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Sharma M, Alemayehu M, Girma E, Milkias B, Stevenson A, Gelaye B, Koenen KC, Teferra S. The cumulative impact of trauma, chronic illness, and COVID-19 stress on mental health in a case-control study of adults with psychotic disorders in Ethiopia. Compr Psychiatry 2024; 134:152508. [PMID: 38917710 DOI: 10.1016/j.comppsych.2024.152508] [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: 12/31/2023] [Revised: 05/25/2024] [Accepted: 06/11/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has profoundly impacted the economic, psychological, and social well-being of people in Ethiopia. Pandemic-related fears can exacerbate anxiety and depression symptoms among those with pre-existing physical and mental health conditions as well as those with prior exposure to traumatic events. METHODS We used data from the Ethiopia NeuroGAP-Psychosis study (898 cases and 941 controls with and without a diagnosis of psychosis respectively, 66% male, mean age = 37 years). Data was collected between November 2021 and June 2022 during the COVID-19 pandemic from four hospitals in Ethiopia (three in Addis Ababa and one in Jimma city). Structural equation modeling analysis was conducted to examine the associations between trauma exposure, physical health conditions (like arthristis, neurological disorders, diabetes), COVID-19 stress, and psychological distress (depression and anxiety symptoms). We assessed direct and indirect effects for mediation, and conducted multigroup analysis to examine moderation by case control status. RESULTS We found evidence that the impact of greater trauma exposure and physical health conditions on higher psychological distress was mediated through higher COVID-19 stress. Sociodemographic characteristics (older age and being maried) were associated with higher psychological distress, with these associations mediated through greater trauma, physical health conditions, and COVID-19 stress. Case-control status also moderated the associations between these variables, with the mediation effects being stronger in cases and weaker in controls. Further, cases reported greater trauma and psychological distress, while controls reported more physical health conditions and COVID-19 stress. IMPLICATIONS Our findings uniquely assess the interaction of health and emergency related factors in understudied settings like Ethiopia. They underscore the importance of including daily hardships and environmental stressors, along with prior trauma exposure, as risk factors for the assessment of mental health symptoms. This study has key implications for mental health screening and intervention research in response to complex emergency contexts like Ethiopia with a history of armed conflict in addition to the COVID-19 pandemic. Our findings can aid the development of targeted services that address the mental health of at-risk groups with pre-existing mental and physical health conditions.
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Affiliation(s)
- Manasi Sharma
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Melkam Alemayehu
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Engida Girma
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Barkot Milkias
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Anne Stevenson
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Stanley Center for Psychiatric Research at Broad Institute of MIT and Harvard, Cambridge, MA, USA; Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Bizu Gelaye
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Stanley Center for Psychiatric Research at Broad Institute of MIT and Harvard, Cambridge, MA, USA; Department of Psychiatry, Harvard Medical School and The Chester M. Pierce MD, Division of Global Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Karestan C Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Stanley Center for Psychiatric Research at Broad Institute of MIT and Harvard, Cambridge, MA, USA; Psychiatric & Neurodevelopmental Genetics Unit, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Solomon Teferra
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Lecomte T, Heyden I, Raffard S, Khazaal Y, Livet A, Power P, Roy MA, Abdel-Baki A, Corbière M. Validation francophone de la CASIG-rev – un outil clinique visant à soutenir le rétablissement des personnes avec un trouble psychiatrique: French validation of the CASIG-rev – a clinical personal recovery assessment for people with psychiatric disorders. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2024:7067437241261481. [PMID: 39033429 DOI: 10.1177/07067437241261481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/23/2024]
Abstract
OBJECTIVE There are few tools capable of measuring the personal recovery of individuals presenting with mental disorders that take into account the various dimensions of recovery. Personal recovery encompasses several objectives at the level of autonomy, positive interpersonal relationships, mental and physical health, self-acceptance, the school/professional domain, as well as developing a life project. A team of practitioners and researchers from four countries (Canada, Belgium, France, and Switzerland) adapted the Client Assessment of Strengths, Interests, and Goals (CASIG) tool to more accurately measure these different aspects of personal recovery. This study aims to validate the revised version of CASIG (CASIG-rev) in French, in terms of construct validity, test-retest reliability, convergent validity, and clinical sensitivity to change. METHOD A total of 272 individuals were recruited across different French-speaking countries to respond to the CASIG-rev online, as well as Ryff's well-being measure, the Recovery Assessment Scale, and the WHODAS. A subgroup of 29 individuals responded again to the CASIG-rev after 1 month (for temporal stability), and 24 again at six months (for sensitivity to change). RESULTS The confirmatory factor analysis suggests a 5-factor model, very similar to the initially proposed model of 6 factors. Convergent validity was demonstrated between the subscales of tools measuring similar concepts, and test-retest reliability was proven for the majority of scales. The CASIG-rev also appears to be sensitive to clinical or rehabilitation changes, notably at the level of the life project. CONCLUSION This study supports the use of the CASIG-rev in French to measure the recovery of individuals presenting with mental disorders, as well as to support practitioners in the evaluation of their programs and interventions. Limitations, as well as the tool's relevance, are presented. An English validation is underway to make the CASIG-rev available in Anglo-Saxon countries.
