scholarly journals Evaluating the mental health impacts of the COVID-19 pandemic: perceived risk of COVID-19 infection and childhood trauma predict adult depressive symptoms in urban South Africa

2020 ◽  
pp. 1-13 ◽  
Author(s):  
Andrew Wooyoung Kim ◽  
Tawanda Nyengerai ◽  
Emily Mendenhall
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Childhood Trauma ◽  
Perceived Risk ◽  
Mental Healthcare ◽  
Public Mental Health ◽  
Health Impacts ◽  
Psychological Resources ◽  
Full Data ◽  
Unit Increase

Abstract Background South Africa's national lockdown introduced serious threats to public mental health in a society where one in three individuals develops a psychiatric disorder during their life. We aimed to evaluate the mental health impacts of the COVID-19 pandemic using a mixed-methods design. Methods This longitudinal study drew from a preexisting sample of 957 adults living in Soweto, a major township near Johannesburg. Psychological assessments were administered across two waves between August 2019 and March 2020 and during the first 6 weeks of the lockdown (late March–early May 2020). Interviews on COVID-19 experiences were administered in the second wave. Multiple regression models examined relationships between perceived COVID-19 risk and depression. Results Full data on perceived COVID-19 risk, depression, and covariates were available in 221 adults. In total, 14.5% of adults were at risk for depression. Higher perceived COVID-19 risk predicted greater depressive symptoms (p < 0.001), particularly among adults with histories of childhood trauma, though this effect was marginally significant (p = 0.063). Adults were about two times more likely to experience significant depressive symptoms for every one unit increase in perceived COVID-19 risk (p = 0.021; 95% CI 1.10–3.39). Qualitative data identified potent experiences of anxiety, financial insecurity, fear of infection, and rumination. Conclusions Higher perceived risk of COVID-19 infection is associated with greater depressive symptoms during the first 6 weeks of quarantine. High rates of severe mental illness and low availability of mental healthcare amidst COVID-19 emphasize the need for immediate and accessible psychological resources.

scholarly journals Evaluating the Mental Health Impacts of the COVID-19 Pandemic in Urban South Africa: Perceived Risk of COVID-19 Infection and Childhood Trauma Predict Adult Depressive Symptoms

2020 ◽  
Author(s):  
Andrew Wooyoung Kim ◽  
Tawanda Nyengerai ◽  
Emily Mendenhall
Keyword(s):  
Mental Health ◽  
South Africa ◽  
Depressive Symptoms ◽  
Childhood Trauma ◽  
Perceived Risk ◽  
Mental Healthcare ◽  
Public Mental Health ◽  
Health Impacts ◽  
Psychological Resources ◽  
Full Data

ABSTRACTSouth Africa’s national lockdown introduced serious threats to public mental health in a society where one in three individuals develop a psychiatric disorder during their life. We aimed to evaluate the mental health impacts of the COVID-19 pandemic using a mixed methods design. This longitudinal study drew from a preexisting sample of 957 adults living in Soweto, a major township near Johannesburg. Psychological assessments were administered across two waves: between August 2019-March 2020 and during the first six weeks of the lockdown (late March-early May 2020). Interviews on COVID-19 experiences were administered in the second wave. Multiple regression models examined relationships between perceived COVID-19 risk and depression. Full data on perceived COVID-19 risk, depression, and covariates were available in 221 adults. 14.5% of adults were at risk for depression. Higher perceived COVID-19 risk predicted greater depressive symptoms (p < 0.001) particularly among adults with histories of childhood trauma, though this effect was marginally significant (p = 0.062). Adults were two times more likely to experience significant depressive symptoms for every one unit increase in perceived COVID-19 risk (p = 0.016; 95% CI [1.14, 3.49]). Qualitative data identified potent experiences of anxiety, financial insecurity, fear of infection, and rumination. Higher perceived risk of COVID-19 infection is associated with greater depressive symptoms among adults with histories of childhood trauma during the first six weeks of quarantine. High rates of severe mental illness and low availability of mental healthcare amidst COVID-19 emphasize the need for immediate and accessible psychological resources in South Africa.

