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Klimek-Johnson P, Yalch MM, Maguen S. Latent Profiles of Disordered Eating Among Veterans: Associations With Mental Health Concerns. Womens Health Issues 2024; 34:437-448. [PMID: 38627139 DOI: 10.1016/j.whi.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 03/05/2024] [Accepted: 03/06/2024] [Indexed: 08/04/2024]
Abstract
BACKGROUND Varying patterns in eating disorder (ED) classification are evident and may impact ED treatment and prevention. However, investigations of patterns of heterogeneity in ED presentations have been limited to civilian samples, despite the high prevalence of EDs in military personnel and veterans. The present study aimed to explore ED-related symptom patterns, including emotional overeating, in women veterans. METHODS Participants were 407 women veterans using health care services at a large Veterans Affairs health care system who completed mental health measures via surveys. Latent profile analyses were used to explore distinct ED symptom patterns (binge eating, purging, heavy exercise, positive and negative emotional overeating, dietary restraint, and shape/weight concerns). Subsequent auxiliary models explored associations with mental health concerns (depressive symptoms, posttraumatic stress disorder, anxiety, alcohol misuse, substance misuse), adjusting for age, race and ethnicity, and service branch. RESULTS A four-class solution demonstrated the best model fit, characterized as follows: 1) Low ED Concerns, 2) Moderate Dietary Restraint/Negative Emotional Eating, 3) High Binge/Emotional Eating, and 4) High ED Concerns. Although all profiles had moderate or higher levels of negative emotional overeating, the High Binge/Emotional Eating and High ED Concerns profiles were distinct in levels of dietary restraint and had the highest probabilities of positive emotional overeating. The High ED Concerns profile also had the most severe mental health concerns relative to the other profiles. CONCLUSIONS The identification of unique ED symptom patterns in women veterans can inform prevention and intervention efforts.
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Affiliation(s)
- Patrycja Klimek-Johnson
- San Francisco Veterans Affairs Health Care System, Mental Health Service, San Francisco, California; Department of Psychiatry and Behavioral Sciences, University of California-San Francisco, San Francisco, California.
| | | | - Shira Maguen
- San Francisco Veterans Affairs Health Care System, Mental Health Service, San Francisco, California; Department of Psychiatry and Behavioral Sciences, University of California-San Francisco, San Francisco, California
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2
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Arifwidodo SD, Chandrasiri O. Urban green space visitation and mental health wellbeing during COVID-19 in Bangkok, Thailand. Front Public Health 2024; 11:1292154. [PMID: 38292382 PMCID: PMC10824833 DOI: 10.3389/fpubh.2023.1292154] [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: 09/11/2023] [Accepted: 12/29/2023] [Indexed: 02/01/2024] Open
Abstract
Urban green spaces offer numerous benefits, and their role in supporting mental health, particularly during global crises such as the COVID-19 pandemic, is of growing interest to researchers and policymakers. This study explored the relationship between urban green space visitation and mental health well-being during the COVID-19 pandemic in Bangkok, Thailand. This cross-sectional study, conducted in Bangkok during the COVID-19 lockdown, used a telephone survey of 579 respondents. A logistic regression model was employed to examine the association between urban green space visitation and the WHO-5 mental health well-being score, considering various factors such as socioeconomic variables, healthy behaviors, and COVID-19-related experiences. The findings revealed a significant association between urban green space visitation during the lockdown and higher mental health well-being. Socioeconomic variables and healthy behaviors of respondents were also notably linked to higher WHO-5 mental health well-being scores. These findings collectively indicate that urban greenspace visitation serves as a crucial determinant of mental health and well-being, especially during the COVID-19 pandemic.
