新型冠状病毒肺炎防控期间认知障碍患者及其照护者精神卫生与心理社会支持专家建议

新型冠状病毒肺炎疫情给公众,尤其是老年人身体和心理都造成了巨大影响。老年认知障碍患者不仅是易感人群,也容易出现心理应激反应,甚至有诱发和加重精神行为症状的风险。其照护者在疫情期间面临更大的照护负担,可能心理应激反应更明显。国内多个老年精神医学与认知障碍相关学术团体联合制定专家建议,针对疫情期间认知障碍患者和照护者可能出现的心理应激反应以及患者已有精神行为问题的波动特点,提出多学科团队进行精神卫生和心理社会干预的策略,指导疫情期间为认知障碍患者提供诊疗及照护的相关人员开展全程管理。     

Late-life alcoholism: issues relevant to the geriatric psychiatrist.

Alcohol use and abuse are often overlooked as an important clinical issue in older adults. However, with a rapidly growing population of older adults who grew up during an era of increased illicit drug and alcohol use, there are reasons to believe that there will be a greater impact of alcohol abuse or dependence on the next generation of older adults. Because older adults seek the majority of behavioral health care either in primary care settings or from mental health providers, it is necessary for primary care providers and geriatric mental health providers to become proficient at assessing and providing interventions. This article discusses the state of research in this area and reviews clinically-relevant concepts related to identifying, assessing, and treating older adults with alcohol-related disability.     

Leisure Activities,Happiness, Life Satisfaction,and Health Perception of Older Korean Adults

The purpose of the present study was to investigate the relationship between types of leisure activities and happiness, life satisfaction, and health perception of older Korean adults during the COVID-19 era. Using snowballing and purposive sampling methods, 123 respondents participated in the study. The results show that participation in outdoor activities and home-based activities served as a strong predictor of happiness, life satisfaction, and health perceptions among older Korean adults. These findings suggest that engaging in outdoor activities and home-based activities is likely to increase the psychological and mental health of older Korean adults during the COVID-19 era.     

One year after the COVID-19 outbreak in Germany: long-term changes in depression,anxiety, loneliness,distress and life satisfaction

Several studies have linked the COVID-19 pandemic to unfavorable mental health outcomes. However, we know little about long-term changes in mental health due to the pandemic so far. Here, we used longitudinal data from a general population sample of 1388 adults from Germany, who were initially assessed between April and May 2020 (i.e., at the beginning of the COVID-19 pandemic in Germany) and prospectively followed up after 6 (n = 1082) and 12 months (n = 945). Depressive and anxiety symptoms as well as loneliness did not change from baseline to 6-month follow-up. While anxiety symptoms did not change in the long run, depressive symptoms and loneliness increased and life satisfaction decreased from baseline to 12-month follow-up. Moreover, vulnerable groups such as younger individuals or those with a history of mental disorders exhibited an overall higher level of psychopathological symptoms across all assessment waves. Our findings suggest a deterioration in mental health during the course of the COVID-19 pandemic, which emphasizes the importance to implement targeted health promotions to prevent a further symptom escalation especially in vulnerable groups.

     

Cogitation on the Mental Health Service System during the COVID-19 Outbreak in China

The spread of the novel coronavirus disease (COVID-19) in China from December 2019 to April 2020 caused serious social panic and other psychological problems among the Chinese public. Thus, reducing the public panic of and the long-term adverse psychological effects on individuals and society resulting from the epidemic became the priority task for mental health professionals in China. Based on the experiences in providing mental health services during SARS outbreak, the perspectives and strategies for targeted mental health services are reported. Furthermore, the cogitation on the problems with mental health services in China during the outbreak of COVID-19 are discussed.     