The non-specific nature of mental health and structural brain outcomes following childhood trauma

2021 ◽  
pp. 1-10
Author(s):  
Theresa K. Haidl ◽  
Dennis M. Hedderich ◽  
Marlene Rosen ◽  
Nathalie Kaiser ◽  
Mauro Seves ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factor ◽  
Depressive Symptoms ◽  
Childhood Trauma ◽  
Brain Structure ◽  
Mental Health Disorders ◽  
Recent Onset ◽  
Increased Risk ◽  
Health Disorders ◽  
Structural Brain

Abstract Background Childhood trauma (CT) is associated with an increased risk of mental health disorders; however, it is unknown whether this represents a diagnosis-specific risk factor for specific psychopathology mediated by structural brain changes. Our aim was to explore whether (i) a predictive CT pattern for transdiagnostic psychopathology exists, and whether (ii) CT can differentiate between distinct diagnosis-dependent psychopathology. Furthermore, we aimed to identify the association between CT, psychopathology and brain structure. Methods We used multivariate pattern analysis in data from 643 participants of the Personalised Prognostic Tools for Early Psychosis Management study (PRONIA), including healthy controls (HC), recent onset psychosis (ROP), recent onset depression (ROD), and patients clinically at high-risk for psychosis (CHR). Participants completed structured interviews and self-report measures including the Childhood Trauma Questionnaire, SCID diagnostic interview, BDI-II, PANSS, Schizophrenia Proneness Instrument, Structured Interview for Prodromal Symptoms and structural MRI, analyzed by voxel-based morphometry. Results (i) Patients and HC could be distinguished by their CT pattern with a reasonable precision [balanced accuracy of 71.2% (sensitivity = 72.1%, specificity = 70.4%, p ≤ 0.001]. (ii) Subdomains ‘emotional neglect’ and ‘emotional abuse’ were most predictive for CHR and ROP, while in ROD ‘physical abuse’ and ‘sexual abuse’ were most important. The CT pattern was significantly associated with the severity of depressive symptoms in ROD, ROP, and CHR, as well as with the PANSS total and negative domain scores in the CHR patients. No associations between group-separating CT patterns and brain structure were found. Conclusions These results indicate that CT poses a transdiagnostic risk factor for mental health disorders, possibly related to depressive symptoms. While differences in the quality of CT exposure exist, diagnostic differentiation was not possible suggesting a multi-factorial pathogenesis.

scholarly journals Depressive Symptoms, Help-Seeking, and Barriers to Mental Healthcare Among Healthcare Professionals in Lithuania

2021 ◽  
Vol 28 (1) ◽  
pp. 3
Author(s):  
Daniel Rogoža ◽  
Robertas Strumila ◽  
Eglė Klivickaitė ◽  
Edgaras Diržius ◽  
Neringa Čėnaitė
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Help Seeking ◽  
Healthcare Professionals ◽  
Mental Health Problems ◽  
Mental Healthcare ◽  
Health Problems ◽  
Poor Mental Health ◽  
Work Related ◽  
Patient Health

Background: Previous research suggests that healthcare professionals (HCPs) experience high levels of work-related psychological distress, including depressive symptoms. Due to the stigma of mental health problems and other barriers, HCPs are likely to be hesitant to seek appropriate mental healthcare. We aimed to explore these phenomena among HCPs in Lithuania.Methods: A web survey inquiring about depressive symptoms, help-seeking, and barriers to mental healthcare was conducted. Depressive symptoms were measured using the Patient Health Questionnaire-9 (PHQ-9). 601 complete questionnaires were included in the analyses. The barriers to help-seeking were identified using the inductive content analysis approach. Descriptive, non-parametric, and robust statistical analysis was performed using SPSS software.Results: Most of the respondents have reported depression-like symptoms over the lifetime, although only about a third of them sought professional help. Of those, roughly half preferred a private specialist. The stigma and neglect of mental health problems were the most common barriers to help-seeking. Around half of the HCPs believed that seeking mental healthcare can imperil their occupational license. About a quarter of the HCPs screened positive for clinically relevant depressive symptoms. Statistically significant differences in the PHQ-9 score were found between categories of healthcare specialty, marital status, religious beliefs, workplace, and years of work as a HCP. Fewer years of work and younger age were associated with the higher PHQ-9 score.Conclusions: Our findings suggest that HCPs in Lithuania may be inclined not to seek appropriate mental healthcare and experience poor mental health, although stronger evidence is needed to verify these findings. 

