Increase in prevalence of current mental disorders in the context of COVID-19: analysis of repeated nationwide cross-sectional surveys

Abstract Aims The United Nations warned of COVID-19-related mental health crisis; however, it is unknown whether there is an increase in the prevalence of mental disorders as existing studies lack a reliable baseline analysis or they did not use a diagnostic measure. We aimed to analyse trends in the prevalence of mental disorders prior to and during the COVID-19 pandemic. Methods We analysed data from repeated cross-sectional surveys on a representative sample of non-institutionalised Czech adults (18+ years) from both November 2017 (n = 3306; 54% females) and May 2020 (n = 3021; 52% females). We used Mini International Neuropsychiatric Interview (MINI) as the main screening instrument. We calculated descriptive statistics and compared the prevalence of current mood and anxiety disorders, suicide risk and alcohol-related disorders at baseline and right after the first peak of COVID-19 when related lockdown was still in place in CZ. In addition, using logistic regression, we assessed the association between COVID-19-related worries and the presence of mental disorders. Results The prevalence of those experiencing symptoms of at least one current mental disorder rose from a baseline of 20.02 (95% CI = 18.64; 21.39) in 2017 to 29.63 (95% CI = 27.9; 31.37) in 2020 during the COVID-19 pandemic. The prevalence of both major depressive disorder (3.96, 95% CI = 3.28; 4.62 v. 11.77, 95% CI = 10.56; 12.99); and suicide risk (3.88, 95% CI = 3.21; 4.52 v. 11.88, 95% CI = 10.64; 13.07) tripled and current anxiety disorders almost doubled (7.79, 95% CI = 6.87; 8.7 v. 12.84, 95% CI = 11.6; 14.05). The prevalence of alcohol use disorders in 2020 was approximately the same as in 2017 (10.84, 95% CI = 9.78; 11.89 v. 9.88, 95% CI = 8.74; 10.98); however, there was a significant increase in weekly binge drinking behaviours (4.07% v. 6.39%). Strong worries about both, health or economic consequences of COVID-19, were associated with an increased odds of having a mental disorder (1.63, 95% CI = 1.4; 1.89 and 1.42, 95% CI = 1.23; 1.63 respectively). Conclusions This study provides evidence matching concerns that COVID-19-related mental health problems pose a major threat to populations, particularly considering the barriers in service provision posed during lockdown. This finding emphasises an urgent need to scale up mental health promotion and prevention globally.

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Influence of military component and deployment-related experiences on mental disorders among Canadian military personnel who deployed to Afghanistan: a cross-sectional survey

BMJ Open ◽

10.1136/bmjopen-2017-018735 ◽

2018 ◽

Vol 8 (3) ◽

pp. e018735 ◽

Cited By ~ 3

Author(s):

David Boulos ◽

Deniz Fikretoglu

Keyword(s):

Mental Health ◽

Anxiety Disorder ◽

Mental Disorders ◽

Mental Disorder ◽

Suicide Ideation ◽

Mental Health Problems ◽

Armed Forces ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Prevalence Difference

