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Heydari M, Mehraeen E, Javaherikiyan E, Mehrabi N, Langarizadeh M, Aghamohammadi V, Moghaddam HR, Nasiri K. Design, development and evaluation of a mobile-based self-care application for patients with COVID-19 not requiring hospitalization; a study of Northwest of Iran. BMC Med Inform Decis Mak 2023; 23:280. [PMID: 38057860 PMCID: PMC10698913 DOI: 10.1186/s12911-023-02381-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 11/27/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Given the effective role of a mobile applications in disease management, disease monitoring, and self-care in patients with COVID-19 disease, we aimed to design, development and evaluation of a self-care Mobile app for COVID-19 patients not requiring hospitalization. METHODS The design, development and evaluation the usability of the self-care and education mobile app for patients with COVID-19 disease were conducted in two main phases at 2021 in Northwest of IRAN; (1) Determine the features and capabilities and (2) Design, development and evaluation of self-care mobile App. JAVA programming languages and Android Operating System were used and selected to design and development of a mobile app. There were 25 participants who conducted evaluations of the mobile app's usability and impact using the mobile health app usability a Questionnaire of User Interface Satisfaction was administered to assess the usability of the developed application. The results were analyzed via Excel 2013. RESULTS The model of developing a mobile app as an Information System was the Waterfall model. The smartphone application based on a set of capabilities and features was designed and consists of two main parts: the login screen for user registration, and the main home menu. The user interface includes three main pages or activities; (a) Main Menu for quick access to all of the pages, (b) Symptom management and monitoring to monitor the signs and symptoms during the illness, and (c) Set Reminders and Alarms to notify patients. The users' mean score of the application usability was calculated as 7.91 out of 9 indicating a good level of satisfaction. CONCLUSION This app can be a guideline and a useful tools for managing and monitoring symptoms, reminding medications, and implementing self-care instructions in outpatients. The authors suggest evaluating the efficacy and functionality test of mobile-based applications for COVID-19 in clinical trial studies.
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Affiliation(s)
- Mohammad Heydari
- Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, Iran.
| | - Esmaeil Mehraeen
- Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, Iran
| | | | - Nahid Mehrabi
- Department of Health Information Technology, Aja University of Medical Sciences, Tehran, Iran
| | - Mostafa Langarizadeh
- Department of health information management, School of health management and information sciences, Iran university of medical sciences, Tehran, Iran
| | | | | | - Khadijeh Nasiri
- Department of Nursing, Khalkhal University of Medical Sciences, Khalkhal, Iran.
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Lal S, Abdel-Baki A, Peredo R. Clinician perspectives on providing telepsychiatry services to young adults with first-episode psychosis during COVID-19. Early Interv Psychiatry 2023; 17:1189-1198. [PMID: 37057704 DOI: 10.1111/eip.13416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 02/28/2023] [Accepted: 03/28/2023] [Indexed: 04/15/2023]
Abstract
BACKGROUND Telepsychiatry has the potential to facilitate access to mental health services for young people with first-episode of psychosis (FEP); however, limited attention has been given regarding the perceptions of mental health providers in this regard. OBJECTIVE To assess service providers' perceptions on the use of telepsychiatry and changes over time. METHODS Longitudinal survey (conducted at two time points) of 26 service providers, including physicians, nurses, social workers, occupational therapists, and peer support workers, recruited from a specialized program for FEP providing telepsychiatry services through REACTS (videoconferencing platform). RESULTS Responses during the initial and the follow-up survey were similar. Most participants used REACTS nine times or more, with more than half reporting that sessions lasted more than 30 min. Over time, there was a trend towards higher frequency of use and lower duration of sessions. The majority perceived REACTS as safe and easy to use and indicated they would recommend REACTS to colleagues. Although participants reported some issues related to set-up and initial use, internet accessibility, and sound and image, most of these concerns decreased during follow-up. Participants appreciated the usability and utility of REACTS, and reported several benefits of telepsychiatry, including facilitating client engagement, assessment and continuity. CONCLUSIONS Service providers expressed positive perceptions regarding the use of telepsychiatry. Despite analysis being limited to a small sample, this study raises awareness of telepsychiatry's value and feasibility for offering services to young populations with FEP and the importance of conducting research on clinician perspectives in this regard.
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Affiliation(s)
- Shalini Lal
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
- Youth Mental Health and Technology Lab, Innovation and Evaluation Hub, University of Montreal Hospital Research Centre (CRCHUM), Montreal, QC, Canada
- Douglas Research Centre, Montreal, QC, Canada
| | - Amal Abdel-Baki
- Youth Mental Health Service, Centre Hospitalier Université de Montréal (CHUM), Montreal, QC, Canada
- Axe Neurosciences, University of Montreal Hospital Research Centre (CRCHUM), Montreal, QC, Canada
- Department of Psychiatry, Université de Montréal, Montreal, QC, Canada
| | - Rossana Peredo
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
- Youth Mental Health and Technology Lab, Innovation and Evaluation Hub, University of Montreal Hospital Research Centre (CRCHUM), Montreal, QC, Canada
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3
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Berglund AM, Raugh IM, Macdonald KI, James SH, Bartolomeo LA, Knippenberg AR, Strauss GP. The effects of the COVID-19 pandemic on hallucinations and delusions in youth at clinical high-risk for psychosis and outpatients with schizophrenia. Eur Arch Psychiatry Clin Neurosci 2023; 273:1329-1338. [PMID: 36680609 PMCID: PMC9862234 DOI: 10.1007/s00406-023-01551-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 01/09/2023] [Indexed: 01/22/2023]
Abstract
Although the COVID-19 pandemic has had detrimental effects on mental health in the general population, the impact on those with schizophrenia-spectrum disorders has received relatively little attention. Assessing pandemic-related changes in positive symptoms is particularly critical to inform treatment protocols and determine whether fluctuations in hallucinations and delusions are related to telehealth utilization and treatment adherence. In the current longitudinal study, we evaluated changes in the frequency of hallucinations and delusions and distress resulting from them across three-time points. Participants included: (1) outpatients with chronic schizophrenia (SZ: n = 32) and healthy controls (CN: n = 31); (2) individuals at clinically high risk for psychosis (CHR: n = 25) and CN (n = 30). A series of questionnaires were administered to assess hallucination and delusion severity, medication adherence, telehealth utilization, and protective factors during the pandemic. While there were no significant increases in the frequency of hallucinations and delusions in SZ and CHR, distress increased from pre-pandemic to early pandemic in both groups and then decreased at the third time point. Additionally, changes in positive symptom severity in SZ were related to psychiatric medication adherence. Findings suggest that positive symptoms are a critical treatment target during the pandemic and that ongoing medication services will be beneficial.
