Change in Finances, Peer Access, and Mental Health Among Trans and Non-binary People in Canada During COVID-19

Purpose COVID-related stressors associated with loss of income and community are compounded with gender minority stress among trans and non-binary people (TNB), which may result in mental health burden. The present study examined the effect of COVID-related change in finances and TNB gathering access on anxiety and depression among TNB people. Methods Participants were 18 years and older (M age = 30) who completed both pre-pandemic baseline (Fall 2019) and pandemic follow-up (Fall 2020) surveys in the Trans PULSE Canada study. Multivariable regression analyses examined associations between change in (1) finances and (2) access to TNB peers and mental health during the pandemic. Results Of 780 participants, 50% reported that COVID had a negative effect on personal income and 58.3% reported loss in access to TNB peer or friend gatherings (in person or online). Depression and anxiety symptoms increased from pre-pandemic to follow-up, and most participants were above measurement cut-offs for clinical levels during the pandemic. Changes in finances and access to peer gatherings were associated with depression symptoms during the pandemic, but effects depended on level of pre-pandemic depression. For participants with high pre-pandemic depression, financial stability was not protective against increased depression at follow-up. Participants experiencing unprecedentedly high levels of depression during COVID may have pursued more TNB gatherings. Neither financial change nor access to TNB gatherings were associated with pandemic anxiety. Conclusion Findings suggest need for a multifaceted approach to mental health programmes and services to address structural barriers, including financial support and meaningful TNB community engagement.

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A machine learning approach for predicting suicidal thoughts and behaviours among college students

Scientific Reports ◽

10.1038/s41598-021-90728-z ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Melissa Macalli ◽

Marie Navarro ◽

Massimiliano Orri ◽

Marie Tournier ◽

Rodolphe Thiébaut ◽

...

Keyword(s):

Mental Health ◽

College Students ◽

Positive Predictive Value ◽

Predictive Value ◽

Screening Tools ◽

Receiver Operating Curve ◽

Depression Symptoms ◽

Suicidal Thoughts ◽

One Year

AbstractSuicidal thoughts and behaviours are prevalent among college students. Yet little is known about screening tools to identify students at higher risk. We aimed to develop a risk algorithm to identify the main predictors of suicidal thoughts and behaviours among college students within one-year of baseline assessment. We used data collected in 2013–2019 from the French i-Share cohort, a longitudinal population-based study including 5066 volunteer students. To predict suicidal thoughts and behaviours at follow-up, we used random forests models with 70 potential predictors measured at baseline, including sociodemographic and familial characteristics, mental health and substance use. Model performance was measured using the area under the receiver operating curve (AUC), sensitivity, and positive predictive value. At follow-up, 17.4% of girls and 16.8% of boys reported suicidal thoughts and behaviours. The models achieved good predictive performance: AUC, 0.8; sensitivity, 79% for girls, 81% for boys; and positive predictive value, 40% for girls and 36% for boys. Among the 70 potential predictors, four showed the highest predictive power: 12-month suicidal thoughts, trait anxiety, depression symptoms, and self-esteem. We identified a parsimonious set of mental health indicators that accurately predicted one-year suicidal thoughts and behaviours in a community sample of college students.

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A co-produced self-management programme improves psychosocial outcomes for people living with depression

Mental Health Review Journal ◽

10.1108/mhrj-05-2014-0017 ◽

2015 ◽

Vol 20 (4) ◽

pp. 242-255 ◽

Cited By ~ 4

Author(s):

