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

Identification of cardiac malformations in mice lacking Ptdsr using a novel high-throughput magnetic resonance imaging technique

BACKGROUND: Congenital heart defects are the leading non-infectious cause of death in children. Genetic studies in the mouse have been crucial to uncover new genes and signaling pathways associated with heart development and congenital heart disease. The identification of murine models of congenital cardiac malformations in high-throughput mutagenesis screens and in gene-targeted models is hindered by the opacity of the mouse embryo. RESULTS: We developed and optimized a novel method for high-throughput multi-embryo magnetic resonance imaging (MRI). Using this approach we identified cardiac malformations in phosphatidylserine receptor (Ptdsr) deficient embryos. These included ventricular septal defects, double-outlet right ventricle, and hypoplasia of the pulmonary artery and thymus. These results indicate that Ptdsr plays a key role in cardiac development. CONCLUSIONS: Our novel multi-embryo MRI technique enables high-throughput identification of murine models for human congenital cardiopulmonary malformations at high spatial resolution. The technique can be easily adapted for mouse mutagenesis screens and, thus provides an important new tool for identifying new mouse models for human congenital heart diseases

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

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

Creating a positive casual academic identity through change and loss

Neoliberalism has significantly impacted higher education institutes across the globe by increasing the number of casual and non-continuing academic positions. Insecure employments conditions have not only affected the well-being of contingent staff, but it has also weakened the democratic, intellectual and moral standing of academic institutions. This chapter provides one practitioner’s account of the challenges of casual work, but rather than dwelling on the negativities, it outlines the potential richness of an identity based on insecurity and uncertainty. This exploration draws on the literature of retired academics and identity theory to illustrate the potential generative spaces within an undefined and incoherent identity

Epiblastic Cited2 deficiency results in cardiac phenotypic heterogeneity and provides a mechanism for haploinsufficiency

AIMS: Deletion of the transcription factor Cited2 causes penetrant and phenotypically heterogenous cardiovascular and laterality defects and adrenal agenesis. Heterozygous human CITED2 mutation is associated with congenital heart disease, suggesting haploinsufficiency. Cited2 functions partly via a Nodal--&gt;Pitx2c pathway controlling left-right patterning. In this present study we investigated the primary site of Cited2 function and mechanisms of haploinsufficiency. METHODS AND RESULTS: A Cited2 conditional allele enabled its deletion in particular cell lineages in mouse development. A lacZ reporter cassette allowed indication of deletion. Congenic Cited2 heterozygous mice were used to investigate haploinsufficiency. Embryos were examined by magnetic resonance imaging, by sectioning and by quantitative real-time polymerase chain reaction (qRT-PCR). Epiblast-specific deletion of Cited2 using Sox2Cre recapitulated penetrant and phenotypically heterogenous cardiovascular and laterality defects. Neural crest-specific deletion using Wnt1Cre affected cranial ganglia but not cardiac development. Mesodermal deletion with Mesp1Cre resulted in low penetrance of septal defect. Mesodermal deletion with T-Cre resulted in adrenal agenesis, but infrequent cardiac septal and laterality defects. beta-Galatactosidase staining and qRT-PCR demonstrated the efficiency and location of Cited2 deletion. Murine Cited2 heterozygosity is itself associated with cardiac malformation, with three of 45 embryos showing ventricular septal defect. Cited2 gene expression in E13.5 hearts was reduced 2.13-fold in Cited2(+/-) compared with wild-type (P = 2.62 x 10(-6)). The Cited2 target gene Pitx2c was reduced 1.5-fold in Cited2(+/-) (P = 0.038) hearts compared with wild-type, and reduced 4.9-fold in Cited2(-/-) hearts (P = 0.00031). Pitx2c levels were reduced two-fold (P = 0.009) in Cited2(+/-) embryos, in comparison with wild-type. Cited2 and Pitx2c expression were strongly correlated in wild-type and Cited2(+/-) hearts (Pearson rank correlation = 0.68, P = 0.0009). Cited2 expression was reduced 7474-fold in Sox2Cre deleted hearts compared with controls (P = 0.00017) and Pitx2c was reduced 3.1-fold (P = 0.013). Deletion of Cited2 with Mesp1Cre resulted in a 130-fold reduction in cardiac Cited2 expression compared with control (P = 0.0002), but Pitx2c expression was not affected. CONCLUSION: These results indicate that phenotypically heterogenous and penetrant cardiac malformations in Cited2 deficiency arise from a primary requirement in epiblast derivatives for left-right patterning, with a secondary cell-autonomous role in the mesoderm. Cardiac malformation associated with Cited2 haploinsufficiency may occur by reducing expression of key Cited2 targets such as Pitx2c

The prevalence, incidence, prognosis and risk factors for symptoms of depression and anxiety in a UK cohort during the COVID-19 pandemic

Background: The COVID-19 pandemic has been shown to have profound consequences for population mental health. However, in whom these effects have been sustained is less clear. Aims: To investigate the prevalence, incidence, prognosis, and risk factors for symptoms of depression and anxiety in a UK cohort over three distinct periods in the pandemic in 2020. Method: An online survey was completed by a UK community cohort at three points (n= 3097 at baseline, n=878 completed all 3 surveys): April (baseline), July-September (T2) and November-December (T3). Participants completed validated measures of depression and anxiety on each occasion and we prospectively explored the role of socio-demographic factors and psychological factors (loneliness, positive mood, perceived risk of and worry about COVID-19) as risk factors. Results: Depression (PHQ-9 means - baseline: 7.69, T2: 5.53, T3: 6.06) and anxiety scores (GAD-7 means -baseline: 6.59, T2: 4.60, T3: 4.98) were considerably greater than pre-pandemic population norms at all timepoints. Women reported greater depression and anxiety symptoms than men. Being younger, having a history of a mental health disorder, more pandemic-related negative life events due to COVID-19, greater loneliness and lower positive mood at baseline were all significant predictors of poorer mental health at time point 3.Conclusion: The negative impact of the COVID-19 pandemic on mental health has persisted to some degree. Younger people and individuals with prior mental health disorders were at greatest risk. Easing of restrictions and the resumption of social interaction could mitigate the specific risk factors of loneliness and positive mood