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Parmar M, Ma R, Attygalle S, Herath MD, Mueller C, Stubbs B, Stewart R, Perera G. Associations between recorded loneliness and adverse mental health outcomes among patients receiving mental healthcare in South London: a retrospective cohort study. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02663-9. [PMID: 38622311 DOI: 10.1007/s00127-024-02663-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 03/19/2024] [Indexed: 04/17/2024]
Abstract
PURPOSE Loneliness disproportionately affects people with mental disorders, but associations with mental health outcomes in groups affected remain less well understood. METHOD A cohort of patients receiving mental healthcare on 30th June 2012 was assembled from a large mental health records database covering a south London catchment area. Recorded loneliness within the preceding 2 years was extracted using natural language processing and outcomes were measured between 30th June 2012 until 30th December 2019, except for survival which applied a censoring point of 6th December 2020 according to data available at the time of extraction. The following mental healthcare outcomes: (i) time to first crisis episode; (ii) time to first emergency presentation; (iii) all-cause mortality; (iv) days active to service per year; and (v) face-to-face contacts per year. RESULTS Loneliness was recorded in 4,483 (16.7%) patients in the study population and fully adjusted models showed associations with subsequent crisis episode (HR 1.17, 95% CI 1.07-1.29), emergency presentation (HR 1.30, 1.21-1.40), days active per year (IRR 1.04, 1.03-1.05), and face-to-face contacts per year (IRR 1.28, 1.27-1.30). Recorded loneliness in patients with substance misuse problems was particularly strongly associated with adverse outcomes, including risk of emergency presentation (HR 1.68, 1.29-2.18) and mortality (HR 1.29, 1.01-1.65). CONCLUSION Patients receiving mental healthcare who are recorded as lonely have a higher risk of several adverse outcomes which may require a need for higher service input.
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Affiliation(s)
- Mayur Parmar
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (King's College London), De Crespigny Park, Box 92, London, SE5 8AF, UK
| | - Ruimin Ma
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (King's College London), De Crespigny Park, Box 92, London, SE5 8AF, UK
| | | | - Maaheshi Deepika Herath
- Ministry of Health Sri Lanka, Colombo, Sri Lanka
- Faculty of Life and Health Sciences, School of Medicine, Ulster University, Belfast, Northern Ireland
| | - Christoph Mueller
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (King's College London), De Crespigny Park, Box 92, London, SE5 8AF, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (King's College London), De Crespigny Park, Box 92, London, SE5 8AF, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Robert Stewart
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (King's College London), De Crespigny Park, Box 92, London, SE5 8AF, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Gayan Perera
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (King's College London), De Crespigny Park, Box 92, London, SE5 8AF, UK.
- South London and Maudsley NHS Foundation Trust, London, UK.
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Henderson J, Reid C. Virtual collaborative creative engagement in a pandemic world: creative connection for older adults with lived experience of dementia. Front Health Serv 2023; 3:1223337. [PMID: 38162191 PMCID: PMC10754963 DOI: 10.3389/frhs.2023.1223337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 11/20/2023] [Indexed: 01/03/2024]
Abstract
Introduction Older adults were disproportionately affected by COVID-19, and isolation and loneliness became key risk factors for mental illness and decreased quality of life. Older adults with lived experience of dementia and their care partners experienced isolation, loneliness, anxiety and depression, already heightened due to social stigma. Reduced access to resources was a notable problem. Objective This Canadian qualitative study investigates the Raising the Curtain on the Lived Experience of Dementia (RTC) Project's virtual turn in program delivery during the pandemic, asking "How did virtual collaborative creative engagement (CCE) impact well-being for people living with dementia and their care partners?"; and "What are key elements of RTC's unique virtual CCE approach?" Methods The study employs reflexive thematic analysis to analyse interviews and focus groups with the project's artist facilitators, researchers, peer collaborators living with dementia, and their care partners. Findings: Themes describe key elements of RTC's unique approach to virtual CCE and include: "Adjusting Expectations and Adapting to Technology"; "Re-imagining Creative Engagement in Virtual Space"; "Sustaining Reciprocal Caring, Learning, and Support"; "Disrupting Stigma and Welcoming a Wider Audience"; and "Supporting Well-being through Empowerment, Community, and Creativity." Discussion Findings offer new perspectives on how virtual CCE not only has the potential to decrease loneliness and isolation and associated mental health risks for older adults living with dementia and their care partners, but also can work to disrupt stigmatizing representations of dementia, promote inclusion, and enhance citizenship.
