1
|
Zuschlag ZD, Lord B, Smith T, Lengerich A, Leonard K, Guereca Y, Kumar A, Milsom VA. COVID-19 and mental health treatment in primary care: Impacts of a global pandemic on a psychopharmacological collaborative care management program. Int J Psychiatry Med 2024:912174241264592. [PMID: 38907723 DOI: 10.1177/00912174241264592] [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: 06/24/2024]
Abstract
OBJECTIVE The COVID-19 pandemic has had a profound impact on individuals with mental health (MH) disorders and on the delivery of MH services. Studies examining treatment models which did not require substantial changes to the delivery of services during pandemic restrictions, such as collaborative care management (CoCM) programs are minimal. Therefore, a longitudinal retrospective cohort analysis was conducted to examine the impacts of the COVID-19 pandemic on a psychopharmacological CoCM program. METHOD Data was collected on all U.S. Veterans enrolled in a CoCM program at a large VA during the first 10 months of the COVID-19 pandemic and compared to a one-year prior date matched control group. Treatment in the program pre-COVID vs. treatment during the pandemic was compared in relation to baseline symptomatology, improvements in MH symptoms, and program adherence. RESULTS 462 Veterans were referred during the control dates, compared to 351 during the pandemic. Veterans enrolled during the first four months of each study arm, done to allow for a minimum of 6 months of follow up data, had no differences in baseline symptoms of depression or anxiety. Veterans receiving care during the pandemic had higher rates of program completion than pre-pandemic controls. COVID-era Veterans had higher rates of depression response than controls, and no differences were observed in depression remission, anxiety response, or anxiety remission. CONCLUSIONS Psychopharmacological CoCM treatment models can successfully manage depression and anxiety with no observed decrease in the effectiveness of this intervention even during periods of unprecedented disruptions to the delivery of MH services.
Collapse
Affiliation(s)
- Zachary D Zuschlag
- Mental Health and Behavioral Sciences Service, James A. Haley Veterans' Hospital, Tampa, FL, USA
- Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, FL, USA
| | - Benjamin Lord
- Mental Health and Behavioral Sciences Service, James A. Haley Veterans' Hospital, Tampa, FL, USA
| | - Teagan Smith
- Research Methodology and Biostatistics Core, University of South Florida, Tampa, FL, USA
| | - Alexander Lengerich
- Department of Psychiatry and Behavioral Health, VA Central Ohio Health Care, Grove City, OH, USA
| | - Kaitlin Leonard
- VA ORD Strategic Initiative for Research and EHR Synergy (OSIRIS), Edward Hines, Jr. VA Hospital, Chicago, IL, USA
| | - Yvette Guereca
- Mental Health and Behavioral Sciences Service, James A. Haley Veterans' Hospital, Tampa, FL, USA
| | - Ambuj Kumar
- Research Methodology and Biostatistics Core, University of South Florida, Tampa, FL, USA
| | - Vanessa A Milsom
- Mental Health and Behavioral Sciences Service, James A. Haley Veterans' Hospital, Tampa, FL, USA
| |
Collapse
|
2
|
Sharma M, Alemayehu M, Girma E, Milkias B, Stevenson A, Gelaye B, Koenen KC, Teferra S. The cumulative impact of trauma, chronic illness, and COVID-19 stress on mental health in a case-control study of adults with psychotic disorders in Ethiopia. Compr Psychiatry 2024; 134:152508. [PMID: 38917710 DOI: 10.1016/j.comppsych.2024.152508] [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: 12/31/2023] [Revised: 05/25/2024] [Accepted: 06/11/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has profoundly impacted the economic, psychological, and social well-being of people in Ethiopia. Pandemic-related fears can exacerbate anxiety and depression symptoms among those with pre-existing physical and mental health conditions as well as those with prior exposure to traumatic events. METHODS We used data from the Ethiopia NeuroGAP-Psychosis study (898 cases and 941 controls with and without a diagnosis of psychosis respectively, 66% male, mean age = 37 years). Data was collected between November 2021 and June 2022 during the COVID-19 pandemic from four hospitals in Ethiopia (three in Addis Ababa and one in Jimma city). Structural equation modeling analysis was conducted to examine the associations between trauma exposure, physical health conditions (like arthristis, neurological disorders, diabetes), COVID-19 stress, and psychological distress (depression and anxiety symptoms). We assessed direct and indirect effects for mediation, and conducted multigroup analysis to examine moderation by case control status. RESULTS We found evidence that the impact of greater trauma exposure and physical health conditions on higher psychological distress was mediated through higher COVID-19 stress. Sociodemographic characteristics (older age and being maried) were associated with higher psychological distress, with these associations mediated through greater trauma, physical health conditions, and COVID-19 stress. Case-control status also moderated the associations between these variables, with the mediation effects being stronger in cases and weaker in controls. Further, cases reported greater trauma and psychological distress, while controls reported more physical health conditions and COVID-19 stress. IMPLICATIONS Our findings uniquely assess the interaction of health and emergency related factors in understudied settings like Ethiopia. They underscore the importance of including daily hardships and environmental stressors, along with prior trauma exposure, as risk factors for the assessment of mental health symptoms. This study has key implications for mental health screening and intervention research in response to complex emergency contexts like Ethiopia with a history of armed conflict in addition to the COVID-19 pandemic. Our findings can aid the development of targeted services that address the mental health of at-risk groups with pre-existing mental and physical health conditions.
Collapse
Affiliation(s)
- Manasi Sharma
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Melkam Alemayehu
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Engida Girma
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Barkot Milkias
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Anne Stevenson
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Stanley Center for Psychiatric Research at Broad Institute of MIT and Harvard, Cambridge, MA, USA; Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Bizu Gelaye
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Stanley Center for Psychiatric Research at Broad Institute of MIT and Harvard, Cambridge, MA, USA; Department of Psychiatry, Harvard Medical School and The Chester M. Pierce MD, Division of Global Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Karestan C Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Stanley Center for Psychiatric Research at Broad Institute of MIT and Harvard, Cambridge, MA, USA; Psychiatric & Neurodevelopmental Genetics Unit, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Solomon Teferra
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| |
Collapse
|
3
|
Lee H, Kennedy CJ, Tu A, Restivo J, Liu CH, Naslund JA, Patel V, Choi KW, Smoller JW. Patterns and correlates of mental healthcare utilization during the COVID-19 pandemic among individuals with pre-existing mental disorder. PLoS One 2024; 19:e0303079. [PMID: 38833458 PMCID: PMC11149861 DOI: 10.1371/journal.pone.0303079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 04/19/2024] [Indexed: 06/06/2024] Open
Abstract
How did mental healthcare utilization change during the COVID-19 pandemic period among individuals with pre-existing mental disorder? Understanding utilization patterns of these at-risk individuals and identifying those most likely to exhibit increased utilization could improve patient stratification and efficient delivery of mental health services. This study leveraged large-scale electronic health record (EHR) data to describe mental healthcare utilization patterns among individuals with pre-existing mental disorder before and during the COVID-19 pandemic and identify correlates of high mental healthcare utilization. Using EHR data from a large healthcare system in Massachusetts, we identified three "pre-existing mental disorder" groups (PMD) based on having a documented mental disorder diagnosis within the 6 months prior to the March 2020 lockdown, related to: (1) stress-related disorders (e.g., depression, anxiety) (N = 115,849), (2) serious mental illness (e.g., schizophrenia, bipolar disorders) (N = 11,530), or (3) compulsive behavior disorders (e.g., eating disorder, OCD) (N = 5,893). We also identified a "historical comparison" group (HC) for each PMD (N = 113,604, 11,758, and 5,387, respectively) from the previous year (2019). We assessed the monthly number of mental healthcare visits from March 13 to December 31 for PMDs in 2020 and HCs in 2019. Phenome-wide association analyses (PheWAS) were used to identify clinical correlates of high mental healthcare utilization. We found the overall number of mental healthcare visits per patient during the pandemic period in 2020 was 10-12% higher than in 2019. The majority of increased visits was driven by a subset of high mental healthcare utilizers (top decile). PheWAS results indicated that correlates of high utilization (prior mental disorders, chronic pain, insomnia, viral hepatitis C, etc.) were largely similar before and during the pandemic, though several conditions (e.g., back pain) were associated with high utilization only during the pandemic. Limitations included that we were not able to examine other risk factors previously shown to influence mental health during the pandemic (e.g., social support, discrimination) due to lack of social determinants of health information in EHR data. Mental healthcare utilization among patients with pre-existing mental disorder increased overall during the pandemic, likely due to expanded access to telemedicine. Given that clinical correlates of high mental healthcare utilization in a major hospital system were largely similar before and during the COVID-19 pandemic, resource stratification based on known risk factor profiles may aid hospitals in responding to heightened mental healthcare needs during a pandemic.
Collapse
Affiliation(s)
- Hyunjoon Lee
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Department of Psychiatry, Center for Precision Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Chris J. Kennedy
- Department of Psychiatry, Center for Precision Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Allison Tu
- Harvard College, Cambridge, Massachusetts, United States of America
| | - Juliana Restivo
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Cindy H. Liu
- Departments of Pediatrics and Psychiatry, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
| | - John A. Naslund
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Karmel W. Choi
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Department of Psychiatry, Center for Precision Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Jordan W. Smoller
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Department of Psychiatry, Center for Precision Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| |
Collapse
|
4
|
Nam Chan JK, Chang DHH, Fung VSC, Ching Chui EM, Wong CSM, Chu RST, So YK, Chan JMT, Chung AKK, Lee KCK, Cheng CPW, Lo HKY, Law CW, Chan WC, Chang WC. Prevalence and correlates of depression, anxiety and trauma-like symptoms in Chinese psychiatric patients during the fifth wave of COVID-19 pandemic: a cross-sectional study in Hong Kong. BMC Psychiatry 2024; 24:372. [PMID: 38760703 PMCID: PMC11100058 DOI: 10.1186/s12888-024-05815-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 05/05/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Psychiatric patients are susceptible to adverse mental health outcome during COVID-19 pandemic, but its associated factors are understudied. This observational cross-sectional study aimed to comprehensively examine prevalence and correlates of psychological distress, in terms of depression, anxiety and post-traumatic-stress-disorder (PTSD)-like symptoms, among Chinese adult psychiatric outpatients amidst the peak of fifth COVID-19 wave in Hong-Kong. METHODS A total of 415 patients (comprising 246 patients with common-mental-disorders [CMD] and 169 with severe-mental-disorders [SMD]) and 399 demographically-matched controls without mental disorders were assessed with self-rated questionnaires between 28-March and 8-April-2022, encompassing illness profile, mental health symptoms, psychosocial measures (loneliness, resilience, coping styles) and COVID-19 related factors. Univariate and multivariable logistic regression analyses were conducted to determine variables associated with moderate-to-severe depressive, anxiety and PTSD-like symptoms among psychiatric patients. RESULTS Our results showed that CMD patients had the greatest psychological distress relative to SMD patients and controls. Approximately 40-55% CMD patients and 25% SMD patients exhibited moderate-to-severe depression, anxiety and PTSD-like symptoms. Multivariable regression analyses revealed that female gender, lower educational attainment, single marital status, being housewife, more severe insomnia, psychotic-like symptoms and cognitive complaints, self-harm behavior, lower resilience, avoidance coping, never contracting COVID-19 infection, greater fear of contagion, and longer exposure to pandemic-related information were independently associated with depression, anxiety and/or PTSD-like symptoms in psychiatric patients. CONCLUSIONS Our results affirm increased vulnerability of psychiatric patients toward psychological distress during pandemic. An array of identified correlates facilitates early detection of high-risk psychiatric patients for targeted strategies to minimize pandemic-related negative psychological impact.
Collapse
Affiliation(s)
- Joe Kwun Nam Chan
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Don Ho Hin Chang
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Vivian Shi Cheng Fung
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | | | - Corine Sau Man Wong
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Ryan Sai Ting Chu
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Yuen Kiu So
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Jacob Man Tik Chan
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Albert Kar Kin Chung
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Krystal Chi Kei Lee
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Calvin Pak Wing Cheng
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Heidi Ka Ying Lo
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Chi Wing Law
- Department of Psychiatry, Queen Mary Hospital, Hospital Authority, Hong Kong, China
| | - Wai Chi Chan
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Wing Chung Chang
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China.
- Department of Psychiatry, The University of Hong Kong Queen Mary Hospital, Pokfulam, Hong Kong, China.
| |
Collapse
|
5
|
Dzinamarira T, Iradukunda PG, Saramba E, Gashema P, Moyo E, Mangezi W, Musuka G. COVID-19 and mental health services in Sub-Saharan Africa: A critical literature review. Compr Psychiatry 2024; 131:152465. [PMID: 38387168 DOI: 10.1016/j.comppsych.2024.152465] [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: 01/16/2024] [Revised: 02/07/2024] [Accepted: 02/16/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has wrought a profound impact on mental health in Sub- Saharan Africa, exacerbating existing disparities and rendering individuals undergoing treatment particularly susceptible. This comprehensive critical review delves into the scope, nature, and extent of COVID-19 impact on mental health services in Sub- Saharan Africa, while concurrently elucidating pivotal lessons and exemplary practices learnt from periods of lockdown. METHODS The methodology was guided by Jesson & Laccy's guide on how to conduct critical literature reviews. Articles were comprehensively sought through two academic databases (PubMed and Google Scholar), complemented by targeted searches on the WHO website and official public health websites of relevant Sub-Saharan African countries. RESULTS The investigation reveals a surge in mental health challenges, notably marked by a significant escalation in anxiety, depression, and post-traumatic stress disorder. Disruptions to care services, financial hardships, and the pervasive effects of social isolation further compound this escalation. The pre-existing inequalities in access to and quality of care were accentuated during this crisis, with marginalized groups encountering heightened impediments to essential services. In navigating this unprecedented challenge, communities emerged as integral agents in establishing supportive networks and implementing culturally sensitive interventions. Technology, such as telemedicine and online resources, played a pivotal role in bridging access gaps, particularly in remote areas. The synthesis of best practices for supporting mental health patients during lockdowns encompasses targeted interventions for vulnerable groups, including adolescents and pregnant women. Empowering communities through economic support and mental health literacy programs was identified as crucial. The integration of technology, such as the development of robust telemedicine frameworks, virtual training in curricula, and the utilization of digital platforms for interventions and public messaging, emerged as a cornerstone in addressing access disparities. Community engagement and resilience-building strategies gained prominence, emphasizing the necessity of collaboration between healthcare providers and communities. Promotion of peer support groups, home-based care, and the preservation of traditional healing practices were underscored as essential components. CONCLUSION The study underscores the need to adapt and optimize mental health services during emergencies. This entails prioritizing mental health within emergency response frameworks, exploring alternative service delivery methods, and fortifying data collection and research efforts.
