scholarly journals Mental and behavioural disorders and COVID-19-associated death in older people

BJPsych Open ◽  
2020 ◽  
Vol 6 (5) ◽  
Author(s):  
Billy Boland ◽  
Tim Gale

Summary Health factors such as diabetes, severe obesity and chronic kidney disease are all associated with a more severe outcome following coronavirus disease 2019 (COVID-19) infection. However, there has been little exploration into the impact of mental and behavioural disorders on outcomes associated with COVID-19. We investigated outcomes for older people who used mental health services. Those who had a COVID-19-associated death had previously rated worse across a range of health and social problems, including mental health related problems. Our findings evidence the need to urgently explore whether mental and behavioural disorders should also be considered a health risk factor for a more severe outcome from COVID-19 infection in older people.

2017 ◽  
Vol 14 (02) ◽  
pp. 103-110
Author(s):  
S. Tomassi ◽  
M. Ruggeri

Summary Background: The global crisis that began in 2007 has been the most prolonged economic recession since 1929. It has caused worldwide tangible costs in terms of cuts in employment and income, which have been widely recognised also as major social determinants of mental health (1, 2). The so-called “Great Recession” has disproportionately affected the most vulnerable part of society of the whole Eurozone (3). Across Europe, an increase in suicides and deaths rates due to mental and behavioural disorders was reported among those who lost their jobs, houses and economic activities as a consequence of the crisis.


2014 ◽  
Vol 64 (4) ◽  
pp. S42
Author(s):  
K.C. Frankel ◽  
C.M. Allegra ◽  
B. Eskin ◽  
J.R. Allegra

2021 ◽  
Author(s):  
Rachael Andrea Evans ◽  
Hamish McAuley ◽  
Ewen M Harrison ◽  
Aarti Shikotra ◽  
Amisha Singapuri ◽  
...  

Background The impact of COVID-19 on physical and mental health, and employment following hospitalisation is poorly understood. Methods PHOSP-COVID is a multi-centre, UK, observational study of adults discharged from hospital with a clinical diagnosis of COVID-19 involving an assessment between two- and seven-months later including detailed symptom, physiological and biochemical testing. Multivariable logistic regression was performed for patient-perceived recovery with age, sex, ethnicity, body mass index (BMI), co-morbidities, and severity of acute illness as co-variates. Cluster analysis was performed using outcomes for breathlessness, fatigue, mental health, cognition and physical function. Findings We report findings of 1077 patients discharged in 2020, from the assessment undertaken a median 5 [IQR4 to 6] months later: 36% female, mean age 58 [SD 13] years, 69% white ethnicity, 27% mechanical ventilation, and 50% had at least two co-morbidities. At follow-up only 29% felt fully recovered, 20% had a new disability, and 19% experienced a health-related change in occupation. Factors associated with failure to recover were female, middle-age, white ethnicity, two or more co-morbidities, and more severe acute illness. The magnitude of the persistent health burden was substantial and weakly related to acute severity. Four clusters were identified with different severities of mental and physical health impairment: 1) Very severe (17%), 2) Severe (21%), 3) Moderate with cognitive impairment (17%), 4) Mild (46%), with 3%, 7%, 36% and 43% feeling fully recovered, respectively. Persistent systemic inflammation determined by C-reactive protein was related to cluster severity, but not acute illness severity. Interpretation We identified factors related to recovery from a hospital admission with COVID-19 and four different phenotypes relating to the severity of physical, mental, and cognitive health five months later. The implications for clinical care include the potential to stratify care and the need for a pro-active approach with wide-access to COVID-19 holistic clinical services. Funding: UKRI and NIHR


BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S311-S312
Author(s):  
Sarah Bradbury ◽  
George Crowther ◽  
Manimegalai Chinnasamy ◽  
Laura Shaw ◽  
Sara Ormerod ◽  
...  

AimsThe number of people over the age of 65 attending Emergency Departments (ED) in the United Kingdom (UK) is increasing. Those who attend with a mental health related problem may be referred to liaison psychiatry for assessment. Improving responsiveness and integration of liaison psychiatry in general hospital settings is a national priority. To do this psychiatry teams must be adequately resourced and organised. However, it is unknown how trends in the number of referrals of older people to liaison psychiatry teams by EDs are changing, making this difficult.MethodWe performed a national multi-centre retrospective service evaluation, analysing existing psychiatry referral data from EDs of people over 65. Sites were selected from a convenience sample of older peoples liaison psychiatry departments. Departments from all regions of the UK were invited to participate via the RCPsych liaison and older peoples faculty email distribution lists. From departments who returned data, we combined the date and described trends in the number and rate of referrals over a 7 year period.ResultReferral data from up to 28 EDs across England and Scotland over a 7 year period were analysed (n = 18828 referrals). There is a general trend towards increasing numbers of older people referred to liaison psychiatry year on year. Rates rose year on year from 1.4 referrals per 1000 ED attenders (>65 years) in 2011 to 4.5 in 2019 . There is inter and intra site variability in referral numbers per 1000 ED attendances between different departments, ranging from 0.1 - 24.3.ConclusionTo plan an effective healthcare system we need to understand the population it serves, and have appropriate structures and processes within it. The overarching message of this study is clear; older peoples mental health emergencies presenting in ED are common and appear to be increasingly so. Without appropriate investment either in EDs or community mental health services, this is unlikely to improve.The data also suggest very variable inter-departmental referral rates. It is not possible to establish why rates from one department to another are so different, or whether outcomes for the population they serve are better or worse. The data does however highlight the importance of asking further questions about why the departments are different, and what impact that has on the patients they serve.


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
D Costa ◽  
M Cunha ◽  
C Ferreira ◽  
A Gama ◽  
A M N Rodrigues ◽  
...  

