The COVID-19 pandemic and maternal mental health in a fragile and conflict-affected setting in Tumaco, Colombia: a cohort study

Strategies to Prevent Violence Against Children in the Home: A Systematic Review of Reviews

Violence against children (VAC) in the home, or by household members, is a human rights and social problem with long-lasting consequences for individuals and society. Global policy instruments like the INSPIRE package have proposed strategies to prevent VAC, including Implementation and enforcement of laws, Norms and values, Safe environments, Parent and caregiver support, Income and economic strengthening, Response and support services, and Education and life skills. This systematic review of reviews aimed to synthesize the recent evidence base (i.e., published since 2000) for each INSPIRE strategy to reduce VAC in the home or by household members. We searched four databases using controlled vocabularies and keywords and searched for additional records in prior reviews of reviews. A total of 67 studies were included in this review, including literature reviews, meta-analyses, systematic reviews, and other types of reviews. We found extensive evidence supporting the effectiveness of parent and caregiver support interventions. However, reviews on other INSPIRE strategies were scarce. We also found a vast underrepresentation of samples from low- and- middle-income countries, children with disabilities, and families affected by forced displacement and conflict. In sum, this systematic review suggests that there are several promising strategies to prevent VAC (e.g., home visiting and parent education), but further research is necessary to strengthen the current body of evidence and effectively inform the implementation and scale-up of evidence-based interventions to protect children from violence globally.

A systematic review on the relationship between socioeconomic conditions and emotional disorder symptoms during Covid-19: unearthing the potential role of economic concerns and financial strain

BACKGROUND

Covid-19 has disrupted the lives of many and resulted in high prevalence rates of mental disorders. Despite a vast amount of research into the social determinants of mental health during Covid-19, little is known about whether the results are consistent with the social gradient in mental health. Here we report a systematic review of studies that investigated how socioeconomic condition (SEC)-a multifaceted construct that measures a person's socioeconomic standing in society, using indicators such as education and income, predicts emotional health (depression and anxiety) risk during the pandemic. Furthermore, we examined which classes of SEC indicators would best predict symptoms of emotional disorders.

METHODS

Following PRISMA guidelines, we conducted search over six databases, including Scopus, PubMed, etc., between November 4, 2021 and November 11, 2021 for studies that investigated how SEC indicators predict emotional health risks during Covid-19, after obtaining approval from PROSPERO (ID: CRD42021288508). Using Covidence as the platform, 362 articles (324 cross-sectional/repeated cross-sectional and 38 longitudinal) were included in this review according to the eligibility criteria. We categorized SEC indicators into 'actual versus perceived' and 'static versus fluid' classes to explore their differential effects on emotional health.

RESULTS

Out of the 1479 SEC indicators used in these 362 studies, our results showed that 43.68% of the SEC indicators showed 'expected' results (i.e., higher SEC predicting better emotional health outcomes); 51.86% reported non-significant results and 4.46% reported the reverse. Economic concerns (67.16% expected results) and financial strains (64.16%) emerged as the best predictors while education (26.85%) and living conditions (30.14%) were the worst.

CONCLUSIONS

This review summarizes how different SEC indicators influenced emotional health risks across 98 countries, with a total of 5,677,007 participants, ranging from high to low-income countries. Our findings showed that not all SEC indicators were strongly predictive of emotional health risks. In fact, over half of the SEC indicators studied showed a null effect. We found that perceived and fluid SEC indicators, particularly economic concerns and financial strain could best predict depressive and anxiety symptoms. These findings have implications for policymakers to further understand how different SEC classes affect mental health during a pandemic in order to tackle associated social issues effectively.

The effect of COVID-19 on the non-COVID health outcomes of crisis-affected peoples: a systematic review

BACKGROUND

The COVID-19 pandemic posed considerable risks to populations affected by humanitarian crises in low- and middle-income countries (LMICs). However, there is limited understanding of how the pandemic may have affected non-COVID health outcomes among crisis-affected populations. Our aim was to examine the evidence on the impact of the COVID-19 pandemic on non-COVID-19 health outcomes for crisis-affected populations in LMICs.

