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Pemau A, Marin-Martin C, Diaz-Marsa M, de la Torre-Luque A, Ayad-Ahmed W, Gonzalez-Pinto A, Garrido-Torres N, Garrido-Sanchez L, Roberto N, Lopez-Peña P, Mar-Barrutia L, Grande I, Guinovart M, Hernandez-Calle D, Jimenez-Treviño L, Lopez-Sola C, Mediavilla R, Perez-Aranda A, Ruiz-Veguilla M, Seijo-Zazo E, Toll A, Elices M, Perez-Sola V, Ayuso-Mateos JL. Risk factors for suicide reattempt: a systematic review and meta-analysis. Psychol Med 2024:1-8. [PMID: 38623694 DOI: 10.1017/s0033291724000904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
BACKGROUND Suicide is one of the main external causes of death worldwide. People who have already attempted suicide are at high risk of new suicidal behavior. However, there is a lack of information on the risk factors that facilitate the appearance of reattempts. The aim of this study was to calculate the risk of suicide reattempt in the presence of suicidal history and psychosocial risk factors and to estimate the effect of each individual risk factor. METHODS This systematic review and meta-analysis were conducted following the PRISMA-2020 guidelines. Studies on suicide reattempt that measured risk factors were searched from inception to 2022. The risk factors studied were those directly related to suicide history: history of suicide prior to the index attempt, and those that mediate the transition from suicidal ideation to attempt (alcohol or drug misuse, impulsivity, trauma, and non-suicidal self-injury). RESULTS The initial search resulted in 11 905 articles. Of these, 34 articles were selected for this meta-analysis, jointly presenting 52 different effect sizes. The pooled effect size across the risk factors was significant (OR 2.16). Reattempt risk may be increased in presence of any of the following risk factors: previous history, active suicidal ideation, trauma, alcohol misuse, and drug misuse. However, impulsivity, and non-suicidal self-injury did not show a significant effect on reattempt. CONCLUSION Most of the risk factors traditionally associated with suicide are also relevant when talking about suicide reattempts. Knowing the traits that define reattempters can help develop better preventive and intervention plans.
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Affiliation(s)
- Andres Pemau
- Universidad Complutense de Madrid, Madrid, Spain
| | | | - Marina Diaz-Marsa
- San Carlos University Clinic Hospital, Madrid, Spain
- Araba University Hospital, Vitoria, Spain
| | - Alejandro de la Torre-Luque
- Universidad Complutense de Madrid, Madrid, Spain
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
| | | | - Ana Gonzalez-Pinto
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Araba University Hospital, Vitoria, Spain
- University of the Basque Country, Bilbao, Spain
| | - Nathalia Garrido-Torres
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Virgen del Rocio University Hospital, Seville, Spain
- Seville Biomedical Research Institute (IBiS), Seville, Spain
| | | | - Natalia Roberto
- Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
| | - Purificación Lopez-Peña
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Araba University Hospital, Vitoria, Spain
- University of the Basque Country, Bilbao, Spain
- BIOARABA, Vitoria, Spain
| | - Lorea Mar-Barrutia
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Araba University Hospital, Vitoria, Spain
- University of the Basque Country, Bilbao, Spain
- BIOARABA, Vitoria, Spain
| | - Iria Grande
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
| | - Marti Guinovart
- Institut d'Investigacio i Innovacio ParcTauli (I3PT), Barcelona, Spain
- Autonomous University of Barcelona, Barcelona, Spain
| | - Daniel Hernandez-Calle
- La Paz University Hospital, Madrid, Spain
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Luis Jimenez-Treviño
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
- Principado de Asturias Health Research Institute (ISPA), Oviedo, Spain
- University of Oviedo, Oviedo, Spain
- Principado de Asturias Neuroscience Research Institute (INEUROPA), Oviedo, Spain
| | - Clara Lopez-Sola
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Roberto Mediavilla
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Autonomous University of Madrid, Madrid, Spain
| | | | - Miguel Ruiz-Veguilla
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Virgen del Rocio University Hospital, Seville, Spain
- Seville Biomedical Research Institute (IBiS), Seville, Spain
- University of Seville, Seville, Spain
| | - Elisa Seijo-Zazo
- Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
- Principado de Asturias Health Research Institute (ISPA), Oviedo, Spain
- University of Oviedo, Oviedo, Spain
- Principado de Asturias Neuroscience Research Institute (INEUROPA), Oviedo, Spain
| | - Alba Toll
- Autonomous University of Barcelona, Barcelona, Spain
- Neurosciences Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
| | - Matilde Elices
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Autonomous University of Barcelona, Barcelona, Spain
- Neurosciences Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
| | - Victor Perez-Sola
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Neurosciences Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
- Hospital de Mar, Mental Health Institute, Barcelona, Spain
- Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain
| | - Jose Luis Ayuso-Mateos
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Autonomous University of Madrid, Madrid, Spain
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Andreo-Jover J, Wootton O, Fernández-Jiménez E, Muñoz-Sanjosé A, Mediavilla R, Bravo-Ortiz MF, Susser E, Gur RC, Stein DJ. Adverse childhood experiences and cognition: A cross-sectional study in Xhosa people living with schizophrenia and matched medical controls. Compr Psychiatry 2024; 130:152459. [PMID: 38330854 DOI: 10.1016/j.comppsych.2024.152459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 01/26/2024] [Accepted: 01/30/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are associated with impaired cognitive function in adult life in the general population as well as in people living with schizophrenia (PLS). Research on cognitive function in PLS in low- and middle-income countries (LMIC) is, however, limited. The objectives of this study were to investigate the association between ACE types and various cognitive domains in a sample of PLS and matched medical controls, and to determine the moderating effect of group membership (PLS vs. medical controls) on these associations, in the South African setting. METHODS Participants (n PLS = 520; n medical controls = 832) completed the Childhood Trauma Questionnaire-Short Form, the Structured Clinical Interview for DSM-IV (SCID-I), and the University of Pennsylvania Computerized Neurocognitive Battery (PennCNB). An efficiency or speed score was used to assess performance across 9 cognitive domains. The association between exposure to different ACE types and 9 cognitive domains was examined using partial correlations and multiple linear regression models, adjusting for sex, age and education years. Finally, potential moderating effects of group membership (PLS vs. medical controls) on the association between ACEs and cognitive domains were tested. RESULTS In the entire sample, emotional and physical abuse predicted worse performance on sensorimotor and emotion identification domains. Also, emotional abuse was negatively associated with motor function, physical abuse was negatively associated with spatial processing, and physical neglect was negatively associated with face memory and emotion identification. In contrast, emotional neglect was related to better performance on abstraction and mental flexibility. No moderating effect of group membership was found on any of these associations. CONCLUSION Exposure to ACEs was associated with social and non-social cognition in adulthood, although the magnitude of these relationships was small and similar between PLS and matched medical controls. The nature of these associations differed across ACE subtype, suggesting the need for a nuanced approach to studying a range of mechanisms that may underlie different associations. However, a number of ACE subtypes were associated with worse performance on emotional identification, indicating that some underlying mechanisms may have more transversal impact. These findings contribute to the sparse body of literature on ACEs and cognition in PLS in LMIC.
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Affiliation(s)
- Jorge Andreo-Jover
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - Olivia Wootton
- Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Eduardo Fernández-Jiménez
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain; Universidad Europea de Madrid, Faculty of Social Sciences and Communication, Madrid, Spain.
| | - Ainoa Muñoz-Sanjosé
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
| | - Roberto Mediavilla
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Universitario La Princesa (IIS-Princesa), Madrid, Spain
| | - María Fe Bravo-Ortiz
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain; Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Ezra Susser
- Department of Epidemiology, Mailman School of Public Health, Columbia University, United States; Department of Psychiatry, New York State Psychiatric Institute, New York, United States
| | - Ruben C Gur
- Brain Behavior Laboratories, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, United States
| | - Dan J Stein
- South African Medical Research Council Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
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3
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Czepiel D, McCormack C, da Silva AT, Seblova D, Moro MF, Restrepo-Henao A, Martínez AM, Afolabi O, Alnasser L, Alvarado R, Asaoka H, Ayinde O, Balalian A, Ballester D, Barathie JA, Basagoitia A, Basic D, Burrone MS, Carta MG, Durand-Arias S, Eskin M, Fernández-Jiménez E, Frey MIF, Gureje O, Isahakyan A, Jaldo R, Karam EG, Khattech D, Lindert J, Martínez-Alés G, Mascayano F, Mediavilla R, Narvaez Gonzalez JA, Nasser-Karam A, Nishi D, Olaopa O, Ouali U, Puac-Polanco V, Ramírez DE, Ramírez J, Rivera-Segarra E, Rutten BP, Santaella-Tenorio J, Sapag JC, Šeblová J, Soto MTS, Tavares-Cavalcanti M, Valeri L, Sijbrandij M, Susser ES, Hoek HW, van der Ven E. Inequality on the frontline: A multi-country study on gender differences in mental health among healthcare workers during the COVID-19 pandemic. Glob Ment Health (Camb) 2024; 11:e34. [PMID: 38572248 PMCID: PMC10988139 DOI: 10.1017/gmh.2024.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 01/15/2024] [Accepted: 02/05/2024] [Indexed: 04/05/2024] Open
Abstract
Healthcare workers (HCWs) were at increased risk for mental health problems during the COVID-19 pandemic, with prior data suggesting women may be particularly vulnerable. Our global mental health study aimed to examine factors associated with gender differences in psychological distress and depressive symptoms among HCWs during COVID-19. Across 22 countries in South America, Europe, Asia and Africa, 32,410 HCWs participated in the COVID-19 HEalth caRe wOrkErS (HEROES) study between March 2020 and February 2021. They completed the General Health Questionnaire-12, the Patient Health Questionnaire-9 and questions about pandemic-relevant exposures. Consistently across countries, women reported elevated mental health problems compared to men. Women also reported increased COVID-19-relevant stressors, including insufficient personal protective equipment and less support from colleagues, while men reported increased contact with COVID-19 patients. At the country level, HCWs in countries with higher gender inequality reported less mental health problems. Higher COVID-19 mortality rates were associated with increased psychological distress merely among women. Our findings suggest that among HCWs, women may have been disproportionately exposed to COVID-19-relevant stressors at the individual and country level. This highlights the importance of considering gender in emergency response efforts to safeguard women's well-being and ensure healthcare system preparedness during future public health crises.
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Affiliation(s)
- Diana Czepiel
- Parnassia Psychiatric Institute, Parnassia Groep, The Hague, The Netherlands
- Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Clare McCormack
- Department of Child and Adolescent Psychiatry, New York University Langone Medical Center, New York, NY, USA
| | - Andréa T.C. da Silva
- Faculty of Medicine, University of São Paulo, São Paulo, Brazil
- Faculty of Medicine Santa Marcelina, São Paulo, Brazil
| | - Dominika Seblova
- Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Maria F. Moro
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Alexandra Restrepo-Henao
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
- Epidemiology Group, National School of Public Health, University of Antioquia, Medellín, Colombia
| | - Adriana M. Martínez
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Oyeyemi Afolabi
- Department of Psychiatry, University College Hospital, Ibadan, Nigeria
| | - Lubna Alnasser
- Population Health Research Section, King Abdullah International Medical Research Center (KAIMRC), King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia
| | - Rubén Alvarado
- Department of Public Health, School of Medicine, University of Valparaíso, Valparaiso, Chile
- School of Public Health, University of Chile, Santiago, Chile
| | - Hiroki Asaoka
- Department of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Olatunde Ayinde
- Department of Psychiatry, University of Ibadan, Ibadan, Nigeria
| | - Arin Balalian
- Question Driven Design and Analysis Group, New York, NY, USA
| | - Dinarte Ballester
- University Hospital, Federal University of Rio Grande, Rio Grande, Brazil
| | - Josleen A.l. Barathie
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
| | - Armando Basagoitia
- Unidad de Investigación, Consultora Salud Global Bolivia, Sucre, Bolivia
| | - Djordje Basic
- Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - María S. Burrone
- Institute of Health Sciences, Universidad de O’Higgins, Rancagua, Chile
| | - Mauro G. Carta
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Sol Durand-Arias
- National Institute of Psychiatry Ramon de la Fuente Muñiz, Mexico City, Mexico
| | - Mehmet Eskin
- Department of Psychology, Koç University, Istanbul, Turkey
| | - Eduardo Fernández-Jiménez
- Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
- European University of Madrid, Madrid, Spain
| | - Marcela I. F. Frey
- Social and Community Academic Unit, University of Chubut, Chubut, Argentina
| | - Oye Gureje
- Department of Psychiatry, University of Ibadan, Ibadan, Nigeria
| | - Anna Isahakyan
- National Institute of Health Named After Academician S. Avdalbekyan, Yerevan, Armenia
| | - Rodrigo Jaldo
- Social and Community Academic Unit, University of Chubut, Chubut, Argentina
| | - Elie G. Karam
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
- Department of Psychiatry and Clinical Psychology, Faculty of Medicine, University of Balamand,Beirut, Lebanon
- Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon
| | - Dorra Khattech
- Department Psychiatry A, Razi Hospital La Manouba, Manouba, Tunisia
| | - Jutta Lindert
- Faculty of Health and Social Work, University of Applied Sciences Emden/Leer, Emden, Germany
| | - Gonzalo Martínez-Alés
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Franco Mascayano
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Roberto Mediavilla
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Universitario La Princesa, Madrid, Spain
| | - Javier A. Narvaez Gonzalez
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
- Maestría en Epidemiología, División de Postgrados, El Bosque University, Bogotá, Colombia
- Departamento de Salud Pública, Facultad de Medicina, Universidad Nacional de Colombia, Sede Bogotá, Bogotá, Colombia
| | - Aimee Nasser-Karam
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
- Department of Psychiatry and Clinical Psychology, Faculty of Medicine, University of Balamand,Beirut, Lebanon
- Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon
| | - Daisuke Nishi
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Olusegun Olaopa
- Department of Oral and Maxillofacial Surgery, University College Hospital, Ibadan, Nigeria
| | - Uta Ouali
- Department Psychiatry A, Razi Hospital La Manouba, Manouba, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Victor Puac-Polanco
- Departments of Health Policy & Management and Epidemiology & Biostatistics, Downstate Health Sciences University, Brooklyn, NY, USA
- Faculty of Medical Sciences, University of San Carlos of Guatemala, Guatemala City, Guatemala
| | - Dorian E. Ramírez
- Faculty of Medical Sciences, University of San Carlos of Guatemala, Guatemala City, Guatemala
| | - Jorge Ramírez
- School of Public Health, University of Chile, Santiago, Chile
| | - Eliut Rivera-Segarra
- School of Behavioral and Brain Sciences, Ponce Research Institute, Ponce Health Sciences University, Ponce, Puerto Rico
| | - Bart P.F. Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Julian Santaella-Tenorio
- Department of Clinical Epidemiology and Biostatistics, Pontifical Xavierian University, Bogotá, Colombia
| | - Jaime C. Sapag
- Department of Public Health and Family Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Jana Šeblová
- Emergency Department, Motol University Hospital, Prague, Czech Republic
- Czech Society for Emergency and Disaster Medicine, Czech Medical Association of J. E. Purkyně, Prague, Czech Republic
| | - María T. S. Soto
- Dirección de Investigación Ciencia y Tecnología, Universidad San Francisco Xavier de Chuquisaca, Sucre, Bolivia
| | - Maria Tavares-Cavalcanti
- School of Medicine and Psychiatric Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Linda Valeri
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Marit Sijbrandij
- Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Amsterdam, The Netherlands
| | - Ezra S. Susser
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Hans W. Hoek
- Parnassia Psychiatric Institute, Parnassia Groep, The Hague, The Netherlands
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
- University Medical Center Groningen, University Center of Psychiatry, University of Groningen, Groningen, The Netherlands
| | - Els van der Ven
- Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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4
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Roos R, Witteveen AB, Ayuso-Mateos JL, Barbui C, Bryant RA, Felez-Nobrega M, Figueiredo N, Kalisch R, Haro JM, McDaid D, Mediavilla R, Melchior M, Nicaise P, Park AL, Petri-Romão P, Purgato M, van Straten A, Tedeschi F, Underhill J, Sijbrandij M. Correction: Effectiveness of a scalable, remotely delivered stepped-care intervention to reduce symptoms of psychological distress among Polish migrant workers in the Netherlands: study protocol for the RESPOND randomised controlled trial. BMC Psychiatry 2024; 24:24. [PMID: 38178056 PMCID: PMC10768119 DOI: 10.1186/s12888-023-05475-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2024] Open
Affiliation(s)
- Rinske Roos
- Department of Clinical, Neuroand Developmental Psychology and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, VU University, Amsterdam, Netherlands.
