Periodicity and severity of changes in depression and anxiety during the COVID-19 pandemic: Ten-wave longitudinal findings from an observational cohort study of community adults.

AIMS: Few multi-wave longitudinal studies have examined mental health changes across the coronavirus 2019 (COVID-19) pandemic. The current study examined: (a) overall changes in depression and anxiety over 10-waves of data collection; (b) subgroup moderators of changes; (c) clinical severity of the changes via minimally important differences (MIDs); and (d) correlates of clinically important changes. METHODS: Using a longitudinal observational cohort design, 1412 non-clinical adults (Mage=36; 60% female) were assessed for depression and anxiety via the PHQ-9 and GAD-7 from October 2018 to April 2022 (3 pre-pandemic, 7 intra-pandemic waves; M retention = 92%). RESULTS: Depression and anxiety exhibited significant intra-pandemic changes, reflecting initial increases, followed by decreases. Pre-pandemic severity moderated changes, with low severity participants exhibiting increases and high severity participants exhibiting non-significant change or decreases. For depression and anxiety, respectively, 10% and 11% exhibited MID increases, while 4% and 6% exhibited MID decreases. Divergent patterns were present by severity subgroup, with the lowest severity exhibiting higher rates of MID increases and the highest severity subgroup exhibiting higher rates of MID decreases. CONCLUSIONS: These findings illuminate the periodicity of depression and anxiety during the COVID-19 pandemic and reveal an unexpected inverse relationship between increases and decreases based on pre-pandemic severity.

Impact of COVID-19 on alcohol use disorder recovery: A qualitative study.

In March 2020, restrictions on in-person gatherings were introduced due to the coronavirus disease (COVID-19) pandemic, requiring alcohol use disorder (AUD) recovery resources to migrate to virtual platforms. This study investigated how these restrictions impacted recovery attempts and explored participant experiences with virtual resources using a qualitative approach. Participants attempting recovery from AUD (N = 62; Mage = 48.2; F = 53.2%; 71% White) completed virtual semistructured interviews from July 2020 to August 2020 on their experience during the COVID-19 lockdown, impacts on recovery, and experiences with online resources. Interviews were recorded, transcribed, and analyzed using a thematic coding process. Three overarching themes were identified: Effect on Recovery, Virtual Recovery Resources, and Effect on General Life. Within each overarching theme, lower order parent themes and subthemes reflected varied participant experiences. Specifically, one group of participants cited negative impacts due to COVID-19, a second group reported positive impacts, and a third group reported experiencing both positive and negative impacts. Participants reported both positive and negative experiences with virtual resources, identifying suggestions for improvement and other resources. Findings suggest that while individuals in AUD recovery experienced significant hardships, a proportion experienced positive impacts as well, and the positive and negative consequences were not mutually exclusive. Additionally, the results highlight the limitations of existing virtual resources. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The intersection of internalizing symptoms and alcohol use during the COVID-19 pandemic: A prospective cohort study.

Given the well-established relationship between alcohol and internalizing symptoms, potential increases in depression and anxiety during the COVID-19 pandemic may lead to increases in alcohol consumption and binge drinking. This study examines this association from before to during two phases of the pandemic in a cohort of Canadian youth. We used linked data from a sub-sample of 1901 secondary school students who participated in three consecutive school years of the Cannabis use, Obesity, Mental health, Physical activity, Alcohol use, Smoking, and Sedentary behaviour (COMPASS) study between 2018/19 and 2020/21. Separate multilevel logistic regression models examined the association between depression and anxiety symptoms with odds of escalation and reduction (vs. maintenance) and initiation (vs. abstinence) of alcohol consumption. Results show that depression and anxiety symptoms significantly increased over the three years, and these changes were moderated by changes in alcohol consumption and binge drinking. Students with increased depression symptoms were less likely to reduce their alcohol consumption in the early pandemic (Adjust odds ratio [AOR] 0.94, 95% CI:0.90-0.98), more likely to initiate alcohol consumption in the ongoing pandemic period (AOR 1.03, 95% CI: 1.01-1.05), and more likely to initiate binge drinking in both periods. The depression-alcohol use association was stronger among females than males. This study demonstrates a modest association between internalizing symptoms and alcohol use, particularly for depression symptoms and in females. The identified depression-alcohol use association suggests that preventing or treating depression might be beneficial for adolescent alcohol use and vice versa.

