Mental health and well-being during the COVID-19 pandemic: longitudinal analyses of adults in the UK COVID-19 Mental Health & Wellbeing study

A united approach to promoting healthy living behaviours and associated health outcomes: a global call for policymakers and decisionmakers

Chronic disease pandemics have challenged societies and public health throughout history and remain ever-present. Despite increased knowledge, awareness and advancements in medicine, technology, and global initiatives the state of global health is declining. The coronavirus disease 2019 (COVID-19) pandemic has compounded the current perilous state of global health, and the long-term impact is yet to be realised. A coordinated global infrastructure could add substantial benefits to public health and yield prominent and consistent policy resulting in impactful change. To achieve global impact, research priorities that address multi-disciplinary social, environmental, and clinical must be supported by unified approaches that maximise public health. We present a call to action for established public health organisations and governments globally to consider the lessons from the COVID-19 pandemic and unite with true collaborative efforts to address current, longstanding, and growing challenges to public health.

Is the meaning of subjective well-being similar in Latin American countries? A cross-cultural measurement invariance study of the WHO-5 well-being index during the COVID-19 pandemic

BACKGROUND

There is an urgent need to assess changes in well-being on a multinational scale during the COVID-19 pandemic, thus culturally valid scales must be available.

METHODS

With this in mind, this study examined the invariance of the WHO well-being index (WHO-5) among a sample of 5183 people from 12 Latin Americans countries (Argentina, Bolivia, Chile, Colombia, Cuba, Ecuador, El Salvador, Guatemala, Mexico, Paraguay, Peru, and Uruguay).

RESULTS

The results of the present study indicate that the WHO-5 is strictly invariant across samples from different Latin American countries. Furthermore, the results of the IRT analysis indicate that all items of the WHO-5 were highly discriminative and that the difficulty required to respond to each of the five items is ascending. Additionally, the results indicated the presence of moderate and small size differences in subjective well-being among most countries.

CONCLUSION

The WHO-5 is useful for assessing subjective well-being in 12 Latin American countries during the COVID-19 pandemic, since the differences between scores can be attributed to differences in well-being and not in other characteristics of the scale.

Should suicide risk assessment be embedded in undergraduate dental curricula?

Aims and objectives The aim of this Plan-Do-Study-Act cycle was to establish if undergraduate students believe they have a role to play in suicide risk assessment, and to discuss the implementation of suicide risk prevention into the undergraduate dental curriculum. Data gathered informed development of a subsequent suicide risk assessment educational workshop.Methodology An online questionnaire was disseminated to undergraduate students as part of a quality improvement service evaluation within a UK dental hospital and school. This sought to gain information on attitudes to suicide prevention, previous suicide awareness training, and the appetite and potential barriers to future training.Results A response rate of 23% (n = 30) was achieved. In total, 87% of undergraduate students responding reported having no experience or training in the identification of suicidal patients, 97% of respondents expressed a desire for training, and 80% stated not knowing what to do if a patient disclosed suicidal thoughts during an appointment.Conclusion The dental team have a role to play in suicide risk assessment and the signposting of at-risk patients to appropriate services. To embed this within daily practice, awareness and training must be introduced to undergraduate curricula.

Formation of polychlorinated dibenzo-p-dioxins and furans (PCDD/Fs) in the electrochemical oxidation of polluted waters with pharmaceuticals used against COVID-19

The COVID-19 pandemic has produced a huge impact on our lives, increasing the consumption of certain pharmaceuticals, and with this, contributing to the intensification of their presence in wastewater and in the environment. This situation demands the implementation of efficient remediation technologies, among them, electrochemical oxidation (ELOX) is one the most applied. This work studies the application of ELOX with the aim of eliminate pharmaceuticals used in the fight against COVID-19, assessing its degradation rate, as well as the risk of formation of toxic trace by-products, such as unintentional POPs like polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs). To this end, model solutions containing 10 mg L^-1 of dexamethasone (DEX), paracetamol (PAR), amoxicillin (AMX), and sertraline (STR) with two different electrolytes (NaCl and Na₂SO₄) have been evaluated. However, electrochemical systems that contain chloride ions in solution together with PCDD/Fs precursor molecules may lead to the formation of these highly toxic by-products. So, PCDD/Fs were quantified under conditions of complete degradation of the drugs. Furthermore, the presence of PCDD/Fs precursors such as chlorophenols was determined, as well as the role of Cl^-, Cl^• and SO 4 • - radicals in the formation of the by-products and PCDD/Fs. The maximum measured concentration of PCDD/Fs was around 2700 pg L^-1 for the amoxicillin case in NaCl medium. The obtained results emphasise the importance of not underestimating the potential formation of these highly toxic trace by-products, in addition to the correct selection of oxidation processes and operation variables, in order to avoid final higher toxicity in the medium.

Demographic and spatial variables associated with spending time in nature during COVID-19 lockdowns

To stop the spread of SARS-CoV-2 coronavirus (COVID-19) governments around the world implemented lockdowns restricting public travel. In the Australian state of Victoria, this included limiting permitted reasons for leaving home and restricting movements to within a 5 km radius of one's home. In 2020, we conducted a state-wide survey (N = 1024) of Victorians that coincided with a lockdown. We asked respondents where they had spent time in nature and how they perceived lockdowns affected the amount of time they spent in nature. We then considered demographic and spatial predictors of spending more or less time in nature. Women, younger people, and those living in areas with higher socio-economic status were likely to report spending more time in nature. Closer proximity of residents to parks and waterways and higher proportional area of native vegetation within a 1-km radius were also associated with more time in nature. Understanding how different groups were affected by restrictions on access to nature can help improve government management of crises like pandemics, including through urban planning for green space, supporting improved individual and societal resilience. We discuss the implications of our findings for improving access to nature during lockdowns as well as opportunities for a post-pandemic relationship with nature, particularly in urban settings.

Depression and anxiety in people with cognitive impairment and dementia during the COVID-19 pandemic: Analysis of the English Longitudinal Study of Ageing

BACKGROUND

Some studies have identified declines in mental health during the Coronavirus Disease 2019 (COVID-19) pandemic in different age groups, including older people. As anxiety and depression are common neuropsychiatric symptoms among people with cognitive impairment, the mental health experiences of older people during the pandemic should take cognitive function into consideration, along with assessments made prior to the pandemic. This study addresses evidence gaps to test whether changes in depression and anxiety among older people through the COVID-19 pandemic were associated with cognitive impairment. It also investigates whether associations varied according to key sources of sociodemographic inequality.

METHODS AND FINDINGS

Using data from the English Longitudinal Study of Ageing (ELSA) collected from 2018/2019 to November/December 2020, we estimated changes in depression and anxiety for people aged 50+ in England across 3 cognitive function groups: no impairment, mild cognitive impairment, and dementia. Conditional growth curve models were estimated for continuous measures over 3 time points (N = 5,286), with mixed-effects logistic regression used for binary measures. All models adjusted for demographics (age, gender, ethnicity, and cohabiting partnership), socioeconomics (education, wealth, and employment status), geography (urban/rural and English region), and health (self-rated and the presence of multimorbidity). We found that depression (measured with CES-D score) worsened from 2018/2019 to November/December 2020 for people with mild cognitive impairment (1.39 (95% CI: 1.29 to 1.49) to 2.16 (2.02 to 2.30)) or no impairment (1.17 (95%CI: 1.12 to 1.22) to 2.03 (1.96 to 2.10)). Anxiety, using a single-item rating of 0 to 10 also worsened among those with mild cognitive impairment (2.48 (2.30 to 2.66) to 3.14 (2.95 to 3.33)) or no impairment (2.20 (2.11 to 2.28) to 2.85 (2.77 to 2.95)). No statistically significant increases were found for those with dementia. Using a clinical cutoff for likely depression (CES-D ≥4), we found statistically significant increases in the probability of depression between 2018/2019 and November/December 2020 for those with no impairment (0.110 (0.099 to 0.120) to 0.206 (0.191 to 0.222)) and mild impairment (0.139 (0.120 to 0.159) to 0.234 (0.204 to 0.263)). We also found that differences according to cognitive function that existed before the pandemic were no longer present by June/July 2020, and there were no statistically significant differences in depression or anxiety among cognitive groups in November/December 2020. Wealth and education appeared to be stronger drivers for depression and anxiety, respectively, than cognitive impairment. For example, those with no impairment in the richest two-thirds scored 1.76 (1.69 to 1.82) for depression in June/July, compared to 2.01 (1.91 to 2.12) for those with no impairment in the poorest third and 2.03 (1.87 to 2.19) for those with impairment in the poorest third. Results may be limited by the small number of people with dementia and are generalizable only to people living in the community, not to those in institutional care settings.

