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1.
BMJ Open ; 12(4): e054897, 2022 Apr 04.
Article in English | MEDLINE | ID: covidwho-1774961

ABSTRACT

INTRODUCTION: Symptoms of anxiety and depression in Indian adolescents are common. Schools can be opportune sites for delivery of mental health interventions. India, however, is without a evidence-based and integrated whole-school mental health approach. This article describes the study design for the safeguarding adolescent mental health in India (SAMA) project. The aim of SAMA is to codesign and feasibility test a suite of multicomponent interventions for mental health across the intersecting systems of adolescents, schools, families and their local communities in India. METHODS AND ANALYSIS: Our project will codesign and feasibility test four interventions to run in parallel in eight schools (three assigned to waitlist) in Bengaluru and Kolar in Karnataka, India. The primary aim is to reduce the prevalence of adolescent anxiety and depression. Codesign of interventions will build on existing evidence and resources. Interventions for adolescents at school will be universal, incorporating curriculum and social components. Interventions for parents and teachers will target mental health literacy, and also for teachers, training in positive behaviour practices. Intervention in the school community will target school climate to improve student mental health literacy and care. Intervention for the wider community will be via adolescent-led films and social media. We will generate intervention cost estimates, test outcome measures and identify pathways to increase policy action on the evidence. ETHICS AND DISSEMINATION: Ethical approval has been granted by the National Institute of Mental Health Neurosciences Research Ethics Committee (NIMHANS/26th IEC (Behv Sc Div/2020/2021)) and the University of Leeds School of Psychology Research Ethics Committee (PSYC-221). Certain data will be available on a data sharing site. Findings will be disseminated via peer-reviewed journals and conferences.


Subject(s)
Depression , Mental Health , Adolescent , Anxiety/epidemiology , Anxiety/prevention & control , Depression/epidemiology , Depression/prevention & control , Feasibility Studies , Humans , India/epidemiology
2.
PLoS One ; 17(3): e0263856, 2022.
Article in English | MEDLINE | ID: covidwho-1759945

ABSTRACT

INTRODUCTION: Depression is a leading mental health problem worldwide. People with long-term conditions are at increased risk of experiencing depression. The COVID-19 pandemic led to strict social restrictions being imposed across the UK population. Social isolation can have negative consequences on the physical and mental wellbeing of older adults. In the Behavioural Activation in Social IsoLation (BASIL+) trial we will test whether a brief psychological intervention (based on Behavioural Activation), delivered remotely, can mitigate depression and loneliness in older adults with long-term conditions during isolation. METHODS: We will conduct a two-arm, parallel-group, randomised controlled trial across several research sites, to evaluate the clinical and cost-effectiveness of the BASIL+ intervention. Participants will be recruited via participating general practices across England and Wales. Participants must be aged ≥65 with two or more long-term conditions, or a condition that may indicate they are within a 'clinically extremely vulnerable' group in relation to COVID-19, and have scored ≥5 on the Patient Health Questionnaire (PHQ9), to be eligible for inclusion. Randomisation will be 1:1, stratified by research site. Intervention participants will receive up to eight intervention sessions delivered remotely by trained BASIL+ Support Workers and supported by a self-help booklet. Control participants will receive usual care, with additional signposting to reputable sources of self-help and information, including advice on keeping mentally and physically well. A qualitative process evaluation will also be undertaken to explore the acceptability of the BASIL+ intervention, as well as barriers and enablers to integrating the intervention into participants' existing health and care support, and the impact of the intervention on participants' mood and general wellbeing in the context of the COVID-19 restrictions. Semi-structured interviews will be conducted with intervention participants, participant's caregivers/supportive others and BASIL+ Support Workers. Outcome data will be collected at one, three, and 12 months post-randomisation. Clinical and cost-effectiveness will be evaluated. The primary outcome is depressive symptoms at the three-month follow up, measured by the PHQ9. Secondary outcomes include loneliness, social isolation, anxiety, quality of life, and a bespoke health services use questionnaire. DISCUSSION: This study is the first large-scale trial evaluating a brief Behavioural Activation intervention in this population, and builds upon the results of a successful external pilot trial. TRIAL REGISTRATION: ClinicalTrials.Gov identifier ISRCTN63034289, registered on 5th February 2021.


Subject(s)
COVID-19 , Ocimum basilicum , Aged , Cost-Benefit Analysis , Depression/prevention & control , Humans , Loneliness , Pandemics , Quality of Life , Randomized Controlled Trials as Topic , Social Isolation
3.
Int J Public Health ; 67: 1604430, 2022.
Article in English | MEDLINE | ID: covidwho-1753425

ABSTRACT

Objectives: To examine the association of non-pharmaceutical interventions (NPIs) with anxiety and depressive symptoms among adults and determine if these associations varied by gender and age. Methods: We combined survey data from 16,177,184 adults from 43 countries who participated in the daily COVID-19 Trends and Impact Survey via Facebook with time-varying NPI data from the Oxford COVID-19 Government Response Tracker between 24 April 2020 and 20 December 2020. Using logistic regression models, we examined the association of [1] overall NPI stringency and [2] seven individual NPIs (school closures, workplace closures, cancellation of public events, restrictions on the size of gatherings, stay-at-home requirements, restrictions on internal movement, and international travel controls) with anxiety and depressive symptoms. Results: More stringent implementation of NPIs was associated with a higher odds of anxiety and depressive symptoms, albeit with very small effect sizes. Individual NPIs had heterogeneous associations with anxiety and depressive symptoms by gender and age. Conclusion: Governments worldwide should be prepared to address the possible mental health consequences of stringent NPI implementation with both universal and targeted interventions for vulnerable groups.


