Measuring COVID-19 related stress and its associated factors among the parents of school-aged children during the first lockdown in France.

BACKGROUND: The COVID-19 pandemic placed important challenges on parents, as they had to meet various demands during lockdown, including childcare, work and homeschooling. Therefore, the current study aimed to investigate perceived stress levels among the parents of school-aged children and explore their association with sociodemographic, environmental and psychological factors during lockdown. METHODS: A cross-sectional study was conducted among the parents of school-aged children ages 8 to 18, who lived in the Grand Est region of France during the first wave of the pandemic. An online survey collected sociodemographic data, living and working conditions, and exposure to COVID-19 as well as parent's levels of perceived stress (PSS-10), self-perceived health status (SF-12), social support (MSPSS) and resilience (BRS). Multivariable logistic regression models were conducted to evaluate the association between moderate to severe perceived stress and various factors. RESULTS: In total, 734 parents were included. The results indicated that 47% were experiencing moderate stress and 7.2% were experiencing severe stress. Factors most strongly associated with risk of moderate to severe levels of stress were lower levels of parental resilience (OR = 3.8, 95% CI: 2.2-6.6) and poor self-perceived mental health status (OR = 7.3, 95% CI: 5.0-10.8). The following risk factors were also identified: female sex; being in the age range of 35-44; difficulties isolating and contracting COVID-19, which involved hospitalization and separation or isolation from family. The support of friends (OR = 0.8, 95% CI: 0.7-1.0) and family (OR = 0.5, 95% CI: 0.3-0.8) were protective factors. CONCLUSIONS: These findings suggest that supportive and preventive programs should focus on the improvement of resilience and mental health management to promote parents' wellbeing. Research has to focus both on individuals' inner potential for increasing resilience and the environmental resources to be activated. Building and boosting resilience among parents could serve as a protective factor against negative outcomes for them and their families.

Child self-report and child-parent agreement regarding health-related quality of life under COVID-19 lockdown in the French Grand Est area.

Nearly 1.6 billion of children and young people in more than 190 countries have been affected by school closures under the first lockdown due to the coronavirus disease. This study aimed to investigate child-reported and parent-rated health-related quality of life among 8- to 18-year-olds and the agreement between the children's assessments and those of their parents during lockdown. A cross-sectional study was conducted among French children living in the Grand Est area. An online survey was used to collect data on the children's sociodemographics, living environments, education and HRQoL. The latter was assessed with KIDSCREEN-27, which consists of five domains. Sex and age differences in parent ratings and child-reported data were analyzed using Mann-Whitney tests. Child-parent agreement was analyzed using the intraclass correlation coefficient (ICC). In total, 471 child-parent pairs from 341 households were included. Compared to European norms, children scored lower on all dimensions during the first lockdown: physical well-being (45.9/49.94 EU), psychological well-being (48.8/49.77 EU), parent relations and autonomy (47.7/49.99 EU), social support and peers (36.4/49.94 EU) and school (48.2/50 EU). Significant child-reported sex and age differences were identified for both psychological and physical well-being dimensions. Moderate to good agreement existed between children's and parents' ratings on all KIDSCREEN dimensions (ICC ranged from 0.60 to 0.76). The study suggests the need to focus on children's social support and peers during epidemics and to consider the children's self-reported HRQoL. Additional research should be conducted to identify ways of minimizing the gap between mental health needs and the services available and to help more children maintain their physical and mental health during the current crisis.

The effects of living and learning conditions on the health-related quality of life of children and adolescents during the COVID-19 lockdown in the French Grand Est region.