| | - Anke B Witteveen
- Department of Clinical, Neuroand Developmental Psychology and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, VU University, Amsterdam, Netherlands
| | - José Luis Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Department of Psychiatry, La Princesa University Hospital, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Corrado Barbui
- Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | - Richard A Bryant
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Mireia Felez-Nobrega
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - Natasha Figueiredo
- Equipe de Recherche en Epidémiologie Sociale (ERES), Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), INSERM, Sorbonne Université Facult? de Médecine St Antoine, Paris, France
| | - Rafael Kalisch
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Focus Program Translational Neuroscience (FTN), Neuroimaging Center (NIC), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Josep Maria Haro
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - David McDaid
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Roberto Mediavilla
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Department of Psychiatry, La Princesa University Hospital, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Maria Melchior
- Equipe de Recherche en Epidémiologie Sociale (ERES), Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), INSERM, Sorbonne Université Facult? de Médecine St Antoine, Paris, France
| | - Pablo Nicaise
- Institute of Health and Society (IRSS), Université Catholique de Louvain, Brussels, Belgium
| | - A-La Park
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | | | - Marianna Purgato
- Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | - Annemieke van Straten
- Department of Clinical, Neuroand Developmental Psychology and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, VU University, Amsterdam, Netherlands
| | - Federico Tedeschi
- Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | | | - Marit Sijbrandij
- Department of Clinical, Neuroand Developmental Psychology and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, VU University, Amsterdam, Netherlands
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5
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Melchior M, Figueiredo N, Roversi A, Dubanchet A, Bui E, Vadell-Martínez J, Barbui C, Purgato M, Ayuso-Mateos JL, Mediavilla R, McDaid D, Park AL, Petri-Romão P, Kalisch R, Nicaise P, Lorant V, Sijbrandij M, Witteveen AB, Bryant R, Felez M, Underhill J, Pollice G, Tortelli A. Addressing mental health problems among persons without stable housing in the context of the COVID-19 pandemic: study protocol for a randomised trial. RESPOND - France. BMC Public Health 2023; 23:2275. [PMID: 37978577 PMCID: PMC10656934 DOI: 10.1186/s12889-023-17238-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 11/16/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has had an impact on population-wide mental health and well-being. Although people experiencing socioeconomic disadvantage may be especially vulnerable, they experience barriers in accessing mental health care. To overcome these barriers, the World Health Organization (WHO) designed two scalable psychosocial interventions, namely the web-based Doing What Matters in Times of Stress (DWM) and the face-to-face Problem Management Plus (PM+), to help people manage stressful situations. Our study aims to test the effectiveness of a stepped-care program using DWM and PM + among individuals experiencing unstable housing in France - a majority of whom are migrant or have sought asylum. METHODS This is a randomised controlled trial to evaluate the effectiveness and cost effectiveness of a stepped-care program using DWM and PM + among persons with psychological distress and experiencing unstable housing, in comparison to enhanced care as usual (eCAU). Participants (N = 210) will be randomised to two parallel groups: eCAU or eCAU plus the stepped-care program. The main study outcomes are symptoms of depression and anxiety measured using the Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS). DISCUSSION This randomised controlled trial will contribute to a better understanding of effective community-based scalable strategies that can help address the mental health needs of persons experiencing socioeconomic disadvantage, whose needs are high yet who frequently have limited access to mental health care services. TRIAL REGISTRATION this randomised trial has been registered at ClinicalTrials.gov under the number NCT05033210.
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Affiliation(s)
- Maria Melchior
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, (IPLESP), Equipe de Recherche en Epidémiologie Sociale, Paris, F75012, France.
| | - Natasha Figueiredo
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, (IPLESP), Equipe de Recherche en Epidémiologie Sociale, Paris, F75012, France
| | - Aurélia Roversi
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, (IPLESP), Equipe de Recherche en Epidémiologie Sociale, Paris, F75012, France
| | - Alexandre Dubanchet
- CHU Caen, & Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", NeuroPresage Team, Cyceron, Caen, 14000, France
| | - Eric Bui
- CHU Caen, & Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", NeuroPresage Team, Cyceron, Caen, 14000, France
| | - Julian Vadell-Martínez
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, (IPLESP), Equipe de Recherche en Epidémiologie Sociale, Paris, F75012, France
| | - Corrado Barbui
- Department of Neuroscience, Biomedicine, and Movement Sciences, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | - Marianna Purgato
- Department of Neuroscience, Biomedicine, and Movement Sciences, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | - José Luis Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Universitario La Princesa, Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Roberto Mediavilla
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Universitario La Princesa, Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - David McDaid
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | - A-La Park
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Papoula Petri-Romão
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Raffael Kalisch
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Pablo Nicaise
- Institute of Health and Society (IRSS), Université Catholique de Louvain, Brussels, Belgium
| | - Vincent Lorant
- Institute of Health and Society (IRSS), Université Catholique de Louvain, Brussels, Belgium
| | - Marit Sijbrandij
- Clinical, Neuro and Developmental Psychology, WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Institute, VU University, Amsterdam, the Netherlands
| | - Anke B Witteveen
- Clinical, Neuro and Developmental Psychology, WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Institute, VU University, Amsterdam, the Netherlands
| | - Richard Bryant
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Mireia Felez
- Institut de recerca Sant Joan de Déu, Dr. Antoni Pujadas, Sant Boi de Llobregat (Barcelona), 4208830, Spain
| | | | - Giulia Pollice
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, (IPLESP), Equipe de Recherche en Epidémiologie Sociale, Paris, F75012, France
| | - Andrea Tortelli
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, (IPLESP), Equipe de Recherche en Epidémiologie Sociale, Paris, F75012, France
- GHU Paris, Psychiatrie & Neurosciences - Pôle Psychiatrie Précarité, Paris, France
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Roos R, Witteveen AB, Ayuso-Mateos JL, Barbui C, Bryant RA, Felez-Nobrega M, Figueiredo N, Kalisch R, Haro JM, McDaid D, Mediavilla R, Melchior M, Nicaise P, Park AL, Petri-Romão P, Purgato M, van Straten A, Tedeschi F, Underhill J, Sijbrandij M. Effectiveness of a scalable, remotely delivered stepped-care intervention to reduce symptoms of psychological distress among Polish migrant workers in the Netherlands: study protocol for the RESPOND randomised controlled trial. BMC Psychiatry 2023; 23:801. [PMID: 37919694 PMCID: PMC10623706 DOI: 10.1186/s12888-023-05288-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 10/17/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has negatively affected the mental health of international migrant workers (IMWs). IMWs experience multiple barriers to accessing mental health care. Two scalable interventions developed by the World Health Organization (WHO) were adapted to address some of these barriers: Doing What Matters in times of stress (DWM), a guided self-help web application, and Problem Management Plus (PM +), a brief facilitator-led program to enhance coping skills. This study examines whether DWM and PM + remotely delivered as a stepped-care programme (DWM/PM +) is effective and cost-effective in reducing psychological distress, among Polish migrant workers with psychological distress living in the Netherlands. METHODS The stepped-care DWM/PM + intervention will be tested in a two-arm, parallel-group, randomized controlled trial (RCT) among adult Polish migrant workers with self-reported psychological distress (Kessler Psychological Distress Scale; K10 > 15.9). Participants (n = 212) will be randomized into either the intervention group that receives DWM/PM + with psychological first aid (PFA) and care-as-usual (enhanced care-as-usual or eCAU), or into the control group that receives PFA and eCAU-only (1:1 allocation ratio). Baseline, 1-week post-DWM (week 7), 1-week post-PM + (week 13), and follow-up (week 21) self-reported assessments will be conducted. The primary outcome is psychological distress, assessed with the Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS). Secondary outcomes are self-reported symptoms of depression, anxiety, posttraumatic stress disorder (PTSD), resilience, quality of life, and cost-effectiveness. In a process evaluation, stakeholders' views on barriers and facilitators to the implementation of DWM/PM + will be evaluated. DISCUSSION To our knowledge, this is one of the first RCTs that combines two scalable, psychosocial WHO interventions into a stepped-care programme for migrant populations. If proven to be effective, this may bridge the mental health treatment gap IMWs experience. TRIAL REGISTRATION Dutch trial register NL9630, 20/07/2021, https://www.onderzoekmetmensen.nl/en/trial/27052.
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Affiliation(s)
- Rinske Roos
- Department of Clinical, Neuro- and Developmental Psychology and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, VU University, Amsterdam, Netherlands.
| | - Anke B Witteveen
- Department of Clinical, Neuro- and Developmental Psychology and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, VU University, Amsterdam, Netherlands
| | - José Luis Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Department of Psychiatry, La Princesa University Hospital, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Corrado Barbui
- Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | - Richard A Bryant
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Mireia Felez-Nobrega
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - Natasha Figueiredo
- Equipe de Recherche en Epidémiologie Sociale (ERES), Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), INSERM, Sorbonne Université, Faculté de Médecine St Antoine, Paris, France
| | - Raffael Kalisch
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Focus Program Translational Neuroscience (FTN), Neuroimaging Center (NIC), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Josep Maria Haro
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - David McDaid
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Roberto Mediavilla
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Department of Psychiatry, La Princesa University Hospital, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Maria Melchior
- Equipe de Recherche en Epidémiologie Sociale (ERES), Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), INSERM, Sorbonne Université, Faculté de Médecine St Antoine, Paris, France
| | - Pablo Nicaise
- Institute of Health and Society (IRSS), Université Catholique de Louvain, Brussels, Belgium
| | - A-La Park
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | | | - Marianna Purgato
- Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | - Annemieke van Straten
- Department of Clinical, Neuro- and Developmental Psychology and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, VU University, Amsterdam, Netherlands
| | - Federico Tedeschi
- Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | | | - Marit Sijbrandij
- Department of Clinical, Neuro- and Developmental Psychology and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, VU University, Amsterdam, Netherlands
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García-Vázquez B, Martínez-Alés G, Fernández-Jiménez E, Andreo-Jover J, Moreno-Küstner B, Minué S, Jaramillo F, Morán-Sánchez I, Martínez-Morata I, Ayuso-Mateos JL, Bayón C, Bravo-Ortiz MF, Mediavilla R. Use of psychological interventions among healthcare workers over the 2-year period following the COVID-19 pandemic: A longitudinal study. PLoS One 2023; 18:e0292932. [PMID: 37903088 PMCID: PMC10615285 DOI: 10.1371/journal.pone.0292932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 10/01/2023] [Indexed: 11/01/2023] Open
Abstract
INTRODUCTION Although healthcare workers (HCWs) have reported mental health problems since the beginning of the COVID-19 pandemic, they rarely use psychological support. Here, we described the use of psychological support among HCWs in Spain over the 2-year period following the initial pandemic outbreak and explore its association with workplace- and COVID-19-related factors measured at baseline, in 2020. MATERIALS AND METHODS We conducted a longitudinal study on HCWs working in Spain. We used an online survey to collect information on sociodemographic characteristics, depressive symptoms, workplace- and COVID-19-related variables, and the use of psychological support at three time points (2020, 2021, and 2022). Data was available for 296, 294, and 251 respondents, respectively at time points 1, 2, and 3. RESULTS Participants had a median age of 43 years and were mostly females (n = 242, 82%). The percentage of HCWs using psychological support increased from 15% in 2020 to 23% in 2022. Roughly one in four HCWs who did not use psychological support reported symptoms compatible with major depressive disorder at follow up. Baseline predictors of psychological support were having to make decisions about patients' prioritisation (OR 5.59, 95% CI 2.47, 12.63) and probable depression (wave 2: OR 1.12, 95% CI 1.06, 1.19; wave 3: OR 1.10, 95% CI 1.04, 1.16). CONCLUSIONS Our results suggest that there is call for implementing mental health promotion and prevention strategies at the workplace, along with actions to reduce barriers for accessing psychological support.
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Affiliation(s)
- Blanca García-Vázquez
- Department of Psychiatry, Clinical Psychology, and Mental Health, Hospital Universitario La Paz, Madrid, Spain
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
| | - Gonzalo Martínez-Alés
- CAUSALab, Harvard TH Chan School of Public Health, Harvard, Boston, Massachusetts, United States of America
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Eduardo Fernández-Jiménez
- Department of Psychiatry, Clinical Psychology, and Mental Health, Hospital Universitario La Paz, Madrid, Spain
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Jorge Andreo-Jover
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Berta Moreno-Küstner
- Department of Personality, Assessment and Psychological Treatment, University of Málaga-IBIMA, Málaga, Spain
| | - Sergio Minué
- Andalusian School of Public Health, Granada, Spain
| | - Fabiola Jaramillo
- Andalusian School of Public Health, Granada, Spain
- University of Chile, Santiago, Chile
| | - Inés Morán-Sánchez
- Murcia BioHealth Research Institute, University of Murcia, Murcia, Spain
| | - Irene Martínez-Morata
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, United States America
| | - José Luis Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry, La Princesa University Hospital - Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
| | - Carmen Bayón
- Department of Psychiatry, Clinical Psychology, and Mental Health, Hospital Universitario La Paz, Madrid, Spain
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - María-Fe Bravo-Ortiz
- Department of Psychiatry, Clinical Psychology, and Mental Health, Hospital Universitario La Paz, Madrid, Spain
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Roberto Mediavilla
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry, La Princesa University Hospital - Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
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Mediavilla R, Fernández-Jiménez E, Andreo J, Morán-Sánchez I, Muñoz-Sanjosé A, Moreno-Küstner B, Mascayano F, Ayuso-Mateos JL, Bravo-Ortiz MF, Martínez-Alés G. Association between perceived discrimination and mental health outcomes among health workers during the initial COVID-19 outbreak. Spanish Journal of Psychiatry and Mental Health 2023; 16:221-224. [PMID: 34153496 PMCID: PMC8253602 DOI: 10.1016/j.rpsm.2021.06.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 05/29/2021] [Accepted: 06/10/2021] [Indexed: 10/27/2022]
Abstract
BACKGROUND During the initial COVID-19 outbreak, health systems faced unprecedented organizational stress. Meanwhile, reports of episodes of discrimination and violence towards healthcare workers increased globally. This study explores the association between perceived discrimination and mental health outcomes in a large sample of healthcare workers in Spain. MATERIALS AND METHODS Healthcare workers from inpatient and outpatient facilities (N=2,053) filled an on-line questionnaire in May or June 2020. Mental health outcomes included depression symptoms (Patient Health Questionnaire [PHQ-9]), psychological distress (General Health Questionnaire [GHQ-12]) and death thoughts (Columbia Suicide Severity Rating Scale [C-SSRS]). We also measured perceived discrimination and/or stigmatization due to being a healthcare worker since pandemic onset. Regression models adjusted for potential confounding sources (age, sex, history of a mental health diagnosis and type of job) were fitted. RESULTS Thirty percent of the respondents reported discrimination and/or stigmatization. Perceived discrimination was associated with higher depression (B=2.4, 95 percent CI: 1.8, 2.9) and psychological distress (B=1.1, 95 percent CI: 0.7, 1.4) scores, and with a 2-fold increase in risk of reporting death thoughts (OR=2.0, 95 percent CI: 1.4, 3.1). CONCLUSIONS Perceived discrimination is a modifiable driver of mental health problems among healthcare workers. Mass media, legislators, and healthcare institutions must put in place prevention and restoration strategies to limit discrimination towards healthcare workers and reduce its mental health impact.