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Affiliation(s)
- Alysia M Berglund
- Department of Psychology, University of Georgia, 125 Baldwin St., Athens, GA, 30602, USA
| | - Ian M Raugh
- Department of Psychology, University of Georgia, 125 Baldwin St., Athens, GA, 30602, USA
| | - Kelsey I Macdonald
- Department of Psychology, University of Georgia, 125 Baldwin St., Athens, GA, 30602, USA
| | - Sydney H James
- Department of Psychology, University of Georgia, 125 Baldwin St., Athens, GA, 30602, USA
| | - Lisa A Bartolomeo
- Department of Psychology, University of Georgia, 125 Baldwin St., Athens, GA, 30602, USA
| | - Anna R Knippenberg
- Department of Psychology, University of Georgia, 125 Baldwin St., Athens, GA, 30602, USA
| | - Gregory P Strauss
- Department of Psychology, University of Georgia, 125 Baldwin St., Athens, GA, 30602, USA.
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4
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Reich D, Evans S, O'Shea M. Stakeholder views on mindfulness for youth at risk for psychosis. Int J Ment Health Nurs 2022; 31:1390-1404. [PMID: 35779266 PMCID: PMC9796432 DOI: 10.1111/inm.13038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/18/2022] [Indexed: 01/01/2023]
Abstract
Interventions incorporating mindfulness for youth identified to be at risk for psychosis show promise for symptom management yet to be addressed by other approaches. Important questions remain as to how to safely and effectively implement these interventions with this cohort. The aim of this research was to collaboratively identify with stakeholders of such interventions, namely youth at risk for psychosis, and practitioners with experience working with youth at risk for psychosis - attitudes towards mindfulness and potential intervention adaptations to ensure the safety, uptake, and effectiveness of mindfulness interventions used with youth at risk for psychosis. Consolidated criteria for reporting qualitative studies were adopted. Eight practitioners and six at risk for psychosis individuals were interviewed. Both groups identified significant potential benefits of mindfulness, for stress and relaxation, managing difficult thoughts and emotions, increasing positive emotions, improving functioning, and patient empowerment within treatment participation. Stakeholders identified the helpfulness of including compassion-based practices, emphasizing experiential and concrete material, shorter and guided exercises, the targeting of anxiety and attenuated psychotic symptomology, and making the goals or intent of practice youth relevant. Significant barriers were identified - poor functioning and low motivation, high self-criticism, concurrent medication and substance use, and perceptions of mindfulness that may impact uptake (e.g. it requires relaxation to work). Formulation of and research into comprehensive clinical guidelines will help ensure the safe and effective use of future mindfulness and compassion-based practices with at risk for psychosis individuals.
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Affiliation(s)
- Daniel Reich
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Subhadra Evans
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Melissa O'Shea
- School of Psychology, Deakin University, Geelong, Victoria, Australia
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5
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Herrera SN, Lyallpuri R, Sarac C, Dobbs MF, Nnaji O, Jespersen R, DeLuca JS, Wyka KE, Yang LH, Corcoran CM, Landa Y. Development of the Brief Educational Guide for Individuals in Need (BEGIN): A psychoeducation intervention for individuals at risk for psychosis. Early Interv Psychiatry 2022; 16:1002-1010. [PMID: 34811878 DOI: 10.1111/eip.13242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 08/30/2021] [Accepted: 11/07/2021] [Indexed: 11/29/2022]
Abstract
AIM Identification of individuals with psychosis risk (PR) through screening and specialized assessment is becoming more widespread in an effort to promote early intervention and improve recovery outcomes. PR individuals report interest in psychoeducation, though such interventions are currently lacking. Our goal was to develop a structured PR psychoeducation intervention grounded in theory and stakeholder feedback. METHODS By following a step-by-step intervention development model, we identified relevant conceptual frameworks, developed the content and format, and obtained stakeholder feedback. This process resulted in a 5-session PR psychoeducation intervention, Brief Educational Guide for Individuals in Need (BEGIN), with content conveyed visually via a slideshow presentation. PR individuals (n = 5) and parents of PR individuals (n = 5) reviewed BEGIN's content and format, and provided feedback through semi-structured qualitative interviews. Major themes were identified through iterative thematic analysis. RESULTS PR individuals and parents had a positive impression of BEGIN's materials and step-by-step format and psychoeducation about the PR condition. They indicated that the intervention was likely to encourage agency. PR participants emphasized the importance of a patient's decision regarding whether their family member(s) should participate in BEGIN. Parents reported that BEGIN is an important first step in treatment and offers a safe therapeutic environment. Feedback was then utilized to modify the intervention. CONCLUSIONS BEGIN is desired by consumers and may lay the foundation for future engagement with treatment by facilitating agency. A feasibility trial is underway and future studies are needed to measure outcomes (e.g., treatment engagement) and evaluate BEGIN as an evidence-based PR psychoeducation model.
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Affiliation(s)
- Shaynna N Herrera
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Romi Lyallpuri
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Cansu Sarac
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Matthew F Dobbs
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,U.S. Department of Veterans Affairs, VISN 2 Mental Illness Research, Education and Clinical Center (MIRECC), James J. Peters Veterans Affairs Medical Center, Bronx, New York, USA
| | - Obiora Nnaji
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Rachel Jespersen
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Joseph S DeLuca
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Katarzyna E Wyka
- Department of Psychiatry, Weill Medical College of Cornell University, New York, New York, USA.,Department of Epidemiology and Biostatistics, CUNY Graduate School of Public Health and Health Policy, New York, New York, USA
| | - Lawrence H Yang
- School of Global Public Health, New York University, New York, New York, USA.,Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Cheryl M Corcoran
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,U.S. Department of Veterans Affairs, VISN 2 Mental Illness Research, Education and Clinical Center (MIRECC), James J. Peters Veterans Affairs Medical Center, Bronx, New York, USA
| | - Yulia Landa
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,U.S. Department of Veterans Affairs, VISN 2 Mental Illness Research, Education and Clinical Center (MIRECC), James J. Peters Veterans Affairs Medical Center, Bronx, New York, USA
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6
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Schutt RK, Xi H, Mueser KT, Killam MA, Delman J, Eack SM, Mesholam-Gately R, Pratt SI, Sandoval L, Santos MM, Golden LR, Keshavan MS. Cognitive Enhancement Therapy vs social skills training in schizophrenia: a cluster randomized comparative effectiveness evaluation. BMC Psychiatry 2022; 22:583. [PMID: 36050663 PMCID: PMC9434502 DOI: 10.1186/s12888-022-04149-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 07/19/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Schizophrenia and related disorders are highly disabling and create substantial burdens for families, communities, and health care systems. Although pharmacological treatments can often lessen the psychotic symptoms that are a hallmark of schizophrenia, they do not lessen the social and cognitive deficits that create the greatest impediments to community engagement and functional recovery. This study builds on prior research on psychosocial rehabilitation by comparing the effectiveness of two treatments demonstrated as efficacious in improving social and community functioning, Cognitive Enhancement Therapy (CET) and a version of Social Skills Training (HOPES/SST). METHODS The study uses a randomized cluster design in which a pair of clinicians at community- and hospital-based mental service centers deliver either CET or HOPES to at least one group of 6-8 eligible clients for 12 months. Clinicians are trained and then supervised weekly, with ongoing process measurement of treatment fidelity, attendance, satisfaction, and retention, and use of other services. Measures administered at baseline and at 6 and 12 months while in treatment, and then at 18 and 24 months after treatment include social adjustment, quality of life, social skills, positive and negative symptoms, and neuro- and social cognition. We hypothesize that CET will be associated with greater improvements than SST in both the primary outcome of community functioning and the secondary outcomes of neuro- and social cognition and social skills. Secondarily, we hypothesize that more cognitive impairment at baseline and younger age will predict more benefit from CET compared to HOPES. DISCUSSION Resource shortages endemic in mental health services and exacerbated by the pandemic highlight the importance of identifying the most effective approach to improving social and community functioning. We aim to improve understanding of the impact of two efficacious psychosocial treatments and to improve clinicians' ability to refer to both treatments the individuals who are most likely to benefit from them. We expect the result to be programmatic improvements that improve the magnitude and durability of gains in community functioning. TRIAL REGISTRATION ClinicalTrial.gov NCT04321759 , registered March 25, 2020.
