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Naik H, Tran KC, Staples JA, Perlis RH, Levin A. Psychiatric Symptoms, Treatment Uptake, and Barriers to Mental Health Care Among US Adults With Post-COVID-19 Condition. JAMA Netw Open 2024; 7:e248481. [PMID: 38662370 PMCID: PMC11046346 DOI: 10.1001/jamanetworkopen.2024.8481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 02/27/2024] [Indexed: 04/26/2024] Open
Abstract
Importance Psychiatric symptoms are reportedly common among adults with post-COVID-19 condition (PCC). However, nationally representative data regarding symptom prevalence, treatment uptake, and barriers to care are needed to inform the development of care models. Objectives To evaluate the prevalence of psychiatric symptoms in US adults with PCC compared with those without PCC and assess treatment uptake and cost-related barriers to treatment. Design, Setting, and Participants Data from the 2022 National Health Interview Survey (NHIS), a nationally representative US cross-sectional survey, were analyzed between October 2023 and February 2024. Exposure Current PCC, defined as new symptoms following SARS-CoV-2 infection lasting more than 3 months and ongoing at the time of interview. Main Outcomes and Measures Depression symptoms were evaluated by the Patient Health Questionnaire-8 and anxiety symptoms were assessed using the General Anxiety Disorder-7 instrument. Participants were classified as having received treatment if they received mental health counseling or therapy or medications for mental health. Sleep difficulties, cognitive difficulties, disabling fatigue, and cost-related barriers were assessed from additional NHIS questions. Results Of the 25 122 participants representing approximately 231 million US adults (median [IQR] age, 46 [32-61] years; 49.8% male and 50.2% female participants), a weighted prevalence (wPr) of 3.4% (95% CI, 3.1%-3.6%) had current PCC. Compared with other US adults, participants with current PCC were more likely to have depression symptoms (wPr, 16.8% vs 7.1%; adjusted odds ratio [AOR], 1.96; 95% CI, 1.51-2.55), anxiety symptoms (wPr, 16.7% vs 6.3%; AOR, 2.21; 95% CI, 1.53-3.19), sleep difficulties (wPr, 41.5% vs 22.7%; AOR 1.95; 95% CI, 1.65-2.29), cognitive difficulties (wPr, 35.0% vs 19.5%; AOR, 2.04; 95% CI, 1.66-2.50), and disabling fatigue (wPr, 4.0% vs 1.6%; AOR, 1.85; 95% CI, 1.20-2.86). Among participants who had depression or anxiety symptoms, those with PCC had a similar likelihood of not having received treatment (wPr, 28.2% vs 34.9%; AOR, 1.02; 95% CI, 0.66-1.57). However, participants with current PCC were more likely to report a cost-related barrier to accessing mental health counseling or therapy (wPr, 37.2% vs 23.3%; AOR, 2.05; 95% CI, 1.40-2.98). Conclusions and Relevance The findings of this study suggest that people with PCC have a higher prevalence of psychiatric symptoms than other adults but are more likely to experience cost-related barriers to accessing therapy. Care pathways for PCC should consider prioritizing mental health screening and affordable treatment.
