Psychological impact of the COVID-19 crisis on young swiss men participating in a cohort study: Differences due to socioeconomic status and work situation

Introduction

The COVID-19 pandemic impacted daily life worldwide. It may also have had a psychological impact, especially on those with less resources already before the crisis and those who reported substantial changes to their work situation.

Objectives

To investigate whether socioeconomic status before the crisis and changes in work situation during the crisis (unemployment, home-office) are associated with psychological impact in a cohort of young Swiss men.

Methods

A total of 2345 young Swiss men (mean age = 29) completed assessments shortly before (April 2019 to February 2020) and early during the COVID-19 crisis (May to June 2020). Assessments covered psychological outcomes assessed before and during COVID-19 crisis (depression, perceived stress and sleep quality), and assessed during the crisis (fear, isolation and COVID-19 psychological trauma), socioeconomic status (relative financial status and difficulty to pay bills) before the crisis and changes in work situation (unemployment, home-office).

Results

About a fifth of the sample were in partial unemployment or lost their job during COVID-19 crisis. Those in partial or full unemployment, those mostly working from home and those with a lower socioeconomic status already prior to the crisis showed overall higher levels of depression, stress, psychological trauma, fear and isolation.

Conclusions

Even in a country with high social security such as Switzerland, the COVID-19 crisis had a higher psychological impact on those who were already disadvantaged before the crisis or experienced deteriorations in their work situation. Supporting disadvantaged subpopulations during the crisis may help to prevent an amplification of pre-existing inequalities.

Disclosure

No significant relationships.

The Cochrane 2018 Review on Brief Interventions in Primary Care for Hazardous and Harmful Alcohol Consumption: A Distillation for Clinicians and Policy Makers

AIMS

An updated Cochrane systematic review assessed effectiveness of screening and brief intervention to reduce hazardous or harmful alcohol consumption in general practice or emergency care settings. This paper summarises the implications of the review for clinicians.

METHODS

Cochrane methods were followed. Reporting accords with PRISMA guidance. We searched multiple resources to September 2017, seeking randomised controlled trials of brief interventions to reduce hazardous or harmful alcohol consumption in people attending general practice, emergency care or other primary care settings for reasons other than alcohol treatment. Brief intervention was defined as a conversation comprising five or fewer sessions of brief advice or brief lifestyle counselling and a total duration of less than 60 min. Our primary outcome was alcohol consumption, measured as or convertible to grams per week. We conducted meta-analyses to assess change in consumption, and subgroup analyses to explore the impact of participant and intervention characteristics.

RESULTS

We included 69 studies, of which 42 were added for this update. Most studies (88%) compared brief intervention to control. The primary meta-analysis included 34 studies and provided moderate-quality evidence that brief intervention reduced consumption compared to control after one year (mean difference -20 g/wk, 95% confidence interval -28 to -12). Subgroup analysis showed a similar effect for men and women.

CONCLUSIONS

Brief interventions can reduce harmful and hazardous alcohol consumption in men and women. Short, advice-based interventions may be as effective as extended, counselling-based interventions for patients with harmful levels of alcohol use who are presenting for the first time in a primary care setting.

Squamous cell carcinoma of the head and neck - screening in patients who misuse alcohol and tobacco in Switzerland: a prospective pilot study

Squamous cell carcinoma (SCC) of the head and neck is the sixth most common cancer worldwide. It is preceded by early asymptomatic lesions which, if identified early enough and removed, would prevent malignant transformation or avoid delaying diagnosis to advanced stages. Our aim was to evaluate the feasibility of a screening programme for SCC of the head and neck in a group of high-risk patients, and to investigate their addiction profile. Patients admitted to an inpatient alcohol addiction centre (n=101) were prospectively enrolled and asked to fill in a questionnaire about their use of tobacco and alcohol, and the presence of warning symptoms for SCC of the head and neck from 23 June 2014 to 21 January2016. Participants in the study had a physical examination by an alcohol addiction physician followed by a full examination of the head and neck by an otorhinolaryngologist to rule out premalignant or malignant lesions of the upper aerodigestive tract. Of the 101 patients, 62 (60%) had at least one warning symptom. Alcohol addiction physicians identified leukoplakia in six (6%) and erythroplakia in two. No pre-malignant or malignant lesions were confirmed on examination by the otolaryngologist. We were unable to draw conclusions about the cost-effectiveness or the yield of the screening programme. Despite our negative findings, we may need further investigation to clarify the relevance of such a programme on health-related outcome given the high compliance rate and minimal delay that was achieved by taking advantage of an in-patient alcohol rehabilitation centre.