CONCLUSIONS

Our findings suggest a convergence in mental health across cognitive function groups during the pandemic. This suggests mental health services will need to meet an increased demand from older adults, especially those not living with cognitive impairment. Further, with little significant change among those with dementia, their existing need for support will remain; policymakers and care practitioners should ensure this group continues to have equitable access to mental health support.

The challenge of estimating the direct and indirect effects of COVID-19 interventions - Toward an integrated economic and epidemiological approach

Decisions on public health measures to contain a pandemic are often based on parameters such as expected disease burden and additional mortality due to the pandemic. Both pandemics and non-pharmaceutical interventions to fight pandemics, however, produce economic, social, and medical costs. The costs are, for example, caused by changes in access to healthcare, social distancing, and restrictions on economic activity. These factors indirectly influence health outcomes in the short- and long-term perspective. In a narrative review based on targeted literature searches, we develop a comprehensive perspective on the concepts available as well as the challenges of estimating the overall disease burden and the direct and indirect effects of COVID-19 interventions from both epidemiological and economic perspectives, particularly during the early part of a pandemic. We review the literature and discuss relevant components that need to be included when estimating the direct and indirect effects of the COVID-19 pandemic. The review presents data sources and different forms of death counts, and discusses empirical findings on direct and indirect effects of the pandemic and interventions on disease burden as well as the distribution of health risks.

Unintended Consequences of COVID-19 Non-Pharmaceutical Interventions (NPIs) for Population Health and Health Inequalities

Since the start of the COVID-19 pandemic in early 2020, governments around the world have adopted an array of measures intended to control the transmission of the SARS-CoV-2 virus, using both pharmaceutical and non-pharmaceutical interventions (NPIs). NPIs are public health interventions that do not rely on vaccines or medicines and include policies such as lockdowns, stay-at-home orders, school closures, and travel restrictions. Although the intention was to slow viral transmission, emerging research indicates that these NPIs have also had unintended consequences for other aspects of public health. Hence, we conducted a narrative review of studies investigating these unintended consequences of NPIs, with a particular emphasis on mental health and on lifestyle risk factors for non-communicable diseases (NCD): physical activity (PA), overweight and obesity, alcohol consumption, and tobacco smoking. We reviewed the scientific literature using combinations of search terms such as 'COVID-19', 'pandemic', 'lockdowns', 'mental health', 'physical activity', and 'obesity'. NPIs were found to have considerable adverse consequences for mental health, physical activity, and overweight and obesity. The impacts on alcohol and tobacco consumption varied greatly within and between studies. The variability in consequences for different groups implies increased health inequalities by age, sex/gender, socioeconomic status, pre-existing lifestyle, and place of residence. In conclusion, a proper assessment of the use of NPIs in attempts to control the spread of the pandemic should be weighed against the potential adverse impacts on other aspects of public health. Our findings should also be of relevance for future pandemic preparedness and pandemic response teams.

Prosocial behavior predicts meaning in life during the COVID-19 pandemic: The longitudinal mediating role of perceived social support

The COVID-19 pandemic was an unexpected, long-term negative event. Meaning in life has been linked to better psychological adjustment to such events. The current study uses longitudinal data collected during the COVID-19 pandemic to discover whether perceived social support mediates the relationship between six dimensions of prosocial behavior (Altruistic, Anonymous, Public, Compliant, Emotional, and Dire) and meaning in life. A sample of Chinese college students (N = 514) was tracked at three time points (T1, T2, and T3) during the COVID-19 outbreak. A cross-lagged panel model (CLPM) was used for mediation analysis. The mediation effect was found in all the dimensions of prosocial behavior except for Public prosocial behavior. We also found a longitudinal, bidirectional association between perceived social support and meaning in life. The current study contributes to the growing literature on the significance of prosocial behavior in predicting meaning in life.

Patterns and predictors of depressive and anxiety symptoms within a population-based sample of adults diagnosed with COVID-19 in Michigan

PURPOSE

The COVID-19 pandemic has had wide-ranging impacts on mental health, however, less is known about predictors of mental health outcomes among adults who have experienced a COVID-19 diagnosis. We examined the intersection of demographic, economic, and illness-related predictors of depressive and anxiety symptoms within a population-based sample of adults diagnosed with COVID-19 in the U.S. state of Michigan early in the pandemic.

METHODS

Data were from a population-based survey of Michigan adults who experienced a COVID-19 diagnosis prior to August 1, 2020 (N = 1087). We used weighted prevalence estimates and multinomial logistic regression to examine associations between mental health outcomes (depressive symptoms, anxiety symptoms, and comorbid depressive/anxiety symptoms) and demographic characteristics, pandemic-associated changes in accessing basic needs (accessing food/clean water and paying important bills), self-reported COVID-19 symptom severity, and symptom duration.

RESULTS

Relative risks for experiencing poor mental health outcomes varied by sex, age, race/ethnicity, and income. In adjusted models, experiencing a change in accessing basic needs associated with the pandemic was associated with higher relative risks for anxiety and comorbid anxiety/depressive symptoms. Worse COVID-19 symptom severity was associated with a higher burden of comorbid depressive/anxiety symptoms. "Long COVID" (symptom duration greater than 60 days) was associated with all outcomes.

CONCLUSION

Adults diagnosed with COVID-19 may face overlapping risk factors for poor mental health outcomes, including pandemic-associated disruptions to household and economic wellbeing, as well as factors related to COVID-19 symptom severity and duration. An integrated approach to treating depressive/anxiety symptoms among COVID-19 survivors is warranted.

The Impact of the COVID-19 Pandemic on the Registration and Care Provision of Mental Health Problems in General Practice: Registry-Based Study

BACKGROUND

The impact of the COVID-19 pandemic on mental health in general practice remains uncertain. Several studies showed an increase in terms of mental health problems during the pandemic. In Belgium, especially during the first waves of the pandemic, access to general practice was limited. Specifically, it is unclear how this impacted not only the registration of mental health problems itself but also the care for patients with an existing mental health problem.

OBJECTIVE

This study aimed to know the impact of the COVID-19 pandemic on (1) the incidence of newly registered mental health problems and (2) the provision of care for patients with mental health problems in general practice, both using a pre-COVID-19 baseline.

METHODS

The prepandemic volume of provided care (care provision) for patients with mental health problems was compared to that from 2020-2021 by using INTEGO, a Belgian general practice morbidity registry. Care provision was defined as the total number of new registrations in a patient's electronic medical record. Regression models evaluated the association of demographic factors and care provision in patients with mental health problems, both before and during the pandemic.

RESULTS

During the COVID-19 pandemic as compared to before the COVID-19 pandemic, the incidence of registered mental health problems showed a fluctuating course, with a sharp drop in registrations during the first wave. Registrations for depression and anxiety increased, whereas the incidence of registered eating disorders, substance abuse, and personality problems decreased. During the 5 COVID-19 waves, the overall incidence of registered mental health problems dropped during the wave and rose again when measures were relaxed. A relative rise of 8.7% and 40% in volume of provided care, specifically for patients with mental health problems, was seen during the first and second years of the COVID-19 pandemic, respectively. Care provision for patients with mental health problems was higher in older patients, male patients, patients living in center cities (centrumsteden), patients with lower socioeconomic status (SES), native Belgian patients, and patients with acute rather than chronic mental health problems. Compared to prepandemic care provision, a reduction of 10% was observed in people with a low SES.

CONCLUSIONS

This study showed (1) a relative overall increase in the registrations of mental health problems in general practice and (2) an increase in care provision for patients with mental health problems in the first 2 years of the COVID-19 pandemic. Low SES remained a determining factor for more care provision, but care provision dropped significantly in people with mental health problems with a low SES. Our findings suggest that the pandemic in Belgium was also largely a "syndemic," affecting different layers of the population disproportionately.

Mental health consequences of the COVID-19 pandemic: Results from a large-scale population-based study in Israel

INTRODUCTION

Contemporary evidence notes the COVID-19 pandemic greatly impacted the utilization of physical and mental health services worldwide. The present study was therefore designed to evaluate the changes in the utilization of mental health services during the first year of the COVID-19 pandemic compared to previous years as well as to estimate the moderating role age had on these changes.

MATERIALS AND METHODS

Psychiatric data was collected from n = 928,044 individuals living in Israel. Rates of receipt of psychiatric diagnoses and purchases of psychotropic medication were extracted for the first year of the COVID-19 pandemic and for two comparison years. The odds of receiving a diagnosis or of purchasing a psychotropic medication during the pandemic were compared to control years using uncontrolled logistic regression models and controlled and logistic regression that accounted for differences between ages.

RESULTS

There was a general reduction of about 3-17% in the odds of receiving a psychiatric diagnosis or purchasing psychotropic medications during the pandemic year compared to control years. The bulk of tests conducted showed that reduction in the rates of receiving diagnoses and purchasing medications during the pandemic were evident or more profound in the older age groups. An analysis of a combined measure conclusive of all other measures revealed decreased rates of utilizing any service examined during 2020, with rates decreasing as age increases up to a decrease of 25% in the oldest age group (80-96).

