Special Issue:
Challenges and Opportunities in Health Anxiety
Kathryn L. Lovero
Department of SociomedicalSciences, Columbia University Mailman School Public Health, New York, USA
Melissa A Stockton
Department of Psychiatry, University of Pennsylvania Perelman School Medicine, Philadelphia, USA
M Claire Greene
Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, USA
Cale Basaraba
Department of Population Health, Grossman School of Medicine, New York University
Saida Khan
Department of Mental Health, Ministry of Health, Maputo, Mozambique
Dirceu Mabunda
Department of Mental Health, Ministry of Health, Maputo, Mozambique
Flavio Mandlate
Department of Mental Health, Ministry of Health, Maputo, Mozambique
Lidia Gouveia
Department of Mental Health, Ministry of Health, Maputo, Mozambique
Wilza Fumo
Department of Mental Health, Ministry of Health, Maputo, Mozambique
Melanie M Wall
Department of Psychiatry, New York State Psychiatric Institute and Columbia University Vagelos College of Physicians and Surgeons, New York, USA; Department of Biostatistics, Columbia University Mailman School of Public Health, New York, USA
Cristiane S Duarte
Department of Psychiatry, New York State Psychiatric Institute and Columbia University Vagelos College of Physicians and Surgeons, New York, USA
Maria A Oquendo
Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA
Milton L Wainberg
Department of Psychiatry, New York State Psychiatric Institute and Columbia University Vagelos College of Physicians and Surgeons, New York, USA
Abstract
Globally, mental and substance use disorders are a leading cause of disease burden. In low- and middle-income countries, where there is an extreme shortage of trained mental health specialists, validated, brief screening tools for mental and substance use disorders are required for non-specialists to efficiently identify patients in need of mental health care. Mozambique, one of the poorest countries in the world, has fewer than two mental health specialists for every 100,000 people. In the present study, we evaluated a comprehensive set of seven measures for depression, anxiety, somatization, alcohol use disorder, substance use disorder, psychosis and mania, and suicide risk among N=911 Mozambican adults in general healthcare settings. All instruments demonstrated acceptable internal consistency (α > 0.75). Compared to diagnoses made by the Mini International Neuropsychiatric Interview, all measures showed good criterion validity (AUC > 0.75), except the Psychosis Screening Questionnaire, which showed low sensitivity (0.58) for psychotic disorder. No substantial differences were observed in internal consistency when stratifying by gender, age, education level, primary language, facility-type, and patient status; criterion validity showed some variability when stratified by sub-population, particularly for education, primary language, and whether the participant was seeking care that day. Exploratory factor analyses indicated that the measures best differentiate categories of diagnoses (common mental disorder, severe mental disorders, substance use disorders, and suicide risk) rather than individual diagnoses, suggesting the utility of a transdiagnostic approach. Our findings support the use of these measures in Mozambique to identify common mental disorders, substance use disorders, and suicide risk, but indicate further research is needed to develop an adequate screen for severe mental disorders. Given the limited mental health specialists in this and other LMIC settings, these brief measures can support non-specialist provision of mental health services and promote closure of the treatment gap.
Deborah R. Gustafson
Department of Neurology, State University of New York Downstate Health Sciences University, Brooklyn, New York
Recai Yucel
Department of Biostatistics, Temple University, Philadelphia, Pennsylvania
Samuel Apple
State University of New York Downstate Health Sciences University, College of Medicine, Brooklyn, New York
Gianna Cirrone
State University of New York Downstate Health Sciences University, College of Medicine, Brooklyn, New York
Haoyuan Gao
Department of Biostatistics, Temple University, Philadelphia, Pennsylvania
Aaron Huang
State University of New York Downstate Health Sciences University, College of Medicine, Brooklyn, New York
Xinrui Ma
Department of Biostatistics, Temple University, Philadelphia, Pennsylvania
Ayesha Saad
State University of New York Downstate Health Sciences University, College of Medicine, Brooklyn, New York
Jeremy Wilson
State University of New York Downstate Health Sciences University, College of Medicine, Brooklyn, New York
Sarah Kabariti
Department of Emergency Medicine, Maimonides Medical Center, Brooklyn, New York; Department of Emergency Medicine, State University of New York Downstate Health Sciences University, Brooklyn New York
Sergey Motov
Department of Emergency Medicine, Maimonides Medical Center, Brooklyn, New York; Department of Emergency Medicine, State University of New York Downstate Health Sciences University, Brooklyn New York
Abstract
Background. Maintaining good mental health among Emergency Department healthcare workers (ED HCW) is paramount to well-functioning healthcare. We measured mental health and COVID-19 symptoms in ED HCW at a COVID-19 epicenter.
