Isolation, Economic Precarity, and Previous Mental Health Issues as Predictors of PTSD Status in Females Living in Fort McMurray During COVID-19

Mobile Apps to Support Mental Health Response in Natural Disasters: Scoping Review

BACKGROUND

Disasters are becoming more frequent due to the impact of extreme weather events attributed to climate change, causing loss of lives, property, and psychological trauma. Mental health response to disasters emphasizes prevention and mitigation, and mobile health (mHealth) apps have been used for mental health promotion and treatment. However, little is known about their use in the mental health components of disaster management.

OBJECTIVE

This scoping review was conducted to explore the use of mobile phone apps for mental health responses to natural disasters and to identify gaps in the literature.

METHODS

We identified relevant keywords and subject headings and conducted comprehensive searches in 6 electronic databases. Studies in which participants were exposed to a man-made disaster were included if the sample also included some participants exposed to a natural hazard. Only full-text studies published in English were included. The initial titles and abstracts of the unique papers were screened by 2 independent review authors. Full texts of the selected papers that met the inclusion criteria were reviewed by the 2 independent reviewers. Data were extracted from each selected full-text paper and synthesized using a narrative approach based on the outcome measures, duration, frequency of use of the mobile phone apps, and the outcomes. This scoping review was reported according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews).

RESULTS

Of the 1398 papers retrieved, 5 were included in this review. A total of 3 studies were conducted on participants exposed to psychological stress following a disaster while 2 were for disaster relief workers. The mobile phone apps for the interventions included Training for Life Skills, Sonoma Rises, Headspace, Psychological First Aid, and Substance Abuse and Mental Health Services Administration (SAMHSA) Behavioural Health Disaster Response Apps. The different studies assessed the effectiveness or efficacy of the mobile app, feasibility, acceptability, and characteristics of app use or predictors of use. Different measures were used to assess the effectiveness of the apps' use as either the primary or secondary outcome.

CONCLUSIONS

A limited number of studies are exploring the use of mobile phone apps for mental health responses to disasters. The 5 studies included in this review showed promising results. Mobile apps have the potential to provide effective mental health support before, during, and after disasters. However, further research is needed to explore the potential of mobile phone apps in mental health responses to all hazards.

Longitudinal trajectories of psychosocial functioning in patients with pre-existing mental disorders after one year of COVID-19 pandemic

Aims of the present study were to prospectively assess psychosocial functioning trajectories during the COVID pandemic and the possible impact of sociodemographic variables, as well as of COVID-19 pandemic-related factors, on these trajectories, in a sample of patients with pre-existing severe mental disorders. Moreover, we aimed at identifying predictors of impairment in psychosocial functioning over a period of 9 months of COVID-19 pandemic. Patients were recruited during the 3rd wave of the COVID-19 pandemic (T0, March-April 2021) while strict containment measures were applied in Italy, and reassessed after 3 months (T1, June-July 2021), and after 6 months from T1 (T2- November-December 2021), during the 4th wave of COVID pandemic. A sample of 300 subject (out of the 527 subjects recruited at baseline) completed the T2 evaluation. Patients were assessed by: Work and Social Adjustment Scale (WSAS) for psychosocial functioning, Generalized Anxiety Disorder 7-Item (GAD-7) for anxiety symptoms, Patient Health Questionnaire-9 (PHQ-9) for depressive symptoms and the Impact of Events Scale-Revised, for post-traumatic symptoms. Cluster analyses identified 4 trajectories of functioning: the High, Stable Functioning group (N = 77), the Improvement Functioning group (N = 62), the Progressive Impairment group (N = 83) and the Persistent Severe Impairment group (N = 78) respectively. We found that predictors of higher WSAS score at T2 were higher WSAS score at T0 (B = 0.43, p < .001), PHQ scores at baseline >10 (B = 2.89, p < .05), while not living alone was found to be a protective factor (B = -2.5, p < .05). Results of the present study provides insights into the vulnerability of individuals with psychiatric disorders during times of crisis. Study findings can contribute to a better understanding of the specific needs of this population and inform interventions and support strategies.

Deepening Depression in Women Balancing Work-Life Responsibilities and Caregiving during the COVID-19 Pandemic: Findings from Gender-Specific Face-to-Face Street Interviews Conducted in Italy

PURPOSE

This study investigated the impact of the COVID-19 pandemic on mental health, quality of life, and family functioning in a sample of the general female population, exploring difficulties encountered in managing family and work responsibilities and burden of care when taking care of a loved one. This study was, moreover, aimed at investigating factors capable of influencing severe depressive symptomatology in the context of socio-demographics, traumatic events, individual vulnerability, and family functioning.

METHOD

The sampling method used in this research was non-probability sampling. The survey took place during a Hospital Open Weekend (8-10 October 2021) organized by the National Gender Observatory on Women's Health "Fondazione Onda" on the occasion of the World Mental Health Day.

RESULTS

A total of 211 women were interviewed (mean age = 35.6, 53% living alone, more than 15% with financial difficulties, 47% exposed to the 2009 L'Aquila earthquake). More than 50% of the sample reported a higher complexity in managing their lives during the COVID-19 pandemic compared to their previous routine, with no statistically significant differences between working women and non-workers, although the latter obtained higher scores for depressive symptomatology and poorer quality of life. Compared to non-caregivers, female caregivers (22.3%) in charge of the care of loved ones affected by physical (10.9%) or psychiatric disabilities (11.4%) complained of a poorer quality of life, especially in general health perception (p = 0.002), physical function (p = 0.011), role limitations related to physical problems (p = 0.017), bodily pain (p = 0.015), mental health (p = 0.004), and social functioning (p = 0.007). Women caring for people affected by mental disorders seemed to experience a more significant worsening in vitality (p = 0.003) and social functioning (p = 0.005). Approximately 20% of the total sample reported severe depressive symptomatology. Previous access to mental health services (O.R. 10.923; p = 0.000), a low level of education (O.R. 5.410; p = 0.021), and difficulties in management of everyday lives during the COVID-19 pandemic (O.R. 3.598; p = 0.045) were found to be the main variables predictive of severe depressive psychopathology. Old age, good problem-solving skills, and ability to pursue personal goals were identified as protective factors.

CONCLUSIONS

The COVID-19 pandemic underlined the need for support amongst emotionally vulnerable women with pre-existing mental health conditions, partly reflecting the cumulative effects of traumas.