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Affiliation(s)
- Julia Henderson
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Colleen Reid
- Department of Therapeutic Recreation, Douglas College, Coquitlam, BC, Canada
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Meckovsky F, Furstova J, Kosarkova A, Meier Z, Tavel P, Malinakova K. Loneliness Is Associated With Problematic Internet Use but Not With the Frequency of Substance Use: A Czech Cross-Sectional Study. Int J Public Health 2023; 68:1606537. [PMID: 38024207 PMCID: PMC10651728 DOI: 10.3389/ijph.2023.1606537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 10/22/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives: This study aimed to assess the associations between loneliness and the frequency of substance use and problematic Internet use (PIU) in different age groups. Methods: Data were collected in April 2021 from a sample of 1,293 participants with main characteristics close to a nationally representative sample (mean age = 50.1 ± 15.4 years; 56% male). We measured loneliness with the Three-Item Loneliness Scale (TILS), PIU with the General Problematic Internet Use Scale-2 (GPIUS-2) and the frequency of drugs, alcohol, smoking or caffeine consumption. Spearman's correlation, the t-test, and one-way and multivariate linear regression models were used to analyze the data. Results: In our study, 43.8% of respondents reported moderate to severe levels of loneliness. Loneliness was associated with the severity of PIU [F (3, 1,277) = 15.25, p < 0.001], with higher loneliness corresponding to higher PIU. No significant relationship was found between loneliness and drugs, alcohol, smoking or caffeine consumption. Conclusion: Regardless of age, loneliness is associated with PIU but not with the frequency of substance use. Professional help for lonely people should focus on problematic Internet use in all age groups.
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Affiliation(s)
- Filip Meckovsky
- Olomouc University Social Health Institute, Palacky University Olomouc, Olomouc, Czechia
| | - Jana Furstova
- Olomouc University Social Health Institute, Palacky University Olomouc, Olomouc, Czechia
| | - Alice Kosarkova
- Department of Christian Education, Sts Cyril and Methodius Faculty of Theology, Palacky University Olomouc, Olomouc, Czechia
| | - Zdenek Meier
- Olomouc University Social Health Institute, Palacky University Olomouc, Olomouc, Czechia
| | - Peter Tavel
- Olomouc University Social Health Institute, Palacky University Olomouc, Olomouc, Czechia
| | - Klara Malinakova
- Olomouc University Social Health Institute, Palacky University Olomouc, Olomouc, Czechia
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Martin E, Schoeler T, Pingault JB, Barkhuizen W. Understanding the relationship between loneliness, substance use traits and psychiatric disorders: A genetically informed approach. Psychiatry Res 2023; 325:115218. [PMID: 37146462 PMCID: PMC10636586 DOI: 10.1016/j.psychres.2023.115218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 04/05/2023] [Accepted: 04/21/2023] [Indexed: 05/07/2023]
Abstract
Loneliness is a common, yet distressing experience associated with adverse outcomes including substance use problems and psychiatric disorders. To what extent these associations reflect genetic correlations and causal relationships is currently unclear. We applied Genomic Structural Equation Modelling (GSEM) to dissect the genetic architecture between loneliness and psychiatric-behavioural traits. Included were summary statistics from 12 genome-wide association analyses, including loneliness and 11 psychiatric phenotypes (range N: 9,537 - 807,553). We first modelled latent genetic factors amongst the psychiatric traits to then investigate potential causal effects between loneliness and the identified latent factors, using multivariate genome-wide association analyses and bidirectional Mendelian randomization. We identified three latent genetic factors, encompassing neurodevelopmental/mood conditions, substance use traits and disorders with psychotic features. GSEM provided evidence of a unique association between loneliness and the neurodevelopmental/mood conditions latent factor. Mendelian randomization results were suggestive of bidirectional causal effects between loneliness and the neurodevelopmental/mood conditions factor. These results imply that a genetic predisposition to loneliness may elevate the risk of neurodevelopmental/mood conditions, and vice versa. However, results may reflect the difficulty of distiguishing between loneliness and neurodevelopmental/mood conditions, which present in similar ways. We suggest, overall, the importance of addressing loneliness in mental health prevention and policy.
