Generalized anxiety among Finnish youth from 2013 to 2021-Trend and the impact of COVID-19.

BACKGROUND: Alarming levels of emotional symptoms among youth were reported during the COVID-19 pandemic. Studies assessing these figures against the pre-pandemic developments are rare. We examined the trend of generalized anxiety (GA) in adolescents in the 2010s and the effect of the COVID-19 pandemic against this trend. METHODS: Data from the Finnish School Health Promotion study with 750,000 participants aged 13-20 between 2013 and 2021 was analyzed using GAD-7 to measure self-reported GA (cut-off ≥10). Inquiries were made about remote learning arrangements. Effects of time and COVID-19 were analyzed with logistic regression. RESULTS: Among females, an increasing trend in GA between 2013 and 2019 was found (OR per year 1.05), and the prevalence increased from 15.5 % to 19.7 %. Among males, the trend was decreasing (OR = 0.98), with prevalence from 6.0 % to 5.5 %. Increase in GA from 2019 to 2021 was stronger in females (19.7 % to 30.2 %) than males (5.5 % to 7.8 %), while the effect of COVID-19 on GA was equally strong (OR = 1.59 vs. OR = 1.60) against the pre-pandemic trends. Remote learning was associated with elevated levels of GA, especially among those with unmet needs for learning support. LIMITATIONS: The design of repeated cross-sectional surveys doesn't allow analyses of within individual changes. CONCLUSIONS: Given the pre-pandemic trends of GA, the COVID-19 effect on it appeared equal in both sexes. The increasing pre-pandemic trend among adolescent females and the strong effect of COVID-19 on GA among both sexes warrants constant monitoring of mental health of the youth in the aftermath of the COVID-19 pandemic.

Incidence and persistence of psychological distress during the COVID-19 pandemic among individuals with and without disability.

OBJECTIVES: We investigated the incidence (becoming distressed at the follow-up) and persistence (distressed at the baseline and the follow-up) of psychological distress among individuals with and without disability in the period from early 2017 (before the COVID-19 pandemic) to late 2020 (the second wave of the pandemic). METHODS: We analyzed the population-based FinHealth 2017 survey and its follow-up conducted in 2020 (number of individuals who participated in both surveys: n = 4881; age = 18+). Logistic regressions were applied to investigate differences in the incidence and persistence of psychological distress between people with and without disability. We also investigated whether age, quality of life at the baseline, and perceived increase in loneliness during the COVID-19 pandemic moderated the association between disability and the incidence of distress. RESULTS: The incidence of psychological distress was higher (OR = 3.01, 95% CI:2.09-4.35) for people with disability (18.9%) than among those without (7.4%), being highest (31.5%) among the youngest participants with disability, aged 18 to 39. People with disability who had a poor quality of life at the baseline were particularly prone to become distressed during the follow-up. People who reported perceived increase in loneliness during the pandemic were prone to become distressed at the follow-up regardless of their disability status. The persistence of distress was more common (OR = 6.00, 95% CI:3.53-10.12) among people with disability (65.7%) than among those without (24.9%). CONCLUSION: The COVID-19 pandemic had more negative mental health effects on people with disability, especially adults with disability who were young and had a low quality of life before the pandemic.

Healthcare workers' heterogeneous mental-health responses to prolonging COVID-19 pandemic: a full year of monthly follow up in Finland.

BACKGROUND: The COVID-19 pandemic strained healthcare workers but the individual challenges varied in relation to actual work and changes in work. We investigated changes in healthcare workers' mental health under prolonging COVID-19 pandemic conditions, and heterogeneity in the mental-health trajectories. METHODS: A monthly survey over a full year was conducted for employees of the HUS Helsinki University Hospital (n = 4804) between 4th June 2020 to 28th May 2021. Pandemic-related potentially traumatic events (PTEs), work characteristics (e.g., contact to COVID-19 patients), local COVID-19 incidence, and demographic covariates were used to predict Mental Health Index-5 (MHI-5) and Insomnia Severity Index (ISI) in generalized multilevel and latent-class mixed model regressions. RESULTS: Local COVID-19 log-incidence (odds ratio, OR = 1.21, with 95% CI = 1.10-1.60), directly caring for COVID-19 patients (OR = 1.33, CI = 1.10-1.60) and PTEs (OR = 4.57, CI = 3.85-5.43) were all independently associated with psychological distress, when (additionally) adjusting for age, sex, profession, and calendar time. Effects of COVID-19 incidence on mental health were dissociable from calendar time (i.e., evolved in time) whereas those on sleep were not. Latent mental-health trajectories were characterized by a large class of "stable mental health" (62% of employees) and minority classes for "early shock, improving" (14%) and "early resilience, deteriorating" mental health (24%). The minority classes, especially "early shock, improving", were more likely to live alone and be exposed to PTEs than the others. CONCLUSIONS: Healthcare workers faced changing and heterogeneous mental-health challenges as the COVID-19 pandemic prolonged. Adversity and mental ill-being may have accumulated in some employees, and factors like living arrangements may have played a role. Knowledge on employees' demographic and socioeconomic background, as well as further research on the factors affecting employees' resilience, may help in maintaining healthy and efficient workforce in the face of a prolonging pandemic.

