Implementing ICMH-CF (International Committee on Mental Health in CF) guidance on screening for depression and anxiety symptoms: A feasibility and pilot study

Background: Portuguese-speaking immigrants are a growing underserved population in the Unites States who experience high levels of psychological distress and increased vulnerability to mental health disorders such as depression and anxiety. Current evidence shows that mindfulness-based interventions (MBIs) are effective to promote physical and mental health among educated English speakers; nonetheless, the lack of diversity in the mindfulness literature is a considerable limitation. To our knowledge, the feasibility and acceptability of MBIs among Portuguese-speaking immigrants have not yet been investigated.Methods: This single-arm pilot study (N = 30) explored the feasibility, acceptability, and cultural aspects of Mindfulness Training for Primary Care (MTPC)-Portuguese among Portuguese-speaking immigrants in the Boston area. MTPC is an 8-week, primary care-adapted, referral-based, insurance-reimbursable, trauma-informed MBI that is fully integrated into a healthcare system. The study also examined intervention preliminary effectiveness on mental health outcomes (depression and anxiety symptoms) and self-regulation (emotional regulation, mindfulness, self-compassion, interoceptive awareness), and initiation of health behavior was explored.Results: Primary care providers referred 129 patients from 2018 to 2020. Main DSM-5 primary diagnoses were depression (76.3%) and anxiety disorders (6.7%). Participants (N = 30) attended a mean of 6.1 (SD 1.92) sessions and reported a mean of 213.7 (SD = 124.3) min of practice per week. All survey finishers would recommend the program to a friend, found the program helpful, and rated the overall program as “very good” or “excellent,” and 93% would participate again, with satisfaction mean scores between 4.6 and 5 (Likert scale 0–5). Participants and group leaders provided feedback to refine MTPC-Portuguese culturally responsiveness regarding materials language, settings, time, food, and community building. Patients exhibited reductions in depression (d = 0.67; p < 0.001) and anxiety (d = 0.48; p = 0.011) symptoms, as well as enhanced emotional regulation (d = 0.45; p = 0.009), and among survey finishers, 50% initiated health behavior change through action plan initiation.Conclusion: This pilot study suggests that MTPC-Portuguese is feasible, acceptable, and culturally appropriate among Portuguese-speaking patients in the Boston area. Furthermore, the intervention might potentially decrease depression and anxiety symptoms, facilitate health behavior change, and improve emotional regulation. MTPC-Portuguese investigation with larger samples in controlled studies is warranted to support its dissemination and implementation in the healthcare system.Clinical Trial Registration: Identifier: NCT04268355.

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COVID-19 pandemic related long-term chronic stress on the prevalence of depression and anxiety in the general population

BMC Psychiatry ◽

10.1186/s12888-021-03385-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tian Qi ◽

Ting Hu ◽

Qi-Qi Ge ◽

Xiao-Na Zhou ◽

Jia-Mei Li ◽

...

Keyword(s):

Mental Health ◽

General Population ◽

Chronic Stress ◽

Protective Factor ◽

Mental Health Problems ◽

Anxiety Symptoms ◽

Binary Logistic Regression Analysis ◽

Depression And Anxiety ◽

Factors Associated

Abstract Background The COVID-19 pandemic has lasted for more than 1 year, causing far-reaching and unprecedented changes in almost all aspects of society. This study aimed to evaluate the long-term consequences of the COVID-19 pandemic on depression and anxiety, and explore the factors associated with it. Methods A cross-sectional study using an online survey was conducted to assess mental health problems from February 2 to February 9, 2021 by using patient health questionnaire-9 (PHQ-9) and generalized anxiety disorder-7 (GAD-7). The insomnia severity index (ISI), demographic data and COVID-19 related variables were measured by a self-designed questionnaire. The factors associated with depressive and anxiety symptoms were identified by Pearson chi-square test and binary logistic regression analysis. Results In the study that 1171 participants enrolled, the overall prevalence of depressive and anxiety symptoms among general people was 22.6 and 21.4% respectively in the present study. Living alone was a potential risk factor for depressive symptoms, while regular exercises was a potential protective factor. The prevalence of depressive and anxiety symptoms was significantly associated with the severity of insomnia symptoms and the negative feelings about pandemic. Conclusion COVID-19 pandemic- related chronic stress has brought about profound impacts on long-term mental health in the general population. The level of insomnia and a negative attitude towards the pandemic are significantly correlated with unfavorable mental health. However, we failed to found a significant association of age and gender with the mental health symptoms, although they were recognized as well-established risk factors during the outbreak by some other studies. This discrepancy may be because the acute and chronic effects of the pandemic are influenced by different factors, which reminds that more attention should be paid to the intrinsic psychological factors and physical reactions towards COVID-19.

