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Wolf K, Schmitz J. Scoping review: longitudinal effects of the COVID-19 pandemic on child and adolescent mental health. Eur Child Adolesc Psychiatry 2024; 33:1257-1312. [PMID: 37081139 PMCID: PMC10119016 DOI: 10.1007/s00787-023-02206-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 04/03/2023] [Indexed: 04/22/2023]
Abstract
The COVID-19 pandemic and associated containment measures have massively changed the daily lives of billions of children and adolescents worldwide. To investigate the global longitudinal effects on various mental health outcomes over a period of 1.5 years, we conducted a scoping review in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). We included the peer-reviewed articles from PubMed, Web of Science, and APA PsycInfo that were published between December 2019 and December 2021, followed a longitudinal or repeated cross-sectional design, and quantitatively assessed with clinical questionnaires the effect of the COVID-19 pandemic or a related stressor on mental health indicators in community samples of children and adolescents.The results of our qualitative analysis of 69 studies indicate a general trend of less psychological well-being and more mental health problems, such as heightened stress, and depressive and anxiety symptoms during the pandemic. Data suggest that both protection measure intensity and infection dynamics were positively associated with severity of the psychopathology. The most reported influencing factors were age, gender, socio-economic status, previous state of mental and physical health, self-regulation abilities, parental mental health, parenting quality, family functioning, social support, isolation and loneliness, health-related worries, and consistent routines and structure. Our results demonstrate that children and adolescents worldwide have experienced more mental health problems due to the COVID-19 pandemic. They call for improved access to child and adolescent mental health care and prioritisation of child and adolescent welfare in political decision making.
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Affiliation(s)
- Kristin Wolf
- Department of Clinical Child and Adolescent Psychology, Wilhelm-Wundt-Institute for Psychology, University of Leipzig, Leipzig, Germany.
| | - Julian Schmitz
- Department of Clinical Child and Adolescent Psychology, Wilhelm-Wundt-Institute for Psychology, University of Leipzig, Leipzig, Germany
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Lee CS, Lim KK, Kim HK. Nudging Public Health Behaviors to Prevent COVID-19: A Systematic Review. HEALTH COMMUNICATION 2024:1-12. [PMID: 38425006 DOI: 10.1080/10410236.2024.2317567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Many countries have implemented strict preventive measures and mandatory policies to curb virus transmission during the COVID-19 pandemic. Some have adopted softer approaches, such as nudge-based intervention, to influence public health behavior. This systematic review, conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2020 guidelines, aims to determine if the nudge-based intervention can effectively influence people's preventive behavior during the early period of the COVID-19 pandemic. The review indicated an overall positive outcome, but results were mixed as nudge-based interventions substantially depended on the situational context. While the review found that the nudging technique that presents and conveys decision-related information was essential to nudging people, a secondary nudge would often applied to deliver the interventions. In addition, there was no indication of an ideal nudge technique that would be effective in most situations. Conversely, our findings indicate that the nudge would likely suffer from habituation after repeated intervention or backfire due to inappropriate use of nudges. Also, the ceiling effect would inhibit any nudge influences regardless of the technique(s) used. In sum, the results and the applicability of nudge-based interventions were mixed, highlighting the need for further research to advance the theory and practical developments.
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Affiliation(s)
- Chei Sian Lee
- Wee Kim Wee School of Communication and Information, Nanyang Technological University
| | - Kok Khiang Lim
- Wee Kim Wee School of Communication and Information, Nanyang Technological University
| | - Hye Kyung Kim
- Wee Kim Wee School of Communication and Information, Nanyang Technological University
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Payne L, Goijen HJ, Cobham V, Bor W, Stathis SS, Coghill DC, Middeldorp CM. The impact of COVID-19 on children and adolescents attending Child and Youth Mental Health Services in Queensland, Australia. Early Interv Psychiatry 2023; 17:1180-1188. [PMID: 37051676 DOI: 10.1111/eip.13421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/27/2023] [Accepted: 03/28/2023] [Indexed: 04/14/2023]
Abstract
OBJECTIVE This explorative study aims to provide insight into impacts of the COVID-19 pandemic and associated restrictions, on mental health of children and adolescents treated at Child and Youth Mental Health Services, and their parents. METHOD The COVID-19 Mental Health Survey was disseminated to parents of children and adolescents under treatment at community Child and Youth Mental Health Services (Brisbane, Australia) between July-November 2020 throughout different stages of COVID-19 related restrictions. Parents of 110 children participated. RESULTS Most reported child's symptoms were sadness (46%), anxiety (60%), lack of focus (61%), lack of joy in their usual activities (38%) and reduction in sleep (42%). Parental emotions were significantly correlated with their child's emotions. Parent's lack of enjoyment of usual activities had the overall strongest average correlation (0.27) but this was no longer significant once other variables were controlled for. Children who attended school remotely for some of the days had a significantly (p < .05) higher risk of having more reported symptoms. Interestingly, in later stages of the lockdown with further easing of restrictions, symptoms also tended to be more severe. CONCLUSION Cross-sectional data on children and adolescents in Queensland, Australia with pre-existing mental health issues suggests mental health continued to deteriorate through the pandemic even as restrictions eased. Changes in schooling seem to be an especially important risk factor.
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Affiliation(s)
- Leanne Payne
- Child Health Research Centre, University of Queensland, St Lucia, Australia
- Child and Youth Mental Health Service, Children's Health Queensland Hospital and Health Service, South Brisbane, Australia
| | - Hedwig J Goijen
- Child Health Research Centre, University of Queensland, St Lucia, Australia
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Vanessa Cobham
- Child and Youth Mental Health Service, Children's Health Queensland Hospital and Health Service, South Brisbane, Australia
- School of Psychology, Faculty of Health and Behavioural Sciences, University of Queensland, St Lucia, Australia
| | - William Bor
- Child and Youth Mental Health Service, Children's Health Queensland Hospital and Health Service, South Brisbane, Australia
| | - Stephen S Stathis
- Child and Youth Mental Health Service, Children's Health Queensland Hospital and Health Service, South Brisbane, Australia
| | - David C Coghill
- Division of Clinical Science, Murdoch Children's Research Institute, Melbourne, Australia
- Departments of Paediatrics and Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
- Division of Neuroscience, University of Dundee, Dundee, UK
- Department of Mental Health, Royal Children's Hospital Melbourne, Parkville, Australia
| | - Christel M Middeldorp
- Child Health Research Centre, University of Queensland, St Lucia, Australia
- Child and Youth Mental Health Service, Children's Health Queensland Hospital and Health Service, South Brisbane, Australia
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Wendel F, Bender S, Breitinger E, Coenen M, Hummel J, Immich G, Kirschneck M, Klünder V, Kunzler AM, Lieb K, Movsisyan A, Li LY, Ravens-Sieberer U, Rehfuess E, Voss S, Jung-Sievers C. Interventions to build resilience and to ameliorate negative psychosocial effects of the COVID-19 pandemic on children and adolescents: a systematic review and meta-analysis. Eur Child Adolesc Psychiatry 2023:10.1007/s00787-023-02280-y. [PMID: 37573565 DOI: 10.1007/s00787-023-02280-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 08/03/2023] [Indexed: 08/15/2023]
Abstract
The psychosocial health of children and adolescents has been particularly affected by the COVID-19 pandemic. Containment measures have restricted social development, education and recreational activities, may have increased family conflicts and, in many cases, led to feelings of loneliness, sleep disturbances, symptoms of anxiety and depression. We conducted a systematic review to identify interventions that seek to ameliorate these detrimental effects of the COVID-19 pandemic and to build resilience in children and adolescents. Literature searches were conducted in the databases MEDLINE, EMBASE, PsycINFO, CENTRAL, WHO COVID-19 Global literature on coronavirus disease and Cochrane COVID-19 Study Register (up to 30 June 2022). The searches retrieved 9557 records of which we included 13 randomized-controlled trials (RCTs) for evidence synthesis. Included studies predominantly implemented online group sessions for school-aged children with either a psychological component, a physical activity component, or a combination of both. A meta-analysis of seven studies on anxiety and five on depressive symptoms provided evidence for a positive effect of interventions by reducing anxiety (Standardized Mean Difference (SMD) (95% CI): - 0.33 (- 0.59; - 0.06)) and depressive symptoms (SMD (95% CI): - 0.26 (- 0.36; - 0.16)) compared to the control interventions. Studies also showed improvements in positive mental health outcomes, such as resilience (n = 2) and mental and psychological wellbeing (n = 2). Exploratory subgroup analyses suggested a greater effectiveness of interventions that (i) are of higher frequency and duration, (ii) enable personal interaction (face-to-face or virtually), and (iii) include a physical activity component. Almost all studies were judged to be at high risk of bias and showed considerable heterogeneity. Further research may focus on the contribution of different intervention components or distinct subgroups and settings, and should examine children and adolescents over longer follow-up periods.
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Affiliation(s)
- Flora Wendel
- Institute for Medical Information Processing, Biometry and Epidemiology IBE, Faculty of Medicine, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany.
