Understanding Canadian experiences of suicidality during the COVID-19 pandemic: protocol of a pan-Canadian qualitative study.

SummaryBackgroundBefore 2020, mental disorders were leading causes of the global health-related burden, with depressive and anxiety disorders being leading contributors to this burden. The emergence of the COVID-19 pandemic has created an environment where many determinants of poor mental health are exacerbated. The need for up-to-date information on the mental health impacts of COVID-19 in a way that informs health system responses is imperative. In this study, we aimed to quantify the impact of the COVID-19 pandemic on the prevalence and burden of major depressive disorder and anxiety disorders globally in 2020.MethodsWe conducted a systematic review of data reporting the prevalence of major depressive disorder and anxiety disorders during the COVID-19 pandemic and published between Jan 1, 2020, and Jan 29, 2021. We searched PubMed, Google Scholar, preprint servers, grey literature sources, and consulted experts. Eligible studies reported prevalence of depressive or anxiety disorders that were representative of the general population during the COVID-19 pandemic and had a pre-pandemic baseline. We used the assembled data in a meta-regression to estimate change in the prevalence of major depressive disorder and anxiety disorders between pre-pandemic and mid-pandemic (using periods as defined by each study) via COVID-19 impact indicators (human mobility, daily SARS-CoV-2 infection rate, and daily excess mortality rate). We then used this model to estimate the change from pre-pandemic prevalence (estimated using Disease Modelling Meta-Regression version 2.1 [known as DisMod-MR 2.1]) by age, sex, and location. We used final prevalence estimates and disability weights to estimate years lived with disability and disability-adjusted life-years (DALYs) for major depressive disorder and anxiety disorders.FindingsWe identified 5683 unique data sources, of which 48 met inclusion criteria (46 studies met criteria for major depressive disorder and 27 for anxiety disorders). Two COVID-19 impact indicators, specifically daily SARS-CoV-2 infection rates and reductions in human mobility, were associated with increased prevalence of major depressive disorder (regression coefficient [B] 0·9 [95% uncertainty interval 0·1 to 1·8; p=0·029] for human mobility, 18·1 [7·9 to 28·3; p=0·0005] for daily SARS-CoV-2 infection) and anxiety disorders (0·9 [0·1 to 1·7; p=0·022] and 13·8 [10·7 to 17·0; p<0·0001]. Females were affected more by the pandemic than males (B 0·1 [0·1 to 0·2; p=0·0001] for major depressive disorder, 0·1 [0·1 to 0·2; p=0·0001] for anxiety disorders) and younger age groups were more affected than older age groups (−0·007 [–0·009 to −0·006; p=0·0001] for major depressive disorder, −0·003 [–0·005 to −0·002; p=0·0001] for anxiety disorders). We estimated that the locations hit hardest by the pandemic in 2020, as measured with decreased human mobility and daily SARS-CoV-2 infection rate, had the greatest increases in prevalence of major depressive disorder and anxiety disorders. We estimated an additional 53·2 million (44·8 to 62·9) cases of major depressive disorder globally (an increase of 27·6% [25·1 to 30·3]) due to the COVID-19 pandemic, such that the total prevalence was 3152·9 cases (2722·5 to 3654·5) per 100 000 population. We also estimated an additional 76·2 million (64·3 to 90·6) cases of anxiety disorders globally (an increase of 25·6% [23·2 to 28·0]), such that the total prevalence was 4802·4 cases (4108·2 to 5588·6) per 100 000 population. Altogether, major depressive disorder caused 49·4 million (33·6 to 68·7) DALYs and anxiety disorders caused 44·5 million (30·2 to 62·5) DALYs globally in 2020.InterpretationThis pandemic has created an increased urgency to strengthen mental health systems in most countries. Mitigation strategies could incorporate ways to promote mental wellbeing and target determinants of poor mental health and interventions to treat those with a mental disorder. Taking no action to address the burden of major depressive disorder and anxiety disorders should not be an option.FundingQueensland Health, National Health and Medical Research Council, and the Bill and Melinda Gates Foundation.

