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1.
PLoS One ; 16(12): e0261921, 2021.
Article in English | MEDLINE | ID: covidwho-1581722

ABSTRACT

Universal screening for suicidal ideation in primary care and mental health settings has become a key prevention tool in many healthcare systems, including the Veterans Healthcare Administration (VHA). In response to the coronavirus pandemic, healthcare providers faced a number of challenges, including how to quickly adapt screening practices. The objective of this analyses was to learn staff perspectives on how the pandemic impacted suicide risk screening in primary care and mental health settings. Forty semi-structured interviews were conducted with primary care and mental health staff between April-September 2020 across 12 VHA facilities. A multi-disciplinary team employed a qualitative thematic analysis using a hybrid inductive/deductive approach. Staff reported multiple concerns for patients during the crisis, especially regarding vulnerable populations at risk for social isolation. Lack of clear protocols at some sites on how to serve patients screening positive for suicidal ideation created confusion for staff and led some sites to temporarily stop screening. Sites had varying degrees of adaptability to virtual based care, with the biggest challenge being completion of warm hand-offs to mental health specialists. Unanticipated opportunities that emerged during this time included increased ability of patients and staff to conduct virtual care, which is expected to continue benefit post-pandemic.


Subject(s)
COVID-19/epidemiology , COVID-19/psychology , Health Personnel , Mass Screening/methods , Pandemics , SARS-CoV-2 , Suicidal Ideation , Veterans Health , Veterans/psychology , COVID-19/prevention & control , COVID-19/virology , Humans , Mental Health , Physical Distancing , Primary Health Care , Risk Assessment/methods , Telemedicine/methods
2.
BMC Pregnancy Childbirth ; 21(1): 826, 2021 Dec 13.
Article in English | MEDLINE | ID: covidwho-1571747

ABSTRACT

BACKGROUND: Postpartum depression affects a significant proportion of women of childbearing age. The birth of a newborn baby is normally considered a joyful event, inhibiting mothers from expressing their depressive feelings. If the condition is not well understood and managed, mothers with postpartum depression are likely to experience suicidal ideation or even commit suicide. This study explored lived experiences of women who had recovered from a clinical diagnosis of postpartum depression in southwestern Uganda. METHODS: This phenomenological study adopted the explorative approach through in-depth interviews as guided by the biopsychosocial model of depression. It was conducted in Mbarara Regional Referral Hospital, Bwizibwera Health Centre IV and Kinoni Health Centre IV located in Mbarara and Rwampara districts, southwestern Uganda. Data were collected from 30 postpartum mothers who were purposively selected, between 9th December 2019 and 25th September 2020. We analyzed this work using thematic data analysis and this was steered by the Colaizzi's six-step phenomenological approach of inquiry. RESULTS: The findings were summarized into five major themes: 1) somatic experiences including insomnia and headache, breast pain, poor breast milk production, weight loss and lack of energy; 2) difficulties in home and family life including overwhelming domestic chores, lack of social support from other family members, fighting at home and financial constraints due to COVID-19 pandemic; 3) negative emotions including anger, self-blame, despondency and feelings of loneliness and regrets of conceiving or marriage; 4) feelings of suicide, homicide and self-harm including suicidal ideation and attempt, homicidal ideations and attempt and feelings of self-harm and 5) coping with postpartum depression including spirituality, termination of or attempt to leave their marital relationships, acceptance, counselling and seeking medical treatment, perseverance. CONCLUSION AND RECOMMENDATIONS: Suicidal and homicidal thoughts are important parts of the postpartum depression experience, and these may put the lives of the mothers, their spouses and their babies at a great risk. Poor relationship quality, intimate partner violence and lack of financial resources contribute significantly to the negative emotional experiences of mothers with PPD.


