The influence of concern about COVID-19 on mental health in the Republic of Georgia: a cross-sectional study.

BACKGROUND: Early evidence indicates increased mental health burden arising from COVID-19 and related control measures. The study aim was to examine concern about COVID-19 and its association with symptoms of mental disorders in the Republic of Georgia. A cross-sectional internet-based survey of adults in Georgia using non-probabilistic sampling was used. Questionnaire topics were: (i) demographic and socio-economic characteristics; (ii) level of burden caused by common causes of COVID-19 related concerns; (iii) strategies used in response to concerns about COVID-19; and (iv) symptoms of mental disorders of anxiety (GAD-7), depression (PHQ-9), PTSD (ITQ) and adjustment disorder (ADNM8). Descriptive and multivariate analyses were conducted. RESULTS: There were 2088 respondents. High levels of symptoms for mental disorders were observed for anxiety (23.9% women, 21.0% men), depression (30.3% women, 25.27% men), PTSD (11.8% women, and 12.5% men), and adjustment disorder (40.7% women, 31.0% men). Factors significantly associated with increased COVID-19 concern included bad/very bad household economic situation, larger household size, current NCD, symptoms of anxiety, adjustment disorder and PTSD. Response strategies significantly associated with reduced mental disorder symptoms included meditation and relaxation exercises, physical exercise, positive thinking, planning for the future, TV/radio, housework/DIY, and working. Drinking alcohol was associated with a greater probability of increased mental disorder symptoms. CONCLUSIONS: High levels of mental disorders were recorded, and they were strongly associated with increased concern about COVID-19. A number of response strategies were identified which may help protect against worse mental health and these could be supported by innovations in mental health care in Georgia

Changes in Mental Health Needs during COVID-19 in the Republic of Georgia: A Longitudinal Follow-up Study

BACKGROUND: To examine changes in COVID-19 stressors and symptoms of mental disorders in the Republic of Georgia. METHODS: A longitudinal design was used. Following on from our study of May-June 2020, this follow-up study in January-March 2021 was conducted at: (i)an individual level with the same respondents involved in the May-June 2020 study (repeat responders/cohort); and (ii) at a population-wide level, using non-probabilistic sampling. Questionnaire sections covered: (i)demographic, socio-economic characteristics; (ii)level of burden caused by COVID-19-related stressors/concern; and (iii)symptoms of anxiety(GAD-7), depression(PHQ-9), PTSD(ITQ), adjustment disorder(ADNM8). Descriptive and multivariable regression analyses were conducted. RESULTS: Among population-level survey respondents(N=1195), the probability of reporting mental ill health symptoms increased in 2021 compared to 2020 for PTSD(OR1.82), depression(OR1.40), adjustment disorder(OR 1.80), and marginally for anxiety(OR1.17). For the individual repeat respondents(N=455), the probability increased for depression(OR1.88) and adjustment disorder(OR2.56). The perceived burden of pandemic concern worsened in 2021 compared to 2020 for almost all stressors, particularly around access to health care, infecting others, and conflict in the home. PTSD was associated with an increased concern score from 2020 to 2021. CONCLUSION: Our study highlights the need to strengthen response strategies to address the elevated mental health needs related to COVID-19 in Georgia. It recommends increasing accessibility of early interventions and the need to modernise mental health services to strengthen access to care. It also calls for monitoring patterns of mental health disorders for better understanding and responses to mental health needs in Georgia

A transdiagnostic psychosocial prevention-intervention service for young people in the Republic of Georgia: early results of the effectiveness study.

