ABSTRACT
BackgroundComprehensive and large-scale assessment of health-related quality of life in patients with idiopathic inflammatory myopathies (IIMs) worldwide is lacking. The second COVID-19 vaccination in autoimmune disease (COVAD-2) study [1] is an international, multicentre, self-reported e-survey assessing several aspects of COVID-19 infection and vaccination as well as validated patient-reported outcome measures (PROMs) to outline patient experience in various autoimmune diseases (AIDs), with a particular focus on IIMs.ObjectivesTo investigate physical and mental health in a global cohort of IIM patients compared to those with non-IIM autoimmune inflammatory rheumatic diseases (AIRDs), non-rheumatic AIDs (NRAIDs), and those without AIDs (controls), using Patient-Reported Outcome Measurement Information System (PROMIS) global health data obtained from the COVAD-2 survey.MethodsDemographics, AID diagnoses, comorbidities, disease activity, treatments, and PROMs were extracted from the COVAD-2 database. The primary outcomes were PROMIS Global Physical Health (GPH) and Global Mental Health (GMH) scores. Secondary outcomes included PROMIS physical function short form-10a (PROMIS PF-10a), pain visual analogue scale (VAS), and PROMIS Fatigue-4a scores. Each outcome was compared between IIMs, non-IIM AIRDs, NRAIDs, and controls. Factors affecting GPH and GMH scores in IIMs were identified using multivariable regression analysis.ResultsA total of 10,502 complete responses from 1582 IIMs, 4700 non-IIM AIRDs, 545 NRAIDs, and 3675 controls, which accrued as of May 2022, were analysed. Patients with IIMs were older [59±14 (IIMs) vs. 48±14 (non-IIM AIRDs) vs. 45±14 (NRAIDs) vs. 40±14 (controls) years, p<0.001] and more likely to be Caucasian [82.7% (IIMs) vs. 53.2% (non-IIM AIRDs) vs. 62.4% (NRAIDs) vs. 34.5% (controls), p<0.001]. Among IIMs, dermatomyositis (DM) and juvenile DM were the most common (31.4%), followed by inclusion body myositis (IBM) (24.9%). Patients with IIMs were more likely to have comorbidities [68.1% (IIMs) vs. 45.7% (non-IIM AIRDs) vs. 45.1% (NRAIDs) vs. 26.3% (controls), p<0.001] including mental disorders [33.4% (IIMs) vs. 28.2% (non-IIM AIRDs) vs. 28.4% (NRAIDs) vs. 17.9% (controls), p<0.001].GPH median scores were lower in IIMs compared to NRAIDs or controls [13 (interquartile range 10–15) IIMs vs. 13 (11–15) non-IIM AIRDs vs. 15 (13–17) NRAIDs vs. 17 (15–18) controls, p<0.001] and PROMIS PF-10a median scores were the lowest in IIMs [34 (25–43) IIMs vs. 40 (34–46) non-IIM AIRDs vs. 47 (40–50) NRAIDs vs. 49 (45–50) controls, p<0.001]. GMH median scores were lower in AIDs including IIMs compared to controls [13 (10–15) IIMs vs. 13 (10–15) non-IIM AIRDs vs. 13 (11–16) NRAIDs vs. 15 (13–17) controls, p<0.001]. Pain VAS median scores were higher in AIDs compared to controls [3 (1–5) IIMs vs. 4 (2–6) non-IIM AIRDs vs. 2 (0–4) NRAIDs vs. 0 (0–2) controls, p<0.001]. Of note, PROMIS Fatigue-4a median scores were the highest in IIMs [11 (8–14) IIMs vs. 8 (10–14) non-IIM AIRDs vs. 9 (7–13) NRAIDs vs. 7 (4–10) controls, p<0.001].Multivariable regression analysis in IIMs identified older age, male sex, IBM, comorbidities including hypertension and diabetes, active disease, glucocorticoid use, increased pain and fatigue as the independent factors for lower GPH scores, whereas coexistence of interstitial lung disease, mental disorders including anxiety disorder and depression, active disease, increased pain and fatigue were the independent factors for lower GMH scores.ConclusionBoth physical and mental health are significantly impaired in patients with IIMs compared to those with non-IIM AIDs or those without AIDs. Our results call for greater attention to patient-reported experience and comorbidities