Subject(s)
COVID-19 , Depression, Postpartum , Financial Stress , Marriage/psychology , Physical Distancing , Stress, Psychological , Suicidal Ideation , Adaptation, Psychological , Adult , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/psychology , Communicable Disease Control/methods , Depression, Postpartum/diagnosis , Depression, Postpartum/physiopathology , Depression, Postpartum/psychology , Female , Financial Stress/etiology , Financial Stress/psychology , Humans , Models, Biopsychosocial , Qualitative Research , SARS-CoV-2 , Social Support/psychology , Stress, Psychological/complications , Stress, Psychological/etiology , Stress, Psychological/physiopathology , Uganda/epidemiology
3.
JAMA Netw Open ; 4(12): e2136137, 2021 12 01.
Article in English | MEDLINE | ID: covidwho-1567891

ABSTRACT

Importance: The COVID-19 pandemic has had a substantial psychological effect on young people. A quantitative assessment of the association between the pandemic and stress and suicidality in youths is needed. Objective: To investigate the association of the COVID-19 pandemic with self-reported stress and suicide-related behaviors in youths. Design, Setting, and Participants: This cross-sectional study used data from the the Korea Youth Risk Behavior Web-based Survey (KYRBWS) conducted in 2019 and 2020 with youths aged 12 to 18 years. Statistical analysis was performed from January to February 2021. Main Outcomes and Measures: The odds ratios (ORs) with 95% CIs for subjective stress level, sadness or despair, suicidal thoughts, suicide planning, and suicide attempts among 2020 participants were compared with those of the 2019 participants using multiple logistic regression analysis with complex sampling using weighted values. Results: The 48 443 youths in the 2019 KYRBWS (24 917 male youths [51.3%]; mean [SD] age, 15.0 [1.7] years) and the 44 216 youths in the 2020 KYRBWS (23 103 male youths [52.5%]; mean [SD] age, 15.1 [1.7] years) were compared. The degree of subjective stress was lower in the 2020 participants than in the 2019 participants (severe stress: adjusted OR [aOR], 0.90 [95% CI, 0.83-0.97]; very severe stress: aOR, 0.65 [95% CI, 0.60-0.72]). Sadness or despair was also lower in the 2020 participants than in the 2019 participants (aOR, 0.81 [95% CI, 0.78-0.84]). There were fewer suicide-related behaviors, including suicidal thoughts, suicide planning, and suicide attempts, among the 2020 participants than among the 2019 participants (suicidal thoughts: aOR, 0.77 [95% CI, 0.73-0.80]; suicide planning: aOR = 0.88 [95% CI, 0.81-0.96]; suicide attempts: aOR, 0.64 [95% CI, 0.58-0.70]). Conclusions and Relevance: This cross-sectional study found that severe stress, sadness or despair and suicide-related behaviors had inverse associations with the early COVID-19 pandemic in Korean youths. These findings suggest that levels of high stress decreased among Korean youths in the early period of the pandemic compared with prepandemic levels.


Subject(s)
COVID-19/psychology , Pandemics , Sadness , Stress, Psychological , Suicidal Ideation , Suicide, Attempted , Adolescent , Cross-Sectional Studies , Female , Humans , Logistic Models , Male , Odds Ratio , SARS-CoV-2
4.
J Adolesc Health ; 70(1): 48-56, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1559813

ABSTRACT

PURPOSE: This study characterized the unobserved patterns in crisis response among youth in the U.S. from March to December 2020 and determined the characteristics of vulnerable subgroups who were at increased risk for suicide due to the pandemic. METHODS: A latent class analysis of crisis support-seeking from a national text-based crisis platform, (n = 179,497, aged 24 years or younger) for 11 crisis concerns (e.g., depression, anxiety/stress, suicidal thoughts, isolation, abuse, bereavement, relationships) was performed on three study periods: (1) January 2017 to December 2020, (2) prepandemic: 1 January 2017 to 12 March 2020, and (3) pandemic: 13 March to 20 December 2020. Demographic characteristics (age, race/ethnicity, sexual orientation, and gender identity) were used as predictors for class membership using the three-step method. RESULTS: Four latent classes were identified: (1) depression/isolation/self-harm (D/I/S) (18,694 texters, 10.4%), (2) interpersonal stress/mood-anxiety (I/M) (32,640 texters, 18.2%), (3) suicidal thoughts/depressed (S/D) (34,067, 19.0%), and (4) adjustment/stress (A/S) (94,096 texters, 52.4%). During the pandemic, an increase in suicidal thoughts and active rescues occurred in the D/I/S and S/D higher-risk subclasses. Characteristics of vulnerable groups in higher-risk classes since the pandemic included children, LGBTQ, American Indian, White, Black, Asian, female, and gender-nonconforming youth. CONCLUSIONS: Results identified a strong association with class membership in more severe risk classes during the pandemic and an increase in suicidal help-seeking, particularly among children and LGBTQ youth. Low-cost and targeted crisis text-based platforms for support-seeking in youth may be one potential safety net strategy to address the effects of the COVID-19 pandemic on mental health in youth.


