Pour une défense collective face à la fatigue pandémique: L'urgence de renforcer les facteurs protecteurs.

Résumé:De nombreux articles publiés récemment ont laissé apparaître l'émergence d'un nouveau phénomène dans notre rapport avec la pandémie de COVID-19 : la fatigue pandémique. Ce phénomène suggère l'apparition d'une tendance générale de lassitude face aux mesures sanitaires et à l'état d'urgence devenu permanent. L'objectif de cet article est de replacer cet enjeu dans le contexte de la réalisation d'un projet de recherche portant sur les impacts psychosociaux durant la pandémie. Si relativement peu de recherches se sont intéressées à la fatigue pandémique, la réalité de ce phénomène a été mise en évidence dans le cadre d'un projet de recherche multi-annuelle effectuée durant la pandémie. En termes de méthode, notre équipe multidisciplinaire à l'Université de Sherbrooke a développé un protocole d'enquête permettant d'évaluer les effets de la pandémie de COVID-19 sur la santé mentale à travers des études transversales répétées. La dernière phase de l'enquête inclut un volet additionnel qui cherche à comprendre de quelle manière les conséquences de la pandémie peuvent s'appliquer à d'autres crises systémiques, notamment aux changements climatiques. Différentes vagues d'enquêtes nationales et internationales ont ainsi été réalisées (8 pays, taille minimale de l'échantillon 1000-1500 et échantillonnage par quota mis en oeuvre adapté à chaque pays et basé sur les données démographiques disponibles), et suivant l'évolution de la pandémie, nous avons introduit la notion de fatigue pandémique, ainsi que de fatigue climatique, afin de pouvoir mesurer l'impact de l'exposition prolongée à ces crises mondiales. Ces nouvelles données confirment nos résultats originaux : l'impact psychosocial de la pandémie est immense, en particulier en termes de fatigue pandémique, phénomène qui se retrouve à la fois au niveau comportemental et informationnel. Cette fatigue est un indicateur important à considérer afin d'améliorer notre capacité de réaction et d'adaptation à cette crise, mais également à celles futures.

Effect of Age-Friendly Communities Action Plan on Trajectories of Older Canadians' Depressive Symptoms Between 2018 and 2020: Multilevel Results From the Canadian Longitudinal Study on Aging.

As the COVID-19 pandemic impacted mental health, this longitudinal study examined the effect of age-friendly communities (AFC) action plan on older adults' depressive symptoms. Using the CLSA, the CLSA COVID-19 Questionnaire study, survey of Canadian municipalities, and the census, the depressive symptoms trajectories were modeled with multilevel multinomial regressions. Most respondents (66.1%) had non-depressed trajectories, 28.1% experienced a moderate increase in depressive symptoms, and 5.8% had a depressed trajectory. AFC action plans did not have a protective effect on these trajectories. Being a female, greater loneliness, lower income, ≥2 chronic conditions, inferior social participation, weaker sense of belonging, COVID-19 infection, and pandemic stressors predicted a depressed trajectory. Neighborhood's deprivation had a weak protective effect on the declining trajectory. Although AFC action plans provided no benefits during the pandemic, volunteers facilitating resource access and social interactions could limit any increase in depressive symptoms.

The relationship between hot temperatures and hospital admissions for psychosis in adults diagnosed with schizophrenia: A case-crossover study in Quebec, Canada.

