Collective emotions during the COVID-19 outbreak.

The COVID-19 pandemic has exposed the world's population to unprecedented health threats and changes to social life. High uncertainty about the novel disease and its social and economic consequences, together with increasingly stringent governmental measures against the spread of the virus, likely elicited strong emotional responses. We analyzed the digital traces of emotional expressions in tweets during 5 weeks after the start of outbreaks in 18 countries and six different languages. We observed an early strong upsurge of anxiety-related terms in all countries, which was related to the growth in cases and increases in the stringency of governmental measures. Anxiety expression gradually relaxed once stringent measures were in place, possibly indicating that people were reassured. Sadness terms rose and anger terms decreased with or after an increase in the stringency of measures and remained stable as long as measures were in place. Positive emotion words only decreased slightly and briefly in a few countries. Our results reveal some of the most enduring changes in emotional expression observed in long periods of social media data. Such sustained emotional expression could indicate that interactions between users led to the emergence of collective emotions. Words that frequently occurred in tweets suggest a shift in topics of conversation across all emotions, from political ones in 2019, to pandemic related issues during the outbreak, including everyday life changes, other people, and health. This kind of time-sensitive analyses of large-scale samples of emotional expression have the potential to inform risk communication. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Caring Contacts to Reduce Psychiatric Morbidity Following Hospitalization During the COVID-19 Pandemic: A Pilot Randomized Controlled Trial.

OBJECTIVES: Caring Contacts are an emerging intervention that aims to reduce distress and suicide risk after acute psychiatric care. This trial aimed to determine whether, during a pandemic, there was any evidence that the mental health benefits and reduction in suicidal ideation (SI) associated with delivering Caring Contacts to recently discharged psychiatric patients were greater than a control communication. The secondary objective was to identify whether the predicted benefits were greater among people living alone or those diagnosed with depression. METHOD: A single-site pilot randomized clinical trial (n = 100), with patients recruited from the adult Inpatient Psychiatry Unit at Sunnybrook Health Sciences Centre, Toronto, Canada between August 2020 and May 2021. Participants were randomized (1:1) to the Caring Contact or control group. Participants received three Caring Contact or control communications via email or mail (on days 4, 21, and 56 post-discharge). Mental health symptoms were assessed using the self-report Hopkins Symptom Checklist-25 (HSCL-25) scores at discharge (baseline) and when participants received each communication. Analysis of variance was used for the primary comparisons and exploratory analyses for subgroups. RESULTS: Both groups experienced a significant worsening of mental health symptoms at all time points post-discharge relative to baseline. There were no significant differences between groups at any time point, however, on day 4 there was a 24.2% and 72.6% attenuated worsening in the Caring Contact group compared to the control group for total symptom severity and SI, respectively. There was no significant interaction effect for the depression subgroup or those living alone. CONCLUSIONS: While this pilot study was not powered to identify significant differences between groups, results are indicative of feasibility and acceptability of the intervention and provide some indication that Caring Contacts may have benefited patients in the days following discharge, supporting the need for larger-scale trials. The study was registered with clinicaltrials.gov (study ID NCT04456062). Abrégé. OBJECTIFS: Les contacts attentionnés sont une nouvelle intervention qui vise à réduire le risque de détresse et de suicide après des soins intensifs psychiatriques. Le présent essai visait à déterminer si, durant une pandémie, des données probantes indiquaient que les avantages pour la santé mentale et la réduction de l'idéation suicidaire (IS) associés à la prestation de soins attentionnés à des patients psychiatriques récemment mis en congé étaient plus puissants que le contrôle des communications. L'objectif secondaire était d'identifier si les avantages escomptés étaient plus grands chez les personnes vivant seules ou chez celles où la dépression était diagnostiquée. MÉTHODE: Un essai clinique randomisé (n = 100) d'un seul site, dont les patients étaient recrutés à l'Unité de psychiatrie pour patients hospitalisés adultes du Centre des sciences de la santé Sunnybrook de Toronto, Canada, entre août 2020 et mai 2021. Les participants ont été randomisés (1:1) aux Contacts attentionnés ou au groupe témoin. Les participants ont reçu trois communications des Contacts attentionnés ou des témoins par courriel ou courrier (aux jours 4, 21, 56 après-congé). Les symptômes de santé mentale ont été évalués à l'aide des scores auto-déclarés à la liste de contrôle des symptômes de Hopkins-25 (HSCL-25) au congé (à la base) et quand les participants ont reçu chaque communication. ANOVA a été utilisée pour les comparaisons primaires, et les analyses exploratoires pour les sous-groupes. RÉSULTATS: Les deux groupes ont connu une aggravation significative des symptômes de santé mentale à différents moments après le congé relativement à la base. Il n'y avait pas de différences significatives entre les groupes à tout moment, cependant au jour 4 il y avait une aggravation atténuée de 24,2% et de 72,6% dans le groupe des Contacts attentionnés comparé au groupe témoin pour la gravité totale des symptômes et les IS respectivement. Il n'y avait pas d'effet d'interaction significatif pour le sous-groupe de la dépression ou de ceux vivant seuls. CONCLUSIONS: Bien que cette étude pilote n'ait pas été mandatée pour identifier les différences significatives entre les groupes, les résultats indiquent la faisabilité et l'acceptabilité de l'intervention et offrent certaines indications à l'effet que Contacts attentionnés puissent avoir été bénéfiques pour les patients dans les jours suivant le congé, appuyant ainsi le besoin d'essais à plus grande échelle. L'étude a été enregistrée à clinicaltrials.gov (ID de l'étude NCT04456062).