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Affiliation(s)
- Sigit D. Arifwidodo
- Department of Landscape Architecture, Faculty of Architecture, Kasetsart University, Chatuchak, Thailand
| | - Orana Chandrasiri
- Activethai.org Research Center, Faculty of Architecture, Kasetsart University, Chatuchak, Thailand
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3
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Qi L, Zhang Z, Robinson L, Bobou M, Gourlan C, Winterer J, Adams R, Agunbiade K, Zhang Y, King S, Vaidya N, Artiges E, Banaschewski T, Bokde ALW, Broulidakis MJ, Brühl R, Flor H, Fröhner JH, Garavan H, Grigis A, Heinz A, Hohmann S, Martinot MLP, Millenet S, Nees F, van Noort BM, Orfanos DP, Poustka L, Sinclair J, Smolka MN, Whelan R, Stringaris A, Walter H, Martinot JL, Schumann G, Schmidt U, Desrivières S. Differing impact of the COVID-19 pandemic on youth mental health: combined population and clinical study. BJPsych Open 2023; 9:e217. [PMID: 37981567 PMCID: PMC10753963 DOI: 10.1192/bjo.2023.601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/25/2023] [Accepted: 09/29/2023] [Indexed: 11/21/2023] Open
Abstract
BACKGROUND Identifying youths most at risk to COVID-19-related mental illness is essential for the development of effective targeted interventions. AIMS To compare trajectories of mental health throughout the pandemic in youth with and without prior mental illness and identify those most at risk of COVID-19-related mental illness. METHOD Data were collected from individuals aged 18-26 years (N = 669) from two existing cohorts: IMAGEN, a population-based cohort; and ESTRA/STRATIFY, clinical cohorts of individuals with pre-existing diagnoses of mental disorders. Repeated COVID-19 surveys and standardised mental health assessments were used to compare trajectories of mental health symptoms from before the pandemic through to the second lockdown. RESULTS Mental health trajectories differed significantly between cohorts. In the population cohort, depression and eating disorder symptoms increased by 33.9% (95% CI 31.78-36.57) and 15.6% (95% CI 15.39-15.68) during the pandemic, respectively. By contrast, these remained high over time in the clinical cohort. Conversely, trajectories of alcohol misuse were similar in both cohorts, decreasing continuously (a 15.2% decrease) during the pandemic. Pre-pandemic symptom severity predicted the observed mental health trajectories in the population cohort. Surprisingly, being relatively healthy predicted increases in depression and eating disorder symptoms and in body mass index. By contrast, those initially at higher risk for depression or eating disorders reported a lasting decrease. CONCLUSIONS Healthier young people may be at greater risk of developing depressive or eating disorder symptoms during the COVID-19 pandemic. Targeted mental health interventions considering prior diagnostic risk may be warranted to help young people cope with the challenges of psychosocial stress and reduce the associated healthcare burden.
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Affiliation(s)
- Lu Qi
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Zuo Zhang
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Lauren Robinson
- Department of Psychological Medicine, Section for Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; and South London and Maudsley NHS Foundation Trust, London, UK
| | - Marina Bobou
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Chantal Gourlan
- Institut National de la Santé et de la Recherche Médicale (INSERM) Research Unit 1299 ‘Trajectoires développementales en psychiatrie’, Université Paris-Saclay, Ecole Normale supérieure Paris-Saclay, CNRS, Centre Borelli, Gif-sur-Yvette, France
| | - Jeanne Winterer
- Department of Psychiatry and Psychotherapy, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Charité Mitte, Berlin, Germany; and Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | - Rebecca Adams
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Kofoworola Agunbiade
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Yuning Zhang
- Psychology Department, University of Southampton, Southampton, UK
| | - Sinead King
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; and School of Medicine, Center for Neuroimaging, Cognition and Genomics, National University of Ireland, Galway, Ireland
| | - Nilakshi Vaidya
- Centre for Population Neuroscience and Stratified Medicine, Department of Psychiatry and Neuroscience, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Eric Artiges
- Institut National de la Santé et de la Recherche Médicale Research Unit 1299 ‘Trajectoires développementales en psychiatrie’, Ecole Normale Supérieure Paris-Saclay, Université Paris-Saclay, CentreNational de la Recherche Scientifique 9010, Centre Borelli, Gif-sur-Yvette, France; and Department of Psychiatry, Etablissement Public de Santé Barthélemy Durand, Etampes, France
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Arun L. W. Bokde
- Discipline of Psychiatry, School of Medicine and Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - M. John Broulidakis
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK; and Department of Psychology, College of Science, Northeastern University, Boston, USA
| | - Rüdiger Brühl
- Physikalisch-Technische Bundesanstalt, Braunschweig, Berlin, Germany
| | - Herta Flor
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; and Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
| | - Juliane H. Fröhner
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Hugh Garavan
- Departments of Psychiatry and Psychology, University of Vermont, Burlington, Vermont, USA
| | - Antoine Grigis
- NeuroSpin, CEA, Université Paris-Saclay, Gif-sur-Yvette, France
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy CCM, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Sarah Hohmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Marie-Laure Paillère Martinot
