Factors Associated With Mental Health Symptoms During the COVID-19 Pandemic in Hong Kong

Background: The COVID-19 pandemic has led to an increasing mental health burden. We examined the factors associated with mental health symptoms in Chinese general adults in Hong Kong.Methods: We conducted a dual-frame (landline and mobile) survey on Chinese adults aged 18 years or older in April 2020. Shortage of preventive materials, perceptions of the outbreak (each item range 1–5), and reduction in income were assessed. Mental health symptoms measured included stress (Perceived Stress Scale-4, range 0–16), anxiety (General Anxiety Disorders-2, range 0–6, cutoff >2), and depressive symptoms (Patient Health Questionnaire-2, range 0–6, cutoff >2). Results were weighted by the general population distribution. Associations were analyzed by multivariable linear (for stress) and logistic (for anxiety and depressive symptoms) regression adjusting for sociodemographic and health-related covariates, including confirmed or in close contacts of confirmed cases, chronic disease, self-rated health, and smoking and alcohol drinking behavior.Results: Of the 1,501 participants (52.5% female, 55.0 aged 30–59 years), the average stress score was 7.20 (SD 2.12). 218 (15.8%) and 206 (14.8%) participants had anxiety and depressive symptoms, respectively. Shortage in facemasks (20.8%), alcohol-based hand sanitizers (13.9%), and cleaning products (7.3%) was reported. Participants generally disagree with the perception of at risk of getting infected in the coming 6 months (mean 2.2, SD 1.1), but tended to agree with the perception of worry that the people around pose a threat to them (mean 3.6, SD 0.9) and the outbreak has greatly affected their daily life (mean 3.7, SD 0.9). 59.3% employed participants had income reduction and 6.2% had become unemployed since the outbreak. Stress, anxiety, and depressive symptoms were more prevalent in those with shortages of preventive materials and negative perceptions of the outbreak (all P < 0.05). Reduction in income and unemployment were associated with more mental health symptoms (all P < 0.05).Conclusions: Shortage of preventive materials, negative perceptions, financial loss, and unemployment were prevalent during the outbreak and found in association with higher stress and more anxiety and depressive symptoms. Further research and urgent actions are warranted to relieve stress and promote mental health, targeting the many risk factors identified by our study.

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Mental Health Assessment of Youth with Sickle Cell Disease and Their Primary Caretakers: Baseline Depression and COVID-19 Pandemic-Associated Psychosocial Stress in a Multi-Site Study

Blood ◽

10.1182/blood-2020-140866 ◽

2020 ◽

Vol 136 (Supplement 1) ◽

pp. 41-42

Author(s):

Nancy S. Green ◽

Deepa Manwani ◽

Kim Smith-Whitley ◽

Banu Aygun ◽

Abena Appiah-Kubi ◽

...

Keyword(s):

