Analyzing Digital Evidence From a Telemental Health Platform to Assess Complex Psychological Responses to the COVID-19 Pandemic: Content Analysis of Text Messages

Background The novel COVID-19 disease has negatively impacted mortality, economic conditions, and mental health. These impacts are likely to continue after the COVID-19 pandemic ends. There are no methods for characterizing the mental health burden of the COVID-19 pandemic, and differentiating this burden from that of the prepandemic era. Accurate illness detection methods are critical for facilitating pandemic-related treatment and preventing the worsening of symptoms. Objective We aimed to identify major themes and symptom clusters in the SMS text messages that patients send to therapists. We assessed patients who were seeking treatment for pandemic-related distress on Talkspace, which is a popular telemental health platform. Methods We used a machine learning algorithm to identify patients’ pandemic-related concerns, based on their SMS text messages in a large, digital mental health service platform (ie, Talkspace). This platform uses natural language processing methods to analyze unstructured therapy transcript data, in parallel with brief clinical assessment methods for analyzing depression and anxiety symptoms. Results Our results show a significant increase in the incidence of COVID-19–related intake anxiety symptoms (P<.001), but no significant differences in the incidence of intake depression symptoms (P=.79). During our transcript analyses, we identified terms that were related to 24 symptoms outside of those included in the diagnostic criteria for anxiety and depression. Conclusions Our findings for Talkspace suggest that people who seek treatment during the pandemic experience more severe intake anxiety than they did before the COVID-19 outbreak. It is important to monitor the symptoms that we identified in this study and the symptoms of anxiety and depression, to fully understand the effects of the COVID-19 pandemic on mental health.

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Digital phenotyping of complex psychological responses to the COVID-19 pandemic (Preprint)

10.2196/preprints.26190 ◽

2020 ◽

Author(s):

Thomas D. Hull ◽

Jacob Levine ◽

Niels Bantilan ◽

Angel N. Desai ◽

Maimuna S. Majumder

Keyword(s):

Mental Health ◽

Language Processing ◽

Anxiety Symptoms ◽

Depression Symptoms ◽

The Novel ◽

Depression And Anxiety ◽

Clinical Assessments ◽

Digital Phenotyping ◽

Novel Coronavirus ◽

Therapy Service

BACKGROUND The novel coronavirus disease 2019 (COVID-19) has negatively impacted mortality, economic conditions, and mental health and these impacts are likely to continue after the pandemic comes to an end. OBJECTIVE At present, no method has characterized the mental health burden of the pandemic distinct from pre-COVID-19 levels. Accurate detection of illness is critical to facilitate pandemic-related treatment to prevent worsening symptoms. METHODS An algorithm for the isolation of pandemic-related concerns on a large digital mental health service is reported that utilized natural language processing (NLP) on unstructured therapy transcript data, in parallel with brief clinical assessments of depression and anxiety symptoms. RESULTS Results demonstrate a significant increase in COVID-related intake anxiety symptoms, but no detectable difference in intake depression symptoms. Transcript analyses identified terms classifiable into 24 symptoms in excess of those included in the diagnostic criteria for anxiety and depression. CONCLUSIONS Findings for this large digital therapy service suggest that treatment seekers are presenting with more severe intake anxiety levels than before the COVID-19 outbreak. Importantly, monitoring additional symptoms as part of a new COVID-19 Syndrome category could be advised to fully capture the effects of COVID019 on mental health.

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Risk perception, mental health impacts and coping strategies during COVID-19 pandemic among Filipino healthcare workers

Journal of Public Health Research ◽

10.4081/jphr.2021.2604 ◽

2021 ◽

Author(s):

Roy Rillera Marzo ◽

Emilio Quilatan Villanueva III ◽

Udita Chandra ◽

Mila Nu Nu Htay ◽

Rajeev Shrestha ◽

...

Keyword(s):

