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Front Public Health ; 11: 1117539, 2023.
Article in English | MEDLINE | ID: covidwho-20245549


Background: Two years after the outbreak of the pandemic, several studies look at the consequences for the well-being and mental health of young people. In particular, creativity and resilience are cited in the scientific literature as resources that promote this well-being in adolescents and young adults. Purpose: This mini-literature review was created with the aim of examining how many articles have explored the relationship between creativity and resilience in adolescents and young adults since the onset of the pandemic. Methods: Particular attention was paid to how many of the articles actually related to the consequences of the pandemic, in which country they were published, their target population, and the models, instruments and variables used to analyze them. Results: Only 4 articles emerged from the screening, of which only one was actually related to pandemic consequences. All articles were published in Asian countries with a target group of university students. Three of the articles used mediation models to examine the relationship between resilience as an independent variable and creativity as a dependent variable. All articles used self-assessment instruments for creativity and resilience, both at the individual and group level. Significance: This mini-review offers us the opportunity to reflect on the lack of studies that have addressed the issue of youth resources in the form of creativity and resilience since the beginning of the pandemic. The results show us a still underdeveloped interest in creativity in the scientific literature, in contrast to what the media reports on the promotion of creativity in daily life.

Mental Health , Pandemics , Humans , Adolescent , Young Adult , Disease Outbreaks , Asia
Arq. ciências saúde UNIPAR ; 27(2): 701-719, Maio-Ago. 2023.
Article in Portuguese | WHO COVID, LILACS (Americas) | ID: covidwho-20242959


Introdução: Estudos indicam que os profissionais de saúde têm alto risco de desenvolver sintomas relacionados à saúde mental, especialmente depressão, ansiedade e estresse. Objetivo: identificar e sintetizar os estudos sobre os preditores relacionados a saúde mental entre enfermeiros que atuam na linha de frente no combate ao COVID- 19. Método: Trata-se de uma revisão de escopo, sem limitação de linguagem e ano, nas bases BVS, PubMed, SCIELO, CINAHL, SCOPUS, Web of Science, MedNar, CAPES e ProQuest. Foi realizada síntese narrativa. Resultados: A pandemia da COVID-19 trouxe sérios impactos a saúde mental dos profissionais de enfermagem, os achados revelaram cinco temas principais sentimento de insegurança, falta de equipamentos de proteção individual, falta de exames diagnósticos, mudanças no fluxo de atendimento e medo do desconhecido. Existe uma associação significativa entre o bem-estar físico e metal e a produtividade laboral. Conclusão: Destaca-se os desafios enfrentados pelos enfermeiros no combate da COVID-19, mesmo com a repercussões no ambiente de trabalho os enfermeiros ainda padecem de reconhecimento adequado que incluem situações de estresse, ansiedade, depressão e estão diretamente relacionadas à frustração, esgotamento físico e mental, sentimento de impotência e insegurança profissional vivenciados durante a pandemia, principalmente por jovens profissionais sem experiência no cuidado de pacientes críticos.

Introduction: Studies indicate that health professionals are at high risk of developing symptoms related to mental health, especially depression, anxiety and stress. Objective: identify and synthesize studies on mental health-related predictors among nurses who work on the front line in the fight against COVID-19. Method: This is a scope review, without language and year limitations, in the VHL, PubMed, SCIELO, CINAHL, SCOPUS, Web of Science, MedNar, CAPES and ProQuest databases. Narrative synthesis was performed. Results: The COVID-19 pandemic had serious impacts on the mental health of nursing professionals, the findings revealed five main themes: feeling of insecurity, lack of personal protective equipment, lack of diagnostic tests, changes in the flow of care and fear of the unknown. There is a significant association between physical and mental well-being and labor productivity. Conclusion: The challenges faced by nurses in the fight against COVID-19 are highlighted, even with the repercussions in the work environment, nurses still suffer from adequate recognition and include situations of stress, anxiety and even depression, which are directly related to frustration , physical and mental exhaustion, feeling of helplessness and professional insecurity experienced during the pandemic, especially by young professionals with no experience in caring for critically ill patients.