including mental disorders to provide targeted approaches and optimise global well-being in patients with IIMs.Reference[1]Fazal ZZ, Sen P, Joshi M, et al. COVAD survey 2 long-term outcomes: unmet need and protocol. Rheumatol Int. 2022;42:2151–58.AcknowledgementsThe authors a e grateful to all respondents for completing the questionnaire. The authors also thank The Myositis Association, Myositis India, Myositis UK, the Myositis Global Network, Cure JM, Cure IBM, Sjögren's India Foundation, EULAR PARE for their contribution to the dissemination of the survey. Finally, the authors wish to thank all members of the COVAD study group for their invaluable role in the data collection.Disclosure of InterestsAkira Yoshida: None declared, Yuan Li: None declared, Vahed Maroufy: None declared, Masataka Kuwana Speakers bureau: Boehringer Ingelheim, Ono Pharmaceuticals, AbbVie, Janssen, Astellas, Bayer, Asahi Kasei Pharma, Chugai, Eisai, Mitsubishi Tanabe, Nippon Shinyaku, Pfizer, Consultant of: Corbus, Mochida, Grant/research support from: Boehringer Ingelheim, Ono Pharmaceuticals, Naveen Ravichandran: None declared, Ashima Makol Consultant of: Boehringer-Ingelheim, Parikshit Sen: None declared, James B. Lilleker: None declared, Vishwesh Agarwal: None declared, Sinan Kardes: None declared, Jessica Day Grant/research support from: CSL Limited, Marcin Milchert: None declared, Mrudula Joshi: None declared, Tamer A Gheita: None declared, Babur Salim: None declared, Tsvetelina Velikova: None declared, Abraham Edgar Gracia-Ramos: None declared, Ioannis Parodis Grant/research support from: Amgen, AstraZeneca, Aurinia Pharmaceuticals, Eli Lilly, Gilead Sciences, GlaxoSmithKline, Janssen Pharmaceuticals, Novartis, and F. Hoffmann-La Roche, Elena Nikiphorou Speakers bureau: Celltrion, Pfizer, Sanofi, Gilead, Galapagos, AbbVie, Eli Lilly, Consultant of: Celltrion, Pfizer, Sanofi, Gilead, Galapagos, AbbVie, Eli Lilly, Grant/research support from: Pfizer, Eli Lilly, Ai Lyn Tan Speakers bureau: AbbVie, Gilead, Janssen, Eli Lilly, Novartis, Pfizer, UCB, Consultant of: AbbVie, Gilead, Janssen, Eli Lilly, Novartis, Pfizer, UCB, Arvind Nune: None declared, Lorenzo Cavagna: None declared, Miguel A Saavedra Consultant of: AbbVie, GlaxoSmithKline, Samuel Katsuyuki Shinjo: None declared, Nelly Ziade Speakers bureau: AbbVie, Boehringer-Ingelheim, Eli Lilly, Janssen, Pfizer, Roche, Consultant of: AbbVie, Boehringer-Ingelheim, Eli Lilly, Janssen, Pfizer, Roche, Grant/research support from: AbbVie, Boehringer-Ingelheim, Eli Lilly, Janssen, Pfizer, Roche, Johannes Knitza: None declared, Oliver Distler Speakers bureau: AbbVie, Amgen, Bayer, Boehringer Ingelheim, Janssen, Medscape, Novartis, Consultant of: 4P-Pharma, AbbVie, Acceleron, Alcimed, Altavant, Amgen, AnaMar, Arxx, AstraZeneca, Baecon, Blade, Bayer, Boehringer Ingelheim, Corbus, CSL Behring, Galderma, Galapagos, Glenmark, Gossamer, iQvia, Horizon, Inventiva, Janssen, Kymera, Lupin, Medscape, Merck, Miltenyi Biotec, Mitsubishi Tanabe, Novartis, Prometheus, Redxpharma, Roivant, Sanofi, Topadur, Grant/research support from: AbbVie, Amgen, Boehringer Ingelheim, Kymera, Mitsubishi Tanabe, Novartis, Roche, Hector Chinoy Grant/research support from: Eli Lilly, UCB, Vikas Agarwal: None declared, Rohit Aggarwal Consultant of: Mallinckrodt, Octapharma, CSL Behring, Bristol Myers-Squibb, EMD Serono, Kezar, Pfizer, AstraZeneca, Alexion, Argenx, Boehringer Ingelheim (BI), Corbus, Janssen, Kyverna, Roivant, Merck, Galapagos, Actigraph, Abbvie, Scipher, Horizontal Therapeutics, Teva, Biogen, Beigene, ANI Pharmaceutical, Nuvig, Capella, CabalettaBio, Grant/research support from: Bristol Myers-Squibb, Pfizer, Mallinckrodt, Janssen, Q32, EMD Serono, Boehringer Ingelheim, Latika Gupta: None declared.