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Affiliation(s)
- Russell K. Schutt
- grid.239395.70000 0000 9011 8547Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA ,grid.266685.90000 0004 0386 3207University of Massachusetts Boston, Boston, USA
| | - Haiyi Xi
- grid.254880.30000 0001 2179 2404Dartmouth College, Hanover, USA
| | - Kim T. Mueser
- grid.189504.10000 0004 1936 7558Boston University, Boston, USA
| | - Matthew A. Killam
- grid.239395.70000 0000 9011 8547Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA
| | - Jonathan Delman
- grid.168645.80000 0001 0742 0364University of Massachusetts Medical School, Worcester, USA
| | - Shaun M. Eack
- grid.21925.3d0000 0004 1936 9000University of Pittsburgh, Pittsburgh, USA
| | - Raquelle Mesholam-Gately
- grid.239395.70000 0000 9011 8547Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA
| | - Sarah I. Pratt
- grid.254880.30000 0001 2179 2404Geisel School of Medicine at Dartmouth, Hanover, USA
| | - Luis Sandoval
- grid.239395.70000 0000 9011 8547Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA
| | - Meghan M. Santos
- grid.254880.30000 0001 2179 2404Geisel School of Medicine at Dartmouth, Hanover, USA
| | - Laura R. Golden
- grid.239395.70000 0000 9011 8547Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA ,grid.266685.90000 0004 0386 3207University of Massachusetts Boston, Boston, USA
| | - Matcheri S. Keshavan
- grid.239395.70000 0000 9011 8547Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA
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Daimer S, Mihatsch LL, Neufeld SAS, Murray GK, Knolle F. Investigating the relationship of COVID-19 related stress and media consumption with schizotypy, depression, and anxiety in cross-sectional surveys repeated throughout the pandemic in Germany and the UK. eLife 2022; 11:75893. [PMID: 35781372 PMCID: PMC9252577 DOI: 10.7554/elife.75893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 06/01/2022] [Indexed: 11/23/2022] Open
Abstract
Background: Studies report a strong impact of the COVID-19 pandemic and related stressors on the mental well-being of the general population. In this paper, we investigated whether COVID-19 related concerns and social adversity affected schizotypal traits, anxiety, and depression using structural equational modelling. In mediation analyses, we furthermore explored whether these associations were mediated by healthy (sleep and physical exercise) or unhealthy behaviours (drug and alcohol consumption, excessive media use). Methods: We assessed schizotypy, depression, and anxiety as well as healthy and unhealthy behaviours and a wide range of sociodemographic scores using online surveys from residents of Germany and the United Kingdom over 1 year during the COVID-19 pandemic. Four independent samples were collected (April/May 2020: N=781, September/October 2020: N=498, January/February 2021: N=544, May 2021: N=486). The degree of schizotypy was measured using the Schizotypal Personality Questionnaire (SPQ), anxiety, and depression symptoms were surveyed with the Symptom Checklist (SCL-27), and healthy and unhealthy behaviours were assessed with the Coronavirus Health Impact Survey (CRISIS). Structural equation models were used to consider the influence of COVID-19 related concerns and social adversity on depressive and anxiety-related symptoms and schizotypal traits in relation to certain healthy (sleep and exercise) and unhealthy behaviours (alcohol and drug consumption, excessive media use). Results: The results revealed that COVID-19 related life concerns were significantly associated with schizotypy in the September/October 2020 and May 2021 surveys, with anxiety in the September/October 2020, January/February 2021, and May 2021 surveys, and with depressive symptoms in all surveys. Social adversity significantly affected the expression of schizotypal traits and depressive and anxiety symptoms in all four surveys. Importantly, we found that excessive media consumption (>4 hr per day) fully mediated the relationship between COVID-19 related life concerns and schizotypal traits in the January/February 2021 survey. Furthermore, several of the surveys showed that excessive media consumption was associated with increased depressive and anxiety-related symptoms in people burdened by COVID-19 related life. Conclusions: The ongoing uncertainties of the pandemic and the restrictions on social life have a strong impact on mental well-being and especially the expression of schizotypal traits. The negative impact is further boosted by excessive media consumption, which is especially critical for people with high schizotypal traits. Funding: FK received funding from the European Union’s Horizon 2020 (Grant number 754,462). SN received funding from the Cundill Centre for Child and Youth Depression at the Centre for Addiction and Mental Health, Toronto, Canada and the Wellcome Trust Institutional Strategic Support Fund from the University of Cambridge. The 2020 COVID-19 pandemic, and the measures different governments took to contain it, harmed many people’s mental well-being. The restrictions, combined with pandemic-related uncertainty, caused many individuals to experience increased stress, depression, and anxiety. Many people turned to unhealthy behaviours to cope, including consuming more alcohol or drugs, using media excessively, developing poor sleeping habits, or reducing the amount of exercise they did. Stress, drugs, poor sleep, and uncertainty can increase an individual’s risk of developing psychotic symptoms, including delusions, hallucinations, or difficulty thinking clearly. These symptoms may be temporary or part of a more lasting condition, like schizophrenia. The risk of developing these symptoms increases in people with ‘schizotypal traits’, such as a lack of close relationships, paranoia, or unusual or implausible beliefs. These individuals may be especially vulnerable to the harmful mental health effects of the pandemic. Daimer et al. demonstrated that people who were more worried about their life stability or financial situation during the 2020 COVID-19 pandemic had worse mental well-being than those who felt secure. In the experiments, volunteers completed a series of online mental health questionnaires at four different time points during the pandemic. People who reported feeling lonely, having negative thoughts, or experiencing fewer positive social interactions had more symptoms of mental illness. People who experienced more life disruptions also reported more anxiety or depression symptoms and more schizotypal traits. Daily consumption of at least four hours of digital media exacerbated negative mental health symptoms, and people with more pandemic-related life concerns also spent more time on digital media Daimer et al. suggest that increased media consumption among people with pandemic-related hardships may have increased mental health symptoms and schizotypal traits in these individuals. The survey results suggest that maintaining a healthy lifestyle, including meaningful relationships, is essential to staying mentally healthy during extreme situations like a global pandemic. Protective interventions – such as strengthening social support networks, providing mental health education, or increasing mental healthcare provisions – are essential to prevent poor mental health outcomes during future crises.
