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Monazzah F, Morady Moghaddam M, Ostovar-Namaghi SA. The Art of Influencing: Exploring Persuasive Strategies in the Writings of Iranian University Students. JOURNAL OF PSYCHOLINGUISTIC RESEARCH 2024; 53:62. [PMID: 39138811 DOI: 10.1007/s10936-024-10106-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/07/2024] [Indexed: 08/15/2024]
Abstract
This study investigates persuasive strategies used in the writings of Iranian university students in the field of teaching English as foreign language (TEFL). The study utilized the 7 principles of persuasive strategies presented by Cialdini (The psychology of persuasion, Quill William Morrow, New York 1984; Pre-suasion: A revolutionary way to influence and persuade, Simon & Schuster, New York 2016), which include 'reciprocity', 'commitment and consistency', 'social proof', 'liking', 'authority', 'scarcity', and 'unity'. The results indicate that strategies such as 'liking', 'unity', and 'authority' were used more frequently than other persuasive strategies. On the other hand, 'scarcity' was the least used strategy by the participants. Significant gender differences were also observed in the data. These findings have important pedagogical implications and suggest the need to incorporate persuasive strategies into instructional materials and teaching practices to enhance the persuasive writing skills of university students. Furthermore, gender differences highlight the importance of considering individual differences when teaching persuasive writing. Finally, the study discusses the pedagogical implications of these findings in the context of learning and teaching.
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Bosnjak MC, Kuljancic D, Vejnovic AM, Hinic D, Knezevic V, Ratkovic D, Bosic V, Vasic V, Sakic B, Segan D, Savic P, Abazovic M, Comic M, Siladji D, Simic-Panic D, Ivetic Poledica O. Rates of Vaccination against COVID-19 in Psychiatric Outpatients. J Pers Med 2024; 14:748. [PMID: 39064002 PMCID: PMC11278123 DOI: 10.3390/jpm14070748] [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: 05/21/2024] [Revised: 07/02/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND The aim of this study was to compare the rates of vaccination against COVID-19 infection in psychiatric outpatients and the general population, as well as rates of infected patients. In addition, the level and type of anxiety due to the pandemic were observed in patients with psychotic, anxiety, and depressive disorders. MATERIALS AND METHODS In the present study, 171 patients with pre-existing mental disorders completed the questionnaire about the doses and types of vaccination against COVID-19. During 2021-2023, patients with different mental disorders, aged from 18 to 80, were included. All patients filled in a self-reported questionnaire including general information (age, sex, marriage, education, working status, comorbid conditions) as well as questions about mental health, receiving vaccination, and the course of COVID-19 infection if it was present. All patients gave informed consent for the interview. RESULTS Patients with pre-existing mental disorders were more likely to be vaccinated against COVID-19 compared with the general population. The Sinopharm vaccine was most frequently applied. In the observed patients, 46.8% were infected, but just 7% had a medium or serious form of infection and were not vaccinated. CONCLUSIONS In our study, the percentage of vaccinated psychiatric patients was greater than that in the general population, except in psychotic patients, who were mostly limited by fear. Such results can be explained by the high percentage of somatic comorbidities in this population and perhaps insufficient information about the positive effects of vaccination.
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Affiliation(s)
- Mina Cvjetkovic Bosnjak
- Medical Faculty, University of Novi Sad, Hajduk Vejkova 3, 21000 Novi Sad, Serbia; (A.-M.V.); (V.K.); (D.R.); (V.B.); (V.V.); (B.S.); (D.S.); (P.S.); (M.A.); (M.C.); (D.S.); (D.S.-P.); (O.I.P.)
- Clinics of Psichiatry, University Clinical Centre of Vojvodina, Hajduk Veljkova 4, 21000 Novi Sad, Serbia
| | - Dusan Kuljancic
- Medical Faculty, University of Novi Sad, Hajduk Vejkova 3, 21000 Novi Sad, Serbia; (A.-M.V.); (V.K.); (D.R.); (V.B.); (V.V.); (B.S.); (D.S.); (P.S.); (M.A.); (M.C.); (D.S.); (D.S.-P.); (O.I.P.)
- Clinics of Psichiatry, University Clinical Centre of Vojvodina, Hajduk Veljkova 4, 21000 Novi Sad, Serbia
| | - Ana-Marija Vejnovic
- Medical Faculty, University of Novi Sad, Hajduk Vejkova 3, 21000 Novi Sad, Serbia; (A.-M.V.); (V.K.); (D.R.); (V.B.); (V.V.); (B.S.); (D.S.); (P.S.); (M.A.); (M.C.); (D.S.); (D.S.-P.); (O.I.P.)
- Clinics of Psichiatry, University Clinical Centre of Vojvodina, Hajduk Veljkova 4, 21000 Novi Sad, Serbia
| | - Darko Hinic
- PMF Kragujevac, University of Kragujevac, Radoja Domanovića 14, 34111 Kragujevac, Serbia;
| | - Vladimir Knezevic
- Medical Faculty, University of Novi Sad, Hajduk Vejkova 3, 21000 Novi Sad, Serbia; (A.-M.V.); (V.K.); (D.R.); (V.B.); (V.V.); (B.S.); (D.S.); (P.S.); (M.A.); (M.C.); (D.S.); (D.S.-P.); (O.I.P.)
- Clinics of Psichiatry, University Clinical Centre of Vojvodina, Hajduk Veljkova 4, 21000 Novi Sad, Serbia
| | - Dragana Ratkovic
- Medical Faculty, University of Novi Sad, Hajduk Vejkova 3, 21000 Novi Sad, Serbia; (A.-M.V.); (V.K.); (D.R.); (V.B.); (V.V.); (B.S.); (D.S.); (P.S.); (M.A.); (M.C.); (D.S.); (D.S.-P.); (O.I.P.)
- Clinics of Psichiatry, University Clinical Centre of Vojvodina, Hajduk Veljkova 4, 21000 Novi Sad, Serbia
| | - Vanja Bosic
- Medical Faculty, University of Novi Sad, Hajduk Vejkova 3, 21000 Novi Sad, Serbia; (A.-M.V.); (V.K.); (D.R.); (V.B.); (V.V.); (B.S.); (D.S.); (P.S.); (M.A.); (M.C.); (D.S.); (D.S.-P.); (O.I.P.)
- Clinics of Psichiatry, University Clinical Centre of Vojvodina, Hajduk Veljkova 4, 21000 Novi Sad, Serbia
| | - Vesna Vasic
- Medical Faculty, University of Novi Sad, Hajduk Vejkova 3, 21000 Novi Sad, Serbia; (A.-M.V.); (V.K.); (D.R.); (V.B.); (V.V.); (B.S.); (D.S.); (P.S.); (M.A.); (M.C.); (D.S.); (D.S.-P.); (O.I.P.)
- Clinics of Psichiatry, University Clinical Centre of Vojvodina, Hajduk Veljkova 4, 21000 Novi Sad, Serbia
| | - Branislav Sakic
- Medical Faculty, University of Novi Sad, Hajduk Vejkova 3, 21000 Novi Sad, Serbia; (A.-M.V.); (V.K.); (D.R.); (V.B.); (V.V.); (B.S.); (D.S.); (P.S.); (M.A.); (M.C.); (D.S.); (D.S.-P.); (O.I.P.)
- Clinics of Psichiatry, University Clinical Centre of Vojvodina, Hajduk Veljkova 4, 21000 Novi Sad, Serbia
| | - Darja Segan
- Medical Faculty, University of Novi Sad, Hajduk Vejkova 3, 21000 Novi Sad, Serbia; (A.-M.V.); (V.K.); (D.R.); (V.B.); (V.V.); (B.S.); (D.S.); (P.S.); (M.A.); (M.C.); (D.S.); (D.S.-P.); (O.I.P.)
- Clinics of Psichiatry, University Clinical Centre of Vojvodina, Hajduk Veljkova 4, 21000 Novi Sad, Serbia
| | - Predrag Savic
- Medical Faculty, University of Novi Sad, Hajduk Vejkova 3, 21000 Novi Sad, Serbia; (A.-M.V.); (V.K.); (D.R.); (V.B.); (V.V.); (B.S.); (D.S.); (P.S.); (M.A.); (M.C.); (D.S.); (D.S.-P.); (O.I.P.)
- Clinics of Psichiatry, University Clinical Centre of Vojvodina, Hajduk Veljkova 4, 21000 Novi Sad, Serbia
| | - Minja Abazovic
- Medical Faculty, University of Novi Sad, Hajduk Vejkova 3, 21000 Novi Sad, Serbia; (A.-M.V.); (V.K.); (D.R.); (V.B.); (V.V.); (B.S.); (D.S.); (P.S.); (M.A.); (M.C.); (D.S.); (D.S.-P.); (O.I.P.)
- Clinics of Psichiatry, University Clinical Centre of Vojvodina, Hajduk Veljkova 4, 21000 Novi Sad, Serbia
| | - Masa Comic
- Medical Faculty, University of Novi Sad, Hajduk Vejkova 3, 21000 Novi Sad, Serbia; (A.-M.V.); (V.K.); (D.R.); (V.B.); (V.V.); (B.S.); (D.S.); (P.S.); (M.A.); (M.C.); (D.S.); (D.S.-P.); (O.I.P.)
- Clinics of Psichiatry, University Clinical Centre of Vojvodina, Hajduk Veljkova 4, 21000 Novi Sad, Serbia
| | - Djendji Siladji
- Medical Faculty, University of Novi Sad, Hajduk Vejkova 3, 21000 Novi Sad, Serbia; (A.-M.V.); (V.K.); (D.R.); (V.B.); (V.V.); (B.S.); (D.S.); (P.S.); (M.A.); (M.C.); (D.S.); (D.S.-P.); (O.I.P.)
- Clinics of Psichiatry, University Clinical Centre of Vojvodina, Hajduk Veljkova 4, 21000 Novi Sad, Serbia
| | - Dusica Simic-Panic
- Medical Faculty, University of Novi Sad, Hajduk Vejkova 3, 21000 Novi Sad, Serbia; (A.-M.V.); (V.K.); (D.R.); (V.B.); (V.V.); (B.S.); (D.S.); (P.S.); (M.A.); (M.C.); (D.S.); (D.S.-P.); (O.I.P.)
- Clinics of Medical Rehabilitation, University Clinical Centre of Vojvodina, Hajduk Veljkova 4, 21000 Novi Sad, Serbia
| | - Olga Ivetic Poledica
- Medical Faculty, University of Novi Sad, Hajduk Vejkova 3, 21000 Novi Sad, Serbia; (A.-M.V.); (V.K.); (D.R.); (V.B.); (V.V.); (B.S.); (D.S.); (P.S.); (M.A.); (M.C.); (D.S.); (D.S.-P.); (O.I.P.)
- Clinics of Psichiatry, University Clinical Centre of Vojvodina, Hajduk Veljkova 4, 21000 Novi Sad, Serbia
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Yao A, Huhn AS, Ellis JD. COVID-19-Related Financial Hardship Is Associated With Depression and Anxiety in Substance Use Treatment Across Gender and Racial Groups. J Nerv Ment Dis 2024; 212:295-299. [PMID: 38598730 PMCID: PMC11008766 DOI: 10.1097/nmd.0000000000001753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
ABSTRACT Many individuals lost their employment during the COVID-19 pandemic and experienced financial hardship. These experiences may increase risk for co-occurring conditions, including substance use disorders (SUDs) and related symptoms of depression and anxiety. This study aimed to examine the associations between COVID-19-related financial hardship and/or job loss and co-occurring symptoms, across gender and racial groups. Respondents (N = 3493) included individuals entering SUD treatment in the United States in March-October of 2020. Results demonstrated that COVID-19-related financial hardship and unemployment in the household was associated with greater depression and anxiety severity among people in SUD treatment (p's < 0.05). Our findings highlight financial hardship and loss of employment as risk factors for co-occurring depression and anxiety. However, additive effects between marginalized identity status and COVID-19 economic hardship on co-occurring symptoms were not observed.
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Affiliation(s)
- Aijia Yao
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224, United States
| | - Andrew S. Huhn
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224, United States
| | - Jennifer D. Ellis
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224, United States
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Sara G, Gould P, Curtis J, Chen W, Lau M, Ramanuj P, Currow D, Burgess P. Vaccine-preventable hospitalisations in adult mental health service users: a population study. Psychol Med 2023; 53:7232-7241. [PMID: 37016779 PMCID: PMC10719683 DOI: 10.1017/s0033291723000776] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 03/03/2023] [Accepted: 03/09/2023] [Indexed: 04/06/2023]
Abstract
BACKGROUND Vaccine-preventable conditions cause preventable illness and may increase mortality in people living with mental illness. We examined how risks of hospitalisation for a wide range of vaccine-preventable conditions varied by age and sex among mental health (MH) service users. METHODS Linked population data from New South Wales (NSW), Australia were used to identify vaccine-preventable hospitalisations (VPH) for 19 conditions from 2015 to 2020. Adult MH service users (n = 418 915) were compared to other NSW residents using incidence rates standardised for age, sex and socioeconomic status. Secondary analyses examined admissions for COVID-19 to September 2021. RESULTS We identified 94 180 VPH of which 41% were influenza, 33% hepatitis B and 10% herpes zoster. MH service users had more VPH admissions [adjusted incidence rate ratio (aIRR) 3.2, 95% CI 3.1-3.3]. Relative risks were highest for hepatitis (aIRR 4.4, 95% CI 4.3-4.6), but elevated for all conditions including COVID-19 (aIRR 2.0, 95% CI 1.9-2.2). MH service users had a mean age of 9 years younger than other NSW residents at first VPH admission, with the largest age gap for vaccine-preventable pneumonias (11-13 years younger). The highest relative risk of VPH was among MH service users aged 45-65. CONCLUSIONS MH service users have increased risk of hospitalisation for many vaccine-preventable conditions. This may be due to reduced vaccination rates, more severe illness requiring hospitalisation, greater exposure to infectious conditions or other factors. People living with mental illness should be prioritised in vaccination strategies.
