What is the Prevalence of Psychological Disorders in the COVID-19 Epidemic in China?

Research Paper Title

Prevalence of psychological disorders in the COVID-19 epidemic in China: A real world cross-sectional study.

Background

This study aimed to explore the prevalence of psychological disorders and associated factors at different stages of the COVID-19 epidemic in China.

Methods

The mental health status of respondents was assessed via the Patient Health Questionnaire-9 (PHQ-9), Insomnia Severity Index (ISI) and the Generalised Anxiety Disorder 7 (GAD-7) scale.

Results

5,657 individuals participated in this study. History of chronic disease was a common risk factor for severe present depression (OR 2.2, 95% confidence interval [CI], 1.82-2.66, p < 0.001), anxiety (OR 2.41, 95% CI, 1.97-2.95, p < 0.001), and insomnia (OR 2.33, 95% CI, 1.83-2.95, p < 0.001) in the survey population. Female respondents had a higher risk of depression (OR 1.61, 95% CI, 1.39-1.87, p < 0.001) and anxiety (OR 1.35, 95% CI, 1.15-1.57, p < 0.001) than males. Among the medical workers, confirmed or suspected positive COVID-19 infection as associated with higher scores for depression (confirmed, OR 1.87; suspected, OR 4.13), anxiety (confirmed, OR 3.05; suspected, OR 3.07), and insomnia (confirmed, OR 3.46; suspected, OR 4.71).

Limitations

The cross-sectional design of present study presents inference about causality. The present psychological assessment was based on an online survey and on self-report tools, albeit using established instruments. The researchers cannot estimate the participation rate, since they cannot know how many potential subjects received and opened the link for the survey.

Conclusions

Females, non-medical workers and those with a history of chronic diseases have had higher risks for depression, insomnia, and anxiety. Positive COVID-19 infection status was associated with higher risk of depression, insomnia, and anxiety in medical workers.

Reference

Wang, M., Zhao, Q., Hu, C., Wang, Y., Cao, J., Huang, S., Li, J., Huang, Y., Liang, Q., Guo, Z., Wang, L., Ma, L., Zhang, S., Wang, H., Ahu, C., Luo, W., Guo, C., Chen, C., Chen, Y., Xu, K., Yang, H., Ye, L., Wang, Q., Zhan, P., Li, G., Yang, M.J., Fang, Y., Zhu, S. & Yang, Y. (2020) Prevalence of psychological disorders in the COVID-19 epidemic in China: A real world cross-sectional study. Journal of Affective Disorders. 281, pp.312-320. doi: 10.1016/j.jad.2020.11.118. Online ahead of print.

Book: New Handbook of Mathematical Psychology – Volume 02

Book Title:

New Handbook of Mathematical Psychology – Volume 02: Modelling and Measurement.

Author(s): William H. Batchelder, Hans Colonius, and Ehtibar N. Dzhafarov (Editors).

Year: 2018.

Edition: First (1st).

Publisher: Cambridge University Press.

Type(s): Hardcover and Kindle.

Synopsis:

The field of mathematical psychology began in the 1950s and includes both psychological theorizing, in which mathematics plays a key role, and applied mathematics motivated by substantive problems in psychology.

Central to its success was the publication of the first Handbook of Mathematical Psychology in the 1960s. The psychological sciences have since expanded to include new areas of research, and significant advances have been made in both traditional psychological domains and in the applications of the computational sciences to psychology.

Upholding the rigor of the original Handbook, the New Handbook of Mathematical Psychology reflects the current state of the field by exploring the mathematical and computational foundations of new developments over the last half-century.

The second volume focuses on areas of mathematics that are used in constructing models of cognitive phenomena and decision making, and on the role of measurement in psychology.

Book: New Handbook of Mathematical Psychology – Volume 01

Book Title:

New Handbook of Mathematical Psychology – Volume 01: Foundation and Methodology.

Author(s): William H. Batchelder, Hans Colonius, Ehtibar N. Dzhafarov, and Jay Myung (Editors).

Year: 2016.

Edition: First (1st), Illustrated Edition.

Publisher: Cambridge University Press.

Type(s): Hardcover, Paperback and Kindle.