Mental health services and research in the Arab world

Although there are 22 Arab countries in the Arab League, the mental health services provided in those countries show several forms of variation. Economic, political, social and cultural factors seem to play a major role in determining the state of the psychiatric profession and the access of the service to citizens. The different needs expressed by Arab colleagues at times seem incompatible with the available allocated resources. Some Arab countries enjoy the highest income per capita, yet this is inconsistent with the quality of mental health services available there. The per capita mental health services, the availability of a Mental Health Act, and the space allocated for mental health in medical curricula are but a few of the concerns that have been expressed by colleagues from the different countries of the Arab region. The following review will attempt to draw up a profile of the situation for mental health services and research in the region, and to suggest some measures for intervention.     

Sleep disturbances among Chinese residents during the Coronavirus Disease 2019 outbreak and associated factors

ObjectivesSleep status can affect the body's immune status and mental health. This study aims to investigate the sleep status of Chinese residents during the outbreak of Coronavirus Disease 2019 (COVID-19) and to evaluate its related risk factors.MethodsThis research carried out a cross-sectional survey in February 2020 (during the COVID-19 outbreak) to investigate the sleep status of residents nationwide in the form of an online questionnaire. Of the 8151 respondents, 6437 were eventually included in the analysis. Logistic regression is applied to analyze the associated factors affecting residents' sleep quality.ResultsDuring the COVID-19 outbreak, the incidence of sleep disturbances in residents was 17.65%. Increased risk of sleep disturbances was found to be associated with older age, female gender, and poor self-reported health status. Moreover, the odds ratios (ORs) were 1.42 (95% CI: 1.1–2.64), 1.35 (95% CI: 1.16–1.59), 5.59 (95% CI: 4.32–7.23), respectively. Those residents who believed COVID-19 had caused a high number of deaths or who thought COVID-19 was not easy to cure were more likely to experience sleep disorders, and the ORs were 1.73 (95% CI: 1.43–2.09), 1.57 (95% CI: 1.29–1.91), respectively. Regular exercise was a protective factor for sleep disturbances, OR = 0.77 (95% CI: 0.63–0.93).ConclusionsDuring the outbreak of COVID-19, nearly one-fifth of participants had sleep disorders. It is necessary to pay more attention to people at high risk for sleep disturbances during the outbreak, adopt effective risk communication methods, enhance residents' rational understanding of COVID-19, and develop practical indoor exercise programs for general public to improve sleep quality.     

Psychological correlates of poor sleep quality among U.S. young adults during the COVID-19 pandemic

ObjectiveUncertainty due to the COVID-19 pandemic may result in problematic sleep that can lead to negative effects on overall health. This unprecedented and stressful time can be even more detrimental for young adults with pre-existing mental health conditions. The purpose of this study is to investigate potential risk factors (i.e., current mental health symptoms, and COVID-19-related grief and worry) on sleep quality of U.S. young adults during the initial months of the global pandemic.MethodThis cross-sectional study examined 908 young adults in the weeks following the declaration of the coronavirus pandemic as a national emergency by the United States. A series of hierarchical multiple regression analyses examined depression, anxiety, and PTSD, as well as COVID-19-related grief and worry as predictors of young adults’ sleep quality.ResultsYoung adults experienced high rates of sleep problems during the first two months (April to May 2020) of the pandemic. Depressive and anxiety symptoms appear to be predictors of sleep quality regardless of any pre-existing diagnosis. Furthermore, high levels of PTSD symptoms and COVID-19-related worry were associated with young adults’ poor sleep.ConclusionsOur findings point to possible psychological factors that uniquely explain young adults’ poor sleep quality during the COVID-19 pandemic in the U.S. This study shed new light on how the COVID-19 pandemic might affect the sleep behaviors of young adults without a pre-existing mental health diagnosis. Implications for supporting young adults sleep and well-being during the pandemic are addressed.     