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Affiliation(s)
- Tania Lecomte
- Département de Psychologie, Université de Montréal, Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montréal, Canada
| | - Isabelle Heyden
- Centre de Rééducation Socioprofessionnelle de L'Est (CRSE), Verviers, Belgique
| | - Stéphane Raffard
- Département de Psychologie Clinique et Neuropsychologie, Université Paul Valéry Montpellier 2, Montpellier, France
| | - Yasser Khazaal
- Centre Hospitalier Universitaire Vaudois (CHUV), Université de Lausanne, Suisse
| | - Audrey Livet
- Center hospitalier de l'Universite de Montréal (CHUM), Montréal, Canada
| | - Paméla Power
- Département de Psychologie, Université de Montréal, Montréal, Canada
| | - Marc-André Roy
- Clinique Notre-Dame-des-Victoires, Département de psychiatrie et neurosciences, Université Laval, Québec, Canada
| | - Amal Abdel-Baki
- Center hospitalier de l'Universite de Montréal (CHUM), Montréal, Canada
| | - Marc Corbière
- Département d'éducation et pédagogie, counseling de carrière, Université du Québec à Montréal (UQAM), Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal (CR-IUSMM), Montréal, Canada
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Kwon S. Preexisting Mental Disorders and Mental Distress During the Pandemic: The Roles of Stress, Risk Perception, and Loneliness. RESEARCH SQUARE 2024:rs.3.rs-4595482. [PMID: 39070631 PMCID: PMC11276009 DOI: 10.21203/rs.3.rs-4595482/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
Purpose The COVID-19 pandemic has imposed unprecedented stressors on individuals globally, leading to significant mental health challenges. This study examines the relationship between perceived adversities experienced during the pandemic-such as stress, risk perception, and loneliness-and the mental health outcomes of individuals with a specific focus on those already grappling with mental disorders. Methods The study analyzed data from 8,259 adults who participated in surveys between waves 4 (April 2020) and 29 (June 2021) of the Understanding American Study. Participants self-reported their psychiatric diagnosis history and completed self-report measures of mental distress (PHQ-4), perceived stress, risk perception, and loneliness. Results Those with preexisting comorbid mental disorders reported higher levels of mental distress, COVID-19 risk perception, perceived stress as well as more days experiencing loneliness during the pandemic. Perceived adversities-stress, risk perception, and loneliness-were all positively associated with increased mental distress, indicating the risk factors for mental distress during the pandemic. Among these factors, loneliness was identified as the primary contributor, accounting for 30%-40% of the mental health gap between individuals with and without preexisting mental diagnoses. Also, the detrimental impact of these adversities was more pronounced for those with preexisting mental disorders. Conclusion The research highlights that those with preexisting mental disorders, particularly those with comorbidities, face an increased risk of experiencing mental distress during the COVID-19 pandemic. These findings underscore the critical importance of providing targeted support and interventions specifically designed for this vulnerable population, with a particular focus on addressing loneliness.
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Caple V, Maude P, Walter R, Ross A. An exploration of loneliness experienced by people living with mental illness and the impact on their recovery journey: An integrative review. J Psychiatr Ment Health Nurs 2023; 30:1170-1191. [PMID: 37382063 DOI: 10.1111/jpm.12945] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 05/15/2023] [Accepted: 06/08/2023] [Indexed: 06/30/2023]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: There is evidence that social isolation and loneliness is more prevalent in people living with mental illness than in the general population. People living with mental illness frequently experience stigma, discrimination, rejection, repeated psychiatric admissions, low self-esteem, low self-efficacy, and increased symptoms of paranoia, depression, and anxiety. There is evidence of common interventions that can be used to improve loneliness and social isolation such as psychosocial skills training and cognitive group therapy. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This paper offers a comprehensive assessment of the evidence between mental illness, loneliness, and recovery. The results suggest that people living with mental illness experience elevated levels of social isolation and loneliness leading to poor recovery and quality of life. Social deprivation, social integration and romantic loneliness are related to loneliness, poor recovery, and reduced quality of life. A sense of belonging, ability to trust and hope are important aspects of improved loneliness, quality of life and recovery. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The existing culture in mental health nursing practice needs to be examined to address loneliness in people living with mental illness and its impact on recovery. Existing tools to research loneliness do not consider dimensions in loneliness experience as reflected in the literature. Practice needs to demonstrate an integrated approach to recovery, optimal service delivery and augmentation of evidence-based clinical practice to improve individual's loneliness, social circumstances, and relationships. Practice needs to demonstrate nursing knowledge in caring for people living with mental illness experiencing loneliness. Further longitudinal research is required to clearly understand the relationship between loneliness, mental illness, and recovery. ABSTRACT INTRODUCTION: To our knowledge, there are no previous reviews on the impact of loneliness experienced by people aged 18-65, who are living with mental illness and their recovery experience. AIM/QUESTION To explore the experience and impact of loneliness in people living with mental illness during recovery. METHOD An integrative review. RESULTS A total of 17 papers met the inclusion criteria. The search was conducted using four electronic databases: MEDLINE, CINAHL, Scopus and PsycINFO. Across these 17 papers, participants were most commonly, diagnosed with schizophrenia or psychotic disorders and recruited from community mental health services. DISCUSSION The review revealed loneliness to be substantial in people living with mental illness and that loneliness affected their recovery, and their quality of life. The review identified many factors that contribute to loneliness including unemployment, financial strain, social deprivation, group housing, internalized stigma and mental illness symptoms. Individual factors such as social/community integration and social network size as well as an inability to trust, a sense of not belonging, hopelessness and lack of romance were also evident. Interventions targeting social functioning skills and social connectedness were found to improve social isolation and loneliness. IMPLICATIONS FOR PRACTICE It is vital for mental health nursing practice to employ an approach integrating physical health as well as social recovery needs, optimal service delivery and augmentation of evidence-based clinical practice to improve loneliness, recovery, and quality of life.
