A Scoping Review Investigating Relationships between Depression, Anxiety, and the PrEP Care Continuum in the United States

Men who have sex with men and transgender women in the United States are at increased risk for HIV and may benefit from pre-exposure prophylaxis (PrEP), a once-a-day pill to prevent HIV. Due to stigma and discrimination, sexual and gender minority (SGM) populations are also at risk for depression and anxiety. This scoping review sought to identify literature addressing relationships between the PrEP care continuum, depression, and anxiety among SGM individuals and others at high risk for HIV. We conducted a systematic review of four databases (i.e., PubMed, PsycInfo, Web of Science, Google Scholar) and identified 692 unique articles that were screened for inclusion criteria, with 51 articles meeting the final inclusion criteria. Data were extracted for key study criteria (e.g., geographic location, participant demographics, study design, main findings). Results suggest that while depression and anxiety are not associated with PrEP awareness or willingness to use, they can be barriers to seeking care and to PrEP adherence. However, empirical studies show that taking PrEP is associated with reductions in anxiety. Findings suggest the need to implement mental health screenings in PrEP clinical care. In addition, addressing systemic and structural issues that contribute to mental health disorders, as well as PrEP-related barriers, is critical.

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Older Adults in the United States and COVID-19: A Qualitative Study of Perceptions, Finances, Coping, and Emotions

Frontiers in Public Health ◽

10.3389/fpubh.2021.660536 ◽

2021 ◽

Vol 9 ◽

Author(s):

R. Turner Goins ◽

Elizabeth Anderson ◽

Hannah Minick ◽

Heather Daniels

Keyword(s):

Mental Health ◽

United States ◽

Older Adults ◽

News Media ◽

Emotional Health ◽

The United States ◽

Stress Appraisal ◽

Risk Of Death ◽

Increased Risk ◽

Precautionary Measures

Introduction: Older adults have the poorest coronavirus (COVID-19) prognosis with the highest risk of death due to complications, making their COVID-19 experiences particularly important. Guided by the stress-appraisal-coping theoretical model, we sought to understand COVID-related perceptions and behaviors of older adults residing in the United States.Materials and Methods: We used convenience sampling to recruit persons with the following inclusion criteria: Aged ≥ 65 years, English fluency, and U.S. residency. Semi structured in-depth interviews were conducted remotely and audio recorded between April 25, 2020 and May 7, 2020. Interviews were professionally transcribed with a final study sample of 43. A low-inference qualitative descriptive design was used to provide a situated understanding of participants' life experiences using their naturalistic expressions.Results: The mean age of participants was 72.4 ± 6.7. Slightly over half were female (55.8%), 90.6% were White, and 18.6% lived alone. The largest percentages of participants resided in a rural area (27.9%) or small city (25.6%). We identified four themes, including (1) risk perception, (2) financial impact, (3) coping, and (4) emotions. Most participants were aware of their greater risk for poor COVID-19 outcomes but many did not believe in their increased risk. Financial circumstances because of the pandemic varied with largely no financial impacts, while others reported negative impacts and a few reported positive impacts. Coping was problem- and emotion-focused. Problem-focused coping included precautionary efforts and emotion-focused coping included creating daily structure, pursuing new and/or creative activities, connecting with others in new ways, and minimizing news media exposure. Overall, emotional health was negatively affected by the pandemic although some participants reported positive emotional experiences.Conclusions: Perceiving themselves as high risk for COVID-19 complications, older adults used precautionary measures to protect themselves from contracting the virus. The precautionary measures included social isolation, which can negatively affect mental health. Older adults will need to be resourceful and draw on existing resources to cope, such as engaging in creative activities and new strategies to connect with others. Our findings underscore the importance of the preservation of mental health during extended periods of isolation by taking advantage of low-to-no-cost existing resources.

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The COVID States Project#54: Mental health in the United States

10.31219/osf.io/8fr6s ◽

2021 ◽

Author(s):

Roy H. Perlis ◽

Jon Green ◽

Matthew D Simonson ◽

David Lazer ◽

Matthew Baum ◽

...