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Affiliation(s)
- Hiten Naik
- Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Post–COVID-19 Interdisciplinary Clinical Care Network, Vancouver, British Columbia, Canada
| | - Karen C. Tran
- Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Post–COVID-19 Interdisciplinary Clinical Care Network, Vancouver, British Columbia, Canada
- Centre for Clinical Epidemiology & Evaluation, Vancouver, British Columbia, Canada
| | - John A. Staples
- Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Clinical Epidemiology & Evaluation, Vancouver, British Columbia, Canada
| | - Roy H. Perlis
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Adeera Levin
- Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Post–COVID-19 Interdisciplinary Clinical Care Network, Vancouver, British Columbia, Canada
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Jaywant A, Gunning FM, Oberlin LE, Santillana M, Ognyanova K, Druckman JN, Baum MA, Lazer D, Perlis RH. Cognitive Symptoms of Post-COVID-19 Condition and Daily Functioning. JAMA Netw Open 2024; 7:e2356098. [PMID: 38353947 PMCID: PMC10867690 DOI: 10.1001/jamanetworkopen.2023.56098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 12/20/2023] [Indexed: 02/16/2024] Open
Abstract
Importance The frequent occurrence of cognitive symptoms in post-COVID-19 condition has been described, but the nature of these symptoms and their demographic and functional factors are not well characterized in generalizable populations. Objective To investigate the prevalence of self-reported cognitive symptoms in post-COVID-19 condition, in comparison with individuals with prior acute SARS-CoV-2 infection who did not develop post-COVID-19 condition, and their association with other individual features, including depressive symptoms and functional status. Design, Setting, and Participants Two waves of a 50-state nonprobability population-based internet survey conducted between December 22, 2022, and May 5, 2023. Participants included survey respondents aged 18 years and older. Exposure Post-COVID-19 condition, defined as self-report of symptoms attributed to COVID-19 beyond 2 months after the initial month of illness. Main Outcomes and Measures Seven items from the Neuro-QoL cognition battery assessing the frequency of cognitive symptoms in the past week and patient Health Questionnaire-9. Results The 14 767 individuals reporting test-confirmed COVID-19 illness at least 2 months before the survey had a mean (SD) age of 44.6 (16.3) years; 568 (3.8%) were Asian, 1484 (10.0%) were Black, 1408 (9.5%) were Hispanic, and 10 811 (73.2%) were White. A total of 10 037 respondents (68.0%) were women and 4730 (32.0%) were men. Of the 1683 individuals reporting post-COVID-19 condition, 955 (56.7%) reported at least 1 cognitive symptom experienced daily, compared with 3552 of 13 084 (27.1%) of those who did not report post-COVID-19 condition. More daily cognitive symptoms were associated with a greater likelihood of reporting at least moderate interference with functioning (unadjusted odds ratio [OR], 1.31 [95% CI, 1.25-1.36]; adjusted [AOR], 1.30 [95% CI, 1.25-1.36]), lesser likelihood of full-time employment (unadjusted OR, 0.95 [95% CI, 0.91-0.99]; AOR, 0.92 [95% CI, 0.88-0.96]) and greater severity of depressive symptoms (unadjusted coefficient, 1.40 [95% CI, 1.29-1.51]; adjusted coefficient 1.27 [95% CI, 1.17-1.38). After including depressive symptoms in regression models, associations were also found between cognitive symptoms and at least moderate interference with everyday functioning (AOR, 1.27 [95% CI, 1.21-1.33]) and between cognitive symptoms and lower odds of full-time employment (AOR, 0.92 [95% CI, 0.88-0.97]). Conclusions and Relevance The findings of this survey study of US adults suggest that cognitive symptoms are common among individuals with post-COVID-19 condition and associated with greater self-reported functional impairment, lesser likelihood of full-time employment, and greater depressive symptom severity. Screening for and addressing cognitive symptoms is an important component of the public health response to post-COVID-19 condition.
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Affiliation(s)
- Abhishek Jaywant
- Department of Psychiatry, Weill Cornell Medicine, New York, New York
| | - Faith M. Gunning
- Department of Psychiatry, Weill Cornell Medicine, New York, New York
