Pre-existing Mental Health Issues Research Articles

Understanding the Relationship Between User Game Preferences and Depressive Symptoms: A Pilot Study.

Objective: Following the initial measures taken to manage the repercussions of the COVID-19 pandemic, mental health conditions have become a critical concern. Mental health has become a foremost priority not only for health care providers but also for many other organizations, such as educational institutions, companies, and government agencies. A significant proportion of the Australian population having experienced mental disorders highlights the need for effective interventions. Those with pre-existing mental health issues experienced particularly pronounced effects. Among these challenges, advancements in technology offer new possibilities for mental health support. Videogames have shown effectiveness in mitigating symptoms of depression. Previous research has shown that game interface preferences correlate with players' emotional responses. This study aims to use MoodJumper, a game we designed, developed, and evaluated to examine the choice of game preferences in individuals with depressive symptoms. Materials and Methods: A pilot study was carried out after obtaining the Human Ethics committee's approval (n = 20). The participants were asked to fill out a Patient Health Questionnaire-9 (PHQ-9) questionnaire. They then played with the MoodJumper game for 20-30 minutes. Upon completing the game session, they were asked to fill out a questionnaire regarding their experience. Results: The results indicate a nonsignificant correlation between music preference, the direction of movement, and depressive symptoms meaning no significant relationship was found between depressive symptoms and chosen settings. However, a significant negative correlation was found between decision-making ability regarding game preferences and Patient Health Questionnaire-9 scores showing the difficulty of choosing preferred settings when having depressive symptoms. Conclusion: This contribution paves the way for designing and evaluating more impactful game experiences for individuals with mental health challenges.

Young people's experiences of the Northern Rivers 2017 flood and its effects on their mental health.

To explore young people's (YP) experiences of catastrophic flooding in the Northern Rivers area of northern NSW in 2017 and its effect on their mental health. Content analysis of free-text survey responses (written responses to open questions, rather than selecting a response option). Northern Rivers NSW. YP aged 16-25 years who were Northern Rivers residents at the time of the 2017 flood. YP found their flood experience to be novel and challenging. They expressed worry, distress, anxiety, and worsened pre-existing mental health issues as a result of the flood. YP reported a number of primary stressors (inadequate preparedness, warning and support during the flood) and secondary stressors (loss/damage of property and possessions, financial strain and disruptions to daily life) which potentially contributed to poor mental health. Some YP reported positive outcomes from their flood experience, notably increased community connectedness and personal resilience. However, they also expressed concern for the future, particularly potential reoccurrence of extreme floods as well as climate change. YP conveyed a desire for better community involvement to improve preparedness for future floods and a clear motivation to take action on climate change. The flood was a challenging experience for YP which was commonly described as negatively affecting their mental health. Understanding what YP view as significant events or issues arising from their personal flood experience may help target support mechanisms and services to maintain their mental. More focus on community-based initiatives to improve disaster preparedness can support mental health in YP.

Rapid-Onset Gender Dysphoria: Parent Reports on 1,655 Possible Cases

During the past decade, there has been a dramatic increase in adolescents and young adults (AYAs) complaining of gender dysphoria. One influential if controversial explanation is that the increase reflects a socially contagious syndrome among emotionally vulnerable youth: rapid-onset gender dysphoria (ROGD). We report results from a survey of parents who contacted the website ParentsofROGDKids.com because they believed their AYA children had ROGD. Results focused on parent reports on 1,655 AYA children whose gender dysphoria began between ages 11 and 21 years, inclusive. These youths were disproportionately (75%) natal female. Natal males had later onset (by 1.9 years) than females, and they were much less likely to have taken steps towards social gender transition (65.7% for females versus 28.6% for males). Pre-existing mental health issues were common, and youths with these issues were more likely than those without them to have socially and medically transitioned. Parents reported that they had often felt pressured by clinicians to affirm their AYA child’s new gender and support their transition. According to the parents, AYA children’s mental health deteriorated considerably after social transition. We discuss potential biases of survey responses from this sample and conclude that there is presently no reason to believe that reports of parents who support gender transition are more accurate than those who oppose transition. To resolve controversies regarding ROGD, it is desirable that future research include data provided by both pro-transition and anti-transition parents, as well as their gender dysphoric AYA children.

A Systematic Review of the Association of Internet Gaming Disorder and Excessive Social Media Use With Psychiatric Comorbidities in Children and Adolescents: Is It a Curse or a Blessing?