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Affiliation(s)
- Ellen Martin
- Division of Psychology and Language Sciences, University College London, London, United Kingdom
| | - Tabea Schoeler
- Division of Psychology and Language Sciences, University College London, London, United Kingdom; Department of Computational Biology, University of Lausanne, Lausanne, Switzerland
| | - Jean-Baptiste Pingault
- Division of Psychology and Language Sciences, University College London, London, United Kingdom; Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College, London, United Kingdom
| | - Wikus Barkhuizen
- Division of Psychology and Language Sciences, University College London, London, United Kingdom.
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Guarnera J, Yuen E, Macpherson H. The Impact of Loneliness and Social Isolation on Cognitive Aging: A Narrative Review. J Alzheimers Dis Rep 2023; 7:699-714. [PMID: 37483321 PMCID: PMC10357115 DOI: 10.3233/adr-230011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 05/28/2023] [Indexed: 07/25/2023] Open
Abstract
Social concepts such as loneliness and social isolation are fairly new factors that have been recently gaining attention as to their involvement in changes in cognitive function and association with dementia. The primary aim of this narrative review was to describe the current understanding of how loneliness and social isolation influence cognitive aging and how they are linked to dementia. Studies have shown that there is an association between loneliness, social isolation, and reduced cognitive function, in older adults, across multiple cognitive domains, as well as a heightened risk of dementia. Numerous changes to underlying neural biomechanisms including cortisol secretion and brain volume alterations (e.g., white/grey matter, hippocampus) may contribute to these relationships. However, due to poor quality research, mixed and inconclusive findings, and issues accurately defining and measuring loneliness and social isolation, more consistent high-quality interventions are needed to determine whether studies addressing loneliness and social isolation can impact longer term risk of dementia. This is especially important given the long-term impact of the COVID-19 pandemic on social isolation in older people is yet to be fully understood.
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Affiliation(s)
- Jade Guarnera
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Eva Yuen
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Melbourne, VIC, Australia
- Centre for Quality and Patient Safety-Monash Health Partnership, Institute for Health Transformation, Deakin University, Melbourne, VIC, Australia
| | - Helen Macpherson
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
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Amendolara A, Noonan E. Telemedicine, Isolation, and Anxiety: The Impact of COVID-19 Lockdowns on an 87-Year-Old Woman. Cureus 2023; 15:e36195. [PMID: 37065320 PMCID: PMC10104680 DOI: 10.7759/cureus.36195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2023] [Indexed: 03/17/2023] Open
Abstract
This report describes an 87-year-old female who received cognitive behavioral therapy and medication for anxiety before, during, and after the coronavirus disease 2019 (COVID-19) lockdowns. Our objective is to highlight the impact of isolation, examine the use of telemedicine during the pandemic, and stress the importance of early implementation of this technology. To this end, a chart review of psychotherapy and psychiatry progress notes from 2019 to 2022 and a patient interview were utilized to assess the impact of COVID-19 and telemedicine on the patient's anxiety symptoms, feelings of isolation, and treatment plan. Feelings of isolation, especially, were exacerbated. Prior to the pandemic, the patient was extremely physically and socially active. The reduced ability to interact with others and maintain her independence was detrimental. As a result, COVID-19 impacted the patient's progress significantly and caused regression of symptoms. However, telemedicine allowed for the continuation of therapy and follow-up to the present time. Though telemedicine allowed the patient to receive regular care for the duration of the lockdown and to regain control of anxiety symptoms, she only recently became comfortable with the technology. Now, the patient prefers the convenience and ease of telemedicine, continues to receive care through this modality, and feels that her current care is equivalent to in-person therapy. This case report should serve as a reminder of the effect that isolation can have on older adults with pre-existing anxiety. Notably, isolation may be related to the recent COVID-19 pandemic or other factors, such as reduced mobility or limited access to social services. In any case, isolation has a substantial impact on older patients' mental health. And, despite the availability of telemedicine, clinicians should be aware of the technical challenges surrounding emergency implementation. We suggest early exposure to telemedicine for patients, as well as staff training focused on the potential technical limitations of those patients. We also suggest an assessment of technical literacy, conducted early on as part of a patient's initial intake. The main limitation of this report, and the conclusions drawn herein, is the lack of quantitative measures available. Thus, assessment of the patient's condition and symptoms was restricted to clinician assessment and self-reported measures. We feel though that this remains a useful example of the long-term benefit of telemedicine for older individuals.