Collapse
Affiliation(s)
- Tafadzwa Dzinamarira
- School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa.
| | | | - Eric Saramba
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | | | - Enos Moyo
- Department of Public Health Medicine, University of KwaZulu Natal, Durban, South Africa
| | - Walter Mangezi
- Department of Mental Health, University of Zimbabwe, Harare, Zimbabwe
| | - Godfrey Musuka
- International Initiative for Impact Evaluation, Harare, Zimbabwe
| |
Collapse
|
6
|
Fountoulakis KN, Vrublevska J, Abraham S, Adorjan K, Ahmed HU, Alarcón RD, Arai K, Auwal SS, Berk M, Bjedov S, Bobes J, Bobes-Bascaran T, Bourgin-Duchesnay J, Bredicean CA, Bukelskis L, Burkadze A, Abud IIC, Castilla-Puentes R, Cetkovich M, Colon-Rivera H, Corral R, Cortez-Vergara C, Crepin P, De Berardis D, Delgado SZ, De Lucena D, De Sousa A, Di Stefano R, Dodd S, Elek LP, Elissa A, Erdelyi-Hamza B, Erzin G, Etchevers MJ, Falkai P, Farcas A, Fedotov I, Filatova V, Fountoulakis NK, Frankova I, Franza F, Frias P, Galako T, Garay CJ, Garcia-Álvarez L, García-Portilla MP, Gonda X, Gondek TM, González DM, Gould H, Grandinetti P, Grau A, Groudeva V, Hagin M, Harada T, Hasan TM, Hashim NA, Hilbig J, Hossain S, Iakimova R, Ibrahim M, Iftene F, Ignatenko Y, Irarrazaval M, Ismail Z, Ismayilova J, Jacobs A, Jakovljević M, Jakšić N, Javed A, Kafali HY, Karia S, Kazakova O, Khalifa D, Khaustova O, Koh S, Kosenko K, Koupidis SA, Lalljee A, Liewig J, Majid A, Malashonkova E, Malik K, Malik NI, Mammadzada G, Mandalia B, Marazziti D, Marčinko D, Martinez S, Matiekus E, Mejia G, Memon RS, Martínez XEM, Mickevičiūtė D, Milev R, Mohammed M, Molina-López A, Morozov P, Muhammad NS, Mustač F, Naor MS, Nassieb A, Navickas A, Okasha T, Pandova M, Panfil AL, Panteleeva L, Papava I, Patsali ME, Pavlichenko A, Pejuskovic B, Da Costa MP, Popkov M, Popovic D, Raduan NJN, Ramírez FV, Rancans E, Razali S, Rebok F, Rewekant A, Flores ENR, Rivera-Encinas MT, Saiz P, de Carmona MS, Martínez DS, Saw JA, Saygili G, Schneidereit P, Shah B, Shirasaka T, Silagadze K, Sitanggang S, Skugarevsky O, Spikina A, Mahalingappa SS, Stoyanova M, Szczegielniak A, Tamasan SC, Tavormina G, Tavormina MGM, Theodorakis PN, Tohen M, Tsapakis EM, Tukhvatullina D, Ullah I, Vaidya R, Vega-Dienstmaier JM, Vukovic O, Vysotska O, Widiasih N, Yashikhina A, Smirnova D. Non-binary gender, vulnerable populations and mental health during the COVID-19 pandemic: Data from the COVID-19 MEntal health inTernational for the general population (COMET-G) study. J Affect Disord 2024; 352:536-551. [PMID: 38382816 DOI: 10.1016/j.jad.2024.02.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 01/31/2024] [Accepted: 02/13/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND The COVID-19 pandemic has brought significant mental health challenges, particularly for vulnerable populations, including non-binary gender individuals. The COMET international study aimed to investigate specific risk factors for clinical depression or distress during the pandemic, also in these special populations. METHODS Chi-square tests were used for initial screening to select only those variables which would show an initial significance. Risk Ratios (RR) were calculated, and a Multiple Backward Stepwise Linear Regression Analysis (MBSLRA) was followed with those variables given significant results at screening and with the presence of distress or depression or the lack of both of them. RESULTS The most important risk factors for depression were female (RR = 1.59-5.49) and non-binary gender (RR = 1.56-7.41), unemployment (RR = 1.41-6.57), not working during lockdowns (RR = 1.43-5.79), bad general health (RR = 2.74-9.98), chronic somatic disorder (RR = 1.22-5.57), history of mental disorders (depression RR = 2.31-9.47; suicide attempt RR = 2.33-9.75; psychosis RR = 2.14-10.08; Bipolar disorder RR = 2.75-12.86), smoking status (RR = 1.15-5.31) and substance use (RR = 1.77-8.01). The risk factors for distress or depression that survived MBSLRA were younger age, being widowed, living alone, bad general health, being a carer, chronic somatic disorder, not working during lockdowns, being single, self-reported history of depression, bipolar disorder, self-harm, suicide attempts and of other mental disorders, smoking, alcohol, and substance use. CONCLUSIONS Targeted preventive interventions are crucial to safeguard the mental health of vulnerable groups, emphasizing the importance of diverse samples in future research. LIMITATIONS Online data collection may have resulted in the underrepresentation of certain population groups.
Collapse
Affiliation(s)
- Konstantinos N Fountoulakis
- 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki Greece, Thessaloniki, Greece
| | | | - Seri Abraham
- Pennine Care NHS Foundation Trust, United Kingdom; Manchester Metropolitan University, Manchester, United Kingdom; Core Psychiatry Training, Health Education England North West, United Kingdom.
| | - Kristina Adorjan
- Department of Psychiatry, Ludiwig-Maximilians-University, Munich, Germany.
| | - Helal Uddin Ahmed
- Child Adolescent and Family Psychiatry, National Institute of Mental Health, Dhaka, Bangladesh
| | - Renato D Alarcón
- Section of Psychiatry and Mental Health, Universidad Peruana Cayetano Heredia, Facultad de Medicina Alberto Hurtado, Lima, Peru; Department of Psychiatry and Psychology, Mayo Clinic School of Medicine, Rochester, MN, USA.
| | - Kiyomi Arai
- School of Medicine and Health Science, Institute of Health Science Shinshu University, Matsumoto, Japan.
| | - Sani Salihu Auwal
- Department of Psychiatry, Bayero University, Kano, Nigeria; Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Michael Berk
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, Deakin University, School of Medicine, Barwon Health, Geelong, Australia; Orygen The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, The University of Melbourne, Melbourne, Australia.
| | - Sarah Bjedov
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Julio Bobes
- Psychiatry Area, Department of Medicine, University of Oviedo, Oviedo, Spain; Department of Psychiatry, Hospital Universitario Central de Asturias, Oviedo, Spain.
| | - Teresa Bobes-Bascaran
- Mental Health Center of La Corredoria, Oviedo, Spain; Department of Psychology, University of Oviedo, Oviedo, Spain.
| | - Julie Bourgin-Duchesnay
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Groupe Hospitalier Nord Essonne, Orsay, France
| | - Cristina Ana Bredicean
- Department of Neuroscience, Discipline of Psychiatry, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Laurynas Bukelskis
- Clinic of Psychiatry, Institute of Clinical Medicine, Medical Faculty, Vilnius University, Vilnius, Lithuania
| | - Akaki Burkadze
- Mental Hub, Tbilisi, Georgia; NGO Healthcare Research and Quality Agency, Tbilisi, Georgia
| | | | - Ruby Castilla-Puentes
- Janssen Research and Development, Johnson & Johnson, American Society of Hispanic Psychiatry and WARMI Women Mental Health, Cincinnati, OH, USA.
| | - Marcelo Cetkovich
- Institute of Translational and Cognitive Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina.
| | - Hector Colon-Rivera
- APM Board Certified in General Psychiatry and Neurology, Addiction Psychiatry, & Addiction Medicine, UPMC, DDAP, Philadelphia, USA
| | - Ricardo Corral
- Department of Teaching and Research, Hospital Borda, Buenos Aires, Argentina; University of Buenos Aires, Buenos Aires, Argentina
| | | | - Piirika Crepin
- Sanitaire and Social Union for Accompaniment and Prevention, Center of Ambulatory Psychiatry of Narbonne and Lezigan, Narbonne, France
| | - Domenico De Berardis
- Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL Teramo, Teramo, Italy; School of Nursing, University of L'Aquila, Italy; Department of Neuroscience and Imaging, School of Psychiatry, University of Chieti, Chieti, Italy.
| | - Sergio Zamora Delgado
- Child and Adolescent Psychiatry Department, Hospital Luis Calvo Mackenna, Santiago, Chile.
| | - David De Lucena
- Departamento de Fisiología e Farmacología, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil.
| | - Avinash De Sousa
- Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, India; Desousa Foundation, Mumbai, India
| | - Ramona Di Stefano
- Department of Biotechnological and Applied Clinical Sciences, Section of Psychiatry, University of L'Aquila, L'Aquila, Italy
| | - Seetal Dodd
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, Deakin University, School of Medicine, Barwon Health, Geelong, Australia; Orygen The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, The University of Melbourne, Melbourne, Australia; University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia
| | - Livia Priyanka Elek
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Anna Elissa
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia
| | - Berta Erdelyi-Hamza
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Gamze Erzin
- Psychiatry Department, Ankara Dışkapı Training and Research Hospital, Ankara, Turkey; Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Martin J Etchevers
- Faculty of Psychology, University of Buenos Aires (UBA), Buenos Aires, Argentina
| | - Peter Falkai
- Department of Psychiatry, Ludiwig-Maximilians-University, Munich, Germany.
| | - Adriana Farcas
- Centre of Neuroscience, Queen's University, Kingston, Ontario, Canada.
| | - Ilya Fedotov
- Department of Psychiatry and Narcology, Ryazan State Medical University n.a. academician I.P. Pavlov, Ryazan, Russia
| | - Viktoriia Filatova
- State Budgetary Institution of the Rostov Region "Psychoneurological Dispensary", Rostov-on-Don, Russia
| | | | - Iryna Frankova
- Medical Psychology, Psychosomatic Medicine and Psychotherapy Department, Bogomolets National Medical University, Kyiv, Ukraine
| | - Francesco Franza
- "Villa dei Pini" Psychiatric Rehabilitation Center, Avellino, Italy; Psychiatric Studies Centre, Provaglio d'Iseo, Italy
| | | | - Tatiana Galako
- Department of Psychiatry, Medical Psychology and Drug Abuse, Kyrgyz State Medical Academy, Bishkek, Kyrgyz Republic
| | - Cristian J Garay
- Faculty of Psychology, University of Buenos Aires (UBA), Buenos Aires, Argentina.
| | | | - Maria Paz García-Portilla
- Psychiatry Area, Department of Medicine, University of Oviedo, Oviedo, Spain; Mental Health Center of La Ería, Oviedo, Spain.
| | - Xenia Gonda
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Tomasz M Gondek
- Specialty Training Section, Polish Psychiatric Association, Wroclaw, Poland
| | | | - Hilary Gould
- Department of Psychiatry, University of California San Diego, San Diego, USA.
| | - Paolo Grandinetti
- Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL Teramo, Teramo, Italy
| | - Arturo Grau
- Child and Adolescent Psychiatry Department, Hospital Luis Calvo Mackenna, Santiago, Chile; Universidad Diego Portales, Santiago, Chile
| | - Violeta Groudeva
- Department of Diagnostic Imaging, University Hospital Saint Ekaterina, Sofia, Bulgaria
| | - Michal Hagin
- Forensic Psychiatry Unit, Abarbanel Mental Health Center, Israel
| | - Takayuki Harada
- Faculty of Human Sciences, Education Bureau of the Laboratory Schools, University of Tsukuba, Tokyo, Japan
| | - Tasdik M Hasan
- Department of Primary Care & Mental Health, University of Liverpool, Liverpool, United Kingdom; Public Health Foundation, Dhaka, Bangladesh
| | - Nurul Azreen Hashim
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia.
| | - Jan Hilbig
- Clinic of Psychiatry, Institute of Clinical Medicine, Medical Faculty, Vilnius University, Vilnius, Lithuania
| | - Sahadat Hossain
- Department of Public Health & Informatics, Jahangirnagar University, Dhaka, Bangladesh.
| | - Rossitza Iakimova
- Second Psychiatric Clinic, University Hospital for Active Treatment in Neurology and Psychiatry "Saint Naum", Sofia, Bulgaria
| | - Mona Ibrahim
- Okasha Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Felicia Iftene
- Department of Psychiatry, Queens University, Kingston, Ontario, Canada.
| | - Yulia Ignatenko
- Education Center, Mental Health Clinic No 1 n.a. N.A. Alexeev of Moscow Healthcare Department, Moscow, Russia
| | - Matias Irarrazaval
- Ministry of Health, Millenium Institute for Research in Depression and Personality, Santiago, Chile.
| | - Zaliha Ismail
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia.
| | - Jamila Ismayilova
- National Mental Health Center of the Ministry of Health of the Republic of Azerbaijan, Baku, Azerbaijan
| | - Asaf Jacobs
- Department of Psychiatry, Westchester Medical Center Health System, Valhalla, NY, USA; New York Medical College, Valhalla, NY, USA
| | | | - Nenad Jakšić
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Afzal Javed
- Institute of Applied Health Research, University of Birmingham, United Kingdom; Warwick Medical School, University of Warwick, United Kingdom; Pakistan Psychiatric Research Centre, Fountain House, Lahore, Pakistan
| | | | - Sagar Karia
- Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, India
| | | | - Doaa Khalifa
- Okasha Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Olena Khaustova
- Medical Psychology, Psychosomatic Medicine and Psychotherapy Department, Bogomolets National Medical University, Kyiv, Ukraine
| | - Steve Koh
- Department of Psychiatry, University of California San Diego, San Diego, USA.
| | - Korneliia Kosenko
- Psychiatry, Drug abuse and Psychology Department, Odessa National Medical University, Odessa, Ukraine
| | | | | | - Justine Liewig
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Groupe Hospitalier Nord Essonne, Orsay, France
| | - Abdul Majid
- Department of Psychiatry, SKIMS Medical College, Srinagar, India
| | - Evgeniia Malashonkova
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Groupe Hospitalier Nord Essonne, Orsay, France.