METHODS

A systematic review methodology was applied following PRISMA guidelines. Eligibility criteria were: crisis-affected populations in LMICS; COVID-19; and all health topics, except for sexual and reproductive health which was covered in a linked review. Five bibliographic databases and additional grey literature sources were searched. The search period was from 2019 to 31 July 2022. Eligible papers were extracted and analysed using a narrative synthesis approach based on the study objectives and relevant health access and systems frameworks. A quality appraisal was also conducted.

FINDINGS

4320 articles were screened, and 15 eligible studies were identified and included in this review. Ten studies collected health outcomes data. Eight related to mental health, which generally showed worse mental health outcomes because of the pandemic, and pandemic-related stressors were identified. Two studies assessed physical health outcomes in children, while none addressed physical health outcomes among adults. Nine studies reported on access to healthcare, revealing worse access levels due to the pandemic and noting key barriers to care. Seven studies reported on the impact on health systems, with key challenges including reduced and distorted health care funding, reduced staff capacity, interrupted medicines and supplies, weak information and mixed-messaging, and weak leadership. All fifteen studies on the social determinants of health, particularly highlighting the effect of increasing poverty, the role of gender, and food insecurity on health outcomes. The quality of papers was limited overall.

CONCLUSION

This review found some limited evidence indicating negative mental health effects, increased barriers to accessing care, damage to health systems and magnified impacts on the social determinants of health for crisis-affected people during the COVID-19 pandemic. However, the small number and limited quality of the studies make the overall strength of evidence quite weak.

Trends in mental health before and after the onset of the COVID-19 pandemic: a longitudinal survey of a conflict-affected population in Colombia

BACKGROUND

Focusing on the Meta region in Colombia, we investigated the relationship between mental health, the COVID-19 pandemic, and social determinants of health influenced by over five decades of civil conflict. We studied the post-2016 peace agreement trends in mental health for the population of Meta, before and after the local onset of the pandemic.

METHOD

We conducted three rounds of a longitudinal health survey in years 2018 with N = 1309 (Women = 709; Men = 600); 2019 with N = 1106 (Women = 597; Men = 509); and 2020 with N = 905 (Women = 499; Men = 406). We measured mental health through the Self-Report Questionnaire (SRQ-20), investigating population trends in the average SRQ score and SRQ-positive frequency (SRQ + , indicating positive tendency towards experiencing mental health disorders).

RESULTS

Between 2018 and 2020, there were reductions in the mean SRQ-20 score by 1.74 points (95% CI -2.30 to -1.18) and in SRQ + frequency by 15 percentage points (95% CI -21.0 to -9.0) for the Meta population. Yet specific subgroups have become more vulnerable to mental illness during the pandemic, for example older age groups (e.g., increase in mean SRQ score among over 60 s by 2.49 points, 95% CI 0.51 to 4.46) and people living with children younger than five years-old (e.g., increase in mean SRQ score by 0.64 points, 95% CI 0.07 to 1.20). Increased mental health vulnerability among specific subgroups may be related to differences in the likelihood of knowing people who tested positive for COVID-19 or died from itf having been in quarantine.

CONCLUSION

Our findings support the importance of public policies in Colombia (and other low- and middle-income countries) that address the social determinants of mental illness whose influence was likely exacerbated by the pandemic, including persistent job insecurity leading to work and financial pressures, and inadequate support networks for isolated individuals and vulnerable caregivers.

Immediate and longer-term changes in mental health of children with parent-child separation experiences during the COVID-19 pandemic

BACKGROUND

The psychological impact of the COVID-19 pandemic has been understudied among vulnerable populations. This study aimed to examine the immediate and longer-term changes in the mental health of children with parent-child separation experiences during the COVID-19 pandemic, and identify potential buffering opportunities for mental health.

