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Farr M, Mamluk L, Jackson J, Redaniel MT, O'Brien M, Morgan R, Costello C, Spencer J, Banks J. Providing men at risk of suicide with emotional support and advice with employment, housing and financial difficulties: a qualitative evaluation of the Hope service. J Ment Health 2024; 33:3-13. [PMID: 35830874 DOI: 10.1080/09638237.2022.2091756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 05/10/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Men at risk of suicide often face difficulties with finances, employment, or housing, yet support services are usually psychologically based. This study evaluated the Hope service which provides integrated psychosocial support alongside practical, financial and specialist advice. AIMS To examine how the Hope service supports men at risk of suicide and factors that influence its impact and usefulness. METHODS Twenty-six qualitative interviews with 16 service users, six Hope staff, two specialist money advice workers funded to work for Hope and two NHS referral staff, thematically analysed. RESULTS The Hope service provided an essential service for men at risk of suicide, with complex needs including addiction, job loss, homelessness, debt, relationship-breakdown and bereavement who often would otherwise have fallen through service provision gaps. Working in a person-centred, non-judgemental way elicited trust and specialist advice tackled problems such as housing needs, debt, benefit claims and employment, enabling men to regain a sense of control over their lives. Some men shared histories of abuse, for which specialist counselling was hard to access. CONCLUSIONS Hope provides an effective integrated support package for suicidal men. Funding for services like Hope are important to tackle structural issues such as homelessness and debt, alongside emotional support.
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Affiliation(s)
- Michelle Farr
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Loubaba Mamluk
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Joni Jackson
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Maria Theresa Redaniel
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Marina O'Brien
- Second Step, Suicide Prevention and Post-Vention Services, Bristol, UK
| | - Rebecca Morgan
- Second Step, Suicide Prevention and Post-Vention Services, Bristol, UK
| | | | - Jez Spencer
- 6188 Ltd., Suicide Prevention and Intervention Trainer, Bristol, UK
| | - Jonathan Banks
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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Santos IS, Tovo-Rodrigues L, Maruyama JM, Barros AJD, Bierhals I, Del Ponte B, Matijasevich A. Impact of covid-19 pandemic over depressive symptoms among mothers from a population-based birth cohort in southern brazil. Arch Womens Ment Health 2023:10.1007/s00737-023-01331-2. [PMID: 37225910 DOI: 10.1007/s00737-023-01331-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 05/19/2023] [Indexed: 05/26/2023]
Abstract
PURPOSE Our aim was to assess the impact of COVID-19 on depressive symptoms among mothers from a population-based birth cohort in Pelotas, Southern Brazil. METHODS A subgroup of mothers from the Pelotas 2004 Birth Cohort was assessed pre-pandemic (November,2019 to March,2020) and mid-pandemic (August-December,2021). In both follow-ups, depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS). Pre-pandemic (T1) and pandemic-related predictors (T2) were analyzed. Prevalence of depression (EPDS score ≥ 13) at T1 and T2 were compared with chi-square test. Changes in EPDS from T1 to T2 were estimated by multivariate latent change score modelling. RESULTS 1,550 women were assessed. Prevalence of depression increased 38.1% (from 18.9% at T1 to 26.1% at T2) (p < 0.001). At T1, higher schooling, higher family income and being employed or working were related to lower EPDS, whereas being beneficiary of a cash transfer program and a larger number of people living in the household predicted higher EPDS. The deterioration of ones' own perception of quality of overall health (β = 0.191; SE = 0.028; p < 0.001) and worst family financial situation due to the pandemic (β = 0.083; SE = 0.024; p = 0.001) predicted the increase in EPDS from T1 to T2. CONCLUSION Almost two years after the beginning of the pandemic, the prevalence of depressive symptoms among the women was higher than before the pandemic. The deterioration of ones' own perception of quality of overall health and worst family financial situation due to the pandemic are proxies for the effect of COVID-19 pandemic (the true exposure of interest) in the women mental health.