- Pettenkofer School of Public Health, Munich, Germany.
| | - Stephan Bender
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Eva Breitinger
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Michaela Coenen
- Institute for Medical Information Processing, Biometry and Epidemiology IBE, Faculty of Medicine, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Julia Hummel
- Institute for Medical Information Processing, Biometry and Epidemiology IBE, Faculty of Medicine, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Gisela Immich
- Institute for Medical Information Processing, Biometry and Epidemiology IBE, Faculty of Medicine, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Michaela Kirschneck
- Institute for Medical Information Processing, Biometry and Epidemiology IBE, Faculty of Medicine, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Vera Klünder
- Institute for Medical Information Processing, Biometry and Epidemiology IBE, Faculty of Medicine, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Angela M Kunzler
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Institute for Evidence in Medicine, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany
| | - Klaus Lieb
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Ani Movsisyan
- Institute for Medical Information Processing, Biometry and Epidemiology IBE, Faculty of Medicine, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Lydia Y Li
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Research Unit Child Public Health, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Research Unit Child Public Health, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Eva Rehfuess
- Institute for Medical Information Processing, Biometry and Epidemiology IBE, Faculty of Medicine, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Stephan Voss
- Institute for Medical Information Processing, Biometry and Epidemiology IBE, Faculty of Medicine, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Caroline Jung-Sievers
- Institute for Medical Information Processing, Biometry and Epidemiology IBE, Faculty of Medicine, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
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Lim CW, Othman A, Hashim HA. The Effect of Online-Delivered Guided Imagery Relaxation on Stress and Well-Being of Primary School Children. Malays J Med Sci 2023; 30:102-115. [PMID: 37655146 PMCID: PMC10467597 DOI: 10.21315/mjms2023.30.4.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 10/20/2022] [Indexed: 09/02/2023] Open
Abstract
Background In the context of the coronavirus (COVID-19) pandemic, effectively coping with daily stressors is crucial for children who experience restrictions on physical movement and social activities. We examined the effects of the online-delivered guided imagery relaxation (GIR) technique on the stress and well-being of primary school children. Methods Thirty-four (N = 34) 11-year-old students were randomly assigned to either intervention (n = 17) or waitlist-control (n = 17) groups. The participants from the intervention group were required to attend a 4-week online GIR session and practice the techniques daily for 5 min-10 min. The Stress in Children (SiC) questionnaire, the Strengths and Difficulties Questionnaire-Parent Reported (SDQ-PR) and tracking form were administered pre- and post-intervention. Results Eleven (64.7%) participants attended all sessions and eight (47.0%) completed daily practices. Mixed-model ANOVA indicated no significant difference between participants from intervention and waitlist-control groups across pre- and post-intervention time points, with P-values greater than 0.05 for stress and well-being. Conclusion Issues regarding online intervention, including managing children's activities from a distance, Internet connectivity, and time limitations might have affected their adherence and the research outcome. Nonetheless, the online-delivered GIR technique is a promising intervention modality. However, its implementation should be improvised to be more impactful.
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Affiliation(s)
- Chean Wei Lim
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Azizah Othman
- Department of Pediatrics, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
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Moss SJ, Mizen SJ, Stelfox M, Mather RB, FitzGerald EA, Tutelman P, Racine N, Birnie KA, Fiest KM, Stelfox HT, Parsons Leigh J. Interventions to improve well-being among children and youth aged 6-17 years during the COVID-19 pandemic: a systematic review. BMC Med 2023; 21:131. [PMID: 37013542 PMCID: PMC10069351 DOI: 10.1186/s12916-023-02828-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 03/10/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic is an example of a global infectious disease outbreak that poses a threat to the well-being of children and youth (e.g., physical infection, psychological impacts). The consequences of challenges faced during COVID-19 may be longstanding and newly developed interventions are being deployed. We present a narrative synthesis of available evidence from the first 2 years of the COVID-19 pandemic on the feasibility, accessibility, and effects of interventions to improve well-being among children and youth to inform the development and refinement of interventions relevant to post-pandemic recovery. METHODS Six databases were searched from inception to August 2022. A total of 5484 records were screened, 39 were reviewed in full text, and 19 studies were included. The definition of well-being and the five domains of well-being as defined by the Partnership for Maternal, Newborn & Child Health and the World Health Organization in collaboration with the United Nations H6 + Technical Working Group on Adolescent Health and Well-Being were used. RESULTS Nineteen studies (74% randomized controlled trials) from 10 countries were identified, involving a total of 7492 children and youth (age range: 8.2-17.2 years; 27.8-75.2% males) and 954 parents that occurred during the COVID-19 pandemic (March 2020 to March 2021). Nearly all interventions (n = 18, 95%) targeted health and nutrition, followed by connectedness (n = 6, 32%), while fewer studies targeted agency and resilience (n = 5, 23%), learning and competence (n = 2, 11%), or safety and support (n = 1, 3%). Five interventions (26%) were self-guided while 13 interventions (68%) were guided synchronous by a trained professional, all of which targeted physical and mental health subdomains within health and nutrition; one intervention (5%) was unclear. CONCLUSIONS Studies deploying synchronous interventions most often reported improved well-being among children and youth largely in the domain of health and nutrition, specifically physical and mental health. Targeted approaches will be crucial to reach sub-groups of children and youth who are most at risk of negative well-being outcomes. Further research is needed to determine how interventions that best supported children and youth early in the pandemic are different from interventions that are required now as we enter into the post-pandemic phase.
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Affiliation(s)
- Stephana J Moss
- Faculty of Health, School of Health Administration, Dalhousie University, Halifax, NS, Canada
| | - Sara J Mizen
- Faculty of Health, School of Health Administration, Dalhousie University, Halifax, NS, Canada
| | - Maia Stelfox
- Faculty of Health, School of Health Administration, Dalhousie University, Halifax, NS, Canada
| | - Rebecca Brundin Mather
- Cumming School of Medicine, Department of Critical Care Medicine, University of Calgary, Calgary, AB, Canada
| | - Emily A FitzGerald
- Faculty of Health, School of Health Administration, Dalhousie University, Halifax, NS, Canada
| | - Perri Tutelman
- Faculty of Science, Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Nicole Racine
- Faculty of Social Sciences, School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Kathryn A Birnie
- Cumming School of Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, University of Calgary, Alberta, Canada
- Cumming School of Medicine, Department of Community Health Sciences, Calgary, AB, Canada
| | - Kirsten M Fiest
- Cumming School of Medicine, Department of Critical Care Medicine, University of Calgary, Calgary, AB, Canada
- Cumming School of Medicine, Department of Community Health Sciences, Calgary, AB, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
| | - Henry T Stelfox
- Cumming School of Medicine, Department of Critical Care Medicine, University of Calgary, Calgary, AB, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
| | - Jeanna Parsons Leigh
- Faculty of Health, School of Health Administration, Dalhousie University, Halifax, NS, Canada.
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A Creative and Movement-Based Blended Intervention for Children in Outpatient Residential Care: A Mixed-Method, Multi-Center, Single-Arm Feasibility Trial. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020207. [PMID: 36832336 PMCID: PMC9954900 DOI: 10.3390/children10020207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/17/2023] [Accepted: 01/20/2023] [Indexed: 01/26/2023]
Abstract
The COVID-19 pandemic led to psychological distress among children and adolescents. Due to multiple psychosocial burdens, the youth in residential care were especially exposed to an increased risk of mental health problems during the pandemic. In a multi-center, single-arm feasibility trial, N = 45 children and adolescents aged 7-14 years were allocated to a 6-week blended care intervention, conducted in six outpatient residential child welfare facilities. The intervention covered a once weekly face-to-face group session for guided creative (art therapy, drama therapy) and movement-oriented (children's yoga, nature therapy) activities. This was accompanied by a resilience-oriented mental-health app. Feasibility and acceptance analyses covered app usage data and qualitative data. Effectiveness was determined by pre-post comparisons in quantitative data on psychological symptoms and resources. Further, subgroups for poorer treatment outcome were explored. The intervention and app were considered to be feasible and were accepted by residential staff and the children. No significant pre-post changes were found across quantitative outcomes. However, being female, being in current psychosocial crisis, a migration background, or a mentally ill parent were correlated with change in score of outcomes from baseline. These preliminary findings pave the way for future research on blended care interventions among at-risk children and adolescents.
