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1.
Innovation in Aging ; 5(Supplement_1):411-412, 2021.
Article in English | PMC | ID: covidwho-1584576

ABSTRACT

Posttraumatic stress disorder (PTSD) is twice as prevalent in women as in men, and is an established risk factor for chronic disease, but few studies have comprehensively assessed lifetime PTSD in middle-aged and older civilian women. We surveyed 33,328 women aged 54-74 from the Nurses’ Health Study II from August 2018 to January 2020 to understand trauma exposure, PTSD based on the Diagnostic and Statistical Manual of Mental Disorders Version 5, and trauma-related treatment use. The majority (82.2%) of women reported one or more lifetime traumas. 10.5% of those with trauma had lifetime PTSD and 1.5% had past-month PTSD. The most common trauma types were sudden or unexpected death of a loved one (44.9%) and interpersonal or sexual violence (43.5%). Almost 30% experienced occupational (nursing-related) trauma. Interpersonal or sexual violence event types explained the largest proportion of PTSD cases (33.6%) out of seven categories of events assessed. Only 25% of women with trauma ever accessed trauma-related treatment, but this proportion was higher (66.4%) among those with diagnosable PTSD, and among those with current depression (35.9%). Treatment was most common among women who experienced interpersonal/sexual violence and lowest among those with occupational trauma, but treatment satisfaction did not vary by worst trauma type. Psychotherapy was the most common type of treatment. These results demonstrate that trauma is nearly universal in middle-aged to older women, which has important implications for their long-term health and well-being—particularly in the era of COVID-19 which is likely to produce additional trauma in this population.

3.
BMC Pregnancy Childbirth ; 21(1): 768, 2021 Nov 12.
Article in English | MEDLINE | ID: covidwho-1528682

ABSTRACT

BACKGROUND: Pregnant and postpartum women face unique challenges and concerns during the COVID-19 pandemic. Thus far, no studies have explored the factors associated with increased levels of worry in this population globally. The current study sought to assess the frequency and sources of worry during the COVID-19 pandemic in an international sample of pregnant and postpartum women. METHODS: We conducted an anonymous, online, cross-sectional survey in 64 countries between May and June 2020. The survey was available in 12 languages and hosted on the Pregistry platform for COVID-19 studies. Participants were sought mainly on social media platforms and online parenting forums. The survey included questions related to demographics, level of worry, support, stress, COVID-19 exposure, frequency of media usage, and mental health indicators. RESULTS: The study included 7561 participants. Eighty-three percent of all participants indicated that they were either 'somewhat' or 'very' worried. Women 13-28 weeks pregnant were significantly more likely to indicate that they were 'very worried' compared to those who were postpartum or at other stages of pregnancy. When compared with women living in Europe, those in Africa, Asia and Pacific, North America and South/Latin America were more likely to have increased levels of worry, as were those who more frequently interacted with social media. Different forms of support and stress also had an impact upon level of worry, while indicators of stress and anxiety were positively associated with worry level. CONCLUSION: Pregnant and postpartum women are vulnerable to the changes in societal norms brought about by the COVID-19 pandemic. Understanding the factors associated with levels of worry within this population will enable society to address potential unmet needs and improve the current and future mental health of parents and children.


Subject(s)
Anxiety/etiology , COVID-19/psychology , Pregnancy Complications/etiology , Adolescent , Adult , Anxiety/epidemiology , Anxiety/psychology , Cross-Sectional Studies , Female , Global Health/statistics & numerical data , Health Surveys , Humans , Logistic Models , Odds Ratio , Postpartum Period/psychology , Pregnancy , Pregnancy Complications/epidemiology , Pregnancy Complications/psychology , Risk Factors , Stress, Psychological/epidemiology , Stress, Psychological/etiology , Stress, Psychological/psychology , Young Adult
4.
J Matern Fetal Neonatal Med ; : 1-9, 2021 Jun 22.
Article in English | MEDLINE | ID: covidwho-1279993

ABSTRACT

BACKGROUND: Stress is a complex condition that can have a profound effect on an individual's sense of wellbeing and their ability to live a happy and healthy life. COVID-19 and its associated stressors have the potential to disrupt numerous facets of our everyday lives. Pregnant and postpartum women are especially vulnerable to changes in the availability of routine health and social care services and of their support networks. The current study sought to explore stress levels and their influencers among an international cohort of pregnant and postpartum women during the COVID-19 pandemic. METHODS: We conducted an anonymous, online, cross-sectional survey in 64 countries between May and June 2020. The survey was hosted on the Pregistry platform and made available in 12 languages, with respondents sought through a variety of social media platforms and parenting forums. In addition to levels of stress, we collected data related to demographics, COVID-19 exposure and worries, lifestyle changes, traditional and social media use, precautionary measures related to COVID-19, and mental health. RESULTS: In total, 7185 women were included in our sample. We found statistically significant (p-value <0.05) reductions in stress score among older women (≥35 years of age), those either living with a partner or married, those who had graduated from college, and those with medical coverage. Higher stress scores were found among women who resided in Africa, Asia and the Pacific, the Middle East, and North America compared with those in Europe. When race and ethnicity were included in the model, black women were found to have higher stress compared to white women. Level of family and community support was inversely associated with level of stress. CONCLUSION: Our study is one of the first to explore stress levels among pregnant and postpartum women during the COVID-19 pandemic. We found statistically significant differences in stress levels by age, education, marital status, region of residence, race/ethnicity and level of support. Understanding stress during the COVID-19 pandemic, and exploring ways to address it, will be key to contributing to the mental and physical health of expectant and new mothers, as well as their children, in both the short and long term.

