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Martínez P, Huynh C, Massamba V, Zefania I, Rochette L, Vasiliadis HM, Nazif-Munoz JI. Changes in the incidence of cannabis-related disorders after the Cannabis Act and the COVID-19 pandemic in Québec, Canada. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 129:104484. [PMID: 38870546 DOI: 10.1016/j.drugpo.2024.104484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 05/17/2024] [Accepted: 06/02/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND The Canadian Cannabis Act (CCA, implemented in October 2018) and the COVID-19 pandemic (April 2020) might have contributed to cannabis-related harms in Québec, known for its stringent cannabis legal framework. We explored changes in incidence rates of cannabis-related disorders (CRD) diagnoses associated with these events in Québec. METHODS We utilized linked administrative health data to identify individuals aged 15 year+ newly diagnosed with CRD during hospitalizations, emergency, and outpatients clinics across Québec, from January 2010 and March 2022 (147 months). Interrupted time-series analyses (ITSA) assessed differences (as percentage changes) in sex- and age-standardized, and sex-stratified, monthly incidence rates (per 100,000 population) attributed to the CCA and the COVID-19 pandemic, compared to counterfactual scenarios where pre-events trends would continue unchanged. RESULTS The overall monthly mean rates of incident diagnoses nearly doubled from the pre-CCA period (1.56 per 100,000 population) to the COVID-19 pandemic period (3.02 per 100,000 population). ITSA revealed no statistically significant level or slope changes between adjacent study periods, except for a decrease in the slope of incidence rates among males by 1.84 % (95 % CI -3.41 to -0.24) during the COVID-19 pandemic compared to the post-CCA period. During the post-CCA period, the trends of incidence rates in the general and male populations grew significantly by 1.22 % (95 % CI 0.08 to 2.35) and 1.44 % (0.04 to 2.84) per month, respectively. Similarly significant increases were observed for the general and female populations during the COVID-19 pandemic, with monthly rates rising by 1.43 % (95 % CI 0.75 to 2.12) and 1.75 % (95 % CI 0.13 to 3.37), respectively. These increases more than doubled pre-CCA rates. CONCLUSIONS The incidence rates of CRD diagnoses across Québec appears to have increased following the implementation of the CCA and during the COVID-19 pandemic. Our findings echo public health concerns regarding potential cannabis-related harms and are consistent with previous Canadian studies.
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Affiliation(s)
- Pablo Martínez
- Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke - Campus Longueuil, 150 Pl. Charles-Le Moyne, Longueuil, QC J4K 0A8, Canada; Centre de Recherche Charles-Le Moyne, 150 Pl. Charles-Le Moyne, Longueuil, QC J4K A08, Canada; Douglas Research Centre, McGill University, 6875 Bd LaSalle, Verdun, QC H4H 1R3, Canada; Institut National de Santé Publique du Québec, 945 Wolfe Av., Québec, QC G1V 5B3, Canada
| | - Chris Huynh
- Institut Universitaire sur les Dépendances, Centre Intégré Universitaire de Santé et des Services Sociaux du Centre-Sud-de-l'Île-de-Montréal, 950 rue Louvain Est, Montréal, QC H2M 2E8, Canada
| | - Victoria Massamba
- Institut National de Santé Publique du Québec, 945 Wolfe Av., Québec, QC G1V 5B3, Canada
| | - Isaora Zefania
- Institut National de Santé Publique du Québec, 945 Wolfe Av., Québec, QC G1V 5B3, Canada
| | - Louis Rochette
- Institut National de Santé Publique du Québec, 945 Wolfe Av., Québec, QC G1V 5B3, Canada
| | - Helen-Maria Vasiliadis
- Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke - Campus Longueuil, 150 Pl. Charles-Le Moyne, Longueuil, QC J4K 0A8, Canada; Centre de Recherche Charles-Le Moyne, 150 Pl. Charles-Le Moyne, Longueuil, QC J4K A08, Canada
| | - José Ignacio Nazif-Munoz
- Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke - Campus Longueuil, 150 Pl. Charles-Le Moyne, Longueuil, QC J4K 0A8, Canada; Centre de Recherche Charles-Le Moyne, 150 Pl. Charles-Le Moyne, Longueuil, QC J4K A08, Canada; Institut Universitaire sur les Dépendances, Centre Intégré Universitaire de Santé et des Services Sociaux du Centre-Sud-de-l'Île-de-Montréal, 950 rue Louvain Est, Montréal, QC H2M 2E8, Canada.
