The contribution of participation in meaningful activities on mental health during the COVID-19 lockdown in the Spanish population / Contribución de la participación en actividades significativas sobre la salud mental en población española durante el confinamiento por COVID-19

Introduction: During the lockdown caused by COVID-19 in Spain, citizens had to stop performing activities in the usual way, which could have had an impact on mental health. The aim of this study was to determine the contribution of participating in meaningful activitieson mental health in the Spanish population during the COVID-19 lockdown. Method:A cross-sectional online survey was developed and administered, where mental health (General Health Questionnaire), resilience (Connor-Davidson Resilience Scale), participation in meaningful activities (Engage-ment in Meaningful Activities Survey) and socio-demographic data were assessed. A hierarchical-linear-regression was used to identify key correla-tions. Results:The participants (N= 311) reported low mental health (M= 16.12/36) and a lower level of resilience (M = 25.48). The results of the re-gression revealed that 32.6% of the variance of the GHQ was significantly explained by the living space, including an outdoor space, resilience and participation in meaningful activities. The loss of meaningful activities was significantly related to mental health, with a significant contribution when controlling for the other variables (β = -.12). Conclusion:Although experi-mental studies are needed to determine causality, this study highlights the relationship between participation in meaningful activities and mental health during the lockdown.(AU)

Introduction: During the lockdown caused by COVID-19 in Spain, citizens had to stop performing activities in the usual way, which could have had an impact on mental health. The aim of this study was to determine the contribution of participating in meaningful activities on mental health in the Spanish population during the COVID-19 lockdown. Method: A cross-sectional online survey was developed and administered, where mental health (General Health Questionnaire), resilience (Connor-Davidson Resilience Scale), participation in meaningful activities (Engagement in Meaningful Activities Survey) and socio-demographic data were assessed. A hierarchical-linear-regression was used to identify key correlations. Results: The participants (N = 311) reported low mental health (M = 16.12/36) and a lower level of resilience (M = 25.48). The results of the regression revealed that 32.6% of the variance of the GHQ was significantly explained by the living space, including an outdoor space, resilience and participation in meaningful activities. The loss of meaningful activities was significantly related to mental health, with a significant contribution when controlling for the other variables (β = -.12). Conclusion: Although experimental studies are needed to determine causality, this study highlights the relationship between participation in meaningful activities and mental health during the lockdown.(AU)

Impacto de problemas de salud mental y apoyo social en la calidad de sueño: Seguimiento longitudinal antes y durante la pandemia de COVID-19 en universitarios chilenos / Impact of mental health problems and social support on sleep quali-ty: Follow-up before and during the first eight months of the COVID-19 pandemic in Chilean university student

Introducción: Antecedentes refieren altos índices de problemas de salud mental en universitarios antes y durante la pandemia por COVID-19, con efectos sobre la baja calidad de sueño; sin embargo, el apoyo social percibido actuaría como un factor protector. Objetivo: Evaluar el impacto de la salud mental (ansiedad, depresión y estrés) sobre la calidad de sueño, de forma transversal y longitudinal, antes y durante la pandemia por COVID-19 en universitarios chilenos, verificando si el apoyo social percibido podría moderar esta relación. Material y Métodos: 1.619 universitarios en el año 2019 y 1.862 en el año 2020 respondieron cuestionarios orientados a medir depresión, ansiedad, estrés, calidad del sueño y apoyo social percibido. Con una fracción de la muestra que respondió en ambos años (n = 325) se realizó análisis longitudinal y se contrastaron los puntajes de los instrumentos entre ambos años, mediante una matriz de transición y un modelo de regresión múltiple. Resultados: Se encuentran altas prevalencias de problemas de salud mental, aumentando en el año 2020 la sintomatología moderada y grave. Se agudizan los problemas de sueño y la percepción de bajo apoyo social. Todas las variables de salud mental pueden predecir la calidad del sueño, excepto el apoyo social y longitudinalmente, aumenta la severidad de la baja calidad de sueño y la depresión. No se encuentran moderaciones significativas entre apoyo social percibido y el resto de las variables. Conclusiones: El efecto de la pandemia en la salud mental es complejo, requiriéndose acciones concretas para apoyar psicológicamente a los estudiantes.(AU)

