Wellness Check: Mental Health

Children may have poorer mental health following a COVID-19 infection

1. In this systematic review and meta-analysis, children with a previous COVID-19 infection had higher rates of anxiety, depression, and appetite issues compared to those with no prior infection.

2. In addition, depression had the highest pooled prevalence among the mental health disorders seen in children following a COVID-19 infection.

Evidence Rating Level: 1 (Excellent)

The COVID-19 pandemic led to several detrimental psychological effects. Notably, the pooled prevalence of several mental health disorders in children and adolescents has increased since pre-pandemic times. Yet, studies have not explicitly focused on the mental health effects of long COVID and prior COVID-19 infections in children. As a result, the objective of the present systematic review was to evaluate the mental health effects of COVID-19 infection in children.

Of 18,48 identified records, 13 studies were included from various databases from January 2019-May 2022. Studies were included if they reported mental health symptoms of long COVID or the treatment of anxiety or depression in children with long COVID. Studies were excluded if they focused on adult patients, did not have outcome data, or used ineligible study designs. The review was performed using PRISMA guidelines. The risk of bias was assessed using the National Institute of Health (NIH) Quality assessment tool for observational cohort and cross-sectional intervention studies. The primary outcome was the pooled prevalence of mental health outcomes in children following a COVID-19 infection.

The results demonstrated that children with a previous COVID-19 infection had higher rates of anxiety, depression, and appetite issues than children with no prior infection, which may be attributable to long COVID. Furthermore, the rates of the various mental health conditions identified in children following a COVID-19 infection were: depression (15%), mood swings (13%), anxiety (9%), concentration problems (6%), and appetite loss (5%). Despite these results, the study was limited by the absence of data on low- and middle-income countries, which may limit the generalizability. Nonetheless, the findings suggest that a prior COVID-19 infection may be associated with increased rates of adverse mental health symptoms in children.

Specific return-to-work interventions may be effective for work-related mental health disorders

1. In this systematic review and meta-analysis, multi-domain and health-focused return-to-work (RTW) interventions were positively associated with RTW rates and quality of life in those with work-related mental health conditions.

2. However, RTW interventions were not associated with improvements in certain outcomes such as absenteeism, stress, or depressive symptoms.

Evidence Rating Level: 1 (Excellent)

Mental health conditions contribute to decreased productivity and constitute a significant proportion of disability claims, especially those originating in the workplace. Though return-to-work (RTW) interventions are common for mental health disorders requiring an extended sick leave, there is a lack of evidence for their use in mental health conditions with a workplace origin. As a result, the objective of the present study was to evaluate the effectiveness of RTW interventions on RTW rates, quality of life, and mental well-being in those with work-related mental health conditions.

Of 26,153 identified records, 28 (n=19 randomized controlled trials, n=9 quasi-experimental trials) studies were included from various databases from 2000-2020. Studies were included if they investigated the effects of RTW interventions on work-related mental health conditions in adults. Studies were excluded if they did not include descriptions of the intervention or did not report on RTW outcomes. The review was performed using PRISMA guidelines. The Critical Appraisal Skills Program (CASP) and the Joanna Briggs Institute (JBI) checklist were used to assess study quality. The primary outcomes were the proportion of patients returning to work, absenteeism rates, stress, depression, and quality of life.

The results demonstrated that health-focused and multi-domain interventions were positively associated with RTW rates and quality of life. However, there was no significant improvement in certain outcomes, such as absenteeism, stress, or depressive symptoms. Despite these results, the study was limited by the inclusion of primarily European studies, which may limit its generalizability. Nonetheless, the present study suggested that tailored interventions may enhance rates of RTW in those with work-related mental health conditions.

Youth and their parents have positive attitudes toward digital health interventions for mental health problems

1. In this scoping review, children, adolescents, and parents demonstrated a positive attitude toward digital health interventions (DHI) for mental health problems, with only three studies indicating a preference for in-person interventions.

2. Users also indicated that DHIs were easy to use, flexible, and had customizable features.

Evidence Rating Level: 1 (Excellent)

With the growing prevalence of mental health disorders worldwide, the use of digital health interventions (DHIs) has been explored as a cost-effective approach to address the increased needs of the population. Currently, there is a lack of evidence examining the attitudes and perceptions of those using DHIs, particularly in children and adolescents. As a result, the objective of the present study was to characterize the perspectives of children, adolescents, and their parents towards DHIs for mental health problems.

Of 1,548 identified records, 30 studies were included from various databases from 2007-2021. Studies were included if they investigated children, adolescents, or parental attitudes toward DHIs for mental health problems. Studies were excluded if their primary objective did not concern usage, preferences, or attitudes regarding DHIs, if the intervention was designed for parents of children, or if the study only explored the perspectives of healthcare professionals. The review was performed using PRISMA-ScR guidelines. The primary outcome was the attitudes of children, adolescents, or their parents toward DHIs for mental health problems.

The results demonstrated that children and adolescents had positive attitudes toward DHIs and mostly preferred DHIs, with only three studies showing a preference for in-person interventions. In addition, children, adolescents, and parents were satisfied with DHIs through their ease of use, flexibility, and customizable features. Despite these results, the study was limited by the heterogenous methodologies used in the included studies, which may have impacted the findings. Nonetheless, the present study added important information supporting the use of DHIs in children and adolescents.

Several factors influenced the mental health of healthcare workers during the COVID-19 pandemic

1. In this systematic review, several factors, including female sex, younger age, frontline work, longer working hours, and fears of contracting COVID-19, were associated with adverse mental health changes in healthcare workers during the COVID-19 pandemic.

2. However, factors such as a supportive environment, access to psychological resources, and availability of personal protective equipment and COVID-19 tests were associated with positive mental health changes.

Evidence Rating Level: 1 (Excellent)

The COVID-19 pandemic led to a deterioration in healthcare workers’ mental health, especially those at the frontline. There remains a lack of understanding concerning the long-term effects of the pandemic on healthcare workers’ mental health and the factors which influence their mental well-being. As a result, the objective of the present study was to review and synthesize existing knowledge regarding the long-term mental health effects of healthcare workers during the COVID-19 pandemic.

Of 3,228 identified records, 18 studies were included from various databases from January 2020-November 2021. Studies were included if they were longitudinal observational studies that assessed any mental health-related outcome in healthcare professionals providing care to patients with COVID-19 infections. Studies were excluded if they only shared preliminary results. The review was performed using PRISMA guidelines. The study quality was assessed using the Joanna Briggs Institute (JBI) tool. The primary outcome was changes in mental health during the COVID-19 pandemic.

The results demonstrated that factors associated with a positive mental health change included having a supportive environment and access to resources, such as mental health supports, personal protective equipment, and COVID-19 testing kits. Factors associated with an adverse change in mental health included female sex, younger age, being a frontline worker, working longer hours, and having a fear of contracting COVID-19. Despite these results, the study was limited by the inclusion of studies from only two databases which may have affected the comprehensiveness of the study. Nonetheless, the present study identified some modifiable factors which may influence the mental health of healthcare workers.

Image: PD

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