Examining the association between urbanicity and first episode psychosis in Chile

This dissertation sought to characterize the association between urbanicity and incidence of first-episode psychosis (FEP) in Chile by using data from national registries, including a national FEP registry, as well as other health and social databases. Numerous large, well-controlled studies from Northern European countries (e.g., Denmark) have found that being born or brought up in urban environments increases the odds of developing psychosis. Given the strength and consistency of these findings over decades, the urbanicity-psychosis association is considered one of the fundamental epidemiologic findings on environment and psychosis, and full-fledged research programs have been examining potential mechanisms. Yet it now appears that the association may not be universal. Studies from some European countries, Latin America, and China have reported null results. These findings have started to change our understanding of the urbanicity-psychosis association and have raised important questions regarding how the association works in understudied, lesser-resourced settings. Chile, with its unique juxtaposition of substantial infrastructure (national registries) and shared challenges with other Latin American countries, offers an unprecedented context for developing such research. Accordingly, the specific aims of this dissertation were to 1) conduct a qualitative systematic literature review on the definitions of urbanicity and community-level social factors in the context of psychosis research, 2) examine whether urbanicity at birth and at admission is associated with increased risk of FEP, and 3) examine the moderation effects of social deprivation in the association between urbanicity and incidence of FEP

Estigma hacia la demencia: una revisión

Dementia, known asmajor neurocognitive disorder on DSM V, is a public health priority due to its increasing prevalence and individual and social consequences. Stigma is a social exclusion and devaluation, as a result of negative perceptions towardsa persons' attribute or behavior. It is considered as a collective phenomenon related to this condition, as it impacts quality of life of people with dementia and their family environments. Among other consequences, stigma becomes a barrier to timely access to diagnosis, treatment and comprehensive support. The main purpose of this review is to describe and to analyze the phenomenon of stigma related to dementia as an emerging issue for Latin America. Stigma towards dementia can be classified as follows: public stigma (members of the community), professional and structural stigma (institutions, public policy, healthcare professionals, etc.), stigma in people with dementia know as self-stigma, and family stigma (carers, family environment). For each of these groups stigma is developed withspecific characteristics andconsequences. Stigma is an important component of dementia strategies involvingdiagnosis, treatment and promotion of social integration for people with dementia and requires an integrated approach from ethical, social and health perspectives

The Association Between Exposure to COVID-19 and Mental Health Outcomes Among Healthcare Workers

Due to the unprecedented impact of the COVID-19 pandemic on health care systems, there has been great interest in the mental wellbeing of healthcare workers. While most studies investigated mental health outcomes among frontline vs. non-frontline healthcare workers, little is known about the impact of various work-related variables. The present study aimed to examine the association between work-related [i.e., having contact with COVID-19 patients, being redeployed due to the pandemic and availability of sufficient personal protective equipment (PPE)] and subjective (i.e., worries about getting infected or infecting others) exposures and self-reported mental health outcomes (i.e., psychological distress, depressive symptoms, and posttraumatic stress symptoms). Between February and May 2021, 994 healthcare workers employed at a variety of healthcare settings in the Netherlands filled out an online survey as part of the COVID-19 HEalth caRe wOrkErS (HEROES) study. Mental health outcomes were measured using the General Health Questionnaire-12, the Patient Health Questionnaire-9, and the Primary Care PTSD Screen for DSM-5. Approximately 13% reported depressive symptoms, 37% experienced psychological distress, and 20% reported posttraumatic stress symptoms. Multilevel linear models consisted of three levels: individual (work-related and subjective exposures), healthcare center (aggregated redeployment and availability of sufficient PPE), and regional (cumulative COVID-19 infection and death rates). Worries about infection were associated with all three mental health outcomes, whereas insufficient PPE was associated with psychological distress and depressive symptoms. There were no differences in outcomes between healthcare centers or provinces with different COVID-19 infection and death rates. Our findings highlight the importance of adequate PPE provision and the subjective experience of the COVID-19 pandemic. These factors should be part of interventions aimed at mitigating adverse mental health outcomes among healthcare workers during the COVID-19 pandemic