DISCUSSION AND CONCLUSION

Changes in utilization of mental health services reveal the interplay between psychological distress that has been documented to increase during the pandemic and people's reluctance to seek professional assistance. This appears to be especially prominent among the vulnerable elderly, who may have received even less professional help for their emerging distress. The results obtained in Israel are likely to be replicated in other countries as well, given the global impact of the pandemic on adults' mental health and individuals' readiness to utilize mental healthcare services. Future research on the long-term impact of the pandemic on utilization of mental healthcare services is warranted, with an emphasis on the response of different populations to emergency situations.

Digital Practices by Citizens During the COVID-19 Pandemic: Findings From an International Multisite Study

BACKGROUND

The COVID-19 pandemic brought digital practices and engagement to the forefront of society, which were based on behavioral changes associated with adhering to different government mandates. Further behavioral changes included transitioning from working in the office to working from home, with the use of various social media and communication platforms to maintain a level of social connectedness, especially given that many people who were living in different types of communities, such as rural, urban, and city spaces, were socially isolated from friends, family members, and community groups. Although there is a growing body of research exploring how technology is being used by people, there is limited information and insight about the digital practices employed across different age cohorts living in different physical spaces and residing in different countries.

OBJECTIVE

This paper presents the findings from an international multisite study exploring the impact of social media and the internet on the health and well-being of individuals in different countries during the COVID-19 pandemic.

METHODS

Data were collected via a series of online surveys deployed between April 4, 2020, and September 30, 2021. The age of respondents varied from 18 years to over 60 years across the 3 regions of Europe, Asia, and North America. On exploring the associations of technology use, social connectedness, and sociodemographic factors with loneliness and well-being through bivariate and multivariate analyses, significant differences were observed.

RESULTS

The levels of loneliness were higher among respondents who used social media messengers or many social media apps than among those who did not use social media messengers or used ≤1 social media app. Additionally, the levels of loneliness were higher among respondents who were not members of an online community support group than among those who were members of an online community support group. Psychological well-being was significantly lower and loneliness was significantly higher among people living in small towns and rural areas than among those living in suburban and urban communities. Younger respondents (18-29 years old), single adults, unemployed individuals, and those with lower levels of education were more likely to experience loneliness.

CONCLUSIONS

From an international and interdisciplinary perspective, policymakers and stakeholders should extend and explore interventions targeting loneliness experienced by single young adults and further examine how this may vary across geographies. The study findings have implications across the fields of gerontechnology, health sciences, social sciences, media communication, computers, and information technology.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.3389/fsoc.2020.574811.

“It’s Allowed Me to Be a Lot Kinder to Myself”: Exploration of the Self-Transformative Properties of Solitude During COVID-19 Lockdowns

The Coronavirus (COVID-19) national lockdowns profoundly affected the lives of many, as significant portions of the U.K. population were involuntarily sequestered away from their usual social landscapes into newfound states of solitude. Many millennials (those between the ages of 25 and 40 at the point of study), having lived in an age of constant connection, found themselves in an extended period of solitude for the first time. The current qualitative study explores through Interpretative Phenomenological Analysis (IPA) how some UK millennials were able to harness the unique self-transformative properties of positive solitude during the COVID-19 national lockdowns. Analysis revealed a narrative of self-discovery, as domains of positive solitude granted the participants freedom from the demands of performative social burdens and encouraged opportunities to engage with mindfulness and meaningful introspection. These activities, within the experience of solitude, encouraged an alignment of inward beliefs and outward behaviors for the participants, thus helping them to cultivate a more congruent self-concept and subsequently a heightened sense of authenticity and enhanced psychological well-being. Clinical implications leading on from the current study highlight the importance of mindfulness and other solitude-promoting interventions as a method to ameliorate depressive symptoms and improve psychological well-being.

COVID-19 in the Eastern Brazilian Amazon: Incidence, Clinical Management, and Mortality by Social Determinants of Health, Symptomatology, and Comorbidities in the Xingu Health Region

This study aims to investigate the relationship between social determinants of health (SDH), incidence, and mortality to verify which sociodemographic factors, symptoms, and comorbidities predict clinical management; second, this study aims to conduct a survival analysis of individuals with COVID-19 in the Xingu Health Region. Consequently, this study adopted an ecological framework, employing secondary data of COVID-19-positive individuals from the Xingu Health Region, Pará State, Brazil. The data were obtained through the database of the State of Pará Public Health Secretary (SESPA) for the period from March 2020 to March 2021. The incidence and mortality were higher in Vitória do Xingu and Altamira. Municipalities with a higher percentage of citizens with health insurance and higher public health expenditure showed a higher incidence and mortality. A higher gross domestic product was associated with a higher incidence. Females were found to be associated with better clinical management. To live in Altamira was a risk factor for intensive care unit admission. The symptoms and comorbidities that predicted worse clinical management were dyspnea, fever, emesis, chills, diabetes, cardiac and renal diseases, obesity, and neurological diseases. There were higher incidence, mortality, and lower survival rates among the elderly. Thus, it can be concluded that SDH indicators, symptomatology, and comorbidities have implications for the incidence, mortality, and clinical management of COVID-19 in the Xingu Health Region of eastern Amazonia, Brazil.

The mental wellbeing of prison staff in England during the COVID-19 pandemic: A cross-sectional study

Background

COVID-19 is likely to have had an impact on the mental wellbeing of prison staff because of the high risk for infectious disease outbreaks in prisons and the pre-existing high burden of mental health issues among staff.

Methods

A cross-sectional study of staff within 26 prisons in England was carried out between 20th July 2020 and 2nd October 2020. Mental wellbeing was measured using the Short-version of Warwick-Edinburgh Wellbeing Scale (SWEMWBS). Staff wellbeing was compared to that of the English population using indirectly standardised data from the Health Survey for England 2010-13 and a one-sample t-test. Multivariate linear regression modelling explored associations with mental wellbeing score.

Results

Two thousand five hundred and thirty-four individuals were included (response rate 22.2%). The mean age was 44 years, 53% were female, and 93% were white. The sample mean SWEMWBS score was 23.84 and the standardised population mean score was 23.57. The difference in means was statistically significant (95% CI 0.09-0.46), but not of a clinically meaningful level. The multivariate linear regression model was adjusted for age category, sex, ethnicity, smoking status, occupation, and prison service region. Higher wellbeing was significantly associated with older age, male sex, Black/Black British ethnicity, never having smoked, working within the health staff team, and working in certain prison regions.

Interpretation

Unexpectedly, prison staff wellbeing as measured by SWEMWBS was similar to that of the general population. Reasons for this are unclear but could include the reduction in violence within prisons since the start of the pandemic. Qualitative research across a diverse sample of prison settings would enrich understanding of staff wellbeing within the pandemic.

Depression risk among community-dwelling older people is associated with perceived COVID-19 infection risk: effects of news report latency and focusing on number of infected cases

Awareness of COVID-19 infection risk and oscillation patterns ('waves') may affect older people's mental health. Empirical data from populations experiencing multiple waves of community outbreaks can inform guidance for maintaining mental health. This study aims to investigate the effects of COVID-19 infection risk and oscillations on depression among community-dwelling older people in Hong Kong.

A rolling cross-sectional telephone survey method was used. Screening for depression risk was conducted among 8,163 older people (age ≥ 60) using the Patient Health Questionnaire-2 (PHQ-2) from February to August 2020. The relationships between PHQ-2, COVID-19 infection risk proxies - change in newly infected cases and effective reproductive number (R_t), and oscillations - stage of a 'wave' reported in the media, were analysed using correlation and regression.

8.4% of survey respondents screened positive for depression risk. Being female (β = .08), having a pre-existing mental health issue (β = .21), change in newly infected cases (β = .05), and screening during the latency period before the media called out new waves (β = .03), contributed to higher depression risk (R² = .06, all p <.01).

While depression risk does not appear alarming in this sample, our results highlight that older people are sensitive to reporting of infection, particularly among those with existing mental health needs. Future public health communication should balance awareness of infection risks with mental health protection.

Psychological mediators of the associations between pandemic-related stressors and suicidal ideation across three periods of the COVID-19 pandemic in Canada

BACKGROUND

The COVID-19 pandemic's mental health impact is well-established. While early evidence suggested suicide deaths remained stable or declined, suicidal ideation (SI) became more prevalent than before the pandemic. Our study: (1) examined the prevalence and distribution of SI among Canadian adults, (2) compared SI among those with and without pre-existing mental illnesses, and (3) evaluated associations between pandemic-related stressors (i.e., unemployment, insecure employment, loss of income, medical vulnerability, COVID-19 exposure) with SI, and whether such associations were mediated by depression, thwarted belongingness, perceived burdensomeness, or perceived discrimination.