Subject(s)
COVID-19 , Adolescent , Child , Female , Gender Identity , Humans , Latent Class Analysis , Male , Pandemics , SARS-CoV-2 , Suicidal Ideation
5.
Int J Environ Res Public Health ; 18(24)2021 12 07.
Article in English | MEDLINE | ID: covidwho-1554853

ABSTRACT

This research uses structural equation modeling to determine the influence of uncertainty due to the COVID-19 pandemic as an independent variable in the negative emotional states and resilience (as mediating variables) vs. drug addiction, alcoholism, and suicide ideation as dependent variables in 5557 students from a public state university in Northern Mexico. The five variables are related through eight hypotheses and tested using partial least squares. We used an adapted questionnaire sent by email in May 2020. Findings show that uncertainty facing the COVID-19 pandemic had a direct and significant influence on negative emotional states and a significant inverse effect on resilience; in the trajectory, drug addiction and alcoholism, and suicide ideation are explained.


Subject(s)
Alcoholism , COVID-19 , Substance-Related Disorders , Alcoholism/epidemiology , Humans , Pandemics , SARS-CoV-2 , Suicidal Ideation , Uncertainty
7.
Prim Care Companion CNS Disord ; 23(6)2021 10 28.
Article in English | MEDLINE | ID: covidwho-1497475
9.
J Affect Disord ; 298(Pt A): 65-68, 2022 02 01.
Article in English | MEDLINE | ID: covidwho-1487796

ABSTRACT

BACKGROUND: There is serious concern over the increase in mental health problems during the coronavirus disease 2019 (Covid-19) pandemic. METHODS: Based on data from two Mexican National Health and Nutrition Surveys conducted in 2018-2019 and 2020 (n = 17,925 and 4,913, respectively), we estimated the prevalence of suicide attempts among adolescents 10-19 years old in the previous year. We constructed a multivariate logistic regression model adjusted by sociodemographic characteristics and contextual variables for the Covid-19 pandemic. RESULTS: The prevalence of suicide attempts in the previous year was similar in both surveys. We found that women, youth in urban localities and individuals living in households where a family member had lost her/his job as a result of the Covid-19 contingency were more likely to attempt suicide compared to their counterparts. On the other hand, attending classes online proved to be a protective factor (aOR=0.3, 95% CI=0.1, 0.8, p = 0.022). LIMITATIONS: The principal limitation of our study concerned the restricted size of our sample for the 2020 survey wave. CONCLUSIONS: Population-level policies aimed at providing economic protection and helping youth to return to school would exert a favorable impact on the mental health and suicidal behavior of youths.


Subject(s)
COVID-19 , Suicide, Attempted , Adolescent , Adult , Child , Disease Outbreaks , Female , Humans , Pandemics , Risk Factors , SARS-CoV-2 , Suicidal Ideation , Young Adult
10.
Int J Environ Res Public Health ; 18(20)2021 10 12.
Article in English | MEDLINE | ID: covidwho-1480718