Keyword(s):

Mental Health ◽

United States ◽

New York ◽

Major Depression ◽

New York Times ◽

The United States ◽

Economic Stress ◽

Depression And Anxiety ◽

Patient Health ◽

The Impact

With rapid progress toward vaccination in the United States along with falling COVID-19 case rates and a reopening economy, federal and state leaders speak optimistically about a return to normalcy this summer. But as cases diminish, have the unprecedented rates of depression and anxiety documented in our reports, and in other US surveys, also begun to normalize? On the one hand, as a recent New York Times op-ed notes, people in general are remarkably resilient. And in our prior work we showed that depression and anxiety were tied closely to economic stress; as the economy improves, we might expect mental health to improve as well. On the other hand, the impact of a year of COVID-19 quarantine and fear of illness – perhaps compounded by political and societal turmoil – might not resolve so readily.In this report, we characterize rates of depression, anxiety, and sleep disturbance, as we have done on a regular basis since May 2020. We used a standard screening measure drawn from primary care, the Patient Health Questionnaire-9 (PHQ-9), which asks about the symptoms of major depression, as well as 2 items that ask about anxiety (the Generalized Anxiety Disorder-2, or GAD-2). We define major depression as a score on the PHQ-9 of 10 or greater, or moderate depression, often the point at which an individual would be referred for treatment. Sleep disruption and thoughts of suicide are defined based on items on the PHQ-9.

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Investigating Mental Health of US College Students During the COVID-19 Pandemic: Cross-Sectional Survey Study

Journal of Medical Internet Research ◽

10.2196/22817 ◽

2020 ◽

Vol 22 (9) ◽

pp. e22817 ◽

Cited By ~ 5

Author(s):

Xiaomei Wang ◽

Sudeep Hegde ◽

Changwon Son ◽

Bruce Keller ◽

Alec Smith ◽

...

Keyword(s):

Mental Health ◽

United States ◽

College Students ◽

Online Survey ◽

The United States ◽

Survey Study ◽

Depression And Anxiety ◽

Cross Sectional Survey ◽

Suicidal Thoughts ◽

The Impact

Background Evidence suggests that the COVID-19 pandemic has generally increased levels of stress and depression among the public. However, the impact on college students in the United States has not been well-documented. Objective This paper surveys the mental health status and severity of depression and anxiety of college students in a large university system in the United States during the COVID-19 pandemic. Methods An online survey was conducted among undergraduate and graduate students recruited from Texas A&M University via email. The survey consisted of two standardized scales—the Patient Health Questionnaire-9 and the General Anxiety Disorder-7—for depression and anxiety, and additional multiple-choice and open-ended questions regarding stressors and coping mechanisms specific to COVID-19. Results Among the 2031 participants, 48.14% (n=960) showed a moderate-to-severe level of depression, 38.48% (n=775) showed a moderate-to-severe level of anxiety, and 18.04% (n=366) had suicidal thoughts. A majority of participants (n=1443, 71.26%) indicated that their stress/anxiety levels had increased during the pandemic. Less than half of the participants (n=882, 43.25%) indicated that they were able to cope adequately with the stress related to the current situation. Conclusions The proportion of respondents showing depression, anxiety, and/or suicidal thoughts is alarming. Respondents reported academic-, health-, and lifestyle-related concerns caused by the pandemic. Given the unexpected length and severity of the outbreak, these concerns need to be further understood and addressed.

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315. A Multi-center Study to Describe Obese Pediatric Patients with COVID-19 Across the United States

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab466.517 ◽

2021 ◽

Vol 8 (Supplement_1) ◽

pp. S263-S264

Author(s):

Roukaya Al Hammoud ◽

James Murphy ◽

Gabriela P Del Bianco ◽

Gloria Heresi ◽

Michael L Chang

Keyword(s):

