Mental Health Challenges Research Articles

Family and Mental Health Challenges Faced by Remote Workers During the COVID-19 Pandemic and the Future Outlook for Remote Working

The COVID-19 pandemic, which began in March 2020, has led to significant changes in the global work environment, particularly in the realm of employment. Many businesses and organizations have transitioned to remote work setups, offering advantages such as increased flexibility and reduced commuting time. However, remote work has brought about several challenges for employees, impacting not only their professional lives but also their personal well-being and family dynamics. Studies have shown an increase in issues like loneliness, depression, and anxiety among remote workers. This article aims to explore the effects of remote work on family dynamics and mental health challenges employees face. It also discusses the future outlook for remote working. The goal is to raise awareness among employers and employees about the various factors influencing the satisfaction and well-being of remote workers in this demanding work environment in order to shape future work policies.

A step towards community inclusion for individuals experiencing mental health challenges: promoting social inclusion and social recovery through physical activity

Purpose After initially positioning this paper within the broader mental health recovery literature, this paper aims to highlight the role that physical activity can play in promoting social inclusion and social recovery for those experiencing mental health challenges. Design/methodology/approach This conceptual paper draws together the limited, but growing, research on how physical activity can facilitate improved social inclusion and benefit an individual’s recovery. Findings For individuals suffering with mental health challenges, not being able to exercise their right to inclusion is concerning from a recovery perspective, because experiencing social inclusion is recognised as a facilitator of recovery. Initial research has demonstrated by embracing community inclusion and supporting initiatives such as physical activity programs, mental health services can better facilitate individuals’ journeys towards social inclusion and social recovery. Research limitations/implications Future research should appreciate the interplay between inclusion, recovery and physical activity. Collaborating with individuals with lived experience, peer mentors and social prescribing teams to explore options for physical activity within local communities fosters empowerment, social inclusion and ensures interventions align with individuals’ preferences and needs. Practical implications Practitioners in health service and community settings should recognise the wide-ranging benefits of physical activity for individuals with mental health challenges, especially in terms of helping their social inclusion and social recovery. Originality/value This paper is unique in synthesising the mental health literature relating to social inclusion, social recovery and physical activity. Initial findings show promise, but more attention is needed to explore the relationship between these elements and how individuals experiencing mental health challenges can be supported using physical activity.

Health Needs Assessment of Unhoused Youth in Charleston, South Carolina.

Over 35000 youth experience homelessness on any given night in the United States (US). Unhoused youth experience unique physical and mental health challenges and face barriers in every social determinant of health (SDoH), which may be amplified in the LGBTQ+population. The objective of this study was to define characteristics of the unhoused youth population and their utilization of healthcare to inform programs to meet their needs. Secondary analysis of data from the College of Charleston's YOUth Count survey was conducted, focusing on health-related characteristics, challenges, healthcare utilization, and SDoH of youth aged 18 to 25 experiencing homelessness in Charleston, SC. Almost three-quarters of respondents (74.6%) reported mental health challenges and 35% reported physical health challenges. A significantly higher proportion of those who engaged in survival sex were LGBTQ+. More than half (68.4%) visited the emergency department (ED) and 29.3% were admitted to the hospital in the past 12months. Housing status, safety, food insecurity, sexual orientation, prior foster care, and survival sex were all significantly associated with ED utilization. Housing status and survival sex were significantly associated with hospital admission. Addressing SDoH is essential to improving health outcomes and healthcare utilization among unhoused youth, particularly in the LGBTQ+population.

How Individuals with Mental Health Challenges Coped During the COVID-19 Pandemic.

