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Asper M, Osika W, Dalman C, Pöllänen E, Simonsson O, Flodin P, Sidorchuk A, Marchetti L, Awil F, Castro R, Niemi ME. Effects of the COVID-19 pandemic and previous pandemics, epidemics and economic crises on mental health: systematic review. BJPsych Open 2022; 8:e181. [PMID: 36214114 PMCID: PMC9551492 DOI: 10.1192/bjo.2022.587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND A rise in mental illness is expected to follow the COVID-19 pandemic, which has also been projected to lead to a deep global economic recession, further adding to risk factors. AIMS The aim of this review was to assess the impact of the COVID-19 pandemic and previous pandemics, epidemics and economic crises on mental health. METHOD Searches were conducted in PubMed, Web of Science, PsycINFO and Sociological Abstracts. We included studies of all populations exposed to the COVID-19 pandemic, and other similar pandemics/epidemics and economic crises, compared with non-exposed time periods or regions. The outcome was mental health. RESULTS The 174 included studies assessed mental health impacts of the COVID-19 pandemic (87 studies), 2008 economic crisis (84 studies) and severe acute respiratory syndrome (SARS) epidemic (three studies). Outcomes were divided into affective disorders, suicides, mental healthcare utilisation and other mental health. COVID-19 pandemic studies were of lesser quality than those for the economic crisis or SARS epidemic. Most studies for all exposures showed increases in affective disorders and other mental health problems. For economic crisis exposure, increases in mental healthcare utilisation and suicides were also found, but these findings were mixed for COVID-19 pandemic exposure. This is probably because of quarantine measures affecting help-seeking and shorter follow-ups of studies of COVID-19 pandemic exposure. CONCLUSIONS Our findings highlight the importance of available, accessible and sustainable mental health services. Also, socioeconomically disadvantaged populations should be particular targets of policy interventions during the COVID-19 pandemic.
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Affiliation(s)
- Michaela Asper
- Department of Global Public Health, Karolinska Institutet, Sweden
| | - Walter Osika
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; and Stockholm Health Care Services, Region Stockholm, Sweden
| | - Christina Dalman
- Department of Global Public Health, Karolinska Institutet, Sweden
| | - Elin Pöllänen
- Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - Otto Simonsson
- Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - Pär Flodin
- Department of Global Public Health, Karolinska Institutet, Sweden
| | - Anna Sidorchuk
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; and Stockholm Health Care Services, Region Stockholm, Sweden
| | | | | | - Rosa Castro
- Federation of European Academies of Medicine, Belgium
| | - Maria E Niemi
- Department of Global Public Health, Karolinska Institutet, Sweden
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de Miquel C, Domènech-Abella J, Felez-Nobrega M, Cristóbal-Narváez P, Mortier P, Vilagut G, Alonso J, Olaya B, Haro JM. The Mental Health of Employees with Job Loss and Income Loss during the COVID-19 Pandemic: The Mediating Role of Perceived Financial Stress. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3158. [PMID: 35328846 PMCID: PMC8950467 DOI: 10.3390/ijerph19063158] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 03/01/2022] [Accepted: 03/04/2022] [Indexed: 12/13/2022]
Abstract
The COVID-19 outbreak, which was followed by home confinement, is expected to have had profound negative impact on the mental health of people. Associated factors, such as losing jobs and income, can be expected to lead to an increased risk of suffering from psychopathological problems. Therefore, this study was aimed at researching the associations of job and income loss with mental health, as well as the possible mediating role of perceived financial stress during the COVID-19 outbreak. The sample included 2381 Spanish workers who were interviewed right after the first COVID-19 lockdown. Measures were taken for generalized anxiety disorder, panic attacks, depression, post-traumatic stress disorder, substance abuse, suicidal thoughts and behaviors, working conditions, sociodemographic variables, and perceived financial stress. Logistic regression models were calculated with psychological variables as outcomes, and with job loss and income loss as predictors. Mediation analyses were performed by adding the financial threat as a mediator. Nineteen point six percent and 33.9% of participants reported having lost their jobs and incomes due to the pandemic, respectively. Only income loss was related to a higher risk of suffering from depression and panic attacks. When adding financial stress as a mediator, the indirect effects of job and income loss on the mental health measures were found to be significant, therefore indicating mediation. These findings pinpoint the vulnerability of this population, and highlight the need for interventional and preventive programs targeting mental health in economic crisis scenarios, such as the current one. They also highlight the importance of implementing social and income policies during the COVID-19 pandemic to prevent mental health problems.
