A hidden pandemic? An umbrella review of global evidence on mental health in the time of COVID-19

2022 ◽  
Author(s):  
Marlee Bower ◽  
Scarlett Smout ◽  
Amarina Donohoe-Bales ◽  
Lily Teesson ◽  
Eleisha Lauria ◽  
...  
Keyword(s):  
Mental Health ◽  
General Population ◽  
Health Outcomes ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Mental Health Outcomes ◽  
Eligibility Criteria ◽  
Pooled Prevalence ◽  
Meta Review ◽  
Meta Analyses

Introduction: Vast available international evidence has investigated the mental health impacts of the COVID-19 pandemic. This review aims to synthesise evidence, identifying populations and characteristics associated with poor mental health.Methods: A meta-review of pooled prevalence of anxiety and depression, with subgroup analyses for the general population, healthcare workers (HCW) and COVID-19 patients; and a meta-synthesis of systematic reviews to collate evidence on associated factors and further mental disorders. Databases searched included Scopus, Embase, PsycINFO, and MEDLINE dated to May 2021. Eligibility criteria included systematic reviews and/or meta-analyses, published post-November 2019, reporting data in English on mental health outcomes during the pandemic.Results: Eighty-one systematic reviews were included, 51 of which incorporated meta-analysis. Meta-review overall anxiety prevalence was 29% (95%CI: 27–31%, I2: 99.83%), with subgroup prevalence as 35% (95%CI: 23–47%, I2: 97.4%) in COVID-19 patients, 29% in HCW (95%CI: 25– 32, I2: 99.8%) and 28% in the general population (95%CI: 25–31%, I2: 99.9%). Meta-review overall depression prevalence was 28% (95%CI: 26–30%, I2: 99.7), with subgroup prevalence as 30% (95%CI: 7–60%, I2: 99.8%) in COVID-19 patients, 28% (95%CI: 25–31%, I2: 99.7%) in HCW and 27% (95%CI: 25–30, I2: 99.8%) in the general population. Meta-synthesis found many experienced psychological distress and PTSD/PTSS during COVID-19, but pooled prevalence ranged substantially. Fear of, proximity to, or confirmed COVID-19 infection; undergoing quarantine; and COVID-19-related news exposure were associated with adverse mental health outcomes. Amongst other factors, people who are younger, female, LGBTIQ, pregnant, parents or experiencing low social support, financial issues or socio-economic disadvantage, tended to have poorer mental health during the pandemic period.Conclusions: Despite high volumes of reviews, the diversity of findings and dearth of longitudinal studies within reviews means clear links between COVID-19 and mental health are not available, although existing evidence indicates probable associations.

scholarly journals Interventions to improve children's access to mental health care: a systematic review and meta-analysis

2019 ◽  
Vol 29 ◽  
Author(s):  
L. Werlen ◽  
D. Gjukaj ◽  
M. Mohler-Kuo ◽  
M.A. Puhan
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Disorders ◽  
Mental Health Care ◽  
Health Outcomes ◽  
Help Seeking ◽  
Meta Analysis ◽  
Mental Health Outcomes ◽  
School Based ◽  
Meta Analyses

Abstract Aims Mental disorders in children are a significant and growing cause of morbidity worldwide. Although interventions to help overcome barriers along the pathway to accessing health care for children with mental disorders exist, there is no overview of randomised controlled trials (RCTs) on these interventions as yet. This study aimed to systematically identify RCTs of interventions to improve access to mental health care for children and synthesise them using a conceptual framework of access to health care. Methods This systematic review was performed following a predefined protocol registered with PROSPERO (ID: CRD42018081714). We searched the databases MEDLINE, EMBASE, PsycINFO and CENTRAL for RCTs up to 15 May 2019 using terms related to the concepts ‘young people,’ ‘mental disorders’ and ‘help-seeking interventions’ and scanned reference lists from relevant studies. Two reviewers independently screened all identified articles in a two-stage process, extracted results on outcomes of interest (knowledge, attitudes, intentions, help-seeking, accessing care, mental health outcomes and satisfaction), assessed the risk of bias and conducted meta-analyses where deemed appropriate. Results After screening 5641 identified articles, 34 RCTs were eligible for inclusion. Eighty per cent of universal school-based interventions measuring knowledge (n = 5) and 67% measuring attitudes (n = 6) reported significantly better results compared with controls on those outcomes, whereas 20% measuring access to care (n = 5) and none measuring mental health outcomes (n = 7) did. In contrast, 71% of interventions targeting at-risk individuals (n = 21) reported better access to care compared with controls, while just 33% (n = 6) did for mental health outcomes. For satisfaction with care, this proportion was 80% (n = 5). Meta-analyses of interventions measuring initial appointment attendance yielded combined odds ratios of 3.11 (2.07–4.67) for appointment reminder interventions and 3.51 (2.02–6.11) for treatment engagement interventions. The outcomes for universal school-based interventions were heterogeneous and could not be summarised quantitatively through meta-analysis. Conclusions To have a population-level effect on improving children's access to mental health care, two-stage interventions that identify those in need and then engage them in the health-care system may be necessary. We need more evidence on interventions to target contextual factors such as affordability and infrastructural barriers.