Introduction: Research has revealed high rates of mental health problems in university students before and during the COVID-19 pan-demic, with effects on poor sleep quality; however, perceived social sup-port appears to act as a protective factor. Objective: To assess the impact of mental health (anxiety, depression, and stress) on sleep quality, cross-sectionally and longitudinally, before and during the COVID-19 pandemic in Chilean university students, verifying whether perceived social support could act as a moderatorin this relationship.Material and Methods: 1,619 university students in 2019 and 1,862 in 2020 answered questionnaires aimed at measuring depression, anxiety, stress, sleep quality, and perceived social support. Longitudinal analysis was per-formed with afraction of the sample that responded in both years (n= 325). The scores of the instruments for both years were contrasted using a transition matrix and a multiple regression model. Results: High prevalence rates of mental health problems were found, with moderate and severe symptoms increasing in 2020. Sleep problems and the perception of low social support worsened. All mental health variables were found to predict sleep quality except for social support; longitudinally, the severity of poor sleep quality and depression increased. No significant moderation effects were found between perceived social support and the rest of the variables. Conclusions: The effect of the pandemic on mental health is complex, re-quiring concrete actions to provide students with psychological suppor.(AU)

The relationship between psychological distress, meaning in life,and life satisfaction in the COVID-19 pandemic / La relación entre la molestia psicológica, el sentido de la vida y la satisfacción con la vida en la pandemia del COVID-19

Durante la pandemia de COVID-19, el miedo a infectarse, perder a familiares y las medidas tomadas para prevenir la contaminación (por ejemplo, cierres, cuarentenas, distanciamiento espacial, etc.) han aumentado el riesgo de depresión, ansiedad y estrés. En el presente estudio, se exploró la relación entre la angustia psicológica, el significado de la vida y la satisfacción con la vida entre personas infectadas y no infectadas con COVID-19 durante la pandemia. El presente estudio es el primero en examinar estas variables simultáneamente. La muestra estuvo compuesta por 687 adultos mayores de 18 años (media = 30,51 años). Los resultados indicaron que las personas adultas con una alta satisfacción con la vida tenían niveles más bajos de angustia psicológica, encontraban la vida más significativa y buscaban menos el significado. El malestar psicológico se relacionó positivamente con la búsqueda de sentido en la vida y negativamente con la existencia de sentido en la vida. Además, la depresión y la existencia de sentido en la vida fueron predictores significativos de la satisfacción con la vida.(AU)

During the COVID-19 pandemic, the fear of being infected, losing relatives, and measures taken to prevent contamination (e.g., lock-downs, quarantining, spatial distancing, etc.) have all increased the risk of depression, anxiety and stress. In the present study, the relationship be-tween psychological distress, meaning in life, and life satisfaction was ex-plored among individuals who were infected and not infected with COVID-19 during the pandemic. The present study is the first to examine these variables simultaneously. The sample comprised 687 adult individuals over the age of 18 years (mean=30.51 years). Results indicated that adult individuals with high life satisfaction had lower levels of psychological dis-tress, find life more meaningful, and seek meaning less. Psychological dis-tress was positively related with the search for meaning in life and nega-tively related with the existence of meaning in life. Moreover, depressive symptoms and the existence of meaning in life were significant predictors of life satisfaction.(AU)

El papel mediador de la fuerza del compromiso entre los estilos de procesamiento de la identidad y el bienestar de jóvenes adultos emergentes / The mediating role of the strength of commitment between the styles of identity processing and the well-being of emerging young adults

Los estilos de identidad buscan conocer cómo las personas se manejan diariamente en las situaciones buscando un compromiso identitario. En este trabajo se propone conocer si los estilos de identidad varían según la edad y el sexo, y analizar la relación entre estos y la fuerza del compromiso con variables de bienestar y malestar psicológico. Método: 278 participantes (M = 22.03; DT = 2.65) reclutados a través de un muestreo no probabilístico por bola de nieve cumplimentaron los cuestionarios. Resultados: Las mujeres puntuaron más alto en fuerza del compromiso y ellos adoptaron más un estilo difuso-evitativo. El estilo informacional correlacionó positivamente con las variables de bienestar (optimismo y florecimiento); el estilo normativo con depresión y ansiedad y el estilo difuso-evitativo correlacionó positivamente con las variables de malestar (depresión, ansiedad y estrés) y negativamente con las de bienestar. Finalmente, a mayor fuerza del compromiso más bienestar y menos malestar. La fuerza del compromiso media parcial o totalmente la relación entre estilos identitarios y las variables de bienestar/malestar. Conclusiones: Se deduce la importancia de la fuerza del compromiso en el bienestar personal y la necesidad de favorecer el desarrollo de la identidad de nuestros jóvenes.(AU)

