Self-Management of Subclinical Common Mental Health Disorders (Anxiety, Depression and Sleep Disorders) Using Wearable Devices.

RATIONALE: Common mental health disorders (CMD) (anxiety, depression, and sleep disorders) are among the leading causes of disease burden globally. The economic burden associated with such disorders is estimated at $2.4 trillion as of 2010 and is expected to reach $16 trillion by 2030. The UK has observed a 21-fold increase in the economic burden associated with CMD over the past decade. The recent COVID-19 pandemic was a catalyst for adopting technologies for mental health support and services, thereby increasing the reception of personal health data and wearables. Wearables hold considerable promise to empower users concerning the management of subclinical common mental health disorders. However, there are significant challenges to adopting wearables as a tool for the self-management of the symptoms of common mental health disorders. AIMS: This review aims to evaluate the potential utility of wearables for the self-management of sub-clinical anxiety and depressive mental health disorders. Furthermore, we seek to understand the potential of wearables to reduce the burden on the healthcare system. METHODOLOGY: a systematic review of research papers was conducted, focusing on wearable devices for the self-management of CMD released between 2018-2022, focusing primarily on mental health management using technology. RESULTS: We screened 445 papers and analysed the reports from 12 wearable devices concerning their device type, year, biometrics used, and machine learning algorithm deployed. Electrodermal activity (EDA/GSR/SC/Skin Temperature), physical activity, and heart rate (HR) are the most common biometrics with nine, six and six reference counts, respectively. Additionally, while smartwatches have greater penetration and integration within the marketplace, fitness trackers have the most significant public value benefit of £513.9 M, likely due to greater retention.

Prevalence and Risk Factors of Psychiatric Symptoms Among Older People in England During the COVID-19 Pandemic: a Latent Class Analysis.

The COVID-19 pandemic has affected mental health and social connections. Older people may be disproportionately affected, placing them at increased risk for complex mental ill-health outcomes and quality of life undermined by anxiety and depression. Understanding gender differences in the determinants of anxiety and depression symptoms is crucial to policy and practice. This study aims to examine gender-specific symptom subtypes (and subthreshold symptoms) in an older English population sampled during the COVID period, in relation to their socio-demographic, social, and health circumstances. The sample comprises all individuals aged 50 years or older and included in the English Longitudinal Study of Ageing COVID-19 sub-study conducted during June-July 2020. Latent class analysis (LCA) defined indicative sample subgroups of clinically relevant anxiety and depression. Multinomial logistic regression assessed associations between socio-demographic characteristics, health and social care indicators, loneliness, and pre-pandemic mental ill-health. LCA derived three classes of self-reported depression and anxiety: for females (1) comorbid depression and anxiety (19.9% of the sample), (2) depression and subthreshold anxiety (31.6%), and (3) no or low symptoms of depression and anxiety (48.5%), and for males (1) comorbid depression and anxiety (12.8%), (2) subthreshold anxiety and depression (29.6%), and (3) no or low depression and anxiety (57.6%). Multinomial logistic regression analyses indicate that compared to those with low/no mental health symptoms, severity of pandemic-era mental ill-health was positively associated with pre-pandemic mental health levels, worry over finances, having access to essentials, loneliness, and access to health and social care services. Findings support the persistence of comorbidity of both depression and anxiety in the pandemic period. Results may inform government health strategy on interventions to prevent social isolation and mitigate the effects of the pandemic on deteriorating mental health in older people who may be more susceptible.

Impact of the COVID-19 Pandemic on Loneliness and Social Isolation: A Multi-Country Study.

The COVID-19 global pandemic and subsequent public health social measures have challenged our social and economic life, with increasing concerns around potentially rising levels of social isolation and loneliness. This paper is based on cross-sectional online survey data (available in 10 languages, from 2 June to 16 November 2020) with 20,398 respondents from 101 different countries. It aims to help increase our understanding of the global risk factors that are associated with social isolation and loneliness, irrespective of culture or country, to support evidence-based policy, services and public health interventions. We found the prevalence of severe loneliness was 21% during COVID-19 with 6% retrospectively reporting severe loneliness prior to the pandemic. A fifth were defined as isolated based on their usual connections, with 13% reporting a substantial increase in isolation during COVID-19. Personal finances and mental health were overarching and consistently cross-cutting predictors of loneliness and social isolation, both before and during the pandemic. With the likelihood of future waves of COVID-19 and related restrictions, it must be a public health priority to address the root causes of loneliness and social isolation and, in particular, address the needs of specific groups such as carers or those living alone.

State-of-the-Art Sensors for Remote Care of People with Dementia during a Pandemic: A Systematic Review.

In the last decade, there has been a significant increase in the number of people diagnosed with dementia. With diminishing public health and social care resources, there is substantial need for assistive technology-based devices that support independent living. However, existing devices may not fully meet these needs due to fears and uncertainties about their use, educational support, and finances. Further challenges have been created by COVID-19 and the need for improved safety and security. We have performed a systematic review by exploring several databases describing assistive technologies for dementia and identifying relevant publications for this review. We found there is significant need for appropriate user testing of such devices and have highlighted certifying bodies for this purpose. Given the safety measures imposed by the COVID-19 pandemic, this review identifies the benefits and challenges of existing assistive technologies for people living with dementia and their caregivers. It also provides suggestions for future research in these areas.

The impact of reduced working on mental health in the early months of the COVID-19 pandemic: Results from the Understanding Society COVID-19 study.

BACKGROUND: The COVID-19 pandemic has precipitated an unpredictable economic crisis, currently affecting daily life for millions of workers. We examined the mental health impact of reduced working in a nationally representative sample of employees. METHOD: We used Wave one (April 2020) of the Understanding Society UK Household Longitudinal Study (UKHLS) COVID-19 study, with linkage to baseline mental health data from the UKHLS annual survey (January 2017- December 2018). Analysis was based on adults aged 18-65 who were employees in January/February 2020 (n=8,708), with psychological distress assessed using the GHQ-12. Logistic regression examined the mental health impact of reduced working and reasons for the reduction. RESULTS: Forty two percent of employees reported reduced working by April 2020, with 22% furloughed. There was no evidence of an association between reduced working per se and psychological distress in the fully adjusted model (OR=1.06, 95%CI 0.91-1.23). Those permanently laid-off (less than 1% of employees) were most vulnerable to adverse mental health effects in the early months of the pandemic (OR=3.60, 95%CI 1.55-8.37). We also found evidence of higher levels of psychological distress among those sick or self-isolating, and those with reduced working due to caring responsibilities. LIMITATIONS: While the GHQ is a widely used and validated instrument in identifying potential psychiatric disorders, it is important to note that it does not represent a clinical assessment. CONCLUSIONS: Longitudinal examination of employment transitions and mental ill-health related to pandemic outcomes is imperative and should help inform public health responses and ongoing government policy in supporting those adversely affected.