Introducción: Los estudios indican que los profesionales de la salud tienen un alto riesgo de desarrollar síntomas relacionados con la salud mental, especialmente depresión, ansiedad y estrés. Objetivo: identificar y sintetizar estudios sobre predictores relacionados a la salud mental entre enfermeros que trabajan en primera línea en la lucha contra el COVID-19. Método: Se trata de una revisión de alcance, sin limitaciones de idioma y año, en las bases de datos BVS, PubMed, SCIELO, CINAHL, SCOPUS, Web of Science, MedNar, CAPES y ProQuest. Se realizó una síntesis narrativa. Resultados: La pandemia de COVID-19 tuvo graves impactos en la salud mental de los profesionales de enfermería, los hallazgos revelaron cinco temas principales: sensación de inseguridad, falta de equipo de protección personal, falta de pruebas diagnósticas, cambios en el flujo de atención y miedo a lo desconocido. Existe una asociación significativa entre el bienestar físico y mental y la productividad laboral. Conclusiones: Se destacan los retos a los que se enfrentan las enfermeras en la lucha contra la COVID-19, aún con las repercusiones en el ámbito laboral, las enfermeras siguen sufriendo un reconocimiento adecuado e incluyen situaciones de estrés, ansiedad e incluso depresión, que están directamente relacionadas con la frustración , el agotamiento físico y mental, la sensación de impotencia y la inseguridad profesional experimentada durante la pandemia, especialmente por profesionales jóvenes sin experiencia en el cuidado de pacientes críticos.

Pandemics , Systematic Reviews as Topic , Psychological Well-Being/psychology , Nurses/psychology , Anxiety/psychology , Mental Health , Libraries, Digital , Emotions , Burnout, Psychological/psychology , COVID-19/psychology
Arq. ciências saúde UNIPAR ; 27(2): 684-700, Maio-Ago. 2023.
Article in Portuguese | WHO COVID, LILACS (Americas) | ID: covidwho-20240059


O objetivo do estudo foi comparar a percepção sobre a massa corporal, comportamentos relacionados à saúde, e a saúde mental de escolares adolescentes durante o período de retorno às atividades escolares presenciais com o período anterior à pandemia de COVID-19. O estudo foi realizado com 425 escolares (16,96±1,39 anos; 60,2% do sexo feminino) selecionados aleatoriamente de escolas das redes pública e privada de Pelotas/RS. Para a coleta dos dados foi utilizado um questionário de autopreenchimento contendo perguntas retrospectivas e atuais sobre as variáveis analisadas. Os resultados indicaram que a percepção sobre a massa corporal, o nível de atividade física, o tempo de sono, e a saúde mental (apenas para as meninas) estão piores (p<0,05) no momento atual quando comparados ao período anterior à pandemia. Por outro lado, hábitos alimentares e tempo de tela recreativo apresentaram melhores resultados (p<0,05) no momento atual do que no período anterior à pandemia. Estes resultados mostram um complexo panorama em relação à saúde de adolescentes no período de retomada das atividades presencias, tornando o retorno às atividades escolares presenciais um desafio para os próprios adolescentes, seus familiares, para professores, e para as escolas.

The aim of this study was to compare the perception of body mass, health- related behaviors and mental health of adolescent schoolchildren during the period of return to face to face school activities with the period before COVID-19 pandemic. The study was carried out with 425 students (16.96±1.39 years; 60.2% female) randomly selected from public and private schools in Pelotas/RS. For data collection, a self-completion questionnaire was used, containing retrospective and current questions about analyzed outcomes. The results indicated that the perception of body mass, level of physical activity, sleep time, and mental health (only for girls) are worse (p<0.05) at present when compared to the period before the pandemic. On the other hand, eating habits and recreational screen time showed better results (p<0.05) at present than in the period before the pandemic. These results show a complex panorama concerning the health of adolescents in the period of resumption of face to face activities, making this return a challenge for the adolescents themselves, their families, teachers and for schools.

El objetivo de este estudio fue comparar la percepción de masa corporal, comportamientos relacionados a la salud y salud mental de escolares adolescentes durante el período de retorno a las actividades escolares presenciales con el período anterior a la pandemia de COVID-19. El estudio fue realizado con 425 alumnos (16,96±1,39 años; 60,2% del sexo femenino) seleccionados aleatoriamente de escuelas públicas y privadas de Pelotas/RS. Para la recolección de datos, se utilizó un cuestionario auto-completado, conteniendo preguntas retrospectivas y actuales sobre los resultados analizados. Los resultados indicaron que la percepción de la masa corporal, el nivel de actividad física, el tiempo de sueño y la salud mental (sólo para las niñas) son peores (p<0,05) en la actualidad en comparación con el período anterior a la pandemia. Por otro lado, los hábitos alimentarios y el tiempo de pantalla recreativo mostraron mejores resultados (p<0,05) en la actualidad que en el periodo anterior a la pandemia. Estos resultados muestran un panorama complejo en relación a la salud de los adolescentes en el período de reanudación de las actividades presenciales, haciendo de este retorno un desafío para los propios adolescentes, sus familias, profesores y para las escuelas.

