Epidemiology of mental health problems in COVID-19: a review

COVID-19 and psychiatric disorders among young people: a cross-sectional study

During the COVID-19 pandemic, a significant rise in mental health issues was observed. Particularly, children and adolescents have shown a higher risk of developing mental disorders than adults. This study aimed to describe the evolving features of the requests for psychiatric emergency interventions during the COVID-19 pandemic in young people. We conducted a cross-sectional study comparing the number, characteristics, and symptoms of people aged between 12 and 18 years old attending one Emergency Department (ED) for psychiatric issues, considering three different periods: T0 (8 March 2019-7 March 2020), T1 (8 March 2020-7 March 2021), and T2 (8 March 2021-7 March 2022). Total admissions were 220: 99 (45%) during T0, 40 (18.1%) for T1, and 81 (36.8%) for T2 ( P  < 0.001). A significant decrease in the mean age from T0 to T1 was found ( P  < 0.01). Admissions for psychomotor agitation decreased, while admission due to anxiety disorder and nonsuicidal self-injury raised significantly ( P  < 0.05), as for first psychiatric presentation ( P  < 0.01). Regarding substance use, a significant reduction was observed ( P  < 0.05). The rates of eating disorders ( P  < 0.001) and early insomnia ( P  < 0.01) increased from T0. These findings highlight the worsening of psychiatric symptoms in the young population during the COVID-19 pandemic.

Effect of maternal depression and anxiety scores on the development of three-month-old babies through the assessment of general movements

BACKGROUND

Depression and anxiety symptoms are common during pregnancy, which poses significant risks not only for mothers but also babies. Exposure of the fetus to maternal distress during pregnancy can lead to impairments of the newborn's development that persist throughout their lives. The objective of this study is to investigate whether prenatal exposure to maternal depression and anxiety symptoms has an impact on the neurological status of infants by assessing the quality of general movements at 3 months of age.

METHODS

In this study, 101 uncomplicated pregnant patients who completed 36 weeks of gestation and their healthy newborns were analyzed. The Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory-Trait (STAI-T) questionnaires were used to assess mothers' distress. 3 months after the birth, general movements (GMs) assessments were conducted using video recordings of their babies. The scores of the questionnaires were compared between the infants grouped as "normal GMs" and "abnormal GMs".

RESULTS

Twenty-six infants exhibited abnormal GMs, while 75 exhibited normal. There was a statistically significant difference in maternal BDI and STAI-T scores between infants exhibiting abnormal and normal GMs.

CONCLUSION

Our study revealed that a mother's higher anxiety and depression scores during the latter stages of pregnancy might negatively affect the early development of the newborn and this can be determined at 3 months of age by evaluating the quality of GMs. This highlights the importance of monitoring the distress experienced by the mother and the quality of GMs exhibited by newborns and taking preventative measures.

Prevalence and correlates of generalized anxiety disorder and subthreshold anxiety symptoms in south China: A network perspective

AIMS

To investigate the prevalence of generalized anxiety disorder (GAD) and subthreshold anxiety symptoms (SAS) in Guangdong province of China, and to identify the central anxiety symptoms, while further exploring their associations with sociodemographic characteristics, lifestyle factors, and somatic diseases.

METHODS

This survey was conducted in 21 administrative regions of Guangdong province with multistage-stratified cluster random sampling method. Multivariate logistic regression analyses were performed to estimate the adjusted odds ratios (ORs) and their 95 % confidence intervals (CIs). Network analyses were conducted to explore the centrality of anxiety symptoms.

RESULTS

A total of 16,377 individuals were included in this study. The weight 12-month prevalence rates for GAD and SAS were 3.5 % and 10.0 %, respectively. Multivariable logistic regression analysis identified several factors significantly associated with increased risks of GAD and SAS, including younger age, female, no spouse, current alcohol consumption, never exercising, comorbidities, sleep duration of less than 7 h. Notably, the factors related to GAD and SAS largely overlapped, with urban residency and napping correlating specifically with SAS, and mental health literacy correlating specifically with GAD. Network analysis identified "Trouble relaxing" (GAD4) as the most central symptom of anxiety.

CONCLUSIONS

GAD and SAS were prevalent among residents in south China. More attention and assistance should be prioritized to individuals with younger age, female, no spouse, current alcohol consumption, sleep less than 7 h, and comorbid with somatic diseases. Taking regular exercise and improving mental health literacy may be beneficial in preventing and controlling anxiety.

Longitudinal analysis of post-COVID-19 surge in hospital admissions for suicide attempts: A five-year study of pandemic and post-pandemic trends

This study investigates trends in psychiatric hospital admissions due to severe suicide attempts, defined as those requiring hospitalization for at least 24 h, in the Madrid region, Spain, over a five-year period (2019-2023), encompassing pre-pandemic, pandemic, and post-pandemic contexts. Using the Minimum Basic Data Set (MBDS) from 34 public hospitals, we analyzed data for individuals requiring hospital admission due to suicidal ideation or attempts. A total of 7681 patients, primarily female (65 %), were included, and analyses were stratified by age and gender. The findings indicate a significant increase in hospitalizations for suicidal behaviors among adolescent females, beginning in late 2020, with this trend persisting through 2023. No substantial changes were observed in other age groups. Despite increases in suicide attempts, overall suicide rates remained stable, possibly reflecting improved intervention efforts. These results underscore the pressing need for targeted prevention strategies, particularly for adolescent girls, who exhibited heightened vulnerability to post-pandemic mental health challenges. This study highlights the critical role of continuous monitoring and intervention in reducing suicidal behaviors in at-risk populations.

Trends in psychotropic medication across occupation types before and during the Covid-19 pandemic: a linked administrative data study

PURPOSE

Using linked administrative data, this study provides the first longitudinal analysis of mental health among workers across occupational groups prior to and during the Covid-19 pandemic. Eleven years of data were analysed to examine whether the pandemic period coincided with changes in psychotropic medication for workers across broad occupational groupings.

METHODS

Data from Northern Ireland (NI) Enhanced Prescribing Database (EPD) was linked with NI Longitudinal Study (NILS) to examine trends in anti-depressants, anxiolytics and hypnotics (2011-2021) among NI workers (N = 200,004) across nine major occupation groups. Quarterly prescriptions were examined prior to and during pandemic restrictions (Q1-2011 to Q4-2019; and Q1-2020 to Q4-2021, respectively). Auto-regressive integrated moving average (ARIMA) models were trained to compare 'forecasted' and 'observed' rates during the pandemic period, stratified by occupational group.

RESULTS

Q2-2020 coincided with lower-than-expected receipt of anxiolytics and anti-depressants for several broad occupation types. Receipt of anxiolytic prescriptions among managers, directors/senior officials dropped below expected levels for the three quarters from Q3-2020 to Q1-2021. Finally, a notable increase in anti-depressants for a prolonged period was found among staff in caring/leisure and related professions, as well as higher rates of hypnotics in Q2-2021.

CONCLUSION

Our study provides the first longitudinal examination of variation in mental health across occupation types prior to and during the Covid-19 pandemic, using available linked administrative data. Findings suggest that occupation type was an important pandemic-related stressor and point to potential higher risk occupations that could be the focus of targeted interventions in future pandemics.

The improvement path of depression and anxiety among adult women in Shanxi Province, China: a fuzzy-set qualitative comparative analysis

Background

Depression and anxiety (D&A) are currently recognized as complex and prevalent mental disorders that pose major threats to mental health. Women are more susceptible to D&A than men.

Methods

We collected data from female participants in Shanxi Province between November 2021 and March 2022 through on-site investigations and an online survey. The survey collected information on sociodemographic traits, lifestyle factors, and physical and mental health. The degree of D&A was evaluated using the Center for Epidemiological Studies Depression Scale (CESD-10) and the Generalized Anxiety Disorder Assessment Scale (GAD-7). We assessed the impact of these factors on D&A symptoms among women using regression and fuzzy-set qualitative comparative analysis (fsQCA).

Results

D&A symptoms had many common influencing factors. Regression analysis identified key protective factors against D&A, including better self-rated health (Depression: OR = 0.11, 95% CI = 0.03-0.47; Anxiety: OR = 0.11, 95% CI = 0.02-0.57) and the absence of recent illness (Depression: OR = 0.56, 95% CI = 0.38-0.83; Anxiety: OR = 0.49, 95% CI = 0.35-0.70). Age exhibited marginal protective effects for both conditions (OR = 0.99, 95% CI = 0.98-1.00). In contrast, occupational stress constituted a significant risk factor, substantially increasing the likelihood of depression (OR = 2.66, 95% CI = 1.43-4.96) and anxiety (OR = 2.99, 95% CI = 1.43-4.96). FsQCA analysis did not identify the conditions for ideal mental health (all consistency < 0.9). However, it did identify eight condition configurations predicting mental health (absence of depression symptoms), each achieving consistency ≥0.87. Additionally, two distinct configurations explained resilience to anxiety (consistency ≥0.80). All configurations met fsQCA's consistency requirements, with self-rated health (present in 10/10 pathways), social support (9/10), and marital status (9/10) playing important roles in most configurations.

