scholarly journals Trends in depression & anxiety symptom severity among mental health service attendees during the COVID-19 pandemic

2021 ◽  
Author(s):  
Rob Saunders ◽  
Joshua Eusty Jonathan Buckman ◽  
Judy Leibowitz ◽  
John Cape ◽  
Stephen Pilling
Keyword(s):  
Mental Health ◽  
Anxiety Symptom ◽  
Psychological Treatment ◽  
Depression And Anxiety ◽  
Treatment Services ◽  
Symptom Scores ◽  
Potential Benefits ◽  
Community Transmission ◽  
The Uk ◽  
Residual Confounding

BackgroundGeneral population surveys have shown that some groups, particularly young women experienced increased distress during nationally mandated restrictions to control the spread of COVID-19. However, there has been limited research on such trends among people with pre-existing mental health conditions, leaving mental health services ill equipped to plan for currents and future lockdowns.MethodsMean weekly scores on the GAD-7 and PHQ-9 between 01/01/2020-22/06/2020 (n=9,538 individuals) for all patients of two psychological treatment services in London, were compared to mean weekly scores from the same time periods in 2017-2019 (n=37,849). The proportion of scores which were above the clinical thresholds for ‘caseness’ each week were compared, and scores between groups based on gender, age group, and ethnicity, were also compared. ResultsConfirmed community transmission in the UK (26/02/2020-03/03/2020) and the announcement of the national ‘lockdown’ (23/03/2020) were associated with significant increases in anxiety symptom scores. ‘Lockdown’ was associated with a decrease in depression scores. These changes were not maintained during lockdown. Significant increases in depression and anxiety were observed at week 23, as restrictions were eased.LimitationsThis was an exploratory analysis in two services only. Residual confounding and selection biases cannot be ruled out.ConclusionsDifferences in the weekly average symptom scores were short-term; they did not continue throughout ‘lockdown’ as might have been expected, except among older people. Replication of this study in other settings and investigating the potential benefits of more regular reviews or more intensive treatments for older adults seeking support, are warranted.

scholarly journals Digital phenotyping of complex psychological responses to the COVID-19 pandemic

2020 ◽  
Author(s):  
Thomas Hull ◽  
Jacob Levine ◽  
Niels Bantilan ◽  
Angel Desai ◽  
Maimuna S. Majumder
Keyword(s):  
Mental Health ◽  
Large Scale ◽  
Anxiety Symptom ◽  
The United States ◽  
Anxiety Symptoms ◽  
Response To Treatment ◽  
Depression Symptom ◽  
Depression And Anxiety ◽  
Psychological Reactions ◽  
Symptom Scores

Background: The novel coronavirus disease 2019 (COVID-19) has negatively impacted mortality, economic conditions, and mental health. A large scale study on psychological reactions to the pandemic to inform ongoing population-level symptom tracking and response to treatment is currently lacking.Methods: Average intake scores for standard depression and anxiety symptom scales were tracked from January 1, 2017 to June 9, 2020 for patients seeking treatment from a digital mental health service to gauge the relationship between COVID-19 and self-reported symptoms. We applied natural language processing (NLP) to unstructured therapy transcript data from patients seeking treatment during the height of the pandemic in the United States between March 1, 2020 and June 9, 2020 to identify words associated with COVID-19 mentions. This analysis was used to identify symptoms that were present beyond those assessed by standard depression and anxiety measures.Results: Depression and anxiety symptoms reported by 169,889 patients between January 1, 2017 and June 9, 2020 were identified. There was no detectable change in intake depression symptom scores. Intake anxiety symptom scores increased 1.42 scale points [95% CI: 1.18, 1.65] between March 15, 2020 and April 1, 2020, when scores peaked. In the transcript data of these 169,889 patients, plus an expanded sample of 49,267 patients without symptom reports, term frequency-inverse document frequency (tf-idf) identified 2,377 positively correlated and 661negatively correlated terms that were significantly (FDR<.01) associated with mentions of the virus. These terms were classifiable into 24 symptoms beyond those included in the diagnostic criteria for anxiety or depression.Conclusions: The COVID-19 pandemic may have increased intake anxiety symptoms for individuals seeking digital mental health treatment. NLP analyses suggest that standard symptom scales for depression and anxiety alone are inadequate to fully assess and track psychological reactions to the pandemic. Symptoms of grief, trauma, obsession-compulsion, agoraphobia, hypochondriasis, panic, and non- suicidal self-injury should be monitored as part of a new COVID-19 Syndrome category.