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When the Bough Breaks: A Systematic Review and Meta-Analysis of Mental Health Symptoms in Mothers of Young Children during the COVID-19 Pandemic

10.31234/osf.io/u8pnh ◽

2021 ◽

Author(s):

Nicole Racine ◽

Rachel Eirich ◽

Jessica Cookee ◽

Jenney Zhu ◽

Paolo Pador ◽

...

Keyword(s):

Mental Health ◽

Young Children ◽

Maternal Mental Health ◽

Meta Analysis ◽

Random Effect ◽

Well Being ◽

Anxiety Symptoms ◽

Study Quality ◽

Depression And Anxiety ◽

Meta Analyses

Parents have experienced considerable challenges and stress during the COVID-19 pandemic, which may impact their well-being. This meta-analysis sought to identify: 1) the prevalence of depression and anxiety in parents of young children (< age 5) during the COVID-19 pandemic, and 2) sociodemographic (e.g., parent age, minority status) and methodological moderators (e.g., study quality) that explain heterogeneity among studies. A systematic search was conducted across four databases from January 1st, 2020 to March 3st, 2021. A total of 18 non-overlapping studies (9,101 participants), all focused on maternal mental health, met inclusion criteria. Random-effect meta-analyses were conducted. Pooled prevalence estimates for clinically significant depression and anxiety symptoms for mothers of young children during the COVID-19 pandemic were 27.4% (95% CI: 21.5-34.3) and 43.5% (95% CI:27.5-60.9), respectively. Prevalence of clinically elevated depression and anxiety symptoms were higher in Europe and North America and among older mothers. Clinically elevated depressive symptoms were lower in studies with a higher percentage of racial and ethnic minority individuals. In comparison, clinically elevated anxiety symptoms were higher among studies of low study quality and in samples with highly educated mothers. Policies and resources targeting improvements in maternal mental health are essential.

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Resonance breathing is associated with improvements in depression and anxiety symptoms during heart rate variability biofeedback sessions

10.31234/osf.io/7g5q8 ◽

2021 ◽

Author(s):

Adam Khan Pettitt ◽

Benjamin W Nelson ◽

Richard Gevirtz ◽

Paul Lehrer ◽

Kristian Ranta ◽

...

Keyword(s):