ObjectiveThe primary objective was to explore differences in mental health problems (MHP) between serving Canadian Armed Forces (CAF) components (Regular Force (RegF); Reserve Force (ResF)) with an Afghanistan deployment and to assess the contribution of both component and deployment experiences to MHP using covariate-adjusted prevalence difference estimates. Additionally, mental health services use (MHSU) was descriptively assessed among those with a mental disorder.DesignData came from the 2013 CAF Mental Health Survey, a cross-sectional survey of serving personnel (n=72 629). Analyses were limited to those with an Afghanistan deployment (population n=35 311; sampled n=4854). Logistic regression compared MHP between RegF and ResF members. Covariate-adjusted prevalence differences were computed.Primary outcome measureThe primary outcomes were MHP, past-year mental disorders, identified using the WHO’s Composite International Diagnostic Interview, and past-year suicide ideation.ResultsResF personnel were less likely to be identified with a past-year anxiety disorder (adjusted OR (AOR)=0.72 (95% CI 0.58 to 0.90)), specifically both generalised anxiety disorder and panic disorder, but more likely to be identified with a past-year alcohol abuse disorder (AOR=1.63 (95% CI 1.04 to 2.58)). The magnitude of the covariate-adjusted disorder prevalence differences for component was highest for the any anxiety disorder outcome, 2.8% (95% CI 1.0 to 4.6); lower for ResF. All but one deployment-related experience variable had some association with MHP. The ‘ever felt responsible for the death of a Canadian or ally personnel’ experience had the strongest association with MHP; its estimated covariate-adjusted disorder prevalence difference was highest for the any (of the six measured) mental disorder outcome (11.2% (95% CI 6.6 to 15.9)). Additionally, ResF reported less past-year MHSU and more past-year civilian MHSU.ConclusionsPast-year MHP differences were identified between components. Our findings suggest that although deployment-related experiences were highly associated with MHP, these only partially accounted for MHP differences between components. Additional research is needed to further investigate MHSU differences between components.

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Mental health consequences of long-term stays in refugee camps: Preliminary evidence from Moria

10.21203/rs.3.rs-18160/v1 ◽

2020 ◽

Author(s):

willemine van de Wiel ◽

Carla Castillo-Laborde ◽

Francisco Urzúa I. ◽

Michelle Fish ◽

Willem F. Scholte

Keyword(s):

Mental Health ◽

Length Of Stay ◽

Mental Health Problems ◽

Average Length ◽

Case Definition ◽

Living Conditions ◽

Refugee Camps ◽

Mental Health Crisis ◽

Cross Sectional ◽

Health Crisis

Abstract Background Over the last decade, millions of refugees have arrived in Europe. Upon arrival refugees reside in designated refugee camps which, even though originally designed to home refugees on a short stay basis only, developed into long-stay facilities. Some of these camps have detention-like characteristics and dire living conditions. One such example is Moria camp on the island of Lesvos, Greece, which has been repeatedly reported for being overcrowded, unhygienic, and unsafe. This study explores the incidence of acute mental health crises and their relationship with the length of stay in the camp. Methods A cross-sectional study was conducted using routinely collected data on 857 consultations during 90 nights at an emergency night clinic in Moria camp. Logistic regression analysis was used to explore whether the length of stay in the camp was predictive of the occurrence of acute mental health crises. Results Of all consultations (n=857), 25⋅5% (n=219) were related to mental health problems; 17⋅4% (n=38) of these met the study’s case definition of acute mental health crisis. Such crises were positively associated with the length of stay in the camp (p=0⋅044); the odds ratio increases with 1·03 for every 10% increase in days of residence. This is notable when considering the average length of stay in the camp (71 days). Conclusion Acknowledging that this study does not provide causal effects on the relation between length of stay and mental health crises, the established link can hardly be related to anything else but the inhumane living conditions in the camp, its inhabitants’ lack of future expectations, and the scarce provision of mental health services. This form of neglect urgently calls for attention of the medical world and Europe’s policy makers.

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Mental health consequences of long-term stays in refugee camps: preliminary evidence from Moria

BMC Public Health ◽

10.1186/s12889-021-11301-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Willemine van de Wiel ◽

Carla Castillo-Laborde ◽

I. Francisco Urzúa ◽

Michelle Fish ◽

Willem F. Scholte

Keyword(s):