Humans , Male , Female , Adolescent , Young Adult , Schools , Students , Adolescent Health , Pandemics , COVID-19 , Sleep , Exercise/psychology , Body Mass Index , Mental Health , Cross-Sectional Studies , Adolescent Behavior , Feeding Behavior/psychology , Screen Time , Sleep Duration
Acta Paul. Enferm. (Online) ; 35: eAPE01406, 2022. tab, graf
Article in Portuguese | WHO COVID, LILACS (Americas) | ID: covidwho-20234685


Resumo Objetivo Identificar, a partir das evidências presentes na literatura, os impactos da COVID-19 na saúde mental de mulheres grávidas. Métodos Trata-se de uma revisão integrativa da literatura, realizada nas bases de dados/biblioteca eletrônica MEDLINE, CINAHL, PUBCOVID19 e MEDRXIV. A busca aconteceu de forma pareada no mês de dezembro de 2020, com artigos disponíveis na íntegra abordando a saúde mental das grávidas na pandemia. Resultados Os estudos que compuseram a amostra foram publicados entre os meses de abril e dezembro de 2020 e nos 10 estudos incluídos, a depressão e a ansiedade são apontados como fatores impactantes na saúde das gestantes, tendo como elementos contribuintes o medo da COVID-19, estresse e preocupações associadas à pandemia. Conclusão Houve impacto na saúde mental das gestantes na pandemia com repercussões de ordem psicossocial, socioeconômica e de assistência à saúde. Nesse contexto, a abordagem do componente psicológico na consulta de enfermagem pode fazer a diferença na atenção à gestação.

Resumen Objetivo Identificar, a partir de evidencias presentes en la literatura, los impactos del COVID-19 en la salud mental de mujeres embarazadas. Métodos Se trata de una revisión integradora de la literatura, realizada en las bases de datos/biblioteca electrónica MEDLINE, CINAHL, PUBCOVID19 y MEDRXIV. La búsqueda se realizó de forma pareada en el mes de diciembre de 2020, con artículos con texto completo disponible que abordaban la salud mental de embarazadas en la pandemia. Resultados Los estudios que formaron la muestra fueron publicados entre los meses de abril y diciembre de 2020. En los diez estudios incluidos, la depresión y la ansiedad son señaladas como factores impactantes en la salud de las mujeres embarazadas, donde los elementos contribuyentes son el miedo al COVID-19, el estrés y las preocupaciones relacionadas con la pandemia. Conclusión Hubo impacto en la salud mental de las mujeres embarazadas en la pandemia, con repercusiones de orden psicosocial, socioeconómica y de atención a la salud. En este contexto, el enfoque del componente psicológico en la consulta de enfermería puede marcar una diferencia en la atención al embarazo.

Abstract Objective To identify the impacts of COVID-19 on pregnant women's mental health from evidence in the literature. Methods This is an integrative literature review performed in MEDLINE, CINAHL, PUBCOVID19 and MEDRXIV databases/electronic libraries. The search took place in pairs in December 2020, with articles available in full addressing pregnant women's mental health in the pandemic. Results The studies that made up the sample were published between April and December 2020 and in the ten studies included, depression and anxiety were identified as factors exerting impact on pregnant women's health, and the fear of COVID-19, stress and worries associated with the pandemic as contributing elements. Conclusion There was an impact on pregnant women's mental health in the pandemic with psychosocial, socioeconomic and health care repercussions. In this context, the approach to the psychological component in the nursing consultation can make a difference in pregnancy care.