INTRODUCTION: Some studies have found hot temperatures to be associated with exacerbations of schizophrenia, namely psychoses. As climate changes faster in Northern countries, our understanding of the association between temperature and hospital admissions (HA) for psychosis needs to be deepened. OBJECTIVES: 1) Among adults diagnosed with schizophrenia, measure the relationship between mean temperatures and HAs for psychosis during summer. 2) Determine the influence of individual and ecological characteristics on this relationship. METHODS: A cohort of adults diagnosed with schizophrenia (n = 30,649) was assembled using Quebec's Integrated Chronic Disease Surveillance System (QICDSS). The follow-up spanned summers from 2001 to 2019, using hospital data from the QICDSS and meteorological data from the National Aeronautics and Space Administration's (NASA) Daymet database. In four geographic regions of the province of Quebec, a conditional logistic regression was used for the case-crossover analysis of the relationship between mean temperatures (at lags up to 6 days) and HAs for psychosis using a distributed lag non-linear model (DLNM). The analyses were adjusted for relative humidity, stratified according to individual (age, sex, and comorbidities) and ecological (material and social deprivation index and exposure to green space) factors, and then pooled through a meta-regression. RESULTS: The statistical analyses revealed a statistically significant increase in HAs three days (lag 3) after elevated mean temperatures corresponding to the 90th percentile relative to a minimum morbidity temperature (MMT) (OR 1.040; 95% CI 1.008-1.074), while the cumulative effect over six days was not statistically significant (OR 1.052; 95% IC 0.993-1.114). Stratified analyses revealed non statistically significant gradients of increasing HAs relative to increasing material deprivation and decreasing green space levels. CONCLUSIONS: The statistical analyses conducted in this project showed the pattern of admissions for psychosis after hot days. This finding could be useful to better plan health services in a rapidly changing climate.

Évaluation de la structure factorielle et des qualités psychométriques de l'Échelle de Fatigue Pandémique parmi la population adulte québécoise: Evaluation of the factorial structure and psychometric qualities of the Pandemic Fatigue Scale among Quebec adult population.

OBJECTIVE: The objective of the study is to evaluate the factorial structure and the psychometric qualities of the Pandemic Fatigue Scale among the Quebec adult population. METHOD: The data analyzed come from a web survey conducted in October 2021 among 10 368 adults residing in Quebec. The scale's factor structure and invariance by gender, age and language used to complete the questionnaire were tested using confirmatory factor analyses. Convergent and divergent validity were also assessed. Finally, the reliability of the scale was estimated from the alpha and omega coefficients. RESULTS: The analyzes suggest the presence of a bidimensional structure in the sample of Quebec adults with informational fatigue and behavioral fatigue. The invariance of the measure is noted for sex, for age subgroups and for the language used for the questionnaire. The results of convergent and divergent validity provide additional evidence for the validity of the scale. Finally, the reliability of the scale scores is excellent. CONCLUSION: The results support the presence of a bidimensional structure as in the initial work of Lilleholt et al. They also confirm that the scale has good psychometric qualities and that it can be used among the adult population of Quebec.

[Indice du potentiel de participation sociale des Québécois âgés : cartographie des inégalités des zones métropolitaines, urbaines et rurales].

Afin de mieux comprendre la distribution géographique des facilitateurs et des obstacles à la participation sociale des Québécois âgés, cette étude visait à documenter l'Indice du potentiel de participation sociale (IPPS) selon les zones métropolitaines, urbaines et rurales. Des analyses de données secondaires, dont l'Enquête transversale sur la santé des collectivités canadiennes, ont permis de développer et de cartographier un indice composé de facteurs environnementaux associés à la participation sociale, pondérés par une analyse factorielle. En zones métropolitaines, l'IPPS était supérieur au centre qu'en périphérie, compte tenu d'une concentration accrue d'aînés et des transports. Bien qu'atténuée, la configuration était similaire en zones urbaines. En zone rurale, un IPPS élevé était associé à une concentration d'aînés et un accès aux ressources accru, sans configuration spatiale. Pour favoriser la participation sociale, l'IPPS soutient que les transports et l'accès aux ressources doivent respectivement être améliorés en périphérie des métropoles et en zone rurale.

Key Age-Friendly Components of Municipalities that Foster Social Participation of Aging Canadians: Results from the Canadian Longitudinal Study on Aging.

Municipalities can foster the social participation of aging adults. Although making municipalities age-friendly is recognized as a promising way to help aging adults stay involved in their communities, little is known about the key components (e.g., services and structures) that foster social participation. This study thus aimed to identify key age-friendly components (AFC) best associated with the social participation of older Canadians. Secondary analyses were carried out using baseline data from the Canadian Longitudinal Study on Aging (n = 25,411) in selected municipalities (m = 110 with ≥ 30 respondents), the Age-friendly Survey, and census data. Social participation was estimated based on the number of community activities outside the home per month. AFC included housing, transportation, outdoor spaces and buildings, safety, recreation, workforce participation, information, respect, health, and community services. Multilevel models were used to examine the association between individual social participation, key AFC, and environmental characteristics, while controlling for individual characteristics. Aged between 45 and 89, half of the participants were women who were engaged in 20.2±12.5 activities per month. About 2.5% of the variance in social participation was attributable to municipalities. Better outdoor spaces and buildings (p < 0.001), worse communication and information (p < 0.01), and lower material deprivation (p < 0.001) were associated with higher social participation. Age was the only individual-level variable to have a significant random effect, indicating that municipal contexts may mediate its impact with social participation. This study provides insights to help facilitate social participation and promote age-friendliness, by maintaining safe indoor and outdoor mobility, and informing older adults of available activities.

