Years of life lost associated with COVID-19 deaths in the USA during the first 2 years of the pandemic.

BACKGROUND: Prior estimates of the years of life lost (YLLs) in the USA associated with coronavirus disease 2019 (COVID-19) were 1.2 million through 11 July 2020 and 3.9 million through 31 January 2021 (which roughly coincides with the first full year of the pandemic). The aim of this study is to update YLL estimates through the first 2 years of the pandemic. METHODS: We employed data regarding COVID-19 deaths through 5 February 2022 by jurisdiction, gender and age group. We used actuarial life expectancy tables by gender and age to estimate YLLs. RESULTS: We estimated roughly 9.7 million YLLs due to COVID-19 deaths. The number of YLLs per 10 000 capita was 297.5, with the highest rate in Mississippi (482.7) and the lowest in Vermont (61.4). There was substantial interstate variation in the timing of YLLs and differences in YLLs by gender. YLLs per death increased from 9.2 in the first year of the pandemic to 10.8 through the first 2 years. CONCLUSIONS: Our findings improve our understanding of how the mortality effects of COVID-19 have evolved. This insight can be valuable to public health officials as the disease moves to an endemic phase.

Clinician Perspectives on the Impact of COVID-19 on the Treatment of Adults and Youth with Anxiety.

We describe the perceptions of mental health clinicians practicing in the United States about the effects of the COVID-19 pandemic on the presentation and treatment course of active clients with anxiety. Clinician participants reported on client symptomology at the beginning of treatment, just before (prior to March 2020), and at a mid-pandemic timepoint (December 2020/January 2021). An initial sample of 70 clinicians responded to a survey assessing their clients' overall anxiety severity, anxiety sensitivity, pathological uncertainty, family accommodation, and avoidance levels. Of these, 54 clinician responses were included in study analyses, providing detailed clinical information on 81 clients. Findings suggest that the COVID-19 pandemic was associated with increases in anxiety severity in the majority of clients; overall, clinicians reported that 53% of clients had symptoms worsen due to COVID-19 and that only 16% experienced improvement of symptoms during treatment. Those who had lower levels of avoidance pre-pandemic and those who increased their frequency of treatment were more likely to experience increases in anxiety severity by the mid-pandemic timepoint. Further research is needed to understand the extended effects of the COVID-19 pandemic on anxiety symptomology and treatment.

Provider perceptions of telehealth and in-person exposure and response prevention for obsessive-compulsive disorder.

Until recently, psychotherapies, including exposure and response prevention (ERP) for obsessive-compulsive disorder (OCD), have primarily been delivered in-person. The COVID-19 pandemic required OCD providers delivering ERP to quickly transition to telehealth services. While evidence supports telehealth ERP delivery, limited research has examined OCD provider perceptions about patient characteristics that are most appropriate for this modality, as well as provider abilities to identify and address factors interfering with effective telehealth ERP. In the present study, OCD therapists (N = 113) rated the feasibility of delivering telehealth ERP relative to in-person for different (1) patient age-groups, (2) levels of OCD severity, and (3) provider ability to identify and address factors interfering with ERP during in-person and telehealth ERP (e.g., cognitive avoidance, reassurance seeking, etc.). Providers reported significantly greater feasibility of delivering telehealth ERP to individuals ages 13-to-65-years relative to other age groups assessed. Greater perceived feasibility for telehealth relative to in-person ERP was reported for lower versus higher symptom severity levels. Lastly, providers felt better able to identify and address problematic factors in-person. These findings suggest that providers should practice appropriate caution when offering telehealth ERP for certain patients with OCD. Future research may examine how to address these potential limitations of telehealth ERP delivery.

Obsessive compulsive disorder during the COVID-19 pandemic: A brief review of course, psychological assessment and treatment considerations.