Internet gaming and social media usage (SMU), particularly among children and teenagers, have witnessed a remarkable surge over the past decade. However, it remains uncertain whether this widespread usage has a positive or negative impact. The primary objective of this systematic review was to investigate the diverse effects of excessive video game playing and extensive SMU, both favorable and detrimental, on the psychological and mental well-being of children and adolescents. To assess the influence of internet gaming disorder (IGD) and disordered SMU on the mental health of children aged 6-12 years and adolescents aged 13-18 years, we conducted a systematic review of20 studies on the subject. These studies utilized a substantial sample size of 48,652 participants, encompassing online and in-person questionnaires administered to children, teenagers, and their parents in educational institutions, healthcare facilities, and online platforms. Our findings suggest that multiple factors contribute to the intricate relationship between SMU, video game playing, and mental health outcomes. The majority of research indicates thatexcessive gaming or SMU among children and teenagers leads to adverse consequences on their mental well-being. Furthermore, certain studies have even reported fatal consequences, while others have identified a worsening of preexisting mental health issues. A few studies have explored the potential positive impacts of SMU and gaming on individuals and society at large. In light of this, we have concluded that it is inappropriate to categorize internet gaming and SMU as solely beneficial or detrimental without considering the broader context and the interplay of various factors.

Health and well-being of refugees, asylum seekers, undocumented migrants, and internally displaced persons under COVID-19: a scoping review.

The objective of this scoping review was to identify what is known about the impact of COVID-19 on the physical and mental well-being of refugees, asylum seekers, undocumented migrants, and internally displaced persons. The aim was also to identify barriers influencing access to treatment or prevention. The search was conducted using PubMed/Medline, CINAHL, Scopus, and ScienceDirect. A mixed methods appraisal tool was used to assess methodological rigor. The study findings were synthesized using a thematic analysis approach. This review comprised 24 studies and were conducted utilizing a mixed method approach incorporating both quantitative and qualitative methodologies. Two major themes were identified related to the impact of COVID-19 on the health and wellbeing of refugees, asylum seekers, undocumented migrants, and internally displaced persons and the key barriers influencing access to treatment or prevention of COVID-19. They often have barriers to accessing healthcare due to their legal status, language barriers, and limited resources. The pandemic has further strained already limited health resources, making it even more challenging for these populations to receive healthcare. This review reveals that refugees and asylum seekers in receiving facilities face a higher risk of COVID-19 infection than the general population due to their less favorable living conditions. The various health impacts stem from a lack of access to accurate information about the pandemic, misinformation, and the exacerbation of pre-existing mental health issues caused by heightened stress, anxiety, and uncertainty, fear of deportation among undocumented migrants, and overcrowding camps and detention facilities that increase exposure risk. Social distancing measures are difficult to implement in these settings, and inadequate sanitation, hygiene, and a lack of personal protective equipment further compound the problem. Moreover, the pandemic has had significant economic consequences for these populations. Many of them rely on informal or precarious employment, which has been disproportionately affected by the pandemic. Job losses and reduced working hours, and limited access to social protection can lead to increased poverty, and food insecurity. Children faced specific challenges, such as disruptions to education, additionally, interruptions in support services for pregnant women. Some pregnant women have avoided seeking maternity care due to fears of contracting COVID-19, resulting in increased home births and delays in accessing healthcare services. Factors that play a role in vaccination reluctance include uncertainty of undocumented migrants' inclusion in vaccination programs, furthermore, a growing vaccine hesitancy in the population; skepticism about the safety of vaccines, inadequate knowledge/education, a variety of access barriers such as language barriers, and logistical challenges including remote locations, and inaccurate information. This review highlights that the physical health of refugees, asylum seekers, undocumented migrants, and internally displaced persons has been significantly impacted by various barriers to healthcare access during the pandemic. These barriers include legal and administrative challenges, such as a lack of documentation. Additionally, the shift to digital tools has introduced new obstacles, not only due to language barriers or limited technical knowledge but also because of structural barriers, such as the requirement of a bank ID that is often inaccessible to these groups. Other factors contributing to limited healthcare access include financial constraints, language barriers, and discrimination. Additionally, limited access to accurate information about health services, prevention measures, and available resources may hinder them from seeking care or following public health guidelines. Misinformation and lack of trust in healthcare systems can also contribute to a reluctance to access care or vaccination programs. There is concerning evidence regarding vaccine hesitancy that needs to be addressed to reduce any future pandemic outbreak, in addition there is a need to explore the factors that play a role in vaccination reluctance among children in these populations.