METHODS

The sample was comprised of data gathered at three timepoints (Wave 1 08/18/2020-10/01/2020, n = 6629; Wave 2 12/21/2020-03/31/2021, n = 5920; Wave 3 09/07/2021-12/07/2021, n = 7354). Quota-based responses from survey research panels which matched the geographic, age, and sex distribution of the Canadian population were supplemented with convenience-sampled responses.

RESULTS

The prevalence of SI was 4.1 % (Wave 1), 5.3 % (Wave 2), and 5.8 % (Wave 3). Odds of SI were higher for respondents under the age of 35 years and with pre-existing mental illnesses. SI was associated with quarantining due to suspected or confirmed COVID-19 exposure, potential COVID-19 exposure at work, medical vulnerability toward COVID-19, insecure employment or unemployment, and income loss. These associations were mediated by psychological experiences, particularly depression and thwarted belongingness.

LIMITATIONS

This cross-sectional, observational study cannot establish temporality or causality.

CONCLUSION

Results highlight groups who may benefit from enhanced screening for depression and suicide risk. Reducing depression and increasing sense of belonging should be prioritized.

Use of mental health services in the aftermath of COVID-19 waves: a retrospective study conducted in a French Psychiatric and Neurosciences University Hospital

OBJECTIVE

The COVID-19 pandemic and the restrictive measures taken to prevent its propagation had profound effects on mental health and well-being, especially in children and young adults (<25 years old). This study aimed to analyse the medium and long-term impact of the COVID-19 pandemic on the use of the mental health services, by age groups and gender.

DESIGN

We conducted a retrospective study using the medical and administrative information system databases of patients, between 2019 and 2021.

SETTING

This study was conducted in the Groupe Hospitalier Universitaire Paris Psychiatry and Neurosciences.

OUTCOME MEASURES

We reported three indicators: the number of new patients attending outpatient clinics, the number of emergency department (ED) visits and the number of hospital admissions.

METHODS

We considered the weekly number of each indicator, by age groups and by gender. We also collected the reasons of ED visits and hospital admissions. The 2020 and 2021 data were compared with the same period in 2019. The evolution of the indicators over the 3 years was analysed with interrupted time-series analysis.

RESULTS

All three indicators showed a dramatic decrease during the first lockdown period (March 2020) especially for the youngest. In 2021, the activity resumed but without reaching its prepandemic level. Moreover, mental healthcare seeking was significantly lower since the beginning of the pandemic compared with the prepandemic period for all age groups, except for young women (<25 years old). Among them, there was a higher level of mental health services use in 2021, compared with 2019: +20% of new patients at the outpatient clinics, +39% of ED visits and+17% of hospital admissions.

CONCLUSIONS

The COVID-19 pandemic has had severe consequences on populations' mental health, especially among young women, which seem to persist months after the end of restrictive measures.

Association of Depression With Precautionary Behavior Compliance, COVID-19 Fear, and Health Behaviors in South Korea: National Cross-sectional Study

BACKGROUND

As of January 2022, the number of people infected with COVID-19 worldwide has exceeded 350 million. As the COVID-19 pandemic continues, people are affected in a wide range of areas of life, which in turn causes numerous psychological problems. Depression is a serious problem for people who have suffered from COVID-19. Depression can worsen COVID-19 precautionary behavior compliance or the health behavior itself. In addition, these depressive symptoms may have different characteristics depending on the individual's gender.

OBJECTIVE

The aim of this study was to determine whether depression is a factor that may affect COVID-19 fear, precautionary behavior compliance, and health behavior, and how these characteristic trends differ by gender.

METHODS

This was a secondary analysis of data from the 2020 Korea Community Health Survey (KCHS), a national cross-sectional survey conducted with complex sampling analysis. In 2020, the KCHS included COVID-19-related questions. For this study, we used the KCHS data from both the COVID-19-related questions and the Patient Health Questionnaire-9 scale. After weighting the data according to the KCHS guidelines, we calculated the distribution of men and women according to depression level. The data were collected using multiple-choice questions related to precautionary behavior compliance, COVID-19-related fears, and health behavior changes.

RESULTS

Of the 204,787 participants, those who were clinically depressed had a greater tendency to not comply with precautionary behaviors. Regarding COVID-19, "fear" showed a decreasing trend in both men (adjusted odds ratio [AOR] 0.72, 95% CI 0.61-0.83) and women (AOR 0.74, 95% CI 0.63-0.86) with clinically relevant depression. Moreover, for both men and women, health behaviors deteriorated as depression intensified; the AOR for sleep duration changes was 2.28 (95% CI 2.00-2.59) in men and was 2.15 (95% CI 1.96-2.36) in women. Notably, the responses of clinically depressed women revealed a doubled increase in both their drinking (AOR 2.25, 95% CI 1.88-2.70) and smoking (AOR 2.71, 95% CI 1.95-3.77) habits compared with those of nondepressed women.

CONCLUSIONS

Both men and women with more severe depression were more likely to violate precautionary health behaviors as their depression worsened. Health behaviors also deteriorated for both genders, but women tended to show a greater change. Therefore, additional studies and interventions for vulnerable groups such as severely depressed people are needed. More research is also necessary to develop interventions based on statistical comparisons of men and women.

The Role of Family Resilience and Pandemic Burnout on Mental Health: A Two-Wave Study in China

Family resilience refers to the processes through which a family adapts to and bounces back from adversities. Pandemic burnout refers to feeling emotionally exhausted, cynical, and lack of accomplishment during the pandemic and/or toward various preventive polices and measures. This two-wave, region-wide, longitudinal study included 796 adult participants residing in mainland China. Participants completed online surveys at two time points during the COVID-19 pandemic. Time 1 (T1) survey was conducted when the number of new infected cases in China stabilized, while Time 2 (T2) was conducted 5 months later when there was a sudden surge of new infected cases. Results of a hierarchical regression analysis revealed that the interaction and main effects of pandemic burnout and family resilience at T2 showed significant incremental prediction of depression and anxiety at T2, after controlling for demographic as well as individual and family resilience at T1. These results supported the hypotheses that current family resilience functions as a protective factor, whereas pandemic burnout functions as a risk factor of mental health during successive waves of pandemic outbreaks. In particular, family resilience at T2 mitigated the negative impact of high pandemic burnout on anxiety and depression at T2.

Did the mental health and well-being of young people increase after the COVID-19 vaccination campaign period? A cross-sectional multicentre study in Austria and Turkey

In 2019, the global Coronavirus (COVID-19) pandemic and associated prevention measures affected the mental health and psychological well-being of young people with and without a migratory background. The present study aimed to compare the mental health and psychological well-being of migrant and non-migrant young people before and after the COVID-19 vaccination campaign period in two countries which had different policies to deal with the pandemic. The "Psychological General Well-being" of young people and their experiences during the pandemic were investigated using an anonymous online survey during two pandemic waves before the vaccination campaign and 6 months after its start. A majority of the 6154 participants (aged between 15 and 25 years in all study groups) reported a decrease of mental health from the time period before the vaccination (BV) to after the vaccination (AV) campaign (b = 0.27, p < .001). This association was higher in females (b = 0.04, p = 0.008) and in youth with financial problems (b = 0.13, p < .001). Furthermore, this decrease was more pronounced in people ≤17 years old (40% to 62%) than in those >17 years (59% to 67%). Contrary to expectation, vulnerable groups such as the economically disadvantaged, younger, and female participants did not experience a significant easing of the pandemic's psychological burden AV. Vaccination campaigns should continue emphasizing the beneficial effects of COVID-19 vaccination on general well-being, but with an acknowledgement that the road to recovery is still a long one. Concurrently, free access to psychological treatment and financial support should be offered, especially for vulnerable groups.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-023-04366-x.

Suicidal ideation in the general population in China after the COVID-19 pandemic was initially controlled

BACKGROUND

The COVID-19 pandemic increases the risk of psychological problems including suicidal ideation (SI) in the general population. In this study, we investigated the risk factors of SI after the COVID-19 pandemic was initially controlled in China.

METHODS

We conducted an online questionnaire via JD Health APP in China in June 2020. Demographic data, feelings and experiences related to the COVID-19 pandemic and psychological problems were collected. The participants (n = 14,690) were divided into the non-SI and SI groups. A binary logistic regression analysis was used to examine the correlates of SI.

