8 results
Students’ emotional well-being and religiosity during the COVID-19 pandemic- an international study in 7 countries
- K. H. Karakula, A. Forma, R. Sitarz, J. Baj, D. Juchnowicz, J. Bogucki, W. Tuszyńska-Bogucka, M. L. Tee, C. A. Tee, J. T. Ly-Uson, M. S. Islam, M. T. Sikder, A. H. El-Monshed, A. Loutfy, M. F. Hussain Qureshi, M. Abbas, S. Taseen, M. Lakhani, S. Jayakumar, S. Ilango, S. Kumar, Á. A. Ruiz-Chow, A. Iturbide, D. D. González-Mille, H. Karakula-Juchnowicz
-
- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S406
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Introduction
There are no conclusive findings about the possible protective role of religion on students’ mental health during the COVID-19 pandemic. Therefore, more research is needed.
ObjectivesThe purpose of this study was to assess the relationship between the level of emotional distress and religiosity among students from 7 different countries during the COVID-19 pandemic.
MethodsData were collected by an online cross-sectional survey that was distributed amongst Polish (N = 1196), Bengali (N = 1537), Indian (N = 483), Mexican (N = 231), Egyptian (N = 565), Philippine (N = 2062), and Pakistani (N = 506) students (N = 6642) from 12th April to 1st June 2021. The respondents were asked several questions regarding their religiosity which was measured by The Duke University Religion Index (DUREL), the emotional distress was measured by the Depression, Anxiety, and Stress Scale-21 (DASS-21).
ResultsEgypt with Islam as the dominant religion showed the greatest temple attendance (organizational religious activity: M=5.27±1.36) and spirituality (intrinsic religiosity: M=5.27±1.36), p<0.0001. On another hand, Egyptian students had the lowest emotional distress measured in all categories DASS-21 (depression: M=4.87±10.17, anxiety: M=4.78±10.13, stress: M=20.76±11.46). Two countries with the dominant Christian religion achieved the highest score for private religious activities (non-organizational religious activity; Mexico: M=3.94±0.94, Poland: M=3.63±1.20; p<0.0001) and experienced a moderate level of depressive symptoms, anxiety, and stress. Students from Mexico presented the lowest attendance to church (M=2.46±1,39) and spirituality (M=6.68± 3.41) and had the second highest level of depressive symptoms (M=19.13±13.03) and stress (M=20.27±1.98). Philippines students had the highest DASS-21 score (depression: M=22.77±12.58, anxiety: M=16.07±10.77, stress: M=4.87±10.08) and their level of religiosity reached average values in the whole group. The performed regression analysis confirmed the importance of the 3 dimensions (organizational religious activity, non-organizational religious activity, intrinsic religiosity) of religiosity for the well-being of students, except for the relationship between anxiety and private religious activities. The result was as presented for depression: R2=0.0398, F(3.664)=91.764, p<0.0001, SE of E: 12.88; anxiety: R2=0.0124, F(3.664)=27.683, p<0.0001, SE of E: 10,62; stress: R2= 0.0350, F(3.664)=80.363, p<0.0001, SE of E: 12.30.
ConclusionsThe higher commitment to organizational religious activity, non-organizational religious activity, and intrinsic religiositywas correlated with the lower level of depressive symptoms, stress, and anxiety among students during the COVID-19 pandemic, but taking into account factors related to religiosity explains the level of emotional well-being to a small extent.
Disclosure of InterestNone Declared
Facing the COVID-19 pandemic – an assessment of students’ mental health and major coping strategies during the COVID-19 pandemic – an international study
- A. A. Forma, K. H. Karakuła, R. Sitarz, D. Juchnowicz, J. Baj, J. Bogucki, J. Rog, M. L. Tee, C. A. Tee, J. T. Ly-Uson, M. S. Islam, M. T. Sikder, A. H. El-Monshed, A. Loutfy, M. F. H. Qureshi, M. Abbas, S. Taseen, M. Lakhani, C. Wang, X. Wan, Y. Tan, R. Pan, R. Ho, S. Jayakumar, S. Ilango, S. Kumar K, Á. A. Ruiz-Chow, A. Iturbide, D. D. González-Mille, L. P. Doan, H. Karakuła-Juchnowicz
-
- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S152-S153
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Introduction
TDuring COVID-19 pandemic, it was noticed that it was students who were mostly affected by the changes that aroused because of the pandemic. The interesting part is whether students’ well-being could be associated with their fields of study as well as coping strategies.
ObjectivesIn this study, we aimed to assess 1) the mental health of students from nine countries with a particular focus on depression, anxiety, and stress levels and their fields of study, 2) the major coping strategies of students after one year of the COVID-19 pandemic.