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Liu JYW, Man DWK, Lai FHY, Cheung TCC, Cheung AKP, Cheung DSK, Choi TKS, Fong GCH, Kwan RYC, Lam SC, Ng VTY, Wong H, Yang L, Shum DHK. A Health App for Post-Pandemic Years (HAPPY) for people with physiological and psychosocial distress during the post-pandemic era: Protocol for a randomized controlled trial. Digit Health 2023; 9:20552076231210725. [PMID: 37928335 PMCID: PMC10623948 DOI: 10.1177/20552076231210725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 10/03/2023] [Indexed: 11/07/2023] Open
Abstract
Objective This article describes a protocol for a randomized controlled trial to evaluate the effects of a three-level Health App for Post-Pandemic Years (HAPPY) on alleviating post-pandemic physiological and psychosocial distress. Methods Convenience and snowball sampling methods will be used to recruit 814 people aged 18+ with physiological and/or psychosocial distress. The experimental group will receive a 24-week intervention consisting of an 8-week regular supervision phase and a 16-week self-help phase. Based on their assessment results, they will be assigned to receive interventions on mindfulness, energy conservation techniques, or physical activity training. The waitlist control group will receive the same intervention in Week 25. The primary outcome will be changes in psychosocial distress, measured using the Kessler Psychological Distress Scale (K10). Secondary outcomes will include changes in levels of fatigue (Chinese version of the Brief Fatigue Inventory), sleep quality (Chinese version of the Pittsburgh Sleep Quality Index), pain intensity (Numeric Rating Scale), positive appraisal (Short version of the 18-item Cognitive Emotion Regulation Questionnaire), self-efficacy (Chinese version of the General Self-efficacy Scale), depression and anxiety (Chinese version of the 21-item Depression Anxiety Stress Scale), and event impact (Chinese version of the 22-item Impact of Event Scale-Revised). All measures will be administered at baseline (T0), Week 8 after the supervision phase (T1), and 24 weeks post-intervention (T2). A generalized estimating equations model will be used to examine the group, time, and interaction (Time × Group) effect of the interventions on the outcome assessments (intention-to-treat analysis) across the three time points, and to compute a within-group comparison of objective physiological parameters and adherence to the assigned interventions in the experimental group. Conclusions The innovative, three-level mobile HAPPY app will promote beneficial behavioral strategies to alleviate post-pandemic physiological and psychosocial distress. Trial registration ClinicalTrials.gov, NCT05459896. Registered on 15 July 2022.
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Affiliation(s)
- Justina Yat-Wa Liu
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - David Wai-Kwong Man
- President's Office, Tung Wah College, Hong Kong SAR, China
- Mental Health Research Centre, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Frank Ho-Yin Lai
- Mental Health Research Centre, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle, UK
| | - Teris Cheuk-Chi Cheung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Mental Health Research Centre, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Amy Ka-Po Cheung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Daphne Sze-Ki Cheung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Mental Health Research Centre, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Thomas Kup-Sze Choi
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Gabriel Ching-Hang Fong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | | | | | - Vincent To-Yee Ng
- University Research Facility in Big Data Analytics, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Heung Wong
- University Research Facility in Big Data Analytics, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Lin Yang
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - David Ho-Keung Shum
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Mental Health Research Centre, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
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Bischops AC, Reinauer C, Pischke C, Mayatepek E, Meißner T. Strengthening the Resilience of Children and Adolescents during a Pandemic: A Scoping Review on Eligible Interventions. KLINISCHE PADIATRIE 2023; 235:13-22. [PMID: 35948048 DOI: 10.1055/a-1849-1355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND The COVID-19 pandemic dramatically affects children's and adolescents' mental health. The accumulation of stress factors and a lack of social support complicate a healthy development. Since the beginning of the pandemic, there has been almost a doubling of mental health problems in children and adolescents. Promoting resilience is a possible approach to reduce the incidence of mental health problems despite these adverse circumstances. OBJECTIVES This literature search aims at identifying and evaluating interventions to promote resilience mechanisms, with a special focus on feasibility in a crisis situation. MATERIALS AND METHODS This scoping review is based on a systematic literature search including the databases Cochrane Library, PubMed, Psyc-Info, Psyndex and Google Scholar (2006-2020). Of 1733 identified articles 75 were included. RESULTS Out of 72 identified intervention studies 28% were feasible under pandemic conditions. The most effective resilience trainings seem to be individualized interventions using cognitive behavioral therapy elements. However, many approaches primarily show short-term success. DISCUSSION Few evidence-based programs are feasible online or under pandemic restrictions. Most of them show short-term effects and focus on parents and individuals. Multiple programs are ready for use, but still lack proof of efficacy. The development and improvement of (digital) resilience interventions should be an essential part of preventive health care, especially for risk groups. HINTERGRUND Die COVID-19-Pandemie beeinflusst die mentale Gesundheit von Kindern und Jugendlichen auf dramatische Weise. Durch eine Akkumulation von Belastungsfaktoren und das Wegfallen sozialer Unterstützung ist eine regelrechte Entwicklung erschwert. Seit Beginn der Pandemie kam es nahezu zu einer Verdopplung der psychischen Auffälligkeiten. Die Förderung der Resilienz kann ein Ansatz sein, das Auftreten von psychischen Auffälligkeiten trotz dieser widrigen Umstände zu vermindern. ZIEL DER ARBEIT Ziel dieser Literaturrecherche ist die Identifikation und Bewertung von Interventionen zur Förderung von Resilienzmechanismen, mit Fokus auf die Durchführbarkeit unter Krisenbedingungen. MATERIAL UND METHODEN Dieses Scoping Review basiert auf einer systematischen Literaturrecherche der Datenbanken Cochrane Library, PubMed, Psyc-Info, Psyndex sowie Google Scholar (2006-2021). Von der insgesamt 1733 Artikel umfassenden Suche wurden 75 Artikel eingeschlossen. ERGEBNISSE Von 72 identifizierten Interventionsstudien sind 28% unter Pandemiebedingungen durchführbar. Die wirksamsten Resilienztrainings scheinen individualisierte Interventionen mit Elementen der kognitiven Verhaltenstherapie zu sein. Viele Ansätze zeigen jedoch in erster Linie kurzfristige Erfolge. DISKUSSION Nur wenige evidenzbasierte Programme sind online oder unter Pandemiebedingungen verfügbar. Die meisten von ihnen zeigen kurzfristige Effekte und konzentrieren sich auf Eltern und Einzelpersonen. Zahlreiche Programme sind nutzbar, allerdings fehlt häufig ein Evidenznachweis. Die Entwicklung und Verbesserung von (digitalen) Resilienzmaßnahmen sollte ein wesentlicher Bestandteil der präventiven Gesundheitsversorgung sein, insbesondere für Risikogruppen.
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Affiliation(s)
- Anne Christine Bischops
- Department of General Paediatrics, Neonatology and Paediatric Cardiology, Medical Faculty, Heinrich-Heine-University, Düsseldorf University Hospital, Düsseldorf, Germany
| | - Christina Reinauer
- Department of General Paediatrics, Neonatology and Paediatric Cardiology, Medical Faculty, Heinrich-Heine-University, Düsseldorf University Hospital, Düsseldorf, Germany
| | - Claudia Pischke
- Institute of Medical Sociology, Universitätsklinikum Düsseldorf Centre for Health and Society, Dusseldorf, Germany
| | - Ertan Mayatepek
- Department of General Paediatrics, Neonatology and Paediatric Cardiology, Medical Faculty, Heinrich-Heine-University, Düsseldorf University Hospital, Düsseldorf, Germany
| | - Thomas Meißner
- Department of General Paediatrics, Neonatology and Paediatric Cardiology, Medical Faculty, Heinrich-Heine-University, Düsseldorf University Hospital, Düsseldorf, Germany
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10
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Cohodes EM, McCauley S, Preece DA, Gross JJ, Gee DG. Parental Assistance with Emotion Regulation Moderates Link Between COVID-19 Stress and Child Mental Health. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2022:1-18. [PMID: 36399629 PMCID: PMC10192455 DOI: 10.1080/15374416.2022.2140431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The COVID-19 pandemic has severely impacted children's mental health. All children have not been affected equally, however, and whether parental emotion socialization might buffer or exacerbate the impact of COVID-19 on children's mental health remains an important question. METHOD During the first peak of the COVID-19 pandemic in the U.S. N = 200 parents of children ages 0-17 (52.5% female) completed questionnaires related to parental assistance with children's emotion regulation, symptomatology, and exposure to COVID-19-related stress. Parents were 74% Non-Hispanic/Latino/a White, 13% Asian, 4.5% Hispanic/Latino/a, 4% Black/African American, 2.5% Native American, and 1.5% bi/multiracial; 0.5% of participants preferred not to state their race/ethnicity. In a series of linear regression analyses, we examined whether parental assistance with children's execution of emotion regulation strategies - across a variety of prototypically-adaptive and -maladaptive strategies - moderates the association between children's exposure to COVID-19-related stress and symptomatology. RESULTS Results suggest that parental assistance with the execution of prototypically-adaptive strategies (i.e., acceptance, problem solving, behavioral disengagement) and prototypically-maladaptive strategies (i.e., suppression, rumination) may buffer or exacerbate, respectively, the impact of COVID-19-related stress on youth mental health. CONCLUSIONS Though interpretation of findings is constrained by limitations inherent in collecting data during a pandemic, results highlight the importance of supporting parents - who play a critical role of supporting children - during public health emergencies that affect family life. Interventions designed to improve child wellbeing during the ongoing pandemic may benefit from training parents to assist their children with specific emotion regulation strategies.