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Affiliation(s)
- Roberto Mediavilla
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
| | - Eduardo Fernández-Jiménez
- Department of Psychiatry, Clinical Psychology and Mental Health, Hospital Universitario La Paz, Madrid, Spain; Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Jorge Andreo
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - Inés Morán-Sánchez
- Institute for Biomedical Research of Murcia (IMIB-Arrixaca), Murcia, Spain; Cartagena Mental Health Centre, Health Service of Murcia, Murcia, Spain
| | - Ainoa Muñoz-Sanjosé
- Department of Psychiatry, Clinical Psychology and Mental Health, Hospital Universitario La Paz, Madrid, Spain; Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Berta Moreno-Küstner
- Department of Personality, Assessment and Psychological Treatment, University of Malaga, Malaga, Spain; Andalusian Group of Psychosocial Research (GAP), Andalusia, Spain; Biomedical Research Institute of Malaga (IBIMA), Malaga, Spain
| | - Franco Mascayano
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United States; New York State Psychiatric Institute, New York, NY, United States
| | - José Luis Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Psychiatry, La Princesa University Hospital, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
| | - María-Fe Bravo-Ortiz
- Department of Psychiatry, Clinical Psychology and Mental Health, Hospital Universitario La Paz, Madrid, Spain; Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - Gonzalo Martínez-Alés
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United States; Department of Psychiatry, Clinical Psychology and Mental Health, Hospital Universitario La Paz, Madrid, Spain
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9
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Riepenhausen A, Veer IM, Wackerhagen C, Reppmann ZC, Köber G, Ayuso-Mateos JL, Bögemann SA, Corrao G, Felez-Nobrega M, Abad JMH, Hermans E, van Leeuwen J, Lieb K, Lorant V, Mary-Krause M, Mediavilla R, Melchior M, Mittendorfer-Rutz E, Compagnoni MM, Pan KY, Puhlmann L, Roelofs K, Sijbrandij M, Smith P, Tüscher O, Witteveen A, Zerban M, Kalisch R, Kröger H, Walter H. Coping with COVID: risk and resilience factors for mental health in a German representative panel study. Psychol Med 2023; 53:3897-3907. [PMID: 35301966 PMCID: PMC8943230 DOI: 10.1017/s0033291722000563] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 11/23/2021] [Accepted: 02/15/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic might affect mental health. Data from population-representative panel surveys with multiple waves including pre-COVID data investigating risk and protective factors are still rare. METHODS In a stratified random sample of the German household population (n = 6684), we conducted survey-weighted multiple linear regressions to determine the association of various psychological risk and protective factors assessed between 2015 and 2020 with changes in psychological distress [(PD; measured via Patient Health Questionnaire for Depression and Anxiety (PHQ-4)] from pre-pandemic (average of 2016 and 2019) to peri-pandemic (both 2020 and 2021) time points. Control analyses on PD change between two pre-pandemic time points (2016 and 2019) were conducted. Regularized regressions were computed to inform on which factors were statistically most influential in the multicollinear setting. RESULTS PHQ-4 scores in 2020 (M = 2.45) and 2021 (M = 2.21) were elevated compared to 2019 (M = 1.79). Several risk factors (catastrophizing, neuroticism, and asking for instrumental support) and protective factors (perceived stress recovery, positive reappraisal, and optimism) were identified for the peri-pandemic outcomes. Control analyses revealed that in pre-pandemic times, neuroticism and optimism were predominantly related to PD changes. Regularized regression mostly confirmed the results and highlighted perceived stress recovery as most consistent influential protective factor across peri-pandemic outcomes. CONCLUSIONS We identified several psychological risk and protective factors related to PD outcomes during the COVID-19 pandemic. A comparison of pre-pandemic data stresses the relevance of longitudinal assessments to potentially reconcile contradictory findings. Implications and suggestions for targeted prevention and intervention programs during highly stressful times such as pandemics are discussed.
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Affiliation(s)
- Antje Riepenhausen
- Department of Psychiatry and Neurosciences - CCM, Research Division of Mind and Brain, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
- Berlin School of Mind and Brain, Faculty of Philosophy, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Ilya M. Veer
- Department of Psychiatry and Neurosciences - CCM, Research Division of Mind and Brain, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
- Department of Developmental Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Carolin Wackerhagen
- Department of Psychiatry and Neurosciences - CCM, Research Division of Mind and Brain, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Zala C. Reppmann
- Department of Psychiatry and Neurosciences - CCM, Research Division of Mind and Brain, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Göran Köber
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
- Freiburg Center for Data Analysis and Modelling, University of Freiburg, Freiburg, Germany
| | - José Luis Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), La Princesa University Hospital, Madrid, Spain
| | - Sophie A. Bögemann
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Giovanni Corrao
- Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
- National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy
| | - Mireia Felez-Nobrega
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - Josep Maria Haro Abad
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - Erno Hermans
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Judith van Leeuwen
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Klaus Lieb
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Vincent Lorant
- Institute of Health and Society (IRSS), Université Catholique de Louvain, Brussels, Belgium
| | - Murielle Mary-Krause
- Department of Social Epidemiology, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, INSERM, 75012 Paris, France
| | - Roberto Mediavilla
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Maria Melchior
- Department of Social Epidemiology, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, INSERM, 75012 Paris, France
| | - Ellenor Mittendorfer-Rutz
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Berzelius väg 3, 17177 Stockholm, Sweden
| | - Matteo Monzio Compagnoni
- Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
- National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy
| | - Kuan-Yu Pan
- Department of Psychiatry, Amsterdam Public Health, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, The Netherlands
| | - Lara Puhlmann
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Research Group Social Stress and Family Health, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Karin Roelofs
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Marit Sijbrandij
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Vrije Universiteit, Amsterdam, The Netherlands
| | - Pierre Smith
- Institute of Health and Society (IRSS), Université Catholique de Louvain, Brussels, Belgium
- Department Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Oliver Tüscher
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Anke Witteveen
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Vrije Universiteit, Amsterdam, The Netherlands
| | - Matthias Zerban
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Raffael Kalisch
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Hannes Kröger
- Socio-Economic Panel (SOEP), German Institute for Economic Research (DIW), Berlin, Germany
- Munich Center for the Economics of Aging (MEA), Max Planck Institute for Social Law and Social Policy, Munich, Germany
| | - Henrik Walter
- Department of Psychiatry and Neurosciences - CCM, Research Division of Mind and Brain, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
- Berlin School of Mind and Brain, Faculty of Philosophy, Humboldt-Universität zu Berlin, Berlin, Germany
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10
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Mediavilla R, Felez-Nobrega M, McGreevy KR, Monistrol-Mula A, Bravo-Ortiz MF, Bayón C, Giné-Vázquez I, Villaescusa R, Muñoz-Sanjosé A, Aguilar-Ortiz S, Figueiredo N, Nicaise P, Park AL, Petri-Romão P, Purgato M, Witteveen AB, Underhill J, Barbui C, Bryant R, Kalisch R, Lorant V, McDaid D, Melchior M, Sijbrandij M, Haro JM, Ayuso-Mateos JL. Effectiveness of a mental health stepped-care programme for healthcare workers with psychological distress in crisis settings: a multicentre randomised controlled trial. BMJ Ment Health 2023; 26:e300697. [PMID: 37263708 PMCID: PMC10254812 DOI: 10.1136/bmjment-2023-300697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 04/25/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND Evidence-based mental health interventions to support healthcare workers (HCWs) in crisis settings are scarce. OBJECTIVE To evaluate the capacity of a mental health intervention in reducing anxiety and depression symptoms in HCWs, relative to enhanced care as usual (eCAU), amidst the COVID-19 pandemic. METHODS We conducted an analyst-blind, parallel, multicentre, randomised controlled trial. We recruited HCWs with psychological distress from Madrid and Catalonia (Spain). The intervention arm received a stepped-care programme consisting of two WHO-developed interventions adapted for HCWs: Doing What Matters in Times of Stress (DWM) and Problem Management Plus (PM+). Each intervention lasted 5 weeks and was delivered remotely by non-specialist mental health providers. HCWs reporting psychological distress after DWM completion were invited to continue to PM+. The primary endpoint was self-reported anxiety/depression symptoms (Patient Health Questionnaire-Anxiety and Depression Scale) at week 21. FINDINGS Between 3 November 2021 and 31 March 2022, 115 participants were randomised to stepped care and 117 to eCAU (86% women, mean age 37.5). The intervention showed a greater decrease in anxiety/depression symptoms compared with eCAU at the primary endpoint (baseline-adjusted difference 4.4, 95% CI 2.1 to 6.7; standardised effect size 0.8, 95% CI 0.4 to 1.2). No serious adverse events occurred. CONCLUSIONS Brief stepped-care psychological interventions reduce anxiety and depression during a period of stress among HCWs. CLINICAL IMPLICATIONS Our results can inform policies and actions to protect the mental health of HCWs during major health crises and are potentially rapidly replicable in other settings where workers are affected by global emergencies. TRIAL REGISTRATION NUMBER NCT04980326.
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Affiliation(s)
- Roberto Mediavilla
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
- Consorcio de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Universitario La Princesa (IIS-Princesa), Madrid, Spain
- Leibniz Institute for Resilience Research, Mainz, Germany
| | - Mireia Felez-Nobrega
- Consorcio de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Parc Sanitari Sant Joan de Deu, Sant Boi de Llobregat, Spain
| | - Kerry R McGreevy
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
- Consorcio de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Anna Monistrol-Mula
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - María-Fe Bravo-Ortiz
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
- Consorcio de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry, Hospital Universitario La Paz - IdiPAZ, Madrid, Spain
| | - Carmen Bayón
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
- Consorcio de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry, Hospital Universitario La Paz - IdiPAZ, Madrid, Spain
| | - Iago Giné-Vázquez
- Consorcio de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - Rut Villaescusa
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - Ainoa Muñoz-Sanjosé
- Department of Psychiatry, Hospital Universitario La Paz - IdiPAZ, Madrid, Spain
| | | | - Natasha Figueiredo
- Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Institut national de la santé et de la recherche médicale (INSERM), Paris, France
| | - Pablo Nicaise
- Institute of Health and Society (IRSS), Université Catholique de Louvain, Brussels, Belgium
| | - A-La Park
- Department of Health Policy, London School of Economics and Political Science, London, UK
| | | | - Marianna Purgato
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation - Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy
| | - Anke B Witteveen
- Department of Clinical Neuro- and Developmental Psychology - WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije University, Amsterdam, Netherlands
| | - James Underhill
- Department of Clinical Neuro- and Developmental Psychology - WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije University, Amsterdam, Netherlands
| | - Corrado Barbui
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation - Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy
| | - Richard Bryant
- School of Psychology, UNSW, Sydney, New South Wales, Australia
| | - Raffael Kalisch
- Leibniz Institute for Resilience Research, Mainz, Germany
- Neuroimaging Center (NIC) - Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Vincent Lorant
- Institute of Health and Society (IRSS), Université Catholique de Louvain, Brussels, Belgium
| | - David McDaid
- Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Maria Melchior
- Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Institut national de la santé et de la recherche médicale (INSERM), Paris, France
| | - Marit Sijbrandij
- Department of Clinical Neuro- and Developmental Psychology - WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije University, Amsterdam, Netherlands
| | - Josep Maria Haro
- Consorcio de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - Jose Luis Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
- Consorcio de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Universitario La Princesa (IIS-Princesa), Madrid, Spain
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11
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Lotito C, Turrini G, Purgato M, Bryant RA, Felez-Nobrega M, Haro JM, Lorant V, McDaid D, Mediavilla R, Melchior M, Nicaise P, Nosè M, Park AL, McGreevy KR, Roos R, Tortelli A, Underhill J, Martinez JV, Witteveen A, Sijbrandij M, Barbui C. Views and experiences of migrants and stakeholders involved in social and health care for migrants in Italy during the COVID-19 pandemic: a qualitative study. BMC Psychol 2023; 11:164. [PMID: 37208725 DOI: 10.1186/s40359-023-01208-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 05/14/2023] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has had major and potentially long-lasting effects on mental health and wellbeing across populations worldwide. However, these impacts were not felt equally, leading to an exacerbation of health inequalities, especially affecting vulnerable populations such as migrants, refugees and asylum seekers. Aiming to inform the adaptation and implementation of psychological intervention programmes, the present study investigated priority mental health needs in this population group. METHODS Participants were adult asylum seekers, refugees and migrants (ARMs) and stakeholders with experience in the field of migration living in Verona, Italy, and fluent in Italian and English. A two-stage process was carried out to examine their needs using qualitative methods including free listing interviews and focus group discussions, according to Module One of the DIME (Design, Implementation, Monitoring, and Evaluation) manual. Data were analyzed using an inductive thematic analyses approach. RESULTS A total of 19 participants (12 stakeholders, 7 ARMs) completed the free listing interviews and 20 participants (12 stakeholders and 8 ARMs) attended focus group discussions. Salient problems and functions that emerged during free listing interviews were discussed during the focus group discussions. During the COVID-19 pandemic, ARMs struggled with many everyday living difficulties in their resettlement country due to social and economic issues, revealing a strong influence of contextual factors in determining mental health. Both ARMs and stakeholders highlighted a mismatch between needs, expectations and interventions as factors that may hamper proper implementation of health and social programmes. CONCLUSIONS The present findings could help in the adaptation and implementation of psychological interventions targeting the needs of asylum seekers, refugees and migrants aiming to find a match between needs, expectations, and the corresponding interventions. TRIAL REGISTRATION Registration number 2021-UNVRCLE-0106707, February 11 2021.
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Affiliation(s)
- Claudia Lotito
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
| | - Giulia Turrini
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy.
- Cochrane Global Mental Health, University of Verona, Verona, Italy.
| | - Marianna Purgato
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
| | - Richard A Bryant
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Mireia Felez-Nobrega
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Josep Maria Haro
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Vincent Lorant
- Institute of Health and Society (IRSS), Université Catholique de Louvain, Brussels, Belgium
| | - David McDaid
- Care Policy and Evaluation Centre, Department of Health, London School of Economics and Political Science, London, UK
| | - Roberto Mediavilla
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Centro de Investigaci?n Biom?dica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Maria Melchior
- Département d'Epidémiologie Sociale, Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, 27 rue de Chaligny, Paris, 75012, France
| | - Pablo Nicaise
- Institute of Health and Society (IRSS), Université Catholique de Louvain, Brussels, Belgium
| | - Michela Nosè
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
| | - A-La Park
- Care Policy and Evaluation Centre, Department of Health, London School of Economics and Political Science, London, UK
| | - Kerry R McGreevy
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Centro de Investigaci?n Biom?dica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Rinske Roos
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Institute and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Andrea Tortelli
- Département d'Epidémiologie Sociale, Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, 27 rue de Chaligny, Paris, 75012, France
| | | | - Julian Vadell Martinez
- Département d'Epidémiologie Sociale, Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, 27 rue de Chaligny, Paris, 75012, France
| | - Anke Witteveen
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Institute and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marit Sijbrandij
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Institute and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Corrado Barbui
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
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12
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Ruiz-Parra E, Manzano-García G, Mediavilla R, Rodríguez-Vega B, Lahera G, Moreno-Pérez AI, Torres-Cantero AM, Rodado-Martínez J, Bilbao A, González-Torres MÁ. The Spanish version of the reflective functioning questionnaire: Validity data in the general population and individuals with personality disorders. PLoS One 2023; 18:e0274378. [PMID: 37023214 PMCID: PMC10079014 DOI: 10.1371/journal.pone.0274378] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 08/26/2022] [Indexed: 04/08/2023] Open
Abstract
INTRODUCTION Mentalization or reflective functioning (RF) is the capacity to interpret oneself or the others in terms of internal mental states. Its failures have been linked to several mental disorders and interventions improving RF have a therapeutic effect. Mentalizing capacity of the parents influences the children's attachment. The Reflective Functioning Questionnaire (RFQ-8) is a widely used tool for the assessment of RF. No instrument is available to assess general RF in Spanish-speaking samples. The aim of this study is to develop a Spanish version of the RFQ-8 and to evaluate its reliability and validity in the general population and in individuals with personality disorders. METHODS 602 non-clinical and 41 personality disordered participants completed a Spanish translation of the RFQ and a battery of self-reported questionnaires assessing several RF related constructs (alexithymia, perspective taking, identity diffusion and mindfulness), psychopathology (general and specific) and interpersonal problems. Temporal stability was tested in a non-clinical sub-sample of 113 participants. RESULTS Exploratory and confirmatory factor analyses suggested a one-factor structure in the Spanish version of the RFQ-8. RFQ-8 understood as a single scale was tested, with low scorings reflecting genuine mentalizing, and high scorings uncertainty. The questionnaire showed good internal consistence in both samples and moderate temporal stability in non-clinical sample. RFQ correlated significantly with identity diffusion, alexithymia, and general psychopathology in both samples; and with mindfulness, perspective taking, and interpersonal problems in clinical sample. Mean values of the scale were significantly higher in the clinical group. DISCUSSION This study provides evidence that the Spanish version of the RFQ-8, understood as a single scale, has an adequate reliability and validity assessing failures in reflective functioning (i.e., hypomentalization) in general population and personality disorders.