Impacts of the COVID-19 public health restrictions on substance use, mental health, and psychosocial functioning among individuals with alcohol use disorder.

Background: The COVID-19 pandemic has been associated with major psychosocial disruptions and there is particular concern for individuals with substance use disorders.Objectives: This study characterized the psychosocial and experiential impacts of the pandemic on individuals seeking alcohol use disorder (AUD) recovery, including pandemic impacts on self-reported drinking, heavy drinking, tobacco, cannabis, and stimulant use.Methods: Participants were 125 AUD+ individuals (% males: 57.60; Mage = 49.11, SD = 12.13) reporting on substance use from January 1st-24th March, 2020 (pre-pandemic) and since the stay-at-home orders commenced, 24th March-June 28th 2020 (intra-pandemic). Within-subjects changes were examined and a latent profile analysis was performed to identify subgroups differentially impacted by the pandemic.Results: Large proportions reported psychosocial impacts of COVID-19, but drinking and other substance use did not reveal significant changes. Latent profile analyses revealed two subgroups: Profile 1 (n = 41/125), "Moderately Impacted") and Profile 2 (n = 84/125), "Severely Impacted"). Compared to the pre-pandemic period, the group that was moderately impacted by the pandemic exhibited significantly fewer heavy drinking days (p = .02) during the intra-pandemic period, but no other substance use changes. The group showing severe pandemic impacts did not exhibit changes in alcohol or other drug use but evidenced more severe anxiety and depression (ps < .001).Conclusions: We found heterogeneous subtypes of pandemic-related impacts in AUD recovery patients. There is need to provide psychosocial support to this particular population and further monitoring substance use and mental health.

Cross-sectional survey of the Mental health and Addictions effects, Service impacts and Care needs of children, youth and families during the COVID-19 pandemic: the COVID-19 MASC study protocol.

INTRODUCTION: The COVID-19 pandemic has had a tremendous negative effect on the mental health and well-being of Canadians. These mental health challenges are especially acute among vulnerable Canadian populations. People living in Canada's most populous province, Ontario, have spent prolonged time in lockdown and under public health measures and there is a gap in our understanding of how this has impacted the mental health system. This protocol describes the Mental health and Addictions Service and Care Study that will use a repeated cross-sectional design to examine the effects, impacts, and needs of Ontario adults during the COVID-19 pandemic. METHODS AND ANALYSIS: A cross-sectional survey of Ontario adults 18 years or older, representative of the provincial population based on age, gender and location was conducted using Delvinia's AskingCanadians panel from January to March 2022. Study sample was 2500 in phases 1 and 2, and 5000 in phase 3. The Alcohol, Smoking and Substance Involvement Screening Test and Diagnostic Statistical Manual-5 Self-Rated Level 1 Cross-Cutting Symptom Measure-Adult were used to assess for substance and mental health concerns. Participants were asked about mental health and addiction service-seeking and/or accessing prior to and during the pandemic. Analyses to be conducted include: predictors of service access (ie, sociodemographics, mental illness and/or addiction, and social supports) before and during the pandemic, and χ2 tests and logistic regressions to analyse for significant associations between variables and within subgroups. ETHICS AND DISSEMINATION: Ethics approval was obtained from the Sunnybrook Research Ethics Board. Dissemination plans include scientific publications and conferences, and online products for stakeholders and the general public.

Examining the Impact of the COVID-19 Pandemic on youth Alcohol Consumption: longitudinal Changes From Pre-to Intra-pandemic Drinking in the COMPASS Study.