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Affiliation(s)
- Vanessa Caple
- School of Nursing and Midwifery, La Trobe. University, Bundoora, Victoria, Australia
| | - Phil Maude
- Violet Vines Marshman Centre for Rural Health Research, La Trobe Rural Health School, Latrobe University, Bendigo, Victoria, Australia
| | - Ruby Walter
- School of Health and Biomedical Sciences Nursing, RMIT University, Bundoora, Victoria, Australia
| | - Alistair Ross
- La Trobe Rural Health School, Latrobe University, Bendigo, Victoria, Australia
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Seierstad A, Schjøtt-Pedersen O, Evensen S, Evensen JH, Gjerstad CL, Sørgård KM, Varga M, Lystad JU. COPSYC-19: The impact of early phase lockdown on mental health among people with psychotic disorders. Schizophr Res 2023; 261:178-184. [PMID: 37778125 DOI: 10.1016/j.schres.2023.09.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 05/15/2023] [Accepted: 09/24/2023] [Indexed: 10/03/2023]
Abstract
PURPOSE On March 12th 2020 extensive measures were implemented to prevent spread of the coronavirus disease-19 (COVID-19). These measures were commonly referred to as "lockdown". In this study we investigate the psychological impact associated with living under these circumstances among patients with psychotic disorders receiving care from specialized mental health services in Norway. METHOD During early phases of lockdown, patients and clinicians receiving and providing mental health care for psychotic disorders in specialized health services at Oslo University Hospital were asked to fill out questionnaires developed for the study. 129 participants from outpatient clinics (91 patients and 38 clinicians) and 89 from inpatient wards (15 patients and 74 clinicians) were recruited. Data regarding mental health and related symptoms were analysed using Wilcoxon signed rank tests and standard multiple regression. RESULTS Outpatients reported significantly less extensive worrying, loneliness and hallucinatory experiences during early phase lockdown compared to the two weeks prior. Reductions in loneliness were predictive of experienced improvement in subjective mental health. However, the majority of clinicians from outpatient clinics believed their patients were experiencing more worrying and loneliness. CONCLUSION The result of this study suggests that many patients with psychosis experienced less loneliness, excessive worrying and hallucinations during the first phase of lockdown. This contrasts the clinicians' perceptions, as the patients show signs of resilience during times of uncertainty. The limitation in the study timeframe should be noted.
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Affiliation(s)
- Andreas Seierstad
- Oslo University Hospital, Division of Mental Health and Addiction, Norway.