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Affiliation(s)
- Eduardo Ruiz-Parra
- Department of Neurosciences, Faculty of Medicine and Nursing, University of the Basque Country, Bilbao, Spain
- Department of Psychiatry, Basurto University Hospital, Osakidetza Basque Health Service, Bilbao, Spain
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain
| | | | - Roberto Mediavilla
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry, School of Medicine, Autonomous University of Madrid (UAM), Madrid, Spain
- La Paz Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Beatriz Rodríguez-Vega
- Department of Psychiatry, School of Medicine, Autonomous University of Madrid (UAM), Madrid, Spain
- La Paz Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
- Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
| | - Guillermo Lahera
- Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
- Department of Psychiatry, Príncipe de Asturias University Hospital, Alcalá de Henares, Madrid, Spain
| | - Ana I. Moreno-Pérez
- Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
- Department of Psychiatry, Príncipe de Asturias University Hospital, Alcalá de Henares, Madrid, Spain
| | - Alberto M. Torres-Cantero
- Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain
- Department of Preventive Medicine, Virgen de la Arrixaca University Clinical Hospital, El Palmar, Murcia, Spain
| | - Juan Rodado-Martínez
- Department of Psychiatry, School of Medicine, University of Murcia, Murcia, Spain
- Department of Psychiatry, Reina Sofía University Hospital, Murcia, Spain
| | - Amaia Bilbao
- Research Unit, Basurto University Hospital, Osakidetza Basque Health Service, Bilbao, Bizkaia, Spain
- Health Service Research Network on Chronic Diseases (REDISSEC), Madrid, Spain
- Kronikgune Institute for Health Services Research, Barakaldo, Spain
| | - Miguel Ángel González-Torres
- Department of Neurosciences, Faculty of Medicine and Nursing, University of the Basque Country, Bilbao, Spain
- Department of Psychiatry, Basurto University Hospital, Osakidetza Basque Health Service, Bilbao, Spain
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain
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13
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Purgato M, Turrini G, Tedeschi F, Serra R, Tarsitani L, Compri B, Muriago G, Cadorin C, Ostuzzi G, Nicaise P, Lorant V, Sijbrandij M, Witteveen AB, Ayuso-Mateos JL, Mediavilla R, Haro JM, Felez-Nobrega M, Figueiredo N, Pollice G, McDaid D, Park AL, Kalisch R, Petri-Romão P, Underhill J, Bryant RA, Nosè M, Barbui C. Effectiveness of a stepped-care programme of WHO psychological interventions in migrant populations resettled in Italy: Study protocol for the RESPOND randomized controlled trial. Front Public Health 2023; 11:1100546. [PMID: 36761135 PMCID: PMC9905848 DOI: 10.3389/fpubh.2023.1100546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 01/06/2023] [Indexed: 01/26/2023] Open
Abstract
Introduction Migrant populations, including workers, undocumented migrants, asylum seekers, refugees, internationally displaced persons, and other populations on the move, are exposed to a variety of stressors and potentially traumatic events before, during, and after the migration process. In recent years, the COVID-19 pandemic has represented an additional stressor, especially for migrants on the move. As a consequence, migration may increase vulnerability of individuals toward a worsening of subjective wellbeing, quality of life, and mental health, which, in turn, may increase the risk of developing mental health conditions. Against this background, we designed a stepped-care programme consisting of two scalable psychological interventions developed by the World Health Organization and locally adapted for migrant populations. The effectiveness and cost-effectiveness of this stepped-care programme will be assessed in terms of mental health outcomes, resilience, wellbeing, and costs to healthcare systems. Methods and analysis We present the study protocol for a pragmatic randomized study with a parallel-group design that will enroll participants with a migrant background and elevated level of psychological distress. Participants will be randomized to care as usual only or to care a usual plus a guided self-help stress management guide (Doing What Matters in Times of Stress, DWM) and a five-session cognitive behavioral intervention (Problem Management Plus, PM+). Participants will self-report all measures at baseline before random allocation, 2 weeks after DWM delivery, 1 week after PM+ delivery and 2 months after PM+ delivery. All participants will receive a single-session of a support intervention, namely Psychological First Aid. We will include 212 participants. An intention-to-treat analysis using linear mixed models will be conducted to explore the programme's effect on anxiety and depression symptoms, as measured by the Patient Health Questionnaire-Anxiety and Depression Scale summary score 2 months after PM+ delivery. Secondary outcomes include post-traumatic stress disorder symptoms, resilience, quality of life, resource utilization, cost, and cost-effectiveness. Discussion This study is the first randomized controlled trial that combines two World Health Organization psychological interventions tailored for migrant populations with an elevated level of psychological distress. The present study will make available DWM/PM+ packages adapted for remote delivery following a task-shifting approach, and will generate evidence to inform policy responses based on a more efficient use of resources for improving resilience, wellbeing and mental health. Clinical trial registration ClinicalTrials.gov, identifier: NCT04993534.
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Affiliation(s)
- Marianna Purgato
- Department of Neuroscience, Biomedicine, and Movement Sciences, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | - Giulia Turrini
- Department of Neuroscience, Biomedicine, and Movement Sciences, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | - Federico Tedeschi
- Department of Neuroscience, Biomedicine, and Movement Sciences, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | - Riccardo Serra
- Department of Neuroscience, Biomedicine, and Movement Sciences, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Lorenzo Tarsitani
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Beatrice Compri
- Department of Neuroscience, Biomedicine, and Movement Sciences, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | - Giulia Muriago
- Department of Neuroscience, Biomedicine, and Movement Sciences, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | - Camilla Cadorin
- Department of Neuroscience, Biomedicine, and Movement Sciences, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | - Giovanni Ostuzzi
- Department of Neuroscience, Biomedicine, and Movement Sciences, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | - Pablo Nicaise
- Institute of Health and Society (IRSS) - UCLouvain, Brussels, Belgium
| | - Vincent Lorant
- Institute of Health and Society (IRSS) - UCLouvain, Brussels, Belgium
| | - Marit Sijbrandij
- Department of Clinical, Neuro- and Developmental Psychology, WHO Collaborating Center for Research and Dissemination of Psychological Interventions, VU University, Amsterdam, Netherlands
| | - Anke B. Witteveen
- Department of Clinical, Neuro- and Developmental Psychology, WHO Collaborating Center for Research and Dissemination of Psychological Interventions, VU University, Amsterdam, Netherlands
| | - José Luis Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry, La Princesa University Hospital, Instituto de Investigación Sanitaria La Princesa (IIS-Princesa), Madrid, Spain
| | - Roberto Mediavilla
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | - Josep Maria Haro
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - Mireia Felez-Nobrega
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - Natasha Figueiredo
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, ERES, Paris, France
| | - Giulia Pollice
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, ERES, Paris, France
| | - David McDaid
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - A-La Park
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - Raffael Kalisch
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
- Leibniz Institute for Resilience Research, Mainz, Germany
| | | | | | - Richard A. Bryant
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Michela Nosè
- Department of Neuroscience, Biomedicine, and Movement Sciences, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | - Corrado Barbui
- Department of Neuroscience, Biomedicine, and Movement Sciences, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
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Rocamora González C, Rodríguez Vega B, Torrijos Zarcero M, Mediavilla R, Bouzó Molina N, Plaza Fernández R, Pascual Migueláñez I, Palao Tarrero Á. Mindfulness based intervention through mobile app for colorectal cancer people awaiting surgery: A randomized clinical trial. Cir Esp 2022; 100:747-754. [PMID: 36064177 DOI: 10.1016/j.cireng.2022.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 10/15/2021] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Colorectal cancer is the third most common cancer worldwide both in men and women. Around one-third of patients with cancer will suffer from anxiety or depression symptoms. The aim of this study was to evaluate the effectiveness of a Mindfulness-based stress reduction intervention through a mobile application ("En Calma en el Quirófano"). METHOD This study is a multicenter, single-blind (evaluator), controlled, randomised trial that compares the effectiveness of a mindfulness training through a mobile application (intervention group) and treatment as usual (control group) in three different moments (T0 or baseline, T1 or hospital discharge and T2 or one month after surgery). Anxiety and depression symptoms (HADS), quality of life (WHOQOL), pain, (VAS) and satisfaction (CSQ) were assessed. RESULTS In all, there were 270 referred patients. Among them, 39 and 43 were assigned to the intervention and control groups respectively. 82 patients were analyzed: 39 patients used the app, and 43 patients continued with the treatment as usual. There were no significant changes between groups and time. We observed a slight trend in which intervention group had less depression and anxiety symptoms since T0 and T2 (B = -0.2; 95% CI between 8.8 and 9.2). CONCLUSIONS The sample of this study had a high mean age (65 years old), and low levels of anxiety and depression and medium levels of pre-surgery quality of life in baseline. These factors could have influenced limiting the effectiveness of the app. Prospective research lines should focus on evaluating the effectiveness of mobile applications for younger patients with surgical pathologies.
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Affiliation(s)
- Cristina Rocamora González
- Servicio de Psiquiatría, Psicología y Salud Mental, Hospital Universitario La Paz, Madrid, Spain; Instituto de Investigación de Salud, Hospital Universitario La Paz (IdiPaz), Madrid, Spain
| | - Beatriz Rodríguez Vega
- Servicio de Psiquiatría, Psicología y Salud Mental, Hospital Universitario La Paz, Madrid, Spain; Instituto de Investigación de Salud, Hospital Universitario La Paz (IdiPaz), Madrid, Spain; Departamento de Psiquiatría, Universidad Autónoma de Madrid, Madrid, Spain
| | - Marta Torrijos Zarcero
- Servicio de Psiquiatría, Psicología y Salud Mental, Hospital Universitario La Paz, Madrid, Spain; Instituto de Investigación de Salud, Hospital Universitario La Paz (IdiPaz), Madrid, Spain; Departamento de Psiquiatría, Universidad Autónoma de Madrid, Madrid, Spain.
| | - Roberto Mediavilla
- Departamento de Psiquiatría, Universidad Autónoma de Madrid, Madrid, Spain; Centro de Investigación Biomédica en Red (CIBERSAM), Madrid, Spain
| | - Nuria Bouzó Molina
- Servicio de Anestesia y Reanimación, Hospital Universitario 12 de Octubre, Madrid, Spain; Instituto de Investigación de Salud, Hospital Universitario 12 de Octubre (i+12), Madrid, Spain
| | - Rocío Plaza Fernández
- Servicio de Psiquiatría, Psicología y Salud Mental, Hospital Universitario La Paz, Madrid, Spain; Instituto de Investigación de Salud, Hospital Universitario La Paz (IdiPaz), Madrid, Spain
| | - Isabel Pascual Migueláñez
- Instituto de Investigación de Salud, Hospital Universitario La Paz (IdiPaz), Madrid, Spain; Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario La Paz, Madrid, Spain
| | - Ángela Palao Tarrero
- Servicio de Psiquiatría, Psicología y Salud Mental, Hospital Universitario La Paz, Madrid, Spain; Instituto de Investigación de Salud, Hospital Universitario La Paz (IdiPaz), Madrid, Spain; Departamento de Psiquiatría, Universidad Autónoma de Madrid, Madrid, Spain
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15
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Mediavilla R, Martínez-Alés G, Andreo-Jover J, Louzao-Rojas I, Cebolla-Lorenzo S, Muñoz-San-José A, Fernández-Jiménez E, Aguirre P, Luis Ayuso-Mateos J, Bravo-Ortiz MF, Bayón-Pérez C. Mental health service requirements after COVID-19 hospitalization: A 1-year follow-up cohort study using electronic health records. Rev Psiquiatr Salud Ment 2022; 16:S1888-9891(22)00108-2. [PMID: 36249883 PMCID: PMC9540701 DOI: 10.1016/j.rpsm.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Roberto Mediavilla
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Gonzalo Martínez-Alés
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United States
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
- CAUSALab, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jorge Andreo-Jover
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Iker Louzao-Rojas
- Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
| | - Susana Cebolla-Lorenzo
- Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
| | - Ainoa Muñoz-San-José
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
- Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
| | - Eduardo Fernández-Jiménez
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
- Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
| | - Pablo Aguirre
- Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
| | - José Luis Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry, La Princesa University Hospital, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
| | - María Fe Bravo-Ortiz
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
- Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
| | - Carmen Bayón-Pérez
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
- Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
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16
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Mediavilla R, McGreevy KR, Felez-Nobrega M, Monistrol-Mula A, Bravo-Ortiz MF, Bayón C, Rodríguez-Vega B, Nicaise P, Delaire A, Sijbrandij M, Witteveen AB, Purgato M, Barbui C, Tedeschi F, Melchior M, van der Waerden J, McDaid D, Park AL, Kalisch R, Petri-Romão P, Underhill J, Bryant RA, Haro JM, Ayuso-Mateos JL. Effectiveness of a stepped-care programme of internet-based psychological interventions for healthcare workers with psychological distress: Study protocol for the RESPOND healthcare workers randomised controlled trial. Digit Health 2022; 8:20552076221129084. [PMID: 36211795 PMCID: PMC9537484 DOI: 10.1177/20552076221129084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 09/11/2022] [Indexed: 11/05/2022] Open
Abstract
Background and aims The coronavirus disease 2019 pandemic has challenged health services worldwide, with a worsening of healthcare workers' mental health within initial pandemic hotspots. In early 2022, the Omicron variant is spreading rapidly around the world. This study explores the effectiveness and cost-effectiveness of a stepped-care programme of scalable, internet-based psychological interventions for distressed health workers on self-reported anxiety and depression symptoms. Methods We present the study protocol for a multicentre (two sites), parallel-group (1:1 allocation ratio), analyst-blinded, superiority, randomised controlled trial. Healthcare workers with psychological distress will be allocated either to care as usual only or to care as usual plus a stepped-care programme that includes two scalable psychological interventions developed by the World Health Organization: A guided self-help stress management guide (Doing What Matters in Times of Stress) and a five-session cognitive behavioural intervention (Problem Management Plus). All participants will receive a single-session emotional support intervention, namely psychological first aid. We will include 212 participants. An intention-to-treat analysis using linear mixed models will be conducted to explore the programme's effect on anxiety and depression symptoms, as measured by the Patient Health Questionnaire - Anxiety and Depression Scale summary score at 21 weeks from baseline. Secondary outcomes include post-traumatic stress disorder symptoms, resilience, quality of life, cost impact and cost-effectiveness. Conclusions This study is the first randomised trial that combines two World Health Organization psychological interventions tailored for health workers into one stepped-care programme. Results will inform occupational and mental health prevention, treatment, and recovery strategies. Registration details ClinicalTrials.gov Identifier: NCT04980326.