The impact of COVID-19 on children and adolescents attending Child and Youth Mental Health Services in Queensland, Australia.

This explorative study aims to provide insight into impacts of the COVID-19 pandemic and associated restrictions, on mental health of children and adolescents treated at Child and Youth Mental Health Services, and their parents. The COVID-19 Mental Health Survey was disseminated to parents of children and adolescents under treatment at community Child and Youth Mental Health Services (Brisbane, Australia) between July-November 2020 throughout different stages of COVID-19 related restrictions. Parents of 110 children participated. Most reported child's symptoms were sadness (46%), anxiety (60%), lack of focus (61%), lack of joy in their usual activities (38%) and reduction in sleep (42%). Parental emotions were significantly correlated with their child's emotions. Parent's lack of enjoyment of usual activities had the overall strongest average correlation (0.27) but this was no longer significant once other variables were controlled for. Children who attended school remotely for some of the days had a significantly (p < .05) higher risk of having more reported symptoms. Interestingly, in later stages of the lockdown with further easing of restrictions, symptoms also tended to be more severe. Cross-sectional data on children and adolescents in Queensland, Australia with pre-existing mental health issues suggests mental health continued to deteriorate through the pandemic even as restrictions eased. Changes in schooling seem to be an especially important risk factor.

RETRACTED ARTICLE: Rapid Onset Gender Dysphoria: Parent Reports on 1655 Possible Cases

During the past decade there has been a dramatic increase in adolescents and young adults (AYA) complaining of gender dysphoria. One influential if controversial explanation is that the increase reflects a socially contagious syndrome: Rapid Onset Gender Dysphoria (ROGD). We report results from a survey of parents who contacted the website ParentsofROGDKids.com because they believed their AYA children had ROGD. Results focused on 1655 AYA children whose gender dysphoria reportedly began between ages 11 and 21 years, inclusive. These youths were disproportionately (75%) natal female. Natal males had later onset (by 1.9 years) than females, and they were much less likely to have taken steps toward social gender transition (65.7% for females versus 28.6% for males). Pre-existing mental health issues were common, and youths with these issues were more likely than those without them to have socially and medically transitioned. Parents reported that they had often felt pressured by clinicians to affirm their AYA child’s new gender and support their transition. According to the parents, AYA children’s mental health deteriorated considerably after social transition. We discuss potential biases of survey responses from this sample and conclude that there is presently no reason to believe that reports of parents who support gender transition are more accurate than those who oppose transition. To resolve controversies regarding ROGD, it is desirable that future research includes data provided by both pro- and anti-transition parents, as well as their gender dysphoric AYA children.

The Role of Pre-Pandemic Mental Health Status and Personality Traits on Psychological Distress during the COVID-19 Lockdown among Italian Young Adults.

The COVID-19 pandemic imposed changes on day-to-day activities and had a detrimental psychological effect on the population, especially among vulnerable individuals, such as adolescents and young adults. The current study aimed to explore variables associated with anxiety, depressive and somatic symptoms in a sample of 608 Italian young adults aged 18 to 25. Data were collected using an online questionnaire administered two months into the COVID-19 lockdown, which explored several areas including sociodemographic information, pre-pandemic and current psychological distress, pre-pandemic and current levels of loneliness, and the traits of intolerance of uncertainty and boredom susceptibility. Results highlighted that having pre-existing mental health issues, being female, and the personality traits of intolerance to uncertainty and boredom susceptibility all played a role in the psychological distress experienced during the pandemic. COVID-19 contributed to negative impacts on young adults' mental health, highlighting the necessity to develop protective psychological intervention tailored for this vulnerable population.