Mental illness stigma research in Argentina

Studies regarding stigma towards mental illness in Argentina blossomed after the first National Mental Health Law was passed in 2010. Methodological limitations and contradictory results regarding community perceptions of stigma hinder comparisons across domestic and international contexts but some lessons may still be gleaned. We examine this research and derive recommendations for future research and actions to reduce stigma. These include tackling culture-specific aspects of stigma, increasing education of the general population, making more community-based services available and exposing mental health professionals to people with mental illness who are on community paths to recovery.Fil: Agrest, Martín. Proyecto Suma; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Mascayano, Franco. Universidad de Chile; ChileFil: Ardila Gómez, Sara Elena. Universidad Nacional de Lanús; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Abeldaño Zuñiga, Roberto Ariel. Universidad Nacional de Córdoba. Facultad de Medicina; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Fernandez, Alicia Ruth. Universidad Nacional de Córdoba. Facultad de Medicina; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Geffner, Norma. Proyecto Suma; ArgentinaFil: Leiderman, Eduardo Adrian. Proyecto Suma; ArgentinaFil: Susser, Ezra. Columbia University; Estados UnidosFil: Valencia, Eliecer. Columbia University; Estados UnidosFil: Yang, Lawrence Hsin. Columbia University; Estados UnidosFil: Zalazar, Virginia. Proyecto Suma; ArgentinaFil: Lipovetzky, Gustavo. Proyecto Suma; Argentin

The Impact of the COVID-19 Pandemic on the Mental Health of Healthcare Workers in Italy: Analyzing the Role of Individual and Workplace-Level Factors in the Reopening Phase After Lockdown

IntroductionItaly is one of the high-income countries hit hardest by Covid-19. During the first months of the pandemic, Italian healthcare workers were praised by media and the public for their efforts to face the emergency, although with limited knowledge and resources. However, healthcare workers soon had to face new challenges at a time when the national health system was working hard to recover. This study focuses on this difficult period to assess the impact of the COVID-19 pandemic on the mental health of Italian healthcare workers. Materials and MethodsHealthcare workers from all Italian regions [n = 5,502] completed an online questionnaire during the reopening phase after the first wave lockdown. We assessed a set of individual-level factors (e.g., stigma and violence against HCWs) and a set of workplace-level factors (e.g., trust in the workplace capacity to handle COVID-19) that were especially relevant in this context. The primary outcomes assessed were score >= 15 on the Patient Health Questionnaire-9 and score >= 4 on the General Health Questionnaire-12, indicators of clinically significant depressive symptoms and psychological distress, respectively. Logistic regression analyses were performed on depressive symptoms and psychological distress for each individual- and workplace-level factor adjusting for gender, age, and profession. ResultsClinically significant depressive symptoms were observed in 7.5% and psychological distress in 37.9% of HCWs. 30.5% of healthcare workers reported having felt stigmatized or discriminated, while 5.7% reported having experienced violence. Feeling stigmatized or discriminated and experiencing violence due to being a healthcare worker were strongly associated with clinically significant depressive symptoms [OR 2.98, 95%CI 2.36-3.77 and OR 4.72 95%CI 3.41-6.54] and psychological distress [OR 2.30, 95%CI 2.01-2.64 and OR 2.85 95%CI 2.16-3.75]. Numerous workplace-level factors, e.g., trust in the workplace capacity to handle COVID-19 [OR 2.43, 95%CI 1.92-3.07] and close contact with a co-worker who died of COVID-19 [OR 2.05, 95%CI 1.56-2.70] were also associated with clinically significant depressive symptoms. Similar results were found for psychological distress. ConclusionsOur study emphasizes the need to address discrimination and violence against healthcare professionals and improve healthcare work environments to strengthen the national health system's capacity to manage future emergencies

El impacto de la pandemia de COVID-19 en la salud mental de los trabajadores de la salud en Chile: datos iniciales de The Health Care Workers Study