Humans , Social Isolation/psychology , Quarantine/psychology , Mental Health/statistics & numerical data , Women's Health , Pregnant Women , COVID-19/psychology , Anxiety , Delivery of Health Care
BMC Psychiatry ; 23(1): 408, 2023 06 07.
Article in English | MEDLINE | ID: covidwho-20241220


OBJECTIVES: To determine the association between internet addiction disorder (IAD) and anxiety and depressive symptomatology in high school students in two private schools in Chiclayo, Peru, during the COVID-19 pandemic. MATERIALS AND METHODS: Analytical cross-sectional investigation of 505 adolescents from two private schools. The dependent variables were anxiety and depressive symptomatology, measured with the Beck Adapted Depression Questionnaire (BDI-IIA) and the Beck Anxiety Inventory (BAI), respectively. The main independent variable was IAD, measured with the Internet Addiction Test instrument(IATI). Prevalence ratios (PR) and 95% confidence intervals (95%CI) were estimated. RESULTS: The average age was 14.16 years and 54.9% were women. 22.2% and 3.2% presented mild and moderate IAD; respectively. 9.3% presented severe anxiety and 34.3% severe depressive symptomatology. In the simple regression, adolescents with mild, moderate and severe IAD presented 19% (PR = 1.19; 95%CI: 1.05-1.35), 25% (PR = 1.25; 95%CI: 1.02-1.53) and 53% (PR = 1.47; 95% CI: 1.47-1.60) higher prevalence of depressive symptomatology; however, this association was not maintained in the multiple model. Anxiety increased 196% in adolescents with severe IAD (PR = 2.96; 95%CI: 1.86-4.71). CONCLUSION: We found that 2, 1, and 3 out of 10 students presented IAD, depressive symptomatology, and anxiety, respectively. We did not find an association between IAD and depressive symptomatology, but we did find an association with anxiety. Among the factors associated with the development of depressive symptomatology were the male sex, the presence of eating disorders, subclinical insomnia, using devices for more than 2 h, and using the Internet for academic activities. About anxiety, the associated factors are the female sex, the presence of eating disorders, subclinical insomnia, and the use of the Internet as social interaction. We recommend implementing counseling programs in view of the imminent introduction of the Internet as a pillar in education.

Behavior, Addictive , COVID-19 , Sleep Initiation and Maintenance Disorders , Adolescent , Humans , Male , Female , Cross-Sectional Studies , Internet Addiction Disorder/epidemiology , Peru/epidemiology , Sleep Initiation and Maintenance Disorders/epidemiology , Mental Health , Pandemics , COVID-19/epidemiology , Students/psychology , Internet , Behavior, Addictive/epidemiology , Behavior, Addictive/psychology , Depression/epidemiology , Depression/psychology
Br J Community Nurs ; 28(6): 306-309, 2023 Jun 02.
Article in English | MEDLINE | ID: covidwho-20240987


Mental health issues are difficult yet common experiences. Considering that one in four people in England experience a mental health problem every year, it is essential that the community nurse has a good understanding of the different types of mental health problems faced by individuals, and be able to adequately provide care and support. In part one of a two-part series on mental health in the community, Sarah Palmer provides details on some of the more common mental health conditions, and the support that primary care can provide to individuals experiencing mental health issues.

Mental Disorders , Mental Health , Humans , England
Int J Environ Res Public Health ; 20(11)2023 May 31.
Article in English | MEDLINE | ID: covidwho-20240590


The COVID-19 pandemic has further aggravated the burden of mental health and presents an opportunity for public health research to focus on evidence-based interventions appropriate for populations residing in resource-constrained, post-conflict settings. Post-conflict settings have a higher service gap in mental health and fewer protective factors, such as economic and domestic security. Post-conflict settings are defined as locations where open warfare has ended but resulting challenges have remained for years. A strong emphasis on the engagement of diverse stakeholders is needed to arrive at sustainable and scalable solutions to mental health service delivery. This review discusses mental health service delivery gaps in post-conflict settings, highlights the urgency of the matter in the context of the COVID-19 pandemic, and provides recommendations for service gaps from evidence-based case study exemplars with an implementation science lens using the Consolidated Framework for Implementation Research (CFIR) as guide to improving adaptation and uptake.

COVID-19 , Mental Health Services , Humans , Mental Health , Implementation Science , COVID-19/epidemiology , Pandemics
PLoS One ; 18(5): e0286321, 2023.
Article in English | MEDLINE | ID: covidwho-20240534


