Mental health interventions following COVID-19 and other coronavirus infections: a systematic review of current recommendations and meta-analysis of randomized controlled trials

The Effectiveness of Mind-Body Intervention on Psychological Well-Being during the COVID-19 Pandemic: A Pilot Pre-Post Interventional Study

The pandemic highlighted the need for alternative, more accessible access to mental health interventions that can be readily administered remotely. The purpose of this pre-post-interventional study was to evaluate the effectiveness of a virtual mind-body medicine training course on stress, anxiety, and depression levels. University employees and members of the Las Vegas community were recruited via self-selection and snowball sampling and subjected to online mind-body practice sessions in December of 2020. Stress, anxiety, depression, and quality of life were assessed pre- and post-intervention using standardized psychometric valid tools. The paired t-test and related samples marginal homogeneity tests were used for continuous and categorical outcomes, respectively. Depression and stress scores were significantly decreased (p < 0.001). Mean scores of professional quality of life improved post-intervention compared to pre-intervention (p = 0.03). A significantly larger proportion of participants reported no depression or stress post-intervention compared with pre-intervention (p < 0.001, p = 0.003, respectively.) This study suggests that virtual mind-body practices had a pronounced impact on stress and depression levels during the pandemic. These findings support virtual, online-guided mind-body medicine training as an effective intervention that can be administered virtually to reduce stress and depression symptoms.

Online Integrative Community Therapy in Latin America: Health Promotion in Times of COVID-19

This study described integrative community therapy (ICT) in the online modality as a health promotion resource in the context of COVID-19 in Latin America, characterizing the ICT circles, the ICT training centers, and the community therapists involved in this practice. It is a descriptive, observational, and cross-sectional study with a quantitative approach. Data were collected from November 2020 to July 2021 through an online questionnaire created on the Google Forms platform. The study's first stage involved the participation of ICT training centers, while the second involved community therapists. Forty-three centers participated in the first stage; 86.1% offered online ICT in the period evaluated, and 74.4% trained professionals to implement this modality. In the second stage, 66 community therapists responded to the questionnaire. Of these, 49 (74.2%) resided in Brazil, 84.8% were female, and 72.7% performed the work voluntarily, with an average of 6.1 hours per week dedicated to online circles. Community-based circles were the most cited, followed by those linked to the public sector, with an average of 20.7 participants/circle in the period. The most frequent themes were stress and negative emotions, problems with work/unemployment, and family conflicts. Strengthening self-care, participation in ICT circles, and personal empowerment stood out among the coping strategies. In conclusion, online ICT proved to be an innovative resource for health promotion during the pandemic through the articulation and engagement of community therapists and different institutions, expanding solidary social networks, and showing itself as a sustainable practice in the Latin American scenario.

"We lost a lot, but something good came out of it too:" Exploring the impact of the COVID-19 pandemic on the mental wellbeing of British Muslim Pakistani women with family responsibilities

BACKGROUND

The COVID-19 pandemic and associated restrictions caused major disruption globally, shedding light on the unprecedented strain upon the mental health and wellbeing of individuals around the world. Poor mental health in the pandemic is reported to be greater in women, with mothers being at increased risk. It is unclear whether there are differences in the impact of mental wellbeing on some ethnic groups over others. The aim of this study was to explore the experiences of British Muslim Pakistani women with family responsibilities during the COVID-19 pandemic, two years on from the first lockdown.

METHODS

Qualitative interviews with women were conducted via telephone using a semi-structured topic guide. The sample included 25 British Muslim Pakistani women with family responsibilities, both English and non-English speaking. Women lived in households that ranged in number and included extended family. Key themes were determined using thematic analysis.

RESULTS

Results were grouped under three themes. These were (1) Community, cultural and religious contributors to poor mental wellbeing, (2) religious and cultural mediators of mental distress, and (3) perceived positive impact on lifestyle. British Muslim Pakistani women were psychologically distressed by the high rates of virus transmission and deaths in their communities and at the prospect of older members of their extended family developing the virus. The impact of restrictions on fundamental religious and cultural interactions further exacerbated poor mental wellbeing in this population. Religion, community social capital and larger household structures were all effective coping strategies for British Muslim Pakistani women. Positive impacts of the pandemic included becoming closer to family and faith, and increased work/life harmony.