PURPOSE: To date, there are few longitudinal studies on the COVID-19 pandemic's ongoing impact on youth drinking. This study examines the changes in drinking during two phases of the pandemic in a sample of Canadian youth. METHODS: We used four-year longitudinal data from the COMPASS study, including 14,085 secondary school students from Quebec and Ontario, Canada who provided linked data for any two consecutive years between 2017/18 and 2018/19 (pre-pandemic) waves, and 2019/20 and 2020/21 (during the initial and ongoing pandemic). A difference-in-difference (D-I-D) model was used to compare changes in the frequency of drinking and binge drinking between pre-COVID-19 to initial- and ongoing-pandemic period, while adjusted for age-related effects. RESULTS: The expected escalation in the frequency of drinking and binge drinking from the pre-pandemic wave (2018/19) to the initial pandemic (2019/20) was less than the changes seen across the 2017/18 to 2018/19 waves among sex and age groups. However, the second year of COVID was associated with an increase in the frequencies of both drinking and binge drinking. Male and younger students (aged 12-14) differentially increased their consumption. DISCUSSION: After a reduction in the initial pandemic period, the frequency of drinking and binge drinking rebounded in the second year, indicating that the pandemic's effects are not singular and have changed over time. Further examination is needed to understand the ongoing effects of the pandemic by continuing to monitor drinking in youth toward informing public health measures and harm reduction strategies.

Risk and Resilience Pathways, Community Adversity, Decision-making, and Alcohol Use Among Appalachian Adolescents: Protocol for the Longitudinal Young Mountaineer Health Study Cohort.

BACKGROUND: Alcohol use impairs psychosocial and neurocognitive development and increases the vulnerability of youth to academic failure, substance use disorders, and other mental health problems. The early onset of alcohol use in adolescents is of particular concern, forecasting substance abuse in later adolescence and adulthood. To date, evidence suggests that youth in rural areas are especially vulnerable to contextual and community factors that contribute to the early onset of alcohol use. OBJECTIVE: The objective of the Young Mountaineer Health Study is to investigate the influence of contextual and health behavior variables on the early onset of alcohol use among middle school-aged youth in resource-poor Appalachian rural communities. METHODS: This is a program of prospective cohort studies of approximately 2200 middle school youth from a range of 20 rural, small town, and small city (population <30,000) public schools in West Virginia. Students are participating in 6 waves of data collection (2 per year) over the course of middle school (sixth to eighth grades; fall and spring) from 2020 to 2023. On the basis of an organizational arrangement, which includes a team of local data collection leaders, supervising contact agents in schools, and an honest broker system to deidentify data linked via school IDs, we are able to collect novel forms of data (self-reported data, teacher-reported data, census-linked area data, and archival school records) while ensuring high rates of participation by a large majority of youth in each participating school. RESULTS: In the spring of 2021, 3 waves of student survey data, 2 waves of data from teachers, and a selection of archival school records were collected. Student survey wave 1 comprised 1349 (response rate 80.7%) participants, wave 2 comprised 1649 (response rate 87%) participants, and wave 3 comprised 1909 (response rate 83.1%) participants. The COVID-19 pandemic has had a negative impact on the sampling frame size, resulting in a reduced number of eligible students, particularly during the fall of 2020. Nevertheless, our team structure and incentive system have proven vitally important in mitigating the potentially far greater negative impact of the pandemic on our data collection processes. CONCLUSIONS: The Young Mountaineer Health Study will use a large data set to test pathways linking rural community disadvantage to alcohol misuse among early adolescents. Furthermore, the program will test hypotheses regarding contextual factors (eg, parenting practices and neighborhood collective efficacy) that protect youth from community disadvantage and explore alcohol antecedents in the onset of nicotine, marijuana, and other drug use. Data collection efforts have been successful despite interruptions caused by the COVID-19 pandemic in 2020 and 2021. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/40451.

Cognitive function following SARS-CoV-2 infection in a population-representative Canadian sample.