Romantic Relationships and Mental Health During the COVID-19 Pandemic in Austria: A Population-Based Cross-Sectional Survey.

Background: Previous studies suggest that romantic relationships can be beneficial to mental health, but may also be a major stressor depending on specific relationship characteristics. Studies examining the role of romantic relationship in mental health are scarce. This study aimed to investigate differences in mental health with regards to relationship characteristics. Methods: We assessed individuals' mental health, i.e., suicidal ideation (via Beck Scale for Suicidal Ideation, BSS), depression (via Patient Health Questionnaire, PHQ-9), anxiety (Hospital Anxiety and Depression Scale, HADS), experience of psychological and physical violence, including changes in suicidal ideation and anxiety compared to before the pandemic, and relationship characteristics (i.e., relationship status, satisfaction, and commitment as well as family structure) with online questionnaires in a population-based cross-sectional study with 3,012 respondents in Austria during the COVID-19 pandemic. Results: There were small to medium-sized group differences with regards to relationship status and satisfaction (η p 2: 0.011-0.056). Most mental health outcomes were less favorable in singles than in individuals in happy relationships, but scores for anxiety (p < 0.001), psychological (p < 0.001) and physical violence (p < 0.001), and the probability of experiencing an increase in anxiety compared to before the pandemic (p < 0.01) were lower in singles as compared to those with low relationship satisfaction. Furthermore, scores for suicidal ideation (p > 0.001) and psychological (p > 0.01) and physical violence (p > 0.01) were highest in individuals in relationships with low commitment and with a child living in the same household, but effect sizes were small (η p 2: 0.004-0.015). Conclusion: During the COVID-19 pandemic, as compared to singles, mental health appeared worse in individuals with low relationship satisfaction and those in a relationship with low commitment and with a child in the household. Living in a happy relationship was associated with somewhat better mental health.

Predictors of vaccine hesitancy during the COVID-19 pandemic in Austria : A population-based cross-sectional study.