Conclusion

Women's mental health faces significant challenges, with D&A being closely intertwined. FsQCA did not identify any specific condition for the absence of D&A symptoms. However, it revealed multiple pathways to mental well-being, highlighting the need for personalized, multifactorial interventions rather than a one-size-fits-all approach. Regression and fsQCA complement each other, offering unique strengths, and their combined insights should be widely applied to broader research and practice.

Parental relationship satisfaction, symptoms of depression and anger/hostility, and the moderating role of perceived social support-a prospective cohort study in the light of the COVID-19 pandemic

Background

The challenging early parenthood time and the strains of the COVID-19 pandemic negatively affected parental mental health, whereas relationship satisfaction and perceived social support acted protective. Previous research focused on mothers, and little is known about mental health factors besides depression. This study aimed to investigate how relationship satisfaction and perceived social support affected symptoms of depression and anger/hostility in mothers and fathers in the light of the COVID-19 pandemic and whether perceived social support moderated these associations.

Methods

n = 1,414 mothers and n = 885 fathers participating in the prospective cohort DREAM study completed questionnaires 14 months and 2 years postpartum. Hierarchical moderated regression analyses were conducted, controlling for the phase in the COVID-19 pandemic (before, during lockdown, during easements, afterwards) during which mental health was assessed.

Results

Greater relationship satisfaction and perceived social support 14 months postpartum predicted fewer symptoms of depression and anger/hostility 2 years postpartum. Greater perceived social support moderated the association between relationship satisfaction and paternal symptoms of anger/hostility. Mental health symptoms were not significantly associated with the COVID-19 pandemic.

Limitations

Limitations concern the limited representation of the post-pandemic group and the undifferentiated measurement of social support sources.

Conclusion

The importance of relationship satisfaction and perceived social support for parental mental health is highlighted. Perceived social support can enhance the protective effect relationship satisfaction has on paternal symptoms of anger/hostility. Implementing corresponding prevention and education classes could improve parental mental health.

Patient Perspective on Dental Care Amidst COVID-19 Pandemic: A Survey During Omicron Stage

The COVID-19 pandemic influenced dental care behaviors, with increased concern over virus transmission. This study provides insights into Thai patient behaviors and attitudes about dental care during the Omicron wave. A cross-sectional survey was conducted via Google Forms in June 2022, collecting sociodemographic data, attitudes, and behaviors related to dental care during the pandemic. Nine hundred and seventy-eight responses were analyzed using descriptive statistics, the Mann-Whitney U-test, and multiple linear regression. Nearly half of the respondents expressed high to extreme concerns about delayed dental care affecting oral health (49.3%) and the risk of contracting COVID-19 in dental settings (45.7%). Individuals who avoided dental visits increased from 8.1% before the pandemic to 36.3% during the pandemic. However, 59.4% of respondents reported confidence in avoiding COVID-19 when dental workers strictly followed preventive measures. The study highlights concern over delayed dental care and COVID-19 risks, leading to increased avoidance of visits. However, strict preventive measures by dental workers boosted confidence, emphasizing the need for effective infection control to ensure continued access to dental care.

Hasselt Corona Impact Study: Impact of COVID-19 on healthcare seeking in a small Dutch town

We investigated healthcare avoidance during the first COVID-19 wave in a Dutch region with high infection rates. A mixed-method, multiphase study used (1) primary care electronic health records to identify patients, (2) questionnaires to capture patients with unreported COVID-19 symptoms, and (3) interviews om care avoidance. Additionally, a natural language model estimated COVID-19 incidence from routine care data. Of 2361 respondents (39% response rate), 535 (23%) reported COVID-19 symptoms; 180 sought help, mainly from GPs. Care-seeking rates did not differ significantly between those with or without relatives who experienced severe illness or death before their own illness (p = 0.270). Interviews showed the main barriers were feeling not ill enough and concerns about an overstressed healthcare system, especially GPs. Only a third of participants with symptoms sought help, mostly from GPs. Serious illness or death of loved ones had no significant impact. Findings highlight the need for clear communication and accessible healthcare, including telemedicine, for future pandemics.

Prevalence and risk factors of depression in rural Chinese hemodialysis patients during the COVID-19 pandemic: a multicenter cross-sectional study

Purpose

This study aimed to assess the prevalence and risk factors of depression among maintenance hemodialysis (MHD) patients in rural China during the COVID-19 pandemic.

Methods

A cross-sectional survey was conducted in 14 hemodialysis centers in northern Guangdong Province from April to October 2021. Depression was evaluated using the Self-Rating Depression Scale. Multivariate logistic regression analysis was employed to identify associated factors.

Results

Of the 450 MHD patients enrolled, 160 (35.6%) met the criteria for depression, with 91.8% cases being of mild severity. After adjusting for demographic, dialysis-related, laboratory, pandemic-associated lifestyle changes, and psychological variables, discomfort during dialysis [Odds ratio (OR) 1.654, 95% Confidence Interval (CI) 1.105-2.474] and infection worry (OR 1.719, 95% CI 1.121-2.636) were significantly associated with an increased risk of depression. In contrast, college education was linked to a lower risk (OR 0.456, 95% CI 0.245-0.846).

Conclusion

During the COVID-19 pandemic in rural China, mild depression were common among MHD patients. Mandatory behavioral interventions did not contribute to depression, while discomfort during dialysis and infection worry emerged as risk factors, and college education was associated with a lower risk.

Food scarcity and decrease in income are associated with depression after COVID-19 pandemic in rural settings

Objective

The current study is a cross-sectional survey that aims to assess an association COVID-19 on mental health in rural areas of Central India.

Methods

Generalized Anxiety Disorder Assessment (GAD-7), Patient Health Questionnaire (PHQ-9), and Impact of Events Scale-Revised (IES-R) were used to evaluate the anxiety, depression, and post-traumatic stress disorder (PTSD) among families with at least one member having been affected by COVID-19 during November 2022 to December 2022 in Durg District of Chhattisgarh State.

Results

A total of 431 participants were interviewed from 18 villages of Durg district of Chhattisgarh state. Symptoms of distress, anxiety and depression were observed in 26.2, 14.8 and 11.8% of participants. The death of family members due to COVID-19 and out of pocket expenditure was considerably associated with a higher risk of mental distress. A reduction in income was significantly associated with depression (p-value = 0.025, OR = 2.066, 95% CI = 1.115-3.817). Decline in income was also linked to depression among study participants (p value = 0.025, OR = 2.066, 95% CI = 1.115-3.817). Education, smoking and out of pocket expenditure was found be independently associated with occurrence of symptoms concerned with PTSD.

Conclusion

The study points to the significance of socioeconomic factors like food security, and income stability during COVID-19 in mental health outcomes even after 1 year of pandemic. Increasing access to mental health resources and support for those affected by financial and food insecurities can help individuals cope with stress and maintain mental well-being.

Change in depression and anxiety symptoms among university students, staff, and faculty during the COVID-19 pandemic: Trojan pandemic response initiative

OBJECTIVE, PARTICIPANTS, & METHODS

The COVID-19 pandemic has exacerbated mental health challenges of university students, staff, and faculty alike. We used linear mixed models to examine demographic predictors of, and change over time in, self-reported depression and anxiety symptoms of a cohort of university students and staff/faculty between surveys administered in August-November 2021 and December 2021-March 2022.

RESULTS

Students who identified as "other" race/ethnicity, Lesbian Gay Bisexual or Queer, and female, reported high baseline levels of both depression and anxiety. The disparity in self-reported depression among students who identify as "other" race/ethnicity compared to White students widened between surveys. Staff/faculty in younger age groups and Trans/Non-Binary staff reported high baseline levels of both depression and anxiety.

CONCLUSION

Mental health challenges have continued well into the pandemic, however there are disproportionate impacts on sexual and gender and racial/ethnic minorities. University administrations should prioritize mental health services and resources accordingly.

Pediatric SARS-CoV-2 infection and development of anxiety and depression

Objective

It remains unclear whether emerging mental health concerns in children infected with SARS-CoV-2 are a direct result of the infection or due to the indirect effects of the pandemic. Therefore, we sought to assess the frequency of new diagnoses of anxiety and/or depression among children diagnosed with and without SARS-CoV-2 infection who were tested in pediatric emergency departments.

Methods

A prospective cohort study with 6- and 12-month follow-ups was conducted across 14 Canadian tertiary-care pediatric emergency departments of the Pediatric Emergency Research Canada (PERC) network. The study included children aged <18 years who were tested for SARS-CoV-2 infection between August 2020 and February 2022. The primary outcome was the diagnosis of anxiety and/or depression reported during follow-up. The surveys incorporated a modified version of the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) Long-COVID Pediatric Questionnaire.