METHODS

This longitudinal cohort study used data from 723 rural Chinese children who provided data before (Oct. 2019) the COVID-19 pandemic and during the following 2 years. Changes in the probability of depressive symptoms, anxiety symptoms, non-suicide self-injurious (NSSI), suicidal ideation, suicide plan, and suicide attempt were tested across four waves using generalized estimating models (GEE).

RESULTS

Compared with children who never experienced parent-child separation, children persistently separated from parents since birth experienced greater deterioration in all mental health in the 2-year follow-up (average change: depressive symptoms: β = 0.59, 95% CI [0.26, 0.93]; anxiety symptoms: β = 0.45, 95% CI [0.10, 0.81]; NSSI: β = 0.66, 95% CI [0.31, 1.01]; suicide ideation: β = 0.67, 95% CI [0.38, 0.96]; suicide plan: β = 0.77, 95% CI [0.38, 1.15]; suicide attempt: β = 1.12, 95% CI [0.63, 1.62]). However, children with childhood separation from their parents but reunited with them during the transition to adolescence showed similar even lower changes to counterparts who never experienced parent-child separation (all ps > 0.05).

CONCLUSION

These results indicating improvements in supportiveness of the caregiving environment during the transition to adolescence may provide the opportunity to buffer the adverse impact of COVID-19 on mental health. Translating such knowledge to inform intervention and prevention strategies for youths exposed to adversity is a critical goal for the field.

Mental health of health professionals and their perspectives on mental health services in a conflict-affected setting: a qualitative study in health centres in the Gaza Strip during the COVID-19 pandemic

OBJECTIVES

To explore how primary care health professionals perceive their own mental health in a conflict-affected setting during and beyond the COVID-19 pandemic and to explore their perspectives on mental health services.

METHODS

The Gaza Strip faces a chronic humanitarian crisis and is suffering from the consequences of the COVID-19 pandemic; United Nations Relief and Works Agency (UNRWA) health centres were used to recruit participants for this study. Semistructured interviews were conducted with 29 health professionals in UNRWA health centres who were sampled using maximum variation sampling. Transcripts were translated, double checked and analysed via thematic analysis.

RESULTS

From the analysis, a thematic map was developed showing how health professionals perceive their mental health impacts. This included difficulties due to the COVID-19 pandemic, as well as the socioeconomic processes stemming from the on-going conflict.Another thematic map was developed showing the perceived strengths and challenges of the health services. The strengths included positive impact of the services to the service users and health professionals. In terms of challenges, health professionals identified socioeconomic processes and aspects of remote service provision during COVID-19.

CONCLUSIONS

Based on the findings, we suggest that an improved signposting mechanism should be developed to address many of the challenges that emergencies bring about; in particular, this could support the health professionals' mental health, as well as improve the response to patients' socioeconomic challenges. We further suggest recommendations for improving mental health services when delivered remotely to increase their resiliency during various emergencies.

A systematic review of mental health in rural Andean populations in Latin America during the COVID-19 pandemic

Background

COVID-19 has been causing mental health problems around the world, with rural and indigenous peoples likely to be the most affected. This systematic review synthesizes and critically analyzes the existing literature on mental disorders in the rural Andean population in Latin America.

Methods

A systematic review with narrative synthesis was carried out following the PRISMA guidelines. We searched nine databases (PubMed/MEDLINE, Scopus, EMBASE, ScienceDirect, Web of Science, Cochrane, Scielo, LILACS, and Latindex), five public prepublication servers (SocArXiv, medRxiv, bioRxiv, SportRXiv, and Preprints), ALICIA, and Google Scholar for articles that included the analysis of mental health problems using data collected from the rural Andean population in Latin America. These were eligible for inclusion. Articles that included Non-Latin American populations (including European or African migrants) and studies conducted prior to the COVID-19 pandemic (since the declaration of national lockdown) were excluded.