In the COVID-19 pandemic, who did we trust? An eight-country cross-sectional study.

Background: Trust is a key determinant of health, but has been undermined by the COVID-19 pandemic and the associated infodemic. Using data from eight countries, we aimed to epidemiologically describe levels of trust in health, governments, news media organisations, and experts, and measure the impact of political orientation and COVID-19 information sources on participant's levels of trust. Methods: We simultaneously conducted a stratified randomised online cross-sectional study across eight countries on adults aged ≥18 years between 6 and 18 November 2020. We employed crude and adjusted weighted regression analyses. Results: We included 9027 adults with a mean age of 47 years (range = 18-99), of whom 4667 (51.7%) were female. Trust in health experts ranked highest across all countries (mean (x̄) = 7.83; 95% confidence interval (CI) = 7.79-7.88), while trust in politicians ranked lowest (x̄ = 5.34; 95% CI = 5.28, 5.40). In adjusted analyses, political orientation and utilised information sources were significantly associated with trust. Individuals using higher levels of health information sources trusted health authorities more than those using lower levels (mean difference = 1.12; 95% CI = 1.02, 1.14). Similarly, individuals using higher levels of government information sources (mean difference = 1.55; 95% CI = 1.43, 1.64) and those using higher levels of new media information sources (mean difference = 1.17; 95% CI = 1.06, 1.28) had highest trust in governments/politicians and news media, respectively. However, there was little difference in trust in health, government, or news media between individuals using higher or lower levels of social media information sources. Conclusions: Trust is a key determinant of health, but has been politically fragile during this infodemic. High compliance with public health measures is key to combatting infectious diseases. In terms of people's trust, our findings suggest that politicians and governments worldwide should coordinate their response with health experts and authorities to maximise the success of public health measures.

Factors Associated with Complicated Grief Following a Railway Tragedy.

On July 6, 2013, a train with 72 crude oil tank cars derailed in the heart of Lac-Mégantic, a small municipality of 6,000 inhabitants located in Québec (Canada). This tragedy killed 47 people. Technological disasters are rarely studied in bereavement research, and train derailments even less. The goal of this article is to increase our understanding of the bereavement consequences of technological disasters. Specifically, we aim to identify the factors that lead to the experience complicated grief and distinguish from the protective factors. A representative population-based survey was conducted among 268 bereaved people, three and a half years after the train accident. Of these, 71 people (26.5%) experienced complicated grief. People with complicated grief (CG) differ significantly from those without CG in terms of psychological health, perception of physical health, alcohol use and medication, as well as social and professional relationships. Hierarchical logistic regression analysis identified four predictive factors for CG: level of exposure to the disaster, having a negative perception of the event, as well as having a paid job and low-income increase the risk of CG. The importance of having health and social practitioners pay attention to these factors of CG are discussed along with future directions for research.

How children make sense of climate change: A descriptive qualitative study of eco-anxiety in parent-child dyads.