Mental Health ◽

Depressive Symptoms ◽

Food Insecurity ◽

Board Of Directors ◽

Research Funding ◽

Assessment Tools ◽

Mental Health Symptoms ◽

Advisory Committees ◽

Health Symptoms ◽

Work Arrangements

Introduction: Youth with sickle cell disease (SCD) and their families are susceptible to stress and depression associated with chronic illness and social factors disproportionately affecting under-resourced U.S. communities. The COVID-19 pandemic has adversely impacted psychosocial and economic well-being, especially in some of these same communities. Our concurrent HABIT multi-site randomized trial aims to improve hydroxyurea adherence in youth with SCD ages 10-18 years through an intervention led by community health workers(NCT03462511). Subjects enrolled as youth-primary caretaker dyads; adults were mostly parents. We hypothesized that some HABIT subjects had depressive symptoms at baseline, and many had additional stressors during the pandemic. Methods: Two self-reported assessment tools were used, with options of English or Spanish: 1) PROMIS® pediatric (8a, v1.0) or adult (4a, v1.0) depression measures, completed at HABIT enrollment, nearly all between May 2018 - March 2020 ("baseline"); 2) A pandemic-related open-access survey originated by Johns Hopkins University on established core adult mental health assessed risks and behaviors.[1] Questions were closely adapted for use by youth. The pandemic survey assessed recent mental health symptoms and substance or domestic abuse. Two validated food insecurity screening questions were added.[2] Of 92 HABIT subjects, 84 were offered survey participation between May - July, 2020. Participants completed both assessment tools via electronic linkage to REDCap data capture. Analyses used chi square or Fisher exact test. Results: In all, 75% (63 of 84) responded to the pandemic survey; 31 were youth-parent dyads and one unpaired parent. Baseline demographics were: Youth (N=31): mean age 12.9±1.9 years, 48.4% female, 80.6% grade 6-12, 45.3% hospitalized within the prior 12 months; Caretakers (N=32): mean age 44.0±9.6 years, 87.5% Black, 18.8% Latinx, 37.50% married or living with a partner, 59.4% with at least some college education. At baseline, youth mean PROMIS® Depression T-Score was 49.9±10.1 (normal <50), with 64.5% reporting mild, moderate or severe depressive symptoms, compared to Caretaker' mean score 46.6±9.4 (normal <55) with 15.5% symptomatic (p=0.0002) (Table). In contrast, the pandemic survey revealed that 3 (9.7%) youth and 8 (25.0%) caretakers had recently felt depressed and/or anxious (NS). Loneliness (1 in 5) and especially not feeling hope for the future (1 in 2) were common in both groups. More youth than caretakers (89.1% vs.46.9%) had changes made to their school or work arrangements (p=0.008). Four (12.5%) caretakers and 1 (3.2%) youth had histories of mental illness. Substance use/abuse or verbal abuse were reported in <10% of each group. Food insecurity was reported in 6 (18.8%) families. "Red flag" replies to the pandemic survey necessitated referral of 6 dyads (18.8%) to their SCD social workers for support. Conclusions: In this sample of subjects from the HABIT Trial, at baseline a higher proportion of youth had depressive symptoms compare to their primary caretakers. During the initial pandemic peak in the Northeast, disrupted work arrangements and especially school cancellation were widespread. Fewer youth but similar proportions of caretakers reported feeling depressed and/or anxious. Both groups commonly reported loneliness or not feeling hopeful for the future. History of mental health conditions, current substance use/abuse or verbal abuse were uncommon. Concordant with concerns for under-resourced communities, a sizeable minority of families reported food insecurity. Under the limitations of using 2 different assessment tools, in this modest sample the majority of youth with SCD but not caretakers were mildly-moderately depressed at baseline and that, during the pandemic, the 2 groups reported similar proportions of mental health symptoms. These findings suggest that screening for mental health symptoms, social disruption and food insecurity may be warranted in this high-risk group overall and during the pandemic. References: 1) COVID-19 and mental health measurement working group, Johns Hopkins Bloomberg School of Public Health, March 18, 2020 2) Barnidge E., et al., Screening for Food Insecurity in Pediatric Clinical Settings. J. Community Health 42(1):51-57, 2017 The HABIT Trial is supported by 5R01NR017206-04 (Green, Smaldone). The authors have no conflicts to disclose. Disclosures Smith-Whitley: Novartis: Membership on an entity's Board of Directors or advisory committees; Global Blood Therapeutics: Membership on an entity's Board of Directors or advisory committees; Prime: Other: Education material; Celgene: Membership on an entity's Board of Directors or advisory committees. Aygun:bluebird bio: Membership on an entity's Board of Directors or advisory committees, Research Funding; National Institute of Nursing Research: Research Funding; Patient-Centered Outsomes Research Institute: Research Funding; National Heart, Lung, and Blood Institute: Research Funding.