The prevalence of major depressive disorder and anxiety disorders among asylum seekers in South Florida

The Critical Relationship Between Anxiety and Depression.

Global burden of anxiety, depression, and self-harm (1990-2021) and the impact of the COVID-19 pandemic.

To determine the prevalence of anxiety and depression in axial spondyloarthritis (SpA) patients by a psychiatrist using the Chinese-bilingual Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, fourth edition patient research version (CB-SCID-I/P), and to examine the effectiveness of the Hospital Anxiety and Depression Scale (HADS) as a screening tool. We recruited 160 Chinese axial-SpA patients to determine the prevalence of anxiety and depression using the CB-SCID-I/P. Recruited subjects were asked to complete the HADS. HADS, HADS-depression (HADS-D) subscale and HADS-anxiety (HADS-A) subscale were analyzed to determine their effectiveness in screening for depressive and anxiety disorders. The prevalence of current major depressive disorder (MDD) and anxiety disorder were 10.6% and 15.6%, respectively. The full-scale HADS outperformed the HADS-D subscale in screening for current MDD (area under the curve [AUC] 0.889; 0.844) and all depressive disorders (AUC 0.885; 0.862) while the HADS-A subscale outperformed the full scale HADS in screening for anxiety disorders (AUC 0.894; 0.846). The optimal cut-off point of the full scale HADS for screening current MDD and all depressive disorders were 7/8 and 6/7, yielding a sensitivity of 82.4% and 83.9%, specificity of 78.7% and 74.8%, respectively. The optimal cut-off point of HADS-A subscale for screening anxiety disorders was 6/7, yielding a sensitivity of 88.0% and specificity of 74.4%. The prevalence of MDD and anxiety disorder in SpA patients were 10.6% and 15.6%, respectively. We recommend using the full-scale HADS in screening for depressive disorders and HADS-A subscale for anxiety disorders.

Aims Healthcare systems have been rapidly restructured to meet COVID-19 demand. Clinicians are working to novel clinical guidelines, treating new patient cohorts and working in unfamiliar environments. Trauma and orthopaedics (T&amp;O) has experienced cancellation of routine clinics and operating, with redistribution of the workload and human resources. To date, no studies have evaluated the mental health impact of these changes on the T&amp;O workforce. We report the results of a novel survey on the impact of the pandemic on the mental health of our orthopaedic workforce and the contributory factors. Methods A 20-question survey-based cross-sectional study of orthopaedic team members was conducted during the COVID-19 pandemic. The primary objective was to identify the impact of the pandemic on mental health in the form of major depressive disorder (MDD) and general anxiety disorder (GAD). The survey incorporated the patient health questionnaire (PHQ-2), which is validated for screening of MDD, and the generalized anxiety disorder questionnaire (GAD-2), which is validated for screening of GAD. Results There were 62 respondents (18 females and 44 males). As compared to the general population, we noted a greater estimated prevalence of GAD (17.7% vs 5.9%, p = 0.0009297) and MDD (19.4% vs 3.3%, p = 0.0000007731). The prevalence of MDD symptoms was greatest among senior house officers (SHOs) (p = 0.02216). Female respondents scored higher for symptoms of MDD (p = 0.03583) and GAD (p = 0.0001086). Those identifying as ‘Black, African, Caribbean or Black British’ displayed a higher prevalence of GAD symptoms (p = 0.001575) and felt least supported at work (p = 0.001341). Conclusion Our study, in the first of its kind, shows a significant prevalence of GAD and MDD in the workforce. We found that SHOs, females and those of Black, African, Caribbean, or Black British origin were disproportionately affected. Action should be taken to help prevent adverse mental health outcomes for our colleagues during the pandemic. Cite this article: Bone Joint Open 2020;1-6:316–325.