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Affiliation(s)
- Roberto Mediavilla
- Department of Psychiatry, Universidad Autónoma de Madrid
(UAM), Madrid, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM),
Instituto de Salud Carlos III, Madrid, Spain
| | - Kerry R McGreevy
- Department of Psychiatry, Universidad Autónoma de Madrid
(UAM), Madrid, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM),
Instituto de Salud Carlos III, Madrid, Spain,Kerry R. McGreevy, Department of
Psychiatry, Universidad Autónoma de Madrid, Arzobispo Morcillo, 4, 28029,
Madrid, Spain.
| | - Mireia Felez-Nobrega
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM),
Instituto de Salud Carlos III, Madrid, Spain,Research and Development Unit, Parc Sanitari Sant Joan de
Déu, Barcelona, Spain
| | - Anna Monistrol-Mula
- Research and Development Unit, Parc Sanitari Sant Joan de
Déu, Barcelona, Spain
| | - María-Fe Bravo-Ortiz
- Department of Psychiatry, Universidad Autónoma de Madrid
(UAM), Madrid, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM),
Instituto de Salud Carlos III, Madrid, Spain,Department of Psychiatry, Clinical Psychology and Mental Health,
Hospital Univeristario La Paz, Madrid, Spain,Instituto de Investigación del Hospital
Universitario La Paz (IdiPAZ), Madrid, Spain
| | - Carmen Bayón
- Department of Psychiatry, Universidad Autónoma de Madrid
(UAM), Madrid, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM),
Instituto de Salud Carlos III, Madrid, Spain,Department of Psychiatry, Clinical Psychology and Mental Health,
Hospital Univeristario La Paz, Madrid, Spain,Instituto de Investigación del Hospital
Universitario La Paz (IdiPAZ), Madrid, Spain
| | - Beatriz Rodríguez-Vega
- Department of Psychiatry, Universidad Autónoma de Madrid
(UAM), Madrid, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM),
Instituto de Salud Carlos III, Madrid, Spain,Department of Psychiatry, Clinical Psychology and Mental Health,
Hospital Univeristario La Paz, Madrid, Spain,Instituto de Investigación del Hospital
Universitario La Paz (IdiPAZ), Madrid, Spain
| | - Pablo Nicaise
- Institute of Health & Society (IRSS), Université Catholique de
Louvain, Brussels, Belgium
| | - Audrey Delaire
- Institute of Health & Society (IRSS), Université Catholique de
Louvain, Brussels, Belgium
| | - Marit Sijbrandij
- Clinical, Neuro- and Developmental Psychology, WHO Collaborating
Centre for Research and Dissemination of Psychological Interventions, Amsterdam
Public Health Institute, Vrije Universiteit
Amsterdam, Amsterdam, the Netherlands
| | - Anke B. Witteveen
- Clinical, Neuro- and Developmental Psychology, WHO Collaborating
Centre for Research and Dissemination of Psychological Interventions, Amsterdam
Public Health Institute, Vrije Universiteit
Amsterdam, Amsterdam, the Netherlands
| | - Marianna Purgato
- WHO Collaborating Centre for Research and Training in Mental Health
and Service Evaluation, Department of Neuroscience, Biomedicine, and Movement
Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Corrado Barbui
- WHO Collaborating Centre for Research and Training in Mental Health
and Service Evaluation, Department of Neuroscience, Biomedicine, and Movement
Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Federico Tedeschi
- WHO Collaborating Centre for Research and Training in Mental Health
and Service Evaluation, Department of Neuroscience, Biomedicine, and Movement
Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Maria Melchior
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé
Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Faculté de
Médecine St Antoine, , Paris, France
| | - Judith van der Waerden
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé
Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Faculté de
Médecine St Antoine, , Paris, France
| | - David McDaid
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political
Science, London, UK
| | - A-La Park
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political
Science, London, UK
| | - Raffael Kalisch
- Leibniz Institute for Resilience Research
(LIR), Mainz, Germany,Neuroimaging Center (NIC), Focus Program Translational Neuroscience
(FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | | | | | - Richard A. Bryant
- School of Psychology, University of New
South Wales, Sydney, NSW, Australia
| | - Josep Maria Haro
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM),
Instituto de Salud Carlos III, Madrid, Spain,Research and Development Unit, Parc Sanitari Sant Joan de
Déu, Barcelona, Spain
| | - José Luis Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid
(UAM), Madrid, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM),
Instituto de Salud Carlos III, Madrid, Spain,Department of Psychiatry, La Princesa University
Hospital, Instituto de Investigación Sanitaria Princesa (IIS-Princesa),
Madrid, Spain
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17
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Mediavilla R, Monistrol-Mula A, McGreevy KR, Felez-Nobrega M, Delaire A, Nicaise P, Palomo-Conti S, Bayón C, Bravo-Ortiz MF, Rodríguez-Vega B, Witteveen A, Sijbrandij M, Turrini G, Purgato M, Vuillermoz C, Melchior M, Petri-Romão P, Stoffers-Winterling J, Bryant RA, McDaid D, Park AL, Ayuso-Mateos JL. Mental health problems and needs of frontline healthcare workers during the COVID-19 pandemic in Spain: A qualitative analysis. Front Public Health 2022; 10:956403. [PMID: 35968478 PMCID: PMC9363705 DOI: 10.3389/fpubh.2022.956403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 07/04/2022] [Indexed: 11/13/2022] Open
Abstract
Background Healthcare workers (HCWs) from COVID-19 hotspots worldwide have reported poor mental health outcomes since the pandemic's beginning. The virulence of the initial COVID-19 surge in Spain and the urgency for rapid evidence constrained early studies in their capacity to inform mental health programs accurately. Here, we used a qualitative research design to describe relevant mental health problems among frontline HCWs and explore their association with determinants and consequences and their implications for the design and implementation of mental health programs. Materials and methods Following the Programme Design, Implementation, Monitoring, and Evaluation (DIME) protocol, we used a two-step qualitative research design to interview frontline HCWs, mental health experts, administrators, and service planners in Spain. We used Free List (FL) interviews to identify problems experienced by frontline HCWs and Key informant (KI) interviews to describe them and explore their determinants and consequences, as well as the strategies considered useful to overcome these problems. We used a thematic analysis approach to analyze the interview outputs and framed our results into a five-level social-ecological model (intrapersonal, interpersonal, organizational, community, and public health). Results We recruited 75 FL and 22 KI interviewees, roughly balanced in age and gender. We detected 56 themes during the FL interviews and explored the following themes in the KI interviews: fear of infection, psychological distress, stress, moral distress, and interpersonal conflicts among coworkers. We found that interviewees reported perceived causes and consequences across problems at all levels (intrapersonal to public health). Although several mental health strategies were implemented (especially at an intrapersonal and interpersonal level), most mental health needs remained unmet, especially at the organizational, community, and public policy levels. Conclusions In keeping with available quantitative evidence, our findings show that mental health problems are still relevant for frontline HCWs 1 year after the COVID-19 pandemic and that many reported causes of these problems are modifiable. Based on this, we offer specific recommendations to design and implement mental health strategies and recommend using transdiagnostic, low-intensity, scalable psychological interventions contextually adapted and tailored for HCWs.
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Affiliation(s)
- Roberto Mediavilla
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Instituto de Investigación del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | - Anna Monistrol-Mula
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - Kerry R. McGreevy
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Mireia Felez-Nobrega
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - Audrey Delaire
- Institute of Health and Society (IRSS), Université catholique de Louvain, Brussels, Belgium
| | - Pablo Nicaise
- Institute of Health and Society (IRSS), Université catholique de Louvain, Brussels, Belgium
| | | | - Carmen Bayón
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Instituto de Investigación del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
- Department of Psychiatry, Hospital Universitario La Paz, Madrid, Spain
| | - María-Fe Bravo-Ortiz
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Instituto de Investigación del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
- Department of Psychiatry, Hospital Universitario La Paz, Madrid, Spain
| | - Beatriz Rodríguez-Vega
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Instituto de Investigación del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
- Department of Psychiatry, Hospital Universitario La Paz, Madrid, Spain
| | - Anke Witteveen
- Department of Clinical, Neuro and Developmental Psychology, WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, Netherlands
| | - Marit Sijbrandij
- Department of Clinical, Neuro and Developmental Psychology, WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, Netherlands
| | - Giulia Turrini
- Department of Neurosciences, Biomedicine and Movement Sciences, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | - Marianna Purgato
- Department of Neurosciences, Biomedicine and Movement Sciences, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | - Cécile Vuillermoz
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, IPLESP, Research Team on Social Epidemiology, Paris, France
| | - Maria Melchior
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, IPLESP, Research Team on Social Epidemiology, Paris, France
| | | | | | - Richard A. Bryant
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - David McDaid
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - A-La Park
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - José Luis Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Psychiatry, La Princesa University Hospital, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
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18
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Mediavilla R, Fernández-Jiménez E, Martinez-Morata I, Jaramillo F, Andreo-Jover J, Morán-Sánchez I, Mascayano F, Moreno-Küstner B, Minué S, Ayuso-Mateos JL, Bryant RA, Bravo-Ortiz MF, Martínez-Alés G. Sustained Negative Mental Health Outcomes Among Healthcare Workers Over the First Year of the COVID-19 Pandemic: A Prospective Cohort Study. Int J Public Health 2022; 67:1604553. [PMID: 35814735 PMCID: PMC9266625 DOI: 10.3389/ijph.2022.1604553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 05/31/2022] [Indexed: 12/03/2022] Open
Abstract
Objective: To characterize the evolution of healthcare workers' mental health status over the 1-year period following the initial COVID-19 pandemic outbreak and to examine baseline characteristics associated with resolution or persistence of mental health problems over time. Methods: We conducted an 8-month follow-up cohort study. Eligible participants were healthcare workers working in Spain. Baseline data were collected during the initial pandemic outbreak. Survey-based self-reported measures included COVID-19-related exposures, sociodemographic characteristics, and three mental health outcomes (psychological distress, depression symptoms, and posttraumatic stress disorder symptoms). We examined three longitudinal trajectories in mental health outcomes between baseline and follow-up assessments (namely asymptomatic/stable, recovering, and persistently symptomatic/worsening). Results: We recruited 1,807 participants. Between baseline and follow-up assessments, the proportion of respondents screening positive for psychological distress and probable depression decreased, respectively, from 74% to 56% and from 28% to 21%. Two-thirds remained asymptomatic/stable in terms of depression symptoms and 56% remained symptomatic or worsened over time in terms of psychological distress. Conclusion: Poor mental health outcomes among healthcare workers persisted over time. Occupational programs and mental health strategies should be put in place.
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Affiliation(s)
- Roberto Mediavilla
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- University Hospital La Paz Research Institute (IdiPAZ), Madrid, Spain
| | - Eduardo Fernández-Jiménez
- University Hospital La Paz Research Institute (IdiPAZ), Madrid, Spain
- University Hospital La Paz, La Paz, Spain
| | - Irene Martinez-Morata
- Mailman School of Public Health, Columbia University, New York City, NY, United States
- Murcia BioHealth Research Institute, University of Murcia, Murcia, Spain
| | - Fabiola Jaramillo
- Andalusian School of Public Health, Granada, Spain
- University of Chile, Santiago, Chile
| | - Jorge Andreo-Jover
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- University Hospital La Paz Research Institute (IdiPAZ), Madrid, Spain
| | - Inés Morán-Sánchez
- Murcia BioHealth Research Institute, University of Murcia, Murcia, Spain
| | - Franco Mascayano
- Mailman School of Public Health, Columbia University, New York City, NY, United States
- New York State Psychiatric Institute (NYSPI), New York City, NY, United States
| | - Berta Moreno-Küstner
- Department of Personality, Assessment, and Psychological Treatment, University of Malaga, Málaga, Spain
- Instituto de Investigaciones Biomédicas de Málaga, Universidad de Málaga, Málaga, Spain
| | - Sergio Minué
- Andalusian School of Public Health, Granada, Spain
| | - José Luis Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Fundación Biomédica, Hospital de La Princesa, Madrid, Spain
| | - Richard A. Bryant
- School of Psychology, University of New South Wales, Kensington, NSW, Australia
| | - María-Fe Bravo-Ortiz
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- University Hospital La Paz Research Institute (IdiPAZ), Madrid, Spain
- University Hospital La Paz, La Paz, Spain
| | - Gonzalo Martínez-Alés
- University Hospital La Paz Research Institute (IdiPAZ), Madrid, Spain
- Mailman School of Public Health, Columbia University, New York City, NY, United States
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Vidal-Villegas M, Andreo Jover J, Mediavilla R, Muñoz-Sanjosé A, Rodríguez-Vega B, Bayón-Pérez C, Palao Tarrero Á, Bravo-Ortiz M. Paralization and online adaptation of an ongoing clinical trial in La Paz University Hospital (Madrid, Spain) during the COVID-19 worldwide pandemic. Eur Psychiatry 2022. [PMCID: PMC9566209 DOI: 10.1192/j.eurpsy.2022.1582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Spain went into lockdown in March of 2020 due to the COVID-19 outbreak. We had to stop the third randomization of our ongoing clinical trial (Mediavilla et al., 2019), pausing weekly group psychotherapy for 12 people with a first episode of psychosis. Only 5 weekly sessions had been delivered, thus many were just starting to form a therapeutic link with the group. In a public health emergency context, psychotherapeutic groups are considered avoidable gatherings. However, stopping psychological therapy abruptly can make participants more vulnerable. The intervention groups were launched in an online format because we could not let anyone go without psychological support in such a difficult time. Objectives Communicate how we adapted an ongoing clinical trial to an online format during the lockdown in Spain. Methods In light of our participants’ needs and their acute deterioration the first two weeks of lockdown, we adapted our intervention. First, both arms (mindfulness-based v. psychoeducational multicomponent intervention) began online adaptations of the interventions. Second, a research assistant made weekly phone calls to provide basic psychosocial support, assure participants groups would continue, and later remind them of each online session. Third and last, the phoneline was accessible 24/7 (WhatsApp). Results The third randomization concluded in December. Six participants were lost in the transition to online groups. However, adherence was comparable to the previous two randomizations (4/12 completed the intervention). Conclusions Online psychotherapy may be used in emergencies such as a lockdown. However, the psychological mid- and long-term effects of a lockdown and online group therapy remain unknown. Disclosure No significant relationships.
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Andreo Jover J, Vidal-Villegas M, Mediavilla R, Louzao Rojas I, Cebolla Lorenzo S, Fernández Jiménez E, Muñoz-Sanjosé A, Bravo-Ortiz M, Martinez-Ales G, Bayón-Pérez C. Mental health service requirements after hospitalization due to COVID-19: a 1- year follow-up study. Eur Psychiatry 2022. [PMCID: PMC9564941 DOI: 10.1192/j.eurpsy.2022.966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Long-term COVID-19 effects has been recently described as persistent and prolonged symptoms after an acute and severe SARS-COV-2 (1). An important concern is that the sequelae of severe COVID-19 may suppose a substantial outpatient 's burden for the specialized services in reopening pandemic phase (2). Objectives To describe the frequency of mental health service use in COVID-19 hospitalized patients after discharge and to estimate the costs associated to the post- discharge consultations. Methods We used a 1-year follow-up cohort of 1455 COVID-19 inpatients hospitalized in La Paz University Hospital of Madrid, Spain between March 16th and April 15th, 2020. Data were retrieved from Psychiatry Service (PS) electronic health records and we described the frequency of mental health reason for consultation. We used information published by the Madrid health Office to estimate the cost of initial and following appointments. Results Our sample consisted of 1,455 patients admitted with a COVID-19 diagnosis between March 16th and April 15th, 2020, and then discharged. Roughly half of them were men (776, 53%), 238 (16%) had a prior history of mental health problems, and 44 (3%) died. 193 participants (13%) visited the mental health department after being discharged. The total cost was estimated in 103,581 USD, of which two-thirds corresponded to patients with prior history of mental health problems. Conclusions Our results indicate that the mental health burden of severe COVID-19 inpatient s after discharge was substantial during the first year of follow-up. This generate important economic impact to mental health providers and society at large. Disclosure No significant relationships.
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21
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Martínez-Alés G, Fernández-Jiménez E, Mediavilla R, Quintana-Díaz M, Louzao I, Cebolla S, Muñoz-Sanjosé A, Bayón C, Susser ES, Bravo-Ortiz MF. Role of medical comorbidity in the association between psychiatric disorders and mortality among patients with COVID-19. Soc Psychiatry Psychiatr Epidemiol 2022; 57:1727-1730. [PMID: 35322285 PMCID: PMC8942759 DOI: 10.1007/s00127-022-02271-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 03/08/2022] [Indexed: 11/30/2022]
Abstract
We examined whether excess chronic medical comorbidity mediated excess COVID-19 inpatient mortality among people with mental disorders in the early phase of the pandemic, a question with important implications for public health and clinical decision-making. Using records of 2599 COVID-19 hospitalized patients, we conducted a formal causal mediation analysis to estimate the extent to which chronic comorbidity mediates the association between mental disorders and COVID-19 mortality. The Odds Ratio (95% CI) for Natural Indirect Effect and Controlled Direct Effect were 1.07(1.02, 1.14) and 1.40 (1.00, 1.95), respectively, suggesting that a large proportion of excess COVID-19 mortality among people with mental disorders may be explained by factors other than comorbidity.