ABSTRACT

Few studies have examined the relationship between the therapeutic alliance in therapy and suicidal experiences. No studies have examined this relationship with people with non-affective psychosis. The present study sought to redress this gap in the literature. Sixty-four participants with non-affective psychosis and suicidal experiences who were receiving a suicide-focused cognitive therapy were recruited. Self-reported suicidal ideation, suicide plans, suicide attempts, depression, and hopelessness were collected from participants prior to starting therapy. Suicidal experience measures were collected again post-therapy at 6 months. Therapeutic alliance ratings were completed by clients and therapists at session 4 of therapy. Dose of therapy was documented in number of minutes of therapy. Data were analyzed using correlation coefficients, independent samples t-tests, a multiple hierarchical regression, and a moderated linear regression. There was no significant relationship found between suicidal ideation prior to therapy and the therapeutic alliance at session 4, rated by both client and therapist. However, there was a significant negative relationship between the client-rated therapeutic alliance at session 4 and suicidal ideation at 6 months, after controlling for pre-therapy suicidal ideation, depression, and hopelessness. Furthermore, the negative relationship between the client-rated alliance and suicidal ideation was the strongest when number of minutes of therapy was 15 h or below. A stronger therapeutic alliance developed in the first few sessions of therapy is important in ameliorating suicidal thoughts in people with psychosis. Nevertheless, it is not necessarily the case that more hours in therapy equates to a cumulative decrease in suicidal ideation of which therapists could be mindful. A limitation of the current study was that the alliance was analyzed only at session 4 of therapy, which future studies could seek to redress.


Subject(s)
Psychotic Disorders , Therapeutic Alliance , Humans , Psychotherapy , Psychotic Disorders/therapy , Suicidal Ideation , Suicide, Attempted
11.
Eur Psychiatry ; 64(1): e63, 2021 10 13.
Article in English | MEDLINE | ID: covidwho-1477491

ABSTRACT

BACKGROUND: Personality traits have been associated with long-term suicide risk but their relationship with short-term risk is still unknown. Therefore, to address this gap, we explored the moderating effect of personality traits on the relationship between the Suicide Crisis Syndrome (SCS) and short-term suicidal behaviors (SB). SAMPLING AND METHODS: Adult participants (N = 459) were administered the Suicide Crisis Inventory (SCI), a validated self-report questionnaire designed to measure the intensity of the Suicidal Crisis Syndrome, the Big Five Inventory for personality traits, and the Columbia Suicide Severity Rating Scale for SB at intake and at a 1-month follow-up. The PROCESS macro in SPSS was used to test the moderation model. Covariates hypothesized to influence the results were added: age, gender, ethnicity, years of education, and depressive symptomatology on the Beck Depression Inventory. This study was a secondary analysis drawn from a larger study on the SCS. RESULTS: SCI total score had a significant positive relationship with SB at the 1-month follow-up for patients with lower levels of extraversion, agreeableness, conscientiousness, and openness, respectively. Hence, these four traits were protective against SB. There was an association between SCI and SB for patients with high levels of neuroticism at the 1-month follow-up. CONCLUSIONS: High levels of neuroticism served as a risk factor, whereas high levels of the other Big Five traits were protective factors against short-term SB in the context of elevated SCS symptoms. Thus, personality traits play a role in moderating the relationship between the SCS and imminent SB.


Subject(s)
Suicidal Ideation , Suicide , Adult , Extraversion, Psychological , Humans , Neuroticism , Risk Factors
12.
Psychiatry Res ; 301: 113998, 2021 07.
Article in English | MEDLINE | ID: covidwho-1475002

ABSTRACT

COVID-19, and efforts to mitigate its spread, are creating extensive mental health problems. Experts have speculated the mental, economic, behavioral, and psychosocial problems linked to the COVID-19 pandemic may lead to a rise in suicide behavior. However, a quantitative synthesis is needed to reach an overall conclusion regarding the pandemic-suicide link. In the most comprehensive test of the COVID-19-suicidality link to date, we meta-analyzed data from 308,596 participants across 54 studies. Our results suggested increased event rates for suicide ideation (10.81%), suicide attempts (4.68%), and self-harm (9.63%) during the COVID-19 pandemic when considered against event rates from pre-pandemic studies. Moderation analysis indicated younger people, women, and individuals from democratic countries are most susceptible to suicide ideation during the COVID-19 pandemic. Policymakers and helping professionals are advised that suicide behaviors are alarmingly common during the COVID-19 pandemic and vary based upon age, gender, and geopolitics. Strong protections from governments (e.g., implementing best practices in suicide prevention) are urgently needed to reduce suicide behaviors during the COVID-19 pandemic.