AimsHealthcare systems have been rapidly restructured to meet COVID-19 demand. Clinicians are working to novel clinical guidelines, treating new patient cohorts and working in unfamiliar environments. Trauma and orthopaedics (T&O) has experienced cancellation of routine clinics and operating, with redistribution of the workload and human resources. To date, no studies have evaluated the mental health impact of these changes on the T&O workforce. We report the results of a novel survey on the impact of the pandemic on the mental health of our orthopaedic workforce and the contributory factors.MethodsA 20-question survey-based cross-sectional study of orthopaedic team members was conducted during the COVID-19 pandemic. The primary objective was to identify the impact of the pandemic on mental health in the form of major depressive disorder (MDD) and general anxiety disorder (GAD). The survey incorporated the patient health questionnaire (PHQ-2), which is validated for screening of MDD, and the generalized anxiety disorder questionnaire (GAD-2), which is validated for screening of GAD.ResultsThere were 62 respondents (18 females and 44 males). As compared to the general population, we noted a greater estimated prevalence of GAD (17.7% vs 5.9%, p = 0.0009297) and MDD (19.4% vs 3.3%, p = 0.0000007731). The prevalence of MDD symptoms was greatest among senior house officers (SHOs) (p = 0.02216). Female respondents scored higher for symptoms of MDD (p = 0.03583) and GAD (p = 0.0001086). Those identifying as ‘Black, African, Caribbean or Black British’ displayed a higher prevalence of GAD symptoms (p = 0.001575) and felt least supported at work (p = 0.001341).ConclusionOur study, in the first of its kind, shows a significant prevalence of GAD and MDD in the workforce. We found that SHOs, females and those of Black, African, Caribbean, or Black British origin were disproportionately affected. Action should be taken to help prevent adverse mental health outcomes for our colleagues during the pandemic.Cite this article: Bone Joint Open 2020;1-6:316–325.

The COVID-19 pandemic has intensified the global burden of mental disorders, yet the gap between observed and counterfactual burdens without the pandemic, especially for major depressive and anxiety disorders, remains unexplored. To assess this gap, including its impact on specific regions and populations, thereby guiding future mental health services and policy development. Data of age-standardized prevalence rate (ASPR), age-standardized incidence rate (ASIR) and age-standardized disability-adjusted life years rate (ASDR) for mental disorders from 1990 to 2021 were extracted from the Global Burden of Disease dataset. This study employed a counterfactual model that combines Autoregressive Integrated Moving Average and Long Short-Term Memory to assess the impact of the COVID-19 pandemic on the global burden of mental disorders by quantifying the difference between actual and predicted rates. In 2021, mental disorders were more prevalent in higher Social Development Index (SDI) regions such as the North Americas, and European region. During the COVID-19 pandemic (2020-2021), these regions, including countries like Denmark and the United States, saw significant increases in the ASPR, ASIR and ASDR of mental disorders, far exceeding predictions. Globally, the ASIR for men increased from a predicted 3917 to an observed 4435 per 100,000, while for women, it rose from a predicted 5497 to an observed 6382 per 100,000. Specific disorders like major depressive disorder and anxiety disorders showed even larger discrepancies, with ASPR of anxiety disorders exceeding predictions by 1135 and 1043 per 100,000 in Bolivia and Peru, respectively, and ASIR of major depressive disorder in Greenland surpassing predictions by 1156 per 100,000. The pandemic also had a significant impact on mental health across different age groups, with individuals aged 15–40 years experiencing the greatest increase in anxiety and major depressive disorders, particularly among women. In conclusion, during the COVID-19 pandemic, the global burden of mental disorders far exceeded the counterfactual predictions, with major depressive and anxiety disorders showing the largest increases. This underscores the pandemic’s severe impact on mental health and the urgent need for enhanced global mental health services, including ongoing evaluation and support.

