Who is at risk of poor mental health following COVID-19 outpatient management?

Background: COVID-19 convalescents are at risk of developing a de novo mental health disorder or of worsening of a pre-existing one. The objectives of our study was to phenotype individuals at highest risk of mental health disorders among COVID-19 outpatients. Methods: We conducted a binational online survey study with adult non-hospitalized COVID-19 convalescents (Austria/AT: n=1157, Italy/IT: n= 893). Primary endpoints were positive screening for depression and anxiety (PHQ-4, Patient Health Questionnaire) and self-perceived overall mental health and quality of life rated with 4 point Likert scales. Psychosocial stress was surveyed with a modified PHQ stress module. Associations of the mental health with socio-demographic variables, COVID-19 course and recovery data were assessed by multi-parameter random forest and serial univariable modeling. Mental disorder risk subsets were defined by self-organizing map and hierarchical clustering algorithms. The survey analyses are publicly available (https://im2-ibk.shinyapps.io/mental_health_dashboard/). Results: In the study cohorts, 4.6 (IT)/6% (AT) of participants reported depression and/or anxiety before to infection. At a median of 79 days (AT)/96 days (IT) post COVID-19 onset, 12.4 (AT)/19.3% (IT) of subjects were screened positive for anxiety and 17.3 (AT)/23.2% (IT) for depression. Over one-fifth of the respondents rated their overall mental health (AT: 21.8%, IT: 24.1%) or quality of life (AT: 20.3%, IT: 25.9%) as fair or poor. In both study collectives, psychosocial stress, high numbers of acute and persistent COVID-19 complaints and the presence of acute neurocognitive symptoms (impaired concentration, confusion, forgetfulness) were the strongest correlates of deteriorating mental health and poor quality of life. In clustering analysis, these variables defined a high risk subset with particularly high propensity of post-COVID-19 mental health impairment and decreased quality of life. Pre-existing depression or anxiety was associated with an increased symptom burden during acute COVID-19 and recovery. Conclusion: Our study revealed a bidirectional relationship between COVID-19 symptoms and mental health. We put forward specific acute symptoms of the disease as red flags of mental health deterioration which should prompt general practitioners to identify COVID-19 patients who may benefit from early psychological and psychiatric intervention. Trial registration: ClinicalTrials.gov: NCT04661462.

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Video-Based Communication and its Association with Loneliness, Mental Health and Quality of Life among Older People during the COVID-19 Outbreak

10.20944/preprints202104.0520.v1 ◽

2021 ◽

Author(s):

Tore Bonsaksen ◽

Hilde Thygesen ◽

Janni Leung ◽

Mary C. Ruffolo ◽

Mariyana Schoultz ◽

...

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Older People ◽

Online Survey ◽

Age Groups ◽

Psychological Outcomes ◽

Age Group ◽

Communication Tools ◽

Study Results

The aim of the study was to examine the use of video-based communication and its association with loneliness, mental health and quality of life in older adults (60-69 years versus 70+ years) during the COVID-19 pandemic. A cross-sectional online survey was conducted in Norway, UK, USA and Australia during April/May 2020, and 836 participants in the relevant age groups were included in the analysis. Multiple regression analyses were conducted to examine associations between use of video-based communication tools and loneliness, mental health and quality of life within age groups, while adjusting by sociodemographic variables. Video-based communication tools were found to be more often used among participants aged 60-69 years (60.1%), compared to participants aged 70 or above (51.8%, p < 0.05). Adjusting for all variables, use of video-based communication was associated with less loneliness (β = -0.12, p < 0.01) and higher quality of life (β = 0.14, p < 0.01) among participants aged 60-69 years, while no associations occurred for participants in the oldest age group. The use of video-based communication tools was therefore associated with favorable psychological outcomes among participants in their sixties, but not among participants in the oldest age group. The study results support the notion that age may influence the association between use of video-based communication tools and psychological outcomes amongst older people.