Methods. A cross-sectional, convenience sample of adult (>18 years) ED HCW in Brooklyn, New York, USA, who were employed at >50% of a full-time effort, was surveyed September–December, 2020 with reference period March-May 2020. An anonymous email-distributed survey assessed gender, age, race, healthcare worker status (clinical versus non-clinical), SARS-CoV-2 testing, number of people to talk to, COVID-19-related home problems, mental health care interruption during COVID-19, loneliness, and survey date. Outcomes included symptoms of depression, psychological distress, perceived stress, post-traumatic stress disorder (PTSD), anxiety, and resilience measured using validated scales.
Results. Of 774 HCW, 247 (31.9%) responded (mean age 38.2±10.8 years; 59.4% White; 52.5% men; 80.1% clinical; 61.6% SARS-CoV-2 tested). Average mental health scores were significantly higher among clinical vs non-clinical HCW (P’s<0.0001-0.019). The proportion reporting a clinically-relevant psychological distress symptom burden was higher among clinical vs non-clinical HCW (35.8% vs 13.8%, p=0.019); and suggested for depression (53.9% clinical vs 35.7% non-clinical, p=0.072); perceived stress (63.6% clinical vs 44.8% non-clinical, p=0.053); and PTSD (18.2% clinical vs 3.6% non-clinical, p=0.064). Compared to non-clinical staff, Medical Doctors and Doctors of Osteopathy reported 4.8-fold higher multivariable-adjusted odds of clinically-relevant perceived stress (95%CI 1.8-12.9, p=0.002); Emergency Medical Technicians reported 15.5-fold higher multivariable-adjusted odds of clinically-relevant PTSD (95%CI 1.6-150.4, p=0.018). Increasing age, number of COVID-19-related home problems and people to talk to, loneliness and mental health care interruption were adversely associated with mental health; being male and SARS-CoV-2 testing were beneficial.
Conclusions. COVID-19-related mental health burden was high among ED HCW in Brooklyn. Mental health support services are essential for ED HCW.
Elizabeth Armstrong-Mensah
Georgia State University School of Public Health, Atlanta, Georgia.
Maha Karim
Georgia State University School of Public Health, Atlanta, Georgia.
Oluwatoyosi Ogunmuyiwa
Georgia State University School of Public Health, Atlanta, Georgia.
Ernest Alema-Mensah
Morehouse School of Medicine, Department of Community Health and Preventive Medicine, Atlanta, Georgia.
Florence Darko
Georgia State University School of Public Health, Atlanta, Georgia.
Kritika Kolla
Georgia State University School of Public Health, Atlanta, Georgia.
Abstract
Objective: The study examined the mental health conditions experienced by working mothers as caregivers in Georgia, United States during the COVID-19 pandemic, the causes and outcomes of the mental health conditions experienced, and the coping mechanisms they employed.
Methods: A mixed methods cross-sectional study design was used to collect data from 132 working mothers in Georgia across six domains using Qualtrics. Quantitative data was analyzed using SPSS and SAS. Qualitative data was analyzed using a thematic approach.
Results: Working mothers experienced depression and anxiety while providing care during the pandemic. The lack of access to childcare and family support (12.5%), home schooling (18.1%), and juggling work and family (25.6%) contributed to the mental health conditions experienced, which led to anger (12.5%), aggression towards partners (11.3%), and the inability to sleep (18.8%). Coping mechanisms employed were drinking (1.3%), smoking (5.6%) and arguing with a spouse (8%).