Synopsis:

The field of mathematical psychology began in the 1950s and includes both psychological theorising, in which mathematics plays a key role, and applied mathematics, motivated by substantive problems in psychology.

Central to its success was the publication of the first Handbook of Mathematical Psychology in the 1960s. The psychological sciences have since expanded to include new areas of research, and significant advances have been made in both traditional psychological domains and in the applications of the computational sciences to psychology.

Upholding the rigor of the first title in this field to be published, the New Handbook of Mathematical Psychology reflects the current state of the field by exploring the mathematical and computational foundations of new developments over the last half-century.

This first volume focuses on select mathematical ideas, theories, and modeling approaches to form a foundational treatment of mathematical psychology.

Book: The Everyday Ayurveda Guide to Self-Care

Book Title:

The Everyday Ayurveda Guide to Self-Care – Rhythms, Routines, and Home Remedies for Natural Healing.

Author(s): Kate O’Donnell.

Year: 2020.

Edition: First (1st).

Publisher: Shambhala Publications Inc.

Type(s): Paperback and Kindle.

Synopsis:

Embrace the ancient principles of Ayurveda to become a more integrated, whole, and healthy version of yourself. This detailed guide walks you through the steps of foundational Ayurvedic practices that can be easily integrated into your existing self-care routine – from self-massage, oil pulling, and tongue scraping to breathing practices, meditation exercises, and eating with intention – to uplift your physical health and state of mind.

In The Everyday Ayurveda Guide to Self-Care, you will:

  • Get acquainted with the tradition of Ayurveda and better understand your doshas (metabolic tendencies) and basic Ayurvedic anatomy.
  • Discover the art of self-care by exploring daily routines and seasonal practices to prevent imbalances in the body and mind.
  • Find out what foods, spices, and herbs carry medicinal qualities that support cleansing, rejuvenation, and management of common ailments.

COVID-19 and the Role of Primary Care in Suicide Prevention

Research Paper Title

Role of Primary Care in Suicide Prevention During the COVID-19 Pandemic.

Background

Primary care providers have an important role in suicide prevention, knowing that among people who die by suicide, 83% have visited a primary care provider in the prior year, and 50% have visited that provider within 30 days of their death, rather than a psychiatrist.

The psychosocial impact of the coronavirus disease 2019 pandemic poses increased risk for suicide and other mental health disorders for months and years ahead.

This article focuses on screening tools, identification of the potentially suicidal patient in the primary care setting, and a specific focus on suicide prevention during widespread, devastating events, such as a pandemic.

Reference

Nelson, P.A. & Adams, S.M. (2020) Role of Primary Care in Suicide Prevention During the COVID-19 Pandemic. The Journal for Nurse Practitioners. doi: 10.1016/j.nurpra.2020.07.015. Online ahead of print.

Psychological Distress & Loneliness

In a survey of almost 1,500 US adults, McGinty and colleagues (2020) studied levels of psychological distress using the Kessler scale and levels of loneliness.

They compared the distress levels with national data from 2018. In 2018, the prevalence of serious psychological distress was 3.9%. In April 2020 it was 13.6%.

The authors note a worrying implication of these findings – that, since the Kessler scale is predictive of serious mental illness, the distress during the pandemic could transfer to longer term psychiatric disorders.

This is not outside the realms of possibility, especially since the social and economic impact of the pandemic is expected to be felt for years to come.

The authors should be commended both for their methodology and for their upfront discussion of its limitations – namely the potential for sampling bias.

People might have been more likely to respond to such a survey in April 2020 compared with 2018; therefore, the 2020 figures could be an overestimate.

Reference

McGinty, E.E., Presskreischer, R., Han, H. & Barry, C.L. (2020) Psychological Distress and Loneliness Reported by US Adults in 2018 and April 2020. JAMA. 324(1), pp.93-94. doi:10.1001/jama.2020.9740.

Mental Health and Stress in Humanitarian Expatriates.

Research Paper Title

Mental Health and Stress in Humanitarian Expatriates.

Background

Humanitarian work is stressful and can have an impact on the mental health of humanitarian expatriates.

In order to reduce stress and its consequences, humanitarian organisations are implementing various measures to keep their staff healthy.

