scholarly journals Mental health outcomes of adults with comorbidity and chronic diseases during the COVID-19 pandemic: a matched case-control study

2020 ◽  
Author(s):  
Abu Sayeed ◽  
Satyajit Kundu ◽  
Hasan Al Banna ◽  
Enryka Christopher ◽  
M Tasdik Hasan ◽  
...  

Background: Individuals with certain pre-existing chronic health conditions have been identified as a high-risk group for fatalities of COVID-19. Therefore, it is likely that individuals with chronic diseases may worry during this pandemic to the detriment of their mental health. This study compares the mental health of Bangladeshi adults affected by chronic disease to a healthy, matched control group during the COVID-19 pandemic. Method: A matched case–control analysis was performed with data collected from 395 respondents with chronic diseases and 395 controls matched for age, gender and residence. Inclusion criteria for cases were respondents who self-reported having asthma, cardiovascular symptoms and/or diabetes. Respondents were recruited using an online survey, which included the DASS-21 measure to assess stress, anxiety, and depression. Chi-square tests, Fisher’s exact tests and a conditional logistic regression were performed to examine associations among variables.Results: The prevalence estimates of stress, anxiety and depression were significantly higher among cases (73.7%; 59%; 71.6%, respectively) than among controls (43.3%; 25.6%; 31.1%). Chi-square tests showed significant associations between having chronic diseases and mental health outcomes. A conditional logistic regression showed that respondents with asthma, diabetes, cardiovascular symptoms, or any combination of these diseases had higher odds of feeling stress, anxiety, and depression than healthy individuals. Conclusion: These results underscore a subpopulation vulnerable to mental health consequences during this pandemic and indicate the need for additional mental health resources to be available to those with chronic diseases.

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yuriy Nesterko ◽  
Michael Friedrich ◽  
Elmar Brähler ◽  
Andreas Hinz ◽  
Heide Glaesmer

Abstract Background In Germany, the term ‘migration background’ has been established to differentiate between immigrants and natives. In the present study post-traumatic stress disorder (PTSD), anxiety, and depression were analysed in immigrant populations in Germany by considering self-attribution as well as attribution by others on one’s own ‘migration background’. Methods In a population-based survey (N = 2317), socio-demographic characteristics, migration background (official statistics definition vs. self-attribution as well as the anticipated attribution by others), PTSD (PCL-5), and symptoms of anxiety and depression (PHQ-4) were assessed. Logistic regression models were applied to predict mental health outcomes by considering socio-demographic and immigration-related factors. Results A total of 10.7% of respondents (N = 248) had a ‘migration background’. Immigrants of the 2nd generation compared to 1st generation immigrants are less likely to see themselves as immigrants. Attribution as an immigrant (self and/or by others) was found as significant predictor for PTSD and depression, but not anxiety. Conclusions It seems useful to focus on immigration-related factors considering subjective perspectives and not only comparing immigrants and natives using a federal statistics definition. Our findings suggest that research on the association between immigration-related factors such as attribution as an immigrant and mental health outcomes might be a promising approach to better identify subgroups at higher risk of mental distress.


Author(s):  
Fei Wan ◽  
Graham A Colditz ◽  
Siobhan Sutcliffe

Abstract Although the need for addressing matching in the analysis of matched case-control studies is well established, debate remains as to the most appropriate analytic method when matching on at least one continuous factor. We compare the bias and efficiency of unadjusted and adjusted conditional logistic regression (CLR) and unconditional logistic regression (ULR) in the setting of both exact and non-exact matching. To demonstrate that case-control matching distorts the association between the matching variables and the outcome in the matched sample relative to the target population, we derive the logit model for the matched case-control sample under exact matching. We conduct simulations to validate our theoretical conclusions and to explore different ways of adjusting for the matching variables in CLR and ULR to reduce biases. When matching is exact, CLR is unbiased in all settings. When matching is not exact, unadjusted CLR tends to be biased and this bias increases with increasing matching caliper size. Spline smoothing of the matching variables in CLR can alleviate biases. Regardless of exact or non-exact matching, adjusted ULR is generally biased unless the functional form of the matched factors is modelled correctly. The validity of adjusted ULR is vulnerable to model specification error. CLR should remain the primary analytic approach.