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Affiliation(s)
- Sarah Daimer
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Lorenz L Mihatsch
- Department of Anaesthesiology and Intensive Care Medicine, Ludwig-Maximilians-Universität München, Munich, Germany.,Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Sharon A S Neufeld
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Graham K Murray
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United Kingdom
| | - Franziska Knolle
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany.,Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
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Young JQ, McCann-Pineo M, Rasul R, Malhotra P, Jan S, Friedman K, Corley SS, Yacht AC, Barone S, Bellehsen M, Parashar N, Schwartz RM. Evidence for validity of the epidemic-pandemic impacts inventory (brief healthcare module): Internal structure and association with other variables. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2022; 78:98-107. [PMID: 35776080 DOI: 10.1080/19338244.2022.2093823] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The COVID-19 pandemic has subjected healthcare workers to enormous stress. Measuring the impact of this public health emergency is essential to developing strategies that can effectively promote resilience and wellness. The Epidemic-Pandemic Impacts Inventory Supplemental Healthcare Module-Brief Version (EPII-SHMb) was developed to measure impacts among occupational cohorts serving on the front lines of healthcare. While this instrument has been utilized in COVID-19 related studies, little is known about its psychometric properties. This study collects evidence for validity of the EPII-SHMb by evaluating its internal structure and how its scores associate with other variables. Physicians and nursing staff across a large New York health system were cross-sectionally surveyed using an online questionnaire between June and November 2020. Exploratory factor analysis resulted in a 3-factor solution, identifying factors Lack of Workplace Safety (7 items), Death/Dying of Patients (3 items), and Lack of Outside Support (2 items). Internal consistency was high overall and within physician/nursing and gender subgroups (Cronbach's alpha: 0.70 - 0.81). Median scores on Death/Dying of Patients were higher among those who directly cared for COVID-19 patients or worked in COVID-19 hospital units. These results are promising. Additional studies evaluating other dimensions of validity are necessary.
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Affiliation(s)
- John Q Young
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Department of Psychiatry, Zucker Hillside Hospital at Northwell Health, Glen Oaks, NY, USA
| | - Molly McCann-Pineo
- The Feinstein Institutes for Medical Research, Northwell Health, Great Neck, NY, USA
- Department of Occupational Medicine Epidemiology and Prevention, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Center for Traumatic Stress, Resilience and Recovery at Northwell Health, Great Neck, NY, USA
| | - Rehana Rasul
- The Feinstein Institutes for Medical Research, Northwell Health, Great Neck, NY, USA
- Department of Occupational Medicine Epidemiology and Prevention, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Center for Traumatic Stress, Resilience and Recovery at Northwell Health, Great Neck, NY, USA
| | - Prashant Malhotra
- Division of Infectious Disease, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Sophia Jan
- The Feinstein Institutes for Medical Research, Northwell Health, Great Neck, NY, USA
- Division of Pediatrics and Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Division of Pediatrics, Steven and Alexandra Cohen Children's Medical Center, New Hyde Park, NY, USA
| | - Karen Friedman
- Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Samantha S Corley
- The Feinstein Institutes for Medical Research, Northwell Health, Great Neck, NY, USA
- Department of Occupational Medicine Epidemiology and Prevention, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Center for Traumatic Stress, Resilience and Recovery at Northwell Health, Great Neck, NY, USA
| | - Andrew C Yacht
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Stephen Barone
- Division of Pediatrics and Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Mayer Bellehsen
- Center for Traumatic Stress, Resilience and Recovery at Northwell Health, Great Neck, NY, USA
- Unified Behavioral Health Center for Military Veterans and their Families, Northwell Health, Great Neck, NY, USA
| | - Nidhi Parashar
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Department of Psychiatry and Resident Mental Health Program, Lenox Hill Hospital, New York, NY, USA
| | - Rebecca M Schwartz
- The Feinstein Institutes for Medical Research, Northwell Health, Great Neck, NY, USA
- Department of Occupational Medicine Epidemiology and Prevention, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Center for Traumatic Stress, Resilience and Recovery at Northwell Health, Great Neck, NY, USA
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9
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Schwartz RM, McCann-Pineo M, Bellehsen M, Singh V, Malhotra P, Rasul R, Corley SS, Jan S, Parashar N, George S, Yacht AC, Young JQ. The Impact of Physicians' COVID-19 Pandemic Occupational Experiences on Mental Health. J Occup Environ Med 2022; 64:151-157. [PMID: 35119424 PMCID: PMC8808755 DOI: 10.1097/jom.0000000000002380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To examine the association between a number of negative COVID-19 occupational experiences and probable anxiety, depression, and PTSD among physicians. METHODS Cross-sectional examination of longitudinal registry data consisting of physician personal and occupational well-being. Multivariable logistic regressions were performed to determine the association between negative COVID-19 experiences and outcomes. RESULTS Of the 620 eligible physicians, approximately half were female (49%), and 71% white with a mean age of 46.51 (SD = 13.28). A one-point increase in negative experience score was associated with a 23% increase in probable anxiety (OR = 1.23, 95% CI: 1.14-1.34), a 23% increase in probable depression (OR = 1.23, 95% CI: 1.13-1.33), and a 41% increase in probable PTSD (OR = 1.41, 95% CI: 1.30-1.52). CONCLUSIONS Negative pandemic experiences were strongly associated with adverse mental health outcomes while greater resilience was protective.