Mental Health ◽

Length Of Stay ◽

Mental Health Problems ◽

Average Length ◽

Case Definition ◽

Living Conditions ◽

Mental Health Crisis ◽

Contributing Factors ◽

Cross Sectional ◽

Health Crisis

Abstract Background Ever since the implementation of the EU-Turkey deal, most refugees that enter Greece via sea are confined to the island on which they arrive until their asylum claims are adjudicated, where they generally reside in camps. Some of these camps have detention-like characteristics and dire living conditions, such as Moria camp on the island of Lesbos, Greece. Aid-organizations have stated that the situation in camp Moria deteriorates the mental health of its inhabitants and there is qualitative evidence to support this. This study explores the quantitative relationship between the incidence of acute mental health crises and the length of stay in the camp. Methods A cross-sectional study was conducted using routinely collected data on 856 consultations of 634 different patients during 90 nights at an emergency clinic in Moria camp. Logistic regression analysis was used to explore whether the length of stay in the camp was predictive of the occurrence of an acute mental health crisis. Results Of the 634 patients, the majority were men (59·3%), the average age was 23·2 years [0–71], and 24·3% was < 18 years. 25·5% (n = 218) of consultations were related to mental health problems; 17·0% (n = 37) of these met the study’s case definition of an acute mental health crisis. Such crises were positively associated with the length of stay in the camp (p = 0·011); the odds ratio of a mental health crisis increases with 1·03 for every 10% increase in days of residence in the camp. This is notable when considering the average length of stay in the camp is 71 days. Conclusion This study offers quantitative support for the notion that the adverse conditions in Moria camp deteriorate the mental health of its inhabitants as suggested in qualitative research. Although this study does not provide evidence of causality, it is likely that the poor and unsafe living conditions, challenging refugee determination procedures, and a lack of mental health services in the camp are significant contributing factors. We urgently call for Europe’s policymakers to honour the ‘51 Geneva refugee convention and terminate the neglectful situation on the Greek archipelago.

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Mental health consequences of long-term stays in refugee camps: Preliminary evidence from Moria

10.21203/rs.3.rs-18160/v2 ◽

2020 ◽

Author(s):

willemine van de Wiel ◽

Carla Castillo-Laborde ◽

Francisco Urzúa I. ◽

Michelle Fish ◽

Willem F. Scholte

Keyword(s):

Mental Health ◽

Length Of Stay ◽

Mental Health Problems ◽

Average Length ◽

Case Definition ◽

Living Conditions ◽

Mental Health Crisis ◽

Contributing Factors ◽

Cross Sectional ◽

Health Crisis

Abstract Background Ever since the implementation of the EU-Turkey deal, most refugees that enter Greece via sea are confined to the island on which they arrive until their asylum claims are adjudicated, where they generally reside camps. Some of these camps have detention-like characteristics and dire living conditions, such as Moria camp on the island of Lesbos, Greece. Aid-organizations have stated that the situation in camp Moria deteriorates the mental health of its inhabitants and there is qualitative evidence to support this. This study explores the quantitative relationship between the incidence of acute mental health crises and the length of stay in the camp. Methods A cross-sectional study was conducted using routinely collected data on 856 consultations of 634 different patients during 90 nights at an emergency clinic in Moria camp. Logistic regression analysis was used to explore whether the length of stay in the camp was predictive of the occurrence of an acute mental health crisis. Results Of the 634 patients, the majority were men (59·3%), the average age was 23·2 years [0–71], and 24·3% was <18 years. 25·5% (n=218) of consultations were related to mental health problems; 17·0% (n=37) of these met the study’s case definition of an acute mental health crisis. Such crises were positively associated with the length of stay in the camp (p=0011); the odds ratio of a mental health crisis increases with 1·03 for every 10% increase in days of residence in the camp. This is notable when considering the average length of stay in the camp is 71 days. Conclusion This study offers quantitative support for the notion that the adverse conditions in Moria camp deteriorate the mental health of its inhabitants as suggested in qualitative research. Although this study does not provide evidence of causality, it is likely that the poor and unsafe living conditions, challenging refugee determination procedures, and a lack of mental health services in the camp are significant contributing factors. We urgently call for Europe’s policymakers to honor the ‘51 Geneva refugee convention and terminate the neglectful situation on the Greek archipelago.