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BackgroundThis study was aimed to investigate whether patients with epilepsy (PWE) have higher depression and anxiety levels than the normal population in low-risk areas for coronavirus disease 2019 (COVID-19) in the northern part of Guizhou Province, China, during the COVID-19 epidemic, to evaluate their knowledge on COVID-19, and to analyze related factors for the psychological distress of PWE at this special time.MethodsThe survey was conducted online from February 28, 2020 to March 7, 2020 via a questionnaire. PWE from the outpatient clinic of epilepsy of the Affiliated Hospital of Zunyi Medical University, and healthy people matched for age and sex, participated in this study. Mental health was assessed via a generalized anxiety self-rating scale (GAD-7) and the self-rating depression scale (PHQ-9). The knowledge of COVID-19 in both groups was investigated.ResultsThere were no significant differences in the general demographics between the PWE and healthy control groups. The scores of PHQ-9 (P < 0.01) and GAD-7 (P < 0.001) were higher in the PWE group than in the healthy group. There was a significant difference in the proportions of respondents with different severities of depression and anxiety, between the two groups, which revealed significantly higher degree of depression and anxiety in PWE than in healthy people (P = 0, P = 0). Overwhelming awareness and stressful concerns for the pandemic and female patients with epilepsy were key factors that affect the level of anxiety and depression in PWE. Further, the PWE had less accurate knowledge of COVID-19 than healthy people (P < 0.001). There was no statistically significant difference between the two groups in the knowledge of virus transmission route, incubation period, susceptible population, transmission speed, clinical characteristics, and isolation measures on COVID-19 (P > 0.05). PWE knew less about some of the prevention and control measures of COVID-19 than healthy people.ConclusionsDuring the COVID-19 epidemic, excessive attention to the epidemic and the female sex are factors associated with anxiety and depression in PWE, even in low-risk areas.
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This study examined psychological health and coping strategies among faculty and staff at a Saudi Arabian university. A web-based self-administered survey was used to assess probable anxiety, depression, post-traumatic stress disorder (PTSD), and coping strategies by using the Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Impact of Event Scale-Revised (IES-R), and Brief-COPE scale, respectively. Of 502 participants (mean age 36.04 ± 10.32 years, male: 66.3%), 24.1% (GAD-7 ≥ 10) had probable anxiety. Anxiety score was significantly higher in females (p < 0.001), those with a history of COVID-19 infection (p = 0.036), and participants with less work experience (p = 0.019). Approximately 40% of participants met the criteria of probable depression, with females (p < 0.001) and participants with less experience having more depressive symptoms. Around one-fourth (27.7%) of study participants indicated probable PTSD (score ≥ 33), with higher symptoms in females (p <0.001), less experienced staff (p < 0.001), and academic staff (p = 0.006). Correlation analysis indicated a significant positive correlation between anxiety and depression (r = 0.844, p < 0.001), anxiety and PTSD (r = 0.650, p < 0.001), and depression and PTSD (r = 0.676, p < 0.001). Active coping, religious/spiritual coping, and acceptance were common coping strategies, while substance use was the least adopted coping method among the study participants. This study indicated a high prevalence of probable psychological ailments among university staff.
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Objective Post-traumatic stress disorder (PTSD) is one of the anxiety disorders caused by a specific event, which can be catastrophic events (natural disasters, war, imprisonment in a forced labor camp) or everyday adversities (death of relatives, divorce, carrying bags). Since patients who have recovered from COVID-19 are exposed to such events, this research was conducted to determine the prevalence of PTSD in this group.Materials & Methods This study was cross-sectional. The statistical population included all patients who recovered from COVID-19 between November 2021 and February 2022 in Hamedan City, Iran;based on Krejcie and Morgan's sample size table, 185 patients were selected by simple random sampling method. The research tool was the demographic questionnaire and the Mississippi post -traumatic stress disorder questionnaire (Mississippi PTSD);the data were analyzed using the Mann -Whitney and Kruskal-Wallis tests.Results The results showed that the Mean +/- SD score of PTSD was 80.37 +/- 17.37 in the subjects who recovered from COVID-19. The relationship between the demographic variables of gender (P=0.01), education (P=0.039), occupation (P=0.24), marriage (P=0.62), age (P=0.048), weight (P=0.047), height (P=0.023) with PTSD were reported.Conclusion The results showed that 76.2% of people who recovered from COVID-19 were exposed to PTSD with moderate and high severity;therefore, techniques to reduce anxiety from the corona -virus are recommended.