Mental Health ◽

Heart Rate ◽

Heart Rate Variability ◽

Resonance Frequency ◽

Treatment Protocol ◽

Anxiety Symptoms ◽

Adjunctive Treatment ◽

Depression And Anxiety ◽

Heart Rate Variability Biofeedback ◽

Item Scale

Heart rate variability (HRV) appears to be a transdiagnostic biomarker for health and disease. Although initial studies using HRV biofeedback (HRVB) to regulate HRV as a potential adjunctive treatment to gold-standard interventions seem promising, more research is needed to determine which aspects of HRVB training provide the most clinical benefits to those suffering from mental health symptoms. In the current study, we sought to investigate whether time spent in resonance, between-person differences in resonance frequency, and/or within-person resonance frequency trajectory across repeated HRVB sessions were related to changes in depression and/or anxiety symptoms during a 12-week digital mental health intervention that contains HRVB as part of the treatment protocol. We used a retrospective cohort study to examine these associations among 387 participants in the Meru Health Program. For depression, we found that average resonance time per HRVB session, but not total time in resonance, was significantly associated with decreased depression as measured by the Patient Health Questionnaire 9-item scale (PHQ-9) across treatment (b=-0.38, 95% CI [-0.76,-0.01], t(377)=-1.99, p=.047). For anxiety symptoms as measured by the Generalized Anxiety Disorder 7-item scale (GAD-7), we found neither association significant. Within-person effects were significant for both depression and anxiety, with steeper slopes of time spent in resonance significantly related to reductions in PHQ-9 and GAD-7 symptoms, respectively. Between-person effects were not significant for either depression or anxiety. Our results demonstrate that improvements in resonance efficiency over time in treatment, independent of how each participant starts, are related to reductions in depression and anxiety symptoms.

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Depression and Anxiety Symptoms of British Adoptive Parents: A Prospective Four-Wave Longitudinal Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16245153 ◽

2019 ◽

Vol 16 (24) ◽

pp. 5153 ◽

Cited By ~ 2

Author(s):

Rebecca E. Anthony ◽

Amy L. Paine ◽

Katherine H. Shelton

Keyword(s):

Mental Health ◽

Depressive Symptoms ◽

Adoptive Parents ◽

Anxiety Symptoms ◽

Depression Symptoms ◽

Parental Anxiety ◽

Depression And Anxiety ◽

Negative Consequences ◽

Adoptive Families ◽

Prospective Longitudinal

The mental health of birth parents has gained attention due to the serious negative consequences for personal, family, and child outcomes, but depression and anxiety in adoptive parents remains under-recognized. Using a prospective, longitudinal design, we investigated anxiety and depression symptoms in 96 British adoptive parents over four time points in the first four years of an adoptive placement. Depression and anxiety symptom scores were relatively stable across time. Growth curve analysis showed that higher child internalizing scores and lower parental sense of competency at five months post-placement were associated with higher initial levels of parental depressive symptoms. Lower parental sense of competency was also associated with higher initial levels of parental anxiety symptoms. Parents of older children and those with higher levels of parental anxiety and sense of competency at five months post-placement had a steeper decrease in depressive symptoms over time. Support for adoptive families primarily focuses on child adjustment. Our findings suggest that professional awareness of parental mental health post-placement may be necessary, and interventions aimed at improving parents’ sense of competency may be beneficial.

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Digital phenotyping of complex psychological responses to the COVID-19 pandemic (Preprint)

10.2196/preprints.26190 ◽

2020 ◽

Author(s):

Thomas D. Hull ◽

Jacob Levine ◽

Niels Bantilan ◽

Angel N. Desai ◽

Maimuna S. Majumder

Keyword(s):

Mental Health ◽

Language Processing ◽

Anxiety Symptoms ◽

Depression Symptoms ◽

The Novel ◽

Depression And Anxiety ◽

Clinical Assessments ◽

Digital Phenotyping ◽

Novel Coronavirus ◽

Therapy Service

BACKGROUND The novel coronavirus disease 2019 (COVID-19) has negatively impacted mortality, economic conditions, and mental health and these impacts are likely to continue after the pandemic comes to an end. OBJECTIVE At present, no method has characterized the mental health burden of the pandemic distinct from pre-COVID-19 levels. Accurate detection of illness is critical to facilitate pandemic-related treatment to prevent worsening symptoms. METHODS An algorithm for the isolation of pandemic-related concerns on a large digital mental health service is reported that utilized natural language processing (NLP) on unstructured therapy transcript data, in parallel with brief clinical assessments of depression and anxiety symptoms. RESULTS Results demonstrate a significant increase in COVID-related intake anxiety symptoms, but no detectable difference in intake depression symptoms. Transcript analyses identified terms classifiable into 24 symptoms in excess of those included in the diagnostic criteria for anxiety and depression. CONCLUSIONS Findings for this large digital therapy service suggest that treatment seekers are presenting with more severe intake anxiety levels than before the COVID-19 outbreak. Importantly, monitoring additional symptoms as part of a new COVID-19 Syndrome category could be advised to fully capture the effects of COVID019 on mental health.