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Affiliation(s)
- Grant Sara
- Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
- School of Psychiatry, Faculty of Medicine and Health, University of NSW, Randwick, Australia
- System Information and Analytics Branch, NSW Ministry of Health, St Leonards, Australia
| | - Patrick Gould
- School of Psychiatry, Faculty of Medicine and Health, University of NSW, Randwick, Australia
| | - Jackie Curtis
- School of Psychiatry, Faculty of Medicine and Health, University of NSW, Randwick, Australia
| | - Wendy Chen
- System Information and Analytics Branch, NSW Ministry of Health, St Leonards, Australia
| | | | | | - David Currow
- Faculty of Health and Behavioural Sciences, University of Wollongong, Wollongong, Australia
| | - Philip Burgess
- School of Population Health, University of Queensland, Brisbane, Australia
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Cheng WJ, Shih HM, Su KP, Hsueh PR. Risk factors for poor COVID-19 outcomes in patients with psychiatric disorders. Brain Behav Immun 2023; 114:255-261. [PMID: 37648008 DOI: 10.1016/j.bbi.2023.08.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 07/26/2023] [Accepted: 08/26/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) has been found to have a greater impact on individuals with pre-existing psychiatric disorders. However, the underlying reasons for this increased risk have yet to be determined. This study aims to investigate the potential factors contributing poor outcomes among COVID-19 patients with psychiatric disorders, including delayed diagnosis of infection, vaccination rates, immune response, and the use of psychotropic medications. METHODS This retrospective cohort study analyzed medical records of 15,783 adult patients who were diagnosed with COVID-19 infection by positive PCR tests between January and September 2022 at a single medical center. We identified psychiatric diagnoses using ICD-9 diagnostic codes from the preceding 3 years before COVID infection. Primary outcome was in-hospital mortality and secondary outcomes were severe illness requiring intensive care or mechanical ventilation, and hospitalization within 45 days after a positive COVID-19 test. We compared the rates of outcomes, viral load, vaccination status at the time of positive test, psychotropic medications prescription within 90 days prior, antiviral medication use, and blood inflammation markers between patients with and without psychiatric disorders. The Cox proportional hazard model was used to examine the association of psychiatric diagnoses, vaccination status, and psychotropic medication prescription with poor outcomes. RESULTS Patients with psychiatric disorders demonstrated higher rates of severe illness (10.4% v.s. 7.1%) and hospitalization (16.4% vs. 11.3%), as well as a shorter duration to in-hospital mortality (6 vs. 12.5 days) compared to non-psychiatric patients. Psychiatric patients had higher vaccination rates and lower levels of inflammatory markers than non-psychiatric patients. Antipsychotic medication use was associated with in-hospital mortality (hazard ratio [HR] = 4.79, 95% confidence interval [CI] = 1.23-18.7), while being unvaccinated was associated with hospitalization (HR = 1.81, 95% CI = 1.29 to 2.54) and severe illness (HR = 3.23, 95% CI = 1.95 to 5.34) among patients with psychiatric disorders. Sedatives prescription was associated with all poor outcomes in general patients. CONCLUSION Considering the narrow time window between a positive COVID-19 test and poor outcomes, healthcare providers should undertake close monitoring of patients with preexisting psychiatric disorders during the initial days after a positive PCR test. Furthermore, caution should be taken when prescribing psychotropic medications, with special attention to antipsychotics.
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Affiliation(s)
- Wan-Ju Cheng
- Department of Public Health, China Medical University, 100 Sec.1, Jingmao Rd., Taichung, Taiwan; National Center for Geriatrics and Welfare Research, National Health Research Institutes, 35 Keyan Road, Miaoli, Taiwan; Department of Psychiatry, China Medical University Hospital, 2 Yude Road, Taichung, Taiwan.
| | - Hong-Mo Shih
- Department of Public Health, China Medical University, 100 Sec.1, Jingmao Rd., Taichung, Taiwan; Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan; School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Kuan-Pin Su
- Mind-Body Interface Research Center (MBI-Lab), China Medical University Hospital, Taichung, Taiwan; An-Nan Hospital, China Medical University, Tainan, Taiwan
| | - Po-Ren Hsueh
- Departments of Laboratory Medicine and Internal Medicine, China Medical University Hospital, China Medical University, Taichung, Taiwan; Department of Laboratory Diagnosis, College of Medicine, China Medical University, Taichung, Taiwan; Ph.D Program for Aging, School of Medicine, China Medical University, Taichung, Taiwan
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Lahoti A, Singh A, Bisen YT, Bakshi AM. Cutaneous Manifestations and Neurological Diseases. Cureus 2023; 15:e47024. [PMID: 37965391 PMCID: PMC10642374 DOI: 10.7759/cureus.47024] [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: 05/24/2023] [Accepted: 10/14/2023] [Indexed: 11/16/2023] Open
Abstract
Our skin and nervous system are tightly connected. Numerous dermatomes on our skin provide sensory information to the brain. Because skin changes can occasionally be the first sign of a neurological problem, understanding skin alterations is crucial as it can indicate early about the underlying condition, which can affect the prognosis of the disease. In these cases, the dermatologists' and neurologists' skills are complementary to each other. In this article, we have categorized diseases with neuro-cutaneous manifestations under different headings, such as infections, metabolic diseases, connective tissue disorders, genodermatoses, nutritional deficiency, and the diagnostic criteria of some commonly encountered diseases. Through tabulation, it has been observed that this categorization can serve as a useful reference for managing day-to-day patients who are either diagnosed with the diseases mentioned above or suspected to have the conditions.
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Affiliation(s)
- Arpita Lahoti
- Department of Dermatology, Venereology and Leprosy, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Adarshlata Singh
- Department of Dermatology, Venereology and Leprosy, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Yuganshu T Bisen
- Department of Dermatology, Venereology and Leprosy, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Amey M Bakshi
- Department of Dermatology, Venereology and Leprosy, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Van Alphen MU, Lim C, Freudenreich O. Mobile Vaccine Clinics for Patients With Serious Mental Illness and Health Care Workers in Outpatient Mental Health Clinics. Psychiatr Serv 2023; 74:982-986. [PMID: 36751907 DOI: 10.1176/appi.ps.20220460] [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] [Indexed: 02/09/2023]
Abstract
OBJECTIVE People with serious mental illness are particularly vulnerable to COVID-19 but face barriers to vaccinations. The authors describe the implementation of a mobile vaccine clinic at an outpatient mental health clinic for patients and health care workers to increase vaccination rates. METHODS In late 2021, mobile vaccine clinics were held in collaboration with a local pharmacy to provide COVID-19 and influenza vaccines to patients and health care workers. Participants in one clinic were asked to fill out a questionnaire about their experience. RESULTS Of 69 individuals who completed the questionnaire, 96% received the COVID-19 booster and 17% received the seasonal flu vaccine. Most patients and health care workers reported that the mobile vaccine clinic was easily accessible and preferable and that they would recommend it. Moreover, the mobile vaccine clinic was cost-effective. CONCLUSIONS Mobile vaccine clinics can improve vaccine access for patients and health care workers in community mental health settings and can be cost-effective.
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Affiliation(s)
- Manjola U Van Alphen
- Department of Psychiatry, Massachusetts General Hospital, and Harvard Medical School, Boston
| | - Carol Lim
- Department of Psychiatry, Massachusetts General Hospital, and Harvard Medical School, Boston
| | - Oliver Freudenreich
- Department of Psychiatry, Massachusetts General Hospital, and Harvard Medical School, Boston
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Moore R, Purvis RS, CarlLee S, Hallgren E, Kraleti S, Willis DE, McElfish PA. Understanding Vaccination Among Hesitant Adopters of the COVID-19 Vaccine Using the Increasing Vaccination Model. JOURNAL OF HEALTH COMMUNICATION 2023; 28:458-476. [PMID: 37394866 PMCID: PMC10443235 DOI: 10.1080/10810730.2023.2224265] [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] [Indexed: 07/04/2023]
Abstract
The coronavirus disease (COVID-19) was the third leading cause of death in 2021 in the United States and has led to historic declines in life expectancy for Americans. While vaccination is an effective mitigation strategy for COVID-19, vaccine hesitancy remains a major barrier to individual and population-level protection. An emerging literature on hesitant adopters of COVID-19 vaccines highlights co-occurrence of hesitancy and vaccine uptake as an understudied phenomenon, with the potential to provide insight into factors that lead hesitant individuals to become vaccinated despite their hesitancy. We use qualitative interviews among hesitant adopters in Arkansas to examine vaccine hesitancy among this understudied group. Drawing on the Increasing Vaccination Model, we find that the most frequently reported motivations of hesitant adopters were within the domain of social processes, pointing to a critical focal point for targeted health communications intervening in this domain (e.g. social norms, social networks, and altruistic behavior). We find that recommendations from health care workers (HCWs) other than physicians/providers may serve as an effective influence to vaccinate. We also demonstrate negative effects of low provider and HCW confidence and weak recommendations on motivations to vaccinate among individuals expressing vaccine hesitancy. Additionally, we find individual information-seeking behaviors among hesitant adopters bolstered confidence in the efficacy of the COVID-19 vaccine. Based on these findings, clear, accessible, and authoritative health communication has a role in combatting the COVID-19 misinformation/disinformation infodemic.
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Affiliation(s)
- Ramey Moore
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, Arkansas, USA
| | - Rachel S Purvis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, Arkansas, USA
| | - Sheena CarlLee
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas, USA
| | - Emily Hallgren
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, Arkansas, USA
| | - Shashank Kraleti
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Don E Willis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, Arkansas, USA
| | - Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, Arkansas, USA
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Wang D, Shi ZH. Do psychological distress and digital sports influence the willingness to take the vaccine and precautionary saving? Empirical evidence from Shanghai. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2023:1-13. [PMID: 37361311 PMCID: PMC10119833 DOI: 10.1007/s10389-023-01915-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 04/05/2023] [Indexed: 06/28/2023]
Abstract
Aim The COVID-19 epidemic has caused risk and uncertainty. This study answers whether and how psychological distress and digital sports influence willingness to take the vaccine and precautionary savings. Subject and methods We conducted a cross-sectional study with an online survey sample of 1016 Shanghai residents who live and work there and are aged between 16-60. All of them experienced the COVID-19 lockdown in Shanghai. We used logistic regressions to examine the relationships between the variables of interest. Results Three findings were demonstrated. First, psychologically distressed individuals are less inclined to take the vaccine. Second, those engaged in fitness activities via digital media platforms are more willing to get vaccinated. Third, psychologically distressed individuals and digital video-based physical exercisers are more likely to precautionary save. Conclusions This study contributes to the literature by documenting how people changed their life from the perspective of finance and health during the lockdown and providing practical implications.
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Affiliation(s)
- Di Wang
- School of Management, Shanwei Institute of Technology, Shanwei, Guangdong China
| | - Zhong-hua Shi
- School of Education, Shanwei Institute of Technology, Shanwei, Guangdong China
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Guo F, Han R, Sun Y, Sun L, Luo T, Zheng L, Gao C. The associations between COVID-19 vaccination and psychological disorders among healthcare workers in China. J Affect Disord 2022; 318:40-47. [PMID: 36031006 PMCID: PMC9420003 DOI: 10.1016/j.jad.2022.08.080] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 05/26/2022] [Accepted: 08/22/2022] [Indexed: 11/17/2022]
Abstract
INTRODUCTION COVID-19 has caused an unprecedented psychological affection that might impact the nationwide vaccination program in China. This study was to explore the association between COVID-19 vaccination and psychological disorders among healthcare workers. METHODS The study included 1571 healthcare workers from an anonymous online survey. Participants' sociodemographic characteristics, uptake data for the COVID-19 vaccine, and scores of the Depression, Anxiety, and Stress Scale (DASS-21) were collected. Nonparametric tests were conducted to compare the mean scores of DASS-21 between different subgroups. The potential factors related to psychological disorders of healthcare workers were analyzed using logistic regression. RESULTS The vaccination rate was 69.6 %, the incidence of vaccine-related adverse events was 35.13 %, and the prevalence of depression, anxiety, and stress were 24.8 %, 32 %, and 33.4 % in this study, respectively. Compared to vaccinated participants (single-dose and double-dose vaccines), unvaccinated participants got significantly higher mean scores of DASS-21 (p < 0.05 for all). Vaccinated participants who suffered no adverse events scored significantly lower than those who suffered 1-2 or ≥3 adverse events (p < 0.05 for all). Vaccination was negatively associated with higher depression, anxiety, and stress, however, the number of vaccine-related adverse events was positively associated with them. LIMITATIONS As this is a cross-sectional study, we could only speculate on the causality. CONCLUSIONS An obvious impact of the psychological disorders on the COVID-19 vaccine coverage and related adverse events was detected in this study. Public health agencies should attach great importance to the psychological states of our citizens before getting vaccinated.