Background: The decade between the ages of 14 and 25 is a particularly vulnerable period for the development of mental health problems, especially of common mental disorders. Mental health and psychosocial prevention and support services for young people in the Republic of Georgia have been extremely limited, leaving a wide treatment and care gap. Club Synergy was designed as an innovative, pragmatic solution that is responsive to the needs of young people and incorporates all necessary levels of care required (prevention, early identification & intervention, and treatment) into a single, trauma-informed service that uses a transdiagnostic approach. This paper presents preliminary findings from the pilot phase of establishing and running the service. Aim: To examine the characteristics of young people presenting to Club Synergy and the effectiveness of contact with the service. Methods: Quantitative evaluation of a consecutive series of young people seen by Club Synergy between November 2019 and July 2020. Demographic information was analysed using descriptive statistics. Pre-post outcomes for anxiety (GAD-7), depression (PHQ-9) and health-related quality of life (EQ-5D-5L) were analysed using the Wilcoxon signed-rank test. Results: Hundred and seventy-four young people were included. The majority (68.9%) self-referred, with referral from The Ministry of Justice due to conflict with law (23%) accounting for most of the other young people seen. Emotional disturbance (73.6%), anxiety (60.3%), problems in interpersonal relationships (57.5%) and low mood (49.4%) were the commonest presenting symptoms. Seventy-three per cent reported 4 or more adverse childhood experiences. After engaging in transdiagnostic modules, median baseline scores for depression and anxiety reduced by 40% and 45%, respectively, and self-rated health improved by 14%. Conclusions: Preliminary analysis indicates that Club Synergy's trauma-informed model of care, based on a transdiagnostic approach, has the potential to provide an effective service to young people in Georgia at risk of developing and with mental health problems. HIGHLIGHTS: This pragmatic study of a newly established mental health service for young people in Georgia suggests that a trauma-informed approach, using transdiagnostic modules, has the potential to effectively prevent and treat common mental health presentations

Puedes no ser capaz de hacer algo al respecto, pero puedes sacar lo mejor de la situación: Un análisis cualitativo de experiencias relacionadas con la pandemia en seis países europeos

The complex system of stressors related to the coronavirus disease 2019 (COVID-19) pandemic has affected the global population, provoking a broad range of psychological reactions. Although numerous studies have investigated the mental health impact of COVID-19, qualitative research and cross-country comparisons are still rare.El complejo sistema de factores estresantes relacionados con la pandemia por la COVID-19 ha afectado a la población mundial, generando un amplio rango de reacciones psicológicas. A pesar de que múltiples estudios han investigado el impacto sobre la salud mental de la COVID-19, las investigaciones cualitativas y las comparaciones entre países aún son infrecuentes

A longitudinal study of risk and protective factors for symptoms of adjustment disorder during the COVID-19 pandemic

Background: The COVID-19 pandemic caused multiple stressors that may lead to symptoms of adjustment disorder. Objective: We longitudinally examined relationships between risk and protective factors, pandemic-related stressors and symptoms of adjustment disorder during the COVID-19 pandemic, as well as whether these relationships differed by the time of assessment. Method: The European Society for Traumatic Stress Studies (ESTSS) ADJUST Study included N = 15,169 participants aged 18 years and above. Participants from 11 European countries were recruited and screened three times at 6-month intervals from June 2020 to January 2022. Associations between risk and protective factors (e.g. gender), stressors (e.g. fear of infection), and symptoms of adjustment disorder (AjD, ADNM-8) and their interaction with time of assessment were examined using mixed linear regression. Results: The following predictors were significantly associated with higher AjD symptom levels: female or diverse gender; older age; pandemic-related news consumption &gt;30 min a day; a current or previous mental health disorder; trauma exposure before or during the pandemic; a good, satisfactory or poor health status (vs. very good); burden related to governmental crisis management and communication; fear of infection; restricted social contact; work-related problems; restricted activity; and difficult housing conditions. The following predictors were associated with lower AjD levels: self-employment or retirement; working in healthcare; and face-to-face contact ≥ once a week with loved ones or friends. The effects of the following predictors on AjD symptoms differed by the time of assessment in the course of the pandemic: a current or previous mental disorder; burden related to governmental crisis management; income reduction; and a current trauma exposure. Conclusions: We identified risk factors and stressors predicting AjD symptom levels at different stages of the pandemic. For some predictors, the effects on mental health may change at different stages of a pandemic.</p

Predictors of traumatic experiences among individuals experiencing pandemic-related stressors: a cross-sectional study in Europe during the COVID-19 crisis