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Background Socioeconomic development,lifestyle changes and the COVID-19 pandemic all have an impact on people's mental and physical health,which may affect the prevalence of mental disorders. Currently,there is still no sufficient epidemiological information of mental disorders in Xinjiang. Objective To investigate the prevalence and influencing factors of common mental disorders among people aged 15 and above in northern Xinjiang,then compare the data with those of their counterparts in southern Xinjiang,and summarize the overall prevalence of common mental disorders in Xinjiang,providing a scientific basis for the formulation of corresponding mental health plans. Methods From November 2021 to July 2022,a multistage,stratified,random sampling method was used to select 3 853 residents from northern Xinjiang to attend a survey. General Demographic Questionnaire,and self-assessment scales(the 12-Item General Health Questionnaire,Mood Disorder Questionnaire,Symptom Checklist-90,etc.) and other assessment scales(Hamilton Depression Inventory,Bech-Rafaelsen Mania Rating Scale,Brief Psychiatric Rating Scale,etc.) were used as survey instruments. Mental disorders were diagnosed by the ICD-10 classification of mental and behavioral disorders by two psychiatrists with at least five years' working experience, or by a chief or associate chief psychiatrist when there is an inconsistency between the diagnoses made by the two psychiatrists. Results The point prevalence rate and age-adjusted rate of common mental disorders in northern Xinjiang were 9.71% (374/3 853) and 10.07%,respectively. The point prevalence rate and age-adjusted rate of common mental disorders in the whole Xinjiang were 9.69%(750/7 736)and 9.90%,respectively. The point prevalence rates of mood disorders,anxiety disorders,schizophrenia,organic mental disorders,and mental retardation in northern Xinjiang were 4.83%(374/7 736),3.63% (281/7 736),0.63%(49/7 736),0.23%(18/7 736),and 0.36%(28/7 736),respectively. Multivariate Logistic regression analysis for northern Xinjiang showed that:the risk of mood disorders in females was 1.854 times higher than that in males 〔95%CI(1.325,2.593)〕;The risk of mood disorders increased by 5.210 times in 25-34-year-olds 〔95%CI(1.348, 20.143)〕 and 3.863 times in 35-44-year-olds 〔95%CI(1.030,14.485)〕 compared with that in those aged ≥ 65 years;The risk of mood disorders increased by 0.199 times in those with high school or technical secondary school education 〔95%CI (0.078,0.509)〕 and 0.147 times in those with two- or three-year college and above education 〔95%CI(0.056,0.388)〕 compared with that in illiteracies. The risk of anxiety disorder in females was 1.627 times higher than that in males 〔95%CI (1.144, 2.315)〕;The risk of anxiety disorder increased by 0.257 times in 15-24-year-olds 〔95%CI(0.091,0.729)〕,0.243 times in 45-54-year-olds 〔95%CI(0.101,0.583)〕,and 0.210 times in 55-64-year-olds 〔95%CI(0.067,0.661)〕 compared to that of those aged ≥ 65 years old. The risk of schizophrenia among people living in villages or towns was 4.762 times higher than that of those living in cities 〔95%CI(1.705,13.300)〕;The risk of schizophrenia among people with high school or technical secondary school education was 0.079 times higher than that of illiteracies 〔95%CI(0.015,0.405)〕. Conclusion The prevalence of mood disorders and anxiety disorders is high among all types of mental disorders in Xinjiang. Females,rural people,or low educated people in northern Xinjiang are more prone to various types of mental disorders. © 2023 Chinese General Practice. All rights reserved.
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Background The COVID-19 pandemic coincides with growing concern regarding the mental health of young people. Older adolescents have faced a particular set of pandemic-related challenges and demonstrate heightened vulnerability to affective disorders (particularly anxiety). Anxiety symptoms are associated with a range of cognitive difficulties. Older adolescents may therefore be susceptible to pandemic-related declines in wellbeing and associated cognitive difficulties. Methods At three timepoints, independent samples of young people aged 16-18 years (N = 607, 242, 618 respectively) completed an online survey. Data collection coincided with periods of lockdown (timepoints 1 and 3) and young people returning to school (timepoint 2). The survey assessed subjective impacts of the pandemic on overall wellbeing, anxiety and cognitive function. Results Findings demonstrated the detrimental impact of the COVID-19 pandemic on older adolescents' psychological wellbeing-a finding that was consistent across samples. The majority of young people at each timepoint experienced heightened anxiety. Crucially, pandemic-related anxiety was associated with self-identified cognitive difficulties, a pattern of association that was evident at all three timepoints. The nature and extent of these difficulties were predictive of specific pandemic-related concerns in this age group. Conclusions Older adolescents' experiences of the pandemic are characterised by subjective declines in wellbeing and stable patterns of association between anxiety and self-identified cognitive difficulties. Implications are discussed with reference to future research and intervention. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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BACKGROUND: Medical work is a complex and interpersonally sensitive job; clinicians interact with patients, colleagues and society-at-large daily, and they are under pressure from a variety of sources. The doctor-patient relationship is of particular concern. OBJECTIVE: To investigate the current mental health status of hospital staff and related influencing factors during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: The Symptom Checklist-90 (SCL-90) and Generalized Anxiety Disorder Scale-7 (GAD-7) were used to survey the current mental health status of hospital employees. The resulting qualitative data was described in the form of frequency and percentage (%), and the quantitative data were expressed as mean±standard deviation (X¯±S). RESULTS: A total of 1,074 employees of The Third Xiangya Hospital of Central South University participated in the mental health survey, of whom 77.47% were women. The SCL-90 score was 133.89±48.87, and the three highest scoring factors were depression, somatisation and obsessions, with factor scores of 19.10±8.14, 16.78±6.21 and 16.27±6.39, respectively. The GAD-7 score was 3.74±4.17 for women and 2.14±3.55 for men. The number of women with anxiety disorders was higher compared with men. CONCLUSION: The mental health status of hospital workers with different demographic characteristics varied greatly during the COVID-19 pandemic. Active attention needs to be paid to the mental health status of hospital staff.