BACKGROUND: COVID-19 caused severe effects on the psychological well-being of Chinese students overseas (COS). Physical activity (PA) is critical to strengthen immunity, prevent infection, and reduce the psychological burden caused by COVID-19. However, there is a severe lack of effective PA intervention for mental health in most countries, and COS have limited access to mental healthcare during the pandemic. OBJECTIVE: We aim to examine the effects of PA on COS' mental health during the pandemic abroad and to better understand that certain types of PA might be associated with a greater reduction in psychological burdens during the pandemic. METHODS AND RESULTS: In a multi-country cross-sectional analysis, a questionnaire was distributed to COS living in 37 foreign countries via WeChat Subscription using a snowball sampling strategy. A total of 10,846 participants were included. Descriptive statistics and Binary logistic regression analysis were used for statistical analysis. We found that COS had negative psychology during the pandemic, especially with fear (2.90, 95% CI 2.88-2.92), anxiety (2.84, 95% CI 2.82-2.85), and stress (2.71, 95% CI 2.69-2.73). PA had meaningful effects on reducing COS self-reported mental health burdens (3.42, 95% CI 3.41-3.44) during the pandemic. The largest associations were seen for recreational and home-based PA (i.e., family games, home aerobic exercise), individual outdoor PA (i.e., walking or running, rope skipping), and PA with a duration of 30 to 70 min per session at frequencies of 4 to 6 times and a total of 150 to 330 min of moderate and vigorous intensity per week tends to be an optimal choice during social distancing times. CONCLUSIONS: COS had several poor mental health conditions during the pandemic. The improvement of PA on COS' psychology was positively effective during the pandemic. Specific types, intensities, durations, and frequencies of PA might have advantages over others for improving COS' mental health during periods of public health emergencies, and the topic may merit interventional study to reveal multiple factors causing COS' psychological burdens and enrich the PA forms for all COS' mental health improvement (i.e., infected, recovered, and asymptomatic COS).

COVID-19 , Exercise , Mental Health , Students , Humans , COVID-19/epidemiology , Cross-Sectional Studies , East Asian People
Pediatr Emerg Care ; 39(7): 542-547, 2023 Jul 01.
Article in English | MEDLINE | ID: covidwho-20240483


OBJECTIVE: We examined emergency department (ED) mental health visit trends by children in relation to periods of school closure and reopening during the COVID-19 pandemic in Alberta, Canada. METHODS: Mental health visits by school-aged children (5 to <18 years) were extracted from the Emergency Department Information System, a province-wide database, from March 11, 2020, to November 30, 2021 (pandemic period; n = 18,997) and March 1, 2019, to March 10, 2020 (1-year, prepandemic comparator period; n = 11,540). We calculated age-specific visit rates and compared rate differences between periods of school closure (March 15-June 30, 2020; November 30, 2020-January 10, 2021; April 22-June 30, 2021) and reopening (September 4-November 29, 2020; January 11-April 21, 2021; September 3-November 30, 2021) to matched prepandemic periods. We used a ratio of relative risk to examine the risk of a visit during closures versus reopenings. RESULTS: The cohort included 11,540 prepandemic visits and 18,997 pandemic visits. Compared with prepandemic periods, ED visit rates increased across all ages during the first (+85.53%; 95% confidence interval [CI], 73.68% to 100.41%) and third (+19.92%; 95% CI, 13.28% to 26.95%) school closures, and decreased during the second closure (-15.37%; 95% CI, -22.22% to -7.92%). During school reopenings, visit rates decreased across all ages during the first reopening (-9.30%; 95% CI, -13.94% to -4.41%) and increased during the third reopening (+13.59%; 95% CI, 8.13% to 19.34%); rates did not change significantly during the second reopening (2.54%; 95% CI, -3.45% to 8.90%). The risk of a visit during school closure versus reopening was only higher for the first closure with 2.06 times the risk (95% CI, 1.88 to 2.25). CONCLUSIONS: Emergency department mental health visit rates were highest during the first school closure of the COVID-19 pandemic, and the risk of a visit during this closure period was twice compared with when schools first reopened.

COVID-19 , Humans , Child , COVID-19/epidemiology , Pandemics , Alberta/epidemiology , Mental Health , Emergency Service, Hospital
Syst Rev ; 12(1): 88, 2023 05 27.
Article in English | MEDLINE | ID: covidwho-20240354