Background: Healthcare workers’ mental health was affected by SARS-CoV-2 pandemic. Aim: To evaluate healthcare workers’ mental health and its associated factors during the pandemic in Chile. Material and Methods: An online self-reported questionnaire was designed including the Goldberg Health Questionnaire, the Patient Health Questionnaire, (PHQ-9), and the Columbia-Suicide Severity Rating Scale among other questions. It was sent to 28,038 healthcare workers. Results: The questionnaire was answered by 1,934 participants, with a median age of 38 years (74% women). Seventy five percent were professionals, and 48% worked at a hospital. Fifty nine percent of respondents had a risk of having a mental health disorder, and 73% had depressive symptoms. Significant associations were found with sex, workplace, and some of the relevant experiences during the pandemic. Fifty one percent reported the need for mental health support, and 38% of them received it. Conclusions: There is a high percentage of health workers with symptoms of psychological distress, depression, and suicidal ideas. The gender approach is essential to understand the important differences found. Many health workers who required mental health care did not seek or received it

[Impact of COVID-19 pandemic on the mental health of healthcare workers].

BACKGROUND: Healthcare workers' mental health was affected by SARS-CoV-2 pandemic. AIM: To evaluate healthcare workers' mental health and its associated factors during the pandemic in Chile. MATERIAL AND METHODS: An online self-reported questionnaire was designed including the Goldberg Health Questionnaire, the Patient Health Questionnaire, (PHQ-9), and the Columbia-Suicide Severity Rating Scale among other questions. It was sent to 28,038 healthcare workers. RESULTS: The questionnaire was answered by 1,934 participants, with a median age of 38 years (74% women). Seventy five percent were professionals, and 48% worked at a hospital. Fifty nine percent of respondents had a risk of having a mental health disorder, and 73% had depressive symptoms. Significant associations were found with sex, workplace, and some of the relevant experiences during the pandemic. Fifty one percent reported the need for mental health support, and 38% of them received it. CONCLUSIONS: There is a high percentage of health workers with symptoms of psychological distress, depression, and suicidal ideas. The gender approach is essential to understand the important differences found. Many health workers who required mental health care did not seek or received it

The impact of the COVID-19 pandemic on the mental health of healthcare workers:study protocol for the COVID-19 HEalth caRe wOrkErS (HEROES) study

BACKGROUND: Preliminary country-specific reports suggest that the COVID-19 pandemic has a negative impact on the mental health of the healthcare workforce. In this paper, we summarize the protocol of the COVID-19 HEalth caRe wOrkErS (HEROES) study, an ongoing, global initiative, aimed to describe and track longitudinal trajectories of mental health symptoms and disorders among health care workers at different phases of the pandemic across a wide range of countries in Latin America, Europe, Africa, Middle-East, and Asia. METHODS: Participants from various settings, including primary care clinics, hospitals, nursing homes, and mental health facilities, are being enrolled. In 26 countries, we are using a similar study design with harmonized measures to capture data on COVID-19 related exposures and variables of interest during two years of follow-up. Exposures include potential stressors related to working in healthcare during the COVID-19 pandemic, as well as sociodemographic and clinical factors. Primary outcomes of interest include mental health variables such as psychological distress, depressive symptoms, and posttraumatic stress disorders. Other domains of interest include potentially mediating or moderating influences such as workplace conditions, trust in the government, and the country’s income level. RESULTS: As of August 2021, ~ 34,000 health workers have been recruited. A general characterization of the recruited samples by sociodemographic and workplace variables is presented. Most participating countries have identified several health facilities where they can identify denominators and attain acceptable response rates. Of the 26 countries, 22 are collecting data and 2 plan to start shortly. CONCLUSIONS: This is one of the most extensive global studies on the mental health of healthcare workers during the COVID-19 pandemic, including a variety of countries with diverse economic realities and different levels of severity of pandemic and management. Moreover, unlike most previous studies, we included workers (clinical and non-clinical staff) in a wide range of settings. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00127-021-02211-9