Differences in Unfavorable Lifestyle Changes during the COVID-19 Pandemic between People with and without Disabilities in Finland: Psychological Distress as a Mediator.

We investigated whether people with disabilities-cognition, vision, hearing, mobility, or at least one of these disabilities-report more COVID-19-related negative lifestyle changes than those without disabilities, and whether psychological distress (MHI-5) mediates the association between disabilities and negative lifestyle changes. Information about COVID-related lifestyle changes among people with disabilities is scarce. We analyzed population-based data from the 2020 FinSote survey carried out between September 2020 and February 2021 in Finland (n = 22,165, aged 20+). Logistic regressions were applied to investigate the effect of the COVID-19 pandemic and related restrictions on negative lifestyle changes-sleeping problems or nightmares, daily exercise, vegetable consumption, and snacking. To test for a mediation effect of psychological distress, the Karlson-Holm-Breen method was used. People with all disability types reported increased sleeping problems or nightmares, and decreased vegetable consumption during the pandemic more frequently than those without. People with mobility and cognitive disabilities more frequently reported decreased daily exercise. People with cognitive disabilities more often reported increased snacking. Psychological distress mediated associations between disabilities and negative lifestyle changes, with the highest association between cognitive disabilities and increased sleeping problems or nightmares (B = 0.60), and the lowest between mobility disabilities and decreased daily exercise (B = 0.08). The results suggest that strategies to promote healthy lifestyles should consider people with disabilities. Alleviating their psychological distress during crisis situations could be one approach.

Suicides from 2016 to 2020 in Finland and the effect of the COVID-19 pandemic.

The COVID-19 pandemic has had negative mental health outcomes in populations, but the suicide numbers in Finland have remained unchanged compared with expected levels based on the pre-pandemic period. We included all deaths from suicide verified by the official cause-of-death investigations, including forensic autopsy with analysis of forensic toxicology samples, between 1 January 2016 and 31 December 2020 in Finland. There was a decline in suicide incidence from 2016 to 2020 in men, and a declining tendency in suicide rates for every consecutive month during the COVID-19 pandemic period. The COVID-19 governmental policy responses do not seem to have led to an increase in suicide numbers.

COVID-19 Pandemic and Helsinki University Hospital Personnel Psychological Well-Being: Six-Month Follow-Up Results.

The COVID-19 pandemic has caused an unequally distributed extra workload to hospital personnel and first reports have indicated that especially front-line health care personnel are psychologically challenged. A majority of the Finnish COVID-19 patients are cared for in the Helsinki University Hospital district. The psychological distress of the Helsinki University Hospital personnel has been followed via an electronic survey monthly since June 2020. We report six-month follow-up results of a prospective 18-month cohort study. Individual variation explained much more of the total variance in psychological distress (68.5%, 95% CI 65.2-71.9%) and negative changes in sleep (75.6%, 95% CI 72.2-79.2%) than the study survey wave (1.6%, CI 0.5-5.5%; and 0.3%, CI 0.1-1.2%). Regional COVID-19 incidence rates correlated with the personnel's psychological distress. In adjusted multilevel generalized linear multiple regression models, potentially traumatic COVID-19 pandemic-related events (OR 6.54, 95% CI 5.00-8.56) and front-line COVID-19 work (OR 1.81, 95% CI 1.37-2.39) was associated with personnel psychological distress but age and gender was not. While vaccinations have been initiated, creating hope, continuous follow-up and psychosocial support is still needed for all hospital personnel.

Personnel Well-Being in the Helsinki University Hospital during the COVID-19 Pandemic-A Prospective Cohort Study.

In March 2020, strict measures took place in Finland to limit the COVID-19 pandemic. Majority of Finnish COVID-19 patients have been located in southern Finland and consequently cared for at the Hospital District of Helsinki and Uusimaa (HUS) Helsinki University Hospital. During the pandemic, HUS personnel's psychological symptoms are followed via an electronic survey, which also delivers information on psychosocial support services. In June 2020, the baseline survey was sent to 25,494 HUS employees, 4804 (19%) of whom answered; altogether, 62.4% of the respondents were nursing staff and 8.9% were medical doctors. While the follow-up continues for a year and a half, this report shares the sociodemographic characteristics of the respondents and the first results of psychological symptoms from our baseline survey. Out of those who were directly involved in the pandemic patient care, 43.4% reported potentially traumatic COVID-19 pandemic-related events (PTEs) vs. 21.8% among the others (p < 0.001). While over a half of the personnel were asymptomatic, a group of respondents reported PTEs and concurrent depression, insomnia, and anxiety symptoms. This highlights the need to ensure appropriate psychosocial support services to all traumatized personnel; especially, nursing staff may require attention.