| | - Lauren E. Oberlin
- Department of Psychiatry, Weill Cornell Medicine, New York, New York
| | - Mauricio Santillana
- Machine Intelligence Group for the Betterment of Health and the Environment, Northeastern University, Boston, Massachusetts
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Katherine Ognyanova
- Department of Communication, School of Communication and Information, Rutgers University, New Brunswick, New Jersey
| | - James N. Druckman
- Department of Political Science, University of Rochester, Rochester, New York
| | - Matthew A. Baum
- John F. Kennedy School of Government and Department of Government, Harvard University, Cambridge, Massachusetts
| | - David Lazer
- Network Science Institute, Northeastern University, Boston, Massachusetts
- Department of Political Science, Northeastern University, Boston, Massachusetts
- Khoury College of Computer Sciences, Northeastern University, Boston, Massachusetts
- Institute for Quantitative Social Science, Harvard University, Cambridge, Massachusetts
| | - Roy H. Perlis
- Center for Quantitative Health, Massachusetts General Hospital, Boston
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
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McCarthy MW, Lindsell CJ, Naggie S. Fluvoxamine vs Placebo and Time to Recovery in Outpatients With Mild to Moderate COVID-19-Reply. JAMA 2023; 329:1702-1703. [PMID: 37191706 DOI: 10.1001/jama.2023.5064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Affiliation(s)
| | - Christopher J Lindsell
- Vanderbilt University Medical Center, Nashville, Tennessee
- Now with the Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina
| | - Susanna Naggie
- Duke Clinical Research Institute, Durham, North Carolina
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Román-Montes CM, Flores-Soto Y, Guaracha-Basañez GA, Tamez-Torres KM, Sifuentes-Osornio J, González-Lara MF, de León AP. Post-COVID-19 syndrome and quality of life impairment in severe COVID-19 Mexican patients. Front Public Health 2023; 11:1155951. [PMID: 37255755 PMCID: PMC10225709 DOI: 10.3389/fpubh.2023.1155951] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 04/14/2023] [Indexed: 06/01/2023] Open
Abstract
Introduction Post-COVID-19 syndrome (PCS) usually occurs 3 months after the onset of COVID-19 with a symptom duration of at least 2 months without an alternative diagnosis. Objective This study aimed to describe the prevalence, characteristics, and impact on the quality of life (QoL) of post-COVID-19 syndrome in patients with a history of hospitalization for COVID-19. Materials and methods We conducted a cross-sectional study. Patients who required hospitalization due to COVID-19 between March 2020 and October 2021 were invited to answer a PCS questionnaire and the EQ-5D instrument. A total of 246 patients were included: 187 (76%) met the definition of PCS and 54% were men, with a median age of 50 years (IQR 41-63). Results From 187 patients with PCS, the median time to symptom onset after hospital discharge was 1 day (IQR 1-20), and the median symptom duration was 150 days (IQR 90-225). A total of 27 different symptoms were reported; the most frequent were difficulty concentrating (81%), dyspnea (75%), arthralgia (71%), fatigue (68%), and hair loss (60%). Some symptoms, such as difficulty concentrating, arthralgia/myalgia, and hair loss, were more prevalent in women with PCS. Patients with PCS had a higher frequency of tobacco smoking (37 vs. 4%, p = 0.02) and increased severity of lung involvement in the initial chest tomography (75 vs. 58%, p = 0.01) than those without PCS. Patients with PCS were less likely to receive antivirals (15.5 vs. 27%, p = 0.04). No difference between ICU admission, mechanical ventilation, and length of hospital stay was found. Patients with PCS had a lower visual analog scale result for EQ-5D vs. those without (80 [IQR 70-90] vs. 89.5 [IQR 75-90], p = 0.05). All five QoL dimensions were affected in PCS patients, showing increased pain/discomfort (67 vs. 39%, p = < 0.001), difficulties in performing usual activities (39.2 vs. 20.3%, p = 0.03), and anxiety/depression (57.5 vs. 37%, p = 0.02). Conclusion PCS occurred in 76% of hospitalized patients with prolonged duration and QoL impairment. Neurological symptoms such as difficulty concentrating were the most frequent symptoms. Timely diagnostic and therapeutic interventions are required.