Background: SARS-CoV-2 infection is believed to adversely affect the brain, but the degree of impact on socially relevant cognitive functioning and decision-making is not well-studied, particularly among those less vulnerable to age-related mortality. The current study sought to determine whether infection status and COVID-19 symptom severity are associated with cognitive dysfunction among young and middled-aged adults in the general population, using self-reported lapses in executive control and a standardized decision-making task. Method: The survey sample comprised 1958 adults with a mean age of 37 years (SD â€‹= â€‹10.4); 60.8% were female. Participants reported SARS-CoV-2 infection history and, among those reporting a prior infection, COVID-19 symptom severity. Primary outcomes were self-reported symptoms of cognitive dysfunction assessed via an abbreviated form of the Barkley Deficits in Executive Functioning Scale (BDEFS) and performance on a validated delay-discounting task. Results: Young and middle-aged adults with a positive SARS-CoV-2 infection history reported a significantly higher number of cognitive dysfunction symptoms (M adj  â€‹= â€‹1.89, SE â€‹= â€‹0.08, CI: 1.74, 2.04; n â€‹= â€‹175) than their non-infected counterparts (M adj  â€‹= â€‹1.63, SE â€‹= â€‹0.08, CI: 1.47,1.80; n â€‹= â€‹1599; ߠ​= â€‹0.26, p â€‹= â€‹.001). Among those infected, there was a dose-response relationship between COVID-19 symptom severity and level of cognitive dysfunction reported, with moderate (ߠ​= â€‹0.23, CI: 0.003-0.46) and very/extremely severe (ߠ​= â€‹0.69, CI: 0.22-1.16) COVID-19 symptoms being associated with significantly greater cognitive dysfunction. These effects remained reliable and of similar magnitude after controlling for demographics, vaccination status, mitigation behavior frequency, and geographic region, and after removal of those who had been intubated during hospitalization. Very similar-and comparatively larger-effects were found for the delay-discounting task, and when using only PCR confirmed SARS-CoV-2 cases. Conclusions: Positive SARS-CoV-2 infection history and moderate or higher COVID-19 symptom severity are associated with significant symptoms of cognitive dysfunction and amplified delay discounting among young and middle-aged adults with no history of medically induced coma.

Public health guideline compliance and perceived government effectiveness during the COVID-19 pandemic in Canada: Findings from a longitudinal cohort study.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has imposed enormous adversity worldwide. Public health guidelines have been a first line of defense but rely on compliance with evolving recommendations and restrictions. This study sought to characterize adherence to and perceptions of public health guidelines over a one-year timeframe during the pandemic. METHODS: Participants were 1435 community adults in Ontario who completed assessments at five time points (April 2020, July 2020, October 2020, January 2021, and April 2021; 92% retention). Participants were assessed for self-reported adherence to government protocols and perceptions of government response (importance, compliance, and effectiveness). Analyses used general linear mixed-effects modelling of overall changes by time and examined differences based on age and sex. FINDINGS: Over time, participants reported high or increasing behavioural engagement in public health guidelines, including physical distancing, restricting activity, and masking. In contrast, participants exhibited significant reductions in perceived importance and compliance, with evidence of more negative changes in younger participants. The largest changes were a substantial reduction in perceived government effectiveness, from predominantly positive perceptions to predominantly negative perceptions. INTERPRETATION: These results illuminate evolving trends in public health compliance and perceptions over the course of the pandemic in Canada, revealing the malleability of public perceptions of public health recommendations and government effectiveness. FUNDING: This research was funded by a grant from the Canadian Institutes of Health Research (CIHR). CIHR had no role in study design, data collection, data analysis, interpretation, or writing of the report.

Is talk cheap? Correspondence between self-attributions about changes in drinking and longitudinal changes in drinking during the 2019 coronavirus pandemic.