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Yang L, Tibbo PG, Stewart SH, Simon P, Bullerwell M, Wang J. A cross-sectional study of the relationship between frequency of cannabis use and psychiatric symptoms among people seeking mental health and addiction services in Nova Scotia (2019-21). J Psychiatr Res 2024; 173:104-110. [PMID: 38518571 DOI: 10.1016/j.jpsychires.2024.03.018] [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: 11/22/2023] [Revised: 02/13/2024] [Accepted: 03/15/2024] [Indexed: 03/24/2024]
Abstract
BACKGROUND Cannabis use may be a modifiable risk factor for mental health problems; however, the role of cannabis use frequency in population seeking mental health and addiction services remains unclear. This study aimed to: 1) compare the prevalence and functional impact of psychiatric symptoms among frequent, infrequent, and non-users of cannabis; and 2) evaluate the associations between cannabis use frequency and functional impact of psychiatric symptoms in help-seeking individuals. METHODS Data from the Mental Health and Addictions (MHA) Central Intake system in Nova Scotia, Canada was used. Participants aged 19-64 who received MHA Intake assessments from September 2019 to December 2021 with complete information about substance use were included (N = 20,611). Cannabis use frequency over past 30 days was categorized into frequent (>4 times a month), infrequent (≤4 times a month), and non-use. Psychiatric symptomatology consists of five domains: mood, anxiety, psychosis, cognition, and externalizing behaviors. Multivariate ordinal logistic regression was used to examine the associations between cannabis use frequency and functional impact of psychiatric symptoms. RESULTS Frequent and infrequent cannabis users had a higher prevalence of psychiatric symptoms in each domain than non-users, while no significant differences were found between frequent and infrequent users. Frequent cannabis use was associated with greater functional impact of psychiatric symptoms in each domain compared to non-users, while infrequent use was only associated with greater functional impact of externalizing behaviors. CONCLUSION Frequent cannabis use is associated with increased prevalence and functional impact of psychiatric symptoms among adults seeking mental health services.
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Affiliation(s)
- Lu Yang
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Canada
| | - Philip G Tibbo
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Canada; Early Psychosis Intervention Nova Scotia, Nova Scotia Health, Canada
| | - Sherry H Stewart
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Canada; Department of Psychiatry, Faculty of Medicine, Dalhousie University, Canada; Department of Psychology and Neuroscience, Faculty of Science, Dalhousie University, Canada
| | - Patryk Simon
- Mental Health and Addiction Program, Nova Scotia Health, Canada
| | | | - JianLi Wang
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Canada; Department of Psychiatry, Faculty of Medicine, Dalhousie University, Canada.
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Bansal S, Garg N, Singh J, Van Der Walt F. Cyberbullying and mental health: past, present and future. Front Psychol 2024; 14:1279234. [PMID: 38288359 PMCID: PMC10823540 DOI: 10.3389/fpsyg.2023.1279234] [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: 09/25/2023] [Accepted: 12/27/2023] [Indexed: 01/31/2024] Open
Abstract
Purpose Cyberbullying has attracted the world's attention, and therefore researchers across the world have contributed to the literature on cyberbullying and mental health. Amongst others, they have conducted bibliometric analyses and associated cyberbullying with various factors but have not determined the impact of cyberbullying on people's mental health. Hence, the aim of this study was to conduct bibliometric analyses of cyberbullying and mental health to analyze the academic performance of the literature on impact of cyberbullying on people's mental health; and to propose future research avenues to make further contributions to this field of study. Methodology Spreadsheets and VOSviewer were used to conduct the bibliometric analysis. The data were extracted from the SCOPUS database which provided an extensive collection of data and journals. Findings Having explored the top active countries publishing on the impact of cyberbullying on people's mental health and the academic performance of such research articles by means of a qualitative bibliometric analysis, the results revealed that this research topic is still to be researched extensively. The study also suggests countries/regions where this research topic can be explored further, as well as possible journals for publication of research results, and further studies to be conducted. Discussion The literature presents a fragmented view on the impact of cyberbullying on people's mental health. Studies on cyberbullying are limited for the reasons as discussed in this article. Hence, bibliometric analysis was conducted to analyze the performance of academic literature on the impact of cyberbullying on people's mental health; the academic performance of research articles on cyberbullying and mental health; and to make proposals toward a future research agenda.