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Affiliation(s)
- Carla Marina Román-Montes
- Clinical Microbiology Laboratory, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- Infectious Diseases Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Yesenia Flores-Soto
- Clinical Microbiology Laboratory, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | - Karla María Tamez-Torres
- Clinical Microbiology Laboratory, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - José Sifuentes-Osornio
- General Direction, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Ma. Fernanda González-Lara
- Clinical Microbiology Laboratory, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Alfredo Ponce de León
- Infectious Diseases Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
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Hazumi M, Okazaki E, Usuda K, Kataoka M, Nishi D. Relationship between attitudes toward COVID-19 infection, depression and anxiety: a cross-sectional survey in Japan. BMC Psychiatry 2022; 22:798. [PMID: 36536342 PMCID: PMC9761043 DOI: 10.1186/s12888-022-04474-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Although negative attitudes are known to develop with experiences of COVID-19 infection, it remains unclear whether such attitudes contribute to depression and anxiety as sequelae of COVID-19. We aimed to investigate the relationships between attitude towards COVID-19 infection and post-COVID-19 depression and anxiety. METHODS A cross-sectional survey of COVID-19 recovered patients was conducted from July to September 2021 in Japan. Outcome variables, depression and anxiety were assessed using the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7); scores of 10 and above were identified as having symptoms of depression and anxiety, respectively. Exposure variables were whether participants were experiencing the following attitude strongly: threat to life due to COVID-19 infection, helplessness regarding COVID-19 infection, blaming a third party who did not restrain from going outside, blaming themselves for their COVID-19 infection, worry about spreading the infection to others, and self-stigma (Self-Stigma Scale-Short). Modified Poisson regression analyses were performed to analyze the findings. RESULTS A total of 6016 responses were included in the analyses. The proportion of depression was 19.88%, and anxiety was 11.47%. The threat of life due to COVID-19 infection, helplessness regarding COVID-19 infection, blaming oneself for their COVID-19 infection, and self-stigma were significantly associated with depression and anxiety after adjusting covariates. Blaming the third party who did not restrain from going outside was associated with anxiety. There was no association between the worry about spreading infection to others and depression or anxiety. CONCLUSION Negative attitudes, including self-stigma with the experience of COVID-19 infection, were related to depression and anxiety. Further studies confirming whether countermeasures for preventing or decreasing the negative attitude towards COVID-19 infection mitigate these symptoms are needed.
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Affiliation(s)
- Megumi Hazumi
- grid.419280.60000 0004 1763 8916Department of Public Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo Japan ,grid.419280.60000 0004 1763 8916Department of Sleep-Wake Disorder, National Center of Neurology and Psychiatry, Kodaira, Tokyo Japan
| | - Emi Okazaki
- grid.419280.60000 0004 1763 8916Department of Public Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo Japan
| | - Kentaro Usuda
- grid.419280.60000 0004 1763 8916Department of Public Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo Japan
| | - Mayumi Kataoka
- grid.419280.60000 0004 1763 8916Department of Public Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo Japan ,grid.26999.3d0000 0001 2151 536XDepartment of Mental Health, Graduate School of Medicine, The University of Tokyo, Bunkyo, Tokyo Japan
| | - Daisuke Nishi
- Department of Public Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan. .,Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Bunkyo, Tokyo, Japan.
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South K, Bakken S, Koleck T, Barcelona V, Elhadad N, Dreisbach C. Women's Experiences of Symptoms of Suspected or Confirmed COVID-19 Illness During the Pandemic. Nurs Womens Health 2022; 26:450-461. [PMID: 36265561 PMCID: PMC9575040 DOI: 10.1016/j.nwh.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 07/19/2022] [Accepted: 09/22/2022] [Indexed: 04/13/2023]
Abstract
OBJECTIVE To explore experiences of symptoms of suspected or confirmed COVID-19 illness among women using the CovidWatcher mobile citizen science app. DESIGN Convergent parallel mixed-methods design. PARTICIPANTS Twenty-eight self-identified women consented for follow-up after using CovidWatcher. Participants' ages ranged from 18 to 83 years old. METHODS We collected data via semistructured, virtual interviews and surveys: the COVID-19 Exposure and Family Impact Survey and Patient-Reported Outcomes Measurement Information System measures. We used directed content analysis to develop codes, categories, themes, and subthemes from the qualitative data and summarized survey data with descriptive statistics. RESULTS We derived five themes related to symptom experiences: (a) Physical Symptoms, (b) Mental Health Symptoms, (c) Symptom Intensity, (d) Symptom Burden, and (e) Symptom Trajectories. Subthemes reflected more nuanced experiences of suspected or confirmed COVID-19 disease. For those without COVID-19, anxiety and mental health symptoms were still present. Of those who attested to one of the PROMIS-measured symptoms, all but one had at least mild severity in one of their reported symptoms. CONCLUSION This study demonstrates the cross-cutting impact of the COVID-19 pandemic on individuals who identify as women. Future research and clinical practice guidelines should focus on alleviating physical and mental health symptoms related to the ongoing pandemic, regardless of COVID-19 diagnosis. Furthermore, clinicians should consider how patients can use symptom reconciliation apps and tracking systems.
