Association entre la fréquence de consultation des médias d’information et la détresse psychologique chez les femmes enceintes durant la pandémie de COVID-19: Association between news media consulting frequency and psychological distress in pregnant women during the COVID-19 pandemic

Objective:

Examine the association between news media use frequency during the COVID-19 pandemic and the scale of psychological distress in pregnant women, considering this distress known harmful effects on the fetus development.

Method:

Pregnant women living in Quebec province (N = 1014) have been recruited in April 2020 through social media, while a state of health emergency was declared. Participants were divided in 4 groups, according to self-reported frequency of news media consulting (little or none; one time a day; several times a day; constant). They filled measures of depressive symptoms, negative affects, post-traumatic stress symptoms and anxiety specific to COVID-19. Instrument scores were grouped under a unique factor of psychological distress.

Results:

An ANCOVA controlling for age, gestational age, education level, household annual revenue and a diagnosed mental disorder present at the time of participation in study shows that news media exposure frequency is significantly associated with psychological distress severity in pregnant women, during COVID-19 pandemic, F(3,998) = 27.02, p < 0.001, η2 partial = 0.08. Given the mean comparisons a posteriori, higher psychological distress rates are found as soon as news media exposure exceeds once a day (effect sizes between 0.38 and 0.81).

Conclusions:

The more pregnant women report consulting the news media during the COVID-19 pandemic, the more likely they are to exhibit psychological distress. Results provide one of the first empirical supports to recommendations of World Health Organization, Canada government and psychiatric associations that encourage population to limit their news media consulting during the COVID-19 pandemic.     

“Don't Just Study our Distress,Do Something”: Implementing and Evaluating a Modified Stepped-Care Model for Health Care Worker Mental Health During the COVID-19 Pandemic

ObjectiveThroughout the COVID-19 pandemic, there have been concerns about the mental health of health care workers (HCW). Although numerous studies have investigated the level of distress among HCW, few studies have explored programs to improve their mental well-being. In this paper, we describe the implementation and evaluation of a program to support the mental health of HCW at University Health Network (UHN), Canada''s largest healthcare network.MethodsUsing a quality improvement approach, we conducted a needs assessment and then created and evaluated a modified stepped-care model to address HCW mental health during the pandemic. This included: online resources focused on psychoeducation and self-management, access to online support and psychotherapeutic groups, and self-referral for individual care from a psychologist or psychiatrist. We used ongoing mixed-methods evaluation, combining quantitative and qualitative analysis, to improve program quality.ResultsThe program is ongoing, running continuously throughout the pandemic. We present data up to November 30, 2021. There were over 12,000 hits to the UHN''s COVID mental health intranet web page, which included self-management resources and information on group support. One hundred and sixty-six people self-referred for individual psychological or psychiatric care. The mean wait time from referral to initial appointment was 5.4 days, with an average of seven appointments for each service user. The majority had moderate to severe symptoms of depression and anxiety at referral, with over 20% expressing thoughts of self-harm or suicide. Post-care user feedback, collected through self-report surveys and semistructured interviews, indicated that the program is effective and valued.ConclusionsDevelopment of a high-quality internal mental health support for HCW program is feasible, effective, and highly valued. By using early and frequent feedback from multiple perspectives and stakeholders to address demand and implement changes responsively, the program was adjusted to meet HCW mental health needs as the pandemic evolved.     