CONCLUSIONS

An exploration of religious and cultural coping mechanisms should be used to inform future national pandemic preparedness plans, as well as effective strategies for building and maintaining social capital. This may increase adherence to physical distancing and other protective behaviours in populations.

Postacute Sequelae of COVID-19 and Adverse Psychiatric Outcomes: Protocol for an Etiology and Risk Systematic Review

BACKGROUND

The postacute sequelae of COVID-19 (PASC) is a syndrome characterized by persistent COVID-19 symptoms or the onset of new symptoms following recovery from the initial or acute phase of the illness. Such symptoms often occur 4 or more weeks after being diagnosed with COVID-19. Although a lot of work has gone into understanding the long-term mental health effects of PASC, many questions related to the etiology and risk of this condition remain.

OBJECTIVE

This protocol is for a systematic review assessing the association between PASC and adverse psychiatric outcomes and whether people with PASC are at greater risk of developing an adverse psychiatric outcome than those without PASC.

METHODS

Various medical literature databases (eg, PubMed and EMBASE) will be searched for eligible articles, using predefined search criteria. Gray literature will also be explored. Epidemiological observational studies and secondary analyses of randomized controlled trials that report a quantitative relationship between PASC and at least one adverse psychiatric outcome will be included. The Population, Exposure of interest, Comparator, and Outcome framework will be used as a standardized framework for the inclusion criteria. The Joanna Briggs Institute critical appraisal tools will be used to assess methodological quality and critically appraise the risk of bias in included studies. A random-effects meta-analysis will be conducted if possible. A formal narrative synthesis will be performed if a meta-analysis is impossible due to substantial heterogeneity across studies. The Grading of Recommendations Assessment, Development and Evaluation approach will be used to rate the cumulative certainty of the evidence for all outcomes. Ethical approval is not required. The study results will be published in a peer-reviewed journal.

RESULTS

This study documents and addresses etiology, risk factors, and long-term symptoms of COVID-19 among people with PASC. It focuses on a key priority area for new evidence syntheses on the clinical management of COVID-19 and pandemic-related conditions. It will include evidence on nonhospitalized and hospitalized patients with a history of PASC.

CONCLUSIONS

Substantial heterogeneity across studies may limit the ability to perform a meta-analysis. Findings will inform disease prevention, decision-making, health care policy, and clinical research (Reviewed by the Plan P #PeerRef Community).

TRIAL REGISTRATION

PROSPERO CRD42022308737; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=308737.

Prevalence and factors associated with self-reported anxiety in adults during the COVID-19 pandemic in Argentina, Brazil, Peru, Mexico, and Spain: A cross-sectional Ibero-American study

The present study evaluated the factors associated with the perception of anxiety during the first wave of covid-19 in Ibero-American countries. This cross-sectional study was carried out with 5.845 participants of both sexes, over 18 years of age, and residents of four Latin American countries-Argentina (16.7%), Brazil (34.5%), Mexico (11.1%), and Peru (17.5%), and one European country-Spain (20.1%). Data were collected in 2020, between April 1st and June 30th in Spain and between July 13th and September 26th in the Latin American countries. We used an online questionnaire with sociodemographic, lifestyle, self-reported anxiety, and covid-19 related questions. The chi-square statistical test and Multivariate logistic regressions were performed to analyze the factors associated with self-reported anxiety. The presence of self-reported anxiety was found in 63.8% of the participants during the isolation period. The association occurred mainly in women (OR:1.52; CI: 1.3-1.7), those aged 18 to 29 years (OR: 1.51; CI: 1.2-1.9) and 30 to 49 years (OR: 1.56; CI: 1.3-1.9), residents of Argentina (OR: 1.55 CI: 1.2-1.9), Brazil (OR: 2.38; CI: 2.0-2.8) and Mexico (OR: 1.52; CI: 1.2-1.9), those who gained weight (OR:1.71 CI: 1.5-1.9) or lost weight (OR: 1.40; CI: 1.2-1.6), and those who reported having slept more (OR: 1.56; CI: 1.3-1.8) or less (OR: 2.89; CI: 2.5-3.4). We conclude that the prevalence of self-reported anxiety in Ibero-American countries was high during the period studied, highlighting a higher likelihood of its occurrence in Brazil, in those who began to sleep less and gained weight.

