Caring for individuals with mental illness involves significant challenges from both the unique symptoms and societal stigma associated with these conditions, often leading to caregiver neglect despite the heightened risk of anxiety and depression among caregivers. This study was designed to quantify the prevalence of anxiety and depression among caregivers and to offer a detailed configurational analysis of their sociodemographic attributes.

Random-effects meta-analyses were conducted using generalized linear mixed models to calculate the prevalence rates for each study. We explored potential sources of heterogeneity through meta-regression and subgroup analyses. Qualitative Comparative Analysis (QCA) was utilized to identify sociodemographic configurations that contribute to anxiety and depression. The study was pre-registered in PROSPERO (CRD42023478003).

A total of 52 studies involving 10,232 participants were included. The prevalence of depression was 43.91 % (95 % CI: 34.62 %-53.65 %), anxiety was 66.56 % (95 % CI: 48.45 %-80.82 %), and comorbidity was 37.24 % (95 % CI, 19.75 %-58.85 %). QCA identified four sociodemographic configurations contributing to depression and two contributing to anxiety. Key contributors to depression included younger, unmarried, highly educated female caregivers, as well as older, married caregivers caring for patients with schizophrenia. Anxiety was more prevalent among older, married caregivers of patients with schizophrenia and younger, highly educated female caregivers.

Differences in the measurement tools used across studies may have impacted the results of this study.

The high prevalence of depression and anxiety among caregivers of individuals with mental illness underscores the need for targeted mental health services and policies.

Following the COVID-19 outbreak, smartphone usage among quarantined Chinese college students surged significantly, leading to a growing dependency on their devices and adversely impacting their emotional well-being. Consequently, the negative emotions associated with smartphone addiction have emerged as critical factors influencing students' life satisfaction. However, the psychological mechanisms linking these emotional effects to life satisfaction, as well as potential sustainable educational interventions, remain insufficiently explored. This study assessed a sample of 322 undergraduates (51.6% male) using the Mobile Phone Addiction Index (MPAI), the Depression, Anxiety, and Stress Scale (DASS-21), and the Satisfaction With Life Scale (SWLS) to construct a mediation model. The aim was to examine the relationships between smartphone addiction, negative emotions, and life satisfaction. Results revealed that smartphone addiction was significantly positively correlated with negative emotions (r = 0.332, p < 0.01), while negative emotions were significantly negatively correlated with life satisfaction (r = -0.391, p < 0.01). Among these negative emotions, depression emerged as a key factor, intensifying smartphone dependence and detrimentally affecting overall life satisfaction. The mediation analysis demonstrated that smartphone addiction contributes to the development of negative emotions, which in turn reduce life satisfaction. Students with higher levels of smartphone addiction reported heightened negative emotions, leading to more pessimistic coping strategies and, ultimately, a decline in mental health and life satisfaction. This study provides valuable insights into the impact of smartphone addiction on college students' life satisfaction and offers actionable educational recommendations to mitigate its harmful effects, promoting healthier and more sustainable lifestyles for students.

The Covid-19 pandemic posed challenges for the psychological care of adolescents, and in particular those in therapeutic groups. Exploring three sessions of a psychoanalytic psychodrama group in early 2021 in a day hospital in Paris, the article considers how the pandemic threatened the intra- and intersubjective relations, and how these dangers were elaborated. The psychodrama group helped the adolescents to create fantasy and symbolisation activities, so that a transitional space could be restored.

This study aims to explore the perceptions of patients affected by COVID-19 and their families regarding the challenges faced, coping strategies used and lessons learnt in Pakistan.

A qualitative exploratory descriptive approach was used to explore the real-time experiences of the participants.

The study was carried out in a tertiary care hospital in Karachi, Pakistan.

Purposive and snowball sampling methods were used to enrol 22 dyads of adult patients diagnosed with COVID-19 and their respective family members (FMs) (spouse, children, siblings or any other FM sharing a residence in Karachi, Pakistan, with the patient before quarantine). The 44 participants, with 23 females and 21 males, had an average age of 43.2 years.

We identified five key themes: practising a healthy diet and physical activity to boost immunity; developing workplace policies for job security, safety and mental well-being; encouraging digitalisation of health through teleconsultation and virtual learning; using technology and artificial intelligence to transform healthcare delivery systems; and empowering resilience and community unity to promote mental well-being.

The study summarises the opinions of people directly affected by COVID-19 and the stakeholders of systemic challenges. The findings of the study can guide further strengthening of the healthcare system and improvements of organisational policies to facilitate better preparation of marginalised communities for future pandemics.

To quantify access to health services during the COVID-19 pandemic and measure the change in use between the prepandemic and the pandemic periods in a population with assessment of psychological distress or diagnosis of mental disorders.

We developed and piloted a search syntax and adapted it to enter the following databases from 1 January 2020 to 31 March 2023: PubMed/MEDLINE, PsycINFO, Web of Science, Epistemonikos and the WHO International Clinical Trials Registry Platform. We reran the searches from the end of the original search to 3 December 2024.

We systematically screened titles, abstracts and full texts of retrieved records.

We included observational studies on any populations and regions, covering health services such as doctor visits, hospital admissions, diagnostic examinations, pharmaceutical therapies and mental health (MH) services. Only studies using validated scales to assess psychological distress or mental disorders as defined in the Diagnostic and Statistical Manual of Mental Disorders were included.

We extracted data using a purposefully designed form and evaluated the studies' quality with the Newcastle-Ottawa Scale. We measured the incidence rate (IR) of access to health services and the IR ratio (IRR) between the prepandemic and the pandemic periods. We calculated contacts days and catchment areas in the different periods. We used the random effects DerSimonian-Laird inverse-variance model and calculated heterogeneity with statistics I² and τ². We computed pooled IR and pooled IRR and tested the hypothesis of no variation (IRR=1).

We retrieved 10 014 records and examined the full text of 580 articles. We included 136 primary studies of which 44 were meta-analysed. The IR of access to services during the pandemic was 2.59 contact months per 10 000 inhabitants (IR=2.592; 95% CI: 1.301 to 5.164). We observed a reduction of 28.5% in the use of services with negligible differences by age group and type of services (IRR=0.715; 95% CI: 0.651 to 0.785). We observed significant differences in effect sizes across studies (τ2=5.44; p<0.001 and τ2=0.090; p<0.001).

By considering MH, our study provides consolidated evidence and quantifies the reduction in the use of health services during the COVID-19 pandemic.

CRD42023403778.

Artificial intelligence (AI) has been recently applied to different mental health illnesses and healthcare domains. This systematic review presents the application of AI in mental health in the domains of diagnosis, monitoring, and intervention. A database search (CCTR, CINAHL, PsycINFO, PubMed, and Scopus) was conducted from inception to February 2024, and a total of 85 relevant studies were included according to preestablished inclusion criteria. The AI methods most frequently used were support vector machine and random forest for diagnosis, machine learning for monitoring, and AI chatbot for intervention. AI tools appeared to be accurate in detecting, classifying, and predicting the risk of mental health conditions as well as predicting treatment response and monitoring the ongoing prognosis of mental health disorders. Future directions should focus on developing more diverse and robust datasets and on enhancing the transparency and interpretability of AI models to improve clinical practice.