“One Degree of Separation”: A Mixed-Methods Evaluation of Canadian Mental Health Care User and Provider Experiences With Remote Care During COVID-19

ObjectivesThe COVID-19 pandemic has contributed to a shift from in-person to remote mental health care. While remote care methods have long existed, their widespread use is unprecedented. There is little research about mental health care user and provider experiences with this transition, and no published studies to date have compared satisfaction between these groups.MethodsCanadian mental health care users (n = 332) and providers (n = 107) completed an online self-report survey from October 2020 to February 2021 hosted by the Canadian Biomarker Integration Network in Depression. Using a mixed-methods approach, participants were asked about their use of remote care, including satisfaction, barriers to use, helpful and unhelpful factors, and suggestions for improvement.ResultsOverall, 59% to 63% of health care users and 59% of health care providers were satisfied with remote care. Users reported the greatest satisfaction with the convenience of remote care, while providers were most satisfied with the speed of provision of care; all groups were least satisfied with therapeutic rapport. Health care providers were less satisfied with the user-friendliness of remote care (P < 0.001) than users, while health care users were less satisfied than providers with continuity of care (P < 0.001). The use of a video-based platform was associated with remote care satisfaction among health care users (P < 0.02), and qualitative responses support the importance of visual cues in maintaining therapeutic rapport remotely. The majority of users (55%) and providers (87%) reported a likelihood of using remote care after the pandemic.ConclusionsRemote mental health care is generally accepted by both users and providers, and the majority would consider using remote care following the pandemic. Suggestions for improvement include greater use of video, increased attention to body language and eye contact, consistency with in-person care, as well as increased provider training and administrative support.     

Cannabis Use and Prospective Long-Term Association with Anxiety: A Systematic Review and Meta-Analysis of Longitudinal Studies: Usage du cannabis et association prospective à long terme avec l’anxiété: une revue systématique et une méta-analyse d’études longitudinales

Objectives:Cannabis use is proposed as a risk factor for psychosis and is associated with depressive disorders. However, the relationship between recreational cannabis use and its longitudinal implications on anxiety conditions is less studied. The aim of this investigation is to systematically evaluate published literature and perform a meta-analysis of the data.Methods:A systematic search was performed of MEDLINE, Embase, and PsychINFO from inception to May 31, 2020, in addition to a hand search. Longitudinal studies that evaluated the relationship of cannabis use and development of anxiety were included. Where applicable, adjusted odds ratios (ORs) were extracted, pooled, and evaluated using random-effects meta-analysis.Results:After screening of unique abstracts (n = 6835), the final evaluation included 24 studies, of which 10 reported ORs that were analyzed quantitatively. Cannabis use was significantly associated with increased odds of developing any anxiety conditions (OR = 1.25; 95% CI, 1.01 to 1.54). Cannabis use was not significantly associated with developing generalized anxiety disorder, panic disorder, or social anxiety disorder. Review of studies not reporting OR revealed mixed results but are suggestive of a link between cannabis use and increased rates/severity of anxiety.Conclusions:Published evidence suggests that cannabis use is likely associated with increased risk of anxiety in the long term but variability of study designs precludes declaration of a causal relationship. Awareness of this association is of relevance for both clinical practice and mental health policy implementation.     

Anxiété et dépression associées à la prise en charge de la COVID-19 chez les personnels de santé au Cameroun

ObjectiveThe COVID-19 pandemic has had a significant impact worldwide, at different levels. The literature consulted indicates that healthcare workers, who are the first to respond, are generally the ones who pay the highest price. The present study assesses the extent of anxious and depressive symptoms among these actors responding to COVID-19, in the context of Cameroon.MethodThe Hospital Anxiety and Depression Scale (HADS) was used to assess anxious and depressive symptoms. Data collection involved the use of a web questionnaire for this purpose through the Google Forms virtual platform. The questionnaire link was sent to professional groups spread throughout Cameroon's ten regions. A total of 331 health professionals were interviewed over the period from April 5 to 19, 2020.ResultThe results show a high rate of anxiety (41.8%) and depression (42.8%). There is a higher susceptibility to depression in young people (30-39 years). Fear of contamination and fear of death are modulators of depression and anxiety. The anxiety-depression comorbidity in the sample is 14.73%. The prevalence rates of major depressive disorder and adjustment disorder in the sample were 8.2% and 3.3%, respectively. The data presented confirm the trends recorded in the literature regarding the impact of fatal epidemics on the mental health of healthcare workers.DiscussionThe results indicate, as is the case with most of the work consulted in the literature, that the Covid 19 pandemic is significantly affecting the mental health of healthcare workers. This underlines the urgency of setting up a specialized aid and/or support system, in the context of the current pandemic, such as that of similar health crises. Such a device does not exist in Cameroon, where the mental health response remains weak.ConclusionThese results suggest that the healthcare staff involved in the response to COVID-19 in Cameroon are significantly affected in their mental health. This underlines the need for specialized psychological help for nursing staff.     