BACKGROUND: Ongoing symptoms or the development of new symptoms following a SARS-CoV-2 diagnosis has caused a complex clinical problem known as "long COVID" (LC). This has introduced further pressure on global healthcare systems as there appears to be a need for ongoing clinical management of these patients. LC personifies heterogeneous symptoms at varying frequencies. The most complex symptoms appear to be driven by the neurology and neuropsychiatry spheres. METHODS: A systematic protocol was developed, peer reviewed, and published in PROSPERO. The systematic review included publications from the 1st of December 2019-30th June 2021 published in English. Multiple electronic databases were used. The dataset has been analyzed using a random-effects model and a subgroup analysis based on geographical location. Prevalence and 95% confidence intervals (CIs) were established based on the data identified. RESULTS: Of the 302 studies, 49 met the inclusion criteria, although 36 studies were included in the meta-analysis. The 36 studies had a collective sample size of 11,598 LC patients. 18 of the 36 studies were designed as cohorts and the remainder were cross-sectional. Symptoms of mental health, gastrointestinal, cardiopulmonary, neurological, and pain were reported. CONCLUSIONS: The quality that differentiates this meta-analysis is that they are cohort and cross-sectional studies with follow-up. It is evident that there is limited knowledge available of LC and current clinical management strategies may be suboptimal as a result. Clinical practice improvements will require more comprehensive clinical research, enabling effective evidence-based approaches to better support patients.

COVID-19 , Humans , SARS-CoV-2 , COVID-19 Testing , Post-Acute COVID-19 Syndrome , Mental Health
Curr Psychiatry Rep ; 25(7): 301-311, 2023 07.
Article in English | MEDLINE | ID: covidwho-20239925


PURPOSE OF REVIEW: To summarize recent findings in global mental health along several domains including socioeconomic determinants, inequities, funding, and inclusion in global mental health research and practice. RECENT FINDINGS: Mental illness continues to disproportionately impact vulnerable populations and treatment coverage continues to be low globally. Advances in integrating mental health care and adopting task-shifting are accompanied by implementation challenges. The mental health impact of recent global events such as the COVID-19 pandemic, geo-political events, and environmental change is likely to persist and require coordinated care approaches for those in need of psychosocial support. Inequities also exist in funding for global mental health and there has been gradual progress in terms of building local capacity for mental health care programs and research. Lastly, there is an increasing effort to include people with lived experiences of mental health in research and policy shaping efforts. The field of global mental health will likely continue to be informed by evidence and perspectives originating increasingly from low- and middle-income countries along with ongoing global events and centering of relevant stakeholders.

COVID-19 , Mental Disorders , Humans , Mental Health , Pandemics , Mental Disorders/epidemiology , Mental Disorders/therapy , Global Health
Int J Environ Res Public Health ; 20(10)2023 05 19.
Article in English | MEDLINE | ID: covidwho-20239858


The present study investigated how altered daily life behavior and its self-evaluation associated with the coronavirus disease 2019 (COVID-19) pandemic relate to psychological health in Japanese working adults, and how such relationships may be moderated by dispositional mindfulness. A total of 1000 participants completed an online survey comprising questions on how they used time and self-evaluated life behavior before and during the pandemic, as well as scales on mindfulness and psychological health. The results revealed that after the pandemic, participants spent significantly more time at home and using a PC/smartphone. They were also more likely to perceive frequent exposure to COVID-19-related media reports and less likely to find their work going well. Many of these variables were significantly correlated with lower psychological health. Moreover, hierarchical multiple regression analyses revealed the moderating effects of mindfulness, such that the perceived frequency of exposure to pandemic-related media reports and poorer views that work was going well were less likely to predict lower psychological health when mindfulness was high. These findings suggest that altered daily life behavior and its self-evaluation after the pandemic are associated with deteriorated psychological health, but that mindfulness can serve as a protective factor against psychological distress among Japanese workers.

COVID-19 , Mental Health , Mindfulness , Adult , Humans , COVID-19/epidemiology , East Asian People , Mindfulness/methods , Pandemics , Personality
BMJ Ment Health ; 26(1)2023 Jun.
Article in English | MEDLINE | ID: covidwho-20239597


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.

COVID-19 , Psychological Distress , Humans , Female , Adult , Male , Mental Health , Pandemics , Health Personnel/psychology
Int J Soc Determinants Health Health Serv ; 53(3): 311-322, 2023 Jul.
Article in English | MEDLINE | ID: covidwho-20239578


Social protection can buffer the negative impacts of unemployment on health. Have stimulus packages introduced during the COVID-19 pandemic mitigated potential harms to health from unemployment? We performed a systematic review of the health effects of job loss during the first year of the pandemic. We searched three electronic databases and identified 49 studies for inclusion. Three United States-based studies found that stimulus programs mitigated the impact of job loss on food security and mental health. Furloughs additionally appeared to reduce negative impacts when they were paid. However, despite the implementation of large-scale stimulus packages to reduce economic harms, we observed a clear pattern that job losses were nevertheless significantly associated with negative impacts, particularly on mental health, quality of life, and food security. We also observe suggestive evidence that COVID-related job loss was associated with child maltreatment, worsening dental health, and poor chronic disease outcomes. Overall, although we did find evidence that income-support policies appeared to help protect people from the negative health consequences of pandemic-related job loss, they were not sufficient to fully offset the threats to health. Future research should ascertain how to ensure adequate access to and generosity of social protection programs during epidemics and economic downturns.