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Affiliation(s)
- Iná S Santos
- Programa de Pós-Graduação Em Epidemiologia, Faculdade de Medicina, Universidade Federal de Pelotas, Rua Marechal Deodoro, 1160, 3º Piso, Pelotas, RS, CEP 96020-220, Brazil.
| | - Luciana Tovo-Rodrigues
- Programa de Pós-Graduação Em Epidemiologia, Faculdade de Medicina, Universidade Federal de Pelotas, Rua Marechal Deodoro, 1160, 3º Piso, Pelotas, RS, CEP 96020-220, Brazil
| | - Jessica M Maruyama
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Aluísio J D Barros
- Programa de Pós-Graduação Em Epidemiologia, Faculdade de Medicina, Universidade Federal de Pelotas, Rua Marechal Deodoro, 1160, 3º Piso, Pelotas, RS, CEP 96020-220, Brazil
| | - Isabel Bierhals
- Programa de Pós-Graduação Em Epidemiologia, Faculdade de Medicina, Universidade Federal de Pelotas, Rua Marechal Deodoro, 1160, 3º Piso, Pelotas, RS, CEP 96020-220, Brazil
| | - Bianca Del Ponte
- Programa de Pós-Graduação Em Epidemiologia, Faculdade de Medicina, Universidade Federal de Pelotas, Rua Marechal Deodoro, 1160, 3º Piso, Pelotas, RS, CEP 96020-220, Brazil
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
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Christl J, Schröder N, Mennicken R, Jänner M, Supprian T. Inpatient Suicides in Late Life: A Retrospective Analysis of a Hospital Group with Nine Psychiatric Clinics. Arch Suicide Res 2022; 26:1436-1446. [PMID: 34006203 DOI: 10.1080/13811118.2021.1922107] [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: 10/21/2022]
Abstract
OBJECTIVE Inpatient suicides are rare incidents; however, the impacts of such events on associated families and hospital staff are severe. Therefore, preventive strategies need to focus on risk factors. Clinical management in a hospital setting must integrate the home environment and social life of patients. Nevertheless, home leaves require careful preparation. METHODS Suicides were reported systematically from all psychiatric departments of the Landschaftsverband Rheinland (an assembly of municipalities) using a structured form during two periods (1995-2004, 2005-2014). From these reports we extracted data on suicide methods and sociodemographic and clinical variables. Only patients 65 years and older were included. RESULTS From a total of 551 reports on suicides in the period of 1995-2014, 103 patients 65 years and older (60 women, 43 men) died by suicide. In contrast to the general trend in Germany during this period, no decline in overall suicide rates was found. Most patients were treated because of depression (73.8%); schizophrenic psychosis was diagnosed in 11.7%; and dementia was only diagnosed in 1.9%. The most frequent suicide method was hanging (40%). All suicides within the hospital were hangings. The majority of suicides occurred outside the hospital during approved home leaves. Only 7% of suicides occurred when patients left the hospital without permission. Almost half of the patients (n = 44) died by suicide during the first month of treatment. With longer duration of hospitalization, the risk of suicide decreased. There were no significant trends with regard to suicide methods between the two periods. CONCLUSIONS In the first weeks of hospitalizations the patients are most endangered to die by suicide. Therefore, home leaves need careful consideration.