Results

A total of 23,761 articles were retrieved, 14 of which met the inclusion requirements. Most were cross-sectional (n = 12) and related to anxiety (n = 9), depression (n = 8), and stress (n = 5). The mental health analysis of 5,976 rural dwellers from four countries in Latin America also included gray literature studies (n = 7) that allowed the quantification of mental health problems in adults (n = 7) and adolescents/children (n = 4). Only one study was multinational, and the quality of publications varied. Despite the high frequency of anxiety, depression, and stress symptoms among rural Latin American populations during COVID-19, published research is very limited. This review found preliminary evidence that the frequency of anxiety (45%), depression (27.6%), and stress (33.1%) in the rural population was associated with pandemic restrictions across countries. Measures of other psychiatric problems, such as distress or suicidal ideation, cannot be estimated.

Conclusion

Regional-wide studies investigating changes in the frequency of symptoms of mental health problems in the context of the COVID-19 pandemic are warranted to inform culturally adapted prevention strategies. This study is limited to a narrative synthesis and may be subject to publication bias.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=320489.

Mental health problems and resilience in adolescents during the COVID-19 pandemic in a post-armed conflict area in Colombia

The impact of COVID-19 pandemic on mental health of adolescents are emerging and require particular attention in settings where challenges like armed conflict, poverty and internal displacement have previously affected their mental wellbeing. This study aimed to determine the prevalence of anxiety symptoms, depressive symptomatology, probable post-traumatic stress disorder and resilience in school-attending adolescents in a post-conflict area of Tolima, Colombia during the COVID-19. A cross-sectional study was carried out with 657 adolescents from 12 to 18 years old, recruited by convenience sampling in 8 public schools in the south of Tolima, Colombia, who completed a self-administered questionnaire. Mental health information was obtained through screening scales for anxiety symptoms (GAD-7), depressive symptomatology (PHQ-8), probable post-traumatic stress disorder (PCL-5) and resilience (CD-RISC-25). The prevalence observed for moderate to severe anxiety symptoms was 18.9% (95% CI 16.0-22.1) and for moderate to severe depressive symptomatology was 30.0% (95% CI 26.5-33.7). A prevalence of probable post-traumatic stress disorder (PTSD) of 22.3% (95% CI 18.1-27.2) was found. The CD-RISC-25 results for resilience had a median score of 54 [IQR 30]. These results suggest that approximately two-thirds of school-attending adolescents in this post-conflict area experienced at least one mental health problem such as anxiety symptoms, depressive symptomatology or probable PTSD during the COVID-19 pandemic. Future studies are of interest to establish the causal relationship between these findings and the impact of the pandemic. These findings highlight the challenge that schools have after pandemic to address the mental health of their students in order to promoting adequate coping strategies and implement prompt multidisciplinary interventions to reduce the burden of mental health problems in adolescents.

COVID-19 and mental health in 8 low- and middle-income countries: A prospective cohort study

BACKGROUND

The Coronavirus Disease 2019 (COVID-19) pandemic and associated mitigation policies created a global economic and health crisis of unprecedented depth and scale, raising the estimated prevalence of depression by more than a quarter in high-income countries. Low- and middle-income countries (LMICs) suffered the negative effects on living standards the most severely. However, the consequences of the pandemic for mental health in LMICs have received less attention. Therefore, this study assesses the association between the COVID-19 crisis and mental health in 8 LMICs.

METHODS AND FINDINGS

We conducted a prospective cohort study to examine the correlation between the COVID-19 pandemic and mental health in 10 populations from 8 LMICs in Asia, Africa, and South America. The analysis included 21,162 individuals (mean age 38.01 years, 64% female) who were interviewed at least once pre- as well as post-pandemic. The total number of survey waves ranged from 2 to 17 (mean 7.1). Our individual-level primary outcome measure was based on validated screening tools for depression and a weighted index of depression questions, dependent on the sample. Sample-specific estimates and 95% confidence intervals (CIs) for the association between COVID-19 periods and mental health were estimated using linear regressions with individual fixed effects, controlling for independent time trends and seasonal variation in mental health where possible. In addition, a regression discontinuity design was used for the samples with multiple surveys conducted just before and after the onset of the pandemic. We aggregated sample-specific coefficients using a random-effects model, distinguishing between estimates for the short (0 to 4 months) and longer term (4+ months). The random-effects aggregation showed that depression symptoms are associated with a increase by 0.29 standard deviations (SDs) (95% CI [-.47, -.11], p-value = 0.002) in the 4 months following the onset of the pandemic. This change was equivalent to moving from the 50th to the 63rd percentile in our median sample. Although aggregate depression is correlated with a decline to 0.21 SD (95% CI [-0.07, -.34], p-value = 0.003) in the period thereafter, the average recovery of 0.07 SD (95% CI [-0.09, .22], p-value = 0.41) was not statistically significant. The observed trends were consistent across countries and robust to alternative specifications. Two limitations of our study are that not all samples are representative of the national population, and the mental health measures differ across samples.