| | - Olivia Schjøtt-Pedersen
- Oslo University Hospital, Division of Mental Health and Addiction, Norway; University of Oslo, Institute of Clinical Medicine, Norway
| | - Stig Evensen
- Oslo University Hospital, Division of Mental Health and Addiction, Norway
| | | | - Christer Lunde Gjerstad
- Oslo University Hospital, Division of Mental Health and Addiction, Norway; University of Oslo, Institute of Clinical Medicine, Norway; Norwegian Armed Forces Joint Medical Services, Institute of Military Psychiatry, Norway
| | - Kari Mette Sørgård
- Oslo University Hospital, Division of Mental Health and Addiction, Norway
| | - Monica Varga
- Oslo University Hospital, Division of Mental Health and Addiction, Norway
| | - June Ullevoldsæter Lystad
- Oslo University Hospital, Division of Mental Health and Addiction, Norway; University of Oslo, Department of Psychology, Norway
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Goh KW, Ishikawa S, Okubo R, Kusumi I, Tabuchi T. Are patients with mental disorders more vulnerable to loneliness and social isolation during the COVID-19 pandemic? - Findings from the Japan COVID-19 and Society Internet Survey. J Affect Disord 2023; 340:72-79. [PMID: 37556872 DOI: 10.1016/j.jad.2023.08.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 07/25/2023] [Accepted: 08/04/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND Loneliness and social isolation are well-known factors that worsen the symptoms among patients with mental disorders. Few previous studies have explored loneliness and social isolation among populations with mental disorders during the coronavirus disease 2019 (COVID-19) pandemic. Therefore, our study examined the mental health impact of the pandemic on these population groups in terms of loneliness and social isolation. METHODS We used data from the Japan COVID-19 and Society Internet Surveys, a large-scale online survey. Using multivariable logistic regression analysis, we calculated the odds ratios and 95 % confidence intervals (CIs) of moderate-to-severe loneliness and high social isolation for major chronic diseases, including mental disorders, after adjusting for potential confounders. Calculations were performed for each type of mental disorder. Finally, calculations were performed to explore the association between moderate-to-severe loneliness or high social isolation and psychiatric symptoms among patients with mental disorders. RESULTS Of the 28,175 participants, 2021 (7.2 %) had a mental disorder. Mental disorders, especially depression and anxiety disorders, were found to be associated with a higher risk of moderate-to-severe loneliness and high social isolation. Patients with mental disorders who experienced moderate-to-severe loneliness and high social isolation were found to have exacerbated psychiatric symptoms. LIMITATION Our findings were obtained from a cross-sectional study design. CONCLUSIONS Patients with mental disorders were more vulnerable to moderate-to-severe loneliness and high social isolation during the pandemic, which contributed to the exacerbation of their symptoms. Depression and anxiety, in particular, were most likely to occur and required special attention.
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Affiliation(s)
| | - Shuhei Ishikawa
- Department of Psychiatry, Hokkaido University Hospital, Sapporo, Japan.
| | - Ryo Okubo
- Department of Psychiatry and Neurology, National Hospital Organization Obihiro Hospital, Obihiro, Japan
| | - Ichiro Kusumi
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
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Tamaian R, Porozov Y, Shityakov S. Exhaustive in silico design and screening of novel antipsychotic compounds with improved pharmacodynamics and blood-brain barrier permeation properties. J Biomol Struct Dyn 2023; 41:14849-14870. [PMID: 36927517 DOI: 10.1080/07391102.2023.2184179] [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: 09/15/2022] [Accepted: 02/18/2023] [Indexed: 03/18/2023]
Abstract
Antipsychotic drugs or neuroleptics are widely used in the treatment of psychosis as a manifestation of schizophrenia and bipolar disorder. However, their effectiveness largely depends on the blood-brain barrier (BBB) permeation (pharmacokinetics) and drug-receptor pharmacodynamics. Therefore, in this study, we developed and implemented the in silico pipeline to design novel compounds (n = 260) as leads using the standard drug scaffolds with improved PK/PD properties from the standard scaffolds. As a result, the best candidates (n = 3) were evaluated in molecular docking to interact with serotonin and dopamine receptors. Finally, haloperidol (HAL) derivative (1-(4-fluorophenyl)-4-(4-hydroxy-4-{4-[(2-phenyl-1,3-thiazol-4-yl)methyl]phenyl}piperidin-1-yl)butan-1-one) was identified as a "magic shotgun" lead compound with better affinity to the 5-HT2A, 5-HT1D, D2, D3, and 5-HT1B receptors than the control molecule. Additionally, this hit substance was predicted to possess similar BBB permeation properties and much lower toxicological profiles in comparison to HAL. Overall, the proposed rational drug design platform for novel antipsychotic drugs based on the BBB permeation and receptor binding might be an invaluable asset for a medicinal chemist or translational pharmacologist.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Radu Tamaian
- ICSI Analytics, National Research and Development Institute for Cryogenics and Isotopic Technologies - ICSI Rm. Vâlcea, Râmnicu Vâlcea, Romania
| | - Yuri Porozov
- Center of Bio- and Chemoinformatics, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Sergey Shityakov
- Laboratory of Chemoinformatics, Infochemistry Scientific Center, ITMO University, Saint-Petersburg, Russia
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Wicks CL, Barton JL, Andrews L, Orbell S, Sandercock G, Wood CJ. The Impact of the Coronavirus Pandemic on the Contribution of Local Green Space and Nature Connection to Mental Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5083. [PMID: 36981991 PMCID: PMC10049389 DOI: 10.3390/ijerph20065083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/08/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Exposure to green space and feeling connected to the natural environment have independently been associated with improved mental health outcomes. During the coronavirus pandemic, people experienced restrictions on access to the outdoors, and health data indicated a decline in mental health in the UK general population. METHODS Data available from two independent surveys conducted prior to and during the pandemic enabled a naturally occurring comparison of mental health and its correlates prior to and during the pandemic. RESULTS Survey responses from 877 UK residents were included in the analyses. Independent t-tests revealed significant declines in mental health scores during the pandemic. After controlling for age and gender, greater nature connection significantly predicted lower depression and stress and improved well-being. Percentage of green space did not significantly predict any mental health outcomes. Further, time point (pre- or during COVID) and the interaction of time point with green space and nature connection did not significantly predict any of the outcome measures. The findings indicate that nature connection may play an important role in promoting mental health. Strategies to improve mental health and reduce mental illness should consider the role of nature connection and the use of interventions that involve direct interaction with natural environments.