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Affiliation(s)
- Fei Guo
- Department of Anesthesiology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, People's Republic of China
| | - Ruili Han
- Department of Anesthesiology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, People's Republic of China
| | - Yiwei Sun
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Li Sun
- Department of Anesthesiology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, People's Republic of China
| | - Ting Luo
- Department of Obstetrics and Gynecology, the Second Xiangya Hospital of Central South University, Changsha, People's Republic of China
| | - Lanlan Zheng
- Department of Anesthesiology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, People's Republic of China
| | - Changjun Gao
- Department of Anesthesiology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, People's Republic of China.
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11
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Batty GD, Deary IJ, Altschul D. Pre-pandemic mental and physical health as predictors of COVID-19 vaccine hesitancy: evidence from a UK-wide cohort study. Ann Med 2022; 54:274-282. [PMID: 35067149 PMCID: PMC8788379 DOI: 10.1080/07853890.2022.2027007] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 12/27/2021] [Accepted: 01/04/2022] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Although several predictors of COVID-19 vaccine hesitancy have been identified, the role of physical health and, particularly, mental health, is poorly understood. METHODS We used individual-level data from a pandemic-focused investigation (COVID Survey), a prospective cohort study nested within the UK Understanding Society (Main Survey) project. In the week immediately following the announcement of successful testing of the first efficacious inoculation (Oxford University/AstraZeneca, November/December 2020), data on vaccine intentionality were collected in 12,035 individuals aged 16-95 years. Pre-pandemic, study members had responded to enquiries about diagnoses of mental and physical health, including the completion of the 12-item General Health Questionnaire for symptoms of psychological distress (anxiety and depression). Peri-pandemic, individuals indicated whether they or someone in their household was shielding; that is, people judged by the UK National Health Service as being particularly clinically vulnerable who were therefore requested to remain at home. Intention to take up vaccination for COVID-19 was also self-reported. RESULTS In an analytical sample of 11,955 people (6741 women), 15.4% indicated that they were vaccine-hesitant. Relative to their disease-free counterparts, shielding was associated with a 24% lower risk of being hesitant (odds ratio; 95% confidence interval: 0.76; 0.59, 0.96), after adjustment for a range of covariates which included age, education, and ethnicity. Corresponding results for cardiometabolic disease were 22% (0.78; 0.64, 0.95), and for respiratory disease were 26% (0.74; 0.59, 0.93). Having a pre-pandemic diagnosis of anxiety or depression, or a high score on the distress symptom scale, were all unrelated to the willingness to vaccine-hesitancy. CONCLUSIONS People with a physical condition were more likely to take up the potential offer of a COVID-19 vaccination. These effects were not apparent for indices of mental health.Key messagesIn understanding predictors of COVID-19 vaccine hesitancy, the role of physical and mental health has not been well-examined despite both groups seemingly experiencing an elevated risk of the disease.In a large UK cohort study, people with a pre-pandemic physical condition were more likely to take up the theoretical offer of vaccination.There were no apparent effects for indices of pre-pandemic mental health.
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Affiliation(s)
- G. David Batty
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Ian J. Deary
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Drew Altschul
- Department of Psychology, University of Edinburgh, Edinburgh, UK
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12
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Lim C, Van Alphen MU, Maclaurin S, Mulligan C, Macri B, Cather C, Freudenreich O. Increasing COVID-19 Vaccination Rates Among Patients With Serious Mental Illness: A Pilot Intervention Study. Psychiatr Serv 2022; 73:1274-1277. [PMID: 35414188 DOI: 10.1176/appi.ps.202100702] [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] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This pilot project aimed to maximize COVID-19 vaccine uptake among patients with serious mental illness. Psychiatric providers were engaged to directly address COVID-19 vaccine-related concerns with patients during outpatient visits. METHODS A quality improvement project encouraged COVID-19 vaccinations in a cohort of outpatients treated with clozapine (N=193, ages 19-81 years, mean age=46.4 years) at a community mental health center. In-service education was provided to clinicians to identify vaccine-hesitant patients and build vaccine confidence. A vaccination-monitoring tool was created and embedded in patients' electronic medical records. Starting in February 2021, the tool guided semistructured interviews at each visit and supported population-based management. RESULTS The full COVID-19 vaccination rate by June 30, 2021, was 84% among the outpatients, compared with the estimated state rate on the same date of between 62.1% and 77.3%. CONCLUSIONS The active involvement of psychiatric providers in preventive health care can help increase vaccination rates among patients with serious mental illness.
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Affiliation(s)
- Carol Lim
- Department of Psychiatry, Massachusetts General Hospital, Boston (Lim, Maclaurin, Mulligan, Cather, Freudenreich); Department of Psychiatry, Harvard Medical School, Boston (Lim, Van Alphen, Cather, Freudenreich); North Suffolk Mental Health Association, Boston (Van Alphen, Maclaurin, Mulligan, Macri)
| | - Manjola U Van Alphen
- Department of Psychiatry, Massachusetts General Hospital, Boston (Lim, Maclaurin, Mulligan, Cather, Freudenreich); Department of Psychiatry, Harvard Medical School, Boston (Lim, Van Alphen, Cather, Freudenreich); North Suffolk Mental Health Association, Boston (Van Alphen, Maclaurin, Mulligan, Macri)
| | - Sarah Maclaurin
- Department of Psychiatry, Massachusetts General Hospital, Boston (Lim, Maclaurin, Mulligan, Cather, Freudenreich); Department of Psychiatry, Harvard Medical School, Boston (Lim, Van Alphen, Cather, Freudenreich); North Suffolk Mental Health Association, Boston (Van Alphen, Maclaurin, Mulligan, Macri)
| | - Caitlin Mulligan
- Department of Psychiatry, Massachusetts General Hospital, Boston (Lim, Maclaurin, Mulligan, Cather, Freudenreich); Department of Psychiatry, Harvard Medical School, Boston (Lim, Van Alphen, Cather, Freudenreich); North Suffolk Mental Health Association, Boston (Van Alphen, Maclaurin, Mulligan, Macri)
| | - Benjamin Macri
- Department of Psychiatry, Massachusetts General Hospital, Boston (Lim, Maclaurin, Mulligan, Cather, Freudenreich); Department of Psychiatry, Harvard Medical School, Boston (Lim, Van Alphen, Cather, Freudenreich); North Suffolk Mental Health Association, Boston (Van Alphen, Maclaurin, Mulligan, Macri)
| | - Corinne Cather
- Department of Psychiatry, Massachusetts General Hospital, Boston (Lim, Maclaurin, Mulligan, Cather, Freudenreich); Department of Psychiatry, Harvard Medical School, Boston (Lim, Van Alphen, Cather, Freudenreich); North Suffolk Mental Health Association, Boston (Van Alphen, Maclaurin, Mulligan, Macri)
| | - Oliver Freudenreich
- Department of Psychiatry, Massachusetts General Hospital, Boston (Lim, Maclaurin, Mulligan, Cather, Freudenreich); Department of Psychiatry, Harvard Medical School, Boston (Lim, Van Alphen, Cather, Freudenreich); North Suffolk Mental Health Association, Boston (Van Alphen, Maclaurin, Mulligan, Macri)
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Heinlein E, Taylor J, Goldberg R, Potts W, RachBeisel J, Medoff D, Li L, Himelhoch S. Impact of a Targeted Intervention on Hepatitis C Care Among African Americans With Serious Mental Illness. Psychiatr Serv 2022; 73:1278-1281. [PMID: 35473365 DOI: 10.1176/appi.ps.202100410] [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: 11/30/2022]
Abstract
OBJECTIVE This study aimed to update findings on the continuum of care for hepatitis C virus (HCV) infection with follow-up data for individuals with serious mental illness and to identify predictors of decisions to decline vaccination. METHODS The screening, testing, immunization, risk reduction, and referral (STIRR) intervention has been shown to increase testing and immunization rates. Prevalence of HCV diagnoses, HCV continuum of care, and hepatitis A (HAV) and B (HBV) vaccination were evaluated with laboratory results and chart review. RESULTS The prevalence of HCV was 15% (N=40 of 270 African Americans receiving the STIRR intervention). Of the 40 individuals identified as having HCV, 75% (N=30) accepted referral to treatment, of whom 47% (N=14) achieved sustained virologic response. Nearly 68% (N=155) of those eligible received at least partial HAV/HBV vaccination. CONCLUSIONS The STIRR intervention facilitated access to treatment for HCV and high acceptance of hepatitis vaccination. Avoidance proved to be a significant factor in decisions to decline vaccination.
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Affiliation(s)
- Emily Heinlein
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore (Heinlein, Taylor, Goldberg, Potts, RachBeisel, Medoff, Li); U.S. Department of Veterans Affairs (VA) Capitol Health Care Network (Veterans Integrated Service Network 5), Mental Illness Research, Education, and Clinical Center, Baltimore (Goldberg); Department of Psychiatry, College of Medicine, University of Kentucky, Lexington (Himelhoch)
| | - Jessica Taylor
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore (Heinlein, Taylor, Goldberg, Potts, RachBeisel, Medoff, Li); U.S. Department of Veterans Affairs (VA) Capitol Health Care Network (Veterans Integrated Service Network 5), Mental Illness Research, Education, and Clinical Center, Baltimore (Goldberg); Department of Psychiatry, College of Medicine, University of Kentucky, Lexington (Himelhoch)
| | - Richard Goldberg
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore (Heinlein, Taylor, Goldberg, Potts, RachBeisel, Medoff, Li); U.S. Department of Veterans Affairs (VA) Capitol Health Care Network (Veterans Integrated Service Network 5), Mental Illness Research, Education, and Clinical Center, Baltimore (Goldberg); Department of Psychiatry, College of Medicine, University of Kentucky, Lexington (Himelhoch)
| | - Wendy Potts
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore (Heinlein, Taylor, Goldberg, Potts, RachBeisel, Medoff, Li); U.S. Department of Veterans Affairs (VA) Capitol Health Care Network (Veterans Integrated Service Network 5), Mental Illness Research, Education, and Clinical Center, Baltimore (Goldberg); Department of Psychiatry, College of Medicine, University of Kentucky, Lexington (Himelhoch)
| | - Jill RachBeisel
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore (Heinlein, Taylor, Goldberg, Potts, RachBeisel, Medoff, Li); U.S. Department of Veterans Affairs (VA) Capitol Health Care Network (Veterans Integrated Service Network 5), Mental Illness Research, Education, and Clinical Center, Baltimore (Goldberg); Department of Psychiatry, College of Medicine, University of Kentucky, Lexington (Himelhoch)
| | - Deborah Medoff
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore (Heinlein, Taylor, Goldberg, Potts, RachBeisel, Medoff, Li); U.S. Department of Veterans Affairs (VA) Capitol Health Care Network (Veterans Integrated Service Network 5), Mental Illness Research, Education, and Clinical Center, Baltimore (Goldberg); Department of Psychiatry, College of Medicine, University of Kentucky, Lexington (Himelhoch)
| | - Lan Li
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore (Heinlein, Taylor, Goldberg, Potts, RachBeisel, Medoff, Li); U.S. Department of Veterans Affairs (VA) Capitol Health Care Network (Veterans Integrated Service Network 5), Mental Illness Research, Education, and Clinical Center, Baltimore (Goldberg); Department of Psychiatry, College of Medicine, University of Kentucky, Lexington (Himelhoch)
| | - Seth Himelhoch
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore (Heinlein, Taylor, Goldberg, Potts, RachBeisel, Medoff, Li); U.S. Department of Veterans Affairs (VA) Capitol Health Care Network (Veterans Integrated Service Network 5), Mental Illness Research, Education, and Clinical Center, Baltimore (Goldberg); Department of Psychiatry, College of Medicine, University of Kentucky, Lexington (Himelhoch)
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14
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Bonkat N, Fellendorf FT, Dalkner N, Reininghaus EZ. Severe mental disorders and vaccinations - a systematic review. World J Biol Psychiatry 2022; 23:501-516. [PMID: 35014937 DOI: 10.1080/15622975.2021.2013095] [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: 01/25/2023]
Abstract
OBJECTIVES People with severe mental illnesses (SMI: schizophrenia, depressive disorder, bipolar disorder) have a high risk of being infected by viruses and suffer a more severe infection illness course than the general population. The aim of this literature review was to elucidate rates as well as immunogenicity and side effects of vaccinations in SMI. METHODS All studies in the English or German language, which investigated either prevalence rates or effects of vaccinations in the target groups, were systematically searched in the databank PubMed by three independent authors using the PRISMA guidelines and discussed in more detail. RESULTS The search found 24 studies reporting epidemiological data and 16 investigating immunogenicity of vaccinations. The results on prevalence rates, antibody production, inflammation response and side effects were inconsistent. About interactions with psychotropic medication, only two studies on clozapine were found. CONCLUSIONS Only a few trials with heterogeneous samples have investigated prevalence and effects of vaccinations in SMI. Sex, age and other factors such as somatic comorbidities and special vaccination programmes have not been considered continuously and may influence rates as well. As individuals with SMI might be at special risk, further research on the willingness to be vaccinated as well as efficacy of vaccinations is needed.