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Snapshot of a social movement: mental health and protest classes in Hong Kong

10.31234/osf.io/hkf3p ◽

2021 ◽

Author(s):

Adrienne Wing Yee Li ◽

Wai Ho CHAK ◽

Kenneth S.L. Yuen

Keyword(s):

Mental Health ◽

Hong Kong ◽

Latent Class ◽

Demographic Data ◽

Mental Health Symptoms ◽

Health Symptoms ◽

Class Differences ◽

Potentially Traumatic Events ◽

Political Views ◽

Tear Gas

Background: Popular protests have broken out in worldwide, particularly in the last few years. In 2019, numerous demonstrations against an extradition bill occurred in Hong Kong until pandemic restrictions were imposed. The policing response relied heavily on methods such as batons, tear gas and rubber bullets. Given the relevance for other geographical contexts, the current study investigated the mental health impacts on protest participants and spillover to community members.Methods: Surveys were disseminated on social media in August and October 2019 to collect demographics, political views, protest participation, exposure to (protest-related) potentially traumatic events (PTEs) and mental health symptoms. A latent class analysis (LCA) was conducted using demographic data and inter-class differences in PTEs and mental health symptoms were examined.Results: There were 37,541 (59.8% female) and 40,703 (50.0% female) responses in August and October. Respondents, even those with low participation, reported significant levels of depression, anxiety, and symptoms of traumatic stress (STS). The LCA suggested a 5-class solution (youth, allies, supporters, sympathizers, and frontliners). Mental health symptoms and PTEs varied with class membership, with 50.8% of frontliners reporting severe STS.Limitations: The non-random sampling and self-reported measures may over-estimate the prevalence of mental distress in the wider population.Conclusions: Large numbers of pro-democracy supporters in Hong Kong reported high rates of depression, anxiety and STS during mass protests. Younger and more heavily involved respondents faced the highest mental health risks, however elevated rates were also observed for respondents with low participation.

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Combat Deployment Experiences and Soldier Mental Health: Examining the Factor Structure of a Combat Experiences Scale

Military Medicine ◽

10.1093/milmed/usab456 ◽

2021 ◽

Author(s):

Haley Sherman ◽

Nicky Frye-Cox ◽

Mallory Lucier-Greer

Keyword(s):

Mental Health ◽

Principal Component Analysis ◽

Depressive Symptoms ◽

Health Outcomes ◽

Factor Structure ◽

Principal Component ◽

Mental Health Outcomes ◽

Mental Health Symptoms ◽

Coping With Stress ◽

Health Symptoms

ABSTRACT Introduction Researchers and practitioners are invested in understanding how deployment experiences impact the nearly 193,000 U.S. service members who deploy in a given year. Yet, there remains a need to adequately identify salient deployment experiences through survey measurement tools and understand how differential experiences are uniquely related to mental health outcomes. Therefore, this study examined the factor structure of an established combat experiences measure from the Army Study to Assess Risk and Resilience in Service members (Army STARRS) dataset to identify underlying survey constructs that reflect nuanced deployment experiences. Then, we examined the association between diverse combat experiences and current mental health symptoms (i.e., anxiety and depressive symptoms) and the mediating role of coping. Materials and Methods Data were drawn from the Army STARRS data (N = 14,860 soldiers), specifically the All Army Study component. A principal component analysis (PCA) was conducted to examine the dimensionality of the combat experiences scale, and then a path model was conducted to examine the relationships between combat experiences, coping with stress following a deployment, and mental health symptoms while controlling for relevant individual and interpersonal factors. Results Results from the principal component analysis suggested that the Army STARRS combat experiences scale encompasses two components, specifically: “Expected combat experiences” and “Responsible for non-enemy deaths.” Both “Expected combat experiences” and “Responsible for non-enemy deaths” were associated with higher levels of anxiety and depressive symptoms, respectively, and “Responsible for non-enemy deaths” was also indirectly linked to these mental health outcomes through coping with stress after deployment. Conclusions These findings provide insight into the dimensionality of combat experiences and offer practitioners a more nuanced understanding of how to process unique combat experiences that differentially relate to mental health symptoms.