There is growing awareness of the significant mental health impacts of the COVID-19 pandemic on many Americans. Less is known about the effects on individuals who were living with mental health conditions prior to the pandemic's onset. In addition, little research has explored how this group is coping positively with the challenges of COVID-19. Understanding the strengths these individuals bring to pandemic demands and disruptions can inform recovery for these individuals in the aftermath of this public health emergency. Using results from a cross-sectional, online survey administered during April and May 2020, we use qualitative methods to examine how individuals with symptoms of depression and anxiety were coping with COVID-19. Participants were recruited from two networks of statewide behavioral health community programs in New Jersey and New York. Data come from 48 participants who reported current symptoms of anxiety assessed by the Generalized Anxiety Disorder-2 Scale and/or depression assessed by the Patient Health Questionnaire-2. These respondents demonstrated resilience in navigating disruptions brought on by COVID-19 and reported a range of healthy coping strategies. We identified three themes characterizing successful coping strategies, including utilizing social support systems, practicing self-care, and adjusting one's mindset to deal with challenging experiences. When designing programs, policies, and clinical approaches to support people with mental health conditions, it is essential to focus on strengths. The coping strategies shared by the individuals in this study demonstrate and build on their resilience. More research is needed to discover the strengths people exhibit to deal with the challenges caused by the COVID-19 pandemic.

Application of Positive Psychology in Digital Interventions for Children, Adolescents, and Young Adults: Systematic Review and Meta-Analysis of Controlled Trials.

The rising prevalence of mental health issues in children, adolescents, and young adults has become an escalating public health issue, impacting approximately 10%-20% of young people on a global scale. Positive psychology interventions (PPIs) can act as powerful mental health promotion tools to reach wide-ranging audiences that might otherwise be challenging to access. This increased access would enable prevention of mental disorders and promotion of widespread well-being by enhancing self-efficacy, thereby supporting the achievement of tangible objectives. We aimed to conduct a comprehensive synthesis of all randomized controlled trials and controlled trials involving children, adolescents, and young adults, encompassing both clinical and nonclinical populations, to comprehensively evaluate the effectiveness of digital PPIs in this age group. After a literature search in 9 electronic databases until January 12, 2023, and gray literature until April 2023, we carried out a systematic review of 35 articles, of which 18 (51%) provided data for the meta-analysis. We included randomized controlled trials and controlled trials mainly based on web-based, digital, or smartphone-based interventions using a positive psychology framework as the main component. Studies included participants with a mean age of <35 years. Outcomes of PPIs were classified into indicators of well-being (compassion, life satisfaction, optimism, happiness, resilience, emotion regulation and emotion awareness, hope, mindfulness, purpose, quality of life, gratitude, empathy, forgiveness, motivation, and kindness) and ill-being (depression, anxiety, stress, loneliness, and burnout). PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were used for the selection of studies and data extraction. Quality assessment was performed following the CONSORT (Consolidated Standards of Reporting Trials) guidelines. For well-being outcomes, meta-analytic results showed that PPIs augmented the feeling of purpose, gratitude, and hope (Hedges g=0.555), compassion (Hedges g=0.447), positive coping behaviors (Hedges g=0.421), body image-related outcomes (Hedges g=0.238), and positive mindset predisposition (Hedges g=0.304). For ill-being outcomes, PPIs reduced cognitive biases (Hedges g=-0.637), negative emotions and mood (Hedges g=-0.369), and stress levels (Hedges g=-0.342). Of note, larger effect sizes were found when a waiting list control group was considered versus a digital control group. A funnel plot showed no publication bias. Meta-regression analyses showed that PPIs tended to show a larger effect size on well-being outcomes in studies including young adults, whereas no specific effect was found for ill-being outcomes. Revised evidence suggests that PPIs benefit young people's well-being and mitigate ill-being symptoms. Digital platforms offer a unique way to address their mental health challenges, although not without limitations. Future research should explore how they work for the needs of the young population and further examine what specific PPIs or combination of interventions is most beneficial with respect to other digital control groups. PROSPERO International Prospective Register of Systematic Reviews CRD42023420092; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=420092.

