Results of the COVID-19 mental health international for the general population (COMET-G) study.

INTRODUCTION: There are few published empirical data on the effects of COVID-19 on mental health, and until now, there is no large international study. MATERIAL AND METHODS: During the COVID-19 pandemic, an online questionnaire gathered data from 55,589 participants from 40 countries (64.85% females aged 35.80 ± 13.61; 34.05% males aged 34.90±13.29 and 1.10% other aged 31.64±13.15). Distress and probable depression were identified with the use of a previously developed cut-off and algorithm respectively. STATISTICAL ANALYSIS: Descriptive statistics were calculated. Chi-square tests, multiple forward stepwise linear regression analyses and Factorial Analysis of Variance (ANOVA) tested relations among variables. RESULTS: Probable depression was detected in 17.80% and distress in 16.71%. A significant percentage reported a deterioration in mental state, family dynamics and everyday lifestyle. Persons with a history of mental disorders had higher rates of current depression (31.82% vs. 13.07%). At least half of participants were accepting (at least to a moderate degree) a non-bizarre conspiracy. The highest Relative Risk (RR) to develop depression was associated with history of Bipolar disorder and self-harm/attempts (RR = 5.88). Suicidality was not increased in persons without a history of any mental disorder. Based on these results a model was developed. CONCLUSIONS: The final model revealed multiple vulnerabilities and an interplay leading from simple anxiety to probable depression and suicidality through distress. This could be of practical utility since many of these factors are modifiable. Future research and interventions should specifically focus on them

Validitas Isi Alat Ukur Burnout Staf Pengajar Fakultas Kedokteran di Indonesia

Staf pengajar kedokteran memiliki tugas dalam pendidikan, penelitian, dan pengabdian kepada masyarakat atau pelayanan kesehatan yang dapat memberikan risiko burnout. Burnout dapat dinilai menggunakan alat ukur seperti Maslach Burnout Inventory Educator Survey (MBI-ES). Penelitian ini bertujuan untuk menilai kesesuaian konten alat ukur MBI-ES untuk mengetahui burnout staf pengajar kedokteran di Indonesia. Penelitian dilaksanakan di Fakultas Kedokteran Universitas Indonesia pada bulan Februari – Mei 2018. Metode potong lintang dengan pendekatan kualitatif dilakukan melalui 2 tahap, yaitu tahap focus group discussion (FGD) terhadap 17 staf pengajar kedokteran dan tahap kajian dari 24 panel ahli. Analisis tematik data transkripsi verbatim FGD menghasilkan 3 tema utama: tugas dan tanggung jawab staf pengajar, pemahaman burnout, dan MBI-ES modifikasi. Tahap telaah oleh panel ahli menganalisis butir pernyataan MBI-ES modifikasi berdasarkan kesepakatan ≥ 80% panel ahli. Kesepakatan meliputi 3 kategori penilaian. Kategori I adalah butir pernyataan MBI-ES modifikasi yang diterima, kategori II butir yang memerlukan perbaikan bahasa dan redaksional, dan kategori III adalah butir yang dieksklusi karena tidak memiliki konteks burnout yang relevan dengan staf pengajar kedokteran. Disimpulkan bahwa MBI-ES belum dapat menggambarkan burnout yang terjadi pada staf pengajar kedokteran di Indonesia. Penelitian selanjutnya perlu difokuskan pada evaluasi validasi konstruk, proses respons, dan validasi konkuren. Content Validity of Burnout Measurement of Medical Teacher in Indonesia Medical teachers have important tasks in teaching, research, and community services/patient care which can be very demanding and might risk them from experiencing burnout. Burnout can be assessed using tools such as Maslach Burnout Inventory Educator Survey (MBI-ES). This study aimed to assess content validity of MBI-ES with the context of burnout in medical education. The study was conducted in Faculty of Medicine Universitas Indonesia in February-May 2018. The cross-sectional design using qualitative approach was carried out through two stages. First, Focus Group Discussion (FGD) with 17 medical teaching staff, and second, expert panel review with 24 experts. Thematic analysis of the verbatim transcription of the FGD resulted in 3 main themes: duties and responsibilities of teaching staff, understanding of burnout, and modified MBI-ES. Analysis of the modified MBI-ES items during expert panel stage was carried out based on an agreement of ≥80% of expert panels. The agreement covers 3 categories: category I is MBI-ES accepted items, category II is accepted items with required language improvement, and category III is excluded items due to irrelevance with burnout among medical teachers. In conclusion, MBI-ES is not yet able to represent burnout in medical teaching staff in Indonesia. Future research will focus on evaluating construct validity, response processes, and concurrent validity if neede