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Affiliation(s)
- Gonzalo Martínez-Alés
- Harvard University T.H. Chan School of Public Health, Boston, MA, USA. .,Columbia University Mailman School of Public Health, New York, NY, USA. .,Mental Health Network Biomedical Research Center (CIBERSAM), Madrid, Spain. .,Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain. .,CAUSALab, Harvard University T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.
| | - Eduardo Fernández-Jiménez
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain ,La Paz University Hospital, Madrid, Spain
| | - Roberto Mediavilla
- Mental Health Network Biomedical Research Center (CIBERSAM), Madrid, Spain ,Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain ,La Paz University Hospital, Madrid, Spain ,Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | | | | | | | - Ainoa Muñoz-Sanjosé
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain ,La Paz University Hospital, Madrid, Spain
| | - Carmen Bayón
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain ,La Paz University Hospital, Madrid, Spain ,Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - Ezra S. Susser
- Columbia University Mailman School of Public Health, New York, NY USA ,New York Psychiatric Institute, New York, NY USA
| | - María Fe Bravo-Ortiz
- Mental Health Network Biomedical Research Center (CIBERSAM), Madrid, Spain ,Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain ,La Paz University Hospital, Madrid, Spain ,Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
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22
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Mascayano F, van der Ven E, Moro MF, Schilling S, Alarcón S, Al Barathie J, Alnasser L, Asaoka H, Ayinde O, Balalian AA, Basagoitia A, Brittain K, Dohrenwend B, Durand-Arias S, Eskin M, Fernández-Jiménez E, Freytes Frey MI, Giménez L, Gisle L, Hoek HW, Jaldo RE, Lindert J, Maldonado H, Martínez-Alés G, Martínez-Viciana C, Mediavilla R, McCormack C, Myer L, Narvaez J, Nishi D, Ouali U, Puac-Polanco V, Ramírez J, Restrepo-Henao A, Rivera-Segarra E, Rodríguez AM, Saab D, Seblova D, Tenorio Correia da Silva A, Valeri L, Alvarado R, Susser E. The impact of the COVID-19 pandemic on the mental health of healthcare workers: study protocol for the COVID-19 HEalth caRe wOrkErS (HEROES) study. Soc Psychiatry Psychiatr Epidemiol 2022; 57:633-645. [PMID: 35064280 PMCID: PMC8782684 DOI: 10.1007/s00127-021-02211-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 12/05/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Preliminary country-specific reports suggest that the COVID-19 pandemic has a negative impact on the mental health of the healthcare workforce. In this paper, we summarize the protocol of the COVID-19 HEalth caRe wOrkErS (HEROES) study, an ongoing, global initiative, aimed to describe and track longitudinal trajectories of mental health symptoms and disorders among health care workers at different phases of the pandemic across a wide range of countries in Latin America, Europe, Africa, Middle-East, and Asia. METHODS Participants from various settings, including primary care clinics, hospitals, nursing homes, and mental health facilities, are being enrolled. In 26 countries, we are using a similar study design with harmonized measures to capture data on COVID-19 related exposures and variables of interest during two years of follow-up. Exposures include potential stressors related to working in healthcare during the COVID-19 pandemic, as well as sociodemographic and clinical factors. Primary outcomes of interest include mental health variables such as psychological distress, depressive symptoms, and posttraumatic stress disorders. Other domains of interest include potentially mediating or moderating influences such as workplace conditions, trust in the government, and the country's income level. RESULTS As of August 2021, ~ 34,000 health workers have been recruited. A general characterization of the recruited samples by sociodemographic and workplace variables is presented. Most participating countries have identified several health facilities where they can identify denominators and attain acceptable response rates. Of the 26 countries, 22 are collecting data and 2 plan to start shortly. CONCLUSIONS This is one of the most extensive global studies on the mental health of healthcare workers during the COVID-19 pandemic, including a variety of countries with diverse economic realities and different levels of severity of pandemic and management. Moreover, unlike most previous studies, we included workers (clinical and non-clinical staff) in a wide range of settings.
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Affiliation(s)
- Franco Mascayano
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
- New York State Psychiatric Institute, New York, NY, USA.
| | - Els van der Ven
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Maria Francesca Moro
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
- Università degli Studi di Cagliari, Cagliari, Italy
| | - Sara Schilling
- School of Public Health, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Sebastián Alarcón
- School of Public Health, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Josleen Al Barathie
- Institute for Development Research Advocacy and Applied Care, Beirut, Lebanon
| | - Lubna Alnasser
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
- Population Health Department, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Hiroki Asaoka
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Olatunde Ayinde
- Department of Psychiatry, University College Hospital, Ibadan, Nigeria
| | - Arin A Balalian
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | | | - Kirsty Brittain
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Bruce Dohrenwend
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Sol Durand-Arias
- Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Mehmet Eskin
- Department of Psychology, Koc University, Istanbul, Turkey
| | - Eduardo Fernández-Jiménez
- Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
| | | | - Luis Giménez
- Instituto de Psicología de la Salud, Facultad de Psicología, Universidad de la República, Montevideo, Uruguay
| | - Lydia Gisle
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Hans W Hoek
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
- Department of Psychiatry, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | | | - Jutta Lindert
- University of Applied Sciences Emden/Leer, Emden, Germany
| | | | - Gonzalo Martínez-Alés
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
- Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
- Centro de Investigación Biomédica en Red (CIBERSAM), Madrid, Spain
| | | | - Roberto Mediavilla
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Centro de Investigación Biomédica en Red (CIBERSAM), Madrid, Spain
| | - Clare McCormack
- Center for Science and Society, Columbia University, New York, NY, USA
| | - Landon Myer
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | | | - Daisuke Nishi
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Uta Ouali
- Psychiatry Department A, Razi Hospital, Tunis, Tunisia
| | - Victor Puac-Polanco
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
- Facultad de Ciencias Médicas, Universidad de San Carlos de Guatemala, Guatemala City, Guatemala
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Jorge Ramírez
- School of Public Health, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Alexandra Restrepo-Henao
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
- Epidemiology Group, Universidad de Antioquia, Medellín, Colombia
| | - Eliut Rivera-Segarra
- School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce, Puerto Rico
| | - Ana M Rodríguez
- Instituto Altos Estudios Dr Arnoldo Gabaldon, Caracas, Venezuela
| | - Dahlia Saab
- Institute for Development Research Advocacy and Applied Care, Beirut, Lebanon
| | - Dominika Seblova
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, The Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, Brazil
| | - Andrea Tenorio Correia da Silva
- Department of Family Medicine, Faculdade Santa Marcelina, São Paulo, Brazil
- Department of Public Health, Faculdade de Medicina de Jundiaí, São Paulo, Brazil
| | - Linda Valeri
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Rubén Alvarado
- School of Public Health, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Ezra Susser
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
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Fernández-Jiménez E, Muñoz-Sanjose A, Mediavilla R, Martínez-Alés G, Louzao II, Andreo J, Cebolla S, Bravo-Ortiz MF, Bayón C. Prospective Analysis Between Neutrophil-to-Lymphocyte Ratio on Admission and Development of Delirium Among Older Hospitalized Patients With COVID-19. Front Aging Neurosci 2021; 13:764334. [PMID: 34887744 PMCID: PMC8650500 DOI: 10.3389/fnagi.2021.764334] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 11/01/2021] [Indexed: 12/23/2022] Open
Abstract
Objective: To examine any prospective association between neutrophil-to-lymphocyte ratio (NLR) at hospital admission and subsequent delirium in older COVID-19 hospitalized patients comparing by sex and age groups. Methods: The sample consisted of 1,785 COVID-19 adult inpatients (minimum sample size required of 635 participants) admitted to a public general hospital in Madrid (Spain) between March 16th and April 15th, 2020. Variables were obtained from electronic health records. Binary logistic regression models were performed between baseline NLR and delirium adjusting for age, sex, medical comorbidity, current illness severity, serious mental illness history and use of chloroquine and dexamethasone. An NLR cut-off was identified, and stratified analyses were performed by age and sex. Also, another biomarker was tested as an exposure (the systemic immune-inflammation index -SII). Results: 55.3% of the patients were men, with a mean age of 66.8 years. Roughly 13% of the patients had delirium during hospitalization. NLR on admission predicted subsequent delirium development (adjusted OR = 1.02, 95 percent CI: 1.00-1.04, p = 0.024). Patients between 69 and 80 years with NLR values > 6.3 presented a twofold increased risk for delirium (p = 0.004). There were no sex differences in the association between baseline NLR and delirium (p > 0.05) nor SII predicted delirium development (p = 0.341). Conclusion: NLR is a good predictor of delirium during hospitalization, especially among older adults, independently of medical comorbidity, illness severity, and other covariates. Routine blood tests on admission might provide valuable information to guide the decision-making process to be followed with these especially vulnerable patients.
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Affiliation(s)
- Eduardo Fernández-Jiménez
- Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain.,Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Ainoa Muñoz-Sanjose
- Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain.,Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Roberto Mediavilla
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain.,Centro de Investigación Biomédica en Red (CIBERSAM), Madrid, Spain
| | - Gonzalo Martínez-Alés
- Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain.,Centro de Investigación Biomédica en Red (CIBERSAM), Madrid, Spain.,Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United States
| | - Iker I Louzao
- Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
| | - Jorge Andreo
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Susana Cebolla
- Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain.,Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - María-Fe Bravo-Ortiz
- Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain.,Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain.,Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain.,Centro de Investigación Biomédica en Red (CIBERSAM), Madrid, Spain
| | - Carmen Bayón
- Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain.,Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain.,Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
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Orosa-Duarte Á, Mediavilla R, Bayón C. Response to Ms. Babu. Med Teach 2021; 43:1460. [PMID: 33970750 DOI: 10.1080/0142159x.2021.1921921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Álvaro Orosa-Duarte
- Psychiatry, Clinical Psychology and Mental Health Department, La Paz University Hospital, Madrid, Spain
- Psychiatry Department, Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain
| | - Roberto Mediavilla
- Psychiatry Department, Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Carmen Bayón
- Psychiatry, Clinical Psychology and Mental Health Department, La Paz University Hospital, Madrid, Spain
- Psychiatry Department, Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain
- Psychiatry, Clinical Psychology and Mental Health Area, La Paz University Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
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25
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Mediavilla R, Fernández-Jiménez E, Martínez-Alés G, Moreno-Küstner B, Martínez-Morata I, Jaramillo F, Morán-Sánchez I, Minué S, Torres-Cantero A, Alvarado R, Ayuso-Mateos JL, Mascayano F, Susser E, Bravo-Ortiz MF. Role of access to personal protective equipment, treatment prioritization decisions, and changes in job functions on health workers' mental health outcomes during the initial outbreak of the COVID-19 pandemic. J Affect Disord 2021; 295:405-409. [PMID: 34507219 PMCID: PMC8403068 DOI: 10.1016/j.jad.2021.08.059] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 08/21/2021] [Accepted: 08/24/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND During the initial COVID-19 outbreak, organizational changes were required to ensure adequate staffing in healthcare facilities. The extent to which organizational changes impacted the mental wellbeing of healthcare workers (HCWs) remains unexplored. Here we analyzed the association between three work-related stressors (reported access to protective equipment, change in job functions, and patient prioritization decision-making) and mental health outcomes (depression symptoms, psychological distress, suicidal thoughts, and fear of infection) in a large sample of Spanish HCWs during the initial COVID-19 outbreak. METHODS We conducted a cross-sectional study including HCWs from three regions of Spain between April 24th and June 22nd, 2020. An online survey measured sociodemographic characteristics, work-related stressors, fear of infection, and mental health outcomes (depression [PHQ-9], psychological distress [GHQ-12], death wishes [C-SSRS]). We conducted mixed-effects regression models to adjust all associations for relevant individual- and region-level sources of confounding. RESULTS We recruited 2,370 HCWs. Twenty-seven percent screened positive for depression and 74% for psychological distress. Seven percent reported death wishes. Respondents were more afraid of infecting their loved ones than of getting infected themselves. All work-related stressors were associated with depression symptoms and psychological distress in adjusted models. LIMITATIONS Non-probabilistic sampling, potential reverse causation. CONCLUSIONS Modifiable work-related stressors are associated with worse mental health among HCWs. Our results suggest that workplace prevention strategies for HCWs should provide sufficient protective equipment, minimize changes in job functions, favor the implementation of criteria for patient triage and on-call bioethics committees, and facilitate access to stepped-care, evidence-based mental health treatment.
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Affiliation(s)
- Roberto Mediavilla
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain,Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Eduardo Fernández-Jiménez
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain,Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
| | - Gonzalo Martínez-Alés
- Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain; Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United States; Institute of Health Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain.
| | - Berta Moreno-Küstner
- Department of Personality, Assessment and Psychological Treatment, University of Malaga, Malaga, Spain,Andalusian Group of Psychosocial Research (GAP), Andalusia, Spain,Biomedical Research Institute of Malaga (IBIMA), Malaga, Spain
| | - Irene Martínez-Morata
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, United States,Institute for Biomedical Research of Murcia (IMIB-Arrixaca), Murcia, Spain
| | - Fabiola Jaramillo
- Andalusian School of Public Health, Andalusia, Spain,Program of Mental Health, Universidad de Chile, Santiago de Chile, Chile
| | - Inés Morán-Sánchez
- Institute for Biomedical Research of Murcia (IMIB-Arrixaca), Murcia, Spain,Cartagena Mental Health Centre, Health Service of Murcia, Murcia, Spain
| | - Sergio Minué
- Andalusian School of Public Health, Andalusia, Spain
| | - Alberto Torres-Cantero
- Institute for Biomedical Research of Murcia (IMIB-Arrixaca), Murcia, Spain,Department of Preventive Medicine, Virgen de la Arrixaca Hospital, Murcia, Spain
| | - Rubén Alvarado
- Program of Mental Health, Universidad de Chile, Santiago de Chile, Chile
| | - José Luis Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain,Institute of Health Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain,Department of Psychiatry, La Princesa University Hospital, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
| | - Franco Mascayano
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United States,New York State Psychiatric Institute, New York, NY, United States
| | - Ezra Susser
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United States,New York State Psychiatric Institute, New York, NY, United States
| | - María-Fe Bravo-Ortiz
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain,Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain,Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain,Institute of Health Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
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26
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Mediavilla R, Muñoz-Sanjose A, Rodriguez-Vega B, Lahera G, Palao A, Bayon C, Vidal-Villegas MP, Chadwick P, Bravo-Ortiz MF. People with psychosis improve affective social cognition and self-care after a mindfulness-based social cognition training program (SocialMIND). Psychiatr Rehabil J 2021; 44:391-395. [PMID: 33570983 DOI: 10.1037/prj0000466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study explores whether social cognition and social functioning improve after a mindfulness-based social cognition training (SocialMIND). METHODS Thirty-eight outpatients with psychosis completed an assessment with social cognition (Eyes Test, Ambiguous Intentions and Hostility Questionnaire [AIHQ], and Hinting Task) and social functioning tasks (Personal and Social Performance [PSP] scale) before and after eight SocialMIND weekly sessions. Mean differences between timepoints were standardized and 95% confidence intervals were obtained with a paired samples t-test. RESULTS The scores of the Eyes Test (95% CI [.43, 3.32], d = .48), the Hostility Bias subscale (AIHQ) (95% CI [-.29, -.01], d = .44), and the self-care difficulties subscale (PSP) (95% CI [-.77, -.09], d = .45) improved after the intervention. CONCLUSIONS and Implications for practice: The results of SocialMIND-8 are very promising in terms of developing comprehensive rehabilitation programs. Further trials must address its effectiveness against a control group during longer follow-up periods. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Roberto Mediavilla
- Hospital La Paz Institute for Health Research (IdiPAZ), Neuroscience Research Area
| | - Ainoa Muñoz-Sanjose
- Hospital La Paz Institute for Health Research (IdiPAZ), Neuroscience Research Area
| | | | | | - Angela Palao
- Hospital La Paz Institute for Health Research (IdiPAZ), Neuroscience Research Area
| | - Carmen Bayon
- Hospital La Paz Institute for Health Research (IdiPAZ), Neuroscience Research Area
| | | | | | - Maria-Fe Bravo-Ortiz
- Hospital La Paz Institute for Health Research (IdiPAZ), Neuroscience Research Area
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Rocamora González C, Rodríguez Vega B, Torrijos Zarcero M, Mediavilla R, Bouzó Molina N, Plaza Fernández R, Pascual Migueláñez I, Palao Tarrero Á. Intervención basada en mindfulness a través de una app móvil para personas con cáncer colorrectal en espera de cirugía: ensayo clínico aleatorizado. Cir Esp 2021. [DOI: 10.1016/j.ciresp.2021.10.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Mediavilla R, López-Arroyo M, Gómez-Arnau J, Wiesepape C, Lysaker PH, Lahera G. Autobiographical memory in schizophrenia: The role of metacognition. Compr Psychiatry 2021; 109:152254. [PMID: 34174693 DOI: 10.1016/j.comppsych.2021.152254] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 05/11/2021] [Accepted: 06/03/2021] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND Autobiographical memory is an important component of declarative memory, which refers to the ability to recall personal events that happened in the past. This requires that the person senses or experiences himself/herself in the past (i.e., conscious recollection). For people with schizophrenia, conscious recollection can be particularly difficult, resulting in difficulty accessing detailed, specific autobiographical information. Our hypothesis is that the ability to monitor and think about one's cognitive processes (metacognition) is a requisite for conscious recollection, and that it mediates the association between having schizophrenia and recalling fewer specific, personal memories. METHODS Participants were 30 adults with schizophrenia and 30 matched healthy controls. The main assessment instruments were the Metacognition Assessment Scale-Abbreviated (MAS-A) and the Autobiographical Memory Test (AMT). Severity of symptoms was assessed using the Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Cognitive performance was measured with the Screen for Cognitive Impairment in Psychiatry (SCIP). Mediation analysis was conducted following Baron and Kenny's procedure. RESULTS People with schizophrenia had more semantic associations and fewer specific memories than controls in the AMT. Metacognition (MAS-A total score) partially mediated the association between having schizophrenia and recalling fewer specific past events, even after controlling for cognitive impairment as a potential confounding source. CONCLUSIONS Metacognitive ability, which can be improved with available programs, intervenes in the process of accessing autobiographical memories in people with schizophrenia. Practical implications of this finding are discussed.