Enjeux psychiques et psychopathologiques des croyances conspirationnistes : de la crise sanitaire du COVID-19 à la crise existentielle

ObjectivesResearch on conspiracy theories (CT) has increased significantly in recent years. Studies come from various disciplines in the field of the humanities and social sciences. They show in particular that adherence to CT rebounds at every moment of “crisis”. The health crisis we are experiencing is no exception: COVID-19 pandemic entails an “infodemic”, according to Tedros Ghebreyesus, General Director of the World Health Organization. Indeed, we are witnessing the production, and international dissemination, of false informations, including conspiracy explanations of the coronavirus and its consequences. This outbreak of CT is an opportunity to examine the psychological and psychopathological issues of this phenomenon in the face of the “crisis”, whether collective or individual, health or existential.MethodologyWe present a review of the important international scientific literature regarding CT related to the health crisis of the COVID-19.ResultsWork that addresses CT related to the COVID-19 crisis has resulted in more than fifty publications in recent months. This research is mainly in the fields of social psychology, medical psychology, differential psychology, political science and public health. The rates of adherence to CT related to COVID-19 are of great concern. The literature mentions predisposing factors to the adherence or diffusion of CT on COVID-19: inclination for CT in general, low level of education, low knowledge of the disease, high level of anxiety, acceptance of xenophobic policies, unfavourable attitude towards marginal groups, nationalist stance. Unsurprisingly, there is widespread agreement in the literature that the conspiracy-prone fringe of the population is less likely to comply with government recommendations related to contamination risks, such as handwashing, social distancing, wearing masks, and using diagnostic tests. This crisis thus demonstrates once again that the circulation of false news and adherence to CT is not just a marginal and inconsequential thinking: it concerns a very large part of the population, with a potentially tragic impact in terms of public health. While there is usually no significant difference in adherence to CT according to gender, it would seem that women are less affected by CT related to the COVID than men, regardless of their political affiliation. Finally, studies on the links between adherence to COVID-related CT and stress levels do not seem to reach a consensus. The same uncertainty can be found in work on other types of CT.ConclusionThese results suggest that in order to understand the psychological causes of CT, it may be useful to address the psychodynamic issues underlying adherence to these beliefs. In particular, a psychopathological approach to this phenomenon enables to understand these beliefs as a defensive solution to cope with psychic vulnerability. CT involves overproducing meaning, as delusion does: CT can be considered as the collective, cultural equivalent of a delusional production. Moreover, it is impervious to arguments and evidences, in the same manner as delusion. However, it differs from it by at least two major characteristics: it is shareable and socializing; it gives rise to a consistent attitude.     

Trends in Suicide Mortality in Canada by Sex and Age Group, 1981 to 2017: A Population-Based Time Series Analysis: Tendances de la mortalité par suicide au Canada selon le sexe et le groupe d’âge, 1981 – 2017 : Une analyse de séries chronologiques dans la population