RESULTS

Nine percent of the participants (1328/14690) reported SI. The regression analysis showed that SI was positively associated with ethnic minority (OR = 1.42 [1.08-1.85]), age (e.g. 18-30 years: OR = 2.31 [1.67-3.20]), having history of mental disorders (OR = 2.75 [2.27-3.35]), daily life disturbance due to health problems (OR = 1.67 [1.38-2.01]), being around someone with the COVID-19 (OR = 1.58 [1.30-1.91]), being uncertain about effective disease control (OR = 1.23 [1.03-1.46]), and having depressive symptoms (OR = 4.40 [3.59-5.39]), insomnia symptoms (OR = 2.49 [2.13-2.90]) or psychological distress (OR = 1.87 [1.59-2.18]).

LIMITATIONS

The main limitation is that the cross-sectional design of this study could not allow us to further explore the causality of SI.

CONCLUSIONS

The prevalence of SI was relatively high in general population after the COVID-19 pandemic was initially controlled in China. SI should be monitored continually after the COVID-19 pandemic.

Experience and perpetration of intimate partner violence and abuse by gender of respondent and their current partner before and during COVID-19 restrictions in 2020: a cross-sectional study in 13 countries

BACKGROUND

Intimate partner violence and abuse (IPVA) includes controlling behaviours, psychological, physical, sexual and financial abuse. Globally, surveys and emergency services have recorded an increase in IPVA since restrictions were imposed to limit COVID-19 transmission. Most studies have only included heterosexual women.

METHODS

Data from the Global Drug Survey (an annual, anonymous, online survey collecting data on drug use) Special Edition were analysed to explore the impact of COVID-19 on people's lives, including their intimate relationships. Five relationship groupings were created using respondents' lived gender identity: women partnered with men (46.9%), women partnered with women (2.1%), men partnered with men (2.9%), men partnered with women (47.2%), and partnerships where one or both partners were non-binary (1%). Self-reported experience and perpetration of IPVA in the past 30 days before (February) and during COVID-19 restrictions (May or June) in 2020 (N = 35,854) was described and compared for different relationship groupings using Fishers Exact Tests. Changes in IPVA during restrictions were assessed using multivariable logistic regression.

RESULTS

During restrictions, 17.8 and 16.6% of respondents had experienced or perpetrated IPVA respectively; 38.2% of survivors and 37.6% of perpetrators reported this had increased during restrictions. Greater proportions of non-binary respondents or respondents with a non-binary partner reported experiencing or perpetrating IPVA (p < .001) than other relationship groupings. 22.0% of respondents who were non-binary or had a non-binary partner, 19.5% of men partnered with men, 18.9% of men partnered with women, 17.1% of women partnered with women and 16.6% of women partnered with men reported experiencing IPVA. Respondents with higher psychological distress, poor coping with pandemic-related changes, relationship tension and changes (increases or increases and decreases) in alcohol consumption reported increased experience of IPVA during restrictions.

CONCLUSIONS

This study confirmed that IPVA can occur in all intimate relationships, regardless of gender of the perpetrator or survivor. Non-binary respondents or respondents with non-binary partners reported the highest use and experience of IPVA. Most IPVA victim support services have been designed for heterosexual, cisgender women. IPVA support services and perpetrator programmes must be tailored to support all perpetrators and survivors during the pandemic and beyond, regardless of their sexual or gender identity.

Temporal Trends and Characteristics of Adult Patients in Emergency Department Related to Suicide Attempt or Self-Harm in Korea, 2016-2020

BACKGROUND

The implementation of an effective suicide prevention program requires the identification and monitoring of subpopulations with elevated risks for suicide in consideration of demographic characteristics, to facilitate the development of tailored countermeasures for tackling the risk factors of suicide. We examined the annual trends in emergency department (ED) visits for suicide attempts (SAs) or self-harm and investigated the sex- and age-specific characteristics of individuals who visited the ED for SA and self-harm.

METHODS

Data on ED visits for SAs or self-harm in Korea from 2016 to 2020 were extracted from the National Emergency Department Information System and assessed. We evaluated the age-standardized incidence rate of ED visits for SAs or self-harm, and hospital mortality among individuals who visited the ED for SAs or self-harm. In addition, the characteristics of the individuals were compared according to sex and age.

RESULTS

We identified 145,963 ED visits for SAs or self-harm (0.42% of the total ED visits) during the study period. The rate of ED visits increased in the youngest age group (19-29 years old), and was more prominent among women (increased by an annual average of 22.5%), despite the coronavirus disease pandemic. The middle-aged group (45-64 years old) had a higher rate of mortality than other age groups, and the highest proportion of individuals on Medical Aid.

CONCLUSION

It is necessary to plan age- and gender-specific suicide prevention programs that focus on improving the limited public mental health resources for the vulnerable populations.

Initial risk factors, self-compassion trajectories, and well-being outcomes during the COVID-19 pandemic: A person-centered approach

Introduction

We investigated whether initial risk classes and heterogeneous trajectories of self-compassion over the course of the pandemic may impact well-being outcomes 1 year into the pandemic.

Methods

A large, representative sample of Canadians (N = 3,613; 50.6% women) was sampled longitudinally over 11 waves (April 2020-April 2021), using a rolling cross-sectional survey design. Analyses were conducted in three steps: (1) latent class analysis to identify heterogeneity in risk factors (sociodemographic, cognitive-personality, health-related) early in the pandemic, (2) latent class growth analysis (LCGA) to identify longitudinal self-compassion trajectories, and (3) GLM to examine effects of risk factor classes and self-compassion trajectories, as well as their interaction, on later well-being (mental health, perceived control, life satisfaction).

Results and Discussion

Four risk factor classes emerged, with 50.9% of participants experiencing low risk, 14.3% experiencing multiple risks, 20.8% experiencing Cognitive-Personality and Health risks, and 14.0% experiencing sociodemographic and Cognitive-Personality risks. Four self-compassion trajectories also emerged, with 47.7% of participants experiencing moderate-high self-compassion that decreased then stabilized, 32.0% experiencing moderate self-compassion that decreased then stabilized, 17.3% experiencing high and stable self-compassion across time, and 3.0% experiencing low and decreasing self-compassion. Comparisons of well-being outcomes 1 year post-pandemic indicated that higher levels of self-compassion over time may protect against the impact of initial risk on well-being outcomes. Further work is still needed on heterogeneity in experiences of risk and protective factors during stressful life events.

Pandemic-Related Stress and Other Emotional Difficulties in a Sample of Men and Women Living in Romantic Relationships during the COVID-19 Pandemic

This study examined the extent to which relationship quality affects variability in perceived stress and other emotional difficulties associated with the pandemic. The study was conducted 2-17 March 2022 using a self-administered online survey. The sample size consisted of 1405 individuals who were in a romantic relationship. The scales used in the study included the PSS-4, ECR-RS, SLS-12 and the standardized Pandemic-ED scale (RMSEA = 0.032). Increased stress levels (U = -5.741), pandemic-related emotional difficulties (U = -8.720), worse romantic relationship quality (U = -2.564) and more frequent anxiety-related attachment (U = -3.371) were characteristic of women. A hierarchical regression model for stress showed that age (b = -0.143), financial situation (b = 0.024), the ECR-RS scores (b = 0.219) and pandemic-related emotional difficulties (b = 0.358) proved to be statistically significant predictors of stress. The hierarchical regression model for pandemic-related emotional difficulties indicated five predictors: gender (b = 0.166), education (b = 0.071), financial situation (b = 0.203), scores on the ECR-RS scale (b = 0.048) and stress (b = 0.367). The SEM model used has satisfactory fit indices (RMSEA = 0.051), romantic relationship quality scores and attachment styles interact with the variability of perceived pandemic-related stress and burdens. The determined model offers conclusions relevant to clinicians working with individuals and couples during periods of intense stress.

Sibling Bullying, School Bullying, and Children's Subjective Well-Being Before and During the COVID-19 Pandemic in Indonesia

The aims of this study are threefold. The first aim is to examine the prevalence of sibling and school bullying before and during the COVID-19 pandemic in Indonesia. The second aim is to investigate the subjective well-being (SWB) of children who were bullied or never bullied before and during COVID-19. The third aim is to investigate factors associated with sibling and school bullying before and during the COVID-19 pandemic. This study uses two separate cross-sectional datasets from the Children's Worlds survey in Indonesia. Data in Study 1 were collected in October 2017 (N = 12,794; 48.2% boys; 51.8% girls, mean age = 10.56), while data in Study 2 were collected from July to September 2021 (N = 2,222; 46.1% boys; 53.9% girls; mean age = 10.77). Five items were used to measure sibling and school bullying. The five-item version of the Children's Worlds Subjective Well-Being Scale (CW-SWBS5) was used as the SWB indicator. Three groups of independent variables (family, friends and school climate) were analysed using linear regression to investigate the contribution of each variable to sibling and school bullying. Results show that the prevalence of sibling bullying during the COVID-19 pandemic is higher than before the pandemic, while the frequency of school bullying incidents during COVID-19 is lower than before COVID-19. SWB scores of children during COVID-19 are lower than SWB scores of children before the COVID-19 pandemic, both for bullied or never-bullied children. The fact that children report that parents listen to them and take what they say into account is positively associated with a lower frequency of being bullied at home before and during COVID-19 and being bullied at school only during the pandemic. Although samples are not strictly comparable, the SWB indicators used in both studies showed sensitivity to the changes in children's lives in previous studies. Therefore, the SWB indicators are supposed to be sensitive to changes associated with children's new everyday life COVID-19 has implied.