The proliferation of chatbots in the digital mental health sector is gaining momentum, offering a promising solution to address the pressing shortage of mental health professionals. By providing accessible and convenient mental health services and support, chatbots are poised to become a primary technological intervention in bridging the gap between mental health needs and available resources.

This study undertakes a thorough bibliometric analysis and discourse on the applications of chatbots in mental health, with the objective of elucidating the underlying scientific patterns that emerge at the intersection of chatbot technology and mental health care on a global scale.

The bibliometric software Biblioshiny and VOSviewer were used to conduct a comprehensive analysis of 261 scientific articles published in the Web of Science Core Collection between 2015 and 2024. Publications distribution are analyzed to measure productivity on countries, institutions, and sources. Scientific collaboration networks are generated to analyze the influence as well as communications between countries and institutions. Research topics and trends are formulated by using a keyword co-occurrence network.

Over the last decade, researches on utilization of chatbots in mental health has appeared to be increasing steadily at an annual rate of 46.19%. The United States have made significant contributions to the development and expansion of publications, accounting for 27.97% of the total research output with 2452 citation counts. England came second to the US in terms of publications and citations, and followed by Australia, China, and France. National Center for Scientific Research in France ranked first among all institutions, followed by Imperial College London and University of Zurich. The number of articles published in Journal of Medical Internet Research was exceptionally high, accounting for 12.26% of the total number of articles, and JMIR Mental Health is the most influential publication sources in terms of average citations per article. Collaboration among universities in the USA, United Kingdom, Switzerland, and Singapore demonstrated a high level. The keyword co-occurrence network highlights the prominent techniques in this multidisciplinary area and reveals 5 research topics, showing a significant overlap between clusters. High-frequency terms such as "ChatGPT", "machine learning", and "large language models" underscore the current state of research, highlighting the cutting-edge advancements and frontiers in this field.

This study provides an in-depth analysis of the most prominent countries, institutions, publications, collaboration status, and research topics associated with utilization of chatbots in mental health over the last decade. It offers insights to mental health professionals without an AI background and individuals interested in the development of mental health chatbots. The findings suggest that chatbots hold a significant role in promoting mental health well-being and exhibit considerable potential in demonstrating empathy, curiosity, understanding, and collaborative capabilities with users.

The COVID-19 pandemic has led to a global health crisis and a significant increase in psychological distress and psychopathological symptoms. We conducted a randomized controlled trial with two online interventions derived from positive psychology (PP) and acceptance and commitment therapy (ACT) in N = 138 "homestayers" during the first lock-down period in Germany. PP exercises had a positive impact on anxiety scores, which decreased significantly during the intervention, particularly in participants without access to a garden. Direct or indirect social contact, movement/exercise, and exposure to nature were the most frequently reported helpful coping strategies. We conclude that low-threshold online interventions with a focus on positive aspects of people's lives may be helpful to support mental health during pandemic crises. From a mental health perspective, the results also reinforce the approach of countries that allow their citizens to, for example, still go for walks during periods of contact restrictions, compared to full lock-down conditions.

The impact of the COVID-19 pandemic on the epidemiological characteristics of depression among adults in the U.S. remains unclear. This study aims to analyze trends in depression prevalence over time and quantify the effect of the COVID-19 pandemic on its prevalence. Using data from 2007 to 2023 provided by the National Health and Nutrition Examination Surveys (NHANES), this study examined 36,472 participants. Results revealed an increasing trend in depression prevalence among U.S. adults from 2007 to 2023. Notably, the overall weighted prevalence of depression following the COVID-19 pandemic (12.4%, 95% CI: 10.6-14.1%) was significantly higher than in all years prior to the pandemic. Subgroups such as females, Mexican Americans, and young adults experienced particularly pronounced increases. By analyzing data from two survey cycles close to the onset of the COVID-19 outbreak, the study identified a significant impact of the pandemic on depression prevalence, with an adjusted odds ratio of 1.58 (95% CI: 1.28-1.94). Individuals with lower socioeconomic status and those without pre-existing conditions exhibited greater increases in depression prevalence, whereas the emotional health of individuals who smoke appeared unaffected by the pandemic.

The COVID-19 pandemic disrupted the ability to receive health care services. Field-based health services became a logistically feasible alternative to medical center-based care. We compared two different field-based approaches to the delivery of SARS-CoV-2 testing and health education services for Latine communities using a quasi-experimental design that included propensity score matching to accommodate the challenges posed to research by the pandemic. From September 2021 through October 2022, we held 434 testing events, of which 234 used a geolocation approach and 200 used a partner-located approach to determine the location of the health services (n = 68 field sites in Oregon). We hypothesized that partner-located sites would obtain higher numbers of tests collected relative to geolocated sites, and that longer drive times to testing sites would be associated with lower testing rates. There were no differences in the number of tests collected by geolocated versus partner-located sites, controlling for population size and time-varying pandemic vulnerabilities measured as COVID-19 cases and deaths. Prior to propensity score weighting, a longer drive time to the testing site (both site types) was associated with a lower likelihood of total tests (IRR = .87, p < .01, CI [0.54, 0.92]), of Latine tests (IRR = .69, p < .001, CI [0.56, 0.84]), and of male tests collected (IRR = .67, p < .05, CI [0.47, 0.94]). The site's number of prior tests was associated with a significant 2% increase in tests collected and the prior week's number of county deaths was associated with a roughly 30% decrease in the likelihood of tests collected. However, the reduced testing rate when the death rate was higher was less likely in geolocated sites (IRR = 1.55, p < .001, CI [1.20, 2.01]). Implications for the utility of propensity score matching and time-varying covariates to accommodate pandemic challenges posed to research are discussed. Clinicaltrials.gov registration number: NCT05082935. Date of registration: 10/15/2021.

This research aimed to comprehensively explore the impact of diverse challenges encountered by older adults on the development of post-traumatic stress disorder (PTSD). It delved into how these effects vary depending on individuals' levels of trust in authority and medical professionals, providing a nuanced understanding of the interplay between external challenges, personal trust, and mental health outcomes in the older population.

The COVID-19 pandemic has imposed significant hardships, particularly on the ageing population, with potential psychological repercussions such as PTSD. Notably, there is a dearth of research exploring this association within the context of Chinese older adults, a group that may experience unique impacts due to cultural differences in the face of global crises.

Data were collected from a representative sample of 1,211 participants aged 60 years and above in Shenzhen. Logistic and hierarchical linear regression methods were utilized to investigate the relationship between the challenges posed by COVID-19, public trust, and the manifestation of PTSD symptoms.

Higher levels of challenges related to 'supplies, services access and safety', 'abuse and conflicts', and 'anger and fear' were associated with PTSD. Furthermore, a lower level of challenges related to 'disease management and information' was associated with PTSD. Trust in authority or medical professionals was the moderator between the challenges brought about by COVID-19 and PTSD, which helped to lower the impact of challenges. Despite the challenges brought by COVID-19 to people, nurturing a stronger sense of trust in authority and medical professionals would ease older adults' psychological stress and concerns.