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Zhou K. The Relationship Between Acceptance, Biopsychosocial Factors, and Quality of Life: A Structural Equation Model. Rehabilitation Counseling Bulletin 2023. [DOI: 10.1177/00343552231155216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Disability acceptance is one of the most significant constructs in the psychosocial adaptation process. Although prior research has examined the relationship among different biopsychosocial factors, disability acceptance, and quality of life (QoL), limited study focused on entering a series of biopsychosocial factors simultaneously into analysis to reflect live experience of individuals with disabilities. This study aimed to examine the role of acceptance regarding the relationship between a series of biopsychosocial factors (i.e., general health, physical functioning, pain, anxiety, depression, stress, loneliness, stigma, sense of community, and neighborhood problems) and QoL based on Livneh’s psychosocial adaptation model to inform psychosocial interventions. A total of 430 participants with disabilities completed an online survey consisting of instruments measuring target variables. Exploratory and confirmatory factor analyses indicated a three-factor structure for selected biopsychosocial factors (i.e., psychological difficulties, physical status, and community issues). Structural equation modeling results showed that the proposed model indicated a fair model fit after respecification. Effect analyses showed that disability acceptance directly affected QoL and partially mediated the relationship between physical status and QoL and psychological difficulties and QoL. In addition, loneliness has been found to significantly and directly predict QoL in the respecified model. The model demonstrated that disability acceptance and loneliness have a significant impact on QoL.
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Greenblatt-Kimron L, Shinan-Altman S, Alperin M, Levkovich I. Depression and Medicine Use among Older Adults during the COVID-19 Pandemic: The Role of Psychosocial Resources and COVID-19 Perceived Susceptibility. Int J Environ Res Public Health 2023; 20:3398. [PMID: 36834090 PMCID: PMC9961318 DOI: 10.3390/ijerph20043398] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 12/26/2022] [Revised: 02/10/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
A relationship was found between the COVID-19 pandemic and depression among older adults and between depressed mood and increased use of antidepressant medication among older adults during the pandemic. With the aim of broadening the understanding of these relationships, the study examined whether COVID-19 perceived susceptibility mediates the relationship between psychosocial resources (optimism and perceived social support) and depressive symptoms and medication use. Participants included 383 older adults (M = 71.75, SD = 6.77) reporting on socio-demographics, health characteristics, depression, optimism, social support, and COVID-19 perceived susceptibility. Medication use was retrieved from participants medical files. Lower optimism, lower social support, and higher COVID-19 perceived susceptibility were associated with greater depression, related with higher medication use. The findings emphasize the buffering effect of psychosocial resources on the adverse effects of depression affecting older adults during the COVID-19 pandemic, and consequently, the increased use of medication in this population. Practitioners should focus interventions on enhancing optimism and expanding social support among older adults. Moreover, interventions focused on alleviating depression among older adults should aim at improving perceptions of perceived susceptibility in the older population.
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Affiliation(s)
| | - Shiri Shinan-Altman
- Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat Gan 5290002, Israel
| | - Mordechai Alperin
- Department of Family Medicine, The Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 3200003, Israel
- Clalit Health Services, Haifa and Western Galilee District, Tel Aviv 6209804, Israel
| | - Inbar Levkovich
- Faculty of Graduate Studies, Oranim Academic College of Education, Kiryat Tivon 3600600, Israel
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Just SA, Seethaler M, Sarpeah R, Waßmuth N, Bermpohl F, Brandl EJ, Just SA. Loneliness in Elderly Inpatients. Psychiatr Q 2022; 93:1017-30. [PMID: 36350482 DOI: 10.1007/s11126-022-10006-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/03/2022] [Indexed: 11/11/2022]
Abstract
PURPOSE Loneliness among the elderly is a widespread phenomenon and is connected to various negative health outcomes. Nevertheless, loneliness among elderly inpatients, especially those with a psychiatric diagnosis, has hardly been examined. Our study assessed loneliness in elderly inpatients, identified predictors, and compared levels of loneliness between inpatients on psychiatric and somatic wards. METHODS N = 100 elderly inpatients of a somatic and psychiatric ward were included. Levels of loneliness were assessed, as were potential predictors such as depression, psychological resilience, severity of mental illness, well-being, daily functioning, and psychiatric diagnosis. Analyses of group differences and hierarchical multiple regression analysis were conducted. RESULTS 37% of all inpatients reported elevated levels of loneliness. Significant predictor variables were self-reported depressive symptoms, well-being, severity of mental illness, being single and living with a caregiver. Hierarchical multiple regression analysis revealed that the full model explained 58% of variance in loneliness. Psychiatric inpatients' loneliness was significantly higher than loneliness in somatic inpatients. When analyzing group differences between inpatients with different main psychiatric diagnoses, highest levels were found in patients with an affective disorder, followed by those treated for organic mental disorder. Since the study took place during the COVID-19 pandemic, potential influence of different measurement points (lockdown vs. no lockdown) were analyzed: Differences in loneliness depending on the phase of the pandemic were non-significant. CONCLUSION Elderly inpatients experience high levels of loneliness, especially those with a mental disorder. Interventions to reduce loneliness in this population should address predictors of loneliness, preferably through multiprofessional interventions.