Obsessive-compulsive disorder (OCD) is an impairing mental health condition defined by intense distress in the presence of unwanted, recurrent thoughts, images, or impulses which are accompanied by compulsions and avoidance performed to reduce distress. During the COVID-19 pandemic, OCD has continued to be an impairing mental health condition regardless of symptom dimensionality (e.g., contamination, harm, etc.) with varying reports of the overall clinical course. However, changes in the assessment, treatment, and diagnosis of OCD have occurred to personalize care and be aligned with public health guidelines. Exposure and response prevention and pharmacotherapy remain the treatment of choice, even though the setting in which treatment is conducted may have shifted. Telehealth in particular has been a 'game-changer' for clinicians and patients alike. Given the continued health risk posed by the pandemic, treatment personalization should still be made to ensure safety for both patients and providers while balancing efficacy and patient preferences.

Brief, parent-led, transdiagnostic cognitive-behavioral teletherapy for youth with emotional problems related to the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic has led to increased stress, anxiety, and depression in children. A six-session, parent-led, transdiagnostic, cognitive-behavioral teletherapy program was adapted from an established protocol to help youth aged between 5 and 13 years manage emotional problems during the pandemic. METHODS: One-hundred twenty-nine parents of youth struggling with emotional problems during the COVID-19 pandemic participated in the program. Parents reported on their children's psychosocial functioning before and after treatment using validated assessments. They also reported on treatment satisfaction. Clinician-rated global improvement was assessed at each session to determine clinically significant treatment response. RESULTS: Significant improvements in parent proxy-reported anxiety (d = 0.56), depression (d = 0.69), stress (d = 0.61), anger (d = 0.69), family relationships (d = 0.32), and COVID-19-related distress (d = 1.08) were found, with 62% of participants who completed the program being classified as treatment responders. Parents reported high levels of satisfaction with the program. LIMITATIONS: This study was limited by use of primarily parent-report assessments and a lack of a control group. CONCLUSIONS: Brief, parent-led, transdiagnostic cognitive-behavioral teletherapy appeared to be an effective way to help youth cope with the pandemic and may be a scalable framework in response to large-scale mental health crises.

A Qualitative Inquiry of Parents' Observations of Their Children's Mental Health Needs During the COVID-19 Pandemic.

Given that children and adolescents are at critical periods of development, they may be particularly vulnerable to the effects of the COVID-19 pandemic. Using a descriptive phenomenological approach, 71 parents' observations of their child's mental health difficulties were explored. Parents sought out treatment because their children were experiencing significant distress. Data used were transcribed from baseline questionnaires and therapy summaries. Data analysis revealed three themes: emotion regulation difficulties, hypervigilance, and despair. The search for strategies and tailored interventions to help mitigate the potential harmful and long-term mental health impacts of the pandemic should be at the forefront of research and clinical practice.

Association of Social Gaming with Well-Being (Escape COVID-19): A Sentiment Analysis.

BACKGROUND: During the 2020-2021 coronavirus disease 2019 (COVID-19) lockdown, social activities were limited by the government-recommended social distancing guidelines, leading to an abundance of mental health issues. METHODS: We hypothesized that Twitter sentiment analysis may shed some light on Animal Crossing: New Horizons and its impact on mental health during the COVID-19 pandemic. RESULTS: We found that social gaming and social media may be used as tools to cope with stress during the COVID-19 pandemic. CONCLUSIONS: Further research, including randomized study designs and prospective measurements of mental health outcomes related to social gaming behavior are required.

Obsessive-Compulsive Disorder During the COVID-19 Pandemic: a Systematic Review.