Results

Among the participants who were eligible for 6- and 12-month follow-ups, 64.7% (268/414) of SARS-CoV-2-positive and 71.9% (743/1,033) of SARS-CoV-2-negative participants completed follow-up at these time points, respectively. The median age was 7.0 [inter-quartile range (IQR): 5.0-11.0] years, and 54.2% (548/1,011) were male. New diagnoses of anxiety and/or depression reported on either survey did not differ significantly between test-positive (4.1%, 11/268) and test-negative (2.8%; 21/743) participants [difference = 1.3% (95% CI: -1.3 to 4.2)]. There was a higher prevalence of new diagnoses of anxiety and/or depression among SARS-CoV-2-negative participants aged ≥12 years relative to those aged <12 years [8.7% (13/149) vs. 1.3% (8/594); difference = 7.4%; 95% CI of the difference = 3.0-12.5], but not among SARS-CoV-2-positive participants [4.4% (2/45) vs. 4.0% (9/223); difference = 0.4%; 95% CI of the difference = -5.6 to 9.4]. At 6 or 12 months, SARS-CoV-2-positive participants were more likely to experience confusion and/or lack of concentration, abdominal pain, and insomnia.

Conclusions

Although no association was found between SARS-CoV-2 infection and new diagnoses of anxiety and/or depression, SARS-CoV-2-positive participants were more likely to experience confusion/lack of concentration, abdominal pain, and insomnia. This finding, in the context of an increased prevalence of new diagnoses of anxiety and depression, underscores the impacts of societal changes on the mental health of children. Our finding that some non-specific symptoms were more frequently reported by SARS-CoV-2-positive participants emphasizes the need for further investigation of the underlying pathophysiologic mechanisms.

The Impact of COVID-19-Related Stress on Diet and Eating Behaviors in US College Students: A Cross-Sectional Study

Background

The COVID-19 pandemic exposed the US population, including college students, to stress posing challenges to psychological and behavioral health. Previous studies have demonstrated that stress can promote unhealthy eating behaviors among college students. This study aimed to examine the relationships of pandemic-related stress with changes in diet and eating behaviors experienced by college students during the Fall 2020 semester.

Methods

758 college students in the Mid-Atlantic region of the US completed an online survey in November 2020. The survey assessed multiple dimensions of pandemic-related stress, diet, and eating behaviors, as well as measures of psychological health and social support.

Results

Pandemic-related stress, particularly academic stress, was correlated with less healthy dietary profiles and potentially maladaptive eating behaviors, including emotional eating and late-night eating. Associations between stress and dietary intake were stronger in females than males, whereas males showed stronger associations between stress and food responsiveness. Pandemic-related stress was associated with perceived changes in diet quality, frequency of eating, and amount of food consumed compared to since before the semester started.

Conclusion

Academic stress during the pandemic had a negative impact on diet and eating behaviors among college students. Our results argue for interventions targeting academic stress in everyday contexts as well as potential future public health crises, to prevent negative impacts on students' eating profiles that may in turn negatively impact health.

Applying AI in the Context of the Association Between Device-Based Assessment of Physical Activity and Mental Health: Systematic Review

BACKGROUND

Wearable technology is used by consumers worldwide for continuous activity monitoring in daily life but more recently also for classifying or predicting mental health parameters like stress or depression levels. Previous studies identified, based on traditional approaches, that physical activity is a relevant factor in the prevention or management of mental health. However, upcoming artificial intelligence methods have not yet been fully established in the research field of physical activity and mental health.

OBJECTIVE

This systematic review aims to provide a comprehensive overview of studies that integrated passive monitoring of physical activity data measured via wearable technology in machine learning algorithms for the detection, prediction, or classification of mental health states and traits.

METHODS

We conducted a review of studies processing wearable data to gain insights into mental health parameters. Eligibility criteria were (1) the study uses wearables or smartphones to acquire physical behavior and optionally other sensor measurement data, (2) the study must use machine learning to process the acquired data, and (3) the study had to be published in a peer-reviewed English language journal. Studies were identified via a systematic search in 5 electronic databases.

RESULTS

Of 11,057 unique search results, 49 published papers between 2016 and 2023 were included. Most studies examined the connection between wearable sensor data and stress (n=15, 31%) or depression (n=14, 29%). In total, 71% (n=35) of the studies had less than 100 participants, and 47% (n=23) had less than 14 days of data recording. More than half of the studies (n=27, 55%) used step count as movement measurement, and 44% (n=21) used raw accelerometer values. The quality of the studies was assessed, scoring between 0 and 18 points in 9 categories (maximum 2 points per category). On average, studies were rated 6.47 (SD 3.1) points.

CONCLUSIONS

The use of wearable technology for the detection, prediction, or classification of mental health states and traits is promising and offers a variety of applications across different settings and target groups. However, based on the current state of literature, the application of artificial intelligence cannot realize its full potential mostly due to a lack of methodological shortcomings and data availability. Future research endeavors may focus on the following suggestions to improve the quality of new applications in this context: first, by using raw data instead of already preprocessed data. Second, by using only relevant data based on empirical evidence. In particular, crafting optimal feature sets rather than using many individual detached features and consultation with in-field professionals. Third, by validating and replicating the existing approaches (ie, applying the model to unseen data). Fourth, depending on the research aim (ie, generalization vs personalization) maximizing the sample size or the duration over which data are collected.

Health-related risk factors for subsequent work disability: A systematic literature review

BackgroundWork disability is a major public health challenge, with various health conditions leading to long-term sickness and early retirement, placing a substantial burden on individuals and society.ObjectiveThis systematic review aimed to identify key health-related risk factors for work disabilities, highlighting the importance of early prevention strategies.MethodsA systematic literature search was conducted in 06/2023 using MEDLINE via PubMed, EMBASE via OVID, and CINAHL via Cochrane Library Trials. Two independent reviewers screened abstracts and reviewed full-text articles describing risk factors for work disabilities. Data extraction followed PRISMA guidelines, with the databases searched using synonymous keywords for "risk factors" and "work disability".ResultsOf the 61,872 articles identified, 17 met the inclusion criteria. The studies identified several health-related risk factors leading to work disabilities. The most frequently reported conditions were common mental disorders and musculoskeletal disorders, often leading to short- or long-term sick leave. The review highlighted that health-related risk factors frequently co-occur and interact, suggesting that work disability is rarely due to a single factor. The quality of the included studies varied, and many relied on self-reported data, which can introduce bias.Conclusion(Chronic) conditions, particularly mental and musculoskeletal disorders, are significant risk factors for work disability. Primary and secondary prevention measures, such as rehabilitation are crucial to mitigate the need for disability retirement. Future research should focus on prospective cohort studies and a thorough scientific investigation of potential intervention factors to provide decision-makers with information on cost-effective prevention programs.Prospero ID: CRD42023422118.

Deprescribing psychoactive drugs in older orthogeriatric patients: findings from the GIOG2.0 Italian survey

BACKGROUND

Psychoactive drugs represent a major contributor to falls in older people. This study aims to evaluate the prescribing practice of psychoactive drugs in older people hospitalized for hip fracture (HF) and to explore independent correlates of deprescribing.

METHODS

Multicenter prospective observational study including patients with HF admitted to 13 Orthogeriatric wards of the Italian Group of Orthogeriatrics (July 2019-August 2022). Patients underwent a comprehensive geriatric assessment. The use of psychoactive drugs associated with a higher risk of falls was assessed using a dedicated checklist. Deprescribing was defined as any reduction in the number of psychoactive drugs upon discharge, and independent correlates of deprescribing were explored using logistic regression analyses. Cluster analysis by Partitioning around Medoids was also performed in the hypothesis that selected clusters of characteristics could be associated with deprescribing.

RESULTS

One thousand eight hundred fifty-four older individuals (mean age 84 years, 77% females) were studied; 1190 (64%) were not prescribed any psychoactive drug, while 474 (26%), 129 (7%), and 61 (3%) took 1, 2, 3 or more psychoactive drugs, respectively. Among 664 patients on psychoactive drugs on admission, 177 (27%) had fewer prescriptions at discharge, mainly anxiolytics from 89 to 10 (50-6%), antipsychotics from 49 to 12 (28-7%) and antidepressants from 98 to 28 (55-16%). On the other count, 51 (8%) were prescribed more psychoactive drugs, mostly antidepressants from 25 to 45 (49-88%) and antipsychotics from 7 to 17 (14-17%). Functional autonomy (ADL aOR 0.87 [95%CI 0.78-0.97] p < 0.001), polipharmacy (aOR 1.15 [95%CI 1.03-1.29] p < 0.001) and the occurrence of post-operative delirium (aOR 1.71 [95%CI 1.09-2.66] p < 0.017) were independent correlates of deprescribing. More specifically, the clustering procedure could not improve the characterization of deprescribing; conversely, the deprescribing propensity significantly depended upon the center-specific prescriptive practice, not explained by other clinical-epidemiological factors.

CONCLUSION

Only a small proportion of patients hospitalized for HF undergoes deprescribing of psychoactive drugs, with considerable heterogeneity among centers, suggesting that the physician's attitude rather than patient-related factors affects deprescribing.