BACKGROUND: There are concerns that the coronavirus disease 2019 (COVID-19) pandemic may increase drinking, but most accounts to date are cross-sectional studies of self-attributions about alcohol-related impacts and the accuracy of those perceptions has not been investigated. The current study examined the correspondence between self-attributions of pandemic-related changes in drinking and longitudinally-measured changes in drinking and alcohol-related consequences in a sample of emerging adults. METHODS: In an existing ongoing longitudinal study on alcohol misuse (≥1 heavy episodic drinking day/month) in emerging adults, 473 individuals (Mage  = 23.8; 41.7% male) received a supplemental assessment from June 17th to July 1st, 2020, during public health restrictions in Ontario, Canada. These intrapandemic data were matched to the most recent assessment prior to the pandemic (~8 months earlier). Self-attributions about changes in drinking were assessed globally (i.e., increases/decreases/no change) and with higher resolution questions clarifying the magnitude of changes. RESULTS: Global self-attributions about changes in drinking substantively paralleled longitudinal changes in weekly drinking days (DD). In the longitudinal data, individuals' who self-reported increases in drinking exhibited significant increases; individuals' who self-reported decreases exhibited significant decreases; and individuals who self-reported no change exhibited nonsignificant changes. Higher resolution items likewise revealed longitudinal patterns of weekly drinking that were substantively consistent with self-attributions. Heavy DD and alcohol-related consequences exhibited similar patterns, but only individuals who self-reported large increases in drinking exhibited increases on these outcomes. Individuals who reported large increases in drinking also exhibited significant increases in depression and posttraumatic stress disorder symptoms. CONCLUSIONS: Self-attributions about drinking closely corresponded to longitudinal changes in drinking, supporting the validity of self-attributions in population-level surveys, particularly in young adults. Notably, a subgroup was identified that exhibited pronounced increases for all alcohol-related outcomes and concurrent increases in internalizing psychopathology.

The trajectories of depressive symptoms among working adults during the COVID-19 pandemic: a longitudinal analysis of the InHamilton COVID-19 study.

BACKGROUND: Longitudinal studies examining the impact of changes in COVID-19 pandemic-related stressors and experiences, and coping styles on the mental health trajectory of employed individuals during the lockdown are limited. The study examined the mental health trajectories of a sample of employed adults in Hamilton, Ontario during the initial lockdown and after the re-opening following the first wave in Canada. Further, this study also identified the pandemic-related stressors and coping strategies associated with changes in depressive symptoms in employed adults during the COVID-19 pandemic. METHODS: The InHamilton COVID-19 longitudinal study involved 579 employees aged 22-88 years from a large public university in an urban area of Hamilton, Ontario at baseline (April 2020). Participants were followed monthly with 6 waves of data collected between April and November 2020. A growth mixture modeling approach was used to identify distinct groups of adults who followed a similar pattern of depressive symptoms over time and to describe the longitudinal change in the outcome within and among the identified sub-groups. RESULTS: Our results showed two distinct trajectories of change with 66.2% of participants displaying low-consistent patterns of depressive symptoms, and 33.8% of participants displaying high-increasing depressive symptom patterns. COVID-19 pandemic-related experiences including health concerns, caregiving burden, and lack of access to resources were associated with worsening of the depressive symptom trajectories. Frequent use of dysfunctional coping strategies and less frequent use of emotion-focused coping strategies were associated with the high and increasing depressive symptom pattern. CONCLUSIONS: The negative mental health impacts of the COVID-19 pandemic are specific to subgroups within the population and stressors may persist and worsen over time. Providing access to evidence-informed approaches that foster adaptive coping, alleviate the depressive symptoms, and promote the mental health of working adults is critical.

COVID-19 Vaccine Perceptions and Differences by Sex, Age, and Education in 1,367 Community Adults in Ontario.