Humanitarian workers, on the other hand, must take care of themselves and apply self-protection mechanisms. Most humanitarian workers are doing well.

The treating doctor plays a key role in detecting people and behaviour at risk. they encourage the expatriate to use their resources and provide the adequate support and medical follow-up if necessary.

Collaboration with the staff health units of humanitarian organisations allows for optimal care of humanitarian workers’ medical conditions.

Reference

Perone, S.A., BAvarel, M., Suzic, D. & Chappuis, F. (2020) [Mental Health and Stress in Humanitarian Expatriates] [Article in French]. Revue Medicale Suisse. 16(693), pp.993-997.

What are the Perceptions of Mental Health and Perceived Barriers to Mental Health Help-Seeking Amongst Refugees?

Research Paper Title

Perceptions of Mental Health and Perceived Barriers to Mental Health Help-Seeking Amongst Refugees: A Systematic Review.

Background

Despite elevated rates of psychological disorders amongst individuals from a refugee background, levels of mental health help-seeking in these populations are low.

There is an urgent need to understand the key barriers that prevent refugees and asylum-seekers from accessing help for psychological symptoms.

This review synthesises literature examining perceptions of mental health and barriers to mental health help-seeking in individuals from a refugee background.

The researchers analysis, which complies with PRISMA reporting guidelines, identified 62 relevant studies.

Methods

Data extraction and thematic analytic techniques were used to synthesise findings from quantitative (n = 26) and qualitative (n = 40) studies.

Results

They found that the salient barriers to help-seeking were:

  • Cultural barriers, including mental health stigma and knowledge of dominant models of mental health;
  • Structural barriers, including financial strain, language proficiency, unstable accommodation, and a lack of understanding of how to access services, and
  • Barriers specific to the refugee experience, including immigration status, a lack of trust in authority figures and concerns about confidentiality.

Conclusions

The researchers discuss and contextualise these key themes and consider how these findings can inform the development of policies and programmes to increase treatment uptake and ultimately reduce the mental health burden amongst refugees and asylum-seekers.

Reference

Byrow, Y., Pajak, R., Specker, P. & Nickerson, A. (2020) Perceptions of Mental Health and Perceived Barriers to Mental Health Help-Seeking Amongst Refugees: A Systematic Review. Clinical Psychology Review. 75:101812. doi: 10.1016/j.cpr.2019.101812. Epub 2019 Dec 24.

Mental Health & COVID-19: Psychological Impacts that Merit Consideration now Rather than Later

Research Paper Title

Mental health in the COVID-19 pandemic.

Background

During any outbreak of an infectious disease, the population’s psychological reactions play a critical role in shaping both spread of the disease and the occurrence of emotional distress and social disorder during and after the outbreak. Despite this fact, sufficient resources are typically not provided to manage or attenuate pandemics’ effects on mental health and well-being. While this might be understandable in the acute phase of an outbreak, when health systems prioritise testing, reducing transmission and critical patient care, psychological and psychiatric needs should not be overlooked during any phase of pandemic management.

There are many reasons for this. It is known that psychological factors play an important role in adherence to public health measures (such as vaccination) and in how people cope with the threat of infection and consequent losses. These are clearly crucial issues to consider in the management of any infectious disease, including COVID-19. Psychological reactions to pandemics include maladaptive behaviours, emotional distress and defensive responses. People who are prone to psychological problems are especially vulnerable.

All of these features are in clear evidence during the current COVID-19 pandemic. One study of 1,210 respondents from 194 cities in China in January and February 2020 found that:

  • 54% of respondents rated the psychological impact of the COVID-19 outbreak as moderate or severe;
  • 29% reported moderate to severe anxiety symptoms; and
  • 17% reported moderate to severe depressive symptoms.

Notwithstanding possible response bias, these are very high proportions – and it is likely that some people are at even greater risk. During the 2009 H1N1 influenza outbreak (‘swine flu’), a study of mental health patients found that children and patients with neurotic and somatoform disorders were significantly over-represented among those expressing moderate or severe concerns.

Against this background, and as the COVID-19 pandemic continues to spread around the world, the authors hypothesise a number of psychological impacts that merit consideration now rather than later.