- Institut National de la Santé et de la Recherche Médicale Research Unit 1299 ‘Trajectoires développementales en psychiatrie’, Université Paris-Saclay, Ecole Normale supérieure Paris-Saclay, CNRS, Centre Borelli, Gif-sur-Yvette, France; and Department of Child and Adolescent Psychiatry, Pitié-Salpêtrière Hospital, AP-HP, Sorbonne University, Paris, France
| | - Sabina Millenet
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Frauke Nees
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; and Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany
| | | | | | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Centre Göttingen, Göttingen, Germany
| | - Julia Sinclair
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Michael N. Smolka
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Robert Whelan
- School of Psychology and Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Argyris Stringaris
- Division of Psychiatry and Department of Clinical, Educational & Health Psychology, University College London, London, UK
| | - Henrik Walter
- Department of Psychiatry and Psychotherapy, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Charité Mitte, Berlin, Germany
| | - Jean-Luc Martinot
- Institut National de la Santé et de la Recherche Médicale Research Unit 1299 ‘Trajectoires développementales en psychiatrie’, Université Paris-Saclay, Ecole Normale supérieure Paris-Saclay, CNRS, Centre Borelli, Gif-sur-Yvette, France
| | - Gunter Schumann
- Centre for Population Neuroscience and Stratified Medicine, Department of Psychiatry and Neuroscience, Charité Universitätsmedizin Berlin, Berlin, Germany; and Institut National de la Santé et de la Recherche Médicale Research Unit 1299 ‘Trajectoires développementales en psychiatrie’, Université Paris-Saclay, Ecole Normale supérieure Paris-Saclay, CNRS, Centre Borelli, Gif-sur-Yvette, France
| | - Ulrike Schmidt
- Institut National de la Santé et de la Recherche Médicale (INSERM) Research Unit 1299 ‘Trajectoires développementales en psychiatrie’, Université Paris-Saclay, Ecole Normale supérieure Paris-Saclay, CNRS, Centre Borelli, Gif-sur-Yvette, France
| | - Sylvane Desrivières
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Lanfredi M, Dagani J, Geviti A, Di Cosimo F, Bussolati M, Rillosi L, Albini D, Pizzi M, Ghidoni R, Fazzi E, Vita A, Rossi R. Risk and protective factors associated with mental health status in an Italian sample of students during the fourth wave of COVID-19 pandemic. Child Adolesc Psychiatry Ment Health 2023; 17:78. [PMID: 37365640 DOI: 10.1186/s13034-023-00615-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 05/15/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND It is well known that the COVID-19 pandemic has caused a global health crisis, especially for young people. However, most studies were conducted during the first waves of the pandemic. Few Italian studies specifically attempted to broadly assess young people's mental health status during the fourth wave of the pandemic. METHODS This study aimed at evaluating the mental health status among a group of Italian adolescents and young adults during the fourth wave of the COVID-19 pandemic. 11,839 high school students and 15,000 university students (age range 14-25) were asked to complete a multidimensional online survey, of which 7,146 (26,6%) agreed to participate. The survey also included standardized measures for depression, anxiety, anger, somatic symptoms, resilience, loneliness and post-traumatic growth. Two separate clusters were identified through cluster analysis. Random forest, classification tree and logistic regressions analyses were applied to identify factors associated to a good or a poor level of mental health and, thus, to define students' mental health profiles. RESULTS Overall, the students in our sample showed high levels of psychopathology. The clustering methods performed identified two separate clusters reflecting groups of students with different psychological features, that we further defined as "poor mental health" and "good mental health". The random forest and the logistic regressions found that the most discriminating variables among those two groups were: UCLA Loneliness Scale score, self-harm behaviors, Connor-Davidson Resilience Scale-10 score, satisfaction with family relationships, Fear of COVID-19 Scale score, gender and binge eating behaviors. The classification tree analysis identified students' profiles, showing that, globally, poor mental health was defined by higher scores of loneliness and self-harm, followed by being of female gender, presenting binge eating behaviors and, finally, having unsatisfying family relationships. CONCLUSIONS The results of this study confirmed the major psychological distress caused by the COVID-19 pandemic in a large sample of Italian students, and provided further insights regarding those factors associated with a good or poor mental health status. Our findings suggest the importance of implementing programs targeting aspects that have been found to be associated to a good mental health.
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Affiliation(s)
- Mariangela Lanfredi
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Via Pilastroni 4, 25125, Brescia, Italy
| | - Jessica Dagani
- SIPEC Foundation, Brescia, Italy
- Department of Clinical and Experimental Sciences, Section of Clinical and Dynamic Psychology, University of Brescia, Brescia, Italy
| | - Andrea Geviti
- Service of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Federica Di Cosimo
- USR Lombardia, Ufficio IV Ambito Territoriale di Brescia, Brescia, Italy
| | | | | | | | - Marina Pizzi
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Roberta Ghidoni
- Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Elisa Fazzi
- Child Neurology and Psychiatry Unit, Spedali Civili Hospital, Brescia, Italy
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Antonio Vita
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Department of Mental Health and Addiction Services, Spedali Civili Hospital, Brescia, Italy
| | - Roberta Rossi
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Via Pilastroni 4, 25125, Brescia, Italy.
