Study into COVID-19 Crisis Using Primary Care Mental Health Consultations and Prescriptions Data.

The effect of the 2020 pandemic, and of the national measures introduced to control it, is not yet fully understood. The aim of this study was to investigate how different types of primary care data can help quantify the effect of the coronavirus disease (COVID-19) crisis on mental health. A retrospective cohort study investigated changes in weekly counts of mental health consultations and prescriptions. The data were extracted from one the UK's largest primary care databases between January 1st 2015 and October 31st 2020 (end of follow-up). The 2020 trends were compared to the 2015-19 average with 95% confidence intervals using longitudinal plots and analysis of covariance (ANCOVA). A total number of 504 practices (7,057,447 patients) contributed data. During the period of national restrictions, on average, there were 31% (3957 ± 269, p < 0.001) fewer events and 6% (4878 ± 1108, p < 0.001) more prescriptions per week as compared to the 2015-19 average. The number of events was recovering, increasing by 75 (± 29, p = 0.012) per week. Prescriptions returned to the 2015-19 levels by the end of the study (p = 0.854). The significant reduction in the number of consultations represents part of the crisis. Future service planning and quality improvements are needed to reduce the negative effect on health and healthcare.

Longitudinal risk factors for persistent fatigue in adolescents.

OBJECTIVE: To examine whether sedentary behavior, obesity, smoking, and depression are risk factors for persistent fatigue in adolescents. DESIGN: Longitudinal population-based survey. SETTING: Twenty-eight randomly selected schools in east London, England, in 2001 and 2003. PARTICIPANTS: A total of 1880 adolescents (49% male; 81% nonwhite British) aged 11 to 12 years and 13 to 14 years in 2000. INTERVENTION: Confidential questionnaires completed in class. MAIN OUTCOME MEASURES: Persistent fatigue (extreme tiredness twice weekly or more often in the previous month at both surveys), sedentary behavior, physical activity, depressive symptoms, body mass index, and smoking. RESULTS: Severe fatigue was reported in 11% of participants aged 11 to 14 years and 17% of participants aged 13 to 16 years. Eighty-four participants (4%) reported persistent fatigue. Across both surveys, only 3 pupils reported chronic fatigue syndrome. In multivariate logistic regression, risk of persistent fatigue was independently associated with being sedentary for more than 4 hours per day (odds ratio = 1.6; 95% confidence interval, 1.1-2.3; P = .01), being physically active (odds ratio = 1.5; 95% confidence interval, 1.1-2.3; P = .004), and depressive symptoms (odds ratio = 2.0; 95% confidence interval, 1.5-2.7; P < .001) in the first survey, after adjustment for age, sex, and socioeconomic status. Obesity and smoking were not associated with fatigue. CONCLUSIONS: Persistent fatigue is common. Being highly sedentary or highly active independently increased the risk of persistent fatigue, suggesting that divergence in either direction from healthy levels of activity increases the risk for persistent fatigue. Mental health is important in the etiology of persistent fatigue. To help define effective preventive strategies, further work is needed on the mechanisms by which these factors contribute to fatigue.

Psychological symptoms and physical health and health behaviours in adolescents: a prospective 2-year study in East London.

AIMS: To examine whether physical health and health-risk behaviours in young people are risk factors for psychological distress and depressive symptoms over a 2-year period. DESIGN/SETTING: A 2-year, prospective epidemiological cohort study in East London. PARTICIPANTS: A total of 1615 adolescents from the Research with East London Adolescents: Community Health Survey (RELACHS)-a representative cohort of young people aged 11-12 and 13-14 years at baseline, followed-up after 2 years. MEASUREMENTS: Psychological distress and depressive symptoms identified by the self-report Strengths and Difficulties Questionnaire and the Short Moods and Feelings Questionnaire at baseline and follow-up. Data on overweight/obesity, general health, long-standing illness, physical activity, smoking, alcohol use and drug use were collected from questionnaires completed by the adolescents at baseline and follow-up. FINDINGS: At follow-up, 10.1% of males and 12.9% of females reported psychological distress; 20% of males and 33.7% of females reported depressive symptoms. Having tried drugs or engaged in two or more health-risk behaviours (smoking, alcohol use or drug use) at baseline predicted psychological distress and depressive symptoms at follow-up. Smoking on its own, long-standing illness, obesity/overweight and activity levels were not associated with later psychological health. Risk of poor psychological health at follow-up was associated strongly with psychological health at baseline. CONCLUSIONS: Psychological health at baseline was the strongest predictor of psychological health at follow-up. Engaging in two or more health-risk behaviours moderately increased the risk of poor psychological health, suggesting that prevention strategies targeting co-occuring substance use may reduce burden of disease.

Variations in associations of health risk behaviors among ethnic minority early adolescents.

PURPOSE: To investigate patterns of vulnerability and protection factors associated with risk behaviors and the co-occurrence of risk behaviors in minority ethnicity early adolescents. METHODS: Analysis of data from the Research with East London Adolescents Community Health Survey (RELACHS), a school-based study of a representative sample of 2789 adolescents age 11-14 in 2001 (sample 73% non-Caucasian, 21% born outside the United Kingdom). Questionnaire data were obtained on sociodemographic variables, ethnicity, smoking, drinking, drug use, psychological well-being, physical health, and social support from family and peers. Models of associations for each behavior and co-occurrence of risk behaviors (defined as engaging in > or = 2 behaviors) were developed by hierarchical stepwise logistic regression. RESULTS: Two hundred ninety-two (10.9%) reported 1 risk behavior, 84 (3.1%) reported 2, and 25 (0.9%) reported 3 behaviors. In multivariate models, psychological morbidity was associated with higher risk of all behaviors and co-occurrence, while higher family support was associated with lower risk in all models. Non-Caucasian ethnicity was associated with lower risk of regular smoking and co-occurrence but not drinking or drugs. Birth outside the United Kingdom was associated with lower risk for individual behaviors but not co-occurrence. Religion and religious observance were associated with lower risk of smoking and drinking but not drug use or co-occurrence. Peer connectedness was associated with drug use, but with increased risk. Socioeconomic status was associated only with smoking. CONCLUSIONS: Patterns of associations of personal, family, and environmental factors appear to differ between smoking, drinking, lifetime drug use, and the co-occurrence of these behaviors. Hypotheses regarding common factors related to health risk behaviors may be misleading in ethnic minorities and immigrants. Co-occurrence may represent a distinct behavioral domain of risk that is partly culturally determined.

Psychotic symptoms in the general population of England--a comparison of ethnic groups (The EMPIRIC study).

BACKGROUND: There is considerable evidence that incidence of schizophrenia and other psychoses varies across ethnic groups in the UK, with particularly high rates for people of African-Caribbean origin. AIMS: The aims of this shady were to estimate in a community-based sample of people from ethnic minorities: 1) the prevalence of psychotic symptoms; and 2) risk factors for reporting psychotic symptoms. METHOD: Face-to-face interviews were carried out with a probabilistic sample of 4281 adults from six ethnic groups living in the UK. Psychotic symptoms were measured using the psychosis screening questionnaire (PSQ). RESULTS: There was a twofold higher rate of reporting psychotic symptoms on the PSQ in Black Caribbean people compared with Whites. Adjustment for demographic factors had little effect on this association. CONCLUSION: Prevalence rates of psychotic symptoms were higher in people from ethnic minorities, but were not consistent with the much higher first contact rates for psychotic disorder reported previously, particularly in Black Caribbeans.