Subject(s)
COVID-19/psychology , Suicidal Ideation , Suicide, Attempted/psychology , Suicide/prevention & control , COVID-19/epidemiology , Female , Humans , Male , Pandemics , SARS-CoV-2 , Self-Injurious Behavior/psychology , Suicide/psychology , Suicide, Attempted/statistics & numerical data
13.
Syst Rev ; 10(1): 232, 2021 08 14.
Article in English | MEDLINE | ID: covidwho-1456005

ABSTRACT

BACKGROUND: Suicide is a leading cause of death in children and youth, with suicidal thoughts and suicide attempts (referred to as non-fatal suicidal behaviors (NFSB)) being among its strongest predictors. Positive parenting (e.g., warmth, responsiveness), negative parenting (e.g., control, hostility), and parent-child relationship quality (e.g., trust, communication) have been reported to be associated with differences in NFSB in this population. To date, no comprehensive systematic review has considered together the wide range of parenting factors studied in relation to NFSB, and no meta-analysis of existing findings has been conducted. The present study will critically appraise and synthesize the existing evidence from observational studies that examine the relationships between parenting factors and (i) suicidal ideation and (ii) suicide attempt in children and youth. METHODS: Studies will be retrieved from APA PsycInfo, MEDLINE, CINAHL, Embase, Scopus, and the Cochrane Library databases. Retrospective, cross-sectional, and longitudinal studies, conducted in clinical and population settings, among youth aged less than 25 years and published as articles and dissertations in English or French will be eligible. Two reviewers will select articles using the Covidence Software after title and abstract screening and full-text assessment, will extract information using double data entry, and will appraise studies' quality using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Any disagreements will be discussed with a third reviewer. Publication bias will be evaluated using funnel plots and Egger's test. In addition to a narrative summary of results, meta-analyses will be conducted using results from at least three studies. Three-level random effect models will allow to derive pooled estimates from dependent effect sizes (from the same sample or study). In case of significant heterogeneity, moderation analyses will be performed considering participants' characteristics and methodological aspects of studies. The results will be reported according to the PRISMA guidelines, and the certainty of evidence will be assessed using the GRADE approach. DISCUSSION: In highlighting parenting factors associated with NFSB and in estimating the overall strength of these associations in children and youth, our results will inform further intervention and prevention strategies designed for young people experiencing NFSB and their families. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020165345.


Subject(s)
Parenting , Suicidal Ideation , Adolescent , Cross-Sectional Studies , Humans , Meta-Analysis as Topic , Observational Studies as Topic , Retrospective Studies , Systematic Reviews as Topic
14.
Curr Psychiatry Rep ; 23(11): 75, 2021 10 06.
Article in English | MEDLINE | ID: covidwho-1453881

ABSTRACT

PURPOSE OF REVIEW: This paper reviews the literature on the psychological effects of the COVID-19 pandemic on children and the reactions of vulnerable children. RECENT FINDINGS: Research reveals increases in clinically significant depression, suicidal ideation and behavior, and some anxiety symptoms. Substance use studies suggest an inadvertent decrease in substance use in some youth though findings are inconsistent across substances and for males and females. Children with pre-existing emotional and behavioral problems are especially vulnerable though some children appear to improve in the context of public health measures which have decreased the stresses associated with school and socialization. In addition, children with pre-existing problems are likely to have established resources and relationships that may protect them relative to other children. COVID-19 has had a major effect on the mental health of children around the world, but findings should be considered preliminary until more rigorous research has been conducted.


Subject(s)
COVID-19 , Pandemics , Adolescent , Anxiety , Child , Female , Humans , Male , SARS-CoV-2 , Suicidal Ideation
15.
Prev Med ; 152(Pt 1): 106734, 2021 11.
Article in English | MEDLINE | ID: covidwho-1447231

ABSTRACT

Since 1999, the Office of the United States Surgeon General has identified suicide prevention as a national public health priority. The National Strategy on Suicide Prevention, coordinated by the public-private Action Alliance, was most recently updated in 2012. In early 2021, the Surgeon General's office released a Call to Action to fully implement the national strategy. Six core types of actions to prevent suicide include adopting a broad public health approach, addressing upstream factors including social determinants of health, reducing access to multiple forms of lethal means, adopting evidence-based care for persons at risk, enhancing crisis care and care transitions, and improving the quality and use of suicide-related data. From 1999 through 2018, suicide rates in the U.S. increased by approximately one-third, and suicide had become the tenth leading cause of death. While most recent national data indicate a small reduction in the suicide rate, decreases were not seen across all demographic groups. Population groups which may require special emphasis or outreach efforts include adolescents, working age adults, military veterans, and American Indians/Alaskan Natives. Increases in social isolation, mental distress, and economic hardship during the COVID-19 pandemic indicate clear needs to address the full spectrum of suicidal behavior. This will require a multisector and whole of government approach, using contemporary evidence-informed approaches and best practices as well as innovative methods including those based on predictive analytics.