Background: COVID-19 is a global pandemic and vaccination efforts may be impeded by vaccine hesitancy. The present study examined willingness to receive a COVID-19 vaccine, the associated reasons for willingness/unwillingness, and vaccine safety perceptions in a cross-sectional assessment of community adults in Ontario. Methods: One thousand three hundred sixty seven individuals (60.6% female, mean age = 37.5%) participated in this study between January 15, 2021 and February 15, 2021. Perceptions of vaccine safety and reasons for willingness/unwillingness to receive the COVID-19 vaccine were investigated using an online assessment. Perceptions were investigated in general and by age, sex and education using analysis of variance. Results: Overall, 82.8% of the sample reported they were willing to receive a COVID-19 vaccine and 17.2% reported they were unwilling. The three most common reasons for unwillingness were long-term side effects (65.5%), immediate side effects (60.5%), and lack of trust in the vaccine (55.2%). Vaccine willingness significantly differed by sex and education level, with female participants and those with less than a bachelor's degree being more likely to report unwillingness. Perception of COVID-19 vaccine safety was significantly lower (-10.3%) than vaccines in general and differed by age, sex and education, with females, older adults, and individuals with less than a bachelor's degree reporting lower perceived COVID-19 vaccine safety. Conclusion: In this sample of community adults, the COVID-19 vaccine hesitancy rate was less than one in five individuals, but with higher rates in population subgroups. Targeting public health messaging to females and individuals with less than bachelor's degree, and addressing concerns about long-term and immediate side effects may increase vaccine uptake.

COVID-19 impacts on drinking and mental health in emerging adults: Longitudinal changes and moderation by economic disruption and sex.

BACKGROUND: There are significant concerns that the COVID-19 pandemic may have negative effects on substance use and mental health, but most studies to date are cross-sectional. In a sample of emerging adults, over a two-week period during the pandemic, the current study examined: (1) changes in drinking-related outcomes, depression, anxiety, and posttraumatic stress disorder and (2) differences in changes by sex and income loss. The intra-pandemic measures were compared to pre-pandemic measures. METHODS: Participants were 473 emerging adults (Mage  = 23.84; 41.7% male) in an existing longitudinal study on alcohol misuse who were assessed from June 17 to July 1, 2020, during acute public health restrictions in Ontario, Canada. These intra-pandemic data were matched to participant pre-pandemic reports, collected an average of 5 months earlier. Assessments included validated measures of drinking, alcohol-related consequences, and mental health indicators. RESULTS: Longitudinal analyses revealed significant decreases in heavy drinking and adverse alcohol consequences, with no moderation by sex or income loss, but with substantial heterogeneity in changes. Significant increases in continuous measures of depression and anxiety were present, both of which were moderated by sex. Females reported significantly larger increases in depression and anxiety. Income loss >50% was significantly associated with increases in depression. CONCLUSIONS: During the initial phase of the pandemic, reductions in heavy drinking and alcohol consequences were present in this sample of emerging adults, perhaps due to restrictions on socializing. In contrast, there was an increase in internalizing symptoms , especially in females, highlighting disparities in the mental health impacts of the pandemic.

Evaluating the impact of Archway: a personalized program for 1st year student success and mental health and wellbeing.

BACKGROUND: First-year students entering postsecondary education must navigate a new and complex academic and social environment. Research indicates that this transition and developmental period can be challenging and stressful - academically, emotionally and socially - and that mental health and wellbeing can be compromised. Additionally, mental health disorders can also compromise students' ability to successfully navigate this transition. In the COVID-19 pandemic, the incoming 2020 cohort of first-year students face heightened and new challenges. Most will have spent the conclusion of high school learning virtually, in quarantine, in an uncertain and difficult time, and are then experiencing their first year of university while living, learning and socializing off-campus, virtually and remotely. In response to COVID-19 and with an appreciation of the considerable stresses students face generally and particularly in 2020-21, and the potential effects on mental health and wellbeing, McMaster University, a mid-sized research intensive university with approximately 30,000 students, has developed an innovative program to support students, called Archway. This initiative has been developed to help to prevent and to intervene early to address common transitional issues students experience that can influence mental health and wellbeing, with the ultimate goals of increasing student connectedness, supports, and retention. METHODS: The current study will use a mixed-method design to evaluate Archway and gain a better understanding of the transition into first-year postsecondary for students who engage and participate in Archway at various levels. The study will not only help to determine the effect of this program for students during COVID-19, but it will help us to better understand the challenges of this transition more broadly. DISCUSSION: Findings have the potential to inform future efforts to support students and protect their mental health and wellbeing through the use of virtual and remote platforms and mechanisms that meet their increasingly diverse needs and circumstances.