Background:Identity styles seek to know how people handle themselves daily in situations looking for an identity commitment. This ar-ticle aims to find out whether identity styles vary according to age and sex, and to analyze the relation between these identity styles and the strength of commitment with variables of well-being and psychological distress. In ad-dition, it investigates whether commitment mediates between identity styles, well-being and psychological distress.Method:278 participants (M = 22.03; DT = 2.65), recruited through a non-probabilistic snowball sam-pling, completed the questionnaires. Results:Women scored higher in strength of commitment and men adopted a more diffusive-avoidant style. Age did not relate to identity style. The informational stylecorrelated posi-tively with well-being variables (flourishing and optimism); the normative style with depression and anxiety and the diffuse-avoidant style correlated positively with psychological distress (depression, anxiety and stress) and negatively with well-being. Finally, the greater the strength of commitment found, the more flourishing and optimism and the less psychological dis-tress there was. The strength of commitment partially or totally mediated the relationship between identity styles and thevariables of well-being / psychological distress. Conclusions:The importance of the strength of com-mitment in personal well-being and the necessity to favour the develop-ment of young people ́s identity is observed / deduced.(AU)

Feeling stressed and depressed? A three-wave follow-up study of the beneficial effects of voluntary work

While symptoms of stress are a major risk factor in the onset of depressive symptoms and major depression, a better understanding of intervening mechanisms in breaking down this positive association is urgently required. It is within this literature that we investigate (1) how symptoms of stress are associated with depressive symptoms and the onset of major depression, and (2) the buffering effect of hours spent on voluntary work on the stress-depression relationship. Using 3-wave longitudinal data, we estimated a direct and reverse auto-regressive path model. We found both cross-sectional and longitudinal support for the positive association between symptoms of stress and depressive symptoms. Next, we found that individuals who experienced more symptoms of stress at T1, T2, and T3 were 1.64 (95%CI [1.46;1.91]), 1.49 (95%CI [1.24;1.74]), and 1.40 (95%CI [1.21;1.60]) times more likely to be prescribed an anti-depression treatment at T3, respectively. Moreover, we found that the number of hours spent volunteering mitigated the (1) longitudinal—but not cross-sectional—stress-depression relationship, and (2) cross-sectional—but not the longitudinal—association between symptoms of stress at T3 and the likelihood of being prescribed an anti-depression treatment. These results point toward the pivotal role of voluntary work in reducing the development of depressive symptoms and major depression in relation to the experience of symptoms of stress. (AU)

Dreaming during a pandemic: Low incorporation of COVID-19-specific themes and lucidity in dreams of psychiatric patients and healthy controls

The present study examined the impact of the COVID-19 pandemic on the emotional quality of dreams, the incorporation of pandemic-related themes, and the occurrence of lucid dreaming. Dream reports and lucidity ratings of psychiatric outpatients (n = 30) and healthy controls (n = 81) during two lockdowns in Germany were compared to those of healthy controls (n = 33) before the pandemic. Results confirmed previous reports that pandemic-specific themes were incorporated into dreams. Overall, however, incorporation into dreams was rare. Contrary to expectations, psychiatric outpatients did not differ from controls in the frequency of dream incorporation of pandemic-related content. Moreover, incorporation was independent of psychiatric symptoms and loneliness. Loneliness was, however, associated with threat-related content, suggesting that it represents a risk for bad dreams but not for crisis-specific dream incorporation. Regarding lucid dreaming, both groups had similar scores for its underlying core dimensions, i.e., insight, control, and dissociation, during the two lockdowns. Scores for control and dissociation but not insight were lower compared to the pre-pandemic sample. Our working hypothesis is that REM sleep during lockdowns intensified as a means of increased emotional consolidation, rendering the associated mental state less hybrid and thereby less lucid. (AU)