| | - Khamelia Malik
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia
| | - Najma Iqbal Malik
- Department of Psychology, University of Sargodha, Sargodha, Pakistan.
| | - Gulay Mammadzada
- Department of Psychiatry, Azerbaijan Medical University, Baku, Azerbaijan
| | | | - Donatella Marazziti
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy; Unicamillus, Saint Camillus International University of Health Sciences, Rome, Italy; Brain Research Foundation onus, Lucca, Italy.
| | - Darko Marčinko
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia.
| | - Stephanie Martinez
- Department of Psychiatry, University of California San Diego, San Diego, USA.
| | - Eimantas Matiekus
- Clinic of Psychiatry, Institute of Clinical Medicine, Medical Faculty, Vilnius University, Vilnius, Lithuania
| | - Gabriela Mejia
- Department of Psychiatry, University of California San Diego, San Diego, USA.
| | - Roha Saeed Memon
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | | | | | - Roumen Milev
- Department of Psychiatry, Queens University, Kingston, Ontario, Canada.
| | - Muftau Mohammed
- Department of Clinical Services, Federal Neuropsychiatric Hospital, Kaduna, Nigeria
| | - Alejandro Molina-López
- General Office for the Psychiatric Services of the Ministry of Health, Mexico City, Mexico
| | - Petr Morozov
- Department of Postgraduate Education, Russian National Research Medical University n.a. N.I. Pirogov, Moscow, Russia
| | - Nuru Suleiman Muhammad
- Department of Community Medicine, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - Filip Mustač
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Mika S Naor
- Sackler School of Medicine New York State American Program, Tel Aviv University, Tel Aviv-Yafo, Israel.
| | - Amira Nassieb
- Okasha Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Alvydas Navickas
- Clinic of Psychiatry, Institute of Clinical Medicine, Medical Faculty, Vilnius University, Vilnius, Lithuania.
| | - Tarek Okasha
- Okasha Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Milena Pandova
- Second Psychiatric Clinic, University Hospital for Active Treatment in Neurology and Psychiatry "Saint Naum", Sofia, Bulgaria
| | - Anca-Livia Panfil
- Compartment of Liaison Psychiatry, "Pius Brinzeu" County Emergency Clinical Hospital, Timisoara, Romania
| | - Liliya Panteleeva
- Department of Medical Psychology, Psychiatry and Psychotherapy, Kyrgyz-Russian Slavic University, Bishkek, Kyrgyz Republic
| | - Ion Papava
- Department of Neuroscience, Discipline of Psychiatry, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania.
| | - Mikaella E Patsali
- School of Social Sciences, Hellenic Open University, Patras, Greece; Department of Internal Medicine, Nicosia General Hospital, Nicosia, Cyprus
| | - Alexey Pavlichenko
- Education Center, Mental Health Clinic No 1 n.a. N.A. Alexeev of Moscow Healthcare Department, Moscow, Russia
| | - Bojana Pejuskovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinical Department for Crisis and Affective Disorders, Institute of Mental Health, Belgrade, Serbia
| | - Mariana Pinto Da Costa
- South London and Maudsley NHS Foundation Trust, London, United Kingdom; Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
| | - Mikhail Popkov
- Department of the Introduction to Internal Medicine and Family Medicine, International Higher School of Medicine, Bishkek, Kyrgyz Republic
| | | | - Nor Jannah Nasution Raduan
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia.
| | - Francisca Vargas Ramírez
- Child and Adolescent Psychiatry Department, Hospital Luis Calvo Mackenna, Santiago, Chile; Universidad Diego Portales, Santiago, Chile
| | - Elmars Rancans
- Department of Psychiatry and Narcology, Riga Stradins University, Riga, Latvia.
| | - Salmi Razali
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia.
| | - Federico Rebok
- Servicio de Emergencia, Acute inpatient Unit, Hospital Moyano, Buenos Aires, Argentina; Argentine Institute of Clinical Psychiatry (IAPC), Buenos Aires, Argentina
| | - Anna Rewekant
- General Psychiatry Unit I, Greater Poland Neuropsychiatric Center, Kościan, Poland
| | | | - María Teresa Rivera-Encinas
- Centro de Investigación en Salud Pública, Facultad de Medicina, Universidad de San Martín de Porres, Instituto Nacional de Salud Mental "Honorio Delgado - Hideyo Noguchi", Lima, Peru.
| | - Pilar Saiz
- Psychiatry Area, Department of Medicine, University of Oviedo, Oviedo, Spain; Mental Health Center of La Corredoria, Oviedo, Spain.
| | | | - David Saucedo Martínez
- Department of Psychiatry, Escuela Nacional de Medicina, TEC de Monterrey, Servicio de geriatría, Hospital Universitario "José Eleuterio González" UANL, Monterrey, Nuevo León, Mexico
| | - Jo Anne Saw
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia.
| | - Görkem Saygili
- Cognitive Science and Artificial Intelligence Department Tilburg University, the Netherlands
| | - Patricia Schneidereit
- Klinik für Allgemeine Psychiatrie und Psychotherapie Ost, Psychiatrische Institutsambulanz, Klinikum am Weissenhof, Weissenhof, Germany.
| | | | - Tomohiro Shirasaka
- Department of Psychiatry, Teine Keijinkai Medical Center, Sapporo, Japan
| | | | - Satti Sitanggang
- Psychiatric Unit, Pambalah Batung General Hospital, South Kalimantan, Amuntai, Indonesia
| | - Oleg Skugarevsky
- Department of Psychiatry and Medical Psychology, Belarusian State Medical University, Minsk, Belarus
| | - Anna Spikina
- Saint Petersburg Psychoneurological Dispensary No2, Saint Petersburg, Russia
| | - Sridevi Sira Mahalingappa
- Derbyshire Healthcare NHS Foundation Trust, The Liasion Team, Royal Derby Hospital, Derby, Derbyshire, United Kingdom.
| | - Maria Stoyanova
- Second Psychiatric Clinic, University Hospital for Active Treatment in Neurology and Psychiatry "Saint Naum", Sofia, Bulgaria
| | - Anna Szczegielniak
- Department of Psychiatric Rehabilitation, Department of Psychiatry and Psychotherapy, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Poland
| | - Simona Claudia Tamasan
- Compartment of Liaison Psychiatry, "Pius Brinzeu" County Emergency Clinical Hospital, Timisoara, Romania
| | - Giuseppe Tavormina
- Psychiatric Studies Centre, Provaglio d'Iseo, Italy; European Depression Association and Italian Association on Depression, Brussels, Belgium; Bedforshire Center for Mental Health Research in association with the University of Cambridge, United Kingdom
| | | | | | - Mauricio Tohen
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of New Mexico, Albuquerque, NM, USA.
| | - Eva Maria Tsapakis
- "Agios Charalambos" Mental Health Clinic, Heraklion, Crete, Greece; 1st Department of Academic Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece.
| | | | - Irfan Ullah
- Kabir Medical College, Gandhara University, Peshawar, Pakistan
| | - Ratnaraj Vaidya
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom.
| | | | - Olivera Vukovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Department for Research and Education, Institute of Mental Health, Belgrade, Serbia
| | - Olga Vysotska
- Educational and Research Center - Ukrainian Family Medicine Training Center, Bogomolets National Medical University, Kyiv, Ukraine
| | - Natalia Widiasih
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia
| | - Anna Yashikhina
- International Centre for Education and Research in Neuropsychiatry (ICERN), Samara State Medical University, Samara, Russia; Department of Psychiatry, Narcology, Psychotherapy and Clinical Psychology, Samara State Medical University, Samara, Russia
| | - Daria Smirnova
- International Centre for Education and Research in Neuropsychiatry (ICERN), Samara State Medical University, Samara, Russia; Department of Psychiatry, Narcology, Psychotherapy and Clinical Psychology, Samara State Medical University, Samara, Russia
| |
Collapse
|
7
|
Ryan SC, Sugg MM, Runkle JD, Wertis L, Singh D, Green S. Short-term changes in mental health help-seeking behaviors following exposure to multiple social stressors and a natural disaster. Soc Sci Med 2024; 348:116843. [PMID: 38603916 PMCID: PMC11134597 DOI: 10.1016/j.socscimed.2024.116843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 02/23/2024] [Accepted: 03/26/2024] [Indexed: 04/13/2024]
Abstract
In 2020, unprecedented circumstances led to significant mental health consequences. Individuals faced mental health stressors that extended beyond the devastating impact of the COVID-19 pandemic, including widespread social unrest following the murder of George Floyd, an intense hurricane season in the Atlantic, and the politically divisive 2020 election. The objective of this analysis was to consider changes in help-seeking behavior following exposure to multiple social stressors and a natural disaster. Data from Crisis Text Line (CTL), a national text-based mental health crisis counseling service, was used to determine how help-seeking behavior changed in the wake of each event. Wilcoxon rank sum tests assessed changes in help-seeking behavior for each event in 2020 as compared to the same period in 2019. AutoRegressive Integrated Moving Average (ARIMA) models examined if changes in crisis conversation volumes following each event differed. Higher median conversation volumes noted for the COVID-19 pandemic (+1 to +5 conversations), Hurricane Laura (+1 to +7 conversations) and the 2020 Election (+1 to +26 conversations). ARIMA models show substantial increases in help-seeking behavior following the declaration of a national emergency for the COVID-19 pandemic (+4.3 to +38.2%) and following the 2020 election (+3 to +24.44%). Our analysis found that the mental health response following social stressors may be distinct from natural events, especially when natural disasters occur in the context of multiple social stressors. This analysis adds to the growing body of literature considering the mental health impact of exposure to multiple co-occurring societal stressors, like police violence and a global pandemic.
Collapse
Affiliation(s)
- Sophia C Ryan
- Department of Geography and Planning, Appalachian State University, Boone NC, 28607, USA.
| | - Margaret M Sugg
- Department of Geography and Planning, Appalachian State University, Boone NC, 28607, USA
| | - Jennifer D Runkle
- North Carolina Institute for Climate Studies, North Carolina State University, Raleigh NC, 27695, USA
| | - Luke Wertis
- Department of Geography and Planning, Appalachian State University, Boone NC, 28607, USA
| | - Devyani Singh
- Data Team, Crisis Text Line, New York City, New York, USA
| | - Shannon Green
- Data Team, Crisis Text Line, New York City, New York, USA
| |
Collapse
|
8
|
Di Gennaro F, Papagni R, Segala FV, Pellegrino C, Panico GG, Frallonardo L, Diella L, Belati A, Santoro CR, Brindicci G, Balena F, Bavaro DF, Montalbò D, Guido G, Calluso L, Di Tullio M, Sgambati M, Fiordelisi D, De Gennaro N, Saracino A. Stigma and mental health among people living with HIV across the COVID-19 pandemic: a cross-sectional study. BMC Infect Dis 2024; 24:423. [PMID: 38649892 PMCID: PMC11034033 DOI: 10.1186/s12879-024-09315-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 04/11/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Mental health (MH) is extremely relevant when referring to people living with a chronic disease, such as people living with HIV (PLWH). In fact - although life expectancy and quality have increased since the advent of antiretroviral therapy (ART) - PLWH carry a high incidence of mental disorders, and this burden has been exacerbated during the COVID-19 pandemic. In this scenario, UNAIDS has set new objectives for 2025, such as the linkage of at least 90% of PLWH to people-centered, context-specific MH services. Aim of this study was to determine the prevalence of MD in PLWH followed at the Clinic of Infectious Diseases of the University of Bari, Italy. METHODS From January 10th to September 10th, 2022, all PLWH patients accessing our outpatient clinic were offered the following standardized tools: HAM-A for anxiety, BDI-II for depression, PC-PTSD-5 for post-traumatic stress disorder, CAGE-AID for alcohol-drug abuse. Factors associated with testing positive to the four MD were explored with a multivariable logistic regression model. RESULTS 578 out of 1110 HIV-patients agreed to receive MH screening, with 141 (24.4%) people resulting positive to at least one MH disorder. HAM-A was positive in 15.8% (n = 91), BDI-II in 18% (n = 104), PC-PTSD-5 in 5% (n = 29) and CAGE in 6.1% (n = 35). The multivariable logistic regression showed a higher probability of being diagnosed with anxiety, depression and post-traumatic stress disorder for PLWH who reported severe stigma, social isolation, psychological deterioration during the COVID-19 pandemic and for those receiving a dolutegravir (DTG)-based regimen. Moreover, history of drug use (OR 1.13; [95% CE 1.06-4.35]), family stigma (2.42 [1.65-3.94]) and social isolation (2.72 [1.55;4.84]) were found to be associated to higher risk for substance use disorder. CONCLUSIONS In this study, stigma was a strong predictor for being diagnosed of a MH disorder among PLWH. Also, the possible role of dolutegravir as a risk factor for the onset of MH disorders should be considered in clinical practice, and MH of patients receiving DTG-containing regimens should be constantly monitored.
Collapse
Affiliation(s)
- Francesco Di Gennaro
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Roberta Papagni
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Francesco Vladimiro Segala
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy.
| | - Carmen Pellegrino
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Gianfranco Giorgio Panico
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Luisa Frallonardo
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Lucia Diella
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Alessandra Belati
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Carmen Rita Santoro
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Gaetano Brindicci
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Flavia Balena
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Davide Fiore Bavaro
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Domenico Montalbò
- Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari 'Aldo Moro', Bari, Italy
| | - Giacomo Guido
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | | | | | - Margherita Sgambati
- Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari 'Aldo Moro', Bari, Italy
| | - Deborah Fiordelisi
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Nicolò De Gennaro
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Annalisa Saracino
- Clinic of Infectious Disases, Department of Precision and Regenerative Medicine and Jonian Area - (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| |
Collapse
|
9
|
Sonuga-Barke EJS, Fearon P. Commentary: Health anxiety in youth during 'COVID' - some thoughts prompted by Rask et al. (2024). J Child Psychol Psychiatry 2024; 65:431-434. [PMID: 38415840 DOI: 10.1111/jcpp.13973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/19/2024] [Indexed: 02/29/2024]
Abstract
Researchers continue to count the short- and longer-term mental health costs for children and adolescents of the COVID-19 pandemic and the associated exceptional restrictions imposed by governments on their lives in an attempt to control the pandemic and its impacts. Despite being at low risk of serious physical illness from COVID-19 themselves, some studies have reported a decline in the mental health of many young people during the pandemic. Some have suggested that this could even create a risk for long-term morbidity. In this commentary, we reflect on the excellent article by Rask and colleagues on paediatric health anxiety and consider key research gaps for the field in general and for the specific challenges and questions posed by the COVID-19 pandemic and its legacy.