Conclusion: While the pandemic affected the mental health of many adults in the US, working mothers providing care were among the population hardest hit. Although the immediate threat of COVID-19 has abated, its impact on mental health cannot be overlooked. By focusing primarily on the mental health of working mothers as caregivers during the pandemic, the study draws attention to, and underscores the need for targeted interventions and policies to be put in place to respond to the mental health needs of this population in the event of a future global health emergency.
Mayur N Mishra, BDS, MDS
Reader, Department Of Public Health Dentistry, K M Shah Dental College and Hospital, Sumandeep Vidhyapith (An institution deemed to be University), Piparia, Vadodara 391760, Gujarat, India.
Suchit Dana, BDS, MDS
Reader, Department of Periodontology, K M Shah dental college and hospital, Sumandeep Vidhyapith (An institution deemed to be University), Waghodia, Vadodara 391760, Gujarat, India.
Pranav Kurup
Senior Lecturer, Department Of Public Health Dentistry, K M Shah Dental College And Hospital, Sumandeep Vidhyapith (An institution deemed to be University), Piparia, Vadodara 391760, Gujarat, India.
Ubaid Kureshi
Senior Lecturer, Department Of Public Health Dentistry, K M Shah Dental College And Hospital, Sumandeep Vidhyapith (An institution deemed to be University), Piparia, Vadodara 391760, Gujarat, India.
Shiba Vijayan
Senior Lecturer, Department Of Public Health Dentistry, Vydehi institute of Dental science and research centre, Whitefield , Bangalore.
Nairuti Dave
General dental practitioner, Bhavnagar.
Abstract
Health workers are central to the COVID-19 pandemic response, balancing additional service delivery needs while preserving access to essential health services and deploying COVID-19 vaccines. They also face higher risks of infection in their efforts to protect the greater community and are exposed to hazards such as psychological distress, fatigue and stigma.
Methodology: A retrospective cross sectional study is carried out among the health care workers residing Gujrat, India. A cross sectional study was carried out among the sample of 600 registered health care workers,(specialist, general physian, nurses, others) who were active during covid pandemics. Online questionnaire (DASS 21 and Maslach burnout inventory) were distributed to the participants to evaluate their stress, anxiety and depression status.
Results: Around 48.1 % participants were suffering from mild-moderate to severe level of depression. Anxiety was found to effect around 60% of health care workers. And almost 68% of health care worker has suffered from stress. The burnout level was also very high among health care worker (table 5). It was found that 52% participants were having low-moderate to high level of burnout.
Conclusion: Stressfulness of work, and practice management were factors in which reality was experienced to be worse than expected. Also, finding a suitable practice was something that appeared more difficult than expected in their early career. Burnout is recognized as a potential problem within a broad range of occupations, and within many different countries.
van der Aa H.P.A
Amsterdam UMC, location Vrije Universiteit Amsterdam, Ophthalmology, De Boelelaan 1117, Amsterdam, The Netherlands/ Amsterdam UMC, location Vrije Universiteit Amsterdam, Public and Occupational health, De Boelelaan 1117, Amsterdam, The Netherlands
van Nassau F
Amsterdam UMC, location Vrije Universiteit Amsterdam, Public and Occupational health, De Boelelaan 1117, Amsterdam, The Netherlands / Amsterdam Public Health, Quality of Care, Mental Health, Aging and Later Life, Amsterdam, The Netherlands
Rozemeijer S.C.A.
Amsterdam UMC, location Vrije Universiteit Amsterdam, Ophthalmology, De Boelelaan 1117, Amsterdam, The Netherlands
Schakel W.
Amsterdam UMC, location Vrije Universiteit Amsterdam, Ophthalmology, De Boelelaan 1117, Amsterdam, The Netherlands / Amsterdam Public Health, Quality of Care, Mental Health, Aging and Later Life, Amsterdam, The Netherlands
van Rens G.H.M.B.
Amsterdam UMC, location Vrije Universiteit Amsterdam, Ophthalmology, De Boelelaan 1117, Amsterdam, The Netherlands
van Nispen R.M.A.