Perceived parental depression, intrusive rumination, and internalizing problems: A three-wave longitudinal study in adolescents

Background/objective: Research suggests that perceiving parental depression elicits internalizing problems in adolescents, but certain studies have indicated that adolescents’ internalizing problems also increase their perception of parental emotion. To further investigate the inconsistent findings about the nature of this relationship, the current study used longitudinal data to examine the causal association between adolescents’ internalizing problems and the parental depression they perceived, as well as the role of intrusive rumination in the relationship. Method: In this longitudinal study, 392 adolescents who experienced the catastrophic Jiuzhaigou earthquake in 2017 were surveyed at three time points after the earthquake: 12 months (T1), 21 months (T2) and 27 months (T3). A cross-lagged panel model was used to carry out the data analysis. Results: Mutual cause-and-effect relationships were found between intrusive rumination and both perceived parental depression and internalizing problems, respectively; a unilateral causal relationship in which internalizing problems positively predicted perceived parental depression was also found. In addition, internalizing problems predicted perceived parental depression via the mediating role of intrusive rumination; similarly, intrusive rumination predicted perceived parental depression via internalizing problems. Conclusions: Internalizing problems were a risk factor for perceived parental depression, and intrusive rumination played an important role in the relationship between internalizing problems and perceived parental depression. (AU)

Relationship (in)congruency may differently impact mental health

Background: Being involved in romantic relationships has historically been related to better mental health compared to being single. However, research exploring heterogeneity within these status groups is still understudied. Our study examined the role of (in)congruency between relationship desire, dismissal, satisfaction with relationship status, and current relationship status on the mental health measured in terms of anxiety, depression, insomnia, and romantic loneliness. Method: The online questionnaire survey included 790 participants aged 18 – 40 (M = 26.51, SD = 5.60) at baseline and 421 at a 1-month follow-up. Participants represented five relationship statuses (single, casual dating, LAT relationships, cohabitation, and engagement/marriage). Results: Our results suggest that greater relationship desire and dismissal at baseline were associated with higher anxiety and depression in casual daters one month later, while greater relationship desire was linked to lower anxiety for individuals in living apart together relationships (LATs). Higher relationship dismissal in casual daters and engaged/married individuals was associated with lower insomnia. Higher satisfaction with relationship status was associated with lower depression in single individuals and lower romantic loneliness in cohabitors and engaged/married individuals. Conclusions: This study highlights that relationship (in)congruency may operate differently across various relationship status subgroups on mental health outcomes. (AU)

Differential associations of leisure music engagement with resilience: A network analysis

Background/Objective: Several factors associated with resilience as the maintenance of mental health despite stress exposure can be strengthened through participation in leisure time activities. Since many people listen to or make music in their leisure time, the aim of the present study was to provide insights into the architecture of how resilience relates to passive and active music engagement. Method: 511 participants regularly listening to and/or making music completed an online survey on resilient outcomes (i.e., mental health and stressor recovery ability), different resilience factors (e.g., optimism, social support), quantitative music engagement (i.e., time spent with music listening/making) and qualitative music engagement (i.e., use of music listening/making for mood regulation). Results: Bivariate correlations showed that subjects spending more time with music making reported better stressor recovery ability and less mental health problems, while partial correlational network analysis revealed no unique associations for quantitative music engagement. Regarding qualitative music engagement, people using music-based mood regulation reported lower mental health, mindfulness, and optimism, but also higher social support. A more heterogeneous pattern emerged for single music-based mood regulation strategies. Conclusions: Our findings highlight the importance of the individual (mal-)adaptive use of music, painting a more nuanced picture of music engagement and resilience. (AU)

Prevalencia de la soledad entre los adolescentes de los centros educativos de las zonas básicas de salud de dos centros de salud de Madrid / Prevalence of loneliness in secondary school adolescents from two primary care health centres in Madrid