2019 ◽  
Author(s):  
Yuriy Nesterko ◽  
Michael Friedrich ◽  
Elmar Brähler ◽  
Andreas Hinz ◽  
Heide Glaesmer

Abstract Background In Germany, the term ‘migration background' has been established to differentiate between immigrants and natives. In the present study post-traumatic stress disorder (PTSD), anxiety and depression were analysed in immigrant populations in Germany by considering self-attribution as well as attribution by others on one’s own ‘migration background’. Methods In a population-based survey (N = 2317), socio-demographic characteristics, migration background (official statistics definition vs. self-attribution as well as the anticipated attribution by others), PTSD (PCL-5), symptoms of anxiety and depression (PHQ-4) were assessed. Logistic regression models were applied to predict mental health outcomes by considering socio-demographic and immigration-related factors. Results A total of 10.7% of the respondents (N = 248) had a ‘migration background’. Immigrants of the 2nd generation compared to 1st generation immigrants are less likely to see themselves as immigrants. Attribution as an immigrant (self and/or by others) was found as significant predictor for PTSD and depression, but not anxiety. Conclusions It seems useful to focus on immigration-related factors considering subjective perspectives and not only comparing immigrants and natives using a federal statistics definition. Our findings suggest that research on the association between immigration-related factors such as attribution as an immigrant and mental health outcomes might be a promising approach to better identify subgroups at higher risk of mental distress.


2020 ◽  
Author(s):  
Muna Alshekaili ◽  
Walid Hassan ◽  
Nazik Al Said ◽  
Fatima Alsulaimani ◽  
Sathish Kumar Jayapal ◽  
...  

OBJECTIVE: This study aims to assess and compare demographic and psychological factors and sleep status of frontline HCWs in relation to non-frontline HCWs DESIGN, SETTINGS, AND PARTICIPANTS This cross-sectional study was conducted using an online survey from the 8th to the 17th of April 2020 across varied health care settings in Oman accruing 1139 HCWS. MAIN OUTCOMES AND MEASURES Mental health status was assessed using Depression, Anxiety, and Stress Scales (DASS-21), and insomnia was evaluated by the Insomnia Severity Index (ISI). Samples were categorized into the frontline and non-frontline groups. Chi-square, odds ratio, and independent t-tests were used to compare groups by demographic and mental health outcomes. Results This study included 1139 HCWs working in Oman. There was a total of 368 (32.3%), 388 (34.1%), 271 (23.8%), and 211 (18.5%) respondents reported to have depression, anxiety, stress, and insomnia, respectively while working during the pandemic period. HCWs in the frontline group were 1.4 times more likely to have anxiety (OR=1.401, p=0.007) and stress (OR=1.404, p=0.015) as compared to those working in the non-frontline group. On indices of sleep-wake cycles, HCWs in the frontline group were 1.37 times more likely to report insomnia (OR=1.377, p=0.037) when compared to those working in the non-frontline group. No significant differences in depression status between workers in the frontline and non-frontline groups were found (p=0.181). CONCLUSIONS AND RELEVANCE To our knowledge, this is the first study to explore the differential impacts of the COVID-19 pandemic on different grades of HCWs. This study suggests that frontline HCWs are disproportionally affected compared to non-frontline HCWs. The problem with managing sleep-wake cycles and anxiety symptoms were highly endorsed among frontline HCWs. As psychosocial interventions are likely to be constrained owing to the pandemic, mental health care must first be directed to frontline HCWs.


2020 ◽  
Vol 70 (3) ◽  
pp. 162-168 ◽  
Author(s):  
R E Marshall ◽  
J S Milligan-Saville ◽  
Z Steel ◽  
R A Bryant ◽  
P B Mitchell ◽  
...  

Abstract Background Pre-employment psychological screening to detect psychological vulnerability is common amongst emergency service organizations worldwide, yet the evidence for its ability to predict poor mental health outcomes is limited with published studies looking at post-recruitment research data rather than data collected by the organizations themselves. Aims The present study sought to investigate the ability of pre-employment screening to predict later psychological injury-related absenteeism amongst police officers. Methods A nested case–control study using prospective data was conducted. One hundred and fifty police officers with a liability-accepted psychological injury were matched to a control group of 150 psychologically healthy officers. Conditional logistic regression was used to examine associations between Minnesota Multiphasic Personality Inventory-2 (MMPI-2) scales measuring factors research has shown to predict psychological injury (Neuroticism, Psychoticism, Introversion, Disconstraint and Aggressiveness) and psychopathology (Depression, Anxiety and post-traumatic stress disorder [PTSD]) with subsequent psychological injury. Results Contrary to expectations, we were unable to demonstrate any association between validated pre-employment measures of personality and psychopathology with mental health outcomes amongst newly recruited police officers over a 7-year follow-up. Conclusions Other measures may be better able to predict future mental health problems in police recruits.


2019 ◽  
pp. 1-37
Author(s):  
Jennifer Dunn ◽  
Colleen Best ◽  
David L. Pearl ◽  
Andria Jones-Bitton

AbstractDespite numerous benefits, a dark side exists in human and veterinary caregiving professions that can negatively impact caregiver mental health. It was postulated that other nonhuman animal caregivers, animal welfare employees, might experience mental health outcomes similar to those in analogous caregiving occupations. This study investigated employee mental health at a Canadian animal welfare organization using five validated mental health instruments: Perceived Stress Scale (stress), Hospital Anxiety and Depression Scale (anxiety and depression), Professional Quality of Life Scale (compassion satisfaction and compassion fatigue), Maslach Burnout Inventory Scale (burnout), and Connor-Davidson Resilience Scale (resilience). Front-line and support staff tended to have poorer mental health outcomes relative to the study population mean, potential for burnout was a notable concern, and resilience was below normal for most employees. These results shed light on the mental health of an animal caregiving occupation that has largely been ignored. Strategies for building employee resilience are discussed.