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Valladares-Garrido MJ, León-Figueroa DA, Dawson FM, Burga-Cachay SC, Fernandez-Canani MA, Failoc-Rojas VE, Pereira-Victorio CJ, Valladares-Garrido D, Inga-Berrospi F. Association between childhood trauma and mental health disorders in adolescents during the second pandemic wave of COVID-19, Chiclayo-Peru. Front Psychiatry 2023; 14:1169247. [PMID: 37426089 PMCID: PMC10323439 DOI: 10.3389/fpsyt.2023.1169247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 05/10/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction The COVID-19 pandemic has significantly affected mental health, with children and adolescents being particularly vulnerable. Evidence on the association between childhood trauma and mental health outcomes in schoolchildren during the pandemic is limited. This study aimed to evaluate this relationship in Chiclayo city, northern Peru, during the second wave of COVID-19. Methods A cross-sectional secondary data study was conducted, measuring childhood trauma using the Marshall's Trauma Scale, depressive symptomatology (PHQ-9), and anxiety symptomatology (GAD-7). Additional variables assessed were alcohol use (AUDIT), resilience (abbreviated CD-RISC), and socio-educational data. Prevalence ratios were estimated using generalized linear models. Results Among 456 participants, 88.2% were female, with a mean age of 14.5 years (SD: 1.33). Depressive symptomatology prevalence was 76.3% (95%CI: 72.14-80.15) and increased by 23% in schoolchildren with childhood trauma (PR: 1.23; 95%CI: 1.10-1.37). Factors positively associated with depressive symptomatology included increasing age, seeking mental health help during the pandemic, and severe family dysfunction. Anxiety symptomatology prevalence was 62.3% (95%CI: 57.65-66.75) and increased by 55% in schoolchildren with childhood trauma (PR: 1.55; 95%CI: 1.31-1.85). Anxiety symptomatology was positively associated with mild, moderate, and severe family dysfunction. Conclusion Schoolchildren exposed to childhood trauma are at increased risk for depressive and anxiety symptoms. Monitoring the impact of the COVID-19 pandemic on adolescent mental health is vital. These findings can assist schools in establishing effective measures to prevent mental health outcomes.
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Affiliation(s)
| | - Darwin A. León-Figueroa
- Facultad de Medicina Humana, Universidad de San Martín de Porres, Chiclayo, Peru
- Centro de Investigación en Atención Primaria de Salud, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | | | | | - Virgilio E. Failoc-Rojas
- Research Unit for Generation and Synthesis Evidence in Health, Universidad San Ignacio de Loyola, Lima, Peru
| | | | - Danai Valladares-Garrido
- Escuela de Medicina, Universidad Cesar Vallejo, Piura, Peru
- Unidad de Epidemiología y Salud Ambiental, Hospital de Apoyo II Santa Rosa, Piura, Peru
| | - Fiorella Inga-Berrospi
- Grupo de Investigación en Gestión y Salud Pública, Universidad Norbert Wiener, Lima, Peru
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Cheng H, Wang D, Wang L, Zou H, Qu Y. Global prevalence of self-harm during the COVID-19 pandemic: a systematic review and meta-analysis. BMC Psychol 2023; 11:149. [PMID: 37147683 PMCID: PMC10160734 DOI: 10.1186/s40359-023-01181-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 04/21/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND COVID-19 and its transmission mitigation measures have caused widespread mental health problems. Previous studies have suggested that psychological, economic, behavioral, and psychosocial problems associated with the COVID-19 pandemic may lead to a rise in self-harm. However, little is known about the prevalence of self-harm worldwide during COVID-19. Therefore, a quantitative synthesis is needed to reach an overall conclusion regarding the prevalence of self-harm during the pandemic. METHODS By using permutations of COVID-19, self-harm or relevant search terms, we searched the following electronic databases from November 2019 to January 2022: Web of Science, PubMed, MEDLINE, Embase, PsycINFO, Cochrane Database of Systematic Reviews, China National Knowledge Infrastructure (CNKI), Wanfang Database and systematically reviewed the evidence according to MOOSE guidelines. We employed Cochran's chi-squared test (Cochran's Q), I2test and subgroup analysis to assess and address the heterogeneity. Sensitivity analysis was conducted by eliminating each included study individually and then combining the effects. RESULTS Sixteen studies that met the inclusion and exclusion criteria were identified, with sample sizes ranging from 228 to 49,227. The methodological quality of the included studies was mostly at the medium level. By using a random effect model, the pooled prevalence of self-harm was 15.8% (95% CI 13.3-18.3). Based on subgroup analysis, the following characteristics of the included studies were more likely to have a higher prevalence of self-harm: studies conducted in Asia or prior to July 2020, cross-sectional studies, samples recruited in hospitals or schools, adolescents, females, the purpose of self-harm (NSSI), mental symptoms and restriction experiences. CONCLUSIONS We provided the first meta-analytic estimated prevalence of self-harm based on a large sample from different countries and populations. The prevalence of self-harm during COVID-19 was not encouraging and requires attention and intervention. Further high-quality and prospective research are needed in order to determine the prevalence of self-harm with greater accuracy because to the clear heterogeneity across the included studies. In addition, this study also provides new directions for future research, including the identification of high-risk groups for self-harm, the formulation and implementation of prevention and intervention programs, and the long-term impact of COVID-19 on self-harm.