CONCLUSIONS

Controlling for seasonality, we documented a large, significant, negative association of the pandemic on mental health, especially during the early months of lockdown. The magnitude is comparable (but opposite) to the effects of cash transfers and multifaceted antipoverty programs on mental health in LMICs. Absent policy interventions, the pandemic could be associated with a lasting legacy of depression, particularly in settings with limited mental health support services, such as in many LMICs. We also demonstrated that mental health fluctuates with agricultural crop cycles, deteriorating during "lean", pre-harvest periods and recovering thereafter. Ignoring such seasonal variations in mental health may lead to unreliable inferences about the association between the pandemic and mental health.

A cross-sectional study of the psychological impact of the COVID-19 pandemic on camped refugees in Ghana

Vulnerable populations such as camped refugees are often exposed to spread of infectious diseases because of their living conditions, limited resources available to them and exclusion from social services. This study examined the psychological state of camped refugees in Ghana during the COVID-19 pandemic and how their background characteristics predict the severity of the pandemic's psychological impact. It covered 763 refugees aged 15 years and above resident in two (Krisan = 316 and Ampain = 447) camps. Nine COVID-19 Anxiety Scale indicators were used to examine the psychological state of camped refugees. A composite indicator was derived to examine the overall psychological impact. Logistic regression was used to examine the factors that were associated with severe psychological impact. The multivariate analysis revealed that sex of the respondent, marital status and age of head of household were the only socio-demographic factors associated with having a severe psychological impact of the pandemic. There was very strong evidence that respondents who had moderate (OR = 1.74, 95% CI = 1.12, 2.7) and high (OR = 1.66, 95% CI = 1.05, 2.63) knowledge of the disease had increased odds of severe psychological impact. Also, those with moderate (OR = 2.97, 95% CI = 1.78, 4.97) and high (OR = 12.98, 95% CI = 7.86, 21.42) adherence had increased odds of severe psychological impact. None of the pre-existing health conditions and challenges were not significantly associated with severe psychological impact. The limited number of significant socio-demographic covariates suggests that severe psychological impact of the pandemic was a problem in the general population, and thus interventions should target the general population of camped refugees. Also, health education should not only focus on enhancing knowledge and promoting preventive measures but also on managing psychological distress.

Determination of Population Mobility Dynamics in Popayán-Colombia during the COVID-19 Pandemic Using Open Datasets

The COVID-19 pandemic is a catastrophic event that marked the history of humanity. The virus's transmissibility has primarily prevented the control of the pandemic, so it has become vital to determine and control the dynamics of the population mobility to reduce the epidemiological impact. Considering the above, this paper uses an exposure indicator based on the movement ranges provided by Facebook to determine the dynamics of population mobility in Popayán city for the period after the appearance of COVID-19. Using statistical analysis techniques, it then contrasts the data obtained with the public circulation reports provided by Google and Apple. The results suggest that the exposure indicator is reliable and presents moderate to strong linear relationships for the public data, which implies that it can be an additional resource for decision-making to curb the spread of the virus.

The global evolution of mental health problems during the COVID-19 pandemic: A systematic review and meta-analysis of longitudinal studies

BACKGROUND

The COVID-19 pandemic impacted mental health, but the global evolution of mental health problems during the pandemic is unknown. We conducted a systematic review and meta-analysis of longitudinal studies to evaluate the global evolution of mental health problems during the pandemic.