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Jackson J, Farr M, Birnie K, Davies P, Mamluk L, O’Brien M, Spencer J, Morgan R, Costello C, Smith J, Banks J, Redaniel MT. Preventing male suicide through a psychosocial intervention that provides psychological support and tackles financial difficulties: a mixed method evaluation. BMC Psychiatry 2022; 22:333. [PMID: 35562796 PMCID: PMC9103598 DOI: 10.1186/s12888-022-03973-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 04/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To help resolve high suicide rates in Bristol, North Somerset and South Gloucestershire, the charity Second Step was commissioned to roll-out the Hope service offering a psychosocial intervention for men, supporting them through acute distress and addressing financial difficulties. This study evaluated the impact of the Hope service on men at risk of suicide experiencing financial and other difficulties. METHODS Mixed methods study using: (i) a prospective cohort study design to compare depression, suicidal ideation and financial self-efficacy scores of men aged 30-64, referred to the service between October 2018 and July 2020, at baseline and 6 months follow-up and between low and moderate to high-intensity service users; and (ii) a qualitative interview study to evaluate the acceptability and impact of the Hope service to Hope service users. RESULTS There was a 49% reduction in depression score (mean reduction - 10.0, 95% CI - 11.7 to - 8.3) and in the proportion of service users with suicidal ideation (percent reduction - 52.5, 95% CI - 64.1% to - 40.9%) at 6 months follow-up compared to baseline. Financial self-efficacy scores increased by 26% (mean increase 2.9, 95% CI 1.8 to 3.9). Qualitative accounts illustrated how 'Hope saved my life' for several men interviewed; most respondents described being able to move forward and tackle challenges with more confidence following the Hope intervention. Professional advice to tackle financial and other difficulties such as housing helped to relieve anxiety and stress and enable practical issues to be resolved. CONCLUSIONS The Hope service offered practical and emotional support to men who have experienced suicidal feelings, redundancy, homelessness and poverty and occupies an important space between mental health and social care provision. Hope demonstrates the value of an intervention which cuts across traditional boundaries between psychiatric care and social advice agencies to provide, what is, in effect, an integrated care service.
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Affiliation(s)
- Joni Jackson
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol Medical School, University of Bristol, 9th floor Whitefriars, Lewins Mead, Bristol, BS1 2NT, UK. .,Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
| | - Michelle Farr
- grid.5337.20000 0004 1936 7603The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol Medical School, University of Bristol, 9th floor Whitefriars, Lewins Mead, Bristol, BS1 2NT UK ,grid.5337.20000 0004 1936 7603Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Kate Birnie
- grid.5337.20000 0004 1936 7603Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Philippa Davies
- grid.5337.20000 0004 1936 7603The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol Medical School, University of Bristol, 9th floor Whitefriars, Lewins Mead, Bristol, BS1 2NT UK ,grid.5337.20000 0004 1936 7603Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Loubaba Mamluk
- grid.5337.20000 0004 1936 7603The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol Medical School, University of Bristol, 9th floor Whitefriars, Lewins Mead, Bristol, BS1 2NT UK ,grid.5337.20000 0004 1936 7603Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | | | | | | | | | - Jonathan Banks
- grid.5337.20000 0004 1936 7603The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol Medical School, University of Bristol, 9th floor Whitefriars, Lewins Mead, Bristol, BS1 2NT UK ,grid.5337.20000 0004 1936 7603Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Maria Theresa Redaniel
- grid.5337.20000 0004 1936 7603The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol Medical School, University of Bristol, 9th floor Whitefriars, Lewins Mead, Bristol, BS1 2NT UK ,grid.5337.20000 0004 1936 7603Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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A Qualitative Scoping Review of the Impacts of Economic Recessions on Mental Health: Implications for Practice and Policy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105937. [PMID: 35627474 PMCID: PMC9140450 DOI: 10.3390/ijerph19105937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 04/12/2022] [Accepted: 05/10/2022] [Indexed: 11/17/2022]
Abstract
In a follow-up to our 2021 scoping review of the quantitative literature on the impacts of economic recessions on mental health, this scoping review summarizes qualitative research to develop a descriptive understanding of the key factors that transmute the socioeconomic stressors of a recession into poorer mental health. The previous study identified 22 qualitative studies from 2008 to 2020, which were updated with search results from six databases for articles published between 2020 and 2021. After inclusion and exclusion criteria were applied to the total 335 identified studies, 13 articles were included. These were peer-reviewed, qualitative studies in developed economies, published from 2008 to 2021, and available online in English. Participants perceived that financial hardship and unemployment during recessions increased stress and led to feelings of shame, loss of structure and identity, and a perceived lack of control, which increased interpersonal conflict, social isolation, maladaptive coping, depression, self-harm, and suicidal behavior. Participants struggled with accessing health and social services and suggested reforms to improve the navigation and efficiency of services and to reduce the perceived harms of austerity measures. Providers should screen for mental distress and familiarize themselves with health and social resources in their community to help patients navigate these complex systems. Policy makers should be aware of the potential protective nature of unemployment safeguards and consider other low-cost measures to bolster mental health supports and informal social networks. Research in this area was limited. Further research would be beneficial given the impacts of the ongoing COVID-19 recession.