scholarly journals Role of Inflammation in Depression and Anxiety: Tests for Disorder Specificity, Linearity and Potential Causality of Association in the UK Biobank

2021 ◽  
Author(s):  
Zheng Ye ◽  
Nils Kappelmann ◽  
Sylvain Moser ◽  
George Davey Smith ◽  
Stephen Burgess ◽  
...  
Keyword(s):  
Anxiety Symptom ◽  
Experimental Studies ◽  
Mendelian Randomisation ◽  
Depression And Anxiety ◽  
Uk Biobank ◽  
Reactive Protein ◽  
Increased Risk ◽  
Symptom Scores ◽  
Using Data ◽  
The Uk

ABSTRACTBackgroundConcentrations of C-reactive protein (CRP), interleukin 6 (IL-6) and other inflammatory markers are elevated in people with depression and anxiety compared to controls, but evidence for disorder-specificity, linearity and potential causality is sparse.MethodsUsing data from up to 144,890 UK Biobank cohort participants, we tested associations of circulating CRP concentrations with depression and anxiety symptom scores and probable diagnosis, including tests for linearity, disorder-specificity and sex difference. We examined potential causality using 1-sample and 2-sample Mendelian randomisation (MR) analyses testing associations of genetically-predicted CRP concentration and IL-6 activity with depression and anxiety.FindingsCRP concentration was associated with depressive and anxiety symptom scores and with probable diagnoses of depression and generalised anxiety disorder (GAD) in a dose-response fashion. These associations were stronger for depression than for anxiety, and for women than for men although less consistently. MR analyses provided consistent results suggesting that genetically predicted higher IL-6 activity was associated with increased risk for depressive symptoms, while genetically-predicted higher CRP concentration was associated with decreased risks of depressive and anxiety symptoms.InterpretationAltered activity of the IL-6/IL-6R pathway could be causally linked to depression. The field now requires experimental studies of IL-6 modulation in humans and animal models to further examine causality, mechanisms and treatment potential. Such studies are also needed to elucidate mechanisms for divergent associations of genetically-predicted higher IL-6 activity (risk increasing) and higher CRP concentrations (protective) with depression/anxiety.FundingMQ (MQDS17/40); Wellcome Trust (201486/Z/16/Z).

Psychological treatments

2013 ◽  
Author(s):  
Philip Wilkinson
Keyword(s):  
Clinical Trials ◽  
Older People ◽  
Psychotropic Medication ◽  
Psychological Treatment ◽  
Psychological Treatments ◽  
Reminiscence Therapy ◽  
Treatment Services ◽  
Barriers To Access ◽  
The Status ◽  
Potential Benefits

This introduction to psychological treatments reviews the range and applications of talking therapies with older people. Reminiscence therapy is described and reference is made to the therapies addressed in later chapters. The potential benefits of psychological therapy are discussed with guidance on applying findings from clinical trials to individual patients. The wider benefits of an understanding of psychological approaches are outlined; these include use of psychological formulations and augmenting the effects of psychotropic medication. The status of psychological treatment services for older people is reviewed and barriers to access are considered.

scholarly journals Maintaining contact with blue-green spaces during the COVID-19 pandemic associated with positive mental health