COVID-19-related mental health difficulties among marginalised populations: A literature review

The COVID-19 pandemic has had negative consequences on the mental health of the population, which has been documented. Marginalised groups that are at risk of poor mental health overall have been particularly impacted. The purpose of this review is to describe the mental health impact of the COVID-19 pandemic on marginalised group (i.e. persons who are socio-economically disadvantaged, migrants and members of ethno-racial minorities, experience homelessness) and identified interventions which could be well-suited to prevent and address mental health difficulties. We conducted a literature review of systematic reviews on mental health difficulties since the beginning of the COVID-19 epidemic and appropriate interventions among marginalised groups published from January 1, 2020 to May 2, 2022, using Google Scholar and PubMed (MEDLINE). Among 792 studies on mental health difficulties among members of marginalised groups identified by keywords, 17 studies met our eligibility criteria. Twelve systematic reviews examining mental health difficulties in one or several marginalised groups during the COVID-19 pandemic and five systematic reviews on interventions that can mitigate the mental health impact of the COVID-19 pandemic were retained in our literature review. The mental health of marginalised groups was severely affected during the COVID-19 pandemic. Most frequently reported mental health difficulties included symptoms of anxiety and depression. Additionally, there are interventions that appear effective and well-suited for marginalised populations, which should be disseminated on a large scale to mitigate the psychiatric burden in these groups and at the population level.

One-year follow-up of depression, anxiety, and quality of life of Peruvian patients who survived COVID-19

PURPOSE

To assess health-related quality of life (HRQoL) and its associated factors in patients who survived COVID-19 and to assess a prospective evaluation of the prevalence and severity of their depression and anxiety symptoms.

METHODS

We followed up a sample of hospitalized patients who survived COVID-19 at 3 and 12 months after discharge. We assessed HRQoL (Euroqol-5D-5L) through telephone interviews. Any problem in any dimension of Euroqol-5D-5L was considered as low HRQoL. The depression and anxiety symptoms were measured using the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 tools, respectively. We estimated the adjusted prevalence ratios (aPR) to low HRQoL using Poisson regression and the changes on their depression and anxiety symptoms during the follow-up.

RESULTS

We included 119 patients with a mean follow-up time of 363.6 days. 74% of the participants had low HRQoL at one year after hospital discharge and were associated with being ≥ 41 years old (aPR: 1.95), having a previous history of psychiatric diagnoses before COVID-19 infection (aPR: 1.47), having any COVID-19 symptom during the follow-up at one year (aPR: 1.84), and having a family member who had died from COVID-19 during the first wave (aPR: 1.24). In addition, the clinically relevant depression symptoms were frequent, and they increased from 3 (14.3%) to 12 months (18.5%).

CONCLUSION

One year after COVID-19 hospitalization discharge, patients had low HRQoL, and their depression symptoms increased. These findings acknowledge the need to provide services that adequately address mental health sequels and HRQoL to reduce the burden of the COVID-19.

Brazilian overview of nurses' training during the COVID-19 pandemic

OBJECTIVE

To present the Brazilian panorama of the training of nurses during the COVID-19 pandemic.

METHOD

a cross-sectional study, carried out with 335 coordinators of undergraduate courses in Nursing and online data collection, between November 2020 and March 2021.

RESULTS

All Brazilian states were represented. Of Higher Education Institutions, 52.5% adopted remote learning within 10 days after determining social distancing and 23% after 100 days; 73.4% kept the students in a mandatory curricular internship. Practical classes had a reduction in the number of students per group (46.0%). Most faculty and students were contaminated by SARS-CoV-2 and showed worsening in mental health.

CONCLUSIONS

The study identified heterogeneity in the resumption of activities, through remote teaching, which mostly occurred synchronously. There was a resumption of curricular internships and practical classes in health services, with a limitation on the number of students per field.