METHODS

To conduct this systematic review, we searched for published articles from APA PsycInfo (Ovid), CINAHL (EBSCOhost), Embase (Ovid), MEDLINE (Ovid), and Web of Science. Longitudinal (at least 2 waves during the COVID-19 pandemic) and peer-reviewed articles on mental health problems conducted as from 2020 and after were included in the current study. Of 394 eligible full texts, 64 articles were included in the analysis. We computed random effects, standardized mean differences, and log odds ratio (LOR) with 95 % CIs. The meta-analysis protocol was registered with PROSPERO (CRD42021273624).

RESULTS

Results showed that anxiety (LOR = -0.33; 95 % CI, -0.54, -0.12) and depression symptoms (LOR = -0.12; 95 % CI, -0.21, -0.04) decreased from baseline to follow up. However, other mental health problems showed no change. Higher prevalence rates (40.9 %; 95 % CI, 16.1 %-65.8 %) of psychological distress were found in months after July 2020, respectively, while there were no significant month differences for the prevalence of other mental health problems. Higher means of anxiety (d = 3.63, 95 % CI, 1.66, 5.61), depression (d = 3.93; 95 % CI, 1.68, 6.17), and loneliness (d = 5.96; 95 % CI, 3.22, 8.70) were observed in May 2020. Higher prevalence of anxiety, depression, and PTSD and higher means of anxiety, depression and loneliness were observed in North America. The prevalence of psychological distress and insomnia was higher in Latin America and Europe, respectively.

LIMITATIONS

There is a lack of longitudinal studies in some parts of the world, such as Africa, the Caribbean, India, the Middle East, in Latin America, and Asia.

CONCLUSIONS

Results indicated that anxiety and depression symptoms decreased during the COVID-19 pandemic while other mental health problems showed no statistical change. The findings reveal that mental health problems peaked in April and May 2020. Prevalence of mental health problems remains high during the pandemic and mental health prevention, promotion and intervention programs should be implemented to mitigate the consequences of the COVID-19 pandemic on the global population.

Influence of the COVID-19 Pandemic on Quality of Life, Mental Health, and Level of Physical Activity in Colombian University Workers: A Longitudinal Study

The COVID-19 pandemic has had a strong influence on people’s quality of life, and the different restrictive measures during the phases of the pandemic have had consequences for physical and mental health. This study determined the changes in health-related quality of life (HRQoL), sleep quality, depression symptoms (DS), and physical activity (PA) level of middle-aged Colombian university personnel during the COVID-19 pandemic. The analysis was performed following a longitudinal design on a sample of 354 people at four points before and during the pandemic. The International Physical Activity Questionnaire (IPAQ), the SF-12v2, the Pittsburgh Sleep Quality Index (PSQI), and the Zung Self-Rating Depression Scale (ZSDS) were included in an online survey. The measurements showed a decrease in quality of life with respect to PCS from 91.66 ± 10.78 to 83.64 ± 17.22 (p = 0.000) and MCS from 87.57 ± 12.23 to 80.90 ± 17.31, while poor sleep quality increased from 25.99% to 47.46% (p = 0.000), with DS reaching the peak during mandatory confinement (14.69%). Regarding the level of physical activity, the period of mandatory confinement inverted the proportion, highlighting active people as a minority (32.2%). In the multivariate analysis, we adjusted for age, sex, BMI, and socioeconomic level, discarding confounding effects and their interactions with the results obtained. In conclusion, this study showed that the pandemic has had a negative impact on sleep quality, HRQoL, DS, and PA level.

The Covid-19 Pandemic and Maternal Mental Health: A Longitudinal Study of Chilean and Foreign-Born Mothers

Objectives: We explore the effects of the pandemic on stress, depressive symptoms and parenting practices of mothers with children aged between 24- and 30-months, residents in Santiago, Chile, and the differences between foreign‐born and native‐born mothers.