scholarly journals Access, accountability, and the proliferation of psychological therapy: On the introduction of the IAPT initiative and the transformation of mental healthcare

2019 ◽  
Vol 49 (4) ◽  
pp. 627-650 ◽  
Author(s):  
Martyn Pickersgill
Keyword(s):  
Mental Health ◽  
Controlled Trial ◽  
Mental Healthcare ◽  
Public Mental Health ◽  
Psychological Therapy ◽  
Behaviour Therapy ◽  
Psychological Therapies ◽  
Treatment Of Depression ◽  
Cognitive Behaviour

Psychological therapy today plays a key role in UK public mental health. In large part, this has been through the development of the (specifically English) Improving Access to Psychological Therapies (IAPT) programme. Through IAPT, millions of citizens have encountered interventions such as cognitive behaviour therapy, largely for the treatment of depression and anxiety. This article interrogates how this national response to problems of mental ill-health – and the problematization itself – was developed, accounted for, and sustained. By imbricating economic expertise with accounts of mental ill-health and mechanisms of treatment, IAPT has revivified psychological framings of pathology and therapy. However, it has done so in ways that are more familiar within biomedical contexts (e.g. through recourse to randomized controlled trial studies). Today, the initiative is a principal player in relation to which other services are increasingly developed. Indeed, in many respects IAPT has transformed from content to context within UK public mental health (in a process of what I term ‘contextification’). By documenting these developments, this paper contributes to re-centring questions about the place and role of psychology in contemporary healthcare. Doing so helps to complicate assumptions about the dominance of linear forms of (de)biomedicalization in health-systems.

Depression, Substance Use and Suicidality in Help-Seeking Adolescents: A Survey of Prevalence

2004 ◽  
Vol 14 (2) ◽  
pp. 162-175 ◽  
Author(s):  
Elizabeth Cosgrave ◽  
Eóin Killackey ◽  
Alison Yung ◽  
Joe Buckby ◽  
Katherine Godfrey ◽  
...  
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Depressive Symptoms ◽  
Substance Use Disorders ◽  
Psychiatric Diagnosis ◽  
Help Seeking ◽  
Mental Health Problems ◽  
Common Mental Disorders ◽  
School Setting ◽  
Public Mental Health

AbstractMental health problems affect a sizeable minority of Australian adolescents. Depression and substance use disorders are common mental disorders reported in this age group. Difficulties of this nature that manifest in adolescence will often continue into adulthood. This report describes a sample of adolescents referred to a public mental health service with respect to their psychiatric diagnoses, depressive symptoms, patterns of substance use and level of suicidality. Mood disorders and substance-use disorders were both prevalent in the sample of participants, with sizeable comorbidity reflected in the number ol participants meeting criteria for both of these diagnoses. Data revealed participants with a psychiatric diagnosis were significantly more likely to have made a suicide attempt than those with no diagnosis. High levels of depressive symptoms were associated with suicidality, illicit substance use, and the likelihood of having a psychiatric diagnosis. Heavy use of alcohol was prevalent in this group, but unrelated to the other variables of interest to the study. These results are discussed with respect to the importance of early detection of vulnerable students in a school setting.