A data-driven simulation approach to quantify the effect of group counseling on system performance of college counseling centers

Objective: To investigate the effectiveness, from a system's perspective, of offering group counseling options in college counseling centers. Methods: We achieve this through a data-driven simulation-based approach with the aim of providing administrators with a quantitative tool that informs their decision-making process. Results: Our simulation experiments reveal that offering group counseling options without resource reallocation does not have the desired positive impact on the system's performance. However, with resource reallocation, our results demonstrate that the introduction of group counseling options can significantly improve the performance of the system by as much as 40%. Conclusions: Group counseling options, coupled with proper resource reallocation strategies, are effective in reducing access time of first-time patients by as much as 40%. The effect of group counseling is highly dependent on both the number of offered groups as well as their scheduling policy. Scheduling policies have to be scrutinized in light of their resulting group waiting time and resource-utilization efficiency.

Psychosocial Wellbeing in Lung Transplants Before and After the COVID-19 Vaccine

OBJECTIVES

Lung transplant recipients are vulnerable to respiratory infections because of their compromised immune response. Limited research has been published on mental health as a result of the COVID-19 pandemic on lung transplant recipients, and uncertainty remains whether the COVID-19 vaccine affected mental health in lung transplant recipients.

MATERIALS AND METHODS

In this longitudinal, retrospective study, we assessed the psychosocial wellbeing of lung transplant recipients during the COVID-19 pandemic at 2 different time points (before and after COVID-19 vaccination). We measured wellbeing with the Hospital Anxiety and Depression Scale (cutoff of 11 points indicated anxiety and depression) and the Symptom Checklist consisting of 9 questions.

RESULTS

Our study included 83 patients (mean age 52.4 ± 14.5 years, 55.4% male). Among the patients, 3.8% and 4.8% of patients with cystic fibrosis had abnormal values for anxiety before and after the vaccine, respectively; abnormal values for depression were shown in 0% and 2.4% of patients with cystic fibrosis before and after the vaccine, respectively. Sex, age, level of education, time since transplant, and chronic allograft dysfunction were not significantly associated with psychosocial wellbeing. Vaccination against COVID-19 was not associated with a change in psychosocial wellbeing.

CONCLUSIONS

We found no evidence that the COVID-19 vaccine affected the psychosocial wellbeing of lung transplant recipients. However, it may be important to monitor wellbeing closely during a pandemic, especially in patients with cystic fibrosis.

The impact of COVID-19 on physical activity and mental health: A mixed-methods approach

This mixed-methods study investigated how and why physical activity (PA), anxiety, depression and self-perceived loneliness are related, and the feasibility of social prescribing (SP). Whilst SP may involve PA with broader effects on health and wellbeing, there is little research exploring perceptions of this intervention. Data from the UCL-Penn Global COVID Study wave 1 (17 April-17 July 2020, N = 1037) were analysed. Twenty-one UK adults who self-identified as low (n = 15) and high (n = 6) on PA at wave 1 were interviewed at wave 4 (18 March-1 August 2022). At wave 1, depression was associated with higher odds of low-PA (OR = 1.05; 95% CI 1.01-1.10, p = 0.02). Both high/low-PA groups cited the threat of contracting COVID-19, general impacts of COVID-19 policies and heightened awareness of the mind-body connection. Five recommendations are made to address challenges in engaging with SP.

Effectiveness of psychological crisis interventions during infectious disease outbreaks in low- and middle-income countries: a systematic review of Randomized Control Trials

The huge mental health treatment gap in low- and middle-income countries (LMICs) is further exacerbated when infectious disease outbreaks occur. To address the increasing mental health needs during outbreaks, the availability of flexible and efficient mental health interventions is paramount, especially in low-resource settings where outbreaks are more common. Psychological interventions may help to address these mental health needs with efficient implementation costs. However, there is a huge paucity of quality evidence to inform psychosocial interventions during outbreaks. This systematic review sought to update the existing evidence to inform the effectiveness of psychological interventions that addresses mental health issues during outbreaks in LMICs. Six electronic databases were searched - Scopus, PubMed, PsycINFO, Embase, Cochrane library and CINAHL. We included randomised controlled trials of psychological interventions aimed to address common mental health conditions among adults affected by infectious disease outbreaks in LMICs. Studies were excluded if they were done among all age groups, used mixed interventions with pharmacotherapies, addressed severe mental health conditions and were published other than in English. The quality of evidence in the included trials was assessed using the Cochrane Collaboration risk of bias tool. We included 17 trials that examined the effectiveness of psychological interventions among outbreak-affected adults in LMICs. The quality of studies was generally average but tended to provide evidence that brief psychoeducational interventions based on cognitive restructuring, mindfulness, relaxation and stress management techniques were effective in reducing perceived stress and anxiety symptoms, and in improving resilience and self-efficacy. Similarly, mindfulness-based interventions and mindfulness stress reduction treatments were effective in addressing depression, anxiety and generalised anxiety disorder. Brief psychological interventions that can be delivered by non-specialists could have value in addressing the huge mental health needs in outbreak contexts.

Anxiety and depression in cancer patients and survivors in the context of restrictions in contact and oncological care during the COVID-19 pandemic

Treatment modifications and contact restrictions were common during the COVID-19 pandemic and can be stressors for mental health. There is a lack of studies assessing pandemic-related risk factors for anxiety and depression of cancer patients and survivors systematically in multifactorial models. A total of 2391 participants, mean age 65.5 years, ≤5 years post-diagnosis of either lung, prostate, breast, colorectal cancer, or leukemia/lymphoma, were recruited in 2021 via the Baden-Württemberg Cancer Registry, Germany. Sociodemographic information, pandemic-related treatment modifications, contact restrictions, and anxiety/depression (Hospital Anxiety and Depression Scale, HADS) were assessed via self-administered questionnaire. Clinical information (diagnosis, stage, and treatment information) was obtained from the cancer registry. Overall, 22% of participants reported oncological care modifications due to COVID-19, mostly in follow-up care and rehabilitation. Modifications of active cancer treatment were reported by 5.8%. Among those, 50.5% had subclinical anxiety and 55.4% subclinical depression (vs. 37.4% and 45.4%, respectively, for unchanged active treatment). Age <60 years, female sex, lung cancer, low income, and contact restrictions to peer support groups or physicians were identified as independent risk factors for anxiety. Risk factors for depression were lung cancer (both sexes), leukemia/lymphoma (females), recurrence or palliative treatment, living alone, low income, and contact restrictions to relatives, physicians, or caregivers. The study demonstrates that changes in active cancer treatment and contact restrictions are associated with impaired mental well-being. The psychological consequences of treatment changes and the importance for cancer patients to maintain regular contact with their physicians should be considered in future responses to threats to public health.

Psychological Distress in Adults With Myocardial Infarction: Implications for Health Care Utilization and Expenditure

Background

Myocardial infarction (MI) poses a major financial burden on the U.S. health care system, but its impact on medical expenses and health care utilization when coupled with psychological distress remains unknown.

Objectives

The study aims to investigate the association between psychological distress and healthcare utilization and medical expenditures in adults with a history of MI.

Methods

We analyzed the 2017-2021 Medical Expenditure Panel Survey to identify 44,716 adults with a history of MI. Psychological distress was measured using the Kessler (K6) questionnaire, with a score of ≥13 indicating clinically significant distress. Differences in medical expenditures and health care utilization between patients with MI with and without psychological distress were assessed using weighted generalized linear and negative binomial regression models. Expenditures, medical visits, and prescribed medications are reported as means and 95% CI.

Results

Among 9,773,458 weighted adults, 970,049 experienced psychological distress. Adults with MI and psychological distress were younger, more likely to be female (51.1% vs 37.5%; P < 0.001), less educated (11.1 vs 12.5 years; P < 0.001), lower income, and were more likely to have public insurance, compared to those without psychological distress. Adults with psychological distress and a history of MI had higher average medical expenses ($31,577 vs $15,830; P < 0.001) and greater health care utilization including office visits (8.3 vs 5.7; P = 0.01), inpatient visits (0.6 vs 0.3; P < 0.001), emergency room visits (0.7 vs 0.3; P < 0.001), and prescribed medications including refills (42.3 vs 28; P < 0.001).

Conclusions

Psychological distress is correlated with increased medical expenditures and health care utilization in patients with MI. This research highlights the need for interventions addressing psychological needs in patients with MI.