Integrating Traditional Medicine with Modern Healthcare: Addressing Maternal and Mental Health in Uganda

Traditional medicine in Uganda, deeply rooted in cultural and historical practices, plays a significant role in addressing maternal and mental health challenges. This review explores the integration of traditional medicine with modern healthcare systems, aiming to enhance maternal and mental health outcomes while preserving cultural heritage. Traditional practices, including herbal remedies, spiritual healing, and the role of traditional birth attendants (TBAs), provide crucial support, particularly in rural areas with limited access to modern medical facilities. The review examines the contributions of traditional medicine to maternal health, including prenatal, labor, and postnatal care, and its role in mental health through spiritual and community-based practices. Despite the valuable contributions, integrating traditional and modern healthcare presents challenges such as cultural barriers, regulatory issues, and the need for standardization. Efforts to integrate these approaches include policy development, educational initiatives, and collaborative health programs. The National Drug Authority (NDA) plays a pivotal role in regulating and standardizing traditional medicine practices, ensuring safety and efficacy through research and quality control measures. Economic impacts of traditional medicine include income generation, local trade, and affordable healthcare options, although practitioners face challenges like lack of formal recognition and regulatory issues. Public perception is influenced by cultural beliefs and trust in traditional practices, with increasing acceptance of integrated approaches in urban areas. In conclusion, integrating traditional medicine with modern healthcare in Uganda offers a promising path towards a more inclusive and culturally sensitive healthcare system. By addressing challenges through mutual respect, collaboration, and evidence-based practices, Uganda can enhance maternal and mental health outcomes and build a more comprehensive healthcare system. Keywords: Traditional Medicine, Modern Healthcare, Maternal, Mental Health in Uganda

Emotional Regulation, Coping, and Resilience in Informal Caregivers: A Network Analysis Approach.

Public health emergencies such as the COVID-19 pandemic can further strain the mental health of informal caregivers who provide unpaid assistance to family members or friends who need support due to illness, disability, or aging. However, there is a lack of research exploring the resources and adaptive strategies that promote resilience in informal caregivers. This cross-sectional study used psychometric network analysis to model the interplay between coping strategies, emotion regulation, trait resilience, and anxiety and depression symptoms in 351 Italian informal caregivers. The results showed that coping through a positive attitude, emotional reappraisal, and trait resilience were the most central and interconnected nodes in the network. These adaptive strategies buffered against the negative impact of anxiety and depression symptoms, providing valuable insights into the mechanisms underlying resilience and well-being in informal caregivers. Clinically, it is crucial to assess and foster these resilience-promoting factors (positive attitude coping, cognitive reappraisal, and trait resilience) to help mitigate the mental health challenges faced by informal caregivers, especially in the context of public health crises such as the COVID-19 pandemic.

Mental Health Challenges in Cancer Patients: A Cross-Sectional Analysis of Depression and Anxiety.

Advancements in cancer treatment and early detection have extended survival rates, transforming many cancers into chronic conditions. However, cancer diagnosis and treatment can trigger significant psychological distress, including depression and anxiety, impacting patient outcomes and care. This study aimed to examine the prevalence of and identify the risk factors for depression and anxiety among cancer patients. A cross-sectional study was conducted, including patients under the care of the oncology department at a tertiary medical center between June 2021 and October 2023. Depression and anxiety were assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS) short forms. Logistic regression analysis identified risk factors for depression and anxiety. The study population included 159 patients, with 40.3% reporting worsening mental health, but only about half of them received therapy. Among the study participants, 22.6% experienced symptoms of depression and 30.2% experienced symptoms of anxiety. Single-cancer patients and those with metastases were at increased risk for depression, while those with a disease duration of more than a year and patients with female-specific cancer were more likely to experience anxiety. Given the high prevalence of mental health deterioration in cancer patients, closer monitoring and validated assessment tools are essential to improve depression and anxiety diagnosis and facilitate early interventions.