The climate crisis not only has significant impacts on biodiversity and the physical health of humans, but its ramifications are also affecting people's mental health. Eco-anxiety, or the emotions that emerge with the awareness of climate change and the apprehension of its detrimental effects, has been investigated in adults and adolescents, but much less attention has been given to the impacts on children's mental health and well-being. Initial evidence confirms that youth are significantly concerned about climate change, but few studies have investigated the resulting emotional responses of children and the role of their parents in tempering these, especially using qualitative methodologies. The present study used a descriptive qualitative design with a convenience sample of parents and child dyads, assessed separately. Children's (n = 15, ages 8-12 years) experiences were explored using semi-structured interviews and their parents' (n = 12) perceptions were captured using a survey with closed and open-ended questions. A reflexive thematic analysis was used to analyze the interview data, and content analysis was used to investigate parent-child experiences. Three themes emerged from the thematic analysis: 1. children's understanding of climate change, 2. their emotional reaction to climate change, and 3. their coping mechanisms to deal with these emotions. The comparative content analysis revealed that parents who were aware that their children had concerns about climate change, had children who used more adaptive coping mechanisms. The results of this qualitative study contribute to a better understanding of children's emotional experience of the awareness of climate change in Canada and how they cope with these emotions. Furthermore, the results provide insight into the role parents might play in helping their children cope with their feelings.

Respiratory and Otolaryngology Symptoms Following the 2019 Spring Floods in Quebec.

BACKGROUND: Although floods may have important respiratory health impacts, few studies have examined this issue. This study aims to document the long-term impacts of the spring floods of 2019 in Quebec by (1) describing the population affected by the floods; (2) assessing the impacts on the respiratory system according to levels of exposure; and (3) determining the association between stressors and respiratory health. METHODS: A population health survey was carried out across the six most affected regions 8-10 months post-floods. Data were collected on self-reported otolaryngology (ENT) and respiratory symptoms, along with primary and secondary stressors. Three levels of exposure were examined: flooded, disrupted and unaffected. RESULTS: One in ten respondents declared being flooded and 31.4% being disrupted by the floods. Flooded and disrupted participants reported significantly more ENT symptoms (adjusted odds ratio (aOR): 3.18; 95% CI: 2.45-4.14; aOR: 1.76; 95% CI: 1.45-2.14) and respiratory symptoms (aOR: 3.41; 95% CI: 2.45-4.75; aOR: 1.45; 95% CI: 1.10-1.91) than the unaffected participants. All primary stressors and certain secondary stressors assessed were significantly associated with both ENT and respiratory symptoms, but no "dose-response" gradient could be observed. CONCLUSION: This study highlights the long-term adverse effects of flood exposure on respiratory health.

Psychological, Physical and Behavioral Health of Adults, 3 Years After Exposure to a Train Derailment.

In July 2013, a train derailment profoundly disrupted the tranquility of the population of Lac-Mégantic for months and even years. In 2016, we conducted a representative population-based survey among 387 people from Lac-Mégantic and 413 from other municipalities with the aim to document psychological and physical health of adults exposed to the disaster. This article examines differences between 3 groups of respondents: those who were highly, moderately or not exposed to the train accident. Khi Square analyses, odds ratios and logistic regressions were used to examine differences between the 3 groups of respondents (high, moderate and no exposure). Results show that the level of exposure to this technological disaster is strongly associated with psychological suffering, post-traumatic growth, physical heath, drinking patterns, and use of prescribed and non-prescribed drugs. We can explain these results by the nature and cause of the event as well as its consequences.

Eco-anxiety in children: A scoping review of the mental health impacts of the awareness of climate change.

Background: Youth are increasingly aware of the negative effects of climate change on the planet and human health, but this knowledge can often come with significant affective responses, such as psychological distress, anger, or despair. Experiencing major "negative" emotions, like worry, guilt, and hopelessness in anticipation of climate change has been identified with the term eco-anxiety. Emerging literature focuses on adults' experience; however, little is known about the ways in which children and youth experience eco-anxiety. Objectives: The aim of this review was to: (1) identify the available evidence on the topic of eco-anxiety in children, (2) clarify the mental health consequences brought by the awareness of climate change in this population, and (3) identify knowledge gaps in the literature and considerations for future research. Methods: Given that the research on the topic of eco-anxiety in children is limited, that there are very few randomized controlled trials, and that the goal is not to analyze individual studies in-depth, a scoping review was used. Keywords pertaining to the themes of eco-anxiety, climate change and children (aged < 18 years) were used as search terms in five databases. Journal articles using qualitative and quantitative methods, as well as gray literature were examined by two independent reviewers. A descriptive-analytical method was used to chart the data that emerged from the literature. Eighteen articles were considered in the final analysis. Results: Evidence confirms that children experience affective responses and eco-anxiety in reaction to then awareness of climate change. Mental health outcomes include depression, anxiety, and extreme emotions like sadness, anger, and fear. Youth from vulnerable communities, like indigenous communities, or those who have strong ties to the land are often identified as being emotionally impacted by climate change. The literature analyzed also describes how children and youth are coping with eco-anxiety, including maladaptive (e.g., denial) and adaptive responses (such as constructive hope, used as a positive coping mechanism). Preliminary considerations for parents, teachers and educators, mental health care providers, school systems, adults and people of power include adding age-appropriate climate education to the school curriculum, considering youth's emotions, and promoting healthy coping through empowerment. Important gaps exist in the definition of eco-anxiety in youth, as various characterizations of this emerging concept are found across articles.