Andy Turner ◽

Alba X. Realpe ◽

Louise M. Wallace ◽

Joanna Kosmala-Anderson

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Health Status ◽

Management Programme ◽

Self Management ◽

Depression Symptoms ◽

Management Skills ◽

Content Type

Purpose – There is growing interest in self-management support for people living with mental health problems. The purpose of this paper is to describe the evaluation of a co-designed and co-delivered self-management programme (SMP) for people living with depression delivered as part of large scale National Health Service quality improvement programme, which was grounded in the principles of co-production. The authors investigated whether participants became more activated, were less psychologically distressed enjoyed better health status, and quality of life, and improved their self-management skills after attending the seven-week SMP. Design/methodology/approach – The authors conducted a longitudinal study of 114 people living with depression who attended the SMP. Participants completed self-reported measures before attending the SMP and at six months follow up. Findings – Patient activation significantly improved six months after the SMP (baseline M=49.6, SD=12.3, follow up M=57.2, SD=15.0, t(113)=4.83, p < 0.001; d=0.61). Participants’ experience of depression symptoms as measured by the Patient Health Questionnaire-9 significantly reduced (baseline M=15.5, SD=6.8, follow up M=10.6, SD=6.9, t(106)=7.22, p < 0.001, d=−0.72). Participants’ anxiety and depression as measured by the Hospital Anxiety Depression Scale also decreased significantly (baseline anxiety: M=13.1, SD=4.2, follow up M=10.2, SD=4.4, t(79)=6.29, p < 0.001, d=−0.69); (baseline depression: M=10.3, SD=4.6, follow up M=7.7, SD=4.5, t(79)=5.32, p < 0.001, d=−0.56). The authors also observed significant improvement in participants’ health status (baseline M=0.5, SD=0.3, follow up M=0.6, SD=0.3, t(97)=−3.86, p < 0.001, d=0.33), and health-related quality of life (baseline M=45.4, SD=20.5, follow up M=60.8, SD=22.8, t(91)=−2.71, p=0.008, d=0.75). About 35 per cent of participant showed substantial improvements of self-management skills. Originality/value – The co-produced depression SMP is innovative in a UK mental health setting. Improvements in activation, depression, anxiety, quality of life and self-management skills suggest that the SMP could make a useful contribution to the recovery services in mental health.

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Impact of COVID-19-like symptoms on occurrence of anxiety/depression during lockdown among the French general population

PLoS ONE ◽

10.1371/journal.pone.0255158 ◽

2021 ◽

Vol 16 (7) ◽

pp. e0255158

Author(s):

Murielle Mary-Krause ◽

Joel José Herranz Bustamante ◽

Mégane Héron ◽

Astrid Juhl Andersen ◽

Tarik El Aarbaoui ◽

...

Keyword(s):

Mental Health ◽

Data Collection ◽

Self Report ◽

Depression Symptoms ◽

Health Related ◽

Mental Health Difficulties ◽

Generalized Estimation Equation ◽

Study Participants ◽

Anxiety Depression

Background The outbreak of the COVID-19 epidemic lead to high levels of morbidity and mortality around the globe. Consequences of this outbreak and possible associated infection are an increase in mental health disorders and an increased likelihood of internalizing problems, particularly depression. However, to date few studies have tested this hypothesis while taking into account individuals’ preexisting mental health difficulties. Methods We used longitudinal data collected among 729 persons in the context of the French TEMPO cohort between March and June 2020 (7 waves of data collection). COVID-19-like symptoms as well as anxiety/depression (assessed by the Adult Self Report), were reported at each wave of data collection. To study the relationship between COVID-19-like symptoms and anxiety/depression, we used generalized estimation equation (GEE) models controlled for socio-demographic and health-related characteristics, including anxiety/depression prior to 2020. Results Overall, 27.2% of study participants reported anxiety/depression during lockdown. 17.1% of participants reported COVID-19-like symptoms during the course of follow-up, 7.3% after the beginning of lockdown, with an average number of 2.7 symptoms, and 3.6% reported respiratory distress. In multivariate analyses, nearly all the considered indicators of COVID-19-like symptoms were associated with higher odds of symptoms of anxiety/depression (symptoms Yes/No: OR = 1.66, 95% CI = 1.08–2.55; symptoms after the beginning of lockdown: OR = 1.91, 95% CI = 1.03–3.52; number of symptoms: OR for each additional symptom = 1.19, 95% CI = 1.02–1.39. This relationship exists after taking into account prior symptoms of anxiety/depression, which are associated with a 5-fold increased likelihood of psychological distress. And this impact is stronger among men than women. Conclusions Our study shows higher risk of anxiety/depression among persons who experienced COVID-19-like symptoms, even after accounting for prior mental health difficulties. COVID-19 infection could have both a direct and indirect impact on the occurrence of psychological difficulties, and this association should be studied in greater detail.

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Uncovering Survivorship Bias in Longitudinal Mental Health Surveys During the COVID-19 Pandemic

10.1101/2021.01.28.21250694 ◽

2021 ◽

Author(s):

M. Czeisler ◽

J. Wiley ◽

C. Czeisler ◽

S. Rajaratnam ◽

M. Howard

Keyword(s):