Mental Health ◽

Risk Perception ◽

Marital Status ◽

Healthcare Workers ◽

The Philippines ◽

Anxiety Symptoms ◽

Mental Illnesses ◽

Anxiety And Depression ◽

Depression Symptoms ◽

Status Occupation

Background: COVID-19 pandemic has caused an extraordinary situation, especially for the healthcare workers (HCWs), leading to increased psychological stress. The aim of the study was to estimate the prevalence of different grades of anxiety and depression across different centers in the Philippines and identify demographic factors associated with them. Design and Method: A cross-sectional, web-based, multi-center study was conducted among HCWs of Philippines from April 20- May 20, 2020. The study instruments used were the Generalized Anxiety Disorder (GAD-7) scale and Patient Health Questionnaire (PHQ-9). Risk perception scores were analyzed using Mann-Whitney and Kruskal-Wallis test. Logistic regression was done to identify factors significantly associated with symptoms of anxiety and depression determined. Results: A total of 516 HCWs were included in the study. Most of them have anxiety symptoms (70.74%), but only half of them have symptoms of depression (50.97%). In addition, gender, age, marital status, living status, occupation, work premises, and availability of mental health services were significantly associated with the participants’ anxiety symptoms; In contrast, gender, marital status, occupation, and work premises were significantly associated with depression symptoms. Conclusion: This study reiterates the fact and demonstrates that COVID-19 has disrupted the mental well-being of HCWs in the Philippines. Majority of HCW was psychologically affected by COVID-19. Therefore, there is a dire need to address mental illness amongst HCWs and frame guidelines based on proven algorithms to overcome these mental illnesses.

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StayWell at Home: A Text Messaging Intervention to Counteract Depression and Anxiety during COVID-19 Social Distancing (Preprint)

10.2196/preprints.25298 ◽

2021 ◽

Author(s):

Adrian Aguilera ◽

Rosa Hernandez-Ramos ◽

Alein Yaritza Haro ◽

Claire Elizabeth Boone ◽

Tiffany Luo ◽

...

Keyword(s):

Mental Health ◽

Text Messaging ◽

The United States ◽

Text Messages ◽

Anxiety Symptoms ◽

Anxiety And Depression ◽

Depression And Anxiety ◽

Negative Consequences ◽

Social Distancing ◽

At Home

BACKGROUND Social distancing and stay-at-home orders are critical interventions to slow down person-to-person transmission of COVID-19. While these societal changes help to contain the pandemic, they also have unintended negative consequences, including anxiety and depression. We developed StayWell, a daily skills-based SMS text messaging program, to mitigate COVID-19 related depression and anxiety symptoms among people who speak English and Spanish in the United States. OBJECTIVE This paper describes the changes in the anxiety and depression levels of participants in the StayWell program after 60 days of exposure to skills-based SMS text messages. METHODS We used self-administered, empirically supported web-based questionnaires to assess the demographic and clinical characteristics of StayWell participants. Anxiety and depression were measured using the 2-item Generalized Anxiety Disorder (GAD-2) scale and the 8-item Patient Health Quesstionanire-8 (PHQ-8) scale at baseline and 60-day timepoints. We used paired t-tests to detect the change in PHQ-8 and GAD-2 scores from baseline to follow-up measured 60 days later. RESULTS The analytic sample includes 193 participants who completed both the baseline and 60-day exit questionnaires. At the 60-day time point, there were statistically significant reductions in both PHQ-8 and GAD-2 scores from baseline. We found an average reduction of -1.72 (95% CI: -2.35, -1.09) in PHQ-8 scores and -0.48 (95% CI: -0.71, -0.25) in GAD-2 scores. This translated to an 18.5% and 17.2% reduction in mean PHQ-8 scores and GAD-2, respectively. CONCLUSIONS StayWell is a low-intensity, cost-effective, and accessible population-level mental health intervention. Participation in StayWell focused on COVID-19 mental health coping skills and was related to improved depression and anxiety symptoms. In addition to improvements in outcomes, we found high levels of engagement during the 60-day intervention period. Text messaging interventions could serve as an important public health tool for disseminating strategies to manage mental health. CLINICALTRIAL ClinicalTrials.gov Identifier: NCT04473599 INTERNATIONAL REGISTERED REPORT RR2-10.2196/23592

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Staff SARS-CoV-2 Seroprevalence and Mental Health as Key Factors in University Response to COVID-19 Pandemic

Frontiers in Public Health ◽

10.3389/fpubh.2021.689919 ◽

2021 ◽

Vol 9 ◽

Author(s):

David G. Lopes ◽

Ana Rita Henriques ◽

Margarida Santos-Dias ◽

Catarina Nunes-da-Silva ◽

Juliana Gonçalves ◽

...