INTRODUCTION: COVID-19 lockdown measures resulted in children and adolescents staying and learning at home. This study investigated health-related quality of life (HRQoL) and its associated factors among youth during the first lockdown. METHODS: A cross-sectional study was conducted among 8- to 18-year-olds from the French Grand Est region. Sociodemographic data and information on living and learning conditions were collected using an online survey. HRQoL was assessed using the KIDSCREEN-27. Multiple regression analysis was performed to explore factors related to low HRQoL in each dimension. RESULTS: In total, 471 children from 341 households were included. Difficulties isolating at home were associated with low HRQoL in the psychological well-being (OR = 2.2, 95% CI: 1.2-4.0) and parent relations and autonomy (OR = 2.1, 95% CI: 1.2-3.8) dimensions. Conflicts with dwelling occupants were related to increased ORs in the psychological well-being (OR = 2.9, 95% CI: 1.9-4.6), parent relations and autonomy (OR = 2.2, 95% CI: 1.4-3.4) and school environment (OR = 2.4, 95% CI: 1.5-3.7) dimensions. Living in an apartment (OR = 1.8, 95% CI: 1.1-3.1), never leaving home (OR = 2.6, 95% CI: 1.2-5.9), having indoor noise at home (OR = 2.3, 95% CI: 1.2-4.6), and having a parent with high anxiety (OR = 1.8, 95% CI: 1.1-3.1) were associated with low HRQoL in the social support and peers dimension. Children working less than 1 h/day on schoolwork had an increased OR of 3.5 (95% CI: 1.4-9.0) in the school environment dimension. CONCLUSION: Living and learning conditions were associated with low HRQoL among children and adolescents during the COVID-19 lockdown. Prevention and intervention programs are needed to support youth by facilitating their interactions and improving their coping and to prepare for future waves.

Effect of the COVID-19 outbreak and lockdown on mental health among post-secondary students in the Grand Est region of France: results of the PIMS-CoV19 study.

BACKGROUND: The COVID-19 epidemic has sent students around the world in to lockdown. This study sought to assess the prevalence of impaired self-perceived mental health and identify associated factors among French post-secondary students during the lockdown. METHODS: A cross-sectional study was conducted among French students living in the Grand Est area in France from May 7 to 17, 2020 during the first lockdown. An online survey was used to collect sociodemographic data, learning and teaching conditions, living conditions, and exposure to COVID-19, and self-perceived mental health was assessed with mental composite score (MCS) of the SF-12. RESULTS: Overall, 4018 were analyzed. Most participants were female (70.7%), and the mean age was 21.7 years (SD 4.0). The mean MCS score was 44.5 (SD 17.3). Impaired mental health, defined by a MCS < 1st Quartile, was mainly associated with female sex; decreased time for learning; not having access to the outside with a garden, a terrace or a balcony; difficulties with the living situation and having someone in the home affected by the SARS-COV2 requiring hospitalization or not. CONCLUSIONS: This study showed that living conditions during lockdown had a clear impact on the mental health of French post-secondary students. There is a need to improve prevention and to access distance education as well as an urgent need for measures to develop healthy coping strategies for students. This is significant challenge and will assist in moderating the risk for the development of further distress and mental health concerns.

Health professional's social representation about ederly subject with mental health disorders: a pilot study on 790 health professionals.

OBJECTIVES: The objective of the present study was to identify the structure and content of the Social Representation (SR) of health professionals regarding elderly subjects with mental health disorders and compare the latter to the lay Social Representation identified in the literature. METHOD: The structure and content of the SR of health professionals was examined in 790 careproviders from the 'Grand Est' region of France through the use of the free and hierarchical associations methodology of Abric and Vergés. A prototypical and categorical analysis as well as a similarity analysis and factorial correspondence analysis were applied to the results. RESULTS: Analysis of the collated data revealed that the items 'chronic', 'dependent', 'behavior disorders', 'memory disorders', 'solitude' and 'social isolation' were the characteristic components of the central core of the social representation. DISCUSSION: Only the peripheral elements were more sensitive to the field of practice of each profession. These findings thus highlight that the SR of health professionals is substantially identical to that of the all-comer SR on several dimensions.

Factors associated with an increased risk of anxiety among adolescents during the COVID-19 lockdown in the French Grand Est area.