Collapse
Affiliation(s)
- Edmund J S Sonuga-Barke
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Pasco Fearon
- Department of Experimental Psychology, University of Cambridge, Cambridge, UK
| |
Collapse
|
10
|
Wirkner J, Brakemeier EL. The crisis is over, long live the crisis: mental health in emerging adulthood during the course of the COVID-19 pandemic. Front Psychol 2024; 15:1283919. [PMID: 38356763 PMCID: PMC10864646 DOI: 10.3389/fpsyg.2024.1283919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 01/16/2024] [Indexed: 02/16/2024] Open
Abstract
Introduction As a multidimensional stressor, the COVID-19 pandemic posed a significant threat to mental health, with studies showing younger age groups to be particularly vulnerable. Thus, this study aimed to monitor mental health, potential risk/protective factors, and pandemic-related variables among young university students during the pandemic. Methods Students of the University of Greifswald (M age = 23.0 years, 73.9% female) participated in five cross-sectional online surveys in December 2020 (N = 1,127), March 2021 (N = 760), June/July 2021 (N = 531), December 2021 (N = 1,226), and December 2022 (N = 814). Sociodemographic data, depression and anxiety severity, loneliness, quality of life, coping strategies, resilience, self-esteem, and emotion regulation were measured. First, results from December 2020 were compared to pre-pandemic normative data. Second, the time course during the pandemic was analyzed. Third, linear models were calculated to examine the influence of risk and protective factures on depression and anxiety severity. Results Higher levels of depression, anxiety, and loneliness, as well as lower levels of self-esteem, physical and mental health, social relationships and well-being were found in December 2020 compared to pre-pandemic. Levels of depression and anxiety severity peaked in December 2022. Female sex, loneliness, and previous mental treatment showed associations with higher depression and anxiety severity, while higher self-esteem, resilience and use of reappraisal strategies appeared to act as protective factors. Discussion The study indicates the pandemic's detrimental impact on students' mental health and quality of life. Identified risk and protective factors provide guidance for tailored prevention and treatment, as well as the design of measures for future pandemics and other crisis.
Collapse
Affiliation(s)
| | - Eva-Lotta Brakemeier
- Department for Clinical Psychology and Psychotherapy, Institute for Psychology, University of Greifswald, Greifswald, Germany
| |
Collapse
|
11
|
Leonhardt M, Bramness JG, Lien L. Incidence of SARS-CoV-2 and all-cause mortality in persons with co-occurring substance use disorder and mental illness during the pandemic: a Norwegian cohort study. Soc Psychiatry Psychiatr Epidemiol 2023:10.1007/s00127-023-02599-6. [PMID: 38015236 DOI: 10.1007/s00127-023-02599-6] [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: 06/01/2023] [Accepted: 11/20/2023] [Indexed: 11/29/2023]
Abstract
PURPOSE Most people were affected by the COVID-19 pandemic. Persons with co-occurring substance use disorder (SUD) and mental illness (MI) are already a marginalized group, with above average mortality. Thus, the study aim was to investigate SARS-CoV-2 incidence and mortality among persons with SUD/MI during the first two years of the pandemic. METHODS This historical cohort study merged data from the Norwegian Patient Register, the Norwegian Surveillance System for Communicable Diseases and census data from Statistics Norway. We calculated crude mortality rates for persons with SUD and mild/moderate vs. severe MI and compared them to persons with physical illnesses or healthy controls. The incidence rate ratios for SARS-CoV-2 infection and mortality were estimated using Poisson regression models. RESULTS Compared to healthy controls, the SARS-Cov-2-infection rate was marginally lower in persons with SUD and mild/moderate MI (IRR,1.19 [95%CI,1.09-1.30]) as in persons with physical illness (IRR,1.35 [95%CI, 1.23-1.47]), whereas persons with SUD and severe MI showed a lower rate compared to healthy controls. Crude mortality rates for persons with SUD/MI were substantially higher and increased much more during the pandemic than for persons with physical illnesses or healthy controls. The IRR for mortality in persons with SUD and mild/moderate MI was 10.61 (95%CI,7.19-15.67) and 11.44 (95%CI,7.50-17.45) for SUD and severe MI, compared to 5.03 (3.34-7.57]) for persons with physical illnesses only. CONCLUSION The analysis showed excess mortality during COVID-19-pandemic for SUD/MI, but without higher SARS-CoV-2 infection rates in this group. Consequently, excess mortality among persons with SUD/MI was not due to SARS-CoV-2 infection.
Collapse
Affiliation(s)
- Marja Leonhardt
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, PB 104, Brumunddal, 2381, Norway.
- Faculty of Health Studies, VID Specialized University, Oslo, Norway.
| | - Jørgen G Bramness
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, PB 104, Brumunddal, 2381, Norway
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway
- Institute of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Lars Lien
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, PB 104, Brumunddal, 2381, Norway
- Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
| |
Collapse
|
12
|
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.
Collapse
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
| | | |
Collapse
|
13
|
Stuenkel M, Koob C, Richardson E, Griffin SF, Sease KK. School-Based Mental Health Service Utilization Through the COVID-19 Pandemic and Beyond. THE JOURNAL OF SCHOOL HEALTH 2023; 93:1000-1005. [PMID: 37525409 DOI: 10.1111/josh.13384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 06/22/2023] [Accepted: 07/17/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND We examined trends in mental health service utilization before, during, and in the immediate return to in-person learning throughout the COVID-19 pandemic. METHODS Retrospective chart review was assessed for changes in odds of any visit being a mental health encounter from five school-based health centers from the 2018-2019 to the 2021-2022 school years. Data are limited to the in-person school year from mid-August to early June. RESULTS Data were assessed from 1239 students seen through 2256 visits over the 4 school years (Mage = 12.93). The odds of any visit being related to a mental health encounter increased each school year, with the 2020 to 2021 and 2021 to 2022 school years having significant increases in odds (both compared to the first and to the antecedent school year). In addition, during the 2019 to 2020 and 2020 to 2021 school years, the odds of a repeated mental health encounter significantly increased from year to year. CONCLUSIONS Findings indicate a steadily increasing number of mental health service utilization needs among adolescent students that was significantly exponentiated throughout the COVID-19 pandemic.
Collapse
Affiliation(s)
- Mackenzie Stuenkel
- Bradshaw Insititute for Community Child Health & Advocacy, Prisma Health Children's Hospital, Greenville, SC
| | - Caitlin Koob
- Department of Public Health Sciences, Clemson University, Clemson, SC
| | - Emily Richardson
- Bradshaw Insititute for Community Child Health & Advocacy, Prisma Health Children's Hospital, Greenville, SC
| | - Sarah F Griffin
- Department of Public Health Sciences, Clemson University, Clemson, SC
| | - Kerry K Sease
- Bradshaw Insititute for Community Child Health & Advocacy, Prisma Health Children's Hospital, Greenville, SC
- Pediatrics, University of South Carolina School of Medicine, Greenville, SC
| |
Collapse
|
14
|
Šagud M, Janović MB, Ćusa ZV, Jakšić N, Krakan LB, Begić D, Grubišin J, Janović Š, Jevtović S, Kosanović Rajačić B, Mamić G, Mikulić SK, Marčinko D, Peleš AM, Lisak MŠ, Štimac Z, Živković M, Ćusa BV, Wang W. Depression and stress levels in patients with different psychiatric disorders during concurrent early-phase COVID-19 pandemic and earthquake in Croatia. BMC Psychiatry 2023; 23:798. [PMID: 37915030 PMCID: PMC10621232 DOI: 10.1186/s12888-023-05302-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 10/23/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND While Croatia shared COVID-19 pandemic with other countries, its capital area was also hit by a 5.6 magnitude earthquake. The simultaneous impact of these two disasters on psychiatric patients is largely unknown, and we addressed those knowledge gaps. METHODS The cross-sectional study was conducted during the pandemic's first peak, in the aftermath of earthquake, by telephonic survey. Measurements included the Patient Health Questionnaire-9, the Perceived Stress Scale and the semi-structured interview to evaluate the impact of pandemic stress and earthquake. Overall 396 patients with depression and/or anxiety disorders (DAD), 229 participants with schizophrenia spectrum disorders (SSD) and 205 healthy controls were enrolled. RESULTS Both patient groups had higher depression and stress levels than controls, independent of sex, age and the presence of somatic comorbidity. After controlling for the same covariates, patient groups had higher COVID-19- and earthquake-related fears than controls. In patients with DAD, both fears were greater than among SSD patients. When comparing the two fears, the fear from earthquake was higher in DAD and control groups, whereas in SSD patients there was no such difference. CONCLUSIONS Patients with DAD were the most vulnerable group during disasters, while earthquake seems to be associated with more fear than the pandemics, at least in DAD patients and healthy individuals. Future longitudinal studies should determine if early psychological support might alleviate stress levels after disasters and prevent further worsening of mental health, particularly among DAD patients.
Collapse
Affiliation(s)
- Marina Šagud
- School of Medicine, University of Zagreb, Zagreb, Croatia
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Maja Bajs Janović
- School of Medicine, University of Zagreb, Zagreb, Croatia
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | | | - Nenad Jakšić
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia.
| | - Lucija Bagarić Krakan
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Dražen Begić
- School of Medicine, University of Zagreb, Zagreb, Croatia
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Jasmina Grubišin
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Špiro Janović
- University Centre Varaždin, University North, Varaždin, Croatia
| | - Saša Jevtović
- School of Medicine, University of Zagreb, Zagreb, Croatia
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Biljana Kosanović Rajačić
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | | | - Suzan Kudlek Mikulić
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Darko Marčinko
- School of Medicine, University of Zagreb, Zagreb, Croatia
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Alma Mihaljević Peleš
- School of Medicine, University of Zagreb, Zagreb, Croatia
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Maja Šeparović Lisak
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Zoran Štimac
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Maja Živković
- School of Medicine, University of Zagreb, Zagreb, Croatia
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Bjanka Vuksan Ćusa
- School of Medicine, University of Zagreb, Zagreb, Croatia
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Wei Wang
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| |
Collapse
|
15
|
Patel A, Daros AR, Irwin SH, Lau P, Hope IM, Perkovic SJM, Laposa JM, Husain MI, Levitan RD, Kloiber S, Quilty LC. Associations between rumination, depression, and distress tolerance during CBT treatment for depression in a tertiary care setting. J Affect Disord 2023; 339:74-81. [PMID: 37392943 DOI: 10.1016/j.jad.2023.06.063] [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: 12/15/2022] [Revised: 06/24/2023] [Accepted: 06/27/2023] [Indexed: 07/03/2023]
Abstract
BACKGROUND Rumination is strongly associated with depressive symptom severity and course. However, changes in rumination during outpatient cognitive behavioral therapy (CBT), and their links to baseline features such as distress tolerance and clinical outcomes, have received limited attention. METHODS 278 outpatients with depression received group or individual CBT. Measures of rumination, distress tolerance, and depression symptom severity were assessed at baseline and periodically during treatment. Mixed effect and regression-based models evaluated changes over time, and associations between rumination, distress tolerance and depression severity. RESULTS Depression and rumination decreased throughout acute treatment. Rumination reduction was concurrently associated with depressive symptom reduction. Lower levels of rumination at each time point prospectively predicted lower depressive symptoms at the next time point. Distress tolerance measured at baseline was positively associated with depression symptom severity; the indirect effect on post-treatment depression symptoms via rumination measured mid-treatment was nonsignificant when rumination at baseline was accounted for. Changes in and associations between depression and rumination were replicated in sensitivity analyses; although changes in depression and rumination were smaller in magnitude in patients receiving treatment during COVID-19. LIMITATIONS Additional assessment points would permit a more nuanced assessment of the role rumination may play in mediating the associations between distress tolerance and depression severity. Additional investigation of treatments in community settings may also further our understanding of variability in rumination during depression treatment. CONCLUSIONS The current study provides unique real-world support for variability in rumination as a key indicator of change over the course of CBT for depression.
Collapse
Affiliation(s)
- Alina Patel
- Campbell Family Mental Health Research Institute, CAMH, Canada; University of Toronto, Canada
| | | | | | - Parky Lau
- Toronto Metropolitan University, Canada
| | - Ingrid M Hope
- Campbell Family Mental Health Research Institute, CAMH, Canada
| | | | - Judith M Laposa
- Campbell Family Mental Health Research Institute, CAMH, Canada; University of Toronto, Canada
| | - M Ishrat Husain
- Campbell Family Mental Health Research Institute, CAMH, Canada; University of Toronto, Canada
| | - Robert D Levitan
- Campbell Family Mental Health Research Institute, CAMH, Canada; University of Toronto, Canada
| | - Stefan Kloiber
- Campbell Family Mental Health Research Institute, CAMH, Canada; University of Toronto, Canada
| | - Lena C Quilty
- Campbell Family Mental Health Research Institute, CAMH, Canada; University of Toronto, Canada.
| |
Collapse
|
16
|
Kennelly CE, Nguyen ATP, Sheikhan NY, Strudwick G, Ski CF, Thompson DR, Bartram M, Soklaridis S, Rossell SL, Castle D, Hawke LD. The lived experience of long COVID: A qualitative study of mental health, quality of life, and coping. PLoS One 2023; 18:e0292630. [PMID: 37831706 PMCID: PMC10575511 DOI: 10.1371/journal.pone.0292630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Abstract
The majority of people who contract COVID-19 experience a short period of symptomatic infection. However, symptoms persist for months or years following initial exposure to the virus in some cases. This has been described as long COVID. Little is known about the lived experience of this condition, as it has only recently emerged. This study aimed to explore the experiences of mental health, quality of life, and coping among people living with long COVID. A sample of 47 adults with lived experience participated in web-based focus groups. Separate focus groups were held for 24 individuals with pre-existing mental health conditions and 23 individuals without pre-existing mental health conditions. Data were analyzed using a codebook thematic analysis approach. Five themes were identified as integral to the long COVID experience: The Emotional Landscape of Long COVID, New Limits to Daily Functioning, Grief and Loss of Former Identity, Long COVID-related Stigmatization, and Learning to Cope with Persisting Symptoms. These findings illustrate the immense impact of long COVID on mental health and quality of life. Minimal differences were found between those with and those without pre-existing mental health conditions, as both groups were substantially impacted by the condition. Attention to the perspectives of people with lived experience of long COVID is necessary to inform future directions for research and clinical practice.