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Affiliation(s)
- Nina Bonkat
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Frederike T Fellendorf
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Nina Dalkner
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Eva Z Reininghaus
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
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15
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Markiewicz-Gospodarek A, Górska A, Markiewicz R, Chilimoniuk Z, Czeczelewski M, Baj J, Maciejewski R, Masiak J. The Relationship between Mental Disorders and the COVID-19 Pandemic—Course, Risk Factors, and Potential Consequences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159573. [PMID: 35954930 PMCID: PMC9368061 DOI: 10.3390/ijerph19159573] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/11/2022] [Accepted: 08/02/2022] [Indexed: 01/10/2023]
Abstract
In this review the authors discuss that COVID-19 has already had a direct impact on the physical health of many people and that it appears to have put at risk the mental health of large populations. In this review, we also discuss the relationship between mental disorders and the SARS-CoV-2 infection. We convey the disorders’ risk factors and the more serious mental disorder consequences of COVID-19. People with mental health disorders could be more susceptible to the emotional responses brought on by the COVID-19 epidemic. The COVID-19 pandemic may adversely influence the mental health of patients with already diagnosed mental disorders. For the aim of dealing better with the psychological problems of people afflicted by the COVID-19 pandemic, new psychological procedures are required.
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Affiliation(s)
| | - Aleksandra Górska
- Department of Human Anatomy, Medical University of Lublin, 4 Jaczewskiego St., 20-090 Lublin, Poland
| | - Renata Markiewicz
- Department of Psychiatric Nursing, Medical University of Lublin, 18 Szkolna St., 20-124 Lublin, Poland
| | - Zuzanna Chilimoniuk
- Student Scientific Group, Department of Family Medicine, Medical University of Lublin, 6a (SPSK1) Langiewicza St., 20-032 Lublin, Poland
| | - Marcin Czeczelewski
- Department of Forensic Medicine, Medical University of Lublin, 8b Jaczewskiego St., 20-090 Lublin, Poland
| | - Jacek Baj
- Department of Human Anatomy, Medical University of Lublin, 4 Jaczewskiego St., 20-090 Lublin, Poland
| | - Ryszard Maciejewski
- Department of Human Anatomy, Medical University of Lublin, 4 Jaczewskiego St., 20-090 Lublin, Poland
| | - Jolanta Masiak
- II Department of Psychiatry and Psychiatric Rehabilitation, Medical University of Lublin, 1 Głuska (SPSK Nr 1) St., 20-059 Lublin, Poland
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16
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Fellendorf FT, Bonkat N, Platzer M, Schönthaler E, Ratzenhofer M, Bengesser SA, Dalkner N, Reininghaus EZ. Willingness to be vaccinated against COVID-19 is equal in individuals with affective disorders and healthy controls. Vaccine X 2022; 11:100186. [PMID: 35755141 PMCID: PMC9213006 DOI: 10.1016/j.jvacx.2022.100186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 03/29/2022] [Accepted: 06/15/2022] [Indexed: 10/26/2022] Open
Abstract
Affective disorders such as major depressive disorder and bipolar disorder are associated with higher infection rates and a more severe course of coronavirus disease (COVID-19). In turn, COVID-19 could trigger mental disease relapse. Vaccinations lead to a reduction of infections and the prevention of severe courses. This work aims to survey the willingness of individuals with affective disorders to get vaccinated and concerns about vaccinations. METHODS An online study (April-May 2021) assessed the current infection and vaccination rate amongst individuals with affective disorder in Austria by surveying attitudes towards the vaccination, the willingness to get vaccinated soon and possible reasons for decision. The analyses included 59 individuals with affective disorders and 59 healthy controls, matched for sex and age. RESULTS There was an overall high willingness to get vaccinated against COVID-19. Individuals with affective disorders were more skeptical about vaccinations in general but there was no significant difference between the groups in the willingness to get vaccinated against COVID-19. In both groups reasons for waiting were mainly fears of acute and/or long-term side effects and the fast development of the vaccines. LIMITATIONS It was a cross sectional design. Due to the online design, no objective rating of current psychopathological symptoms was assessed. Willingness to get vaccinated in general and against COVID-19 in particular were self-created variables, whereas item statistics and factor analysis were conducted. DISCUSSION Because of the higher risk for individuals with affective disorders, preventive strategies like vaccinating should be promoted in this group. It is important to help individuals with AD to overcome barriers such as negative beliefs and concerns about acute and/or long-term side effects.
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Affiliation(s)
- Frederike T Fellendorf
- Department of Psychiatry & Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Nina Bonkat
- Department of Psychiatry & Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Martina Platzer
- Department of Psychiatry & Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Elena Schönthaler
- Department of Psychiatry & Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Michaela Ratzenhofer
- Department of Psychiatry & Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Susanne A Bengesser
- Department of Psychiatry & Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Nina Dalkner
- Department of Psychiatry & Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Eva Z Reininghaus
- Department of Psychiatry & Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
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17
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Schor SH, Gibbs JS, Gouse BM, Brown HE. A call to action: Increased mortality from COVID-19 among individuals with schizophrenia calls for coordinated vaccination efforts. Schizophr Res 2022; 246:63-64. [PMID: 35716577 PMCID: PMC9167853 DOI: 10.1016/j.schres.2022.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/31/2022] [Accepted: 06/01/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Shayna H. Schor
- Boston University School of Medicine, Boston, MA 02118, United States of America
| | - Jada S. Gibbs
- Department of Psychiatry, Boston Medical Center, Boston, MA 02118, United States of America
| | - Brittany M. Gouse
- Department of Psychiatry, Boston University School of Medicine, Boston Medical Center, Boston, MA 02118, United States of America
| | - Hannah E. Brown
- Department of Psychiatry, Boston University School of Medicine, Boston Medical Center, Boston, MA 02118, United States of America,Corresponding author
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Raffard S, Bayard S, Eisenblaetter M, Attal J, Andrieu C, Chereau I, Fond G, Leignier S, Mallet J, Tattard P, Urbach M, Misdrahi D, Laraki Y, Capdevielle D. Attitudes towards Vaccines, Intent to Vaccinate and the Relationship with COVID-19 Vaccination Rates in Individuals with Schizophrenia. Vaccines (Basel) 2022; 10:vaccines10081228. [PMID: 36016116 PMCID: PMC9414756 DOI: 10.3390/vaccines10081228] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/25/2022] [Accepted: 07/28/2022] [Indexed: 02/06/2023] Open
Abstract
Schizophrenia patients are at high risk of developing severe COVID-19 outcomes but recent evidence suggests that they are under-vaccinated. This study explored the role of potential attitudinal barriers by comparing schizophrenia patients with participants from the general population regarding COVID-19 vaccination rates, general attitudes towards vaccines, and willingness to take a COVID-19 vaccine. We conducted a cross-sectional study between April 2021 and October 2021. A total of 100 people with schizophrenia and 72 nonclinical controls were recruited. In our study, individuals with schizophrenia were under-vaccinated, despite similar general attitudes towards vaccination and higher willingness to be vaccinated against COVID-19 compared to nonclinical participants. In patients, negative attitudes toward vaccines were related to higher levels of negative psychotic symptoms and higher levels of paranoid ideation. As a whole, participants with more negative attitudes towards vaccines were less likely to be vaccinated against COVID-19 and had lower levels of trust in institutions. Vaccine hesitancy does not appear to be a major barrier for COVID-19 vaccine uptake amongst people with schizophrenia. This study suggests that disparities in COVID-19 vaccination rates in schizophrenia do not seem related to attitudinal but rather structural barriers.
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Affiliation(s)
- Stéphane Raffard
- Laboratory EPSYLON, Paul Valéry University Montpellier 3, CEDEX 5, 34199 Montpellier, France; (S.B.); (M.E.); (Y.L.)
- University Department of Adult Psychiatry, CHU Montpellier, 34000 Montpellier, France; (J.A.); (P.T.); (D.C.)
- Correspondence: ; Tel.: +33-4-67-33-97-02
| | - Sophie Bayard
- Laboratory EPSYLON, Paul Valéry University Montpellier 3, CEDEX 5, 34199 Montpellier, France; (S.B.); (M.E.); (Y.L.)
| | - Margot Eisenblaetter
- Laboratory EPSYLON, Paul Valéry University Montpellier 3, CEDEX 5, 34199 Montpellier, France; (S.B.); (M.E.); (Y.L.)
| | - Jérôme Attal
- University Department of Adult Psychiatry, CHU Montpellier, 34000 Montpellier, France; (J.A.); (P.T.); (D.C.)
| | - Christelle Andrieu
- Pôle Psychiatrie, Centre Expert Dépression Résistante et Schizophrénie Fonda Mental, CHU La Conception, 13005 Marseille, France; (C.A.); (G.F.)
- CEReSS-health Service Research and Quality of Life Center, Aix-Marseille University, 27 Boulevard Jean-Moulin, 13005 Marseille, France
| | - Isabelle Chereau
- CHU Clermont-Ferrand, Service de Psychiatrie B, Université Clermont Auvergne, 63000 Clermont-Ferrand, France;
- Centre Référent de Réhabilitation Psychosociale et de Remeédiation Cognitive (C3R), CH Alpes Iseère, 38400 Saint-Martin-d’Hères, France;
| | - Guillaume Fond
- Pôle Psychiatrie, Centre Expert Dépression Résistante et Schizophrénie Fonda Mental, CHU La Conception, 13005 Marseille, France; (C.A.); (G.F.)
- CEReSS-health Service Research and Quality of Life Center, Aix-Marseille University, 27 Boulevard Jean-Moulin, 13005 Marseille, France
| | - Sylvain Leignier
- Centre Référent de Réhabilitation Psychosociale et de Remeédiation Cognitive (C3R), CH Alpes Iseère, 38400 Saint-Martin-d’Hères, France;
| | - Jasmina Mallet
- AP-HP, Department of Psychiatry, Louis Mourier Hospital, 92700 Colombes, France;
- INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, University Paris Descartes, 75006 Paris, France
- Faculté de Médecine, Université Paris Diderot, Sorbonne Paris Cité, 75013 Paris, France
| | - Philippe Tattard
- University Department of Adult Psychiatry, CHU Montpellier, 34000 Montpellier, France; (J.A.); (P.T.); (D.C.)
| | - Mathieu Urbach
- Department of Adult Psychiatry and Addictology, Versailles Hospital, Centre Hospitalier de Versailles, 177 rue de Versailles, 78157 Le Chesnay, France;
- DisAP-DevPsy-CESP, INSERM UMR1018, University of Paris-Saclay, University of Versailles Saint-Quentin-En-Yvelines, 94807 Villejuif, France
| | - David Misdrahi
- Department of Adult Psychiatry, Charles Perrens Hospital, University of Bordeaux, Laboratory of Nutrition and Integrative Neurobiology (UMR INRA 1286), 33000 Bordeau, France;
| | - Yasmine Laraki
- Laboratory EPSYLON, Paul Valéry University Montpellier 3, CEDEX 5, 34199 Montpellier, France; (S.B.); (M.E.); (Y.L.)
- University Department of Adult Psychiatry, CHU Montpellier, 34000 Montpellier, France; (J.A.); (P.T.); (D.C.)
| | - Delphine Capdevielle
- University Department of Adult Psychiatry, CHU Montpellier, 34000 Montpellier, France; (J.A.); (P.T.); (D.C.)
- IGF, University Montpellier, CNRS, INSERM, 34000 Montpellier, France
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19
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Murphy S, O'Reilly D, Owen RK, Akbari A, Lowthian E, Bedston S, Torabi F, Beggs J, Chuter A, de Lusignan S, Hobbs R, Robertson C, Katikireddi SV, Sheikh A, Bradley DT. Variations in COVID-19 vaccination uptake among people in receipt of psychotropic drugs: cross-sectional analysis of a national population-based prospective cohort. Br J Psychiatry 2022; 221:417-424. [PMID: 35249568 DOI: 10.1192/bjp.2022.36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) has disproportionately affected people with mental health conditions. AIMS We investigated the association between receiving psychotropic drugs, as an indicator of mental health conditions, and COVID-19 vaccine uptake. METHOD We conducted a cross-sectional analysis of a prospective cohort of the Northern Ireland adult population using national linked primary care registration, vaccination, secondary care and pharmacy dispensing data. Univariable and multivariable logistic regression analyses investigated the association between anxiolytic, antidepressant, antipsychotic, and hypnotic use and COVID-19 vaccination status, accounting for age, gender, deprivation and comorbidities. Receiving any COVID-19 vaccine was the primary outcome. RESULTS There were 1 433 814 individuals, of whom 1 166 917 received a COVID-19 vaccination. Psychotropic medications were dispensed to 267 049 people. In univariable analysis, people who received any psychotropic medication had greater odds of receiving COVID-19 vaccination: odds ratio (OR) = 1.42 (95% CI 1.41-1.44). However, after adjustment, psychotropic medication use was associated with reduced odds of vaccination (ORadj = 0.90, 95% CI 0.89-0.91). People who received anxiolytics (ORadj = 0.63, 95% CI 0.61-0.65), antipsychotics (ORadj = 0.75, 95% CI 0.73-0.78) and hypnotics (ORadj = 0.90, 95% CI 0.87-0.93) had reduced odds of being vaccinated. Antidepressant use was not associated with vaccination (ORadj = 1.02, 95% CI 1.00-1.03). CONCLUSIONS We found significantly lower odds of vaccination in people who were receiving treatment with anxiolytic and antipsychotic medications. There is an urgent need for evidence-based, tailored vaccine support for people with mental health conditions.