Objectives:Suicide is a complex global public health issue. The objective of this study was to assess time trends in suicide mortality in Canada by sex and age group.Methods:We extracted data from the Canadian Vital Statistics Death Database for all suicide deaths among individuals aged 10 years and older based on International Statistical Classification of Diseases and Related Health Problems, Ninth Revision (E950-959; 1981 to 1999) and International Statistical Classification of Diseases and Related Health Problems, 10th Revision (X60-X84, Y87·0; 2000 to 2017) for a 37-year period, from 1981 to 2017. We calculated annual age-standardized, sex-specific, and age group-specific suicide mortality rates, and used Joinpoint Regression for time trend analysis.Results:The age-standardized suicide mortality rate in Canada decreased by 24.0% from 1981 to 2017. From 1981 to 2007, there was a significant annual average decrease in the suicide rate by 1.1% (95% confidence interval, −1.3 to −0.9), followed by no significant change between 2007 and 2017. From 1981 to 2017 and from 1990 to 2017, females aged 10 to 24 and 45 to 64 years old, respectively, had a significant increase in suicide mortality rates. However, males had the highest suicide mortality rates in all years in the study; the average male-to-female ratio was 3.4:1.Conclusion:The 3-decade decline in suicide mortality rates in Canada paralleled the global trend in rate reductions. However, since 2008, the suicide rate in Canada was relatively unchanged. Although rates were consistently higher among males, we found significant rate increases among females in specific age groups. Suicide prevention efforts tailored for adult males and young and middle-aged females could help reduce the suicide mortality rate in Canada.     

COVID-19 pandemic and mental health consequences: Systematic review of the current evidence

BackgroundDuring the COVID-19 pandemic general medical complications have received the most attention, whereas only few studies address the potential direct effect on mental health of SARS-CoV-2 and the neurotropic potential. Furthermore, the indirect effects of the pandemic on general mental health are of increasing concern, particularly since the SARS-CoV-1 epidemic (2002–2003) was associated with psychiatric complications.MethodsWe systematically searched the database Pubmed including studies measuring psychiatric symptoms or morbidities associated with COVID-19 among infected patients and among none infected groups the latter divided in psychiatric patients, health care workers and non-health care workers.ResultsA total of 43 studies were included. Out of these, only two studies evaluated patients with confirmed COVID-19 infection, whereas 41 evaluated the indirect effect of the pandemic (2 on patients with preexisting psychiatric disorders, 20 on medical health care workers, and 19 on the general public). 18 of the studies were case-control studies/compared to norm, while 25 of the studies had no control groups. The two studies investigating COVID-19 patients found a high level of post-traumatic stress symptoms (PTSS) (96.2%) and significantly higher level of depressive symptoms (p = 0.016). Patients with preexisting psychiatric disorders reported worsening of psychiatric symptoms. Studies investigating health care workers found increased depression/depressive symptoms, anxiety, psychological distress and poor sleep quality. Studies of the general public revealed lower psychological well-being and higher scores of anxiety and depression compared to before COVID-19, while no difference when comparing these symptoms in the initial phase of the outbreak to four weeks later. A variety of factors were associated with higher risk of psychiatric symptoms and/or low psychological well-being including female gender, poor-self-related health and relatives with COVID-19.ConclusionResearch evaluating the direct neuropsychiatric consequences and the indirect effects on mental health is highly needed to improve treatment, mental health care planning and for preventive measures during potential subsequent pandemics.     

Patient-level Characteristics and Inequitable Access to Inpatient Electroconvulsive Therapy for Depression: A Population-based Cross-sectional Study: Caractéristiques au niveau du patient et accès inéquitable à la thérapie électroconvulsive pour patients hospitalisés