Collapse
Affiliation(s)
- Colleen E. Kennelly
- University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Anh T. P. Nguyen
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Natasha Yasmin Sheikhan
- University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Gillian Strudwick
- University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Chantal F. Ski
- Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom
| | - David R. Thompson
- Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom
| | - Mary Bartram
- Mental Health Commission of Canada, Ottawa, Ontario, Canada
| | - Sophie Soklaridis
- University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Susan L. Rossell
- Swinburne University of Technology, Melbourne, Victoria, Australia
| | - David Castle
- University of Tasmania, Hobart, Tasmania, Australia
| | - Lisa D. Hawke
- University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| |
Collapse
|
17
|
Jensen P, Madsen C, Hauge LJ, Gustavson K, Lund IO, Pettersen JH, Knudsen AKS, Reneflot A, Brandlistuen RE, Valdimarsdóttir UA, Ask H, Nesvåg R. Contact with primary care physicians among adults with pre-existing common mental health problems during the COVID-19 pandemic: a registry-based study from Norway. BMC Health Serv Res 2023; 23:1085. [PMID: 37821874 PMCID: PMC10568894 DOI: 10.1186/s12913-023-10108-3] [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: 05/03/2023] [Accepted: 10/03/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND During the COVID-19 pandemic, individuals with pre-existing mental health problems may have experienced additional stress, which could worsen symptoms or trigger relapse. Thus, this study aimed to investigate if the number of consultations with general practitioners (GPs) among individuals with a pre-existing common mental health problem during the pandemic differed from pre-pandemic years. METHODS Data on consultations with GPs among 18-65-year-olds registered with common mental health problems in 2017-2021 were retrieved from the Norwegian Control and Payment of Health Reimbursements Database. Based on data from the pre-pandemic years (2017-2019), we predicted the number of consultations per week for depression, anxiety disorder, phobia/obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and eating disorders during the pandemic (March 2020-December 2021) among individuals with pre-existing mental health problems. The forecasted and observed trends in GP consultations per week during the pandemic were stratified by diagnosis, gender, and age groups. RESULTS The observed number of consultations for anxiety disorder, PTSD, and eating disorders were significantly higher than forecasted during extended periods of the two pandemic years. The differences were largest for PTSD (on average 37% higher in men and 47% higher in women during the pandemic), and for eating disorders among women (on average 87% higher during the pandemic). There were only minor differences between the predicted and observed number of consultations for depression and phobia/OCD. CONCLUSIONS During the pandemic, individuals with a recent history of mental health problems were more likely to seek help for anxiety disorder, PTSD, and eating disorders, as compared to pre-pandemic years.
Collapse
Grants
- #324620 Norges Forskningsråd
- #324620 Norges Forskningsråd
- #324620 Norges Forskningsråd
- #324620 Norges Forskningsråd
- #324620 Norges Forskningsråd
- #324620 Norges Forskningsråd
- #324620 Norges Forskningsråd
- #324620 Norges Forskningsråd
- #105668, #138929, #156298 NordForsk
- #105668, #138929, #156298 NordForsk
- #105668, #138929, #156298 NordForsk
- #105668, #138929, #156298 NordForsk
- #105668, #138929, #156298 NordForsk
- Norwegian Institute of Public Health (FHI)
Collapse
Affiliation(s)
- Pia Jensen
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway.
- Department of Psychology, University of Oslo, Oslo, Norway.
| | - Christian Madsen
- Department of Disease Burden, Norwegian Institute of Public Health, Bergen, Norway
| | - Lars Johan Hauge
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
| | - Kristin Gustavson
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Ingunn Olea Lund
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Johanne Hagen Pettersen
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | | | - Anne Reneflot
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Unnur Anna Valdimarsdóttir
- Centre of Public Health Sciences, Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
- Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Helga Ask
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Ragnar Nesvåg
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
| |
Collapse
|
18
|
Onur D, Usta H, Ayık B, Sönmez E, Özdemir C. Attitudes toward COVID-19 pandemic measures and clinical symptom severity in schizophrenia patients: a preliminary cross-sectional study. J Int Med Res 2023; 51:3000605231195449. [PMID: 37698373 PMCID: PMC10498707 DOI: 10.1177/03000605231195449] [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: 04/11/2023] [Accepted: 08/01/2023] [Indexed: 09/13/2023] Open
Abstract
OBJECTIVES The study aim was to compare clinical symptom severity and quality of life (QoL) among schizophrenia patients according to their attitudes toward pandemic measures and reported lockdown-related disruption. METHODS Patients with schizophrenia attending follow-up sessions at two community mental health centers were included in this cross-sectional study. Sociodemographic and clinical characteristics of patients were assessed using a standardized form and the following psychometric instruments: the Positive and Negative Syndrome Scale, Brief Psychiatric Rating Scale, State-Trait Anxiety Inventory, Heinrich-Carpenter Quality of Life Scale and Clinical Global Impressions Ratings-Severity scale. Patients were grouped according to their attitudes toward pandemic measures (positive attitudes or non-positive attitudes). RESULTS No significant differences were found in sociodemographic and clinical variables, clinical symptom severity or QoL between schizophrenia patients with positive attitudes and those without positive attitudes toward pandemic measures. Guilt feelings and trait anxiety levels were positively related to lockdown-related disruption. CONCLUSIONS Positive attitudes toward pandemic measures may be affected by factors other than the sociodemographic and clinical status of schizophrenia patients. It is important that such factors are assessed in future studies to better manage pandemic-related challenges among schizophrenia patients.
Collapse
Affiliation(s)
- Durmaz Onur
- Erenköy Mental Health and Neurology Training and Research Hospital, Department of Psychiatry, Istanbul 34736, Turkey
| | - Haluk Usta
- Erenköy Mental Health and Neurology Training and Research Hospital, Department of Psychiatry, Istanbul 34736, Turkey
| | - Batuhan Ayık
- Erenköy Mental Health and Neurology Training and Research Hospital, Department of Psychiatry, Istanbul 34736, Turkey
| | - Ekin Sönmez
- Erenköy Mental Health and Neurology Training and Research Hospital, Department of Psychiatry, Istanbul 34736, Turkey
| | - Cemre Özdemir
- Erenköy Mental Health and Neurology Training and Research Hospital, Department of Psychiatry, Istanbul 34736, Turkey
| |
Collapse
|
19
|
Siette J, Dodds L, Brooks C, Deckers K. Older adults' perspectives towards optimizing lifestyle behaviors and strategies to support healthy brain ageing during COVID-19 restrictions. Front Public Health 2023; 11:1205001. [PMID: 37711233 PMCID: PMC10499331 DOI: 10.3389/fpubh.2023.1205001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 08/14/2023] [Indexed: 09/16/2023] Open
Abstract
Introduction It is unknown how the impact of COVID-19 restrictions has affected brain healthy behaviors that contribute to dementia risk reduction in older adults. Our aim was to explore perspectives of older adults on lifestyle behaviors that support positive brain health and dementia risk reduction during and following COVID-19 restrictions. Methods Community-dwelling older Australians (N = 159) during June to October 2021 (the second wave of COVID-19 restrictions) who had taken part in a pre-post dementia risk reduction intervention program were invited to discuss the impact of COVID-19 on their lifestyle behaviors. Semi-structured interviews explored individual's adaptability to pandemic restrictions, intended behavior changes following restrictions easing, and feedback on the effectiveness of ongoing intervention programs for sustaining brain health. Thematic data analysis was performed using a deductive approach. Results Participants had an average age of 73.1 years (SD = 5.6; range: 65-90), majority were female (74.7%), lived in a major city (82.2%) and mean 9.5 years (SD = 1.7) of education. Older adults' views about lifestyle prevention strategies during the pandemic were both positive (e.g., more spare time and adaptive leisure activities) and negative (e.g., social isolation, lack of motivation, adverse emotions). Participants highlighted a continuous conscious effort to adapt certain brain healthy behaviors despite the persistence of adverse impacts of COVID-19 restrictions. Participants also expressed the intention and desire to revert to their previous lifestyle before the COVID-19 pandemic or a sense of the 'new normal'. Conclusion This formative research will inform future interventions targeting dementia risk reduction to consider the immediate and lasting effects of COVID-19 restrictions on older adult's lifestyle behavior.
Collapse
Affiliation(s)
- Joyce Siette
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Sydney, NSW, Australia
- Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
| | - Laura Dodds
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Sydney, NSW, Australia
| | - Cristy Brooks
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia
| | - Kay Deckers
- Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, Netherlands
| |
Collapse
|
20
|
Barbalat G, Tanguy Melac A, Zante E, Haesebaert F, Franck N. Predictors of mental well-being over the first lockdown period due to the COVID-19 pandemic in France. A repeated cross-sectional study. Front Public Health 2023; 11:1234023. [PMID: 37701911 PMCID: PMC10493269 DOI: 10.3389/fpubh.2023.1234023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 08/07/2023] [Indexed: 09/14/2023] Open
Abstract
Introduction Numerous studies have investigated the positive and negative effects of potential predictors of well-being during lockdowns due to COVID-19. Yet, little is known on whether these effects significantly changed with time spent in lockdown. In the current study, we described the association of mental well-being with a large number of background characteristics (e.g., socio-demographic or health-related factors), COVID-related factors, and coping strategies, over the duration of the first lockdown due to COVID-19 in France. Methods A nationwide online survey was conducted over 7 of the 8 weeks of the 1st lockdown in France, i.e., from 25 March 2020 to 10 May 2020. The level of mental well-being was reported using the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS). We also measured various background characteristics (e.g., age, sex, education, health issues), COVID-related factors (e.g., health and economic risks, agreement with lockdown), and coping strategies. Our analytical strategy enabled us to disentangle effects aggregated over the study period from those that linearly vary with time spent in lockdown. Results Our final dataset included 18,957 participants. The level of mental well-being dropped gradually from the third to the eighth week of lockdown [49.7 (sd 7.9) to 45.5 (sd 10.6)]. Time in lockdown was associated with a decrease in well-being (for each additional 10 days of lockdown: B = -0.30, 95%CI: -0.62, -0.15). Factors that showed significantly negative and positive effects on well-being as time in lockdown progressed were (for each additional 10 days of lockdown): having current psychiatric problems (B = -0.37; 95%CI: -0.63, -0.04), worries about having access to personal protective equipment (B = -0.09; 95%CI: -0.18, -0.01), coping by having positive beliefs about the future of the pandemics (B = 0.29; 95%CI: 0.04, 0.62), being supported by neighbors (B = 0.24; 95%CI: 0.04, 0.44), and being involved in collective actions (B = 0.23; 95%CI: 0.04, 0.46). Discussion Participants from our sample saw a drop in their mental well-being throughout the first period of COVID-19 lockdown. Policymakers should be mindful of factors contributing to greater deterioration of mental well-being over time, such as having current psychiatric issues. Promoting collective actions and local support from neighbors may alleviate the deterioration of mental well-being over time.
Collapse
Affiliation(s)
- Guillaume Barbalat
- Centre Ressource de Réhabilitation Psychosociale, Centre hospitalier Le Vinatier, Bron, France
- UMR 5229, CNRS and Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
- Pôle Centre rive gauche, Centre hospitalier Le Vinatier, Bron, France
| | | | - Elodie Zante
- Centre Ressource de Réhabilitation Psychosociale, Centre hospitalier Le Vinatier, Bron, France
| | - Frédéric Haesebaert
- Centre Ressource de Réhabilitation Psychosociale, Centre hospitalier Le Vinatier, Bron, France
- PSYR2, INSERM U1028, CNRS UMR 5292, CRNL, Université de Lyon, UCBL, Lyon, France
| | - Nicolas Franck
- Centre Ressource de Réhabilitation Psychosociale, Centre hospitalier Le Vinatier, Bron, France
- UMR 5229, CNRS and Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
- Pôle Centre rive gauche, Centre hospitalier Le Vinatier, Bron, France
| |
Collapse
|
21
|
Krupp MB, King PR, Wade M, Buchholz LJ. Health service utilization among women veterans who report eating disorder symptoms. Int J Eat Disord 2023; 56:1593-1602. [PMID: 37166105 DOI: 10.1002/eat.23984] [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: 10/19/2022] [Revised: 04/24/2023] [Accepted: 04/25/2023] [Indexed: 05/12/2023]
Abstract
OBJECTIVE Describe health service utilization in women veterans with eating disorder symptoms and characterize the nature of mental health services received. METHOD Women veterans (N = 191) in a northeastern Veterans Health Administration region completed the Eating Disorders Examination Questionnaire. Health service utilization was then observed for 5 years across multiple domains (i.e., mental health, primary care, telephone consultations, emergency services); negative binomial or zero-inflated negative binomial regression models (mental health) estimated the relative impact of reported eating disorder symptoms on health service utilization. RESULTS After adjusting for the effects of age and body mass index, higher eating disorder symptoms were associated with higher primary care, mental health services, and telephone consultations. Eating disorder diagnoses were infrequent across the sample. DISCUSSION Women veterans with higher self-reported eating disorder symptoms evidence higher health service utilization across common healthcare domains. Encounter data suggest that eating disorder symptoms are rarely identified or clinically addressed by providers. Existing mental health visits may represent an opportunity for selective screening for eating disorder symptoms, particularly among women who evidence known risk factors. PUBLIC SIGNIFICANCE This study reveals that women veterans with higher levels of eating disorder symptoms (e.g., dietary restriction, poor body image) use more primary care, mental health, and telephone consultations than others, but may not receive services that target disordered eating. Opportunities may exist to better identify eating disorder symptoms in the context of existing mental health visits, or potentially to combine treatment for eating disorder symptoms into their mental health care.