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Affiliation(s)
- Roberto Mediavilla
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Spain; Mental Health Networking Biomedical Research Centre (CIBERSAM), Madrid, Spain
| | | | | | - Courtney Wiesepape
- Richard L Roudebush VA Medical Center, Department of Psychiatry, Indianapolis, IN, United States
| | - Paul H Lysaker
- Richard L Roudebush VA Medical Center, Department of Psychiatry, Indianapolis, IN, United States; Indiana University School of Medicine, Department of Psychiatry, Indianapolis, IN, United States
| | - Guillermo Lahera
- University of Alcala, IRyCIS, Alcala de Henares, Spain; Principe de Asturias University Hospital, Alcalá de Henares, Spain; Mental Health Networking Biomedical Research Centre (CIBERSAM), Madrid, Spain.
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Ayuso-Mateos JL, Mediavilla R, Rodriguez KR, Bravo MF. Informing the response to COVID-19 in Spain: priorities for mental health research. Rev Psiquiatr Salud Ment (Engl Ed) 2021; 14:79-82. [PMID: 33992223 PMCID: PMC8114090 DOI: 10.1016/j.rpsm.2021.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 04/13/2021] [Indexed: 01/01/2023]
Affiliation(s)
- J L Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Spain; Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa),, Madrid, Spain.
| | - R Mediavilla
- Department of Psychiatry, Universidad Autónoma de Madrid, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Spain; Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - K R Rodriguez
- Department of Psychiatry, Universidad Autónoma de Madrid, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Spain
| | - M F Bravo
- Department of Psychiatry, Universidad Autónoma de Madrid, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Spain; Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Department of Psychiatry, Clinical Psychology and Mental Health, Hospital Universitario La Paz, Madrid, Spain
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Orosa-Duarte Á, Mediavilla R, Muñoz-Sanjose A, Palao Á, Garde J, López-Herrero V, Bravo-Ortiz MF, Bayón C, Rodríguez-Vega B. Mindfulness-based mobile app reduces anxiety and increases self-compassion in healthcare students: A randomised controlled trial. Med Teach 2021; 43:686-693. [PMID: 33645416 DOI: 10.1080/0142159x.2021.1887835] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To compare the effect of a mindfulness-based mobile application versus an in-person mindfulness-based training program in terms of reducing anxiety and increasing empathy, self-compassion, and mindfulness in a population of healthcare students. METHODS The authors conducted a single-blind, randomised controlled trial with three parallel groups. Participants were allocated to the mobile app, the in-person mindfulness-based program (IMBP), or a control group. Assessments at baseline and postintervention (8 weeks) included measures of anxiety, empathy, self-compassion, and mindfulness. RESULTS Of 168 students randomised, 84 were analysed on an intention-to-treat basis (app: n = 31; IMBP: n = 23; control: n = 30). The mobile app group showed a large effect size for reductions in trait anxiety compared with controls (g = 0.85, p = 0.003), and a medium, nonsignificant effect compared with the IMBP group (g = 0.52, p = 0.152). Participants from both interventions experienced a significant increase in self-compassion and mindfulness compared with controls. Levels of empathy remained unchanged for the 3 arms. CONCLUSIONS A mobile app can be as effective as an IMBP in reducing anxiety and increasing self-compassion and mindfulness among healthcare students.
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Affiliation(s)
- Álvaro Orosa-Duarte
- Psychiatry, Clinical Psychology and Mental Health Department, La Paz University Hospital, Madrid, Spain
- Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain
| | - Roberto Mediavilla
- Psychiatry, Clinical Psychology and Mental Health Area, La Paz University Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
- Faculty of Psychology, National University of Distance Education (UNED), Madrid, Spain
| | - Ainoa Muñoz-Sanjose
- Psychiatry, Clinical Psychology and Mental Health Department, La Paz University Hospital, Madrid, Spain
- Psychiatry, Clinical Psychology and Mental Health Area, La Paz University Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Ángela Palao
- Psychiatry, Clinical Psychology and Mental Health Department, La Paz University Hospital, Madrid, Spain
- Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain
- Psychiatry, Clinical Psychology and Mental Health Area, La Paz University Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Joaquín Garde
- Psychiatry, Clinical Psychology and Mental Health Department, La Paz University Hospital, Madrid, Spain
- Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain
| | | | - María-Fe Bravo-Ortiz
- Psychiatry, Clinical Psychology and Mental Health Department, La Paz University Hospital, Madrid, Spain
- Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain
- Psychiatry, Clinical Psychology and Mental Health Area, La Paz University Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Carmen Bayón
- Psychiatry, Clinical Psychology and Mental Health Department, La Paz University Hospital, Madrid, Spain
- Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain
- Psychiatry, Clinical Psychology and Mental Health Area, La Paz University Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Beatriz Rodríguez-Vega
- Psychiatry, Clinical Psychology and Mental Health Department, La Paz University Hospital, Madrid, Spain
- Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain
- Psychiatry, Clinical Psychology and Mental Health Area, La Paz University Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
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Ayuso-Mateos JL, Mediavilla R, Rodriguez KR, Bravo MF. Informing the response to COVID-19 in Spain: priorities for mental health research. Rev Psiquiatr Salud Ment (Engl Ed) 2021; 14:79-82. [PMID: 34127209 PMCID: PMC8193968 DOI: 10.1016/j.rpsmen.2021.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 04/13/2021] [Indexed: 01/12/2023]
Affiliation(s)
- J L Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Spain; Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa),, Madrid, Spain.
| | - R Mediavilla
- Department of Psychiatry, Universidad Autónoma de Madrid, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Spain; Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - K R Rodriguez
- Department of Psychiatry, Universidad Autónoma de Madrid, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Spain
| | - M F Bravo
- Department of Psychiatry, Universidad Autónoma de Madrid, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Spain; Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Department of Psychiatry, Clinical Psychology and Mental Health, Hospital Universitario La Paz, Madrid, Spain
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Torrijos‐Zarcero M, Mediavilla R, Rodríguez‐Vega B, Del Río‐Diéguez M, López‐Álvarez I, Rocamora‐González C, Palao‐Tarrero Á. Mindful Self‐Compassion program for chronic pain patients: A randomized controlled trial. Eur J Pain 2021; 25:930-944. [DOI: 10.1002/ejp.1734] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 12/29/2020] [Accepted: 01/16/2021] [Indexed: 01/15/2023]
Affiliation(s)
- Marta Torrijos‐Zarcero
- Psychiatry, Clinical Psychology and Mental Health Department La Paz University Hospital Madrid Spain
- La Paz Hospital Institute for Health Research (IdiPAZ) Madrid Spain
| | | | - Beatriz Rodríguez‐Vega
- Psychiatry, Clinical Psychology and Mental Health Department La Paz University Hospital Madrid Spain
- La Paz Hospital Institute for Health Research (IdiPAZ) Madrid Spain
- Autonomous University of Madrid (UAM) Madrid Spain
| | | | - Inés López‐Álvarez
- Psychiatry, Clinical Psychology and Mental Health Department La Paz University Hospital Madrid Spain
- La Paz Hospital Institute for Health Research (IdiPAZ) Madrid Spain
| | - Cristina Rocamora‐González
- Psychiatry, Clinical Psychology and Mental Health Department La Paz University Hospital Madrid Spain
- La Paz Hospital Institute for Health Research (IdiPAZ) Madrid Spain
| | - Ángela Palao‐Tarrero
- Psychiatry, Clinical Psychology and Mental Health Department La Paz University Hospital Madrid Spain
- La Paz Hospital Institute for Health Research (IdiPAZ) Madrid Spain
- Autonomous University of Madrid (UAM) Madrid Spain
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Hernández-Calle D, Martínez-Alés G, Mediavilla R, Aguirre P, Rodríguez-Vega B, Bravo-Ortiz MF. Trends in Psychiatric Emergency Department Visits Due to Suicidal Ideation and Suicide Attempts During the COVID-19 Pandemic in Madrid, Spain. J Clin Psychiatry 2020; 81. [PMID: 32898342 DOI: 10.4088/jcp.20l13419] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
| | - Gonzalo Martínez-Alés
- 722 W 168th St, New York, NY 10032. .,Columbia University Mailman School of Public Health, New York, New York, USA
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34
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Mediavilla R, Munoz-Sanjosé A, Rodríguez-Vega B, Bayón C, Palao A, Vidal-Villegas MP, Bravo-Ortiz MF. Clinical trials of psychological interventions cancelled due to the COVID-19 outbreak: how should we respond? Actas Esp Psiquiatr 2020; 48:233. [PMID: 33210281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 09/01/2020] [Indexed: 06/11/2023]
Abstract
The measures to contain the spread of the COVID-19 outbreak have no precedent in the recent history of many countries. Around 2,000 million people in the world are in isolation or quarantine, and gatherings of people have been expressly banned in many countries. In Spain, this prohibition affects workplaces, schools, and the national health system, where most of the healthcare is being provided either on the phone or online.
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Affiliation(s)
- Roberto Mediavilla
- Instituto de Investigación Hospital Universitario La Paz (IdiPAZ) Po Castellana, 261 C.P. 28046 Madrid (España)
| | - Ainoa Munoz-Sanjosé
- Instituto de Investigación Hospital Universitario La Paz (IdiPAZ) PIo Castellana, 261 C.P. 28046 Madrid (España) Hospital Universitario La Paz Po Castellana, 261 C.P. 28046 Madrid (España)
| | - Beatriz Rodríguez-Vega
- Instituto de Investigación Hospital Universitario La Paz (IdiPAZ) Po Castellana, 261 C.P. 28046 Madrid (España) Instituto de Investigación Hospital Universitario La Paz (IdiPAZ) Po Castellana, 261 C.P. 28046 Madrid (España) Hospital Universitario La Paz Po Castellana, 261 C.P. 28046 Madrid (España) Universidad Autónoma de Madrid (UAM) C/ Arzobispo Morcillo, 4 C.P. 28046 Madrid (España)
| | - Carmen Bayón
- Instituto de Investigación Hospital Universitario La Paz (IdiPAZ) Po Castellana, 261 C.P. 28046 Madrid (España) Instituto de Investigación Hospital Universitario La Paz (IdiPAZ) Po Castellana, 261 C.P. 28046 Madrid (España) Hospital Universitario La Paz Po Castellana, 261 C.P. 28046 Madrid (España) Universidad Autónoma de Madrid (UAM) C/ Arzobispo Morcillo, 4 C.P. 28046 Madrid (España)
| | - Angela Palao
- Instituto de Investigación Hospital Universitario La Paz (IdiPAZ) Po Castellana, 261 C.P. 28046 Madrid (España) Instituto de Investigación Hospital Universitario La Paz (IdiPAZ) Po Castellana, 261 C.P. 28046 Madrid (España) Hospital Universitario La Paz Po Castellana, 261 C.P. 28046 Madrid (España) Universidad Autónoma de Madrid (UAM) C/ Arzobispo Morcillo, 4 C.P. 28046 Madrid (España)
| | - María Paz Vidal-Villegas
- Instituto de Investigación Hospital Universitario La Paz (IdiPAZ) Po Castellana, 261 C.P. 28046 Madrid (España)
| | - María Fe Bravo-Ortiz
- Instituto de Investigación Hospital Universitario La Paz (IdiPAZ) Po Castellana, 261 C.P. 28046 Madrid (España) Instituto de Investigación Hospital Universitario La Paz (IdiPAZ) Po Castellana, 261 C.P. 28046 Madrid (España) Hospital Universitario La Paz Po Castellana, 261 C.P. 28046 Madrid (España) Universidad Autónoma de Madrid (UAM) C/ Arzobispo Morcillo, 4 C.P. 28046 Madrid (España)
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Mediavilla R, Fernández-Jiménez E, Rodríguez-Vega B, Gotor-Martínez L, Rivelles-Sevilla RV, Rojano-Capilla P, Bravo-Ortiz MF. Adapting mental health care after the COVID-19 outbreak: Preliminary findings from a public general hospital in Madrid (Spain). Psychiatry Res 2020; 289:113077. [PMID: 32434094 PMCID: PMC7214322 DOI: 10.1016/j.psychres.2020.113077] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 05/08/2020] [Indexed: 11/29/2022]
Affiliation(s)
| | - Eduardo Fernández-Jiménez
- Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain,Corresponding author
| | - Beatriz Rodríguez-Vega
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain,Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain,Autonomous University of Madrid (UAM), Madrid, Spain
| | - Laura Gotor-Martínez
- Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
| | | | - Pilar Rojano-Capilla
- Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
| | - María-Fe Bravo-Ortiz
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain,Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain,Autonomous University of Madrid (UAM), Madrid, Spain
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Rodriguez-Vega B, Palao Á, Muñoz-Sanjose A, Torrijos M, Aguirre P, Fernández A, Amador B, Rocamora C, Blanco L, Marti-Esquitino J, Ortiz-Villalobos A, Alonso-Sañudo M, Cebolla S, Curto J, Villanueva R, de-la-Iglesia MJ, Carracedo D, Casado C, Vidal E, Trigo D, Iglesias N, Cabañas D, Mellado L, García D, Fernández-Encinas C, Navarro R, Mediavilla R, Vidal-Villegas MP, Bravo-Ortiz MF, Bayón C. Implementation of a Mindfulness-Based Crisis Intervention for Frontline Healthcare Workers During the COVID-19 Outbreak in a Public General Hospital in Madrid, Spain. Front Psychiatry 2020; 11:562578. [PMID: 33329103 PMCID: PMC7673433 DOI: 10.3389/fpsyt.2020.562578] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 10/07/2020] [Indexed: 12/13/2022] Open
Abstract
Introduction: The COVID-19 outbreak is having an impact on the well-being of healthcare workers. Mindfulness-based interventions have shown effectiveness in reducing stress and fostering resilience and recovery in healthcare workers. There are no studies examining the feasibility of brief mindfulness-based interventions during the COVID-19 outbreak. Materials and Methods: This is an exploratory study with a post intervention assessment. We describe an on-site brief mindfulness intervention and evaluate its helpfulness, safety, and feasibility. Results: One thousand out of 7,000 (14%) healthcare workers from La Paz University Hospital in Madrid (Spain) participated in at least one session. One hundred and fifty out of 1,000 (15%) participants filled out a self-report questionnaire evaluating the helpfulness of the intervention for on-site stress reduction. Ninety two subjects (61%) participated in more than one session. Most of the participants were women (80%) with a mean age of 38.6 years. Almost half of the sample were nurses (46%). Sessions were perceived as being helpful with a mean rating of 8.4 on a scale from 0 to 10. Only 3 people (2%) reported a minor adverse effect (increased anxiety or dizziness). Discussion: Our data supports the utility, safety and feasibility of an on-site, brief mindfulness-based intervention designed to reduce stress for frontline health workers during a crisis. There is a need to continue testing this type of interventions, and to integrate emotion regulation strategies as an essential part of health workers' general training. Clinical Trial Registration number: NCT04555005.