BACKGROUND: Unwillingness to get vaccinated against the coronavirus disease 2019 (COVID-19) is a major barrier in managing the pandemic. Previous studies have explored predictors of hesitancy to be vaccinated against COVID-19, but evidence on these predictors was partly mixed, and the number of assessed predictors was often limited. This study aimed to explore a wide range of potential predictors of vaccine hesitancy in a population-based cross-sectional study. METHODS: We assessed associations of vaccine hesitancy with individuals' fears about the future, social media use, and sociodemographics in a hierarchical multiple regression analysis. Data were collected via online questionnaires in a population-based cross-sectional study with 4018 respondents representative of the Austrian adult population between October and December 2020. RESULTS: Vaccine hesitancy was predicted by freedom-related fears (i.e., fears regarding the political situation, particularly loss of personal freedoms), but were negatively associated with health-related fears (i.e., fears about physical or mental health) and society-related fears (i.e., fears regarding societal issues such as solidarity, distance learning, and isolation). Social media use as well as female gender, younger age, lower education, lower income, and living in rural regions were further predictors of vaccine hesitancy. CONCLUSION: The study confirms that public health efforts targeting unvaccinated persons need to address freedom-related fears and social media discourse in order to improve vaccine uptake in the population. Particularly individuals in socially and economically disadvantaged groups and social media users need to be targeted to reduce vaccine hesitancy.

Romantic Relationships and Mental Health During the COVID-19 Pandemic in Austria: A Population-Based Cross-Sectional Survey

Background Previous studies suggest that romantic relationships can be beneficial to mental health, but may also be a major stressor depending on specific relationship characteristics. Studies examining the role of romantic relationship in mental health are scarce. This study aimed to investigate differences in mental health with regards to relationship characteristics. Methods We assessed individuals’ mental health, i.e., suicidal ideation (via Beck Scale for Suicidal Ideation, BSS), depression (via Patient Health Questionnaire, PHQ-9), anxiety (Hospital Anxiety and Depression Scale, HADS), experience of psychological and physical violence, including changes in suicidal ideation and anxiety compared to before the pandemic, and relationship characteristics (i.e., relationship status, satisfaction, and commitment as well as family structure) with online questionnaires in a population-based cross-sectional study with 3,012 respondents in Austria during the COVID-19 pandemic. Results There were small to medium–sized group differences with regards to relationship status and satisfaction (ηp2: 0.011–0.056). Most mental health outcomes were less favorable in singles than in individuals in happy relationships, but scores for anxiety (p < 0.001), psychological (p < 0.001) and physical violence (p < 0.001), and the probability of experiencing an increase in anxiety compared to before the pandemic (p < 0.01) were lower in singles as compared to those with low relationship satisfaction. Furthermore, scores for suicidal ideation (p > 0.001) and psychological (p > 0.01) and physical violence (p > 0.01) were highest in individuals in relationships with low commitment and with a child living in the same household, but effect sizes were small (ηp2: 0.004–0.015). Conclusion During the COVID-19 pandemic, as compared to singles, mental health appeared worse in individuals with low relationship satisfaction and those in a relationship with low commitment and with a child in the household. Living in a happy relationship was associated with somewhat better mental health.

Suicide trends in the early months of the COVID-19 pandemic: an interrupted time-series analysis of preliminary data from 21 countries.