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Attitudes About COVID-19 and Health: A Mixed-Methods Smartphone-App and Online Survey Study (Preprint)

10.2196/preprints.29963 ◽

2021 ◽

Author(s):

Anna M. Hood ◽

Hanne Stotesbury ◽

Jennifer Murphy ◽

Melanie Kölbel ◽

April Slee ◽

...

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Data Collection ◽

Physical Health ◽

Online Survey ◽

Smartphone App ◽

The Uk ◽

The Impact ◽

Monthly Survey

BACKGROUND Behavioral mitigation strategies to slow the spread of COVID-19 have resulted in sweeping lifestyle changes, with short and long-term psychological, well-being, and quality of life implications. The Attitudes About COVID-19 and Health (ATTACH) study focuses on understanding attitudes and beliefs whilst considering the impact on mental and physical health and the influence of broader demographic and geographic factors on attitudes, beliefs, and mental health burden. OBJECTIVE In this assessment of our first wave of data collection, we provide baseline cohort descriptives of ATTACH study participants in the United Kingdom (UK), United States of America (USA), and Mexico. Additionally, we assess responses to daily poll questions related to COVID-19 and conduct a cross-sectional analysis of baseline assessments collected in the UK between June 26 and October 31, 2020. METHODS The ATTACH study uses smartphone-app technology and online survey data collection. Participants completed poll questions twice daily related to COVID-19 and a monthly survey assessing mental health, social isolation, physical health, and quality of life. Poll question responses were graphed using 95% Clopper-Pearson (exact) tests with 95% confidence intervals. Pearson correlations, hierarchical linear regression analyses, and generalized linear models assessed relationships, predictors of self-reported outcomes, and group differences, respectively. RESULTS By October 31, 2020, 1405, 80, and 90 participants had consented to participate in the UK, USA, and Mexico, respectively. Descriptive data for the UK daily poll questions indicated that participants were generally following social distancing measures, but worry and negative impacts on families increased as the pandemic progressed. Although participants generally reported feeling that the reasons for current measures had been made clear, there was low trust that the government was doing everything in its power to meet public needs. In the UK, 1282 participants also completed a monthly survey (95% white, 72% female, 21% key or essential workers). Nineteen percent of UK participants reported a pre-existing mental health disorder, 31% reported a pre-existing chronic medical illness, and 35% were over 65. Fifty-seven percent of participants reported being more sedentary since the pandemic began, and 41% reported reduced access to medical care. Those with poorer mental health outcomes lived in more deprived neighborhoods, in larger households (ps < .05), had more pre-existing mental health disorders and medical conditions, and were younger than 65 years (all ps < .001). CONCLUSIONS Communities who have been exposed to additional harm during the COVID-19 pandemic were experiencing worse mental outcomes. Factors including having a medical condition, or living in a deprived neighborhood or larger household were associated with heightened risk. Future longitudinal studies should investigate the link between COVID-19 exposure, mental health, and sociodemographic and residential characteristics.

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Higher levels of autistic traits associated with lower levels of self-efficacy and wellbeing for performing arts professionals

PLoS ONE ◽

10.1371/journal.pone.0246423 ◽

2021 ◽

Vol 16 (2) ◽

pp. e0246423

Author(s):