Methods: Using data from the longitudinal project Mil Primeros Días and lagged-dependent models, we analyzed parental stress, depressive symptoms and parenting practices for native-born and foreign-born mothers. Lagged-dependent model allows us to take advantage of the longitudinal data by controlling for the previous score and baseline individual characteristics.

Results: After 8 months of the pandemic, mothers of young children have more depressive symptoms, are more stressed, and show more hostility towards their children. Foreign-born mothers had 0.29 and 0.22 standard deviations (SD) more than native-born mothers in the parental distress and difficult child scales from the Parental Stress Index (PSI), respectively, and 0.17 SD more in the hostile-reactive parental behavior dimension.

Conclusion: Findings suggest the need to implement policies and programs that prevent mental health deterioration for mothers, especially migrant mothers, to improve women’s psychological condition and child wellness.

Psychological distress and mental health trajectories during the COVID-19 pandemic in Argentina: a longitudinal study

Psychological-distress increased at the onset of the COVID-19 pandemic in Argentina. Longitudinal studies in developing countries are scarce. Particularly, Argentina had one of the longest lockdowns. Differences in preventive measures against the virus spread between countries may differentially affect the mental health of the populations. Here we aimed to characterize distinct psychological-distress and related-symptoms trajectories associated with the pandemic and explore risk/protective factors. In this longitudinal study, data from 832 Argentineans were collected every 3–5 months, between April 2020–August 2021. Mean psychological-distress levels and related-symptoms tended to increase over time. However, latent-class analysis identified four distinct psychological-distress trajectories. Most individuals had consistently good mental health (Resilient). Two classes showed psychological-distress worsening during the initial phase of the pandemic and recovered at different time points (Fast Recovery; Slow Recovery). The remaining class maintained a mild -level of psychological-distress and began to deteriorate in March 2021 (Deteriorating) continuously. Individuals who are younger, female, have pre-existing psychiatric diagnoses, or have high neuroticism or lower resilience were more likely to experiencing fluctuations in psychological-distress. The mental health trajectory during the pandemic had a complex dynamic. Although most participants remained resilient, a vulnerable group was detected, which deteriorated over time and should be considered by health-services.

The impact of COVID-19 on the living and survival conditions of internally displaced persons in Burkina Faso

In recent years, as in other parts of the Sahel, the threat of terrorism has escalated in Burkina Faso. In 2019, this country hosted the fourth highest number of new conflict-related internal displaced persons (IDPs) in the world. These people have to cope simultaneously with the full spectrum of environmental, social and health-related stresses in the long, medium and short term, respectively. We seek to compare the living conditions of IDPs before and during the lockdown implemented by the authorities (between 27 March and 5 May 2020) to contain the spread of the virus. Interviews were conducted with 106 IDPs in Kongoussi (Central-Northern region). Although no respondent reported having been directly affected by the virus, 84.9% of the IDPs surveyed had no income-generating activities during the lockdown and the remaining 15.1% who continued to work reported that their activities had been greatly scaled-down. For a large majority of them, their living conditions, already described as difficult under 'normal' circumstances (insufficient food, insignificant financial assistance, or difficult access to health care), further deteriorated. In addition, IDPs were unable to leave the camps or regions where they were located to search for better living conditions or to return home. Lastly, 96.2% of respondents believed that the COVID-19 pandemic would have a negative impact on their future. These IDPs, like many in the sub-region and around the world, therefore require urgent assistance from the authorities and humanitarian NGOs, as the slightest new stress is likely to considerably worsen their already vulnerable state.

Association between Pet Ownership and Mental Health and Well-Being of Canadians Assessed in a Cross-Sectional Study during the COVID-19 Pandemic

The objective of this cross-sectional study was to assess the association between pet ownership and quality of life (QoL), loneliness, anxiety, stress, overall health, and mental health of Canadians during the COVID-19 pandemic using a One Health perspective. An online bilingual survey was completed by 1500 Canadians in April-May 2021. Socio-demographics, health, QoL, stress and anxiety, loneliness, social support, pet ownership, and attitude towards pets data were collected. Crude and adjusted associations between pet ownership and mental health and well-being indicators were estimated. The 1500 participants were from all provinces and territories, half were women; half of the participants were pet owners by design. The crude association estimates showed that pet owners had poorer QoL, overall health, and mental health than non-pet owners, and were lonelier, more stressed, and more anxious than non-pet owners. Adjusted estimates showed that these associations disappeared with the inclusion of the confounders (socio-economic, demographic, health, and pet-related variables). Our results suggest that there was no association between pet ownership and the mental health and well-being indicators measured in the present study.