PURPOSE OF REVIEW: This systematic review evaluated the impact of the COVID-19 pandemic on obsessive-compulsive symptoms. RECENT FINDINGS: Most studies showed that obsessive-compulsive symptoms worsened during the early stages of the pandemic, particularly for individuals with contamination-related obsessive-compulsive disorder (OCD), though other symptoms dimensions were found to worsen as well. Many patients and individuals in the general population experienced new obsessive-compulsive-like symptoms centered on COVID-19. Self-reported rates of symptom exacerbation and COVID-19-focused symptoms were consistently lower in studies that recruited patients from specialty clinics (compared to online samples). Most studies were conducted in Spring/Summer, 2020. The COVID-19 pandemic has been an enormous stressor for individuals with OCD, especially for those with contamination symptoms. Regardless, there is strong reason to believe gold standard treatment approaches for OCD have maintained strong efficacy. Disseminating and effectively delivering evidence-based treatments for OCD is an urgent public health priority.

Impact of the Texas-Wide Premedical Mentoring Program during the COVID-19 pandemic.

The COVID-19 pandemic disrupted the usual processes and support systems related to applying to medical school in the United States. The Texas-Wide Premedical Mentoring Program (TPMP) was established to pair medical student mentors in Texas with medical school applicants attending Texas colleges and universities. Our objective was to demonstrate the effect of the TPMP on application preparedness and self-reported mental health outcomes of program participants. A survey was developed to understand the program's impact on both mentees and mentors. Participants were sent a survey link 3 months after the TPMP launch. In total, 313 participants, comprising 62% premedical student mentees and 38% medical student mentors, completed the survey. Mentees reported a significantly positive effect of the program on anxiety, uncertainty of acceptance, connection to medicine, and making the road to medical school seem less impossible. After participation, mentees felt less alone and reported a positive impact on their perception of the application process. The TPMP positively impacted the mental wellness of both mentees and mentors, and about 80% of mentors felt more fulfilled despite not participating in clinical duties in light of suspensions. In conclusion, program participation was associated with decreasing application knowledge gaps, easing anxiety, and providing alliance for mentees. The TPMP had a similarly positive influence on the mental wellness of mentees and mentors as well as contributed to medical student mentors' sense of fulfillment.

Psychological Distress Among the U.S. General Population During the COVID-19 Pandemic.

The COVID-19 pandemic is taking a significant global toll on emotional well-being, but evidence of mental health impacts in the United States remains limited. In April 2020, we conducted an exploratory survey of U.S. residents to understand prevalence of and factors associated with psychological distress during the pandemic. Data collection was conducted using Qualtrics, an online survey platform, and U.S. adult respondents were recruited via Amazon's Mechanical Turk platform. Among 1,366 respondents, 42% (n = 571) reported clinically significant anxiety and 38% (n = 519) reported clinically significant depression. Factors associated with anxiety and depressive symptoms included Hispanic/Latino ethnicity; younger age; lower income; employment as or living with a health care worker-first responder; caregiver status; SARS-CoV-2 infection status; decreased frequency of engagement in healthy behaviors; and changed frequency of engagement in unhealthy behaviors. That some of these factors are associated with elevated distress during the pandemic is not yet widely appreciated and might be useful in informing management of mental health care resources.

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Addressing the mental health needs of learners and nonlearners in an academic medical center during COVID-19.

The coronavirus disease (COVID-19) has impacted life for people throughout the world, especially for those in health care who experience unique stressors. To support the psychological needs of staff, faculty, and learners at a biomedical sciences university, faculty at Baylor College of Medicine created a mental health and wellness support program consisting of multiple behavioral health care pathways, including phone support, a self-guided mental health app, a coping skills group, and individual therapy services. The authors present this program as a model for academic institutions to support the well-being of faculty, staff, and learners.

Years of life lost associated with COVID-19 deaths in the USA during the first year of the pandemic.

