Mental health in the UK during the COVID-19 pandemic: cross-sectional analyses from a community cohort study

Objectives: Previous pandemics have resulted in significant consequences for mental health. Here, we report the mental health sequelae of the COVID-19 pandemic in a UK cohort and examine modifiable and non-modifiable explanatory factors associated with mental health outcomes. We focus on the first wave of data collection, which examined short-term consequences for mental health, as reported during the first 4–6 weeks of social distancing measures being introduced.Design: Cross-sectional online survey.Setting: Community cohort study.Participants: N=3097 adults aged ≥18 years were recruited through a mainstream and social media campaign between 3 April 2020 and 30 April 2020. The cohort was predominantly female (n=2618); mean age 44 years; 10% (n=296) from minority ethnic groups; 50% (n=1559) described themselves as key workers and 20% (n=649) identified as having clinical risk factors putting them at increased risk of COVID-19.Main outcome measures: Depression, anxiety and stress scores.Results: Mean scores for depression (Embedded Image =7.69, SD=6.0), stress (Embedded Image =6.48, SD=3.3) and anxiety (Embedded Image = 6.48, SD=3.3) significantly exceeded population norms (all p < 0.0001). Analysis of non-modifiable factors hypothesised to be associated with mental health outcomes indicated that being younger, female and in a recognised COVID-19 risk group were associated with increased stress, anxiety and depression, with the final multivariable models accounting for 7%–14% of variance. When adding modifiable factors, significant independent effects emerged for positive mood, perceived loneliness and worry about getting COVID-19 for all outcomes, with the final multivariable models accounting for 54%–57% of total variance.Conclusions: Increased psychological morbidity was evident in this UK sample and found to be more common in younger people, women and in individuals who identified as being in recognised COVID-19 risk groups. Public health and mental health interventions able to ameliorate perceptions of risk of COVID-19, worry about COVID-19 loneliness and boost positive mood may be effective

Psychological Predictors of Self-reported COVID-19 Outcomes: Results From a Prospective Cohort Study

Background: Previous research has shown that psychological factors, such as stress and social support, are associated with greater susceptibility to viral respiratory illnesses and more severe symptoms. During the COVID-19 pandemic there has been a well-documented deterioration in psychological well-being and increased social isolation. This raises questions as to whether those experiencing psychological adversity during the pandemic are more at risk of contracting and/or experiencing COVID-19 symptoms.Purpose: To examine the relationship between psychological factors and the risk of COVID-19 self-reported infection and the symptomatic experience of SARS CoV-2 (indicated by the number and severity of symptoms)Methods: As part of a longitudinal prospective observational cohort study, 1087 adults completed validated measures of psychological wellbeing during April 2020 and self-reported incidence of COVID-19 infection and symptom experience across the pandemic through to December 2020. Regression models were used to explore these relationships controlling for demographic and occupational factors.Results: Greater psychological distress during the early phase of the pandemic was significantly associated with subsequent self-reported SARS CoV-2 infection as well as the experience of a greater number and more severe symptoms.Conclusion: COVID-19 infection and symptoms may be more common among those experiencing elevated psychological distress. Further research to elucidate the mechanisms underlying these associations is needed

The melanoma-specific graded prognostic assessment does not adequately discriminate prognosis in a modern population with brain metastases from malignant melanoma

The melanoma-specific graded prognostic assessment (msGPA) assigns patients with brain metastases from malignant melanoma to 1 of 4 prognostic groups. It was largely derived using clinical data from patients treated in the era that preceded the development of newer therapies such as BRAF, MEK and immune checkpoint inhibitors. Therefore, its current relevance to patients diagnosed with brain metastases from malignant melanoma is unclear. This study is an external validation of the msGPA in two temporally distinct British populations.Performance of the msGPA was assessed in Cohort I (1997-2008, n=231) and Cohort II (2008-2013, n=162) using Kaplan-Meier methods and Harrell's c-index of concordance. Cox regression was used to explore additional factors that may have prognostic relevance.The msGPA does not perform well as a prognostic score outside of the derivation cohort, with suboptimal statistical calibration and discrimination, particularly in those patients with an intermediate prognosis. Extra-cerebral metastases, leptomeningeal disease, age and potential use of novel targeted agents after brain metastases are diagnosed, should be incorporated into future prognostic models.An improved prognostic score is required to underpin high-quality randomised controlled trials in an area with a wide disparity in clinical care

Young people, mental health and COVID-19 infection: The canaries we put in the coal-mine