Development of mental health disorders in endometrial cancer survivors and the impact on overall survival—a population-based cohort study

To better understand the risk of developing a mental health disorder and the association on outcomes in endometrial cancer patients. Endometrial cancer patients ≥18 years old diagnosed between 1997–2012 were identified from the Utah Population Database and matched with up to 5 cancer free women from the general population. Mental health disorders were identified by International Classification of Diseases ICD-9 diagnostic codes. Endometrial cancer survivors with pre-existing mental health issues were excluded. Diagnosis of a mental health disorder in endometrial cancer patients was compared with the endemic rate. The impact of a mental health disorders on overall survival (OS) and cause specific survival (CSS) was evaluated. There were 2941 endometrial cancer patients and 12,192 general population matched subjects that met criteria with a median follow up time of 7.1 years (range 0–19.2) and 7.7 years (0.4–19.2) respectively. Within the first 1.5 years from diagnosis, there was an association of endometrial cancer patients being diagnosed with a mental health disorder (Hazard radio (HR) 3.09, 95% confidence interval (CI) 2.66–3.59). However, no association was found in endometrial cancer patients being diagnosed with a mental health disorder between 1.5–3 years (HR 1.07, 95% CI 0.83–1.38) and ≥3 years (HR 1.09, 95% CI 0.95–1.26). Treatment with tri-modality (surgery, radiation and chemotherapy) and advanced disease was associated with mental health disorders. OS was worse in endometrial cancer survivors who developed an anxiety disorder (p = 0.0265). CSS was worse in endometrial cancer patients diagnosed with all mental health disorders and anxiety disorders (p &lt; 0.0001, p = 0.002). Endometrial cancer patients have an increased diagnosis of mental health disorders within the first 1.5 years of cancer diagnosis compared to the general population. Endometrial cancer survivors with anxiety disorder have worse OS. Anxiety disorders and all mental health disorders have a worse CSS.

Effects of Tele-Counseling on Reducing Anxiety Levels of COVID-19 Patients in Isolation Wards: An Observational Study.

COVID-19 causes psychological distress and anxiety due to fear of infection and the possibility of worsening symptoms leading to mortality. Public health measures like contact tracing and lockdowns further increase the panic among infected patients and the public. We intended to assess the effect of telecounseling in reducing anxiety in patients admitted to isolation wards. In this multi-center observational study, we administered a Generalized Anxiety Disorder-7 (GAD-7) scale before and after telecounseling. The study group consisted of participants who gave consent for telecounseling, and those who did not give consent constituted the control group. The telecounseling was based on the Psychological First Aid model, due to its simplicity. There was a statistically significant decrease in anxiety after telecounseling in the study group (P value ≤ 0.001, effect size = 0.484). There was a statistically significant decrease in anxiety in the study group compared to the control group (P value ≤ 0.001). Telecounseling contributed to the reduction in anxiety in COVID-19 patients in isolation wards. Several other factors like severity of the infection, comorbid medical illness, pre-existing mental health issues, individual's level of coping with stress, and duration and place of admission may have affected the anxiety levels in the patients.

MENTAL HEALTH IMPLICATIONS OF COVID-19: A NARRATIVE REVIEW OF THE LITERATURE

Introduction: The novel coronavirus disease, which the World Health Organization (WHO) officially designated as COVID-19, originated in Wuhan, China, as a cluster of unexplained pneumonia cases. It has affected countries worldwide and has been classified as a pandemic. To deal with this global health crisis and to curtail the spread of the virus, stringent public health measures have been implemented. There is evidence of a positive correlation between widespread outbreaks of contagious diseases, symptoms of psychiatric illness, and psychological distress. Aim: Considering the need to develop a deeper understanding of COVID-19 to devise strategies to deal with and prevent impact of COVID-19 on mental health thereby present review is undertaken. Method: A narrative review was conducted in May 2020. Result: Findings are suggestive that healthcare workers engaged in providing care to patients affected by COVID-19 are at a risk of developing psychological issues such as vicarious traumatization. With regards to the public, certain populations, including individuals with preexisting mental health issues, are more vulnerable to adverse psychological impacts from COVID-19. To conclude it, the review findings highlight the hidden mental health impact of COVID-19 and allows health care workers in all specialty to watch for vulnerable patients, their family members, and colleagues who may adversely psychologically affected by COVID-19.

Experiences and practices of people categorised as being ‘at risk’ based on age during the COVID-19 pandemic: a qualitative study in the UK and Germany

ObjectivesThe aim of this study was to comparatively explore the social representations of risk in individuals categorised ‘at risk’ based on age during the COVID-19 pandemic. What characterised their sense-making...