Objective:A variety of patient characteristics drive the use of electroconvulsive therapy (ECT) in depression. However, the extent to which each characteristic influences the receipt of ECT, and whether they are appropriate, is unknown. The aim of this study is to identify patient-level characteristics associated with receiving inpatient ECT for depression.Method:We identified all psychiatric inpatients with a major depressive episode admitted to hospital ≥3 days in Ontario, Canada (2009 to 2017). The association between patient-level characteristics at admission and receipt of inpatient ECT was determined using logistic regression, where a generalized estimating equations approach accounted for repeat admissions.Results:The cohort included 53,174 inpatients experiencing 75,429 admissions, with 6,899 admissions involving ECT (9.2%). Among demographic factors, age was most associated with ECT—younger adults had reduced (OR = 0.30, 95%CI, 0.24 to 0.37; 18 to 25 years) while older adults had increased (OR = 3.08, 95%CI, 2.41 to 3.93; 85+ years) odds compared to middle-aged adults (46 to 55 years). The likelihood of ECT was greater for individuals who were married/partnered, had postsecondary education, and resided in the highest neighborhood income quintile. Among clinical factors, illness polarity was most associated with receiving ECT—bipolar depression had reduced odds of receiving ECT (OR = 0.62, 95%CI, 0.57 to 0.69) The likelihood of receiving ECT was greater in psychotic depression, more depressive symptoms, and incapable to consent to treatment and was reduced with comorbid substance use disorders and several medical comorbidities.Conclusions:Nearly 1 in 10 admissions for depression in Ontario, Canada, involve ECT. Many clinical factors associated with receiving inpatient ECT were concordant with clinical guidelines; however, nonclinical factors associated with its use warrant investigation of their impact on equitable access to ECT.     

The Canadian 24-Hour Movement Guidelines and Psychological Distress among Adolescents: Les Directives canadiennes en matière de mouvement sur 24 heures et la détresse psychologique chez les adolescents

Objective:The Canadian 24-Hour Movement Guidelines for Children and Youth recommend at least 60 minutes of physical activity per day, 2 hours or less of recreational screen time per day, and 9 to 11 hours of sleep per night for 5 to 13 years old and 8 to 10 hours per night for 14 to 17 years old. This study examined the association between meeting these guidelines and psychological distress among adolescents.Methods:The present cross-sectional sample included 6,364 students aged 11 to 20 years from the 2017 Ontario Student Drug Use and Health Survey. This provincially representative school-based survey is based on a 2-stage cluster design. A confirmatory factor analysis (CFA) was first conducted to confirm the factor structure of the K6, and structural equation modeling adjusted for age, sex, ethnoracial background, subjective socioeconomic status, and body mass index z-score was used to investigate the association between meeting the 24-Hour Movement Guidelines and K6 factors among adolescents.Results:The CFA demonstrated that a 2-factor model (representing anxiety and depressive symptoms) of the K6 fit the data well. The anxiety and depression items demonstrated a composite reliability (Cronbach’s α) of 0.86 and 0.83, respectively, indicating a high level of internal consistency. Compared to meeting none of the recommendations, meeting all 3 movement behavior recommendations was associated with lower anxiety (β = −0.076; P = 0.028) and depressive symptoms (β = −0.067; P = 0.028). Meeting the screen time + sleep duration recommendations had the strongest association with anxiety (β = −0.157; P < 0.001) and depressive symptoms (β = −0.139; P < 0.001), followed by meeting the sleep duration recommendation only for both anxiety (β = −0.135; P < 0.001) and depressive symptoms (β = −0.106; P < 0.001).Conclusions:Meeting the 24-Hour Movement Guidelines was associated with lower anxiety and depressive symptoms among adolescents, and these associations appear mainly driven by meeting the sleep duration recommendation.     

The Impact of the COVID-19 Pandemic on the Mental Health of First-Year Undergraduate Students Studying at a Major Canadian University: A Successive Cohort Study