Objetivo: Conocer la prevalencia de la soledad nodeseada en adolescentes de centros educativosvinculados a dos zonas básicas de salud, así comodescribir su perfil según las variables analizadas.Diseño. Estudio descriptivo de corte transversal.Emplazamiento. Centros educativos correspondientes a dos zonas básicas de salud de Madrid.Participantes. Adolescentes que cursaban tercero ycuarto de ESO durante el curso lectivo 2021-2022.Variables. Nivel de soledad medido por la escalaDJGLS (0-11 puntos) y variables sociodemográficas y de ocio.Resultados. Un 47,1% de los participantes manifiesta que se siente solo con una intensidad moderada, mientras que el 6,51% manifiestan sufrirsoledad extrema y un 11,3% soledad severa. Un34,9% de los participantes no sufre soledad.Conclusiones. Nuestros resultados ponen de relieve que la soledad no deseada es un problemaque afecta a adolescentes, siendo esto importantepara el desarrollo de políticas de salud e intervenciones adaptadas a este momento del ciclo vital. (AU)

Objective: To evaluate the prevalence of unwantedloneliness in adolescents from educational centres belonging to two “basic health areas”. Moreover, to report their profile according to the variables analyzed.Design. Cross-sectional descriptive study.Location. Educational centres belonging to two “basichealth areas” of Madrid.Participants. Adolescents who were studying thirdand fourth year of secondary school during the 2021-2022 school year.Variables. Degree of loneliness as measured by theDJGLS scale (0-11 points) as well as sociodemographicand leisure variables.Results. A total of 47.1%, 6.51% and 11.3% of participants reported moderate, extreme and severe loneliness, respectively. Only 34.9% of participants did notsuffer from loneliness.Conclusions. Our study highlights that unwanted loneliness is an adolescents’ issue as well as the importance of developing health policies in this regard. Interventions need to be tailored to this developmentalstage. (AU)

The network structure of self-reported psychopathological dimensions in common mental disorders (CMDs)

Background and objectives: Common mental disorders (CMDs) in mental health settings show high rates of comorbidities. While semi-structured interviews are the gold standard to establish a diagnosis, there are self-report instruments such as the Psychiatric Diagnostic Screening Questionnaire (PDSQ) that aids clinicians in improving the diagnostic process in a time-efficient manner.MethodsNetwork analysis of the 13 domains of the PDSQ was applied to a sample of 374 first-contact outpatients to identify domains of psychopathology acting as hubs and bridges of interconnections within the CMDs.ResultsA global network densely connected with positive connections among PDSQ domains was found. The global network has four main clusters: depression-anxiety, somatoform, psychosis and substance-related domains. This network allowed for the identification of main ‘nodes’ acting as hubs favoring interconnections between dimensions and main ‘bridges’ easing the connections between clusters.ConclusionThe network structure of the PDSQ domains might provide a complementary explanation to the high rates of comorbidity among CMDs. Moreover, our results support the relevance of the self-administered PDSQ inventory to account for a deeper understanding of comorbidities among CMDs. (AU)

Evaluación de las consecuencias físicas y psicosociales de la diástasis de rectos abdominales y su interferencia en la salud: un estudio mixto / Evaluation of the physical and psychosocial consequences of the diastasis of the rectus abdominis and its interference in health: A mixed study

Introducción: La diástasis de rectos abdominales (DRA) se define como la separación de los rectos abdominales a lo largo de la línea alba. Esta condición puede darse en ambos sexos, siendo frecuente en la mujer durante el embarazo y posparto. Existe poca evidencia sobre las consecuencias de la DRA en la calidad de vida de las mujeres. Objetivo: El análisis de la percepción de los síntomas de DRA y su repercusión a nivel físico, psicológico y social en mujeres afectadas por esta condición. Pacientes y métodos: Estudio observacional por medio de una encuesta online semiestructurada, compuesta por 30 preguntas cerradas y 2 abiertas. Los criterios de inclusión fueron mujeres adultas de habla hispana, que hubiesen dado a luz y que presentasen diástasis abdominal. Los datos se analizaron de forma cuantitativa y la información cualitativa se obtuvo mediante un análisis de contenido de las preguntas abiertas. Resultados: Trescientas diecinueve mujeres con DRA fueron incluidas. Los resultados mostraron una afectación negativa de la DRA en la calidad de vida, las capacidades funcionales y en la salud uroginecológica y digestiva. Así mismo se evidenció un impacto negativo a nivel emocional, en la imagen corporal y una mala salud autopercibida. Conclusión:La DRA tiene un impacto negativo en la salud de la mujer. Las mujeres con DRA presentan una afectación de la calidad de vida y de las capacidades funcionales, una alteración de la imagen corporal, sentimientos de abandono por parte de las instituciones sanitarias, vergüenza, tristeza, impotencia, falta de autoestima, resignación y presión social.(AU)