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Impact of arthritis on the perceived need and use of mental healthcare among Canadians with mental disorders: nationally representative cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-041371 ◽

2020 ◽

Vol 10 (12) ◽

pp. e041371

Author(s):

Alyssa Howren ◽

J Antonio Aviña-Zubieta ◽

Deborah Da Costa ◽

Joseph H Puyat ◽

Hui Xie ◽

...

Keyword(s):

Mental Health ◽

Mental Disorders ◽

Mental Disorder ◽

Clinical Care ◽

Mental Healthcare ◽

Cluster Sampling ◽

Cross Sectional ◽

Perceived Need ◽

Mental Health Support ◽

Health Support

ObjectiveTo evaluate the association between having arthritis and the perceived need for mental healthcare and use of mental health support among individuals with mental disorders.DesignA cross-sectional analysis using data from Canadian Community Health Survey—Mental Health (2012).SettingThe survey was administered across Canada’s 10 provinces using multistage cluster sampling.ParticipantsThe study sample consisted of individuals reporting depression, anxiety or bipolar disorder.Study variables and analysisThe explanatory variable was self-reported doctor-diagnosed arthritis, and outcomes were perceived need for mental healthcare and use of mental health support. We computed overall and gender-stratified multivariable binomial logistic regression models adjusted for age, gender, race/ethnicity, income and geographical region.ResultsAmong 1774 individuals with a mental disorder in the study sample, 436 (20.4%) reported having arthritis. Arthritis was associated with increased odds of having a perceived need for mental healthcare (adjusted OR (aOR) 1.71, 95% CI 1.06 to 2.77). In the gender-stratified models, this association was increased among men (aOR 2.69, 95% CI 1.32 to 5.49) but not women (aOR 1.48, 95% CI 0.78 to 2.82). Evaluation of the association between arthritis and use of mental health support resulted in an aOR of 1.50 (95% CI 0.89 to 2.51). Individuals with arthritis tended to use medications and professional services as opposed to non-professional support.ConclusionComorbid arthritis among individuals with a mental disorder was associated with an increased perceived need for mental healthcare, especially in men, underscoring the importance of understanding the role of masculinity in health seeking. Assessing the mental health of patients with arthritis continues to be essential for clinical care.

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Tobacco smoking and mental disorders in Australian adolescents

Australian & New Zealand Journal of Psychiatry ◽

10.1177/00048674211009617 ◽

2021 ◽

pp. 000486742110096

Author(s):

David Lawrence ◽

Sarah E Johnson ◽

Francis Mitrou ◽

Sharon Lawn ◽

Michael Sawyer

Keyword(s):

Mental Health ◽

Mental Disorders ◽

Mental Disorder ◽

Tobacco Smoking ◽

Mental Health Problems ◽

Health Problems ◽

Major Depressive ◽

Current Smoking ◽

Self Harm ◽

Current Tobacco

Objectives: This study aimed to (1) examine the strength of the association between mental disorders/mental health problems, risk behaviours and tobacco smoking among Australian adolescents, (2) compare rates of tobacco smoking among Australian adolescents with major depressive disorder, attention-deficit/hyperactivity disorder and/or conduct disorder in 2013/14 vs 1998, and (3) identify the extent to which an association between tobacco smoking and mental health problems among adolescents can be attributed to non-mental health risk factors. Methods: The study utilised data from the first (1998) and second (2013/14) child and adolescent components of the National Surveys of Mental Health and Wellbeing. Both surveys identified nationally representative samples of Australian young people aged 4–17 years, living in private dwellings. Information was collected from parents and 13- to 17-year-olds about mental disorders, mental health problems, risk behaviours and tobacco smoking. Results: In the 2013/14 survey, the rate of current tobacco smoking among those with a mental disorder was 20% compared to 5% in those without a mental disorder. Rates were highest for young people with conduct disorder (50%), major depressive disorder (24%) and anxiety disorders (19%). In 2013/14, 38% of current tobacco smokers had a mental disorder and 32% reported self-harm and/or suicidal ideation vs 10% and 5%, respectively, among adolescents who had never smoked. Females with mental disorders or reporting self-harm or suicidal ideation had higher rates of current smoking than males. Other significant factors associated with current smoking included school-related problems, binge eating and having had more than one sexual partner. Conclusion: While smoking rates in 13- to 17-year-olds with mental disorders had declined since 1998, the strength of the association between mental disorders and smoking had increased, especially among females. Our findings highlight the need to address the tobacco smoking among adolescents with mental disorders, particularly females.