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Affiliation(s)
- Suhans Bansal
- University School of Management and Entrepreneurship (USME), Delhi Technological University, New Delhi, India
| | - Naval Garg
- University School of Management and Entrepreneurship (USME), Delhi Technological University, New Delhi, India
| | - Jagvinder Singh
- Department of Operational Research, University of Delhi, New Delhi, India
| | - Freda Van Der Walt
- Faculty of Management Sciences, Department of Business Management, Central University of Technology, Bloemfontein, South Africa
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Mehra K, Rup J, Wiese JL, Watson TM, Bonato S, Rueda S. Changes in self-reported cannabis use during the COVID-19 pandemic: a scoping review. BMC Public Health 2023; 23:2139. [PMID: 37915021 PMCID: PMC10621278 DOI: 10.1186/s12889-023-17068-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 10/26/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic is affecting mental health and substance use (MHSU) issues worldwide. The purpose of this study was to characterize the literature on changes in cannabis use during the pandemic and the factors associated with such changes. METHODS We conducted a scoping review by searching peer-reviewed databases and grey literature from January 2020 to May 2022 using the Arksey and O'Malley Framework. Two independent reviewers screened a total of 4235 documents. We extracted data from 129 documents onto a data extraction form and collated results using content analytical techniques. RESULTS Nearly half (48%) of the studies reported an increase/initiation of cannabis use, while 36% studies reported no change, and 16% reported a decrease/cessation of cannabis use during the pandemic. Factors associated with increased cannabis use included socio-demographic factors (e.g., younger age), health related factors (e.g., increased symptom burden), MHSU factors (e.g., anxiety, depression), pandemic-specific reactions (e.g., stress, boredom, social isolation), cannabis-related factors (e.g., dependence), and policy-related factors (e.g., legalization of medical/recreational cannabis). CONCLUSION Public health emergencies like the COVID-19 pandemic have the potential to significantly impact cannabis use. The pandemic has placed urgency on improving coping mechanisms and supports that help populations adapt to major and sudden life changes. To better prepare health care systems for future pandemics, wide-reaching education on how pandemic-related change impacts cannabis use is needed.
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Affiliation(s)
- Kamna Mehra
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College Street, Toronto, ON, M5T 1R8, Canada
| | - Jennifer Rup
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College Street, Toronto, ON, M5T 1R8, Canada
| | - Jessica L Wiese
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College Street, Toronto, ON, M5T 1R8, Canada
| | - Tara Marie Watson
- Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1V7, Canada
| | - Sarah Bonato
- Library Services, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada
| | - Sergio Rueda
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada.
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College Street, Toronto, ON, M5T 1R8, Canada.
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, 250 College Street, Toronto, ON, M5T 1R8, Canada.
- Institute of Health Policy, Management and Evaluation, Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A1, Canada.
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Vartanian K, Fish D, Kenton N, Gronowski B, Wright B, Robicsek A. Integrating patient-reported physical, mental, and social impacts to classify long COVID experiences. Sci Rep 2023; 13:16288. [PMID: 37770554 PMCID: PMC10539528 DOI: 10.1038/s41598-023-43615-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 09/26/2023] [Indexed: 09/30/2023] Open
Abstract
Long COVID was originally identified through patient-reported experiences of prolonged symptoms. Many studies have begun to describe long COVID; however, this work typically focuses on medical records, instead of patient experiences, and lacks a comprehensive view of physical, mental, and social impacts. As part of our larger My COVID Diary (MCD) study, we captured patient experiences using a prospective and longitudinal patient-reported outcomes survey (PROMIS-10) and free-text narrative submissions. From this study population, we selected individuals who were still engaged in the MCD study and reporting poor health (PROMIS-10 scores < 3) at 6 months (n = 634). We used their PROMIS-10 and narrative data to describe and classify their long COVID experiences. Using Latent Class Analysis of the PROMIS-10 data, we identified four classifications of long COVID experiences: a few lingering issues (n = 107), significant physical symptoms (n = 113), ongoing mental and cognitive struggles (n = 235), and numerous compounding challenges (n = 179); each classification included a mix of physical, mental, and social health struggles with varying levels of impairment. The classifications were reinforced and further explained by patient narratives. These results provide a new understanding of the varying ways that long COVID presents to help identify and care for patients.