Validitas Isi Alat Ukur Burnout Staf Pengajar Fakultas Kedokteran di Indonesia

Staf pengajar kedokteran memiliki tugas dalam pendidikan, penelitian, dan pengabdian kepada masyarakat atau pelayanan kesehatan yang dapat memberikan risiko burnout. Burnout dapat dinilai menggunakan alat ukur seperti Maslach Burnout Inventory Educator Survey (MBI-ES). Penelitian ini bertujuan untuk menilai kesesuaian konten alat ukur MBI-ES untuk mengetahui burnout staf pengajar kedokteran di Indonesia. Penelitian dilaksanakan di Fakultas Kedokteran Universitas Indonesia pada bulan Februari – Mei 2018. Metode potong lintang dengan pendekatan kualitatif dilakukan melalui 2 tahap, yaitu tahap focus group discussion (FGD) terhadap 17 staf pengajar kedokteran dan tahap kajian dari 24 panel ahli. Analisis tematik data transkripsi verbatim FGD menghasilkan 3 tema utama: tugas dan tanggung jawab staf pengajar, pemahaman burnout, dan MBI-ES modifikasi. Tahap telaah oleh panel ahli menganalisis butir pernyataan MBI-ES modifikasi berdasarkan kesepakatan ≥ 80% panel ahli. Kesepakatan meliputi 3 kategori penilaian. Kategori I adalah butir pernyataan MBI-ES modifikasi yang diterima, kategori II butir yang memerlukan perbaikan bahasa dan redaksional, dan kategori III adalah butir yang dieksklusi karena tidak memiliki konteks burnout yang relevan dengan staf pengajar kedokteran. Disimpulkan bahwa MBI-ES belum dapat menggambarkan burnout yang terjadi pada staf pengajar kedokteran di Indonesia. Penelitian selanjutnya perlu difokuskan pada evaluasi validasi konstruk, proses respons, dan validasi konkuren. Content Validity of Burnout Measurement of Medical Teacher in Indonesia Medical teachers have important tasks in teaching, research, and community services/patient care which can be very demanding and might risk them from experiencing burnout. Burnout can be assessed using tools such as Maslach Burnout Inventory Educator Survey (MBI-ES). This study aimed to assess content validity of MBI-ES with the context of burnout in medical education. The study was conducted in Faculty of Medicine Universitas Indonesia in February-May 2018. The cross-sectional design using qualitative approach was carried out through two stages. First, Focus Group Discussion (FGD) with 17 medical teaching staff, and second, expert panel review with 24 experts. Thematic analysis of the verbatim transcription of the FGD resulted in 3 main themes: duties and responsibilities of teaching staff, understanding of burnout, and modified MBI-ES. Analysis of the modified MBI-ES items during expert panel stage was carried out based on an agreement of ≥80% of expert panels. The agreement covers 3 categories: category I is MBI-ES accepted items, category II is accepted items with required language improvement, and category III is excluded items due to irrelevance with burnout among medical teachers. In conclusion, MBI-ES is not yet able to represent burnout in medical teaching staff in Indonesia. Future research will focus on evaluating construct validity, response processes, and concurrent validity if neede

Burnout and coping strategies among resident physicians at an Indonesian tertiary referral hospital during COVID-19 pandemic.

BackgroundThe COVID-19 pandemic has increased the burden on resident physicians. They may use different coping strategies to manage those burdens, which partly determine their mental health outcomes, including burnout syndrome. This study explores the relationship between coping strategies and burnout among resident physicians during the COVID-19 pandemic in an Indonesian tertiary referral hospital.MethodsThis online cross-sectional study was conducted from June to August 2020, involving nine residency programs in the Faculty of Medicine Universitas Indonesia-Cipto Mangunkusumo Hospital. Burnout syndrome was assessed using Maslach Burnout Inventory, while Brief COPE measured coping strategies.ResultsA total of 388 residents participated in this study. High emotional exhaustion (EE), depersonalization (DP), and low personal accomplishment (PA) were found in 15.5%, 5.2%, and 39.2%, respectively. Residents more often use adaptive than maladaptive coping strategies. Higher PA was correlated to residents using problem-focused (r = 0.299; p ConclusionThe use of dysfunctional coping strategies is linked to higher emotional exhaustion and depersonalization aspect of burnout. However, a higher sense of personal accomplishment is linked to problem-focused and emotion-focused strategies. Appropriate identification and intervention of residents with dysfunctional coping strategies may be beneficial in reducing burnout risk

Social factors influence on anxiety, depression level and psychological trauma of obstetrics and gynecology residents during COVID-19 pandemic