Meta-Analysis of Psychological Interventions for Reducing Stress, Anxiety, and Depression among University Students during the COVID-19 Pandemic

(1) Background: The aim of this study is to investigate the effects of internet-based intervention programs for reducing stress, anxiety, and depression among university students during the COVID-19 pandemic by conducting a meta-analysis. (2) Methods: Searches were conducted in the following databases: MEDLINE, EbscoHost Academic Search Ultimate, and PsycArticles, using a combination of “Covid-19 AND ‘Randomized Controlled Trial’ AND students”, as well as a combination of the following search terms: “internet”, “online”, “treat_”, “psycholog_”, “intervention”, “program_”, “stress_”, “depress_”, “anxiety”, “university”, “college”, ”freshm_”, “sophomore_”, and “undergraduat_”. The population, intervention, control, outcomes, and study design (PICOS) framework was used (P (population): university students during the COVID-19 pandemic; I (intervention): internet-based intervention programs for reducing stress, anxiety, and depression; C (control): no intervention, usual care, or on a waiting list; O (outcomes): stress, anxiety, and depression indicators; S (study design): meta-analysis including only randomized controlled trials (RCTs)). A meta-analysis was performed on the 10 retrieved studies published between 2021 and 2022. Only RCTs were analyzed. (3) Results: All 10 analyzed papers revealed a trend in the effectiveness of internet-based intervention for reducing stress, anxiety, and depression in university students during COVID-19. Significant effects from the included RCTs with interventions for reducing stress and depression were established. (4) Conclusions: Psychological internet-based interventions may help to reduce depression and stress among university students; however, more research is needed to determine their effectiveness in reducing anxiety.

Panorama brasileiro da formação de enfermeiros durante a pandemia da COVID-19

RESUMO Objetivo: Apresentar o panorama brasileiro da formação de enfermeiros durante a pandemia da COVID-19. Método: estudo transversal, realizado com 335 coordenadores de curso de graduação em Enfermagem e coleta de dados on-line, entre novembro de 2020 e março de 2021. Resultados: Houve representação de todos os estados brasileiros. Das Instituições de Ensino Superior, 52,5% adotaram o ensino remoto em até 10 dias após a determinação do distanciamento social e 23% depois de 100 dias; 73,4% mantiveram os estudantes em estágio curricular obrigatório. As aulas práticas tiveram redução no número de estudantes por grupo (46,0%). A maioria dos docentes e discentes foi contaminada pelo SARS-CoV-2 e apresentaram piora na saúde mental. Conclusões: O estudo identificou heterogeneidade na retomada das atividades, por meio do ensino remoto, que ocorreu majoritariamente de forma síncrona. Houve retomada de estágios curriculares e aulas práticas em serviços de saúde, com limitação do número de estudantes por campo.

Protecting vulnerable communities and health professionals from COVID-19 associated mental health distress: a comprehensive approach led by a public-civil partnership in rural Chiapas, Mexico

BACKGROUND

The COVID-19 pandemic has stricken mental health worldwide. Marginalized populations in low- and middle-income countries have been the most affected, as they were already experiencing barriers to accessing mental health care prior to the pandemic and are unequally exposed to the stressors associated with the health emergency, such as economic ravages or increased risk of complicated disease outcomes.

OBJECTIVE

The aim of this paper is to describe a comprehensive initiative resulting from a public-civil partnership to address the increased burden of mental health illness associated with the COVID-19 pandemic in rural Chiapas, Mexico.

METHODS

To address the emerging health needs of the general population and health professionals resulting from the pandemic, Compañeros En Salud (CES), a non-profit civil society organization based in Chiapas, implemented a comprehensive strategy to compensate for the shortage of mental health services in the region in collaboration with the Chiapas Ministry of Health. The strategy included three components: capacity building in mental health care delivery, psychosocial support to the general population, and provision of mental health care to CES collaborating staff. In this capacity building article, implementers from CES and the government share descriptive information on the specific interventions carried out and their beneficiaries, as well as a critical discussion of the strategy followed.

RESULTS

Through this strategy, we have been successful in filling the gaps in the public health system to ensure that CES-served populations and CES-collaborating health professionals have access to mental health care. However, further studies to quantify the impact of this intervention in alleviating the burden of mental health illnesses associated with the pandemic are needed.

CONCLUSIONS

The current situation represents an opportunity to reimagine global mental health. Only through the promotion of community-based initiatives and the development of integrated approaches will we ensure the well-being of marginalized populations.