COVID-19 , Child , Humans , United States/epidemiology , COVID-19/epidemiology , Pandemics/prevention & control , Quality of Life , Unemployment/psychology , Mental Health
JAMA Netw Open ; 6(6): e2318045, 2023 06 01.
Article in English | MEDLINE | ID: covidwho-20239516


Importance: Although telehealth services expanded rapidly during the COVID-19 pandemic, the association between state policies and telehealth availability has been insufficiently characterized. Objective: To investigate the associations between 4 state policies and telehealth availability at outpatient mental health treatment facilities throughout the US. Design, Setting, and Participants: This cohort study measured whether mental health treatment facilities offered telehealth services each quarter from April 2019 through September 2022. The sample comprised facilities with outpatient services that were not part of the US Department of Veterans Affairs system. Four state policies were identified from 4 different sources. Data were analyzed in January 2023. Exposures: For each quarter, implementation of the following policies was indexed by state: (1) payment parity for telehealth services among private insurers; (2) authorization of audio-only telehealth services for Medicaid and Children's Health Insurance Program (CHIP) beneficiaries; (3) participation in the Interstate Medical Licensure Compact (IMLC), permitting psychiatrists to provide telehealth services across state lines; and (4) participation in the Psychology Interjurisdictional Compact (PSYPACT), permitting clinical psychologists to provide telehealth services across state lines. Main Outcome and Measures: The primary outcome was the probability of a mental health treatment facility offering telehealth services in each quarter for each study year (2019-2022). Information on the facilities was obtained from the Mental Health and Addiction Treatment Tracking Repository based on the Substance Abuse and Mental Health Services Administration Behavioral Health Treatment Service Locator. Separate multivariable fixed-effects regression models were used to estimate the difference in the probability of offering telehealth services after vs before policy implementation, adjusting for characteristics of the facility and county in which the facility was located. Results: A total of 12 828 mental health treatment facilities were included. Overall, 88.1% of facilities offered telehealth services in September 2022 compared with 39.4% of facilities in April 2019. All 4 policies were associated with increased odds of telehealth availability: payment parity for telehealth services (adjusted odds ratio [AOR], 1.11; 95% CI, 1.03-1.19), reimbursement for audio-only telehealth services (AOR, 1.73; 95% CI, 1.64-1.81), IMLC participation (AOR, 1.40, 95% CI, 1.24-1.59), and PSYPACT participation (AOR, 1.21, 95% CI, 1.12-1.31). Facilities that accepted Medicaid as a form of payment had lower odds of offering telehealth services (AOR, 0.75; 95% CI, 0.65-0.86) over the study period, as did facilities in counties with a higher proportion (>20%) of Black residents (AOR, 0.58; 95% CI, 0.50-0.68). Facilities in rural counties had higher odds of offering telehealth services (AOR, 1.67; 95% CI, 1.48-1.88). Conclusion and Relevance: Results of this study suggest that 4 state policies that were introduced during the COVID-19 pandemic were associated with marked expansion of telehealth availability for mental health care at mental health treatment facilities throughout the US. Despite these policies, telehealth services were less likely to be offered in counties with a greater proportion of Black residents and in facilities that accepted Medicaid and CHIP.

COVID-19 , Telemedicine , United States/epidemiology , Child , Female , Pregnancy , Humans , COVID-19/epidemiology , Cohort Studies , Mental Health , Pandemics , Ambulatory Care Facilities
BMC Psychiatry ; 23(1): 386, 2023 06 01.
Article in English | MEDLINE | ID: covidwho-20239357