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Disentangling the Sleep-Pain Relationship in Pediatric Chronic Pain: The Mediating Role of Internalizing Mental Health Symptoms

Pain Research and Management ◽

10.1155/2017/1586921 ◽

2017 ◽

Vol 2017 ◽

pp. 1-9 ◽

Cited By ~ 14

Author(s):

Maria Pavlova ◽

Jennifer Ference ◽

Megan Hancock ◽

Melanie Noel

Keyword(s):

Mental Health ◽

Chronic Pain ◽

Depressive Symptoms ◽

Sleep Quality ◽

Poor Sleep ◽

Poor Sleep Quality ◽

Mental Health Symptoms ◽

Health Symptoms ◽

Pediatric Chronic Pain ◽

Pain Outcomes

Background. Pediatric chronic pain often emerges in adolescence and cooccurs with internalizing mental health issues and sleep impairments. Emerging evidence suggests that sleep problems may precede the onset of chronic pain as well as anxiety and depression. Studies conducted in pediatric populations with pain-related chronic illnesses suggest that internalizing mental health symptoms may mediate the sleep-pain relationship; however, this has not been examined in youth with primary pain disorders.Objective. To examine whether anxiety and depressive symptoms mediated relationships between sleep quality and pain outcomes among youth with chronic pain.Methods. Participants included 147 youth (66.7% female) aged 8–18 years who were referred to a tertiary-level chronic pain program. At intake, the youth completed psychometrically sound measures of sleep quality, pain intensity, pain interference, and anxiety and depressive symptoms.Results. As hypothesized, poor sleep quality was associated with increased pain intensity and pain interference, and anxiety and depressive symptoms mediated these sleep-pain relationships.Discussion. For youth with chronic pain, poor sleep quality may worsen pain through alterations in mood and anxiety; however, prospective research using objective measures is needed. Future research should examine whether targeting sleep and internalizing mental health symptoms in treatments improve pain outcomes in these youth.

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Association of coping strategies with mental health trajectories during the first twenty-one weeks of COVID-19 lockdown

10.31234/osf.io/hy5wb ◽

2020 ◽

Author(s):

Meg Fluharty ◽

Feifei Bu ◽

Andrew Steptoe ◽

Daisy Fancourt

Keyword(s):

Mental Health ◽

Social Support ◽

Depressive Symptoms ◽

Coping Strategies ◽

Negative Impact ◽

Social Study ◽

Mental Health Symptoms ◽

Health Symptoms ◽

Health Trajectories ◽

Over Time

The negative impact of the COVID-19 pandemic on mental health is well evidenced. However, there is little research on how individuals’ coping strategies during the pandemic were related to changes in mental health over time. The current study used data from the COVID-19 Social Study (N=26,505) to explore whether particular coping strategies (problem-focused, emotion-focused, avoidant, and supportive) were associated with (i) better mental health as lockdown was introduced, and (ii) faster recovery from symptoms across 21 weeks. People with greater use of problem-focused, avoidant, and supportive coping displayed more mental health symptoms, while greater use of emotion-focused coping was associated with fewer mental health symptoms. Symptoms decreased over time for all coping strategies, but only supportive coping was associated with a faster decrease in anxiety and depressive symptoms, indicating a potential protective effect of social support on psychological distress.

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Mental health screening amongst police officers: factors associated with under-reporting of symptoms

BMC Psychiatry ◽

10.1186/s12888-021-03125-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ruth E. Marshall ◽

Josie Milligan-Saville ◽

Katherine Petrie ◽

Richard A. Bryant ◽

Philip B. Mitchell ◽

...

Keyword(s):

Mental Health ◽

Police Officers ◽

Common Mental Disorder ◽

Health Screening ◽

Mental Health Screening ◽

Self Report ◽

Post Traumatic Stress ◽

Mental Health Symptoms ◽

Health Symptoms ◽

Factors Associated

Abstract Background Mental health screening in the workplace aims to identify employees who are becoming symptomatic, in order to provide timely support and evidence-based interventions to those affected. Given the stigma associated with mental illness, accurate disclosure of mental health symptoms cannot be assumed. The present study sought to investigate factors associated with the accurate reporting of mental health symptoms amongst police officers. Methods A total of 90 serving police officers completed identical mental health screening surveys, one administered by the employer and the other anonymously by an independent organisation. Responses were then linked to compare differences in the number and severity of mental health symptoms reported on each questionnaire. Results Comparisons of matched self-report scores indicated that employees under-reported symptoms of mental health disorders when completing screening administered by their employer, with only 76.3% of symptoms declared. Under-reporting occurred regardless of gender and symptom type. Less senior staff (p = 0.05) and those with the most severe post-traumatic stress disorder and common mental disorder symptoms (p = 0.008) were significantly more likely to under-report symptoms. Conclusions Employer-administered mental health screening is not able to accurately capture all mental health symptoms amongst first responders. The fact that the severity of symptoms predicted the level of under-reporting means that simple changes to cut-off values cannot correct this problem.