PurposeCoronavirus disease 2019 (COVID-19) pandemic is the significant public health crisis of the 21st century that has disrupted personal, local, and international territorial relationships. Earlier studies have shown that people with HIV were at least twice at risk of dying from COVID-19 than the general population. There are also deep concerns about the indirect impact of COVID-19 on women within the reproductive age group in Sub-Saharan Africa who were already struggling to access reproductive healthcare services. In addition, pregnant HIV-positive women have an increased rate of anxiety and depression. This study, therefore, examined depression and anxiety disorders in pregnant HIV-positive women in response to the COVID-19 pandemic.Patients and MethodsThis cross-sectional study used a structured questionnaire containing sociodemographic information, Patient Health Questionnaire-9 (PHQ-9), and General Anxiety Disorder-7 (GAD-7) assessment tools. Data obtained were analyzed using Statistical Package for Social Science version 26.ResultsNinety-nine (99) representing 78% of 127 pregnant HIV-positive women enrolled in the PMTCT program were eligible for this study. This number matched 99 randomly selected pregnant HIV-negative in the study areas as controls. Major depressive disorder (MDD) and severe anxiety disorder were significantly higher among the HIV-positive group than in the HIV-negative group (PHQ-9 Mean ± SD 8.0 ± 5.4 vs 2.3 ± 2.9; p = 0.000) and (GAD-7 Mean ± SD 5.9 ± 4.6 vs 1.2 ± 2.2; p = 0.000).ConclusionGiven the high prevalence of major depressive disorder and severe anxiety disorder among pregnant HIV-positive women, mental health care should be incorporated into the prevention with positive interventions and strategies to reduce the indirect consequences of the COVID-19 pandemic.

Factors Associated With College Students' Mental Health During the COVID-19 Pandemic Krista M. Soria (bio) and Bonnie Horgos (bio) In December 2019, an outbreak of severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), the virus that causes coronavirus disease (COVID-19), was first reported in China. By March 11, 2020, the World Health Organization declared COVID-19 a global pandemic, forcing many higher education institutions to take measures to promote students' safety. The COVID-19 pandemic continues to upend the lives of students in higher education institutions. In particular, the pandemic has had deleterious effects on students' mental health, leading to increased prevalence of major depressive disorder (MDD) and generalized anxiety disorder (GAD; Healthy Minds Network & American College Health Association [HMN], 2020). Students' mental health has become a paramount concern to institutional leaders: over 90% of college presidents expressed concern about students' mental health during the pandemic (Lederman, 2020). As faculty, student affairs practitioners, administrators, and mental health providers brace for the impact of increasing numbers of students who experience mental health disorders in upcoming semesters, they may benefit from an enhanced understanding of the students who are likely to experience mental health disorders and of the roles that other stressors or supports can play in students' mental health. The unique context surrounding the pandemic may create conditions that alter previous research findings related to students' mental health; therefore, we designed this study to examine the associations between individual, interpersonal, institutional, health, and stress-related factors and undergraduates' risks for clinically significant MDD and GAD. MENTAL HEALTH DISORDERS AMONG COLLEGE STUDENTS Even before the pandemic, the frequency of college students' mental health disorders was increasing at an alarming rate. Recent estimates indicate that 31% of students experienced GAD and 41% experienced MDD during the pandemic (HMN, 2020). College students are a particularly vulnerable group when it comes to their risk for mental health disorders, many of which first present themselves in late adolescence and early adulthood (Liu et al., 2020). Some of the variables associated with college students' mental health can be grouped into five broad categories: (a) individual characteristics (e.g., gender and sexual orientation), (b) interpersonal factors (e.g., sense of belonging), (c) institutional factors (e.g., perceptions of a supportive environment), (d) health and safety factors (e.g., nutrition and sleep), and, (e) stressors (e.g., financial and academic; Fink, 2014; [End Page 236] Oswalt & Wyatt, 2011). The unique conditions surrounding the COVID-19 pandemic might exacerbate the effects of some of the aforementioned factors on students' MDD and GAD. While emerging studies on college students' mental health during the COVID-19 pandemic present useful information to practitioners, the majority of those studies are limited because of small sample sizes, single-institution samples, or a limited number of independent variables (Huckins et al., 2020; Liu et al., 2020). We examined a wide variety of factors associated with college students' rates of MDD and GAD with variables specific to students' experiences during the pandemic; our sample was drawn from 8 large, public research universities; and, our sample size allowed us to examine the effects among demographic groups typically excluded in studies because of their small numbers. CONCEPTUAL FRAMEWORK We drew from Fink's (2014) integrated model of college students' mental health, which combines Astin's (1993) input–environment–outcome model, the VicHealth framework (Keheler & Armstrong, 2005), and Keyes's (2002) mental health continuum. Fink examined the effects of students' individual characteristics, interpersonal factors, and institutional factors on students' mental health. We extended Fink's framework by adding stressors that we theorized would impact students' mental health, including health and safety factors and financial and academic stressors. METHOD Instrument and Sample We used the Student Experience in the Research University (SERU) COVID-19 survey, developed by members of the SERU Consortium. Eight large, public research universities located in different regions of the US administered the census survey in June and July 2020. The response rates ranged from 13% to 30%, 90% of students answered all items in the survey; we excluded responses with missing data, and the final sample was N = 27,118. Detailed information about the sample is available in Table 1. Measures Our individual measures include...