United States ◽

Children And Adolescents ◽

The United States ◽

Supplemental Oxygen ◽

Inclusion Criteria ◽

Obese Children ◽

Radiological Findings ◽

Increased Risk ◽

Gender And Age ◽

Multi Center Study

Abstract Background Obesity is linked to increased risk of complications and is reported to be the most common underlying condition for severely ill SARS-CoV-2 infected individuals. Therefore, we aim further to explore the clinical outcomes of obese children with COVID-19. Methods Data were from the Pediatric COVID-19 Case Registry, which includes any patient < 21 years of age diagnosed with COVID-19 at 170 instructions across the United States. A total of 778 COVID-19 positive non-immunocompromised hospitalized patients aged 24 months or older were included. Patients were assigned as obese or non-obese based on BMI as reported from medical records referenced to CDC BMI by gender and age classification (https://www.cdc.gov/growthcharts/clinical_charts.htm). Results Patients meeting inclusion criteria included 56% not obese and 44% obese. Compared to matched US population, obese children and adolescents appeared in this database at a rate of 2.3 times their frequency in the population. Obese patients were more likely to be Hispanic and older, symptomatic, have abnormal radiological findings, and require oxygen and ICU admission. Mortality, in this analysis, was similar across the groups. Demographic and clinical characteristics. NS: Not significant *within seven days of COVID diagnosis ***mild: no need for supplemental oxygen; moderate: need for supplemental oxygen and severe: need for mechanical ventilation. Conclusion The incidence of obesity in hospitalized COVID children is higher than that of the general population (34% vs. 19%), highlighting obesity as an important risk factor for hospitalization associated with SARS-CoV-2 infected. Therefore, obese children and adolescents with COVID should be prioritized for COVID immunization and managed aggressively, given their significant COVID morbidity. Disclosures All Authors: No reported disclosures

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Abortion, substance abuse and mental health in early adulthood: Thirteen-year longitudinal evidence from the United States

SAGE Open Medicine ◽

10.1177/2050312116665997 ◽

2016 ◽

Vol 4 ◽

pp. 205031211666599 ◽

Cited By ~ 11

Author(s):

Donald Paul Sullins

Keyword(s):

Mental Health ◽

United States ◽

Mental Disorders ◽

Confidence Interval ◽

Pregnancy Outcomes ◽

Pregnancy Loss ◽

Early Adulthood ◽

The United States ◽

Mental Health Disorder ◽

Increased Risk

Objective: To examine the links between pregnancy outcomes (birth, abortion, or involuntary pregnancy loss) and mental health outcomes for US women during the transition into adulthood to determine the extent of increased risk, if any, associated with exposure to induced abortion. Method: Panel data on pregnancy history and mental health history for a nationally representative cohort of 8005 women at (average) ages 15, 22, and 28 years from the National Longitudinal Study of Adolescent to Adult Health were examined for risk of depression, anxiety, suicidal ideation, alcohol abuse, drug abuse, cannabis abuse, and nicotine dependence by pregnancy outcome (birth, abortion, and involuntary pregnancy loss). Risk ratios were estimated for time-dynamic outcomes from population-averaged longitudinal logistic and Poisson regression models. Results: After extensive adjustment for confounding, other pregnancy outcomes, and sociodemographic differences, abortion was consistently associated with increased risk of mental health disorder. Overall risk was elevated 45% (risk ratio, 1.45; 95% confidence interval, 1.30–1.62; p < 0.0001). Risk of mental health disorder with pregnancy loss was mixed, but also elevated 24% (risk ratio, 1.24; 95% confidence interval, 1.13–1.37; p < 0.0001) overall. Birth was weakly associated with reduced mental disorders. One-eleventh (8.7%; 95% confidence interval, 6.0–11.3) of the prevalence of mental disorders examined over the period were attributable to abortion. Conclusion: Evidence from the United States confirms previous findings from Norway and New Zealand that, unlike other pregnancy outcomes, abortion is consistently associated with a moderate increase in risk of mental health disorders during late adolescence and early adulthood.

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Social exclusion, mental health, and social well-being among African immigrants in the United States

International Social Work ◽

10.1177/0020872820963425 ◽

2021 ◽

pp. 002087282096342

Author(s):

Sherinah Saasa ◽

David Okech ◽

Yoon Joon Choi ◽

Larry Nackerud ◽

Tenesha Littleton

Keyword(s):

Mental Health ◽

United States ◽

Social Exclusion ◽

African Immigrants ◽

Well Being ◽

The United States ◽

Depression And Anxiety ◽

Negative Effects ◽

Economic Exclusion ◽

Social Work Interventions

This study examined the effects of social exclusion (socio-cultural and structural-economic exclusion) on the mental health and social well-being of African immigrants in the United States ( N = 409). We found that social exclusion increased depression and anxiety symptoms, decreased societal trust, increased subjective isolation, and increased worries about one’s safety among African immigrants. The results further indicated strong negative effects of discrimination on mental health and social well-being. The findings highlight the need for social work interventions that target discrimination and structural exclusionary mechanisms in efforts to improve the mental health and social well-being of African immigrants in the United States.