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Affiliation(s)
- Siobhán Murphy
- Centre for Public Health, Queen's University Belfast, UK
| | | | | | - Ashley Akbari
- Swansea University Medical School, Swansea University, UK
| | - Emily Lowthian
- Swansea University Medical School, Swansea University, UK
| | - Stuart Bedston
- Population Data Science, Swansea University Medical School, Swansea University, UK
| | - Fatemeh Torabi
- Swansea University Medical School, Swansea University, UK
| | - Jillian Beggs
- Breathe, The Health Data Research Hub for Respiratory Health, UK
| | - Antony Chuter
- Breathe, The Health Data Research Hub for Respiratory Health, UK
| | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, UK
| | - Richard Hobbs
- Nuffield Department of Primary Care Health Sciences, University of Oxford, UK
| | - Chris Robertson
- Public Health Scotland, UK and Department of Mathematics and Statistics, University of Strathclyde, UK
| | | | - Aziz Sheikh
- Usher Institute, University of Edinburgh, UK
| | - Declan T Bradley
- Centre for Public Health, Queen's University Belfast, UK and Public Health Agency, UK
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20
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Wiegand HF, Maicher B, Rueb M, Wessels P, Besteher B, Hellwig S, Pfennig A, Rohner H, Unterecker S, Hölzel LP, Philipsen A, Domschke K, Falkai P, Lieb K, Adorjan K. COVID-19 vaccination rates in hospitalized mentally ill patients compared to the general population in Germany - results from the COVID Ψ Vac study. Eur Psychiatry 2022; 65:e41. [PMID: 35762046 PMCID: PMC9300974 DOI: 10.1192/j.eurpsy.2022.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background Mental illness is known to come along with a large mortality gap compared to thegeneral population and it is a risk for COVID-19 related morbidity andmortality. Achieving high vaccination rates in people with mental illness is therefore important. Reports are conflicting on whether vaccination rates comparable to those of the general population can be achieved and which variables represent risk factors for nonvaccination in people with mental illness. Methods The COVID Ψ Vac study collected routine data on vaccination status, diagnostic groups, sociodemographics, and setting characteristics from in- and day-clinic patients of 10 psychiatric hospitals in Germany in August 2021. Logistic regression modeling was used to determine risk factors for nonvaccination. Results Complete vaccination rates were 59% (n = 776) for the hospitalized patients with mental illness versus 64% for the regionally and age-matched general population. Partial vaccination rates were 68% (n = 893) for the hospitalised patients with mental illness versus 67% for the respective general population and six percentage (n = 74) of this hospitalized population were vaccinated during the hospital stay. Rates showed a large variation between hospital sites. An ICD-10 group F1, F2, or F4 main diagnosis, younger age, and coercive accommodation were further risk factors for nonvaccination in the model. Conclusions Vaccination rates were lower in hospitalized people with mental illness than in the general population. By targeting at-risk groups with low-threshold vaccination programs in all health institutions they get in contact with, vaccination rates comparable to those in the general population can be achieved.
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Affiliation(s)
- Hauke Felix Wiegand
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz
| | - Birgit Maicher
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Medical Faculty, Technische Universität Dresden
| | - Mike Rueb
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich; Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich; Pettenkofer School of Public Health, Munich
| | - Paula Wessels
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg
| | - Bianca Besteher
- Department of Psychiatry and Psychotherapy, Jena University hospital
| | - Sabine Hellwig
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine University of Freiburg, Germany
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Medical Faculty, Technische Universität Dresden
| | - Henrik Rohner
- Department of Psychiatry and Psychotherapy, University Hospital of Bonn
| | - Stefan Unterecker
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg
| | - Lars Peer Hölzel
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz and Oberberg Parkklinik Schlangenbad, Wiesbaden Schlangenbad
| | | | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine University of Freiburg, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich
| | - Klaus Lieb
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz
| | - Kristina Adorjan
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich
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21
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Scendoni R, Fedeli P, Cingolani M. The Network of Services for COVID-19 Vaccination in Persons With Mental Disorders: The Italian Social Health System, Its Organization, and Bioethical Issues. Front Public Health 2022; 10:870386. [PMID: 35795707 PMCID: PMC9252269 DOI: 10.3389/fpubh.2022.870386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 05/31/2022] [Indexed: 12/02/2022] Open
Abstract
The adoption of restrictive measures aimed at curtailing the spread of SARS-CoV2 has had a harmful impact on socio-affective relationships, while limiting the scope of interventions and activities to promote social inclusion, with considerable negative repercussions for patients with mental disorders. Vaccination has been and will continue to be a valid tool to overcome the barriers of social isolation and to protect the health of this category of patients. In this paper we present an overview of the Italian network of social and healthcare services for COVID-19 vaccination among patients with mental disorders. Some aspects of medical ethics are discussed in order to share good practices for improving the health of this vulnerable group of people. We then consider the measures implemented by the health system in Italy to deal with the phenomenon of vaccine hesitancy before addressing the issue of autonomy and restricted access to vaccination points. Finally, we illustrate some of the perspectives already adopted by the Italian system, which may be useful to the global scientific community.
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Affiliation(s)
- Roberto Scendoni
- Department of Law, Institute of Legal Medicine, University of Macerata, Macerata, Italy
- *Correspondence: Roberto Scendoni
| | | | - Mariano Cingolani
- Department of Law, Institute of Legal Medicine, University of Macerata, Macerata, Italy
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22
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Wu Z, Wang X, Zhang S, Ding N, Zhang G, Zhao C, Xu H, Lai X, Tu X, Yang X. Do Attitudes, Mental Health Status, and Interpersonal Factors Predict COVID-19 Vaccine Hesitancy at the Early Phase of the Pandemic? A Longitudinal Study in Chinese College Students. Front Psychol 2022; 13:876116. [PMID: 35664204 PMCID: PMC9161085 DOI: 10.3389/fpsyg.2022.876116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose The present study examined whether and how attitudes toward the COVID-19 vaccine (i.e., safety, efficacy, and price), mental health statuses (i.e., perceived stress and depression), and interpersonal factors (i.e., online social support, perceived social support) would predict COVID-19 vaccine hesitancy. Patients and methods The two-wave longitudinal surveys were conducted in December 2019 and 2020 in Chinese medical college students (N = 194). Well- validated measures were used, including the Perceived Stress Scale, the Center for Epidemiologic Studies Depression Scale, the Online Social Support Questionnaire, and the Perceived Social Support Scale. Perceived safety, efficacy, price of COVID-19 vaccine, vaccine hesitancy, and actual intake were also measured. Results Only 2.1% of participants had been vaccinated against COVID-19 in the early stages of the pandemic; 13.4% intended to get vaccinated in the next 3 months, and 66% intended to have it in the next 12 months upon follow-up. Multiple regression analyses revealed that perceived stress (βm = -0.15, p < 0.05) and depression (βm = -0.15, p < 0.05) were risk factors for positive attitudes toward the COVID-19 vaccine; online social support (ORm = 1.41, p < 0.01) and positive attitudes toward the COVID-19 vaccine (ORm = 1.83, p < 0.01) were protective factors of intention to get vaccinated in future. Conclusion Findings suggest that intervention efforts should be made to reduce negative attitudes toward the COVID-19 vaccine among people with poor mental health and enhance online social support to promote COVID-19 vaccination.
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Affiliation(s)
- Zhipeng Wu
- School of Educational Science, Gannan Normal University, Ganzhou, China
| | - Xin Wang
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Sha Zhang
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Nani Ding
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Guohua Zhang
- The Affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou, China
| | - Chengjia Zhao
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Huihui Xu
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Xinyi Lai
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Xiaolian Tu
- Renji College, Wenzhou Medical University, Wenzhou, China
| | - Xue Yang
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
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23
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Miles LW, Thatcher B, Thomas MC, Winters B. Treatment pearls: Management of physical healthcare needs in patients with mental illness. Nurse Pract 2022; 47:20-28. [PMID: 35604294 DOI: 10.1097/01.npr.0000829784.91687.8c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Clinicians caring for persons with mental illness should be aware of increased mortality, physical problems, and health disparities in this population. This article provides a brief overview of physical health problems in the context of mental illness as well as those related to psychotropic medications, and discusses strategies to manage treatment effectively.
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24
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Kumar N, Janmohamed K, Nyhan K, Martins SS, Cerda M, Hasin D, Scott J, Sarpong Frimpong A, Pates R, Ghandour LA, Wazaify M, Khoshnood K. Substance, use in relation to COVID-19: A scoping review. Addict Behav 2022; 127:107213. [PMID: 34959077 PMCID: PMC8684053 DOI: 10.1016/j.addbeh.2021.107213] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 10/24/2021] [Accepted: 12/11/2021] [Indexed: 02/06/2023]
Abstract
Background We conducted a scoping review focused on various forms of substance use amid the pandemic, looking at both the impact of substance use on COVID-19 infection, severity, and vaccine uptake, as well as the impact that COVID-19 has had on substance use treatment and rates. Methods A scoping review, compiling both peer-reviewed and grey literature, focusing on substance use and COVID-19 was conducted on September 15, 2020 and again in April 15, 2021 to capture any new studies. Three bibliographic databases (Web of Science Core Collection, Embase, PubMed) and several preprint servers (EuropePMC, bioRxiv, medRxiv, F1000, PeerJ Preprints, PsyArXiv, Research Square) were searched. We included English language original studies only. Results Of 1564 articles screened in the abstract and title screening phase, we included 111 research studies (peer-reviewed: 98, grey literature: 13) that met inclusion criteria. There was limited research on substance use other than those involving tobacco or alcohol. We noted that individuals engaging in substance use had increased risk for COVID-19 severity, and Black Americans with COVID-19 and who engaged in substance use had worse outcomes than white Americans. There were issues with treatment provision earlier in the pandemic, but increased use of telehealth as the pandemic progressed. COVID-19 anxiety was associated with increased substance use. Conclusions Our scoping review of studies to date during COVID-19 uncovered notable research gaps namely the need for research efforts on vaccines, COVID-19 concerns such as anxiety and worry, and low- to middle-income countries (LMICs) and under-researched topics within substance use, and to explore the use of qualitative techniques and interventions where appropriate. We also noted that clinicians can screen and treat individuals exhibiting substance use to mitigate effects of the pandemic. Funding Study was funded by the Institution for Social and Policy Studies, Yale University and The Horowitz Foundation for Social Policy. DH was funded by a NIDA grant (R01DA048860). The funding body had no role in the design, analysis, or interpretation of the data in the study.
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25
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Payberah E, Payberah D, Sarangi A, Gude J. COVID-19 vaccine hesitancy in patients with mental illness: strategies to overcome barriers—a review. JOURNAL OF THE EGYPTIAN PUBLIC HEALTH ASSOCIATION 2022; 97:5. [PMID: 35079435 PMCID: PMC8777419 DOI: 10.1186/s42506-022-00102-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 12/31/2021] [Indexed: 01/12/2023]
Abstract
Abstract
Background
People with mental health problems are at particular risk both for infection with COVID-19 and for more severe course of illness. Understanding COVID-19 vaccine hesitancy is crucial in promoting vaccine acceptance among people with mental health diagnoses. This review aims to identify the prevalence and discuss factors associated with COVID-19 vaccine hesitancy among the mentally ill population.
Main body
We conducted a detailed literature search and included 15 articles for discussion in this review. Several studies showed varying trends of vaccine hesitancy rates among different countries. Major factors involved in vaccine hesitancy in general include mistrust, misinformation, believing in conspiracy theories, and negative attitudes towards vaccines. It was surprising that none of the studies were focused on vaccine acceptance rates and factors associated with vaccine hesitancy among the mentally ill population. However, studies do show that COVID-19 is associated with worse healthcare outcomes for psychiatric patients, and vaccine hesitancy correlated with a lower likelihood of receiving mental health treatment and vaccinations. Psychiatrists need to address issues among patients who are particularly vulnerable to the fear of vaccines which include anxiety, panic attacks, certain phobias including trypanophobia and agoraphobia, obsessive-compulsive disorder, and certain types of traumas. Psychiatrists need to communicate effectively, show respect, empathy, and deliver accurate and honest information about the vaccines. Motivational interviewing, getting people with mental health illness to organize vaccine campaigns, and involving families with mental health problems may promote vaccine acceptance among this group.
Conclusion
Existing literature on the rates of vaccine hesitancy among people with mental health illness is limited. The mental health illness may increase the risk of hesitancy especially in patients having certain emotional disorders such as anxiety and phobia. More studies addressing vaccine hesitancy rates and factors associated with the mentally ill population need to be done in the future.
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26
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Vai B, Mazza MG, Marisa CD, Beezhold J, Kärkkäinen H, Saunders J, Samochowiec J, Benedetti F, Leboyer M, Fusar-Poli P, De Picker L. Joint European policy on the COVID-19 risks for people with mental disorders: An umbrella review and evidence- and consensus-based recommendations for mental and public health. Eur Psychiatry 2022; 65:e47. [PMID: 35971656 PMCID: PMC9486830 DOI: 10.1192/j.eurpsy.2022.2307] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Abstract
As COVID-19 becomes endemic, identifying vulnerable population groups for severe infection outcomes and defining rapid and effective preventive and therapeutic strategies remains a public health priority. We performed an umbrella review, including comprehensive studies (meta-analyses and systematic reviews) investigating COVID-19 risk for infection, hospitalization, intensive care unit (ICU) admission, and mortality in people with psychiatric disorders, and outlined evidence- and consensus-based recommendations for overcoming potential barriers that psychiatric patients may experience in preventing and managing COVID-19, and defining optimal therapeutic options and current research priorities in psychiatry. We searched Web of Science, PubMed, and Ovid/PsycINFO databases up to 17 January 2022 for the umbrella review. We synthesized evidence, extracting when available pooled odd ratio estimates for the categories “any mental disorder” and “severe mental disorders.” The quality of each study was assessed using the AMSTAR-2 approach and ranking evidence quality. We identified four systematic review/meta-analysis combinations, one meta-analysis, and three systematic reviews, each including up to 28 original studies. Although we rated the quality of studies from moderate to low and the evidence ranged from highly suggestive to non-significant, we found consistent evidence that people with mental illness are at increased risk of COVID-19 infection, hospitalization, and most importantly mortality, but not of ICU admission. The risk and the burden of COVID-19 in people with mental disorders, in particular those with severe mental illness, can no longer be ignored but demands urgent targeted and persistent action. Twenty-two recommendations are proposed to facilitate this process.