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Affiliation(s)
- Claire L. Wicks
- School of Health and Social Care, University of Essex, Colchester CO4 3SQ, UK
| | - Jo L. Barton
- School of Sport, Rehabilitation and Exercise Science, University of Essex, Colchester CO4 3SQ, UK
| | - Leanne Andrews
- School of Health and Social Care, University of Essex, Colchester CO4 3SQ, UK
| | - Sheina Orbell
- Department of Psychology, University of Essex, Colchester CO4 3SQ, UK
| | - Gavin Sandercock
- School of Sport, Rehabilitation and Exercise Science, University of Essex, Colchester CO4 3SQ, UK
| | - Carly J. Wood
- School of Sport, Rehabilitation and Exercise Science, University of Essex, Colchester CO4 3SQ, UK
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Lederman Z. Loneliness-a clinical primer. Br Med Bull 2023; 145:132-140. [PMID: 36752026 DOI: 10.1093/bmb/ldad003] [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: 09/19/2022] [Revised: 01/14/2023] [Accepted: 01/21/2023] [Indexed: 02/09/2023]
Abstract
INTRODUCTION loneliness is prevalent worldwide. It is also associated with an increased risk for depression, high blood pressure, cardiovascular disease, stroke and early death. As such, loneliness is a major public health issue. This paper summarizes the salient points clinicians should know and encourages clinicians to assume an active part in the identification, mitigation and prevention of loneliness. SOURCES OF DATA white papers, academic publications. AREAS OF AGREEMENT loneliness is a distressful subjective experience, which does not always correlate with social isolation. Both internal (personal) and external (contextual, societal) factors determine whether an individual would feel lonely in a given situation. AREAS OF CONTROVERSY identifying loneliness in the clinic may be time consuming and challenging. There is a scarce robust evidence to support interventions. GROWING POINTS due to increased individualization and incidence of infectious diseases, loneliness is likely to become even more prevalent. AREAS TIMELY FOR DEVELOPING RESEARCH more research is needed to further elucidate the health impacts of loneliness as well as to find evidence-based interventions to prevent and mitigate loneliness that could then be implemented by policy-makers and clinicians.
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Affiliation(s)
- Zohar Lederman
- Medical Ethics and Hum anities Unit, Hong Kong University, Hong Kong.,Centre for Medical Ethics and Law, Hong Kong University, Hong Kong.,International Center of Health, Law, and Ethics, University of Haifa, Israel
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Newbronner E, Walker L, Wadman R, Crosland S, Johnston G, Heron P, Spanakis P, Gilbody S, Peckham E. Influences on the physical and mental health of people with serious mental ill-health during the COVID-19 pandemic: a qualitative interview study. Int J Qual Stud Health Well-being 2022; 17:2122135. [PMID: 36073745 PMCID: PMC9467576 DOI: 10.1080/17482631.2022.2122135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 08/15/2022] [Accepted: 09/04/2022] [Indexed: 11/30/2022] Open
Abstract
PURPOSE People with severe mental ill-health (SMI) experience profound health inequalities. The Optimizing Wellbeing in Self-isolation study (OWLS) explored the effects of the COVID-19 pandemic restrictions on people with SMI, including how and why their physical and mental health may have changed during the pandemic. METHODS The OLWS study comprised two surveys and two nested qualitative studies. Of 367 people recruited to the study, 235 expressed interest in taking part in a qualitative interview. In the first qualitative study eighteen interviews were conducted with a purposive sample of participants. RESULTS We identified six factors which influenced peoples' health, positively and negatively: Staying Physically Active; Maintaining a Balanced and Healthy Diet; Work or Not Working; Daily Routine and Good Sleep; Staying Connected to Family, Friends and the Local Community; and Habits, Addictions and Coping with Anxiety Created by the Pandemic. CONCLUSIONS Different aspects of lifestyle are highly interconnected. For people with SMI, loss of routine and good sleep, poor diet and lack of exercise can compound each other, leading to a decline in physical and mental health. If people are supported to understand what helps them stay well, they can establish their own frameworks to draw on during difficult times.