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Affiliation(s)
- Huan Cheng
- Department of Nursing, Peking University First Hospital, No. 8 Xi Shi Ku Street, Xi Cheng District, Beijing, 100034, China
| | - Di Wang
- School of Nursing, Anhui Medical University, No. 69 Mei Shan Road, ShuShan District, Hefei, 230031, Anhui Province, China
| | - Lu Wang
- School of Nursing, Anhui Medical University, No. 69 Mei Shan Road, ShuShan District, Hefei, 230031, Anhui Province, China.
| | - Haiou Zou
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 33 Badachu Road, Shi Jing Shan District, Beijing, 100144, China
| | - Yanhua Qu
- Department of Nursing, Beijing HuiLongGuan Hospital, Nandian Road, Chang Ping District, Beijing, 102208, China
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7
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Curtin EL, Johnson L, Salway R, Hinton EC. Snacking and anxiety during the coronavirus disease (COVID-19) pandemic: A prospective cohort study. Appetite 2023; 183:106491. [PMID: 36775067 PMCID: PMC9912813 DOI: 10.1016/j.appet.2023.106491] [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: 11/04/2022] [Revised: 02/03/2023] [Accepted: 02/09/2023] [Indexed: 02/12/2023]
Abstract
Anxiety and snacking increased during the initial coronavirus disease 2019 (COVID-19) lockdowns, but it remains unknown whether this change in snacking persisted and if it related to anxiety levels. We used prospective data to examine changes in snacking frequency from t1 (eased restrictions in England in May-June 2020) to t2 (national lockdown in December 2020-March 2021), the association of anxiety (assessed by the Generalised Anxiety Disorder-7 questionnaire at t1) with the snacking change, and the mediating and moderating effects of disinhibition and flexible restraint (assessed by the Three Factor Eating Questionnaire in 2016-17). Analyses including 2128 adults (mean age 28.4 y) residing in England from the Avon Longitudinal Study of Parents and Children showed that snacking frequency increased over time (mean change 1.23 (95% CI 0.81, 1.65) snacks/wk). Linear regressions of snacking adjusted for sociodemographic covariates showed that having clinical levels of generalised anxiety at t1, versus not, was associated with 1.22 (95% CI 0.07, 2.37) more snacks/wk at t2. Disinhibition partially mediated the association between Generalised Anxiety Disorder and snacking (βindirect = 0.15, 95% CI 0.01, 0.32), while there was no evidence that flexible restraint moderated the association (β = 0.05, 95% CI -0.57, 0.66). Our longitudinal findings highlight a detrimental anxiety-snacking association partly operating via disinhibition, suggesting future research could target mitigating anxiety and disinhibited eating behaviours to benefit diet-related outcomes following the pandemic.
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Affiliation(s)
- Esther L. Curtin
- Population Health Sciences, University of Bristol, BS8 2PS, UK,Corresponding author. Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Laura Johnson
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, BS8 1TZ, Bristol, UK; NatCen Social Research, 35 Northampton Square, London, EC1V 0AX, UK.
| | - Ruth Salway
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, BS8 1TZ, Bristol, UK.
| | - Elanor C. Hinton
- NIHR Bristol Biomedical Research Centre, Nutrition Theme, University of Bristol, BS2 8AE, Bristol, UK
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8
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Shakeshaft A, Blakey R, Kwong ASF, Riglin L, Davey Smith G, Stergiakouli E, Tilling K, Thapar A. Mental-health before and during the COVID-19 pandemic in adults with neurodevelopmental disorders. J Psychiatr Res 2023; 159:230-239. [PMID: 36753897 PMCID: PMC9885110 DOI: 10.1016/j.jpsychires.2023.01.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 01/11/2023] [Accepted: 01/26/2023] [Indexed: 01/31/2023]
Abstract
The COVID-19 pandemic negatively impacted mental health globally. Individuals with neurodevelopmental disorders (NDDs), including autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD), are at elevated risk of mental health difficulties. We investigated the impact of the pandemic on anxiety, depression and mental wellbeing in adults with NDDs using data from the Avon Longitudinal Study of Parents and Children (n = 3058). Mental health data were collected pre-pandemic (age 21-25) and at three timepoints during the pandemic (ages 27-28) using the Short Mood and Feelings Questionnaire, Generalized Anxiety Disorder Assessment-7, and Warwick Edinburgh Mental Wellbeing Scale. ADHD and ASD were defined using validated cut-points of the Strengths and Difficulties Questionnaire and Autism Spectrum Quotient, self-reported at age 25. We used multi-level mixed-effects models to investigate changes in mental health in those with elevated ADHD/ASD traits compared to those without. Prevalences of depression, anxiety and poor mental wellbeing were higher at all timepoints (pre-pandemic and during pandemic) in those with ADHD and ASD compared to those without. Anxiety increased to a greater extent in those with ADHD (β = 0.8 [0.2,1.4], p = 0.01) and ASD (β = 1.2 [-0.1,2.5], p = 0.07), while depression symptoms decreased, particularly in females with ASD (β = -3.1 [-4.6,-1.5], p = 0.0001). On average, mental wellbeing decreased in all, but to a lesser extent in those with ADHD (β = 1.3 [0.2,2.5], p = 0.03) and females with ASD (β = 3.0 [0.2,5.9], p = 0.04). To conclude, anxiety disproportionately increased in adults with NDDs during the pandemic, however, the related lockdowns may have provided a protective environment for depressive symptoms in the same individuals.