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Effects of the Great Recession on suicide mortality in Chile and contributing factors. SSM - MENTAL HEALTH 2022. [DOI: 10.1016/j.ssmmh.2022.100104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Ilic M, Ilic I. Trends in suicide by hanging, strangulation, and suffocation in Serbia, 1991-2020: A joinpoint regression and age-period-cohort analysis. World J Psychiatry 2022; 12:505-520. [PMID: 35433320 PMCID: PMC8968500 DOI: 10.5498/wjp.v12.i3.505] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 11/18/2021] [Accepted: 02/10/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Hanging is one of the most commonly used methods for suicide in both sexes worldwide. In a number of countries, hanging mortality has increased over the last decades. Nevertheless, there is a scarcity of studies that have explored the patterns and trends for mortality of suicide by hanging on global, regional and national levels, as most evaluations are limited to certain populations.
AIM To assess the trends of suicide mortality by hanging, strangulation, and suffocation in Serbia, from 1991 to 2020.
METHODS This nationwide study, with epidemiological descriptive study design, was carried out based on official data. The age-standardized rates (ASRs, expressed per 100000 persons) were calculated by direct standardization, using the World Standard Population. Mortality trends from suicide by hanging were assessed using the joinpoint regression analysis: The average annual percent change (AAPC) with the corresponding 95% confidence interval (95%CI) was calculated. Age-period-cohort analysis was performed to address the possible underlying reasons for the observed suicide trends.
RESULTS Over the 30-year period studied, there were 24340 deaths by hanging (17750 males and 6590 females) in Serbia. In 2020, the ASR of deaths by hanging was 4.5 per 100000 persons in both sexes together (7.6 in males vs 1.7 in females). The trends of suicide mortality by hanging decreased significantly between 1991 and 2020 in both males (AAPC = -1.7% per year; 95%CI: -2.0 to -1.4) and females (AAPC = - 3.5% per year; 95%CI: -3.9 to -3.1). Mortality rates of suicide by hanging had a continuously decreasing tendency in both sexes together in all age groups: The only exception was among males in 40-49 age group, with an increasing trend of suicide by hanging from 1991 to 2011 (by +0.3% per year).
CONCLUSION The trends in suicide mortality by hanging have been decreasing in Serbia in the last three decades in both sexes, but this was more pronounced in women than in men. Despite the decreasing trends observed in mortality of suicide by hanging, further research is needed for better clarification of trends and help in suicide prevention in the future.
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Affiliation(s)
- Milena Ilic
- Department of Epidemiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac 34000, Serbia
| | - Irena Ilic
- Faculty of Medicine, University of Belgrade, Belgrade 11000, Serbia
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Hunt IM, Richards N, Bhui K, Ibrahim S, Turnbull P, Halvorsrud K, Saini P, Kitson S, Shaw J, Appleby L, Kapur N. Suicide rates by ethnic group among patients in contact with mental health services: an observational cohort study in England and Wales. Lancet Psychiatry 2021; 8:1083-1093. [PMID: 34762843 DOI: 10.1016/s2215-0366(21)00354-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 08/09/2021] [Accepted: 08/12/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Recent evidence on suicide rates among psychiatric patients from minority ethnic backgrounds is scarce. We aimed to examine suicide rates among minority ethnic psychiatric patients and describe their social and clinical characteristics. METHODS We did a retrospective observational cohort study on a national case-series of patients in England and Wales who died by suicide within 12 months of contact with mental health services between 2007 and 2018. Data were collected as part of the National Confidential Inquiry into Suicide and Safety in Mental Health. Suicide rates and standardised mortality ratios (SMRs) were estimated for South Asian (Indian, Pakistani, and Bangladeshi), Black African, Black Caribbean, Chinese, and White patients. FINDINGS A total of 698 patients in the four minority ethnic groups of South Asian, Black Caribbean, Black African, and Chinese were included (482 [69%] men; 216 [31%] women; mean age 41 years [SD 14·9, range 12-91] and compared with 13 567 White patients (9030 [66·6%] men; 4537 [33·4%] women; mean age 48 years [SD 15·8, range 10-100]). Rates and SMRs for suicide among minority ethnic patients were lower than for White patients (2·73 deaths, 95% CI 2·68-2·78) per 100 000 population. Differences were found between ethnic groups with higher suicide rates in Black Caribbean patients (1·89 deaths [95% CI 1·55-2·23] per 100 000 population) and lower rates in South Asian patients (1·49 deaths [1·33-1·64] per 100 000 population). There was an increase in rates among White patients in 2007-12 followed by a fall but no change among other ethnic groups. Schizophrenia was more common among Black African patients (54%) and Black Caribbean patients (44%), while affective disorder was more common among South Asian patients (41%). Minority ethnic patients overall showed markers of social adversity and received higher intensity care yet were viewed by clinicians as at lower risk than White patients. INTERPRETATION Effective approaches to prevention might differ between minority ethnic groups. Clinicians and the services in which they work should be aware of the common and distinct social and clinical needs of minority ethnic patients with mental illness. FUNDING The Healthcare Quality Improvement Partnership.