The COVID-19 pandemic has impacted adolescent mental health worldwide. The current study aims to assess the feelings of French adolescents and the factors related to anxiety among these adolescents during the first lockdown due to COVID-19. A sample of 284 French adolescents from the Grand Est region aged 12-18 years completed an online survey evaluating their pandemic-related anxiety symptoms, behaviors, and feelings regarding the contingent strategies of lockdown that were taken and their living and learning conditions, family relationships, and social support. The Generalized Anxiety Disorder Scale (GAD-6) was used to assess anxiety. Data on parents' mental health status were also collected. A word cloud was generated to visualize respondents' feelings according to word use frequency. Cross-sectional analysis with linear regression was performed to identify the factors associated with a higher level of anxiety in adolescents. Higher anxiety scale scores were observed among females than among males (ß = 1.2; P = 0.0005), among adolescents experiencing conflicts at home (ß = 0.9; P = 0.03) and difficulties in isolation (ß = 1.1; P = 0.02) than among those who did not report any difficulty, and among those working less than 2 h a day (ß = 1.1; P = 0.003) than among those working more. Anxiety scale scores were lower in adolescents with higher family social support (ß = -0.66; P < 0.001) and those with parents with no anxiety (ß = -2.28; P < 0.001), lower anxiety (ß = -1.38; P = 0.018), and higher mental health-related quality of life (ß = -0.04; P = 0.03). These findings suggest a need to support interventions targeting parents' anxiety, develop strategies to increase family support, and establish consistent work schedules for children.

Process of Deinstitutionalization of Aging Individuals With Severe and Disabling Mental Disorders: A Review.

Background: For more than 60 years, psychiatric services has gradually gone from an asylum model to a community model. This change has led to the emergence of a deinstitutionalization movement. This movement seems to have left behind long-term hospitalized aging individuals with severe and disabling mental disorders. The objective of this article is to conduct a review on the challenges and issues associated with the process of deinstitutionalization among hospitalized aging individuals with severe and disabling mental disorders. Methods: Using PRISMA statement, the research methodology was carried out in English and French in 16 databases with a combination of 3 lists of keywords. The selection process was then followed by a thematic analysis which aimed at categorizing by theme and classifying the writings selected. Results: A total of 83 articles published between 1978 and 2019 were selected and organized into six categories: (a) a forgotten population in research and health policies, (b) an economic presentation of the deinstitutionalization process, (c) an improvement in quality of life and global functioning for deinstitutionalized patients (d) from stigmatization to the rejection of elderly psychiatric inpatients from deinstutionalization process, (e) a difficult community-based care offer and a difficult epistemological identification, (f) from the lack of community services to the phenomenon of transinstitutionalization. The current state of scientific research, institutional policies and clinical practices associated with the deinstitutionalization process of SVPTSIH are then commented. Conclusions: Recommendations are proposed to researchers and professionals concerned with the support of long-term hospitalized aging individuals with severe and disabling mental disorders.

Mental Health Status of French School-Aged Children's Parents during the COVID-19 Lockdown and Its Associated Factors.

The COVID-19 pandemic has led to widespread social isolation. This study aimed to determine anxiety levels among parents of school-aged children and investigate the associated factors. Data on sociodemographic characteristics, living and working conditions, family relationships, social support (MSPSS) and health status (SF-12) were collected from French parents through an online survey. The Generalized Anxiety Disorder Scale (GAD-7) was used to assess anxiety. Logistic regression analysis was performed to identify the factors associated with moderate to severe anxiety. Among 698 parents, 19.2% experienced moderate to severe anxiety. A low level of resilience (OR = 4.3, 95% CI: 2.7-6.7) and confirmed COVID-19 cases involving hospitalization (OR = 3.8, 95% CI: 2.0-7.3) among individuals in one's household or in the family circle were found to be the main risk factors for moderate to severe anxiety. Other factors were also identified: a level of education less than high school (OR = 2.1, 95% CI: 1.3-3.2), conflicts at home (OR = 2.3, 95% CI: 1.4-3.7), noises outside the home (OR = 2.0, 95% CI: 1.0-3.9), confirmed cases not involving hospitalization (OR = 1.8, 95% CI: 1.0-3.1) and suspected cases (OR = 1.9, 95% CI: 1.0-3.8). Family support was a protective factor. These findings suggest some need for support programs to help parents cope with public health crises and work-family challenges.