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Affiliation(s)
- Rebecca M Schwartz
- The Feinstein Institutes for Medical Research, Northwell Health, Great Neck, New York (Dr Schwartz, Dr McCann-Pineo, Rasul, Corley, Dr Jan); Department of Occupational Medicine Epidemiology and Prevention, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York (Dr Schwartz, Dr McCann-Pineo, Rasul, Corley); Center Traumatic Stress, Resilience and Recovery at Northwell Health, Great Neck, New York (Dr Schwartz, Dr McCann-Pineo, Dr Bellehsen, Rasul, Corley); Unified Behavioral Health Center for Military Veterans and their Families, Northwell Health, Great Neck, New York (Dr Bellehsen); Division of Infectious Disease, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York (Dr Singh, Dr Malhotra); Division of Pediatrics and Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York (Dr Jan); Division of Pediatrics, Steven and Alexandra Cohen Children's Medical Center, New Hyde Park, New York (Dr Jan); Department of Psychiatry and Resident Mental Health Program, Lenox Hill Hospital, New York, New York (Dr Parashar); Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York (Dr Parashar, Dr Young); Division of Hospital Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York (Dr George); Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York (Dr Yacht); Department of Psychiatry, Zucker Hillside Hospital at Northwell Health, Glen Oaks, New York (Dr Young)
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10
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The impact of the COVID-19 pandemic on negative symptoms in individuals at clinical high-risk for psychosis and outpatients with chronic schizophrenia. Eur Arch Psychiatry Clin Neurosci 2022; 272:17-27. [PMID: 33881621 PMCID: PMC8057945 DOI: 10.1007/s00406-021-01260-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 03/30/2021] [Indexed: 12/14/2022]
Abstract
Negative symptoms are core features of schizophrenia-spectrum disorders that are frequently observed across all phases of illness. By their nature, COVID-19 social isolation, physical distancing, and health precautions induce behavioural aspects of negative symptoms. However, it is unclear whether these prevention measures also lead to increases in experiential negative symptoms, whether such effects are equivalent across individual negative symptom domains, and if exacerbations occur equivalently across phases of illness. The current study compared negative symptom severity scores obtained during the pandemic to pre-pandemic assessments in two samples: (1) outpatients with chronic schizophrenia (SZ: n = 32) and matched healthy controls (CN: n = 31) and (2) individuals at clinical high risk for psychosis (CHR: n = 25) and matched CN (n = 30). Pre-pandemic ratings of negative symptoms were clinically elevated in SZ and CHR groups, which did not differ from each other in severity. In SZ, ratings obtained during the pandemic were significantly higher than pre-pandemic ratings for all 5 domains (alogia, blunted affect, anhedonia, avolition, and asociality) and item-level analyses indicated that exacerbations occurred on both experiential and behavioral symptoms of anhedonia, avolition, and asociality. In contrast, CHR only exhibited increases in anhedonia and avolition items during the pandemic compared to pre-ratings. Findings suggest that negative symptoms should be a critical treatment target during and after the pandemic in the schizophrenia spectrum given that they are worsening and critically related to risk for conversion, functional outcome, and recovery.
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11
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DeLuca JS, Novacek DM, Adery LH, Herrera SN, Landa Y, Corcoran CM, Walker EF. Equity in Mental Health Services for Youth at Clinical High Risk for Psychosis: Considering Marginalized Identities and Stressors. EVIDENCE-BASED PRACTICE IN CHILD AND ADOLESCENT MENTAL HEALTH 2022; 7:176-197. [PMID: 35815004 PMCID: PMC9258423 DOI: 10.1080/23794925.2022.2042874] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Prevention and early intervention programs have been initiated worldwide to serve youth at Clinical High Risk for Psychosis (CHR-P), who are adolescents and young adults experiencing subclinical psychosis and functional impairment. The primary goals of these efforts are to prevent or mitigate the onset of clinical psychosis, while also treating comorbid issues. It is important to consider issues of diversity, equity, and inclusion in CHR-P work, especially as these programs continue to proliferate around the world. Further, there is a long history in psychiatry of misdiagnosing and mistreating psychosis in individuals from racial and ethnic minority groups. Although there have been significant developments in early intervention psychosis work, there is evidence that marginalized groups are underserved by current CHR-P screening and intervention efforts. These issues are compounded by the contexts of continued social marginalization and significant mental health disparities in general child/adolescent services. Within this narrative review and call to action, we use an intersectional and minority stress lens to review and discuss current issues related to equity in CHR-P services, offer evidence-based recommendations, and propose next steps. In particular, our intersectional and minority stress lenses incorporate perspectives for a range of marginalized and underserved identities related to race, ethnicity, and culture; faith; immigration status; geography/residence; gender identity; sexual orientation; socioeconomic status/class; and ability status.
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Affiliation(s)
- Joseph S. DeLuca
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, , New York, NY, USA
| | - Derek M. Novacek
- Desert Pacific Mental Illness Research, Education, and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, , Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Laura H. Adery
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Shaynna N. Herrera
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, , New York, NY, USA
| | - Yulia Landa
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, , New York, NY, USA
- New York Mental Illness Research, Education and Clinical Center, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA
| | - Cheryl M. Corcoran
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, , New York, NY, USA
- New York Mental Illness Research, Education and Clinical Center, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA
| | - Elaine F. Walker
- Department of Psychology, Emory University, Atlanta, GA, USA
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
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12
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Martinez RG, van Dyk IS, Kroll JL, Emerson ND, Bursch B. Recommendations for building telemental health relationships with youth: A systematic review and resource for clinicians. EVIDENCE-BASED PRACTICE IN CHILD AND ADOLESCENT MENTAL HEALTH 2022; 7:349-362. [PMID: 36248612 PMCID: PMC9562612 DOI: 10.1080/23794925.2021.1970050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Ruben G. Martinez
- Department of Psychiatry & Biobehavioral Sciences, UCLA Jane & Terry Semel Institute for Neuroscience & Human Behavior, Los Angeles, CA
| | - Ilana Seager van Dyk
- Department of Social & Behavioral Science, Yale School of Public Health, New Haven, CT
| | - Juliet L. Kroll
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TC
| | - Natacha D. Emerson
- Department of Psychiatry & Biobehavioral Sciences, UCLA Jane & Terry Semel Institute for Neuroscience & Human Behavior, Los Angeles, CA
| | - Brenda Bursch
- Department of Psychiatry & Biobehavioral Sciences, UCLA Jane & Terry Semel Institute for Neuroscience & Human Behavior, Los Angeles, CA,Department of Pediatrics, UCLA David Geffen School of Medicine, Los Angeles, CA
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13
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Herrera SN, Sarac C, Bilgrami ZR, Dobbs MF, Jespersen R, Haas SS, Garg S, Shaik RB, Landa Y, Corcoran CM. A case report and first-person account of an individual at risk for psychosis who improved during the COVID-19 pandemic. PSYCHOSIS 2022; 14:190-199. [PMID: 36017476 PMCID: PMC9398192 DOI: 10.1080/17522439.2021.1915369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Background The COVID-19 pandemic is expected to increase stress and mental health symptoms. We present the case of a young man at risk for psychosis who has paradoxically shown symptomatic and functional improvement as a result of circumstances produced by COVID-19. These changes were unexpected given the client's persistent mental health struggles in the year leading up to the COVID-19 outbreak in the United States and the expectation of an exacerbation of psychotic-like symptoms. Methods This report is based on clinical assessments and the client's first-person account during the height of the pandemic when stay at home orders were in place. Results During the pandemic, the client demonstrated increased agency by taking on more responsibility at home and obtaining part-time employment. He showed improvement in his mood and relationships with others, had less symptom-related distress, and significantly reduced his cannabis use. The client interpreted these improvements in terms of changing his mindset toward more adaptive thoughts and engaging in healthy coping skills such as praying, reading, and healthy eating. Conclusions This case highlights the importance of fostering agency in clients during a time of crisis and ensuring that clinicians be aware of potential biases about mental health symptom exacerbation.