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Affiliation(s)
- Isabelle M Hunt
- National Confidential Inquiry into Suicide and Safety in Mental Health, Centre for Mental Health and Safety, School of Health Sciences, University of Manchester, Manchester, UK.
| | - Nicola Richards
- National Confidential Inquiry into Suicide and Safety in Mental Health, Centre for Mental Health and Safety, School of Health Sciences, University of Manchester, Manchester, UK
| | - Kamaldeep Bhui
- Department of Psychiatry, University of Oxford, Oxford, UK; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK; Synergi Collaborative Centre, University of Oxford, Oxford, UK
| | - Saied Ibrahim
- National Confidential Inquiry into Suicide and Safety in Mental Health, Centre for Mental Health and Safety, School of Health Sciences, University of Manchester, Manchester, UK
| | - Pauline Turnbull
- National Confidential Inquiry into Suicide and Safety in Mental Health, Centre for Mental Health and Safety, School of Health Sciences, University of Manchester, Manchester, UK
| | - Kristoffer Halvorsrud
- Department of Psychiatry, University of Oxford, Oxford, UK; NIHR ARC North Thames, Department of Applied Health Research, University College London, London, UK
| | - Pooja Saini
- School of Psychology, Liverpool John Moore's University, Liverpool, UK
| | - Sadie Kitson
- National Confidential Inquiry into Suicide and Safety in Mental Health, Centre for Mental Health and Safety, School of Health Sciences, University of Manchester, Manchester, UK
| | - Jenny Shaw
- National Confidential Inquiry into Suicide and Safety in Mental Health, Centre for Mental Health and Safety, School of Health Sciences, University of Manchester, Manchester, UK
| | - Louis Appleby
- National Confidential Inquiry into Suicide and Safety in Mental Health, Centre for Mental Health and Safety, School of Health Sciences, University of Manchester, Manchester, UK
| | - Nav Kapur
- National Confidential Inquiry into Suicide and Safety in Mental Health, Centre for Mental Health and Safety, School of Health Sciences, University of Manchester, Manchester, UK; NIHR Greater Manchester Patient Safety Translational Research Centre, Manchester, UK; Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
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Guerra O, Eboreime E. The Impact of Economic Recessions on Depression, Anxiety, and Trauma-Related Disorders and Illness Outcomes-A Scoping Review. Behav Sci (Basel) 2021; 11:119. [PMID: 34562956 PMCID: PMC8464685 DOI: 10.3390/bs11090119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/20/2021] [Accepted: 08/25/2021] [Indexed: 11/30/2022] Open
Abstract
In the wake of a global economic recession secondary to the COVID-19 pandemic, this scoping review seeks to summarize the current quantitative research on the impact of economic recessions on depression, anxiety, traumatic disorders, self-harm, and suicide. Seven research databases (PsycINFO, MEDLINE, Embase, Web of Science: Core Collection, National Library of Medicine PubMed, PubMed Central, and Google Scholar) were searched for keywords returning 3412 preliminary results published since 2008 in Organisation for Economic Coordination and Development (OECD)nations. These were screened by both authors for inclusion/exclusion criteria resulting in 127 included articles. Articles included were quantitative studies in OECD countries assessing select mental disorders (depression, anxiety, and trauma-/stress-related disorders) and illness outcomes (self-harm and suicide) during periods of economic recession. Articles were limited to publication from 2008 to 2020, available online in English, and utilizing outcome measures specific to the disorders and outcomes specified above. A significant relationship was found between periods of economic recession and increased depressive symptoms, self-harming behaviour, and suicide during and following periods of recession. Results suggest that existing models for mental health support and strategies for suicide prevention may be less effective than they are in non-recession times. It may be prudent to focus public education and medical treatments on raising awareness and access to supports for populations at higher risk, including those vulnerable to the impacts of job or income loss due to low socioeconomic status preceding the recession or high levels of financial strain, those supporting others financially, approaching retirement, and those in countries with limited social safety nets. Policy makers should be aware of the potential protective nature of unemployment safeguards and labour program investment in mitigating these negative impacts. Limited or inconclusive data were found on the relationship with traumatic disorders and symptoms of anxiety. In addition, research has focused primarily on the working-age adult population with limited data available on children, adolescents, and older adults, leaving room for further research in these areas.