Amsterdam UMC, location Vrije Universiteit Amsterdam, Ophthalmology, De Boelelaan 1117, Amsterdam, The Netherlands / Amsterdam Public Health, Quality of Care, Mental Health, Aging and Later Life, Amsterdam, The Netherlands
Abstract
Purpose: Mental health problems are common in patients with macular oedema, who receive repeated intravitreal injections with anti-vascular endothelial growth factor. A guided internet-based self-help intervention, called E-PsEYE, was developed to reduce these problems. Patients were referred by their ophthalmologist to follow E-PsEYE individually at home, guided by a social worker from low vision services. Since e-mental health is new in this setting and professionals were collaborating in a novel way, barriers and facilitators during implementation and for future scale-up were evaluated.
Methods: Semi-structured interviews were performed with patients (n=8), ophthalmologists (n=4), heads of ophthalmology departments (n=2), doctor’s assistants (n=3), social workers (n=6) and managers from low vision services (n=2), and representatives from a health insurer (n=2). Data were analyzed using a thematic approach.
Results: Both patients and professionals were satisfied with the potential efficiency and added value of the intervention. They indicated that sufficient digital skills in patients and social workers, information technology (IT) support and adding personalized face-to-face contacts, could facilitate implementation. However, a high workload within the different settings (i.e., hospital and low vision services) and the reluctance of both patients and professionals in focusing on mental health problems could hinder implementation. Moreover, evidence on cost-effectiveness and incorporation in current guidelines were expected to be important for reimbursement and scale-up.
Conclusions: Both on the individual level and in the interaction between stakeholders and their context, different important barriers and facilitators were expressed. To facilitate the use of E-PsEYE in practice, strategies that focus on these aspects could be implemented, e.g. healthcare providers could discuss and normalize mental health complaints and their digital skills could be supported.
Georgia Konstantopoulou
Department of Educational Sciences and Social Work, University of Patras, Greece
Martha Toli
Department of Educational Sciences and Social Work, University of Patras, Greece
Maria Skondra
Department of Psychiatry, Faculty of Medicine, University of Patras, Greece
Marina Charalampopoulou
Department of Psychiatry, Faculty of Medicine, University of Patras, Greece
Panagiotis Felemegkas
Department of Psychiatry, Faculty of Medicine, University of Patras, Greece
Panagiotis Alexopoulos
Department of Psychiatry, Faculty of Medicine, University of Patras, Greece
Eliza Georgiou
Department of Psychiatry, Faculty of Medicine, University of Patras, Greece
Abstract
Background: This study investigates the influence of anxiety and anger on the brain health of primary school children and how these emotions manifest in daily life. While anxiety and anger are normal emotional responses, chronic experiences can impact both physical and psychological well-being.
Method: The study involved 96 primary school students from Patras, aged between eight and twelve, with younger grades excluded due to comprehension difficulties. Participants completed questionnaires assessing their health, physical activity, mood, and the frequency and intensity of anxiety and anger symptoms. Descriptive statistics were utilized to analyze the data.
Results: Among the participants, 56.25% were girls and 43.75% were boys. Most reported very good (51.04%) or excellent (33.33%) health. High levels of physical activity and substantial energy were common, with 54.17% being very active and 62.50% having a lot of energy. Positive moods predominated, though 57.29% sometimes felt angry and 76.04% rarely felt sadness. Physical symptoms of anxiety, such as stomach pain (51.04%) and tachycardia (40.63%), were prevalent.
Conclusion: The findings underscore the significant presence of anxiety and anger among children, highlighting their impact on physical symptoms and potential implications for brain health. Early intervention and support are essential to manage these emotions constructively. Addressing environmental and social factors that trigger anxiety and anger is crucial for fostering healthy emotional development and maintaining optimal brain health.
Ehiremhen Ozah
Urology Unit, Department of Surgery, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
Esteem Tagar
General Surgery Unit, Department of Surgery, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
William Akerele
Paediatric Surgery Unit, Department of Surgery, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
Abstract
Background: Coronavirus disease had a devastating effect on the World, with significant disruption in healthcare, the burgeoning impact is still unfolding. The inequities and fragilities amongst nations particularly low and medium economic countries whose patients are dependent on out of pocket expenditure to access healthcare, has occasioned varied consequence of the pandemic on patients in the health care setting and it has reshaped how health care is practiced.
Aims: The aim of this review article was to assess the impact of Coronavirus disease on health care utilization by non -COVID patient during the pandemic.