An eight country cross-sectional study of the psychosocial effects of COVID-19 induced quarantine and/or isolation during the pandemic.

Forced quarantine and nationwide lockdowns have been a primary response by many jurisdictions in their attempt at COVID-19 elimination or containment, yet the associated mental health burden is not fully understood. Using an eight country cross-sectional design, this study investigates the association between COVID-19 induced quarantine and/or isolation on probable generalized anxiety disorder (GAD) and major depressive episode (MDE) psychological outcomes approximately eight months after the pandemic was declared. Overall, 9027 adults participated, and 2937 (32.5%) were indicated with GAD and/or MDE. Reported quarantine and/or isolation was common, with 1199 (13.8%) confined for travel or health requirements, 566 (6.5%) for being close contact, 720 (8.3%) for having COVID-19 symptoms, and 457 (5.3%) for being COVID-19 positive. Compared to those not quarantining or isolating, the adjusted estimated relative risks of GAD and/or MDE associated with quarantine and/or isolation was significant (p < 0.001), ranging from 1.24 (95% confidence interval [CI]: 1.07, 1.43) for travel/health to 1.37 (95% CI 1.19, 1.59) for COVID-19 symptom isolation reasons. While almost universally employed, quarantine and/or isolation is associated with a heavy mental health toll. Preventive strategies are needed, such as minimizing time-limits imposed and providing clear rationale and information, together with additional treatment and rehabilitation resources.

Building resilience in oncology teams: Protocol for a realist evaluation of multiple cases.

BACKGROUND: Teams caring for people living with cancer face many difficult clinical situations that are compounded by the pandemic and can have serious consequences on professional and personal life. This study aims to better understand how a multi-component intervention builds resilience in oncology teams. The intervention is based on a salutogenic approach, theories and empirical research on team resilience at work. This intervention research involves partnership between researchers and stakeholders in defining situations of adversity and solutions appropriate to context. METHODS: The principles of realist evaluation are used to develop context-mechanism-outcome configurations of a multi-component intervention developed by researchers and field partners concerned with the resilience of oncology teams. The multiple case study involves oncology teams in natural contexts in four healthcare establishments in Québec (Canada). Qualitative and quantitative methods are employed. Qualitative data from individual interviews, group interviews and observation are analyzed using thematic content analysis. Quantitative data are collected through validated questionnaires measuring team resilience at work and its effect on teaming processes and cost-effectiveness. Integration of these data enables the elucidation of associations between intervention, context, mechanism and outcome. DISCUSSION: The study will provide original data on contextual factors and mechanisms that promote team resilience in oncology settings. It suggests courses of action to better manage difficult situations that arise in a specialized care sector, minimize their negative effects and learn from them, during and after the waves of the pandemic. The mechanisms for problem resolution and arriving at realistic solutions to professional workforce and team effectiveness challenges can help improve practices in other settings.

Psychological symptoms associated with self-reported events of COVID-19 contact, symptoms, or diagnosis: a large community-based survey among adults in Quebec, Canada.