ObjectiveTo examine the impact of the COVID-19 pandemic on first year undergraduate student mental health.MethodsAs part of the Queen’s University U-Flourish Student Well-Being and Academic Success study, three successive cohorts of students entering undergraduate studies in 2018 (pre-pandemic), 2019 (transitional), and 2020 (during pandemic) completed electronic surveys at entry and completion of first year. Validated self-report measures were used to assess mental health status including symptom levels of anxiety, depression, and insomnia, self-harm and frequency of substance use. Propensity matching and multivariable log-binomial regression were used in comparisons of mental health indicators across the cohorts.ResultsClinically significant symptoms of depression, anxiety, insomnia, and self-harm were reported more frequently in the 2020–2021 cohort, coincident with remote learning and pandemic restrictions. In female students, screen positive rates for anxiety and depression, and suicidal ideation increased from about one-third to just under one-half in association with the pandemic (χ², p < .01), while increases in mental health concerns were less pronounced among males. Among females, increases in clinically significant symptoms over first year appeared greatest during the pandemic year, while striking decreases in alcohol consumption in both females and males were reported in that same year. Studying under pandemic conditions had a negative impact on student well-being, social relationships and school connectedness, quality of learning experience, leisure activities, and optimism about future prospects.ConclusionsMental health concerns including anxiety, depression and sleep problems increased in first year students during the pandemic, especially among females, while alcohol use declined. These findings highlight the negative mental health impact associated with studying under pandemic restrictions involving remote learning and social distancing.     

Postsecondary Mental Health Policy in Canada: A Scoping Review of the Grey Literature: Politique de santé mentale post-secondaire au Canada: un examen de la portée de la littérature grise

Objective:Concerns surrounding the mental health and well-being of Canadian postsecondary students have increased in recent years, with data suggesting increases in the prevalence of self-reported stress and psychological distress. Strategies to address postsecondary mental health have emerged at the national, provincial, and institutional levels. While reviews of the academic literature on the subject have been conducted, a detailed review of the grey literature has not. The objective of this study was to map the current state of grey literature related to current or recommended action supporting postsecondary mental health and well-being in Canada, with a focus on policy documents and guiding frameworks.Methods:We conducted a review following Arksey and O’Malley’s 5-step framework for scoping reviews, as well as the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Our search was restricted to documents with a primary focus on postsecondary mental health, a national or provincial scope, and publication date between 2000 and 2019.Results:While a national policy or guiding framework applicable to all postsecondary institutions across Canada does not yet exist, recommendations for policy at both the national and provincial levels were well aligned, emphasizing the need for a comprehensive approach to addressing mental health services through the use of a whole-campus approach that encompasses both upstream and downstream services.Conclusion:Postsecondary sector stakeholders should consider how existing policy documents and guiding frameworks can be used to inform evidence-based, institutionally specific action on postsecondary mental health. More work is required to align the fragmented action occurring across Canada and incentivize postsecondary institutions to create a sustainable, effective strategy to address the increasingly complex and unique mental health needs of their students, staff, and faculty.     

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.     

Greater Arterial Stiffness in Children with or without Second-generation Antipsychotic Treatment for Mental Health Disorders: Rigidité Artérielle Plus Importante Chez Les Enfants Avec ou Sans Traitement Par Antipsychotiques de la Deuxième Génération Pour des Troubles de Santé Mentale

Objective:Second-generation antipsychotics (SGAs) are used for a variety of mental disorders and are associated with cardiometabolic side effects in children. The objective of this study was to assess the cardiovascular health of children with mental disorders that are SGA-treated or SGA-naive.Methods:SGA-treated (n = 47) or SGA-naive (n = 37) children (aged 6 to 18 years) with mental disorders and control children (n = 83, no mental disorder) underwent assessment for cardiac function and morphology by echocardiography, aortic pulse wave velocity (PWV), and carotid intima-media thickness (cIMT). Body mass index (BMI) z-scores, waist circumference z-scores, systolic and diastolic blood pressure (BP) percentiles for height and sex, and fasting plasma glucose, insulin, triglycerides, and cholesterol were also assessed. Differences between SGA-treated, SGA-naive, and control children were assessed by linear and log-linear regression models.Results:SGA-treated children had greater BMI z-scores and overweight/obesity (BMI ≥ 85th percentile for age and sex) and hypertension than SGA-naive and control children. The PWV geometric mean was 11.1% higher in SGA-treated (95%CI, 3.95 to 18.77) and 12.9% higher in SGA-naive children (95% CI, 5.60 to 20.59) compared to controls in models adjusted for age, sex, BMI, and systolic BP percentile. Left ventricular (LV) end-diastolic dimension/body surface area (BSA), LV end-systolic dimension/BSA, and LV ejection fraction were lower in SGA-treated and SGA-naive children compared to controls in models adjusted for sex and age.Conclusions:Children with mental disorders have greater arterial stiffness and altered cardiac structure/function than children with no mental health diagnosis. SGA treatment in children is not associated with alterations in cardiovascular structure/function.     