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Affiliation(s)
- Emily M. Cohodes
- Department of Psychology, Yale University, 2 Hillhouse Avenue, New Haven, CT 06520
| | - Sarah McCauley
- Department of Psychology, Yale University, 2 Hillhouse Avenue, New Haven, CT 06520
| | - David A. Preece
- School of Psychology and Speech Pathology, Curtin University, Kent Street, Bentley, Perth, WA 6102, Australia
- School of Psychological Science, University of Western Australia, 35 Stirling Highway, Crawley, Perth WA 6009, Australia
| | - James J. Gross
- Department of Psychology, Stanford University, Jordan Hall, 450 Jane Stanford Way, Building 420, Stanford, CA 94305
| | - Dylan G. Gee
- Department of Psychology, Yale University, 2 Hillhouse Avenue, New Haven, CT 06520
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11
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Bai MS, Miao CY, Zhang Y, Xue Y, Jia FY, Du L. COVID-19 and mental health disorders in children and adolescents (Review). Psychiatry Res 2022; 317:114881. [PMID: 36252421 PMCID: PMC9550277 DOI: 10.1016/j.psychres.2022.114881] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/23/2022] [Accepted: 10/01/2022] [Indexed: 01/05/2023]
Abstract
The new coronavirus has been present for two years and has had a widespread and sustained impact worldwide. There is growing evidence in the literature that COVID-19 may have negative effects on mental illness in patients and in healthy populations. The unprecedented changes brought about by COVID-19, such as social isolation, school closures, and family stress, negatively affect people's mental health, especially that of children and adolescents. The purpose of this paper is to review the literature and summarize the impact of COVID-19 disorders on children's and adolescents' mental health, the mechanisms and risk factors, screening tools, and intervention and prevention. We hope that the mental dysfunction caused by the pandemic will be mitigated through appropriate and timely prevention and intervention.
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Affiliation(s)
| | | | | | | | | | - Lin Du
- Department of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun, China.
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12
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Hossain MM, Nesa F, Das J, Aggad R, Tasnim S, Bairwa M, Ma P, Ramirez G. Global burden of mental health problems among children and adolescents during COVID-19 pandemic: An umbrella review. Psychiatry Res 2022; 317:114814. [PMID: 36055064 PMCID: PMC9420079 DOI: 10.1016/j.psychres.2022.114814] [Citation(s) in RCA: 52] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 08/24/2022] [Accepted: 08/26/2022] [Indexed: 12/30/2022]
Abstract
Mental health problems among children and adolescents are increasingly reported amidst the coronavirus disease (COVID-19) pandemic. In this umbrella review, we aimed to synthesize global evidence on the epidemiologic burden and correlates of child and adolescent mental health (CAMH) problems during this pandemic from existing systematic reviews and meta-analyses. Adopting the Joanna Briggs Institute (JBI) methodology, we evaluated 422 citations and identified 17 eligible reviews with medium to high methodological quality. Most of the reviews reported a high prevalence of anxiety, depression, sleep disorders, suicidal behavior, stress-related disorders, attention-deficit/hyperactivity disorder, and other mental health problems. Also, factors associated with CAMH such as age, gender, place of residence, educational attainment, household income, sedentary lifestyle, social media and internet use, comorbidities, family relationships, parents' psychosocial conditions, COVID-19 related experiences, closure of schools, online learning, and social support were reported across reviews. As most studies were cross-sectional and used nonrepresentative samples, future research on representative samples adopting longitudinal and intervention designs is needed. Lastly, multipronged psychosocial care services, policies, and programs are needed to alleviate the burden of CAMH problems during and after this pandemic.
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Affiliation(s)
- M. Mahbub Hossain
- Department of Decision and Information Sciences, C.T. Bauer College of Business, University of Houston, Houston, TX 77204, USA,Department of Health Systems and Population Health Sciences, Tilman J. Fertitta Family College of Medicine, University of Houston, Houston, TX 77204, USA,Corresponding author at: Department of Decision and Information Sciences, C.T. Bauer College of Business, University of Houston, Houston, TX 77204, USA
| | - Fazilatun Nesa
- Research Initiative for Health Equity, Khulna, Bangladesh
| | - Jyoti Das
- Research Initiative for Health Equity, Khulna, Bangladesh
| | - Roaa Aggad
- School of Public Health, Texas A&M University, College Station, TX 77840, USA
| | - Samia Tasnim
- School of Public Health, Texas A&M University, College Station, TX 77840, USA
| | - Mohan Bairwa
- All Indian Institute of Medical Sciences, New Delhi, India
| | - Ping Ma
- School of Public Health, Texas A&M University, College Station, TX 77840, USA
| | - Gilbert Ramirez
- Robert Stempel College of Public Health and Social Work, Florida International University, FL 33174, USA
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13
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A Remote Assessment of Anxiety on Young People: Towards Their Views and Their Different Pet Interaction. Healthcare (Basel) 2022; 10:healthcare10071242. [PMID: 35885769 PMCID: PMC9320218 DOI: 10.3390/healthcare10071242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/15/2022] [Accepted: 06/21/2022] [Indexed: 11/17/2022] Open
Abstract
The lockdown was imposed in Italy on 9 March 2020 due to the COVID-19 outbreak. Restrictions severely limiting individual freedom were indispensable to protect the population and reduce virus diffusion. Italian people had never before experienced similar restrictions that undoubtedly tested psychological health. After 1 week, we developed an electronic survey to collect demographic data and information on the presence of pets and the type of interaction with them and to administer a self-assessment anxiety test. A total of 3905 subjects, pet owners and non pet owners, filled in the electronic survey; 652 (16.7%, mean age 21.6) of them were young subjects, adolescents, and university students. The study first showed the feasibility and success of the technological solution used, capable of providing, at a distance, structured information on the participants and quantitative data on the psychological condition. Second, it reported that 23.1% of the youths showed anxiety above an attention level during the lockdown, in line with other studies. Third, it indicated, based on the outcome of the self-assessment test, that the pet presence could have a positive effect in mitigating the psychological impact and encourage to continue and deepen these investigations. Fourth, it reported positive feedback from the participants on the procedure, found useful during the pandemic and for the post-pandemic future. The study highlights the importance of investing in these solutions based on mobile technology and useful both for mental health and to deepen the investigation of the impact of the pet presence on the human psychology.
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14
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Ulitin A, Mier-Alpaño JD, Labarda M, Juban N, Mier AR, Tucker JD, Tang W, Auplish M, Chan PL. Youth social innovation during the COVID-19 pandemic in the Philippines: a quantitative and qualitative descriptive analyses from a crowdsourcing open call and online hackathon. BMJ INNOVATIONS 2022. [PMCID: PMC9157324 DOI: 10.1136/bmjinnov-2021-000887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Introduction Young people have played a pivotal role as part of the COVID-19 response, including developing health messages and social innovations. Social innovation in health engages multiple stakeholders in linking social change and health improvement. The study examined the feasibility of youth ideas and innovations to address the impacts of the COVID-19 pandemic using quantitative and qualitative descriptive analyses. Methods In partnership with the WHO, academic institutions, youth organisations and civil society groups, we conducted a crowdsourcing open call among Filipino youth (15–30 years old) using a structured Special Programme for Research and Training in Tropical Diseases/Social Innovation in Health Initiative process. The open call had three categories: youth voices to cocreate the post-COVID-19 world (entries were texts, images, videos and music), youth-led COVID-19 social innovations, and youth-led social innovations not related to COVID-19. Each submission was evaluated by three independent judges. Finalists were selected in each of the categories alongside four grand winners. All finalists were invited to attend a 1 day online civic hackathon. Results We received a total of 113 entries (youth voices to cocreate the post-COVID world=76; youth-led COVID-19 social innovations=17; youth-led social innovations not related to COVID-19=20). Twelve entries focused on youth mental health during the pandemic. The online hackathon provided the participants mentorship for further development of their ideas. Finalists were able to produce draft health communication campaigns and improved social innovations. Conclusion Many Filipino youth created exceptional entries in response to the open call. This suggests the feasibility of including youth voices in strategic planning processes. A global youth social innovation call is recommended.