Keyword(s):

Mental Health ◽

Medical School ◽

Urban Areas ◽

Academic Community ◽

Anxiety Symptoms ◽

Anxiety And Depression ◽

Blood Collection ◽

Depression Symptoms ◽

Blood Draw ◽

Negatively Associated

Background: In response to rapid global spread of the newly emerged coronavirus disease 2019 (COVID-19), universities transitioned to online learning and telework to decrease risks of inter-person contact. To help administrators respond to the COVID-19 pandemic and better understand its impacts, we surveyed SARS-CoV-2 seroprevalence among NOVA University employees and assessed community mental health.Methods: Data were collected from voluntary participants at six NOVA University locations, in the Lisbon metropolitan area, from June 15–30, 2020. All subjects provided written informed consent. Of 1,627 recruited participants (mean age 42.0 ± 12.3 years), 1,624 were tested. Prior to blood collection, participants completed a questionnaire that assessed: COVID-19 symptoms during the previous 14 days, chronic non-communicable diseases, chronic medication, anxiety, and depression symptoms. SARS-CoV-2 serology tests were then performed, and results communicated approximately 4 days after blood draw. Participants with positive serology tests were contacted to assess COVID-19 symptoms since February.Results: Estimated prevalence of SARS-CoV-2 IgG antibodies was 3.1% (n = 50), of which 43.5% reported symptoms in the previous 4 months. The Medical School had the highest seroprevalence (6.2%). Participants reported having at least one chronic disease (63.7%), depression-like symptoms (2.1%), and anxiety symptoms (8.1%). Rates of depression and anxiety symptoms were significantly higher in women, with sleep hours and occasional alcohol consumption negatively associated with depression. Male gender, older age, and sleep hours negatively associated with anxiety symptoms. School of employment and presence of comorbidities positively associated with anxiety.Conclusion: By measuring seroprevalence of SARS-CoV-2 antibodies among NOVA employees and assessing subjects' mental health, we aim to help administrators at European public universities in urban areas, such as Lisbon, Portugal, better understand the needs of their communities. This study resulted in implementation of a stricter contingency plan in the Medical School, while other schools continued to follow Government mitigation guidelines. These findings may also guide the development of tailored strategies to ensure physical and mental health of the academic community during this pandemic crisis. We conclude that, together with COVID-19 contingency plans, psychological support services and facilities to help people effectively face pandemic-associated challenges and minimise anxiety and depression should be implemented.

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The relationship between stress, trait emotional intelligence and mental health amongst Gaza’s basic-year medical students during the COVID-19 outbreak

Middle East Current Psychiatry ◽

10.1186/s43045-021-00146-0 ◽

2021 ◽

Vol 28 (1) ◽

Author(s):

Basel El-Khodary ◽

Siham Alshawamreh ◽

Mariam Abu Salah ◽

Amro Hamada ◽

Baraa Alhendawi ◽

...

Keyword(s):

Mental Health ◽

Emotional Intelligence ◽

Medical Students ◽

Anxiety Symptoms ◽

Stressful Events ◽

Anxiety And Depression ◽

Depression Symptoms ◽

Trait Emotional Intelligence ◽

The Relationship ◽

Stress Domains

Abstract Background This study investigates the relationship between exposure to stress, trait emotional intelligence (trait EI) and mental health problems (anxiety and depression symptoms) amongst basic-year medical students during COVID-19. The sample consists of 379 basic-year medical students. Off them, 160 (42.4%) were male and 218 (57.5%) were female. The following measures were used in the study: The Medical Student Stressor Questionnaire (MSSQ), Trait Emotional Intelligence Questionnaire—Short Form (TEIQue-ASF), The anxiety symptoms scale and the depression scale. Results The majority of students reported high to severe level ARS and mild to moderate DRS. Female students showed higher levels of ARS, TLRS, SRS, GARS and anxiety symptoms compared to male ones. Moreover, students with higher levels of academic performance reported lower levels of ARS and DRS, higher levels of trait EI and lower levels of anxiety and depression symptoms. In addition, trait EI has a significant negative association with anxiety and depression symptoms and stress domains (ARS, IRS, TLRS, SRS, DRS, GARS) and total stress. Finally, stress domains are positively correlated with anxiety and depression symptoms. Conclusion Basic-year medical students in the Gaza Strip are exposed to stressful events which aggravate the effect of exposure and cause higher levels of anxiety and depression symptoms.