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Affiliation(s)
- Carlota de Miquel
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain; (C.d.M.); (J.D.-A.); (M.F.-N.); (P.C.-N.); (J.M.H.)
| | - Joan Domènech-Abella
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain; (C.d.M.); (J.D.-A.); (M.F.-N.); (P.C.-N.); (J.M.H.)
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), 28029 Madrid, Spain
| | - Mireia Felez-Nobrega
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain; (C.d.M.); (J.D.-A.); (M.F.-N.); (P.C.-N.); (J.M.H.)
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), 28029 Madrid, Spain
| | - Paula Cristóbal-Narváez
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain; (C.d.M.); (J.D.-A.); (M.F.-N.); (P.C.-N.); (J.M.H.)
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), 28029 Madrid, Spain
| | - Philippe Mortier
- Health Services Research Unit, Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain; (P.M.); (G.V.); (J.A.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Gemma Vilagut
- Health Services Research Unit, Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain; (P.M.); (G.V.); (J.A.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Jordi Alonso
- Health Services Research Unit, Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain; (P.M.); (G.V.); (J.A.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, 08003 Barcelona, Spain
| | - Beatriz Olaya
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain; (C.d.M.); (J.D.-A.); (M.F.-N.); (P.C.-N.); (J.M.H.)
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), 28029 Madrid, Spain
| | - Josep Maria Haro
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain; (C.d.M.); (J.D.-A.); (M.F.-N.); (P.C.-N.); (J.M.H.)
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), 28029 Madrid, Spain
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Soldevila-Domenech N, Forero CG, Alayo I, Capella J, Colom J, Malmusi D, Mompart A, Mortier P, Puértolas B, Sánchez N, Schiaffino A, Vilagut G, Alonso J. Mental well-being of the general population: direct and indirect effects of socioeconomic, relational and health factors. Qual Life Res 2021; 30:2171-2185. [PMID: 33847868 PMCID: PMC8298347 DOI: 10.1007/s11136-021-02813-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2021] [Indexed: 12/01/2022]
Abstract
PURPOSE The aim of this study was to analyse the association between individual mental well-being and social, economic, lifestyle and health factors. METHODS Cross-sectional study on a representative sample of 13,632 participants (> 15y/o) from the Catalan Health Interview Survey 2013-2016 editions. Mental well-being was assessed with the Warwick-Edinburg Mental Well-being Scale (WEMWBS). Linear regressions were fitted to associate well-being and sociodemographic, relational, lifestyle and health variables according to minimally sufficient adjustment sets identified using directed acyclic graphs. Predictors entered the model in blocks of variable types and analysed individually. Direct and total effects were estimated. RESULTS Health factors significantly contributed to mental well-being variance. Presence of a mental disorder and self-reported health had the largest effect size (eta2 = 13.4% and 16.3%). The higher individual impact from a variable came from social support (β = - 12.8, SE = 0.48, eta2 = 6.3%). A noticeable effect gradient (eta2 = 4.2%) from low to high mental well-being emerged according to economic difficulties (from β = 1.59, SE = 0.33 for moderate difficulties to β = 6.02 SE = 0.55 for no difficulties). Younger age (β = 5.21, SE = 0.26, eta2 = 3.4%) and being men (β = 1.32, SE = 0.15, eta2 = 0.6%) were associated with better mental well-being. Direct gender effects were negligible. CONCLUSIONS This study highlights health and social support as the most associated factors with individual mental well-being over socioeconomic factors. Interventions and policies aimed to these factors for health promotion would improve population mental well-being.