Subject(s)
COVID-19 , SARS-CoV-2 , Adult , Anxiety/epidemiology , Anxiety/prevention & control , Anxiety Disorders , COVID-19/epidemiology , COVID-19/prevention & control , Depression/epidemiology , Depression/prevention & control , Humans
4.
Front Public Health ; 9: 743625, 2021.
Article in English | MEDLINE | ID: covidwho-1686557

ABSTRACT

Background: Quarantine, a public health measure used to control the coronavirus disease 2019 (COVID-19) pandemic, has been linked to an increased risk of developing adverse psychological sequelae. This study sought to investigate whether quarantining during the COVID-19 pandemic was associated with depression among Koreans. Methods: Data were obtained from the Seoul COVID-19 Study of Quarantine (SCS-Q) and the 2019 Korea Community Health Survey (KCHS). Using propensity scores estimated based on sociodemographic and health conditions, 919 individuals undergoing quarantine in the SCS-Q were matched with 919 individuals who did not experience quarantine in the 2019 KCHS. Depressive symptoms were measured using the Korean version of the Patient Health Questionnaire-9 (PHQ-9), where major depression is defined as a PHQ-9 score ≥ 10. Logistic regression models were adjusted for sociodemographic and health-related factors. Results: Depression prevalence was higher in quarantined individuals than in the control group (7.8 vs. 3.8%, p < 0.001). Logistic regression analyses revealed that quarantining was associated with higher likelihoods of having major depression [odds ratio (OR) = 2.28, 95% confidence interval (CI): 1.49, 3.51] after adjusting for relevant covariates. Limitations: Due to the online nature of the SCS-Q, this study included a limited number of elderly participants, limiting the generalizability of the findings to the general Korean population. Conclusions: The findings suggest that Koreans undergoing COVID-19 quarantine are at higher risk of depression. While further investigation is warranted, public health measures to control infectious disease outbreaks, such as quarantine, would benefit from incorporating strategies to address unintended adverse psychological effects, such as depression.


Subject(s)
COVID-19 , Aged , Anxiety , Depression/epidemiology , Depression/prevention & control , Humans , Pandemics , Propensity Score , Quarantine , Republic of Korea/epidemiology , SARS-CoV-2
5.
PLoS One ; 17(2): e0263228, 2022.
Article in English | MEDLINE | ID: covidwho-1674010

ABSTRACT

OBJECTIVES: The aim was to investigate the impact of a group-based weight management programme on symptoms of depression and anxiety compared with self-help in a randomised controlled trial (RCT). METHOD: People with overweight (Body Mass Index [BMI]≥28kg/m2) were randomly allocated self-help (n = 211) or a group-based weight management programme for 12 weeks (n = 528) or 52 weeks (n = 528) between 18/10/2012 and 10/02/2014. Symptoms were assessed using the Hospital Anxiety and Depression Scale, at baseline, 3, 12 and 24 months. Linear regression modelling examined changes in Hospital Anxiety and Depression Scale between trial arms. RESULTS: At 3 months, there was a -0.6 point difference (95% confidence interval [CI], -1.1, -0.1) in depression score and -0.1 difference (95% CI, -0.7, 0.4) in anxiety score between group-based weight management programme and self-help. At subsequent time points there was no consistent evidence of a difference in depression or anxiety scores between trial arms. There was no evidence that depression or anxiety worsened at any time point. CONCLUSIONS: There was no evidence of harm to depression or anxiety symptoms as a result of attending a group-based weight loss programme. There was a transient reduction in symptoms of depression, but not anxiety, compared to self-help. This effect equates to less than 1 point out of 21 on the Hospital Anxiety and Depression Scale and is not clinically significant.


Subject(s)
Anxiety Disorders/prevention & control , Depression/prevention & control , Quality of Life , Self-Management/methods , Weight Loss , Weight Reduction Programs/statistics & numerical data , Anxiety Disorders/epidemiology , Case-Control Studies , Cost-Benefit Analysis , Depression/epidemiology , Female , Humans , Male , Middle Aged , Quality-Adjusted Life Years , United Kingdom
6.
BMC Public Health ; 22(1): 126, 2022 01 18.
Article in English | MEDLINE | ID: covidwho-1637483