What did the Covid-19 pandemic reveal to deaf young people about their lives as young adults?

The Covid-19 pandemic changed the structures of communication, interaction and daily life for everyone. In this study, we examine what those changed social circumstances revealed to deaf young people about their identity, opportunities, strengths and vulnerabilities. Forty-six deaf young people aged 16–19 during the pandemic were interviewed by either deaf co-inquirers or academic researchers with a strong background in working with deaf people. Data were analysed using reflexive thematic analysis. Findings demonstrate that the mental health challenges of the times were not new to many participants but rather just more of the familiar experiences of limited contact with others. However, the circumstances spotlighted attributes deaf people had which had been hidden previously to others including resilience, digital skills and creativity. Improved educational access through digital media was positive eventually but required some self-advocacy to achieve parity.

Nurturing Black Male Mental Health Through the Black Church: A Conceptual Approach from a Social Work Perspective

ABSTRACT This article introduces a conceptual framework rooted in social work principles to support the mental well-being of Black males within the nurturing and supportive setting of the Black Church. It addresses how historical trauma, societal views of Black masculinity, and social determinants of health have made Black men more likely to experience mental health challenges. The framework combines vulnerability theory and social work theory to focus on Black men’s strengths and cultural sensitivities. It emphasizes the Black Church as a critical resource for promoting mental wellness and resilience. The approach includes implementing effective interventions to challenge stigma, improve the availability of mental health services, and encourage Black men to seek assistance. This article presents a holistic approach aimed at addressing mental health disparities experienced by Black males. It proposes using the strengths of the Black Church to promote resilience, facilitate healing, and encourage Black men to prioritize their mental well-being.

Neuroprognostication, withdrawal of care and long-term outcomes after cardiopulmonary resuscitation.

Survivors of cardiac arrest often have increased long-term risks of mortality and disability that are primarily associated with hypoxic-ischemic brain injury (HIBI). This review aims to examine health-related long-term outcomes after cardiac arrest. A notable portion of cardiac arrest survivors face a decline in their quality of life, encountering persistent physical, cognitive, and mental health challenges emerging years after the initial event. Within the first-year postarrest, survivors are at elevated risk for stroke, epilepsy, and psychiatric conditions, along with a heightened susceptibility to developing dementia. Addressing these challenges necessitates establishing comprehensive, multidisciplinary care systems tailored to the needs of these individuals. HIBI remains the leading cause of disability among cardiac arrest survivors. No single strategy is likely to improve long term outcomes after cardiac arrest. A multimodal neuroprognostication approach (clinical examination, imaging, neurophysiology, and biomarkers) is recommended by guidelines, but fails to predict long-term outcomes. Cardiac arrest survivors often experience long-term disabilities that negatively impact their quality of life. The likelihood of such outcomes implements a multidisciplinary care an integral part of long-term recovery.

Severe odontogenic infections in patients with mental disorders—the challenge of ineffective initial treatment

ObjectivesThis study clarified possible delays and deficiencies in severe odontogenic infection (OI) treatment in patients with mental disorders. Study DesignData of hospitalized patients with severe OI were evaluated retrospectively. The outcome variable was preceding health care visits prior to hospitalization. The primary predictor was patient's mental disorder. Explanatory variables were age, sex, smoking, heavy alcohol use, immunocompromised disease or medication, and time span from beginning of symptoms to hospitalization. Also, factors leading to intensive care unit (ICU) care were evaluated. ResultsPreceding visits prior to hospitalization were found in 61 (35.5%) out of 172 patients with OI. In total, 27 patients (15.7%) had a current mental disorder, more commonly in women (26.0%) than in men (8.1%) (P=0.001). Patients with mental disorders had preceding health care visits related to the current infection notably more often than patients without recent psychiatric history (51.9% vs. 32.4%), P=0.053). Patient-related treatment delay remained non-significant. Heavy alcohol use (P=0.010) and smoking (P=0.025) predicted ICU treatment, but no association with patient's mental disorder was found. ConclusionsA patient's mental disorder can complicate diagnosis of OI. Effective and timely treatment requires the professional's ability to simultaneously identify the patient's mental health challenges and progressing OI.