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Affiliation(s)
- Elizabeth Newbronner
- Mental Health and Addiction Research Group, Department of Health Sciences, University of York, York, UK
| | - Lauren Walker
- Mental Health and Addiction Research Group, Department of Health Sciences, University of York, York, UK
| | - Ruth Wadman
- Mental Health and Addiction Research Group, Department of Health Sciences, University of York, York, UK
| | - Suzanne Crosland
- Mental Health and Addiction Research Group, Department of Health Sciences, University of York, York, UK
| | | | - Paul Heron
- Mental Health and Addiction Research Group, Department of Health Sciences, University of York, York, UK
| | - Panagiotis Spanakis
- Mental Health and Addiction Research Group, Department of Health Sciences, University of York, York, UK
| | - Simon Gilbody
- Mental Health and Addiction Research Group, Department of Health Sciences, University of York, York, UK
| | - Emily Peckham
- Mental Health and Addiction Research Group, Department of Health Sciences, University of York, York, UK
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Stuck Inside: How Social Functioning in Schizophrenia Changed During the COVID-19 Pandemic. J Nerv Ment Dis 2022; 210:915-924. [PMID: 35703234 PMCID: PMC9712495 DOI: 10.1097/nmd.0000000000001558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Social distancing policies enacted during the COVID-19 pandemic altered our social interactions. People with schizophrenia, who already exhibit social deficits, may have been disproportionally impacted. In this pilot study, we a) compared prepandemic social functioning to functioning during the pandemic in people with schizophrenia ( n = 21) who had data at both time points; and b) examined if patterns of decline in schizophrenia differed from healthy controls ( n = 21) across a series of repeated-measures analyses of variance. We observed larger declines in social functioning in schizophrenia (η 2 = 0.07, medium effect size) during the pandemic compared with the control group. Between-group declines did not extend to other domains, suggesting that declines are specific to social functioning. Our findings signal that treatments focusing on reconnecting people with schizophrenia to their social networks should be prioritized. Future studies should continue tracking social functioning after the pandemic to illustrate patterns of recovery.
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Mueller-Stierlin AS, Meixner F, Lehle J, Kohlmann A, Schumacher M, Woehler S, Haensel A, Reuter S, Herder K, Bias N, Becker T, Kilian R. Perceived empowerment and the impact of negative effects of the COVID-19 pandemic on the quality of life of persons with severe mental illness. PLoS One 2022; 17:e0276123. [PMID: 36264893 PMCID: PMC9584414 DOI: 10.1371/journal.pone.0276123] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 09/27/2022] [Indexed: 11/07/2022] Open
Abstract
Purpose Beyond its direct effects on physical health the COVID-19 pandemic has been shown to have negative effects on the living situation of people with severe mental illness (SMI). To date, there has been little research on resilience factors preventing people with SMI from experiencing negative effects of the COVID-19 pandemic. The objective of this study was to investigate the role of perceived empowerment (PE) as a resilience factor, preventing people with SMI from experiencing negative effects of the COVID-19 pandemic on daily living. Methods We investigated negative effects of the COVID-19 pandemic on daily living in 931 persons with SMI at two times within six month between June 2020 and Mai 2021. To take into account the longitudinal structure of the data we applied mixed effects regression analyses and longitudinal path models. Results A majority of participants experienced negative effects of the COVID-19 pandemic on several dimensions of daily living. Negative effects increased with rising levels of illness-related impairment but decreased as the level of PE rose. While negative effects of the COVID-19 pandemic at follow-up were negatively associated with overall subjective quality of life baseline, PE was negatively associated with the negative impact of the pandemic and positively with quality of life. Conclusion Patients with SMI need support to reduce negative effects of the COVID-19 pandemic on their quality of life. The promotion of PE could help strengthen resilience in this target group. Trial registration German Clinical Trial Register, DRKS00019086, registered on 3 January 2020. (https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00019086).