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27
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COVID-19 and severe mental illness in Israel: testing, infection, hospitalization, mortality and vaccination rates in a countrywide study. Mol Psychiatry 2022; 27:3107-3114. [PMID: 35459901 PMCID: PMC9028900 DOI: 10.1038/s41380-022-01562-2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 03/25/2022] [Accepted: 04/04/2022] [Indexed: 01/20/2023]
Abstract
Previous studies on psychiatric patients infected with COVID-19 have reported a more severe course of disease and higher rates of mortality compared with the general population. This cohort study linked Israeli national databases including all individuals ever hospitalized for a psychiatric disorder (cases), and COVID-19 testing, infection, hospitalization, mortality, and vaccinations, between March 1st 2020 and March 31st 2021. Cases were 125,273 individuals aged 18 and above ever hospitalized in a psychiatric facility (ICD-10 F10-F69 or F90-F99), compared to the total population, n = 6,143,802. Compared with the total population, cases were less likely to be tested for COVID-19, 51.2% (95% CI: 50.8-51.7) vs 62.3% (95% CI 62.2-62.4) and had lower rates of confirmed COVID infection, 5.9% (95% CI: 5.8-6.1) vs 8.9% (95% CI: 8.9-8.9). Among those infected, risks for COVID-19 hospitalization, COVID-19 attributed mortality and all-cause mortality were higher for cases than the total population, adjusted odds ratios were 2.10; (95% CI: 1.96-2.25), 1.76; (95% CI: 1.54-2.01) and 2.02; (95% CI: 1.80-2.28), respectively. These risks were even higher for cases with non-affective psychotic disorders and bipolar disorder. Age adjusted rates of vaccination were lower in cases, 60.4% (95% CI: 59.9-60.8) vs 74.9% (95% CI: 74.8-75.0) in the total population, and particularly low for cases with non-affective psychotic disorders, 56.9% (95% CI: 56.3-57.6). This study highlights the need to increase testing for COVID-19 in individuals ever hospitalized for a psychiatric disorder, closely monitor those found positive, and to reach out to encourage vaccination.
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28
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Eyllon M, Dang AP, Barnes JB, Buresh J, Peloquin GD, Hogan AC, Shimotsu ST, Sama SR, Nordberg SS. Associations between psychiatric morbidity and COVID-19 vaccine hesitancy: An analysis of electronic health records and patient survey. Psychiatry Res 2022; 307:114329. [PMID: 34910966 PMCID: PMC8648380 DOI: 10.1016/j.psychres.2021.114329] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 12/02/2021] [Accepted: 12/04/2021] [Indexed: 01/08/2023]
Abstract
Psychiatric illness confers significant risk for severe COVID-19 morbidity and mortality; identifying psychiatric risk factors for vaccine hesitancy is critical to mitigating risk in this population. This study examined the prevalence of vaccine hesitancy among those with psychiatric illness and the associations between psychiatric morbidity and vaccine hesitancy. Data came from electronic health records and a patient survey obtained from 14,365 patients at a group medical practice between February and May 2021. Logistic regression was used to calculate odds for vaccine hesitancy adjusted for sociodemographic characteristics and physical comorbidity. Of 14,365 participants 1,761 (12.3%) participants reported vaccine hesitancy. Vaccine hesitancy was significantly more prevalent among participants with substance use (29.6%), attention deficit and hyperactivity (23.3%), posttraumatic stress (23.1%), bipolar (18.0%), generalized anxiety (16.5%), major depressive (16.1%), and other anxiety (15.5%) disorders, tobacco use (18.6%), and those previously infected with COVID-19 (19.8%) compared to participants without . After adjusting for sociodemographic characteristics and physical comorbidities, substance use disorders and tobacco use were significantly associated with increased odds for vaccine hesitancy and bipolar disorder was significantly inversely associated with vaccine hesitancy. Interventions to improve uptake in these populations may be warranted.
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Affiliation(s)
- Mara Eyllon
- Practice Research Network, Reliant Medical Group, Worcester, MA, United States.
| | - Alexander P. Dang
- OptumLabs, UnitedHealth Group, Minneapolis, Minnesota, United States
| | - J. Ben Barnes
- Practice Research Network, Reliant Medical Group, Worcester, MA, United States,Department of Psychiatry, University of Massachusetts Chan Medical School
| | - John Buresh
- OptumLabs, UnitedHealth Group, Minneapolis, Minnesota, United States
| | | | - Annika C. Hogan
- Practice Research Network, Reliant Medical Group, Worcester, MA, United States
| | - Scott T. Shimotsu
- OptumLabs, UnitedHealth Group, Minneapolis, Minnesota, United States
| | - Susan R. Sama
- Practice Research Network, Reliant Medical Group, Worcester, MA, United States,Department of Public Health, University of Massachusetts, Lowell, Lowell, MA, United States
| | - Samuel S. Nordberg
- Practice Research Network, Reliant Medical Group, Worcester, MA, United States,Behavioral Health Department, Reliant Medical Group, Worcester, MA, United States
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29
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Mazereel V, Vanbrabant T, Desplenter F, Detraux J, De Picker L, Thys E, Popelier K, De Hert M. COVID-19 Vaccination Rates in a Cohort Study of Patients With Mental Illness in Residential and Community Care. Front Psychiatry 2021; 12:805528. [PMID: 34975599 PMCID: PMC8716918 DOI: 10.3389/fpsyt.2021.805528] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 11/26/2021] [Indexed: 12/14/2022] Open
Abstract
Background: Patients with mental illness are at increased risk for COVID-19-related morbidity and mortality. Vaccination against COVID-19 is important to prevent or mitigate these negative consequences. However, concerns have been raised over vaccination rates in these patients. Methods: We retrospectively examined vaccine uptake in a large sample of Belgian patients admitted to or residing in a university psychiatric hospital or community mental health care setting between 29th of March 2021 and 30th of September 2021 in the Flanders Region. All patients were offered vaccination. Descriptive statistics were used to analyse the data. Logistic regression was used to examine factors associated with vaccine uptake. Results: 2,105 patients were included in the sample, of which 1,931 agreed to be vaccinated, corresponding with a total vaccination rate of 91.7%. Logistic regression showed an effect of the diagnosis "other disorders" (OR = 0.08, CI = 0.005-0.45), age (OR = 1.03, CI = 1.02-1.04) and residing in the psychosocial care center (OR = 0.50, CI = 0.32-0.80) on vaccination status. Conclusion: Vaccine uptake among people with mental illness is high and comparable to the general population, when implementing a targeted vaccination program.
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Affiliation(s)
- Victor Mazereel
- University Psychiatric Center KU Leuven, Leuven, Belgium
- Department of Biomedical Sciences, Center for Clinical Psychiatry, KU Leuven, Leuven, Belgium
| | - Tom Vanbrabant
- University Psychiatric Center KU Leuven, Leuven, Belgium
| | - Franciska Desplenter
- University Psychiatric Center KU Leuven, Leuven, Belgium
- Department of Pharmaceutical and Pharmacological Sciences, Clinical Pharmacology and Pharmacotherapy, KU Leuven, Leuven, Belgium
| | - Johan Detraux
- University Psychiatric Center KU Leuven, Leuven, Belgium
| | - Livia De Picker
- Scientific Initiative for Neuropsychiatric and Pyschopharmacological Studies, University Psychiatric Hospital Campus Duffel, Duffel, Belgium
| | - Erik Thys
- Psycho-Sociaal Centrum St.-Alexius-Elsene Vzw, Ixelles, Belgium
| | - Ken Popelier
- Psycho-Sociaal Centrum St.-Alexius-Elsene Vzw, Ixelles, Belgium
| | - Marc De Hert
- University Psychiatric Center KU Leuven, Leuven, Belgium
- Department of Biomedical Sciences, Center for Clinical Psychiatry, KU Leuven, Leuven, Belgium
- Antwerp Health Law and Ethics Chair – AHLEC University Antwerpen, Antwerp, Belgium
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30
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Weinstein O, Krieger I, Cohen AD, Tzur Bitan D. COVID-19 vaccination among individuals with autism spectrum disorder: A population-based study. RESEARCH IN AUTISM SPECTRUM DISORDERS 2021; 89:101865. [PMID: 34548878 PMCID: PMC8445801 DOI: 10.1016/j.rasd.2021.101865] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 09/14/2021] [Accepted: 09/14/2021] [Indexed: 05/08/2023]
Abstract
BACKGROUND Individuals with autistic spectrum disorder (ASD) are more susceptible to COVID-19 morbidity and should therefore be prioritized for vaccination. Although individuals with neurodevelopmental disabilities are given some priority in Israel, it is unclear to what extent individuals with ASD are being vaccinated relative to that of the general population. This study was aimed to assess vaccination prevalence among individuals with ASD. METHOD Individuals with ASD, and age- and sex-matched controls (total n = 11,080), were assessed for prevalence of COVID-19 vaccination by February 2021, approximately a month and a half after the national vaccination distribution plan was launched in Israel. Data were obtained from the database of Clalit Health Services (CHS), the largest healthcare organization in Israel. RESULTS Individuals with ASD were more likely to be vaccinated for COVID-19 (OR = 2.55, 95 %CI 2.35-2.75, p < .001) across both sexes, but only in the 16-20 (OR = 2.04, 95 %CI 1.79-2.32, p < .001) and 21-40 (OR = 3.95, 95 %CI 3.52-4.43, p < .001) age groups. After adjusting for chronic illnesses, ASD remained significant in predicting the uptake of COVID-19 vaccination. CONCLUSIONS Efforts to prioritize ASD patients may improve vaccination prevalence among individuals with ASD, especially among younger individuals. Healthcare providers worldwide should therefore consider prioritization policies so as to increase vaccination rates among this vulnerable population.
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Affiliation(s)
- Orly Weinstein
- Hospitals Division, Clalit Health Services, Tel Aviv, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Israel Krieger
- Shalvata Mental Health Center, Affiliated With the Sackler School of Medicine, Tel Aviv University, Israel
| | - Arnon Dov Cohen
- Department of Quality Measurements and Research, Clalit Health Services, Tel Aviv, Israel
- Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Dana Tzur Bitan
- Department of Behavioral Sciences, Ariel University, Israel
- Shalvata Mental Health Center, Affiliated With the Sackler School of Medicine, Tel Aviv University, Israel
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31
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Implementation and Outcomes of COVID-19 Vaccinations at a Child and Adolescent Psychiatric Hospital. J Am Acad Child Adolesc Psychiatry 2021; 60:1332-1334. [PMID: 34481918 PMCID: PMC8410143 DOI: 10.1016/j.jaac.2021.08.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/11/2021] [Accepted: 08/26/2021] [Indexed: 11/20/2022]
Abstract
Increasing coronavirus disease 2019 (COVID-19) vaccination rates has been identified by the US Centers of Disease Control and Prevention as critical to ending the COVID-19 pandemic.1 On May 10, 2021, the Pfizer-BioNTech COVID-19 vaccine (BNT162b2; Pfizer, Inc, New York, New York, and BioNTech SE, Mainz, Germany) was approved for emergency use authorization by the US Food and Drug Administration for patients 12 years of age or older. Here we report a retrospective study describing the implementation of a COVID-19 vaccination program at our child and adolescent psychiatric hospital. To our knowledge, this is the first report detailing the administration of the COVID-19 vaccination in this setting.