2020 ◽  
Author(s):  
Sarai Pouso ◽  
Angel Borja ◽  
Lora E. Fleming ◽  
Erik Gómez-Baggethun ◽  
Mathew White ◽  
...  
Keyword(s):  
Mental Health ◽  
Well Being ◽  
Natural World ◽  
Decision Makers ◽  
Green Spaces ◽  
Depression And Anxiety ◽  
Symptoms Of Depression ◽  
Outdoor Spaces ◽  
Potential Benefits ◽  
Negative Impacts

There is growing evidence that exposure to the natural world (blue-green spaces) has potential benefits for mental health and well-being. The COVID-19 pandemic and the measures adopted to control it provide a natural experiment to investigate the links between nature exposure and mental health under extreme conditions. Using a survey distributed online and based on 6,080 responses, we tested three hypotheses: (1) people will show different levels of symptoms of depression and anxiety depending on the level of lockdown (severity) and ability to maintain contact with outdoor spaces; and (2) where access to outdoor public spaces was restricted, those with access to private outdoor spaces (2a) or even a green-blue nature view (2b) will show fewer symptoms of depression and anxiety and a more positive mood. Lockdown severity significantly affected mental health, while contact with nature helped people to cope with these impacts. The buffering effect of nature was especially relevant for those under strict lockdowns. People perceived that nature helped them to cope with lockdown measures; and emotions were more positive among individuals with accessible outdoor spaces and blue-green elements in their views. These findings can help decision-makers in developing potential future lockdown measures to mitigate the negative impacts, helping people to be more resilient and maintain better mental health.

scholarly journals Mental health during the COVID-19 pandemic in two longitudinal UK population cohorts

2020 ◽  
Author(s):  
Alex S. F. Kwong ◽  
Rebecca M. Pearson ◽  
Mark J. Adams ◽  
Kate Northstone ◽  
Kate Tilling ◽  
...  
Keyword(s):  
Mental Health ◽  
Family Health ◽  
Health Study ◽  
Depression And Anxiety ◽  
Relevant Effect ◽  
Parents And Children ◽  
Two Generations ◽  
The Uk ◽  
University Of Bristol ◽  
The Impact

SummaryBackgroundThe impact of COVID-19 on mental health is unclear. Evidence from longitudinal studies with pre pandemic data are needed to address (1) how mental health has changed from pre-pandemic levels to during the COVID-19 pandemic and (2), whether there are groups at greater risk of poorer mental health during the pandemic?MethodsWe used data from COVID-19 surveys (completed through April/May 2020), nested within two large longitudinal population cohorts with harmonised measures of mental health: two generations of the Avon Longitudinal Study of Parents and Children (ALPSAC): the index generation ALSPAC-G1 (n= 2850, mean age 28) and the parent’s generation ALSPAC-G0 (n= 3720, mean age = 59) and Generation Scotland: Scottish Family Health Study (GS, (n= 4233, mean age = 59), both with validated pre-pandemic measures of mental health and baseline factors. To answer question 1, we used ALSPAC-G1, which has identical mental health measures before and during the pandemic. Question 2 was addressed using both studies, using pre-pandemic and COVID-19 specific factors to explore associations with depression and anxiety in COVID-19.FindingsIn ALSPAC-G1 there was evidence that anxiety and lower wellbeing, but not depression, had increased in COVID-19 from pre-pandemic assessments. The percentage of individuals with probable anxiety disorder was almost double during COVID-19: 24% (95% CI 23%, 26%) compared to pre-pandemic levels (13%, 95% CI 12%, 14%), with clinically relevant effect sizes. In both ALSPAC and GS, depression and anxiety were greater in younger populations, women, those with pre-existing mental and physical health conditions, those living alone and in socio-economic adversity. We did not detect evidence for elevated risk in key workers or health care workers.InterpretationThese results suggest increases in anxiety and lower wellbeing that may be related to the COVID-19 pandemic and/or its management, particularly in young people. This research highlights that specific groups may be disproportionally at risk of elevated levels of depression and anxiety during COVID-19 and supports recent calls for increasing funds for mental health services.FundingThe UK Medical Research Council (MRC), the Wellcome Trust and University of Bristol.