Strategies Adopted by Addiction Facilities during the Coronavirus Pandemic to Support Treatment for Individuals in Recovery or Struggling with a Substance Use Disorder: A Scoping Review

This review aimed to identify and synthesize strategies and actions adopted by addiction facilities to support and maintain treatment during the coronavirus disease 2019 (COVID-19) pandemic. A scoping review was conducted using the following information sources: Virtual Health Library, SCOPUS, Web of Science, PubMed, CINAHL, and Latin American and Caribbean Health Science Literature. From a total of 971 articles, 28 studies were included. The strategies to maintain the care offer were telehealth/telemedicine, counselling/screening, 24-h telephone, webinars, conducting group therapy and support among users, adaptation for electronic health records, increased methadone/naloxone dispensing, restriction in the number of medication dispensing/day, and electronic prescription and home delivery medications. These strategies can be used to support health professionals in addressing the impact of the pandemic on the treatment of those in recovery or struggling with a substance use disorder when in-person treatment is not possible.

Effect of non-alcoholic beer containing matured hop bitter acids on mood states in healthy adults: A single-arm pilot study

This study aimed to investigate the effect of non-alcoholic beer containing matured hop bitter acids on mood states among healthy adults older than 20 years. This study was an open-label longitudinal intervention design in which each participant served as their control. For three weeks, we evaluated the effect of non-alcoholic beer containing 35 mg of matured hop bitter acids on mood, sleep quality, and work performance. The data of 97 participants (age range: 23-72 years, median age: 42) were analyzed. After the intervention, we found that matured hop bitter acids significantly improved total mood state, including anxiety, depression, fatigue, and vigor, compared with the baseline. Furthermore, sleep quality and absolute presenteeism were significantly improved after the intervention compared with the baseline. The present exploratory study suggested that 3-week supplementation with matured hop bitter acids improved mood and peripheral symptoms in persons of a wide range of ages. Although further investigation is needed, the findings suggested that non-alcoholic beer in daily life might become a choice for maintaining mood states. This article is protected by copyright. All rights reserved.

COVID-19 related psychological distress and fears among mothers and pregnant women in Saudi Arabia

OBJECTIVES

This study objectives were to investigate maternal psychological distress, mothers' fear of their children contracting COVID-19, mothers' perceptions of the information available regarding children and COVID-19, changes in children's behavior during lockdown, and concerns of pregnant women in Saudi Arabia.

METHODS

This cross-sectional study surveyed women aged 18 years and older who either had children under 10 years of age or were pregnant at the time of the survey. The outcomes included psychological distress, mothers' fear of their children contracting COVID-19, change in children's behaviors during COVID-19 lockdown and pregnant women's concerns. Multivariable ordinary least squares regression models were employed to examine the adjusted associations between sociodemographic factors and psychological distress, as well as fear of COVID-19.

RESULTS

Of 628 women, 11.8% (n = 74) were pregnant at the time of survey. Most of the pregnant women (89.2%, n = 66) had some degree of concerns about their unborn babies getting infected during delivery in the hospital. Among mothers of children under 10 years of age (n = 564), half (n = 282) reported change in their children's behavior during the lockdown. Most mothers and pregnant women (94.9%, n = 569) had some degree of psychological distress. Mothers and pregnant women with a college degree had significantly lower psychological distress (β = -1.346; p = 0.014) than women with a high school education or less. Similarly, mothers and pregnant women with monthly family income ≥ US$ 1,333 had lower psychological distress than those with < US$ 1,333. Women with pre-existing chronic physical (β = 2.424; p < 0.001) or mental (β = 4.733; p < 0.001) conditions had higher psychological distress than those without these conditions. Having children in the house was a contributory factor for higher psychological distress. For example, mothers with one child (β = 2.602; p = 0.007) had significantly higher psychological distress compared to expectant mothers without children in the house.

CONCLUSIONS

Most mothers and expectant mothers in our study had moderate to high levels of psychological distress during the COVID-19 pandemic outbreak in Saudi Arabia. Education, family income and chronic mental and physical conditions were associated with high psychological distress in Saudi Arabia during COVID-19.