Eleanor Buckley ◽

Elizabeth Pellicano ◽

Anna Remington

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Self Efficacy ◽

Performing Arts ◽

Online Survey ◽

Autistic Traits ◽

Autistic People ◽

First Time ◽

The Relationship

This study sought for the first time to identify the extent to which autistic people are pursuing careers in the performing arts, and to determine the nature of the relationship between individuals’ autistic traits and their reported wellbeing. To address these aims, we recruited a self-selecting, community-based sample of individuals working in the performing arts and invited them to complete an online survey. A total of 1,427 respondents took part. We collected responses on participants’ backgrounds, including diagnostic history as well as measures assessing their level of autistic traits, perceived occupational self-efficacy, quality of life, and mental health. They were also asked open-ended questions about support needed, received, or desired in their workplace. Eleven of the 1,427 professionals (1%) reported a clinical diagnosis of autism. Correlational analyses demonstrated that higher levels of autistic traits were significantly associated with lower levels of quality of life, lower levels of occupational self-efficacy and greater severity of mental health conditions. Almost half the sample of professionals (N = 621; 44%) reported a desire for more employment-based support, and autistic traits were significantly higher in those participants who wanted greater support. Within the community of those working in the performing arts, there are a minority of individuals who are autistic or who have high levels of autistic traits. We have demonstrated for the first time that these individuals may be especially vulnerable to lower wellbeing.

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Sleep disorder prevalence in at-risk adolescents and potential effects of nightmare triad syndrome

International Journal of Adolescent Medicine and Health ◽

10.1515/ijamh-2017-0125 ◽

2018 ◽

Vol 0 (0) ◽

Author(s):

Natalia D. McIver ◽

Barry Krakow ◽

Jessica Krakow ◽

Michael R. Nadorff ◽

Victor A. Ulibarri ◽

...

Keyword(s):

Quality Of Life ◽

Mental Health ◽

At Risk ◽

High School Students ◽

Sleep Disorders ◽

Anxiety Symptoms ◽

Depression And Anxiety ◽

School Students ◽

At Risk Adolescents

Abstract Objective At-risk high school students, those considered to have a higher probability for academic failure or dropping out, were assessed for various sleep disorders. Effects were compared between students with and without the nightmare triad syndrome (NTS+), the sleep disorders’ cluster of frequent nightmares, insomnia disorder and suspected sleep-disordered breathing (SDB). Methods Data were gathered at a charter school for at-risk youth using: computer based surveys, physical airway exams, and mental health interviews by school social worker. Ninety-two students were enrolled, and 70 completed all study components. Results Students were teenaged [17.10 (1.50) years], male (52.2%) slightly overweight [BMI 25.50 (6.41)] Hispanics (87.0%); two-thirds (65 of 92) subjectively reported a sleep problem. Frequent nightmares (39.1%), insomnia (ISI ≥ 12, 41.3%), and SDB risk (79.3%) were common. Several presumptive sleep disorders (insomnia, SDB risk, parasomnia, or nightmares) were associated with worse sleep quality and lower quality of life. Nineteen students met criteria for NTS. Compared to NTS−, NTS+ showed significantly lower quality of life (p < 0.003, g = 0.84). Regression analyses revealed higher levels of depression and anxiety symptoms in NTS+ students. NTS was associated with reduced quality of life independent of anxiety symptoms. Conclusion Prevalence of presumptive sleep disorders was high with a tendency for clusters of sleep disorders in the same individual. Students with NTS+ showed worse outcomes and reduced quality of life, mediated partially by depression and anxiety. To examine relationships between sleep disorders and mental health in at-risk adolescents, research investigations must include both subjective and objective measurements of sleep.

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Changes in the Health of Adolescent Athletes: A Comparison of Health Measures Collected Before and During the CoVID-19 Pandemic

Journal of Athletic Training ◽

10.4085/1062-6050-0739.20 ◽

2021 ◽

Author(s):

Timothy A. McGuine ◽

Kevin Biese ◽

Scott J. Hetzel ◽

Labina Petrovska ◽

Stephanie Kliethermes ◽

...