BACKGROUND: The COVID-19 pandemic is having profound mental health consequences for many people. Concerns have been expressed that, at their most extreme, these consequences could manifest as increased suicide rates. We aimed to assess the early effect of the COVID-19 pandemic on suicide rates around the world. METHODS: We sourced real-time suicide data from countries or areas within countries through a systematic internet search and recourse to our networks and the published literature. Between Sept 1 and Nov 1, 2020, we searched the official websites of these countries' ministries of health, police agencies, and government-run statistics agencies or equivalents, using the translated search terms "suicide" and "cause of death", before broadening the search in an attempt to identify data through other public sources. Data were included from a given country or area if they came from an official government source and were available at a monthly level from at least Jan 1, 2019, to July 31, 2020. Our internet searches were restricted to countries with more than 3 million residents for pragmatic reasons, but we relaxed this rule for countries identified through the literature and our networks. Areas within countries could also be included with populations of less than 3 million. We used an interrupted time-series analysis to model the trend in monthly suicides before COVID-19 (from at least Jan 1, 2019, to March 31, 2020) in each country or area within a country, comparing the expected number of suicides derived from the model with the observed number of suicides in the early months of the pandemic (from April 1 to July 31, 2020, in the primary analysis). FINDINGS: We sourced data from 21 countries (16 high-income and five upper-middle-income countries), including whole-country data in ten countries and data for various areas in 11 countries). Rate ratios (RRs) and 95% CIs based on the observed versus expected numbers of suicides showed no evidence of a significant increase in risk of suicide since the pandemic began in any country or area. There was statistical evidence of a decrease in suicide compared with the expected number in 12 countries or areas: New South Wales, Australia (RR 0·81 [95% CI 0·72-0·91]); Alberta, Canada (0·80 [0·68-0·93]); British Columbia, Canada (0·76 [0·66-0·87]); Chile (0·85 [0·78-0·94]); Leipzig, Germany (0·49 [0·32-0·74]); Japan (0·94 [0·91-0·96]); New Zealand (0·79 [0·68-0·91]); South Korea (0·94 [0·92-0·97]); California, USA (0·90 [0·85-0·95]); Illinois (Cook County), USA (0·79 [0·67-0·93]); Texas (four counties), USA (0·82 [0·68-0·98]); and Ecuador (0·74 [0·67-0·82]). INTERPRETATION: This is the first study to examine suicides occurring in the context of the COVID-19 pandemic in multiple countries. In high-income and upper-middle-income countries, suicide numbers have remained largely unchanged or declined in the early months of the pandemic compared with the expected levels based on the pre-pandemic period. We need to remain vigilant and be poised to respond if the situation changes as the longer-term mental health and economic effects of the pandemic unfold. FUNDING: None.

Suicide and resilience-related Google searches during the first 12 months of the COVID-19 pandemic.

Online searches related to suicide may sometimes be an early proxy indicator for behavioural outcomes. We used interrupted time series regression analyses to examine changes in suicide and resilience-related Google searches worldwide and in the United States during the first 12 months of the COVID-19 pandemic. Searches for the word "suicide" were unchanged worldwide (-1%; 95%CI, -12%-11%) and in the US (-7%; 95%CI, -15%-2%) with decreased searches for "suicide methods" and increased searches for "how to kill yourself" and for resilience-related terms. This study provides potential evidence that suicides may not increase worldwide during the first year of the pandemic.

Effects of suicide prevention videos developed by and targeting adolescents: a randomized controlled trial.

Suicide prevention videos featuring young people's personal narratives of hope and recovery are increasingly used in suicide prevention, but research on their effects is scarce. A double-blind randomized controlled trial was conducted to test the effects of a suicide prevention video featuring an adolescent mastering his suicidal ideation by getting help on 14 to 19-year-olds. N = 299 adolescents were randomly allocated to watch the intervention video (n = 148) or a control video unrelated to mental health (n = 151). Questionnaire data were collected before (T1) and immediately after exposure (T2), and 4 weeks later (T3). Data were analyzed with a repeated-measures ANCOVA. The primary outcome was suicidal ideation, assessed with the Reasons for Living Inventory for Adolescents. Secondary outcomes were help-seeking intentions, attitudes towards suicide, stigmatization of suicidality, and mood. There was an immediate beneficial effect of the intervention on suicidal ideation (T2 mean change from baseline within intervention group MChange = - 0.16 [95% CI - 0.20 to - 0.12], mean difference compared to control group MDiff = - 0.09 [95% CI - 0.15 to - 0.03], ηp2 = 0.03), which was not maintained at T3. Participants reported significantly higher help-seeking intentions, which was maintained at 4-week follow-up. They also reported a sustained reduction of favorable attitudes to suicide. Effects on suicidal ideation were mediated by identification with the featured protagonist. Adolescents appear to benefit from suicide prevention narratives featuring personal stories from peers on coping with suicidal ideation and help-seeking.Trial registration DRKS00017405; 24/09/19; retrospectively registered.

The Impact of a Harry Potter-Based Cognitive-Behavioral Therapy Skills Curriculum on Suicidality and Well-being in Middle Schoolers: A Randomized Controlled Trial.

