Oxytocin as a transdiagnostic biomarker of well-being in severe mental illness during the Covid-19 pandemic.

Individuals with severe mental illness (SMI) have been found to suffer a greater decline in psychological well-being compared to the general population in times of stress. The present study aimed to examine clinical and endocrine resilience factors of psychological well-being in SMI patients during the Covid-19 pandemic. METHODS: After Covid-19 crisis outburst in Israel 112 participants, 69 outpatients, and 43 inpatients and day treatment patients were recruited. Outpatients signed an online informed consent and filled in questionnaires regarding their level of mental health symptoms (OQ-45), fear of Covid-19 (FCV), and psychological well-being (PWB). Inpatients answered the same questionnaires and in addition, went through a positive social interaction paradigm while providing three saliva samples to measure their s-IgA and oxytocin (OT) levels. RESULTS: A strong negative correlation was found in the whole sample between reported mental health symptoms, fear of Covid-19, and well-being. Hierarchical regression did not find additional contribution of the fear of the pandemic in predicting well-being beyond the impact of symptomatology. For inpatients (N = 39) only, hierarchical regression found that oxytocin, but not s-IgA could explain 5% of the variance of well-being (R2 = 0.05) in individuals with SMI regardless of their mental health symptoms (R2 = 0.46) and their marital status (R2 = 0.21). CONCLUSIONS: OT is suggested as a possible independent biological resilience factor of well-being in times of major stress among SMI patients. It is still unknown whether OT is a mediator that contributes to well-being or a biological marker that indicates the degree of beneficial social interactions.

Moral Injury and Suicide Ideation Among Combat Veterans.

Background: Modern warfare in a civilian setting may expose combatants to severe moral challenges. Whereas most of these challenges are handled effectively, some potentially morally injurious events (PMIEs) may have deleterious psychological effects on the combatants, such as suicide ideation (SI). Self-disclosure, which includes sharing distressing thoughts and emotions, has been recognized as a protective factor against SI in the aftermath of stressful events. The current study is the first to examine the moderating role of self-disclosure in the relationship between PMIE exposure and SI among combat veterans. Method: A sample of 190 recently discharged Israeli combat veterans completed validated self-report questionnaires measuring combat exposure, PMIEs, depressive symptoms, SI, and self-disclosure in a cross-sectional design study. Results: PMIE dimensions and self-disclosure significantly contributed to current SI. Notably, the moderating model indicated that self-disclosure moderated the link between PMIE-Self and current SI, as PMIE-Self and current SI demonstrated a stronger association among veterans with low self-disclosure than among those with high self-disclosure. Limitations: Cross-sectional design of volunteers, the findings may not be directly generalizable to veterans' population. Conclusion: Self-disclosure, as a factor promoting a sense of belongingness, interpersonal bonding, and support, might diminish SI risk following PMIE exposure. Various mechanisms accounting for these associations are suggested, and the clinical implications of these interactions are discussed.

COVID-19 vaccine hesitancy scale and its association with actual COVID-19 vaccine uptake in Israel.

BACKGROUND: The public's willingness to get vaccinated continues to be a source of concern. In this study we assessed the psychometric properties of the COVID-19 vaccine hesitancy scale (C19-VHS) as well as the association between the scale and self-reported past COVID-19 vaccination, approximately two weeks after the national vaccine distribution plan was launched in Israel. METHODS: Participants were recruited via an online survey distributed through social media platforms and mailing lists. A total of 650 individuals completed the C19-VHS, the general vaccine hesitancy scale, and the fear of COVID-19 scale, and reported on demographic and pandemic-related characteristics. Principal component and Cronbach's alpha analyses were performed to assess the factor structure and reliability of the scale. Logistic regressions were employed to assess the scale's convergent and discriminative validity. RESULTS: Two factors pertaining to "lack of confidence" (Factor 1) and "risk perception" (Factor 2) emerged. Cronbach's alpha indicated good reliability of Factor 1 (0.93), with lower reliability of Factor 2 (0.72). Younger age was associated with higher risk perception, with women showing less confidence and perceiving greater risks. Lower hesitancy significantly predicted actual COVID-19 vaccine uptake after adjusting for demographic and pandemic-related factors (OR = 1.16, 95%CI 1.11-1.21, p <.001). Older age, being a woman, and receiving the flu vaccine in the past year were also predictive of COVID-19 vaccine uptake. DISCUSSION: The C19-VHS measure shows robust psychometric properties and is associated with actual vaccine uptake. Future studies assessing COVID-19 vaccination attitudes may utilize this scale to assess current COVID-19 vaccine hesitancy in different contexts and cultures.