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OBJECTIVES: To describe self-reported characteristics and symptoms of treatment-seeking patients with post-COVID-19 syndrome (PCS). To assess the impact of symptoms on health-related quality of life (HRQoL) and patients' ability to work and undertake activities of daily living. DESIGN: Cross-sectional single-arm service evaluation of real-time user data. SETTING: 31 post-COVID-19 clinics in the UK. PARTICIPANTS: 3754 adults diagnosed with PCS in primary or secondary care deemed suitable for rehabilitation. INTERVENTION: Patients using the Living With Covid Recovery digital health intervention registered between 30 November 2020 and 23 March 2022. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was the baseline Work and Social Adjustment Scale (WSAS). WSAS measures the functional limitations of the patient; scores of ≥20 indicate moderately severe limitations. Other symptoms explored included fatigue (Functional Assessment of Chronic Illness Therapy-Fatigue), depression (Patient Health Questionnaire-Eight Item Depression Scale), anxiety (Generalised Anxiety Disorder Scale, Seven-Item), breathlessness (Medical Research Council Dyspnoea Scale and Dyspnoea-12), cognitive impairment (Perceived Deficits Questionnaire, Five-Item Version) and HRQoL (EQ-5D). Symptoms and demographic characteristics associated with more severe functional limitations were identified using logistic regression analysis. RESULTS: 3541 (94%) patients were of working age (18-65); mean age (SD) 48 (12) years; 1282 (71%) were female and 89% were white. 51% reported losing ≥1 days from work in the previous 4 weeks; 20% reported being unable to work at all. Mean WSAS score at baseline was 21 (SD 10) with 53% scoring ≥20. Factors associated with WSAS scores of ≥20 were high levels of fatigue, depression and cognitive impairment. Fatigue was found to be the main symptom contributing to a high WSAS score. CONCLUSION: A high proportion of this PCS treatment-seeking population was of working age with over half reporting moderately severe or worse functional limitation. There were substantial impacts on ability to work and activities of daily living in people with PCS. Clinical care and rehabilitation should address the management of fatigue as the dominant symptom explaining variation in functionality.
Subject(s)
COVID-19 , Quality of Life , Adult , Female , Humans , Male , Middle Aged , Activities of Daily Living , COVID-19/complications , Cross-Sectional Studies , Fatigue/etiology , Post-Acute COVID-19 Syndrome , Adolescent , Young Adult , AgedABSTRACT
A man in his mid-30s presented to the emergency department with a 1-week history of fatigue, loss of appetite, fever and productive (yellow) cough. This progressed to requiring admission to intensive care needing a oxygen therapy via high-flow nasal cannula for acute hypoxaemic respiratory failure. He had recently started vortioxetine for major depressive disorder, and his acute symptoms correlated with an increase in the dose of vortioxetine. For more than 20 years, rare but consistent reports of serotonergic medications have been implicated in eosinophilic pulmonary conditions. During this same period, serotonergic medications have become a mainstay solution for a wide range of depressive symptoms and disorders. This is the first report of an eosinophilic pneumonia-like syndrome occurring while consuming the novel serotonergic medication vortioxetine.