ABSTRACT

BACKGROUND: Although numerous studies have been published on the predictors of COVID-19 vaccine hesitancy, some possible predictors remain underexplored. In this study, we explored the associations of unwillingness and indecisiveness regarding COVID-19 vaccination with generalized trust, mental health conditions such as depression and generalized anxiety, and fear of COVID-19. METHODS: Data of wave 1 (from October 27 till November 6, 2020) and wave 3 (from April 23 till May 6, 2021) of a longitudinal online study conducted in Japan were used for the analyses. Unvaccinated participants were asked at wave 3 about their willingness to be vaccinated, with possible responses of willing, unwilling, or undecided. These three responses were used as the outcome variable, and multinomial logistic regression analyses were conducted with willingness to be vaccinated as the reference group. Explanatory variables included generalized trust, depression, generalized anxiety, and fear of COVID-19 both at wave 1 and 3, and sociodemographic and health-related variables. RESULTS: Of the 11,846 valid respondents, 209 (1.8%) answered that they had already been vaccinated against COVID-19, 7089 (59.8%) responded that they were willing to be vaccinated, 3498 (29.5%) responded that they were undecided, and 1053 (8.9%) responded that they were unwilling to be vaccinated. After adjusting for covariates, we found that: (1) participants with lower levels of generalized trust at wave 1 and 3 were more likely to be undecided or unwilling at wave 3; (2) respondents with moderately severe or severe depression at wave 1 and 3 were more likely to be undecided at wave 3; (3) participants with moderate or severe levels of generalized anxiety at wave 3 but not at wave 1 were more likely to be unwilling at wave 3; and (4) respondents with high levels of fear of COVID-19 at wave 1 and 3 were less likely to be undecided and unwilling at wave 3. CONCLUSIONS: Generalized trust, mental health conditions such as depression and generalized anxiety, and low level of fear of COVID-19 are associated with unwillingness or indecision regarding being vaccinated against COVID-19.


Subject(s)
COVID-19 Vaccines , COVID-19 , Anxiety/epidemiology , Depression/epidemiology , Depression/prevention & control , Fear , Humans , SARS-CoV-2 , Trust
7.
Eur Rev Med Pharmacol Sci ; 25(24): 7964-7970, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1608921

ABSTRACT

OBJECTIVE: The aim of the study was to develop mental health nursing strategies for the inbound quarantined population based on the results of a survey study and frontline nursing experiences. SUBJECTS AND METHODS: A mixed research method was selected, we collected data by questionnaires from 128 quarantined people, and by semi-structured interviews from 5 registered nurses. Generalized anxiety disorder-7 (GAD-7), the patient health questionnaire-9 (PHQ-9), the Pittsburgh Sleep Quality Index (PSQI), Social Support Rating Scale (SSRS) were used in the quantitative research to identify the prevalence of psychological issues and risk factors. Semi-structured interviews were conducted in the qualitative study to conclude nursing experiences from RNs. RESULTS: The overall prevalence of anxiety, depression, and insomnia were 34%, 41%, and 18% respectively. Binary logistic regression analysis showed that social support, urban residence, and chronic disease were associated with mental health problems in certain aspects. Three themes were emerged from the analysis of RNs interviews: personality, chronic diseases, and social support. CONCLUSIONS: The prevalence of mental health issues in the inbound quarantined population was the same as the general population in the initial stage of COVID-19 outbreak, and significantly lower than people who lived in high-risk areas. Living in urban areas, with chronic diseases, and obtaining less social support are the risk factors. Finally, four nursing strategies were proposed by the research team for mental health well-being.


Subject(s)
COVID-19/prevention & control , Mental Health/statistics & numerical data , Nurses/organization & administration , Psychiatric Nursing/organization & administration , Quarantine/psychology , Adult , Anxiety/epidemiology , Anxiety/prevention & control , Anxiety/psychology , COVID-19/epidemiology , COVID-19/transmission , China/epidemiology , Cross-Sectional Studies , Depression/epidemiology , Depression/prevention & control , Depression/psychology , Humans , Male , Pandemics/prevention & control , Prevalence , Professional Role , Quarantine/standards , Risk Factors , Self Report/statistics & numerical data , Sleep Initiation and Maintenance Disorders/epidemiology , Sleep Initiation and Maintenance Disorders/prevention & control , Sleep Initiation and Maintenance Disorders/psychology , Social Support/psychology , Social Support/statistics & numerical data , Young Adult
8.
Epidemiol Health ; 43: e2021085, 2021.
Article in English | MEDLINE | ID: covidwho-1594853

ABSTRACT

OBJECTIVES: Identifying determinants of prevention behaviours during the emergence of a new infectious disease is important. We investigated the associations between information-seeking and prevention behaviours during the coronavirus disease 2019 (COVID-19) pandemic and mediating effects of psychiatric factors. METHODS: In total, 1,970 participants from the Cardiovascular and Metabolic Etiology Research Center cohort participated in an online survey 55 days after the first COVID-19 case in Korea was diagnosed. Time spent seeking information related to COVID-19; information sources; psychiatric factors, including anxiety, depression, post-traumatic stress symptoms (PTSS), and the fear of COVID-19; and prevention behaviours were examined. The mediating effect of psychiatric factors was estimated using mediation analysis. RESULTS: Time spent seeking information and information sources affected several behavioural responses. In men, anxiety mediated associations between information-seeking and prevention behaviours, including purchasing sanitary supplies (effect size [ES], 0.038; 95% confidence interval [CI], 0.002 to 0.095) and hoarding (ES, 0.029; 95% CI, 0.002 to 0.068). The fear of COVID-19 also mediated associations between information-seeking and prevention behaviours including refraining from going out (men: ES, 0.034; 95% CI, 0.009 to 0.068; women: ES, 0.052; 95% CI, 0.030 to 0.080), wearing face masks (men: ES, 0.085; 95% CI, 0.031 to 0.184), avoiding public transportation (men: ES, 0.020; 95% CI, 0.000 to 0.044; women: ES, 0.031; 95% CI, 0.015 to 0.051), hoarding (women: ES, 0.051; 95% CI, 0.029 to 0.792), and trying alternative remedies (men: ES, 0.024; 95% CI, 0.004 to 0.053). Depressive symptoms and PTSS did not have any mediating effects. CONCLUSIONS: While the availability of information related to COVID-19 can help prevent infections, it can also promote anxiety and fear, leading to negative behaviours such as hoarding and trying unverified alternative treatments.