scholarly journals Discrimination, Life Stress, and Mental Health among Muslims: A Preregistered Meta-analysis and Systematic Review

2019 ◽  
Author(s):  
Ummul-Kiram Kathawalla ◽  
Moin Syed
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Life Stress ◽  
Meta Analysis ◽  
Mental Health Outcomes ◽  
Life Stressors ◽  
Muslim Community ◽  
Western Countries ◽  
Individual Discrimination ◽  
Meta Analyses

Stage 1 Registered Report: How is the current context of Islamophobia, anti-Muslim prejudice, and discrimination, associated with Muslim mental health in Western countries? A body of evidence suggests that experiences of discrimination and racism are associated with negative mental health outcomes for marginalized, minority populations (e.g., Paradies et al., 2015). Studies specifically with Muslim populations in Western countries have found mostly similar findings of an association between discrimination and negative mental health outcomes (Samari, Alcalá, & Sharif, 2018). The varied results in the literature calls for using statistical rigor and synthesis to provide clarity of the etiology of psychopathology in the Muslim community. In this study, we plan to conduct meta-analyses of the associations of both perceived discrimination and mental health and life stressors and mental health for Muslims living in Western countries. We aim to contribute to the literature on the experiences of Muslims and to the debate on the contribution of discrimination vs. life stressors on the development of mental health using meta-analytic methods. For added specificity, we examine both perceived individual discrimination and group discrimination and positive and negative mental health outcomes. We also plan to examine various study-related (e.g., publication bias), demographic, and identity-related moderators in these associations. In the current sociopolitical climate, this study is an important step to better serve the needs of the growing global Muslim community.

scholarly journals T147. CAN HIGH INTENSITY INTERVAL TRAINING (HIIT) IMPROVE PHYSICAL AND MENTAL HEALTH OUTCOMES? A META-REVIEW OF THE GLOBAL BENEFITS OF HIIT AND FOCUSED SYSTEMATIC REVIEW OF THE EFFECTS OF HIIT IN MENTAL DISORDERS

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S286-S287
Author(s):  
Rebecca Martland ◽  
Brendon Stubbs ◽  
Fiona Gaughran
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Systematic Reviews ◽  
Intervention Studies ◽  
Meta Analysis ◽  
Interval Training ◽  
Mental Illnesses ◽  
Mental Health Outcomes ◽  
Schizophrenia Spectrum Disorders ◽  
Physical And Mental Health