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Affiliation(s)
- Beatriz Rodriguez-Vega
- Psychiatry, Clinical Psychology and Mental Health Department, La Paz University Hospital, Madrid, Spain.,Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain.,Autonomous University of Madrid (UAM), Madrid, Spain
| | - Ángela Palao
- Psychiatry, Clinical Psychology and Mental Health Department, La Paz University Hospital, Madrid, Spain.,Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain.,Autonomous University of Madrid (UAM), Madrid, Spain
| | - Ainoa Muñoz-Sanjose
- Psychiatry, Clinical Psychology and Mental Health Department, La Paz University Hospital, Madrid, Spain.,Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Marta Torrijos
- Psychiatry, Clinical Psychology and Mental Health Department, La Paz University Hospital, Madrid, Spain
| | - Pablo Aguirre
- Psychiatry, Clinical Psychology and Mental Health Department, La Paz University Hospital, Madrid, Spain
| | - Arancha Fernández
- Psychiatry, Clinical Psychology and Mental Health Department, La Paz University Hospital, Madrid, Spain
| | - Blanca Amador
- Psychiatry, Clinical Psychology and Mental Health Department, La Paz University Hospital, Madrid, Spain
| | - Cristina Rocamora
- Psychiatry, Clinical Psychology and Mental Health Department, La Paz University Hospital, Madrid, Spain
| | - Laura Blanco
- Psychiatry, Clinical Psychology and Mental Health Department, La Paz University Hospital, Madrid, Spain
| | - Jesús Marti-Esquitino
- Psychiatry, Clinical Psychology and Mental Health Department, La Paz University Hospital, Madrid, Spain
| | - Aránzazu Ortiz-Villalobos
- Psychiatry, Clinical Psychology and Mental Health Department, La Paz University Hospital, Madrid, Spain
| | - Mónica Alonso-Sañudo
- Psychiatry, Clinical Psychology and Mental Health Department, La Paz University Hospital, Madrid, Spain
| | - Susana Cebolla
- Psychiatry, Clinical Psychology and Mental Health Department, La Paz University Hospital, Madrid, Spain.,Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Javier Curto
- Psychiatry, Clinical Psychology and Mental Health Department, La Paz University Hospital, Madrid, Spain
| | - Rosa Villanueva
- Psychiatry, Clinical Psychology and Mental Health Department, La Paz University Hospital, Madrid, Spain
| | - María-Jesús de-la-Iglesia
- Psychiatry, Clinical Psychology and Mental Health Department, La Paz University Hospital, Madrid, Spain
| | - Diego Carracedo
- Psychiatry, Clinical Psychology and Mental Health Department, La Paz University Hospital, Madrid, Spain
| | - Carlos Casado
- Psychiatry, Clinical Psychology and Mental Health Department, La Paz University Hospital, Madrid, Spain
| | - Emma Vidal
- Psychiatry, Clinical Psychology and Mental Health Department, La Paz University Hospital, Madrid, Spain
| | - Daniel Trigo
- Psychiatry, Clinical Psychology and Mental Health Department, La Paz University Hospital, Madrid, Spain
| | - Noelia Iglesias
- Psychiatry, Clinical Psychology and Mental Health Department, La Paz University Hospital, Madrid, Spain
| | - Diana Cabañas
- Psychiatry, Clinical Psychology and Mental Health Department, La Paz University Hospital, Madrid, Spain
| | - Loreto Mellado
- Psychiatry, Clinical Psychology and Mental Health Department, La Paz University Hospital, Madrid, Spain
| | - Daniel García
- Psychiatry, Clinical Psychology and Mental Health Department, La Paz University Hospital, Madrid, Spain
| | | | - Rubén Navarro
- Psychiatry, Clinical Psychology and Mental Health Department, La Paz University Hospital, Madrid, Spain
| | | | - María-Paz Vidal-Villegas
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain.,Autonomous University of Madrid (UAM), Madrid, Spain
| | - María-Fe Bravo-Ortiz
- Psychiatry, Clinical Psychology and Mental Health Department, La Paz University Hospital, Madrid, Spain.,Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain.,Autonomous University of Madrid (UAM), Madrid, Spain
| | - Carmen Bayón
- Psychiatry, Clinical Psychology and Mental Health Department, La Paz University Hospital, Madrid, Spain.,Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain.,Autonomous University of Madrid (UAM), Madrid, Spain
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Mediavilla R, Muñoz-Sanjose A, Rodriguez-Vega B, Bayon C, Palao A, Lahera G, Sanchez-Castro P, Roman E, Cebolla S, de Diego A, Pastor JM, Bravo-Ortiz MF. Mindfulness-based social cognition training (SocialMIND) versus psychoeducational multicomponent intervention for people with a first episode of psychosis: a study protocol for a randomised controlled trial. BMC Psychiatry 2019; 19:233. [PMID: 31357965 PMCID: PMC6664759 DOI: 10.1186/s12888-019-2206-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 07/08/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND People who suffer a first episode of psychosis experience higher levels of distress and suffering. Early intervention programs combine pharmacological and psychosocial strategies that include different components, such as cognitive-behavioural therapy, psychosocial interventions, medication adherence, family psychoeducation, counselling, etc. Among the complementary approaches, mindfulness-based interventions help participants to cultivate a radical acceptance of their psychotic experiences within a person-centered framework. They show promising results for people with longer duration of psychosis, but there is still no evidence for people who have recently experienced their first episode of psychosis. METHODS The present parallel-group, single-blind (evaluator), randomised (1:1 ratio), controlled (versus active comparator), superiority, clinical trial will compare the effectiveness of SocialMIND on social functioning as measured by the Personal and Social Performance (PSP) scale. The active comparator will be a psychoeducational multicomponent intervention (PMI) that incorporates elements of early intervention programs that are effective for people who have suffered a first episode of psychosis. Both SocialMIND and PMI encompass eight weekly sessions, four bi-weekly sessions, and five monthly sessions. Changes in primary and secondary outcomes will be measured after weekly (8th week), bi-weekly (16th week) and monthly sessions (56th week), and 3 months after completing the intervention (68th week). Secondary outcomes include symptoms of psychosis, anxiety and depression, as well as indicators of general functioning. Tertiary outcomes are measures of social cognition, neurocognition, mindfulness, and indicators of inflammation and oxidative stress. A final sample of 80 participants is proposed to detect clinically significant differences in social functioning. DISCUSSION This is the first mindfulness-based social cognition training for people with psychosis. SocialMIND aims to generate changes in the real-life functioning of people who have experienced a first episode of psychosis, and to be at least as effective as a psychoeducational multicomponent program. Adherence to the interventions is a common problem among young people with psychosis, so several difficulties are anticipated, and some methodological issues are discussed. TRIAL REGISTRATION The trial was registered in ClinicalTrials.gov in October 2018 (NCT03309475).
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Affiliation(s)
- Roberto Mediavilla
- Psychiatry and Mental Health Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain. .,National University of Distance Education (UNED), Madrid, Spain.
| | - Ainoa Muñoz-Sanjose
- grid.440081.9Psychiatry and Mental Health Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain ,0000 0000 8970 9163grid.81821.32La Paz University Hospital, Madrid, Spain
| | - Beatriz Rodriguez-Vega
- grid.440081.9Psychiatry and Mental Health Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain ,0000 0000 8970 9163grid.81821.32La Paz University Hospital, Madrid, Spain ,0000000119578126grid.5515.4Autonomous University of Madrid (UAM), Madrid, Spain
| | - Carmen Bayon
- grid.440081.9Psychiatry and Mental Health Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain ,0000 0000 8970 9163grid.81821.32La Paz University Hospital, Madrid, Spain ,0000000119578126grid.5515.4Autonomous University of Madrid (UAM), Madrid, Spain
| | - Angela Palao
- grid.440081.9Psychiatry and Mental Health Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain ,0000 0000 8970 9163grid.81821.32La Paz University Hospital, Madrid, Spain ,0000000119578126grid.5515.4Autonomous University of Madrid (UAM), Madrid, Spain
| | - Guillermo Lahera
- 0000 0004 1937 0239grid.7159.aUniversity of Alcala (UAH), Alcala de Henares, Spain ,grid.469673.9Mental Health Networking Biomedical Research Centre (CIBERSAM), Madrid, Spain
| | - Pilar Sanchez-Castro
- grid.440081.9Psychiatry and Mental Health Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain ,0000 0000 8970 9163grid.81821.32La Paz University Hospital, Madrid, Spain
| | - Eva Roman
- grid.440081.9Psychiatry and Mental Health Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain ,0000 0000 8970 9163grid.81821.32La Paz University Hospital, Madrid, Spain
| | - Susana Cebolla
- grid.440081.9Psychiatry and Mental Health Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain ,0000 0000 8970 9163grid.81821.32La Paz University Hospital, Madrid, Spain
| | - Alvaro de Diego
- grid.440081.9Psychiatry and Mental Health Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain ,0000 0000 8970 9163grid.81821.32La Paz University Hospital, Madrid, Spain
| | - Juan Manuel Pastor
- grid.440081.9Psychiatry and Mental Health Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain ,0000 0000 8970 9163grid.81821.32La Paz University Hospital, Madrid, Spain
| | - Maria Fe Bravo-Ortiz
- grid.440081.9Psychiatry and Mental Health Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain ,0000 0000 8970 9163grid.81821.32La Paz University Hospital, Madrid, Spain ,0000000119578126grid.5515.4Autonomous University of Madrid (UAM), Madrid, Spain
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Mediavilla R, Muñoz-Sanjose A, Rodriguez-Vega B, Bayon C, Lahera G, Palao A, Bravo-Ortiz MF. Mindfulness-Based Social Cognition Training (SocialMind) for People With Psychosis: A Feasibility Trial. Front Psychiatry 2019; 10:299. [PMID: 31118909 PMCID: PMC6506722 DOI: 10.3389/fpsyt.2019.00299] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Accepted: 04/16/2019] [Indexed: 12/27/2022] Open
Abstract
Introduction: Difficulties in social functioning are common among people with psychosis. Negative symptoms such as blunted affect or social withdrawal are often linked to these difficulties and worsen real-life outcomes. One important dimension associated with social functioning is social cognition, which refers to the psychological processes that are necessary to perceive, encode, store, retrieve, and regulate social information. Mindfulness-based interventions for people with psychosis are safe and effective in improving anxiety and depressive symptoms; however, no mindfulness-based interventions addressing social cognition have yet been developed. Method: A pilot, single-arm, nonrandomized, noncontrolled feasibility trial is proposed. The main objectives are to assess the tolerability of mindfulness-based social cognition training (SocialMind) and to test the feasibility of a further randomized controlled trial. Results: A final sample of 25 outpatients with schizophrenia spectrum disorders was included. Attrition rate was lower than usual for this population, and most participants completed the training. No adverse effects were identified in terms of hospitalizations, emergency room visits, dissociative and psychotic symptoms, or state of anxiety during the sessions. Conclusion: This is the first implementation of SocialMind, which is the first mindfulness-based social cognition training. It is well tolerated by participants with schizophrenia spectrum disorders, and a further randomized controlled trial is proposed for people who have suffered their first episode of psychosis within the past 5 years. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT03434405.
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Affiliation(s)
- Roberto Mediavilla
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain.,School of Psychology, National University of Distance Education (UNED), Madrid, Spain
| | - Ainoa Muñoz-Sanjose
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain.,Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
| | - Beatriz Rodriguez-Vega
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain.,Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain.,School of Medicine, Autonomous University of Madrid (UAM), Madrid, Spain
| | - Carmen Bayon
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain.,Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain.,School of Medicine, Autonomous University of Madrid (UAM), Madrid, Spain
| | - Guillermo Lahera
- School of Medicine, University of Alcala (UAH), Madrid, Spain.,Mental Health Networking Biomedical Research Centre (CIBERSAM), Madrid, Spain
| | - Angela Palao
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain.,Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain.,School of Medicine, Autonomous University of Madrid (UAM), Madrid, Spain
| | - Maria Fe Bravo-Ortiz
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain.,Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain.,School of Medicine, Autonomous University of Madrid (UAM), Madrid, Spain
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Abstract
BACKGROUND This cross-sectional study examined whether changes occur in people’s capacity to coordinate two simultaneous tasks (dual-task) when transitioning from adulthood to later life. The central executive, Baddeley’s working memory model component, is responsible for this coordination. Contradictory results have been reported regarding the relationship between ageing and dual-task performance; but these seem to be related to methodological issues that have been addressed in this study. METHODS Nine hundred and seventy-two participants, aged between 35 and 90 years old, volunteered to carry out a verbal digit span task, followed by single and concurrent (dual-task) tests: first, a box crossing task, then, the digit recall task in relation to their memory span, and finally, both these tests simultaneously. RESULTS We found no difference in people’s capacity to coordinate their attention when doing two tasks in adulthood or healthy later life, including those in the oldest age groups. Furthermore, gender and educational level were not related to dual-task performance. CONCLUSIONS The results support the normal functioning of the central executive in very old people. These data contrast with research with patients suffering from different types of dementia, which show a decrease in their dual-task performance.
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Abstract
BACKGROUND Older people complain of difficulties in recalling telephone numbers and being able to dial them in the correct order. This study examined the developmental trend of verbal forward digit span across adulthood and aging in a Spanish population, as an index of one of the components of Baddeley’s working memory model—the phonological loop—, which illustrates these two aspects. METHOD A verbal digit span was administered to an incidental sample of 987 participants ranging from 35 to 90 years old. The maximum length was defined that participants could recall of at least two out of three series in the same order as presented with no errors. Demographic variables of gender and educational level were also examined. RESULTS The ANOVA showed that the three main factors (age group, gender and educational level) were significant, but none of the interactions was. Verbal forward digit span decreases during the lifespan, but gender and educational level affect it slightly. CONCLUSION Phonological loop is affected by age. The verbal forward digit span in this study is generally lower than the one reported in other studies.
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Urtiaga A, Bringas E, Mediavilla R, Ortiz I. The role of liquid membranes in the selective separation and recovery of zinc for the regeneration of Cr(III) passivation baths. J Memb Sci 2010. [DOI: 10.1016/j.memsci.2010.03.034] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Woods JW, Dravida S, Mediavilla R. Image estimation using doubly stochastic gaussian random field models. IEEE Trans Pattern Anal Mach Intell 1987; 9:245-253. [PMID: 21869394 DOI: 10.1109/tpami.1987.4767898] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The two-dimensional (2-D) doubly stochastic Gaussian (DSG) model was introduced by one of the authors to provide a complete model for spatial filters which adapt to the local structure in an image signal. Here we present the optimal estimator and 2-D fixed-lag smoother for this DSG model extending earlier work of Ackerson and Fu. As the optimal estimator has an exponentially growing state space, we investigate suboptimal estimators using both a tree and a decision-directed method. Experimental results are presented.
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Affiliation(s)
- J W Woods
- Department of Electrical, Computer, and Systems Engineering, Rensselaer Polytechnic Institute, Troy, NY 12180
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