Respondents, even those with low participation, reported significant levels of depression, anxiety, and symptoms of traumatic stress (STS). The LCA suggested a 5-class solution (youth, allies, supporters, sympathizers, and frontliners). Mental health symptoms and PTEs varied with class membership, with 50.8% of frontliners reporting severe STS. LIMITATIONS The non-random sampling and self-reported measures may over-estimate the prevalence of mental distress in the wider population. CONCLUSIONS Large numbers of pro-democracy supporters in Hong Kong reported high rates of depression, anxiety and STS during mass protests. Younger and more heavily involved respondents faced the highest mental health risks, however elevated rates were also observed for respondents with low participation.
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Affiliation(s)
- Adrienne W Y Li
- Toronto Rehabilitation Institute, University Health Network, Canada; York University, Toronto, Canada
| | - W H Chak
- Department of Applied Mathematics, University of California Davis, United States
| | - Kenneth S L Yuen
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany; Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany.
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Wong RS, Tung KT, Fu KW, Bacon-Shone J, Molasiotis A, Li WO, Lee LYK, Lum TY, Lau JT, Chan C, To SM, Ip P. Examining social context and the pathways to mental wellness in young adults during social movement: A parallel mediation analysis. J Affect Disord 2021; 294:876-882. [PMID: 34375215 DOI: 10.1016/j.jad.2021.07.100] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 07/18/2021] [Accepted: 07/27/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Good family relationships are important for mental health. However, the mechanism linking family perceptions to mental wellness during political and social turmoil remains unclear. This study aimed to examine whether psychological and social factors could protect university students from detrimental mental health conditions in a time of social chaos. METHODS Participants included young adults (n = 1874, mean age = 22.19 years) who had been enrolled in Hong Kong local tertiary intuitions during Hong Kong's 2019 social movement. An online survey assessing various conditions, including family satisfaction, social support, personal resilience, negative moods, sense of school belonging, and mental health conditions before and during the movement, was administered to these students. Mediation analyses were performed to examine the role of negative affect, support from family, and school belongingness as mediators of the association between family satisfaction and mental health condition during the movement overall and by resilience subgroups. RESULTS Higher levels of satisfaction with family relationships before the onset of movement was associated with lower levels of negative affect and higher levels of support from family and school belongingness during the movement, in turn benefiting the student's mental health. The links of family satisfaction and school belongingness with mental wellness were particularly strong among low-resilient students. LIMITATIONS Mediation analysis using retrospective survey data CONCLUSIONS: Family conditions would interact with personal resilience to influence mental health status during social turmoil. The findings underscore the importance of early interventions particularly for those students facing family difficulties to enhance their social chaos and emergency preparedness.
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Affiliation(s)
- Rosa S Wong
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Keith Ts Tung
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - King-Wa Fu
- Journalism and Media Studies Centre, The University of Hong Kong, Hong Kong SAR, China
| | - John Bacon-Shone
- Social Sciences Research Centre, The University of Hong Kong, Hong Kong SAR, China
| | - Alex Molasiotis
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Wang On Li
- Department of Counselling and Psychology, Hong Kong Shue Yan University, Hong Kong SAR, China
| | - Linda Yin-King Lee
- School of Nursing and Health Studies, The Open University of Hong Kong, Hong Kong SAR, China
| | - Terry Ys Lum
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
| | - Joseph Tf Lau
- Center for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China
| | - Chitat Chan
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Siu-Ming To
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China.