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Affiliation(s)
- Annabel Sandra Mueller-Stierlin
- Department of Psychiatry II, Ulm University, Günzburg, Germany
- Department of General Practice and Primary Care, Ulm University, Ulm, Germany
- * E-mail:
| | | | - Jutta Lehle
- Department of Psychiatry II, Ulm University, Günzburg, Germany
| | - Anne Kohlmann
- Department of Psychiatry II, Ulm University, Günzburg, Germany
| | - Mara Schumacher
- Department of Psychiatry II, Ulm University, Günzburg, Germany
| | | | - Anke Haensel
- Department of Psychiatry II, Ulm University, Günzburg, Germany
| | - Sabrina Reuter
- Department of Psychiatry II, Ulm University, Günzburg, Germany
| | - Katrin Herder
- Department of Psychiatry II, Ulm University, Günzburg, Germany
| | - Nicole Bias
- Department of Psychiatry II, Ulm University, Günzburg, Germany
| | - Thomas Becker
- Department of Psychiatry, University of Leipzig, Leipzig, Germany
| | - Reinhold Kilian
- Department of Psychiatry II, Ulm University, Günzburg, Germany
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Dost K, Heinrich F, Graf W, Brennecke A, Kowalski V, Leider A, Kraus A, van Rüth V, Ondruschka B, Püschel K, König HH, Bertram F, Hajek A. Predictors of Loneliness among Homeless Individuals in Germany during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12718. [PMID: 36232018 PMCID: PMC9566392 DOI: 10.3390/ijerph191912718] [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] [Received: 07/29/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
PURPOSE The aim of the study was to identify the frequency of loneliness and to examine the factors associated with loneliness among homeless individuals in Germany during the COVID-19 pandemic. METHODS Data were taken from the 'national survey on the psychiatric and somatic health of homeless individuals during the COVID-19 pandemic'. The data collection took place from 26th July to 17th September 2021 (the analytical sample included n = 491 observations). The well-established UCLA-3 tool was used to quantify loneliness. Independent variables included sex, age, marital status, the existence of children and pets, level of education, country of origin, duration of homelessness, alcohol and drug consumption, mental health concerns and concerns regarding COVID-19 illness. Multiple logistic regressions were used to examine the predictors of loneliness. RESULTS The frequency of loneliness was 41.7% for the total sample. Multiple logistic regression analysis stratified by gender showed that a higher likelihood of loneliness was associated with being born in Germany, being middle aged (40 to 49 years compared to 18 to 29 years), having mental health problems and a short period of homelessness (1 month compared to longer periods) among women. In men, a higher likelihood of loneliness was associated with a higher fear of COVID-19 and a short period of homelessness. CONCLUSIONS Our study revealed a high frequency rate of loneliness among homeless individuals. The study results highlight the associations between some explanatory variables (i.e., the duration of homelessness and mental health problems). Identifying the factors associated with loneliness may help to adequately address the problems of homeless individuals at risk of loneliness. Longitudinal studies are required to confirm our findings.
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Affiliation(s)
- Katharina Dost
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, 22529 Hamburg, Germany
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Fabian Heinrich
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, 22529 Hamburg, Germany
| | - Wiebke Graf
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, 22529 Hamburg, Germany
| | - Anna Brennecke
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, 22529 Hamburg, Germany
| | - Veronika Kowalski
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, 22529 Hamburg, Germany
| | - Anna Leider
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, 22529 Hamburg, Germany
| | - Anika Kraus
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, 22529 Hamburg, Germany
| | - Victoria van Rüth
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, 22529 Hamburg, Germany
| | - Benjamin Ondruschka
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, 22529 Hamburg, Germany
| | - Klaus Püschel
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, 22529 Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Franziska Bertram
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, 22529 Hamburg, Germany
| | - André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
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Wittlund S, Butenko D, Brandseth OL, Brinchmann B, Killackey E, McDaid D, Rinaldi M, Mykletun A. Impact of Covid-19 Restrictions on Individual Placement and Support Service Delivery in Northern Norway. JOURNAL OF PSYCHOSOCIAL REHABILITATION AND MENTAL HEALTH 2022; 10:203-213. [PMID: 36159447 PMCID: PMC9483489 DOI: 10.1007/s40737-022-00304-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 08/22/2022] [Indexed: 11/29/2022]
Abstract
Individual Placement and Support (IPS) is an evidence-based supported employment program that helps people with severe mental illness to achieve steady, meaningful employment in competitive mainstream jobs. The purpose of this study is to investigate the impact of Covid-19 restrictions on IPS service delivery in Northern Norway between March and October 2020. In Norway, IPS is in the early stages of full-scale implementation and is therefore potentially sensitive to external stressors such as the Covid-19 pandemic. In October 2020 we conducted a retrospective, cross-sectional survey with IPS employment specialists in Northern Norway (n = 25). The purpose was to collect information about how Covid-19 restrictions between March and October 2020 impacted their ability to deliver IPS services. As a result of Covid-19 restrictions, more than half the employment specialists were reassigned to other roles or non-IPS related work tasks. They also reported less collaborative engagement with clinical teams and employers. 69 (20.4%) of IPS users supported by employment specialists gained employment after the Covid-19 restrictions were introduced and 82.8% of unemployed IPS users continued to seek competitive employment despite Covid-19 restrictions. Covid-19 restrictions appear to have created obstacles for IPS service delivery in Northern Norway and have negatively impacted the employment specialists' collaborative engagement with clinical teams. However, IPS employment specialists have shown strong capabilities in overcoming these challenges and services users have remained motivated to seek employment during the pandemic.
