Understanding inequalities in mental health by family structure during COVID-19 lockdowns: evidence from the UK Household Longitudinal Study.

PURPOSE: The COVID-19 pandemic increased psychiatric distress and impacts differed by family structure. We aimed to identify mechanisms contributing to these inequalities. METHODS: Survey data were from the UK Household Longitudinal Study. Psychiatric distress (GHQ-12) was measured in April 2020 (first UK lockdown; n = 10,516), and January 2021 (lockdown re-introduced following eased restrictions; n = 6,893). Pre-lockdown family structure comprised partner status and presence of children (< 16 years). Mediating mechanisms included: active employment, financial strain, childcare/home-schooling, caring, and loneliness. Monte Carlo g-computation simulations were used to adjust for confounding and estimate total effects and decompositions into: controlled direct effects (effects if the mediator was absent), and portions eliminated (PE; representing differential exposure and vulnerability to the mediator). RESULTS: In January 2021, after adjustment, we estimated increased risk of distress among couples with children compared to couples with no children (RR: 1.48; 95% CI 1.15-1.82), largely because of childcare/home-schooling (PE RR: 1.32; 95% CI 1.00-1.64). Single respondents without children also had increased risk of distress compared to couples with no children (RR: 1.55; 95% CI 1.27-1.83), and the largest PE was for loneliness (RR: 1.16; 95% CI 1.05-1.27), though financial strain contributed (RR: 1.05; 95% CI 0.99-1.12). Single parents demonstrated the highest levels of distress, but confounder adjustment suggested uncertain effects with wide confidence intervals. Findings were similar in April 2020 and when stratified by sex. CONCLUSION: Access to childcare/schooling, financial security and social connection are important mechanisms that need addressing to avoid widening mental health inequalities during public health crises.

Assessment of Stress, Anxiety, and Depression Levels Among COVID-19 Positive Patients Admitted in Rural Tertiary Care Hospital

Objective: The aim of the present study was to investigate the psychiatric distress, including stress, anxiety, and depression levels, among COVID-19 positive patients who were admitted between 01 July 2020 to 31 August 2020 to the COVID-19 isolation ward of the Uttar Pradesh University of Medical Sciences, Saifai, Etawah India. Participants included 100 patients, with 55 males and 45 females. The majority of admitted patients (81%) were illiterate. Out of 100 patients, 83 were married, 16 were unmarried, and only 1 was a widow. Method(s): Levels of anxiety, depression, and stress level were noted in admitted patients using Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire (PHQ-9) depression assessment, and Perceived Stress Scale 4 (PSS-4) assessment techniques, respectively. Result(s): Patient Health Questionnaire (PHQ-9) depression assessment results showed minimal, mild, and moderate depression in 9, 25, and 66 patients, respectively, with a 10.6 median score of PHQ-9. Mild, moderate, and severe anxiety (GAD-7 score) was present in 22, 28, and 50 of the patients surveyed. The mean Perceived Stress Scale 4 (PSS-4) was also analyzed, and it reported 6.1 values. The results of the study demonstrated that the patients had a high label of psychiatric distress, but still, admitted patients believe that they will come out from this pandemic condition. Conclusion(s): Although patients claimed psychiatric distress and mental health illness, they still denied the requirement of any mental health professionals to minimize stress levels and were satisfied with the medical facilities available in a hospital located in a rural area.Copyright © 2022 Bentham Science Publishers.

Investigating the potential association of temporary employment and job dissatisfaction with alcohol use disorder and depressive symptoms: a 13-wave longitudinal analysis.

BACKGROUND: There has been growing interest in protecting workers' mental health. Identifying social determinants that affect workers' mental health could play an important role in preventing psychiatric diseases. AIMS: We investigated the effects of temporary employment and job dissatisfaction on alcohol use disorder and depressive symptoms. METHOD: The Korea Welfare Panel Study data-set (2009-2021) was used, and 9611 participants with 52 639 observations were included. Generalised linear mixed models were employed to estimate odds ratios and 95% confidence intervals. The relative excess risk due to interaction (RERI) was calculated to assess supra-additive interactions between temporary employment and job dissatisfaction. RESULTS: Increased risks for depressive symptoms were observed among fixed-term workers (odds ratio 1.12, 95% CI 1.00-1.26) and daily labourers (odds ratio 1.68, 95% CI 1.44-1.95). Daily labourers were associated with an increased risk of alcohol use disorder (odds ratio 1.54, 95% CI 1.22-1.95). Job dissatisfaction was associated with alcohol use disorder (odds ratio 1.78, 95% CI 1.52-2.08) and depressive symptoms (odds ratio 4.88, 95% CI 4.36-5.46). This effect became stronger when workers were concurrently exposed to temporary employment and job dissatisfaction. Daily labourers with job dissatisfaction showed the highest risks for alcohol use disorder (odds ratio 2.99, 95% CI 2.21-4.03) and depressive symptoms (odds ratio 9.00, 95% CI 7.36-11.02). RERIs between daily employment and job dissatisfaction were >0 for alcohol use disorder (0.91, 95% CI 0.06-1.76) and depressive symptoms (3.47, 95% CI 1.80-5.14), indicating a supra-additive interaction. CONCLUSIONS: We revealed that temporary employment and job dissatisfaction had detrimental effects on alcohol use disorder and depressive symptoms.