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Physical Activity ◽

Online Survey ◽

Depression Symptoms ◽

Physical And Mental Health ◽

Adolescent Athletes ◽

Cross Sectional ◽

Health Measures

ABSTRACT Context: In the spring of 2020, schools closed to in-person teaching and sports were cancelled to control the transmission of CoVID-19. The changes that took place to the physical and mental health among young athletes during this time remain unknown, however. Objective: Identify changes in the health (mental health, physical activity and quality of life) of athletes that occurred during the CoVID-19 pandemic. Design: Cross-sectional study. Setting: Sample recruited via social media. Patients or Other Participants: 3243 Wisconsin adolescent athletes (age=16.2±1.2 yrs., female=58% female) completed an online survey in May 2020 (DuringCoVID-19). Health measures for this cohort were compared with previously reported data for Wisconsin adolescent athletes (n=5231, age=15.7±1.2, 47% female) collected in 2016–2018 (PreCoVID-19). Main Outcome Measure(s): Demographic information included: sex, grade and sports played. Health assessments included the Patient Health Questionnaire-9 Item (PHQ-9) to identify depression symptoms, the Pediatric Functional Activity Brief Scale (PFABS) for physical activity, and the Pediatric Quality of Life Inventory 4.0 (PedsQL) for health related quality of life (HRQoL). Univariable comparisons of these variables between groups were made via t-tests or chi-square tests. Means and 95% confidence intervals (CI) for each group were estimated by survey weighted ANOVA models. RESULTS: Compared to PreCoVID-19, a larger proportion of the During-CoVID-19 participants reported rates of moderate to severe levels of depression (9.7% vs 32.9%, p<0.001). During-CoVID-19 participants reported 50% lower (worse) PFABS scores (mean:12.2 [95%CI: 11.9, 12.5] vs 24.7 [24.5, 24.9] p<0.001) and lower (worse) PedsQL total scores compared to the PreCoVID-19 participants (78.4 [78.0, 78.8] vs. 90.9 [90.5, 91.3] p<0.001). CONCLUSIONS: During the CoVID-19 pandemic, adolescent athletes reported increased symptoms of depression, decreased physical activity and decreased quality of life compared to adolescent athletes in previous years.

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Evaluation of Perceived Stress in Family Members of Stroke Patients

International Journal of Health Sciences and Research ◽

10.52403/ijhsr.20210819 ◽

2021 ◽

Vol 11 (8) ◽

pp. 131-136

Author(s):

Gayatri T. Batkulwar ◽

Gaurav C. Mhaske

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Perceived Stress ◽

Stroke Patient ◽

Chronic Condition ◽

Online Survey ◽

Family Members ◽

High Morbidity ◽

Stroke Patients

Background - Family members play important role in recovery of stroke patient. As stroke is a common, chronic condition with high morbidity, mortality and disability. The aim of study was to estimate stress level in family members of stroke patients. Method - It was an observational study, done on 100 caregivers of stroke patients, by using PSS-10 scale to assess level of stress in family members. Online survey was done by making Google forms. Result - 57% of family members of stroke patient perceived moderate level of stress, this affects the mental health and quality of life of caregivers. Conclusion - This study concludes that the stress was more in wives, sons, daughters in first relation whereas in second relation stress was more in daughter in law. Some interventions should be structured to reduce the level of stress in family members. Key words: Stress, stroke, caregivers, perceived, PSS.

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Burnout, Mental Health, and Quality of Life Among Employees of a Malaysian Hospital: A Cross-sectional Study

Annals of Work Exposures and Health ◽

10.1093/annweh/wxaa075 ◽

2020 ◽

Vol 64 (9) ◽

pp. 1007-1019

Author(s):