2145 Physical and mental health needs of older transgender adults in the U.K.: a scoping review

Abstract Introduction The number of adults in the UK who identify as transgender is increasing, through greater recognition of trans identity and growing numbers of individuals transitioning in later life. The term ‘Transgender’ encompasses a diverse range of experiences and identities, including those who identify as non-binary, gender-fluid, and gender-queer. However, within this review, we use the shortened term ‘trans’ and the following broad definition: ‘people whose gender is different from the gender assigned to them at birth.’ We conducted this exploratory review to examine the literature regarding the specific health and social care needs of older trans adults. Methods We utilised scoping review methodology and thematic qualitative analysis to systematically search and map the literature related to the physical and mental health challenges related to the ageing experience among trans adults in the UK. Results We identified 22 relevant papers through combined systematic search and additional manual reference review. We recognised five key themes within the literature: Systems and Structural Factors, Health and Mental Health, Social Care, Diversity and The Future. The former three themes relate to limitations presented by current models of care, barriers within services and potential areas for development. Key areas identified include challenges related to the application of a binary gender model within healthcare systems as well as advanced care planning and ensuring gender-affirming care where capacity is lost including living with dementia. The latter two themes identify gaps in the current literature and provide examples of trans-inclusive positive practice. Conclusions There is an ongoing need for researchers, clinicians and policymakers to ensure that the needs of older trans adults are studied, understood and accommodated within policy and practice. Service providers delivering care to older adults must understand trans-specific needs, particularly around advanced care planning, to ensure that trans people are supported to age well.

A Cross-Sectional Study of Health-Related Quality of Life in Patients with Predominantly Antibody Deficiency.

Health-related quality of life (HRQoL) measures individual well-being across physical, psychological, and social domains. Patients with predominantly antibody deficiency (PAD) are at risk for morbidity and mortality, however, the effect of these complications on HRQoL requires additional study. Patients with PAD were asked to voluntarily complete the Centers for Disease Control (CDC) HRQoL-14 Healthy Days Measure questionnaire. These results were compared to data from the CDC-initiated Behavioral Risk Factor Surveillance System (BRFSS), a cross-sectional questionnaire including questions from CDC-HRQOL-14. Statistical analyses included two-proportion Z-test, t-tests, and analysis of variance. 83 patients with PAD completed the survey. Patients were sub-stratified into mild (23.7%), moderate (35.5%), severe (40.8%), and secondary (8.4%) PAD. "Fair or poor" health status was reported in 52.6% of PAD patients. Mental health challenges ≥ 14days/month occurred in 25% of patients. Physical health issues ≥ 14days/month was reported in 44.7% of patients. Activity limitations were noted by 80.3% of patients. There were no statistically significant differences by PAD severity. Patients with autoimmune and inflammatory disease co-morbidities reported more mental health challenges compared to those without (78% vs. 54.3%, p = 0.02). Compared to the CDC-BRFSS data, significantly more patients with PAD reported "fair or poor" health status (53% vs 12.0%; p < 0.0001), mental health challenges (24.1% vs 14.7%; p = 0.02), and poor physical health (44.6% vs 8.0%; p < 0.0001). Patients with PAD had significantly reduced HRQoL compared to CDC-BRFSS respondents from a similar geographical region. Decreased HRQoL was prevalent across all PAD severity levels. Additional research is needed to improve HRQoL for patients with PAD.