Methods: The review article was carried out with a search engine focused on articles related to impact of Coronavirus disease published between December 2019 till date, which were identified and reviewed.
Conclusion: The review article gave an insight to the significant disruptions in health care services amongst patients witnessed across countries of the world, the disparities in the disruptions were due to heterogeneity amongst nations, national policies and health policies during the pandemic and the socioeconomic realities that ensued. Outpatient services witnessed varying reduction across the globe ranging between 30-50%. Sub-Saharan Africa witnessed disruption as much as 50% depending on load of COVID-19 infection amongst populace. The reason for the interruptions across the world was the fear of contracting the disease, access to health care setting due to lock down and shortage of health care personnel, in addition in sub-Saharan Africa, the economic down turn occasioned by the pandemic reduced household income which in turn reduced expenditure on health since most countries were dependent on out of pocket expenditure to fund health care services.
In-patient care was also not spared of the disruptions witnessed even though emergency care was prioritized. Overall, there was a reported reduction in admissions for respiratory diseases due to non- pharmacological measures aimed at stemming COVID-19 infection which was equally effective for other respiratory diseases. In some countries like United States the reduction in hospital admissions was paralleled by increasing mortality particularly amongst Hispanic blacks as more acute and severe cases were deemed to have presented for admissions. Surgical priority was maintaining emergency services and prioritization of cancer care, there was a measurable reduction in surgical procedures as elective surgeries were postponed or cancelled. Most laparoscopic and endoscopic procedures were cancelled because of the perceived notion that they are aerosol generating and could increase transmission of COVID-19 infection from asymptomatic carriers, however US jettisoned cancellation of its surgical procedures after 35 days considering that it could not cope. The psychosocial impact of the pandemic and health care access spiraled into increasing anxiety and depression for both health care workers and patients, while the fear of stigmatization was rife from contracting the disease.
Thaisa Mara Leal Cintra Rodrigues
PhD student in Sciences at the University of São Paulo – Interunit Program at the Ribeirão Preto School of Nursing, Ribeirão Preto, São Paulo, Brazil.
Rita de Cássia de Marchi Barcellos Dal
Phd at the University of São Paulo at Ribeirão Preto College of Nursing, EERP-USP, Ribeirão Preto, São Paulo, Brazil.
Carla Aparecida Arena Ventura
Full Professor at the University of São Paulo at Ribeirão Preto College of Nursing, EERP-USP, Ribeirão Preto, São Paulo, Brazil.
Abstract
Background: The post-pandemic historical moment of COVID-19 has had consequences on the mental health of workers, evidenced by the growing statistics of depression, anxiety, suicidal ideation, panic syndrome, burnout syndrome, psychotic episodes, alcohol and drug addiction, stress, fatigue, and professional exhaustion.
Aims: Analyse the recommendations of the International Labour Organization and the Brazilian laws applicable to occupational mental health to identify documents that address intervening laws in workers’ mental health in the international scientific literature and introduce Bill 3,588/2020, which aims to regulate occupational psychosocial risks.
Methods: Narrative review of the scientific literature in the databases Scopus, Lilacs BVS, PubMed, Cinhal, and Ebesco and document analysis of Brazilian legislation and international recommendations on workers’ mental health and norms related to exposure to occupational psychosocial risks and measures of intervention in mental health.
Results: The International Labour Organization established three Conventions to protect workers’ health. In the Brazilian legal system, six broad and general norms were identified. The narrative prediction resulted in nine intervening laws that address the worker’s mental health. Conclusion: In Brazil, there is no specific legislation regarding the worker’s right to mental health, nor any regulation through Regulatory Norms, which demonstrates the need for the approval of Bill 3,588/2020, pending in the National Congress, which aims at regulating psychosocial risks, such as intervention, management, and prevention measures capable of minimizing mental illness at work.
