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BACKGROUND: The prevalence of medical illnesses is high among patients with psychiatric disorders. The current study aimed to investigate multi-comorbidity in patients with psychiatric disorders in comparison to the general population. Secondary aims were to investigate factors associated with metabolic syndrome and treatment appropriateness of mental disorders. METHODS: The sample included 54,826 subjects (64.73% females; 34.15% males; 1.11% nonbinary gender) from 40 countries (COMET-G study). The analysis was based on the registration of previous history that could serve as a fair approximation for the lifetime prevalence of various medical conditions. RESULTS: About 24.5% reported a history of somatic and 26.14% of mental disorders. Mental disorders were by far the most prevalent group of medical conditions. Comorbidity of any somatic with any mental disorder was reported by 8.21%. One-third to almost two-thirds of somatic patients were also suffering from a mental disorder depending on the severity and multicomorbidity. Bipolar and psychotic patients and to a lesser extent depressives, manifested an earlier (15-20 years) manifestation of somatic multicomorbidity, severe disability, and probably earlier death. The overwhelming majority of patients with mental disorders were not receiving treatment or were being treated in a way that was not recommended. Antipsychotics and antidepressants were not related to the development of metabolic syndrome. CONCLUSIONS: The finding that one-third to almost two-thirds of somatic patients also suffered from a mental disorder strongly suggests that psychiatry is the field with the most trans-specialty and interdisciplinary value and application points to the importance of teaching psychiatry and mental health in medical schools and also to the need for more technocratically oriented training of psychiatric residents.
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Antipsicóticos , Transtornos Mentais , Síndrome Metabólica , Masculino , Feminino , Humanos , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/tratamento farmacológico , Transtornos Mentais/epidemiologia , Transtornos Mentais/tratamento farmacológico , Antipsicóticos/uso terapêutico , Saúde Mental , ComorbidadeRESUMO
INTRODUCTION: The current study aimed to investigate the rates of anxiety, clinical depression, and suicidality and their changes in health professionals during the COVID-19 outbreak. MATERIALS AND METHODS: The data came from the larger COMET-G study. The study sample includes 12,792 health professionals from 40 countries (62.40% women aged 39.76 ± 11.70; 36.81% men aged 35.91 ± 11.00 and 0.78% non-binary gender aged 35.15 ± 13.03). Distress and clinical depression were identified with the use of a previously developed cut-off and algorithm, respectively. STATISTICAL ANALYSIS: Descriptive statistics were calculated. Chi-square tests, multiple forward stepwise linear regression analyses, and Factorial Analysis of Variance (ANOVA) tested relations among variables. RESULTS: Clinical depression was detected in 13.16% with male doctors and 'non-binary genders' having the lowest rates (7.89 and 5.88% respectively) and 'non-binary gender' nurses and administrative staff had the highest (37.50%); distress was present in 15.19%. A significant percentage reported a deterioration in mental state, family dynamics, and everyday lifestyle. Persons with a history of mental disorders had higher rates of current depression (24.64% vs. 9.62%; p < 0.0001). Suicidal tendencies were at least doubled in terms of RASS scores. Approximately one-third of participants were accepting (at least to a moderate degree) a non-bizarre conspiracy. The highest Relative Risk (RR) to develop clinical depression was associated with a history of Bipolar disorder (RR = 4.23). CONCLUSIONS: The current study reported findings in health care professionals similar in magnitude and quality to those reported earlier in the general population although rates of clinical depression, suicidal tendencies, and adherence to conspiracy theories were much lower. However, the general model of factors interplay seems to be the same and this could be of practical utility since many of these factors are modifiable.