Theories, models, and frameworks provide the foundation for occupational therapy education, research, and clinical practice. While most have a systems approach focus, other factors, such as societal influences and structural inequities, also contribute to health. Using a cross-sectional design, this study identified the gaps in occupational therapy models of practice and presents a novel approach, the PAIRE (Recognize Privilege, Acknowledge Injustice, and Reframe Perspective to Reach Equity) Model. PAIRE is focused on achieving occupational equity through the reciprocal and intersectional impact of the provider/team, the person/people seeking occupational therapy, and the occupation-in-context, with continuous influences of access, context, and justice. We describe the components of PAIRE and illustrate its functionality in education, research, and clinical practice contexts as well as case examples.

Mental health encompasses the ability to cope with important stresses of life and to realize one's abilities in the community, and the COVID-19 pandemic represented a very stressful event for people with mental illnesses. Our aim was to assess mental well-being in people living with different mental disorders, comparing results obtained in 2016 with those observed after the COVID-19 pandemic. Ninety-six participants were assessed using the Mental Health Continuum Short Form and classified as "flourishing," "moderately mentally healthy," and "languishing." Overall, a significant increase in the prevalence of "flourishing" and "moderately mentally healthy" subjects and a reduction of "languishing" subjects ( p = 0.003) were observed. However, a significant improvement in well-being ( p = 0.005) was observed only in the schizophrenia spectrum disorder group. Moreover, only subjects that never contracted SARS-CoV-2 showed a significant ( p = 0.019) increase in positive well-being states. Lockdowns may have led caregivers to spend more time with the participants, also increasing treatment adherence, resulting in an improvement of overall well-being in several participants.

Integrating robots and artificial intelligence (AI) into workplaces is becoming increasingly prevalent across various sectors, including hospitality. This trend has raised concerns regarding employee anxiety and the potential for higher turnover intentions, particularly when AI technologies are perceived to undermine professional expertise. This study explores the relationship between awareness of robotics and AI and employee turnover intentions, framed within the Conservation of Resources Theory (COR). To address the challenges posed by AI in the workforce, hotel managers must prioritise organizational support in areas such as financial resources, policy development, career advancement, and employee adaptation. The hospitality industry is leveraging AI and robotics to enhance guest interactions and service delivery, yet this technological shift may inadvertently increase employees' intentions to leave their positions. Employing a cross-sectional design, we gathered data through a structured questionnaire utilizing a five-point Likert scale, targeting 435 employees from 5- and 7-star hotels in Lahore, Pakistan, including CEOs, managers, directors, supervisors, executives, and room service operators. Our findings reveal a significant positive relationship between awareness of robotics and AI and employee turnover intentions. Moreover, mutual trust (MT) emerged as a moderating factor positively affecting the association between robotics awareness and turnover intentions. While technical grooming (TG) and job insecurity (JI) were not previously discussed in the literature, our research indicates that they also play critical roles in this context, highlighting the complex interplay of factors influencing turnover intentions in the face of advancing technology.

The COVID-19 pandemic has had a significant impact on global suicide attempt rates. This study evaluated the effect of the COVID-19 pandemic on suicide attempts in the Kerman Province, eastern Iran.

This is a cross-sectional study. Data on suicide attempt cases in Kerman Province was obtained from the database of Mental, Social, and Addiction Health Office of the Deputy for Health of Medical Sciences Universities from 2018 to 2021. An interrupted time-series model was used to assess the changes in suicide attempts before and after the pandemic.

Suicide attempts exhibited a decreasing trend before the pandemic, with a monthly decrease of 0.9% (P<0.001). The immediate effect of the pandemic indicated that, at the beginning of the pandemic, there was a 4.5% increase in suicide attempts (P=0.134). The sustained effect of the pandemic showed that in the months following the onset of the pandemic, the rate of suicide attempts increased by 1.8% compared to before the pandemic (P<0.001). By the end of 2021, the number of suicide attempts per month exceeded the predicted amount based on pre-pandemic data. Factors such as marital status, education, occupation, place of residence, and previous suicide attempts were found to influence suicide attempts during the pandemic.

Given the significant increase in suicide attempts following the onset of the pandemic, it is crucial to prioritize the implementation of prevention and intervention programs during this crisis.

The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides a comprehensive assessment of health and risk factor trends at global, regional, national, and subnational levels. This study aims to examine the burden of diseases, injuries, and risk factors in the USA and highlight the disparities in health outcomes across different states.

GBD 2021 analysed trends in mortality, morbidity, and disability for 371 diseases and injuries and 88 risk factors in the USA between 1990 and 2021. We used several metrics to report sources of health and health loss related to specific diseases, injuries, and risk factors. GBD 2021 methods accounted for differences in data sources and biases. The analysis of levels and trends for causes and risk factors within the same computational framework enabled comparisons across states, years, age groups, and sex. GBD 2021 estimated years lived with disability (YLDs) and disability-adjusted life-years (DALYs; the sum of years of life lost to premature mortality and YLDs) for 371 diseases and injuries, years of life lost (YLLs) and mortality for 288 causes of death, and life expectancy and healthy life expectancy (HALE). We provided estimates for 88 risk factors in relation to 155 health outcomes for 631 risk-outcome pairs and produced risk-specific estimates of summary exposure value, relative health risk, population attributable fraction, and risk-attributable burden measured in DALYs and deaths. Estimates were produced by sex (male and female), age (25 age groups from birth to ≥95 years), and year (annually between 1990 and 2021). 95% uncertainty intervals (UIs) were generated for all final estimates as the 2·5th and 97·5th percentiles values of 500 draws (ie, 500 random samples from the estimate's distribution). Uncertainty was propagated at each step of the estimation process.