Clinical risk assessment rating and all-cause mortality in secondary mental healthcare: the South London and Maudsley NHS Foundation Trust Biomedical Research Centre (SLAM BRC) Case Register

2011 ◽  
Vol 42 (8) ◽  
pp. 1581-1590 ◽  
Author(s):  
C.-Y. Wu ◽  
C.-K. Chang ◽  
R. D. Hayes ◽  
M. Broadbent ◽  
M. Hotopf ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Assessment ◽  
Mental Health Service ◽  
Health Service ◽  
Mental Healthcare ◽  
Research Centre ◽  
Case Register ◽  
All Cause Mortality ◽  
Unit Increase ◽  
Clinical Risk Assessment

BackgroundMental disorders are widely recognized to be associated with increased risk of all-cause mortality. However, the extent to which highest-risk groups for mortality overlap with those viewed with highest concern by mental health services is less clear. The aim of the study was to investigate clinical risk assessment ratings for suicide, violence and self-neglect in relation to all-cause mortality among people receiving secondary mental healthcare.MethodA total of 9234 subjects over the age of 15 years were identified from the South London and Maudsley Biomedical Research Centre Case Register who had received a second tier structured risk assessment in the course of their clinical care. A cohort analysis was carried out. Total scores for three risk assessment clusters (suicide, violence and self-neglect) were calculated and Cox regression models used to assess survival from first assessment.ResultsA total of 234 deaths had occurred over an average 9.4-month follow-up period. Mortality was relatively high for the cohort overall in relation to national norms [standardized mortality ratio 3.23, 95% confidence interval (CI) 2.83–3.67] but not in relation to other mental health service users with similar diagnoses. Only the score for the self-neglect cluster predicted mortality [hazard ratio (HR) per unit increase 1.14, 95% CI 1.04–1.24] with null findings for assessed risk of suicide or violence (HRs per unit increase 1.00 and 1.06 respectively).ConclusionsLevel of clinician-appraised risk of self-neglect, but not of suicide or violence, predicted all-cause mortality among people receiving specific assessment of risk in a secondary mental health service.

scholarly journals Improving throughput in a youth mental health service

2017 ◽  
Vol 30 (3) ◽  
pp. 224-234
Author(s):  
Dominiek Coates ◽  
Deborah Howe
Keyword(s):  
Mental Health ◽  
Treatment Options ◽  
Mental Healthcare ◽  
Public Mental Health ◽  
Working Party ◽  
Youth Mental Health ◽  
Service Improvement ◽  
Service Model ◽  
Content Type ◽  
Service Models

Purpose The discrepancy between increasing demand and limited resources in public mental health is putting pressure on services to continuously review their practices and develop innovative models of care that redress this discrepancy. To ensure the service models continue to meet the needs of all stakeholders, children and young people’s mental health (CYPMH) conducts regular reviews of its service models. Accordingly, the youth mental health (YMH) model at CYPMH has evolved significantly over time in response to the needs of young people and service demand. The purpose of this paper is to outline the findings of a recent review of the YMH service, and the subsequent changes to the service model. Design/methodology/approach Informed by a participatory action philosophy, feedback was sought from staff on the service model through a range of methods including a questionnaire, staff consultations through a working party and interviews. This feedback was used to redesign the model, which was then evaluated again. Findings Staff identified a number of challenges with the service model and a range of service improvement solutions. The key issues included exceedingly high caseloads, workplace tensions, and fragmentation of the client journey. This paper outlines the primary solution to these key concerns, namely, the introduction of brief intervention (BI) as the entry point to the service. Originality/value BI approaches provide a solution to overly high caseloads as the direct and focussed approach of BI generally reduces the number of sessions people need. BI is an important addition to other treatment options and should be seen as a valid component of the continuum of mental healthcare.

scholarly journals When altruists cannot help: The influence of altruism on mental health during COVID-19 pandemic

2020 ◽  
Author(s):  
Yi Feng ◽  
Dan Dong ◽  
Min Zong ◽  
Zhizun Yang ◽  
Zhihong Qiao
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Negative Affect ◽  
Perceived Risk ◽  
Structural Equation ◽  
Online Survey ◽  
Depression Scale ◽  
Well Being ◽  
Self Report ◽  
Valuable Insight