In the first instance, it should be recognised that, even in the normal course of events, people with established mental illness have a lower life expectancy and poorer physical health outcomes than the general population. As a result, people with pre-existing mental health and substance use disorders will be at increased risk of infection with COVID-19, increased risk of having problems accessing testing and treatment and increased risk of negative physical and psychological effects stemming from the pandemic.

Second, we anticipate a considerable increase in anxiety and depressive symptoms among people who do not have pre-existing mental health conditions, with some experiencing post-traumatic stress disorder in due course. There is already evidence that this possibility has been under-recognised in China during the current pandemic.

Third, it can be anticipated that health and social care professionals will be at particular risk of psychological symptoms, especially if they work in public health, primary care, emergency services, emergency departments and intensive or critical care. The World Health Organisation has formally recognised this risk to healthcare workers, so more needs to be done to manage anxiety and stress in this group and, in the longer term, help prevent burnout, depression and post-traumatic stress disorder.

There are several steps that can and should be taken now to minimise the psychological and psychiatric effects of the COVID-19 pandemic.

First, while it might be ostensibly attractive to re-deploy mental health professionals to work in other areas of healthcare, this should be avoided. Such a move would almost certainly worsen outcomes overall and place people with mental illness at disproportionate risk of deterioration in physical and mental health. If anything, this group needs enhanced care at this time.

Second, the authors recommend the provision of targeted psychological interventions for communities affected by COVID-19, particular supports for people at high risk of psychological morbidity, enhanced awareness and diagnosis of mental disorders (especially in primary care and emergency departments) and improved access to psychological interventions (especially those delivered online and through smartphone technologies). These measures can help diminish or prevent future psychiatric morbidity.

Finally, there is a need for particular focus on frontline workers including, but not limited to, healthcare staff. In the USA, the Centres for Disease Control and Prevention offer valuable advice for healthcare workers in order to reduce secondary traumatic stress reactions, including increased awareness of symptoms, taking breaks from work, engaging in self-care, taking breaks from media coverage and asking for help. This kind of advice needs to be underpinned by awareness of this risk among employers, enhanced peer-support and practical assistance for healthcare workers who find themselves exhausted, stressed and feeling excessive personal responsibility for clinical outcomes during what appears to be the largest pandemic of our times.

Even in this emergency circumstance, or especially in this emergency circumstance, we neglect mental health at our peril and to our long-term detriment.

Reference

Cullen, W., Gulati, G. & Kelly, B.D. (2020) Mental Health in the COVID-19 Pandemic. QJM: An International Journal of Medicine. 113(5), pp.311-312.

What Progression has there been of Mental Health Services During the COVID-19 Outbreak in China?

Research Paper Title

Progression of Mental Health Services During the COVID-19 Outbreak in China.

Background

The novel coronavirus disease (COVID-19) has been rapidly transmitted in China, Macau, Hong Kong, and other Asian and European counterparts.

This COVID-19 epidemic has aroused increasing attention nationwide.

Patients, health professionals, and the general public are under insurmountable psychological pressure which may lead to various psychological problems, such as anxiety, fear, depression, and insomnia.

Psychological crisis intervention plays a pivotal role in the overall deployment of the disease control.

The National Health Commission of China has summoned a call for emergency psychological crisis intervention and thus, various mental health associations and organisations have established expert teams to compile guidelines and public health educational articles/videos for mental health professionals and the general public alongside with online mental health services.

In addition, mental health professionals and expert groups are stationed in designated isolation hospitals to provide on-site services.

Experts have reached a consensus on the admission of patients with severe mental illness during the COVID-19 outbreak in mental health institutions.

Nevertheless, the rapid transmission of the COVID-19 has emerged to mount a serious challenge to the mental health service in China.

Reference

Wen, Li., Yuan, Yang., Zi-Han, Liu., Yan-Jie, Zhao., Qinge, Zhang., Ling, Zhang., Teris, Cheung. & Yu-Tao, Xiang. (2020) Progression of Mental Health Services During the COVID-19 Outbreak in China. International Journal of Biological Sciences. 16(10), pp.1732-1738. doi: 10.7150/ijbs.45120. eCollection 2020.