Collapse
Affiliation(s)
- Meghan B Krupp
- Behavioral VA Careline, VA Western New York Healthcare System, Buffalo, New York, USA
- Department of Psychology, 204 Park Hall, University at Buffalo, Buffalo, New York, USA
| | - Paul R King
- Center for Integrated Healthcare, VA Western New York Healthcare System, Buffalo, New York, USA
- Department of Counseling, School, and Educational Psychology, 409 Baldy Hall, University at Buffalo, Buffalo, New York, USA
| | - Michael Wade
- Center for Integrated Healthcare, Syracuse VA Medical Center, Syracuse, New York, USA
| | - Laura J Buchholz
- Behavioral VA Careline, VA Western New York Healthcare System, Buffalo, New York, USA
- Center for Integrated Healthcare, VA Western New York Healthcare System, Buffalo, New York, USA
| |
Collapse
|
22
|
Rosa-Alcázar Á, Parada-Navas JL, García-Hernández MD, Pozza A, Tondi P, Rosa-Alcázar AI. Severity and Changes in OCD Dimensions during COVID-19: A Two-Year Longitudinal Study. Brain Sci 2023; 13:1151. [PMID: 37626507 PMCID: PMC10452262 DOI: 10.3390/brainsci13081151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/23/2023] [Accepted: 07/27/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic appears to be associated with a worsening of obsessive-compulsive symptoms in both young people and adults with OCD and it is necessary to analyze the variables involved in this worsening over time. The main aim of this study was to examine long-term changes in total severity and obsessive-compulsive dimensions in obsessive-compulsive patients during the COVID-19 pandemic. METHOD A total 250 OCD patients were selected from various associations, clinical centers and hospitals. We discarded 75 as they did not meet the inclusion criteria. A total of 175 obsessive-compulsive participants aged between 16 and 58 years old (M = 33.33, SD = 9.42) were evaluated in obsessive-compulsive symptom severity and dimensions OCD assessed using the Y-BOCS and D-YBOCS scales in T1 (April-June 2020) and in T2 (March-April 2022). The evaluation was carried out through an online survey and face-to-face with a professional clinician at both time points. RESULTS Intragroup differences in severity were observed, reaching higher scores for patients with contamination, somatic, aggressive and religious. Some patients changed their main dimension, increasing the percentage of patients with contamination and somatic obsessions. CONCLUSIONS COVID-19 was associated with both changes in severity and also affected some dimensions more than others, particularly those related to the virus itself (contamination and somatic).
Collapse
Affiliation(s)
- Ángel Rosa-Alcázar
- Department of Personality, Assessment & Psychological Treatment, University of Murcia, Espinardo, 30100 Murcia, Spain; (Á.R.-A.); (M.D.G.-H.); (P.T.)
| | | | - Maria Dolores García-Hernández
- Department of Personality, Assessment & Psychological Treatment, University of Murcia, Espinardo, 30100 Murcia, Spain; (Á.R.-A.); (M.D.G.-H.); (P.T.)
| | - Andrea Pozza
- Department of Medical, Surgical and Neuroscience Sciences, University of Siena, 53100 Siena, Italy;
| | - Paolo Tondi
- Department of Personality, Assessment & Psychological Treatment, University of Murcia, Espinardo, 30100 Murcia, Spain; (Á.R.-A.); (M.D.G.-H.); (P.T.)
| | - Ana Isabel Rosa-Alcázar
- Department of Personality, Assessment & Psychological Treatment, University of Murcia, Espinardo, 30100 Murcia, Spain; (Á.R.-A.); (M.D.G.-H.); (P.T.)
| |
Collapse
|
23
|
Bryant EM, Richardson R, Graham BM. The relationship between salivary Fibroblast Growth Factor-2 and cortisol reactivity and psychological outcomes prior to and during the COVID-19 pandemic. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2023; 13:100606. [PMID: 37304226 PMCID: PMC10246939 DOI: 10.1016/j.jadr.2023.100606] [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: 01/09/2023] [Revised: 05/09/2023] [Accepted: 06/02/2023] [Indexed: 06/13/2023] Open
Abstract
Background Fibroblast growth factor-2 (FGF2) is a biomarker that is associated with depression, anxiety and stress in rodents. In humans, we have previously demonstrated that salivary FGF2 increased following stress in a similar pattern to cortisol, and FGF2 (but not cortisol) reactivity predicted repetitive negative thinking, a transdiagnostic risk factor for mental illness. The current study assessed the relationship between FGF2, cortisol, and mental health before and during the COVID-19 pandemic. Methods We employed a longitudinal correlational design using a convenience sample. We assessed whether FGF2 and cortisol reactivity following the Trier Social Stress Task (TSST) were associated with DASS-21 depression, anxiety and stress, measured at the time of the TSST in 2019-20 (n = 87; time 1), and then again in May 2020 during the first wave of COVID-19 in Sydney (n = 34 of the original sample; time 2). Results FGF2 reactivity (but not absolute FGF2 levels) at time 1 predicted depression, anxiety, and stress across timepoints. Cortisol reactivity at time 1 was associated with stress over timepoints, and absolute cortisol levels were associated with depression across timepoints. Limitations The sample was comprised of mostly healthy participants from a student population, and there was high attrition between timepoints. The outcomes need to be replicated in larger, more diverse, samples. Conclusions FGF2 and cortisol may be uniquely predictive of mental health outcomes in healthy samples, potentially allowing for early identification of at-risk individuals.
Collapse
Affiliation(s)
- Emma M Bryant
- University of New South Wales, School of Psychology, Sydney, NSW 2052, Australia
| | - Rick Richardson
- University of New South Wales, School of Psychology, Sydney, NSW 2052, Australia
| | - Bronwyn M Graham
- University of New South Wales, School of Psychology, Sydney, NSW 2052, Australia
| |
Collapse
|
24
|
Brasso C, Cisotto M, Del Favero E, Giordano B, Villari V, Rocca P. Impact of COVID-19 pandemic on major depressive disorder in acute psychiatric inpatients. Front Psychol 2023; 14:1181832. [PMID: 37303894 PMCID: PMC10249995 DOI: 10.3389/fpsyg.2023.1181832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 05/02/2023] [Indexed: 06/13/2023] Open
Abstract
Introduction The spread of the coronavirus disease 2019 (COVID-19) pandemic and the subsequent restrictions significantly affected mental health, especially major depressive disorder (MDD) whose incidence increased by 27.6% in 2020, after the COVID-19 outbreak. Few studies focused on the impact of the pandemic on the clinical characteristics of outpatients with MDD and even fewer on inpatients admitted for a major depressive episode (MDE). We aimed to compare the characteristics of MDD of two groups of patients admitted for an MDE before and after the pandemic outbreak and to investigate which variables are significantly related to post-lockdown hospitalizations. Methods This retrospective study included 314 patients with MDD hospitalized from January 2018 to December 2021 for an MDE (DSM-5) before (n = 154) and after (n = 160) the Italian lockdown (9th of March 2020). We compared patients' sociodemographic and clinical characteristics. The characteristics significantly different between the two groups were included in a logistic regression to identify the factors more strictly associated with post-lockdown hospitalizations. Results During post-lockdown hospitalization, we found a higher rate of severe MDE (33 patients, 21.4%, in the pre-lockdown and 55 patients, 34.4%, in the post), MDE with psychotic features (3 patients, 2.0%, in the pre-lockdown and 11 patients, 6.9%, in the post-lockdown), and suicidal ideation (42, 27.3%, in the pre-lockdown and 67, 41.9%, in the post-lockdown), with a lower proportion of patients followed by psychiatric services before admission (106 patients, 68.8%, in the pre-lockdown and 90 patients, 56.3%, in the post-lockdown) and a higher percentage of them in treatment with psychotherapy (18 patients, 11.7% in the pre-lockdown and 32, 20.0%, in the post-lockdown) and more frequent increase of the antidepressant dosage (16 patients, 10.4% in the pre-lockdown and 32 patients, 20.0% in the post-lockdown) and adoption of augmentation strategies (13 patients, 8.4%, in the pre-lockdown and 26 patients, 16.3%, in the post-lockdown) to treat the MDE. In the regression model, post-lockdown hospitalizations were significantly associated with suicidal ideation (OR = 1.86; p = 0.016) and psychotic features (OR = 4.41; p = 0.029) at admission, the increase in the antidepressant daily dose (OR = 2.45; p = 0.009), and the employment of an augmentation therapy (OR = 2.25; p = 0.029). Discussion These results showed an association between the COVID-19 pandemic and the occurrence of MDE with more severe clinical features. This might be true also for future calamities, suggesting that in these emergency contexts, patients with MDD would require more attention, resources, and intense treatments with a specific focus on suicide prevention.
Collapse
Affiliation(s)
- Claudio Brasso
- Dipartimento di Neuroscienze “Rita Levi Montalcini, ” Università degli Studi di Torino, Turin, Italy
| | - Marta Cisotto
- Dipartimento di Neuroscienze “Rita Levi Montalcini, ” Università degli Studi di Torino, Turin, Italy
- Dipartimento di Neuroscienze e Salute Mentale, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
| | - Elisa Del Favero
- Dipartimento di Neuroscienze “Rita Levi Montalcini, ” Università degli Studi di Torino, Turin, Italy
| | - Benedetta Giordano
- Dipartimento di Neuroscienze “Rita Levi Montalcini, ” Università degli Studi di Torino, Turin, Italy
- Dipartimento di Neuroscienze e Salute Mentale, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
| | - Vincenzo Villari
- Dipartimento di Neuroscienze e Salute Mentale, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
| | - Paola Rocca
- Dipartimento di Neuroscienze “Rita Levi Montalcini, ” Università degli Studi di Torino, Turin, Italy
- Dipartimento di Neuroscienze e Salute Mentale, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
| |
Collapse
|
25
|
Moulton V, Sullivan A, Patalay P, Fitzsimons E, Henderson M, Bann D, Ploubidis GB. Association between psychological distress trajectories from adolescence to midlife and mental health during the pandemic: evidence from two British birth cohorts. Psychol Med 2023; 53:1-13. [PMID: 36935416 PMCID: PMC10600943 DOI: 10.1017/s0033291722003877] [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: 02/11/2022] [Revised: 08/31/2022] [Accepted: 12/06/2022] [Indexed: 03/21/2023]
Abstract
BACKGROUND This paper examined whether distinct life-course trajectories of psychological distress from adolescence to midlife were associated with poorer mental health outcomes during the pandemic. METHODS We present a secondary analysis of two nationally representative British birth cohorts, the 1958 National Child Development Study (NCDS) and 1970 British Cohort Study (BCS70). We used latent variable mixture models to identify pre-pandemic longitudinal trajectories of psychological distress and a modified Poisson model with robust standard errors to estimate associations with psychological distress, life satisfaction and loneliness at different points during the pandemic. RESULTS Our analysis identified five distinct pre-pandemic trajectories of psychological distress in both cohorts. All trajectories with prior symptoms of psychological distress irrespective of age of onset, severity and chronicity were associated with a greater relative risk of poorer mental health outcomes during the pandemic and the probability of poorer mental health associated with psychological distress trajectories remained fairly constant. The relationship was not fully attenuated when most recent pre-pandemic psychological distress and other midlife factors were controlled for. CONCLUSIONS Whilst life-course trajectories with any prior symptoms of psychological distress put individuals at greater risk of poor mental health outcomes during the pandemic, those with chronic and more recent occurrences were at highest risk. In addition, prior poor mental health during the adult life-course may mean individuals are less resilient to shocks, such as pandemics. Our findings show the importance of considering heterogeneous mental health trajectories across the life-course in the general population in addition to population average trends.
Collapse
Affiliation(s)
- V. Moulton
- Centre for Longitudinal Studies, University College London, London, UK
| | - A. Sullivan
- Centre for Longitudinal Studies, University College London, London, UK
| | - P. Patalay
- Centre for Longitudinal Studies, University College London, London, UK
- MRC Unit for Lifelong Health, University College London, London, UK
| | - E. Fitzsimons
- Centre for Longitudinal Studies, University College London, London, UK
| | - M. Henderson
- Centre for Longitudinal Studies, University College London, London, UK
| | - D. Bann
- Centre for Longitudinal Studies, University College London, London, UK
| | - G. B. Ploubidis
- Centre for Longitudinal Studies, University College London, London, UK
| |
Collapse
|
26
|
Stracke M, Heinzl M, Müller AD, Gilbert K, Thorup AAE, Paul JL, Christiansen H. Mental Health Is a Family Affair-Systematic Review and Meta-Analysis on the Associations between Mental Health Problems in Parents and Children during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20054485. [PMID: 36901492 PMCID: PMC10001622 DOI: 10.3390/ijerph20054485] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/22/2023] [Accepted: 02/28/2023] [Indexed: 05/13/2023]
Abstract
As a multidimensional and universal stressor, the COVID-19 pandemic negatively affected the mental health of children, adolescents, and adults worldwide. In particular, families faced numerous restrictions and challenges. From the literature, it is well known that parental mental health problems and child mental health outcomes are associated. Hence, this review aims to summarize the current research on the associations of parental mental health symptoms and child mental health outcomes during the COVID-19 pandemic. We conducted a systematic literature search in Web of Science (all databases) and identified 431 records, of which 83 articles with data of over 80,000 families were included in 38 meta-analyses. A total of 25 meta-analyses resulted in significant small to medium associations between parental mental health symptoms and child mental health outcomes (r = 0.19 to 0.46, p < 0.05). The largest effects were observed for the associations of parenting stress and child mental health outcomes. A dysfunctional parent-child interaction has been identified as a key mechanism for the transmission of mental disorders. Thus, specific parenting interventions are needed to foster healthy parent-child interactions, to promote the mental health of families, and to reduce the negative impacts of the COVID-19 pandemic.
Collapse
Affiliation(s)
- Markus Stracke
- Department of Clinical Child and Adolescent Psychology, Philipps University Marburg, 35032 Marburg, Germany
- Correspondence:
| | - Miriam Heinzl
- Department of Clinical Child and Adolescent Psychology, Philipps University Marburg, 35032 Marburg, Germany
| | - Anne Dorothee Müller
- Research Unit, Child and Adolescent Mental Health Center, 2100 Copenhagen, Denmark
| | - Kristin Gilbert
- Department of Clinical Child and Adolescent Psychology, Philipps University Marburg, 35032 Marburg, Germany
| | - Anne Amalie Elgaard Thorup
- Research Unit, Child and Adolescent Mental Health Center, 2100 Copenhagen, Denmark
- Institute for Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Jean Lillian Paul
- Mental Health Research Program, The Village, Ludwig Boltzmann Gesellschaft, 6020 Innsbruck, Austria
- Division of Psychiatry I, Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, 6020 Innsbruck, Austria
| | - Hanna Christiansen
- Department of Clinical Child and Adolescent Psychology, Philipps University Marburg, 35032 Marburg, Germany
| |
Collapse
|
27
|
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.