Introduction: Diastasis rectus abdominis (DRA) is defined as the separation of the rectus abdominis along the linea alba. This condition can occur in both sexes, being frequent in women during pregnancy and pospartum. There is little evidence on the consequences of DRA on the quality of life of women. Objective: The analysis of the perception of the symptoms of and its repercussion on a physical, psychological and social level in women affected by this condition. Patients and methods: Observational study through a semi-structured online survey, composed of 30 closed questions and 2 open ones. The inclusion criteria were adult Spanish-speaking women who had given birth and who presented abdominal diástasis. The data were analyzed quantitatively and the qualitative information was obtained through a content analysis of the open questions. Results: 319 women with DRA were included. The results showed a negative effect of DRA on quality of life, functional capacities, and urogynecological and digestive health. Likewise, a negative impact was evidenced at an emotional level, on body image and poor self-perceived health. Conclusion: DRA has a negative impact on women's health. Women with DRA present an impairment of the quality of life and functional capacities, an alteration in body image, feelings of abandonment by health institutions, shame, sadness, powerlessness, lack of self-esteem, resignation and social pressure.(AU)

Recursos digitais na promoção da saúde mental de trabalhadores: Protocolo de revisão sistemática / Recursos digitales en la promoción de la salud mental de trabajadores: Protocolo de revisión sistemática / Digital resources in the promotion of workers' mental health: Systematic review protocol

Introdução: Os agravos decorrentes das cargas psíquicas de trabalho são expressos no corpo do mesmo pela ocorrência de doenças ocupacionais, principalmente em trabalhadores da saúde, que estão diretamente ligados aos pacientes. Objetivo: Analisar as evidências científicas disponíveis na literatura, sobre o uso de recursos digitais na promoção da saúde mental de trabalhadores da saúde, os quais serão considerados neste estudo, todos aqueles que têm contato direto com pacientes. Método: Protocolo de revisão sistemática segundo o Manual Cochrane, onde utilizará o anagrama PICOS para Patient, Intervention, Comparator, Outcomes e Study design no desenvolvimento da pesquisa. Serão consultadas as plataformas: Medical Literature Analysis and Retrieval System Online, Cumulative Index to Nursing and Allied Health Literature, Literatura Latino-Americana e do Caribe em Ciências da Saúde, banco de dados produzido pela Associação Americana de Psicologia, banco de dados da Elsevier, Cochrane Central Register of Controlled Trials e a base da Clarivate Analytics. Resultados: Serão apresentados em forma narrativa, com esquemas, tabelas e quadros. Conclusão: O protocolo de pesquisa garante o rigor metodológico do processo de revisão. Dessa forma espera-se encontrar evidências de intervenções por meios digitais que promovam a saúde mental do trabalhador.

Introducción: Las lesiones resultantes de las cargas de trabajo psíquicas se expresan en el organismo por la ocurrencia de enfermedades profesionales; principalmente en trabajadores de la salud, quienes tienen vínculo directo con pacientes. Objetivo: Analizar la evidencia científica disponible en la literatura sobre el uso de recursos digitales para promover la salud mental de trabajadores de la salud, considerando a quienes tienen contacto directo con pacientes. Método: Se trata de un protocolo de revisión sistemática según el Manual Cochrane, donde se utilizará el anagrama PICOS para paciente, intervención, comparador, resultados y diseño de estudios en el desarrollo de la investigación. Se consultarán las siguientes plataformas: Medical Literature Analysis and Retrieval System Online, Cumulative Index to Nursing and Allied Health Literature, Latin American and Caribbean Literature in Health Sciences, una base de datos producida por la American Psychological Association, la base de datos de Elsevier, Cochrane Central Register of Controlled Trials, que es la base de Clarivate Analytics. Resultados: Se presentarán de forma narrativa, con esquemas, tablas y gráficos. Conclusión: El protocolo de investigación garantiza el rigor metodológico del proceso de revisión. De esta forma, se espera encontrar evidencias de intervenciones a través de medios digitales que promuevan la salud mental de la persona trabajadora.