We found disparities in health outcomes and risk factors across US states. Our analysis of GBD 2021 highlighted the relative decline in life expectancy and HALE compared with other countries, as well as the impact of COVID-19 during the first 2 years of the pandemic. We found a decline in the USA's ranking of life expectancy from 1990 to 2021: in 1990, the USA ranked 35th of 204 countries and territories for males and 19th for females, but dropped to 46th for males and 47th for females in 2021. When comparing life expectancy in the best-performing and worst-performing US states against all 203 other countries and territories (excluding the USA as a whole), Hawaii (the best-ranked state in 1990 and 2021) dropped from sixth-highest life expectancy in the world for males and fourth for females in 1990 to 28th for males and 22nd for females in 2021. The worst-ranked state in 2021 ranked 107th for males (Mississippi) and 99th for females (West Virginia). 14 US states lost life expectancy over the study period, with West Virginia experiencing the greatest loss (2·7 years between 1990 and 2021). HALE ranking declines were even greater; in 1990, the USA was ranked 42nd for males and 32nd for females but dropped to 69th for males and 76th for females in 2021. When comparing HALE in the best-performing and worst-performing US states against all 203 other countries and territories, Hawaii ranked 14th highest HALE for males and fifth for females in 1990, dropping to 39th for males and 34th for females in 2021. In 2021, West Virginia-the lowest-ranked state that year-ranked 141st for males and 137th for females. Nationally, age-standardised mortality rates declined between 1990 and 2021 for many leading causes of death, most notably for ischaemic heart disease (56·1% [95% UI 55·1-57·2] decline), lung cancer (41·9% [39·7-44·6]), and breast cancer (40·9% [38·7-43·7]). Over the same period, age-standardised mortality rates increased for other causes, particularly drug use disorders (878·0% [770·1-1015·5]), chronic kidney disease (158·3% [149·6-167·9]), and falls (89·7% [79·8-95·8]). We found substantial variation in mortality rates between states, with Hawaii having the lowest age-standardised mortality rate (433·2 per 100 000 [380·6-493·4]) in 2021 and Mississippi having the highest (867·5 per 100 000 [772·6-975·7]). Hawaii had the lowest age-standardised mortality rates throughout the study period, whereas Washington, DC, experienced the most improvement (a 40·7% decline [33·2-47·3]). Only six countries had age-standardised rates of YLDs higher than the USA in 2021: Afghanistan, Lesotho, Liberia, Mozambique, South Africa, and the Central African Republic, largely because the impact of musculoskeletal disorders, mental disorders, and substance use disorders on age-standardised disability rates in the USA is so large. At the state level, eight US states had higher age-standardised YLD rates than any country in the world: West Virginia, Kentucky, Oklahoma, Pennsylvania, New Mexico, Ohio, Tennessee, and Arizona. Low back pain was the leading cause of YLDs in the USA in 1990 and 2021, although the age-standardised rate declined by 7·9% (1·8-13·0) from 1990. Depressive disorders (56·0% increase [48·2-64·3]) and drug use disorders (287·6% [247·9-329·8]) were the second-leading and third-leading causes of age-standardised YLDs in 2021. For females, mental health disorders had the highest age-standardised YLD rate, with an increase of 59·8% (50·6-68·5) between 1990 and 2021. Hawaii had the lowest age-standardised rates of YLDs for all sexes combined (12 085·3 per 100 000 [9090·8-15 557·1]), whereas West Virginia had the highest (14 832·9 per 100 000 [11 226·9-18 882·5]). At the national level, the leading GBD Level 2 risk factors for death for all sexes combined in 2021 were high systolic blood pressure, high fasting plasma glucose, and tobacco use. From 1990 to 2021, the age-standardised mortality rates attributable to high systolic blood pressure decreased by 47·8% (43·4-52·5) and for tobacco use by 5·1% (48·3%-54·1%), but rates increased for high fasting plasma glucose by 9·3% (0·4-18·7). The burden attributable to risk factors varied by age and sex. For example, for ages 15-49 years, the leading risk factors for death were drug use, high alcohol use, and dietary risks. By comparison, for ages 50-69 years, tobacco was the leading risk factor for death, followed by dietary risks and high BMI.

GBD 2021 provides valuable information for policy makers, health-care professionals, and researchers in the USA at the national and state levels to prioritise interventions, allocate resources effectively, and assess the effects of health policies and programmes. By addressing socioeconomic determinants, risk behaviours, environmental influences, and health disparities among minority populations, the USA can work towards improving health outcomes so that people can live longer and healthier lives.

Bill & Melinda Gates Foundation.

Mental healthcare was fundamentally altered during the COVID-19 pandemic, perhaps most prominently through the massive shift towards telehealth. Herein, we evaluated effects of the transition to teletherapy on treatment adherence and depressive symptoms for 3,476 patients at three outpatient psychiatric clinics, the majority of whom were low-income and experienced ethnoracial minoritization. Number of missed appointments decreased (mean: 6.27 vs. 3.77, p < .0001), and PHQ-9 scores decreased (mean: 8.17 vs. 6.82, p < .0001) between six months prior to and following the March 18, 2020 switch to telehealth. These conclusions held when adjusting for covariates including age, sex, race/ethnicity, and insurance status (i.e., socioeconomic status). Stratified analyses (i.e., adults, emerging adults, and youth) yielded the same conclusions, with the exception of emerging adults, for whom the PHQ-9 change was not significant. Results indicated the transition from in-person to teletherapy was associated with significantly reduced mean numbers of missed visits and depressive symptoms. Such results during this especially tumultuous period may underscore telehealth's effectiveness. Future research should explore whether there is a causal relationship between telehealth or mixed hybrid options, positive treatment outcomes, and prescriptive care delivery models, as well as applications of e-mental health tools for diverse, underserved patient populations.

This study examined how compensatory and enabling domains of an Age-Friendly City (AFC) moderate the relationship between suspected mental health problems and depressive and anxiety symptoms among older adults. Four thousand six hundred and twenty-five Hong Kong Chinese aged ≥60 years completed a telephone survey between April and July 2022, including PHQ-2 and GAD-2. AFC indices sourced from prior territory-wide study. Linear mixed models showed that enabling AFC domains, namely, social participation, respect and social inclusion, and civic participation and employment, alleviated the effects of suspected mental health problems on respondents' depressive and anxiety symptoms (b = -0.40 to -0.56). Three-way interaction models revealed that the protective effects of all compensatory and enabling AFCC domains (b = -1.23 to -6.18), except civic participation and employment, were stronger in old-old (70-79 years) and oldest-old (≥80 years) than young-old (60-69 years). AFCC-based interventions should focus on compensatory and enabling domains to support older adults' mental health.

As the COVID-19 pandemic response continues to evolve, the need to protect more vulnerable populations in society becomes more apparent. Studies are still emerging on how different population groups have been impacted by the COVID-19 pandemic. Our study explored the impact of COVID-19 for African migrants in New South Wales, Australia, and their coping strategies.

We employed inductive, exploratory qualitative interpretive research design using individual semi-structured in-depth interviews with 21 African migrants.

COVID-19 lockdowns disrupted the African sense of community. Social isolation, financial insecurity due to joblessness, or reduced working hours led to stress, frustration, anxiety, sadness, loneliness, and depression. On the other hand, COVID-19 lockdowns allowed for more family time, reflecting, and appreciating the gift of life and personal intellectual growth. Despite such challenges, there was much community support, especially from religious organisations. Support from government agencies was available, but access was hampered by misinformation, digital literacy, and immigration status. Holding on to religion and faith was a key coping mechanism, followed by indulging in self-care practices such as healthy eating, exercise, Yoga, meditation, sleep, and limited interaction with social media.

The COVID-19 lockdown disrupted the collectivist culture of African migrants and had untoward socioeconomic impacts that affected their wellbeing, many of which reflect an exacerbation of pre-existing inequities. To ensure that African migrant COVID-19-related health and wellbeing needs are met, the African migrant community must be actively involved in every facet of the NSW COVID-19 and other future outbreak response efforts.

This study examines how local user associations of mental health service-user organizations were affected by the pandemic, in order to provide guidance to user organizations and surrounding actors on future advancements. The pandemic is used as a case to explore organizational resilience and digitalization during crisis.

Data from focus group interviews and individual interviews with representatives of ten local associations were analysed using qualitative content analysis. A theoretical framework combining governance theory and organizational theory was applied.