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Affiliation(s)
- Amy Shakeshaft
- Division of Psychological Medicine and Clinical Neurosciences, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, UK; Wolfson Centre for Young People's Mental Health, Cardiff University, UK
| | - Rachel Blakey
- Population Health Sciences and MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Alex S F Kwong
- Population Health Sciences and MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK; Division of Psychiatry, University of Edinburgh, UK
| | - Lucy Riglin
- Division of Psychological Medicine and Clinical Neurosciences, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, UK; Wolfson Centre for Young People's Mental Health, Cardiff University, UK
| | - George Davey Smith
- Population Health Sciences and MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Evie Stergiakouli
- Population Health Sciences and MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Kate Tilling
- Population Health Sciences and MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Anita Thapar
- Division of Psychological Medicine and Clinical Neurosciences, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, UK; Wolfson Centre for Young People's Mental Health, Cardiff University, UK.
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9
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Reas DL, Wisting L, Lindvall Dahlgren C. Co-occurrence of nonsuicidal self-injury and eating disorder pathology in adolescents. Int J Eat Disord 2023; 56:439-445. [PMID: 36524669 PMCID: PMC10107669 DOI: 10.1002/eat.23826] [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: 05/02/2022] [Revised: 09/29/2022] [Accepted: 09/30/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Little is known about the co-occurrence of nonsuicidal self-injurious (NSSI) behaviors and eating disorder (ED) pathology in community samples of adolescents. METHODS A total of 1558 Norwegian upper secondary school students (Grades 11, 12, and 13) completed the Deliberate Self-Harm Inventory and a measure of ED pathology. RESULTS Adolescents (53.1% F, 46.9% M) were a mean age of 17.1 years. A higher level of ED pathology was reported (12.1 vs. 5.3, p < .001) among adolescents who had a history of NSSI. Significantly higher levels of ED pathology were found among females who reported hitting themselves until bruised, head banging, severe scratching, and burning with a lighter, but not cutting, or the other forms of self-injury. Of adolescents with a history of NSSI, 60% of females and 15% of males scored above a cutoff for ED pathology. Of adolescents scoring above a cutoff for ED pathology, 42.5% of females and 37.1% of males had engaged in lifetime NSSI. DISCUSSION Adolescents-in particular, females- with a history of NSSI reported significantly greater ED pathology. Notably, a higher proportion of males with ED pathology reported lifetime self-injury than vice versa, underscoring the importance of carefully screening for the presence of self-harm among males with ED pathology. PUBLIC SIGNIFICANCE STATEMENT Over 1500 upper secondary school students with an average age of 17 years completed an online survey assessing current ED pathology and lifetime NSSI. Adolescents, particularly females, with a history of self-harm reported significantly more ED pathology. Findings also indicated the need to carefully screen for self-harm among males with ED pathology. Parents, schools, and health professionals should be aware that self-harm and ED pathology commonly co-occur and warrant assessment.
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Affiliation(s)
- Deborah Lynn Reas
- Division of Mental Health and Addiction, Regional Department of Eating Disorders, Oslo University Hospital, Oslo, Norway
| | - Line Wisting
- Division of Mental Health and Addiction, Regional Department of Eating Disorders, Oslo University Hospital, Oslo, Norway
| | - Camilla Lindvall Dahlgren
- Division of Mental Health and Addiction, Regional Department of Eating Disorders, Oslo University Hospital, Oslo, Norway.,Department of Psychology, Oslo New University College, Oslo, Norway
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10
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Foster S, Estévez-Lamorte N, Walitza S, Mohler-Kuo M. The Impact of the COVID-19 Pandemic on Young Adults' Mental Health in Switzerland: A Longitudinal Cohort Study from 2018 to 2021. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2598. [PMID: 36767967 PMCID: PMC9915161 DOI: 10.3390/ijerph20032598] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 01/23/2023] [Accepted: 01/28/2023] [Indexed: 06/18/2023]
Abstract
Most of the studies that examine the effect of the COVID-19 pandemic on mental health have been restricted to pandemic mental health data alone. The aim of the current study was to estimate the pandemic's effect on young Swiss adults' mental health by comparing pandemic to pre-pandemic mental health. Longitudinal data of 1175 young Swiss adults who participated in the S-YESMH study in 2018 and were followed-up in 2020 and 2021 were analyzed. The study outcomes were self-reported symptoms of depression, generalized anxiety disorder (GAD), attention-deficit/hyperactivity disorder (ADHD), thoughts about death or self-harm, and risky single-occasion drinking (RSOD). Generalized estimation equations, logistic regression and statistical mediation analysis were used to analyze the data. Evidence was found of increased depression, GAD, and ADHD among young women and increased depression among young men, resulting from the COVID-19 pandemic. Uncertainty about the future predicted young women's depression and anxiety in 2021. COVID-19 stress in 2021 fully mediated the effect of COVID-19 stress in 2020 on depression and GAD in 2021. Young Swiss women's and men's mental health appears to have been adversely affected by the COVID-19 pandemic, especially during the second pandemic year. Uncertainty about the future and stress becoming chronic in 2021 likely explain some of the adverse effects.