The Psychological Nursing Interventions Based on Pygmalion Effect Could Alleviate Negative Emotions of Patients with Suspected COVID-19 Patients: a Retrospective Analysis

PURPOSE

This study aims to explore the psychological status of suspected COVID-19 patients during quarantine and put forward a new yet effective psychological nursing strategy for intervention.

PATIENTS AND METHODS

We performed a retrospective study with suspected COVID-19 patients who were hospitalized to the two hospitals of Hunan province, China and accepted the intervention of psychological nursing from 01/2020 to 03/2020. The control group received routine psychological nursing care and the observation group received the new psychological nursing intervention according to Pygmalion effect.

RESULTS

A total of 89 objects were included in the analysis. Results of the questionnaire before intervention showed that the majority of isolated suspected COVID-19 patients showed negative emotions, with the incidence of depression (51.69%), anxiety (14.617%), inverted provocation (22.47%), extraverted provocation (25.84%). And the extraverted provocation scores of female patients was significantly higher than that of male counterparts (P < 0.05). At discharge, compared with the control group, the scores of depression, anxiety, introversion and extraversion of patients in the observation group were significantly lower after nursing intervention based on Pygmalion effect. The satisfaction rate of psychological care based on Pygmalion effect was 86.66%.

CONCLUSION

Suspected COVID-19 patients tend to show the symptoms of depression, anxiety and irritation during quarantine. The psychological nursing based on Pygmalion effect is helpful to alleviate their negative emotions.

Barriers and Facilitators to Resuming In-Person Psychotherapy with Perinatal Patients amid the COVID-19 Pandemic: A Multistakeholder Perspective

During the COVID-19 pandemic, outpatient psychotherapy transitioned to telemedicine. This study aimed to examine barriers and facilitators to resuming in-person psychotherapy with perinatal patients as the pandemic abates. We conducted focus group and individual interviews with a sample of perinatal participants (n = 23), psychotherapy providers (n = 28), and stakeholders (n = 18) from Canada and the U.S. involved in the SUMMIT trial, which is aimed at improving access to mental healthcare for perinatal patients with depression and anxiety. Content analysis was used to examine perceived barriers and facilitators. Reported barriers included concerns about virus exposure in a hospital setting (77.8% stakeholders, 73.9% perinatal participants, 71.4% providers) or on public transportation (50.0% stakeholders, 26.1% perinatal participants, 25.0% providers), wearing a mask during sessions (50.0% stakeholders, 25.0% providers, 13.0% participants), lack of childcare (66.7% stakeholders, 46.4% providers, 43.5% perinatal participants), general transportation barriers (50.0% stakeholders, 47.8% perinatal participants, 25.0% providers), and the burden of planning and making time for in-person sessions (35.7% providers, 34.8% perinatal participants, 27.8% stakeholders). Reported facilitators included implementing and communicating safety protocols (72.2% stakeholders, 47.8% perinatal participants, 39.3% providers), conducting sessions at alternative or larger locations (44.4% stakeholders, 32.1% providers, 17.4% perinatal participants), providing incentives (34.8% perinatal participants, 21.4% providers, 11.1% stakeholders), and childcare and flexible scheduling options (31.1% perinatal participants, 16.7% stakeholders). This study identified a number of potential barriers and illustrated that COVID-19 has fostered and amplified barriers. Future interventions to facilitate resuming in-person sessions should focus on patient-centered strategies based on empathy regarding ongoing risk-aversion among perinatal patients despite existing safety protocols, and holistic thinking to make access to in-person psychotherapy easier and more accessible for perinatal patients.