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Naltrexone Implant for Opioid Use Disorder

Neurology International ◽

10.3390/neurolint14010004 ◽

2021 ◽

Vol 14 (1) ◽

pp. 49-62

Author(s):

Amber N. Edinoff ◽

Catherine A. Nix ◽

Claudia V. Orellana ◽

Samantha M. StPierre ◽

Erin A. Crane ◽

...

Keyword(s):

Mental Health ◽

United States ◽

Compliance Rate ◽

The United States ◽

Opioid Use Disorder ◽

Endogenous Opioids ◽

Opioid Use ◽

Opioid Agonist ◽

Increased Risk ◽

Health Related

The continued rise in the availability of illicit opioids and opioid-related deaths in the United States has left physicians, researchers, and lawmakers desperate for solutions to this ongoing epidemic. The research into therapeutic options for the treatment of opioid use disorder (OUD) began with the introduction of methadone in the 1960s. The approval of oral naltrexone initially showed much promise, as the drug was observed to be highly potent in antagonizing the effects of opioids while producing no opioid agonist effects of its own and having a favorable side effect profile. Patients that routinely take their naltrexone reported fewer days of heroin use and had more negative drug tests than those without treatment. Poor outcomes in OUD patients treated with naltrexone have been directly tied to short treatment time. Studies have shown that naltrexone given orally vs. as an implant at the 6-month interval showed a higher non-compliance rate among those who used oral medications at the 6-month mark and a slower return to use rate. There were concerns that naltrexone could possibly worsen negative symptoms seen in opiate use disorder related to blockade of endogenous opioids that are important for pleasurable stimuli. Studies have shown that naltrexone demonstrated no increase in levels of anxiety, depression and anhedonia in participants and another study found that those treated with naltrexone had a significant reduction in mental health-related hospitalizations. The latter study also concluded that there was no increased risk for mental health-related incidents in patients taking naltrexone via a long-acting implant. Although not yet FDA approved in the United States, naltrexone implant has shown promising results in Europe and Australia and may provide a novel treatment option for opioid addiction.

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Investigating Mental Health of US College Students During the COVID-19 Pandemic: Cross-Sectional Survey Study (Preprint)

10.2196/preprints.22817 ◽

2020 ◽

Cited By ~ 1

Author(s):

Xiaomei Wang ◽

Sudeep Hegde ◽

Changwon Son ◽

Bruce Keller ◽

Alec Smith ◽

...

Keyword(s):

Mental Health ◽

United States ◽

College Students ◽

Online Survey ◽

The United States ◽

Survey Study ◽

Depression And Anxiety ◽

Cross Sectional Survey ◽

Suicidal Thoughts ◽

The Impact

BACKGROUND Evidence suggests that the COVID-19 pandemic has generally increased levels of stress and depression among the public. However, the impact on college students in the United States has not been well-documented. OBJECTIVE This paper surveys the mental health status and severity of depression and anxiety of college students in a large university system in the United States during the COVID-19 pandemic. METHODS An online survey was conducted among undergraduate and graduate students recruited from Texas A&M University via email. The survey consisted of two standardized scales—the Patient Health Questionnaire-9 and the General Anxiety Disorder-7—for depression and anxiety, and additional multiple-choice and open-ended questions regarding stressors and coping mechanisms specific to COVID-19. RESULTS Among the 2031 participants, 48.14% (n=960) showed a moderate-to-severe level of depression, 38.48% (n=775) showed a moderate-to-severe level of anxiety, and 18.04% (n=366) had suicidal thoughts. A majority of participants (n=1443, 71.26%) indicated that their stress/anxiety levels had increased during the pandemic. Less than half of the participants (n=882, 43.25%) indicated that they were able to cope adequately with the stress related to the current situation. CONCLUSIONS The proportion of respondents showing depression, anxiety, and/or suicidal thoughts is alarming. Respondents reported academic-, health-, and lifestyle-related concerns caused by the pandemic. Given the unexpected length and severity of the outbreak, these concerns need to be further understood and addressed.