Typically, associations swiftly restructured activities to support members to meet the urgent needs that arose, not least in relation to the digital transition. Simultaneously, face-to-face interactions was valued and some members became isolated. Public sector actors often did not prioritize collaboration, and the associations had limited agency and influence in advocacy activities.

User organizations can play an important role in times of crisis. Surrounding social systems should provide resources to counteract resource dependencies and allow organizations to develop operating reserves. They should value collaboration and establish collaborative practices to ensure a readiness to utilize the organizations' capacities when needed. User organizations should have control over future developments, both to harness the potential of digital connectivity and to prevent a digital divide.

Schizophrenia (SCZ) is a common psychiatric disorder that has a complex pathological mechanism. During the Coronavirus disease 2019 (COVID-19) epidemic, patients with SCZ had substantially higher rates of infection with SARS-CoV-2, the virus that causes COVID-19, as well as higher COVID-19 mortality relative to patients with other mental disorders. However, the reasons for these increased rates in patients with SCZ remain unknown. In this review, we hypothesize that certain molecular pathways exhibit abnormal function in both COVID-19 and SCZ, with a focus on those related to energy metabolism dysregulation, immune system disruption, and abnormalities of the central nervous system. We review that dysregulation of energy metabolism can result in disruptions to the immune system and abnormalities within the central nervous system (CNS). Furthermore, immune system disturbances may also contribute to CNS abnormalities in both SCZ and COVID-19. We also discuss macro-factors associated with the high infection and mortality rates of COVID-19 in patients with SCZ, including sociodemographic factors, reduced access to psychiatric healthcare, structural barriers to COVID-19 vaccination, and proposed approaches to mitigate these macro-factors.

We examine precursors of child emotional distress during the COVID-19 pandemic in a prospective intergenerational Australian cohort study.

Parents (N = 549, 60% mothers) of 934 1-9-year-old children completed a COVID-19 specific module in 2020 and/or 2021. Decades prior, a broad range of individual, relational and contextual factors were assessed during parents' own childhood, adolescence and young adulthood (7-8 to 27-28 years old; 1990-2010) and again when their children were 1 year old (2012-2019).

After controlling for pre-pandemic socio-emotional behaviour problems, COVID-19 child emotional distress was associated with a range of pre-pandemic parental life course factors including internalising difficulties, lower conscientiousness, social skills problems, poorer relational health and lower trust and tolerance. Additionally, in the postpartum period, pre-pandemic parental internalising difficulties, lower parental warmth, lower cooperation and fewer behavioural competencies predicted child COVID-19 emotional distress.

Findings highlight the importance of taking a larger, intergenerational perspective to better equip young populations for future adversities. This involves not only investing in child, adolescent, and young adult emotional and relational health, but also in parents raising young families.

We used natural language processing (NLP) in convergent mixed methods to evaluate young adults' experiences with Call it a Night (CIAN), a digital personalized feedback and coaching sleep-alcohol intervention. Young adults with heavy drinking (N = 120) were randomized to CIAN or controls (A + SM: web-based advice + self-monitoring or A: advice; clinicaltrials.gov, 8/31/18, #NCT03658954). Most CIAN participants (72.0%) preferred coaching to control interventions. Control participants found advice more helpful than CIAN participants (X2 = 27.34, p < 0.001). Most participants were interested in sleep factors besides alcohol and appreciated increased awareness through monitoring. NLP corroborated generally positive sentiments (M = 15.07(10.54)) and added critical insight that sleep (40%), not alcohol use (12%), was a main participant motivator. All groups had high adherence, satisfaction, and feasibility. CIAN (Δ = 0.48, p = 0.008) and A + SM (Δ = 0.55, p < 0.001) had higher reported effectiveness than A (F(2, 115) = 8.45, p < 0.001). Digital sleep-alcohol interventions are acceptable, and improving sleep and wellness may be important motivations for young adults.

This study examines how pandemic-related worries affected mental health in India's adults from 2020 to 2022. Using data from the Global COVID-19 Trends and Impact Survey (N = 2,576,174), it explores the associations between worry variables (financial stress, food insecurity, and COVID-19-related health worries) and self-reported symptoms of depression and anxiety. Our analysis, based on complete cases (N = 747,996), used survey-weighted models, adjusting for demographics and calendar time. The study finds significant associations between these worries and mental health outcomes, with financial stress being the most significant factor affecting both depression (adjusted odds ratio, aOR: 2.36; 95% confidence interval, CI: [2.27, 2.46]) and anxiety (aOR: 1.91; 95% CI: [1.81, 2.01])). Models with interaction terms revealed gender, residential status, and calendar time as effect modifiers. This study demonstrates that social media platforms like Facebook can effectively gather large-scale survey data to track mental health trends during public health crises.

We aimed to determine the incidence of mental health diagnoses and associated health and social risk factors among perinatal people in three different COVID-19 phases.

We conducted a population-based, retrospective cohort study using linked administrative datasets. We included persons with live, in-hospital births in Ontario, Canada from January 1 to March 31 in 2019, 2021, or 2022 (three phases relative to COVID-19 with different public health policy measures). We excluded people with prior mental health diagnoses. We used diagnostic codes to identify new onset of depression, anxiety, or adjustment disorder in the antenatal and postpartum period. We developed multivariable, modified Poisson models to examine associations between sociodemographic and clinical factors and new mental health diagnoses in each phase.

There were 72,242 people in our cohort. Antenatal mental health diagnoses were significantly higher in 2021 (aRR = 1.32; CI = 1.20-1.46) and 2022 (aRR = 1.22; CI = 1.11-1.35) versus 2019. Postpartum diagnoses were significantly greater in 2021 (aRR = 1.16; CI = 1.08-1.25) versus 2019. Antenatal diagnoses were associated with birth year, previous stillbirth, pre-existing hypertension, multiparity, residential instability, and ethnocultural diversity. Postpartum diagnoses were associated with birth year, maternal age, multiparity, care provider profession, assisted reproductive technology, birthing mode, pre-existing hypertension, intensive care admission, hospital readmission, residential instability, and ethnocultural diversity. Family physicians increasingly made mental health diagnoses in 2021 and 2022.

Increased incidence of perinatal mental health diagnoses during COVID-19 suggests complex dynamics involving pandemic and health and social risk factors.

This study was registered with Clinicaltrials.gov (NCT05663762) on December 21, 2022.