OBJECTIVES: Psychological consequences of COVID-19 contact, symptoms, or diagnosis are being increasingly reported. Few studies have examined the psychological effects tied to these events, using an unaffected comparison group. Most did not consider confounding factors like fear and stigma. This study aims to (1) identify individual characteristics associated with COVID-19 contact/symptoms or diagnosis and (2) examine the independent association between COVID-19 contact/symptoms or diagnosis and psychological symptoms. METHODS: From September 2020 to February 2021, 20,327 adults participated in community-based surveys in Quebec. Using repeated cross-sectional online questionnaire, data were collected on probable generalized anxiety disorder (GAD) and major depression episode (MDE), using the GAD-7 and the PHQ-9 scales, respectively. Self-reported events of (1) contact with a case or symptoms of COVID-19, and (2) diagnosis of COVID-19 were examined, along with several sociodemographic and pandemic-related factors. RESULTS: COVID-19 contact, symptoms, or diagnosis was more frequent in young adults, healthcare or social services workers, adults living with children, and those reporting a greater sense of threat, stigma, financial losses, or daily stress. COVID-19 contact or symptoms and diagnosis were associated with probable MDE relative to the unaffected group (adjusted odds ratio [aOR]: 1.25, 95% CI: 1.12-1.39 and aOR:1.82, 95% CI: 1.48-2.2, respectively). Suicidal thoughts and psychomotor retardation were the symptoms most closely associated with a COVID-19 diagnosis. CONCLUSION: Results from this study stress the need for better understanding, recognition, and support for people suffering from psychological symptoms following a COVID-19 diagnosis.

RéSUMé: OBJECTIFS: Les conséquences psychologiques d'un contact, de symptômes ou d'un diagnostic de COVID-19 sont de plus en plus signalées. Peu d'études ont examiné les effets psychologiques liés à ces évènements en utilisant des groupes non affectés et n'ont pas tenu compte des facteurs de confusion tels que la peur et la stigmatisation. Cette étude vise à 1) identifier les caractéristiques associées au contact/symptômes ou diagnostic de COVID-19 et 2) examiner l'association entre un contact/symptômes ou diagnostic de COVID-19 et les symptômes psychologiques. MéTHODES: Un total de 20 327 adultes ont participé à une enquête transversale populationnelle au Québec entre septembre 2020 et février 2021. À l'aide d'un questionnaire en ligne, des données ont été recueillies sur l'anxiété généralisée probable (GAD-7) et la dépression majeure probable (PHQ-9). Les évènements autodéclarés de 1) contact avec un cas ou de symptômes de COVID-19 et 2) diagnostics de COVID-19 furent examinés, ainsi que plusieurs facteurs sociodémographiques et liés à la pandémie. RéSULTATS: Les contacts, symptômes ou diagnostics de COVID-19 étaient plus fréquents chez les jeunes adultes, les travailleurs de la santé, les adultes vivant avec des enfants, et ceux rapportant plus de stigmatisation, pertes financières, stress quotidien ou un plus haut niveau de menace perçue. Des contacts ou symptômes de COVID-19 et un diagnostic de COVID-19 étaient associés à de la dépression majeure probable comparativement au groupe non affecté (RCa : 1,25, IC à 95% : 1,12-1,39 et RCa : 1,82, IC à 95% : 1,48-2,2, respectivement). Les pensées suicidaires et le retard psychomoteur étaient aussi plus étroitement associés à un diagnostic de COVID-19. CONCLUSION: Les résultats de cette étude soulignent le besoin d'améliorer nos connaissances et notre soutien pour les personnes souffrant de symptômes psychologiques suite à un diagnostic de COVID-19.

Patterns of Suicide Ideation Across Eight Countries in Four Continents During the COVID-19 Pandemic Era: Repeated Cross-sectional Study.