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COVID-19 , Humanos , Feminino , Masculino , COVID-19/epidemiologia , Saúde Mental , Ideação Suicida , Depressão/epidemiologia , Ansiedade/epidemiologia , Ansiedade/psicologia , Pessoal de SaúdeRESUMO
BACKGROUND: During the COVID-19 pandemic healthcare workers have been under pressure of high workload and an increased risk of contracting the SARS-Cov-2 virus, while confronting the most tragic and devastating aspects of the pandemic-related medical realities. These factors could lead to severe distress with potential consequences for productivity in performing professional duties, and substantially increased risk for affective reactions, including clinical states of anxiety, depression and suicidality as compared to the general population. Thus, we aimed to investigate the changes in rates of anxiety, depression and suicidality in response to the pandemic among medical staff as compared to a sample of the general population and to the period of prepandemic time. SUBJECTS AND METHODS: This study is part of the large-scale, international multicentre COMET-G project. We assessed the extents of anxiety, depression and suicidality risks using the Stait-Trait Anxiety Inventory (STAI) with a cut-off score 39/40, Center for Epidemiologic Studies Depression Scale (CES-D) with a cut-off score 23/24, and the Risk Assessment Suicidality Scale (RASS) with a cut-off score 499/500, respectively, in samples of Russian healthcare workers and the general population. RESULTS: Among 7777 respondents participating in the study, responses to a query about occupation indicated 1216 healthcare workers. 45.8% of medical staff vs 40.4% of non-medical staff (χ2=12.42, p<0.001) reported the increased anxiety, in excess of the clinical anxiety state threshold score of 39 according to the STAI. High suicidality risks, according to a RASS score > 500, were reported by 8.2% of medical professionals vs 10.6% of non-medical personnel (χ2=6.35, p=0.012). The increase in depression rates, including cases of clinical depression according to the threshold of CES-D ≥ 24, did not differ between the groups. CONCLUSIONS: A larger proportion of healthcare system staff, as compared to the general population, reported a significant increase in anxiety in response to the pandemic. Compared to medical doctors, other healthcare system workers had a significantly higher prevalence of depression and suicidality rates. Exploratory analysis suggested that it was not the occupation per se, but rather the burden of meaningful working duties that could be associated with psychological defense mechanisms against depression and suicidality among medical staff.
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COVID-19 , Pessoal de Saúde , Ansiedade/epidemiologia , COVID-19/epidemiologia , COVID-19/psicologia , Depressão/epidemiologia , Pessoal de Saúde/psicologia , Humanos , Pandemias , SuicídioRESUMO
BACKGROUND: The COVID-19 pandemic has substantially contributed to increased anxiety rates among the general population worldwide. Pandemic-related health anxiety and worries about getting COVID-19 can lead to generalized anxiety and anxiety somatization, which, together with insalubrious daily life habits, are risk factors of worsening somatic health in people with SARS-Cov-2 infection. SUBJECTS AND METHODS: The current study is a part of the COMET-G project (40 countries, n=55589; approved by the Ethics Committee of the Aristotle University of Thessaloniki), which represents an intermediate analysis of data collected anonymously via online links from a national sample of the Russian general population (n=9936, 31.09±12.16 y.o., 58.7% females) to estimate anxiety using STAI-S and self-reported changes in anxiety and life habits (physical activity, nutrition and weight, internet use, sleep) during the lockdown. All statistical calculations (descriptive statistics, between group comparisons using chi-square test, MANOVA, ANOVA, significant at p<0.05) were performed with IBM SPSS 27. RESULTS: Overall STAI-S scores were 29±5.4, a subjective feeling of anxiety increase was reported in 40.3% of respondents (43.9% significantly > in females), worsening to clinical anxiety in 2.1% (2.4% > in females). 54.2% of respondents reported decreased physical activity, 33.1% gained weight, 72% used internet more often, 52.6% experienced worries related to the information about COVID-19 (56.8% > in females). 88% experienced worsened sleep quality, 69.2% stayed up until late, 23.2% took sleeping pills, and 31% had nightmares in which they felt trapped. To ANOVA, such life habits as reduced physical activity during the lockdown, increased time spent online, internet browsing about COVID-19, tendency to stay up late, use of sleeping pills and disturbing dreams with scenario of being trapped were significantly related to worsening of clinical anxiety. However, eating behaviour, weight changes, and social media use did not contribute to the clinical anxiety increase. CONCLUSIONS: Factors of decreased physical activity and sleep disturbances related to the lockdown, as well as excessive internet browsing for information about COVID-19, emerged as risk factors for increased anxiety, more notably in women than in men. Preventive measures should be targeted against relevant factors imparting anxiety in the vulnerable population.