Evidence has suggested an increased risk of psychiatric manifestations following viral infections including coronavirus disease-2019 (COVID-19). However, psychiatric adverse events (AEs) after COVID-19 vaccination, which were documented in case reports and case series, remain unclear. This study is aimed to investigate the psychiatric AEs after COVID-19 vaccination from a large population-based cohort in Seoul, South Korea. We recruited 50% of the Seoul-resident population randomly selected from the Korean National Health Insurance Service (KNHIS) claims database on 1, January, 2021. The included participants (n = 2,027,353) from the Korean National Health Insurance Service claims database were divided into two groups according to COVID-19 vaccination. The cumulative incidences per 10,000 of psychiatric AEs were assessed on one week, two weeks, one month, and three months after COVID-19 vaccination. Hazard ratios (HRs) and 95% Confidence interval (CIs) of psychiatric AEs were measured for the vaccinated population. The cumulative incidence of depression, anxiety, dissociative, stress-related, and somatoform disorders, sleep disorders, and sexual disorders at three months following COVID-19 vaccination were higher in the vaccination group than no vaccination group. However, schizophrenia and bipolar disorders showed lower cumulative incidence in the vaccination group than in the non-vaccinated group. Depression (HR [95% CI] = 1.683 [1.520-1.863]), anxiety, dissociative, stress-related, and somatoform disorders (HR [95% CI] = 1.439 [1.322-1.568]), and sleep disorders (HR [95% CI] = 1.934 [1.738-2.152]) showed increased risks after COVID-19 vaccination, whereas the risks of schizophrenia (HR [95% CI] = 0.231 [0.164-0.326]) and bipolar disorder (HR [95% CI] = 0.672 [0.470-0.962]). COVID-19 vaccination increased the risks of depression, anxiety, dissociative, stress-related, and somatoform disorders, and sleep disorders while reducing the risk of schizophrenia and bipolar disorder. Therefore, special cautions are necessary for administering additional COVID-19 vaccinations to populations vulnerable to psychiatric AEs.

In recent times, the world has witnessed unprecedented challenges, with the COVID-19 pandemic being a major disruptor to various aspects of daily life. This article delves into the profound impact of pandemics on primary care, specifically focussing on changes in antidepressant prescriptions and mental health referrals before, during, and after lockdowns in England, UK.

In this retrospective study, we used anonymised individual-level electronic health record data from general practitioner (GP) practices in the North of England, UK. We applied a negative binomial-logit hurdle model and a multinominal logit regression model to assess the impact on antidepressant prescriptions and GP referral types, respectively.

The initiation of antidepressant prescriptions showed a notable decrease during and post lockdowns, with a minor uptick in ongoing antidepressant prescriptions during the lockdown periods. Over the course of lockdowns and beyond, there was a growing trend of patients being referred to social prescribing interventions. Notably, individuals from ethnic minorities were more inclined to receive fewer medical treatments and more social prescribing interventions.

The increase in antidepressant prescriptions during the pandemic-related lockdowns was expected due to these challenging circumstances. Reduced referrals to secondary mental health services occurred as online counselling services were deemed inappropriate by some doctors, and patients were hesitant to seek face-to-face help. Notably, there was a rise in social prescribing referrals, emerging as a valuable resource for psychological support amid heightened mental health strain. Additionally, ethnic minority patients were less likely to receive medical treatments but more likely to be referred to social prescribing services. Despite the inevitable negative impacts of the COVID-19 pandemic, these findings highlight the active role of non-clinical support in a social model of health, addressing unmet needs and reducing barriers to mental health care for certain groups.

Anxiety disorders are psychiatric conditions characterized by prolonged and generalized anxiety experienced by individuals in response to various events or situations. At present, anxiety disorders are regarded as the most widespread psychiatric disorders globally. Medication and different types of psychotherapies are employed as the primary therapeutic modalities in clinical practice for the treatment of anxiety disorders. However, combining these two approaches is known to yield more significant benefits than medication alone. Nevertheless, there is a lack of resources and a limited availability of psychotherapy options in underdeveloped areas. Psychotherapy methods encompass relaxation techniques, controlled breathing exercises, visualization exercises, controlled exposure exercises, and cognitive interventions such as challenging negative thoughts. These methods are vital in the treatment of anxiety disorders, but executing them proficiently can be demanding. Moreover, individuals with distinct anxiety disorders are prescribed medications that may cause withdrawal symptoms in some instances. Additionally, there is inadequate availability of face-to-face psychotherapy and a restricted capacity to predict and monitor the health, behavioral, and environmental aspects of individuals with anxiety disorders during the initial phases. In recent years, there has been notable progress in developing and utilizing artificial intelligence (AI) based applications and environments to improve the precision and sensitivity of diagnosing and treating various categories of anxiety disorders. As a result, this study aims to establish the efficacy of AI-enabled environments in addressing the existing challenges in managing anxiety disorders, reducing reliance on medication, and investigating the potential advantages, issues, and opportunities of integrating AI-assisted healthcare for anxiety disorders and enabling personalized therapy.

COVID-19 has a lasting impact on mental health, particularly within the Hispanic/Latinx communities. This paper empirically investigates the post-COVID-19 presence and severities of depression, one of the most common mental health disorders, among adults in a predominantly U.S.-born Hispanic/Latinx community in South Texas composed primarily of Mexican Americans.

Multiple statistic regression models were applied to data from 515 adults in Nueces County who completed all questions in a survey from convenience sampling between June 2022 and May 2023. Depression was assessed using both standard PHQ-2 and PHQ-9 measurements.

Of the 515 participants, 377 (64.5%) were Hispanic, and 441 (85.6%) had a high school education or higher, reflecting the county's demographics. About half of the participants (47%) reported mild/moderate to severe depression. The regression model estimation results reveal that female participants, those not in full-time employment, and individuals with disabilities were more likely to feel depressed after COVID-19. Middle-aged adults demonstrated greater resilience to depression compared to other age groups. Notably, non-Hispanic participants in the study reported higher levels of depression compared to their Hispanic counterparts. Additionally, COVID-19-related experiences, such as testing positive for the virus, being hospitalized, or having a history of depression before COVID-19, were associated with higher levels of reported depression.

COVID-19 has significantly impacted the mental health of this predominantly U.S.-born Hispanic/Latinx community. These findings can assist healthcare providers and policymakers in developing targeted strategies to tailor interventions aimed at enhancing mental health well-being, reducing disparities, and fostering overall improvement within the Hispanic/Latinx community.

The COVID-19 pandemic has left a profound mark on global health, leading to substantial morbidity and mortality worldwide. Beyond the immediate symptoms of infection, the emergence of "long COVID", the long-term effects of SARS-CoV-2, has become a significant public health concern. Long COVID is a multifaceted condition affecting various organs and systems, including the cardiovascular, digestive, nervous, and endocrine systems. Individuals diagnosed with polycystic ovary syndrome (PCOS) may face an increased risk of severe COVID-19 symptoms and infection. It is crucial to comprehend how long COVID affects PCOS patients to devise effective treatment and care strategies. Here, we review the detrimental effects of COVID-19 and its long-term effects on reproductive health, endocrine function, inflammation, metabolism, cardiovascular health, body composition, lifestyle, and mental health in patients with PCOS. We offer recommendations for the post-covid-19 management of PCOS, emphasizing the necessity of a comprehensive, multidisciplinary approach to patient care. Furthermore, we discuss prospective research directions, highlighting the significance of continued investigations and clinical trials to evaluate treatment approaches for long COVID and its ramifications in individuals with PCOS.

With the seeming end of the COVID-19 epidemic, international focus is rethinking its spillover consequences, such as on the routine provision and usage of healthcare. This study uses China's national death records to estimate the potential spillover effects of the COVID-19 pandemic on the mortality of non-COVID diseases in China, such as chronic diseases and mental disorders.

A longitudinal study.

Using the difference-in-difference strategy, our results showed a sizeable increase in total non-COVID deaths and mortality from cardiovascular diseases, chronic kidney disease, diabetes, mental diseases, and suicide.