Christine B. Weldon, MBA
The Center for Business Models in Healthcare
Brittani James, MD
University of Illinois at Chicago, UI Health Mile Square Health Center
Kimberly Jinnett, PhD, MSPH
Genentech
Caroline Solon, MSc
Genentech
Claire Thesing, MD
University of Illinois at Chicago, UI Health Mile Square Health Center
Judes Fleurimont
UI Health Mile Square Health Centers
Karriem S. Watson, DHS, MS, MPH
University of Illinois at Chicago, UI Health Mile Square Health Center
Julia R. Trosman, PhD, MBA
The Center for Business Models in Healthcare
Abstract
There is an under-addressed need to help patients who experience mild-to-moderate COVID-19 symptoms or are asymptomatic, to manage their disease at home. While no approved COVID-19 medical treatments exist for these patients, home-based self-management is crucial because it has the potential to relieve patients’ symptom burden and provide concrete actions that help mitigate anxiety, isolation and loss of personal control associated with the disease. Existing resources often provide a deluge of information, which may not be readily actionable by patients. Additionally, existing resources focus primarily on managing severe symptoms. A 4R COVID-19 toolkit was developed to address the unmet need for patients with mild or moderate COVID-19 symptoms based on expert discussions and a literature review. The toolkit applies the principles of the previously developed 4R Oncology Model of providing patients with a project plan for the course of their COVID-19 care, information on self-management of mild to moderate symptoms, and criteria for contacting their medical provider. The toolkit was developed with support from Genentech; it is not intended to substitute for the medical advice of a healthcare provider. The 4R COVID-19 toolkit continues to be improved as updated information is available via patient and clinician feedback, literature, and expert guidance. A copy of the current toolkit is attached to this paper for use and adaptation by care providers, practices, and institutions.
Maria Evandrou
ESRC Centre for Population Change, University of Southampton, Southampton, UK; Centre for Research on Ageing, University of Southampton, Southampton, UK
Jane Falkingham
ESRC Centre for Population Change, University of Southampton, Southampton, UK
Min Qin
ESRC Centre for Population Change, University of Southampton, Southampton, UK
Athina Vlachantoni
ESRC Centre for Population Change, University of Southampton, Southampton, UK; Centre for Research on Ageing, University of Southampton, Southampton, UK
Abstract
Objectives: The COVID-19 crisis significantly reshaped individuals’ daily lives and work, potentially also affecting their mental health. This study examines changes in psychological stress, anxiety, and depression during the first lockdown amongst five British cohorts at different stages of the life course: older adolescence, early adulthood, mid-career, and later life. It investigates the correlation between self-reported stress and life changes across a range of domains including health; education and the move to home schooling; working patterns and furlough; and living arrangements and family life.
Methods: The study analyses data from 14,130 cohort members participating in the special COVID-19 surveys conducted in May 2020. These surveys are part of the ongoing 1946, 1958, 1970, and 2000-01 British birth cohorts, as well as the Next Steps cohort (born in 1989-90). Probit regression models assess the likelihood of increased stress among individuals reporting pandemic-related life changes compared to those who did not, across a range of different life domains. The study also examines the association between heightened stress and subsequent anxiety and depression.
Results: The research highlights the diverse challenges faced by individuals at different life stages during the early phase of the pandemic. Young people faced disrupted education, with many returning to the parental home; parents had to cope with the closure of schools and childcare services, dealing with young children at home; mid-career professionals also found themselves balancing work and family responsibilities; retirees faced cancelled medical appointments and disrupted home care services. All these challenges were associated with significantly increased reported stress among affected individuals; particularly in adolescence and young adulthood, where mental health outcomes were poorer than in older cohorts. Moreover, heightened stress substantially raised the risk of developing anxiety and depression.
Conclusions: The study affirms that individuals in various life stages faced exceptional challenges during the initial lockdown, adversely affecting mental well-being. Adolescents and young adults, experiencing more life changes but lacking coping resources, felt the disruption especially heavily. Going forward, given the potential health consequences of prolonged stress, anxiety, and depression, policymakers must consider these temporary challenges through a life course lens when designing appropriate interventions and support services.
Abstract
Introduction: Childhood and adult trauma are common experiences in perinatal women worldwide. Psychological trauma has a well-documented effect on mothers’ mental health, but less is known about its impact on breastfeeding.
Objectives: This article synthesizes the results from recent studies on trauma on breastfeeding and perinatal mental health. I describe possible mechanisms by which trauma influences breastfeeding and mental health and provide practical suggestions for working effectively with this population.