Adaptation and initial psychometric study of the anxiety and fear of COVID-19 scale in the United Kingdom population

Objective

The aim of the study was the initial psychometric study to validate the anxiety and fear of COVID-19 (AMICO) assessment scale in the general population of the United Kingdom population.

Materials and methods

A descriptive, cross-sectional, psychometric validation and descriptive study was conducted, performing univariate and bivariate analyses, as well as exploratory and confirmatory factor analysis.

Results

The sample was 658 people living in the United Kingdom over 16 years. Of the total, 80.5% were female, with a mean age of 48.25 years (SD = 14.861). A mean score for the AMICO scale of 4.85 (SD = 2.398) was obtained, with a range of scores from 1 to 10. The study of percentiles and quartiles allowed for the identification of three proposed levels of anxiety.

Conclusion

The AMICO_UK scale is reliable to measure the presence of anxiety and fear related to the COVID-19 disease in the United Kingdom population. The majority of the United Kingdom population presented low levels of anxiety and fear at the time the scale was administered.

Trajectory of suicidal ideation among medical students during the COVID-19 pandemic: the role of childhood trauma

BACKGROUND

The aim of this study was to understand the longitudinal trajectory of suicidal ideation (SI) among Chinese medical students and the role of childhood trauma (CT).

METHODS

Using a whole-group sampling method, we assessed SI in 2192 (male = 834, female = 1358) medical students on three occasions over a period of one year. The Suicidal Ideation Self-Assessment Scale (SISAS) and the Childhood Trauma Questionnaire-Short Form (CTQ-SF) were used to assess SI and CT. The growth mixture modeling (GMM) was used to classify the developmental trajectory of SI.

RESULTS

A greater number of medical students were experiencing suicidal ideation during the COVID-19 pandemic. The trajectory of SI among medical students was divided into two groups: a low risk, slowly rising group and a high risk, continuous group. The low risk, slowly rising group had a significant time effect (B = 1.57, p < 0.001) and showed a slowly increasing trend. Emotional neglect (EN), physical neglect (PN), emotional abuse (EA) and physical abuse (PA) all had significant positive predictive effects for the high risk, continuous group (B = 0.18-0.65, P < 0.01).

CONCLUSION

The trajectory of SI among medical students can be divided into a low risk, slowly rising group and a high risk, continuous group; the more EN, PN, EA and PA experienced during childhood, the more likely medical students are to develop a high risk, continuous state of SI.

Heterogeneity in depressive and anxiety symptoms and loneliness during the COVID-19 pandemic: Results from three Dutch psychiatric case-control cohorts from April 2020 to February 2022

OBJECTIVE

While research found heterogeneous changes in mental health during the COVID-19 pandemic, less is known about the long-term changes in mental health in psychiatric groups. Therefore, we applied a data-driven method to detect sub-groups with distinct trajectories across two years into the pandemic in psychiatric groups, and described their differences in socio-demographic and clinical characteristics.

METHOD

We conducted sixteen rounds of questionnaires between April 2020 and February 2022 among participants (n = 1722) of three psychiatric case-control cohorts that started in the 2000's. We used Growth Mixture Modelling and (multinomial) logistic regression to identify characteristics associated with trajectory membership.

RESULTS

We found low decreasing (1228 [72%] participants), intermediate (n = 348 [22%] participants) and high stable (106 [6%] participants) trajectories of depressive symptoms; decreasing low/intermediate (1507 [90%] participants) and high stable (161 [10%] participants) trajectories of anxiety symptoms; and stable low (1109 [61%] participants), stable high (315 [17%] participants), temporary lowered (123 [9%]) and temporary heightened (175 [13%] participants) trajectories of loneliness. Chronicity and severity of pre-pandemic mental disorders predicted unfavourable sub-group membership for all outcomes. Being female, having a low education and income level were associated with unfavourable trajectories of depression, being younger with unfavourable trajectories of anxiety and being female and living alone with unfavourable trajectories of loneliness.

CONCLUSION

We found relatively stable trajectories of depression and anxiety symptoms over two years, suggesting low heterogeneity in outcomes during the pandemic. For loneliness, we found two specific sub-groups with temporary increase and decrease in loneliness during the pandemic.

A global portrait of expressed mental health signals towards COVID-19 in social media space

Globally, the COVID-19 pandemic has induced a mental health crisis. Social media data offer a unique opportunity to track the mental health signals of a given population and quantify their negativity towards COVID-19. To date, however, we know little about how negative sentiments differ across countries and how these relate to the shifting policy landscape experienced through the pandemic. Using 2.1 billion individual-level geotagged tweets posted between 1 February 2020 and 31 March 2021, we track, monitor and map the shifts in negativity across 217 countries and unpack its relationship with COVID-19 policies. Findings reveal that there are important geographic, demographic, and socioeconomic disparities of negativity across continents, different levels of a nation's income, population density, and the level of COVID-19 infection. Countries with more stringent policies were associated with lower levels of negativity, a relationship that weakened in later phases of the pandemic. This study provides the first global and multilingual evaluation of the public's real-time mental health signals to COVID-19 at a large spatial and temporal scale. We offer an empirical framework to monitor mental health signals globally, helping international authorizations, including the United Nations and World Health Organization, to design smart country-specific mental health initiatives in response to the ongoing pandemic and future public emergencies.

Young Adults' Mental Health and Unmet Service Needs in the Context of the COVID-19 Pandemic Across Canada and France

While young adults experienced mental health challenges during the COVID-19 pandemic, little is known about how their mental health needs were subsequently met through access to mental health services (MHS). From October to December 2020, we conducted an online survey of young adults (18-29 years) living in Canada and France to investigate factors associated with unmet MHS needs. Of the 3222 participants expressing a need to access MHS (50.7% of the total sample), 58.2% in Canada and 74.8% in France reported unmet MHS needs. In both countries, those who identified as men and those who lost income due to COVID-19, were more likely to report unmet MHS needs. In Canada, participants from Quebec, those living in rural areas, and those who experienced ethno-racial discrimination had higher odds of reporting such unmet needs. Urgent investments are needed to improve access to MHS for young adults during and after the COVID-19 pandemic.

Time-Series Trends of Depressive Levels of Korean Adults During the 2020 COVID-19 Pandemic in South Korea

OBJECTIVE

This study aimed to observe the changes in people's depressive levels over 9 months since the coronavirus disease of 2019 (COVID-19) outbreak as well as to identify the predictors of people's depressive levels including COVID-19 infection fear in the context of South Korea in 2020.

METHODS

For these purposes, four cross-sectional surveys were periodically implemented from March to December 2020. We randomly recruited 6,142 Korean adults (aged 19 to 70) by using a quota survey. Along with descriptive analysis, which included a one-way analysis of variance and correlations, multiple regression models were built to identify the predictors of people's depressive levels during the pandemic.

RESULTS

Overall, people's depressive levels and fear of COVID-19 infection gradually increased since the COVID-19 outbreak. In addition to demographic variables (i.e., being a female, young age, unemployed, and living alone) and the duration of the pandemic, people's COVID-19 infection fear was associated with their depressive levels.

CONCLUSION

To ameliorate these rising mental health issues, access to mental health services should be secured and expanded, particularly for individuals who present greater vulnerabilities due to socioeconomic characteristics that may affect their mental health.

European Working Group on SARS-CoV-2: Current Understanding, Unknowns, and Recommendations on the Neurological Complications of COVID-19

The emergence of COVID-19 was rapidly followed by infection and the deaths of millions of people across the globe. With much of the research and scientific advancement rightly focused on reducing the burden of severe and critical acute COVID-19 infection, the long-term effects endured by those who survived the acute infection has been previously overlooked. Now, an appreciation for the post-COVID-19 condition, including its neurological manifestations, is growing, although there remain many unknowns regarding the aetiology and risk factors of the condition, as well as how to effectively diagnose and treat it. Here, drawing upon the experiences and expertise of the clinicians and academics of the European working group on COVID-19, we have reviewed the current literature to provide a comprehensive overview of the neurological sequalae of the post-COVID-19 condition. In this review, we provide a summary of the neurological symptoms associated with the post-COVID-19 condition, before discussing the possible mechanisms which may underly and manifest these symptoms. Following this, we explore the risk factors for developing neurological symptoms as a result of COVID-19 and the post-COVID-19 condition, as well as how COVID-19 infection may itself be a risk factor for the development of neurological disease in the future. Lastly, we evaluate how the post-COVID condition could be accurately diagnosed and effectively treated, including examples of the current guidelines, clinical outcomes and tools that have been developed to aid in this process, as well as addressing the protection provided by COVID-19 vaccines against post-COVID-19 condition. Overall, this review provides a comprehensive overview of the neurological sequalae of the post-COVID-19 condition.

