Registered psychiatric service use, self-harm and suicides of children and young people aged 0-24 before and during the COVID-19 pandemic : a systematic review

Background The COVID-19 pandemic has impacted on psychiatric symptoms of children and young people, but many psychiatric services have been disrupted. It is unclear how service use, self-harm and suicide has changed since the pandemic started. To gain timely information, this systematic review focused on studies based on administrative data that compared psychiatric service use, self-harm and suicide before and during the pandemic among children and young people. Methods and finding A systematic review of studies published in English from 1 January 2020 to 22 March 2021 was conducted, using the Web of Science, PubMed, Embase and PsycINFO databases. Increases or reductions in service use were calculated and compared using percentages. Of the 2,676 papers retrieved, 18 were eligible for the review and they provided data from 19 countries and regions. Most studies assessed changes during the early phase of the COVID-19 pandemic, from March to July 2020, and three assessed the changes until October 2020. Fifteen studies reported a total of 21 service use outcomes that were quantitively examined. More than three-quarters of the 21 outcomes (81%) fell by 5-80% (mean reduction = 27.9%, SD = 35%). Ten of the 20 outcomes for psychiatric emergency department (ED) services reduced by 5% to 80% (mean = 40.1%, SD = 34.9%) during the pandemic. Reductions in service use were also recorded for ED visits due to suicide ideation and self-harm, referrals to secondary mental health services, psychiatric inpatient unit admissions and patients receiving treatment for eating disorders. However, there were also some increases. Suicide rate and the number of ED visits due to suicide attempts have increased, and there was an increase in the number of treatment sessions in a service that provided telemedicine. Conclusion Most of the studies showed reductions in the use of psychiatric services by children and young people during the early phase of the pandemic and this highlighted potential delays or unmet needs. Suicide rate has increased during the second wave of the pandemic. Further studies are needed to assess the pattern of service use in the later phases of the COVID-19 pandemic.Peer reviewe

Associations of subjective and objective cognitive functioning after COVID-19 : A six-month follow-up of ICU, ward, and home-isolated patients

Publisher Copyright: © 2023 The AuthorsBackground: Subjective and objective cognitive dysfunction are reported after COVID-19 but with limited data on their congruence and associations with the severity of the acute disease. The aim of this cohort study is to describe the prevalence of subjective and objective cognitive dysfunction at three and six months after COVID-19 and the associations of subjective cognitive symptoms and psychological and disease-related factors. Methods: We assessed a cohort of 184 patients at three and six months after COVID-19: 82 patients admitted to the Intensive Care Unit (ICU), 53 admitted to regular hospital wards, and 49 isolated at home. A non-COVID control group of 53 individuals was included. Demographic and clinical data were collected. Subjective cognitive symptoms, objective cognitive impairment, and depressive and post-traumatic stress disorder (PTSD) symptoms were assessed. Results: At six months, subjective cognitive impairment was reported by 32.3% of ICU-treated, 37.3% of ward-treated, and 33.3% of home-isolated patients and objective cognitive impairment was observed in 36.1% of ICU-treated, 34.7% of ward-treated, and 8.9% of home-isolated patients. Subjective cognitive symptoms were associated with depressive and PTSD symptoms and female sex, but not with objective cognitive assessment or hospital metrics. Conclusions: One-third of COVID-19 patients, regardless of the acute disease severity, reported high levels of subjective cognitive dysfunction which was not associated with results from objective cognitive screening but with psychological and demographic factors. Our study stresses the importance of thorough assessment of patients reporting long-term subjective symptoms, screening for underlying mental health related factors such as PTSD or depression.Peer reviewe

The advantages and limitations of digital games in children’s health promotion

Childhood is an important period for forming the foundation for future health and well-being, and there is need for new methods for these health promotion purposes. Digital games are promising methods that could cover the challenges current health promotion efforts are facing. Ethical acceptability is an essential aspect of health promotion methods and special attention needs to be paid when promoting the health of children. This and increased interest in digital games as health promotion methods highlight the need for discussing the limitations, in addition to reasoning the advantages of digital games in children’s health promotion, to advance ethically sustainable development and use of health games. The aim of this overview review is to summarize and discuss the advantages and limitations of digital games in children’s health promotion based on the previous literature.We conducted a systematic literature search from scientific databases, and supplemented the search with a manual search. In total 42 articles and other forms of literature were included to the content analysis. We found several advantages and limitations of digital games in children’s health promotion. The findings considered: 1) issues related to the implementation of health promotion using digital games (perspectives of the provider and the player), and 2) possible outcomes of digital games in children (perspectives of physical, psychological, cognitive, social and health behavior related outcomes).The found advantages give good reasons for the use of digital games in children’s health promotion. However, the developers, publishers and professionals should consider carefully also the limitations of digital games in children’s health promotion to support ethically sustainable development and use of health games in children. As the interest in health games and thereby the utilization of them increases, there is a need for guidelines for developers, publishers and professional who develop and recommend health games especially for children