Subject(s)
Depressive Disorder, Major , Pulmonary Eosinophilia , Respiratory Insufficiency , Male , Humans , Vortioxetine/adverse effects , Depressive Disorder, Major/drug therapy , Depressive Disorder, Major/diagnosis , Pulmonary Eosinophilia/chemically induced , Pulmonary Eosinophilia/diagnosis , Pulmonary Eosinophilia/drug therapy , Syndrome , Respiratory Insufficiency/chemically induced , Respiratory Insufficiency/therapyABSTRACT
BACKGROUND: Evidence-based mental health interventions to support healthcare workers (HCWs) in crisis settings are scarce. OBJECTIVE: To evaluate the capacity of a mental health intervention in reducing anxiety and depression symptoms in HCWs, relative to enhanced care as usual (eCAU), amidst the COVID-19 pandemic. METHODS: We conducted an analyst-blind, parallel, multicentre, randomised controlled trial. We recruited HCWs with psychological distress from Madrid and Catalonia (Spain). The intervention arm received a stepped-care programme consisting of two WHO-developed interventions adapted for HCWs: Doing What Matters in Times of Stress (DWM) and Problem Management Plus (PM+). Each intervention lasted 5 weeks and was delivered remotely by non-specialist mental health providers. HCWs reporting psychological distress after DWM completion were invited to continue to PM+. The primary endpoint was self-reported anxiety/depression symptoms (Patient Health Questionnaire-Anxiety and Depression Scale) at week 21. FINDINGS: Between 3 November 2021 and 31 March 2022, 115 participants were randomised to stepped care and 117 to eCAU (86% women, mean age 37.5). The intervention showed a greater decrease in anxiety/depression symptoms compared with eCAU at the primary endpoint (baseline-adjusted difference 4.4, 95% CI 2.1 to 6.7; standardised effect size 0.8, 95% CI 0.4 to 1.2). No serious adverse events occurred. CONCLUSIONS: Brief stepped-care psychological interventions reduce anxiety and depression during a period of stress among HCWs. CLINICAL IMPLICATIONS: Our results can inform policies and actions to protect the mental health of HCWs during major health crises and are potentially rapidly replicable in other settings where workers are affected by global emergencies. TRIAL REGISTRATION NUMBER: NCT04980326.
Subject(s)
COVID-19 , Psychological Distress , Humans , Female , Adult , Male , Mental Health , Pandemics , Health Personnel/psychologyABSTRACT
Only a few studies seem to address suicidality as an effect of the COVID-19 pandemic in persons previously affected by psychiatric disorders. The relationship between fear and stress caused by the COVID-19 pandemic and the level of social support and suicidality in patients diagnosed with affective and stress-induced psychiatric disorders prior to the onset of the COVID-19 pandemic were investigated. This study was observational and involved 100 participants. The examined period was from April 2020 to April 2022. The Fear of COVID-19 Scale (FCV-19S), the Oslo Social Support Scale 3 (OSSS-3) and general psychiatric interviews were used to obtain data. A statistically significant relationship between the impact of COVID-19-related distress on the occurrence of suicidality and the year of the pandemic χ2(2, N = 100) = 8.347, p = 0.015 was observed. No statistically significant correlation was found between suicidal behavior, stress intensity, fear and the score on the social support scale (p > 0.05). Fear related to the COVID-19 pandemic can only be seen as a contributor to suicidality. Overall, social support does not always act protectively. Previously stressful experiences such as wars, poverty and natural disasters seem to play a significant role in the resilience to each new public health crisis.
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BACKGROUND: To determine: whether young adults (aged 18-24) not in education, employment or training (NEET) have different psychological treatment outcomes to other young adults; any socio-demographic or treatment-related moderators of differential outcomes; and whether service-level changes are associated with better outcomes for those who are NEET. METHODS: A cohort was formed of 20 293 young adults treated with psychological therapies in eight Improving Access to Psychological Therapies services. Pre-treatment characteristics, outcomes, and moderators of differential outcomes were compared for those who were and were not NEET. Associations between outcomes and the following were assessed for those that were NEET: missing fewer sessions, attending more sessions, having a recorded diagnosis, and waiting fewer days between referral and starting treatment. RESULTS: Those who were NEET had worse outcomes: odds ratio (OR) [95% confidence interval (CI)] for reliable recovery = 0.68 (0.63-0.74), for deterioration = 1.41 (1.25-1.60), and for attrition = 1.31 (1.19-1.43). Ethnic minority participants that were NEET had better outcomes than those that were White and NEET. Living in deprived areas was associated with worse outcomes. The intensity of treatment (high or low) did not moderate outcomes, but having more sessions was associated with improved outcomes for those that were NEET: odds (per one-session increase) of reliable recovery = 1.10 (1.08-1.12), deterioration = 0.94 (0.91-0.98), and attrition = 0.68 (0.66-0.71). CONCLUSIONS: Earlier treatment, supporting those that are NEET to attend sessions, and in particular, offering them more sessions before ending treatment might be effective in improving clinical outcomes. Additional support when working with White young adults that are NEET and those in more deprived areas may also be important.