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Affiliation(s)
- Keri Vartanian
- Center for Outcomes Research and Education (CORE), Providence St. Joseph Health, 5251 NE Glisan Street, Portland, OR, USA
| | - Daniel Fish
- Center for Outcomes Research and Education (CORE), Providence St. Joseph Health, 5251 NE Glisan Street, Portland, OR, USA
| | - Natalie Kenton
- Center for Outcomes Research and Education (CORE), Providence St. Joseph Health, 5251 NE Glisan Street, Portland, OR, USA
| | - Benjamin Gronowski
- Center for Outcomes Research and Education (CORE), Providence St. Joseph Health, 5251 NE Glisan Street, Portland, OR, USA.
| | - Bill Wright
- Providence Research Network, 1801 Lind Ave SW, Renton, WA, USA
| | - Ari Robicsek
- Providence Research Network, 1801 Lind Ave SW, Renton, WA, USA
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Hellwig S, Domschke K. [Anxiety and substance abuse disorders-Focus on alcohol and cannabis]. DER NERVENARZT 2023:10.1007/s00115-023-01502-7. [PMID: 37341771 DOI: 10.1007/s00115-023-01502-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 05/03/2023] [Indexed: 06/22/2023]
Abstract
Anxiety disorders are frequent, with a 12-month prevalence of 14%, tend to be chronic, and display a high comorbidity with substance abuse disorders. Anxiety and substance abuse disorders are associated with a pronounced individual as well as socioeconomic burden. This article reviews the epidemiological, etiological, and clinical aspects of the dual diagnosis of anxiety and substance abuse disorders, with a particular focus on alcohol and cannabis. The treatment comprises nonpharmacological strategies, mainly cognitive behavioral therapy combined with elements of motivational interviewing (MI) and pharmacological management with antidepressants; however, the use of selective serotonin reuptake inhibitors (SSRI)/serotonin and noradrenaline reuptake inhibitors (SNRI) is not unreservedly recommended. The use of gabapentinoids requires careful risk-benefit consideration because of their potential for abuse and dependence in substance abuse disorders. Benzodiazepines are reserved exclusively for crisis management. Rapid diagnosis and treatment initiation targeting both disorders are essential for successful treatment of comorbid anxiety and substance abuse disorders.
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Affiliation(s)
- Sabine Hellwig
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Hauptstr. 5, 79104, Freiburg, Deutschland.
| | - Katharina Domschke
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Hauptstr. 5, 79104, Freiburg, Deutschland
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Nogueira-Leite D, Diniz JM, Cruz-Correia R. Mental Health Professionals' Attitudes Toward Digital Mental Health Apps and Implications for Adoption in Portugal: Mixed Methods Study. JMIR Hum Factors 2023; 10:e45949. [PMID: 37266977 DOI: 10.2196/45949] [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: 01/23/2023] [Revised: 03/28/2023] [Accepted: 04/15/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Digital health apps are among the most visible facets of the ongoing digital transition in health care, with mental health-focused apps as one of the main therapeutic areas. However, concerns regarding their scientific robustness drove regulators to establish evaluation procedures, with Germany's Digitale Gesundheitsanwendungen program pioneering in app prescription with costs covered by statutory health insurance. Portugal gathers a set of conditions and requirements that position it as an excellent test bed for digital health apps. Its daunting mental health landscape reinforces the potential interest in new interventions. To understand if they would be acceptable, we need to understand the supply side's attitudes and perceptions toward them, that is, those of psychiatrists and psychologists. OBJECTIVE This study aims to understand the attitudes and expectations of psychiatrists and psychologists toward digital mental health apps (DMHAs) in the Portuguese context, as well as perceived benefits, barriers, and actions to support their adoption. METHODS We conducted a 2-stage sequential mixed methods study. Stage 1 consisted of a cross-sectional web survey adapted to the Portuguese context that was delivered to mental health professionals and psychologists. Stage 2 complemented the insights of the web survey results with a key opinion leader analysis. RESULTS A total of 160 complete survey responses were recorded, most of which were from psychologists. This is the most extensive study