Luke Sy-Cherng Woon ◽

Chea Ping Tiong

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Online Survey ◽

Multivariate Regression Analysis ◽

Cross Sectional Study ◽

Mediating Effect ◽

Financial Problem ◽

Cross Sectional ◽

Work Burnout

Abstract Burnout and mental health issues are common among healthcare workers. Burnout and mental ill-health may also adversely affect quality of life (QOL). This study aimed to determine the prevalence of burnout, mental ill-health, and QOL among employees of Hospital Bentong in Pahang state, Malaysia. This was a 2-week, cross-sectional online survey for Hospital Bentong employees. It consisted of (i) sociodemographic data, (ii) respondents’ perceptions, (iii) Malay-version Copenhagen Burnout Inventory (CBI), (iv) 21-item Depression, Anxiety and Stress scale (DASS-21), and (v) WHO Quality of Life-BREF (WHOQOL-BREF) instrument. In total, 52.4% of hospital employees (N = 251) participated in the study. The burnout rates were 17.5% (personal burnout), 13.9% (work burnout), and 6.0% (client burnout). The prevalence rates of depression, anxiety, and stress were 18.7, 38.6, and 12.0%, respectively. In multivariate regression analysis, personal burnout was associated with Malay ethnicity [odds ratio (OR) = 4.54, 95% confidence interval (CI) = 1.41–18.17], management and professional position (OR = 3.89, 95% CI = 1.34–11.29), and having financial problem (OR = 3.29, 95% CI = 1.53–7.06). Work burnout was associated with management and professional position (OR = 7.26, 95% CI = 1.84–28.59), having problem with colleagues (OR = 2.85, 95% CI = 1.08–7.50), and having financial problem (OR = 4.41, 95% CI = 1.82–10.72), while age (OR = 1.12, 95% CI = 1.00–1.25) and male gender (OR = 7.14, 95% CI = 2.00–25.55) were significant factors for client burnout. There were moderate-to-strong correlations between CBI, DASS-21, and WHOQOL-BREF scores (P values <0.01). In mediation analysis, mental ill-health was shown to have significant mediating effect in the relationship between burnout and poor QOL. Such findings need to be replicated across different hospital settings. Studies on effectiveness strategies to manage identified issues will be required.

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Changes in the Health of Adolescent Athletes: A Comparison of Health Measures Collected Before and During the CoVID-19 Pandemic

10.1101/2021.01.12.20248726 ◽

2021 ◽

Author(s):

Timothy A. McGuine ◽

Kevin Biese ◽

Scott J. Hetzel ◽

Labina Petrovska ◽

Stephanie Kliethermes ◽

...

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Physical Activity ◽

Online Survey ◽

Depression Symptoms ◽

List Type ◽

Adolescent Athletes ◽

Symptoms Of Depression ◽

Health Measures

ABSTRACTContextIn the spring of 2020, schools closed to in-person teaching and sports were cancelled to control the transmission of CoVID-19. The changes that took place to the physical and mental health among young athletes during this time remain unknown, however.ObjectiveIdentify changes in the health (mental health, physical activity and quality of life) of athletes that occurred during the CoVID-19 pandemic.DesignCross sectional study.SettingSample recruited via social media.Patients or Other Participants3243 Wisconsin adolescent athletes (age=16.2±1.2 yrs., female=58% female) completed an online survey in May 2020 (DuringCoVID-19). Health measures for this cohort were compared with previously reported data for Wisconsin adolescent athletes (n=5231, age=15.7±1.2, 47% female) collected in 2016–2018 (PreCoVID-19).Main Outcome Measure(s)Demographic information included: sex, grade and sports played. Health assessments included the Patient Health Questionnaire-9 Item (PHQ-9) to identify depression symptoms, the Pediatric Functional Activity Brief Scale (PFABS) for physical activity, and the Pediatric Quality of Life Inventory 4.0 (PedsQL) for health related quality of life (HRQoL). Univariable comparisons of these variables between groups were made via t-tests or chi-square tests. Means and 95% confidence intervals (CI) for each group were estimated by survey weighted ANOVA models.RESULTSCompared to PreCoVID-19, a larger proportion of the During-CoVID-19 participants reported rates of moderate to severe levels of depression (9.7% vs 32.9%, p<0.001). During-CoVID-19 participants reported 50% lower (worse) PFABS scores (mean:12.2 [95%CI: 11.9, 12.5] vs 24.7 [24.5, 24.9] p<0.001) and lower (worse) PedsQL total scores compared to the PreCoVID-19 participants (78.4 [78.0, 78.8] vs. 90.9 [90.5, 91.3] p<0.001).CONCLUSIONSDuring the CoVID-19 pandemic, adolescent athletes reported increased symptoms of depression, decreased physical activity and decreased quality of life compared to adolescent athletes in previous years.Key pointsAdolescent athletes during CoVID-19 were three times more likely to report moderate to severe symptoms of depression compared to data collected prior to CoVID-19.Adolescent athletes during CoVID-19 reported significantly lower physical activity and quality of life scores compared to high school athletes prior to the CoVID-19 pandemicPost CoVID-19 policies should be implemented to improve the health of adolescent athletes in the US.