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Affiliation(s)
- Allan Ulitin
- Institute of Health Policy and Development Studies - National Institutes of Health, University of the Philippines Manila, Manila, Philippines
| | | | - Meredith Labarda
- Department of Medicine, University of the Philippines Manila - School of Health Sciences, Palo, Leyte, Philippines
| | - Noel Juban
- Department of Clinical Epidemiology, University of the Philippines Manila, Manila, Philippines
| | | | - Joseph D Tucker
- IGHID, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Weiming Tang
- University of North Carolina Project-China, Guangzhou, China
| | - Mallika Auplish
- World Health Organization-Regional Office for the Western Pacific, Manila, Philippines
| | - Po-lin Chan
- World Health Organization-Regional Office for the Western Pacific, Manila, Philippines
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15
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Pet Presence Can Reduce Anxiety in the Elderly: The Italian Experience during COVID-19 Lockdown Assessed by an Electronic Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106135. [PMID: 35627672 PMCID: PMC9142058 DOI: 10.3390/ijerph19106135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/05/2022] [Accepted: 05/07/2022] [Indexed: 11/17/2022]
Abstract
The lockdown imposed in Italy due to the COVID-19 outbreak required restrictions that severely limited individual freedom to protect the population and reduce virus diffusion. This situation psychologically challenged the entire Italian population but mostly the elderly. The "Digital mental health approach" employs digital tools to evaluate and prevent increasing mental health problems. "Anonymous online electronic surveys" are digital tools that assess rates of mental health outcomes (using for example self-assessment/awareness tools). Immediately at the beginning of restrictions, we designed an electronic survey a) to remotely investigate the psychological impact of the lockdown and b) to compare the anxiety between pet owners and not-pet owners. A total of 3905 subjects filled out the survey; we focused our study on 781 (20%) elderly subjects. Dividing elderly patients between pet-owners (n = 405) and not-pet owners (n = 376), the pet owners showed a Zung scale score significantly lower in respect to the not-pet owners. We observed that, during the COVID-19 outbreak, the pet presence could have a positive effect on anxiety in the elderly subject. These results: (A) encourage the use of mobile technologies for the assessment of psychological disorders that can be promptly employed in emergencies such as the COVID-19 outbreak; (B) highlight the positive effect of pet interaction to mitigate the psychological distress in elderly people.
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16
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Tymofiyeva O, Hu MY, Sipes BS, Jakary A, Glidden DV, Jariwala N, Bhandari S, Parks KC, Nguyen C, Henje E, Yang TT. A Feasibility Study of a Remotely-Delivered Mindfulness-Based Training for Adolescents During the COVID-19 Pandemic. Front Psychiatry 2022; 13:838694. [PMID: 35633797 PMCID: PMC9133427 DOI: 10.3389/fpsyt.2022.838694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 03/17/2022] [Indexed: 11/17/2022] Open
Abstract
Social distancing, home confinement, economic challenges, and COVID-19-related illness and deaths during the COVID-19 pandemic can significantly affect mental health in youth. One promising approach to reduce anxiety and depression in adolescents is the neuroscience-based mindfulness intervention Training for Awareness, Resilience, and Action (TARA). The objective of this individually randomized waitlist-controlled trial (RCT) was (1) to test the feasibility of TARA, delivered partially over Zoom, and (2) to assess changes in the emotional wellbeing in healthy adolescents between the ages of 14-18 years old during the COVID-19 pandemic. METHODS Twenty-one healthy adolescents were randomized to the TARA intervention or to the waitlist control group in February 2020, just before the start of the pandemic. The TARA group intervention was delivered in person for the first five sessions and remotely over Zoom for the remaining seven sessions due to the pandemic. The participants' acceptability of TARA was assessed weekly using the Child Session Rating Scale (CSRS). The primary outcome was the emotional wellbeing measured using emotional symptoms subscale of the Strengths and Difficulties Questionnaire (SDQ) pre/post-TARA. We also explored weekly changes in TARA participants' wellbeing using the Child Outcome Rating Scale (CORS). RESULTS The overall session rating in TARA participants improved after the switch to Zoom (Cohen's d = 1.2, p = 0.008). The results of the two-way ANOVA showed no statistically significant difference in the change of the SDQ emotional symptoms during the 12 weeks between the TARA group and waitlist-control group (timepoint × group interaction: F = 0.77, p = 0.38). The exploratory analysis using the CORS in the TARA participants showed a significant improvement in their functioning over the weeks of training. CONCLUSION Our results support the feasibility of TARA delivered over Zoom. While our primary outcome did not provide support for the improvement of the emotional wellbeing with TARA compared to a passive control group, our exploratory analysis in the intervention group indicated an improved functioning over the weeks of TARA training. The important general positive impact of this study lies in the possibility of offering a neuroscience-based mindfulness intervention remotely to youth living in remote areas and for all youth during pandemic times.
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Affiliation(s)
- Olga Tymofiyeva
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Melody Y. Hu
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Langley Porter Psychiatric Institute, University of California, San Francisco, San Francisco, CA, United States
| | - Benjamin S. Sipes
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Angela Jakary
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - David V. Glidden
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States
| | - Namasvi Jariwala
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Sarina Bhandari
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Kendall C. Parks
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Ca Nguyen
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Eva Henje
- Department of Clinical Science, Child and Adolescent Psychiatry, Umeå University, Umeå, Sweden
| | - Tony T. Yang
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Langley Porter Psychiatric Institute, University of California, San Francisco, San Francisco, CA, United States
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
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17
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Bonardi O, Wang Y, Li K, Jiang X, Krishnan A, He C, Sun Y, Wu Y, Boruff JT, Markham S, Rice DB, Thombs-Vite I, Tasleem A, Santo TD, Yao A, Azar M, Agic B, Fahim C, Martin MS, Sockalingam S, Turecki G, Benedetti A, Thombs BD. Effects of COVID-19 Mental Health Interventions Among Children, Adolescents, and Adults Not Quarantined or Undergoing Treatment Due to COVID-19 Infection: A Systematic Review of Randomised Controlled Trials. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2022; 67:336-350. [PMID: 35275494 PMCID: PMC9065490 DOI: 10.1177/07067437211070648] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Our objective was to assess the effects of mental health interventions for children, adolescents, and adults not quarantined or undergoing treatment due to COVID-19 infection. METHODS We searched 9 databases (2 Chinese-language) from December 31, 2019, to March 22, 2021. We included randomised controlled trials of interventions to address COVID-19 mental health challenges among people not hospitalised or quarantined due to COVID-19 infection. We synthesized results descriptively due to substantial heterogeneity of populations and interventions and risk of bias concerns. RESULTS We identified 9 eligible trials, including 3 well-conducted, well-reported trials that tested interventions designed specifically for COVID-19 mental health challenges, plus 6 other trials with high risk of bias and reporting concerns, all of which tested standard interventions (e.g., individual or group therapy, expressive writing, mindfulness recordings) minimally adapted or not specifically adapted for COVID-19. Among the 3 well-conducted and reported trials, 1 (N = 670) found that a self-guided, internet-based cognitive-behavioural intervention targeting dysfunctional COVID-19 worry significantly reduced COVID-19 anxiety (standardized mean difference [SMD] 0.74, 95% confidence interval [CI], 0.58 to 0.90) and depression symptoms (SMD 0.38, 95% CI, 0.22 to 0.55) in Swedish general population participants. A lay-delivered telephone intervention for homebound older adults in the United States (N = 240) and a peer-moderated education and support intervention for people with a rare autoimmune condition from 12 countries (N = 172) significantly improved anxiety (SMD 0.35, 95% CI, 0.09 to 0.60; SMD 0.31, 95% CI, 0.03 to 0.58) and depressive symptoms (SMD 0.31, 95% CI, 0.05 to 0.56; SMD 0.31, 95% CI, 0.07 to 0.55) 6-week post-intervention, but these were not significant immediately post-intervention. No trials in children or adolescents were identified. CONCLUSIONS Interventions that adapt evidence-based strategies for feasible delivery may be effective to address mental health in COVID-19. More well-conducted trials, including for children and adolescents, are needed.