Interplay of socio-emotional vulnerability and physiological stress response: Unraveling distress patterns amidst the COVID-19 pandemic

The COVID-19 pandemic led to increased internalizing symptoms (IS) among adults, with notable interindividual differences. Cross-sectional studies suggest that both biological (physiological stress) and psychological (socio-emotional) factors independently contribute to IS. This longitudinal study examined whether physiological stress during the pandemic moderated the relationship between socio-emotional vulnerability and IS. In June 2020, 94 adults (average age 34.16, SD = 8.86) provided a 6 cm hair sample, allowing the quantification of cumulative hair cortisol concentrations (HCC) during the three months preceding the pandemic (Segment A) and the three months of the first wave of the pandemic in Quebec, Canada (Segment B). We calculated HCC reactivity (rHCC) as the percent change between the two segments. A socio-emotional composite score (SECS) was derived using the Anxiety Sensitivity Index, Intolerance of Uncertainty Scale, and Perseverative Thinking Questionnaire. Every three months from June 2020 to March 2021, participants completed the Depression Anxiety Stress Scales and Impact of Event Scale. Analyses revealed an interaction between Time, SECS, and rHCC on stress, and between SECS and rHCC on depressive symptoms. High rHCC was associated with a stronger correlation between SECS and stress symptoms in September and December 2020 (these months were significant transition periods during the pandemic in Quebec). Additionally, individuals with low rHCC exhibited greater depressive symptoms, regardless of time. Our findings suggest that the activation of the physiological stress system at the beginning of the pandemic was associated with increased stress symptoms during subsequent transition periods. Conversely, lower activation of the stress system contributed to greater depressive symptoms over time, particularly in individuals with heightened socio-emotional vulnerability. This highlights the role of physiological responses in modulating emotional outcomes under prolonged stress and adds to the growing literature on vulnerability factors in response to enduring stressors.

Exploring mental health symptoms in elite athletes during the COVID-19 pandemic: A systematic review and meta-analysis on sex differences

The COVID-19 pandemic significantly affected elite athletes, leading to increased mental health issues such as stress, anxiety, and depression. Sex differences in mental health may exist among athletes during the COVID-19 crisis. This study aimed to perform a systematic review and meta-analysis to examine sex differences in mental health symptoms among elite athletes during the COVID-19 pandemic. We systematically searched the databases including Pubmed, EMBASE, and manually checked previous systematic reviews for relevant studies in March 2024. Authors were also contacted for sex-specific data. Studies were included if they compared mental health symptoms between male and female elite athletes during the COVID-19 pandemic. We used a random-effects model to summarize the rate ratio (RR) between female and male athletes across studies. Risk of bias in studies was assessed using a 9-item tool. We included 18 studies in this review. The results indicated that female athletes reported higher levels of anxiety (RR 1.24, 95% CI = 1.08 to 1.43) and depression (RR 1.36, 95% CI = 1.15 to 1.61) than male athletes during the pandemic. They also had a higher risk of stress or distress (RR 1.27, 95% CI = 0.99 to 1.63) than their male counterparts. No significant differences were found regarding alcohol use or misuse between female and male athletes (RR 1.01, 95% CI = 0.75 to 1.37). Limited evidence was available for eating disorders, gambling, substance use, and sleep problems. In conclusion, female and male athletes differed in mental health symptoms during the COVID-19 pandemic. Female athletes were more likely to report anxiety, depression, and distress. Incorporating mental health resources may be particularly important for women's sports, which have smaller financial margins and greater career uncertainty than men's sports.

Psychotropic medications: a descriptive study of prescription trends in Tabriz, Iran, 2021-2022

INTRODUCTION

Mental disorders, such as anxiety and depression, significantly impacted global populations in 2019 and 2020, with COVID-19 causing a surge in prevalence. They affect 13.4% of the people worldwide, and 21% of Iranians have experienced them. Prescription analysis is critical for evaluating and improving medical care in a cost-effective manner. This study examined prescription patterns for psychotropic drugs in outpatient settings to improve the understanding of medication utilization in a variety of patients. It aimed to assist healthcare professionals in making well-informed decisions about drug prescriptions, a topic not much addressed in Iran.

METHOD

A descriptive study was conducted using data extracted from the Social Security Organization in Iran. We analyzed prescriptions in Tabriz from March 2021 to March 2022. Prescription data were categorized by medication category, physician specialty, age group, and sex. Then statistical analysis was performed using SPSS 2022.

RESULTS

We analyzed the number of psychotropic medication prescriptions issued by 7246 doctors to a group of 413,466 individuals over a year representing 44.9% of our target population. The average age of individuals receiving psychotropic drugs was 45.57 years. Gabapentin had the highest prescription rate, followed by sertraline. Antidepressants accounted for 38.1% of all prescriptions, with anxiolytics accounting for 18.6%. Other psychotropic drugs included alprazolam, chlordiazepoxide, and valproate. Adults in all age groups had the highest frequency of prescriptions for psychotropic medications. The majority of patients were female (63.5%). General practitioners had the highest number of instances of prescribing psychotropic drugs, with psychiatrists contributing 54.7% of the total prescriptions.

CONCLUSION

Approximately 45% of the target population received psychotropic medication, which highlights the significant prevalence of mental health issues in Iran. Antidepressants were the most commonly administered class, highlighting the need for training programs that specifically address their possible negative effects and the correct dosage. The goal is to provide healthcare practitioners with a comprehensive understanding of prescription trends, enabling them to administer the most appropriate treatments.

Internal Validation of the Latvian Version of 16-Item Prodromal Questionnaire in A Help-Seeking Adolescent Population: Psychometric Analysis and Associated Factors

OBJECTIVES

The prodromal phase of a psychotic disorder is a period of altered functioning before the onset of the acute state; several interviews have been developed to determine whether individuals present with prodromal symptoms. The 16-item Prodromal Questionnaire (PQ-16) is a screening tool for evaluating those at risk of developing a psychotic disorder. The study aimed to evaluate the psychometric properties of the Latvian version of the PQ-16 in a sample of help-seeking adolescents referred for diagnostic assessment and look for possible associated socio-demographic and health-related factors.

METHODS

A cross-sectional study included patients admitted for evaluation between November 2022 and February 2023 in Riga's Children's Clinical University Hospital Child Psychiatry clinic. The data were collected during outpatient consultations by mental health professionals. We used the Latvian translation of PQ-16 and the socio-demographic and health-related factors questionnaire. Data were analysed with IBM SPSS 28; the scale's diagnostic accuracy and internal validity were examined.

RESULTS

The study involved 107 adolescents aged 12% to 17%, 80.5% female, with a mean age of 14.98 (CI 14.70-15.26). Socio-demographic data and health-related variables did not significantly differ between the sexes (p > 0.05). The Latvian PQ-16 demonstrated excellent internal reliability with a Cronbach's alpha of 0.890. All 16 items were found to be valid with p < 0.001. A significant number of participants (73.8%) scored above the current cut-off of ≥ 6 with a mean of 9.17 (95% CI 8.41-9.93). Certain socio-demographic factors, such as female gender (p < 0.001), fair school performance (p = 0.048) and recent changes in school performance (p < 0.001), demonstrated a significant association with higher scores. Additionally, there were found significant associations between positive screening and health-related factors such as obstetric complications (p = 0.044), smoking (p = 0.002), alcohol consumption (p = 0.021), history of bullying in school (p < 0.001) and emotional abuse at home (p = 0.011).

CONCLUSIONS

Latvian translation of PQ-16 showed high internal reliability and validity levels. Positive PQ-16 screening was associated with female gender, worsened school performance, obstetric complications, substance abuse and experienced emotional violence. The average score of 9.17 positive answers and 73.8% of participants screening positive for attenuated psychotic symptoms is significantly higher than in recent studies under similar conditions.

The Impact of the COVID-19 Pandemic on Suicide Attempts in Kerman Province: An Interrupted Time Series Analysis

Background

The COVID-19 pandemic has had a significant impact on global suicide attempt rates. This study evaluated the effect of the COVID-19 pandemic on suicide attempts in the Kerman Province, eastern Iran.

Methods

This is a cross-sectional study. Data on suicide attempt cases in Kerman Province was obtained from the database of Mental, Social, and Addiction Health Office of the Deputy for Health of Medical Sciences Universities from 2018 to 2021. An interrupted time-series model was used to assess the changes in suicide attempts before and after the pandemic.

Results

Suicide attempts exhibited a decreasing trend before the pandemic, with a monthly decrease of 0.9% (P<0.001). The immediate effect of the pandemic indicated that, at the beginning of the pandemic, there was a 4.5% increase in suicide attempts (P=0.134). The sustained effect of the pandemic showed that in the months following the onset of the pandemic, the rate of suicide attempts increased by 1.8% compared to before the pandemic (P<0.001). By the end of 2021, the number of suicide attempts per month exceeded the predicted amount based on pre-pandemic data. Factors such as marital status, education, occupation, place of residence, and previous suicide attempts were found to influence suicide attempts during the pandemic.

Conclusion

Given the significant increase in suicide attempts following the onset of the pandemic, it is crucial to prioritize the implementation of prevention and intervention programs during this crisis.

Changes in Rates of Special Considerations in Higher Education Applications Pre- and During the COVID-19 Pandemic in Victoria, Australia

BACKGROUND AND AIMS

Since the onset of the COVID-19 pandemic, a significant rise in mental ill health has been observed globally in young people, particularly those in their final years of secondary school. Students' negative experiences coincide with a critical transitional period which can disrupt milestones in social and educational development. This study aimed to use innovative population-level data to map the impact of the pandemic on students entering higher education.

METHODS

Pre-pandemic (2019/2020) and pandemic (2020/2021) tertiary education application data were obtained from the Victorian Tertiary Admissions Centre. Prevalence of applications for special consideration related to mental ill health were compared between cohorts across various geographical areas and applicant demographic subgroups. Relative risk regression models were used to understand the role of different risk factors.

