Linking Age, COVID-19 & First Episodes Psychosis

Research Paper Title

Impact of the first Covid-19 pandemic wave on first episode psychosis in Milan, Italy.

Background

The ongoing Corona Virus Disease 2019 (COVID-19) pandemic appears to increase risk for mental illness, either directly due to inflammation caused by the virus or indirectly due to related psychosocial stress, resulting in the development of both anxious-depressive and psychotic symptoms.

The purpose of the present study was to assess the frequency and characteristics of all patients with First Episodes Psychosis (FEP) without COVID-19 infection hospitalised in the first four months since lockdown in Milan.

Methods

The researchers recruited sixty-two patients hospitalised between 08 March to 08 July 2020 versus those first hospitalised in the same period in 2019.

The two subgroups were compared for sociodemographic variables and clinical characteristics of the episodes.

Results

Patients with FEP in 2020 were significantly older than patients with FEP in 2021, and presented with significantly less substances abuse.

Interestingly, patients presenting with FEP in 2020 were significantly older than patients with FEP in 2019.

Conclusions

These data are compatible with the greater vulnerability to stressful factors during the pandemic, as well as with the greater concern regarding a possible COVID-19 infection producing brain damage causing the FEP.

Reference

Esposito, C.M., D’Agostino, A., Osso, B.D., Fiorentini, A., Prunas, C., Callari, A., Oldani, L., Fontana, E., Gargano, G., Viscardi, B., Giordano, B., D’Angelo, S., Widenmann, F., Macellaro, M., Giorgetti, F., Turtulici, N., Gambini, O. & Brambilla, P. (2021) Impact of the first Covid-19 pandemic wave on first episode psychosis in Milan, Italy. Psychiatry Research. doi: 10.1016/j.psychres.2021.113802. Online ahead of print.

What are the Challenges to Engaging in Late-Life Mental Health Research?

Research Paper Title

Engaging in Late-Life Mental Health Research: a Narrative Review of Challenges to Participation.

Background

This narrative review seeks to ascertain the challenges older patients face with participation in mental health clinical research studies and suggests creative strategies to minimise these obstacles.

Recent Findings

Challenges to older adults’ engagement in mental health research include practical, institutional, and collaboration-related barriers applicable to all clinical trials as well as more personal, cultural, and age-related patient barriers specific to geriatric mental health research.

Universal research challenges include:

  1. Institutional barriers of lack of funding and researchers, inter-researcher conflict, and sampling bias;
  2. Collaboration-related barriers involving miscommunication and clinician concerns; and
  3. Practical patient barriers such as scheduling issues, financial constraints, and transportation difficulties.

Challenges unique to geriatric mental health research include:

  1. Personal barriers such as no perceived need for treatment, prior negative experience, and mistrust of mental health research;
  2. Cultural barriers involving stigma and lack of bilingual or culturally matched staff; and
  3. Chronic medical issues and concerns about capacity.

Summary

Proposed solutions to these barriers include increased programmatic focus on and funding of geriatric psychiatry research grants, meeting with clinical staff to clarify study protocols and eligibility criteria, and offering transportation for participants.

To minimise stigma and mistrust of psychiatric research, studies should devise community outreach efforts, employ culturally competent bilingual staff, and provide patient and family education about the study and general information about promoting mental health.

Reference

Newmark, J., Gebara, M.A., Aizenstein, H. & Karp, J. (2020) Engaging in Late-Life Mental Health Research: a Narrative Review of Challenges to Participation. Current Treatment Options in Psychiatry. doi: 10.1007/s40501-020-00217-9. Online ahead of print.

Feeling Sad: Have Kids, then Move Them Out!

When it comes to who is happier, people with kids or those without, most research points to the latter.

Now it seems that parents are happier than their peers later in life – when their children move out.

Most surveys of parental happiness have focused on those whose children still live at home. These tend to show that people with kids are less happy than their child-free peers because they have less free time, sleep and money.

Christoph Becker at Heidelberg University in Germany and his colleagues wondered if the story might be different for parents whose kids have left home.

To find out, they analysed data from a European survey that asked 55,000 people aged 50 and older about their emotional well-being.

They found that those with children had greater life satisfaction and fewer symptoms of depression than people without children, but only if their kids had left home (Becker, Kirchmaier & Trautmann, 2019).

This may be because when children grow up and move out they provide social enrichment to their parents minus the day-to-day stress of looking after them (Becker, Kirchmaier & Trautmann, 2019). The researchers also believe they may also give something back by providing care and financial support to their parents.

The picture is similar in the US, says Nicholas Wolfinger at the University of Utah. He recently analysed 40 years of data and found that empty-nest parents aged 50 to 70 were 5-6% more likely to report being very happy than those with kids still at home.

If parents baulk at the idea of waiting for their kids to move out to maximise their potential happiness, they could move to a country with better childcare support, says Wolfinger.

A 2016 study found that parents with children at home were slightly happier than their child-free peers if they lived in places that have paid parental leave, generous childcare subsidies and holiday and sick leave, like Norway, Portugal and Sweden.

Reference

Becker, C., Kirchmaier, I. & Trautmann, S.T. (2019) Marriage, parenthood and social network: Subjective well-being and mental health in old age. PLOS One. https://doi.org/10.1371/journal.pone.0218704.