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COVID-19 , Mídias Sociais , Ansiedade/epidemiologia , Controle de Doenças Transmissíveis , Exercício Físico , Feminino , Hábitos , Humanos , Internet , Masculino , Pandemias , Fatores de Risco , SARS-CoV-2RESUMO
BACKGROUND: The COVID-19 pandemic has brought significant mental health challenges, particularly for vulnerable populations, including non-binary gender individuals. The COMET international study aimed to investigate specific risk factors for clinical depression or distress during the pandemic, also in these special populations. METHODS: Chi-square tests were used for initial screening to select only those variables which would show an initial significance. Risk Ratios (RR) were calculated, and a Multiple Backward Stepwise Linear Regression Analysis (MBSLRA) was followed with those variables given significant results at screening and with the presence of distress or depression or the lack of both of them. RESULTS: The most important risk factors for depression were female (RR = 1.59-5.49) and non-binary gender (RR = 1.56-7.41), unemployment (RR = 1.41-6.57), not working during lockdowns (RR = 1.43-5.79), bad general health (RR = 2.74-9.98), chronic somatic disorder (RR = 1.22-5.57), history of mental disorders (depression RR = 2.31-9.47; suicide attempt RR = 2.33-9.75; psychosis RR = 2.14-10.08; Bipolar disorder RR = 2.75-12.86), smoking status (RR = 1.15-5.31) and substance use (RR = 1.77-8.01). The risk factors for distress or depression that survived MBSLRA were younger age, being widowed, living alone, bad general health, being a carer, chronic somatic disorder, not working during lockdowns, being single, self-reported history of depression, bipolar disorder, self-harm, suicide attempts and of other mental disorders, smoking, alcohol, and substance use. CONCLUSIONS: Targeted preventive interventions are crucial to safeguard the mental health of vulnerable groups, emphasizing the importance of diverse samples in future research. LIMITATIONS: Online data collection may have resulted in the underrepresentation of certain population groups.
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COVID-19 , Transtornos Relacionados ao Uso de Substâncias , Humanos , Feminino , Masculino , COVID-19/epidemiologia , Saúde Mental , Pandemias , Grupos Populacionais , Populações Vulneráveis , Controle de Doenças Transmissíveis , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Depressão/epidemiologiaRESUMO
BACKGROUND: Suicidality is a complex clinical phenomenon reflecting vulnerability to suicidal behavior which can be explained via the biopsychosocial paradigm and in relationship with a variety of country-specific factors. Data on suicides within the Russian population are inconsistent (from 11.7 up to 25.1 per 100.000), whereas the population's suicidality risks have not been investigated in detail. Suicidality estimates during the multifactorial influence of the COVID-19 pandemic could serve as a basis to learn more about this mental health indicator. METHODS: The current study is a part of the COMET-G international project (40 countries, n=55.589), which represents an analysis of data collected from Russia's general population (n=7714, 33±12 y.o., 61% female) to estimate suicidality using the Risk Assessment Suicidality Scale (RASS) and its relationships with socio-demographic, clinical, and life-habit characteristics during the COVID-19 pandemic. The evaluation of the statistical data (descriptive statistics, ANOVA, LASSO linear regression, significant at α=0.05) was undertaken using TIBCO Statistica. RESULTS: According to the RASS, at least 20.68%, and up to 29.15%, of the general population in Russia demonstrated increased risk of suicidality during the pandemic. Modelling these risks pointed to the key vulnerabilities related to mental and behavioral disorders, such as (i) current severe depression and a history of mental disorders, (ii) bipolar disorder, (iii) use of illicit drugs surprisingly outranking the alcohol misuse, and psychiatric compounds (hypnotics), highlighting sleep quality deterioration, (iv) a history of suicide attempts and self-harm - though not self-reported changes in depression - in response were predictors of the risk of suicidality, which can be explained by the phenomenon of "learned suicidality", a habitual behavioral suicidality pattern completion accumulated over the background. Such (v) socio-demographic indicators as younger age (disregarding the gender factor), a marital status of single, having no children, living with fewer people in the household, a recent increase in family conflicts, increased need for emotional support, decreased need for communication, and not believing in precautionary measures against COVID-19, contributed to the increase of suicidality risk in the context of the pandemic. CONCLUSIONS: The findings of this study revealed new suicide risk factors that should be taken into account in suicidality risk assessments for the Russian population and in the implementation of suicide prevention programs in the region.