on mental health professionals' attitudes and perceptions of DMHAs in Portugal. A total of 87.2% (136/156) of the respondents supported the opportunity to prescribe DMHAs. Increased health literacy (139/160, 86.9%), wider adherence to treatment (137/160, 85.6%), and proper disease management (127/160, 79.4%) were the most frequently agreed upon benefits of DMHAs. However, only less than half (68/156, 43.6%) of the respondents planned to prescribe or recommend DMHAs, with psychologists being more favorable than psychiatrists. Professionals faced substantial barriers, such as a lack of information on DMHAs (154/160, 96.3%), the level of initial training effort (115/160, 71.9%), and the need for adjustments of clinical processes and records (113/160, 70.6%). Professionals reported that having more information on the available apps and their suitability for health objectives (151/160, 94.4%), more scientific evidence of the validity of the apps as a health intervention (147/160, 91.9%), and established recommendations of apps by specific clinical guidelines or professional societies (145/160, 90.6%) would be essential to foster adoption. CONCLUSIONS More information about DMHAs regarding their clinical validity and how they work is necessary so that such an intervention can be adopted in Portugal. Recommendations from professional and scientific societies, as well as from governmental bodies, are strongly encouraged. Although the benefits of and the barriers to using these apps are consensual, more evidence, along with further promotion of mental health professionals' digital literacy, is needed. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/41040.
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Affiliation(s)
- Diogo Nogueira-Leite
- Department of Community Medicine, Information and Decision in Health, Faculty of Medicine, University of Porto, Porto, Portugal
- Nova School of Business and Economics Health Economics and Management Knowledge Center, New University of Lisbon, Lisbon, Portugal
- Programme in Health Data Science, Faculty of Medicine, University of Porto, Porto, Portugal
| | - José Miguel Diniz
- Department of Community Medicine, Information and Decision in Health, Faculty of Medicine, University of Porto, Porto, Portugal
- Nova School of Business and Economics Health Economics and Management Knowledge Center, New University of Lisbon, Lisbon, Portugal
- Programme in Health Data Science, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Ricardo Cruz-Correia
- Department of Community Medicine, Information and Decision in Health, Faculty of Medicine, University of Porto, Porto, Portugal
- Center for Health Technology and Services Research, Porto, Portugal
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Pudpong N, Julchoo S, Sinam P, Uansri S, Kunpeuk W, Suphanchaimat R. Self-Reported Anxiety and Depression among Parents of Primary School Children during the COVID-19 Pandemic in Thailand, 2022. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095622. [PMID: 37174142 PMCID: PMC10178323 DOI: 10.3390/ijerph20095622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 04/06/2023] [Accepted: 04/20/2023] [Indexed: 05/15/2023]
Abstract
One significant concern during the COVID-19 pandemic is parents' mental health, which may consequently affect children's health and well-being. The objective of this study is to investigate generalized anxiety and depression in parents of primary-school-aged children and identify risk factors for mental health problems. A cross-sectional survey comprising 701 parents of primary school children in five of Thailand's major provinces was carried out from January to March 2022. Generalized anxiety and depression levels were assessed using the GAD-7 and PHQ-9. Logistic regression was performed to determine the effects of independent variables on anxiety and depression. Results showed that the prevalence of generalized anxiety and depression was 42.7% and 28.5%, respectively, among Thai parents. Three strong associative factors included: (1) having a youngest child with mental health problems; (2) not assisting their children every day; and (3) drinking alcohol. These findings show that the parents must deal with several difficulties when trying to maintain work and parenting duties while being confined at home during emergency situations. The government should provide sufficient assistance to parents who lack skills in handling children with emotional and behavioral problems. Meanwhile, health promotion to reduce alcohol consumption should continue to be an area of focus.