BACKGROUND: Years of Life Lost (YLLs) measure the shortfall in life expectancy due to a medical condition and have been used in multiple contexts. Previously it was estimated that there were 1.2 million YLLs associated with coronavirus disease 2019 (COVID-19) deaths in the USA through 11 July 2020. The aim of this study is to update YLL estimates for the first full year of the pandemic. METHODS: We employed data regarding COVID-19 deaths in the USA through 31 January 2021 by jurisdiction, gender and age group. We used actuarial life expectancy tables by gender and age to estimate YLLs. RESULTS: We estimated roughly 3.9 million YLLs due to COVID-19 deaths, which correspond to roughly 9.2 YLLs per death. We observed a large range across states in YLLs per 10 000 capita, with New York City at 298 and Vermont at 12. Nationally, the YLLs per 10 000 capita were greater for males than females (136.3 versus 102.3), but there was significant variation in the differences across states. CONCLUSIONS: Our estimates provide further insight into the mortality effects of COVID-19. The observed differences across states and genders demonstrate the need for disaggregated analyses of the pandemic's effects.

Expert opinion in obsessive-compulsive disorder: Treating patients with obsessive-compulsive disorder during the COVID-19 pandemic

This commentary outlines assessment and treatment of patients with OCD during the era of COVID-19. The ongoing COVID-19 pandemic has required providers to make important considerations in treatment, including how usual risk is defined, as well as the use of personal protective equipment and telehealth services. These considerations have allowed providers to continue using both reliable and valid assessment procedures, as well as previously established and efficacious interventions. These adjustments create a context in which patient care for OCD remains fundamentally unchanged;however, important considerations should still be made because of the COVID-19 pandemic.

Deep Brain Stimulation for Parkinson's Disease During the COVID-19 Pandemic: Patient Perspective.

BACKGROUND: Public health guidelines have recommended that elective medical procedures, including deep brain stimulation (DBS) surgery for Parkinson's disease (PD), should not be scheduled during the coronavirus (COVID-19) pandemic to prevent further virus spread and overload on health care systems. However, delaying DBS surgery for PD may not be in the best interest of individual patients and is not called for in regions where virus spread is under control and inpatient facilities are not overloaded. METHODS: We administered a newly developed phone questionnaire to 20 consecutive patients with PD who received DBS surgery in Ruijin Hospital in Shanghai during the COVID-19 pandemic. The questionnaire was designed to gather the patients' experiences and perceptions on the impact of COVID-19 on their everyday activities and access to medical care. RESULTS: Most of the patients felt confident about the preventive measures taken by the government and hospitals, and they have changed their daily living activities accordingly. Moreover, a large majority of patients felt confident obtaining access to regular and COVID-19-related health care services if needed. Routine clinical referral, sense of security in the hospital during the outbreak, and poor control of PD symptoms were the three main reasons given by patients for seeking DBS surgery during the COVID-19 pandemic. CONCLUSION: The COVID-19 pandemic has considerably impacted medical care and patients' lives but elective procedures, such as DBS surgery for PD, do not need to be rescheduled when the health care system is not overloaded and adequate public health regulations are in place.

Impact of the COVID-19 pandemic on exposure and response prevention outcomes in adults and youth with obsessive-compulsive disorder.

The COVID-19 pandemic has created novel mental health challenges for those with pre-existing problems including obsessive-compulsive disorder (OCD). Our study reports on clinician perceptions regarding the effect of the COVID-19 pandemic on patients with OCD receiving exposure and response prevention treatment (ERP) prior to and during the pandemic. Participating clinicians completed a survey which included questions adapted from National Institute of Mental Health-Global Obsessive-Compulsive Scale (NIMH-GOCS) and Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Clinicians rated clinical features at treatment initiation, just prior to the pandemic, and mid-pandemic (July/August, 2020). Findings suggest that the COVID-19 pandemic was associated with attenuation of ERP progress from expected rates in most patients during first several months of the pandemic; clinicians estimated that 38% of their patients had symptoms worsen during the pandemic and 47% estimated that symptoms remained unchanged despite participating in ERP. Those who endured financial distress or were medically at-risk for severe COVID-19 disease had worse ERP course. Adults also had a worse ERP course during than pandemic than youth. Further research is needed to better understand the effect of the COVID-19 pandemic on OCD symptomatology and treatment trajectory post-pandemic.