Subject(s)
COVID-19 , Pandemics , Anxiety/epidemiology , Anxiety/psychology , Depression/epidemiology , Depression/etiology , Depression/prevention & control , Fear/psychology , Female , Humans , Information Seeking Behavior , Male , Pandemics/prevention & control , Republic of Korea/epidemiology , SARS-CoV-2
9.
Int J Environ Res Public Health ; 18(24)2021 12 14.
Article in English | MEDLINE | ID: covidwho-1572474

ABSTRACT

Despite several empirical studies on the 2019 coronavirus disease (COVID-19) pandemic that have highlighted its detrimental effect on individuals' mental health, the identification of psychological factors that may moderate its impact on individuals' behavior and well-being remains partly unexplored. The present study was conceived to examine the mediation role of regulatory emotional self-efficacy in the relationship between positivity and anxiety, depression, and perceived self-efficacy in complying with the containment measures to contrast the COVID-19 spread. Furthermore, the moderation role of age was tested. A sample of 1258 participants (64.2% women; Mage = 42.09, SD = 13.62) enrolled from the Italian general population answered an online survey aimed at investigating the role of individual differences in facing the COVID-19 pandemic. We opted for a snowball recruiting procedure to find participants. The online survey was disseminated through email invitation and using social media platforms (i.e., Facebook, Instagram). A multi-group path analysis model was performed using Mplus 8.4 to explore the hypothesized relations among variables. The following criteria were employed to evaluate the goodness of fit: χ2 likelihood ratio statistic, CFI and TLI > 0.95, RMSEA < 0.06 and SRMR < 0.08. The findings corroborated the protective role of both positivity and regulatory emotional self-efficacy in reducing individuals' anxiety and depressive symptoms, as well as in fostering individuals' capabilities in complying with the containment measures imposed by the government to reduce the risk of illness and to contain the spread of the virus COVID-19. Specifically, regulatory emotional self-efficacy beliefs partially mediated the relations between positivity and anxiety and depressive symptoms and fully mediated the effect of positivity on perceived self-efficacy beliefs in complying with the containment measures. These paths were equal across ages. The results of the present study appear relevant to implementing psychological interventions aimed to reduce the deleterious effects of the COVID-19 pandemic on mental health through the promotion of individuals' optimistic orientation and emotion regulation.


Subject(s)
COVID-19 , Pandemics , Adult , Anxiety/epidemiology , Depression/epidemiology , Depression/prevention & control , Emotions , Female , Humans , Male , SARS-CoV-2 , Self Efficacy
10.
Arch Gerontol Geriatr ; 98: 104560, 2022.
Article in English | MEDLINE | ID: covidwho-1525685

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has led to social isolation measures, forcing many people to stay indoors, stop daily outdoor activities, and limit face-to-face social interactions with friends, colleagues, and family. This study aimed to identify if non-face-to-face interaction affects depressive symptoms and frailty in older adults. METHODS: We included 3834 older adults (age: 71.1 ± 6.9 [mean ± standard deviation] years; range: 60-96 years; 2153 women) from the National Center for Geriatrics and Gerontology-Study of Geriatric Syndromes. Interaction status was assessed using a self-reported questionnaire. Participants were categorized into: "both interactions" (both face-to-face and non-face-to-face interactions), "face-to-face only" (only face-to-face interactions), "non-face-to-face only" (only non-face-to-face interactions), "no interactions" (neither face-to-face nor non-face-to-face interactions) groups. Depressive symptoms and frailty were measured using the 15-item Geriatric Depression Scale and Kihon Checklist, respectively. RESULTS: Potential confounding factors-adjusted odds ratios for both, face-to-face only and non-face-to-face only groups for developing depressive symptoms were 0.39 (95%CI, 0.26-0.57; p<0.001), 0.56 (95%CI, 0.38-0.84; p=0.004), and 0.51 (95%CI, 0.27-0.96; p=0.038), respectively, and those for development of frailty were 0.44 (95%CI, 0.30-0.65; p<0.001), 0.59 (95%CI, 0.39-0.87; p=0.008), and 0.63 (95%CI, 0.34-1.15; p=0.128), respectively. CONCLUSIONS: Our findings indicate that non-face-to-face interactions are also important in preventing the deterioration of mental health, which is a concern during the COVID-19 pandemic. However, non-face-to-face interactions alone may not be sufficient to maintain physical health, and it is important to maintain opportunities for face-to-face interaction among older adults, particularly during the COVID-19 pandemic.