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Li W, Zhao YJ, Zhang SF, Yang B, Cheung T, Jackson T, Sha S, Xiang YT. Mapping post-traumatic stress disorder symptoms and quality of life among residents of Wuhan, China after the COVID-19 outbreak: A network perspective. J Affect Disord 2022; 318:80-87. [PMID: 36030998 PMCID: PMC9420032 DOI: 10.1016/j.jad.2022.08.074] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 08/06/2022] [Accepted: 08/22/2022] [Indexed: 12/04/2022]
Abstract
OBJECTIVES The Coronavirus Disease 2019 (COVID-19) outbreak may have a long-term impact on mental health in the general population. This study examined inter-relationships between post-traumatic stress disorder symptoms (PTSS) and quality of life (QOL) in Wuhan residents after the COVID-19 outbreak using network approach. METHODS A cross-sectional survey was conducted between May 25 and June 18, 2020. PTSS and QOL were measured using Chinese versions of the Post -Traumatic Stress Disorder Checklist - Civilian Version and the World Health Organization Quality of Life Questionnaire - brief version, respectively. RESULTS A total of 2598 participants were included. A network analysis revealed "Avoiding reminders", "Feeling emotionally numb", "Avoiding thoughts", "Hypervigilance", and "Reliving experiences" as the most central (influential) nodes in PTSS network models both before and after controlling for covariates. The connection between "Avoiding thoughts" and "Avoiding reminders" had the strongest edge. Three symptom communities were detected and can be summarized as "re-experiencing and avoidance", "negative changes in thinking and mood", and "hyperarousal". The bridge symptoms connecting PTSS and QOL were "Sleep disturbances", "Irritability", and "Loss of interest". LIMITATIONS Limitations included the cross-sectional study design, self-report measures in data collection, and lack of follow-ups beyond the initial phase of the pandemic. CONCLUSIONS PTSS were common among Wuhan residents even after the initial COVID-19 outbreak had passed. Attention should be paid to lingering symptoms of avoiding reminders, emotional numbness, avoiding thoughts, hypervigilance, and reliving experiences in treating PTSS related to the COVID-19 outbreak.
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Affiliation(s)
- Wen Li
- Shanghai Key Laboratory of Forensic Medicine, Key Laboratory of Forensic Science, Ministry of Justice China, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai, China
| | - Yan-Jie Zhao
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao; Centre for Cognitive and Brain Sciences, University of Macau, Macao; Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao
| | - Shu-Fang Zhang
- Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, Hubei, China,; Department of Psychiatry, Wuhan Mental Health Center, Wuhan, Hubei province, China
| | - Bingxiang Yang
- School of Nursing, Wuhan University, Wuhan, Hubei, China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong kong
| | - Todd Jackson
- Department of Psychology, University of Macau, Macao
| | - Sha Sha
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao; Centre for Cognitive and Brain Sciences, University of Macau, Macao; Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao.
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Sinyor M, Zaheer R, Webb RT, Knipe D, Eyles E, Higgins JP, McGuinness L, Schmidt L, Macleod-Hall C, Dekel D, Gunnell D, John A. SARS-CoV-2 Infection and the Risk of Suicidal and Self-Harm Thoughts and Behaviour: A Systematic Review. Can J Psychiatry 2022; 67:812-827. [PMID: 35532916 PMCID: PMC9096003 DOI: 10.1177/07067437221094552] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The COVID-19 pandemic has had a complex impact on risks of suicide and non-fatal self-harm worldwide with some evidence of increased risk in specific populations including women, young people, and people from ethnic minority backgrounds. This review aims to systematically address whether SARS-CoV-2 infection and/or COVID-19 disease confer elevated risk directly. METHOD As part of a larger Living Systematic Review examining self-harm and suicide during the pandemic, automated daily searches using a broad list of keywords were performed on a comprehensive set of databases with data from relevant articles published between January 1, 2020 and July 18, 2021. Eligibility criteria for our present review included studies investigating suicide and/or self-harm in people infected with SARS-CoV-2 with or without manifestations of COVID-19 disease with a comparator group who did not have infection or disease. Suicidal and self-harm thoughts and behaviour (STBs) were outcomes of interest. Studies were excluded if they reported data for people who only had potential infection/disease without a confirmed exposure, clinical/molecular diagnosis or self-report of a positive SARS-CoV-2 test result. Studies of news reports, treatment studies, and ecological studies examining rates of both SARS-CoV-2 infections and suicide/self-harm rates across a region were also excluded. RESULTS We identified 12 studies examining STBs in nine distinct samples of people with SARS-CoV-2. These studies, which investigated STBs in the general population and in subpopulations, including healthcare workers, generally found positive associations between SARS-CoV-2 infection and/or COVID-19 disease and subsequent suicidal/self-harm thoughts and suicidal/self-harm behaviour. CONCLUSIONS This review identified some evidence that infection with SARS-CoV-2 and/or COVID-19 disease may be associated with increased risks for suicidal and self-harm thoughts and behaviours but a causal link cannot be inferred. Further research with longer follow-up periods is required to confirm these findings and to establish whether these associations are causal.