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Tzur Bitan D, Kridin K, Cohen AD, Weinstein O. COVID-19 hospitalisation, mortality, vaccination, and postvaccination trends among people with schizophrenia in Israel: a longitudinal cohort study. Lancet Psychiatry 2021; 8:901-908. [PMID: 34364406 PMCID: PMC8342316 DOI: 10.1016/s2215-0366(21)00256-x] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/21/2021] [Accepted: 07/02/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND Individuals with schizophrenia have an increased risk of severe COVID-19 outcomes, nonetheless, no previous study has provided a year-long account of this risk, or assessed postvaccination trends in this population. This study assessed temporal trends in COVID-19 hospitalisation and mortality among people with schizophrenia during the first year of the pandemic, the predictors for COVID-19 vaccination, postvaccination infection, admission to hospital, and mortality. METHODS In this longitudinal cohort study, people with schizophrenia (n=25 539) and controls (n=25 539) were assessed for COVID-19 outcomes before and after vaccination, up to April 30, 2021. Cox proportional hazard regression models and Kaplan-Meier analyses were done to assess longitudinal trends. The study used the databases of Clalit Health Services, the largest health-care organisation in Israel. FINDINGS The sample included 51 078 participants, of which 31 141 (61·0%) male and 19 937 (39·0%) female participants, with a mean age of 51·94 years (SD 15·62). Most of the sample was from the general Jewish population (75·9%), followed by the Arab (19·1%) and Jewish Ultraorthodox population (5·1%). Overall of 51 078 individuals, 356 (0·7%) people had been hospitalised, 133 (0·3%) had died, and a total of 27 400 (53·6%) had been vaccinated. People with schizophrenia showed a higher risk for COVID-19 hospitalisation (HR 4·81, 95% CI 3·57-6·48, p<0·0001) and mortality (HR 2·52, 95% CI 1·64-3·85, p<0·0001), and showed a sharper decline in survival as time progressed. The control group showed a sharper incline in probability to vaccinate (log-rank=309·88, p<0·0001). Medical comorbidity of diabetes, hypertension, obesity, or ischaemic heart disease played a significant role in predicting vaccination rates in the schizophrenia group (all p<0·0001), but not in the control group. Hospitalisation and mortality disparities remained higher among people with schizophrenia who had not been vaccinated in comparison to controls (incidence rate difference of 6·2 and 3·2, respectively) but substantially declined in fully vaccinated groups (incidence rate difference of 1·1 and -0·9, respectively). INTERPRETATION People with schizophrenia have higher hospitalisation and mortality risk, yet have lower rates of vaccination than in the general population. Disparities in COVID-19 severe outcomes can be substantially reduced by national vaccination plans aimed at actively reaching out to people with schizophrenia. FUNDING No funding.
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Affiliation(s)
- Dana Tzur Bitan
- Department of Behavioral Sciences, Ariel University, Ariel, Israel; Shalvata Mental Health Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Khalaf Kridin
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany; Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel; Unit of Dermatology and Skin Research Laboratory, Baruch Padeh Poria Medical Center, Poria, Israel
| | - Arnon Dov Cohen
- Department of Quality Measurements and Research, Clalit Health Services, Tel Aviv, Israel; Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Orly Weinstein
- Hospital Division, Clalit Health Services, Tel Aviv, Israel; Department of Health Systems Administration, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
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33
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COVID-19 vaccine willingness amongst patients with mental illness compared with the general population. Acta Neuropsychiatr 2021; 33:273-276. [PMID: 33998428 DOI: 10.1017/neu.2021.15] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Patients with mental illness are at an increased risk of COVID-19 infection, morbidity, and mortality, and prioritisation of this group for COVID-19 vaccination programmes has therefore been suggested. Vaccine uptake may, however, be compromised by vaccine hesitancy amongst patients with mental illness, posing a critical public health issue. We conducted two surveys to provide weighted estimates of vaccine willingness amongst patients with mental illness and the general population of Denmark. Vaccine willingness was high in both groups, but slightly lower amongst patients with mental illness (84.8%), compared with the general population (89.5%) (p < .001). Based on these findings, vaccine hesitancy does not appear to be a major barrier for vaccine uptake amongst patients with mental illness in Denmark, but may be so in other countries with lower general vaccine willingness. Replication of the present study in other countries is strongly warranted.
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Abstract
OBJECTIVE This study examined the feasibility of offering COVID-19 vaccinations to patients in inpatient psychiatric facilities (IPFs). METHODS Descriptive analyses were conducted to examine relationships among measures of influenza immunization, transmission of transition records, and attainment of follow-up care with data from 1,602 IPFs in 2018 and the COVID-19 Community Vulnerability Index. RESULTS One-quarter of IPFs were in counties with high or very high COVID-19 vulnerability. On average, 84% of patients at IPFs were screened for influenza immunization status and were offered an immunization if indicated. Only 57% of patients had their records transmitted to another provider within 24 hours of discharge, and 50% had a follow-up visit with a mental health provider within 30 days. Scores on attainment of follow-up care were worse in counties with higher COVID-19 vulnerability. CONCLUSIONS IPFs may be well positioned to offer COVID-19 vaccinations but will need new processes and improved rates of follow-up care to ensure that patients receive the second dose.
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Varshney P, Mamtani H, Kumar CN, Chandra PS. COVID-19 Vaccination for Persons With Severe Mental Illnesses: An Indian Perspective. Indian J Psychol Med 2021; 43:436-441. [PMID: 34584310 PMCID: PMC8450732 DOI: 10.1177/02537176211033933] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Prateek Varshney
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Harkishan Mamtani
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | | | - Prabha S Chandra
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
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36
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Usher K. Ensuring COVID-19 vaccine uptake by people with severe mental illness: A mental health nursing priority. Int J Ment Health Nurs 2021; 30:819-820. [PMID: 34142420 PMCID: PMC8447367 DOI: 10.1111/inm.12879] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Kim Usher
- School of Health, University of New England, Armidale, New South Wales, Australia
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37
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Tzur Bitan D. Patients with schizophrenia are under-vaccinated for COVID-19: a report from Israel. World Psychiatry 2021; 20:300-301. [PMID: 34002527 PMCID: PMC8129849 DOI: 10.1002/wps.20874] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Affiliation(s)
- Dana Tzur Bitan
- Department of Behavioral Sciences, Ariel University, Ariel, Israel
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38
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Warren N, Kisely S, Siskind D. Maximizing the Uptake of a COVID-19 Vaccine in People With Severe Mental Illness: A Public Health Priority. JAMA Psychiatry 2021; 78:589-590. [PMID: 33320243 DOI: 10.1001/jamapsychiatry.2020.4396] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- Nicola Warren
- School of Medicine, University of Queensland, Brisbane, Queensland, Australia.,Metro South Addiction and Mental Health, Brisbane, Queensland, Australia
| | - Steve Kisely
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Dan Siskind
- School of Medicine, University of Queensland, Brisbane, Queensland, Australia.,Metro South Addiction and Mental Health, Brisbane, Queensland, Australia
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39
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Usher K. Editorial: Ensuring COVID-19 vaccine uptake by people with severe mental illness: a mental health nursing priority. Int J Ment Health Nurs 2021; 30:587-589. [PMID: 33960098 PMCID: PMC8206829 DOI: 10.1111/inm.12880] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Kim Usher
- School of Health, University of New England, Armidale, New South Wales, Australia
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40
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De Picker LJ, Yolken R, Benedetti F, Borsini A, Branchi I, Fusar-Poli P, Carlos Leza J, Pariante C, Pollak T, Tamouza R, Vai B, Vernon AC, Benros ME, Leboyer M. Viewpoint | European COVID-19 exit strategy for people with severe mental disorders: Too little, but not yet too late. Brain Behav Immun 2021; 94:15-17. [PMID: 33493625 PMCID: PMC9761870 DOI: 10.1016/j.bbi.2021.01.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 01/11/2021] [Indexed: 10/22/2022] Open
Affiliation(s)
- Livia J. De Picker
- University Psychiatric Hospital Campus Duffel, Duffel, Belgium,Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, Antwerp, Belgium,Corresponding author at: Wetenschappelijk Onderzoek t.a.v. Livia De Picker, UPC Duffel, Stationsstraat 22c, 2570 Duffel Belgium
| | - Robert Yolken
- The Stanley Neurovirology Laboratory, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA.
| | - Francesco Benedetti
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milano, Italy; Vita-Salute San Raffaele University, Milano, Italy.
| | - Alessandra Borsini
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom.
| | - Igor Branchi
- Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy.
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
| | - Juan Carlos Leza
- Department of Pharmacology & Toxicology, Faculty of Medicine, Universidad Complutense Madrid, CIBERSAM, Imas12, IUINQ, Madrid, Spain.
| | - Carmine Pariante
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom.
| | - Thomas Pollak
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom.
| | - Ryad Tamouza
- Translational Neuropsychiatry Lab, Université Paris Est Creteil (UPEC), INSERM U955, IMRB, F-94010 Creteil, France; Département Medico-Universitaire de Psychiatrie et d'Addictologie (DMU ADAPT), AP-HP, Hopital Henri Mondor, F-94010 Creteil, France; Fondation FondaMental, Creteil, France.
| | - Benedetta Vai
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milano, Italy; Fondazione Centro San Raffaele, Italy.
| | - Anthony C. Vernon
- MRC Centre for Neurodevelopmental Disorders, Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Michael E. Benros
- Copenhagen Research Centre for Mental Health, Copenhagen University Hospital, Denmark,Department of Immunology & Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Marion Leboyer
- Translational Neuropsychiatry Lab, Université Paris Est Creteil (UPEC), INSERM U955, IMRB, F-94010 Creteil, France; Département Medico-Universitaire de Psychiatrie et d'Addictologie (DMU ADAPT), AP-HP, Hopital Henri Mondor, F-94010 Creteil, France; Fondation FondaMental, Creteil, France.
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41
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Mazereel V, Van Assche K, Detraux J, De Hert M. COVID-19 vaccination for people with severe mental illness: why, what, and how? Lancet Psychiatry 2021; 8:444-450. [PMID: 33548184 PMCID: PMC7906686 DOI: 10.1016/s2215-0366(20)30564-2] [Citation(s) in RCA: 91] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/09/2020] [Accepted: 12/10/2020] [Indexed: 12/13/2022]
Abstract
Psychiatric disorders, and especially severe mental illness, are associated with an increased risk of severe acute respiratory syndrome coronavirus 2 infection and COVID-19-related morbidity and mortality. People with severe mental illness should therefore be prioritised in vaccine allocation strategies. Here, we discuss the risk for worse COVID-19 outcomes in this vulnerable group, the effect of severe mental illness and psychotropic medications on vaccination response, the attitudes of people with severe mental illness towards vaccination, and, the potential barriers to, and possible solutions for, an efficient vaccination programme in this population.
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Affiliation(s)
- Victor Mazereel
- Center for Clinical Psychiatry, KU Leuven, Leuven, Belgium; Department of Neurosciences, and University Psychiatric Center, KU Leuven, Leuven, Belgium
| | - Kristof Van Assche
- Research Group Personal Rights and Property Rights, Faculty of Law, University of Antwerp, Antwerp, Belgium
| | - Johan Detraux
- Public Health Psychiatry, KU Leuven, Leuven, Belgium; Department of Neurosciences, and University Psychiatric Center, KU Leuven, Leuven, Belgium
| | - Marc De Hert
- Center for Clinical Psychiatry, KU Leuven, Leuven, Belgium; Department of Neurosciences, and University Psychiatric Center, KU Leuven, Leuven, Belgium; Antwerp Health Law and Ethics Chair, University of Antwerp, Antwerp, Belgium.
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42
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Batty GD, Deary IJ, Altschul D. Pre-pandemic mental and physical health as predictors of COVID-19 vaccine hesitancy: evidence from a UK-wide cohort study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.04.27.21256185. [PMID: 34013297 PMCID: PMC8132272 DOI: 10.1101/2021.04.27.21256185] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
IMPORTANCE Although several predictors of COVID-19 vaccine hesitancy have been identified, the role of physical health has not been well-examined, and the association with mental health is unknown. OBJECTIVE To examine the association of pre-pandemic mental health, physical health, and shielding with vaccine hesitancy after the announcement of the successful testing of the Oxford University/AstraZeneca vaccine. DESIGN SETTING AND PARTICIPANTS We used individual-level data from a pandemic-focused investigation (COVID Survey), a prospective cohort study nested within the UK Understanding Society (Main Survey) project. In the week immediately following the announcement of successful testing of the first efficacious inoculation (November/December 2020), data on vaccine intentionality were collected in 12,035 individuals aged 16-95 years. Pre-pandemic, study members had responded to enquiries about diagnoses of mental and physical health, completed the 12-item General Health Questionnaire for symptoms of psychological distress (anxiety and depression), and indicated whether they or someone in their household was shielding. MAIN OUTCOME MEASURES Self-reported intention to take up a vaccination for COVID-19. To summarise our results, we computed odds ratios with accompanying 95% confidence intervals for indices of health and shielding adjusted for selected covariates. RESULTS In an analytical sample of 11,955 people (6741 women), 15.4% indicated that they were vaccine hesitant. Relative to their disease-free counterparts, shielding was associated with a 24% lower risk of being hesitant (odds ratio; 95% confidence interval: 0.76; 0.59, 0.96), after adjustment for a range of covariates which included age, education, and ethnicity. Corresponding results for cardiometabolic disease were 22% (0.78; 0.64, 0.95), and for respiratory disease were 26% (0.74; 0.59, 0.93). Having a pre-pandemic diagnosis of anxiety or depression, or a high score on the distress symptom scale, were all unrelated to the willingness to take up a vaccine. CONCLUSIONS AND RELEVANCE People who have been prioritised for COVID-19 vaccination owing to a physical condition are more likely to take it up. These effects were not apparent for indices of mental health.
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Affiliation(s)
- G David Batty
- Department of Epidemiology and Public Health, University College London, UK
| | - Ian J Deary
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, UK
| | - Drew Altschul
- Department of Psychology, University of Edinburgh, UK
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43
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Mellis AM, Kelly BC, Potenza MN, Hulsey JN. Trust in a COVID-19 vaccine among people with substance use disorders. Drug Alcohol Depend 2021; 220:108519. [PMID: 33461150 PMCID: PMC7797771 DOI: 10.1016/j.drugalcdep.2021.108519] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 12/21/2020] [Accepted: 12/23/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Alexandra M Mellis
- Neuroscience Institute, New York University Grossman School of Medicine, New York, NY, USA
| | | | - Marc N Potenza
- Departments of Psychiatry and Neuroscience and Child Study Center, Yale University School of Medicine, New Haven, CT, USA; Connecticut Council on Problem Gambling, Wethersfield, CT, USA; Connecticut Mental Health Center, New Haven, CT, USA.
