Trauma Exposure, Social Support and Mental Health in the General Population in Belgium.

INTRODUCTION: International research has shown that trauma exposure can lead to mental health disorders and affect social support. However, there is little insight into trauma exposure and its related issues in the general population of Belgium. METHODS: Secondary cross-sectional data on the general adult population were retrieved from the Belgian Health Interview Survey. Using a representative sample, data were collected on trauma exposure in the past 12 months, and the disclosure of trauma, social support, depressive/anxiety symptoms and background factors were investigated. RESULTS: In total, 7728 participants were included in this study, and 4.8% (N = 369) reported trauma exposure within the past 12 months. People with trauma exposure (4.8%, N = 369) consistently had more anxiety and depressive symptoms than those without trauma (p < 0.001), and people with multiple trauma exposures had more symptoms than those with a single trauma (p < 0.001). Social support was observed to be lower among those with trauma exposure (p < 0.001), and 17.1% had never disclosed their trauma to anyone. Sexual violence was higher among women (64.5%) and was also the least disclosed form of trauma. CONCLUSIONS: Trauma exposure is associated with poorer mental health in Belgium. Around a fifth of those who experience trauma do not disclose their trauma, which is the most common after sexual violence.

Data collection in pandemic times: the case of the Belgian COVID-19 health surveys.

BACKGROUND: Survey data were needed to assess the mental and social health, health related behaviors and compliance with preventive measures of the population during the COVID-19 pandemic. Yet, the pandemic challenged classical survey methods. Time and budgetary constraints at the beginning of the pandemic led to ad hoc recruitment of participants and easily manageable data collection modes. This paper describes the methodological choices and results in terms of participation for the COVID-19 health surveys conducted in Belgium. METHODS: The COVID-19 health surveys refer to a series of ten non-probability web surveys organized between April 2020 and March 2022. The applied recruitment strategies were diverse including, amongst others, a launch through the website and the social media of the organizing research institute. In addition, the survey links were shared in articles published in the national press and participants were requested to share the surveys in their network. Furthermore, participants were asked consent to be re-contacted for next survey editions using e-mail invitations. RESULTS: These mixed approaches allowed to reach a substantial number of participants per edition ranging from 49339 in survey 1 to 13882 in survey 10. In addition, a longitudinal component was created; a large share of the same individuals were followed up over time; 12599 participants completed at least 5 surveys. There were, however, sex, age, educational level and regional differences in participation. Post-stratification weighting on socio-demographic factors was applied to at least partly take this into account. CONCLUSION: The COVID-19 health surveys allowed rapid data collection after the onset of the pandemic. Data from these non-probability web surveys had their limitations in terms of representativeness due to self-selection but were an important information source as there were few alternatives. Moreover, by following-up the same individuals over time it was possible to study the effect of the different crisis phases on, amongst others, the mental health. It is important to draw lessons from these experiences: initiatives in order to create a survey infrastructure better equipped for future crises are needed.

Anxiety and Depression in Belgium during the First 15 Months of the COVID-19 Pandemic: A Longitudinal Study.

The COVID-19 pandemic and policy measures enacted to contain the spread of the coronavirus have had nationwide psychological effects. This study aimed to assess the impact of the first 15 months of the COVID-19 pandemic on the level of anxiety (GAD-7 scale) and depression (PHQ-9 scale) of the Belgian adult population. A longitudinal study was conducted from April 2020 to June 2021, with 1838 respondents participating in 6 online surveys. Linear mixed models were used to model the associations between the predictor variables and the mental health outcomes. Results showed that the prevalence of symptoms of anxiety and depression was higher in times of stricter policy measures. Furthermore, after the initial stress from the outbreak, coping and adjustment were observed in participants, as symptoms of anxiety and depression decreased during times of lower policy restrictions to almost the same level as in pre-COVID times (2018). Though time trends were similar for all population subgroups, higher levels of both anxiety and depression were generally found among women, young people, people with poor social support, extraverts, people having pre-existing psychological problems, and people who were infected/exposed to the COVID-19 virus. Therefore, investment in mental health treatment programs and supports, especially for those risk groups, is crucial.

COVID-19 and people who use drugs: Impact of the pandemic on general anxiety and depressive disorders among adults in Belgium.

BACKGROUND: During previous pandemics people who use drugs (PWUD) were categorized among the most vulnerable. In the current study, firstly, we wanted to evaluate the impact of the COVID-19 crisis on the prevalence of anxiety and depressive disorders among PWUD. Furthermore, we wanted to compare the prevalence of these disorders with that of members from the general population who did not use drugs. METHODS: We used a matched cohort design based on two separate repeated cross-sectional online surveys (April and November 2020) among PWUD and the general population. Results of GAD-7 and PHQ-9 were used as outcome variables. We calculated absolute and relative risks for matched pairs for both affective disorders, and logistic regression to compare affective disorders over both waves for PWUD. RESULTS: In April, the prevalence of affective disorders was similar for PWUD and the general population. In November, the risks for anxiety disorders increased with 64% for PWUD compared to non-PWUD (RR = 1.64, 95%CI 1.42-1.88), whereas the risks for depressive disorders more than doubled (RR = 2.29, 95%CI 1.97-2.67). Having a job and being male were protective factors for PWUD for both anxiety and depressive disorders. LIMITATIONS: As this study used self-reported data, GAD-7 and PHQ-9 give an indication of the presence of anxiety and depression which might differ from a clinician's judgement. CONCLUSIONS: PWUD might be disproportionally affected by COVID-19. Health care providers should be attentive to substance use as an indicator for increased risk of mental health problems.