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Affiliation(s)
- Olivia Bonardi
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Yutong Wang
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Kexin Li
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Xiaowen Jiang
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Ankur Krishnan
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Chen He
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Ying Sun
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Yin Wu
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Psychiatry, 5620McGill University, Montreal, Quebec, Canada
| | - Jill T Boruff
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, 5620McGill University, Montreal, Quebec, Canada
| | - Sarah Markham
- Department of Biostatistics and Health Informatics, King's College London, London, United Kingdom
| | - Danielle B Rice
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Psychology, 5620McGill University, Montreal, Quebec, Canada
| | - Ian Thombs-Vite
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Amina Tasleem
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Psychology, 5620McGill University, Montreal, Quebec, Canada
| | - Tiffany Dal Santo
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Psychology, 5620McGill University, Montreal, Quebec, Canada
| | - Anneke Yao
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Psychology, 5620McGill University, Montreal, Quebec, Canada
| | - Marleine Azar
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Branka Agic
- 7978Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, 7938University of Toronto, Toronto, Ontario, Canada
| | - Christine Fahim
- Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada
| | - Michael S Martin
- School of Epidemiology and Public Health, University of Ottawa, Ontario, Canada.,Correctional Service of Canada, Ottawa, Ontario, Canada
| | - Sanjeev Sockalingam
- 7978Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,149914Department of Psychiatry, 7938University of Toronto, Toronto, Ontario, Canada
| | - Gustavo Turecki
- Department of Psychiatry, 5620McGill University, Montreal, Quebec, Canada.,McGill Group for Suicide Studies, Douglas Mental Health University Institute, 5620McGill University, Montreal, Quebec, Canada
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics, and Occupational Health, 5620McGill University, Montreal, Quebec, Canada.,Department of Medicine, 5620McGill University, Montreal, Quebec, Canada.,Respiratory Epidemiology and Clinical Research Unit, 5620McGill University Health Centre, Montreal, Quebec, Canada
| | - Brett D Thombs
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Psychiatry, 5620McGill University, Montreal, Quebec, Canada.,Department of Psychology, 5620McGill University, Montreal, Quebec, Canada.,Department of Epidemiology, Biostatistics, and Occupational Health, 5620McGill University, Montreal, Quebec, Canada.,Department of Medicine, 5620McGill University, Montreal, Quebec, Canada.,Department of Educational and Counselling Psychology, 5620McGill University, Montreal, Quebec, Canada.,Biomedical Ethics Unit, 5620McGill University, Montreal, Quebec, Canada
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18
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Guzick AG, Leong AW, Dickinson EM, Schneider SC, Zopatti K, Manis J, Meinert AC, Barth AM, Perez M, Campo DM, Weinzimmer SA, Cepeda SL, Mathai D, Shah A, Goodman WK, Salloum A, Kennedy S, Ehrenreich-May J, Storch EA. Brief, parent-led, transdiagnostic cognitive-behavioral teletherapy for youth with emotional problems related to the COVID-19 pandemic. J Affect Disord 2022; 301:130-137. [PMID: 35031335 PMCID: PMC8752168 DOI: 10.1016/j.jad.2022.01.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 01/02/2022] [Accepted: 01/08/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND The COVID-19 pandemic has led to increased stress, anxiety, and depression in children. A six-session, parent-led, transdiagnostic, cognitive-behavioral teletherapy program was adapted from an established protocol to help youth aged between 5 and 13 years manage emotional problems during the pandemic. METHODS One-hundred twenty-nine parents of youth struggling with emotional problems during the COVID-19 pandemic participated in the program. Parents reported on their children's psychosocial functioning before and after treatment using validated assessments. They also reported on treatment satisfaction. Clinician-rated global improvement was assessed at each session to determine clinically significant treatment response. RESULTS Significant improvements in parent proxy-reported anxiety (d = 0.56), depression (d = 0.69), stress (d = 0.61), anger (d = 0.69), family relationships (d = 0.32), and COVID-19-related distress (d = 1.08) were found, with 62% of participants who completed the program being classified as treatment responders. Parents reported high levels of satisfaction with the program. LIMITATIONS This study was limited by use of primarily parent-report assessments and a lack of a control group. CONCLUSIONS Brief, parent-led, transdiagnostic cognitive-behavioral teletherapy appeared to be an effective way to help youth cope with the pandemic and may be a scalable framework in response to large-scale mental health crises.
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Affiliation(s)
- Andrew G Guzick
- Baylor College of Medicine, 1977 Butler Blvd., Houston, TX 77030, USA.
| | - Alicia W Leong
- Baylor College of Medicine, 1977 Butler Blvd., Houston, TX 77030, USA; Icahn School of Medicine at Mount Sinai, USA
| | - Emily M Dickinson
- Baylor College of Medicine, 1977 Butler Blvd., Houston, TX 77030, USA; Florida International University School of Medicine, USA
| | | | - Katherine Zopatti
- Baylor College of Medicine, 1977 Butler Blvd., Houston, TX 77030, USA; University of Houston, USA
| | - Jamie Manis
- Baylor College of Medicine, 1977 Butler Blvd., Houston, TX 77030, USA; University of Houston, USA
| | - Allison C Meinert
- Baylor College of Medicine, 1977 Butler Blvd., Houston, TX 77030, USA; University of Houston, USA
| | - Alexandra M Barth
- Baylor College of Medicine, 1977 Butler Blvd., Houston, TX 77030, USA; University of Houston, USA
| | - Mayra Perez
- Baylor College of Medicine, 1977 Butler Blvd., Houston, TX 77030, USA
| | - Daphne M Campo
- Baylor College of Medicine, 1977 Butler Blvd., Houston, TX 77030, USA
| | | | | | | | - Asim Shah
- Baylor College of Medicine, 1977 Butler Blvd., Houston, TX 77030, USA
| | - Wayne K Goodman
- Baylor College of Medicine, 1977 Butler Blvd., Houston, TX 77030, USA
| | | | | | | | - Eric A Storch
- Baylor College of Medicine, 1977 Butler Blvd., Houston, TX 77030, USA
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19
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Espinoza G, Hernandez HL. Adolescent loneliness, stress and depressive symptoms during the
COVID
‐19 pandemic: The protective role of friends. INFANT AND CHILD DEVELOPMENT 2022; 31:e2305. [PMID: 35464827 PMCID: PMC9015336 DOI: 10.1002/icd.2305] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 12/17/2021] [Accepted: 12/20/2021] [Indexed: 11/06/2022]
Affiliation(s)
- Guadalupe Espinoza
- Child and Adolescent Studies Department California State University Fullerton California USA
| | - Hannah L. Hernandez
- Child and Adolescent Studies Department California State University Fullerton California USA
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20
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Porche MV, Folk JB, Tolou-Shams M, Fortuna LR. Researchers' Perspectives on Digital Mental Health Intervention Co-Design With Marginalized Community Stakeholder Youth and Families. Front Psychiatry 2022; 13:867460. [PMID: 35530032 PMCID: PMC9072625 DOI: 10.3389/fpsyt.2022.867460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 03/28/2022] [Indexed: 01/07/2023] Open
Abstract
Co-design of digital mental health technology with youth and families is a relatively new but growing approach to intervention development. In this perspective article, researchers used collaborative reflexivity through duoethnography methodology to reflect and report on experiences and lessons learned conducting co-designed projects with marginalized youth and families. Researchers engaged in written reflective dialogue regarding projects designed to co-develop technology-based apps and computer programs to support mental health of youth and their families. Reflections described the barriers and challenges for sharing responsibilities with stakeholders who have extensive lived experience but limited exposure to research. Researchers shared insights about their own intersectionality and positionality from marginalized to privileged, relative to co-design participants, and what it means to share authority, authentic partnership, and responsibility in the research process. Cultural understanding may diverge, even between acculturated minority researchers and matched minority stakeholders. While there are a variety of approaches that researchers might refer to as co-design, it is important to be intentional in the implementation of these processes so that collaborations with stakeholder youth and families are neither disingenuous nor exploitative. Implications for equitable and meaningful engagement of marginalized communities in co-design projects for youth mental health are discussed.
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Affiliation(s)
- Michelle V Porche
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Johanna B Folk
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Marina Tolou-Shams
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Lisa R Fortuna
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
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21
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Kasparik B, Saupe LB, Mäkitalo S, Rosner R. Online training for evidence-based child trauma treatment: evaluation of the German language TF-CBT-Web. Eur J Psychotraumatol 2022; 13:2055890. [PMID: 35401949 PMCID: PMC8986224 DOI: 10.1080/20008198.2022.2055890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Evidence-based trauma-focused interventions for treating PTSD in children and youth are barely used in practice. Web-based training has proven to be an effective way of transferring knowledge to healthcare professionals. OBJECTIVE TF-CBT Web is a web-based training programme designed to foster the dissemination of Trauma Focused Cognitive Behavioural Therapy (TF-CBT) for children and youth, and is run by the Medical University of South Carolina. This paper describes the characteristics of healthcare professionals who registered for the adapted German language version of TF-CBT Web. It evaluates the effectiveness and user friendliness of the programme. METHOD : Similar to the TF-CBT treatment manual, the German language TF-CBT Web contains 12 modules. Between 2018 and 2020, 4,020 users registered for the programme. During the registration process users provided demographic information. The knowledge of users regarding the TF-CBT components was assessed via pre-tests and post-tests in each module. RESULTS The programme was accessed by a sample of mostly German users with varying professional health care backgrounds and a wide-ranging spread of work experience. The results indicated a significant knowledge gain and high rates of user satisfaction with the programme. CONCLUSIONS In summary, the results of this study suggested that web-based training is an effective and well-accepted method for knowledge gain in trauma-focused interventions. Future research should evaluate the actual application of the taught methods in clinical practice. HIGHLIGHTS Children and adolescents with PTSD require trauma-focused treatment. However, evidence-based interventions for this patient population are barely used. Therefore, it is necessary to expand professional training for the treatment of traumatised children and adolescents.Our evaluation showed the effectiveness and feasibility of a web-based training programme for mental health practitioners in an evidence-based treatment for children and youth with PTSD (TF-CBT). Results show a significant knowledge gain of users who participate in the web-based training programme.The user satisfaction survey also revealed that users found the modus and content of the web-based training applicable and relevant for their clinical practice.