Mental Health ◽

Demographic Factors ◽

Longitudinal Survey ◽

Anxiety And Depression ◽

Depression Symptoms ◽

Mental Health Symptom ◽

Cross Sectional ◽

Survey Participation ◽

Survivorship Bias

AbstractAimsMarkedly elevated adverse mental health symptoms were widely observed early in the coronavirus disease 2019 (COVID-19) pandemic. Unlike the U.S., where cross-sectional data indicate anxiety and depression symptoms have remained elevated, such symptoms reportedly declined in the U.K., according to analysis of repeated measures from a largescale longitudinal study. However, nearly 40% of U.K. respondents (those who did not complete multiple follow-up surveys) were excluded from analysis, suggesting that survivorship bias might partially explain this discrepancy. We therefore sought to assess survivorship bias among participants in our longitudinal survey study as part of The COVID-19 Outbreak Public Evaluation (COPE) Initiative.MethodsSurvivorship bias was assessed 4,039 U.S. respondents who completed surveys including the assessment of mental health as part of The COPE Initiative in April 2020 and were invited to complete follow-up surveys. Participants completed validated screening instruments for symptoms of anxiety, depression, and insomnia. Survivorship bias was assessed for (1) demographic differences in follow-up survey participation, (2) differences in initial adverse mental health symptom prevalences adjusted for demographic factors, and (3) differences in follow-up survey participation based on mental health experiences adjusted for demographic factors.ResultsAdjusting for demographics, individuals who completed only one or two out of four surveys had higher prevalences of anxiety and depression symptoms in April 2020 (e.g., one-survey versus four-survey, anxiety symptoms, adjusted prevalence ratio [aPR]: 1.30, 95% confidence interval [CI]: 1.08-1.55, P=0.0045; depression symptoms, aPR: 1.43, 95% CI: 1.17-1.75, P=0.00052). Moreover, individuals who experienced incident anxiety or depression symptoms had higher odds of not completing follow-up surveys (adjusted odds ratio [aOR]: 1.68, 95% CI: 1.22-2.31, P=0.0015, aOR: 1.56, 95% CI: 1.15-2.12, P=0.0046, respectively).ConclusionsOur findings revealed significant survivorship bias among longitudinal survey respondents, indicating that restricting analytic samples to only respondents who provide repeated assessments in longitudinal survey studies could lead to overly optimistic interpretations of mental health trends over time. Cross-sectional or planned missing data designs may provide more accurate estimates of population-level adverse mental health symptom prevalences than longitudinal surveys.

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Evaluation of an On-Demand Mental Health System for Depression Symptoms: Retrospective Observational Study (Preprint)

10.2196/preprints.17902 ◽

2020 ◽

Author(s):

Sarah Kunkle ◽

Manny Yip ◽

Watson Ξ ◽

Justin Hunt

Keyword(s):

Mental Health ◽

Health System ◽

Mental Health System ◽

Mobile App ◽

Depression Symptoms ◽

Clinical Services ◽

Chi Square ◽

On Demand ◽

Chi Square Test

BACKGROUND Depression is an extremely prevalent issue in the United States, with an estimated 7% of adults experiencing at least one major depressive episode in 2017. Although psychotherapy and medication management are effective treatments for depression, significant barriers in accessing care persist. Virtual care can potentially address some of these obstacles. OBJECTIVE We conducted a preliminary investigation of utilization characteristics and effectiveness of an on-demand health system for reducing depression symptoms. METHODS Data were analyzed from 1662 users of an on-demand mental health system that includes behavioral health coaching, clinical services (therapy and psychiatry), and self-guided content and assessments primarily via a mobile app platform. Measures included engagement characterized by mobile app data, member satisfaction scores collected via in-app surveys, and depression symptoms via the Patient Health Questionnaire-2 (PHQ-2) at baseline and 8-12 week follow-up. Descriptive statistics are reported for measures, and pre/post-PHQ-2 data were analyzed using the McNemar test. A chi-square test was used to test the association between the proportion of individuals with an improvement in PHQ-2 result and care modality (coaching, therapy, and psychiatry, or hybrid). RESULTS During the study period, 65.5% of individuals (1089/1662) engaged only in coaching services, 27.6% of individuals (459/1662) were engaged in both coaching and clinical services, 3.3% of individuals (54/1662) engaged only in clinical services, and 3.7% of individuals (61/1662) only used the app. Of the 1662 individuals who completed the PHQ-2 survey, 772 (46.5%) were considered a positive screen at intake, and 890 (53.6%) were considered a negative screen at intake. At follow-up, 477 (28.7%) of individuals screened positive, and 1185 (71.3%) screened negative. A McNemar test showed that there was a statistically significant decrease in the proportion of users experiencing depressed mood and anhedonia more than half the time at follow-up (<i>P</i><.001). A chi-square test showed there was no significant association between care modality and the proportion of individuals with an improvement in PHQ-2 score. CONCLUSIONS This study provides preliminary insights into which aspects of an on-demand mental health system members are utilizing and levels of engagement and satisfaction over an 8-12 week window. Additionally, there is some signal that this system may be useful for reducing depression symptoms in users over this period. Additional research is required, given the study limitations, and future research directions are discussed.