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Prevalence of depression and suicide ideation in Hong Kong doctors: a cross-sectional study

Scientific Reports ◽

10.1038/s41598-021-98668-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Amy Pui Pui Ng ◽

Weng Yee Chin ◽

Eric Yuk Fai Wan ◽

Julie Chen ◽

Chak Sing Lau

Keyword(s):

Mental Health ◽

Hong Kong ◽

Depressive Symptoms ◽

Suicidal Ideation ◽

Help Seeking ◽

Suicide Ideation ◽

Cross Sectional Study ◽

Cross Sectional ◽

Factors Associated ◽

Poor Individual

AbstractDepression amongst physicians can lead to poor individual and institutional outcomes. This study examined the prevalence and factors associated with depression and suicidal ideation amongst doctors in Hong Kong. Doctors who graduated from medical school at the University of Hong Kong between 1995 and 2014 were invited to participate in a survey measuring depressive symptoms, suicidal ideation and thoughts of self-harm, lifestyle behaviours, career satisfaction and socio-demographic characteristics. Data collection occurred between January and April 2016. The prevalence of screened-positive depression was 16.0% and 15.3% of respondents reported having suicidal ideation. Amongst those with positive depression screening scores, less than half reported having a diagnosed mood disorder. Sleeping fewer hours was associated with higher depression scores (P < 0.001) and an increased odds of meeting the cut-off for depression (P < 0.001). Factors associated with suicidal ideation included being unmarried (P = 0.012) and sleeping fewer hours (P = 0.022). Hong Kong doctors appear to have high rates of undiagnosed depression, and high levels of depressive symptoms and suicidal ideations. There is a need for greater awareness of the morbidity due to depression and to promote better mental health help-seeking among physicians. Barriers to mental health help-seeking need to be addressed and appropriate resources allocated to reduce suffering.

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Factors Associated with Current and Severe Pain among People Living with HIV: Results from a Statewide Sample

10.21203/rs.2.22132/v1 ◽

2020 ◽

Author(s):

Verlin Joseph ◽

Abenaa Jones ◽

Shantrel Canidate ◽

Zachary Mannes ◽

Huiyin Lu ◽

...

Keyword(s):

Mental Health ◽

Substance Use ◽

Severe Pain ◽

Short Form ◽

People Living With Hiv ◽

Mental Health Symptoms ◽

Health Symptoms ◽

Factors Associated ◽

Living With Hiv ◽

The Relationship

Abstract Background People living with HIV (PLWH) are more likely to suffer from pain compared to the general public. Pain often clusters with mental health symptoms and substance use. This study sought to evaluate mental health and substance use factors associated with and pain and severe pain intensities among PLWH. Methods Data were derived from HIV+ adults (N=733) recruited from community health centers across Florida who completed questionnaires regarding demographics, chronic pain, HIV clinical outcomes, mental health symptoms, and substance use information. Pain was assessed using the Brief Pain Inventory (BPI) short form. Multivariate logistic regression analysis was utilized to assess the relationship between selected covariates and pain. Results Approximately half (45.0%) of participants reported having current pain. After controlling for covariates, PLWH reporting current symptoms of anxiety or PTSD were 2.49 (CI=1.48, 4.18) and 1.69 (CI= 1.11, 2.57) times as likely to report pain compared to PLWH without those factors respectively. PLWH reporting current symptoms of anxiety and male participants were 2.03 (CI= 1.03, 4.01) and 2.02 (CI= 1.26, 3.24) times as likely to report severe pain compared to PLWH without those factors respectively. Conclusion The relationship between pain and mental health is complex, thus future research is needed to determine if pain treatments may reduce mental health symptoms or if treatments can be targeted to address both issues simultaneously