Psychological impact of the COVID-19 outbreak on students in a French region severely affected by the disease: results of the PIMS-CoV 19 study.

The COVID-19 has sent billions of students worldwide into lockdown. The study aimed to assess the prevalence of anxiety and identify the factors associated with anxiety among French students during lockdown.A cross-sectional study was conducted to collect sociodemographic data, living and learning conditions, anxiety symptoms and social support. Among 3936 students, 15.2%, experienced moderate anxiety and 9.8%, severe anxiety.Female gender (OR=2.2, 95% CI: 1.8-2.7) and having relatives or acquaintances from their housing hospitalized for COVID-19 (OR=3.3, 95% CI: 1.4-7.9) were the main risk factors for anxiety. Tensions at home (OR=1.8, 95% CI: 1.5-2.1), difficulties isolating (OR=1.4, 95% CI: 1.1-1.6), noises inside (OR=1.6, 95% CI: 1.3-1.9) or outside the housing (OR=1.5, 95% CI: 1.3-1.8), no direct outdoor access (OR=1.6, 95% CI: 1.3-2.0), delay in final examination (OR=1.6, 95% CI: 1.3-2.1), reduced time for learning (OR=1.3, 95% CI: 1.1-1.6), increased tobacco consumption (OR=1.9, 95% CI: 1.4-2.6), ineffectiveness of using media entertainment (OR=2.2, 95% CI: 1.1-4.4) and reading (OR=1.9, 95% CI: 1.3-2.7) to calm down, were identified as risk factors. Family (OR=0.85, 95% CI: 0.8-0.91) and friend (OR=0.88, 95% CI: 0.82-0.94) support were protective factors. This suggests the need to focus on students during epidemics, especially those living with someone hospitalized with COVID-19.

Stress and associated factors among French university students under the COVID-19 lockdown: The results of the PIMS-CoV 19 study.

OBJECTIVES: The novel coronavirus disease has caused a global public health emergency. This study aimed to investigate perceived stress levels due to the COVID-19 outbreak and explore associated factors among students under lockdown. METHODS: Sociodemographic data, living and learning conditions and existing scales of perceived stress (PSS) and social support (MSPSS) were administered to French students via an online survey. Multivariate logistic regression models were used to evaluate the association between severe perceived stress and different factors. RESULTS: Among 3764 university students, the average PSS score was 19.2 (SD=8.3), and 22% experienced high perceived stress. The presence of someone hospitalized for COVID-19 in one's household (OR=6, 95% CI: 2.4-14.6) and female gender (OR=2.3, 95% CI: 1.9-2.9) were the main risk factors for severe perceived stress. The following risk factors were also identified: enrollment in the arts, humanities and language program; postponement of a final examination; reduced learning time; conflicts at home and with neighbors; difficulties isolating; noise inside or outside one's home; a lack of direct outdoor access; increased alcohol and tobacco consumption; and the perceived ineffectiveness of the use of media entertainment to calm down. Friend support (OR=0.87, 95% CI: 0.82-0.93) and family support (OR=0.79, 95% CI: 0.74-0.84) and the perceived effectiveness of physical exercise (OR=0.5, 95% CI: 0.4-0.6) for calming down were protective factors. CONCLUSION: These findings highlight the factors that should be taken into account to counteract students' stress and the need to focus on students during epidemics.

The psychosocial age: a tool to reduce the institutional stigma of elderly people with mental disorders.

In line with previous studies on elderly with mental disorders discrimination, a concept called "Psychosocial age" has been methodologically formalized and mathematically modelized. Its aim is to support health providers and hinder stigmatization process which is influenced by social representations of our population. This article presents the construction of this indicator and its clinical implications. A literature review was therefore firstly conducted to isolate the involved cognitive functions in psychosocial adaptation. Then a second literature review isolated French-language valid tests and their retained scores for mathematical modelization on each aforementioned selected cognitive function. Nine databases were reviewed (PsychInfo and PsycArticles, ScienceDirect, Web of Science, PubMed (Medline), Taylor & Francis, the Wiley Online Library, Cairn and Google Scholar). The selected articles are both in French or English and the publication period is between 2000 and 2017. The mathematical modelization is then psychometrically presented and illustrated by too clinical illustrations. Finally, strength and limits of the psychosocial age are exposed especially highlighting its interest in the institutional decision process.