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Change in Physical Activity During the Coronavirus Disease 2019 Lockdown in Norway: The Buffering Effect of Resilience on Mental Health

Frontiers in Psychology ◽

10.3389/fpsyg.2020.598481 ◽

2020 ◽

Vol 11 ◽

Author(s):

Frederick Anyan ◽

Odin Hjemdal ◽

Linda Ernstsen ◽

Audun Havnen

Keyword(s):

Mental Health ◽

Physical Activity ◽

Mental Health Problems ◽

Depression Scale ◽

Health Problems ◽

Anxiety Symptoms ◽

Anxiety And Depression ◽

Depression Symptoms ◽

Cross Sectional Survey ◽

Common Mental Health Problems

Imposition of lockdown restrictions during the coronavirus disease 2019 (COVID-19) pandemic was sudden and unprecedented and dramatically changed the life of many people, as they were confined to their homes with reduced movement and access to fitness training facilities. Studies have reported significant associations between physical inactivity, sedentary behavior, and common mental health problems. This study investigated relations between participants’ reports of change in physical activity (PA; i.e., Reduced PA, Unchanged PA, or Increased PA) and levels of anxiety and depression symptoms during the COVID-19 pandemic lockdown in Norway in the time period from March 12, 2020 to June 15, 2020. The relations between age and gender and levels of anxiety and depression symptoms as well as how different levels of resilience influenced the relation between changes in PA and levels of anxiety and depression symptoms were also investigated. A cross-sectional survey design was used. Participants (N = 1,314; females = 31%) were members of an endurance sports organization aged between 18 and 81 years (M = 49 years; SD = 11.50 years). Participants completed the Resilience Scale for Adults and the Hospital Anxiety and Depression Scale and reported their changes in PA after lockdown restrictions were implemented on March 12, 2020. Regression analysis, independent samples t-test, and two-way multivariate analysis of variance were conducted. Reduced PA was associated with a higher risk of anxiety and depression symptoms. Younger participants in Reduced PA and Unchanged PA subgroups scored significantly higher on levels of anxiety symptoms and significantly higher on depression symptoms in Unchanged PA subgroup. Females in Unchanged PA and Increased PA subgroups scored significantly higher on levels of anxiety symptoms, whereas no gender differences were found for depression symptoms. The main and interaction effects of change in PA and resilience were significantly associated with depression symptoms. For anxiety symptoms, only the main effect of resilience, but not PA, and the interaction effect were significant. Results further showed that resilience was an important factor that influenced the levels of change in PA. High levels of resilience were associated with lower anxiety and depression symptoms in Reduced, Unchanged, and Increased PA subgroups during the COVID-19 lockdown. Promoting PA while boosting resilience factors such as confidence in own ability and drawing on the social support of even reduced social networks or connections while under lockdown can protect against common mental health problems.

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Childhood Material Hardship and Adolescent Mental Health

Youth & Society ◽

10.1177/0044118x211001896 ◽

2021 ◽

pp. 0044118X2110018

Author(s):

Chrisse Edmunds ◽

Melissa Alcaraz

Keyword(s):

Mental Health ◽

Adolescent Depression ◽

Adolescent Mental Health ◽

Anxiety And Depression ◽

Fragile Families ◽

Depression Symptoms ◽

Depression And Anxiety ◽

Material Hardship ◽

Critical Age ◽

The Relationship

Adolescent mental health has implications for current and future wellbeing. While a link exists between poverty and mental health, little is known about how experiencing material hardship, such as insecurity of food, housing, utilities, and medical care, throughout early childhood affects adolescent mental health. We examine the relationship between material hardship in childhood and adolescent mental health. We use Poisson regression to examine the effect of material hardship experienced at different stages of childhood on adolescent depression and anxiety outcomes at age 15. We use longitudinal data from the Fragile Families and Child Wellbeing Study ( N = 3,222). We find that recently experiencing material hardship during childhood is positively and significantly associated with anxiety and depression symptoms at age 15, even when controlling for material hardship at age 15. Additionally, we find that insecurity during mid-childhood and the stress of lacking basic needs during a critical age may influence mental health in adolescence.

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Religious and Sexual Identities: An Intersectional, Longitudinal Examination of Change in Therapy

The Counseling Psychologist ◽

10.1177/0011000017702721 ◽

2017 ◽

Vol 45 (3) ◽

pp. 387-413 ◽

Cited By ~ 8

Author(s):

G. Tyler Lefevor ◽

Rebecca A. Janis ◽

So Yeon Park

Keyword(s):

Mental Health ◽

Hierarchical Linear Modeling ◽

Anxiety Symptoms ◽

Anxiety And Depression ◽

Linear Modeling ◽

Data Set ◽

Sexual Identities ◽

Rates Of Change ◽

Lower Baseline ◽

Longitudinal Examination

The current study employs an intersectional framework to understand how well counselors are meeting the needs of lesbian, gay, bisexual, queer, questioning (LGBQQ) and religious clients by examining clients’ initial anxiety and depression levels and changes in these symptoms through psychotherapy. Data from 12,825 participants from the Center for Collegiate Mental Health 2012–2014 data set were analyzed. Results from hierarchical linear modeling indicate lower baseline anxiety and depression among religious clients and faster rates of change of anxiety symptoms among nonreligious clients. LGBQQ clients presented with higher initial anxiety and depression, but there were no differences in rates of change of anxiety and depression between heterosexual and LGBQQ clients. Significant but minimal interaction effects between religious and sexual identities were found, indicating a need for further research. Counselors are encouraged to be mindful of these disparities in therapy.