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Gajardo AI, Wagner TD, Howell KD, González-Santa Cruz A, Kaufman JS, Castillo-Carniglia A. Effects of 2019's social protests on emergency health services utilization and case severity in Santiago, Chile: a time-series analysis. LANCET REGIONAL HEALTH. AMERICAS 2021; 5:100082. [PMID: 36776456 PMCID: PMC9903909 DOI: 10.1016/j.lana.2021.100082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/01/2021] [Accepted: 09/06/2021] [Indexed: 10/19/2022]
Abstract
Background On October 18th, 2019, protestors gathered across Chile to call for social equity, resulting in widespread civil unrest and violent confrontation with the police. In this study, we quantify the effects of the 2019 Chilean protests on emergency health services utilization and inpatient admission in Santiago. Methods We used weekly emergency department (ED) admissions (2015-2019) from three large public hospitals near the focal point of protests in Santiago. The exposure period was from October 18th to December 31st, 2019. The outcomes were the number of weekly consultations and hospitalizations by trauma and respiratory causes and the proportion of hospitalizations among consultants per 1,000. We implemented Bayesian structural time series models to calculate the absolute and relative effects and 95% credible intervals (CrI). Findings During the first ten weeks of protests ED consultations declined on average by 14% for trauma (95%CrI: -40·2%, 11·5%) and 30% for respiratory causes (95%CrI: -89·4%, 30·2%), 7% for respiratory hospitalizations (95%CrI: -43·6%, 30·8%); however, none of these three results were statistically distinguishable from the null. Trauma hospitalizations, on the other hand, increased by 15% (95%CrI: 4·0%, 26·4%), and the proportion of hospitalizations per consultations increased by 40% for trauma (95%CrI: 13·1%, 68·0%) and 59% for respiratory causes (95%CrI: 29·4%, 87·9%). Interpretation The 2019 Chilean protests affected the use of emergency health services by increasing the trauma hospitalizations and the case hospitalization ratio per 1,000 consultations for trauma and respiratory causes. Crowd-control protocols must be reviewed to prevent the negative effects of civil unrest.
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Affiliation(s)
- Abraham I.J. Gajardo
- Intensive Care Unit, Department of Medicine, Hospital Clínico Universidad de Chile, Universidad de Chile. Dr. Carlos Lorca Tobar 999, Independencia, Santiago, Chile
| | - Thomas D. Wagner
- Vagelos College of Physicians & Surgeons, Columbia University. 630 W 168th St, New York, NY 10032, USA
| | - Kristina Devi Howell
- Mailman School of Public Health, Columbia University. 722 W 168th St, New York, NY 10032, USA
| | - Andrés González-Santa Cruz
- Society and Health Research Center and School of Public Health, Universidad Mayor, Chile. Badajoz 130, Las Condes, Santiago, Chile
| | - Jay S. Kaufman
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University. 1020 Pine Avenue West, Montreal, QC H3A1A2, Canada
| | - Alvaro Castillo-Carniglia
- Society and Health Research Center and School of Public Health, Universidad Mayor, Chile. Badajoz 130, Las Condes, Santiago, Chile,Department of Population Health, New York University Grossman School of Medicine. 180 Madison Avenue, New York, NY 10016, USA,Corresponding author: Alvaro Castillo-Carniglia, Society and Health Research Center, Facultad de Humanidades, Universidad Mayor, Chile. Badajoz 130, Suite 1305, Las Condes, Santiago, Chile. Phone: +56.2.2518.9800
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Cheung T, Jin Y, Lam S, Su Z, Hall BJ, Xiang YT. Network analysis of depressive symptoms in Hong Kong residents during the COVID-19 pandemic. Transl Psychiatry 2021; 11:460. [PMID: 34489416 PMCID: PMC8419676 DOI: 10.1038/s41398-021-01543-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 07/12/2021] [Accepted: 07/26/2021] [Indexed: 02/08/2023] Open
Abstract
In network theory depression is conceptualized as a complex network of individual symptoms that influence each other, and central symptoms in the network have the greatest impact on other symptoms. Clinical features of depression are largely determined by sociocultural context. No previous study examined the network structure of depressive symptoms in Hong Kong residents. The aim of this study was to characterize the depressive symptom network structure in a community adult sample in Hong Kong during the COVID-19 pandemic. A total of 11,072 participants were recruited between 24 March and 20 April 2020. Depressive symptoms were measured using the Patient Health Questionnaire-9. The network structure of depressive symptoms was characterized, and indices of "strength", "betweenness", and "closeness" were used to identify symptoms central to the network. Network stability was examined using a case-dropping bootstrap procedure. Guilt, Sad Mood, and Energy symptoms had the highest centrality values. In contrast, Concentration, Suicide, and Sleep had lower centrality values. There were no significant differences in network global strength (p = 0.259), distribution of edge weights (p = 0.73) and individual edge weights (all p values > 0.05 after Holm-Bonferroni corrections) between males and females. Guilt, Sad Mood, and Energy symptoms were central in the depressive symptom network. These central symptoms may be targets for focused treatments and future psychological and neurobiological research to gain novel insight into depression.
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Affiliation(s)
- Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China.
| | - Yu Jin
- College of Education for the Future, Beijing Normal University, Beijing, China
| | - Simon Lam
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Zhaohui Su
- Center on Smart and Connected Health Technologies, Mays Cancer Center, School of Nursing, UT Health San Antonio, San Antonio, TX, USA
| | - Brian J Hall
- Global and Community Mental Health Research Group, New York University (Shanghai), Shanghai, China
- School of Global Public Health, New York University, New York, NY, USA
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China.