Notably, the deaths from diabetes and suicide increased by 4.60% and 7.08%, respectively, relative to the regions without pandemic cases in the first outbreak and escalated by 3.57% and 5.00%, respectively, when the control group switched to the same period in 2019.

These results documented adverse spillover effects of COVID-19 on mortality of non-COVID diseases, suggesting inadequate provision and utilization of regular healthcare. The government and healthcare industry should adopt expedient policies for non-epidemic diseases and reallocate health resources to mitigate future pandemics like COVID-19.

People with mental health conditions were potentially more vulnerable than others to the neuropsychiatric effects of the COVID-19 pandemic and the global efforts taken to contain it. The aim of this multinational study was to examine the changes in psychotropic drug prescribing during the pandemic among people with depressive and anxiety disorders.

This study included electronic medical records and claims data from nine databases in six countries (France, Germany, Italy, the UK, South Korea, and the USA) of patients with a diagnosis of depressive or anxiety disorders between 2016 and 2021. The outcomes were monthly prevalence rates of antidepressant, antipsychotic, and anxiolytic drug prescribing. The associations between the pandemic and psychotropic drug prescribing were examined with interrupted time series analyses for the total sample and stratified by sex and age group. People with lived experience were not involved in the research and writing process.

Between Jan 1, 2016 and Dec 31, 2020, an average of 16 567 914 patients with depressive disorders (10 820 956 females [65·31%] and 5 746 958 males [34·69%]) and 15 988 451 patients with anxiety disorders (10 688 788 females [66·85%] and 5 299 663 males [33·15%]) were identified annually. Most patients with depressive disorders and anxiety disorders were aged 45-64 years. Ethnicity data were not available. Two distinct trends in prescribing rates were identified. The first pattern shows an initial surge at the start of the pandemic (eg, antipsychotics among patients with depressive disorders in MDCD_US (rate ratio [RR] 1·077, 95% CI 1·055-1·100), followed by a gradual decline towards the counterfactual level (RR 0·990, 95% CI 0·988-0·992). The second pattern, observed in four databases for anxiolytics among patients with depressive disorders and two for antipsychotics among patients with anxiety disorders, shows an immediate increase (eg, antipsychotics among patients with anxiety disorders in IQVIA_UK: RR 1·467, 95% CI 1·282-1·675) without a subsequent change in slope (RR 0·985, 95% CI 0·969-1·003). In MDCD_US and IQVIA_US, the anxiolytic prescribing rate continued to increase among patients younger than 25 years for both disorders.

The study reveals persistently elevated rates of psychotropic drug prescriptions beyond the initial phase of the pandemic. These findings underscore the importance of enhanced mental health support and emphasise the need for regular review of psychotropic drug use among this patient group in the post-pandemic era.

University Grants Committee, Research Grants Council, The Government of the Hong Kong Special Administrative Region.

The implementation of quick response (QR) code check-in compliance behaviour during the COVID-19 pandemic featured in infection control strategies in several global jurisdictions, but was of particular interest in the Australian context, where it became mandated on a nationwide scale. We aimed to identify the salient beliefs people hold toward complying with the QR code check-in using a Theory of Planned Behaviour belief-based framework.

An elicitation study using open-ended questions (Queensland; N = 93, Mage = 4.77 years, SD = 13.62 and Victoria; N = 76, Mage = 44.92 years, SD = 11.63) and a prospective correlational study using a two-wave online survey (Queensland; N = 290, Mage = 38.99, 46.6% female and Victoria; N = 290, Mage = 38.27, 53.4% female) were conducted.

Qualitative data were coded through an iterative content analysis, while quantitative data were analysed using linear multiple regression. Behavioural, normative and control beliefs were associated with intention and behaviour in both samples. Variation in beliefs across the states also were observed.

Across both samples, beliefs in positive outcomes consistently exhibited stronger associations with both intention and behaviour than the reported negative outcomes. Distinct differences emerged between the two samples in terms of regression effects. SO WHAT?: Results indicate individual experience may affect the beliefs which guide behaviour, supporting the potential efficacy of health promotion campaigns tapping into context specific beliefs and experiences if QR code check-in is to be implemented as an infection control measure in future.

Intermittent catheterization (IC) has been identified as one of the critical techniques used by spinal cord injury (SCI) patients to cope with emptying the bladder, despite several problems impeding this procedure.

The study aimed accordingly to explore the lived experience of Arab male patients on IC after their SCI.

This study was carried out by using a descriptive qualitative approach with a phenomenological analysis of data.

A qualitative study was carried out on 10 Arab male patients from the Rehabilitation Hospital at King Fahad Medical City (KFMC), Riyadh, Saudi Arabia who were utilizing intermittent catheters following SCI. The interviews were analysed using Husserl's phenomenology and the Colaizzi method of data analysis.

Two major themes and six sub-themes were identified from exploring the patients experience. These themes are as follows: Theme 1: The Way to IC; with two sub-themes: (i) 'service provided and acceptance' and (ii) 'educational experience'; Theme 2: Lifestyle and self-adaptation; with four sub-themes: (i) 'Flexibility and freedom', (ii) 'Physical access to the community', (iii) 'Traveling' and (iv) 'Work and Social life balance'.

It is evident that using an intermittent catheter among patients with SCI influenced almost all aspects of the participant's life, including their social lives and body image appearance.

The long-term mental and physical health implications of childhood interpersonal trauma on adult survivors is immense, however, there is a lack of available trauma-focused treatment services that are widely accessible. This study, utilizing a user-centered design process, sought feedback on the initial design and development of a novel, self-paced psychoeducation and skills-based treatment intervention for this population.

To explore the views and perspectives of adult survivors of childhood interpersonal trauma on the first two modules of an asynchronous trauma-focused treatment program.

Fourteen participants from our outpatient hospital service who completed the modules consented to provide feedback on their user experience. A thematic analysis of the three focus groups was conducted.

Four major themes emerged from the focus groups: (1) technology utilization, (2) module content, (3) asynchronous delivery, and (4) opportunity for interactivity. Participants noted the convenience of the platform and the use of multimedia content to increase engagement and did not find the modules to be emotionally overwhelming.

Our research findings suggest that an asynchronous virtual intervention for childhood interpersonal trauma survivors may be a safe and acceptable way to provide a stabilization-focused intervention on a wider scale.

Previous research has assessed the impact of the COVID-19 pandemic on adolescent mental health (MH). How the pandemic changed healthcare resource utilisation for MH conditions was investigated less, however, in particular in Italy.

Data concerning outpatient visits in child and adolescent mental health services (CAMHSs), access to emergency departments (EDs), hospital admissions and drug prescriptions collected in administrative databases of the Lombardy Region, Italy, concerning adolescents 12-17 years old and occurring in the 2016-2021 period were analysed.Annual and monthly prevalence of healthcare (CAHMS/ED visits/hospital admissions) use for MH conditions and of psychotropic drug prescriptions were estimated. A negative binomial regression model was used to model the pre-pandemic monthly number of prevalent cases by gender. The total number of pandemic (1 March 2020 to 31 December 2021) cases predicted from the model was compared with the number of observed cases.