Prevalence of mental, neurological, and substance use disorders in China and India: a systematic analysis

The association between widowhood and mental health problems, such as depressive symptomatology and anxiety, has been examined extensively. Few studies, however, have explored the prevalence and incidence of mood and anxiety disorders based on diagnostic criteria after the loss of the partner. We conducted a systematic review, and searched major bibliographical databases for studies examining mood and anxiety disorders in widowhood. We included all studies examining the prevalence or incidence of mood and anxiety disorders in the widowed, according to diagnostic criteria as assessed with a structured diagnostic interview. Eleven studies were identified, exploring the prevalence and incidence of mood and anxiety disorders in 3481 widowed individuals and 4685 non-widowed controls. As expected, the prevalence of Major Depressive Disorder (MDD) and anxiety disorders were considerably elevated in widowed individuals, especially in the first year after the loss of a spouse. During the first year of bereavement, almost 22% of the widowed were diagnosed as having MDD; almost 12% met diagnostic criteria for Post Traumatic Stress Disorder; and there were higher risks of Panic Disorder and Generalized Anxiety Disorder. The incidence rate of MDD and several anxiety disorders ranged from 0.08–0.50. The relative risk of developing a mood or anxiety disorder ranged from 3.49–9.76, in the widowed, compared to control subjects.

Dynamic changes and future trend predictions of the global burden of anxiety disorders: analysis of 204 countries and regions from 1990 to 2021 and the impact of the COVID-19 pandemic.

Anxiety disorders and major depressive disorder (MDD) are common and disabling mental disorders. This paper aims to test the hypothesis that common mental disorders have become more prevalent over the past two decades. We conducted a systematic review of prevalence, remission, duration, and excess mortality studies for anxiety disorders and MDD and then used a Bayesian meta-regression approach to estimate point prevalence for 1990, 2005, and 2010. We also conducted a post-hoc search for studies that used the General Health Questionnaire (GHQ) as a measure of psychological distress and tested for trends to present a qualitative comparison of study findings This study found no evidence for an increased prevalence of anxiety disorders or MDD. While the crude number of cases increased by 36%, this was explained by population growth and changing age structures. Point prevalence of anxiety disorders was estimated at 3.8% (3.6-4.1%) in 1990 and 4.0% (3.7-4.2%) in 2010. The prevalence of MDD was unchanged at 4.4% in 1990 (4.2-4.7%) and 2010 (4.1-4.7%). However, 8 of the 11 GHQ studies found a significant increase in psychological distress over time. The perceived "epidemic" of common mental disorders is most likely explained by the increasing numbers of affected patients driven by increasing population sizes. Additional factors that may explain this perception include the higher rates of psychological distress as measured using symptom checklists, greater public awareness, and the use of terms such as anxiety and depression in a context where they do not represent clinical disorders.

A Global Call for Action to Prioritize Healthcare Worker Suicide Prevention During the COVID-19 Pandemic and Beyond.