Background: The number of people testing positive for SARS-COV-2 in the UK, particularly among young adults, is increasing. We report here on the mental health of young adults and related psychological and behavioural responses to the pandemic, and consider the role of these factors in fuelling the increase in Coronavirus 2019 (COVID-19) in this group.Methods: An online survey was completed during the first six weeks of the first UK-wide lockdown by 3097 respondents, including data for 364 respondents between the ages of 18-24 years. The survey included measures of mental health and indices capturing related psychological and behavioural responses to the pandemic.Results: The mental health of 18-24 years olds in the first 6 weeks of lockdown was significantly poorer than that of older respondents and previously published norms: with 84% reporting symptoms of depression and 72% reporting symptoms of anxiety. Young adults also reported significantly greater loneliness and reduced positive mood, both of which were also associated with greater mental health difficulties.Conclusions: We contend that the combination of mental health, social and economic considerations may have contributed to the rise of COVID-19 infections in young adults and ascribing blame to this group will not aid our efforts to regain control of the disease

Risk Factors and Changes in Depression and Anxiety over Time in New Zealand during COVID-19: A Longitudinal Cohort Study

This longitudinal study investigated changes in and risk factors for anxiety and depression during the COVID-19 pandemic in a New Zealand cohort. Online surveys were distributed to 681 participants at three time-points: May 2020 (Time 1), August–September 2020 (Time 2), and March–April 2021 (Time 3). Participants completed measures of anxiety and depression, alongside measures of possible risk/protective factors. A total of 261 participants completed all three surveys and were included in analyses. Depression and anxiety reduced over time; however, levels were still significantly higher than pre-pandemic norms. Being younger, having a prior mental health disorder, experiencing negative life events due to COVID-19, and being a pet owner were risk factors for poorer depression and anxiety, whereas having higher positive mood was protective. This study demonstrates persisting negative effects of the pandemic on anxiety and depression in a context of low transmission and highlights the importance of providing psychological help to those most at risk

Designing a water leasing market for the Mimbres River, New Mexico.

The objective of this study is to develop a conceptual framework for establishing water leasing markets in New Mexico using the Mimbres River as a test case. Given the past and growing stress over water in New Mexico and the Mimbres River in particular, this work will develop a mechanism for the short term, efficient, temporary transfer of water from one user to another while avoiding adverse effects on any user not directly involved in the transaction (i.e., third party effects). Toward establishing a water leasing market, five basic tasks were performed, (1) a series of stakeholder meetings were conducted to identify and address concerns and interests of basin residents, (2) several gauges were installed on irrigation ditches to aid in the monitoring and management of water resources in the basin, (3) the hydrologic/market model and decision support interface was extended to include the Middle and Lower reaches of the Mimbres River, (4) experiments were conducted to aid in design of the water leasing market, and (5) a set of rules governing a water leasing market was drafted for future adoption by basin residents and the New Mexico Office of the State Engineer

The Next Generation Platform as A Service: Composition and Deployment of Platforms and Services

The emergence of widespread cloudification and virtualisation promises increased flexibility, scalability, and programmability for the deployment of services by Vertical Service Providers (VSPs). This cloudification also improves service and network management, reducing the Capital and Operational Expenses (CAPEX, OPEX). A truly cloud-native approach is essential, since 5G will provide a diverse range of services - many requiring stringent performance guarantees while maximising flexibility and agility despite the technological diversity. This paper proposes a workflow based on the principles of build-to-order, Build-Ship-Run, and automation; following the Next Generation Platform as a Service (NGPaaS) vision. Through the concept of Reusable Functional Blocks (RFBs), an enhancement to Virtual Network Functions, this methodology allows a VSP to deploy and manage platforms and services, agnostic to the underlying technologies, protocols, and APIs. To validate the proposed workflow, a use case is also presented herein, which illustrates both the deployment of the underlying platform by the Telco operator and of the services that run on top of it. In this use case, the NGPaaS operator facilitates a VSP to provide Virtual Network Function as a Service (VNFaaS) capabilities for its end customers

Routine cognitive errors: A trait-like predictor of individual differences in anxiety and distress

Five studies (N=361) sought to model a class of errors—namely, those in routine tasks—that several literatures have suggested may predispose individuals to higher levels of emotional distress. Individual differences in error frequency were assessed in choice reaction-time tasks of a routine cognitive type. In Study 1, it was found that tendencies toward error in such tasks exhibit trait-like stability over time. In Study 3, it was found that tendencies toward error exhibit trait-like consistency across different tasks. Higher error frequency, in turn, predicted higher levels of negative affect, general distress symptoms, displayed levels of negative emotion during an interview, and momentary experiences of negative emotion in daily life (Studies 2–5). In all cases, such predictive relations remained significant with individual differences in neuroticism controlled. The results thus converge on the idea that error frequency in simple cognitive tasks is a significant and consequential predictor of emotional distress in everyday life. The results are novel, but discussed within the context of the wider literatures that informed them