5.
J Psychosom Res ; 148: 110552, 2021 09.
Article in English | MEDLINE | ID: covidwho-1275529

ABSTRACT

OBJECTIVE: We aimed to investigate the mental health impact of COVID-19 on a demographically well-characterized population cohort by gender and previous depression status. METHODS: Among people who participated in a community cohort study between 2013 and 2018 with previous depression measurement, a total of 1928 people without quarantine experience (680 men and 1249 women) were included after responding to an online survey in March 2020. In the 2020 survey, people were queried about daily needs supply, social support, risk perception, change during the COVID-19 pandemic, as well as mental health indices measuring loneliness, anxiety symptoms, post-traumatic stress disorder (PTSD), and depression. Separate analyses by gender were conducted to assess the association between COVID-19-related experiences and each mental health index, using multivariable logistic regressions with additional adjustment and stratification with pre-existing depression status. RESULTS: We could not observe significant gender differences for depression, anxiety, PTSD, and loneliness at 55 days after the start of the COVID-19 outbreak. Most external support, including daily needs supply and social support, protected men and women from experiencing severe anxiety (for life supply, OR = 0.92 (95%CI 0.88-0.97) (men) and OR = 0.95 (95% CI 0.91-0.99) (women); for social support, OR = 0.92(both for men and women, p < 0.01)). The results were similar for depression and PTSD. External support showed a larger reduction in the likelihoods for anxiety and depression during the COVID-19 pandemic among people with pre-existing depression compared to previously healthy people, and it was more prominent in men. CONCLUSION: COVID-19 significantly affected the mental health of both men and women in the early period of the pandemic. Having enough supply of daily needs and social support seems important, especially for people with previous depression.


Subject(s)
COVID-19/epidemiology , Depression/epidemiology , Health Surveys , Mental Health/statistics & numerical data , Adult , Aged , Anxiety/epidemiology , Causality , Female , Humans , Male , Middle Aged , Pandemics , Prospective Studies , SARS-CoV-2 , Stress Disorders, Post-Traumatic/epidemiology , Time Factors
6.
PLoS One ; 16(4): e0249780, 2021.
Article in English | MEDLINE | ID: covidwho-1197377

ABSTRACT

Pregnant and postpartum women face unique challenges during the COVID-19 pandemic that may put them at elevated risk of mental health problems. However, few large-scale and no cross-national studies have been conducted to date that investigate modifiable pandemic-related behavioral or cognitive factors that may influence mental health in this vulnerable group. This international study sought to identify and measure the associations between pandemic-related information seeking, worries, and prevention behaviors on perinatal mental health during the COVID-19 pandemic. An anonymous, online, cross-sectional survey of pregnant and postpartum women was conducted in 64 countries between May 26, 2020 and June 13, 2020. The survey, available in twelve languages, was hosted on the Pregistry platform for COVID-19 studies (https://corona.pregistry.com) and advertised in social media channels and online parenting forums. Participants completed measures on demographics, COVID-19 exposure and worries, information seeking, COVID-19 prevention behaviors, and mental health symptoms including posttraumatic stress via the IES-6, anxiety/depression via the PHQ-4, and loneliness via the UCLA-3. Of the 6,894 participants, substantial proportions of women scored at or above the cut-offs for elevated posttraumatic stress (2,979 [43%]), anxiety/depression (2,138 [31%], and loneliness (3,691 [53%]). Information seeking from any source (e.g., social media, news, talking to others) five or more times per day was associated with more than twice the odds of elevated posttraumatic stress and anxiety/depression, in adjusted models. A majority of women (86%) reported being somewhat or very worried about COVID-19. The most commonly reported worries were related to pregnancy and delivery, including family being unable to visit after delivery (59%), the baby contracting COVID-19 (59%), lack of a support person during delivery (55%), and COVID-19 causing changes to the delivery plan (41%). Greater worries related to children (i.e., inadequate childcare, their infection risk) and missing medical appointments were associated with significantly higher odds of posttraumatic stress, anxiety/depression and loneliness. Engaging in hygiene-related COVID-19 prevention behaviors (face mask-wearing, washing hands, disinfecting surfaces) were not related to mental health symptoms or loneliness. Elevated posttraumatic stress, anxiety/depression, and loneliness are highly prevalent in pregnant and postpartum women across 64 countries during the COVID-19 pandemic. Excessive information seeking and worries related to children and medical care are associated with elevated symptoms, whereas engaging in hygiene-related preventive measures were not. In addition to screening and monitoring mental health symptoms, addressing excessive information seeking and women's worries about access to medical care and their children's well-being, and developing strategies to target loneliness (e.g., online support groups) should be part of intervention efforts for perinatal women. Public health campaigns and medical care systems need to explicitly address the impact of COVID-19 related stressors on mental health in perinatal women, as prevention of viral exposure itself does not mitigate the pandemic's mental health impact.