The overall annual rate of healthcare service utilisation slightly increased in the 2016-2019 period (from 63.8‰ to 67.8‰), decreased in 2020 (57.1‰) and returned to values similar to 2016 (64.9‰) the following year. A 2% relative increase was observed in girls, and a 10% decrease in boys, when comparing the prevalence in 2021 with that in 2019. Differences between genders were particularly evident for ED attendance, with an observed/predicted cases ratio in 2021 of 0.81 (95% CI 0.79 to 0.83) in boys, and 1.18 (95% CI 1.16 to 1.20) in girls, and for psychotropic drug prescriptions (0.83 (95% CI 0.82 to 0.84) and 1.24 (95% CI 1.23 to 1.25), respectively).

The current study confirms that the use of health services for MH conditions during the COVID-19 pandemic increased among adolescent girls but decreased among boys, and that gender differences emerged in the MH impact of the pandemic.

The COVID-19 pandemic and its economic impact have heightened the risk of mental health and pain-related issues. The integration of acupuncture with conventional medicine shows promise in improving treatment outcomes for these conditions. The Alberta Complementary Health Integration Project (ABCHIP) aimed to provide acupuncture to youth (aged 24 and under) and seniors (aged 55 and above) experiencing chronic pain, pain management issues, mental health issues, and/or related conditions. The program aimed to promote integrative care, assess the effectiveness and cost-effectiveness of these therapies, and deliver patient-centered care.

ABCHIP provided acupuncture to address pain, mental health, and addiction issues at no cost to two vulnerable populations in Alberta: youth and the older adult. A total of 606 patients aged 14-65 received 5,424 acupuncture treatments. Outcome measures included pain interference, pain severity, sleep quality, depression, anxiety, fatigue, anger, and quality of life. Short-term outcomes were assessed through questionnaires completed at the beginning and completion of the treatments, while long-term benefits were estimated using these outcome indicators and existing literature on the economic cost of illnesses.

The cost-effectiveness analysis revealed the following ratios per Quality-Adjusted Life Year (QALY): CND12,171 for the overall sample, CND10,766 for patients with pain, CND9,331 for individuals with depression, and CND9,030 for those with anxiety. The cost-benefit analysis demonstrated annual cost savings ranging from CND1,487 to CND5,255, with an average of CND3,371.

The study findings indicate that ABCHIP's treatment for pain, depression, anxiety, and sleep issues is cost-effective, leading to substantial cost savings and improved quality of life for patients. The program's cost per Quality-Adjusted Life Year (QALY) is significantly lower than benchmarks used in other countries, demonstrating high cost-effectiveness and value. Patients receiving 12 treatments experienced significant improvements across all measures, with estimated economic benefits surpassing treatment costs. In summary, ABCHIP offers a cost-effective and economically efficient therapy choice for individuals dealing with pain and mental health issues.

This study examined whether the average levels and the temporal extension of self-continuity varied over the course of the COVID-19 pandemic. Three demographically matched adult life-span samples (n = 223 each) were gathered in the U.S. in fall 2016, summer 2020, and winter 2022/23. Participants rated their self-continuity 1/5/10 years into the past and future. Multi-level analyses examined the effects of temporal distance, past/future direction, and assessment time while controlling for demographics. Average self-continuity did not vary across assessments, but the tendency to report lower self-continuity for more distant times was weaker during the pandemic, and the tendency to report lower self-continuity for past versus future was weaker during and after the pandemic. Discussion focuses on the role of slowed time perception during the pandemic and the possibility that mid- and post-pandemic reports of past self-continuity were elevated by nostalgic self-reflection, coupled with increased uncertainty about the future.

The purpose of this study is to examine factors associated with increased suicide deaths during the coronavirus disease 2019 (COVID-19) pandemic in Japan using primary data from postmortem examinations.

We explored factors associated with suicides that occurred during the COVID-19 pandemic (February 2020 to December 2021) using data from 115 postmortem examinations of suicides that occurred in one city in the Kanto region between January 2017 and December 2021.

Multivariate analysis using graphical modelling and logistic regression analysis showed that both female sex (adjusted odds ratio: 3.732; 95% confidence interval: 1.044-13.345) and multiple mental disorders (adjusted odds ratio: 7.344; 95% confidence interval: 1.316-40.987) were significantly associated with suicide during the COVID-19 pandemic among the young age group (39 years or under).

The study results suggest that in addition to the factor of female sex previously identified, morbidity due to multiple mental disorders may be associated with the increased suicides in Japan during the COVID-19 pandemic. Furthermore, this study presented the new methodological possibility of analyzing background factors of suicide using postmortem examination data. In preparation for similar emergencies in the future, it is necessary to establish a system that provides care for multiple mental disorders and a continuous suicide-monitoring system that combines methods such as psychological autopsies with other methods.

The COVID-19 pandemic has contributed to the increase in mortality and morbidity rates globally, but it has also led to a generalized worsening of mental health and risk behaviors in different population groups regardless of the measures adopted by different governments. In this paper, using data from a Spanish survey of emotional well-being, we aim to explore through mixed graphical models the complex structure of relationships between the mental health of populations, their lifestyles, and forms of cultural and leisure consumption during the pandemic. The results bring to light some interesting findings, such as the association between teleworking and greater rest or greater stress with the use of social media, a variable that enables the connection with other mental health problems of greater severity. Increased physical activity and the consumption of streaming content at home, as well as increased care for family, friends, and neighbors, are some of the variables that show relevant associations. These findings highlight the usefulness and versatility of this network approach for the study of health behaviors and health outcomes, which offer the researcher a holistic and organic view of the relational structure of complex data characterized by high dimensionality and variables with different levels of measurement.

Food insecurity is defined as not having safe and regular access to nutritious food to meet basic needs. This review aimed to systematically examine the evidence analysing the impacts of the COVID-19 pandemic on food insecurity and diet quality in households with children <18 years in high-income countries.

EMBASE, Cochrane Library, International Bibliography of Social Science, and Web of Science; and relevant sites for grey literature were searched on 01/09/2023. Observational studies published from 01/01/2020 until 31/08/2023 in English were included. Systematic reviews and conference abstracts were excluded. Studies with population from countries in the Organisation for Economic Co-Operation and Development were included. Studies were excluded if their population did not include households with children under 18 years. The National Heart, Lung, and Blood institute (NIH) tool for observational cohort and cross-sectional studies was used for quality assessment. The results are presented as a narrative review.

5,626 records were identified and 19 studies were included. Thirteen were cross-sectional, and six cohorts. Twelve studies were based in the USA, three in Canada, one each in Italy and Australia and two in the UK. Twelve studies reported that the COVID-19 pandemic worsened food insecurity in households with children. One study reported that very low food security had improved likely due to increase in benefits as part of responsive actions to the pandemic by the government.

Although studies measured food insecurity using different tools, most showed that the pandemic worsened food security in households with children. Lack of diversity in recruited population groups and oversampling of high-risk groups leads to a non-representative sample limiting the generalisability. Food insecure families should be supported, and interventions targeting food insecurity should be developed to improve long-term health.