RESULTS

Rates of mental health-related special consideration applications increased by 38% among all applications (pre-pandemic: 7.8%, n = 56 916; pandemic: 10.8%, n = 58 260). Highest increases were observed among students in areas with both extended and close-quarter lockdown experiences, and areas impacted by 2019/2020 black summer bushfires. The increases were higher among Year 12 students and students with other special consideration needs (e.g., physical condition, learning disability). Slightly higher increases were observed in areas with higher socio-economic status, which may potentially be related to inequality in mental health service access.

CONCLUSION

As consequences of mental health difficulties and academic disruption in youth can be long lasting, it is critical to establish a mental health support framework both in and outside of higher education to facilitate young people's recovery from the pandemic.

Gender and remote work: associations between mental health and hours of remote work and housework

To investigate the association between hours of remote work (RWHs) and housework (HWHs), independently, as well as the combined total of work hours (WHs), with gender and mental health of remote workers during the COVID-19 pandemic. Cross-sectional study with data from the ELSA-Brasil (N = 2,318). On average, women reported more time spent on HWHs and WHs than men, while no difference was found in RWHs. Depression, anxiety and stress were more prevalent among women. Women with longer working hours (RWHs, HWHs and WHs) had higher odds of displaying anxiety or stress symptoms than men with shorter working hours. For symptoms of depression, the highest odds ratios were found only among those women with medium or long HWHs and long WHs. A gender perspective into studies of remote work effects has contributed to the recognition of health inequalities between men and women.

Clinical risk factors of long-term post-traumatic stress symptoms, anxiety, and depression in COVID-19 survivors

The COVID-19 pandemic has a profound and lasting impact on the mental health of recovered individuals. To investigate the clinical risk factors associated with long-term post-traumatic stress symptoms (PTSS), anxiety, and depression in COVID-19 survivors, demographic information and medical records were collected during February 19 and March 20, 2020. Assessments of PTSS, anxiety, and depressive symptoms were conducted at two months (April to May 2020, Session 1) and two years (April to May 2022, Session 2) post-discharge. Session 1 included 127 survivors who were infected with the early strains of SARS-CoV-2, and 54 of these participants took part in Session 2. PTSS (median: Session 1 = 9, Session 2 = 7; p = 0.522) and depression (median: Session 1 = 5, Session 2 = 4; p = 0.127) remained unchanged over the two years following COVID-19 infection, while anxiety (median: Session 1 = 5, Session 2 = 2; p < 0.001) significantly decreased at the two-year mark. Severe COVID-19 symptoms were consistently identified as significant risk factors for depression at both time points (Session 1: dyspnea [beta = -0.268, p = 0.016], nausea or vomiting [beta = 0.239, p = 0.031]; Session 2: headache [beta = 0.414, p = 0.014]). They also emerged as risk factors for PTSS and anxiety at the two-month mark (PTSS: cough [beta = -0.334, p = 0.002]; anxiety: continued oxygen therapy [beta = 0.343, p = 0.002], cough [beta = -0.267, p = 0.013]). At the two-year mark, blood sample characteristics were identified as risk factors for PTSS (albumin: beta = 0.455, p = 0.010), anxiety (total bilirubin: beta = 0.440, p = 0.013), and depression (total bilirubin: beta = 0.386, p = 0.021). Mann-Whitney U-tests showed that female survivors had higher anxiety (p = 0.012) and depression (p = 0.046) levels than males at the two-month mark. The sample size was relatively small, and further investigation is needed to determine whether our findings can be directly applied to other samples, including those involving different variants of SARS-CoV-2. Our study may highlight the differences between short-term and long-term clinical risk factors for PTSS, anxiety, and depression in COVID-19 survivors. The identified predictors could provide valuable insights for tailoring interventions to improve the PTSS, anxiety, and depression outcomes at different stages of recovery in COVID-19 survivors.

Continuous worsening of population emotional stress globally: universality and variations

BACKGROUND

Understanding emotional stress stability in populations is crucial because stress is a key factor in causing depression, and it worsens well-being.

METHOD

In this study, using repeated cross-sectional data from 149 countries from 2007 to 2021 (N = 2,450,043), we examined time trends of psychological stress in populations worldwide.

RESULTS

Over half of the population experienced emotional stress in 20 countries, and 85% of the countries reported worse psychological stress in 2020 compared with 2008. We found that psychological well-being declined most rapidly among young people compared with other age groups. Individuals living and working in all types of locations (rural/farm, town/village, large city, and suburban areas) and employment (full-time, self-employed, part-time, and unemployed), respectively, experienced continuously worsening emotional stress when comparing three time periods (2008-2011, 2012-2019, and 2020-2021). Furthermore, reducing physical pain and increasing income were noted to be more important than solving health problems for the purpose of decreasing stress.

CONCLUSION

Emotional stress continuously worsened worldwide over the past few decades, but the trend varied among countries. Our findings highlight the significance of improving people's living environments to reduce their likelihood of experiencing emotional stress.

Exploring the relationship between personal and cohabiting family members' COVID-19 infection experiences and fear of COVID-19: a longitudinal study based on the Japan COVID-19 and Society Internet Survey (JACSIS)

OBJECTIVES

This study aims to explore the relationship between the combined experiences of COVID-19 infection in individuals and their family members and the resulting fear of COVID-19, with a focus on the severity of symptoms and various sociodemographic factors.

DESIGN

Longitudinal survey study.

SETTING

The Japan COVID-19 and Society Internet Survey (JACSIS), a large-scale web panel survey administered in Japan.

PARTICIPANTS

Analysis was based on responses from 15 542 individuals who participated in all three waves of JACSIS conducted between 2020 and 2022.

MAIN OUTCOME MEASURES

The primary measure was the fear of COVID-19, assessed using the Fear of COVID-19 Scale. The study employed a two-way analysis of variance without repetition, Games-Howell post hoc tests and ordinary least-squares linear regression analysis, with time points treated as fixed effects.

RESULTS

The study revealed significant differences in fear levels based on the combined COVID-19 infection experiences of respondents and their family members, with variations observed across different time points. Mild symptoms in either the respondents or their family members correlated with reduced fear (β=-0.584, SE=0.181, p=0.001), while severe symptoms were associated with increased fear (β=1.244, SE=0.217, p<0.001). Gender, age, marital status and a history of respiratory disease or mental illness were also significant factors. For instance, females reported higher fear levels compared with males (β=0.707, SE=0.049, p<0.001), and those with a history of respiratory diseases showed increased fear (β=1.632, SE=0.286, p<0.001). Over time, the general fear of COVID-19 decreased, with the sharpest decline observed at T3 compared with T1 (β=-1.399, SE=0.061, p<0.001).

CONCLUSION

The study highlights the significant influence of the combined COVID-19 infection experiences of individuals and their family members (the severity of symptoms, in particular) on the fear of COVID-19. These results underscore the need for tailored mental health interventions that consider both personal and familial infection experiences, as well as other sociodemographic factors. The findings also reflect the evolving public response to the changing dynamics of the pandemic.

Pediatric SARS-CoV-2 long term outcomes study (PECOS): cross sectional analysis at baseline

BACKGROUND

PECOS is an ongoing study aimed to characterize long-term outcomes following pediatric SARS-CoV-2 infection.

METHODS

This is a cross-sectional analysis of infected and uninfected cohorts at baseline. Participants (0-21 years) with laboratory-confirmed SARS-CoV-2 infection were enrolled as infected. Uninfected were defined as individuals without history or laboratory evidence of SARS-CoV-2 infection. Outcome measures included demographics, medical history, review of symptoms, physical exam, cardiopulmonary evaluation and validated psychological and developmental surveys. Primary outcomes were cohort comparisons for abnormalities on all measures.

RESULTS

654 participants (541 infected, 113 uninfected) completed baseline visits by June 30, 2023. Infected participants were more likely to report constitutional (OR: 2.24), HEENT (OR: 3.74); respiratory (OR: 2.41), or gastrointestinal (OR: 2.58) symptoms. Infected had worse scores in domains of Pain, Fatigue, Global Health, Physical and Cognitive functioning, Mobility and Sleep disturbances when compared to uninfected controls using Patient Reported Outcomes. Cardiopulmonary findings were similar among cohorts.

CONCLUSIONS

The first report of this ongoing longitudinal study demonstrates that infected participants were more likely to report symptoms compared to uninfected controls, which may affect performance and quality of life of these individuals. Longitudinal data will increase understanding of long-term effects of SARS-CoV-2 infection in children.

CLINICALTRIALS

gov Identifier: NCT04830852 IMPACT: This study establishes a large, diverse, prospective, longitudinal, multi-center cohort of children with history of SARS-CoV-2 infection compared to an uninfected cohort to be followed for 3 years. Cross-sectional cohort analysis at study entry showed infected participants were more likely to report constitutional, respiratory, and GI symptoms compared to uninfected controls. Infected participants were more likely to have significantly worse parent-reported performance in 6 of 10 Patient Reported Outcome Measures domains. Continued study of this cohort will help identify clinical sequelae of COVID-19, characterize the immune response to SARS-CoV-2 infection, and identify potential genetic/immunologic factors associated with long-term outcomes.