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Affiliation(s)
- Mark Sinyor
- Department of Psychiatry, Sunnybrook Health Sciences Centre,
Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Rabia Zaheer
- Department of Psychiatry, Sunnybrook Health Sciences Centre,
Toronto, Canada
- Department of Education Services, Centre for Addiction and Mental
Health, Toronto, Canada
| | - Roger T. Webb
- Division of Psychology and Mental Health, University of Manchester,
Manchester, UK
- National Institute for Health Research Greater Manchester Patient
Safety Translational Research Centre, Manchester, UK
| | - Duleeka Knipe
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Emily Eyles
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- The National Institute of Health and Care Research Applied Research
Collaboration West (NIHR ARC West), University Hospitals Bristol NHS Foundation
Trust, Bristol, UK
| | - Julian P.T. Higgins
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- The National Institute of Health and Care Research Applied Research
Collaboration West (NIHR ARC West), University Hospitals Bristol NHS Foundation
Trust, Bristol, UK
- The National Institute of Health and Care Research Biomedical
Research Centre, University Hospitals Bristol NHS Foundation Trust and the
University of Bristol, Bristol, UK
| | - Luke McGuinness
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Lena Schmidt
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Sciome LLC, Research Triangle Park, NC, USA
| | | | - Dana Dekel
- Population Data Science, Swansea University, Swansea, UK
| | - David Gunnell
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- The National Institute of Health and Care Research Biomedical
Research Centre, University Hospitals Bristol NHS Foundation Trust and the
University of Bristol, Bristol, UK
| | - Ann John
- Population Data Science, Swansea University, Swansea, UK
- Public Health Wales NHS Trust, Wales, UK
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Hazumi M, Usuda K, Okazaki E, Kataoka M, Nishi D. Differences in the Course of Depression and Anxiety after COVID-19 Infection between Recovered Patients with and without a Psychiatric History: A Cross-Sectional Study. Int J Environ Res Public Health 2022; 19:ijerph191811316. [PMID: 36141588 PMCID: PMC9517442 DOI: 10.3390/ijerph191811316] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/05/2022] [Accepted: 09/06/2022] [Indexed: 05/03/2023]
Abstract
BACKGROUND This study aimed to examine the course of depression and anxiety in COVID-19 survivors with a psychiatric history compared with those without a psychiatric history. METHODS A web-based cross-sectional survey for COVID-19 survivors was conducted from July to September 2021. A total of 6016 COVID-19 survivors, the accuracy of whose responses was determined to be assured, were included in analyses. Exposures included psychiatric history and time since COVID-19 infection, and the main outcomes and measures included severity of depression and anxiety, as assessed using the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), respectively. RESULTS Mean severity of PHQ-9 and GAD-7 were significantly higher in participants with a psychiatric history than in those without a psychiatric history. Two-way analysis of covariance for PHQ-9 showed a significant main effect of the presence of psychiatric history and a significant interaction effect of psychiatric history × time since infection. Two-way analysis of covariance for the GAD-7 score revealed a significant main effect of the presence of psychiatric history and time since COVID-19 infection and the interaction effect of these factors. CONCLUSIONS The course of depression and anxiety was more severe in COVID-19 survivors with a psychiatric history than in those without a psychiatric history.