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Simkin L, Yung P, Greig F, Perera G, Tsamakis K, Rizos E, Stewart R, Velayudhan L, Mueller C. The impact of the first UK COVID-19 lockdown on presentations with psychosis to mental health services for older adults: An electronic health records study in South London. Int J Geriatr Psychiatry 2022; 37:10.1002/gps.5834. [PMID: 36333839 PMCID: PMC9828419 DOI: 10.1002/gps.5834] [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] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 10/17/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVES Social distancing restrictions in the COVID-19 pandemic may have had adverse effects on older adults' mental health. Whereby the impact on mood is well-described, less is known about psychotic symptoms. The aim of this study was to compare characteristics associated with psychotic symptoms during the first UK lockdown and a pre-pandemic comparison period. METHODS In this retrospective observational study we analysed anonymised records from patients referred to mental health services for older adults in South London in the 16-week period of the UK lockdown starting in March 2020, and in the comparable pre-pandemic period in 2019. We used logistic regression models to compare the associations of different patient characteristics with increased odds of presenting with any psychotic symptom (defined as hallucinations and/or delusion), hallucinations, or delusions, during lockdown and the corresponding pre-pandemic period. RESULTS 1991 referrals were identified. There were fewer referrals during lockdown but a higher proportion of presentations with any psychotic symptom (48.7% vs. 42.8%, p = 0.018), particularly hallucinations (41.0% vs. 27.8%, p < 0.001). Patients of non-White ethnicity (adjusted odds ratio (OR): 1.83; 95% confidence interval (CI): 1.13-2.99) and patients with dementia (adjusted OR: 3.09; 95% CI: 1.91-4.99) were more likely to be referred with psychotic symptoms during lockdown. While a weaker association between dementia and psychotic symptoms was found in the pre-COVID period (adjusted OR: 1.55; 95% CI: 1.19-2.03), interaction terms indicated higher odds of patients of non-White ethnicity or dementia to present with psychosis during the lockdown period. CONCLUSIONS During lockdown, referrals to mental health services for adults decreased, but contained a higher proportion with psychotic symptoms. The stronger association with psychotic symptoms in non-White ethnic groups and patients with dementia during lockdown suggests that barriers in accessing care might have increased during the COVID-19 pandemic.
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Affiliation(s)
- Lauren Simkin
- Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Paul Yung
- South London and Maudsley NHS Foundation TrustLondonUK
| | - Flora Greig
- South London and Maudsley NHS Foundation TrustLondonUK
| | - Gayan Perera
- Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Konstantinos Tsamakis
- Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
- Second Department of PsychiatryNational and Kapodistrian University of Athens‘Attikon’ University General HospitalAthensGreece
| | - Emmanouil Rizos
- Second Department of PsychiatryNational and Kapodistrian University of Athens‘Attikon’ University General HospitalAthensGreece
| | - Robert Stewart
- Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
- South London and Maudsley NHS Foundation TrustLondonUK
| | - Latha Velayudhan
- Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
- South London and Maudsley NHS Foundation TrustLondonUK
| | - Christoph Mueller
- Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
- South London and Maudsley NHS Foundation TrustLondonUK
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Chu BL, Zhang W. Impact of transient and chronic loneliness on progression and reversion of frailty in community-dwelling older adults: four-year follow-up. BMC Geriatr 2022; 22:642. [PMID: 35927717 PMCID: PMC9351253 DOI: 10.1186/s12877-022-03283-1] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 07/08/2022] [Indexed: 11/30/2022] Open
Abstract
Background Frailty is a common condition in older adults that is characterized by transitions between frailty states in both directions (progression and reversion) over time. Loneliness has been reported to be associated with the incidence of frailty, but few studies have explored the impact of persistent loneliness over time on frailty. In this study, we aimed to whether and how two different types of loneliness, transient and chronic, were associated with changes in frailty status in older adults. Methods The analytic sample contained 2961 adults aged ≥ 60 years who completed interviews for both the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study. The logistic regression model was used to examine the relationship between transient and chronic loneliness and progression and reversion of