Examining the Interplay of Psychological Well-Being, Health, and Aging in Older LGBT Adults: A Systematic Review

Abstract Introduction Lesbian, gay, bisexual, and transgender (LGBT) individuals face mental health challenges and psychological issues due to societal pressures. Discrimination based on sexual orientation and gender identity continues to affect the well-being of older LGBT adults, despite progress in acceptance and equality. This systematic review examines the health and mental health challenges faced by older LGBT adults. Methods We conducted a search of four electronic databases to retrieve primary studies published between 2000 and 2022. Fifteen articles were included in the systematic review. Results Our findings reveal that older LGBT adults face victimization and are often forced to conceal their identity. Differential victimization based on sexual identity leads to severe outcomes, such as stress, post-traumatic stress disorder, and loneliness. Discrimination against older LGBT adults contributes to an unhealthy life, disability, depression, and physical health problems. Conclusions Tailored interventions, including sensitizing the public and changing perceptions, should address the health challenges and psychological issues faced by older LGBT adults in their lifetime. Discrimination against older LGBT adults must be addressed to ensure they receive the appropriate care and support they require. Policy Implications This systematic review highlights the need for targeted interventions and policies to support the mental health and well-being of older LGBT adults. Such policies should aim to sensitize society, challenge discrimination, and address the unique challenges faced by older LGBT adults.

Navigating challenges and shaping futures through mental health nursing in the United Kingdom.

WHAT IS KNOWN ON THE SUBJECT?: Mental health nurses in the UK play a critical role in providing care, advocating for patients and navigating the complexities associated with mental health challenges. Acknowledging and supporting the efforts of mental health nurses is essential for advancing mental health care, promoting inclusivity and fostering community resilience amidst ongoing challenges within existing health care organisations. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Highlights the integral role of mental health nurses in the UK's health system as both care providers and advocates, underpinning the importance of addressing the growing demand for mental health services Introduces innovative digital tools like the 'Hub of Hope' and the potential of social prescribing as effective strategies for improving access to mental health care and support. Emphasises the need for enhanced support and recognition of mental health nurses to ensure the sustainable advancement of mental health services and the well-being of communities. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health nurses should integrate innovative digital tools like the 'Hub of Hope' into their practice to improve signposting and access to mental health resources for individuals in need. There is a critical need for ongoing education and support for mental health nurses within practice settings to maintain their well-being and enhance their ability to provide holistic care despite increasing clinical demands. Advocacy for increased investment in mental health resources and support for research activities lead by mental health nurses is essential to address current service gaps and promote the development of more effective interventions.

Well-being among university students in the post-COVID-19 era: a cross-country survey

University students have to handle crucial challenges for their future lives, such as succeeding in academic studies and finding attachment figures. These processes could potentially involve their well-being and mental health, with possible sociocultural differences based on the country of study. In order to explore such potential differences, a cross-sectional, multi-center survey was performed involving students from the University of Torino (Italy), Sevilla (Spain), and Lusòfona (Portugal). The survey, conducted from May to November 2023, investigated students’ demographic and educational details, socioeconomic status, social support, mental health, academic environment, perceived COVID-19 pandemic impact, and future plans. Demographic profiles showed a predominance of female participants and straight sexual orientation, followed by bisexuality. Italian students showed the lowest levels of mental well-being and the highest rates of mental problems (anxiety and depression) and suicidal risk across the three countries despite the relatively similar profiles of social support. The prevalence of the students’ confidence in their professional future is higher in Spain than in Italy and Portugal. This study provides a comprehensive examination of university students’ mental health and well-being in three Southern European countries, addressing the major mental health challenges among university students and offering valuable insights for public health purposes.

A Concept Analysis of Maternal Resilience against Pregnancy-Related Mental Health Challenges in Low- and Middle-Income Countries.