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Affiliation(s)
- Simon Foster
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, 8032 Zurich, Switzerland
| | - Natalia Estévez-Lamorte
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, 8032 Zurich, Switzerland
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, 1004 Lausanne, Switzerland
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, 8032 Zurich, Switzerland
| | - Meichun Mohler-Kuo
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, 8032 Zurich, Switzerland
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, 1004 Lausanne, Switzerland
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11
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Loose T, Geoffroy MC, Orri M, Chadi N, Scardera S, Booij L, Breton E, Tremblay R, Boivin M, Coté S. Pathways of association between disordered eating in adolescence and mental health outcomes in young adulthood during the COVID-19 pandemic. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2022; 114:22-32. [PMID: 36482144 PMCID: PMC9734974 DOI: 10.17269/s41997-022-00715-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 10/21/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The COVID-19 pandemic has been associated with increased mental health problems. We investigated (1) associations between disordered eating in adolescence and mental health problems after one year of the pandemic and (2) the mechanisms explaining associations. METHOD We analyzed data from a population-based birth cohort in Quebec, Canada (557 males and 759 females). High and low levels of disordered eating symptom trajectories were previously estimated (age 12, 15, 17, and 20 years). Anxiety, depression, non-suicidal self-injury, and suicidal ideation were assessed at 23 years (March-June 2021). Putative mediators included loneliness and social media use (age 22 years, July-August 2020). Analyses controlled for mental health and socio-economic status at age 10-12 years and were conducted for males and females separately. RESULTS Females in the high-level disordered eating symptom trajectory were at increased risk for non-suicidal self-injury (OR 1.60; 95% CI 1.02-2.52) and suicidal ideation (2.16; 1.31-3.57), whereas males were at increased risk for severe anxiety (2.49; CI 1.11-5.58). Males and females in the high-level trajectory were more likely to report severe depression (2.26; 1.14-5.92 and 2.15, 1.36-3.38 respectively). Among females, associations were partially explained (17-35%) by loneliness during the first 4 months of the pandemic. CONCLUSION Young adults who experienced disordered eating as adolescents were at increased risk of mental health problems during the pandemic. Loneliness partially mediated the effect, suggesting that pandemic mitigation resulting in increased social isolation may have exacerbated mental health problems among women with a history of disordered eating.
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Affiliation(s)
- Tianna Loose
- Department of Social and Preventive Medicine, Université de Montréal School of Public Health, Montreal, QC Canada ,Sainte-Justine University Hospital Research Centre, Montreal, QC Canada
| | - Marie Claude Geoffroy
- Department of Educational and Counselling Psychology, McGill University, Montreal, QC Canada ,Douglas Research Centre and Department of Psychiatry, McGill University, Montreal, QC Canada
| | - Massimiliano Orri
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, QC Canada
| | - Nicholas Chadi
- Sainte-Justine University Hospital Research Centre, Montreal, QC Canada ,Department of Pediatrics, University of Montreal, Montreal, QC Canada
| | - Sara Scardera
- Department of Educational and Counselling Psychology, McGill University, Montreal, QC Canada
| | - Linda Booij
- Sainte-Justine University Hospital Research Centre, Montreal, QC Canada ,Department of Psychology, Concordia University, Montreal, QC Canada ,Department of Psychiatry, McGill University, Montreal, QC Canada
| | - Edith Breton
- Sainte-Justine University Hospital Research Centre, Montreal, QC Canada ,Department of Psychiatry and Addictology, University of Montreal, Montreal, QC Canada
| | - Richard Tremblay
- Department of Pediatrics and School of Psychology, Université de Montréal, Montreal, QC Canada
| | - Michel Boivin
- School of Psychology, Université Laval, Québec City, QC Canada
| | - Sylvana Coté
- Department of Social and Preventive Medicine, Université de Montréal School of Public Health, Montreal, QC, Canada. .,Sainte-Justine University Hospital Research Centre, Montreal, QC, Canada.