Distress and Well-Being Among Psychiatric Patients in the Aftermath of the First COVID-19 Lockdown in Israel: A Longitudinal Study.

Objectives: Studies assessing the effect of the COVID-19 pandemic on psychiatric patients have mostly focused on cross-sectional evaluations of differences in levels of distress. In this study, we aimed to assess changes in distress and well-being following the COVID-19 pandemic outbreak as compared with pre-pandemic levels, as well as potential predictors of symptomatic deterioration, among psychiatric outpatients treated in a public mental health hospital in Israel. Methods: Patients evaluated for distress and well-being before the pandemic (n = 55) were re-evaluated at the end of the first lockdown in Israel. Results: Analyses revealed a significant decrease in the patients' sense of personal growth. Increases in distress were significantly associated with fear of COVID-19 beyond patient characteristics. Conclusion: These results suggest that the pandemic has a short-term effect on patients' well-being, and that fear of the pandemic is associated with elevations in distress.

Buffering effect of in-patient psychiatric care on the link between fear of covid-19 and mental health consequences.

BACKGROUND& AIMES: Psychiatric admissions during the covid-19 pandemic were limited, overlooking their possible benefit. This study focused on assessing the effect of the fear of covid on the mental health and well-being of inpatients as opposed to outpatients. METHODS: During the first lockdown, forty-four inpatients and day care patients (inpatient group) and 74 outpatients (outpatient group) were recruited after an informed consent procedure. Fear of the infection was assessed using the Fear of COVID-19 (FCV-19S); severity of mental health symptomatology was evaluated with the outcome questionnaire-45 (OQ-45); wellbeing was assessed with the Psychological well-being scale (PWB). OUTCOMES: There was no difference between the inpatient group and outpatient group in their fear of COVID-19 levels.FCV-19 predicted changes in the outpatient OQ total score (B â€‹= â€‹2.21, p â€‹< 0.001), OQ interpersonal relation subscale (B â€‹= â€‹0.34, p â€‹= 0.01), PWB total score (B â€‹= â€‹-0.05, p â€‹< 0.001), PWB environmental mastery subscale (B â€‹= â€‹-0.07, p â€‹< 0.001) and PWB positive relation subscale (B â€‹= â€‹-0.05, p â€‹< 0.001), but not in the inpatient group. CONCLUSIONS: Mental health and wellbeing of the outpatient group, which had less therapeutic contact than the inpatient group, correlated with the fear of covid, supporting the hypothesis that intensive psychiatric therapy had a protective effect on the mental health consequences of "fear of covid".

Attitudes of patients with severe mental illness towards COVID-19 vaccinations: A preliminary report from a public psychiatric hospital.

BACKGROUND: As patients with severe mental illness are at increased risk for COVID-19 mortality, the issue of willingness to be vaccinated is of extreme importance. METHODS: During February 2021 Shalvata Mental Health hospital provided Covid-19 vaccines to its patients. Fifty one patients suffering from severe mental illness, out of 196 patients hospitalized in closed, open or day wards during that period, signed the informed consent and were assessed for their clinical condition (OQ-45), fear of Covid-19 (FCV-19S) and approach to the vaccine (C19-VHS). All patients who were not vaccinated in February 2021 (baseline) were re-approached a month later to assess whether they had gotten vaccinated since. RESULTS: Patients who were not vaccinated at baseline had an oppositional approach to the vaccine, and did not significantly differ in their fear of Covid-19 levels or in levels of clinical severity (t(49) = 2.51, p = 0.02) from those who were vaccinated. From the 29 patients who were not vaccinated at baseline approach to the vaccine was a good predictor to getting vaccinated after one month (79% positive predictive value). CONCLUSIONS: The majority of patients suffering from a severe mental illness are willing to get vaccinated, and their decision of whether or not to get vaccinated is based on their viewpoint on the vaccine rather than being an outcome of their level of distress (OQ-45). It is important to allow vaccine accessibility to hospitalized patients, to consider their opinions and to provide useful information to lower vaccine hesitancy and improve vaccination rates.