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Affiliation(s)
- Nareerut Pudpong
- International Health Policy Program, Ministry of Public Health, Nonthaburi 11000, Thailand
| | - Sataporn Julchoo
- International Health Policy Program, Ministry of Public Health, Nonthaburi 11000, Thailand
| | - Pigunkaew Sinam
- International Health Policy Program, Ministry of Public Health, Nonthaburi 11000, Thailand
| | - Sonvanee Uansri
- International Health Policy Program, Ministry of Public Health, Nonthaburi 11000, Thailand
| | - Watinee Kunpeuk
- International Health Policy Program, Ministry of Public Health, Nonthaburi 11000, Thailand
| | - Rapeepong Suphanchaimat
- International Health Policy Program, Ministry of Public Health, Nonthaburi 11000, Thailand
- Division of Epidemiology, Department of Disease Control, Ministry of Public Health, Nonthaburi 11000, Thailand
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Kim S, Rajack N, Mondoux SE, Tardelli VS, Kolla NJ, Le Foll B. The COVID-19 impact and characterization on substance use-related emergency department visits for adolescents and young adults in Canada: Practical implications. J Eval Clin Pract 2023; 29:447-458. [PMID: 36752167 DOI: 10.1111/jep.13817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 01/27/2023] [Accepted: 01/29/2023] [Indexed: 02/09/2023]
Abstract
RATIONALE Coronavirus (COVID-19)-related stressors precipitated the mental health crisis and increased substance use in Canada and worldwide. As the pandemic continues to evolve, monitoring and updating substance use-related ED visit trends is essential to ensure the stability and quality of ED services under the prolonged pandemic timeline. AIMS AND OBJECTIVES This study examined the trends and characterization of substance use-related ED visits during the pandemic among adolescents and young adults (aged 13-25 years) in Ontario, Canada. METHODS Descriptive statistics and binary logistic regression analyses were conducted using population-based, repeated cross-sectional data. The volume, patient characteristics (age and sex) and hospital/ED visit features (triage to end time, timing of the visit, triage level and referral source) were compared before (2019) and during COVID-19 (2020 and 2021) by each substance type (alcohol, opioid, cannabis, sedatives, cocaine, stimulants and multiple psychoactive substances). RESULTS Substance use-related ED visits decreased by 1.5 times during the pandemic compared to the prepandemic level. However, opioid-related ED visits continued to show an increasing trend and did not recover to the prepandemic level in 2021. Moreover, a significant increase in emergent/life-threatening triage levels (Canadian Triage and Acuity Scales 1 and 2) in substance-related ED visits is alarming (2019 = 36.8%, 2020 = 38.7% and 2021 = 38.4%). We also found a general decrease in weekend visits, overnight visits and visits on statutory holidays, and substance use-related ED patients tended to stay longer (over 6 h) in the ED during the pandemic. CONCLUSION Our findings indicate unmet substance use treatment needs due to the limited accessibility and heightened threshold for ED visits during the pandemic. Providing access to substance treatment/programs outside ED is critical to reducing substance use-related complications presenting in the ED. Also, policies addressing the pandemic-related complexities in the ED and Health Human Resource challenges are warranted.
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Affiliation(s)
- Soyeon Kim
- Waypoint Research Institute, Waypoint Centre for Mental Health Care, Penetanguishene, Ontario, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Natalie Rajack
- Waypoint Research Institute, Waypoint Centre for Mental Health Care, Penetanguishene, Ontario, Canada
| | - Shawn E Mondoux
- Emergency Department, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada.,Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Vitor S Tardelli
- Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Nathan J Kolla
- Waypoint Research Institute, Waypoint Centre for Mental Health Care, Penetanguishene, Ontario, Canada.,Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada
| | - Bernard Le Foll
- Waypoint Research Institute, Waypoint Centre for Mental Health Care, Penetanguishene, Ontario, Canada.,Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada
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Kil H, Lacourse E, Mageau GA, Pelletier-Dumas M, Dorfman A, Stolle D, Lina JM, de la Sablonnière R. Initial risk factors, self-compassion trajectories, and well-being outcomes during the COVID-19 pandemic: A person-centered approach. Front Psychol 2023; 13:1016397. [PMID: 36846478 PMCID: PMC9945549 DOI: 10.3389/fpsyg.2022.1016397] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 12/28/2022] [Indexed: 02/11/2023] Open
Abstract
Introduction We investigated whether initial risk classes and heterogeneous trajectories of self-compassion over the course of the pandemic may impact well-being outcomes 1 year into the pandemic. Methods A large, representative sample of Canadians (N = 3,613; 50.6% women) was sampled longitudinally over 11 waves (April 2020-April 2021), using a rolling cross-sectional survey design. Analyses were conducted in three steps: (1) latent class analysis to identify heterogeneity in risk factors (sociodemographic, cognitive-personality, health-related) early in the pandemic, (2) latent class growth analysis (LCGA) to identify longitudinal self-compassion trajectories, and (3) GLM to examine effects of risk factor classes and self-compassion trajectories, as well as their interaction, on later well-being (mental health, perceived control, life satisfaction). Results and Discussion Four risk factor classes emerged, with 50.9% of participants experiencing low risk, 14.3% experiencing multiple risks, 20.8% experiencing Cognitive-Personality and Health risks, and 14.0% experiencing sociodemographic and Cognitive-Personality risks. Four self-compassion trajectories also emerged, with 47.7% of participants experiencing moderate-high self-compassion that decreased then stabilized, 32.0% experiencing moderate self-compassion that decreased then stabilized, 17.3% experiencing high and stable self-compassion across time, and 3.0% experiencing low and decreasing self-compassion. Comparisons of well-being outcomes 1 year post-pandemic indicated that higher levels of self-compassion over time may protect against the impact of initial risk on well-being outcomes. Further work is still needed on heterogeneity in experiences of risk and protective factors during stressful life events.