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Gaming your mental health: A narrative review on mitigating depression and anxiety symptoms via commercial video games (Preprint)

JMIR Serious Games ◽

10.2196/26575 ◽

2020 ◽

Author(s):

Magdalena Kowal ◽

Eoin Conroy ◽

Niall Ramsbottom ◽

Tim Smithies ◽

Adam Toth ◽

...

Keyword(s):

Mental Health ◽

Video Games ◽

Anxiety Symptoms ◽

Narrative Review ◽

Depression And Anxiety

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The Mental Health Impact of COVID-19 Outbreak: A Nationwide Survey in Iran

10.21203/rs.3.rs-23425/v3 ◽

2020 ◽

Author(s):

Reza Shahriarirad ◽

Amirhossein Erfani ◽

Keivan Ranjbar ◽

Amir Bazrafshan ◽

Alireza Mirahmadizadeh

Keyword(s):

Mental Health ◽

Risk Factor ◽

General Population ◽

Protective Factor ◽

Disease Outbreak ◽

Demographic Variables ◽

Anxiety Symptoms ◽

Depression And Anxiety ◽

Cross Sectional ◽

Risk Of Death

Abstract Background: Disease outbreak not only carries the risk of death to the public due to the infection, but it also can lead to unbearable psychological impact on the mental health of the individuals. This study aims to explore and evaluate the burden of psychological problems on the Iranian general population during the outbreak of COVID-19.Method: A cross-sectional web-based survey was conducted among the general population of Iran age 15 and above. Demographic variables, depression, and anxiety symptoms were evaluated using the Patient Health Questionnaire-9 and General Anxiety Disorder-7 questionnaires.Results: Among the 8591 participants, the mean age was 34.37 (±11.25) years and 66.4% were female while 33.6% were male. Based on our results, 1295 (15.1%) and 1733 (20.1%) of the general population clinically significant depressive and anxiety symptoms respectively. Based on the demographic variables, female gender was associated with a higher risk for developing depression and anxiety symptoms, whereas getting information about the disease from medical journals and articles, being older, and being married were considered as associated protective factors. In terms of depression, being a healthcare worker was an associated risk factor. On the other hand, for anxiety, having higher education was a protective factor while a higher number of individuals in a household was considered as a risk factor.Conclusions: This study identified a major mental health problem in the Iranian population during the time of the COVID-19 outbreak. Therefore, establishing a targeted mental health support program during the time of public emergencies, such as the disease outbreak, is advised.

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“We can’t carry the weight of the whole world”: illness experiences among Peruvian older adults with symptoms of depression and anxiety

International Journal of Mental Health Systems ◽

10.1186/s13033-020-00381-8 ◽

2020 ◽

Vol 14 (1) ◽

Cited By ~ 1

Author(s):

Oscar Flores-Flores ◽

Alejandro Zevallos-Morales ◽

Ivonne Carrión ◽

Dalia Pawer ◽

Lorena Rey ◽

...

Keyword(s):