The COVID-19 pandemic is a manifestation of trauma exposure that could eventuate in psychological distress, anxiety, depression, and various mental health disturbances, especially in people who have experienced an additional stressor such as a traumatic event. This cross-sectional study assessed the relationship between pandemic-related stressors, post-traumatic stress disorder (PTSD), the risk for severe or life-threatening symptoms, and resilience among individuals with a traumatic history amidst the coronavirus disease. This study is part of a longitudinal pan-European research, the ADJUST study. The present study consisted of 14.106 participants. The questionnaires utilized included: sociodemographics, health aspects, the Criterion A section of the PTSD Checklist for DSM-5 (PCL-5), the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5), the Pandemic Stressor Scale (PaSS), and the Resilience Evaluation Scale (RES). For the analysis, descriptive statistics and logistic regression analysis were applied. 29% of the respondents reported a traumatic history. Fear of infection, burden of infection, crisis management and communication, restricted activity, risk for severe or life-threatening symptoms of the coronavirus disease, PTSD, and resilience were the predictive factors in the trauma-exposed population. This research provides insights into the stressors that individuals with a traumatic background might experience through the COVID-19 pandemic. Future interventions and worldwide health policies should target trauma-exposed populations to enhance psychological health amidst COVID-19 and other stressful events

Factores de riesgo y protectores para el trastorno de éstres postráumatico en individuos expuestos a trauma durante la pandemia COVID-19 – hallazgos de un estudio paneuropeo

Background: The COVID-19 pandemic is a health emergency resulting in multiple stressors that may be related to posttraumatic stress disorder (PTSD). Objective: This study examined relationships between risk and protective factors, pandemic-related stressors, and PTSD during the COVID-19 pandemic. Methods: Data from the European Society of Traumatic Stress Studies (ESTSS) ADJUST Study were used. N = 4,607 trauma-exposed participants aged 18 years and above were recruited from the general populations of eleven countries (Austria, Croatia, Georgia, Germany, Greece, Italy, Lithuania, the Netherlands, Poland, Portugal, and Sweden) from June to November 2020. We assessed sociodemographic (e.g. gender), pandemic-related (e.g. news consumption), and health-related (e.g. general health condition) risk and protective factors, pandemic-related stressors (e.g. fear of infection), and probable PTSD (PC-PTSD-5). The relationships between these variables were examined using logistic regression on multiple imputed data sets. Results: The prevalence of probable PTSD was 17.7%. Factors associated with an increased risk for PTSD were younger age, female gender, more than 3 h of daily pandemic-related news consumption (vs. no consumption), a satisfactory, poor, or very poor health condition (vs. a very good condition), a current or previous diagnosis of a mental disorder, and trauma exposure during the COVID-19 pandemic. Factors associated with a reduced risk for PTSD included a medium and high income (vs. very low income), face-to-face contact less than once a week or 3–7 times a week (vs. no contact), and digital social contact less than once a week or 1–7 days a week (vs. no contact). Pandemic-related stressors associated with an increased risk for PTSD included governmental crisis management and communication, restricted resources, restricted social contact, and difficult housing conditions. Conclusion: We identified risk and protective factors as well as stressors that may help identify trauma-exposed individuals at risk for PTSD, enabling more efficient and rapid access to care.Antecedentes: La pandemia COVID-19 es una emergencia sanitaria que genera múltiples estresores que pueden estar relacionados con el trastorno de estrés postraumático (TEPT). Objetivo: Este estudio examinó las relaciones entre los factores de riesgo y protectores, estresores relacionados con la pandemia y TEPT durante la pandemia de COVID-19. Métodos: Se utilizaron los datos del estudio ADJUST de la Sociedad Europea de Estudios de Estrés Traumático (ESTSS por sus siglas en ingles). N=4.607 participantes mayores de 18 años expuestos a trauma fueron reclutados de la población general de once países (Austria, Croacia, Georgia, Alemania, Grecia, Italia, Lituania, Países Bajos, Polonia, Portugal y Suecia) desde junio a noviembre 2020. Evaluamos factores de riesgo y protectores sociodemográficos (p.ej. género), relacionados con la pandemia (p.ej. consumo de noticias) y relacionados con la salud (p.ej. estado de salud general), estresores relacionados con la pandemia (p.ej. temor a la infección) y TEPT probable (PC-PTSD-5 por sus siglas en ingles). Las relaciones entre estas variables se examinaron mediante regresión logística en múltiples conjuntos de datos imputados. Resultados: La prevalencia de TEPT probable fue del 17.7%. Los factores asociados con un mayor riesgo de TEPT fueron edad más joven, sexo femenino, más de 3 horas de consumo diario de noticias relacionadas con la pandemia (frente a ningún consumo), un estado de salud satisfactorio, malo o muy malo (frente a un estado muy bueno), un diagnóstico de trastorno mental actual o previo y exposición a un trauma durante la pandemia de COVID-19. Los factores asociados con un riesgo reducido de TEPT incluyeron ingresos medios y altos (frente a ingresos muy bajos), contacto cara a cara menos de una vez a la semana o de 3 a 7 veces por semana (frente a ningún contacto) y contacto social digital menos de una vez a la semana o de 1 a 7 días a la semana (frente a ningún contacto). Los estresores relacionados con la pandemia asociados con un mayor riesgo de TEPT incluyeron la gestión y comunicación de crisis gubernamental, recursos restringidos, contacto social restringido y condiciones de vivienda difíciles. Conclusiones: Identificamos factores de riesgo y protectores, así como estresores que pueden ayudar a identificar a las personas expuestas a traumas en riesgo de TEPT, lo que permite un acceso más eficiente y rápido a la atención