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Affiliation(s)
- Megumi Hazumi
- Department of Public Mental Health Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan
- Department of Sleep-Wake Disorder, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan
| | - Kentaro Usuda
- Department of Public Mental Health Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan
| | - Emi Okazaki
- Department of Public Mental Health Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan
| | - Mayumi Kataoka
- Department of Public Mental Health Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8654, Japan
| | - Daisuke Nishi
- Department of Public Mental Health Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8654, Japan
- Correspondence:
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Perlis RH, Simonson MD, Green J, Lin J, Safarpour A, Lunz Trujillo K, Quintana A, Chwe H, Della Volpe J, Ognyanova K, Santillana M, Druckman J, Lazer D, Baum MA. Prevalence of Firearm Ownership Among Individuals With Major Depressive Symptoms. JAMA Netw Open 2022; 5:e223245. [PMID: 35311961 PMCID: PMC8938748 DOI: 10.1001/jamanetworkopen.2022.3245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Both major depression and firearm ownership are associated with an increased risk for death by suicide in the United States, but the extent of overlap among these major risk factors is not well characterized. OBJECTIVE To assess the prevalence of current and planned firearm ownership among individuals with depression. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional survey study using data pooled from 2 waves of a 50-state nonprobability internet survey conducted between May and July 7, 2021. Internet survey respondents were 18 years of age or older and were sampled from all 50 US states and the District of Columbia. MAIN OUTCOMES AND MEASURES Self-reported firearm ownership; depressive symptoms as measured by the 9-item Patient Health Questionnaire. RESULTS Of 24 770 survey respondents (64.6% women and 35.4% men; 5.0% Asian, 10.8% Black, 7.5% Hispanic, and 74.0% White; mean [SD] age 45.8 [17.5]), 6929 (28.0%) reported moderate or greater depressive symptoms; this group had mean (SD) age of 38.18 (15.19) years, 4587 were female (66.2%), and 406 were Asian (5.9%), 725 were Black (10.5%), 652 were Hispanic (6.8%), and 4902 were White (70.7%). Of those with depression, 31.3% reported firearm ownership (n = 2167), of whom 35.9% (n = 777) reported purchasing a firearm within the past year. In regression models, the presence of moderate or greater depressive symptoms was not significantly associated with firearm ownership (adjusted odds ratio [OR], 1.07; 95% CI, 0.98-1.17) but was associated with greater likelihood of a first-time firearm purchase during the COVID-19 pandemic (adjusted OR, 1.77; 95% CI, 1.56-2.02) and greater likelihood of considering a future firearm purchase (adjusted OR, 1.53; 95% CI, 1.23-1.90). CONCLUSIONS AND RELEVANCE In this study, current and planned firearm ownership was common among individuals with major depressive symptoms, suggesting a public health opportunity to address this conjunction of suicide risk factors.
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Affiliation(s)
- Roy H. Perlis
- Department of Psychiatry and Center for Quantitative Health, Massachusetts General Hospital, Boston
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Matthew D. Simonson
- Network Science Institute and Institute for Qualitative Social Science, Northeastern University, Boston, Massachusetts
- Department of Political Science, University of Pennsylvania, Philadelphia
| | - Jon Green
- Network Science Institute and Institute for Qualitative Social Science, Northeastern University, Boston, Massachusetts
| | - Jennifer Lin
- Department of Political Science, Northwestern University, Evanston, Illinois
| | - Alauna Safarpour
- Network Science Institute and Institute for Qualitative Social Science, Northeastern University, Boston, Massachusetts
- Harvard Kennedy School of Government, Cambridge, Massachusetts
| | - Kristin Lunz Trujillo
- Network Science Institute and Institute for Qualitative Social Science, Northeastern University, Boston, Massachusetts
- Harvard Kennedy School of Government, Cambridge, Massachusetts
| | - Alexi Quintana
- Network Science Institute and Institute for Qualitative Social Science, Northeastern University, Boston, Massachusetts
