Attachment--and loss.

The COVID-19 pandemic is suggested to have a negative impact on mental health. To prevent the spread of Sars-CoV-2, governments worldwide have implemented different forms of public health measures ranging from physical distancing recommendations to stay-at-home orders, which have disrupted individuals' everyday life tremendously. However, evidence on the associations of the COVID-19 pandemic and public health measures with mental health are limited so far. In this study, we investigated the role of sociodemographic and COVID-19 related factors for immediate mental health consequences in a nationwide community sample of adults from Germany (N = 4335). Specifically, we examined the effects of different forms and levels of restriction resulting from public health measures (e.g. quarantine, stay-at-home order) on anxiety and depression symptomatology, health anxiety, loneliness, the occurrence of fearful spells, psychosocial distress and life-satisfaction. We found that higher restrictions due to lockdown measures, a greater reduction of social contacts and greater perceived changes in life were associated with higher mental health impairments. Importantly, a subjectively assumed but not an officially announced stay-at-home order was associated with poorer mental health. Our findings underscore the importance of adequate risk communication and targeted mental health recommendations especially for vulnerable groups during these challenging times.

Lockdown, quarantine measures, and social distancing: Associations with depression, anxiety and distress at the beginning of the COVID-19 pandemic among adults from Germany.

Background The unprecedented worldwide crisis caused by the rapid spread of COVID-19 and the restrictive public health measures enforced by some countries to slow down its transmission have severely threatened the physical and mental wellbeing of communities globally. Methods We conducted a systematic review and meta-analysis to determine the prevalence of anxiety in the general population during the COVID-19 pandemic. Two researchers independently searched for cross-sectional community-based studies published between December 1, 2019 and August 23, 2020, using PubMed, WoS, Embase, and other sources (e.g., grey literature, manual search). Results Of 3049 records retrieved, 43 studies were included. These studies yielded an estimated overall prevalence of anxiety of 25%, which varied significantly across the different tools used to measure anxiety. Consistently reported risk factors for the development of anxiety included initial or peak phase of the outbreak, female sex, younger age, marriage, social isolation, unemployment and student status, financial hardship, low educational level, insufficient knowledge of COVID-19, epidemiological or clinical risk of disease and some lifestyle and personality variables. Conclusions As the overall global prevalence of anxiety disorders is estimated to be 7.3% normally, our results suggest that rates of anxiety in the general population could be more than 3 times higher during the COVID-19 pandemic. These findings suggest a substantial impact on mental health that should be targeted by individual and population-level strategies.

Prevalence of anxiety in the COVID-19 pandemic: An updated meta-analysis of community-based studies.

There is minimal knowledge about the impact of large scale epidemics on community mental health, particularly during the acute phase. This gap in knowledge means we are critically ill-equipped to support communities as they face the unprecedented COVID-19 pandemic. This study aimed to provide data urgently needed to inform government policy and resource allocation now and in other future crises. The study was the first to survey a representative sample from the Australian population at the early acute phase of the COVID-19 pandemic. Depression, anxiety, and psychological wellbeing were measured with well-validated scales (PHQ-9, GAD-7, WHO-5). Using linear regression, we tested for associations between mental health and exposure to COVID-19, impacts of COVID-19 on work and social functioning, and socio-demographic factors. Depression and anxiety symptoms were substantively elevated relative to usual population data, including for individuals with no existing mental health diagnosis. Exposure to COVID-19 had minimal association with mental health outcomes. Recent exposure to the Australian bushfires was also unrelated to depression and anxiety, although bushfire smoke exposure correlated with reduced psychological well-being. In contrast, pandemic-induced impairments in work and social functioning were strongly associated with elevated depression and anxiety symptoms, as well as decreased psychological wellbeing. Financial distress due to the pandemic, rather than job loss per se, was also a key correlate of poorer mental health. These findings suggest that minimising disruption to work and social functioning, and increasing access to mental health services in the community, are important policy goals to minimise pandemic-related impacts on mental health and wellbeing. Innovative and creative strategies are needed to meet these community needs while continuing to enact vital public health strategies to control the spread of COVID-19.

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The Effect of COVID-19 on Mental Health and Wellbeing in a Representative Sample of Australian Adults

BACKGROUND: The Coronavirus Disease 2019 (COVID-19) outbreak has escalated the burden of psychological distress. We aimed to evaluate factors associated with psychological distress among the predominantly general population during the COVID-19 pandemic. METHODS: We searched PubMed, EMBASE, Scopus, Cochrane Library, PsycINFO, and World Health Organization COVID-19 databases (Dec 2019-15 July 2020). We included cross-sectional studies that reported factors associated with psychological distress during the COVID-19 pandemic. Primary outcomes were self-reported symptoms of anxiety and depression. Random-effects models were used to pool odds ratios (OR) and 95% confidence intervals (CI). The protocol was registered in PROSPERO (#CRD42020186735). FINDINGS: We included 68 studies comprising 288,830 participants from 19 countries. The prevalence of anxiety and depression was 33% (95% CI: 28%-39%) and 30% (26%-36%). Women versus men (OR: 1.48 [95% CI: 1.29-1.71; I2 = 90.8%]), younger versus older (< versus ≥35 years) adults (1.20 [1.13-1.26]; I2 = 91.7%), living in rural versus urban areas (1.13 [1.00-1.29]; I2 = 82.9%), lower versus higher socioeconomic status (e.g. lower versus higher income: 1.45 [1.24-1.69; I2 = 82.3%]) were associated with higher anxiety odds. These factors (except for residential area) were also associated with higher depression odds. Furthermore, higher COVID-19 infection risk (suspected/confirmed cases, living in hard-hit areas, having pre-existing physical or mental conditions) and longer media exposure were associated with higher odds of anxiety and depression. INTERPRETATION: One in three adults in the predominantly general population have COVID-19 related psychological distress. Concerted efforts are urgently needed for interventions in high-risk populations to reduce urban-rural, socioeconomic and gender disparities in COVID-19 related psychological distress.

