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1.
J Affect Disord ; 334: 43-49, 2023 08 01.
Article in English | MEDLINE | ID: covidwho-2311986

ABSTRACT

BACKGROUND: We aimed to characterize the prevalence of social disconnection and thoughts of suicide among older adults in the United States, and examine the association between them in a large naturalistic study. METHODS: We analyzed data from 6 waves of a fifty-state non-probability survey among US adults conducted between February and December 2021. The internet-based survey collected the PHQ-9, as well as multiple measures of social connectedness. We applied multiple logistic regression to analyze the association between presence of thoughts of suicide and social disconnection. Exploratory analysis, using generalized random forests, examined heterogeneity of effects across sociodemographic groups. RESULTS: Of 16,164 survey respondents age 65 and older, mean age was 70.9 (SD 5.0); the cohort was 61.4 % female and 29.6 % male; 2.0 % Asian, 6.7 % Black, 2.2 % Hispanic, and 86.8 % White. A total of 1144 (7.1 %) reported thoughts of suicide at least several days in the prior 2 week period. In models adjusted for sociodemographic features, households with 3 or more additional members (adjusted OR 1.73, 95 % CI 1.28-2.33) and lack of social supports, particularly emotional supports (adjusted OR 2.60, 95 % CI 2.09-3.23), were independently associated with greater likelihood of reporting such thoughts, as was greater reported loneliness (adjusted OR 1.75, 95 % CI 1.64-1.87). The effects of emotional support varied significantly across sociodemographic groups. CONCLUSIONS: Thoughts of suicide are common among older adults in the US, and associated with lack of social support, but not with living alone. TRIAL REGISTRATION: NA.


Subject(s)
Social Isolation , Suicidal Ideation , Suicide , Aged , Female , Humans , Male , Loneliness/psychology , Social Isolation/psychology , Suicide/psychology , United States/epidemiology
2.
Am J Geriatr Psychiatry ; 31(5): 326-337, 2023 05.
Article in English | MEDLINE | ID: covidwho-2245933

ABSTRACT

OBJECTIVE: Older adults are disproportionally impacted by the COVID-19 pandemic, causing a mental health crisis in late life, due to physical restrictions (e.g., quarantine), limited access to services, and lower literacy and access to technology. Despite established benefits, systematic screening of mental health needs of older adults in community and routine care settings is limited and presents multiple challenges. Cross-disciplinary collaborations are essential for identification and evaluation of mental health needs and service delivery. METHODS: Using a research-practice partnership model, we developed and implemented a routine mental health needs identification and tracking tool at a community-based social services organization. Repeated screenings were conducted remotely over 5 months and included depression, anxiety, perceived loneliness, social support, and related domains such as sleep quality, resilience, and trauma symptoms linked to COVID-19. We examined symptomatic distress levels and associations between different domains of functioning. RESULTS: Our project describes the process of establishing a research-practice partnership during the COVID-19 pandemic. We collected 292 screenings from 124 individuals; clients were mildly to moderately depressed and anxious, reporting large amounts of time alone and moderate levels of loneliness. Those reporting higher depressive symptoms reported higher anxiety symptoms, poorer sleep quality, lower quality of life, lower capacity to adapt to challenging situations, and greater trauma symptoms due to COVID-19. CONCLUSION: Our routine screening tool can serve as a blueprint for case management agencies and senior centers nationwide, beyond the pressing mental health crisis due to COVID-19, to continue identifying needs as they emerge in the community.


Subject(s)
COVID-19 , Humans , Aged , Mental Health , Pandemics/prevention & control , Quality of Life , Anxiety/diagnosis , Anxiety/psychology , Depression/diagnosis , Depression/epidemiology , Depression/psychology
3.
The American Journal of Geriatric Psychiatry ; 30(4, Supplement):S6, 2022.
Article in English | ScienceDirect | ID: covidwho-1739866

ABSTRACT

Social isolation and loneliness have health consequences that rival those of smoking and obesity. Older adults are at particularly high risk for the negative consequences of loneliness and social disconnection due to compounding effects of age-related declines in functioning, cognition, and sensory function. Up to 29% of adults age 60 and older experience loneliness. The Covid-19 pandemic led to increased social isolation and depression among older adults, as a result of prolonged quarantine and the heightened risk of severe illness and death. While the negative consequences of loneliness and social isolation are clear, strategies to intervene and the underlying mechanisms of interventions are poorly understood, thus hindering prevention and intervention efforts. In this session, Nili Solomonov, Ph.D. will present preliminary findings from a novel neuroimaging-based social reward paradigm she developed examine the relationship between processing of social rewards and depression severity. Ellen Lee, M.D. will present work on the role of compassion and self-compassion in loneliness and development of a positive affect-driven intervention for underserved community-dwelling older adults. Kimberly Van Orden, Ph.D. will present results from a randomized trial of a social volunteering program for lonely older adults;specifically, predictors of engagement in the program (versus discontinuing the program). Bret Rutherford, M.D. will moderate and lead a discussion of mechanisms and treatment targets to reduce social isolation in the aging population. All presenters will put their research in the context of COVID-19 pandemic-related restrictions.

5.
Gen Hosp Psychiatry ; 73: 24-29, 2021.
Article in English | MEDLINE | ID: covidwho-1427941

ABSTRACT

In the midst of the Spring 2020 initial surge of the COVID-19 pandemic in New York, members of the Psychiatry Department of Weill Cornell Medicine/NewYork-Presbyterian Hospital rapidly created and implemented a brief, behavioral skills-based intervention program, "CopeNYP", to address the immediate mental health needs of the employees of the hospital and medical school. We describe the development, implementation and evolution of this telehealth-delivered program staffed primarily by in-house clinical psychologists, postdoctoral fellows, pre-doctoral interns and counselors who were redeployed or volunteered their time to provide urgent support for employees. We discuss the challenges and lessons learned in providing brief, skills-based psychological interventions for employees subjected to chronic stress. As the impact of the pandemic became prolonged, employees faced compounding stressors including social isolation, fear of infection, grief and loss, and sequelae of COVID-19-related illness combined with work-related demands. Our goal is to present our program design, implementation, and utilization as a blueprint for other institutions that would like to develop an evidence-based clinician-staffed psychological intervention program to support ongoing employee mental health needs.


Subject(s)
COVID-19 , Psychological Distress , Crisis Intervention , Humans , Pandemics , Personnel, Hospital , SARS-CoV-2
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