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Ethnicity , Unemployment , Humans , Young Adult , Minority Groups , Employment , Treatment OutcomeABSTRACT
The prolonged pandemic context by the new Coronavirus aggravated the physical and emotional strain of healthcare workers, negatively impacting mental health. The objectives of this study were to verify the prevalence of Mild Depression Disorder (MDD) and Mild Anxiety Disorder (MAD) and their associated factors. A cross-sectional study was conducted with nurses and nursing assistants from a private hospital in the city of Sao Paulo, Brazil. The sample consisted of 184 nursing workers, who answered a form using Google Forms (R), released by the social media group (WhatsApp (R)), restricted to employees and managers of the sectors. Demographic, occupational, clinical data, and indicators of MDD and MAD were obtained through the Hospital Anxiety and Depression Scale. Descriptive statistics and association tests between independent and dependent variables were used. There was a predominance of women (88%), in the role of nurse technicians and/or assistants (63.6%), and those who worked in specific units of patients with COVID-19 (58.7%). The prevalence of MDD was 43.5% (95% CI: 36.4% - 50.7%) and MAD was 46.2% (95% CI: 39.1% - 53.4%). There was a statistically significant association between MAD, age between 25 and 35 years (p=0.01) and hospital unit not specific for COVID-19 (p=0.04). The prevalence of mild depression and anxiety disorders was considered high. Mild anxiety disorder had a higher prevalence among younger workers and those working in units not specific to COVID-19.
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This chapter presents a model for combining Eye Movement Desensitization and Reprocessing (EMDR) and art therapy for the Gen Z population (young people born in the United States between 1997 and 2007). Adolescents and young adults have increased rates of depression, anxiety, addiction, reports of loneliness, and suicide attempts compared to previous generations. The COVID-19 pandemic has exacerbated these worrisome trends. The chapter offers techniques for enhancing eight phases of EMDR through a variety of art therapy directives identified in multiple case studies. Art prompts, scripts, and case studies for art directives offer readers a comprehensive understanding for creative case conceptualization using EMDR with adolescents and young adults. When EMDR and art therapy are combined, these two disciplines can be incredibly effective and transformative, serving as a new avenue to meet specific needs of young people. Newer research revealing the unique stage of brain development during adolescence reinforces the need to enhance EMDR protocols for adolescents and young adults with the creative interventions of art therapy. This comprehensive model includes a conceptual framework to understand this generation and to provide ideas and directives. Each creative intervention is designed to be replicated by clinicians to help young people. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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The aim of the review was to analyze published studies on the impact of the COVID-19 pandemic on the health status (mental and physical) of people with mental disorders. Materials and methods: by keywords "COVID-19”, "depressive disorders”, "affective disorders”, "schizophrenia”, "anxiety disorders” search for papers in English and Russian in the databases MEDLINE/ PubMed, Scopus, Web of Science, eLibrary for the period from 2017 to 2022 was carried out. Conclusion: the analysis of published works has demonstrated that factors such as social distancing, isolation, or changing the availability of medical services can have a signifi cant infl uence on the health of people with mental disorders. It has been established that people suffering from mental illness are at a higher risk of contracting COVID-19, they have less effective post-vaccination immunity and have a more severe course of the disease. The past coronavirus infection can lead to both an increase in pre-existing symptoms of a mental disorder, and the emergence of new ones. Possible physiological mechanisms of mental disorders after past COVID-19 include a wide range of pathogenetic processes: from prolonged systemic infl ammation of varying intensity to vascular microthrombosis and neurodegenerative changes. Cognitive impairment during COVID-19, associated with damage to brain structures by the virus, may exacerbate existing psychopathological symptoms. The special features of psychopathological symptoms that develop in response to a pandemic situation are closely related to the structure of the previous mental status of patients, and therefore the types of psychosocial assistance needed is different for people with various mental disorders. © 2023, Psychiatry (Moscow). All Rights Reserved.
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Anxiety and depression were relatively common in children and adolescents before the COVID-19 pandemic1;not surprisingly, study findings suggest that these conditions' prevalence has increased.2 Typical support systems for children and adolescents-friends, family, school, and extracurricular activities-look much different during the current pandemic. There are many misconceptions about psychotropic medications and stigmas because of mental health problems in general. National organizations such as the American Academy of Pediatrics and the American Association of Child and Adolescent Psychiatry have developed resources to help pediatricians feel more comfortable with offering mental health care, and groups such as The REACH Institute offer postgraduate training programs that provide education and ongoing support.