BACKGROUND: The COVID-19 pandemic and countries' response measures have had a globally significant mental health impact. This mental health burden has also been fueled by an infodemic: an information overload that includes misinformation and disinformation. Suicide, the worst mental health outcome, is a serious public health problem that can be prevented with timely, evidence-based, and often low-cost interventions. Suicide ideation, one important risk factor for suicide, is thus important to measure and monitor, as are the factors that may impact on it. OBJECTIVE: This investigation had 2 primary aims: (1) to estimate and compare country-specific prevalence of suicide ideation at 2 different time points, overall and by gender and age groups, and (2) to investigate the influence of sociodemographic and infodemic variables on suicide ideation. METHODS: A repeated, online, 8-country (Canada, the United States, England, Switzerland, Belgium, Hong Kong, Philippines, and New Zealand), cross-sectional study was undertaken with adults aged ≥18 years, with measurement wave 1 conducted from May 29, 2020 to June 12, 2020 and measurement wave 2 conducted November 6-18, 2021. Self-reported suicide ideation was derived from item 9 of the Patient Health Questionnaire-9 (PHQ-9). Age-standardized suicide ideation rates were reported, a binomial regression model was used to estimate suicide ideation indication rates for each country and measurement wave, and logistic regression models were then employed to relate sociodemographic, pandemic, and infodemic variables to suicide ideation. RESULTS: The final sample totaled 17,833 adults: 8806 (49.4%) from measurement wave 1 and 9027 (50.6%) from wave 2. Overall, 24.2% (2131/8806) and 27.5% (2486/9027) of participants reported suicide ideation at measurement waves 1 and 2, respectively, a difference that was significant (P<.001). Considerable variability was observed in suicide ideation age-standardized rates between countries, ranging from 15.6% in Belgium (wave 1) to 42.9% in Hong Kong (wave 2). Frequent social media usage was associated with increased suicide ideation at wave 2 (adjusted odds ratio [AOR] 1.47, 95% CI 1.25-1.72; P<.001) but not wave 1 (AOR 1.11, 95% CI 0.96-1.23; P=.16). However, having a weaker sense of coherence (SOC; AOR 3.80, 95% CI 3.18-4.55 at wave 1 and AOR 4.39, 95% CI 3.66-5.27 at wave 2; both P<.001) had the largest overall effect size. CONCLUSIONS: Suicide ideation is prevalent and significantly increasing over time in this COVID-19 pandemic era, with considerable variability between countries. Younger adults and those residing in Hong Kong carried disproportionately higher rates. Social media appears to have an increasingly detrimental association with suicide ideation, although having a stronger SOC had a larger protective effect. Policies and promotion of SOC, together with disseminating health information that explicitly tackles the infodemic's misinformation and disinformation, may importantly reduce the rising mental health morbidity and mortality triggered by this pandemic.

Psychological response to the COVID-19 pandemic in Canada: main stressors and assets.

BACKGROUND: The COVID-19 crisis has unique features that increase the sense of fear, and comes with additional stressors (e.g., confusion, discrimination, quarantine), which can lead to adverse psychological responses. There is however limited understanding of differences between sociocultural contexts in psychological response to pandemics and other disasters. OBJECTIVE: To examine how Canadians in different provinces, and with different governance modes and sociocultural contexts, understand and react to the COVID-19 pandemic. METHODS: A web-based survey was conducted from April 8-11, 2020, among a representative sample of 600 Canadian adults from two different contexts (n=300 in Quebec, the French part of Canada, and n=300 elsewhere in Canada). Two psychological outcomes were assessed: probable post-traumatic stress disorder (PTSD), and probable generalized anxiety disorder (GAD). The roles of various stressors (i.e., threat perceived for oneself or family/friends, quarantine or isolation, financial losses, victims of stigma), assets (i.e., trust in authorities, information received, and compliance with directives) and sources of information used on these two outcomes were also examined. Chi-square tests were performed to examine differences in the distribution of probable PTSD and GAD according to these stressors and assets. RESULTS: Probable PTSD and GAD were observed in 25.5% and 25.4% of the respondents, respectively. These proportions were significantly lower in Quebec than elsewhere in Canada. Perceiving a high level of threat and being a victim of stigma were positively associated with probable PTSD and GAD (but not quarantine/isolation and financial losses). A high level of trust in authorities was the only asset associated with a lower risk of PTSD or GAD. Interestingly, this asset was more frequently reported in Quebec than elsewhere in Canada. CONCLUSION: The COVID-19 pandemic represents a unique opportunity to evaluate the psychosocial impacts on various sociocultural groups and contexts, providing important lessons that could help respond to future disasters.

Consequences of the COVID-19 Pandemic on Children's Mental Health: A Meta-Analysis.