A systematic review of the mental health changes of children and young people before and during the COVID-19 pandemic

There is increasing knowledge that the COVID-19 pandemic has had an impact on mental health of children and young people. However, the global evidence of mental health changes before compared to during the COVID-19 pandemic focusing on children and young people has not been systematically reviewed. This systematic review examined longitudinal and repeated cross-sectional studies comparing before and during COVID-19 pandemic data to determine whether the mental health of children and young people had changed before and during the COVID-19 pandemic. The Web of Science, PubMed, Embase and PsycINFO databases were searched to identify peer-reviewed studies that had been published in English and focused on children and young people between 0 and 24 years of age. This identified 21 studies from 11 countries, covering more than 96,000 subjects from 3 to 24 years of age. Pre-pandemic and pandemic data were compared. Most studies reported longitudinal deterioration in the mental health of adolescents and young people, with increased depression, anxiety and psychological distress after the pandemic started. Other findings included deteriorated negative affect, mental well-being and increased loneliness. Comparing data for pandemic and pre-pandemic periods showed that the COVID-19 pandemic may negatively impact the mental health of children and young people. There is an urgent need for high-quality research to address the impact, risks and protective factors of the pandemic on their mental health, as this will provide a good foundation for dealing with future health emergencies and other crises

Registered psychiatric service use, self-harm and suicides of children and young people aged 0–24 before and during the COVID-19 pandemic: a systematic review

BackgroundThe COVID-19 pandemic has impacted on psychiatric symptoms of children and young people, but many psychiatric services have been disrupted. It is unclear how service use, self-harm and suicide has changed since the pandemic started. To gain timely information, this systematic review focused on studies based on administrative data that compared psychiatric service use, self-harm and suicide before and during the pandemic among children and young people.Methods and findingA systematic review of studies published in English from 1 January 2020 to 22 March 2021 was conducted, using the Web of Science, PubMed, Embase and PsycINFO databases. Increases or reductions in service use were calculated and compared using percentages. Of the 2,676 papers retrieved, 18 were eligible for the review and they provided data from 19 countries and regions. Most studies assessed changes during the early phase of the COVID-19 pandemic, from March to July 2020, and three assessed the changes until October 2020. Fifteen studies reported a total of 21 service use outcomes that were quantitively examined. More than three-quarters of the 21 outcomes (81%) fell by 5–80% (mean reduction = 27.9%, SD = 35%). Ten of the 20 outcomes for psychiatric emergency department (ED) services reduced by 5% to 80% (mean = 40.1%, SD = 34.9%) during the pandemic. Reductions in service use were also recorded for ED visits due to suicide ideation and self-harm, referrals to secondary mental health services, psychiatric inpatient unit admissions and patients receiving treatment for eating disorders. However, there were also some increases. Suicide rate and the number of ED visits due to suicide attempts have increased, and there was an increase in the number of treatment sessions in a service that provided telemedicine.ConclusionMost of the studies showed reductions in the use of psychiatric services by children and young people during the early phase of the pandemic and this highlighted potential delays or unmet needs. Suicide rate has increased during the second wave of the pandemic. Further studies are needed to assess the pattern of service use in the later phases of the COVID-19 pandemic.</p

The neuropsychological effects of COVID-19 three and six months after the acute phase from a self-reported symptoms and cognitive screening perspective