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Vicarious Racism and Vigilance During the COVID-19 Pandemic: Mental Health Implications Among Asian and Black Americans

Public Health Reports ◽

10.1177/00333549211018675 ◽

2021 ◽

pp. 003335492110186

Author(s):

David H. Chae ◽

Tiffany Yip ◽

Connor D. Martz ◽

Kara Chung ◽

Jennifer A. Richeson ◽

...

Keyword(s):

Mental Health ◽

Asian American ◽

Mental Health Problems ◽

Black Americans ◽

The United States ◽

Racial Group ◽

Depression And Anxiety ◽

Linear Regression Models ◽

Symptoms Of Depression ◽

Increased Risk

Objectives Experiences of vicarious racism—hearing about racism directed toward one’s racial group or racist acts committed against other racial group members—and vigilance about racial discrimination have been salient during the COVID-19 pandemic. This study examined vicarious racism and vigilance in relation to symptoms of depression and anxiety among Asian and Black Americans. Methods We used data from a cross-sectional study of 604 Asian American and 844 Black American adults aged ≥18 in the United States recruited from 5 US cities from May 21 through July 15, 2020. Multivariable linear regression models examined levels of depression and anxiety by self-reported vicarious racism and vigilance. Results Controlling for sociodemographic characteristics, among both Asian and Black Americans, greater self-reported vicarious racism was associated with more symptoms of depression (Asian: β = 1.92 [95% CI, 0.97-2.87]; Black: β = 1.72 [95% CI, 0.95-2.49]) and anxiety (Asian: β = 2.40 [95% CI, 1.48-3.32]; Black: β = 1.98 [95% CI, 1.17-2.78]). Vigilance was also positively related to symptoms of depression (Asian: β = 1.54 [95% CI, 0.58-2.50]; Black: β = 0.90 [95% CI, 0.12-1.67]) and anxiety (Asian: β = 1.98 [95% CI, 1.05-2.91]; Black: β = 1.64 [95% CI, 0.82-2.45]). Conclusions Mental health problems are a pressing concern during the COVID-19 pandemic. Results from our study suggest that heightened racist sentiment, harassment, and violence against Asian and Black Americans contribute to increased risk of depression and anxiety via vicarious racism and vigilance. Public health efforts during this period should address endemic racism as well as COVID-19.

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The unfolding COVID-19 pandemic: A probability-based, nationally representative study of mental health in the United States

Science Advances ◽

10.1126/sciadv.abd5390 ◽

2020 ◽

Vol 6 (42) ◽

pp. eabd5390 ◽

Cited By ~ 5

Author(s):

E. Alison Holman ◽

Rebecca R. Thompson ◽

Dana Rose Garfin ◽

Roxane Cohen Silver

Keyword(s):

Mental Health ◽

United States ◽

Depressive Symptoms ◽

Acute Stress ◽

Empirical Studies ◽

The United States ◽

Representative Study ◽

Nationally Representative ◽

Mental And Physical Health ◽

Over Time

The COVID-19 (coronavirus disease 2019) pandemic is a collective stressor unfolding over time; yet, rigorous empirical studies addressing its mental health consequences among large probability-based national samples are rare. Between 18 March and 18 April 2020, as illness and death escalated in the United States, we assessed acute stress, depressive symptoms, and direct, community, and media-based exposures to COVID-19 in three consecutive representative samples from the U.S. probability-based nationally representative NORC AmeriSpeak panel across three 10-day periods (total N = 6514). Acute stress and depressive symptoms increased significantly over time as COVID-19 deaths increased across the United States. Preexisting mental and physical health diagnoses, daily COVID-19–related media exposure, conflicting COVID-19 information in media, and secondary stressors were all associated with acute stress and depressive symptoms. Results have implications for targeting public health interventions and risk communication efforts to promote community resilience as the pandemic waxes and wanes over time.

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