A Systematic Review of COVID-19 Risk Factors Impact on the Mental Health of LGBTQ+ Youth

Youth who identify as lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ+) are a growing population in the U.S. and are disproportionately impacted by mental health disparities. The COVID-19 pandemic has been associated with increased depression, anxiety, and other psychological issues among the general population. The purpose of this review was to examine risk factors exacerbated by COVID-19 and their effects on the mental health of LGBTQ+ youth. The PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) method for reporting was used to identify, analyze, and synthesize the selected literature. Thirteen studies were identified that met the inclusion criteria. COVID-19 risk factors were categorized at the individual, relational, community, and societal levels. The results suggest that the following factors were associated with poorer mental health: individual factors of less education, income, and employment; concerns about COVID-19; pre-existing mental health issues and being a sexual or gender minority; and relationship factors of reduced socialization and spending more time with unsupportive family. Additionally, loss of safe spaces (school, youth organizations, etc) at the community level, social distancing policies, and a loss of access to gender-affirming care at the societal level were detrimental to mental health.&amp;nbsp; LGBTQ+ youth can benefit from resources which allow them to stay connected to peers, friends, community resources, the LGBTQ+ community, and supportive educational environments during &amp;ldquo;stay at home&amp;rdquo; orders. The COVID-19 pandemic worsened many risk factors for LGBTQ+ youth, making mental health resources vital for this group.

502 Estimation of Return to Work After Burn Injury

IntroductionA major milestone of recovery from a burn injury is returning to work (RTW). A systematic review by Mason et al. suggested that perhaps 28% of burn survivors do not return to work, while other studies have identified complex factors that affect RTW, including patient age, pre-existing mental health issues, injury locations such as hands, and type of work they do. Due to the large number of complex interactions involved, predicting a timeline for RTW is challenging.We anticipate that underestimations of RTW may result in frustration, and perhaps contribute to negative psychological outcomes. Therefore, we wished to exam the accuracy of our surgeons estimates of RTW.MethodsA retrospective chart review of inpatients treated at our center with burn injury, with Worker's Compensation as insurance, with follow up at our outpatient clinic, and admitted during the calendar years 2018 to 2019, produced 23 records with sufficient documentation. Hospital admission was taken as the starting point, and number of days until the (first) estimated RTW date was compared to the number of days until the actual date of RTW if documented, or else the final documented surgeons estimate.ResultsLimited demographic information and results are found in table 1. in 6 cases (23%), patients had not returned to work by one-year post hospitalization. Reasons for non-return to work in all cases included chronic pain requiring a pain management specialist, or psychologic sequelae requiring psychological treatment, or both.Table 1 - Demographics and Results. SD = standard deviation, IQR = interquatile range, TBSA = Total Body Surface Area burned.We found that our surgeons estimated an average RTW date 65 days post admission date, whereas the average actual RTW was 177 days after admission. Expressed as a ratio, the actual time was 2.9x the estimated time, and expressed as a difference, the surgeons underestimated by 112 days.ConclusionsThe actual time needed for RTW was much longer that the surgeons initial assessment. These findings suggest that despite a wealth of experience in burn care, surgeons are prone to underestimate recovery time and especially time to RTW.

COVID-19 Outbreaks and Control Measures Are Associated With Depression Risk Among Older Adults

Local COVID-19 outbreaks and infection control measures may affect mental health in older persons. This study aims to investigate the effects of COVID-19 outbreaks and control measures on depression risk in community-dwelling older adults in Hong Kong. With rolling cross-sectional design, telephone screenings for depressive risk were conducted among 8163 older people using Patient Health Questionnaire-2 (PHQ-2) from February to September 2020. COVID-19 outbreaks across thirty weeks were measured using real-time effective reproductive number (Rt), infected new cases, and change of infected new cases by week. Infection control measures were assessed using four policy indices, including government response, government stringency, containment and health, and economic support. Linear regressions were used to test the associations of depression risk with COVID-19 outbreaks and control measures. We found that being female and higher Rt were associated with higher depression risk in the overall sample. In older adults without pre-existing mental health issues, higher depression risk were related to older age (t=-1.974, 95%CI[-0.006, 0.000], p<0.05), a higher level of government stringency (t=2.954, 95%CI[0.007, 0.033], p<0.01), and less stringent containment and health-related policy (t=-2.599, 95%CI[-0.041, -0.006], p<0.01). In older adults with pre-existing mental health issues, greater changes in newly infected cases were related to higher depression risk (t=2.813, 95%CI[0.002, 0.010], p<0.01). In conclusion, the effects of COVID-19 infection risk and control measures on depression risk differ among older Chinese by pre-existing mental health issues. Future public health communication could build on resilience to balance awareness of infection risks and mental health risks in older persons.