Effect of COVID-19 on mental health among the young population in Lebanon

BackgroundCOVID-19 is a global pandemic that has raised worldwide public health concerns. The wide spread of the virus has led to unprecedented disturbance to regular life for people around the globe and impacted their mental health.AimsThe aims of the current study were to investigate the prevalence of psychiatric symptoms related to insomnia, depression, and anxiety, and identify risk factors contributing to psychological stress in Lebanese young population during COVID-19 pandemic.MethodA cross-sectional study was done on the Lebanese young population. Participants were 4397 males and females aged 18 to 35 years who filled a self-administered online questionnaire. Three validated scales were used to measure the mental health status of the participants during the COVID-19 pandemic: 7-item Insomnia Severity Index for insomnia, the Patient Health Questionnaire 9-item depression module for depression, and the 7-item Generalized Anxiety Disorder scale for anxiety.ResultsThe median interquartile range scores for anxiety, insomnia, and depression, were 8 (4–13), 10 (5–14), and 9 (5–12) respectively. Higher anxiety scores were reported with female gender (P < 0.001) and alcohol usage (P = 0.04). Moderate to severe insomnia was associated with single (P = 0.02) and divorced marital status (P = 0.003), university education (P < 0.001), consumption of caffeinated beverages (P = 0.02) and energy drinks (P = 0.03). Higher depression scores were associated with status of being the only person working at home (P = 0.01), family income more than 500 USD (P = 0.008), multiple insurance plans (P = 0.01), and contact with a confirmed COVID-19 case (P = 0.01).ConclusionsThe findings of this study demonstrate the considerable impact of COVID-19 pandemic and lockdown on Lebanese young population's mental status such as anxiety, depression and insomnia. Further follow-up studies are warranted to assess the long-term mental effects that can be imposed by the pandemic.     

Real versus illusory personal growth in response to COVID-19 pandemic stressors

BackgroundThere is considerable evidence of widespread emotional distress associated with the COVID-19 pandemic. A growing number of studies have assessed posttraumatic growth related to the current pandemic; but, none have considered whether reported growth is real or illusory (i.e., characterized by avoidant or defensive coping that results in higher levels of distress). The purpose of this study was to extend this literature by assessing growth specific to the pandemic in people reporting high levels of COVID-related stress and estimating the extent of real and illusory COVID-19-related growth.MethodsParticipants were 893 adults from Canada and the United States with high levels of COVID-related stress who provided complete responses on measures of posttraumatic growth, disability, and measures of general and COVID-related distress as part of a larger longitudinal survey.ResultsApproximately 77 % of participants reported moderate to high growth in at least one respect, the most common being developing greater appreciation for healthcare workers, for the value of one’s own life, for friends and family, for each day, as well as changing priorities about what is important in life and greater feelings of self-reliance. Consistent with predictions, cluster analysis identified two clusters characterized by high growth, one comprising 32 % of the sample and reflective of real growth (i.e., reporting little disability and stable symptoms across time) and the other comprising 17 % of the sample and reflective of illusory growth (i.e., reporting high disability and worsening symptoms). These clusters did not differ in terms of socially desirable response tendencies; but, the illusory growth cluster reported greater increases in alcohol use since onset of the pandemic.ConclusionConsistent with research regarding personal growth in response to prior pandemics and COVID-19, we found evidence to suggest moderate to high levels of COVID-related growth with respect to appreciation for healthcare workers, life, friends and family, and self-reliance. Findings from our cluster analysis support the thesis that many reports of COVID-related personal growth reflect ineffectual pandemic-related coping as opposed to true growth. These findings have important implications for developing strategies to optimize stress resilience and posttraumatic growth during chronically stressful events such as pandemics.     