Introduction: The human body expresses the injuries resulting from psychic workloads by the occupational diseases, mainly in health workers, who are directly linked to the patients. Objective: To analyze the scientific evidence available in the literature about the use of digital resources to promote the mental health of health workers who will be then considered for this study (all who had had direct contact with patients). Method: this is a systematic review protocol that follows the Cochrane manual and that will use the PICOS anagram for Patient, Intervention, Comparator, Outcomes and Study design during the development of the research. The following platforms will be consulted: Medical Literature Analysis and Retrieval System Online, Cumulative Index to Nursing and Allied Health Literature, Latin American and Caribbean Literature in Health Sciences, a database produced by the American Psychological Association, Elsevier's database, Cochrane Central Register of Controlled Trials (a foundation of Clarivate Analytics). Results: The results will be presented in narrative form, with graphs, tables and charts. Conclusion: The research protocol guarantees the methodological rigor of the review process. In this way, it is expected to find evidence of interventions through digital means that promote the mental health of the worker.

340º Reunião Ordinária do Conselho Nacional de Saúde - 16 mar. 2023

Clinical practice guidelines for cardiovascular disease: how is depression addressed? Protocol for a systematic review.

INTRODUCTION: Depression frequently affects patients with cardiovascular disease (CVD). When these conditions co-occur, outcomes such as quality of life and life expectancy worsen. In everyday practice, this specific and prevalent disease-disease interaction complicates patient management. Clinical practice guidelines (CPGs) aim to provide the best available advice for clinical decision-making to improve patient care. This study will aim to evaluate how CPGs specifically address depression in patients with CVD, and whether they provide any operational guidance for screening and management of depression in the primary care and outpatient setting. METHODS AND ANALYSIS: We will conduct a systematic review of CPGs on CVD management published from 2012 to 2023. A broad literature search for guidelines will be performed through electronic medical databases, grey literature search tools, and websites of national and professional medical organisations.Based on the inclusion criteria, two independent reviewers will evaluate eligible guidelines for screening and management recommendations on depression in patients with CVD. Additional points to be evaluated will be any mention of drug-drug or drug-disease interactions, other aspects of specific relevance to treating physicians, as well as general information on mental health. We will assess the quality of CPGs with a recommendation regarding depression in CVD patients using the Appraisal of Guidelines for Research and Evaluation II. ETHICS AND DISSEMINATION: As this systematic review is based on available published data, ethics approval and consent are not applicable. Our intent is that our results will be published in a peer-reviewed journal, presented at international scientific meetings, and distributed to healthcare providers. PROSPERO REGISTRATION NUMBER: CRD42022384152.

[Psychological, psychiatric and neurological aspects of COVID-19]. / Psikhologicheskie, psikhiatricheskie i nevrologicheskie aspekty COVID-19.