Abstract Background The positive predictive effect of altruism on physical and psychological well-being has been extensively demonstrated in previous studies, but few studies have examined the effect of altruism on negative mental health outcomes when altruists cannot perform altruistic behaviors. This study explored the influence of altruism on negative affect and mental health (anxiety and depression) during the outbreak of the COVID-19 pandemic, when people self-isolated at home in China.Method: College students were recruited via a cross-sectional online survey during the outbreak of COVID-19 in China. Self-reported perceived risk, altruism, negative affect, anxiety and depressive symptoms were measured using the Self-Report Altruism Scale (SRA), the Positive and Negative Affect Schedule (PANAS), the 7-item Generalized Anxiety Disorder Scale (GAD-7) and the 9-item PHQ depression scale (PHQ-9). A structural equation model was used to analyze the mediating and moderating effects on mental health.Results The final sample comprised 1346 Chinese participants (Mage = 19.76 ± 2.23 years, 73% female). Overall, the higher risk people perceived, the more negative affect they exhibited (β = 0.16, p < .001); thus, the more anxious and depressed they felt (β = 0.134, p < .001), but this relationship between risk perception and negative affect was moderated by altruism. Paradoxical to previous studies, the increase in negative affect associated with increased perceived risk was pronounced among individuals with high altruism ( t = 7.68, p < .001).Conclusions Individuals with high altruism exhibited more negative affect, indirectly increasing their anxiety and depressive symptoms. The findings enrich the theory of altruism and provide valuable insight into the influence of altruism on mental health during the COVID-19 outbreak.

scholarly journals Perinatal mental health around the world: priorities for research and service development in China

2020 ◽  
Vol 17 (3) ◽  
pp. 50-53 ◽  
Author(s):  
Simone Eliane Schwank ◽  
Qiongjie Zhou ◽  
Yanling He ◽  
Ganesh Acharya
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Perceived Risk ◽  
Help Seeking ◽  
Healthcare Providers ◽  
Mental Healthcare ◽  
Healthcare Services ◽  
Service Development ◽  
Community Healthcare ◽  
Help Seeking Behaviour

China's healthcare is improving together with rapid economic growth. Yet, mental healthcare is lagging behind. Prevalence of perinatal depression is high among women of the one-child generation, but access to qualified care is limited. Chinese healthcare professionals, policy makers and patients alike express concerns about insufficient knowledge among the public as well as healthcare providers regarding mental disorders. There appears to be a general lack of help-seeking behaviour for mental disorders owing to perceived risk of social stigmatisation. Social support through family and friends, use of online resources and community healthcare services are preferred, rather than seeking help from mental health specialists.

scholarly journals Depression and Psychological Trauma: An Overview Integrating Current Research and Specific Evidence of Studies in the Treatment of Depression in Public Mental Health Services in Chile

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Verónica Vitriol ◽  
Alfredo Cancino ◽  
Kristina Weil ◽  
Carolina Salgado ◽  
Maria Andrea Asenjo ◽  
...  
Keyword(s):  
Mental Health ◽  
Childhood Trauma ◽  
Interpersonal Relationships ◽  
Psychiatric Symptoms ◽  
Public Mental Health ◽  
Psychological Trauma ◽  
Outpatient Intervention ◽  
High Prevalence ◽  
Psychosocial Difficulties ◽  
Early Trauma

In the last two decades, different research has demonstrated the high prevalence of childhood trauma, including sexual abuse, among depressive women. These findings are associated with a complex, severe, and chronic psychopathology. This can be explained considering the neurobiological changes secondary to early trauma that can provoke a neuroendocrine failure to compensate in response to challenge. It suggests the existence of a distinguishable clinical-neurobiological subtype of depression as a function of childhood trauma that requires specific treatments. Among women with depression and early trauma receiving treatment in a public mental health service in Chile, it was demonstrated that a brief outpatient intervention (that screened for and focused on childhood trauma and helped patients to understand current psychosocial difficulties as a repetition of past trauma) was effective in reducing psychiatric symptoms and improving interpersonal relationships. However, in this population, this intervention did not prevent posttraumatic stress disorder secondary to the extreme earthquake that occurred in February 2010. Therefore in adults with depression and early trauma, it is necessary to evaluate prolonged multimodal treatments that integrate pharmacotherapy, social support, and interpersonal psychotherapies with trauma focused interventions (specific interventions for specific traumas).

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