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BackgroundA widely held belief is that "Medical student syndrome” is frequently experienced by young medical students, that is, they experience the symptoms of the diseases they are studying or fear of having such illness. A hypothesis is that because medical students constantly learn about life-threatening conditions and diseases, they experience persistent fear and stress regarding having a severe medical condition, an anxiety-related illness called nosophobia.ResultsAlthough medical students scored an average of 14.14 on a scale measuring potential nosophobia a, the difference between their scores and those of non-medical students, who scored an average of 0.11, is significantly higher (p 0.001). According to the presented analysis, non-medical and medical students exhibit distinct levels of nosophobia. The analysis of responses to hypochondriacal behaviors revealed that students from non-medical faculties scored an average of 1.43 points. By contrast, the average score for medical students was 7.87, which is significantly higher than that of the non-medical students (p 0.001).ConclusionsMedical students are at higher risk for health anxiety and hypochondrial attitudes than non-medical students are.
ABSTRACT
The COVID-19 pandemic exacerbated the prevalence of anxiety disorders, making it a population health concern in the United States and worldwide. The growing need for effective prevention and treatment of anxiety coincides with a deficit of mental health providers and physicians. With the healthcare system currently overwhelmed and the slow training pipeline of new providers, the gap between patient demand and treatment providers will not be closed in the next decade. There is a growing need for evidence-based treatments for anxiety disorders that can increase access to care while addressing the underlying mechanisms of anxiety. Digital therapeutics is a fast-developing field that can be one such solutions provided in ?one-to-many? format. It can be used in conjunction with individual therapy, as well as independently, depending on the severity of patients? symptoms. This quantitative dissertation study aimed to investigate the mechanism of reducing anxiety in the digital application (app) Unwinding Anxiety Program and its impact on emotion regulation, self-representation (self-esteem), and the degree of attachment security in adults. The study used a single-case experimental design to assess the effect size of the intervention in these domains. Five study participants completed the program. The results of the study demonstrated the efficacy of the intervention for reducing anxiety among participants with medium to large effect size and decrease of attachment-related anxiety for all participants with small effect size. All study participants demonstrated improved emotion regulation with moderate effect size for the sample. Self-esteem scores improved for some participants, while decreased for others. These findings support the existing evidence for the efficacy of mindfulness-based interventions for anxiety demonstrating the key role of emotion regulation in the mechanism of change. This study brings the novelty of examining the impact of digital therapeutic intervention on attachment security. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
ABSTRACT
The objectives of the present study were two-folded: first, to examine the predictive association of health-related anxiety with generalized anxiety, obsessive compulsive tendencies and COVID-19 anxiety;second, to examine the differences between vaccinated and non-vaccinated adults on health-related anxiety, generalized anxiety, obsessive compulsive tendencies and COVID-19 anxiety. A purposive sample of 350 adults falling between ages of 25-55 years (Mage = 21.58, SD= 2.45) were administered Health Anxiety Inventory, Yale-Brown Obsessive-Compulsive Scale, Generalized Anxiety Disorders Scale and Coronavirus Anxiety Scale. Results of linear regression analysis reveal health-related anxiety as significant predictor of generalized anxiety, obsessive compulsive tendencies and COVID-19 anxiety. Further, independent t-test reveals that vaccinated adults scored significantly lower than non-vaccinated adults on health-related anxiety, obsessive compulsive tendencies, generalized anxiety and COVID anxiety. The implications and future directions are proposed.
ABSTRACT
There are a very limited number of sport-specific mental health and sport performance interventions available for athletes of color. This study examined The Optimum Performance Program in Sports (TOPPS) in a biracial adolescent athlete who was diagnosed with Agoraphobia and Social Anxiety Disorder. A multiple-baseline across behaviors case trial design was used to evaluate outcomes. A battery of psychological measures specific to mental health and sport performance was administered at baseline, post-intervention, and a 3-month follow-up. Social skill sets (i.e., positive assertion and negative assertion) were systematically targeted sequentially in a virtual format using HIPAA compliant video-conferencing technology to safeguard against contracting COVID-19. Results demonstrated improvement in negative and positive assertion skills when targeted by the intervention. Severity of concurrent symptoms associated with Social Anxiety Disorder and Agoraphobia Symptoms, general psychiatric functioning, relationships with coaches, teammates and family, and factors interfering with sports performance improved from pre- to post-intervention. These improvements were maintained at the 3-month follow-up. Athlete ratings indicated their satisfaction with TOPPS was high, and intervention components were implemented with high integrity. [ FROM AUTHOR] Copyright of Clinical Case Studies is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)