Mental health impact of the COVID-19 pandemic in U.S. military veterans: a population-based, prospective cohort study.

BACKGROUND: The coronavirus disease-2019 (COVID-19) pandemic has caused myriad health, social, and economic stressors. To date, however, no known study has examined changes in mental health during the pandemic in the U.S. military veteran population. METHODS: Data were analyzed from the 2019-2020 National Health and Resilience in Veterans Study, a nationally representative, prospective cohort survey of 3078 veterans. Pre-to-peri-pandemic changes in psychiatric symptoms were evaluated, as well as pre-pandemic risk and protective factors and pandemic-related correlates of increased psychiatric distress. RESULTS: The prevalence of generalized anxiety disorder (GAD) positive screens increased from pre- to peri-pandemic (7.1% to 9.4%; p < 0.001) and was driven by an increase among veterans aged 45-64 years (8.2% to 13.5%; p < 0.001), but the prevalence of major depressive disorder and posttraumatic stress disorder positive screens remained stable. Using a continuous measure of psychiatric distress, an estimated 13.2% of veterans reported a clinically meaningful pre-to-peri-pandemic increase in distress (mean = 1.1 standard deviation). Veterans with a larger pre-pandemic social network size and secure attachment style were less likely to experience increased distress, whereas veterans reporting more pre-pandemic loneliness were more likely to experience increased distress. Concerns about pandemic-related social losses, mental health COVID-19 effects, and housing stability during the pandemic were associated with increased distress, over-and-above pre-pandemic factors. CONCLUSIONS: Although most U.S. veterans showed resilience to mental health problems nearly 1 year into the pandemic, the prevalence of GAD positive screens increased, particularly among middle-aged veterans, and one of seven veterans experienced increased distress. Clinical implications of these findings are discussed.

Psychiatric distress in family caregivers of patients with COVID-19.

PURPOSE: Many COVID-19 patients with low to moderate disease severity were cared for at home by family members. Caring for relatives with COVID-19 could have a psychiatric disorder for informal caregivers. Therefore, this study aimed to investigate the psychiatric disorders of family caregivers of relatives with COVID-19, in Iran. METHODS: This online survey was conducted with 350 family caregivers over 18 years from April to July 2020, which was guided by the STROBE checklist. The study survey consisted of socio-demographic items, 7-items fear of COVID-19 scale, and a 21-item version of the depression, anxiety, and stress scales. RESULTS: The mean (standard deviation) scores for depression, anxiety, and stress were 20 (0.40), 19.52 (0.39), and 19.72 (0.35), respectively, moreover for fear of COVID-19 was 20.33 (0.43). Of all family caregivers, 77.75%, 75%, and 80% had depression, anxiety, and stress, respectively. Sixty-nine percent of caregivers had fear with moderate to high severity. Being younger, married, having a health-related occupation, not exercising, and high monthly salary were significant predictors of the total score of depression, anxiety, and stress scale (P < 0.05). Further, being married, having a health-related occupation, and not exercising, having comorbidity, high income, and being younger were independent predictors of fear of COVID-19 (P < 0.05). Only 32% and 33% of the variance of total depression, anxiety, and stress, and fear of COVID-19 scores were predicted by the studied variables (p < 0.001). CONCLUSION: Our study demonstrated the high prevalence of psychiatric disorders in family caregivers, which requires swift and comprehensive attention from authorities.

The psychological impact of the COVID-19 pandemic on otolaryngologists: Should we be concerned?

OBJECTIVE: Physicians on the frontline of the COVID-19 pandemic are at increased risk of contracting the disease. Otolaryngologists are amongst the high-risk practitioners, as they are in close proximity to patient's upper airway, which may induce their psychological stress. METHODS: A cross-sectional survey study, conducted among otolaryngologists in Saudi Arabia from June 11 to June 22. Survey consisted of sociodemographic questionnaire, Coronavirus Anxiety Scale (CAS), Obsession with COVID-19 Scale (OCS) and Patient Health Questionnaire-9 (PHQ-9). Available otolaryngologists with no history of mental health problems were included. A P-value lower than .05 was considered statistically significant. RESULTS: The study included 129 participants; 63.6% men and 36.4% women. 81.4% of participants were living with family, 57.4% living with either a child or an elderly family member. Nearly 7.8% of participants had dysfunctional COVID-19 anxiety and 75.2% had COVID-19-related depression symptoms ranging from minimal to severe. Obsession and dysfunctional thinking regarding COVID-19 were found in 26.4% of participants. Single otolaryngologists had significantly higher CAS (P = .025), OCS (P = .048), and PHQ-9 (P < .001) scores. Participants who lived with children or elderly individuals had significantly higher OCS scores (P = .005). When comparing job ranks, residents had significantly higher scores for the CAS (P = .016) and PHQ-9 (P < .001). CONCLUSION: COVID-19 has a considerable psychological impact on otolaryngologists. Specifically, the young and single who have less social support. This indicates the importance of psychological support to this group. Additional thorough studies should explore the psychological impact of COVID-19 in this field as it may carry devastating long-term consequences if left unattended. LEVEL OF EVIDENCE: Level 4.