Background: The COVID-19 pandemic has exacerbated mental health problems in many individuals, including children. Children with pre-existing socio-demographic or developmental risk factors may be particularly vulnerable to the negative effects of the pandemic and associated public health preventive measures. Objective: This systematic review and meta-analysis explored the impacts of the COVID-19 pandemic on the mental health of children aged 5-13 years-old, while highlighting the specific difficulties experienced by children with neurodevelopmental issues or chronic health conditions. Methods: A systematic search of the published literature was conducted in Medline, ERIC, PsycINFO, and Google Scholar, followed by a quantitative meta-analysis of the eligible studies. Results: Out of the 985 articles identified, 28 empirical studies with prospective or retrospective longitudinal data were included in the quantitative synthesis. COVID-19 lockdown measures were associated with negative general mental health outcomes among children (g = 0.28, p < 0.001, and k = 21), but of small magnitude. Sleep habits were also changed during the pandemic, as sleep duration significantly increased in children (g = 0.32; p = 0.004, and k = 9). Moreover, results did not differ between children from the general population and those from clinical populations such as children with epilepsy, oncology, neurodevelopmental disorders, or obesity. Effect sizes were larger in European vs. Asian countries. Conclusions: Studies included in this review suggest that children's mental health was generally negatively impacted during the COVID-19 pandemic. More research is needed to understand the long-term effects of the COVID-19 pandemic on children's mental health and the influence of specific risks factors as they evolve over time.

The Evolution in Anxiety and Depression with the Progression of the Pandemic in Adult Populations from Eight Countries and Four Continents.

Nearly a year after the classification of the COVID-19 outbreak as a global pandemic, it is clear that different factors have contributed to an increase in psychological disorders, including public health measures that infringe on personal freedoms, growing financial losses, and conflicting messages. This study examined the evolution of psychosocial impacts with the progression of the pandemic in adult populations from different countries and continents, and identified, among a wide range of individual and country-level factors, which ones are contributing to this evolving psychological response. An online survey was conducted in May/June 2020 and in November 2020, among a sample of 17,833 adults (Phase 1: 8806; Phase 2: 9027) from eight countries/regions (Canada, the United States, England, Switzerland, Belgium, Hong Kong, the Philippines, New Zealand). Probable generalized anxiety disorder (GAD) and major depressive episode (MDE) were assessed. The independent role of potential factors was examined using multilevel logistic regression. Probable GAD or MDE was indicated by 30.1% and 32.5% of the respondents during phases 1 and 2, respectively (a 7.9% increase over time), with an important variation according to countries/regions (range from 22.3% in Switzerland to 38.8% in the Philippines). This proportion exceeded 50% among young adults (18-24 years old) in all countries except for Switzerland. Beyond young age, several factors negatively influenced mental health in times of pandemic; important factors were found, including weak sense of coherence (adjusted odds ratio aOR = 3.89), false beliefs (aOR = 2.33), and self-isolation/quarantine (aOR = 2.01). The world has entered a new era dominated by psychological suffering and rising demand for mental health interventions, along a continuum from health promotion to specialized healthcare. More than ever, we need to innovate and build interventions aimed at strengthening key protective factors, such as sense of coherence, in the fight against the adversity caused by the concurrent pandemic and infodemic.

Beliefs in Conspiracy Theories and Misinformation About COVID-19: Comparative Perspectives on the Role of Anxiety, Depression and Exposure to and Trust in Information Sources.

While COVID-19 spreads aggressively and rapidly across the globe, many societies have also witnessed the spread of other viral phenomena like misinformation, conspiracy theories, and general mass suspicions about what is really going on. This study investigates how exposure to and trust in information sources, and anxiety and depression, are associated with conspiracy and misinformation beliefs in eight countries/regions (Belgium, Canada, England, Philippines, Hong Kong, New Zealand, United States, Switzerland) during the COVID-19 pandemic. Data were collected in an online survey fielded from May 29, 2020 to June 12, 2020, resulting in a multinational representative sample of 8,806 adult respondents. Results indicate that greater exposure to traditional media (television, radio, newspapers) is associated with lower conspiracy and misinformation beliefs, while exposure to politicians and digital media and personal contacts are associated with greater conspiracy and misinformation beliefs. Exposure to health experts is associated with lower conspiracy beliefs only. Higher feelings of depression are also associated with greater conspiracy and misinformation beliefs. We also found relevant group- and country differences. We discuss the implications of these results.