Collapse
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.
| |
Collapse
|
28
|
Marzano L, Hawley M, Fraser L, Lainez Y, Marsh J, Hawton K. Media coverage and speculation about the impact of the COVID-19 pandemic on suicide: a content analysis of UK news. BMJ Open 2023; 13:e065456. [PMID: 36854584 PMCID: PMC9979592 DOI: 10.1136/bmjopen-2022-065456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
OBJECTIVES Since the start of the COVID-19 pandemic, there has been much concern and speculation about rises in suicide rates, despite evidence that suicides did not in fact increase in the first year of the pandemic in most countries with real-time suicide data. This public narrative is potentially harmful, as well as misleading, and is likely to be perpetuated by sensational news coverage. METHOD Using a bespoke database, we analysed the quality and content of print and online UK news (including opinion pieces) on the impact of COVID-19 on suicidality, based on adherence to international recommendations. χ2 tests were conducted to examine variability in relation to key characteristics (eg, type of publication) and to four 'restriction phases' (based on UK government official lockdown measures) over the first 14 months of the pandemic. RESULTS We identified 372 stories about COVID-19 and suicidality in online and print news between the first UK lockdown (March 2020) and May 2021 (when restrictions were significantly eased in the UK). Throughout this period, over a third of articles (39.2%) and headlines (41.4%) claimed or predicted a rise in suicide, often attributed to feelings of entrapment and poor mental health (especially among young people) and fueled by expert commentary and speculation. Almost a third of reports were rated as being of negative quality (116, 31.2%), and at least half included no signposting to help and support. However, reporting improved in phases of less stringent COVID-19 restrictions and over time, with later articles and headlines including fewer negative statements and predictions about rises in suicides, and greater reliance on academic evidence. CONCLUSIONS As the longer-term consequences of the pandemic develop, and other national and global events unfold, it is increasingly important that the media, and the wider community of experts shaping its narratives, strive for a positive and evidence-informed approach to news coverage of suicide.
Collapse
Affiliation(s)
| | | | | | | | - James Marsh
- University of Oxford, Oxford, Oxfordshire, UK
| | - Keith Hawton
- Psychiatry, Centre for Suicide Research, Oxford University, Oxford, UK
| |
Collapse
|
29
|
Elsayed MEG, El-Abasiri RA, Marzo RR, Dardeer KT, Kamal MA, Abdelaziz H, Soliman SB, Htay MNN. Mental health, risk perception, and coping strategies among healthcare workers in Egypt during the COVID-19 pandemic. PLoS One 2023; 18:e0282264. [PMID: 36848375 PMCID: PMC9970061 DOI: 10.1371/journal.pone.0282264] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 02/11/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND Coronavirus disease-19 emerged in December 2019. Healthcare workers were exposed to this highly infectious virus during the pandemic and suffered several social and psychological consequences, such as anxiety, psychological distress, and burnout. OBJECTIVES To assess the psychological distress, anxiety, depression, coping strategies, risk perception, and attitude toward interprofessional teamwork among Egyptian healthcare workers during the COVID-19 pandemic. METHODS We conducted a cross-sectional online survey which consisted of five sections. The primary outcomes were anxiety (GAD-7), depression (PHQ-9), risk perception towards COVID-19, interprofessional teamwork attitude, and coping strategies during the Coronavirus disease-19 pandemic. The web-based questionnaire was distributed to Egyptian healthcare workers from the 20th of April 2020 to the 20th of May 2020. A snowball sampling method was used. Regression analysis was conducted to test the relationship between the socioeconomic characteristics and the previously mentioned outcomes. RESULTS A total of 403 participants responded to the online questionnaire. The majority were females (70.5%) and within the age group of 26-40 years (77.7%), with 2-5 years of work experience (43.2%). Most participants were pharmacists (33%) and physicians (22.1%). Eighty-two participants (21%) reported moderate to severe anxiety, and 79 participants reported (19.4%) moderate to severe depressive symptoms. In the univariate model, the marital status was associated with depression (OR 0.47, 95% CI 0.28-0.78), anxiety (OR 0.52, 95% CI 0.32-0.85), and an attitude toward interprofessional teamwork (β = -1.96 95% CI -2.72 to -1.2). Providing direct care to the patients was associated with lower anxiety symptoms (AOR 0.256, 95% CI 0.094-0.697). More severe anxiety and depressive symptoms were associated with difficulties in everyday life and the professional work environment (AOR 4.246 and 3.3, P = 0.003 and 0.01, respectively). Availability of mental health facilities at the workplace was associated with a lower risk perception towards COVID-19 (β = -0.79, 95% CI -1.24 to -0.34) and a more positive attitude towards teamwork (β = 2.77 95% CI 1.38-4.15). CONCLUSIONS According to our results, the COVID-19 pandemic was associated with mild anxiety and depression among healthcare workers in Egypt, especially pharmacists and physicians. We recommend more research targeting the mental health of healthcare workers in Egypt. If proven cost-effective and needed, wide-scale mental health screening and public health campaigns can facilitate effective prevention and treatment strategies. In addition, the availability of mental health facilities at the workplace could alleviate some of the risk perception associated with health emergencies and improve interprofessional teamwork.
Collapse
Affiliation(s)
- Mohamed E. G. Elsayed
- Department of Psychiatry and Psychotherapy III, University of Ulm, Ulm, Germany
- Department of Psychiatry, School of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
- * E-mail: , (MEGE); (KTD)
| | - Radwa Abdullah El-Abasiri
- Nuffield Department of Population Health, Old Road Campus, University of Oxford Richard Doll Building, Oxford, United Kingdom
| | - Roy Rillera Marzo
- Department of Community Medicine, International Medical School, Management and Science University, Selangor, Malaysia
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia
- Institute of Applied Health Sciences, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, United Kingdom
| | - Khaled T. Dardeer
- Faculty of Medicine, Cairo University, Cairo, Egypt
- * E-mail: , (MEGE); (KTD)
| | | | - Heba Abdelaziz
- Public Health Department, The National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt
| | | | - Mila Nu Nu Htay
- Department of Community Medicine, Faculty of Medicine, Manipal University College Malaysia, Melaka, Malaysia
| |
Collapse
|
30
|
Zimmerman M, D'Avanzato C, King BT. Telehealth treatment of patients with major depressive disorder during the COVID-19 pandemic: Comparative safety, patient satisfaction, and effectiveness to prepandemic in-person treatment. J Affect Disord 2023; 323:624-630. [PMID: 36521663 PMCID: PMC9742046 DOI: 10.1016/j.jad.2022.12.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 12/02/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND The COVID-19 pandemic impelled a transition from in-person to telehealth psychiatric treatment. There are no studies of partial hospital telehealth treatment for major depressive disorder (MDD). In the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project, we compared the effectiveness of partial hospital care of patients with MDD treated virtually versus in-person. METHODS Outcome was compared in 294 patients who were treated virtually from May 2020 to December 2021 to 542 patients who were treated in the in-person partial program in the 2 years prior to the pandemic. Patients completed self-administered measures of patient satisfaction, symptoms, coping ability, functioning, and general well-being. RESULTS In both the in-person and telehealth groups, patients with MDD were highly satisfied with treatment and reported a significant reduction in symptoms from admission to discharge. Both groups also reported a significant improvement in positive mental health, general well-being, coping ability, and functioning. A large effect size of treatment was found in both treatment groups. Contrary to our hypothesis, the small differences in outcome favored the telehealth-treated patients. The length of stay and the likelihood of staying in treatment until completion were significantly greater in the virtually treated patients. LIMITATIONS The treatment groups were ascertained sequentially, and telehealth treatment was initiated after the COVID-19 pandemic began. Outcome assessment was limited to a self-administered questionnaire. CONCLUSIONS In an intensive acute care setting, delivering treatment to patients with MDD using a virtual, telehealth platform was as effective as treating patients in-person.
Collapse
Affiliation(s)
- Mark Zimmerman
- Department of Psychiatry and Human Behavior, Brown Medical School, Rhode Island Hospital, Providence, RI, United States.
| | - Catherine D'Avanzato
- Department of Psychiatry and Human Behavior, Brown Medical School, Rhode Island Hospital, Providence, RI, United States
| | - Brittany T King
- Department of Psychiatry and Human Behavior, Brown Medical School, Rhode Island Hospital, Providence, RI, United States
| |
Collapse
|
31
|
Cox N, Raizada SR, Barkham N, Venkatachalam S, Sheeran TP, Adizie T, Sapkota H, Scott IC, Muller S, Bateman J. The impact of the COVID-19 pandemic and stringent social distancing measures on health-related quality of life and COVID-19 infection rates in patients with rheumatic disease: a longitudinal analysis through the pandemic. Rheumatol Adv Pract 2023; 7:rkad009. [PMID: 36751643 PMCID: PMC9897299 DOI: 10.1093/rap/rkad009] [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: 09/09/2022] [Accepted: 12/29/2022] [Indexed: 01/17/2023] Open
Abstract
Objective The aim was to evaluate the impact of the coronavirus disease 2019 (COVID-19) pandemic and stringent social isolation measures on patients with rheumatic disease (RD) from the beginning of the pandemic (April 2020). Methods In this UK-based single-centre, prospective, observational cohort study, all RD follow-up patients at our centre were invited by SMS text message in April 2020 to participate in the study. Participants completed questionnaires at four time points between April 2020 and December 2021. We collected demographics, clinically extremely vulnerable (CEV) status, short form 12 mental (MCS) and physical health component scores (PCS) for health-related quality of life, vaccination status, COVID-19 infection rates and incidence of long COVID. Results We enrolled 1605 patients (female, 69.0%; CEV, 46.5%); 906 of 1605 (56.4%) completed linked responses to our final questionnaire. MCS improved (+0.6, P < 0.05), whereas PCS scores deteriorated (-1.4, P < 0.001) between April 2020 and December 2021. CEV patients had worse mental and physical health scores than non-CEV patients at entry (PCS, 36.7 and 39.3, respectively, P < 0.001; MCS, 40.9 and 43.0, respectively, P < 0.001) and at each time point throughout the study; both mental and physical health outcomes were worse in CEV compared with non-CEV patients (P < 0.001 and P = 0.004, respectively). At study close, 148 of 906 (16.3%) reported COVID infection, with no difference in infection, vaccination or long COVID rates between CEV and non-CEV patients. Conclusions Mental and physical health in RD patients has changed throughout the pandemic; outcomes for both metrics of health were worse in CEV patients, although there were no differences in infection rates between the groups. These data might assist the understanding and planning of future health-care policy and social restrictions in RD patients. Trial registration ClinicalTrials.gov, www.clinicaltrials.gov, NCT04542031.
Collapse
Affiliation(s)
- Natasha Cox
- Correspondence to: Natasha Cox, Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, Newcastle-under-Lyme, UK. E-mail:
| | | | - Nick Barkham
- The Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | | | - Tom P Sheeran
- The Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | | | - Hem Sapkota
- The Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - Ian C Scott
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, Newcastle-under-Lyme, UK
| | - Sara Muller
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, Newcastle-under-Lyme, UK
| | - James Bateman
- The Royal Wolverhampton NHS Trust, Wolverhampton, UK,Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| |
Collapse
|
32
|
Garey L, Zvolensky MJ, Gallagher MW, Vujanovic A, Kendzor DE, Stephens L, Cheney MK, Cole AB, Kezbers K, Matoska CT, Robison J, Montgomery A, Zappi CV, Businelle MS. A Smartphone-Based Intervention for Anxiety and Depression in Racially and Ethnically Diverse Adults (EASE): Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e40713. [PMID: 36409958 PMCID: PMC9728024 DOI: 10.2196/40713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 11/14/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Clear health disparities have emerged in the rates of COVID-19 exposure, hospitalization, and death among Black, Hispanic, and American Indian (BHAI) individuals, relative to non-Hispanic White (NHW) individuals. BHAI populations have been disproportionately affected by lower behavioral health access and heightened negative mental health outcomes during the pandemic. OBJECTIVE This project directly addresses health disparities in access to behavioral health care during the COVID-19 pandemic among BHAI populations via an adaptation of the established, initially validated, low-cost, mobile app Easing Anxiety Sensitivity for Everyone (EASE) among individuals with symptoms of elevated anxiety or depression or both. METHODS The EASE trial is a 2-arm, prospective, randomized, blinded-assessor study with intention-to-treat analysis. Participants (N=800; n=200, 25%, Black; n=200, 25%, Hispanic; n=200, 25%, American Indian; and n=200, 25%, NHW) are randomized to receive either EASE or an active comparison condition for anxiety and depression. Participants compete an online prescreener, an enrollment call to provide informed consent, a baseline survey, a 6-month intervention period, and 3- and 6-month postbaseline assessments. Select participants also complete a 3- and 6-month postbaseline qualitative interview via phone or an online platform (eg, Zoom). Participants complete 2 scheduled daily ecological momentary assessments (EMAs) during the 6-month study period. These twice-daily EMAs guide a just-in-time approach to immediate, personalized behavioral health care. RESULTS Outcomes include reductions in anxiety and depressive symptoms and functional impairment at 3 and 6 months postrandomization. We also will examine putative mechanisms (eg, anxiety sensitivity [AS] and COVID-19-specific stress and fear) of the intervention effects. Further, as treatment effects may differ across sociocultural factors, perceived discrimination, social support, and socioeconomic status (SES) will be evaluated as potential moderators of treatment effects on the primary outcomes. Process evaluation using data collected during the study, as well as individual interviews with participants, will complement quantitative data. CONCLUSIONS Data from this efficacy trial will determine whether EASE successfully improves symptoms of anxiety and depression and whether these improvements outperform an active comparison control app. If successful, findings from this study have the potential to decrease anxiety and depression symptoms among vulnerable populations determined to be most at risk of exacerbated, long-lasting negative health sequelae. Data from this study may be used to support an implementation and dissemination trial of EASE within real-world behavioral health and social service settings. TRIAL REGISTRATION ClinicalTrials.gov NCT05074693; https://clinicaltrials.gov/ct2/show/NCT05074693. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/40713.