Subject(s)
COVID-19 , Pandemics , Aged , Depression/epidemiology , Depression/prevention & control , Female , Humans , SARS-CoV-2 , Social Isolation
11.
PLoS Med ; 18(10): e1003779, 2021 10.
Article in English | MEDLINE | ID: covidwho-1463302

ABSTRACT

BACKGROUND: Older adults, including those with long-term conditions (LTCs), are vulnerable to social isolation. They are likely to have become more socially isolated during the Coronavirus Disease 2019 (COVID-19) pandemic, often due to advice to "shield" to protect them from infection. This places them at particular risk of depression and loneliness. There is a need for brief scalable psychosocial interventions to mitigate the psychological impacts of social isolation. Behavioural activation (BA) is a credible candidate intervention, but a trial is needed. METHODS AND FINDINGS: We undertook an external pilot parallel randomised trial (ISRCTN94091479) designed to test recruitment, retention and engagement with, and the acceptability and preliminary effects of the intervention. Participants aged ≥65 years with 2 or more LTCs were recruited in primary care and randomised by computer and with concealed allocation between June and October 2020. BA was offered to intervention participants (n = 47), and control participants received usual primary care (n = 49). Assessment of outcome was made blind to treatment allocation. The primary outcome was depression severity (measured using the Patient Health Questionnaire 9 (PHQ-9)). We also measured health-related quality of life (measured by the Short Form (SF)-12v2 mental component scale (MCS) and physical component scale (PCS)), anxiety (measured by the Generalised Anxiety Disorder 7 (GAD-7)), perceived social and emotional loneliness (measured by the De Jong Gierveld Scale: 11-item loneliness scale). Outcome was measured at 1 and 3 months. The mean age of participants was aged 74 years (standard deviation (SD) 5.5) and they were mostly White (n = 92, 95.8%), and approximately two-thirds of the sample were female (n = 59, 61.5%). Remote recruitment was possible, and 45/47 (95.7%) randomised to the intervention completed 1 or more sessions (median 6 sessions) out of 8. A total of 90 (93.8%) completed the 1-month follow-up, and 86 (89.6%) completed the 3-month follow-up, with similar rates for control (1 month: 45/49 and 3 months 44/49) and intervention (1 month: 45/47and 3 months: 42/47) follow-up. Between-group comparisons were made using a confidence interval (CI) approach, and by adjusting for the covariate of interest at baseline. At 1 month (the primary clinical outcome point), the median number of completed sessions for people receiving the BA intervention was 3, and almost all participants were still receiving the BA intervention. The between-group comparison for the primary clinical outcome at 1 month was an adjusted between-group mean difference of -0.50 PHQ-9 points (95% CI -2.01 to 1.01), but only a small number of participants had completed the intervention at this point. At 3 months, the PHQ-9 adjusted mean difference (AMD) was 0.19 (95% CI -1.36 to 1.75). When we examined loneliness, the adjusted between-group difference in the De Jong Gierveld Loneliness Scale at 1 month was 0.28 (95% CI -0.51 to 1.06) and at 3 months -0.87 (95% CI -1.56 to -0.18), suggesting evidence of benefit of the intervention at this time point. For anxiety, the GAD adjusted between-group difference at 1 month was 0.20 (-1.33, 1.73) and at 3 months 0.31 (-1.08, 1.70). For the SF-12 (physical component score), the adjusted between-group difference at 1 month was 0.34 (-4.17, 4.85) and at 3 months 0.11 (-4.46, 4.67). For the SF-12 (mental component score), the adjusted between-group difference at 1 month was 1.91 (-2.64, 5.15) and at 3 months 1.26 (-2.64, 5.15). Participants who withdrew had minimal depressive symptoms at entry. There were no adverse events. The Behavioural Activation in Social Isolation (BASIL) study had 2 main limitations. First, we found that the intervention was still being delivered at the prespecified primary outcome point, and this fed into the design of the main trial where a primary outcome of 3 months is now collected. Second, this was a pilot trial and was not designed to test between-group differences with high levels of statistical power. Type 2 errors are likely to have occurred, and a larger trial is now underway to test for robust effects and replicate signals of effectiveness in important secondary outcomes such as loneliness. CONCLUSIONS: In this study, we observed that BA is a credible intervention to mitigate the psychological impacts of COVID-19 isolation for older adults. We demonstrated that it is feasible to undertake a trial of BA. The intervention can be delivered remotely and at scale, but should be reserved for older adults with evidence of depressive symptoms. The significant reduction in loneliness is unlikely to be a chance finding, and replication will be explored in a fully powered randomised controlled trial (RCT). TRIAL REGISTRATION: ISRCTN94091479.


Subject(s)
COVID-19/psychology , Depression/prevention & control , Health Promotion/methods , Health Services for the Aged , Loneliness , Pandemics , Social Isolation , Aged , Exercise , Female , Health Behavior , Humans , Internet , Male , Pilot Projects , Program Evaluation , SARS-CoV-2 , Social Participation , State Medicine , United Kingdom
12.
Soc Sci Med ; 286: 114337, 2021 10.
Article in English | MEDLINE | ID: covidwho-1364481