Exploring the impact of smartphone addiction on mental health among college students during the COVID-19 pandemic: The role of resilience and parental attachment

Smartphone addiction is an increasingly severe issue in modern society, particularly impacting the mental health of college students during the COVID-19 pandemic. This study aims to explore the relationship between smartphone addiction and mental health issues among college students, and the mediating and moderating roles of psychological resilience and parental attachment. We employed a cross-sectional study design with 100,097 college Chinese students to examine the relationships between smartphone addiction, mental health (anxiety and depression), and the mediating role of psychological resilience. Parental attachment was assessed as a moderator within these relationships. Data were analyzed using multiple regression and mediation/moderation models, controlling for relevant covariates. Our findings revealed a significant positive correlation between smartphone addiction and both anxiety and depression. Psychological resilience mediated these relationships, suggesting that higher resilience levels can mitigate the negative psychological impacts of smartphone addiction. Additionally, parental attachment moderated the effects of smartphone addiction on psychological outcomes; stronger attachment was associated with less pronounced effects of addiction on anxiety and depression. Specifically, for students with low parental attachment, the predictive effect of smartphone addiction on anxiety and depression was more pronounced, whereas higher attachment levels were protective.

Leaflet information by the local government on mental health during the coronavirus disease 2019 pandemic: a cross-sectional study in a rural area in Japan

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic and associated infodemic increased depression and anxiety. Proper information can help combat the infodemic and promotes mental health; however, rural residents have more difficulties in getting correct information than urban residents.

OBJECTIVE

To examine whether the information on COVID-19 provided by the local government maintained the mental health of rural residents in Japan.

METHODS

A self-administered questionnaire survey of Okura Village (northern district of Japan) residents aged ≥16 years was conducted in October 2021. The main outcomes, depressive symptoms, psychological distress, and anxiety were measured using the Center for Epidemiologic Studies Depression Scale, Kessler Psychological Distress Scale, and Generalized Anxiety Disorder scale 7-item. Exposure was defined as whether the resident read the leaflet on COVID-19 distributed by the local government. The targeted maximum likelihood estimation was used to analyse the effect of leaflet reading on the main outcomes.

RESULTS

A total of 974 respondents were analysed. Reading the leaflet was significantly lower risk for depressive symptoms relative risk (95% confidence interval): 0.64 (0.43-0.95). Meanwhile, no clear effects of leaflet reading were observed on mental distress and anxiety.

CONCLUSIONS

In rural areas with local governments, analogue information may be effective to prevent depression.

Alexithymia in people with tattoos

Introduction

Tattoos are a form of body modifications. Alexithymia is a complex personality structure that includes emotional and cognitive deficits such as difficulty in recognizing and describing feelings.

Aim

To assess the prevalence of alexithymia among tattooed individuals. Moreover, we aimed to check if the type of tattoo is related to alexithymia.

Material and methods

This was a cross-sectional survey, conducted on 403 individuals from Poland. 200 of them had tattoos and were assigned to the study group, and 203 of them had no tattoos and were assigned to the control group.

Results

Most respondents (24%) had one tattoo. Most tattoos (29.8%) were situated on forearms and palms, had a plant motif (21.8%) and were done to express personality of the respondents (20.7%). In the research group 80 (19.9%) respondents were classified as alexithymic ones. Out of them, 47 (11.7%) individuals had tattoos and 33 (8.9%) belonged to the non-tattooed group. 35 (17.5%) respondents with non-verbal tattoos were screened as alexithymic while 12 (6%) individuals with verbal, personal tattoos were classified as alexithymic ones (p < 0.05). Twenty-two (11%) respondents who did their tattoos for psychological reasons and 25 (12.5%) individuals who did their tattoos for aesthetic reasons were classified as alexithymic (NS).

Conclusions

Subjects with tattoos should be regarded as a group with increased prevalence of alexithymia. Individuals with non-verbal tattoos had a higher tendency to be screened as alexithymic as alexithymic ones. Motivation for getting the tattoo does not seem to have a significant impact on the prevalence of alexithymia.

How the Occupational Competence and Quality of Life in Parents of Children with Autism Spectrum Disorder Changed During the COVID-19 Pandemic: A Mixed Design Study

This study aimed to evaluate the impact of the pandemic on the occupational competence and quality of life of parents of children with autism using a mixed-methods design. It compared 220 parents of children with autism to 300 parents of neurotypical children, utilizing the Occupational Self-Assessment, Short Form 36 Health Survey, and qualitative interviews for data collection. Quantitative results revealed significant differences in occupational competence and quality of life between the two groups. Qualitative interviews underscored changes in parents' professional and social roles, along with reductions in self-care, productivity, and recreational activities, particularly affecting parents of children with autism.

Effect of COVID-19 on pediatric gunshot wounds to the head at a level 1 trauma center

Background

The United States (US) has one of the highest rates of gunshot-related incidents in the world. Gunshot wounds to the head (GSWH) in the pediatric population are also common, with high morbidity and mortality rates.

Methods

We performed a retrospective study to analyze if there was a notable change in trends in pediatric GSWH at our Level 1 Pediatric Trauma Center due to the COVID-19 pandemic. A retrospective study was conducted including patients under the age of 18 presenting with GSWH from January 2014 to May 2023. Variables assessed included demographics, interventions, and outcomes. Data from the county's Child Death Review Team Annual Report on mortality related to gunshot-related deaths from January 2014 to June 2023 were analyzed.

Results

In total, thirty-five patients were evaluated at our institution for GSWH. Nineteen patients were treated during the 6 years before the pandemic and sixteen during the 3-year pandemic. Nine patients died at the hospital, with an overall increase during the pandemic. In the county, seventy-two children were killed from gun violence, with 58% (42) from GSWH. Death from GSWH increased in the county cohort during the pandemic.

Conclusion

The pandemic affected the outcomes of patients with GSWH at our institution with an overall increase in rates of self-inflicted and drive-by shootings, a doubling of neurosurgical interventions, an increase in acuity of care for long-term disposition, and an increase in mortality. At a county level, there was an increase in overall deaths from GSWHs, the majority of which were nonaccidental.

The mediating effect of social intelligence in the association between social anxiety and mental health among Chinese nursing students

Social anxiety is highly prevalent among nursing students and is associated with poor mental health. However, the underlying mechanism in such an association remains unclear. This study aimed to examine the potential mediating role of social intelligence in the association between social anxiety and mental health using the Stress-Coping Model (SCM) as the theoretical framework. A cross-sectional study was conducted among 748 nursing students recruited from a Chinese University from December 2022 to March 2023. Students completed an online questionnaire to assess their social anxiety, social intelligence, and mental health. The PROCESS SPSS Macro (model 4) was used to test the mediation effect of social intelligence on the association between social anxiety and mental health. The results showed that nursing students had moderate levels of social anxiety, social intelligence, and mental health, which varied according to their profile characteristics. Social anxiety was negatively associated with mental health, and the association was partially mediated by social intelligence. Our study offers fresh insights into the impact of social anxiety on mental health and sheds light on the intricate mediating role of social intelligence. These findings offer valuable insights for research and clinical endeavors aimed at formulating psychosocial interventions to enhance the mental health of nursing students.

The genetic landscape of neuro-related proteins in human plasma

Understanding the genetic basis of neuro-related proteins is essential for dissecting the molecular basis of human behavioural traits and the disease aetiology of neuropsychiatric disorders. Here the SCALLOP Consortium conducted a genome-wide association meta-analysis of over 12,000 individuals for 184 neuro-related proteins in human plasma. The analysis identified 125 cis-regulatory protein quantitative trait loci (cis-pQTL) and 164 trans-pQTL. The mapped pQTL capture on average 50% of each protein's heritability. At the cis-pQTL, multiple proteins shared a genetic basis with human behavioural traits such as alcohol and food intake, smoking and educational attainment, as well as neurological conditions and psychiatric disorders such as pain, neuroticism and schizophrenia. Integrating with established drug information, the causal inference analysis validated 52 out of 66 matched combinations of protein targets and diseases or side effects with available drugs while suggesting hundreds of repurposing and new therapeutic targets.

Trends in the nonmedical misuse of benzodiazepines and Z-hypnotics among school-aged adolescents (2016-2021): gender differences and related factors

BACKGROUND

The misuse of psychotropic medication has increased during the past decade, especially among adolescents. The aim of our study was to describe the prevalence and patterns of the nonmedical use of benzodiazepines (BDZ) and Z-hypnotics among school-aged adolescents through the lens of sex. In addition, we sought to analyze the temporal evolution of the nonmedical use of these drugs during the period 2016-2021.

METHODS

The temporal evolution of the nonmedical use of these drugs was analyzed based on survey data collected in 2016, 2018 and 2021, which includes the first years of the COVID-19 pandemic. To assess the possible effect of the COVID-19 pandemic, the year at survey was conducted was introduced as a categorical variable. We used data from the Spanish State Survey on Drug Use in Secondary Education, which covers drug use among students aged 14-18 years. Using multivariate logistic regression models, we estimated the independent effect of different variables (sociodemographic data, use of other psychoactive substances, risk perception and availability) on the nonmedical use of BDZ and Z-hypnotics.