Subject(s)
COVID-19 , Suicide , Adolescent , Adult , Humans , Pandemics , SARS-CoV-2 , Suicidal Ideation , Suicide/prevention & control , United States
16.
Health Promot Chronic Dis Prev Can ; 41(11): 378-391, 2021 11 10.
Article in English, French | MEDLINE | ID: covidwho-1441443

ABSTRACT

INTRODUCTION: Many Canadians report decreased mental health during the COVID-19 pandemic, and concerns have been raised about possible increases in suicide. This study investigates the pandemic's potential impact on adults' suicide ideation. METHODS: We compared self-reported suicide ideation in 2020 versus 2019 by analyzing data from the Survey on COVID-19 and Mental Health (11 September to 4 December 2020) and the 2019 Canadian Community Health Survey. Logistic regression was conducted to determine which populations were at higher risk of suicide ideation during the pandemic. RESULTS: The percentage of adults reporting suicide ideation since the pandemic began (2.44%) was not significantly different from the percentage reporting suicide ideation in the past 12 months in 2019 (2.73%). Significant differences in the prevalence of recent suicide ideation in 2020 versus 2019 also tended to be absent in the numerous sociodemographic groups we examined. Risk factors of reporting suicide ideation during the pandemic included being under 65 years, Canadian-born or a frontline worker; reporting pandemic-related income/job loss or loneliness/isolation; experiencing a lifetime highly stressful/traumatic event; and having lower household income and educational attainment. CONCLUSION: Evidence of changes in suicide ideation due to the pandemic were generally not observed in this research. Continued surveillance of suicide and risk/protective factors is needed to inform suicide prevention efforts.


Subject(s)
COVID-19 , Pandemics , Adult , Canada/epidemiology , Humans , SARS-CoV-2 , Suicidal Ideation
17.
J Psychosom Res ; 150: 110619, 2021 11.
Article in English | MEDLINE | ID: covidwho-1440221

ABSTRACT

OBJECTIVE: This study aims to detail changes in presentations at a United States Emergency Department for suicidality before and after the outbreak of COVID-19. METHODS: A retrospective chart review was conducted of all adult patients who presented to an ED with suicidality and underwent psychiatric consultation during the study period. The cohorts consisted of patients who presented between December 2018 - May 2019 and December 2019 - May 2020. Information was collected on demographics, characteristics of suicidality, reasons for suicidality and disposition. The first wave from March - May 2020 was examined, using a difference-in-differences design to control for factors other than COVID-19 that may have influenced the outcomes' trend. RESULTS: Immediately following the pandemic outbreak there was a statistically significant increase in the proportion of undomiciled patients represented in visits for suicidality (40.7% vs. 57.4%; p-value <0.001). In addition, the proportion of patient visits attributed to social (18.0% vs. 29.2%; p-value 0.003) and structural (14.2% vs. 26.4%; p value <0.001) reasons for suicidality increased. Conversely, the proportion of visits due to psychiatric symptoms (70.5% vs 50.0%; p-value <0.001) decreased. Furthermore, patient visits were more likely to result in a medical admission (2.1% vs. 8.3%; p-value 0.002) and less likely to result in a psychiatric admission (68.4% vs 48.6%; p-value <0.001) during the initial phase of the pandemic. CONCLUSIONS: COVID-19 was associated with increased ED presentations for suicidality among undomiciled patients, as well as greater likelihood of social and structural reasons driving suicidality among all visits.