The utility of the Center for Epidemiological Studies-Depression Scale in older primary care patients

The consequences of depression in older medically ill adults are quite severe. Medically ill and depressed older adults die sooner and are more disabled by their illness than are medically ill older adults who are not depressed. Research demonstrates that early recognition and intervention can prevent negative medical and social consequences of depression in late life. While most older adults who are depressed seek mental health services from their physicians, recognition rates of late-life depression in medical settings are poor. Some have suggested using screening instruments, such as CES-D, to increase physician recognition of geriatric depression. While the CES-D has been found to be a reliable instrument in medical settings and in older adults, the utility of the CES-D and instruments like it has not been tested on older medical patients from different ethnic groups. We analysed the reliability and item functions of the CES-D in a low-income, ethnically diverse population. The results indicate that the CES-D has good internal consistency as a scale, but at the item level the scale does not function similarly across age and ethnic groups.     

The relationship between perceived stress and emotional distress during the COVID-19 outbreak: Effects of boredom proneness and coping style

The outbreak of a novel coronavirus (COVID-19) pandemic was a great threat to the physical and mental health of the general population. Our research aimed to investigate the relationship between perceived stress and emotional distress during the initial outbreak. Furthermore, potential risks and protective factors, i.e., coping and boredom proneness, of stress-related emotional distress were also explored. Data from 3233 participants in China were collected through an online survey platform during the initial outbreak of the COVID-19 from January 31 to February 9 in 2020. Results showed that higher perceived stress was associated with more emotional distress including depression, fear, compulsion-anxiety, neurasthenia, and hypochondria. Boredom proneness significantly and positively mediated the relationship between perceived stress and emotional distress. Moreover, coping style moderated the stress-emotional distress relationship, i.e., individuals who mainly adopted positive coping strategies suffered fewer symptoms of depression, compulsion-anxiety, and neurasthenia under stress, while negative coping strategies aggravated emotional distress. These results from the present study provide practical value for mental health intervention during the emergent public health events.     

Psychometric Properties of the Arabic Version of the Fear of COVID-19 Scale (FCV-19S) Among Jordanian Adults

International Journal of Mental Health and Addiction - There is an urgent need to assess the impacts of the Coronavirus-19 disease (COVID-19) outbreak on mental health among the general population...     

Research-Practice Partnership to Develop and Implement Routine Mental Health Symptom Tracking Tool Among Older Adults During COVID-19

ObjectiveOlder adults are disproportionally impacted by the COVID-19 pandemic, causing a mental health crisis in late life, due to physical restrictions (e.g., quarantine), limited access to services, and lower literacy and access to technology. Despite established benefits, systematic screening of mental health needs of older adults in community and routine care settings is limited and presents multiple challenges. Cross-disciplinary collaborations are essential for identification and evaluation of mental health needs and service delivery.MethodsUsing a research-practice partnership model, we developed and implemented a routine mental health needs identification and tracking tool at a community-based social services organization. Repeated screenings were conducted remotely over 5 months and included depression, anxiety, perceived loneliness, social support, and related domains such as sleep quality, resilience, and trauma symptoms linked to COVID-19. We examined symptomatic distress levels and associations between different domains of functioning.ResultsOur project describes the process of establishing a research-practice partnership during the COVID-19 pandemic. We collected 292 screenings from 124 individuals; clients were mildly to moderately depressed and anxious, reporting large amounts of time alone and moderate levels of loneliness. Those reporting higher depressive symptoms reported higher anxiety symptoms, poorer sleep quality, lower quality of life, lower capacity to adapt to challenging situations, and greater trauma symptoms due to COVID-19.ConclusionOur routine screening tool can serve as a blueprint for case management agencies and senior centers nationwide, beyond the pressing mental health crisis due to COVID-19, to continue identifying needs as they emerge in the community.     

Debate: COVID-19 to the under 19 – a Singapore school mental health response

The 2019 novel coronavirus (COVID-19) pandemic causes much disruption globally on sociopolitical, economic and healthcare fronts. While much of the impact has focused on the epidemiology and medical management of the pandemic, more need to be focused on the mental health impact of COVID-19. This article describes the impact of COVID-19 pandemic on Singapore’s schools and the response and adaptation of the school community mental health services. Singapore’s response is one of balancing the needs of the population and demands in this crisis, with the utilization of technology and outbreak and support control measures. Further consideration needs to be afforded to increase capacity of the school and mental health services to support youth and tapping on technological innovations.     