Collapse
Affiliation(s)
- Lorra Garey
- HEALTH Institute, University of Houston, Houston, TX, United States
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Michael J Zvolensky
- HEALTH Institute, University of Houston, Houston, TX, United States
- Department of Psychology, University of Houston, Houston, TX, United States
- Department of Behavioral Science, MD Anderson Cancer Center, University of Texas, Houston, TX, United States
| | - Matthew W Gallagher
- HEALTH Institute, University of Houston, Houston, TX, United States
- Department of Psychology, University of Houston, Houston, TX, United States
- Texas Institute for Measurement, Evaluation, and Statistics, University of Houston, Houston, TX, United States
| | - Anka Vujanovic
- HEALTH Institute, University of Houston, Houston, TX, United States
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Darla E Kendzor
- TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, United States
- Department of Family and Preventive Medicine, Health Sciences Center, University of Oklahoma, Oklahoma City, OK, United States
| | - Lancer Stephens
- College of Public Health, Health Sciences Center, University of Oklahoma, Oklahoma City, OK, United States
- Oklahoma Shared Clinical and Translational Research Resources, Health Sciences Center, University of Oklahoma, Oklahoma City, OK, United States
| | - Marshall K Cheney
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, United States
| | - Ashley B Cole
- Department of Psychology, Oklahoma State University, Stillwater, OK, United States
| | - Krista Kezbers
- TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, United States
| | - Cameron T Matoska
- HEALTH Institute, University of Houston, Houston, TX, United States
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Jillian Robison
- TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, United States
| | - Audrey Montgomery
- TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, United States
| | - Christopher V Zappi
- HEALTH Institute, University of Houston, Houston, TX, United States
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Michael S Businelle
- TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, United States
- Department of Family and Preventive Medicine, Health Sciences Center, University of Oklahoma, Oklahoma City, OK, United States
| |
Collapse
|
33
|
Lewis C, Lewis K, Edwards B, Evison C, John A, Pearce H, Raisanen L, Richards N, Roberts A, Jones I, Bisson JI. Posttraumatic growth related to the COVID-19 pandemic among individuals with lived experience of psychiatric disorder. J Trauma Stress 2022; 35:1756-1768. [PMID: 36322379 PMCID: PMC9877956 DOI: 10.1002/jts.22884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 12/03/2022]
Abstract
Although the COVID-19 pandemic has been shown to be detrimental to mental health, it may hold a parallel potential for positive change. Little is known about posttraumatic growth (PTG) as a potential outcome for individuals with lived experience of psychiatric disorders following trauma exposure, especially in the context of the COVID-19 pandemic. Participants were 1,424 adults with lived experience of a psychiatric disorder who took part in a longitudinal study of mental health during the COVID-19 pandemic conducted by the National Centre for Mental Health. PTG was measured using the Posttraumatic Growth Inventory-Short Form (PTGI-SF). Factors hypothesized to be associated with PTG were investigated using linear regression. The mean participant PTGI score was 12.64 (SD = 11.01). On average, participants reported the highest scores on items related to appreciation of life and lowest on those related to spiritual change subscale. We found the strongest evidence of associations between higher levels of PTG and higher scores on assessment items related to perceived social support, B = 2.86; perceptions of the pandemic as traumatic, B = 4.89; and higher psychological well-being, B = 0.40. Taken together, we did not observe evidence of widespread PTG related to the COVID-19 pandemic among individuals with lived experiences of psychiatric disorders.
Collapse
Affiliation(s)
- Catrin Lewis
- National Centre for Mental Health, Division of Psychological Medicine and Clinical NeurosciencesCardiff University School of MedicineCardiffUnited Kingdom
| | - Katie Lewis
- National Centre for Mental Health, Division of Psychological Medicine and Clinical NeurosciencesCardiff University School of MedicineCardiffUnited Kingdom
| | - Bethan Edwards
- National Centre for Mental Health, PÂRCardiff University School of MedicineCardiffUnited Kingdom
| | - Claudia Evison
- National Centre for Mental Health, Division of Psychological Medicine and Clinical NeurosciencesCardiff University School of MedicineCardiffUnited Kingdom
| | - Ann John
- National Centre for Mental Health, Population Data ScienceSwansea University Medical SchoolSwanseaUnited Kingdom
| | - Holly Pearce
- National Centre for Mental Health, Division of Psychological Medicine and Clinical NeurosciencesCardiff University School of MedicineCardiffUnited Kingdom
| | - Lawrence Raisanen
- National Centre for Mental Health, Division of Psychological Medicine and Clinical NeurosciencesCardiff University School of MedicineCardiffUnited Kingdom
| | - Natalie Richards
- National Centre for Mental Health, Division of Psychological Medicine and Clinical NeurosciencesCardiff University School of MedicineCardiffUnited Kingdom
| | - Alice Roberts
- National Centre for Mental Health, Division of Psychological Medicine and Clinical NeurosciencesCardiff University School of MedicineCardiffUnited Kingdom
| | - Ian Jones
- National Centre for Mental Health, Division of Psychological Medicine and Clinical NeurosciencesCardiff University School of MedicineCardiffUnited Kingdom
| | - Jonathan I. Bisson
- National Centre for Mental Health, Division of Psychological Medicine and Clinical NeurosciencesCardiff University School of MedicineCardiffUnited Kingdom
| |
Collapse
|
34
|
Crisan RM, Băcilă CI, Toboltoc PC, Morar S. Completed Suicide Linked to the COVID-19 Pandemic by Using the Psychological Autopsy Method in Sibiu County, Romania: Case Series and Literature Review. Healthcare (Basel) 2022; 10:healthcare10122377. [PMID: 36553902 PMCID: PMC9777587 DOI: 10.3390/healthcare10122377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 11/29/2022] Open
Abstract
The COVID-19 pandemic is associated with suicide, as some data suggests. Our study aims to investigate the emergence of eleven completed suicide cases suspected to be linked to the COVID-19 pandemic during the restrictive measures imposed by the Romanian government, and to identify the consequences of mental health, suicidal motivation, and behavioral changes. To this end, we analyzed the deceased's medical records and applied the psychological autopsy method to the relatives/caregivers of the deceased for a suicidal investigation history, within conducted free-flow discussions. To highlight behavioral changes that occurred in the distant antecedents as well as immediately before the suicidal act, we used two sets of closed questions comprised of fifteen alarm signs, including depressive and/or anxiety symptoms. Our results showed that a deterioration of the mental status, especially concerning depressive and anxiety symptoms, was evident in people without or with pre-existing psychiatric pathology. The suicidal motivation proved to be complex including, in addition to the SARS-CoV-2 infection, social and economic consequences of the COVID-19 pandemic. We noted an intensification of the investigated alarm signs and even the emergence of new warning signs in the recent antecedents. Based on our findings, we reaffirmed the important role of the psychological autopsy method in suicide investigation, proving that it can detect the specific impact of the COVID-19 pandemic on people prone to suicide. This impact can be psycho-emotional, social, and/or economical, and thus we can state that the COVID-19 pandemic and its consequences can be, at least, a triggering factor that enhances completed suicide risk. Further studies are needed in this particular area because correlations between the COVID-19 pandemic and completed suicide do not appear to be accidental.
Collapse
Affiliation(s)
- Roxana-Mihaela Crisan
- Doctoral Department, Faculty of Medicine, Lucian Blaga University of Sibiu, 550024 Sibiu, Romania
- Forensic Department, County Clinical Emergency Hospital of Sibiu, Corneliu Coposu Boulevard 2-4, 550245 Sibiu, Romania
| | - Ciprian Ionuț Băcilă
- 'Dr. Gheorghe Preda' Clinical Psychiatry Hospital, 550082 Sibiu, Romania
- Dental Medicine and Nursing Department, Faculty of Medicine, Lucian Blaga University of Sibiu, 550024 Sibiu, Romania
| | - Paul-Cătălin Toboltoc
- Doctoral Department, Faculty of Medicine, Lucian Blaga University of Sibiu, 550024 Sibiu, Romania
- Department of Anatomical Pathology, County Clinical Emergency Hospital of Sibiu, Corneliu Coposu Boulevard 2-4, 550245 Sibiu, Romania
| | - Silviu Morar
- Forensic Department, County Clinical Emergency Hospital of Sibiu, Corneliu Coposu Boulevard 2-4, 550245 Sibiu, Romania
- Preclinical Department, Faculty of Medicine, Lucian Blaga University of Sibiu, 550024 Sibiu, Romania
| |
Collapse
|
35
|
Roberts R, Johnson C, Hopwood M, Firth J, Jackson K, Sara G, Allan J, Calder R, Manger S. The Potential Impact of a Public Health Approach to Improving the Physical Health of People Living with Mental Illness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11746. [PMID: 36142019 PMCID: PMC9516962 DOI: 10.3390/ijerph191811746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 08/30/2022] [Accepted: 08/31/2022] [Indexed: 06/16/2023]
Abstract
With already wide disparities in physical health and life expectancy, COVID-19 presents people with mental illness with additional threats to their health: decreased access to health services, increased social isolation, and increased socio-economic disadvantage. Each of these factors has exacerbated the risk of poor health and early death for people with mental illness post-COVID-19. Unless effective primary care and preventative health responses are implemented, the physical illness epidemic for this group will increase post the COVID-19 pandemic. This perspective paper briefly reviews the literature on the impact of COVID-19 on service access, social isolation, and social disadvantage and their combined impact on physical health, particularly cancer, respiratory diseases, heart disease, smoking, and infectious diseases. The much-overlooked role of poor physical health on suicidality is also discussed. The potential impact of public health interventions is modelled based on Australian incidence data and current research on the percentage of early deaths of people living with mental illnesses that are preventable. Building on the lessons arising from services' response to COVID-19, such as the importance of ensuring access to preventive, screening, and primary care services, priority recommendations for consideration by public health practitioners and policymakers are presented.
Collapse
Affiliation(s)
- Russell Roberts
- Faculty of Business, Justice and Behavioural Science, Charles Sturt University, Bathurst, NSW 2795, Australia
| | - Caroline Johnson
- Melbourne Medical School, University of Melbourne, Parkville, VIC 3010, Australia
| | - Malcolm Hopwood
- Melbourne Medical School, University of Melbourne, Parkville, VIC 3010, Australia
| | - Joseph Firth
- Division of Psychology and Mental Health, University of Manchester, Manchester M13 9PL, UK
| | - Kate Jackson
- NSW Ministry of Health, St Leonards, NSW 2065, Australia
| | - Grant Sara
- NSW Ministry of Health, St Leonards, NSW 2065, Australia
- Sydney Medical School, Northern Clinical School, University of Sydney, Sydney, NSW 2001, Australia
| | - John Allan
- Queensland Health, University of Queensland, Brisbane, QLD 4072, Australia
| | - Rosemary Calder
- Mitchell Institute, Victoria University, Melbourne, VIC 3000, Australia
| | - Sam Manger
- College of Dentistry and Medicine, James Cook University, Townsville, QLD 4811, Australia
| |
Collapse
|
36
|
Lewis C, Lewis K, Roberts A, Evison C, Edwards B, John A, Lloyd K, Pearce H, Poole R, Richards N, Robinson C, Jones I, Bisson JI. COVID-19-related posttraumatic stress disorder in adults with lived experience of psychiatric disorder. Depress Anxiety 2022; 39:564-572. [PMID: 35536094 PMCID: PMC9348441 DOI: 10.1002/da.23262] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 03/09/2022] [Accepted: 04/16/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Prevalence estimates of COVID-19-related posttraumatic stress disorder (PTSD) have ranged from 1% to over 60% in the general population. Individuals with lived experience of a psychiatric disorder may be particularly vulnerable to COVID-19-related PTSD but this has received inadequate attention. METHODS Participants were 1571 adults with lived experience of psychiatric disorder who took part in a longitudinal study of mental health during the COVID-19 pandemic. PTSD was assessed by the International Trauma Questionnaire (ITQ) anchored to the participant's most troubling COVID-19-related experiencevent. Factors hypothesised to be associated with traumatic stress symptoms were investigated by linear regression. RESULTS 40.10% of participants perceived some aspect of the pandemic as traumatic. 5.28% reported an ICD-11 PTSD qualifying COVID-19 related traumatic exposure and 0.83% met criteria for probable ICD-11 COVID-19-related PTSD. Traumatic stress symptoms were associated with younger age, lower income, lower social support, and financial worries, and lived experience of PTSD/complex PTSD. Depression and anxiety measured in June 2020 predicted traumatic stress symptoms at follow-up approximately 20 weeks later in November 2020. CONCLUSIONS We did not find evidence of widespread COVID-19-related PTSD among individuals with lived experience of a psychiatric disorder. There is a need for future research to derive valid prevalence estimates of COVID-19-related PTSD.
Collapse
Affiliation(s)
- Catrin Lewis
- Division of Psychological Medicine and Clinical Neurosciences, National Centre for Mental HealthCardiff University School of MedicineCardiffUK
| | - Katie Lewis
- Division of Psychological Medicine and Clinical Neurosciences, National Centre for Mental HealthCardiff University School of MedicineCardiffUK
| | - Alice Roberts
- Division of Psychological Medicine and Clinical Neurosciences, National Centre for Mental HealthCardiff University School of MedicineCardiffUK
| | - Claudia Evison
- Division of Psychological Medicine and Clinical Neurosciences, National Centre for Mental HealthCardiff University School of MedicineCardiffUK
| | - Bethan Edwards
- Division of Psychological Medicine and Clinical Neurosciences, National Centre for Mental HealthCardiff University School of MedicineCardiffUK
| | - Ann John
- National Centre for Mental Health, Population Data ScienceSwansea University Medical SchoolSwanseaUK
| | - Keith Lloyd
- National Centre for Mental Health, Population Data ScienceSwansea University Medical SchoolSwanseaUK
| | - Holly Pearce
- Division of Psychological Medicine and Clinical Neurosciences, National Centre for Mental HealthCardiff University School of MedicineCardiffUK
| | - Rob Poole
- National Centre for Mental Health, Centre for Mental Health and SocietyBangor UniversityBangorUK
| | - Natalie Richards
- Division of Psychological Medicine and Clinical Neurosciences, National Centre for Mental HealthCardiff University School of MedicineCardiffUK
| | - Catherine Robinson
- Social Care and Society, School of Health SciencesUniversity of ManchesterManchesterUK
| | - Ian Jones
- Division of Psychological Medicine and Clinical Neurosciences, National Centre for Mental HealthCardiff University School of MedicineCardiffUK
| | - Jonathan I. Bisson
- Division of Psychological Medicine and Clinical Neurosciences, National Centre for Mental HealthCardiff University School of MedicineCardiffUK
| |
Collapse
|