Abstract Background High intensity interval training (HIIT) has been shown to improve physical and mental health in healthy individuals and those with physical illnesses, such as cardiovascular and cardiometabolic diseases. Initial work has shown that HIIT may have similar benefits in people experiencing mental illnesses including schizophrenia. Thus, it has been proposed that HIIT may be a promising exercise intervention that has the potential to target the poor health of those with mental illnesses. Despite the rapid interest in HIIT, there is a lack of clarity in the totality of the evidence for which outcomes and under what regimes HIIT is effective and safe, both in populations with and without mental illnesses. Methods A review of the literature was undertaken, comprising a) a meta-review investigating HIIT in all populations and all health outcomes to identify the global health benefits of HIIT; b) a traditional systematic review of all individual interventions of HIIT in all mental disorders (including schizophrenia), to see specifically what has been done in mental health populations. Firstly, major databases were searched for systematic reviews (with/without meta-analyses) of randomised & non-randomised trials that compared HIIT to a control in any human population. Findings were summarised narratively. Secondly, major databases were searched for intervention studies investigating HIIT among people with mental illnesses. Findings were summarised narratively, and a preliminary meta-analysis was undertaken. Results Regarding our first search, 33 systematic reviews (including 25 meta-analyses) were retrieved encompassing healthy subjects and people with physical health complications. Evidence suggested HIIT improved cardiorespiratory fitness (21/23, 91% systematic reviews), arterial compliance and vascular function (3/5, 60% systematic reviews), cardiac function (2/3, 67%), muscle mass (2/3, 67%), quality of life (2/4, 50%) exercise capacity (2/3, 67%) and inflammatory markers (3/5, 60% reviews), versus control. Improvements in muscular structure, anxiety and depression, and blood pressure were seen, compared to pre-training. Additionally, no acute injuries were reported, and mean adherence rates surpassed 80% in most systematic reviews. Regarding our second search, 12 intervention studies, (including 7 RCTs), were included encompassing Major Depressive Disorder, Schizophrenia-Spectrum Disorders, Bipolar Disorder, Substance Use Disorder, Panic Disorder and ADHD. Evidence suggested HIIT improved cardiorespiratory fitness (5/8 intervention studies, 63%), anthropometric variables (3/4, 75%), mental health outcomes (9/12, 75%), cardiovascular fitness (5/9, 56%), physical fitness (1/1, 100%) and motor skills (1/1, 100%), compare to pre-training. The preliminary meta-analysis of pre-post changes found HIIT increased High-Density-Lipoprotein (SMD:0.373 [95%CI 0.18; 0.57], p=0.0002) and possibly reduced general psychopathology (SMD:-1.58 [95%CI -3.35; 0.18], p=0.08) in people with schizophrenia-spectrum disorders. HIIT reduced depression severity (Standardised mean difference (SMD):-1.36 [95%CI-1.63;-1.089], p<0.0001) and possibly improved VO2max (SMD:0.18 [95%CI -0.02; 0.37], p=0.08) in people with depression. No acute injuries were reported, mean adherence to HIIT sessions ranged from 64–94%, and dropout ranged from 0–50%. Discussion HIIT appears to be associated with multiple benefits in healthy subjects and people with physical health complications. HIIT may also improve a range of physical and mental health outcomes among people with mental illnesses including schizophrenia. Nonetheless, high-quality well-powered trials are needed to reaffirm these findings.

To meta-analyse or not to meta-analyse: abortion, birth and mental health

2012 ◽  
Vol 200 (1) ◽  
pp. 12-14 ◽  
Author(s):  
Tim Kendall ◽  
Victoria Bird ◽  
Roch Cantwell ◽  
Clare Taylor
Keyword(s):  
Mental Health ◽  
Health Risk ◽  
Health Outcomes ◽  
Physical Health ◽  
Meta Analysis ◽  
Unwanted Pregnancy ◽  
Mental Health Outcomes ◽  
Physical Health Outcomes ◽  
The Individual ◽  
Meta Analyses

SummaryTwo recent meta-analyses claim that abortion leads to a deterioration in mental health. Previous reviews concluded that the mental health outcomes following an unwanted pregnancy are much the same whether the woman gives birth or terminates the pregnancy, although there is an increased mental health risk with an unwanted pregnancy. Meta-analysis is particularly susceptible to bias in this area. The physical health outcomes for women with an unwanted pregnancy have improved greatly by making abortion legal. To further improve the mental health outcomes associated with an unwanted pregnancy we should focus practice and research on the individual needs of women with an unwanted pregnancy, rather than how the pregnancy is resolved.

scholarly journals Potential impact of physical distancing on physical and mental health: a rapid narrative umbrella review of meta-analyses on the link between social connection and health

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e042335
Author(s):  
Nexhmedin Morina ◽  
Ahlke Kip ◽  
Thole Hilko Hoppen ◽  
Stefan Priebe ◽  
Thomas Meyer
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Social Isolation ◽  
Physical Symptoms ◽  
Vaccine Uptake ◽  
Living Alone ◽  
Mental Health Outcomes ◽  
Social Connection ◽  
Physical And Mental Health ◽  
Meta Analyses

