Serious mental illness and in-hospital mortality among hospitalized patients with acute COVID-19: A large-database analysis in Japan.

OBJECTIVE: The association of serious mental illness (affective or non-affective psychotic disorders) with higher mortality in patients infected with acute coronavirus disease 2019 (COVID-19) has been suggested. Although this association remains significant after adjusting for medical comorbidities in previous studies, admission clinical status and treatment modalities should be considered as important confounding factors. METHODS: We aimed to assess whether serious mental illness is associated with in-hospital mortality, in patients with COVID-19 by adjusting for comorbidities, admission clinical status, and treatment modalities. Our nationwide cohort in Japan included consecutive patients admitted to 438 acute care hospitals for laboratory-confirmed acute COVID-19 from January 1, 2020 to November 30, 2021. RESULTS: Of 67,348 hospitalized patients (mean [standard deviation] age, 54 [18.6] years; 3891 [53.0%] female), 2524 patients (3.75%) had serious mental illness. In-hospital mortality was 282/2524 (11.17%) among patients with serious mental illness, while it was 2118/64,824 (3.27%) in other patients. In the fully adjusted model, serious mental illness was significantly associated with in-hospital mortality (odds ratio, 1.49; 95% CI, 1.27-1.72). E-value analysis confirmed the robustness of the results. CONCLUSION: Serious mental illness remains a risk for mortality in acute COVID-19 after adjusting for comorbidities, admission clinical status, and treatment modalities. Vaccination, diagnosis, early assessment and treatment should be prioritized for this vulnerable group.

Impact of overtime working and social interaction on the deterioration of mental well-being among full-time workers during the COVID-19 pandemic in Japan: Focusing on social isolation by household composition.

OBJECTIVES: The coronavirus disease (COVID-19) pandemic has forced many employees to alter both their work style and lifestyle. This study aimed to examine how the combination of changes in overtime working hours and social interaction affects the full-time employees' mental well-being, focusing on the difference in household composition. METHODS: In November 2020, we conducted a cross-sectional Internet survey that included 4388 Japanese men and women aged 25-64 years, who continued the same full-time job during the pandemic. We performed a logistic regression analysis using a combination of the changes in overtime working hours and social interaction as an independent variable, and the presence/absence of deterioration of mental well-being as the dependent variable. RESULTS: Overall, 44% of participants reported the deterioration of mental well-being compared to before the outbreak. The multivariate analysis revealed that the participants coded as "increased overtime/decreased interaction" were significantly associated with the deterioration of mental well-being compared to those with "unchanged overtime/unchanged interaction" (odds ratio [OR] 2.14, 95% confidence interval [CI] 1.59-2.89). Moreover, this association was relatively stronger among single-person households (OR 2.66, 95% CI 1.50-4.69). CONCLUSIONS: The negative combination of increasing overtime working hours and decreasing social interaction may have an impact on the deterioration of mental well-being during the COVID-19 pandemic, and this association was comparably strong among single-person households. In the pandemic, it is necessary to pay close attention to both overtime working hours and the presence of social interaction to address the mental well-being among employees.