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18579-e18579
Author(s):  
Joanna Zurko ◽  
Aniko Szabo ◽  
Yee Chung Cheng ◽  
Sailaja Kamaraju ◽  
John Burfeind ◽  
...  

e18579 Background: Patients with cancer have increased risk of developing SARS-Cov-2 (COVID-19) infection. It is unknown if characteristics related to breast cancer increase the risk of COVID-19 infection. In this retrospective matched case control study, we aim to identify breast cancer related risk factors associated with developing COVID-19 and describe outcomes of patients with breast cancer diagnosed with COVID-19. Methods: Women with breast cancer treated at the Medical College of Wisconsin and diagnosed with COVID-19 between March and December 2020 served as cases. Women with breast cancer without COVID-19 diagnosis within the same time frame were identified as potential controls. Controls were chosen by matching for age (≥60 vs <60), obesity (BMI <30 vs ≥30), county (Milwaukee vs suburban), race (white vs non-white) and diabetes mellitus (DM) with 3:1 matching planned. Univariate comparisons between cases and controls were done via Rao-Scott stratified chi-square test for categorical outcomes and stratified t-test for continuous variables. Conditional logistic regression was done to evaluate the joint effect of multiple characteristics on the odds of being a COVID-19 case. Results: Twenty-five cases and 77 controls were identified. All cases were fully matched by age, obesity, county, and race with 3 cases not able to be matched for DM. Mean age was 54.6 vs 54.9 (p=0.88), BMI 31.0 vs 31.6 (p=0.69), 48% lived in Milwaukee county and 68% were white (cases 24% black & 8% American Indian; controls 32% black). Regarding COVID outcomes, 24.0% (n=6) of cases were hospitalized, median length of stay was 2 days, 8% (n=2) needed oxygen, 4% (n=1) were intubated and 4% (n=1) died due to COVID-19. COVID-19 led to treatment delays in 40% of cases. On univariate analysis of cases vs controls, 64 vs 75% were ER/PR+ (p=0.31), 6.5 vs 5.2% HER2+ (p=0.34), and 9.0 vs 4.2% triple negative (p=0.10). There were no significant differences in breast cancer stage. At time of COVID diagnosis (or last clinic contact if control), 16 vs 14% had active disease (p=0.81), 72 vs 74% were on active treatment (p=0.85), with 21 vs 4% being on chemotherapy (p=0.007), and 44 vs 52% on endocrine therapy (p=0.49). On conditional logistic regression, being on active chemotherapy (OR 5.8, p=0.043) significantly increased the likelihood of developing COVID with a trend seen for triple negative disease (OR 2.8, p=0.12). Conclusions: In this matched case control study of patients with breast cancer, active chemotherapy was significantly associated with an increased likelihood of developing COVID-19 with a trend seen for triple negative disease. Rates of death due to COVID-19 were overall low. Our analysis was limited by small numbers and an inability to fully match patients for DM. These findings support continued strict precautions for those on active chemotherapy and warrants further analysis in those with triple negative disease.


2017 ◽  
Vol 25 (1) ◽  
pp. 19-28 ◽  
Author(s):  
Jennifer Sumner ◽  
Jan R Böhnke ◽  
Patrick Doherty

Background The presence of mental health conditions in cardiac rehabilitation (CR) patients such as anxiety and depression can lead to reduced programme adherence, increased mortality and increased re-occurrence of cardiovascular events undermining the aims and benefit of CR. Earlier research has identified a relationship between delayed commencement of CR and poorer physical activity outcomes. This study wished to explore whether a similar relationship between CR wait time and mental health outcomes can be found and to what degree participation in CR varies by mental health status. Methods Data from the UK National Audit of Cardiac Rehabilitation, a dataset that captures information on routine CR practice and patient outcomes, was extracted between 2012 and 2016. Logistic and multinomial regression models were used to explore the relationship between timing of CR and mental health outcomes measured on the hospital anxiety and depression scale. Results The results of this study showed participation in CR varied by mental health status, particularly in relation to completion of CR, with a higher proportion of non-completers with symptoms of anxiety (5% higher) and symptoms of depression (8% higher). Regression analyses also revealed that delays to CR commencement significantly impact mental health outcomes post-CR. Conclusion In these analyses CR wait time has been shown to predict the outcome of anxiety and depression status to the extent that delays in starting CR are detrimental. Programmes falling outside the 4-week window for commencement of CR following referral must strive to reduce wait times to avoid negative impacts to patient outcome.


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