Impact of COVID-19 on Children's Attention Deficit Hyperactivity Disorder Symptomology, Daily Life, and Problem Behavior During Virtual Learning.

To explore the impact of COVID-19 on daily life and problem behavior during virtual learning, we created and administered a survey to 64 school-aged children (in 2019, M = 9.84 years; SD = 0.55 years). Results indicated significant increases in hyperactivity (t = -2.259; p = .027) and inattention (t = -2.811; p = .007) from 2019 to 2020. Decreases in sleep were associated with increases in hyperactivity (B = -0.27; p = .04); increases in time exercising were associated with smaller increases in inattention (B = -0.34, p = .01); and higher levels of parent stress, specifically related to virtual learning, were associated with increases in child inattention (B = 0.57, p = .01). Furthermore, hyperactivity predicted problem behavior during virtual learning (B = 0.31, p = .03).

Premorbid traumatic stress and veteran responses to the COVID-19 pandemic.

The COVID-19 pandemic has had unprecedented effects on lifestyle stability and physical and mental health. We examined the impact of preexisting posttraumatic stress disorder (PTSD), alcohol use disorder (AUD), and depression on biopsychosocial responses to the pandemic, including psychiatric symptoms, COVID-19 exposure, and housing/financial stability, among 101 U.S. military veterans enrolled in a longitudinal study of PTSD, a population of particular interest given veterans' trauma histories and defense-readiness training. Participants (83.2% male, 79.2% White, Mage  = 59.28 years) completed prepandemic, clinician-administered psychiatric diagnostic interviews and a phone-based assessment between May and September 2020 using a new measure, the Rapid Assessment of COVID-19-Related Experiences (RACE), which was used to assess pandemic responses and its effects on mental and physical health; COVID-19 diagnosis and testing were also extracted from electronic medical records. Multivariate regressions showed that, controlling for demographic characteristics, prepandemic PTSD, ß = .332; p = .003, and AUD symptoms, ß = .228; p = .028, were associated with increased pandemic-related PTSD symptoms. Prepandemic AUD was associated with increased substance use during the pandemic, ß = .391; p < .001, and higher rates of self-reported or medical record-based COVID-19 diagnosis, ß = .264; p = .019. Minority race was associated with pandemic-related housing/financial instability, ß = -.372; p < .001, raising concerns of population inequities. The results suggest that preexisting PTSD and AUD are markers for adverse pandemic-related psychiatric outcomes and COVID-19 illness. These findings carry implications for the importance of targeting prevention and treatment efforts for the highest-risk individuals.

Evaluation of myCOPD, a digital self-management technology for people with COPD, in a remote and rural population

Aim: The prevalence of chronic obstructive pulmonary disease (COPD) in poor, remote, and rural populations is twice that of cities (15.4% versus 8.4%).1 COPD costs the NHS an estimated £1.9bn/year2 and is characterised by exacerbation frequency and severity. Disease education and self-management are critical to reducing the healthcare burden for patients with COPD. We evaluated myCOPD, a digital self-management technology in a predominantly remote and rural population. We (Figure presented) assessed whether myCOPD was effective in reducing hospital admissions, inpatient bed days and other NHS service usage. Method: 120 people were recruited over 6 months. We compared data regarding hospital admissions, inpatient bed days, clinic attendances, out of hours contacts and home visits 12 months before and up to 12 months after myCOPD activation. To account for differences in activation rates and the early termination of the study due to COVID-19 data was reported as daily outcome measures. Results: The average participant age was 67, with a GOLD score 1-4 (average 2.7). The average 6-fold urban-rural score was 4.23 indicating a predominantly remote and/or rural population. 78% of patients activated myCOPD, 70% recorded their symptom score at least once, and 45% used >1 myCOPD module. There was no association between myCOPD use and participant demographics. There were no statistically significant differences in hospital admissions, inpatient bed days, or other health service utilisation before and after myCOPD activation. However, a subgroup analysis found that those individuals with the greatest degree of myCOPD engagement either by frequency of symptom scoring (figure 1A) or by numbers of modules used (figure 1B) did show a reduction in bed days. Conclusion: These data indicate no association between myCOPD use and either reduced bed days or other NHS service use on a whole group level however it may be of benefit to individuals with higher levels of engagement. Overall these results have significant implications regarding the design and evaluation of novel service innovations in COPD and other chronic disorders.