ABSTRACT

Against the backdrop of evidence that physical activity can protect against depression, there has been growing interest in the mechanisms through which this relationship operates (e.g., biological adaptations), and the factors that might moderate it (e.g., physical activity intensity). However, no attempt has been made to examine whether, or through what mechanisms, depression-related benefits might arise from belonging to groups that engage in physical activity. Across two studies, we addressed these shortcomings by (a) examining whether engaging in physical activity specifically in the context of sport or exercise groups protects against depression and (b) testing two pathways through which benefits might arise: greater physical activity and reduced loneliness. Study 1 (N = 4549) used data from three waves of a population study of older adults residing in England. Sport or exercise group membership predicted fewer depression symptoms four years later. This relationship was underpinned by sport or exercise group members engaging in physical activity more frequently and feeling less lonely. Clinical depression rates were almost twice as high among non-group members than group members. Study 2 (N = 635) included Australian adults who were members of sport and exercise groups, recruited during the enforced suspension of all group-based sport and exercise due to COVID-19 restrictions. The more sport or exercise groups participants had lost physical access to, the more severe their depression symptoms. Clinical depression rates were over twice as high among those who had lost access to >2 groups compared to those who had lost access to <2 groups. The relationship between number of groups lost and depression symptom severity was mediated by greater loneliness, but not by overall physical activity. Overall, findings suggest that belonging to groups that engage in physical activity can protect against depression, and point to the value of initiatives that aim to promote people's engagement in such groups.


Subject(s)
COVID-19 , Depression , Aged , Australia , Depression/epidemiology , Depression/prevention & control , Exercise , Humans , SARS-CoV-2
13.
S Afr Fam Pract (2004) ; 63(1): e1-e4, 2021 07 14.
Article in English | MEDLINE | ID: covidwho-1335290

ABSTRACT

The effect of coronavirus disease 2019 (COVID-19) on the mood responses of individuals is an important indicator of how society is coping with the pandemic. Characterising mood responses in a South African sample could prepare clinicians for possible presentations of mental health concerns in general practice. This study described mood responses during COVID-19 Alert Level 1. The sample of 641 participants who completed the Brunel Mood State Scale during November 2020 was drawn from primary healthcare and family medicine clinics and practices in Cape Town. Their mood response profile was described and compared with pre-COVID-19 norms. The mood profile represented an inverse iceberg profile, with mean scores deviating significantly from pre-COVID-19 norms across all six mood dimensions measured. The inverse iceberg profile had been associated with a range of psychopathologies, suggesting an increased risk of psychological disorders. The current profile of mood responses could alert clinicians to the possibility of increased mental health needs of patients. Patient reports of prolonged anxiety and fatigue, particularly when combined with low mood and low vigour, could signal the need for intervention or referral for further mental health support.


Subject(s)
Affect , Anxiety/psychology , COVID-19/psychology , Depression/prevention & control , Family Practice/organization & administration , Adaptation, Psychological , Adult , Anxiety/prevention & control , COVID-19/epidemiology , Depression/psychology , Female , Humans , Male , Mental Health/statistics & numerical data , Middle Aged , South Africa , Surveys and Questionnaires
14.
BJS Open ; 5(4)2021 07 06.
Article in English | MEDLINE | ID: covidwho-1331540

ABSTRACT

INTRODUCTION: Core surgical training programmes are associated with a high risk of burnout. This study aimed to assess the influence of a novel enhanced stress-resilience training (ESRT) course delivered at the start of core surgical training in a single UK statutory education body. METHOD: All newly appointed core surgical trainees (CSTs) were invited to participate in a 5-week ESRT course teaching mindfulness-based exercises to develop tools to deal with stress at work and burnout. The primary aim was to assess the feasibility of this course; secondary outcomes were to assess degree of burnout measured using Maslach Burnout Inventory (MBI) scoring. RESULTS: Of 43 boot camp attendees, 38 trainees completed questionnaires, with 24 choosing to participate in ESRT (63.2 per cent; male 13, female 11, median age 28 years). Qualitative data reflected challenges delivering ESRT because of arduous and inflexible clinical on-call rotas, time pressures related to academic curriculum demands and the concurrent COVID-19 pandemic (10 of 24 drop-out). Despite these challenges, 22 (91.7 per cent) considered the course valuable and there was unanimous support for programme development. Of the 14 trainees who completed the ESRT course, nine (64.3 per cent) continued to use the techniques in daily clinical work. Burnout was identified in 23 trainees (60.5 per cent) with no evident difference in baseline MBI scores between participants (median 4 (range 0-11) versus 5 (1-11), P = 0.770). High stress states were significantly less likely, and mindfulness significantly higher in the intervention group (P < 0.010); MBI scores were comparable before and after ESRT in the intervention cohort (P = 0.630, median 4 (range 0-11) versus 4 (1-10)). DISCUSSION: Despite arduous emergency COVID rotas ESRT was feasible and, combined with protected time for trainees to engage, deserves further research to determine medium-term efficacy.