Mental health at the COVID-19 frontline: An assessment of distress, fear, and coping among staff and attendees at screening clinics of rural/regional settings of Victoria, Australia.

Research examining psychological well-being associated with COVID-19 in rural/regional Australia is limited. This study aimed to assess the extent of psychological distress, fear of COVID-19, and coping strategies among the attendees in COVID-19 screening clinics at 2 rural Victorian settings. A cross-sectional study was conducted during July 2020 to February 2021 inclusive. Participants were invited to fill in an online questionnaire. Kessler Psychological Distress Scale (K-10), Fear of COVID-19 Scale, and Brief Resilient Coping Scale were used to assess psychological distress, fear of COVID-19, and coping, respectively. Among 702 total participants, 69% were females and mean age (±SD) was 49 (±15.8) years. One in 5 participants (156, 22%) experienced high to very high psychological distress, 1 in 10 (72, 10%) experienced high fear, and more than half (397, 57%) had medium to high resilient coping. Participants with mental health issues had higher distress (AOR 10.4, 95% CI: 6.25-17.2) and fear (2.56, 1.41-4.66). Higher distress was also associated with having comorbidities, increased smoking (5.71, 1.04-31.4), and alcohol drinking (2.03, 1.21-3.40). Higher fear was associated with negative financial impact, drinking alcohol (2.15, 1.06-4.37), and increased alcohol drinking. Medium to high resilient coping was associated with being ≥60 years old (1.84, 1.04-3.24) and completing Bachelor and above levels of education. People who had pre-existing mental health issues, comorbidities, smoked, and consumed alcohol were identified as high-risk groups for poorer psychological well-being in rural/regional Victoria. Specific interventions to support the mental well-being of these vulnerable populations, along with engaging health care providers, should be considered.

S1150 A Remarkable Increase in Alcohol-Related Liver Disease in the Setting of COVID-19

Introduction: COVID-19 has had a profound effect on everyday life. In one survey, 30.8% of respondents reported “drinking a lot more than normal” during the pandemic. We examined the incidence of alcohol related liver diseases from 2015 to the present to determine whether there was a significant increase of these diseases in the setting of the COVID-19 pandemic. Methods: The number of patients at a large academic center with a first occurrence of alcoholic cirrhosis and alcoholic hepatitis were extracted for each quarter between 2015 and 2021. A quarter was defined as a three-month period with the first quarter (Q1) being the first three months of the year, the second quarter (Q2) the next three months, and so on. Data was further broken down by whether the diagnosis was made inpatient, outpatient, or in the emergency department. This data was compared to the number of outpatient visits for all liver related illnesses in each quarter to standardize the data to a rate per 1000 visits. Diagnoses and inpatients per 1000 visits from Q2 2019 to Q1 2020 of alcoholic cirrhosis and alcoholic hepatitis was compared to that of Q2 2020 to Q1 2021. A Fisher’s exact test was done to determine if there was a significant difference. Results: Diagnoses of alcoholic cirrhosis per quarter fluctuated between 55 and 90 from Q1 2016 to Q1 2020 before increasing to a peak of 267 in Q1 2021. The same trend was found in diagnoses per 1000 visits. (Figure 1) New cases and diagnoses per 1000 visits of alcoholic hepatitis have generally increased from Q1 2016 to Q1 2020 with a more precipitous increase thereafter. In the 12-month period encompassing Q2 2019 to Q1 2020, diagnoses of alcoholic cirrhosis per 1000 visits were 12.3, increasing to 20.5 in the next 12-month period with inpatients per 1000 visits increasing from 5.4 to 8. Both differences have a p-value of < 0.001. When comparing these periods for alcoholic hepatitis, there was an increase in diagnoses per 1000 visits from 5.8 to 7.5 (P = 0.014) and from 4.2 to 5.4 for inpatients per 1000 visits (P = 0.047). Conclusion: There have been more diagnoses and inpatient visits of alcohol related liver diseases since Q2 2020, the first full quarter affected by COVID-19. This could be due to worsening of pre-existing mental health issues or lack of social support during this period. Regardless of the cause, this data is useful for understanding public health needs as we recover from the current pandemic and in future pandemics.Figure 1.: Kaplan-Meier Plot on All-cause Mortality.