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Trauma and Mental Health in Resettled Refugees: Mediating Effect of Host Language Acquisition on Posttraumatic Stress Disorder, Depressive and Anxiety Symptoms

Transcultural Psychiatry ◽

10.1177/1363461518789538 ◽

2018 ◽

Vol 56 (1) ◽

pp. 3-23 ◽

Cited By ~ 6

Author(s):

Dzenana Kartal ◽

Nathan Alkemade ◽

Litza Kiropoulos

Keyword(s):

Mental Health ◽

Language Acquisition ◽

Posttraumatic Stress ◽

Community Sample ◽

Anxiety Symptoms ◽

Mediating Effect ◽

Depression Symptoms ◽

Indirect Pathway ◽

Traumatic Exposure ◽

The Relationship

This study examined the relationship between traumatic exposure, host language acquisition and mental health (posttraumatic stress, depressive and anxiety symptoms) in long-term resettled refugees. Participants included a community sample of Bosnian refugees ( N = 138, 55% male, mean age of 40 years old) that had resettled in Australia and Austria on average 18 years prior. Two mediation models were tested based on two competing theories. Model A examined whether language acquisition mediates the relationship between traumatic exposure and mental health problems experienced by refugees. Model B examined whether mental health symptoms mediate the relationship between exposure to traumatic events and the acquisition of host language. Model A fit the data well (CFI = 1.00, SRMR = .017, RMSEA < .001, χ2 p = .526), while Model B was rejected as an acceptable model for the data (CFI = .556, SRMR = .136, RMSEA = .352). In Model A, the indirect pathway from trauma to mental health via language acquisition was significant for PTSD ( β = .067, p = .028) and anxiety symptoms ( β = .063, p = .026) but not depression symptoms ( β = .048, p = .071). Intervention strategies aimed at improving host language acquisition may be important not only in successful adaptation to daily living in the host country, but also to improve the mental health of traumatized refugees.

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Anxiety and depression prevalence in digestive cancers: a systematic review and meta-analysis

BMJ Supportive & Palliative Care ◽

10.1136/bmjspcare-2021-003275 ◽

2021 ◽

pp. bmjspcare-2021-003275

Author(s):

Mohammad Zamani ◽

Shaghayegh Alizadeh-Tabari

Keyword(s):

Oesophageal Cancer ◽

Meta Analysis ◽

Anxiety Symptoms ◽

Anxiety And Depression ◽

Depression Symptoms ◽

Hepatic Cancer ◽

Early Management ◽

Pooled Prevalence ◽

Digestive Cancers ◽

Gi Cancers

BackgroundCancers of the digestive system can be associated with disturbing and disabling symptoms, which can contribute to a negative psychological pressure on patients.AimTo investigate the reported prevalence of symptoms of anxiety and depression in patients with major digestive cancers, including oesophageal, gastric, colorectal, pancreatic or hepatic cancers.MethodsWe searched Embase, PubMed, Scopus and Web of Science for articles published from inception to December 2020. We included studies reporting the prevalence of anxiety or depression symptoms using validated questionnaires in adult patients (≥18 years).ResultsIn total, 51 eligible papers were finally included. Overall, the pooled prevalence of anxiety symptoms was 20.4% (95% CI 17% to 23.8%). The estimate in patients with gastrointestinal (GI) cancers was 19.1% and in patients with hepatic cancer was 29.1%. Among GI cancers, the highest pooled prevalence of anxiety symptoms related to oesophageal cancer (20.6%), while the lowest pooled prevalence pertained to gastric cancer (18.7%). Regarding depression symptoms, the overall pooled prevalence was 30.2% (95% CI 24.3% to 36.1%). The estimate in patients with GI cancers was 31% and in patients with hepatic cancer was 21.5%. Among GI cancers, the highest pooled prevalence of depression symptoms related to oesophageal cancer (45.2%), while the lowest pooled prevalence pertained to colorectal cancer (22.9%).ConclusionA considerable prevalence of anxiety and depression symptoms is observed in patients with digestive cancers. Screening and preventive measures with early management of these psychological problems by clinicians could possibly improve outcomes for these patients.PROSPERO registration numberCRD42020210079.

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