| | - Hanyu Chwe
- Network Science Institute and Institute for Qualitative Social Science, Northeastern University, Boston, Massachusetts
| | | | - Katherine Ognyanova
- School of Communication and Information, Rutgers University, New Brunswick, New Jersey
| | - Mauricio Santillana
- Department of Pediatrics, Harvard Medical School, Cambridge, Massachusetts
- Department of Epidemiology, T.H. Chan School of Public Health, Harvard University, Cambridge, Massachusetts
- Computational Health Informatics Program, Boston Children’s Hospital, Boston, Massachusetts
| | - James Druckman
- Department of Political Science, Northwestern University, Evanston, Illinois
| | - David Lazer
- Network Science Institute and Institute for Qualitative Social Science, Northeastern University, Boston, Massachusetts
| | - Matthew A. Baum
- Harvard Kennedy School of Government, Cambridge, Massachusetts
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Perlis RH, Ognyanova K, Santillana M, Lin J, Druckman J, Lazer D, Green J, Simonson M, Baum MA, Della Volpe J. Association of Major Depressive Symptoms With Endorsement of COVID-19 Vaccine Misinformation Among US Adults. JAMA Netw Open 2022; 5:e2145697. [PMID: 35061036 PMCID: PMC8783266 DOI: 10.1001/jamanetworkopen.2021.45697] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Misinformation about COVID-19 vaccination may contribute substantially to vaccine hesitancy and resistance. OBJECTIVE To determine if depressive symptoms are associated with greater likelihood of believing vaccine-related misinformation. DESIGN, SETTING, AND PARTICIPANTS This survey study analyzed responses from 2 waves of a 50-state nonprobability internet survey conducted between May and July 2021, in which depressive symptoms were measured using the Patient Health Questionnaire 9-item (PHQ-9). Survey respondents were aged 18 and older. Population-reweighted multiple logistic regression was used to examine the association between moderate or greater depressive symptoms and endorsement of at least 1 item of vaccine misinformation, adjusted for sociodemographic features. The association between depressive symptoms in May and June, and new support for misinformation in the following wave was also examined. EXPOSURES Depressive symptoms. MAIN OUTCOMES AND MEASURES The main outcome was endorsing any of 4 common vaccine-related statements of misinformation. RESULTS Among 15 464 survey respondents (9834 [63.6%] women and 5630 [36.4%] men; 722 Asian respondents [4.7%], 1494 Black respondents [9.7%], 1015 Hispanic respondents [6.6%], and 11 863 White respondents [76.7%]; mean [SD] age, 47.9 [17.5] years), 4164 respondents (26.9%) identified moderate or greater depressive symptoms on the PHQ-9, and 2964 respondents (19.2%) endorsed at least 1 vaccine-related statement of misinformation. Presence of depression was associated with increased likelihood of endorsing misinformation (crude odds ratio [OR], 2.33; 95% CI, 2.09-2.61; adjusted OR, 2.15; 95% CI, 1.91-2.43). Respondents endorsing at least 1 misinformation item were significantly less likely to be vaccinated (crude OR, 0.40; 95% CI, 0.36-0.45; adjusted OR, 0.45; 95% CI, 0.40-0.51) and more likely to report vaccine resistance (crude OR, 2.54; 95% CI, 2.21-2.91; adjusted OR, 2.68; 95% CI, 2.89-3.13). Among 2809 respondents who answered a subsequent survey in July, presence of depression in the first survey was associated with greater likelihood of endorsing more misinformation compared with the prior survey (crude OR, 1.98; 95% CI, 1.42-2.75; adjusted OR, 1.63; 95% CI, 1.14-2.33). CONCLUSIONS AND RELEVANCE This survey study found that individuals with moderate or greater depressive symptoms were more likely to endorse vaccine-related misinformation, cross-sectionally and at a subsequent survey wave. While this study design cannot address causation, the association between depression and spread and impact of misinformation merits further investigation.
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Affiliation(s)
- Roy H. Perlis
- Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, Massachusetts
| | | | - Mauricio Santillana
- Harvard Medical School, Boston, Massachusetts
- Boston Children’s Hospital, Boston, Massachusetts
| | | | | | - David Lazer
- Northeastern University, Boston, Massachusetts
| | - Jon Green
- Northeastern University, Boston, Massachusetts
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