Trauma-informed responses in addressing public mental health consequences of the COVID-19 pandemic: position paper of the European Society for Traumatic Stress Studies (ESTSS)

The COVID-19 pandemic has changed life in Europe and globally. The pandemic affects both individuals and the broader society across many domains, including physical and psychological health, the economy and general welfare. The measures taken to counteract the pandemic have significantly altered daily life and, along with the threat of contracting the coronavirus and uncertainties surrounding future developments, created a complex system of stressors with a negative impact on public mental health. This paper aims to outline the ESTSS strategy to address mental health issues related to COVID-19 and focuses on (1) trauma-informed policies, (2) capacity building, (3) collaborative research and (4) knowledge-exchange. To facilitate implementation of a trauma-informed approach and appropriate measures, ESTSS has developed a toolkit of recommendations on mental health and psychosocial assistance to be provided during the different phases of crisis and its aftermath. To promote capacity building, ESTSS offers a certification programme based on a curriculum in psychotraumatology and corresponding on-line training to the European community of mental health professionals. To assure evidence-based approaches and methods tailored to current circumstances, ESTSS has initiated a pan-European research project with international cooperation aimed at studying the mental health consequences of the pandemic, with a focus on psychological trauma and other stress-related reactions. To foster knowledge-exchange, the European Journal of Psychotraumatology (EJPT), the official journal of ESTSS, is publishing a special issue on COVID-19

University Students' Life Stressors and Mental Health in Georgia and German-Speaking Switzerland

Background: The university years are associated with a variety of stressors, and recently, COVID-19 has presented an additional burden on students’ mental well-being. As mental health manifestations of stressors may differ between countries, this study compared students from Switzerland and the Republic of Georgia regarding the burden of stressors and the role of potentially culture-dependent risk and protective factors of mental health (i.e., help-seeking, cross-cultural coping, fatalism, sense of coherence). Method: We assessed two samples of university students in Georgia ( N = 425) and German-speaking Switzerland ( N = 298), using a cross-sectional design. Quantitative data were collected with online questionnaires during the third wave of the pandemic. Mental health screenings included measures of depression, anxiety, and adjustment disorder. Results: General life- and COVID-19-related stress levels were higher in Georgia than in Switzerland. Georgian students experienced more adjustment disorder symptoms but lower levels of depression and anxiety. While Swiss students reported more protective factors (formal and informal help-seeking, sense of coherence), Georgian students experienced more risk factors (fatalism and avoidance coping). Despite significant correlations between potentially culture-dependent risk and protective factors and mental health, few associations remained significant above and beyond the impact of general life stress. Conclusions: The high prevalence of stressors and adjustment disorder symptoms and risk factors for mental health among Georgian students illustrates a potential need for psychosocial support with stress management. The cross-cultural applicability of Western models of student mental health services should be evaluated