frailty. Demographics (age, sex, education level, marital status, urban–rural residence), living alone, chronic conditions, physical function, and depressive symptoms from the 2011 wave were adjusted. Results After four years, 21% of the studied sample reported progression, 20% reported reversion in frailty, 31% reported transient loneliness, and 14% reported chronic loneliness. There was no significant difference in participants who reported transient loneliness (OR = 1.10, 95% CI [0.89,1.37]), or chronic loneliness (OR = 1.14, 95% CI [0.84,1.57]) on the progression of frailty, compared with no report of loneliness. Participants reporting chronic loneliness (OR = 0.68, 95% CI [0.50,0.93]) were less likely to report reversion in their level of frailty compared to participants who did not report loneliness but not transient loneliness (OR = 0.87, 95% CI [0.70,1.08]). Conclusions Roughly the same percentage, a fifth, of older Chinese adults progressed or reversed in frailty status without active intervention. Chronic loneliness was related to a lower probability of reversion in the frail group than in the no loneliness group, but not in the transient loneliness group. More attention should be given to older adults with chronic loneliness.
Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03283-1.
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Affiliation(s)
- Bin-Lin Chu
- School of Nursing, Anqing Medical College, Anqing, China
| | - Wen Zhang
- Department of Social Work and Social Administration, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China.
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Reilly ED, Chamberlin ES, Duarte BA, Harris JI, Shirk SD, Kelly MM. The Impact of COVID-19 on Self-Reported Substance Use, Well-Being, and Functioning Among United States Veterans: A Cross-Sectional Study. Front Psychol 2022; 13:812247. [PMID: 35478735 PMCID: PMC9035845 DOI: 10.3389/fpsyg.2022.812247] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 03/14/2022] [Indexed: 12/24/2022] Open
Abstract
As the COVID-19 pandemic sweeps the globe, many veterans with substance use issues have faced the closure of treatment facilities, mandates to shelter in place, and social distancing measures. To better understand their pandemic experiences, substance use changes, and functioning, a survey was nationally administered to a sample of United States veterans reporting substance use issues during the pandemic. The purpose of this cross-sectional online survey for veterans (N = 409) was to report on COVID-19 experiences, safety behaviors, and infection experiences while also investigating the relationship among addictive behaviors, mental and physical health, and COVID-19 impact. Measures also assessed specific substance use concerns, pandemic-related loneliness, and functioning. Though few veterans reported personally receiving a confirmed COVID-19 medical diagnosis (10.5%), the impact of pandemic stressors was evident, with a majority reporting anxiety related to contracting COVID-19 (61.4%) or fear of a family member or close friend contracting COVID-19 (58.7%). Participants reported increased use of alcohol (45.3%), sedatives (36.6%), inhalants (35.7%), tobacco (35.0%), and cannabis (34.9%), attributed specifically to the pandemic. Regression analyses revealed that even when controlling for the contribution of problematic substance use issues, negative pandemic impacts and self-reported COVID-19 related loneliness were related to more impaired physical and mental health functioning during the pandemic. Findings from this sample of veterans with addiction issues add to the growing literature suggesting unique and adverse effects of COVID-19 stressors on functioning while also revealing specific pandemic impacts for this group.
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Affiliation(s)
- Erin D. Reilly
- Mental Illness Research, Education, and Clinical Center (MIRECC), VA Bedford Healthcare System, Bedford, MA, United States
- The Department of Psychiatry and Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
- *Correspondence: Erin D. Reilly,
| | - Elizabeth S. Chamberlin
- Mental Illness Research, Education, and Clinical Center (MIRECC), VA Bedford Healthcare System, Bedford, MA, United States
| | | | - J. Irene Harris
- Mental Illness Research, Education, and Clinical Center (MIRECC), VA Bedford Healthcare System, Bedford, MA, United States
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Steven D. Shirk
- Mental Illness Research, Education, and Clinical Center (MIRECC), VA Bedford Healthcare System, Bedford, MA, United States
- The Department of Psychiatry and Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Megan M. Kelly
- Mental Illness Research, Education, and Clinical Center (MIRECC), VA Bedford Healthcare System, Bedford, MA, United States
- The Department of Psychiatry and Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
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