OBJECTIVE: To analyze neurological, psychological and psychiatric aspects of COVID-19, as well as to study the current state of the problem. MATERIAL AND METHODS: The study included 103 patients with COVID-19. The main research method was clinical/psychopathological. To study the impact of activities related to the care of patients with COVID-19 in a hospital setting, the medical and psychological state of 197 hospital workers involved in the treatment of patients with COVID-19 was assessed. The level of anxiety distress was assessed with the Psychological Stress Scale (PSM-25), distress indicators corresponded to values of more than 100 points. The severity of anxiety and depressive symptoms was assessed using the Hospital Anxiety and Depression Scale (HADS). RESULTS: When considering psychopathological disorders in the context of COVID-19, it is necessary to distinguish between two main groups of disorders: mental disorders during the pandemic, and mental disorders directly caused by the causative agent SARS-CoV-2. The analysis of psychological and psychiatric aspects in various periods of the initial stage of COVID-19 showed that each of them was characterized by specific features depending on the nature of the influence of different pathogenic factors. In the structure of nosogenic mental disorders in patients with COVID-19 (103 patients), the following clinical forms were identified: acute reaction to stress (9.7%), anxiety-phobic disorders (41.7%), depressive symptoms (28.1%), hyponosognosic nosogenic reactions (20.5%). At the same time, the majority of the patients had manifestations of somatogenic asthenia (93.2%). A comparative analysis of neurological and psychological/psychiatric aspects of COVID-19 showed that the main mechanisms of the impact of highly contagious coronaviruses, including the SARS-CoV-2, on the central nervous system are: cerebral thrombosis and cerebral thromboembolism, damage to the neurovascular unit, neurodegeneration, including that induced by cytokines, and immune-mediated demyelinating nerve damage. CONCLUSION: Neurological and psychological/psychiatric aspects of COVID-19 should be taken into account both at the stage of disease treatment and in the post-infection period due to the pronounced neurotropism of SARS-CoV-2 and its effect on the neurovascular unit. Along with helping patients, an important aspect is the preservation of the mental health of medical personnel working in hospitals for infectious diseases, due to special working conditions and a high level of professional stress.

AIDS Drug Assistance Program disenrollment is associated with loss of viral suppression beyond differences in homelessness, mental health, and substance use disorders: An evaluation in Washington state 2017-2019.

AIDS Drug Assistance Programs (ADAPs) are state-administered programs that pay for medical care for people living with HIV in the US. Maintaining enrollment in the programs is challenging, and a large proportion of clients in Washington state (WA) fail to recertify and are disenrolled. In this study we sought to quantify the impact of disenrollment from ADAPs on viral suppression. We conducted a retrospective cohort study of the 5238 clients in WA ADAP from 2017 to 2019 and estimated the risk difference (RD) of viral suppression before and after disenrollment. We performed a quantitative bias analysis (QBA) to assess the effect of unmeasured confounders, as the factors that contribute to disenrollment and medication discontinuation may overlap. Of the 1336 ADAP clients who disenrolled ≥1 time, 83% were virally suppressed before disenrollment versus 69% after (RD 12%, 95%CI 9-15%). The RD was highest among clients with dual Medicaid-Medicare insurance (RD 22%, 95%CI 9-35%) and lowest among privately insured individuals (RD 8%, 95%CI 5-12%). The results of the QBA suggest that unmeasured confounders do not negate the overall RD. The ADAP recertification procedures negatively impact the care of clients who struggle to stay in the program; alternative procedures may reduce this impact.

School-based Psychosocial interventions on mental health among Chinese rural children with traumatic experiences: a protocol using cluster randomized controlled trial.

BACKGROUND: The first aim of this study is to test the effectiveness of school-based psychosocial interventions for improving mental health in rural Chinese children with traumatic experiences. The second aim is to examine which individual, family and school related factors could explain the effectiveness of school-based psychosocial interventions. Third, we will investigate whether individual, family, and school related conditions play a moderator role on the effectiveness of school-based psychosocial interventions. METHODS: This study will conduct a cluster randomized controlled trial (RCT) in a large sample of Chinese rural children. Four rural counties in Shandong (Central China), Henan (Central China), Inner Mongolia (Northern China), and Xinjiang (Western China) will be selected as study settings from which schools will be sampled. Each sampled school will be randomly allocated either the intervention groups or a control group. Randomization will be performed by the research member who is not involved in the intervention stage. In each school students in grade 5 or higher will be recruited to ensure that approximately 50 children aged 10 to 18 years will be included. In each county, one high school, one middle school, and one primary school will be randomly chosen as the intervention group, and the other three similar schools will be chosen as control (waiting list) groups. A standardized and uniform research protocol will be applied in all intervention schools. All school social workers and psychological teachers would receive one week of in-person training following procedures. School-based psychosocial interventions included 14 group sessions for 14 consecutive weeks. DISCUSSION: This study would develop school-based mental health promotion policy recommendations to improve Chinese rural children's mental health. This study can provide solid evidence for the promotion of school-based intervention in general. TRIAL REGISTRATION: ChiCTR2300069405, Registered on 15 March 2023.