Method: Studies were identified via searches in PubMed and PsychInfo. Key words were adverse childhood experiences, child abuse, child maltreatment, intimate partner violence, birth trauma, pregnancy, postpartum, breastfeeding, postpartum depression, postpartum anxiety, and posttraumatic stress disorder (PTSD). Preference was given to studies published in the past 5 years, but older studies were included if more recent studies were not available. Review articles were also included.
Results: Psychological trauma can affect anyone regardless of income, religion, country of origin, age, or race and ethnicity. Pregnant and postpartum women are no exception. Traumatic experiences can make breastfeeding more difficult, but it is often an important goal for trauma survivors. Some studies have found that trauma survivors are more likely to breastfeed. Breastfeeding may be particularly important for trauma survivors in that it lessens trauma symptoms, improves mental health, and lowers the risk of mothers maltreating their children. When working with trauma survivors, it is important that practitioners avoid making assumptions that mothers will not breastfeed. It is important to support their breastfeeding goals.
Clinical Implications: Providers who work with new mothers will likely encounter a substantial percentage who are trauma survivors. Trauma survivors may not share their stories with providers, even if they directly ask, but these mothers’ experiences can influence both breastfeeding and their mental health. Practitioners who understand trauma and support breastfeeding in a trauma-informed way can positively influence both breastfeeding and mental health outcomes. Both childhood and adult trauma can have a negative effect on breastfeeding, but the mechanism may vary. Recent trauma can directly impact hormones needed for breastfeeding whereas childhood trauma may impact it via trauma sequelae, such as depression, anxiety, and PTSD.
Giovana Cugini Sanches
Universidade de Taubaté (São Paulo – Brazil)
Juliana Santos de Lima
Universidade de Taubaté (São Paulo – Brazil)
Marcella Vizcaya Val Delatorre
Faculdade Israelita de Ciências da Saúde Albert Einstein (São Paulo – Brazil)
Abstract
Introduction: During the Covid-19 pandemic, a rise in symptoms of anxiety and depression was described in the general population. It’s critical to analyze these symptoms in the pediatric population, considering the influence of mental health across the social and academic domains, and its impact on neurodevelopment, morbidity, and mortality. This study aims to recognize and compare its risk factors, and suggest evidence-based policies to mitigate the adverse effects of future pandemics on youth.
Methodology: Using a search strategy through PubMed, CINAHL, and Scholar Google platforms, after screening 106 articles, 50 were read in full. After its analysis, 10 met the inclusion criteria of a publication date after March 2020, cross-section or cohort/case-control study with data including general pediatric population mental health or pediatric population infected with Covid-19 mental health.
Discussion: In the general pediatric population, isolation, higher time of screen use, and information restriction to one news vehicle were factors associated with the self-reported psychological distress. Nonetheless, the time spent exercising was suggested as a protection element. In the sociodemographic domain, older age, low socioeconomic status, migration background, and limited living space were associated with adverse mental health. Hospitalization and Long-Covid were risk factors associated with the pediatric population infected with the SARSCov-2.
Conclusion: It’s crucial to measure and discuss the impact of the Covid-19 pandemic on the mental health of vulnerable children and adolescents. Applicable interferences that showed less anxiety in hospitalized kids were contacting the family member through free teleconferencing programs and providing video games for children in isolation. There are still COVID-19 worldwide studies and data to be released, it’s a subject to continue its discussion, and formulation of evidence-based policies.
Stephanie F. Dailey
College of Education and Human Development, George Mason University, Fairfax, Virginia. 4400 University Drive MSN 1H1 Fairfax, VA 22030.
Abstract
This article explores the nuanced relationship between COVID-related stressors and mental health outcomes, with a particular focus on sociodemographic patterns and implications for practice. It illuminates the psychological impacts of the pandemic, explores sociodemographic disparities outcomes among historically marginalized communities, and offers recommendations for practitioners and policymakers to address mental health challenges. It reviews current research highlighting the direct correlation between pandemic-related stressors and heightened levels of depression, anxiety, and economic instability across diverse demographic groups, while also exploring the most widely reported barriers these communities face in accessing mental health services. Through a comprehensive review of the literature, key strategies for addressing mental health disparities emphasize the importance of promoting social connectedness and dispositional mindfulness as protective factors. By integrating culturally responsive interventions, promoting mental health literacy, building resilience and coping skills, strengthening support systems, and advocating for policy changes, this article contributes to efforts aimed at reducing mental health inequities and promoting equitable access to care for all individuals affected by the pandemic.
