Health Wellbeing and Inclusion
http://hdl.handle.net/20.500.12904/62
2024-03-29T01:24:15ZResults of the COVID-19 mental health international for the health professionals (COMET-HP) study: depression, suicidal tendencies and conspiracism.
http://hdl.handle.net/20.500.12904/17588
Results of the COVID-19 mental health international for the health professionals (COMET-HP) study: depression, suicidal tendencies and conspiracism.
Mahalingappa, Sridevi
INTRODUCTION: The current study aimed to investigate the rates of anxiety, clinical depression, and suicidality and their changes in health professionals during the COVID-19 outbreak. MATERIALS AND METHODS: The data came from the larger COMET-G study. The study sample includes 12,792 health professionals from 40 countries (62.40% women aged 39.76 ± 11.70; 36.81% men aged 35.91 ± 11.00 and 0.78% non-binary gender aged 35.15 ± 13.03). Distress and clinical depression were identified with the use of a previously developed cut-off and algorithm, respectively. STATISTICAL ANALYSIS: Descriptive statistics were calculated. Chi-square tests, multiple forward stepwise linear regression analyses, and Factorial Analysis of Variance (ANOVA) tested relations among variables. RESULTS: Clinical depression was detected in 13.16% with male doctors and 'non-binary genders' having the lowest rates (7.89 and 5.88% respectively) and 'non-binary gender' nurses and administrative staff had the highest (37.50%); distress was present in 15.19%. A significant percentage reported a deterioration in mental state, family dynamics, and everyday lifestyle. Persons with a history of mental disorders had higher rates of current depression (24.64% vs. 9.62%; p < 0.0001). Suicidal tendencies were at least doubled in terms of RASS scores. Approximately one-third of participants were accepting (at least to a moderate degree) a non-bizarre conspiracy. The highest Relative Risk (RR) to develop clinical depression was associated with a history of Bipolar disorder (RR = 4.23). CONCLUSIONS: The current study reported findings in health care professionals similar in magnitude and quality to those reported earlier in the general population although rates of clinical depression, suicidal tendencies, and adherence to conspiracy theories were much lower. However, the general model of factors interplay seems to be the same and this could be of practical utility since many of these factors are modifiable.
Associations between treatment adherence-competence-integrity (ACI) and adult psychotherapy outcomes : a systematic review and meta-analysis.
http://hdl.handle.net/20.500.12904/15793
Associations between treatment adherence-competence-integrity (ACI) and adult psychotherapy outcomes : a systematic review and meta-analysis.
Power, Niall; Firth, Nick
Objective: To provide a comprehensive assessment of the association between psychological treatment adherence/competence/integrity (ACI) and clinical outcomes. Method: The review protocol was pre registered (CRD42020193889). Studies that assessed ACI-outcome relationships for adult psychotherapy were searched across three databases (Scopus, PsycINFO, MEDLINE). Random effects meta-analyses were conducted on adherence-outcome, competence-outcome and integrity-outcome relationships. Separate analyses were performed for studies with hierarchical (i.e. patients nested within therapist) versus non-hierarchical study designs. Moderator analyses were performed according to pre defined clinical and methodological features. GRADE assessments rated the quality of each meta analytic comparison. Results: The review identified 62 studies suitable for inclusion (45 adherence outcome, 39 competence-outcome and 7 integrity-outcome effect sizes; N=8,210 across all analyses). No significant adherence-outcome association was found. A small significant positive association was found only in non-hierarchical studies between competence and outcome (r = 0.17, 95% CI [0.07- 0.26], p < 0.001, ~d = .34, GRADE = moderate). Small-to-moderate significant positive associations between integrity and outcome were found for both non-hierarchical (r = 0.15, 95% CI [0.06 – 0.23], p < 0.001, ~d = .30, GRADE = high) and hierarchical study designs (r = 0.23, 95% CI [0.01,0.43], p < 0.044, ~d = .47, GRADE = low). Diagnosis, treatment modality and year of publication significantly moderated the strength of ACI-outcome correlations. Conclusions: Competence and integrity are significantly associated with clinical outcome, with a magnitude comparable to wider common factors. Further research is required to study these process-outcome associations with greater precision in routine-care settings and to understand the role of moderating variables.
Author(s) accepted version. 26/09/2022
The effect of different degrees of lockdown and self-identified gender on anxiety, depression and suicidality during the COVID-19 pandemic: Data from the international COMET-G study.
http://hdl.handle.net/20.500.12904/15715
The effect of different degrees of lockdown and self-identified gender on anxiety, depression and suicidality during the COVID-19 pandemic: Data from the international COMET-G study.
Mahalingappa, Sridevi
INTRODUCTION: During the COVID-19 pandemic various degrees of lockdown were applied by countries around the world. It is considered that such measures have an adverse effect on mental health but the relationship of measure intensity with the mental health effect has not been thoroughly studied. Here we report data from the larger COMET-G study pertaining to this question. MATERIAL AND METHODS: During the COVID-19 pandemic, data were gathered with an online questionnaire from 55,589 participants from 40 countries (64.85% females aged 35.80 ± 13.61; 34.05% males aged 34.90±13.29 and 1.10% other aged 31.64±13.15). Anxiety was measured with the STAI, depression with the CES-D and suicidality with the RASS. Distress and probable depression were identified with the use of a previously developed cut-off and algorithm respectively. STATISTICAL ANALYSIS: It included the calculation of Relative Risk (RR), Factorial ANOVA and Multiple backwards stepwise linear regression analysis RESULTS: Approximately two-thirds were currently living under significant restrictions due to lockdown. For both males and females the risk to develop clinical depression correlated significantly with each and every level of increasing lockdown degree (RR 1.72 and 1.90 respectively). The combined lockdown and psychiatric history increased RR to 6.88 The overall relationship of lockdown with severity of depression, though significant was small. CONCLUSIONS: The current study is the first which reports an almost linear relationship between lockdown degree and effect in mental health. Our findings, support previous suggestions concerning the need for a proactive targeted intervention to protect mental health more specifically in vulnerable groups.
Administration and Policy in Mental Health and Mental Health Services Research
http://hdl.handle.net/20.500.12904/15105
Administration and Policy in Mental Health and Mental Health Services Research
Firth, Nick
Dropout during psychological intervention is a signifcant problem. Previous evidence for associations with socioeconomic deprivation is mixed. This study aimed to review the evidence for associations between deprivation and dropout from contemporary adult psychological interventions for common mental disorders (CMDs). Systematic review, narrative synthesis and random efects meta-analysis of peer-reviewed English language journal articles published June 2010–June 2020 was conducted. Data sources included medline, PsycInfo, databases indexed by web of science, ProQuest social science database and sociology collection, and the Cochrane Library, supplemented by forward and backward citation searching. Five studies were eligible for inclusion (mean N=170, 68% female, 60% White Caucasian, 32% dropout rate, predominantly cognitive behaviour therapy/cognitive processing therapy). Narrative synthesis indicated an overall non-signifcant efect of deprivation on dropout. Meta-analytic signifcance of controlled (k=3) and uncontrolled (k=4) efects depended on the measure of deprivation included for those studies using more than one measure (controlled OR 1.21–1.32, p=0.019–0.172, uncontrolled OR 1.28–1.76, p=0.024–0.423). The low number of included studies meant sub-group comparisons were limited, despite some tentative indications of potential diferential effects. A comparator set of excluded studies showed similar uncertainty. There was limited evidence that did not overall suggest a clear signifcant effect of deprivation on dropout from contemporary individual CMD interventions. However, more contemporary research is needed, as effects may vary according to clinical and methodological factors, and for dropout versus non-initiation.