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Affiliation(s)
- Olivia Guerra
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada;
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Shuster A, O’Brien M, Luo Y, Berner LA, Perl O, Heflin M, Kulkarni K, Chung D, Na S, Fiore VG, Gu X. Emotional adaptation during a crisis: decline in anxiety and depression after the initial weeks of COVID-19 in the United States. Transl Psychiatry 2021; 11:435. [PMID: 34417441 PMCID: PMC8377451 DOI: 10.1038/s41398-021-01552-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 07/22/2021] [Accepted: 08/10/2021] [Indexed: 11/30/2022] Open
Abstract
Crises such as the COVID-19 pandemic are known to exacerbate depression and anxiety, though their temporal trajectories remain under-investigated. The present study aims to investigate fluctuations in depression and anxiety using the COVID-19 pandemic as a model crisis. A total of 1512 adults living in the United States enrolled in this online study beginning April 2, 2020 and were assessed weekly for 10 weeks (until June 4, 2020). We measured depression and anxiety using the Zung Self-Rating Depression scale and State-Trait Anxiety Inventory (state subscale), respectively, along with demographic and COVID-related surveys. Linear mixed-effects models were used to examine factors contributing to longitudinal changes in depression and anxiety. We found that depression and anxiety levels were high in early April, but declined over time. Being female, younger age, lower-income, and previous psychiatric diagnosis correlated with higher overall levels of anxiety and depression; being married additionally correlated with lower overall levels of depression, but not anxiety. Importantly, worsening of COVID-related economic impact and increase in projected pandemic duration exacerbated both depression and anxiety over time. Finally, increasing levels of informedness correlated with decreasing levels of depression, while increased COVID-19 severity (i.e., 7-day change in cases) and social media use were positively associated with anxiety over time. These findings not only provide evidence for overall emotional adaptation during the initial weeks of the pandemic, but also provide insight into overlapping, yet distinct, factors contributing to depression and anxiety throughout the first wave of the pandemic.
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Affiliation(s)
- Anastasia Shuster
- grid.59734.3c0000 0001 0670 2351Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Madeline O’Brien
- grid.59734.3c0000 0001 0670 2351Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Yi Luo
- grid.438526.e0000 0001 0694 4940Fralin Biomedical Research Institute at VTC, Virginia Tech, Roanoke, VA USA
| | - Laura A. Berner
- grid.59734.3c0000 0001 0670 2351Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Ofer Perl
- grid.59734.3c0000 0001 0670 2351Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Matthew Heflin
- grid.59734.3c0000 0001 0670 2351Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Kaustubh Kulkarni
- grid.59734.3c0000 0001 0670 2351Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Dongil Chung
- grid.42687.3f0000 0004 0381 814XDepartment of Biomedical Engineering, UNIST, Ulsan, South Korea
| | - Soojung Na
- grid.59734.3c0000 0001 0670 2351Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Vincenzo G. Fiore
- grid.59734.3c0000 0001 0670 2351Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Xiaosi Gu
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA. .,Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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