The impact of the COVID-19 pandemic on the mental health of healthcare workers: study protocol for the COVID-19 HEalth caRe wOrkErS (HEROES) study

Background

Preliminary country-specific reports suggest that the COVID-19 pandemic has a negative impact on the mental health of the healthcare workforce. In this paper, we summarize the protocol of the COVID-19 HEalth caRe wOrkErS (HEROES) study, an ongoing, global initiative, aimed to describe and track longitudinal trajectories of mental health symptoms and disorders among health care workers at different phases of the pandemic across a wide range of countries in Latin America, Europe, Africa, Middle-East, and Asia.

Methods

Participants from various settings, including primary care clinics, hospitals, nursing homes, and mental health facilities, are being enrolled. In 26 countries, we are using a similar study design with harmonized measures to capture data on COVID-19 related exposures and variables of interest during two years of follow-up. Exposures include potential stressors related to working in healthcare during the COVID-19 pandemic, as well as sociodemographic and clinical factors. Primary outcomes of interest include mental health variables such as psychological distress, depressive symptoms, and posttraumatic stress disorders. Other domains of interest include potentially mediating or moderating influences such as workplace conditions, trust in the government, and the country’s income level.

Results

As of August 2021, ~ 34,000 health workers have been recruited. A general characterization of the recruited samples by sociodemographic and workplace variables is presented. Most participating countries have identified several health facilities where they can identify denominators and attain acceptable response rates. Of the 26 countries, 22 are collecting data and 2 plan to start shortly.

Conclusions

This is one of the most extensive global studies on the mental health of healthcare workers during the COVID-19 pandemic, including a variety of countries with diverse economic realities and different levels of severity of pandemic and management. Moreover, unlike most previous studies, we included workers (clinical and non-clinical staff) in a wide range of settings.

     

Assessment of Fear of COVID-19 in Older Adults: Validation of the Fear of COVID-19 Scale

International Journal of Mental Health and Addiction - There is no information in Peru on the prevalence of mental health problems associated with COVID-19 in older adults. In this sense, the aim...     

Mental Health Multimorbidity among Caregivers of Older Adults During the COVID-19 Epidemic

ObjectiveTo investigate mental health status and associated factors among caregivers of older adults during the COVID-19 epidemic in China.MethodsFrom March 1 to 31, 2020, 916 caregivers of older adults participated in an online cross-sectional survey on the prevalence of anxiety, depression, and sleep problems. The seven-item Generalized Anxiety Disorder Scale (GAD-7) was administered to measure anxiety symptoms, the two-item Patient Health Questionnaire (PHQ-2) was used to assess depressive symptoms, and a self-developed questionnaire was used to assess sleep quality and duration. Six questions about COVID-19-related experiences were used to assess community-level infection contact and the level of exposure to media information. The prevalence rates of anxiety, depression and sleep problems were computed. The Wald χ² were applied to compare the differences between subgroups. Multiple logistic regression analyses were performed to investigate factors associated with anxiety, depression, sleep problems, and multimorbidity.ResultsThe prevalence rates of anxiety, depression, and sleep problems were 46.8%, 29.8%, and 10.8%, respectively. Approximately 263 participants (28.7%) presented with two or more mental health problems. Being female (OR, 2.254; 95% CI, 1.510–3.363), having community-level COVID-19 contact (OR, 1.856; 95% CI, 1.189–2.898), and having a mental disorder (OR, 3.610; 95% CI, 1.644–7.930) were associated with increased risk of multimorbidity among caregivers. Caregivers who preferred positive information (OR, 0.652; 95% CI, 0.472–0.899) had reduced risk of multimorbidity.ConclusionAnxiety and depression were common among caregivers of older adults during the COVID-19 epidemic. Being female and having community-level COVID-19 contact were independent risk factors for experiencing multiple mental health problems. Preexisting mental disorders increased the risk of multimorbidity among caregivers, while enhanced access to positive media information decreased the risk of multimorbidity.     