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Affiliation(s)
- Barbara Kasparik
- Department of Psychology, Catholic University Eichstätt-Ingolstadt Ingolstadt, Germany
| | - Laura B Saupe
- Department of Psychology, Catholic University Eichstätt-Ingolstadt Ingolstadt, Germany
| | - Svenja Mäkitalo
- Department of Psychology, Catholic University Eichstätt-Ingolstadt Ingolstadt, Germany
| | - Rita Rosner
- Department of Psychology, Catholic University Eichstätt-Ingolstadt Eichstätt, Germany
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22
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Maunula L, Dabravolskaj J, Maximova K, Sim S, Willows N, Newton AS, Veugelers PJ. "It's Very Stressful for Children": Elementary School-Aged Children's Psychological Wellbeing during COVID-19 in Canada. CHILDREN (BASEL, SWITZERLAND) 2021; 8:children8121185. [PMID: 34943381 PMCID: PMC8700526 DOI: 10.3390/children8121185] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/06/2021] [Accepted: 12/12/2021] [Indexed: 12/14/2022]
Abstract
Emerging evidence suggests that the COVID-19 pandemic and associated public health measures, including lockdowns and school closures, have been negatively affecting school-aged children’s psychological wellbeing. To identify supports required to mitigate the negative impacts of the COVID-19 pandemic, we gathered in-depth information on school-aged children’s and parents’ lived experiences of COVID-19 and perceptions of its impact on psychological wellbeing in grade 4–6 students in Canada. In this qualitative study, we conducted telephone-based semi-structured interviews with parents (n = 15) and their children (n = 16) from six schools in small and mid-sized northern prairie communities in Canada. Interviews were analyzed through thematic analysis. Three interrelated themes have emerged. First, the start of COVID-19 brought sudden and stressful changes to children’s lives. Second, disruptions to daily life led to feelings of boredom and lack of purpose. Third, limited opportunities for social interaction led to loneliness and an increase in screen time to seek social connection with peers. Results underscore the need for resilience building and the promotion of positive coping strategies to help school-aged children thrive in the event of future health crises or natural disasters.
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Affiliation(s)
- Laena Maunula
- School of Public Health, University of Alberta, 3-50E University Terrace, 8303 112 Street NW, Edmonton, AB T6G 1K4, Canada; (L.M.); (J.D.); (S.S.); (P.J.V.)
| | - Julia Dabravolskaj
- School of Public Health, University of Alberta, 3-50E University Terrace, 8303 112 Street NW, Edmonton, AB T6G 1K4, Canada; (L.M.); (J.D.); (S.S.); (P.J.V.)
| | - Katerina Maximova
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 209 Victoria Street, Toronto, ON M5B 1T8, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College St Room 500, Toronto, ON M5T 3M7, Canada
- Correspondence: ; Tel.: +1-416-360-4000
| | - Shannon Sim
- School of Public Health, University of Alberta, 3-50E University Terrace, 8303 112 Street NW, Edmonton, AB T6G 1K4, Canada; (L.M.); (J.D.); (S.S.); (P.J.V.)
| | - Noreen Willows
- Department of Agricultural, Food & Nutritional Science, Faculty of Agricultural, Life & Environmental Sciences, University of Alberta, Edmonton, AB T6G 2P5, Canada;
| | - Amanda S. Newton
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB T6G 1C9, Canada;
| | - Paul J. Veugelers
- School of Public Health, University of Alberta, 3-50E University Terrace, 8303 112 Street NW, Edmonton, AB T6G 1K4, Canada; (L.M.); (J.D.); (S.S.); (P.J.V.)
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23
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Kostev K, Weber K, Riedel-Heller S, von Vultée C, Bohlken J. Increase in depression and anxiety disorder diagnoses during the COVID-19 pandemic in children and adolescents followed in pediatric practices in Germany. Eur Child Adolesc Psychiatry 2021; 32:873-879. [PMID: 34825964 PMCID: PMC8619647 DOI: 10.1007/s00787-021-01924-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 11/23/2021] [Indexed: 12/14/2022]
Abstract
The coronavirus pandemic and related restrictions impacted the daily lives of children and youth, partly due to the closure of schools and the absence of outdoor activities. The aim of this study was to investigate, quantify, and critically discuss the effect of the pandemic and related restrictions on consultations pertaining to depression and anxiety disorders in children and adolescents. This retrospective cross-sectional study was based on medical record data from the Disease Analyzer database (IQVIA) and included all children and adolescents aged 2-17 years with at least one visit to one of 168 German pediatric practices between April 2019 and December 2019 (n = 454,741) or between April 2020 and December 2020 (n = 417,979). The number of children and adolescents with depression and anxiety disorder diagnoses per practice and the prevalence of these diagnoses were compared for April 2020-December 2020 versus April 2019-December 2019. The number of children and adolescents with depression and anxiety diagnoses per practice increased in April 2020-December 2020 compared to the same period in 2019 (anxiety: + 9%, depression: + 12%). The increase was much greater in girls than in boys (anxiety: + 13% vs. + 5%; depression + 19% vs. + 1%). The prevalence of anxiety disorder increased from 0.31 to 0.59% (p < 0.001), and that of depression from 0.23 to 0.47% (p < 0.001). The biggest increases were observed for girls (anxiety from 0.35 to 0.72% (+ 106%, p < 0.001), depression from 0.28 to 0.72% (+ 132%, p < 0.001). This study shows an increase in the number of pediatric diagnoses of depression and anxiety disorders in the pandemic year 2020 compared to the previous year.
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Affiliation(s)
- Karel Kostev
- Epidemiology, IQVIA, Unterschweinstiege 2-14, 60549, Frankfurt am Main, Germany.
| | - Kerstin Weber
- Retired Pediatrician, Currently Senior Physician at COVID-19 Vaccination Center, Berlin, Germany
| | - Steffi Riedel-Heller
- Institute for Social Medicine, Occupational Medicine, and Public Health (ISAP) of the Medical Faculty at the University of Leipzig, Leipzig, Germany
| | | | - Jens Bohlken
- Institute for Social Medicine, Occupational Medicine, and Public Health (ISAP) of the Medical Faculty at the University of Leipzig, Leipzig, Germany
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24
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Doherty A, Benedetto V, Harris C, Boland P, Christian DL, Hill J, Bhutani G, Clegg AJ. The effectiveness of psychological support interventions for those exposed to mass infectious disease outbreaks: a systematic review. BMC Psychiatry 2021; 21:592. [PMID: 34814859 PMCID: PMC8610770 DOI: 10.1186/s12888-021-03602-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 11/08/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Mass outbreaks such as pandemics are associated with mental health problems requiring effective psychological interventions. Although several forms of psychological interventions may be advocated or used, some may lack strong evidence of efficacy and some may not have been evaluated in mass infectious disease outbreaks. This paper reports a systematic review of published studies (PROSPERO CRD:42020182094. Registered: 24.04.2020) examining the types and effectiveness of psychological support interventions for the general population and healthcare workers exposed to mass infectious disease outbreaks. METHODS A systematic review was conducted. Randomised Controlled Trials (RCT) were identified through searches of electronic databases: Medline (Ovid), Embase (Ovid), PsycINFO (EBSCO) and the Cochrane Library Database from inception to 06.05.2021 using an agreed search strategy. Studies were included if they assessed the effectiveness of interventions providing psychological support to the general population and / or healthcare workers exposed to mass infectious disease outbreaks. Studies were excluded if they focused on man-made or natural disasters or if they included armed forces, police, fire-fighters or coastguards. RESULTS Twenty-two RCTs were included after screening. Various psychological interventions have been used: therapist-guided therapy (n = 1); online counselling (n = 1); 'Emotional Freedom Techniques' (n = 1); mobile phone apps (n = 2); brief crisis intervention (n = 1); psychological-behavioural intervention (n = 1); Cognitive Behavioural Therapy (n = 3); progressive muscle relaxation (n = 2); emotional-based directed drawing (n = 1); psycho-educational debriefing (n = 1); guided imagery (n = 1); Eye Movement Desensitization and Reprocessing (EMDR) (n = 1); expressive writing (n = 2); tailored intervention for patients with a chronic medical conditions (n = 1); community health workers (n = 1); self-guided psychological intervention (n = 1), and a digital behaviour change intervention (n = 1). Meta-analyses showed that psychological interventions had a statistically significant benefit in managing depression (Standardised Mean Difference [SMD]: -0.40; 95% Confidence Interval [CI]: - 0.76 to - 0.03), and anxiety (SMD: -0.72; 95% CI: - 1.03 to - 0.40). The effect on stress was equivocal (SMD: 0.16; 95% CI: - 0.19 to 0.51). The heterogeneity of studies, studies' high risk of bias, and the lack of available evidence means uncertainty remains. CONCLUSIONS Further RCTs and intervention studies involving representative study populations are needed to inform the development of targeted and tailored psychological interventions for those exposed to mass infectious disease outbreaks.