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Affiliation(s)
| | - Cansu Sarac
- Icahn School of Medicine at Mount Sinai, New York, NY 10029
| | | | | | | | | | - Sahil Garg
- Icahn School of Medicine at Mount Sinai, New York, NY 10029
| | - Riaz B. Shaik
- Icahn School of Medicine at Mount Sinai, New York, NY 10029
| | - Yulia Landa
- Icahn School of Medicine at Mount Sinai, New York, NY 10029
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14
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Oh H, Schiffman J, Marsh J, Zhou S, Koyanagi A, DeVylder J. COVID-19 Infection and Psychotic Experiences: Findings From the Healthy Minds Study 2020. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2021; 1:310-316. [PMID: 34877564 PMCID: PMC8639180 DOI: 10.1016/j.bpsgos.2021.05.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/19/2021] [Accepted: 05/23/2021] [Indexed: 12/04/2022] Open
Abstract
Background Clinical reports from across the world have documented psychosis in the context of COVID-19 infection; however, there has yet to be a large-scale epidemiological study to confirm this association. Methods We analyzed data from the Healthy Minds Study (N = 15,935; conducted between September and December 2020), which was administered online to students attending one of 28 colleges in the United States. Using multivariable logistic regression, we examined the associations between COVID-19 infection/severity and psychotic experiences over the past 12 months, adjusting for age, gender, race/ethnicity, and international student status as well as anxiety and depression. Results More than one fifth of the analytic sample reported COVID-19 infection, and about one in six students with COVID-19 infection reported psychotic experiences over the past 12 months. In weighted multivariable logistic regression models, COVID-19 infection was associated with significantly greater odds of having psychotic experiences (adjusted odds ratio 1.36, 95% CI 1.19–1.48). Compared with being asymptomatic, having moderate (adjusted odds ratio 1.85, 95% CI 1.03–3.31) or severe (adjusted odds ratio 1.76, 95% CI 1.11–2.77) symptoms was associated with significantly greater odds of having psychotic experiences. These associations became statistically nonsignificant when adjusting for depression and anxiety. Hospitalization was not significantly associated with psychotic experiences among students with COVID-19 infection. Conclusions Psychotic experiences are associated with COVID-19 infections, though much of the association is attenuated when accounting for anxiety and depression. Findings based on this sample of college students should be replicated outside of the college context to determine whether psychosis is a neuropsychiatric symptom during and after COVID-19 infection.
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Affiliation(s)
- Hans Oh
- University of Southern California, Los Angeles, California
| | | | | | - Sasha Zhou
- Wayne State University, Detroit, Michigan
| | - Ai Koyanagi
- Parc Sanitari Sant Joan de Deu/CIBERSAM/ICREA, Barcelona, Spain
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15
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Ellis LA, Meulenbroeks I, Churruca K, Pomare C, Hatem S, Harrison R, Zurynski Y, Braithwaite J. The Application of e-Mental Health in Response to COVID-19: Scoping Review and Bibliometric Analysis. JMIR Ment Health 2021; 8:e32948. [PMID: 34666306 PMCID: PMC8651237 DOI: 10.2196/32948] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/28/2021] [Accepted: 10/14/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic and its mitigation measures and impacts, such as shelter-in-place orders, social isolation, restrictions on freedoms, unemployment, financial insecurity, and disrupted routines, have led to declines in mental health worldwide and concomitant escalating demands for mental health services. Under the circumstances, electronic mental health (e-mental health) programs and services have rapidly become the "new normal." OBJECTIVE The aim of this study was to assess key characteristics and evidence gaps in the e-mental health literature published in relation to the COVID-19 pandemic via a scoping review and bibliometric analysis. METHODS We conducted a search of four academic databases (ie, MEDLINE, Embase, PsycInfo, and CINAHL) for documents published from December 31, 2019, to March 31, 2021, using keywords for e-mental health and COVID-19. Article information was extracted that was relevant to the review objective, including journal, type of article, keywords, focus, and corresponding author. Information was synthesized by coding these attributes and was then summarized through descriptive statistics and narrative techniques. Article influence was examined from Altmetric and CiteScore data, and a network analysis was conducted on article keywords. RESULTS A total of 356 publications were included in the review. Articles on e-mental health quickly thrived early in the pandemic, with most articles being nonempirical, chiefly commentaries or opinions (n=225, 63.2%). Empirical publications emerged later and became more frequent as the pandemic progressed. The United States contributed the most articles (n=160, 44.9%), though a notable number came from middle-income countries (n=59, 16.6%). Articles were spread across 165 journals and had above-average influence (ie, almost half of the articles were in the top 25% of output scores by Altmetric, and the average CiteScore across articles was 4.22). The network analysis of author-supplied keywords identified key topic areas, including specific mental disorders, eHealth modalities, issues and challenges, and populations of interest. These were further explored via full-text analysis. Applications of e-mental health during the pandemic overcame, or were influenced by, system, service, technology, provider, and patient factors. CONCLUSIONS COVID-19 has accelerated applications of e-mental health. Further research is needed to support the implementation of e-mental health across system and service infrastructures, alongside evidence of the relative effectiveness of e-mental health in comparison to traditional modes of care.