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Exploring Factors Associated with Pregnant Womxn’s Experiences of Material Hardship during COVID-19

10.21203/rs.3.rs-569023/v1 ◽

2021 ◽

Author(s):

Laura Johnson

Keyword(s):

Mental Health ◽

Intimate Partner Violence ◽

Partner Violence ◽

Intimate Partner ◽

Financial Strain ◽

Material Hardship ◽

Mental Health Symptoms ◽

Health Symptoms ◽

Economic Abuse ◽

Factors Associated

Abstract Background: The COVID-19 pandemic has exacerbated the financial insecurity of women and their families globally. Some studies have explored the impact of financial strain among pregnant women, in particular, during the pandemic. However, less is known about the factors associated with pregnant women’s experiences of material hardship. Methods: This study examined the factors associated with pregnant women’s experiences of material hardship during the COVID-19 pandemic using data collected from 183 pregnant womxn who participated in an online Qualtrics panel survey during January 2021. In addition to socio-demographic characteristics, individuals were asked about their finances and predictors of financial well-being, mental health symptoms, and intimate partner violence experiences. Ordinary least squares regression was used to calculate unadjusted and adjusted estimates. Study findings showed that the majority of womxn in the sample experienced at least one form of material hardship in the past year. Results: Economic self-sufficiency, financial strain, posttraumatic stress disorder, and economic abuse were all significantly associated with material hardship. Conclusions: Overall, findings are consistent with other studies that have documented the association between financial hardship and mental health symptoms among pregnant womxn during the COVID-19 pandemic. However, a unique contribution of this study is that it highlights the significant, positive association between economic abuse, a unique form of intimate partner violence, and material hardship among pregnant womxn during the pandemic. These findings suggest the need for policy and practice interventions that help to ameliorate the financial insecurity experienced by some pregnant womxn, as well as respond to associated bidirectional vulnerabilities (e.g., mental health symptoms, experiences of intimate partner violence).

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The 12-month prevalence of psychotic experiences and their association with clinical outcomes in Hong Kong: an epidemiological and a 2-year follow up studies

Psychological Medicine ◽

10.1017/s0033291720001452 ◽

2020 ◽

pp. 1-8

Author(s):

Sherry Kit Wa Chan ◽

Kaspar Kit Wai Lee ◽

Veronica Hei Yan Chan ◽

Herbert H. Pang ◽

Corine Sau Man Wong ◽

...

Keyword(s):

Mental Health ◽

Hong Kong ◽

Chinese Population ◽

Latent Class ◽

Community Dwelling ◽

Psychotic Experiences ◽

Mental Health Symptoms ◽

Health Symptoms ◽

The Relationship

Abstract Background The relationship between the subtypes of psychotic experiences (PEs) and common mental health symptoms remains unclear. The current study aims to establish the 12-month prevalence of PEs in a representative sample of community-dwelling Chinese population in Hong Kong and explore the relationship of types of PEs and common mental health symptoms. Method This is a population-based two-phase household survey of Chinese population in Hong Kong aged 16–75 (N = 5719) conducted between 2010 and 2013 and a 2-year follow-up study of PEs positive subjects (N = 152). PEs were measured with Psychosis Screening Questionnaire (PSQ) and subjects who endorsed any item on the PSQ without a clinical diagnosis of psychotic disorder were considered as PE-positive. Types of PEs were characterized using a number of PEs (single v. multiple) and latent class analysis. All PE-positive subjects were assessed with common mental health symptoms and suicidal ideations at baseline and 2-year follow-up. PE status was also assessed at 2-year follow-up. Results The 12-month prevalence of PEs in Hong Kong was 2.7% with 21.1% had multiple PEs. Three latent classes of PEs were identified: hallucination, paranoia and mixed. Multiple PEs and hallucination latent class of PEs were associated with higher levels of common mental health symptoms. PE persistent rate at 2-year follow-up was 15.1%. Multiple PEs was associated with poorer mental health at 2-year follow-up. Conclusions Results highlighted the transient and heterogeneous nature of PEs, and that multiple PEs and hallucination subtype of PEs may be specific indices of poorer common mental health.

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