The Impact of COVID-19 and Telehealth Services on Attrition Rates in Psychotherapy

Attrition in psychotherapy has been identified as a significant obstacle in the productive delivery of mental health services. Defined generally as the ending of a treatment prior to proper optimal benefit, attrition both hinders treatment efficacy and costeffectiveness in therapy. With the demands for quality mental health services increasing, resources must be identified to reduce barriers to such services. The COVID-19 pandemic has resulted in the emergence of one potential resources: telehealth services. The current study aims to identify how COVID-19 and telehealth services have influenced attrition by analyzing attrition rates from both before and during the pandemic in a community health center where a transition to telehealth was made at the start of the pandemic. In addition, the variables of age, gender, socioeconomic status, and insurance coverage were also tested as potential predictors of attrition. Using de-identified patient information, clients who had participated in therapy services within a six-month period at a community health center (N = 329) were selected. A survival analysis was used to assess the time taken from initial appointment to the point of attrition. Results indicated that those who attended therapy via telehealth were less likely to stop attending treatment than those who participated in therapy in person. Individuals who used both in-person and telehealth visits were the least likely to terminate treatment prematurely. Clinical implications include the need for therapists to offer both telehealth and in-person services in order to give clients more resources to reduce a large barrier to needed mental healthcare treatment.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10591-023-09661-0.

Role of rumination and hope on negative life events and suicidal ideation under the background of normalization of pandemic prevention and control: A moderated mediation model

Introduction

The study aimed to investigate the impact and mechanism of negative life events on college students' suicidal ideation during the COVID-19 pandemic and the buffering effect of hope under the background of normalization of pandemic.

Methods

A total of 5211 participants took part in this study. Self-reported negative life events, rumination, hope and suicide ideation were measured using a range of questions and scales. Our research demonstrated that the incidence of suicidal ideation among college freshmen in the past week was higher during the COVID-19 pandemic than that before the pandemic. In this study, conditional process model 15 was used to verify the hypothetical model of rumination as a potential mediator and hope as a moderator.

Results

The hypothesized moderated mediation model was verified significant (β = -0.047, 95% CI = [-0.061, -0.035]), and hope was found to moderate the direct effect of negative life events on suicidal ideation (β = -0.039, t = -2.937, 95% CI = [-0.065, -0.013]) as well as the indirect effect of through the mediator rumination (β = -0.134, t = -10.850, 95% CI = [-0.158, -0.110]).

Discussion

We found that rumination partially mediated the effect of negative life events on suicidal ideation, and hope buffered the direct and indirect effect of negative life events on suicidal ideation. The implications of the findings for clinical interventions are discussed, including the importance of hope arousal as a protective factor and rumination as a cognitive mechanism for emotion regulation under the background of normalization of pandemic.

Breastfeeding in the pandemic: A qualitative analysis of breastfeeding experiences among mothers from Canada and the United Kingdom

BACKGROUND

Previous research shows that the COVID-19 pandemic resulted in both barriers and facilitators to breastfeeding. However, little research has looked specifically at first-time mothers' experiences of breastfeeding during the pandemic or compared experiences of mothers living in different countries.

AIM

This research explores mothers' breastfeeding experiences to describe how the COVID-19 pandemic has affected breastfeeding journeys in Canada and the United Kingdom.

METHODS

Ten semi-structured online interviews were undertaken with first-time mothers who breastfed their baby at least once during the COVID-19 pandemic and are living in Canada or the United Kingdom. Interview transcripts were coded inductively using thematic analysis.

FINDINGS

One overarching theme (all on mother) and four sub-themes were identified: 1) accessing and advocating for health care, 2) social support, 3) becoming a mother in isolation, and 4) breastfeeding baby. Similar themes were constructed for both countries.

DISCUSSION

Mothers reported that diminished health care and social support created challenges in their breastfeeding journey. Many mothers reported receiving virtual breastfeeding support, which was largely experienced as unhelpful. Some mothers reported fewer distractions from visitors and more one-on-one time with their infant, which helped them to establish breastfeeding and a strong mother-infant bond.

CONCLUSION

In both Canada and the United Kingdom, new mothers need consistent, reliable health care and social support when breastfeeding. This study supports the need to protect breastfeeding support in the midst of a global emergency and beyond to ensure positive breastfeeding experiences for both mother and baby.

Counseling for Health: How Psychological Distance Influences Continuance Intention towards Mobile Medical Consultation

As mobile healthcare services entered the public sight with high frequency during the COVID-19 pandemic, patients are increasingly recognizing the effectiveness of mobile medical consultation (MMC). Earlier studies have investigated what influences continuance intention (CI) towards MMC, but few studies have scrutinized it from the perspective of patients' psychological distance. We formulated a framework to examine the psychological factors influencing CI towards MMC by integrating the information systems continuance model and psychological distance theory. The framework was validated using the partial least squares structural equation modeling (PLS-SEM) approach and data from 475 MMC users in China. The empirical results revealed that immediacy, telepresence, intimacy, and substitutability were significant predictors of CI, while satisfaction mediated these pathways. Pandemic-induced anxiety positively moderated the effect of immediacy on satisfaction and the effect of satisfaction on CI. Practical implementations for MMC healthcare practitioners, designers, and marketers are drawn.

Come together: The importance of arts and cultural engagement within the Liverpool City Region throughout the COVID-19 lockdown periods

Introduction

Arts and cultural engagement activities have long been found to support wellbeing within the general population. In particular, community arts and cultural involvement during the COVID-19 pandemic have been an invaluable source of mental health and wellbeing support for many individuals across the globe. The initial move to remote engagement following the first United Kingdom lockdown demonstrated the importance of hybrid provisions, with isolated and vulnerable individuals finding online provisions important for wellbeing. With restrictions on movement and service access in the United Kingdom having gradually eased from March 2021, it is now important to explore how individuals navigated the ability to engage with either remote or in-person provisions. The current study aimed to explore the impact of the COVID-19 pandemic on arts and cultural engagement during periods of restrictions and initial easings on movement within the Liverpool City Region.

Method

The study consisted of two waves of qualitative interviews within a broader longitudinal study. Twelve interviews were conducted during wave 1, which aimed to capture data during the initial COVID-19 lockdown period and the initial easing of restrictions. Eight of these participants were interviewed again for wave 2, which aimed to capture data during the winter 2020 lockdown period.

Results

Framework analysis revealed three overarching themes: (1) The Importance of Arts and Culture for Personal Enrichment, (2) Belongingness through Socialization, and (3) Transitioning and Adjusting Throughout the COVID-19 Pandemic.

Discussion

Findings presented in the current study provide further evidence of the value of arts and cultural activities in supporting wellbeing. Specifically, the current data emphasize the value of arts and cultural engagement throughout the COVID-19 pandemic and particularly during times of national restriction. Furthermore, the current study demonstrated that remote engagement provided important wellbeing support throughout the pandemic in a way that protected against mental health consequences, but with limitations on feelings of social connectedness within online environments. Amidst continuing risks from the COVID-19 virus and feelings of uncertainty, this study highlights the importance of hybrid provisions.

A Retrospective Longitudinal Analysis of Mental Health Admissions: Measuring the Fallout of the Pandemic

BACKGROUND

In this research article, we review the infrequently considered long-term impact of the pandemic on inpatient mental health, by reviewing the clinical parameters of all psychiatric admissions to Mount Carmel Hospital, our region's main psychiatric healthcare facility, from 2019-2021.

METHODS

4292 patients were admitted during the research period of this retrospective longitudinal analysis. Taking 2019 as the pre-COVID reference year, we compared mean monthly admissions from 2020 and 2021, looking at patient demographics, status under the Mental Health Act, diagnosis, and self-injurious behaviour.

RESULTS

While the pandemic was reflected in a moderate increase in mean monthly presentations with suicidal ideation and suicidal self-injury, presentations in 2020 otherwise remained largely stable. This contrasted with a surge in presentations in 2021 with mood disorders, schizophrenia, anxiety, personality disorders, and autism spectrum disorders. Furthermore, presentations involving self-injurious behaviour continued to grow. Involuntary admissions also increased significantly in 2021.

CONCLUSIONS

This paper highlights the pernicious long-term impact of the pandemic on mental health presentations, demonstrated by an increase in hospital admissions and more serious presentations. These findings should be considered in the guidance for responses to any future pandemic, giving attention to the evidence of the impact of restrictive measures on mental health.