Mental health among head and neck surgeons in Brazil during the COVID-19 pandemic: A national study.

PURPOSE: Head and neck surgeons are among the highest risk for COVID-19 exposure, which also brings great risk to their mental wellbeing. In this study, we aim to evaluate mental health symptoms among head and neck surgeons in Brazil surrounding the time it was declared the epicenter of the virus. MATERIALS AND METHODS: A cross-sectional, survey-based study evaluating burnout, anxiety, distress, and depression among head and neck surgeons in Brazil, assessed through the single-item Mini-Z burnout assessment, 7-item Generalized Anxiety Disorder scale, 22-item Impact of Event Scale-Revised, and 2-item Patient Health Questionnaire, respectively. RESULTS: 163 physicians completed the survey (74.2% males). Anxiety, distress, burnout, and depression symptoms were reported in 74 (45.5%), 43 (26.3%), 24 (14.7%), and 26 (16.0%) physicians, respectively. On multivariable analysis, female physicians were more likely to report a positive screening for burnout compared to males (OR 2.88, CI [1.07-7.74]). Physicians 45 years or older were less likely to experience anxiety symptoms than those younger than 45 years (OR 0.40, CI [0.20-0.81]). Physicians with no self-reported prior psychiatric conditions were less likely to have symptoms of distress compared to those with such history (OR 0.11, CI [0.33-0.38]). CONCLUSION: Head and neck surgeons in Brazil reported symptoms of burnout, anxiety, distress and depression during our study period within the COVID-19 pandemic. Institutions should monitor these symptoms throughout the pandemic. Further study is required to assess the long-term implications for physician wellness.

Snapshot Impact of COVID-19 on Mental Wellness in Nonphysician Otolaryngology Health Care Workers: A National Study.

OBJECTIVE: Nonphysician health care workers are involved in high-risk patient care during the COVID-19 pandemic, placing them at high risk of mental health burden. The mental health impact of COVID-19 in this crucial population has not been studied thus far. Thus, the objective of this study is to assess the psychosocial well-being of these providers. STUDY DESIGN: National cross-sectional online survey (no control group). SETTING: Academic otolaryngology programs in the United States. SUBJECTS AND METHODS: We distributed a survey to nonphysician health care workers in otolaryngology departments across the United States. The survey incorporated a variety of validated mental health assessment tools to measure participant burnout (Mini-Z assessment), anxiety (Generalized Anxiety Disorder-7), distress (Impact of Event Scale), and depression (Patient Health Questionnaire-2). Multivariable logistic regression analysis was performed to determine predictive factors associated with these mental health outcomes. RESULTS: We received 347 survey responses: 248 (71.5%) nurses, 63 (18.2%) administrative staff, and 36 (10.4%) advanced practice providers. A total of 104 (30.0%) respondents reported symptoms of burnout; 241 (69.5%), symptoms of anxiety; 292 (84.1%), symptoms of at least mild distress; and 79 (22.8%), symptoms of depression. Upon further analysis, development of these symptoms was associated with factors such as occupation, practice setting, and case load. CONCLUSION: Frontline otolaryngology health care providers exhibit high rates of mental health complications, particularly anxiety and distress, in the wake of COVID-19. Adequate support systems must be put into place to address these issues.

Mental health among otolaryngology resident and attending physicians during the COVID-19 pandemic: National study.

BACKGROUND: Otolaryngologists are among the highest risk for COVID-19 exposure. METHODS: This is a cross-sectional, survey-based, national study evaluating academic otolaryngologists. Burnout, anxiety, distress, and depression were assessed by the single-item Mini-Z Burnout Assessment, 7-item Generalized Anxiety Disorder Scale, 15-item Impact of Event Scale, and 2-item Patient Health Questionnaire, respectively. RESULTS: A total of 349 physicians completed the survey. Of them, 165 (47.3%) were residents and 212 (60.7%) were males. Anxiety, distress, burnout, and depression were reported in 167 (47.9%), 210 (60.2%), 76 (21.8%), and 37 (10.6%) physicians, respectively. Attendings had decreased burnout relative to residents (odds ratio [OR] 0.28, confidence interval [CI] [0.11-0.68]; P = .005). Females had increased burnout (OR 1.93, CI [1.12.-3.32]; P = .018), anxiety (OR 2.53, CI [1.59-4.02]; P < .005), and distress (OR 2.68, CI [1.64-4.37]; P < .005). Physicians in states with greater than 20 000 positive cases had increased distress (OR 2.01, CI [1.22-3.31]; P = .006). CONCLUSION: During the COVID-19 pandemic, the prevalence of burnout, anxiety, and distress is high among academic otolaryngologists.