RESULTS

In total, survey data from 95,700 adolescents were included in our analysis. The nonmedical use of BDZ and Z-hypnotics increased among adolescents during the study period. The adjusted odds ratio (AOR) from 2016 to 2018 was 1.11 (95% CI 0.94-1.31) and from 2018 to 2021 the AOR was 1.26 (95% CI 1.08-1.46), using 2016 and 2018, respectively, as reference years. The nonmedical use of BDZ and Z-hypnotics was more likely in adolescent girls than boys (AOR = 2.11). The nonmedical use of prescription opioids (AOR = 3.44), novel psychoactive substances and other illicit psychoactive drugs (AOR = 4.10) were risk factors for the nonmedical use of BDZ and Z-hypnotics in both sexes. Use of cannabis (AOR = 1.38) was a predictor of nonmedical use in female adolescents only.

CONCLUSIONS

This study shows that the trend of the nonmedical use of BDZ and Z-hypnotics among school-aged adolescents in Spain increased between 2016 and 2021. Among adolescents aged 14 to 18, the probability of nonmedical use of these psychoactive substances was twice as high for female adolescents as for male adolescents.

Exploring the relationship between coping styles and well-being among Chinese university students: A longitudinal study based on the transactional stress model

In the context of the COVID-19 pandemic, university students were exposed to increased stress, which significantly affected their well-being. This study examines the coping mechanisms employed by Chinese university students during this crisis, with a particular focus on the potential protective role of coping flexibility in maintaining their well-being. Using the transactional stress model and the dual-process theory of coping flexibility, this longitudinal study analyzed the responses of 206 Chinese university students at three measurement points in late 2022. The findings suggest that disruptions in daily life during the pandemic likely led students to engage in problematic internet use as a coping strategy, which subsequently led to reduced well-being. However, the study also shows that coping flexibility plays a crucial protective role in maintaining students' well-being. These findings highlight the urgent need for targeted interventions aimed at enhancing coping flexibility among university students, especially in the evolving post-pandemic landscape.

Utilization of Probiotic-Derived Extracellular Vesicles as Postbiotics and Their Role in Mental Health Therapeutics

As consumers become more interested in healthier lifestyles, the global functional food market is expanding. Probiotics have gained attention because of their numerous health benefits to the host and may even treat various pathological conditions. Probiotics interact with host cells, and particularly, probiotics-derived extracellular vesicles (PEVs) are key factors in the health benefits of probiotics. Additionally, extracellular vesicles are nano-scaled lipid-bilayer particles that carry various biological molecules, indicating potential as new postbiotics that can provide the same health benefits as probiotics while complementing the side effects associated with probiotics. The importance of mental health care is becoming increasingly prominent considering societal conditions, such as the recent aging population and the coronavirus disease 2019 pandemic. However, the response to mental health issues among modern individuals is insufficient, and there is a need for the development of new personalized treatments to overcome the limitations of current mental health therapies. PEVs have various physiological functions, including mediating cellular communication in the central nervous system, which indicates associations among mental disorders. Therefore, we focused on the beneficial effects of PEVs on the brain and mental health. Recent research has shown that PEVs can adjust the expression of brain-derived neurotrophic factors in vitro and in vivo, demonstrating antidepressant and cognitive function improvement effects. This suggests that PEVs have potential as therapeutic agents for improving mental health and treating brain disorders. Based on this, we review these findings and present the beneficial effects of PEVs on mental health and the challenges that need to be addressed.

The association of micro and macro worries with psychological distress in people living with chronic kidney disease during the COVID-19 pandemic

BACKGROUND

Psychological distress can be exacerbated by micro (personal) and macro (societal) worries, especially during challenging times. Exploration of this relationship in people with chronic kidney disease is limited.

OBJECTIVES

(1) To identify the types and levels of worries concerning people with chronic kidney disease in the context of the COVID-19 pandemic; (2) to explore the association of worries with psychological distress including depression, stress, anxiety, and health anxiety.

DESIGN AND PARTICIPANTS

A cross-sectional online survey collected data at two time points (Autumn 2020, n = 528; Spring 2021, n = 241). Participants included kidney transplant recipients and people with non-dialysis dependent chronic kidney disease.

MEASUREMENTS

The survey included questions about worry taken from the World Health Organisation COVID-19 Survey, the Depression, Anxiety and Stress Scale, and the Short Health Anxiety Index. Data were analysed using descriptive statistics and multiple regression.

RESULTS

Worries about loved ones' health, the healthcare system becoming overloaded, losing a loved one, economic recession, and physical health were the highest rated concerns. Worrying about mental health was associated with higher depression, stress, anxiety, and health anxiety. Worrying about physical health was associated with anxiety and health anxiety. Worrying about losing a loved one was associated with health anxiety, and worrying about not being able to pay bills was associated with stress.

CONCLUSIONS

People with kidney disease reported micro and macro worries associated with psychological distress during the COVID-19 pandemic. This study highlights factors that should be considered to improve the mental health and well-being of people with kidney disease.

Young adults, particularly young women, account for an increasingly large share of Dutch mental healthcare expenditure over the period between 2015 and 2021

AIMS

There is increasing concern over the mental distress of youth in recent years, which may impact mental healthcare utilisation. Here we aim to examine temporal patterns of mental healthcare expenditures in the Netherlands by age and sex in the period between 2015 and 2021.

METHODS

Comprehensive data from health insurers in the Netherlands at the 3-number postal code level were used for cluster weighted linear regressions to examine temporal patterns of mental healthcare expenditure by age group (18-34 vs 35-65). The same was done for medical specialist and general practitioner costs. Additionally, we examined interactions with gender, by adding the interaction between age, year and sex to the model.

RESULTS

Mental healthcare costs for younger adults (18-34) were higher than those for older adults (35-65) at all time points (β = 0.22, 95%-CI = 0.19; 0.25). Furthermore there was an increase in the strength of the association between younger age and mental healthcare costs from β = 0.22 (95%-CI = 0.19; 0.25) in 2015 to β = 0.37 (95%-CI = 0.35; 0.40) in 2021 (p < 0.0001) and this was most evident in women (p < 0.0001). Younger age was associated with lower general practitioner costs at all time points, but this association weakened over time. Younger age was also associated with lower medical specialist costs, which did not weaken over time.

CONCLUSIONS

Young adults, particularly young women, account for an increasing share of mental healthcare expenditure in the Netherlands. This suggests that mental distress in young people is increasingly met by a response from the medical system. To mitigate this trend a public mental health approach is needed.

Is primary care ready for a potential new public health emergency in the wake of the COVID-19 pandemic, now subsided?

INTRODUCTION

The lingering burden of the COVID-19 pandemic on primary care clinicians and practices poses a public health emergency for the United States. This study uses clinician-reported data to examine changes in primary care demand and capacity.

METHODS

From March 2020 to March 2022, 36 electronic surveys were fielded among primary care clinicians responding to survey invitations as posted on listservs and identified through social media and crowd sourcing. Quantitative and qualitative analyses were performed on both closed- and open-ended survey questions.

RESULTS

An average of 937 respondents per survey represented family medicine, pediatrics, internal medicine, geriatrics, and other specialties. Responses reported increases in patient health burden, including worsening chronic care management and increasing volume and complexity. A higher frequency of dental- and eyesight-related issues was noted by respondents, as was a substantial increase in mental or emotional health needs. Respondents also noted increased demand, "record high" wait times, and struggles to keep up with patient needs and the higher volume of patient questions. Frequent qualitative statements highlighted the mismatch of patient needs with practice capacity. Staffing shortages and the inability to fill open clinical positions impaired clinicians' ability to meet patient needs and a substantial proportion of respondents indicated an intention to leave the profession or knew someone who had.

CONCLUSION

These data signal an urgent need to take action to support the ability of primary care to meet ongoing patient and population health care needs.

Impacts of the COVID-19 pandemic on healthcare utilization among Home Care Aides in Washington, U.S

This study assesses the impacts of the COVID-19 pandemic on healthcare access for Washington State Home Care Aides (HCAs). Analyzing 62 months of medical claims data from over 35,000 HCAs, the research reveals significant healthcare disruptions during the early pandemic, especially in outpatient settings. However, healthcare utilization rebounded swiftly, surpassing pre-COVID levels as new variants emerged. Furthermore, the analysis indicated significant decreases in healthcare utilization for respiratory conditions in later stages of the pandemic, suggesting that the implementation of non-pharmaceutical and pharmaceutical interventions played a crucial role in preventing the transmission of respiratory diseases. Notably, behavioral health-related utilization among HCAs increased significantly throughout most pandemic phases, underscoring the importance of enhancing behavioral health support during public health crises. This research represents the first comprehensive study unveiling the effects of the COVID-19 pandemic on HCAs' healthcare access and opening avenues for further research and policy development to support this essential workforce.

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

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.