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Study into COVID-19 Crisis Using Primary Care Mental Health Consultations and Prescriptions Data

Studies in Health Technology and Informatics - Public Health and Informatics ◽

10.3233/shti210277 ◽

2021 ◽

Author(s):

Agnieszka Lemanska ◽

Uy Hoang ◽

Nathan Jeffreys ◽

Clare Bankhead ◽

Kam Bhui ◽

...

Keyword(s):

Mental Health ◽

Primary Care ◽

Cohort Study ◽

Retrospective Cohort ◽

Service Planning ◽

Analysis Of Covariance ◽

Quality Improvements ◽

Negative Effect ◽

Mental Health Consultations

The effect of the 2020 pandemic, and of the national measures introduced to control it, is not yet fully understood. The aim of this study was to investigate how different types of primary care data can help quantify the effect of the coronavirus disease (COVID-19) crisis on mental health. A retrospective cohort study investigated changes in weekly counts of mental health consultations and prescriptions. The data were extracted from one the UK’s largest primary care databases between January 1st 2015 and October 31st 2020 (end of follow-up). The 2020 trends were compared to the 2015-19 average with 95% confidence intervals using longitudinal plots and analysis of covariance (ANCOVA). A total number of 504 practices (7,057,447 patients) contributed data. During the period of national restrictions, on average, there were 31% (3957 ± 269, p < 0.001) fewer events and 6% (4878 ± 1108, p < 0.001) more prescriptions per week as compared to the 2015-19 average. The number of events was recovering, increasing by 75 (± 29, p = 0.012) per week. Prescriptions returned to the 2015-19 levels by the end of the study (p = 0.854). The significant reduction in the number of consultations represents part of the crisis. Future service planning and quality improvements are needed to reduce the negative effect on health and healthcare.

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Ageing on the autism spectrum: A 4-year follow-up study of mental health and quality of life in autistic adults

10.22541/au.162912521.10897548/v1 ◽

2021 ◽

Author(s):

Dr Amanda Roestorf ◽

Patricia Howlin ◽

Dermot M. Bowler

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Autistic Traits ◽

Autism Spectrum ◽

Health Conditions ◽

Depression Symptoms ◽

Mental Health Conditions ◽

Autistic Adults

Background: Poor mental health is known to adversely affect functional abilities, social isolation and quality of life (QoL). It is, therefore, crucial to consider the long-term impacts of mental health conditions as autistic adults grow older. Objectives: Our objectives were to understand the extent of: (i) autistic traits, co-occurring physical and mental health conditions; (ii) age-related differences in those conditions; and (iii) their impact on everyday living and QoL. Method: Fifty-two autistic adults (aged 18-79 years) participated in the first study (T1); 28 took part in a follow-up at T2 (mean retest interval 2.5 years). Standardised self-report measures of autistic traits, mental health and QoL were completed at both time points. Results: Over half of autistic adults experienced at least one co-occurring condition, and over a third met the criteria for 3+ conditions. Depression symptoms were particularly high in autistic women. Mental and physical health problems were related to autistic traits, difficulties in everyday life, and were a strong and consistent predictor of poor QoL (T1; T2) across the lifespan. Conclusion: Our findings highlighted that mental health difficulties persisted into older age and did not reduce over time. Together, these findings raise important questions about mental health provision in adult autism.

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Sustained negative mental health outcomes among healthcare workers over the first year of the COVID-19 pandemic: a prospective cohort study

10.1101/2021.11.21.21266594 ◽

2021 ◽

Author(s):

Roberto Mediavilla ◽

Eduardo Fernandez-Jimenez ◽

Irene Martinez-Morata ◽

Fabiola Jaramillo ◽

Jorge Andreo-Jover ◽

...