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INTRODUCTION: There are few published empirical data on the effects of COVID-19 on mental health, and until now, there is no large international study. MATERIAL AND METHODS: During the COVID-19 pandemic, an online questionnaire gathered data from 55,589 participants from 40 countries (64.85% females aged 35.80 ± 13.61; 34.05% males aged 34.90±13.29 and 1.10% other aged 31.64±13.15). Distress and probable depression were identified with the use of a previously developed cut-off and algorithm respectively. STATISTICAL ANALYSIS: Descriptive statistics were calculated. Chi-square tests, multiple forward stepwise linear regression analyses and Factorial Analysis of Variance (ANOVA) tested relations among variables. RESULTS: Probable depression was detected in 17.80% and distress in 16.71%. A significant percentage reported a deterioration in mental state, family dynamics and everyday lifestyle. Persons with a history of mental disorders had higher rates of current depression (31.82% vs. 13.07%). At least half of participants were accepting (at least to a moderate degree) a non-bizarre conspiracy. The highest Relative Risk (RR) to develop depression was associated with history of Bipolar disorder and self-harm/attempts (RR = 5.88). Suicidality was not increased in persons without a history of any mental disorder. Based on these results a model was developed. CONCLUSIONS: The final model revealed multiple vulnerabilities and an interplay leading from simple anxiety to probable depression and suicidality through distress. This could be of practical utility since many of these factors are modifiable. Future research and interventions should specifically focus on them.
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Ansiedade/epidemiologia , COVID-19/complicações , COVID-19/psicologia , Depressão/epidemiologia , Saúde Mental , Adulto , Ansiedade/etiologia , COVID-19/epidemiologia , Depressão/etiologia , Feminino , Carga Global da Doença , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , SARS-CoV-2 , Estresse Psicológico/etiologia , Ideação SuicidaRESUMO
INTRODUCTION: During the COVID-19 pandemic various degrees of lockdown were applied by countries around the world. It is considered that such measures have an adverse effect on mental health but the relationship of measure intensity with the mental health effect has not been thoroughly studied. Here we report data from the larger COMET-G study pertaining to this question. MATERIAL AND METHODS: During the COVID-19 pandemic, data were gathered with an online questionnaire from 55,589 participants from 40 countries (64.85% females aged 35.80 ± 13.61; 34.05% males aged 34.90±13.29 and 1.10% other aged 31.64±13.15). Anxiety was measured with the STAI, depression with the CES-D and suicidality with the RASS. Distress and probable depression were identified with the use of a previously developed cut-off and algorithm respectively. STATISTICAL ANALYSIS: It included the calculation of Relative Risk (RR), Factorial ANOVA and Multiple backwards stepwise linear regression analysis RESULTS: Approximately two-thirds were currently living under significant restrictions due to lockdown. For both males and females the risk to develop clinical depression correlated significantly with each and every level of increasing lockdown degree (RR 1.72 and 1.90 respectively). The combined lockdown and psychiatric history increased RR to 6.88 The overall relationship of lockdown with severity of depression, though significant was small. CONCLUSIONS: The current study is the first which reports an almost linear relationship between lockdown degree and effect in mental health. Our findings, support previous suggestions concerning the need for a proactive targeted intervention to protect mental health more specifically in vulnerable groups.