Insomnia,anxiety, and depression during the COVID-19 pandemic: an international collaborative study

Importance and study objectiveThe COVID-19 pandemic has produced unprecedented changes in social, work, and leisure activities, which all have had major impact on sleep and psychological well-being. This study documented the prevalence of clinical cases of insomnia, anxiety, and depression and selected risk factors (COVID-19, confinement, financial burden, social isolation) during the first wave of the pandemic in 13 countries throughout the world.Design and participantsInternational, multi-center, harmonized survey of 22 330 adults (mean age = 41.9 years old, range 18–95; 65.6% women) from the general population in 13 countries and four continents. Participants were invited to complete a standardized web-based survey about sleep and psychological symptoms during the first wave of the COVID-19 pandemic from May to August 2020.ResultsClinical insomnia symptoms were reported by 36.7% (95% CI, 36.0–37.4) of respondents and 17.4% (95% CI, 16.9–17.9) met criteria for a probable insomnia disorder. There were 25.6% (95% CI, 25.0–26.2) with probable anxiety and 23.1% (95% CI, 22.5–23.6) with probable depression. Rates of insomnia symptoms (>40%) and insomnia disorder (>25%) were significantly higher in women, younger age groups, and in residents of Brazil, Canada, Norway, Poland, USA, and United Kingdom compared to residents from Asian countries (China and Japan, 8% for disorder and 22%–25% for symptoms) (all Ps < 0.01). Proportions of insomnia cases were significantly higher among participants who completed the survey earlier in the first wave of the pandemic relative to those who completed it later. Risks of insomnia were higher among participants who reported having had COVID-19, who reported greater financial burden, were in confinement for a period of four to five weeks, and living alone or with more than five people in same household. These associations remained significant after controlling for age, sex, and psychological symptoms.Conclusion and relevanceInsomnia, anxiety, and depression were very prevalent during the first wave of the COVID-19 pandemic. Public health prevention programs are needed to prevent chronicity and reduce long-term adverse outcomes associated with chronic insomnia and mental health problems.     

A Longitudinal Cohort Study of Youth Mental Health and Substance use Before and During the COVID-19 Pandemic in Ontario,Canada: An Exploratory Analysis

BackgroundYouth mental health appears to have been negatively impacted by the COVID-19 pandemic. The impact on substance use is less clear, as is the impact on subgroups of youth, including those with pre-existing mental health or substance use challenges.ObjectiveThis hypothesis-generating study examines the longitudinal evolution of youth mental health and substance use from before the COVID-19 pandemic to over one year into the pandemic among youth with pre-existing mental health or substance use challenges.MethodA total of 168 youth aged 14–24 participated. Participants provided sociodemographic data, as well as internalizing disorder, externalizing disorder, and substance use data prior to the pandemic’s onset, then every two months between April 2020–2021. Linear mixed models and Generalized Estimating Equations were used to analyze the effect of time on mental health and substance use. Exploratory analyses were conducted to examine interactions with sociodemographic and clinical characteristics.ResultsThere was no change in internalizing or externalizing disorder scores from prior to the pandemic to any point throughout the first year of the pandemic. Substance use scores during the pandemic declined compared to pre-pandemic scores. Exploratory analyses suggest that students appear to have experienced more mental health repercussions than non-students; other sociodemographic and clinical characteristics did not appear to be associated with mental health or substance use trajectories.ConclusionsWhile mental health remained stable and substance use declined from before the COVID-19 pandemic to during the pandemic among youth with pre-existing mental health challenges, some youth experienced greater challenges than others. Longitudinal monitoring among various population subgroups is crucial to identifying higher risk populations. This information is needed to provide empirical evidence to inform future research directions.