Mental health concerns during the COVID-19 pandemic as revealed by helpline calls

Brülhart, Marius; Klotzbücher, Valentin; Lalive, Rafael; Reich, Stephanie K.

doi:10.1038/s41586-021-04099-6

Cited by 127 publications

(102 citation statements)

References 39 publications

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“…We evaluated the risk of mental health disorders in people with covid-19 compared with a contemporary control group that experienced the same pandemic related factors (eg, economic, social, environmental stressors) and a historical control group that predated the pandemic, which represented a baseline for people unaffected by the pandemic. Despite evidence showing that the burden of mental health disorders might have increased among the general population during the covid-19 pandemic, 22 23 our results suggested that people with covid-19 are at even higher risk of incident mental health disorders than their contemporaries without covid-19; the risk was also evident in comparisons with the historical control group. Taken together, the findings suggest enhanced vulnerability to these outcomes in people with covid-19.…”

Section: Discussioncontrasting

confidence: 92%

Risks of mental health outcomes in people with covid-19: cohort study

Xie

Al‐Aly

2022

BMJ

276

238

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Objective To estimate the risks of incident mental health disorders in survivors of the acute phase of covid-19. Design Cohort study. Setting US Department of Veterans Affairs. Participants Cohort comprising 153 848 people who survived the first 30 days of SARS-CoV-2 infection, and two control groups: a contemporary group (n=5 637 840) with no evidence of SARS-CoV-2, and a historical control group (n=5 859 251) that predated the covid-19 pandemic. Main outcomes measures Risks of prespecified incident mental health outcomes, calculated as hazard ratio and absolute risk difference per 1000 people at one year, with corresponding 95% confidence intervals. Predefined covariates and algorithmically selected high dimensional covariates were used to balance the covid-19 and control groups through inverse weighting. Results The covid-19 group showed an increased risk of incident anxiety disorders (hazard ratio 1.35 (95% confidence interval 1.30 to 1.39); risk difference 11.06 (95% confidence interval 9.64 to 12.53) per 1000 people at one year), depressive disorders (1.39 (1.34 to 1.43); 15.12 (13.38 to 16.91) per 1000 people at one year), stress and adjustment disorders (1.38 (1.34 to 1.43); 13.29 (11.71 to 14.92) per 1000 people at one year), and use of antidepressants (1.55 (1.50 to 1.60); 21.59 (19.63 to 23.60) per 1000 people at one year) and benzodiazepines (1.65 (1.58 to 1.72); 10.46 (9.37 to 11.61) per 1000 people at one year). The risk of incident opioid prescriptions also increased (1.76 (1.71 to 1.81); 35.90 (33.61 to 38.25) per 1000 people at one year), opioid use disorders (1.34 (1.21 to 1.48); 0.96 (0.59 to 1.37) per 1000 people at one year), and other (non-opioid) substance use disorders (1.20 (1.15 to 1.26); 4.34 (3.22 to 5.51) per 1000 people at one year). The covid-19 group also showed an increased risk of incident neurocognitive decline (1.80 (1.72 to 1.89); 10.75 (9.65 to 11.91) per 1000 people at one year) and sleep disorders (1.41 (1.38 to 1.45); 23.80 (21.65 to 26.00) per 1000 people at one year). The risk of any incident mental health diagnosis or prescription was increased (1.60 (1.55 to 1.66); 64.38 (58.90 to 70.01) per 1000 people at one year). The risks of examined outcomes were increased even among people who were not admitted to hospital and were highest among those who were admitted to hospital during the acute phase of covid-19. Results were consistent with those in the historical control group. The risk of incident mental health disorders was consistently higher in the covid-19 group in comparisons of people with covid-19 not admitted to hospital versus those not admitted to hospital for seasonal influenza, admitted to hospital with covid-19 versus admitted to hospital with seasonal influenza, and admitted to hospital with covid-19 versus admitted to hospital for any other cause. Conclusions The findings suggest that people who survive the acute phase of covid-19 are at increased risk of an array of incident mental health disorders. Tackling mental health disorders among survivors of covid-19 should be a priority.

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Section: Discussioncontrasting

confidence: 92%

Risks of mental health outcomes in people with covid-19: cohort study

Xie

Al‐Aly

2022

BMJ

276

238

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“…In relation to the reasons for consultations/calls, consistent with what has been found in previous literature [ 36 , 38 , 40 , 43 , 44 ], the presence of anxiety symptomatology was the main concern of callers (38% as the main reason and 52.4% as a reason in general). In relation to these symptoms, we can also highlight that concern for family or friends (16–20.1%), fear of infection (8–16.4%) and insomnia (1–5.6%), depressive symptoms (4–23.1%), calls due to prior psychological condition (7–11.7%), bereavement symptoms (4–5.1%), and loneliness (2–6.6%) were also very common.…”

Section: Discussionsupporting

confidence: 88%

Analysis of the Calls Received during the COVID-19 Lockdown by the Mental Health Crisis Helpline Operated by the Professional College of Psychology of Aragon

Monreal-Bartolomé

López‐Del‐Hoyo

Cabrera-Gil³

et al. 2022

IJERPH

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COVID-19 has had a direct impact on the physical and mental health of millions of people worldwide. Therefore, a Mental Health Crisis Helpline (MHCH) was set up and offered free of charge by the Professional College of Psychology of Aragon (COPPA) during the lockdown period. This research aims to study the reasons for the calls, to describe the population segments that used it, and to analyse the possible relationships between the variables studied. A total of 1411 calls were answered and 598 were registered. The main reasons for the calls were: anxiety symptoms, concern for a relative, previous mental health problems, conflicts, and depressive symptoms. Significantly more men called for anxiety symptoms (60.8% vs. 49.5%) versus more women calling regarding a chronic physical illness (3.5% vs. 0.7%), concern about a relative (22.7% vs. 12.4%), care guidelines (6% vs. 1.3%), and bereavement (6.2% vs. 2%). Calls regarding conflict increased slightly as the lockdown period progressed (p < 0.001; r = 0.15), in contrast with calls regarding previous psychological conditions and anxiety symptoms (p = 0.035; r = −0.09; p = 0.005; r = −0.12). These results highlight the intensive use of the MHCH, confirming the need for the implementation of specific psychological care resources in times of crisis.

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“…Various reviews of the effects of loneliness find moderate associations between loneliness and such facets of mental health [ 22 ]. Furthermore, during the COVID-19 crisis, loneliness has been especially prevalent among helpline callers, particularly during periods of strict social restrictions [ 23 ]. Thus, research that adopts a multifactorial, integrative perspective to the study of COVID-19 social restriction measures is likely to be best positioned to provide informative explanations regarding the effects of these restrictions on individuals’ mental health [ 3 , 21 ].…”

Section: Discussionmentioning

confidence: 99%