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Affiliation(s)
- Hali Kil
- Department of Psychology, Université de Montréal, Montreal, QC, Canada
- Department of Psychology, Simon Fraser University, Burnaby, BC, Canada
| | - Eric Lacourse
- Department of Sociology, Université de Montréal, Montreal, QC, Canada
| | | | | | - Anna Dorfman
- Department of Psychology, Bar Ilan University, Ramat Gan, Israel
| | - Dietlind Stolle
- Department of Political Science, McGill University, Montreal, QC, Canada
| | - Jean-Marc Lina
- École de Technologie Supérieure, Université du Québec, Montreal, QC, Canada
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Bonnet U, Specka M, Roser P, Scherbaum N. Cannabis use, abuse and dependence during the COVID-19 pandemic: a scoping review. J Neural Transm (Vienna) 2023; 130:7-18. [PMID: 36346483 PMCID: PMC9641691 DOI: 10.1007/s00702-022-02564-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 10/26/2022] [Indexed: 11/10/2022]
Abstract
The interaction between cannabis use or addiction and SARS-COV-2 infection rates and COVID-19 outcomes is obscure. As of 08/01/2022 among 57 evaluated epidemiological/clinical studies found in Pubmed-database, most evidence for how cannabis use patterns were influenced by the pandemic was given by two systematic reviews and 17 prospective studies, mostly involving adolescents. In this age group, cannabis use patterns have not changed markedly. For adults, several cross-sectional studies reported mixed results with cannabis use having increased, decreased or remained unchanged. Two cross-sectional studies demonstrated that the severity of adults´ cannabis dependence was either increased as a consequence of increasing cannabis use during the pandemic or not changed. Regarding the effect of cannabis use on COVID-19 outcomes, we found only five retrospective/cross-sectional studies. Accordingly, (i) cannabis use did not impact mild COVID-19 symptoms; (ii) cannabis using individuals experienced more COVID-19-related hospitalizations; (iii) cannabis using veterans were associated with reduced SARS-COV-2 infection rates; (iv) frequent cannabis use was significantly associated with COVID-19 mortality, and (v) cannabis dependents were at higher risk of COVID-19 breakthrough after vaccination. It should be outlined that the validity of these retrospective/cross-sectional studies (all self-reports or register/e-health-records) is rather low. Future prospective studies on the effects of cannabis use on SARS-COV-2 infection rates and COVID-19 outcomes are clearly required for conclusive risk-benefit assessments of the role of cannabis on users' health during the pandemic. Moreover, substance dependence (including cannabis) is associated with (often untreated) somatic comorbidity, which severity is a proven key risk factor for worse COVID-19 outcomes.
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Affiliation(s)
- Udo Bonnet
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Evangelisches Krankenhaus Castrop-Rauxel, Academic Teaching Hospital, University of Duisburg-Essen, Grutholzallee 21, 44577 Castrop-Rauxel, Germany ,Department of Psychiatry and Psychotherapy, Faculty of Medicine, LVR-Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Michael Specka
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, LVR-Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Patrik Roser
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, LVR-Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Norbert Scherbaum
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, LVR-Hospital Essen, University of Duisburg-Essen, Essen, Germany
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