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Affiliation(s)
- Natalia Soldevila-Domenech
- Health Services Research Group, Epidemiology and Public Health Program, Hospital del Mar Medical Research Institute (IMIM), Carrer del Doctor Aiguader, 88, PRBB Building, 08003, Barcelona, Spain
- Integrative Pharmacology and Systems Neurosciences Research Group, Neurosciences Research Program, Hospital del Mar Medical Research Institute (IMIM), Carrer del Doctor Aiguader, 88, PRBB Building, 08003, Barcelona, Spain
- Department of Experimental and Health Sciences, Pompeu Fabra University (UPF), Carrer del Doctor Aiguader, 88, PRBB Building, 08003, Barcelona, Spain
| | - Carlos G Forero
- School of Medicine, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Itxaso Alayo
- Health Services Research Group, Epidemiology and Public Health Program, Hospital del Mar Medical Research Institute (IMIM), Carrer del Doctor Aiguader, 88, PRBB Building, 08003, Barcelona, Spain
- CIBER en Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5, 28029, Madrid, Spain
| | - Jordina Capella
- Programme on substance Abuse, Agency of Public Health of Catalonia, Carrer Roc Boronat, 81-95, 08005, Barcelona, Spain
- Direcció General d'Ordenació i Regulació Sanitàries, Departament de Salut, Generalitat de Catalunya, Travessera de les Corts, 131-159, 08028, Barcelona, Spain
| | - Joan Colom
- Programme on substance Abuse, Agency of Public Health of Catalonia, Carrer Roc Boronat, 81-95, 08005, Barcelona, Spain
| | - Davide Malmusi
- CIBER en Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5, 28029, Madrid, Spain
- Ajuntament de Barcelona, Barcelona, Spain
| | - Anna Mompart
- Direcció General de Planificació en Salut, Departament de Salut, Generalitat de Catalunya, Travessera de les Corts, 131-159, 08028, Barcelona, Spain
| | - Philippe Mortier
- Health Services Research Group, Epidemiology and Public Health Program, Hospital del Mar Medical Research Institute (IMIM), Carrer del Doctor Aiguader, 88, PRBB Building, 08003, Barcelona, Spain
- CIBER en Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5, 28029, Madrid, Spain
| | - Beatriz Puértolas
- Health Services Research Group, Epidemiology and Public Health Program, Hospital del Mar Medical Research Institute (IMIM), Carrer del Doctor Aiguader, 88, PRBB Building, 08003, Barcelona, Spain
- CIBER en Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5, 28029, Madrid, Spain
| | - Néstor Sánchez
- School of Medicine, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Anna Schiaffino
- Direcció General de Planificació en Salut, Departament de Salut, Generalitat de Catalunya, Travessera de les Corts, 131-159, 08028, Barcelona, Spain
- Institut Català D'Oncologia, Gran Via de l'Hospitalet 199-203, 08908, l'Hospitalet de Llobregat, Spain
| | - Gemma Vilagut
- Health Services Research Group, Epidemiology and Public Health Program, Hospital del Mar Medical Research Institute (IMIM), Carrer del Doctor Aiguader, 88, PRBB Building, 08003, Barcelona, Spain.
- CIBER en Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5, 28029, Madrid, Spain.
| | - Jordi Alonso
- Health Services Research Group, Epidemiology and Public Health Program, Hospital del Mar Medical Research Institute (IMIM), Carrer del Doctor Aiguader, 88, PRBB Building, 08003, Barcelona, Spain.
- Department of Experimental and Health Sciences, Pompeu Fabra University (UPF), Carrer del Doctor Aiguader, 88, PRBB Building, 08003, Barcelona, Spain.
- CIBER en Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5, 28029, Madrid, Spain.
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Abstract
The worldwide economic crisis of the last decade, and still unresolved, led to a great recession involving all major economies. Since economic factors may influence mental wellbeing, not surprisingly a rise in poor mental health was observed in different countries, while representing a great challenge to psychiatric interventions. This paper aims at reviewing the available English literature focusing on the impact of the current economic crisis on mental health, with a special focus on depression and suicide. Available studies indicate that consequences of economic crisis, such as unemployment, increased workload or work reorganization, and reduced staff and wages, may constitute important stressing factors with a negative impact on mental health. Although data are not easily comparable in different countries, depression seems to be the most common psychiatric disorders especially in middle-aged men. Even suicide rates seem to be increased in men, mainly in countries with no public welfare or poor family relationships. All these findings require a careful attention from both governments that cut resources on public health instead of investing in it, and psychiatric associations that should implement appropriate strategies to face and to manage this sort of depression epidemic driven by economic crisis. Again, as available data suggest that the impact of the crisis might have been attenuated in countries with higher spending in social protection, they clearly urge policy makers to take into account possible health externalities associated to inadequate social protection systems.
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