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Factors associated with psychological distress during the coronavirus disease 2019 (COVID-19) pandemic on the predominantly general population: A systematic review and meta-analysis.

The loneliness pandemic: Loneliness and other concomitants of depression, anxiety and their comorbidity during the COVID-19 outbreak.

A prominent feature of anxiety in late life is concerns regarding physical health Anxiety symptoms among older adults have been connected with various psychological outcomes, including social isolation and loneliness During the coronavirus disease 2019 (COVID-19) pandemic, many societies have demonstrated increased ageist attitudes, encouraging older adults to distance themselves from society Accordingly, the current study examined the moderating role of COVID-19-related ageism in the connection between COVID-19 health worries and anxiety symptoms among older adults Data were collected from 243 older adults (age range 60-92; M = 6975, SD = 669), who completed scales assessing COVID-19-related health worries and ageism, as well as anxiety symptoms The results demonstrated that both health worries and ageism were positively associated with anxiety symptoms Moreover, the connection between health worries and anxiety symptoms was more pronounced among older adults with high ageism levels The study highlights the vulnerability of older adults in general, and ageist older adults in particular, to the negative consequences of COVID-19-related health worries, and emphasizes the role of the increased ageist stance of society during the pandemic in this regard

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COVID-19 health worries and anxiety symptoms among older adults: the moderating role of ageism.

Negative attitudes towards patients with borderline personality disorder (BPD) may affect their treatment. We aimed to identify attitudes toward patients with BPD. Clinicians in four psychiatric hospitals in Israel (n = 710; psychiatrists, psychologists, social workers and nurses) were approached and completed questionnaires on attitudes toward these patients. Nurses and psychiatrists reported encountering a higher number of patients with BPD during the last month, and exhibited more negative attitudes and less empathy toward these patients than the other two professions. The whole sample evaluated the decision to hospitalize such a patient as less justified than the decision to hospitalize a patient with Major Depressive Disorder. Negative attitudes were positively correlated with caring for greater numbers of patients with BPD in the past month and in the past 12 months. Nurses expressed the highest interest in studying short-term methods for treating patients with BPD and a lower percentage of psychiatrists expressed an interest in improving their professional skills in treating these patients. The findings show that nurses and psychiatrists differ from the other professions in their experience and attitudes toward patients with BPD. We conclude that nurses and psychiatrists may be the target of future studies on their attitudes toward provocative behavioral patterns (e.g., suicide attempts) characterizing these patients. We also recommend implementing workshops for improving staff attitudes toward patients with BPD.

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The attitudes of psychiatric hospital staff toward hospitalization and treatment of patients with borderline personality disorder.

Staff attitudes toward patients with borderline personality disorder

Background: Ageism, a form of prejudice in which one relates negatively to people due to their age, exists throughout life. However, no attempt has been made to compare ageist attitudes across the life cycle, from young adulthood to old age. Consequently, the current study examined age and gender differences in ageism throughout adulthood. Methods: 955 Israeli participants (age range: 18-98 years) were divided into three age-groups: young (18-39), middle-aged (40-67), and old (68-98), and were administered the Fraboni Scale of Ageism. Age and gender differences were examined both for the three groups and for subgroups within the older adult cohort. Results: Multivariate analysis of variance revealed that middle-aged participants were significantly more ageist than younger and older groups. Across all age groups, men exhibited more avoidance and stereotypical attitudes toward older adults than women. Among the old age group, participants aged 81-98 held more ageist stereotypes and reported more avoidance of older adults than those aged 68-73. Within the older adult cohort, gender was a significant predictor for ageist attitudes among those aged 68-73 and 81-98, but not for people aged 74-80. Conclusions: Ageism demonstrates a changing pattern across the life span. While gender differences remain stable, ageist attitudes toward growing old as we age ourselves are constantly changing. In order to gain a better understanding of ageism as a general and global phenomenon, we need to consider the role of such attitudes in different stages of life.

http://education.biu.ac.il/files/education/shared/Fridel.pdf

Sara Cohen-Fridel

Papers

The loneliness pandemic: Loneliness and other concomitants of depression, anxiety and their comorbidity during the COVID-19 outbreak.

COVID-19 health worries and anxiety symptoms among older adults: the moderating role of ageism.

The attitudes of psychiatric hospital staff toward hospitalization and treatment of patients with borderline personality disorder.

Staff attitudes toward patients with borderline personality disorder

Different dimensions of ageist attitudes among men and women: a multigenerational perspective.