Uncertainty, Anxiety and Isolation: Experiencing the COVID-19 Pandemic and Lockdown as a Woman with Polycystic Ovary Syndrome (PCOS).

Background: The COVID-19 pandemic and the related lockdown measures presented a significant risk to physical and mental wellbeing in affected populations. Women with polycystic ovary syndrome (PCOS) are predisposed to several cardio-metabolic risk factors which increase the susceptibility to severe COVID-19 and also exhibit increased likelihood of impaired mental health wellbeing. Therefore, these women who usually receive care from multiple primary and specialist healthcare services may be disproportionately impacted by this pandemic and the related restrictions. This study aimed to explore the lived experience of the first UK national lockdown as a woman with PCOS. Methods: As part of a larger cross-sectional study, 12 women with PCOS living in the UK during the first national COVID-19 lockdown were recruited to a qualitative study. Telephone interviews were conducted in June/July of 2020, and data collected were subjected to thematic analysis. Results: Five themes were identified. “My PCOS Journey” describes participants’ experiences of diagnosis, treatment and ongoing management of their PCOS. “Living Through Lockdown” describes the overall experience and impact of the lockdown on all aspects of participants’ lives. “Self-care and Managing Symptoms” describe multiple challenges to living well with PCOS during the lockdown, including lack of access to supplies and services, and disruption to weight management. “Healthcare on Hold” describes the uncertainty and anxiety associated with delays in accessing specialised healthcare for a range of PCOS aspects, including fertility treatment. “Exacerbating Existing Issues” captures the worsening of pre-existing mental health issues, and an increase in health anxiety and feelings of isolation. Conclusion: For the women with PCOS in this study, the COVID-19 pandemic and the first national lockdown was mostly experienced as adding to the pre-existing challenges of living with their condition. The mental health impact experienced by the study participants was increased due to lack of access to their normal support strategies, limitations on healthcare services and uncertainty about their risk of COVID-19.

Mental Health Impact of Gender-Based Violence Amid COVID-19 Pandemic: A Review

Gender-based violence (GBV) and poor mental health have received particular attention among healthcare professionals, policymakers, and researchers amid the COVID-19 pandemic. This paper presents a review of available literature to understand the dynamics of GBV and its mental health impact in the context of COVID-19. Confinement and control by abusive partners, social and economic disruption, and restricted access to healthcare services were identified as the main contributing factors of GBV. The paper elaborates on the contribution of broader socioeconomic determinants of health as well as cultural and societal factors of victimization in shaping GBV by placing specific populations or individuals in a more vulnerable position within the society based on their gender. Socioeconomic determinants included socioeconomic status, education, migration and racial, ethnic, or gender-based minoritisation. Cultural and societal factors of victimization are mostly related to gender-based structural power discrepancies and communication patterns. Evidence suggests a complex relationship between COVID-19 specific stressors, such as health anxiety and intolerance of uncertainty, GBV, and mental health issues. COVID-19 stressors might directly trigger the mechanism of aggression and cause physical or psychological violence and associated mental health implications in victims, or it might be mediated by pre-existing mental health issues experienced by perpetrators. Bangladesh Journal of Medical Science Vol.20(5) 2021 p.17-25

The Mental Health of High School Students During the COVID-19 Pandemic

The American Psychological Association (APA) reports 81% of Gen Z teens (ages 13–17) have experienced more intense stress during the COVID-19 pandemic. This study uses a survey-based approach along with robust statistical analyses to identify key stressors from a set of students in a high school in Midwest United States. Our survey includes a broad range of stressors (15 explanatory variables) specific to high schoolers, controls (4 factors for pre-existing conditions), and mental health estimators (7 dependent variables) to identify changes in mental wellbeing during the pandemic. The results (n = 107) show good consistency in our estimators (Cronbach’s α = 0.78) and statistically significant (t = 0.636, p ≪ 0.001) degradation in the mental health. Correlation (r = 0.2, p = 0.034) and regression analysis showed that online learning (β1 = -0.96, p = 0.004) has the most influence on degradation in mental health, with some race-based differences. Exercise time helps reduce mental health degradation (β3 = -0.153, p = 0.037). Many other factors such as gender, homework time, school time, pre-existing mental health issues, and therapy did not have a significant influence on mental health degradation. Analysis of freeform feedback identified the following three recurring themes: increased stress due homework (13.2%), social isolation or lack of social interactions (8.5%), and lack of support for mental wellbeing (12.3%).