Subject(s)
Burnout, Professional/prevention & control , Curriculum , General Surgery/education , Resilience, Psychological , Stress, Psychological/prevention & control , Surgeons/psychology , Adult , Anxiety/prevention & control , COVID-19/epidemiology , Depression/prevention & control , Feasibility Studies , Female , Humans , Male , Mindfulness , Pandemics , Surveys and Questionnaires , United Kingdom , Work Schedule Tolerance
16.
Medicine (Baltimore) ; 100(15): e25290, 2021 Apr 16.
Article in English | MEDLINE | ID: covidwho-1289779

ABSTRACT

ABSTRACT: Health care employees are the front liners whom are directly involved in the management of COVID-19 at high risk of developing psychological distress and other mental health illness. We aim to assess the burden of depression during this pandemic on health care employees treating COVID-19 in Saudi Arabia. We also will shed the light on the best solutions of how to encounter depression.A cross-sectional, hospital-based survey conducted via a region-stratified, 2-stage cluster sample was conducted for 554 participants in >15 hospitals from April 29, 2020, to June 30, 2020. Depression is measured using the established PHQ9 score system. We grade PHQ9 depression scores as: normal, 0 to 4, mild, 5 to 9, significant (moderate or severe), 10 to 27. χ2/Fisher exact test was used; significant association between level of depression and survey characteristics were made. P value <0.05 was considered statistically significant.A total of 554 participants completed the survey. A total of 18.9% (n = 105) were aged <29 years, 51.2% (n = 284) were between 30 to 39 years and female represent 70% of all participants. Of all participants, 53.7% (n = 298) were nurses, and 38.6% (n = 214) were physicians; 68.5% (n = 380) worked in central area hospitals in Saudi Arabia. No significant (P = .432, 95% confidence interval [CI]) association was observed between sex and depression classifications. However, female had high proportion of significant depression 75.0% (n = 76) was observed as compared to male 24.8% (n = 25). Depression was significant in Saudis 61.4% (n = 62) (P < .001, 95% CI) and medical staff who encountered corona patients 51.5% (n = 52) (P < .002, 95% CI). Hospital preparedness associated with more freedom of depression symptoms 69.1% (n = 199/288) (P < .001, 95% CI).Frontline young health care workers especially physician in Saudi Arabia reported a high rate of depression symptoms. Countermeasures for health care workers represent a key component for the mental and physical well-being as part of public health measures during this pandemic. Attention to hospital preparedness and adequacy of personal protective equipment contributed to milder depression symptoms. Further studies need to be conducted on crisis management and depression.


Subject(s)
Anxiety , COVID-19 , Depression , Health Personnel , Infection Control , Occupational Stress , Adult , Anxiety/diagnosis , Anxiety/etiology , Anxiety/prevention & control , COVID-19/epidemiology , COVID-19/psychology , Cross-Sectional Studies , Depression/diagnosis , Depression/etiology , Depression/prevention & control , Female , Health Personnel/classification , Health Personnel/psychology , Hospitalists/psychology , Hospitalists/statistics & numerical data , Humans , Infection Control/methods , Infection Control/organization & administration , Infection Control/standards , Male , Mental Health/statistics & numerical data , Occupational Health/standards , Occupational Stress/prevention & control , Occupational Stress/psychology , Personal Protective Equipment/supply & distribution , SARS-CoV-2 , Saudi Arabia/epidemiology
17.
JNCI Cancer Spectr ; 5(3): pkab031, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1261049

ABSTRACT

Oncology health-care workers (HCWs) are facing substantial stressors during the current coronavirus disease 2019 pandemic, resulting in a wide range of acute stress responses. To appropriately meet the growing mental health needs of HCWs, it is imperative to differentiate expectable stress responses from posttraumatic stress disorder and mental illness, because traditional mental health interventions may pathologize healthy stress reactions and risk retraumatizing HCWs under acute duress. Further, HCWs are experiencing protracted forms of acute stress as the pandemic continues, including moral injury, and require mental health interventions that are flexible and can adapt as the acuity of stressors changes. Previously developed frameworks to support people experiencing acute stress, such as Psychological First Aid, are particularly relevant for HCWs in the ongoing pandemic. Acute stress interventions like Psychological First Aid are guided by the Stress Continuum Model, which conceptualizes stress reactions on a continuum, from a zone of normal readiness and expectable consequences to a zone of more persistent and extreme reactions such as posttraumatic stress disorder and major depression. Key principles of the Stress Continuum Model include the expectation that emotional reactivity does not lead to psychiatric problems, that interventions need to be appropriately targeted to symptoms along the stress continuum, and that people will return to normal recovery. Various core actions to reduce acute stress include delivering practical assistance, reducing arousal, mobilizing support, and providing targeted collaborative services. This nonpathologizing approach offers a valuable framework for delivering both individual and organizational-level interventions during the coronavirus disease 2019 pandemic.


Subject(s)
COVID-19/prevention & control , Health Personnel/psychology , Mental Health , Neoplasms/therapy , Psychosocial Support Systems , Adaptation, Psychological , Anxiety/prevention & control , Anxiety/psychology , Attitude of Health Personnel , COVID-19/epidemiology , COVID-19/virology , Depression/prevention & control , Depression/psychology , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Neoplasms/diagnosis , Pandemics/prevention & control , SARS-CoV-2/physiology , Stress, Psychological/prevention & control , Stress, Psychological/psychology
18.
Prev Chronic Dis ; 18: E53, 2021 05 27.
Article in English | MEDLINE | ID: covidwho-1248369