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Affiliation(s)
- Sina Wittlund
- Centre for Work and Mental Health, Nordland Hospital Trust, Bodø, Norway
- Department of Community Medicine, UiT – The Arctic University of Norway, Tromsø, Norway
| | - Daniil Butenko
- Centre for Work and Mental Health, Nordland Hospital Trust, Bodø, Norway
- Department of Clinical Medicine, The University of Bergen, Bergen, Norway
- Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway
| | | | - Beate Brinchmann
- Centre for Work and Mental Health, Nordland Hospital Trust, Bodø, Norway
- Department of Community Medicine, UiT – The Arctic University of Norway, Tromsø, Norway
| | - Eóin Killackey
- Orygen, Melbourne, Australia Centre for Youth Mental Health, Melbourne, Australia
- The University of Melbourne, Melbourne, Australia
| | - David McDaid
- Department of Health Policy, Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Miles Rinaldi
- Centre for Work and Mental Health, Nordland Hospital Trust, Bodø, Norway
- Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway
- South West London and St George’s Mental Health NHS Trust, London, UK
| | - Arnstein Mykletun
- Centre for Work and Mental Health, Nordland Hospital Trust, Bodø, Norway
- Department of Community Medicine, UiT – The Arctic University of Norway, Tromsø, Norway
- Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway
- Division for Health Sciences, Norwegian Institute of Public Health, Oslo, Norway
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Patulny R, Bower M. Beware the "loneliness gap"? Examining emerging inequalities and long-term risks of loneliness and isolation emerging from COVID-19. THE AUSTRALIAN JOURNAL OF SOCIAL ISSUES 2022; 57:562-583. [PMID: 35942301 PMCID: PMC9349775 DOI: 10.1002/ajs4.223] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/22/2022] [Accepted: 05/23/2022] [Indexed: 06/15/2023]
Abstract
Emerging evidence suggests COVID lockdowns have not only increased the social problem of loneliness but widened the 'loneliness gap' between the most and least lonely people. Qualitative investigation can reveal why this gap might have increased, for whom, and whether the loneliness gap will remain long term. Using multi-wave qualitative survey data conducted during Australia's 2020 lockdown period and beyond, we examine personal experiences of interaction transitioning out of lockdown. We find substantial and uneven impacts of COVID lasting well beyond lockdown. Participants reported heightened loneliness attributable to: physical isolation, health anxieties, ceased activities, reduced connection quality, and poor motivation. COVID also created new interactive difficulties for singles, those with physical and mental disabilities, their carers, and those with low social capital. There was also reported 'pruning' of social networks (i.e. reduced bridging, increased bonding social capital), and evidence that increased digital interaction did not substitute for lost physical contact. Younger people also experienced isolating COVID-induced life disruptions (e.g. travel, university attendance etc). Findings suggest COVID has increased potential long-term inequalities in loneliness, highlight the post COVID risks faced by vulnerable groups, and suggest caution in advocating digital solutions as a panacea for diminished physical interaction in the post-pandemic world.
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Affiliation(s)
- Roger Patulny
- Arts Social Science and HumanitiesUniversity of WollongongWollongongNew South WalesAustralia
| | - Marlee Bower
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
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Kølbæk P, Gil Y, Schmidt FCL, Speed M, Østergaard SD. Symptom severity and well-being of patients with mental illness during the COVID-19 pandemic: a two-wave survey. Nord J Psychiatry 2022; 77:293-303. [PMID: 35834531 DOI: 10.1080/08039488.2022.2099581] [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] [Indexed: 10/17/2022]
Abstract
PURPOSE OF THE ARTICLE To examine changes in symptom severity and well-being during the coronavirus disease 2019 (COVID-19) pandemic among individuals with pre-existing mental illness. MATERIALS AND METHODS In February 2021, we conducted a follow-up questionnaire-based survey among adults with mental illness, who responded to a similar survey on mental health in June 2020. The participants completed the 18-item Brief Symptom Inventory (BSI-18), the five-item World Health Organization Well-Being Index (WHO-5), and 14 questions evaluating worsening or improvement in mental health using the pre-pandemic period as reference. The survey data were merged with sociodemographic and clinical data from the medical records of all invitees to the first survey, enabling analysis of attrition and weighting of the results. RESULTS A total of 613 of 992 (62%) invitees participated in the follow-up wave of the survey. The weighted mean WHO-5 and BSI-18 scores were 38 and 27, respectively, and did not differ statistically significantly from the first wave. Multivariate logistic regression showed that having a vocational education (skilled worker/craftsman) was positively associated with reporting deterioration in psychological well-being (OR: 2.95, 95%CI: 1.14-7.81), while being unemployed was negatively associated with reporting deterioration in psychological well-being (OR: 0.20, 95%CI: 0.07-0.56) from the first to the second survey wave. The most common reason for self-reported deterioration in mental health was loneliness (70%). CONCLUSIONS Approximately one year into the COVID-19 pandemic, the level of symptoms remained high, whereas the level of psychological well-being remained low among patients with mental illness.
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Affiliation(s)
- Pernille Kølbæk
- Department of Affective Disorders, Aarhus University Hospital-Psychiatry, Aarhus, Denmark.,Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Yael Gil
- Department of Affective Disorders, Aarhus University Hospital-Psychiatry, Aarhus, Denmark
| | | | - Maria Speed
- Department of Affective Disorders, Aarhus University Hospital-Psychiatry, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Søren Dinesen Østergaard
- Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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