Tavoitteet: Koronavirustauti COVID-19 aiheuttaa osalla tautiin sairastuneista potilaista neuropsykologisia ongelmia sairastumista seuraavien kuukausien aikana ja pidemmällä aikavälillä. Toistaiseksi on kertynyt vähän tietoa siitä, miten akuuttivaiheen edellyttämä hoidon taso (teho-osastohoito, vuodeosastohoito, kotihoito) vaikuttaa neuropsykologisten oireiden esiintymiseen ja ajalliseen muutokseen. Tämän tutkimuksen tavoitteena oli kartoittaa COVID-19-taudin neuropsykologisia vaikutuksia potilaan itseraportoitujen oireiden sekä kognitiivisen seulonnan näkökulmasta. Työssä tarkastellaan akuuttivaiheen edellyttämän hoidon tason ja sairastumisesta kuluneen ajan vaikutusta itseraportoituihin oireisiin sekä kognitiivisen seulonnan tuloksiin kolme ja kuusi kuukautta akuuttivaiheen jälkeen. Lisäksi tavoitteena oli havainnollistaa näiden arvioiden välistä yhteyttä. Menetelmät: Aineisto kerättiin HUS:n ja HY:n RECOVID-20-projektin yhteydessä. Tutkittavat (N = 164, joista 96 naista, keski-ikä 54.1 vuotta) sairastivat COVID-19-taudin keväällä 2020. Aineistoa kerättiin kolmelta eri akuuttivaiheen edellyttämältä hoidon tasolta: tehohoitopotilailta, vuodeosastopotilailta ja kotona sairastaneilta potilailta. Tutkittavien itseraportoituja oireita kartoitettiin A-B Neuropsychological Assessment Schedule -kyselyllä (ABNAS) ja kognitiivista suoriutumista mitattiin Montreal Cognitive Assessment-Blind -seulontamenetelmällä (MoCA-B) kolme ja kuusi kuukautta akuuttivaiheen jälkeen. Ryhmäeroja ja ajallista muutosta tutkittiin monimuuttujavarianssianalyyseillä ja lineaarisilla sekamalleilla. Tulokset ja johtopäätökset: Noin joka kolmas potilas raportoi neuropsykologisia oireita riippumatta akuuttivaiheen edellyttämän hoidon tasosta sekä kolme että kuusi kuukautta akuuttivaiheen jälkeen. Oireilu painottui väsyvyyteen, hidastumiseen ja keskittymisongelmiin. Kognitiivisessa seulonnassa teho- ja vuodeosastolla hoidetut potilaat suoriutuivat heikommin kotona sairastaneisiin verrattuna, mutta kun ikä vakioitiin, tilastollisesti merkitsevää vaikutusta ei ilmennyt. Itseraportoitujen oireiden määrä oli tilastollisesti merkitsevästi yhteydessä kognitiiviseen suoriutumiseen ainoastaan tehohoitopotilailla kolme kuukautta akuuttivaiheen jälkeen. Vaikka valtaosalla COVID-19-potilaista ei ole merkittäviä neuropsykologisia oireita, on myös potilaita, joilla on viitteellisiä merkkejä pitkittyvästä oirekuvasta sekä itseraportoitujen oireiden että kognitiivisen seulonnan perusteella. Lisää tutkimusta tarvitaan näiden oireiden syiden kartoittamiseksi.Objective: The coronavirus disease COVID-19 causes neuropsychological problems to a proportion of patients having contracted the illness in the months following the illness and on a more long-term basis. Currently there is little knowledge about how the required level of care in the acute phase affects the presence of symptoms and their change over time. The objective of this study was to investigate the neuropsychological effects of COVID-19 from a patient self-reported symptoms and cognitive screening perspective. The study examines the effects of the required level of care in the acute phase and time since contracting the illness on self-reported symptoms and cognitive screening results three and six months after the acute phase. Furthermore, the aim was to illustrate the relationship between these two assessments. Methods: The data was collected within the RECOVID-20 project (Helsinki and Uusimaa Hospital District and University of Helsinki). Subjects (N = 164, of which 96 women, mean age 54.1 years) contracted COVID-19 in the spring of 2020. The data was collected from three different levels of care as required by the acute phase: intensive care unit patients, regular inpatient wards and patients who were ill at home. Self-reported symptoms were assessed with the A-B Neuropsychological Assessment Schedule and cognitive performance was measured by the Montreal Cognitive Assessment-Blind screening tool three and six months after the acute phase. Group differences and change over time was analysed using multivariate variance analyses and linear mixed models. Results and conclusions: About a third of all patients reported neuropsychological symptoms regardless of the level of care required in the acute phase both three and six months after the acute phase. Symptoms consisted mainly of fatigue, slowing and concentration problems. In the cognitive screening patients having received ICU and inpatient ward care performed worse compared to patients having been ill at home, but a statistically significant result was not detected when controlling for age. A statistically significant relationship between self-reported symptoms and cognitive performance was observed only in ICU patients at three months. Although the majority of COVID-19 patients do not have significant symptoms after the acute phase, there are patients that show preliminary signs of more chronic symptoms based on both self-reported symptoms and cognitive screening. More research is needed to investigate the causes of these symptoms