OBJECTIVE: To evaluate the impact of a Harry Potter-based mental health literacy curriculum, imparting cognitive behavioral therapy (CBT) skills, on suicidality and well-being in middle-schoolers. METHODS: Students (aged 11-14; grades 7-8) who received a 3-month teacher-delivered intervention embedded in the language arts curriculum (N=200) were compared to a wait-list control group (N=230) in the largest urban school board in Canada. Suicidality defined as a composite measure of self-reported suicidal ideation and attempts [primary outcome], self-reported emotion dysregulation, interpersonal chaos, confusion about self, and impulsivity [Life Problems Inventory (LPI)] and self-reported depression and anxiety symptoms [Revised Child Anxiety and Depression Scale (RCADS)] were the outcomes of interest. Measurements occurred prior to and after curriculum delivery with independent t-tests used to compare mean change scores between groups clustered by class. RESULTS: Thirty-seven English teachers in 46 classes across 15 schools comprised the planned study cohort. Composite suicidality scores were significantly worse in the control than intervention group at endpoint (0.05±0.54 vs. 0.17±0.47, t= -2.60, df=428, p=0.01). There were also significant improvements in LPI and RCADS scores in the intervention group compared to controls (LPI:-3.74±7.98 vs. 1.16±10.77 t=5.28, df=428, p<.001; RCADS: (-3.08±5.49 vs. -1.51±6.53 t=2.96, df=429, p=0.01). Sub-analyses revealed that these improvements were largely driven by a significant difference in scores in girls. LIMITATIONS: Sample size constraints as study terminated prematurely during COVID pandemic. CONCLUSIONS: This study demonstrates significant improvement in suicidality, emotional regulation, self-concept, interpersonal difficulties, depression and anxiety in youth, particularly girls following this intervention. Replication studies in larger samples are needed to confirm these results.

Tracking online searches for emotional wellbeing concerns and coping strategies in the UK during the COVID-19 pandemic: a Google Trends analysis [version 1;peer review: awaiting peer review]

Background: The coronavirus disease 2019 (COVID-19) pandemic is the largest acute public health emergency of this century. Government intervention to contain the virus focuses on non-pharmacological approaches such as physical distancing/lockdown (stay-at-home orders). As the situation develops, the impact of these measures on mental health and coping strategies in individuals and the population is unknown. Methods: We used Google Trends data (01 Jan 2020 to 09 Jun 2020) to explore the changing pattern of public concern in the UK to government measures as indexed by changes in search frequency for topics related to mental distress as well as coping and resilience. We explored the changes of specific topics in relation to key dates during the pandemic. In addition, we examined terms whose search frequency increased most. Results: Following lockdown, public concerns - as indexed by relative search trends - were directly related to COVID-19 and practicalities such as ‘furlough’ (paid leave scheme for people in employment) in response to the pandemic. Over time, searches with the most substantial growth were no longer directly or indirectly related to COVID-19. In contrast to relatively stable rates of searches related to mental distress, the topics that demonstrated a sustained increase were those associated with coping and resilience such as exercise and learning new skills. Conclusions: Google Trends is an expansive dataset which enables the investigation of population-level search activity as a proxy for public concerns. It has potential to enable policy makers to respond in real time to promote adaptive behaviours and deliver appropriate support.

A structured open dataset of government interventions in response to COVID-19.

In response to the COVID-19 pandemic, governments have implemented a wide range of non-pharmaceutical interventions (NPIs). Monitoring and documenting government strategies during the COVID-19 crisis is crucial to understand the progression of the epidemic. Following a content analysis strategy of existing public information sources, we developed a specific hierarchical coding scheme for NPIs. We generated a comprehensive structured dataset of government interventions and their respective timelines of implementation. To improve transparency and motivate collaborative validation process, information sources are shared via an open library. We also provide codes that enable users to visualise the dataset. Standardization and structure of the dataset facilitate inter-country comparison and the assessment of the impacts of different NPI categories on the epidemic parameters, population health indicators, the economy, and human rights, among others. This dataset provides an in-depth insight of the government strategies and can be a valuable tool for developing relevant preparedness plans for pandemic. We intend to further develop and update this dataset until the end of December 2020.