Abstract Objective To measure the impact of the economic crisis on the mental health correlates of Portuguese children attending primary school during 2016. Methods Cross-sectional analysis of primary school-aged children and their parents (n = 1157), conducted in public and private schools of three Portuguese districts. Parent reports of children mental health symptoms (Strengths and Difficulties Questionnaire - SDQ) and children self-reports of health-related quality of life (KIDSCREEN-27) and depressive, anxiety and stress symptoms (Depression, Anxiety and Stress Scales, Children version - DASS-C), were compared according to a set of yes/no questions on how the economic crisis changed the normal aspects of routine life (e.g. During the financial crisis did you had to use savings? Started buying cheaper food?). Linear regression models were fitted for the SDQ, the KIDSCREEN-27 and the DASS-C as dependent variables adjusted for children sex, socioeconomic status and district of residence. Results Affirmative answers to the crisis impact questions were associated with more frequent psychosocial functioning problems in children, with poorer self-reported health-related quality of life and with more frequent symptoms of depression, anxiety and stress. Conclusions Portuguese children mental health correlates show significant worse scores for those whose parents declared having to change daily routine habits as a result of the recent macroeconomic financial crisis, compared to those who did not change habits. Public Health programs should be developed to mitigate the potential negative impact of the financial crisis to the mental health of children. Key messages A negative impact on children mental health was observed as a result of the economic crisis. Public health programs designed to mitigate the impact of the economic crisis should include primary-school aged children.


2020 ◽  
Vol 146 (4) ◽  
pp. 331 ◽  
Author(s):  
Tessa E. Bruins ◽  
Martinus M. van Veen ◽  
Tanja Mooibroek-Leeuwerke ◽  
Paul M. N. Werker ◽  
Dieuwke C. Broekstra ◽  
...  

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  

Abstract The world's population is aging rapidly. Globally, the population of older people will nearly double in the next 30 years, from 12% to 22%. Unfortunately, many elderly people are often vulnerable to the development of mental health problems. Besides the development of mental disorders (such as depression) or neurological disorders (such as cognitive impairment), they often experience several health ailments and loss of functionality, which negatively impacts their mental health and wellbeing. The WHO points out that mental health problems among this group of people are under-identified by healthcare professionals and by older people and their relatives themselves, and that stigma surrounding these conditions makes people often reluctant to seek help. Therefore, more scientific research and debate is needed on mental health of older persons, especially from a public health perspective. By bringing together researchers on this domain from different countries and background, this workshop aims to contribute to the scientific insight in this topic and finally to the improvement of the mental health and wellbeing of this growing group of people. In this workshop, research findings on the prevalence of (undetected) mental health problems and the impact of organizational, social and physical conditions on these problems, among older persons, both institutionalized and not, will be presented and discussed by five researchers from different European countries. Dr. Sunwoo Lee (Czech Republic) will talk about the demographic, psychosocial, and health-related risk factors for suicidal ideation among older adults in 12 European countries. Dr. Patricia De Vriendt (Belgium) will give a presentation on the unnoticed mild cognitive problems in nursing homes in Flanders. Dr. Henriette van der Roest (the Netherlands) will show the relationship between organizational adaptions in Dutch nursing homes and cognitive improvement and quality of life among older persons with dementia. Dr. Jutta Lindert (Germany) will focus on the impact of social stress and strain on the episodic memory and executive functioning of the “Midlife in the United States (MIDUS) cohort. And finally Dr. Mauro Carta (Italy) will illustrate the positive effect of moderate physical activity on cognitive functioning and general wellbeing of older people. Key messages Mental health problems among the growing group of older people are prevalent and of different kind. More scientific insight is needed on the prevalence and determinants of these problems, in order to provide timely and adequate support and prevention.


2019 ◽  
Vol 54 (20) ◽  
pp. 1188-1194 ◽  
Author(s):  
Juliana S Oliveira ◽  
Cathie Sherrington ◽  
Elizabeth R Y Zheng ◽  
Marcia Rodrigues Franco ◽  
Anne Tiedemann

BackgroundOlder people are at high risk of physical inactivity. Activity trackers can facilitate physical activity. We aimed to investigate the effect of interventions using activity trackers on physical activity, mobility, quality of life and mental health among people aged 60+ years.MethodsFor this systematic review, we searched eight databases, including MEDLINE, Embase and CENTRAL from inception to April 2018. Randomised controlled trials of interventions that used activity trackers to promote physical activity among people aged 60+ years were included in the analyses. The study protocol was registered with PROSPERO, number CRD42017065250.ResultsWe identified 23 eligible trials. Interventions using activity trackers had a moderate effect on physical activity (23 studies; standardised mean difference (SMD)=0.55; 95% CI 0.40 to 0.70; I2=86%) and increased steps/day by 1558 (95% CI 1099 to 2018 steps/day; I2=92%) compared with usual care, no intervention and wait-list control. Longer duration activity tracker-based interventions were more effective than short duration interventions (18 studies, SMD=0.70; 95% CI 0.47 to 0.93 vs 5 studies, SMD=0.14; 95% CI −0.26 to 0.54, p for comparison=0.02). Interventions that used activity trackers improved mobility (three studies; SMD=0.61; 95% CI 0.31 to 0.90; I2=10%), but not quality of life (nine studies; SMD=0.09; 95% CI −0.07 to 0.25; I2=45%). Only one trial included mental health outcomes and it reported similar effects of the activity tracker intervention compared with control.ConclusionsInterventions using activity trackers improve physical activity levels and mobility among older people compared with control. However, the impact of activity tracker interventions on quality of life, and mental health is unknown.


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