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Natural kinds of mental disorder

Synthese ◽

10.1007/s11229-021-03239-9 ◽

2021 ◽

Author(s):

Sander Werkhoven

Keyword(s):

Mental Health ◽

Mental Disorders ◽

Mental Disorder ◽

Mental Health Problems ◽

Natural Kinds ◽

Health Problems ◽

Abnormal Behaviour ◽

Diagnostic Categories ◽

Socially Constructed

AbstractAre mental disorders (autism, ADHD, schizophrenia) natural kinds or socially constructed categories? What is at stake if either of these views prove to be true? This paper offers a qualified defence for the view that there may be natural kinds of mental disorder, but also that the implications of this claim are generally overestimated. Especially concerns about over-inclusiveness of diagnostic categories and medicalisation of abnormal behaviour are not addressed by the debate. To arrive at these conclusions the paper opens with a discussion of kind formation in science, followed by an analysis of natural kinds. Seven principled and empirically informed objections to the possibility of natural kinds of mental disorder are considered and rejected. The paper ends with a reflection on diagnostics of mental health problems that don’t fall into natural kinds. Despite the defence of the possibility of natural kinds of mental disorder, this is likely to be the majority of cases.

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Economic burden of silent mental disorders: a case study of agnosia in schizophrenia

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20175821 ◽

2017 ◽

Vol 5 (1) ◽

pp. 401

Author(s):

Vijay Kumar Chattu ◽

Paula Mahon

Keyword(s):

Mental Health ◽

Mental Disorders ◽

Mental Disorder ◽

Mental Health Problems ◽

Action Plan ◽

Developed Countries ◽

World Health ◽

Economic Output ◽

The World

Mental health problems affect society as a whole, and not just a small, isolated segment. In developed countries with well-organized healthcare systems, between 44% and 70% of patients with mental disorders do not receive treatment whereas in developing countries the treatment gap being close to 90%. Schizophrenia is a severe mental disorder affecting more than 21 million people worldwide. People with schizophrenia are 2-2.5 times more likely to die early than the general population. The case study highlights about agnosia in a schizophrenic patient in a primary care setting and how to address the management at a broader perspective using the appropriate antipsychotic medication and ensuring the support from a family without violating the human rights of the patient. The World Economic Forum estimated that the cumulative global impact of mental disorders in terms of lost economic output will amount to US$ 16 trillion over the next 20 years, equivalent to more than 1% of the global gross domestic product. Mental health should be a concern for all of us, rather than only for those who suffer from a mental disorder. The mental health action plan 2013-2020, endorsed by the World Health Assembly in 2013, highlights the steps required to provide appropriate services for people with mental disorders including schizophrenia. A key recommendation of the action plan is to shift services from institutions to the community. Mental health must be considered a focus of renewed investment not just in terms of human development and dignity but also in terms of social and economic development.