Background and aim: The novel coronavirus disease 2019 (COVID-19) has enforced obstetrics and gynecology (ObGyn) residency training process to undergo wide changes including lessons modifications, yet their mental health were not evaluated. Hence, this study aimed to evaluate the influence of social factors on anxiety, depression level, and psychological trauma of ObGyn residents during the COVID-19 pandemic as well as the impact of COVID-19 to residency training program. Methods: A cross-sectional study was conducted in three institutions in Indonesia: the University of Indonesia, the University of Lambung Mangkurat, and the University of Syiah Kuala. A total of 169 ObGyn residents agreed to participate and were enrolled in this study. Results: Total 169 residents were eligible with a mean age of 26–42 years. 76.9% of the residents were exposed to COVID-19 patients during clinical rotation. Approximately half of them (52.6%) thought COVID-19 has brought negative effects. Long-distance learning was considered of good quality by 40.2% of participants. The majority experienced enough resting periods, nearly half of them (45.5%) were concerned about the impact of being a less competent specialist. Conclusion: Overall, no significant statistical relationship were revealed between social factors and depression, anxiety and psychological trauma in ObGyn residents during COVID-19 pandemic

Association of rs1344706 in the ZNF804A gene with schizophrenia in a case/control sample from Indonesia

Background: Association of rs1344706 in the ZNF804A gene (2q32.1) with schizophrenia was first reported in a genome wide scan conducted in a sample of 479 cases and replicated in 6666 cases. Subsequently, evidence by replication was obtained in several samples with European- and Asian ancestral background. Methods: We report ascertainment, clinical characterization, quality control, and determination of ancestral background of a case control sample from Indonesia, comprising 1067 cases and 1111 ancestry matched controls. Genotyping was performed using a fluorescence-based allelic discrimination assay (TaqMan SNP genotyping assay) and a newly designed PCR-RFLP assay for confirmation of rs1344706 genotypes. Results: We confirmed association of the T-allele of rs1344706 with schizophrenia in a newly ascertained sample from Indonesia with Southeast Asian ancestral background (P = 0.019, OR = 1.155, 95%, CI 1.025-1.301). In addition, we studied several SNPs in the vicinity of rs1344706, for which nominally significant results had been reported. None of the association P values of the additional SNPs exceeded that of rs1344706. Conclusion: We provide additional evidence for association of the ZNF804A gene with schizophrenia. We conclude that rs1344706 or a yet unknown polymorphism in linkage disequilibrium is also involved in conferring susceptibility to schizophrenia in samples with different (Asian) ancestral backgrounds

The effect of different degrees of lockdown and self-identified gender on anxiety, depression and suicidality during the COVID-19 pandemic: Data from the international COMET-G study.

INTRODUCTION: During the COVID-19 pandemic various degrees of lockdown were applied by countries around the world. It is considered that such measures have an adverse effect on mental health but the relationship of measure intensity with the mental health effect has not been thoroughly studied. Here we report data from the larger COMET-G study pertaining to this question. MATERIAL AND METHODS: During the COVID-19 pandemic, data were gathered with an online questionnaire from 55,589 participants from 40 countries (64.85% females aged 35.80 ± 13.61; 34.05% males aged 34.90±13.29 and 1.10% other aged 31.64±13.15). Anxiety was measured with the STAI, depression with the CES-D and suicidality with the RASS. Distress and probable depression were identified with the use of a previously developed cut-off and algorithm respectively. STATISTICAL ANALYSIS: It included the calculation of Relative Risk (RR), Factorial ANOVA and Multiple backwards stepwise linear regression analysis RESULTS: Approximately two-thirds were currently living under significant restrictions due to lockdown. For both males and females the risk to develop clinical depression correlated significantly with each and every level of increasing lockdown degree (RR 1.72 and 1.90 respectively). The combined lockdown and psychiatric history increased RR to 6.88 The overall relationship of lockdown with severity of depression, though significant was small. CONCLUSIONS: The current study is the first which reports an almost linear relationship between lockdown degree and effect in mental health. Our findings, support previous suggestions concerning the need for a proactive targeted intervention to protect mental health more specifically in vulnerable groups

Results of the COVID-19 mental health international for the health professionals (COMET-HP) study: depression, suicidal tendencies and conspiracism.