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45
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Elbakary N, Riaz S, Mahran I, Assar A, Abdallah O, Abukuhail R, AlKhuzaei N, Eltorki Y. Using a quality improvement project to enhance the standard vaccination rate for long-term patients in mental health services in Qatar. HEART AND MIND 2021. [DOI: 10.4103/hm.hm_47_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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46
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Goldman ML, Druss BG, Horvitz-Lennon M, Norquist GS, Kroeger Ptakowski K, Brinkley A, Greiner M, Hayes H, Hepburn B, Jorgensen S, Swartz MS, Dixon LB. Mental Health Policy in the Era of COVID-19. Psychiatr Serv 2020; 71:1158-1162. [PMID: 32517639 DOI: 10.1176/appi.ps.202000219] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The response to the global COVID-19 pandemic has important ramifications for mental health systems and the patients they serve. This article describes significant changes in mental health policy prompted by the COVID-19 crisis across five major areas: legislation, regulation, financing, accountability, and workforce development. Special considerations for mental health policy are discussed, including social determinants of health, innovative technologies, and research and evaluation. These extraordinary advances provide an unprecedented opportunity to evaluate the effects of mental health policies that may be adopted in the post-COVID-19 era in the United States.
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Affiliation(s)
- Matthew L Goldman
- Department of Psychiatry, University of California, San Francisco, San Francisco (Goldman); Rollins School of Public Health (Druss) and Department of Psychiatry and Behavioral Sciences (Norquist), Emory University, Atlanta; RAND Corporation, Boston, and Health Equity Research Lab, Cambridge Health Alliance and Harvard Medical School, Cambridge, Massachusetts (Horvitz-Lennon); Department of Policies, Programs, and Partnerships, American Psychiatric Association, Washington, D.C. (Kroeger Ptakowski); Indiana Department of Mental Health and Addiction, Indianapolis (Brinkley); Department of Psychiatry, Weill Cornell Medical Center, New York (Greiner); Oklahoma Department of Mental Health and Substance Abuse Services, Oklahoma City (Hayes); National Association of State Mental Health Program Directors, Alexandria, Virginia (Hepburn); Department of Psychiatry, University of Iowa Hospitals and Clinics, Iowa City (Jorgensen); Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina (Swartz); Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York (Dixon)
| | - Benjamin G Druss
- Department of Psychiatry, University of California, San Francisco, San Francisco (Goldman); Rollins School of Public Health (Druss) and Department of Psychiatry and Behavioral Sciences (Norquist), Emory University, Atlanta; RAND Corporation, Boston, and Health Equity Research Lab, Cambridge Health Alliance and Harvard Medical School, Cambridge, Massachusetts (Horvitz-Lennon); Department of Policies, Programs, and Partnerships, American Psychiatric Association, Washington, D.C. (Kroeger Ptakowski); Indiana Department of Mental Health and Addiction, Indianapolis (Brinkley); Department of Psychiatry, Weill Cornell Medical Center, New York (Greiner); Oklahoma Department of Mental Health and Substance Abuse Services, Oklahoma City (Hayes); National Association of State Mental Health Program Directors, Alexandria, Virginia (Hepburn); Department of Psychiatry, University of Iowa Hospitals and Clinics, Iowa City (Jorgensen); Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina (Swartz); Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York (Dixon)
| | - Marcela Horvitz-Lennon
- Department of Psychiatry, University of California, San Francisco, San Francisco (Goldman); Rollins School of Public Health (Druss) and Department of Psychiatry and Behavioral Sciences (Norquist), Emory University, Atlanta; RAND Corporation, Boston, and Health Equity Research Lab, Cambridge Health Alliance and Harvard Medical School, Cambridge, Massachusetts (Horvitz-Lennon); Department of Policies, Programs, and Partnerships, American Psychiatric Association, Washington, D.C. (Kroeger Ptakowski); Indiana Department of Mental Health and Addiction, Indianapolis (Brinkley); Department of Psychiatry, Weill Cornell Medical Center, New York (Greiner); Oklahoma Department of Mental Health and Substance Abuse Services, Oklahoma City (Hayes); National Association of State Mental Health Program Directors, Alexandria, Virginia (Hepburn); Department of Psychiatry, University of Iowa Hospitals and Clinics, Iowa City (Jorgensen); Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina (Swartz); Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York (Dixon)
| | - Grayson S Norquist
- Department of Psychiatry, University of California, San Francisco, San Francisco (Goldman); Rollins School of Public Health (Druss) and Department of Psychiatry and Behavioral Sciences (Norquist), Emory University, Atlanta; RAND Corporation, Boston, and Health Equity Research Lab, Cambridge Health Alliance and Harvard Medical School, Cambridge, Massachusetts (Horvitz-Lennon); Department of Policies, Programs, and Partnerships, American Psychiatric Association, Washington, D.C. (Kroeger Ptakowski); Indiana Department of Mental Health and Addiction, Indianapolis (Brinkley); Department of Psychiatry, Weill Cornell Medical Center, New York (Greiner); Oklahoma Department of Mental Health and Substance Abuse Services, Oklahoma City (Hayes); National Association of State Mental Health Program Directors, Alexandria, Virginia (Hepburn); Department of Psychiatry, University of Iowa Hospitals and Clinics, Iowa City (Jorgensen); Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina (Swartz); Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York (Dixon)
| | - Kristin Kroeger Ptakowski
- Department of Psychiatry, University of California, San Francisco, San Francisco (Goldman); Rollins School of Public Health (Druss) and Department of Psychiatry and Behavioral Sciences (Norquist), Emory University, Atlanta; RAND Corporation, Boston, and Health Equity Research Lab, Cambridge Health Alliance and Harvard Medical School, Cambridge, Massachusetts (Horvitz-Lennon); Department of Policies, Programs, and Partnerships, American Psychiatric Association, Washington, D.C. (Kroeger Ptakowski); Indiana Department of Mental Health and Addiction, Indianapolis (Brinkley); Department of Psychiatry, Weill Cornell Medical Center, New York (Greiner); Oklahoma Department of Mental Health and Substance Abuse Services, Oklahoma City (Hayes); National Association of State Mental Health Program Directors, Alexandria, Virginia (Hepburn); Department of Psychiatry, University of Iowa Hospitals and Clinics, Iowa City (Jorgensen); Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina (Swartz); Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York (Dixon)
| | - Amy Brinkley
- Department of Psychiatry, University of California, San Francisco, San Francisco (Goldman); Rollins School of Public Health (Druss) and Department of Psychiatry and Behavioral Sciences (Norquist), Emory University, Atlanta; RAND Corporation, Boston, and Health Equity Research Lab, Cambridge Health Alliance and Harvard Medical School, Cambridge, Massachusetts (Horvitz-Lennon); Department of Policies, Programs, and Partnerships, American Psychiatric Association, Washington, D.C. (Kroeger Ptakowski); Indiana Department of Mental Health and Addiction, Indianapolis (Brinkley); Department of Psychiatry, Weill Cornell Medical Center, New York (Greiner); Oklahoma Department of Mental Health and Substance Abuse Services, Oklahoma City (Hayes); National Association of State Mental Health Program Directors, Alexandria, Virginia (Hepburn); Department of Psychiatry, University of Iowa Hospitals and Clinics, Iowa City (Jorgensen); Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina (Swartz); Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York (Dixon)
| | - Miranda Greiner
- Department of Psychiatry, University of California, San Francisco, San Francisco (Goldman); Rollins School of Public Health (Druss) and Department of Psychiatry and Behavioral Sciences (Norquist), Emory University, Atlanta; RAND Corporation, Boston, and Health Equity Research Lab, Cambridge Health Alliance and Harvard Medical School, Cambridge, Massachusetts (Horvitz-Lennon); Department of Policies, Programs, and Partnerships, American Psychiatric Association, Washington, D.C. (Kroeger Ptakowski); Indiana Department of Mental Health and Addiction, Indianapolis (Brinkley); Department of Psychiatry, Weill Cornell Medical Center, New York (Greiner); Oklahoma Department of Mental Health and Substance Abuse Services, Oklahoma City (Hayes); National Association of State Mental Health Program Directors, Alexandria, Virginia (Hepburn); Department of Psychiatry, University of Iowa Hospitals and Clinics, Iowa City (Jorgensen); Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina (Swartz); Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York (Dixon)
| | - Heath Hayes
- Department of Psychiatry, University of California, San Francisco, San Francisco (Goldman); Rollins School of Public Health (Druss) and Department of Psychiatry and Behavioral Sciences (Norquist), Emory University, Atlanta; RAND Corporation, Boston, and Health Equity Research Lab, Cambridge Health Alliance and Harvard Medical School, Cambridge, Massachusetts (Horvitz-Lennon); Department of Policies, Programs, and Partnerships, American Psychiatric Association, Washington, D.C. (Kroeger Ptakowski); Indiana Department of Mental Health and Addiction, Indianapolis (Brinkley); Department of Psychiatry, Weill Cornell Medical Center, New York (Greiner); Oklahoma Department of Mental Health and Substance Abuse Services, Oklahoma City (Hayes); National Association of State Mental Health Program Directors, Alexandria, Virginia (Hepburn); Department of Psychiatry, University of Iowa Hospitals and Clinics, Iowa City (Jorgensen); Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina (Swartz); Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York (Dixon)
| | - Brian Hepburn
- Department of Psychiatry, University of California, San Francisco, San Francisco (Goldman); Rollins School of Public Health (Druss) and Department of Psychiatry and Behavioral Sciences (Norquist), Emory University, Atlanta; RAND Corporation, Boston, and Health Equity Research Lab, Cambridge Health Alliance and Harvard Medical School, Cambridge, Massachusetts (Horvitz-Lennon); Department of Policies, Programs, and Partnerships, American Psychiatric Association, Washington, D.C. (Kroeger Ptakowski); Indiana Department of Mental Health and Addiction, Indianapolis (Brinkley); Department of Psychiatry, Weill Cornell Medical Center, New York (Greiner); Oklahoma Department of Mental Health and Substance Abuse Services, Oklahoma City (Hayes); National Association of State Mental Health Program Directors, Alexandria, Virginia (Hepburn); Department of Psychiatry, University of Iowa Hospitals and Clinics, Iowa City (Jorgensen); Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina (Swartz); Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York (Dixon)
| | - Shea Jorgensen
- Department of Psychiatry, University of California, San Francisco, San Francisco (Goldman); Rollins School of Public Health (Druss) and Department of Psychiatry and Behavioral Sciences (Norquist), Emory University, Atlanta; RAND Corporation, Boston, and Health Equity Research Lab, Cambridge Health Alliance and Harvard Medical School, Cambridge, Massachusetts (Horvitz-Lennon); Department of Policies, Programs, and Partnerships, American Psychiatric Association, Washington, D.C. (Kroeger Ptakowski); Indiana Department of Mental Health and Addiction, Indianapolis (Brinkley); Department of Psychiatry, Weill Cornell Medical Center, New York (Greiner); Oklahoma Department of Mental Health and Substance Abuse Services, Oklahoma City (Hayes); National Association of State Mental Health Program Directors, Alexandria, Virginia (Hepburn); Department of Psychiatry, University of Iowa Hospitals and Clinics, Iowa City (Jorgensen); Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina (Swartz); Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York (Dixon)
| | - Marvin S Swartz
- Department of Psychiatry, University of California, San Francisco, San Francisco (Goldman); Rollins School of Public Health (Druss) and Department of Psychiatry and Behavioral Sciences (Norquist), Emory University, Atlanta; RAND Corporation, Boston, and Health Equity Research Lab, Cambridge Health Alliance and Harvard Medical School, Cambridge, Massachusetts (Horvitz-Lennon); Department of Policies, Programs, and Partnerships, American Psychiatric Association, Washington, D.C. (Kroeger Ptakowski); Indiana Department of Mental Health and Addiction, Indianapolis (Brinkley); Department of Psychiatry, Weill Cornell Medical Center, New York (Greiner); Oklahoma Department of Mental Health and Substance Abuse Services, Oklahoma City (Hayes); National Association of State Mental Health Program Directors, Alexandria, Virginia (Hepburn); Department of Psychiatry, University of Iowa Hospitals and Clinics, Iowa City (Jorgensen); Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina (Swartz); Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York (Dixon)
| | - Lisa B Dixon
- Department of Psychiatry, University of California, San Francisco, San Francisco (Goldman); Rollins School of Public Health (Druss) and Department of Psychiatry and Behavioral Sciences (Norquist), Emory University, Atlanta; RAND Corporation, Boston, and Health Equity Research Lab, Cambridge Health Alliance and Harvard Medical School, Cambridge, Massachusetts (Horvitz-Lennon); Department of Policies, Programs, and Partnerships, American Psychiatric Association, Washington, D.C. (Kroeger Ptakowski); Indiana Department of Mental Health and Addiction, Indianapolis (Brinkley); Department of Psychiatry, Weill Cornell Medical Center, New York (Greiner); Oklahoma Department of Mental Health and Substance Abuse Services, Oklahoma City (Hayes); National Association of State Mental Health Program Directors, Alexandria, Virginia (Hepburn); Department of Psychiatry, University of Iowa Hospitals and Clinics, Iowa City (Jorgensen); Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina (Swartz); Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York (Dixon)
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