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Affiliation(s)
- Louise A Ellis
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
- National Health and Medical Research Council Partnership Centre for Health System Sustainability, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Isabelle Meulenbroeks
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
- National Health and Medical Research Council Partnership Centre for Health System Sustainability, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Kate Churruca
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Chiara Pomare
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Sarah Hatem
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Reema Harrison
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Yvonne Zurynski
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
- National Health and Medical Research Council Partnership Centre for Health System Sustainability, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Jeffrey Braithwaite
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
- National Health and Medical Research Council Partnership Centre for Health System Sustainability, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
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16
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Abraham A, Jithesh A, Doraiswamy S, Al-Khawaga N, Mamtani R, Cheema S. Telemental Health Use in the COVID-19 Pandemic: A Scoping Review and Evidence Gap Mapping. Front Psychiatry 2021; 12:748069. [PMID: 34819885 PMCID: PMC8606591 DOI: 10.3389/fpsyt.2021.748069] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 10/15/2021] [Indexed: 01/07/2023] Open
Abstract
Background: The COVID-19 pandemic has highlighted telemedicine use for mental illness (telemental health). Objective: In the scoping review, we describe the scope and domains of telemental health during the COVID-19 pandemic from the published literature and discuss associated challenges. Methods: PubMed, EMBASE, and the World Health Organization's Global COVID-19 Database were searched up to August 23, 2020 with no restrictions on study design, language, or geographical, following an a priori protocol (https://osf.io/4dxms/). Data were synthesized using descriptive statistics from the peer-reviewed literature and the National Quality Forum's (NQF) framework for telemental health. Sentiment analysis was also used to gauge patient and healthcare provider opinion toward telemental health. Results: After screening, we identified 196 articles, predominantly from high-income countries (36.22%). Most articles were classified as commentaries (51.53%) and discussed telemental health from a management standpoint (86.22%). Conditions commonly treated with telemental health were depression, anxiety, and eating disorders. Where data were available, most articles described telemental health in a home-based setting (use of telemental health at home by patients). Overall sentiment was neutral-to-positive for the individual domains of the NQF framework. Conclusions: Our findings suggest that there was a marked growth in the uptake of telemental health during the pandemic and that telemental health is effective, safe, and will remain in use for the foreseeable future. However, more needs to be done to better understand these findings. Greater investment into human and financial resources, and research should be made by governments, global funding agencies, academia, and other stakeholders, especially in low- and middle- income countries. Uniform guidelines for licensing and credentialing, payment and insurance, and standards of care need to be developed to ensure safe and optimal telemental health delivery. Telemental health education should be incorporated into health professions curricula globally. With rapidly advancing technology and increasing acceptance of interactive online platforms amongst patients and healthcare providers, telemental health can provide sustainable mental healthcare across patient populations. Systematic Review Registration: https://osf.io/4dxms/.
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Affiliation(s)
- Amit Abraham
- Institute for Population Health, Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar
| | - Anupama Jithesh
- Institute for Population Health, Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar
| | | | | | - Ravinder Mamtani
- Institute for Population Health, Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar
| | - Sohaila Cheema
- Institute for Population Health, Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar
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17
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Mittal VA, Walker EF, Strauss GP. The COVID-19 Pandemic Introduces Diagnostic and Treatment Planning Complexity for Individuals at Clinical High Risk for Psychosis. Schizophr Bull 2021; 47:1518-1523. [PMID: 34259874 PMCID: PMC8344621 DOI: 10.1093/schbul/sbab083] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
COVID-19 has led to a great deal of general suffering and an increased prevalence of psychiatric illness worldwide. Within the area of psychosis-risk syndromes, a highly heterogeneous clinical population, the picture is quite nuanced as the social restrictions resulting from the pandemic have reduced stress for some and increased it for others. Further, a number of pandemic-related societal and cultural changes have obfuscated the diagnostic and treatment landscape in this area as well. In this opinion article, we describe several prototypical cases, representative of presentations seen in our clinical high-risk (CHR) research programs. The cases highlight considerable clinical variability and, in addition, speak to the current complexities faced by diagnosticians and treatment providers. In addition to discussing these issues, this piece introduces potential solutions highlighting the promise of incorporating data-driven strategies to identify more homogenous CHR subtypes and employ precision medicine.
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Affiliation(s)
- Vijay A Mittal
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Elaine F Walker
- Department of Psychology, Emory University, Atlanta, GA, USA
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18
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van Doorn M, Nijhuis LA, Egeler MD, Daams JG, Popma A, van Amelsvoort T, McEnery C, Gleeson JF, Öry FG, Avis KA, Ruigt E, Jaspers MWM, Alvarez-Jimenez M, Nieman DH. Online Indicated Preventive Mental Health Interventions for Youth: A Scoping Review. Front Psychiatry 2021; 12:580843. [PMID: 33995136 PMCID: PMC8116558 DOI: 10.3389/fpsyt.2021.580843] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 03/30/2021] [Indexed: 12/16/2022] Open
Abstract
Objective: Between the ages of 12 and 25 the onset of mental disorders typically occurs, and the burden of mental health problems is greatest for this group. Indicated preventive interventions to target individuals with subclinical symptoms to prevent the transition to clinical levels of disorders have gained considerable traction. However, the threshold to seek help appears to be high even when help is needed. Online interventions could offer a solution, especially during the COVID-19 pandemic. This scoping review will present an overview of the recent research of indicated online preventive interventions for youth (12-25 years) experiencing the early stages of mental health complaints with the aim of identifying the nature and extent of the research evidence. Methods: The 5-stage framework by Arksey and O'Malley was used. Academic literature published from 2013 onwards in printed or electronic format was included from Scopus, PsychINFO, and Ovid MEDLINE(R) ALL. Results: The search yielded 11,122 results, with the final selection resulting in inclusion of 30 articles for this review. In total, the articles included 4,950 participants. 26.7% of the selected articles focused on youth between 12 and 25 years. Of the articles 60% did not screen for, nor exclude participants with clinical levels of symptoms. Most studies used a common evidence-based therapy for the disorder-category targeted. More than half of the online interventions included some form of human support. Adherence levels ranged between 27.9 and 98%. The results indicate general effectiveness, usability and acceptability of online indicated preventive interventions. The most commonly used approach was CBT (n = 12 studies). Studies varied in their size, rigor of study, effectiveness and outcome measures. Online interventions with a combination of clinical and peer moderation (n = 3 studies) appear to result in the most stable and highest effect sizes. Conclusion: Online indicated preventive mental health interventions for youth with emerging mental health issues show promise in reducing various mental health complaints, and increasing positive mental health indicators such as well-being and resilience. Additionally, high levels of usability and acceptability were found. However, the included studies show important methodological shortcomings. Also, the research has mainly focused on specific diagnostic categories, meaning there is a lack of transdiagnostic approaches. Finally, clear definitions of- as well as instruments to measure- emerging or subclinical mental health symptoms in youth remain are missing.