Mental Health ◽

Older Adults ◽

Mental Health Professionals ◽

Emotional Support ◽

Anxiety Symptoms ◽

Health Interventions ◽

Depression And Anxiety ◽

Community Based ◽

Illness Experiences ◽

Mental Health Interventions

Abstract Background Despite the high levels of depression and anxiety symptoms in old age, the use of mental health services in this population is low. Help-seeking behaviors are shaped by how an individual perceives and experiences their illness. The objective of this study was to characterize the illness experiences of Peruvian older adults with depression and anxiety symptoms in order to lay the foundation for tailored community-based mental health interventions. Methods In this qualitative study, we conducted in-depth interviews with a purposively selected sample of older adults (≥ 60 years) from peri-urban areas of Lima, Peru. We included individuals with only depressive symptoms (Patient Health Questionnaire-9 ≥ 10), only anxiety symptoms (Beck Anxiety Inventory ≥ 16), with depressive and anxiety symptoms, and older adults who mentioned they had received mental health treatment/care. The interview guide included the following topics: perceptions and experiences about depression and anxiety; perceptions about the relationship between physical chronic diseases and mental health; experiences with mental health professionals and treatments, and coping mechanisms. Data collection was conducted between October 2018 and February 2019. Results We interviewed 38 participants (23 women, 15 men) with a mean age of 67.9 years. Participants’ ideas and perceptions of depression and anxiety showed considerable overlap. Participants attributed depression and anxiety mainly to familial and financial problems, loneliness, loss of independence and past traumatic experiences. Coping strategies used by older adults included ‘self-reflection and adaptation’ to circumstances, ‘do your part’, and seeking ‘emotional support’ mainly from non-professionals (relatives, friends, acquaintances, and religion). Conclusions Illness experiences of depression and anxiety set the pathway for tailored community-based mental health interventions for older adults. Overlapping narratives and perceptions of depression and anxiety suggest that these conditions should be addressed together. Mental health interventions should incorporate addressing areas related to depression and anxiety such as prevention of loss of independence, trauma, and loneliness. Good acceptability of receiving emotional support for non-professionals might offer an opportunity to incorporate them when delivering mental health care to older adults.

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StayWell at Home: A Text Messaging Intervention to Counteract Depression and Anxiety during COVID-19 Social Distancing (Preprint)

10.2196/preprints.25298 ◽

2021 ◽

Author(s):

Adrian Aguilera ◽

Rosa Hernandez-Ramos ◽

Alein Yaritza Haro ◽

Claire Elizabeth Boone ◽

Tiffany Luo ◽

...

Keyword(s):

Mental Health ◽

Text Messaging ◽

The United States ◽

Text Messages ◽

Anxiety Symptoms ◽

Anxiety And Depression ◽

Depression And Anxiety ◽

Negative Consequences ◽

Social Distancing ◽

At Home

BACKGROUND Social distancing and stay-at-home orders are critical interventions to slow down person-to-person transmission of COVID-19. While these societal changes help to contain the pandemic, they also have unintended negative consequences, including anxiety and depression. We developed StayWell, a daily skills-based SMS text messaging program, to mitigate COVID-19 related depression and anxiety symptoms among people who speak English and Spanish in the United States. OBJECTIVE This paper describes the changes in the anxiety and depression levels of participants in the StayWell program after 60 days of exposure to skills-based SMS text messages. METHODS We used self-administered, empirically supported web-based questionnaires to assess the demographic and clinical characteristics of StayWell participants. Anxiety and depression were measured using the 2-item Generalized Anxiety Disorder (GAD-2) scale and the 8-item Patient Health Quesstionanire-8 (PHQ-8) scale at baseline and 60-day timepoints. We used paired t-tests to detect the change in PHQ-8 and GAD-2 scores from baseline to follow-up measured 60 days later. RESULTS The analytic sample includes 193 participants who completed both the baseline and 60-day exit questionnaires. At the 60-day time point, there were statistically significant reductions in both PHQ-8 and GAD-2 scores from baseline. We found an average reduction of -1.72 (95% CI: -2.35, -1.09) in PHQ-8 scores and -0.48 (95% CI: -0.71, -0.25) in GAD-2 scores. This translated to an 18.5% and 17.2% reduction in mean PHQ-8 scores and GAD-2, respectively. CONCLUSIONS StayWell is a low-intensity, cost-effective, and accessible population-level mental health intervention. Participation in StayWell focused on COVID-19 mental health coping skills and was related to improved depression and anxiety symptoms. In addition to improvements in outcomes, we found high levels of engagement during the 60-day intervention period. Text messaging interventions could serve as an important public health tool for disseminating strategies to manage mental health. CLINICALTRIAL ClinicalTrials.gov Identifier: NCT04473599 INTERNATIONAL REGISTERED REPORT RR2-10.2196/23592

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