Leveraging Campus Landscapes for Public Health: A Pilot Study to Understand the Psychological Effects of Urban Sheep Grazing on College Campuses

Since the 1980s, college students in the U.S. have self-reported a decline in their physical and emotional health. With these conditions compounded by the COVID-19 pandemic and its physical distancing restrictions, higher education institutions have an increased responsibility to establish strategic interventions and health-promoting programs for their students. Research collaborations between public health professionals and environmental designers have highlighted the benefits of environmental factors, such as wildlife, street trees, and public parks, on mental health. This pilot project aims to build upon the transdisciplinary dialogue between ecology, design, and public health by examining the social benefits of grazing lawnscape management, which is the practice of using herbivorous livestock to manage turfgrass areas. Through the design of an accessible central campus grazing space for a flock of 25 sheep and use of online questionnaires, a smartphone-based single-item survey, and open-ended feedback given via social media, the UC Davis Sheepmower Project addresses three primary questions: (1) Are there differences in self-reported stress levels and well-being between people who did not watch grazing sheep (no sheepmower group) compared with those who did watch grazing sheep (sheepmower group)? (2) Does holding sheep grazing events create opportunities for education about well-being and engagement with the campus community? (3) Can this type of urban grazing installation ultimately contribute to the overall identity of a college campus? Web-based questionnaire results indicate there is no significant difference in self-reported stress levels between the two groups; however, the moment-in-time smartphone-based single item question suggests that the presence of sheep provides temporary, noticeable relief and enhanced mood for those who observe the animals. Reflections posted on social media suggested that participants found the sheep grazing events fostered feelings of community and placemaking within the campus identity. However, the questionnaire sample indicated the grazing events did not have a significant effect on participants' sense of place or overall campus identity. This transdisciplinary effort breaks down traditionally siloed approaches to human and environmental health and is an example of a whole-systems approach to developing innovative solutions and encouraging applied collective action.

The impact of patient involvement on participant opinions of information sheets

BACKGROUND

Patient and public involvement (PPI) groups can provide valuable input to create more accessible study documents with less jargon. However, we don't know whether this procedure improves accessibility for potential participants.

AIMS

We assessed whether participant information sheets were rated as more accessible after PPI review and which aspects of information sheets and study design were important to mental health patients compared with a control group with no mental health service use.

METHOD

This was a double-blind quasi-experimental study using a mixed-methods explanatory design. Patients and control participants quantitatively rated pre- and post-review documents. Semi-structured interviews were thematically analysed to gain qualitative feedback on opinions of information sheets and studies. Two-way multivariate analysis of variance was used to detect differences in ratings between pre- and post-review documents.

RESULTS

We found no significant (P < 0.05) improvements in patient (n = 15) or control group (n = 21) ratings after PPI review. Patients and controls both rated PPI as of low importance in studies and considered the study rationale as most important. However, PPI was often misunderstood, with participants believing that it meant lay patients would take over the design and administration of the study. Qualitative findings highlight the importance of clear, friendly and visually appealing information sheets.

CONCLUSIONS

Researchers should be aware of what participants want to know about so they can create information sheets addressing these priorities, for example, explaining why the research is necessary. PPI is poorly understood by the wider population and efforts must be made to increase diversity in participation.

Investigation of changes in ankylosing spondylitis disease activity through 2021 COVID-19 wave in Taiwan by using electronic medical record management system

We aim to investigate the alteration in disease activity of ankylosing spondylitis (AS) individuals before, during, and after the COVID-19 wave in Taiwan by using electronic medical-record management system (EMRMS). We identified 126 AS individuals from the single center, and gathered data of the three disease activities (Bath Ankylosing Spondylitis Disease Activity Index [BASDAI], Ankylosing Spondylitis Disease Activity Score with erythrocyte sedimentation rate [ASDAS-ESR], and Ankylosing Spondylitis Disease Activity Score with C-Reactive Protein [ASDAS-CRP]) by using EMRMS before (7 February to 1 May, 2021), during (2 May to 24 July, 2021), and after the COVID-19 wave (25 July to 16 October, 2021). We compared the disease activity measures of the three phases through a paired t test. Among the 126 individuals, CRP was significantly higher during the COVID-19 wave (0.2 (0.1, 0.5) mg/dl, p = 0.001) than before the wave (0.2 (0.1, 0.4) mg/dl), ESR (8.0 (4.0, 15.0) mm/h, p = 0.003) and ASDAS-ESR (1.4 (1.0, 1.9), p = 0.032) were significantly higher after the wave than during the wave (6.0 (3.0, 12.0) mm/h and 1.2 (0.9, 1.8) mm/h) e. ESR, CRP, ASDAS-ESR and ASDAS-CRP were all significant higher after COVID-19 wave than before. The disease activities of AS individuals in Taiwan worsened after 2021 COVID-19 wave in Taiwan.

Typologies of people's preexisting political ideology and values would determine their post-pandemic mental health and political behaviors: Evidence from China

The pandemic of COVID-19 has caused economic and social crisis across the world. Existing studies have shown that the uncertain social context has profoundly affected people's life, triggering a variety of social psychological phenomena including the deterioration of mental health and the change of political behavioral patterns. However, little has been known about the differences in people's pre-pandemic political ideology and their influences on people's mental health and political behaviors after the pandemic. Using the secondary data from the 2018 and 2020 China Family Panel Studies, we measured nationalism tendencies, state performance ratings, social justice evaluation and life satisfaction of 29,629 adults before the pandemic. Using latent profile analysis (LPA), we examined the typologies of respondents' political ideology and values. Five types emerged to identify respondents with different political ideology and values: (Class-1) High nationalism tendency, country evaluation, social justice perception, and life satisfaction; (Class-2) Low life satisfaction; (Class-3) Moderate ratings; (Class-4) Low nationalism tendency; and (Class-5) Low country evaluation, low social justice perception. We further explored the predicting roles of those typologies on people's depressive symptoms and political engagement behaviors after the pandemic. We found that, after the pandemic, although the depressive symptoms of people with low life satisfaction (Class-2) and low country and society ratings (Class-5) eased, they still tended to have more severe depressive symptoms than the Moderate ratings group (Class-3). People with low life satisfaction (Class-2) were also less likely to follow political information than the moderate group (Class-3). Our research revealed how the psychology and behaviors of Chinese people with different political views changed when faced with uncertainty in social context. Further research needs to be carried out to depict how these changes occur.

Promoting Liberal Education through Introductory Psychology: The Perspective-Based Approach

Introductory psychology is typically presented to undergraduates as a set of loosely related topics reflecting the organization of most textbooks. The empirically based evidence presented in the topical format is likely to be limited by progressive knowledge obsolesce and replicability challenges impacting contemporary science. We suggest that psychology instructors consider an alternative course format organized by theories or perspectives. A perspective-centered introductory psychology provides a consistent and pluralistic view of the field and embeds research findings and methodology within psychology’s major explanatory theories. Current trends in undergraduate higher education emphasize career readiness. Development of critical thinking and applying psychological principles to real-world situations, including students’ own lives, may be better achieved through a perspective-based approach. Given that the typical introductory psychology student is a non-major taking the course to fulfil liberal arts requirements, a perspective approach offers several advantages. A focus on understanding human behavior from multiple vantage points is a skill valued by prospective employers of new bachelor’s degree recipients. With its emphasis on divergent and dialectical reasoning, a perspectivecenteredintroductory psychology course can become the centerpiece of the general education curriculum. In addition to promoting post-formal reasoning, a perspective-centered introductory psychology illustrates the diverse epistemologies that have shaped our field.

Emergence of Covid-19 as a Novel Concept Shifts Existing Semantic Spaces

Conceptual knowledge is dynamic, fluid, and flexible, changing as a function of contextual factors at multiple scales. The Covid-19 pandemic can be considered a large-scale, global context that has fundamentally altered most people's experiences with the world. It has also introduced a new concept, COVID (or COVID-19), into our collective knowledgebase. What are the implications of this introduction for how existing conceptual knowledge is structured? Our collective emotional and social experiences with the world have been profoundly impacted by the Covid-19 pandemic, and experience-based perspectives on concept representation suggest that emotional and social experiences are critical components of conceptual knowledge. Such changes in collective experience should, then, have downstream consequences on knowledge of emotion- and social-related concepts. Using a naturally occurring dataset derived from the social media platform Twitter, we show that semantic spaces for concepts related to our emotional experiences with Covid-19 (i.e., emotional concepts like FEAR)-but not for unrelated concepts (i.e., animals like CAT)-show quantifiable shifts as a function of the emergence of COVID-19 as a concept and its associated emotional and social experiences, shifts which persist 6 months after the onset of the pandemic. The findings support a dynamic view of conceptual knowledge wherein shared experiences affect conceptual structure.