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Affiliation(s)
- Alison Doherty
- Synthesis, Economic Evaluations and Decision Science (SEEDS) Group, Faculty of Health & Care, University of Central Lancashire (UCLan), Preston, PR1 2HE UK
| | - Valerio Benedetto
- Synthesis, Economic Evaluations and Decision Science (SEEDS) Group, Faculty of Health & Care, University of Central Lancashire (UCLan), Preston, PR1 2HE UK
| | - Catherine Harris
- Synthesis, Economic Evaluations and Decision Science (SEEDS) Group, Faculty of Health & Care, University of Central Lancashire (UCLan), Preston, PR1 2HE UK
| | - Paul Boland
- Synthesis, Economic Evaluations and Decision Science (SEEDS) Group, Faculty of Health & Care, University of Central Lancashire (UCLan), Preston, PR1 2HE UK
| | - Danielle L. Christian
- Synthesis, Economic Evaluations and Decision Science (SEEDS) Group, Faculty of Health & Care, University of Central Lancashire (UCLan), Preston, PR1 2HE UK
| | - James Hill
- Synthesis, Economic Evaluations and Decision Science (SEEDS) Group, Faculty of Health & Care, University of Central Lancashire (UCLan), Preston, PR1 2HE UK
| | - Gita Bhutani
- Lancashire & South Cumbria NHS Foundation Trust & University of Liverpool, Liverpool, UK
| | - Andrew J. Clegg
- Synthesis, Economic Evaluations and Decision Science (SEEDS) Group, Faculty of Health & Care, University of Central Lancashire (UCLan), Preston, PR1 2HE UK
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25
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Thorisdottir IE, Asgeirsdottir BB, Kristjansson AL, Valdimarsdottir HB, Jonsdottir Tolgyes EM, Sigfusson J, Allegrante JP, Sigfusdottir ID, Halldorsdottir T. Depressive symptoms, mental wellbeing, and substance use among adolescents before and during the COVID-19 pandemic in Iceland: a longitudinal, population-based study. Lancet Psychiatry 2021; 8:663-672. [PMID: 34090582 DOI: 10.1016/s2215-0366(21)00156-5] [Citation(s) in RCA: 152] [Impact Index Per Article: 50.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 04/13/2021] [Accepted: 04/14/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND Adolescence represents a crucial developmental period in shaping mental health trajectories. In this study, we investigated the effect of the COVID-19 pandemic on mental health and substance use during this sensitive developmental stage. METHODS In this longitudinal, population-based study, surveys were administered to a nationwide sample of 13-18-year-olds in Iceland in October or February in 2016 and 2018, and in October, 2020 (during the COVID-19 pandemic). The surveys assessed depressive symptoms with the Symptom Checklist-90, mental wellbeing with the Short Warwick Edinburgh Mental Wellbeing Scale, and the frequency of cigarette smoking, e-cigarette use, and alcohol intoxication. Demographic data were collected, which included language spoken at home although not ethnicity data. We used mixed effects models to study the effect of gender, age, and survey year on trends in mental health outcomes. FINDINGS 59 701 survey responses were included; response rates ranged from 63% to 86%. An increase in depressive symptoms (β 0·57, 95% CI 0·53 to 0·60) and worsened mental wellbeing (β -0·46, 95% CI -0·49 to -0·42) were observed across all age groups during the pandemic compared with same-aged peers before COVID-19. These outcomes were significantly worse in adolescent girls compared with boys (β 4·16, 95% CI 4·05 to 4·28, and β -1·13, 95% CI -1·23 to -1·03, respectively). Cigarette smoking (OR 2·61, 95% CI 2·59 to 2·66), e-cigarette use (OR 2·61, 95% CI 2·59 to 2·64), and alcohol intoxication (OR 2·59, 95% CI 2·56 to 2·64) declined among 15-18-year-olds during COVID-19, with no similar gender differences. INTERPRETATION Our results suggest that COVID-19 has significantly impaired adolescent mental health. However, the decrease observed in substance use during the pandemic might be an unintended benefit of isolation, and might serve as a protective factor against future substance use disorders and dependence. Population-level prevention efforts, especially for girls, are warranted. FUNDING Icelandic Research Fund. TRANSLATION For the Icelandic translation of the abstract see Supplementary Materials section.
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Affiliation(s)
| | | | - Alfgeir Logi Kristjansson
- Icelandic Center for Social Research and Analysis, Reykjavik, Iceland; Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Heiddis Bjork Valdimarsdottir
- Department of Psychology, Reykjavik University, Reykjavik, Iceland; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Jon Sigfusson
- Icelandic Center for Social Research and Analysis, Reykjavik, Iceland
| | - John Philip Allegrante
- Department of Health and Behavior Studies, Teachers College, Columbia University, New York, NY, USA; Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Inga Dora Sigfusdottir
- Icelandic Center for Social Research and Analysis, Reykjavik, Iceland; Department of Psychology, Reykjavik University, Reykjavik, Iceland; Department of Health and Behavior Studies, Teachers College, Columbia University, New York, NY, USA
| | - Thorhildur Halldorsdottir
- Department of Psychology, Reykjavik University, Reykjavik, Iceland; Centre of Public Health Sciences, University of Iceland, Reykjavik, Iceland.
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26
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Rajkumar RP. Suffering and Salutogenesis: A Conceptual Analysis of Lessons for Psychiatry From Existential Positive Psychology (PP2.0) in the Setting of the COVID-19 Pandemic. Front Psychol 2021; 12:646334. [PMID: 33897551 PMCID: PMC8064119 DOI: 10.3389/fpsyg.2021.646334] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 03/17/2021] [Indexed: 12/18/2022] Open
Abstract
The COVID-19 pandemic has had a widespread effect on the thoughts, emotions and behavior of millions of people all around the world. In this context, a large body of scientific literature examining the mental health impact of this global crisis has emerged. The majority of these studies have framed this impact in terms of pre-defined categories derived from psychiatric nosology, such as anxiety disorders, depression or post-traumatic stress disorder. These constructs often fail to capture the complexity of the actual experiences of the individuals being studied; more specifically, they describe these experiences exclusively in terms of disease, while neglecting their potentially adaptive or “salutogenic” aspects. Similarly, discussion of psychological assistance for these individuals has largely been confined to a reiteration of “evidence-based” psychological or pharmacological techniques which can be delivered using remote access technology. In the context of the COVID-19 pandemic, these approaches are likely to be of mixed efficacy. Conversely, “negative emotions” or distressing psychological experiences may actually be functional in the setting of a disaster or crisis, serving to minimize harm, maximize social coherence and compliance, and facilitate adherence to safety measures. The limitations of the “conventional” approach are, to a certain degree, inherent to the prevailing medical model of mental health. Beyond these considerations lies the concept of “salutogenesis,” a term which refers to the innate capacity of individuals to create and maintain health and well-being in the face of adversity. Using principles derived from the second wave of positive psychology (PP2.0), particularly its emphasis on the totality of human experience and the possibility of deriving meaning and character growth from suffering, this paper conceptually analyses the relevant aspects of salutogenesis and PP2.0, and proposes an alternate approach for addressing mental health concerns during the COVID-19 pandemic. Such an approach, while acknowledging the utility of the conventional medical-psychotherapeutic model in specific cases, reduces the risk of medicalizing human experience, and provides individuals and communities with opportunities for growth and adaptation. The benefits of this proposal could potentially extend far beyond the current crisis, offering an opportunity for the field of psychiatry and mental health research to move away from a purely “disease-centered” model.
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Affiliation(s)
- Ravi Philip Rajkumar
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
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27
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L. G, K. M, J. N, A. TL, E. T, M. U, N. C, S. C, E. CV. Child and Adolescent Psychosocial Support Programs Following Natural Disasters-a Scoping Review of Emerging Evidence. Curr Psychiatry Rep 2021; 23:82. [PMID: 34652557 PMCID: PMC8517063 DOI: 10.1007/s11920-021-01293-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/05/2021] [Indexed: 12/01/2022]
Abstract
PURPOSE OF REVIEW This review aimed to identify and describe evidence published in the past 3 years from trials of psychosocial support programs for children and adolescents affected by natural disasters. RECENT FINDINGS Previous reviews have indicated these programs are beneficial overall. Positive impacts were documented in school-based programs conducted by trained teachers and paraprofessionals with stronger effects achieved by more qualified professionals. The review found supporting evidence for positive impacts of post-disaster psychosocial programs. However, the strength of evidence is limited due to heterogeneity in interventions and evaluations. The stepped care model was found to be useful in differentiating between programs and level of available evidence. Hobfoll's five essential elements of mass trauma intervention provide an additional means of guiding program content and assessments, particularly for universal programs. Identified gaps in evidence included groups likely to be at most risk: preschool children, ethnically diverse groups, those with disability, and social disadvantage. There were promising indications of program benefits for groups with repeated exposure to natural disasters.
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Affiliation(s)
- Gibbs L.
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC Australia ,Centre for Disaster Management and Public Safety, University of Melbourne, Melbourne, VIC Australia
| | - Marinkovic K.
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC Australia
| | - Nursey J.
- Phoenix Australia: Centre for Posttraumatic Mental Health, Melbourne, Australia
| | - Tong L. A.
- Department of Economics, Deakin University, Burwood, VIC Australia
| | - Tekin E.
- School of Public Affairs, American University, Washington, D.C USA ,National Bureau of Economic Research (NBER), Cambridge, USA ,Institute of Labor Economics (IZA), Bonn, Germany
| | - Ulubasoglu M.
- Department of Economics, Deakin University, Burwood, VIC Australia
| | - Callard N.
- Children’s Health Queensland Hospital and Health Service, Queensland, Australia
| | - Cowlishaw S.
- Phoenix Australia: Centre for Posttraumatic Mental Health, Melbourne, Australia
| | - Cobham V. E.
- School of Psychology, The University of Queensland, Queensland, Australia ,Children’s Health Queensland Child and Youth Mental Health Service, Queensland, Australia
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