Subject(s)
COVID-19 , Suicidal Ideation , Adult , Emergency Service, Hospital , Humans , Retrospective Studies , SARS-CoV-2 , United States/epidemiology
18.
J Psychiatr Res ; 143: 350-356, 2021 11.
Article in English | MEDLINE | ID: covidwho-1433578

ABSTRACT

BACKGROUND: This study aimed to examine the cross-sectional and longitudinal associations between sleep disturbance and suicidal ideation (SI) in a large cohort of adolescents experiencing the Coronavirus disease 2019 (COVID-19) crisis in China. METHODS: One two-wave longitudinal web-based survey of sleep, SI, and depression was conducted among 67,905 college students (mean age = 20.23 years, SD = 1.63 years; 31.3% male) during the COVID-19 outbreak (Time1, T1: Feb 3rd to 10th, 2020) and initial remission period (Time2, T2: March 24th to April 3rd, 2020). RESULTS: At T1 and T2, 8.5% and 9.7% of students reported sleep disturbance, 7.6% and 10.0% reported SI, respectively. The prevalence rates of SI at T1 and T2 increased significantly with sleep disturbance and short sleep duration. After adjusting for demographics, pandemic related factors, and depression at T1, sleep disturbance and short sleep duration at T1 were significantly associated with increased risk for SI at T2. Furthermore, sleep disturbance and short sleep duration predicted the new onset and persistence of SI. CONCLUSION: These findings suggested that sleep disturbance predicts the development and persistence of SI. Early assessment and treatment of sleep disturbance may be an important strategy for prevention and intervention of SI in individuals after exposure to the special public health emergency of COVID-19.


Subject(s)
COVID-19 , Pandemics , Adolescent , Adult , Cross-Sectional Studies , Depression/epidemiology , Female , Humans , Longitudinal Studies , Male , SARS-CoV-2 , Sleep , Suicidal Ideation , Young Adult
20.
Prog Neuropsychopharmacol Biol Psychiatry ; 110: 110304, 2021 08 30.
Article in English | MEDLINE | ID: covidwho-1410756

ABSTRACT

AIMS: The present investigation aimed at evaluating differences in psychiatric hospitalizations in Italy during and after the lockdown due to the novel coronavirus disease 2019 (COVID-19), compared to the same periods in 2018 and 2019. METHODS: We obtained and analyzed anonymized data on psychiatric admissions (n = 4550) from 12 general hospital psychiatric wards (GHPWs) in different Italian regions (catchment area = 3.71 millions of inhabitants). Using a mixed-effects Poisson regression model, we compared admission characteristics across three periods: (a) March 1-June 30, 2018 and 2019; (b) March 1-April 30, 2020 (i.e., lockdown); and (c) May 1-June 30, 2020 (i.e., post-lockdown). RESULTS: During the COVID-19 lockdown, there was a 41% reduction (IRR = 0.59; p < 0.001, CI: 0.45-0.79) in psychiatric admissions in the enrolled GHPWs with respect to the 2018 and 2019 control period. Conversely, admission rates in the post-lockdown period were similar to those observed in the control period. Notably, a consistent and significant reduction in psychiatric hospitalizations of older patients (aged >65 years) was observed in the lockdown (40%; IRR = 0.60; 95% CI: 0.44-0.82) and post-lockdown (28%; IRR = 0.72; 95% CI: 0.54-0.96) periods. Long-stay admissions (>14 days) increased (63%; IRR = 1.63; 95% CI: 1.32-2.02) during the lockdown and decreased by 39% thereafter (IRR = 0.61; 95% CI: 0.49-0.75). A significant 35% increase in patients reporting suicidal ideation was observed in the post-lockdown period, compared to the rate observed in the 2018 and 2019 control period (IRR = 1.35; 95% CI: 1.01-1.79). CONCLUSION: The COVID-19 lockdown was associated with changes in the number of psychiatric admissions, particularly for older patients and long-stay hospitalizations. Increased admission of patients reporting suicidal ideation in the post-lockdown period merits special attention. Further studies are required to gain insight into the observed phenomena.


Subject(s)
COVID-19/psychology , Hospitalization/statistics & numerical data , Psychiatric Department, Hospital/statistics & numerical data , Suicidal Ideation , Adult , Age Factors , Aged , COVID-19/complications , COVID-19/epidemiology , Communicable Disease Control , Female , Humans , Italy/epidemiology , Length of Stay/statistics & numerical data , Male , Middle Aged , Young Adult
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