Management of Clinical Depression and Anxiety

2017 ◽  
Keyword(s):  
Mental Health ◽  
Cancer Patients ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Psychological Treatment ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Comprehensive Description ◽  
Psychiatric Emergencies ◽  
Self Harm

This companion guide for clinicians working with oncology patients outlines clinical management of depression, demoralization and anxiety in a pragmatic format for use in everyday practice. The specific aim is to describe treatments that can be utilized by cancer clinicians and by mental health professionals training in psycho-oncology. The guide is not intended to replace national clinical guidelines and policies but gives a more generic international overview of the important factors and elements that need to be considered when dealing with clinical anxiety and depression in cancer patients at all points on the treatment trajectory. The guide covers assessment methods for clinical anxiety, demoralization and depression, psychopharmacological and psychological treatment methods, along with information on dealing with psychiatric emergencies and self-harm issues. The guide does not offer a comprehensive description of psychotherapy techniques: these can be found in the IPOS Handbook of Psychotherapy in Cancer Care. Policies, service issues, ethical, confidentiality, and communication issues are also covered. The guide is intended as a brief pocketbook manual that can be used for quick reference.

scholarly journals Substance misuse in adolescents

2000 ◽  
Vol 6 (3) ◽  
pp. 201-210 ◽  
Author(s):  
Harith Swadi
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Drug Use ◽  
Health Services ◽  
Substance Misuse ◽  
Preventive Measures ◽  
Treatment Services ◽  
High Prevalence ◽  
The Uk

There is increasing evidence that substance misuse among British adolescents is escalating (Miller & Plant, 1996; Sutherland & Willner, 1998). Swadi (1992) found that, among adolescents aged 12–17 years referred to mental health services, the prevalence of drug use was 13.1% (16.3% among boys and 9.3% among girls). Despite this relatively high prevalence, there are very few organised treatment services for adolescents in the UK. Instead, there is extensive emphasis on prevention even though there is no universal agreement on what prevention can achieve. This approach also overlooks the fact that a significant number of adolescents fail to respond to preventive measures in any form.

The influence of social support, conflict, and stressful life events on PTSD, depression, and anxiety symptom severity in U.S. army female veterans

2011 ◽  
Vol 26 (S2) ◽  
pp. 1678-1678
Author(s):  
A.M. Nayback-Beebe
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Life Events ◽  
Symptom Severity ◽  
Anxiety Symptom ◽  
Stressful Life Events ◽  
Stressful Life ◽  
Female Veterans ◽  
Depression And Anxiety ◽  
The Social

IntroductionThere have been prevailing gender differences in negative mental health outcomes for female U.S. veterans returning from combat deployments. Research has validated the importance of post-deployment social support in mitigating the effects of these experiences on mental health; however, the influence of conflict within the social network has not been thoroughly explored.Aims(1)Examine the relationships between social support, conflict, and stressful life events to PTSD, depression, and anxiety symptom severity in female veterans 6–12 months after deployment.(2)Determine whether the absence of social support or the presence of social conflict is more influential in the severity of these symptoms.MethodsDescriptive, correlationalResultsThere were significant positive bivariate correlations (p < .01) between conflict and stressful life events and significant negative bivariate correlations (p < .01) between social support and each of the three outcome variables: PTSD, depression, and anxiety symptoms. Hierarchical linear regression showed that co-morbid depression, greater post-deployment stressful life events, and greater conflict within the social network best explained the presence of greater PTSD symptom severity. Stressful life events did not contribute to greater anxiety symptom severity; however, symptom severity was affected by the absence of social support. In contrast, greater depression symptom severity was best explained by the presence of co-morbid PTSD symptoms and the absence of social support.ConclusionsTreatment programs for PTSD and anxiety in female veterans’ post-deployment must assess and address sources of intrapersonal conflict within their social networks. Family therapy may be integral to treatment success.