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12
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Wiedemann A, Stochl J, Neufeld SAS, Fritz J, Bhatti J, Hook RW, Goodyer IM, Dolan RJ, Bullmore ET, Chamberlain SR, Fonagy P, Perez J, Jones PB. The impact of the initial COVID-19 outbreak on young adults' mental health: a longitudinal study of risk and resilience factors. Sci Rep 2022; 12:16659. [PMID: 36198725 PMCID: PMC9533974 DOI: 10.1038/s41598-022-21053-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 09/22/2022] [Indexed: 11/09/2022] Open
Abstract
Few studies assessing the effects of COVID-19 on mental health include prospective markers of risk and resilience necessary to understand and mitigate the combined impacts of the pandemic, lockdowns, and other societal responses. This population-based study of young adults includes individuals from the Neuroscience in Psychiatry Network (n = 2403) recruited from English primary care services and schools in 2012-2013 when aged 14-24. Participants were followed up three times thereafter, most recently during the initial outbreak of the COVID-19 outbreak when they were aged between 19 and 34. Repeated measures of psychological distress (K6) and mental wellbeing (SWEMWBS) were supplemented at the latest assessment by clinical measures of depression (PHQ-9) and anxiety (GAD-7). A total of 1000 participants, 42% of the original cohort, returned to take part in the COVID-19 follow-up; 737 completed all four assessments [mean age (SD), 25.6 (3.2) years; 65.4% female; 79.1% White]. Our findings show that the pandemic led to pronounced deviations from existing mental health-related trajectories compared to expected levels over approximately seven years. About three-in-ten young adults reported clinically significant depression (28.8%) or anxiety (27.6%) under current NHS guidelines; two-in-ten met clinical cut-offs for both. About 9% reported levels of psychological distress likely to be associated with serious functional impairments that substantially interfere with major life activities; an increase by 3% compared to pre-pandemic levels. Deviations from personal trajectories were not necessarily restricted to conventional risk factors; however, individuals with pre-existing health conditions suffered disproportionately during the initial outbreak of the COVID-19 pandemic. Resilience factors known to support mental health, particularly in response to adverse events, were at best mildly protective of individual psychological responses to the pandemic. Our findings underline the importance of monitoring the long-term effects of the ongoing pandemic on young adults' mental health, an age group at particular risk for the emergence of psychopathologies. Our findings further suggest that maintaining access to mental health care services during future waves, or potential new pandemics, is particularly crucial for those with pre-existing health conditions. Even though resilience factors known to support mental health were only mildly protective during the initial outbreak of the COVID-19 pandemic, it remains to be seen whether these factors facilitate mental health in the long term.
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Affiliation(s)
- Anna Wiedemann
- Department of Psychiatry, University of Cambridge, Douglas House, 18B Trumpington Road, Cambridge, CB2 8AH, UK. .,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK. .,National Institute for Health Research, Applied Research Collaboration, East of England, Cambridge, UK.
| | - Jan Stochl
- Department of Psychiatry, University of Cambridge, Douglas House, 18B Trumpington Road, Cambridge, CB2 8AH, UK.,National Institute for Health Research, Applied Research Collaboration, East of England, Cambridge, UK.,Department of Kinanthropology and Humanities, Charles University, Prague, Czechia
| | - Sharon A S Neufeld
- Department of Psychiatry, University of Cambridge, Douglas House, 18B Trumpington Road, Cambridge, CB2 8AH, UK
| | - Jessica Fritz
- Department of Psychiatry, University of Cambridge, Douglas House, 18B Trumpington Road, Cambridge, CB2 8AH, UK.,Department of Clinical Psychology, Philipps University of Marburg, Marburg, Germany
| | - Junaid Bhatti
- Department of Psychiatry, University of Cambridge, Douglas House, 18B Trumpington Road, Cambridge, CB2 8AH, UK
| | - Roxanne W Hook
- Department of Psychiatry, University of Cambridge, Douglas House, 18B Trumpington Road, Cambridge, CB2 8AH, UK
| | | | - Ian M Goodyer
- Department of Psychiatry, University of Cambridge, Douglas House, 18B Trumpington Road, Cambridge, CB2 8AH, UK
| | - Raymond J Dolan
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, London, UK
| | - Edward T Bullmore
- Department of Psychiatry, University of Cambridge, Douglas House, 18B Trumpington Road, Cambridge, CB2 8AH, UK
| | - Samuel R Chamberlain
- Department of Psychiatry, Faculty of Medicine, University of Southampton, Southampton, UK.,Southern Health NHS Foundation Trust, Southampton, UK
| | - Peter Fonagy
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Jesus Perez
- Department of Psychiatry, University of Cambridge, Douglas House, 18B Trumpington Road, Cambridge, CB2 8AH, UK.,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK.,National Institute for Health Research, Applied Research Collaboration, East of England, Cambridge, UK.,Norwich Medical School, University of East Anglia, Norwich, UK.,Department of Medicine, Institute of Biomedical Research (IBSAL), University of Salamanca, Salamanca, Spain
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Douglas House, 18B Trumpington Road, Cambridge, CB2 8AH, UK.,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK.,National Institute for Health Research, Applied Research Collaboration, East of England, Cambridge, UK
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