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Characterizing Changes in Screen Time During the COVID-19 Pandemic School Closures in Canada and Its Perceived Impact on Children With Autism Spectrum Disorder

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.702774 ◽

2021 ◽

Vol 12 ◽

Author(s):

Robyn E. Cardy ◽

Annie Dupuis ◽

Evdokia Anagnostou ◽

Justine Ziolkowski ◽

Elaine A. Biddiss ◽

...

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Screen Time ◽

Community Sample ◽

Autism Spectrum ◽

Survey Study ◽

Children And Families ◽

School Closures ◽

Perceived Impact

The COVID-19 pandemic has led to an increase in screen time for children and families. Traditionally, screen time has been associated with negative physical and mental health outcomes, and children with autism spectrum disorder (ASD) are at increased risk of these outcomes. The primary objectives of this study were to (1) characterize the change in screen time during COVID-19 school closures for children with ASD, and (2) examine the parent perceived impact of screen time on mental health and quality of life of children and their families. Canadian parents and caregivers of children 19 years of age and younger were eligible to participate in an anonymous, online survey study. This survey was available in English, consisted of 28 questions, took ~10-min to complete, and was available for 6 weeks (May 22 through July 6, 2020). The total sample consisted of 414 responses (ASD: n = 127, mean age = 11.7 ± 4.06 years; community sample: n = 287, mean age = 9.4 ± 4.26 years). Seventy-one respondents were missing responses to our primary question and removed from the analyses (final sample n = 344). Compared to the community sample, the ASD group had a significantly higher screen time use before and during the COVID-19 pandemic school closures [weekdays: difference = 1.14 (SE = 0.18), t = 6.56, p < 0.0001; weekends: difference = 1.41 (SE = 0.20), t = 6.93, p < 0.0001]. Mean total screen time during the pandemic was 6.9 h (95% CI 6.49, 7.21) on weekdays and 6.3 h (95% CI 5.91, 6.63) on weekends for the ASD group, and 5.6 h (95% CI 5.28, 5.92) on weekdays and 5.0 h (95% CI 4.70, 5.34) on weekends for the community sample. There was a significant increase in screen time during the COVID-19 pandemic as compared to before the pandemic period in the ASD group [weekdays: mean difference = 3.8 h (95% CI 3.35–4.25), p < 0.0001; weekends: mean difference = 1.5 h (95% CI 1.17–1.92), p < 0.0001]. Gender was a significant predictor of parent perceived mental health and quality of life, with male gender associated with a higher likelihood of negative impact [quality of life (child/family) OR = 1.8 (95% CI 1.1–2.9), corrected p = 0.040; mental health OR = 1.9 (95% CI 1.1–3.1), corrected p = 0.0028]. Parents' most frequently endorsed emotions toward screen time were guilt, frustration, and worry. Results of this survey study revealed that children with ASD were less likely to benefit from screen time to cope with social isolation, and screen time resulted in significantly more lost time on social interactions than the community sample, which may exacerbate difficulties in social domains. Given the unprecedented circumstances of the COVID-19 pandemic and the novel context of technology use, the findings of this study highlight the need for revision of screen time recommendations to reflect the current needs of children and families.

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