TY - JOUR
T1 - Mental health, substance use, and suicidal ideation during a prolonged COVID-19-related lockdown in a region with low SARS-CoV-2 prevalence
AU - Czeisler, Mark
AU - Wiley, Joshua F.
AU - Facer-Childs, Elise R.
AU - Robbins, Rebecca
AU - Weaver, Matthew D.
AU - Barger, Laura K.
AU - Czeisler, Charles A.
AU - Howard, Mark E.
AU - Rajaratnam, Shantha M.W.
N1 - Funding Information:
M.?. Czeisler was supported by The Kinghorn Foundation through a 2020 Australian-American Fulbright Scholarship. J.F. Wiley was supported by a NHMRC fellowship (1178487). E.R. Facer-Childs was supported by the Department of Industry, Innovation and Science (Australian Government, ICG000899), and a Science Industry Endowment (SEIF) Fund Ross Metcalf STEM+ Business Fellowship administered by the Commonwealth Scientific Industrial Research Organisation (CSIRO). R. Robbins was supported by the National Heart, Lung, and Blood Institute (K01HL150339). M.D. Weaver was supported in part by the National Institute for Occupational Safety and Health (R01OH011773) and the National Heart, Lung, and Blood Institute (R56HL151637). L.K. Barger and C.A. Czeisler were supported in part by the National Institute for Occupational Safety and Health (R01OH011773) and the National Institute on Aging (2R01 AG044416). C.A. Czeisler was supported in part by the National Institute on Aging (5P01AG 009975) and is the incumbent of an endowed professorship provided to the Harvard Medical School by Cephalon, Inc. The authors thank The COPE Initiative survey respondents, and Qualtrics research services team that supported the data collection: Mallory Colys, Rebecca Toll, Sneha Baste, and Daniel Chong.
Funding Information:
M.É. Czeisler, C.A. Czeisler, M.E. Howard, and S.M.W. Rajaratnam reported receiving institutional contracts to Monash University to support The COVID-19 Outbreak Public Evaluation (COPE) Initiative from the CDC Foundation with funding from BNY Mellon and from WHOOP, Inc., as well as a gift from Hopelab, Inc. M.É. Czeisler reported receiving grants from the Australian-American Fulbright Commission administered through a 2020–2021 Fulbright Future Scholarship funded by The Kinghorn Foundation during the conduct of the study and receiving personal fees from Vanda Pharmaceuticals outside the submitted work. E.R. Facer-Childs reported a grant from the Science and Industry Endowment Fund Ross Metcalf STEM+ Business Fellowship administered by the Commonwealth Scientific and Industrial Research Organisation, Canberra, Australia. R. Robbins reported personal fees from Denihan Hospitality, Rituals Cosmetics, SleepCycle, Dagmejan, and byNacht. L.K. Barger reported a grant from the National Institute for Occupational Safety and Health and personal fees from the University of Pittsburgh, CurAegis, Casis, Puget Sound Pilots, Boston Children's Hospital, and Charles A. Czeisler. C.A. Czeisler reported receiving grants to support The COPE Initiative and grants from Brigham and Women's Physician's Organization during the conduct of the study; being a paid consultant to or speaker for Ganésco, Institute of Digital Media and Child Development, Klarman Family Foundation, M. Davis and Co, Physician's Seal, Samsung Group, State of Washington Board of Pilotage Commissioners, Tencent Holdings, Teva Pharma Australia, and Vanda Pharmaceuticals, in which C.A. Czeisler holds an equity interest; receiving travel support from Aspen Brain Institute, Bloomage International Investment Group, UK Biotechnology and Biological Sciences Research Council, Bouley Botanical, Dr. Stanley Ho Medical Development Foundation, Illuminating Engineering Society, National Safety Council, Tencent Holdings, and The Wonderful Co; receiving institutional research and/or education support from Cephalon, Mary Ann and Stanley Snider via Combined Jewish Philanthropies, Harmony Biosciences, Jazz Pharmaceuticals PLC, Johnson and Johnson, Neurocare, Peter Brown and Margaret Hamburg, Philips Respironics, Regeneron Pharmaceuticals, Regional Home Care, Teva Pharmaceuticals Industries, Sanofi S.A., Optum, ResMed, San Francisco Bar Pilots, Schneider National, Serta, Simmons Betting, Sysco, Vanda Pharmaceuticals; being or having been an expert witness in legal cases, including those involving Advanced Power Technologies; Aegis Chemical Solutions; Amtrak; Casper Sleep; C and J Energy Services; Complete General Construction; Dallas Police Association; Enterprise Rent-A-Car; Steel Warehouse Co; FedEx; Greyhound Lines; Palomar Health District; PAR Electrical, Product, and Logistics Services; Puckett Emergency Medical Services; South Carolina Central Railroad Co; Union Pacific Railroad; UPS; and Vanda Pharmaceuticals; serving as the incumbent of an endowed professorship provided to Harvard University by Cephalon; and receiving royalties from McGraw Hill and Philips Respironics for the Actiwatch-2 and Actiwatch Spectrum devices. C.A. Czeisler's interests were reviewed and are managed by the Brigham and Women's Hospital and Mass General Brigham in accordance with their conflict of interest policies. S.M.W. Rajaratnam reported receiving institutional consulting fees from CRC for Alertness, Safety, and Productivity; Teva Pharmaceuticals; Vanda Pharmaceuticals; Circadian Therapeutics; BHP Billiton; and Herbert Smith Freehills; receiving grants from Teva Pharmaceuticals and Vanda Pharmaceuticals; and serving as chair for the Sleep Health Foundation outside the submitted work. No other disclosures were reported.