Keyword(s):

Mental Health ◽

Cohort Study ◽

Psychological Distress ◽

Health Outcomes ◽

Healthcare Workers ◽

Mental Health Problems ◽

Mental Health Outcomes ◽

Depression Symptoms ◽

Over Time

Objective: To characterize the evolution of healthcare workers' mental health status over the 1-year period following the initial COVID-19 pandemic outbreak and to examine baseline characteristics associated with resolution or persistence of mental health problems over time. Methods: We conducted an 8-month follow-up cohort study. Eligible participants were healthcare workers working in Spain. Baseline data were collected during the initial pandemic outbreak. Survey-based self-reported measures included COVID-19-related exposures, sociodemographic characteristics, and three mental health outcomes (psychological distress, depression symptoms, and posttraumatic stress disorder symptoms). We examined three longitudinal trajectories in mental health outcomes between baseline and follow-up assessments (namely asymptomatic/stable, recovering, and persistently symptomatic/worsening). Results: We recruited 1,807 participants. Between baseline and follow-up assessments, the proportion of respondents screening positive for psychological distress and probable depression decreased, respectively, from 74% to 56% and from 28% to 21%. Two-thirds remained asymptomatic/stable in terms of depression symptoms and 56% remained symptomatic or worsened over time in terms of psychological distress. Conclusions: Poor mental health outcomes among healthcare workers persisted over time. Occupational programs and mental health strategies should be put in place.

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GROUPS 4 HEALTH protects against unanticipated threats to mental health: Evaluating two interventions during COVID-19 lockdown among young people with a history of depression and loneliness. Journal of Affective Disorders.

10.31234/osf.io/tyvhg ◽

2021 ◽

Author(s):

Tegan Cruwys ◽

Catherine Haslam ◽

S. Alex Haslam ◽

Elyse Williams ◽

Joanne Rathbone

Keyword(s):

Mental Health ◽

Young People ◽

Social Connectedness ◽

Well Being ◽

Symptom Improvement ◽

Control Group ◽

Depression Symptoms ◽

Cognitive Behaviour ◽

One Year

Background. Decades of research indicate that when social connectedness is threatened, mental health is at risk. However, extant interventions to tackle loneliness have had only modest success, and none have been trialled under conditions of such threat.Method. 174 young people with depression and loneliness were randomised to one of two evidence-based treatments: cognitive behaviour therapy (CBT) or GROUPS 4 HEALTH (G4H), an intervention designed to increase social group belonging. Depression, loneliness, and well-being outcomes were evaluated at one-year follow-up; COVID-19 lockdown restrictions were imposed partway through follow-up assessments. This provided a quasi-experimental test of the utility of each intervention in the presence (lockdown group) and absence (control group) of a threat to social connectedness. Results. At one-year follow-up, participants in lockdown reported significantly poorer wellbeing than controls who completed follow-up before lockdown, t(152)=2.41, p=.017. Although both CBT and G4H led to symptom improvement, the benefits of G4H were more robust following an unanticipated threat to social connectedness for depression (2(16)=31.35, p=.001), loneliness (2(8)=21.622, p=.006), and wellbeing (2(8)=22.938, p=.003). Limitations. Because the COVID-19 lockdown was unanticipated, this analysis represents an opportunistic use of available data. As a result, we could not measure the specific impact of restrictions on participants, such as reduced income, degree of isolation, or health-related anxieties.Conclusions. G4H delivered one year prior to COVID-19 lockdown offered greater protection than CBT against relapse of loneliness and depression symptoms. Implications are discussed with a focus on how these benefits might be extended to other life stressors and transitions.

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Impact of Status-Based Rejection Sensitivity on Depression and Anxiety Symptoms in Gay Men

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17051546 ◽

2020 ◽

Vol 17 (5) ◽

pp. 1546

Author(s):

Joseph Slimowicz ◽

Jedidiah Siev ◽

Paula M. Brochu

Keyword(s):

Mental Health ◽

Health Outcomes ◽

Gay Men ◽

Minority Stress ◽

Rejection Sensitivity ◽

Anxiety Symptoms ◽

Mental Health Outcomes ◽

Depression Symptoms ◽

Depression And Anxiety

Status-based rejection sensitivity refers to the anxious expectation and tendency to perceive rejection in ambiguous social scenarios based on one’s minority identification. This study evaluates the implications of sensitivity to rejection based on sexual orientation identity on negative mental health outcomes. Current minority stress models include rejection sensitivity as a factor that may contribute to adverse negative psychosocial outcomes in LGBT persons. This study evaluates the role of rejection sensitivity alongside demographically relevant predictors such as age, race, education, and level of sexuality disclosure in predicting the presence of significant depression and anxiety scores among a sample of gay men. Results indicate that rejection sensitivity, sexuality openness, and anxiety were significant predictors of depression symptoms, whereas age and depression were significant predictors of anxiety symptoms. This study supports the role of rejection sensitivity as a contributor to negative mental health outcomes among gay men, particularly as it pertains to internalizing mental health disorders.

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