BackgroundThe imperative for physical distancing (mostly referred to as social distancing) during COVID-19 pandemic may deteriorate physical and mental health. We aimed at summarising the strength of evidence in the published literature on the association of physical and mental health with social connection via social isolation, living alone and loneliness.MethodsWe conducted a systematic search in April 2020 to identify meta-analyses using the Medline, PsycINFO and Web of Science databases. The search strategy included terms of social isolation, loneliness, living alone and meta-analysis. Eligible meta-analyses needed to report any sort of association between an indicator of social connection and any physical or mental health outcome. The findings were summarised in a narrative synthesis.ResultsTwenty-five meta-analyses met our criteria, of which 10 focused on physical health and 15 on mental health outcomes. The results suggest that lack of social connection is associated with chronic physical symptoms, frailty, coronary heart disease, malnutrition, hospital readmission, reduced vaccine uptake, early mortality, depression, social anxiety, psychosis, cognitive impairment in later life and suicidal ideation.ConclusionsThe existing evidence clearly indicates that social connection is associated with a range of poor physical and mental health outcomes. A potential negative impact on these outcomes needs to be considered in future decisions on physical distancing measures.

scholarly journals Efficacy and safety of instantaneous wave-free ratio in patients undergoing coronary revascularisation: protocol for a systematic review

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e017868
Author(s):  
Joey S.W. Kwong ◽  
Sheyu Li ◽  
Wan-Jie Gu ◽  
Hao Chen ◽  
Chao Zhang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Adverse Outcomes ◽  
Coronary Revascularisation ◽  
Eligibility Criteria ◽  
Registration Number ◽  
Collection Form ◽  
Randomised Controlled ◽  
Meta Analyses

IntroductionEffective selection of coronary lesions for revascularisation is pivotal in the management of symptoms and adverse outcomes in patients with coronary artery disease. Recently, instantaneous ‘wave-free’ ratio (iFR) has been proposed as a new diagnostic index for assessing the severity of coronary stenoses without the need of pharmacological vasodilation. Evidence of the effectiveness of iFR-guided revascularisation is emerging and a systematic review is warranted.Methods and analysisThis is a protocol for a systematic review of randomised controlled trials and controlled observational studies. Electronic sources including MEDLINE via Ovid, Embase, Cochrane databases and ClinicalTrials.gov will be searched for potentially eligible studies investigating the effects of iFR-guided strategy in patients undergoing coronary revascularisation. Studies will be selected against transparent eligibility criteria and data will be extracted using a prestandardised data collection form by two independent authors. Risk of bias in included studies and overall quality of evidence will be assessed using validated methodological tools. Meta-analysis will be performed using the Review Manager software. Our systematic review will be performed according to the guidance from the Cochrane Handbook for Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.Ethics and disseminationEthics approval is not required. Results of the systematic review will be disseminated as conference proceedings and peer-reviewed journal publication.Trial registration numberThis protocol is registered in the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42017065460.

scholarly journals Impact of Internet-Based Interventions on Caregiver Mental Health: Systematic Review and Meta-Analysis (Preprint)

2018 ◽  
Author(s):  
Diana Sherifali ◽  
Muhammad Usman Ali ◽  
Jenny Ploeg ◽  
Maureen Markle-Reid ◽  
Ruta Valaitis ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Chronic Condition ◽  
Intervention Program ◽  
Meta Analysis ◽  
Informal Caregivers ◽  
Intervention Programs ◽  
Mental Health Outcomes ◽  
The Impact ◽  
Internet Based Intervention