Specialized partial hospitalization for older adults: a clinical description of an intermediate-term program

The field of geriatric mental health is confronted with the dilemma of a sharp rise in the elderly segment of the population and a concomitant shortage of age-appropriate psychiatric intervention services. There is tremendous need for specialized hospital-based intervention for older adults with mental health problems. A creative and rapid response is imperative and should be based on a continuum of geropsychiatric services that includes acute inpatient, partial hospitalization, and outpatient services. Because Medicare reimbursement for partial hospitalization is restricted to hospital-based programs, private psychiatric hospitals are uniquely positioned to assume a dominant role in the geriatric mental health service delivery system. This article details one hospital's specialized, intermediate-term partial-hospital program for older adults. Partial hospitalization is demonstrated to be an essential component of comprehensive geropsychiatric services that can overcome problems of cost-effectiveness, accessibility, and acceptability to consumers--all factors that presently restrict the development and use of such programs. Based on empirical findings, clinical adaptations to assessment and treatment procedures specific to older adults are presented.     

Psychological Impacts of Coronavirus Outbreaks on Adults: A Rapid Evidence Review

A recent rapid review highlighted the negative psychological impacts of quarantining during coronavirus outbreaks on the public. However, to date, there has been no review of the psychological impacts of coronavirus on adults using research from community samples and not restricted to people quarantined during coronavirus. A rapid review was conducted to provide timely evidence about the mental health implications of coronavirus outbreaks on adults and to inform psychological research concerning the current COVID-19 outbreak. Three databases and Google Scholar were searched and a total of 27 studies were identified. Symptoms of anxiety and depression were identified during coronavirus outbreaks alongside concerns about becoming infected and family becoming infected. Those with pre-existing mental health conditions, young adults, women and those reporting physical symptoms appear to be vulnerable to negative psychological outcomes during coronavirus outbreaks. How people think about and understand coronavirus, and the coping strategies employed by people, may play a role in mitigating negative psychological outcomes. Results demonstrate the adverse psychological impacts of coronavirus outbreaks on adults and the need for continued investment in mental health services for the wider community during these times. Further longitudinal research is required to ascertain the long-term psychological consequences of coronavirus outbreaks. This review can be used to inform continued research on the psychological impacts of COVID-19 on adults.     

A Future Research Agenda for Digital Geriatric Mental Healthcare

The proliferation of mobile, online, and remote monitoring technologies in digital geriatric mental health has the potential to lead to the next major breakthrough in mental health treatments. Unlike traditional mental health services, digital geriatric mental health has the benefit of serving a large number of older adults, and in many instances, does not rely on mental health clinics to offer real-time interventions. As technology increasingly becomes essential in the everyday lives of older adults with mental health conditions, these technologies will provide a fundamental service delivery strategy to support older adults’ mental health recovery. Although ample research on digital geriatric mental health is available, fundamental gaps in the scientific literature still exist. To begin to address these gaps, we propose the following recommendations for a future research agenda: 1) additional proof-of-concept studies are needed; 2) integrating engineering principles in methodologically rigorous research may help science keep pace with technology; 3) studies are needed that identify implementation issues; 4) inclusivity of people with a lived experience of a mental health condition can offer valuable perspectives and new insights; and 5) formation of a workgroup specific for digital geriatric mental health to set standards and principles for research and practice. We propose prioritizing the advancement of digital geriatric mental health research in several areas that are of great public health significance, including 1) simultaneous and integrated treatment of physical health and mental health conditions; 2) effectiveness studies that explore diagnostics and treatment of social determinants of health such as “social isolation” and “loneliness;” and 3) tailoring the development and testing of innovative strategies to minority older adult populations.