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Affiliation(s)
| | | | - Mees D. Egeler
- Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Joost G. Daams
- Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Arne Popma
- Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Thérèse van Amelsvoort
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, Netherlands
| | - Carla McEnery
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - John F. Gleeson
- Orygen, Parkville, VIC, Australia
- Healthy Brain and Mind Research Centre and School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| | - Ferko G. Öry
- Erasmus University College, Rotterdam, Netherlands
| | - Kate A. Avis
- Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Emma Ruigt
- Amsterdam University Medical Centers, Amsterdam, Netherlands
- Minddistrict, Amsterdam, Netherlands
| | | | - Mario Alvarez-Jimenez
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
- Orygen, Parkville, VIC, Australia
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Fernández-Álvarez J, Fernández-Álvarez H. Videoconferencing Psychotherapy During the Pandemic: Exceptional Times With Enduring Effects? Front Psychol 2021; 12:589536. [PMID: 33679513 PMCID: PMC7933024 DOI: 10.3389/fpsyg.2021.589536] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 01/12/2021] [Indexed: 12/16/2022] Open
Abstract
With the advent of COVID-19, a sudden, unexpected, and forced shift has been produced in the field of psychotherapy. Worldwide, many therapists closed their offices and started to deliver psychotherapy online through a screen. Although different media started to be incorporated, videoconferencing is undoubtedly the most common way in which therapists are doing therapy these days. This is catalyzing a rapid change in the practice of psychotherapy with probable lasting effects and deserves to be carefully reflected upon. Therefore, in this paper our aim is to outline the main challenges for a medium that may have arrived to stay. In that sense, we review the literature to describe the state-of-the-art regarding the main aspects of videoconferencing psychotherapy as well as to suggest possible avenues for future research and practice.
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Affiliation(s)
- Javier Fernández-Álvarez
- Department of Basic Psychology, Clinical and Psychobiology, Jaume I University, Castellón de la Plana, Spain
- Asociación Aiglé, Valencia, Spain
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20
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Raj S, Ghosh D, Singh T, Verma SK, Arya YK. Theoretical Mapping of Suicidal Risk Factors During the COVID-19 Pandemic: A Mini-Review. Front Psychiatry 2021; 11:589614. [PMID: 33551864 PMCID: PMC7862110 DOI: 10.3389/fpsyt.2020.589614] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 12/09/2020] [Indexed: 01/19/2023] Open
Abstract
Suicide prevention in times of COVID-19 pandemic has become more challenging than ever due to unusual circumstances. The common risk factors identified with regard to suicidal behavior are fear of COVID-19, economic instability, poor access to healthcare facilities, pre-existing psychiatric disorders, and social disconnect. The studies done so far have reported either case studies or have made an effort to understand the risk factors. An understanding of the underlying causal pattern from existing theories, behind these risks, will enable adopting appropriate prevention mechanisms. Hence, this review examines evidence related to risk factors of suicides that occurred during COVID 19 and discusses it in the light of three major theoretical approaches: interpersonal model, stress diathesis model, and cognitive model. The insights obtained from the three viewpoints reveal that perceived burdensomeness, thwarted belongingness, stress sensitivity, cognitive errors such as magnification, catastrophic thinking, arbitrary inference, and mind-reading are likely reasons behind these risk factors for suicide. It is suggested that awareness regarding COVID-19 stressors, use of community-based approaches like gatekeeper training, and brief online psychotherapy by using techniques of mindfulness, interpersonal psychotherapy, and cognitive behavior therapy can be useful in reducing suicide risk during COVID-19.
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Affiliation(s)
- Saurabh Raj
- Department of Psychology, Ramdayalu Singh College (Babasaheb Bhimrao Ambedkar Bihar University), Muzaffarpur, India
| | - Debasruti Ghosh
- Department of Psychology, Mahant Darshan Das Mahila College (Babasaheb Bhimrao Ambedkar Bihar University), Muzaffarpur, India
| | - Tushar Singh
- Department of Psychology, Faculty of Social Sciences, Banaras Hindu University, Varanasi, India
| | - Sunil K. Verma
- Department of Applied Psychology, Vivekananda College, University of Delhi, New Delhi, India
| | - Yogesh K. Arya
- Department of Psychology, Faculty of Social Sciences, Banaras Hindu University, Varanasi, India
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Boldrini T, Schiano Lomoriello A, Del Corno F, Lingiardi V, Salcuni S. Psychotherapy During COVID-19: How the Clinical Practice of Italian Psychotherapists Changed During the Pandemic. Front Psychol 2020; 11:591170. [PMID: 33192932 PMCID: PMC7641613 DOI: 10.3389/fpsyg.2020.591170] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 09/16/2020] [Indexed: 12/17/2022] Open
Abstract
Aims: Italy was one of the first countries to be significantly affected by the coronavirus disease 2019 (COVID-19) pandemic, determining a unique scenario for Italian psychotherapists to consider changing the modality in which they deliver treatment. The present study aimed at studying which factors related to psychotherapists and their clinical practice had a major role in predicting two main outcomes: (1) the rate of interrupted treatments during lockdown and (2) psychotherapists' satisfaction with the telepsychotherapy modality. Methods: An online survey was administered to licensed psychotherapists (n = 306), who worked mainly as private practitioners, between April 5 and May 10, 2020 (i.e., the peak of the pandemic in Italy). Results: Psychotherapists reported that 42.1% (SD = 28.9) of their treatments had been interrupted, suggesting that Italy faced an important undersupply of psychotherapy during the lockdown. Using the Akaike information criterion (AIC) model selection, we identified three predictors of the rate of interrupted treatments: (1) psychotherapists' lack of experience with telepsychotherapy prior to the lockdown, (2) their theoretical orientation (with cognitive behavioral psychotherapists reporting a higher rate of interrupted treatments), and (3) patients' lack of privacy at home, as reported to the psychotherapists. Furthermore, we found four predictors of psychotherapists' satisfaction with the telepsychotherapy modality: (1) the rate of interrupted treatments, (2) psychotherapists' previous experience with telepsychotherapy, (3) their beliefs about the compatibility of telepsychotherapy with their theoretical orientation, and (4) their use of a video-conferencing modality, rather than telephone. Conclusion: The following recommendations can help policy makers, professional associations, and practitioners in promoting the continuity of psychotherapy treatments during the COVID-19 outbreak and in future emergencies: (i) disseminating training programs for practitioners on telepsychotherapy, (ii) supporting patients to pragmatically access a private space at home, (iii) encouraging practitioners to use video-conferencing (instead of telephone) to deliver remote therapy, and (iv) increasing the acceptance of telepsychotherapy among both clinicians and the general public.
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Affiliation(s)
- Tommaso Boldrini
- Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy
| | - Arianna Schiano Lomoriello
- Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy
- Department of Cognitive System, Denmark Technical University (DTU), Copenhagen, Denmark
| | - Franco Del Corno
- Association for Research in Clinical Psychology (ARP), Milan, Italy
| | - Vittorio Lingiardi
- Department of Dynamic and Clinic Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Silvia Salcuni
- Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy
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