BACKGROUND The health of informal caregivers of adults with chronic conditions is increasingly vital since caregivers comprise a large proportion of supportive care to family members living in the community. Due to efficiency and reach, internet-based interventions for informal caregivers have the potential to mitigate the negative mental health outcomes associated with caregiving. OBJECTIVE The objective of this systematic review and meta-analysis was to examine the impact of internet-based interventions on caregiver mental health outcomes and the impact of different types of internet-based intervention programs. METHODS MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane, and AgeLine databases were searched for randomized controlled trials or controlled clinical trials published from January 1995 to April 2017 that compared internet-based intervention programs with no or minimal internet-based interventions for caregivers of adults with at least 1 chronic condition. The inclusion criteria were studies that included (1) adult informal caregivers (aged 18 years or older) of adults living in the community with a chronic condition; (2) an internet-based intervention program to deliver education, support, or monitoring to informal caregivers; and (3) outcomes of mental health. Title and abstract and full-text screening were completed in duplicate. Data were extracted by a single reviewer and verified by a second reviewer, and risk of bias assessments were completed accordingly. Where possible, data for mental health outcomes were meta-analyzed. RESULTS The search yielded 7923 unique citations of which 290 studies were screened at full-text. Of those, 13 studies met the inclusion criteria; 11 were randomized controlled trials, 1 study was a controlled clinical trial, and 1 study comprised both study designs. Beneficial effects of any internet-based intervention program resulted in a mean decrease of 0.48 points (95% CI –0.75 to –0.22) for stress and distress and a mean decrease of 0.40 points (95% CI –0.58 to –0.22) for anxiety among caregivers. For studies that examined internet-based information and education plus professional psychosocial support, the meta-analysis results showed small to medium beneficial effect sizes of the intervention for the mental health outcomes of depression (–0.34; 95% CI –0.63 to –0.05) and anxiety (–0.36; 95% CI –0.66 to –0.07). Some suggestion of a beneficial effect on overall health for the use of information and education plus combined peer and professional support was also shown (1.25; 95% CI 0.24 to 2.25). Overall, many studies were of poor quality and were rated at high risk of bias. CONCLUSIONS The review found evidence for the benefit of internet-based intervention programs on mental health for caregivers of adults living with a chronic condition, particularly for the outcomes of caregiver depression, stress and distress, and anxiety. The types of interventions that predominated as efficacious included information and education with or without professional psychological support, and, to a lesser extent, with combined peer and psychological support. Further high-quality research is needed to inform the effectiveness of interactive, dynamic, and multicomponent internet-based interventions. CLINICALTRIAL PROSPERO CRD42017075436; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=75436 (Archived by WebCite at http://www.webcitation.org/709M3tDvn)

scholarly journals National or population level interventions addressing the social determinants of mental health – an umbrella review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Neha Shah ◽  
Ian F. Walker ◽  
Yannish Naik ◽  
Selina Rajan ◽  
Kate O’Hagan ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Systematic Reviews ◽  
Social Determinants ◽  
Population Level ◽  
Evidence Base ◽  
Mental Health Outcomes ◽  
Umbrella Review ◽  
The Social ◽  
Quality Evidence

Abstract Background Social circumstances in which people live and work impact the population’s mental health. We aimed to synthesise evidence identifying effective interventions and policies that influence the social determinants of mental health at national or scaled population level. We searched five databases (Cochrane Library, Global Health, MEDLINE, EMBASE and PsycINFO) between Jan 1st 2000 and July 23rd 2019 to identify systematic reviews of population-level interventions or policies addressing a recognised social determinant of mental health and collected mental health outcomes. There were no restrictions on country, sub-population or age. A narrative overview of results is provided. Quality assessment was conducted using Assessment of Multiple Systematic Reviews (AMSTAR 2). This study was registered on PROSPERO (CRD42019140198). Results We identified 20 reviews for inclusion. Most reviews were of low or critically low quality. Primary studies were mostly observational and from higher income settings. Higher quality evidence indicates more generous welfare benefits may reduce socioeconomic inequalities in mental health outcomes. Lower quality evidence suggests unemployment insurance, warm housing interventions, neighbourhood renewal, paid parental leave, gender equality policies, community-based parenting programmes, and less restrictive migration policies are associated with improved mental health outcomes. Low quality evidence suggests restriction of access to lethal means and multi-component suicide prevention programmes are associated with reduced suicide risk. Conclusion This umbrella review has identified a small and overall low-quality evidence base for population level interventions addressing the social determinants of mental health. There are significant gaps in the evidence base for key policy areas, which limit ability of national policymakers to understand how to effectively improve population mental health.

Sign in / Sign up

Export Citation Format

Share Document