Suicide accounts for 33% of deaths of women during the postnatal period in many low- and middle-income countries (LMICs). Resilience refers to an ability to adapt and recover from adversity or misfortune. Resilience building against mental health challenges during pregnancy and the postnatal period is critical for women to raise their child efficiently and maintain a healthy life. The exploration of maternal resilience against mental health challenges including its developmental processes and the determinants of its successful or unsuccessful cultivation among mothers during pregnancy and childbirth is of paramount importance. Understanding why a subset of mothers effectively develops resilience while others significantly struggle is critical for devising targeted interventions and support mechanisms aimed at improving maternal well-being. This inquiry not only seeks to delineate the factors that contribute to or hinder the development of resilience but also aims to inform the creation of comprehensive support systems that can bolster maternal health outcomes. This paper endeavors to present a comprehensive analysis of maternal resilience, aiming to cultivate a nuanced and profound understanding of the concept within the framework of previous traumatic events and adverse pregnancy outcomes in LMICs. The eight-step method approach proposed by Walker and Avant was utilized for this concept analysis. Several defining attributes were identified in the analysis including social adaptation, support system, optimistic approach, and mindfulness. This analysis contributes to knowledge advancement regarding maternal resilience and provides nurses and other healthcare professionals with a clear understanding of the concept of maternal resilience to help promote resilience among mothers.

An advanced Artificial Intelligence platform for a personalised treatment of Eating Disorders.

Eating Disorders (EDs) affect individuals globally and are associated with significant physical and mental health challenges. However, access to adequate treatment is often hindered by societal stigma, limited awareness, and resource constraints. The project aims to utilize the power of Artificial Intelligence (AI), particularly Machine Learning (ML) and Deep Learning (DL), to improve EDs diagnosis and treatment. The Master Data Plan (MDP) will collect and analyze data from diverse sources, utilize AI algorithms for risk factor identificat io n, treatment planning, and relapse prediction, and provide a patient-facing chatbot for information and support. This platform will integrate patient data, support healthcare professionals, and empower patients, thereby enhancing care accessibility, personalizing treatment plans, and optimizing care pathways. Robust data governance measures will ensure ethical and secure data management. Anticipated outcomes include enhanced care accessibility and efficiency, personalized treatment plans leading to improved patient outcomes, reduced waiting lists, heightened patient engagement, and increased awareness of EDs with improved resource allocation. This project signifies a pivotal shift towards data-driven, patient-centered ED care in Italy. By integrat ing AI and promoting collaboration, it seeks to redefine mental healthcare standards and foster better well- being among individuals with EDs.

Deterioration of people with Parkinson’s symptoms during COVID-19 lockdown: results of a web-based survey in Northwestern Italy

Objectives COVID-19 lockdowns were introduced to control the pandemic, however, they resulted in a global disruption of daily life and of individual and global health. Reduced accessibility of health services, unavailability of food and drugs, and mental health challenges had a huge impact on older people and on people living with disabling conditions such as Parkinson’s disease (PD). We assessed whether and to what extent the more disabled and vulnerable people with Parkinson’s (PwP) were affected by lockdowns. Method We analysed responses collected through a web-based survey of PwP according to their self-sufficiency [self-sufficient (SS); nearly self-sufficient (nSS); non-self-sufficient, cared for by family (NSS/F); non-self-sufficient, needs professional care (NSS/PC)]. Results Fears due to COVID-19 and difficulties with food supply were highest in NSS/F PwP. Difficulties with the supply of Parkinson’s medication or other drugs were apparently not an issue, while problems accessing primary care physicians and neurologists were similar across all patient groups. On the contrary, difficulties with daily and motor activities were higher in NSS/F and NSS/PC PwP. PwP symptoms worsened in all groups, with NSS/F and NSS/PC participants experiencing the worst deterioration. Notably, the deterioration of PwP symptoms was specifically related to changes in daily and motor activities, with participants who reported less engagement in daily and motor activities experiencing the worst deterioration. Conclusion Findings strongly support the need for decision-makers and healthcare providers to carefully re-evaluate the risk–benefit ratio of limiting healthcare accessibility for PwP, since evidence shows that lockdown measures primarily impact the groups who are most fragile and vulnerable.