MethodsWe conducted an anonymous online cross-sectional survey on 12th April – 1st June 2021 that was distributed among the students from Poland, Mexico, Egypt, India, Pakistan, China, Vietnam, Philippines, and Bangladesh. To measure the emotional distress, we used the Depression, Anxiety, and Stress Scale-21 (DASS-21), and to identify the major coping strategies of students - the Brief-COPE.
ResultsWe gathered 7219 responses from students studying five major studies: medical studies (N=2821), social sciences (N=1471), technical sciences (N=891), artistic/humanistic studies (N=1094), sciences (N=942). The greatest intensity of depression (M=18.29±13.83; moderate intensity), anxiety (M=13.13±11.37; moderate intensity ), and stress (M=17.86±12.94; mild intensity) was observed among sciences students. Medical students presented the lowest intensity of all three components - depression (M=13.31±12.45; mild intensity), anxiety (M=10.37±10.57; moderate intensity), and stress (M=13.65±11.94; mild intensity). Students of all fields primarily used acceptance and self-distraction as their coping mechanisms, while the least commonly used were self-blame, denial, and substance use. The group of coping mechanisms the most frequently used was ‘emotional focus’. Medical students statistically less often used avoidant coping strategies compared to other fields of study. Substance use was only one coping mechanism that did not statistically differ between students of different fields of study. Behavioral disengagement presented the highest correlation with depression (r=0.54), anxiety (r=0.48), and stress (r=0.47) while religion presented the lowest positive correlation with depression (r=0.07), anxiety (r=0.14), and stress (r=0.11).
Conclusions1) The greatest intensity of depression, anxiety, and stress was observed among sciences students, while the lowest intensity of those components was found among students studying medicine.
2) Not using avoidant coping strategies might be associated with lower intensity of all DASS components among students.
3) Behavioral disengagement might be strongly associated with greater intensity of depression, anxiety, and stress among students.
4) There was no coping mechanism that provided the alleviation of emotional distress in all the fields of studies of students.
Disclosure of InterestNone Declared
A diet rich in polyunsaturated fatty acids as supportive therapy in the treatment and prevention of psychotic disorders
- R. Sitarz, D. Juchnowicz, K. Karakuła, A. Forma, J. Baj, J. Rog, R. Karpiński, A. Machrowska, H. Karakuła-Juchnowicz
-
- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S1085-S1086
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Introduction
Proper nutrition with fats has a protective effect on the functioning of the nervous system. However, a disturbed ratio of essential polyunsaturated fatty acids supply is nowadays a common phenomenon. A diet overloaded with saturated fats and a shortage of those essential ones in the company with possibly some unfavorable genetic endowment could lead to the release of psychosis from the framework of diet defined by nature for thousands of years.
ObjectivesThe study aims to review the literature to assess the influence of supplementation with polyunsaturated fatty acids in the occurrence of psychotic disorders prevention, as well as their impact on remission prolongation.
MethodsLiterature review in PubMed, Google Scholar, and Web of Science using the keywords [psychosis] OR [psychotic] OR [schizophrenia] OR [unipolar] OR [bipolar] OR [schizoaffective] OR [depression] OR [manic] OR [hypomanic] OR [mania] OR [hypomania] OR [first episode psychosis] OR [ultra-high risk] OR [UHR] AND [polyunsaturated fatty acids] OR [PUFA] OR [prostaglandin] OR [phospholipid] OR [phospholipase A2] OR [arachidonic acid] OR [linoleic acid] OR [alpha-linolenic acid] OR [omega-3] OR [omega-6] OR [nutrition] OR [diet]. The review included original articles, reviews, systematic reviews, meta-analyses, and case reports from 1977-2022 in Polish and English.
Results86 articles devoted to diet and nutrition in psychotic disorders were analyzed. Patients with schizophrenia, bipolar disorder, and schizoaffective disorders exhibit deficiencies in polyunsaturated fatty acids. Such results may indicate compliance with David Horrobin’s theory of the psychotic disorders development in predisposed individuals.
ConclusionsSupplementation with polyunsaturated fatty acids may be a chance for a selected group of patients to prolong remission but also hope to prevent the occurrence of psychotic disorders in particularly vulnerable individuals.
Disclosure of InterestNone Declared
Reduced Healthcare Resource Utilization in Patients With Chronic Insomnia 24 Months After Treatment With Digital CBT-I: A Matched-Control Study
- Felicia Forma, Tyler Knight, Rebecca Baik, Matthew Wallace, Dan Malone, Xiaorui Xiong, Fulton Velez, Frances Thorndike, Yuri Maricich
-
- Journal:
- CNS Spectrums / Volume 28 / Issue 2 / April 2023
- Published online by Cambridge University Press:
- 14 April 2023, pp. 228-229
-
- Article
-
- You have access Access
- Export citation
-
Introduction
This analysis examined the impact of a digital therapeutic for treating chronic insomnia (currently marketed as Somryst®, at the time called Sleep Healthy Using The internet [SHUTi]) on healthcare resource use (HCRU) by comparing patients treated with the digital cognitive behavioral therapy for insomnia (dCBTi) to patients not treated with dCBTi, but with insomnia medications.