OBJECTIVES: In March 2020, France faced a health crisis due to the COVID-19 outbreak that, like previous infectious disease crises, involved high psychological and emotional stress, a series of factors that influenced the ongoing mental health crisis. METHODS: We recruited 384 respondents to complete an online questionnaire during the second month of isolation: 176 psychotherapy recipients (68 were currently attending psychiatric care) and 208 healthy controls. We measured demographic characteristics, impulsivity, aggression, hopelessness, suicidal risk, and the global level of anxiety and depression in order to estimate potential discrepancies in clinical measures across these populations. RESULTS: Our results indicate that the group currently undergoing psychiatric care was prone to loneliness and social isolation. Regarding clinical and nonclinical population, there were differences in suicidal risk, depression, anxiety, and hopelessness but mainly in aggression. Regression analysis also demonstrated that aggression surprisingly influenced anxiety levels. Patients undergoing therapy compared with patients who were not displayed differences only in suicidal risk, anxiety, and hopelessness, with those undergoing therapy having higher scores. The outpatient group undergoing therapy had a significantly lower level of impulsivity. Moreover, the regression to predict anxiety and depression levels from correlated factors highlighted the potentially heightened role of aggression in predicting anxiety in the clinical group. CONCLUSION: New research into stress reactions should assess other clinical signals, such as aggression, and examine preventive mental health interventions in times of crisis.

COVID-19 , Humans , Anxiety/psychology , Anxiety Disorders/epidemiology , Aggression/psychology , Mental Health , Depression/psychology
BMC Psychol ; 11(1): 179, 2023 Jun 08.
Article in English | MEDLINE | ID: covidwho-20239351


BACKGROUND: The Coronavirus disease 2019 (COVID-19) pandemic has impacted parental and child mental health and wellbeing in the UK. This study aimed to explore the experiences of parents of children with rare neurological and neurodevelopmental conditions with a known or suspected genetic cause (neurogenetic) across the first year of the pandemic in the UK. METHODS: Semi-structured interviews were conducted with 11 parents of children with rare neurogenetic conditions. Parents were recruited via opportunity sampling from the CoIN Study, a longitudinal quantitative study exploring the impact of the pandemic on the mental health and wellbeing of families with rare neurogenetic conditions. Interviews were analysed using Interpretative Phenomenological Analysis. RESULTS: Four main themes were identified: (1) "A varied impact on child wellbeing: from detrimental to 'no big drama'"; (2) "Parental mental health and wellbeing: impact, changes, and coping"; (3) "'The world had shut its doors and that was that': care and social services during the pandemic"; and (4) "Time and luck: abstract concepts central to parents' perspectives of how they coped during the pandemic". The majority of parents described experiencing an exacerbation of pre-pandemic challenges due to increased uncertainty and a lack of support, with a minority reporting positive effects of the pandemic on family wellbeing. CONCLUSIONS: These findings offer a unique insight into the experiences parents of children with rare neurogenetic conditions across the first year of the pandemic in the UK. They highlight that the experiences of parents were not pandemic-specific, and will continue to be highly relevant in a non-pandemic context. Future support should to be tailored to the needs of families and implemented across diverse future scenarios to promote coping and positive wellbeing.

COVID-19 , Pandemics , Child , Humans , COVID-19/epidemiology , Parents/psychology , Adaptation, Psychological , Mental Health
Am J Mens Health ; 17(3): 15579883231178752, 2023.
Article in English | MEDLINE | ID: covidwho-20239172


The ability of a cricket player to manage their mental health helps them to perform optimally. This study investigated how mental health is related to performance of male cricket players during the resumption of sporting events after coronavirus disease 2019 (COVID-19) restrictions. Mental health profiles were established using the Depression, Anxiety, Stress Scale-21 (DASS-21), Athlete Burnout Questionnaire (ABQ), and Satisfaction with Life Scale (SWLS) instruments among male semiprofessional cricket players (n = 63). Performance metrics included: body fat percentage (BF%), range of motion (ROM), push-abdominal test, crazy catch test, t-test, 40-m sprint, and Cooper's test. Inferential statistics included Spearman's correlations with a significance level set at α < .05. Spearman's correlation reported a statistically significant relationship for SWLS and body mass index (BMI) (r = -0.263; p = .037) as well as between stress and abdominal test (r = 0.355; p = .004); crazy catch test (r = 0.249; p = .049); Cooper's test (r = 0.335; p = .009), VO2max (r = 0.308; p = .014), stress and abdominal test (r = -0.313; p = .012); as well as anxiety and 40-m sprint (r = 0.488; p = .027). This study provides an important snapshot of how symptoms of mental health are associated with performance. Further research should investigate the relationship between mental health and performance parameters among male players at varied skill levels.

Athletic Performance , COVID-19 , Humans , Male , Mental Health , Anxiety/psychology , Anxiety Disorders