Funding Information:
M.É. Czeisler was supported by The Kinghorn Foundation through a 2020 Australian-American Fulbright Scholarship. J.F. Wiley was supported by a NHMRC fellowship (1178487). E.R. Facer-Childs was supported by the Department of Industry, Innovation and Science (Australian Government, ICG000899 ), and a Science Industry Endowment (SEIF) Fund Ross Metcalf STEM+ Business Fellowship administered by the Commonwealth Scientific Industrial Research Organisation (CSIRO). R. Robbins was supported by the National Heart, Lung, and Blood Institute ( K01HL150339 ). M.D. Weaver was supported in part by the National Institute for Occupational Safety and Health ( R01OH011773 ) and the National Heart, Lung, and Blood Institute ( R56HL151637 ). L.K. Barger and C.A. Czeisler were supported in part by the National Institute for Occupational Safety and Health ( R01OH011773 ) and the National Institute on Aging ( 2R01 AG044416 ). C.A. Czeisler was supported in part by the National Institute on Aging ( 5P01AG 009975 ) and is the incumbent of an endowed professorship provided to the Harvard Medical School by Cephalon, Inc. The authors thank The COPE Initiative survey respondents, and Qualtrics research services team that supported the data collection: Mallory Colys, Rebecca Toll, Sneha Baste, and Daniel Chong.
Publisher Copyright:
© 2021 Elsevier Ltd
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/8
Y1 - 2021/8
N2 - The coronavirus disease 2019 (COVID-19) pandemic has been associated with mental health consequences due to direct (i.e., SARS-CoV-2 infection, potentially due to neuronal or astrocytic infection, microvascular, or inflammatory mechanisms) and indirect (i.e., social and economic impacts of COVID-19 prevention measures) effects. Investigation of mental health in a region with one of the longest lockdowns and lowest COVID-19 prevalence globally (Victoria, Australia) allowed for evaluation of mental health in the absence of substantial direct pandemic mental health consequences. Surveys were administered during 15–24 September 2020 to Victorian residents aged ≥18 years for The COVID-19 Outbreak Public Evaluation (COPE) Initiative. Responses were compared cross-sectionally with April-2020 data, and longitudinally among respondents who completed both surveys. Multivariable Poisson regressions were used to estimate prevalence ratios for adverse mental health symptoms, substance use, and suicidal ideation adjusted for demographics, sleep, and behaviours (e.g., screen-time, outdoor-time). In September-2020, among 1157 Victorians, one-third reported anxiety or depressive disorder symptoms, one-fifth reported suicidal ideation, and one-tenth reported having seriously considered suicide in the prior 30 days. Young adults, unpaid caregivers, people with disabilities, and people with diagnosed psychiatric or sleep conditions showed increased prevalence of adverse mental health symptoms. Prevalence estimates of symptoms of burnout, anxiety, and depressive disorder were unchanged between April-2020 and September-2020. Persistently common experiences of adverse mental health symptoms despite low SARS-CoV-2 prevalence during prolonged lockdown highlight the urgent need for mental health support services.
AB - The coronavirus disease 2019 (COVID-19) pandemic has been associated with mental health consequences due to direct (i.e., SARS-CoV-2 infection, potentially due to neuronal or astrocytic infection, microvascular, or inflammatory mechanisms) and indirect (i.e., social and economic impacts of COVID-19 prevention measures) effects. Investigation of mental health in a region with one of the longest lockdowns and lowest COVID-19 prevalence globally (Victoria, Australia) allowed for evaluation of mental health in the absence of substantial direct pandemic mental health consequences. Surveys were administered during 15–24 September 2020 to Victorian residents aged ≥18 years for The COVID-19 Outbreak Public Evaluation (COPE) Initiative. Responses were compared cross-sectionally with April-2020 data, and longitudinally among respondents who completed both surveys. Multivariable Poisson regressions were used to estimate prevalence ratios for adverse mental health symptoms, substance use, and suicidal ideation adjusted for demographics, sleep, and behaviours (e.g., screen-time, outdoor-time). In September-2020, among 1157 Victorians, one-third reported anxiety or depressive disorder symptoms, one-fifth reported suicidal ideation, and one-tenth reported having seriously considered suicide in the prior 30 days. Young adults, unpaid caregivers, people with disabilities, and people with diagnosed psychiatric or sleep conditions showed increased prevalence of adverse mental health symptoms. Prevalence estimates of symptoms of burnout, anxiety, and depressive disorder were unchanged between April-2020 and September-2020. Persistently common experiences of adverse mental health symptoms despite low SARS-CoV-2 prevalence during prolonged lockdown highlight the urgent need for mental health support services.
KW - Anxiety
KW - Australia
KW - Coronavirus
KW - Depression
KW - Victoria
UR - http://www.scopus.com/inward/record.url?scp=85108429723&partnerID=8YFLogxK
U2 - 10.1016/j.jpsychires.2021.05.080
DO - 10.1016/j.jpsychires.2021.05.080
M3 - Article
C2 - 34174556
AN - SCOPUS:85108429723
SN - 0022-3956
VL - 140
SP - 533
EP - 544
JO - Journal of Psychiatric Research
JF - Journal of Psychiatric Research
ER -