Elena Soto Vega
Escuela de Medicina, Universidad Anáhuac Puebla
Maria Fernanda Pérez Zepeda
Escuela de Medicina, Universidad Anáhuac Puebla
Eduardo Lome Gutierrez
Escuela de Medicina, Universidad Anáhuac Puebla
Maria del Carmen Cabrera Martinez
Escuela de Medicina, Universidad Anáhuac Puebla
Samia Julieta Gomez Gomez
Escuela de Medicina, Universidad Anáhuac Puebla
Sebastian Duno Caldera
Escuela de Medicina, Universidad Anáhuac Puebla
Abstract
The accessibility of online health information has changed the decision-making process for patients concerning their health. Nevertheless, concerns persist regarding the quality and reliability of the information available on the Internet. The Internet has emerged as the dominant global source of health-related information, with a significant proportion of individuals utilizing it to retrieve information on nutrition, diseases, symptoms, and treatment options. However, the unregulated nature of online health information poses challenges in terms of assessing its credibility and accuracy. Increasingly, patients are actively engaged in healthcare decision-making, empowered by the information they acquire online. Consequently, a paradigm shift from the traditional physician-centric model to a more collaborative and patient-centered approach has occurred. Patients now have access to an expanded array of healthcare professionals and possess the ability to make informed decisions regarding their treatment and care. Nonetheless, the variability in quality of online health information and patients’ limited capacity to effectively evaluate it can give rise to misunderstandings, misinformation, and an elevated propensity for self-diagnosis and self-treatment.
Furthermore, patients’ reliance on online information can impact the patient-physician relationship, with discrepancies between online findings and physician diagnoses leading to dissatisfaction and conflicts. Barriers obstructing effective patient-physician communication on online health information include patient’s apprehension about challenging physicians, perceived resistance from physicians themselves, and difficulties in comprehending and articulating the information sourced online. Addressing these barriers and enhancing the patient-physician relationship can yield positive outcomes, including timely diagnosis, effective treatment, and shared decision-making. While Internet use brings advantages such as increased accessibility to healthcare providers and enhanced patient empowerment, it also introduces certain disadvantages. The prevalence of misinformation and disinformation on the Internet engenders risks, contributing to confusion and a lack of trust in healthcare institutions. Additionally, patients may encounter challenges in interpreting and prioritizing the information they find online, which can result in heightened anxiety and uncertainty regarding their health. This review critically examines the impact of Internet use on patient decision-making and its effect on the patient-physician relationship.
Joseph Donnelly
Department of Public Health, Montclair State University
Elena Saldutti
Department of Public Health, Montclair State University
Abstract
This commentary provides a comprehensive overview of the influence of social media on the health and well-being of adolescents, focusing on emotional/mental health, self-esteem, alcohol and drug use, peer pressure, and both negative and positive influences. It highlights concerns about the potential negative impact of social media, including increased levels of anxiety, depression, and loneliness, as well as the impact on self- esteem through seeking validation and unrealistic comparisons. Furthermore, it discusses how social media exposes adolescents to content promoting alcohol and drug use and amplifies peer pressure, leading to potential substance abuse and negative decision-making. Despite these drawbacks, the abstract acknowledges the positive aspects of social media, such as providing social support, educational resources, and mental health awareness. It emphasizes that social media can be leveraged in the high school classroom to promote healthy behaviors. Strategies for responsible social media use, critical thinking skills, digital literacy, cyberbullying prevention, and content creation are suggested as ways to navigate the online world safely and foster positive online interactions. By understanding both the negative and positive impacts of social media, collectively we can guide adolescents in using social media in a way that promotes resilience, well-being, and healthy habits. Employing strategies that harness the positive aspects of social media, educators, parents, and society can play a pivotal role in helping adolescents navigate the digital landscape, promoting healthy behaviors, and fostering resilience in the face of online challenges.