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China.
- Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao SAR, China.
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Gonzalez-Diaz JM, Córdoba R, Zamora DC. Mental health in Colombia: Amid a global virus, tear gases and rifle shots. LANCET REGIONAL HEALTH. AMERICAS 2021; 3:100050. [PMID: 36777407 PMCID: PMC9904056 DOI: 10.1016/j.lana.2021.100050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 08/04/2021] [Accepted: 08/04/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Jairo M. Gonzalez-Diaz
- UR Center for Mental Health – CERSAME, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia,Barcelona Clinic Schizophrenia Unit, Neurosciences Institute, Institution: Hospital Clínic - Universidad de Barcelona, Barcelona, Spain,Clínica Nuestra Señora de la Paz, Bogotá, Colombia,Corresponding Author. Tel: (+57) 322 277 64 50; Carrera 69 N° 12 - 75.
| | - Rodrigo Córdoba
- UR Center for Mental Health – CERSAME, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Diana C. Zamora
- School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
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Abdalla SM, Ettman CK, Cohen GH, Galea S. Mental health consequences of COVID-19: a nationally representative cross-sectional study of pandemic-related stressors and anxiety disorders in the USA. BMJ Open 2021; 11:e044125. [PMID: 34373289 PMCID: PMC8354762 DOI: 10.1136/bmjopen-2020-044125] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE To document the prevalence of anxiety disorders in the USA during the COVID-19 pandemic. DESIGN A cross-sectional analysis. SETTING A nationally representative sample in the USA between 31 March and 13 April 2020. PARTICIPANTS 1450 English-speaking adult participants in the AmeriSpeak Panel. AmeriSpeak is a probability-based panel designed to be representative of households in the USA. MAIN OUTCOME MEASURES Prevalence of probable generalised anxiety disorder (GAD) using the GAD-7 and post-traumatic stress symptoms (PTSS) using the four-item PTSD (post-traumatic stress disorder) checklist. Both outcomes were stratified by demographics and COVID-19-related stressors. RESULTS The majority of participants were female (51.8%), non-Hispanic white (62.9%) and reported a household saving of $5000 or more. Those between 18 and 29 years old were the largest age group (38.1%) compared with 40-59 years (32.0%) and 60 years or more (29.9%). The prevalence of probable GAD was 10.9% (95% CI 9.1% to 13.2%) and the prevalence of PTSS was 21.7% (95% CI 19.1% to 24.6%). Among participants reporting five or more COVID-19-related stressors, the prevalence of probable GAD was 20.5% (95% CI 16.1% to 25.8%) and the prevalence of PTSS was 35.7% (95% CI 30.2% to 41.6%). Experiencing five or more COVID-19-related stressors was a predictor of both probable GAD (OR=4.5, 95% CI 2.3 to 8.8) and PTSS (OR=3.3, 95% CI 2.1 to 5.1). CONCLUSIONS The prevalence of probable anxiety disorders in the USA, as the COVID-19 pandemic and policies implemented to tackle it unfolded, is higher than estimates reported prior to the pandemic and estimates reported following other mass traumatic events. Exposure to COVID-19-related stressors is associated with higher prevalence of both probable GAD and PTSS, highlighting the role these stressors play in increasing the risk of developing anxiety disorders in the USA. Mitigation and recovery policies should take into account the mental health toll the pandemic had on the USA population.
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Affiliation(s)
- Salma M Abdalla
- Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Catherine K Ettman
- Boston University School of Public Health, Boston, Massachusetts, USA
- Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Gregory H Cohen
- Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Sandro Galea
- Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
- Boston University School of Public Health, Boston, Massachusetts, USA
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Chung EYH. Inclusion and Participation of Young People Who Experienced Distress During Social Unrest: A Community-based Inclusive Development Approach. Asia Pac J Public Health 2021; 33:972-974. [PMID: 34291652 DOI: 10.1177/10105395211033486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Eva Yin-Han Chung
- Department of Special Education and Counselling, The Education University of Hong Kong, Hong Kong
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Hou K, Xu J. WITHDRAWN: Risk assessment of group psychology health in the evolution of public health emergencies in colleges and universities. Work 2021:WOR205376. [PMID: 34308891 DOI: 10.3233/wor-205376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Ahead of Print article withdrawn by publisher.
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