Using consumption and reward simulations to increase the appeal of plant-based foods

The production of meat is a main contributor to current dangerous levels of greenhouse gas emissions. However, the shift to more plant-based diets is hampered by consumers finding meat-based foods more attractive than plant-based foods. How can plant-based foods best be described to increase their appeal to consumers? Based on the grounded cognition theory of desire, we suggest that descriptions that trigger simulations, or re-experiences, of eating and enjoying a food will increase the attractiveness of a food, compared to descriptions emphasizing ingredients. In Study 1, we first examined the descriptions of ready meals available in four large UK supermarkets (N = 240). We found that the labels of meat-based foods contained more references to eating simulations than vegetarian foods, and slightly more than plant-based foods, and that this varied between supermarkets. In Studies 2 and 3 (N = 170, N = 166, pre-registered), we manipulated the labels of plant-based and meat-based foods to either include eating simulation words or not. We assessed the degree to which participants reported that the description made them think about eating the food (i.e., induced eating simulations), and how attractive they found the food. In Study 2, where either sensory or eating context words were added, we found no differences with control labels. In Study 3, however, where simulation-based labels included sensory, context, and hedonic words, we found that simulation-based descriptions increased eating simulations and attractiveness. Moreover, frequent meat eaters found plant-based foods less attractive, but this was attenuated when plant-based foods were described with simulation-inducing words. We suggest that language that describes rewarding eating experiences can be used to facilitate the shift toward healthy and sustainable diets.Peer reviewe

Using consumption and reward simulations to increase the appeal of plant-based foods

The production of meat is a main contributor to current dangerous levels of greenhouse gas emissions. However, the shift to more plant-based diets is hampered by consumers finding meat-based foods more attractive than plant-based foods. How can plant-based foods best be described to increase their appeal to consumers? Based on the grounded cognition theory of desire, we suggest that descriptions that trigger simulations, or re-experiences, of eating and enjoying a food will increase the attractiveness of a food, compared to descriptions emphasising ingredients. In Study 1, we first examined the descriptions of ready meals available in four large UK supermarkets (N = 240). We found that the labels of meat-based foods contained more references to eating simulations than vegetarian foods, and slightly more than plant-based foods, and that this varied between supermarkets. In Studies 2 and 3 (N =170, N = 166, pre-registered), we manipulated the labels of plant-based and meat-based foods to either include eating simulation words or not. We assessed the degree to which participants reported that the description made them think about eating the food (i.e., induced eating simulations), and how attractive they found the food or whether they would order it. In Study 2, where either sensory or eating context words were added, we found no differences with neutral control labels. In Study 3, however, where simulation-based labels included sensory, context, and hedonic words, we found that simulation-based descriptions increased eating simulations and attractiveness. Moreover, frequent meat eaters found plant-based foods less attractive, but this was attenuated when plant-based foods were described with simulation-inducing words. We suggest that language that describes rewarding eating experiences can be used to facilitate the shift toward healthy and sustainable diets

A systematic review of the mental health changes of children and young people before and during the COVID-19 pandemic

There is increasing knowledge that the COVID-19 pandemic has had an impact on mental health of children and young people. However, the global evidence of mental health changes before compared to during the COVID-19 pandemic focusing on children and young people has not been systematically reviewed. This systematic review examined longitudinal and repeated cross-sectional studies comparing before and during COVID-19 pandemic data to determine whether the mental health of children and young people had changed before and during the COVID-19 pandemic. The Web of Science, PubMed, Embase and PsycINFO databases were searched to identify peer-reviewed studies that had been published in English and focused on children and young people between 0 and 24 years of age. This identified 21 studies from 11 countries, covering more than 96,000 subjects from 3 to 24 years of age. Pre-pandemic and pandemic data were compared. Most studies reported longitudinal deterioration in the mental health of adolescents and young people, with increased depression, anxiety and psychological distress after the pandemic started. Other findings included deteriorated negative affect, mental well-being and increased loneliness. Comparing data for pandemic and pre-pandemic periods showed that the COVID-19 pandemic may negatively impact the mental health of children and young people. There is an urgent need for high-quality research to address the impact, risks and protective factors of the pandemic on their mental health, as this will provide a good foundation for dealing with future health emergencies and other crises. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00787-022-02060-0