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The scale of the problem

Psychiatry ◽

10.1093/oso/9780198754008.003.0006 ◽

2019 ◽

Author(s):

Rebecca McKnight ◽

Jonathan Price ◽

John Geddes

Keyword(s):

Mental Health ◽

Mental Disorders ◽

Mental Disorder ◽

Mental Health Problems ◽

Clinical Medicine ◽

Well Being ◽

World Health ◽

The Social ◽

Definition Of ◽

Health Organization

One in four individuals suffer from a psychiatric disorder at some point in their life, with 15– 20 per cent fitting criteria for a mental disorder at any given time. The latter corresponds to around 450 million people worldwide, placing mental disorders as one of the leading causes of global morbidity. Mental health problems represent five of the ten leading causes of disability worldwide. The World Health Organization (WHO) reported in mid 2016 that ‘the global cost of mental illness is £651 billion per year’, stating that the equivalent of 50 million working years was being lost annually due to mental disorders. The financial global impact is clearly vast, but on a smaller scale, the social and psychological impacts of having a mental disorder on yourself or your family are greater still. It is often difficult for the general public and clinicians outside psychiatry to think of mental health disorders as ‘diseases’ because it is harder to pinpoint a specific pathological cause for them. When confronted with this view, it is helpful to consider that most of medicine was actually founded on this basis. For example, although medicine has been a profession for the past 2500 years, it was only in the late 1980s that Helicobacter pylori was linked to gastric/ duodenal ulcers and gastric carcinoma, or more recently still that the BRCA genes were found to be a cause of breast cancer. Still much of clinical medicine treats a patient’s symptoms rather than objective abnormalities. The WHO has given the following definition of mental health:… Mental health is defined as a state of well- being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.… This is a helpful definition, because it clearly defines a mental disorder as a condition that disrupts this state in any way, and sets clear goals of treatment for the clinician. It identifies the fact that a disruption of an individual’s mental health impacts negatively not only upon their enjoyment and ability to cope with life, but also upon that of the wider community.

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The influence of concern about COVID-19 on mental health in the Republic of Georgia: a cross-sectional study

Globalization and Health ◽

10.1186/s12992-020-00641-9 ◽

2020 ◽

Vol 16 (1) ◽

Author(s):

Nino Makhashvili ◽

Jana Darejan Javakhishvili ◽

Lela Sturua ◽

Ketevan Pilauri ◽

Daniela C. Fuhr ◽

...

Keyword(s):

Mental Health ◽

Mental Disorders ◽

Mental Disorder ◽

Adjustment Disorder ◽

Control Measures ◽

Positive Thinking ◽

Republic Of Georgia ◽

Cross Sectional ◽

Response Strategies ◽

The Republic

Abstract Background Early evidence indicates increased mental health burden arising from COVID-19 and related control measures. The study aim was to examine concern about COVID-19 and its association with symptoms of mental disorders in the Republic of Georgia. A cross-sectional internet-based survey of adults in Georgia using non-probabilistic sampling was used. Questionnaire topics were: (i) demographic and socio-economic characteristics; (ii) level of burden caused by common causes of COVID-19 related concerns; (iii) strategies used in response to concerns about COVID-19; and (iv) symptoms of mental disorders of anxiety (GAD-7), depression (PHQ-9), PTSD (ITQ) and adjustment disorder (ADNM8). Descriptive and multivariate analyses were conducted. Results There were 2088 respondents. High levels of symptoms for mental disorders were observed for anxiety (23.9% women, 21.0% men), depression (30.3% women, 25.27% men), PTSD (11.8% women, and 12.5% men), and adjustment disorder (40.7% women, 31.0% men). Factors significantly associated with increased COVID-19 concern included bad/very bad household economic situation, larger household size, current NCD, symptoms of anxiety, adjustment disorder and PTSD. Response strategies significantly associated with reduced mental disorder symptoms included meditation and relaxation exercises, physical exercise, positive thinking, planning for the future, TV/radio, housework/DIY, and working. Drinking alcohol was associated with a greater probability of increased mental disorder symptoms. Conclusions High levels of mental disorders were recorded, and they were strongly associated with increased concern about COVID-19. A number of response strategies were identified which may help protect against worse mental health and these could be supported by innovations in mental health care in Georgia.

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