Toward a clinic of temporality?

The discovery of time cells has expanded our knowledge in the field of spatial and temporal information coding and the key role of the hippocampus. The internal clock model complemented with the attentional gate model allows a more in-depth understanding of the perception of time. The motor representation of duration is ensured by the basal ganglia, while the cerebellum synchronizes short duration for the movement. The right prefrontal cortex seemingly intervenes in the handling of temporal information in working memory. The temporal lobe ensures the comparison of durations, especially the right lobe for the reference durations and the medial lobe for the reproduction of durations in episodic memory. During normal aging, the hypothesis of slowing of the temporal processor is evoked when noting the perception of the acceleration of the passage of time that seemingly occurs with advancing age. The various studies pertaining specifically to time cognition, albeit heterogeneous in terms of methodology, attest to the wide-ranging disturbances of this cognitive field during the course of numerous disorders, whether psychiatric - depression and schizophrenia notably - or neurological. Hence, perturbations in temporality are observed in focal brain lesions and in subcortical disorders, such as Parkinson's disease or Huntington's chorea. Alzheimer's disease represents a particularly fertile field of exploration with regard to time cognition and temporality. The objectified deconstruction of temporal experience provides insights into the very processes of temporality and their nature: episodic, semantic and procedural. In addition to exploration based on elementary stimuli, one should also consider the time lived, i.e. that of the subject, to better understand cognition as it relates to time. While the temporal dimension permeates the whole cognitive field, it remains largely neglected: integration of a genuine time cognition and temporality clinic in daily practice remains to be implemented.

How to facilitate the orientation of elderly subjects with psychical disabilities to a health alternative to hospitalization?

This paper is aimed to improve the socio-psycho-therapeutic support for older patients with heavy psychiatric disability. First, we review the literature to question the specific grounds reported by professionals regarding the orientation of these vulnerable subjects. Secondly, we emphasize that integration of these subjects within alternatives to hospitalization requires a type of support similar to that usually proposed, an accompaniment of psychosocial rehabilitation. Then, we propose to build an indicator called the psychosocial age, which reduces the weight of the chronological age for the orientation of these subjects. Ultimately, we question the health policies in psychiatry.

Healing gardens and cognitive behavioral units in the management of Alzheimer's disease patients: the Nancy experience.

The French Alzheimer Plan 2008-2012 anticipates the implementation of new Units specialized in cognitive rehabilitation and psycho-behavioral therapy of Alzheimer's disease (AD) patients. Conceived for AD and other dementia patients of all ages, their objectives are to propose a cognitive rehabilitation program, to prevent or treat psycho-behavioral crises, and to provide support and educational therapy to the family and professional caregivers, in order to ease the patient's return to his or her previous way of life. Studies on green spaces and healing gardens in health-care settings have revealed objective and measurable improvements in the patient's well-being. The Plan officially stipulates for the first time the need to make healing gardens an integral part of these Units, but it does not provide specific recommendations or criteria for implementing such gardens. Although green spaces and gardens are available in many French Care Units, they are rarely specifically adapted to the needs of AD patients. In Nancy, the Art, Memory and Life garden, a specific concept guided by a neuropsychological approach, was developed and complemented by an artistic vision based on cultural invariants. The main objective of this article is to describe the various steps of the process that led to the creation of this garden: the collection of experiences and information by a pilot group, surveys of patients, visitors, and caregivers before and after establishment of the garden, and implementation of a multi-professional group project. The specifications, the organizational criteria, the therapeutic project, and the criteria for the conception of such a garden stemming from our clinical experience with the Art, Memory and Life garden in Nancy, are described herein. We also present the first assessment following the implementation of the project.