scholarly journals Reducing worry and rumination in young adults via a mobile phone app: study protocol of the ECoWeB (Emotional Competence for Well-Being in Young Adults) randomised controlled trial focused on repetitive negative thinking

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Daniel Edge ◽  
Alexandra Newbold ◽  
Thomas Ehring ◽  
Tabea Rosenkranz ◽  
Mads Frost ◽  
...  
Keyword(s):  
Mental Health ◽  
Young Adults ◽  
Young People ◽  
Emotional Competence ◽  
Well Being ◽  
Poor Mental Health ◽  
Depression And Anxiety ◽  
Repetitive Negative Thinking ◽  
Randomised Controlled ◽  
The Uk

Abstract Background Promoting well-being and preventing poor mental health in young people is a major global priority. Building emotional competence skills via a mobile app may be an effective, scalable and acceptable way to do this. A particular risk factor for anxiety and depression is elevated worry and rumination (repetitive negative thinking, RNT). An app designed to reduce RNT may prevent future incidence of depression and anxiety. Method/design The Emotional Competence for Well-Being in Young Adults study developed an emotional competence app to be tested via randomised controlled trials in a longitudinal prospective cohort. This off-shoot study adapts the app to focus on targeting RNT (worry, rumination), known risk factors for poor mental health. In this study, 16–24 year olds in the UK, who report elevated worry and rumination on standardised questionnaires are randomised to (i) receive the RNT-targeting app immediately for 6 weeks (ii) a waiting list control who receive the app after 6 weeks. In total, the study will aim to recruit 204 participants, with no current diagnosis of major depression, bipolar disorder or psychosis, across the UK. Assessments take place at baseline (pre-randomisation), 6 and 12 weeks post-randomisation. Primary endpoint and outcome for the study is level of rumination assessed on the Rumination Response Styles Questionnaire at 6 weeks. Worry, depressive symptoms, anxiety symptoms and well-being are secondary outcomes. Compliance, adverse events and potentially mediating variables will be carefully monitored. Discussion This trial aims to better understand the benefits of tackling RNT via an mobile phone app intervention in young people. This prevention mechanism trial will establish whether targeting worry and rumination directly via an app provides a feasible approach to prevent depression and anxiety, with scope to become a widescale public health strategy for preventing poor mental health and promoting well-being in young people. Trial registration ClinicalTrials.gov, NCT04950257. Registered 6 July 2021 – Retrospectively registered.

Mental Health Considerations for Exercise Practitioners Delivering Telehealth Services

2021 ◽  
Vol 10 (1) ◽  
pp. 20-28
Author(s):  
Oscar Lederman ◽  
Bonnie Furzer ◽  
Kemi Wright ◽  
Grace McKeon ◽  
Simon Rosenbaum ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Illnesses ◽  
Mental Health Team ◽  
Team Members ◽  
Exercise Interventions ◽  
Face To Face ◽  
Potential Benefits ◽  
Community Transmission ◽  
Reduce Risk

ABSTRACT In Australia, exercise practitioners (i.e., clinical professionals specializing in exercise assessment and delivery) are increasingly recognized as core mental health team members. In response to the COVID-19 pandemic, exercise practitioners, like other mental health professions, have had to adapt methods of clinical service delivery to ensure social distancing and reduce risk of community transmission. As such, telehealth interventions have rapidly replaced most face-to-face services. To date, evidence surrounding the application of telehealth exercise interventions for people living with mental illness is scarce, and currently there is no consensus or recommendations on how exercise practitioners can provide telehealth services for this population. As such, the aim of this article is to draw on existing research and expert opinion to provide practical and service-based guidance for exercise practitioners delivering telehealth services to people with mental illnesses. Specifically, we explore the potential benefits of telehealth exercise interventions, the various challenges and considerations of telehealth exercise among those with mental illness, and some practical solutions to guide exercise practitioners in delivering telehealth services.

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