INTRODUCTION: The current study aimed to investigate the rates of anxiety, clinical depression, and suicidality and their changes in health professionals during the COVID-19 outbreak. MATERIALS AND METHODS: The data came from the larger COMET-G study. The study sample includes 12,792 health professionals from 40 countries (62.40% women aged 39.76 ± 11.70; 36.81% men aged 35.91 ± 11.00 and 0.78% non-binary gender aged 35.15 ± 13.03). Distress and clinical depression were identified with the use of a previously developed cut-off and algorithm, respectively. STATISTICAL ANALYSIS: Descriptive statistics were calculated. Chi-square tests, multiple forward stepwise linear regression analyses, and Factorial Analysis of Variance (ANOVA) tested relations among variables. RESULTS: Clinical depression was detected in 13.16% with male doctors and 'non-binary genders' having the lowest rates (7.89 and 5.88% respectively) and 'non-binary gender' nurses and administrative staff had the highest (37.50%); distress was present in 15.19%. A significant percentage reported a deterioration in mental state, family dynamics, and everyday lifestyle. Persons with a history of mental disorders had higher rates of current depression (24.64% vs. 9.62%; p < 0.0001). Suicidal tendencies were at least doubled in terms of RASS scores. Approximately one-third of participants were accepting (at least to a moderate degree) a non-bizarre conspiracy. The highest Relative Risk (RR) to develop clinical depression was associated with a history of Bipolar disorder (RR = 4.23). CONCLUSIONS: The current study reported findings in health care professionals similar in magnitude and quality to those reported earlier in the general population although rates of clinical depression, suicidal tendencies, and adherence to conspiracy theories were much lower. However, the general model of factors interplay seems to be the same and this could be of practical utility since many of these factors are modifiable

Results of the COVID-19 mental health international for the health professionals (COMET-HP) study : depression, suicidal tendencies and conspiracism

Publisher Copyright: © 2023, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.Introduction: The current study aimed to investigate the rates of anxiety, clinical depression, and suicidality and their changes in health professionals during the COVID-19 outbreak. Materials and methods: The data came from the larger COMET-G study. The study sample includes 12,792 health professionals from 40 countries (62.40% women aged 39.76 ± 11.70; 36.81% men aged 35.91 ± 11.00 and 0.78% non-binary gender aged 35.15 ± 13.03). Distress and clinical depression were identified with the use of a previously developed cut-off and algorithm, respectively. Statistical analysis: Descriptive statistics were calculated. Chi-square tests, multiple forward stepwise linear regression analyses, and Factorial Analysis of Variance (ANOVA) tested relations among variables. Results: Clinical depression was detected in 13.16% with male doctors and ‘non-binary genders’ having the lowest rates (7.89 and 5.88% respectively) and ‘non-binary gender’ nurses and administrative staff had the highest (37.50%); distress was present in 15.19%. A significant percentage reported a deterioration in mental state, family dynamics, and everyday lifestyle. Persons with a history of mental disorders had higher rates of current depression (24.64% vs. 9.62%; p < 0.0001). Suicidal tendencies were at least doubled in terms of RASS scores. Approximately one-third of participants were accepting (at least to a moderate degree) a non-bizarre conspiracy. The highest Relative Risk (RR) to develop clinical depression was associated with a history of Bipolar disorder (RR = 4.23). Conclusions: The current study reported findings in health care professionals similar in magnitude and quality to those reported earlier in the general population although rates of clinical depression, suicidal tendencies, and adherence to conspiracy theories were much lower. However, the general model of factors interplay seems to be the same and this could be of practical utility since many of these factors are modifiable.Peer reviewe

Somatic multicomorbidity and disability in patients with psychiatric disorders in comparison to the general population : a quasi-epidemiological investigation in 54,826 subjects from 40 countries (COMET-G study)

Background The prevalence of medical illnesses is high among patients with psychiatric disorders. The current study aimed to investigate multi-comorbidity in patients with psychiatric disorders in comparison to the general population. Secondary aims were to investigate factors associated with metabolic syndrome and treatment appropriateness of mental disorders. Methods The sample included 54,826 subjects (64.73% females; 34.15% males; 1.11% nonbinary gender) from 40 countries (COMET-G study). The analysis was based on the registration of previous history that could serve as a fair approximation for the lifetime prevalence of various medical conditions. Results About 24.5% reported a history of somatic and 26.14% of mental disorders. Mental disorders were by far the most prevalent group of medical conditions. Comorbidity of any somatic with any mental disorder was reported by 8.21%. One-third to almost two-thirds of somatic patients were also suffering from a mental disorder depending on the severity and multicomorbidity. Bipolar and psychotic patients and to a lesser extent depressives, manifested an earlier (15–20 years) manifestation of somatic multicomorbidity, severe disability, and probably earlier death. The overwhelming majority of patients with mental disorders were not receiving treatment or were being treated in a way that was not recommended. Antipsychotics and antidepressants were not related to the development of metabolic syndrome. Conclusions The finding that one-third to almost two-thirds of somatic patients also suffered from a mental disorder strongly suggests that psychiatry is the field with the most trans-specialty and interdisciplinary value and application points to the importance of teaching psychiatry and mental health in medical schools and also to the need for more technocratically oriented training of psychiatric residents