ABSTRACT

INTRODUCTION: The disproportionate impact of the COVID-19 pandemic on Latino communities has resulted in greater reports of depression, anxiety, and stress. We present a community-led intervention in Latino communities that integrated social services in mental health service delivery for an equity-based response. METHODS: We used tracking sheets to identify 1,436 unique participants (aged 5-86) enrolled in Latino Health Access's Emotional Wellness program, of whom 346 enrolled in the pre-COVID-19 period (March 2019-February 2020) and 1,090 in the COVID-19 period (March-June 2020). Demographic characteristics and types of services were aggregated to assess monthly trends using Pearson χ2 tests. Regression models were developed to compare factors associated with referrals in the pre-COVID-19 and COVID-19 periods. RESULTS: During the pandemic, service volume (P < .001) and participant volume (P < .001) increased significantly compared with the prepandemic period. Participant characteristics were similar during both periods, the only differences being age distribution, expanded geographic range, and increased male participation during the pandemic. Nonreferred services, such as peer support, increased during the pandemic period. Type of referrals significantly changed from primarily mental health services and disease management in the prepandemic period to affordable housing support, food assistance, and supplemental income. CONCLUSION: An effective mental health program in response to the pandemic must incorporate direct mental health services and address social needs that exacerbate mental health risk for Latino communities. This study presents a model of how to integrate both factors by leveraging promotor-led programs.


Subject(s)
Anxiety , COVID-19 , Community Mental Health Services/organization & administration , Depression , Stress, Psychological , Adult , Anxiety/etiology , Anxiety/prevention & control , COVID-19/epidemiology , COVID-19/psychology , Depression/etiology , Depression/prevention & control , Emotional Adjustment , Female , /statistics & numerical data , Humans , Male , Mental Health/ethnology , Psychosocial Support Systems , SARS-CoV-2 , Social Work/methods , Stress, Psychological/etiology , Stress, Psychological/prevention & control , United States/epidemiology
19.
Transl Psychiatry ; 11(1): 329, 2021 05 28.
Article in English | MEDLINE | ID: covidwho-1246354

ABSTRACT

Emerging evidence shows that the coronavirus disease 2019 (COVID-19) pandemic is negatively affecting mental health around the globe. Interventions to alleviate the psychological impact of the pandemic are urgently needed. Whether mindfulness practice may protect against the harmful emotional effects of a pandemic crisis remains hitherto unknown. We investigated the influence of mindfulness training on mental health during the COVID-19 outbreak in China. We hypothesized that mindfulness practitioners might manifest less pandemic-related distress, depression, anxiety, and stress than non-practitioners and that more frequent practice would be associated with an improvement in mental health during the pandemic. Therefore, we assessed pandemic-related distress and symptoms of depression, anxiety, and stress, as well as the frequency of meditation practice at the peak of new infections (Feb 4-5; N = 673) and three weeks later (Feb 29-30; N = 521) in mindfulness practitioners via online questionnaires. Self-reported symptoms were also collected from non-practitioners at peak time only (N = 1550). We found lower scores of pandemic-related distress in mindfulness practitioners compared to non-practitioners. In general, older participants showed fewer symptoms of depression and anxiety. In younger practitioners, pandemic-related distress decreased from peak to follow-up. Importantly, increased mindfulness training during the preceding two weeks was associated with lower scores of depression and anxiety at both assessments. Likewise, practice frequency predicted individual improvement in scores of depression, anxiety, and stress at follow-up. Our results indicate that mindfulness meditation might be a viable low-cost intervention to mitigate the psychological impact of the COVID-19 crisis and future pandemics.


Subject(s)
COVID-19 , Mindfulness , Anxiety/epidemiology , China/epidemiology , Depression/epidemiology , Depression/prevention & control , Humans , Mental Health , Pandemics/prevention & control , SARS-CoV-2 , Stress, Psychological
20.
BMC Psychiatry ; 21(1): 273, 2021 05 26.
Article in English | MEDLINE | ID: covidwho-1244915

ABSTRACT

BACKGROUND: The world is facing a public health emergency situation caused by the COVID-19 pandemic. Psychological wellbeing among individuals worldwide has been negatively affected by the pandemic especially in low- and middle-income countries such as Bangladesh. The present study aimed to assess the estimate of depressive symptoms and investigated its associations with COVID-19 preventive practice measures, daily activities in home quarantine, and suicidal behaviors in a large-scale Bangladeshi online survey. METHODS: An online-based cross-sectional survey was widely distributed to Bangladeshi citizens. A total of 13,654 participants (61.0% male; mean age = 24.0 years [SD = 6.0]; age range 18-65 years) completed the survey between May and June (2020). The survey included socio-demographics and COVID-19-related questions, along with lifestyle, suicidal, and psychometric measures. Hierarchical regression was performed to determine significant associations between depression and examined variables. RESULTS: The estimate of depressive symptoms during the COVID-19 pandemic was 43.5%. Based on hierarchical regression analysis, depression was significantly associated with not engaging in COVID-19 preventive measures, daily activities in home quarantine (e.g., playing videogames), and suicidal behaviors. CONCLUSIONS: Depressive symptoms appeared to be high during the COVID-19 pandemic in Bangladesh. To fight against the pandemic, mental health issues as well as physical health issues need to be taken into consideration.


Subject(s)
COVID-19 , Depression , Adolescent , Adult , Aged , Anxiety , Bangladesh/epidemiology , Cross-Sectional Studies , Depression/epidemiology , Depression/prevention & control , Female , Humans , Male , Mental Health , Middle Aged , Pandemics , Quarantine , SARS-CoV-2 , Suicidal Ideation , Young Adult
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