Subject(s)
COVID-19/epidemiology , COVID-19/psychology , Mental Disorders/epidemiology , Mental Health , Pregnancy/psychology , Adult , Anxiety/epidemiology , Anxiety/psychology , Cross-Sectional Studies , Depression/epidemiology , Depression/psychology , Female , Humans , Loneliness/psychology , Middle Aged , Pandemics , Parturition/psychology , Perinatal Care , Postpartum Period/psychology , SARS-CoV-2/isolation & purification , Stress, Psychological/epidemiology , Stress, Psychological/etiology , Surveys and Questionnaires , Women's Health
9.
Preprint | SSRN | ID: ppcovidwho-1682

ABSTRACT

Background: Empirical studies on the effect of COVID-19 on mental health are limited by reliance on cross-sectional data and focus on specific at-risk groups. T

10.
Eur J Psychotraumatol ; 11(1): 1762995, 2020 Jun 29.
Article in English | MEDLINE | ID: covidwho-631889

ABSTRACT

Our submission is responsive to the urgent need for public mental health action prompted by the escalating COVID-19 pandemic. In it, we review the evidence calling for urgent public mental health action, propose a mental health equivalent fo the World Health Organization's 'Do the Five' concept, and describe the 'REACH for Mental Health' public health measure we have launched at the Harvard T.H. Chan School of Public Health.


Nuestra presentación responde a la necesidad urgente de acciones en la salud mental pública debido a la creciente pandemia de COVID-19. En esta presentación revisamos la evidencia que exige acciones urgentes de la salud mental pública, proponemos un equivalente de salud mental del concepto 'Haz los cinco' de la Organización Mundial de la Salud, y describimos la intervención de salud pública 'REACH (por sus siglas en ingles) para Salud Mental' que hemos lanzado en la Escuela T.H. Chan de Salud Pública de Harvard.本文是对因COVID-19大流行升级而急需采取公共精神卫生行动的回应。在本文中, 我们综述了呼吁采取紧急公共精神卫生行动的证据, 提出了与世界卫生组织的'做到五点 (Do the Five)'概念相当的心理健康措施, 并描述了我们在哈佛大学陈水清公共卫生学院共同发起的'为精神卫生提供REACH心理健康'公共卫生干预措施。我们描述了这种干预措施以支持必要的公共卫生行动, 以防止随着COVID-19大流行的全面展开而引发的广泛精神卫生危机。.

11.
Cancer Epidemiol Biomarkers Prev ; 29(7): 1283-1289, 2020 07.
Article in English | MEDLINE | ID: covidwho-219604

ABSTRACT

The rapid pace of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; COVID-19) pandemic presents challenges to the real-time collection of population-scale data to inform near-term public health needs as well as future investigations. We established the COronavirus Pandemic Epidemiology (COPE) consortium to address this unprecedented crisis on behalf of the epidemiology research community. As a central component of this initiative, we have developed a COVID Symptom Study (previously known as the COVID Symptom Tracker) mobile application as a common data collection tool for epidemiologic cohort studies with active study participants. This mobile application collects information on risk factors, daily symptoms, and outcomes through a user-friendly interface that minimizes participant burden. Combined with our efforts within the general population, data collected from nearly 3 million participants in the United States and United Kingdom are being used to address critical needs in the emergency response, including identifying potential hot spots of disease and clinically actionable risk factors. The linkage of symptom data collected in the app with information and biospecimens already collected in epidemiology cohorts will position us to address key questions related to diet, lifestyle, environmental, and socioeconomic factors on susceptibility to COVID-19, clinical outcomes related to infection, and long-term physical, mental health, and financial sequalae. We call upon additional epidemiology cohorts to join this collective effort to strengthen our impact on the current health crisis and generate a new model for a collaborative and nimble research infrastructure that will lead to more rapid translation of our work for the betterment of public health.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Data Collection/methods , Pandemics , Pneumonia, Viral/epidemiology , Software , COVID-19 , Coronavirus Infections/diagnosis , Humans , Models, Biological , Pneumonia, Viral/diagnosis , Public Health , SARS-CoV-2 , Smartphone , United Kingdom/epidemiology , United States/epidemiology
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