MethodsA retrospective observational study using health claims data was conducted in two cohorts across the United States: patients who registered for dCBTi (cases) between June 1, 2016 and October 31, 2018 (index date) vs. patients who did not register for dCBTi but initiated a second prescription for an insomnia medication in the same time period (controls). Observation period was 16–24 months. No other inclusion/exclusion criteria were used. Control patients were matched using a nearest neighbor within-caliper matching without replacement approach. Incidence rates for HCRU encounter type were calculated using a negative binomial model for both cohorts. Costs were estimated by multiplying HCRU by published average costs for each medical resource.
ResultsEvaluated were 248 cases (median age 56.5 years, 57.3% female, 52.4% treated with sleep-related medications) and 248 matched controls (median age 55.0 years, 56.0% female, 100.0% treated with sleep-related medications). Over the course of 24 months post-initiation, cases had significantly lower incidences of inpatient stays (55% lower, IRR: 0.45; 95% CI: 0.28–0.73; P=0.001), significantly fewer emergency department (ED) visits without inpatient admission (59% lower; IRR: 0.41; 95% CI: 0.27–0.63; P<0.001), and significantly fewer hospital outpatient visits (36% lower; IRR: 0.64; 95% CI: 0.49–0.82; P<0.001). There was also a trend for fewer ambulatory surgical center visits (23% lower; IRR: 0.77; 95% CI: 0.52–1.14; P=0.197) and fewer office visits (7% lower; IRR: 0.93; 95% CI: 0.81–1.07; P=0.302) with the use of SHUTi. Use of sleep medications was more than four times greater in controls vs. cases, with 9.6 (95% CI: 7.88–11.76) and 2.4 (95% CI: 1.91–2.95) prescriptions/patient, respectively (P<0.001). All-cause per-patient HCRU costs were $8,202 lower over 24 months for cases vs. controls, driven primarily by a lower incidence of hospitalizations (-$4,996 per patient) and hospital outpatient visits (-$2,003 per patient).
ConclusionsPatients with chronic insomnia who used a digital CBTi treatment had significant and durable real-world reductions in hospital inpatient stays, ED visits, hospital outpatient visits, and office visits compared to matched controls treated with medications.
FundingPear Therapeutics (US), Inc.
Viral topic about the COVID-19 vaccination: the attitudes towards it and the relationship with the well-being and religiosity in a group of Polish students
- K. Karakula, A. Forma, E. Sitarz, J. Rog, J. Baj, D. Juchnowicz, H. Karakula-Juchnowicz
-
- Journal:
- European Psychiatry / Volume 65 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 01 September 2022, pp. S496-S497
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Introduction
The COVID-19 pandemic currently remains the most significant stressor affecting the global population. Researchers continually report widespread mistrust and negative attitudes towards vaccination, but only a little focus on its association with the emotional well-being.
ObjectivesWe aimed to investigate the attitudes towards vaccination against COVID-19, as well as its relationship with well-being and religiosity after one year of the pandemic duration amongst Polish students.
MethodsWe conducted an anonymous online cross-sectional survey between 12th April – 1st June 2021 amongst Polish students (n=1202). To evaluate emotional distress, we used the Depression, Anxiety, and Stress Scale-21 (DASS-21), for measuring spirituality/religiosity we used The Duke University Religion Index.
ResultsThe highest rate of vaccinated individuals was noted in a group of medical students (69.9%), the lowest - among responders studying science (1.9%). Students who wanted to be vaccinated had higher levels of depressive, anxiety, and stress symptoms compared to those who were already vaccinated (p=0.04); they also had higher depressive symptoms than unvaccinated and unwilling participants (p=0.028). Students who didn’t want to be vaccinated against COVID-19 showed the highest religiosity compared to those who would like to be vaccinated (p<0.001) or were vaccinated (p=0.003). There was a negative correlation between the level of religiosity and severity of depressive and anxiety symptoms (p=0.002).
Conclusions1. The attitudes towards vaccination against COVID-19 depended on the fields of study. 2. Religiousness has been linked with the attitudes towards COVID-19 vaccination as well as level of depression and anxiety amongst Polish students.
DisclosureNo significant relationships.
Comparative Effectiveness of an FDA-Authorized Digital Therapeutic to Medications and Cognitive Behavioral Therapy Treating Chronic Insomnia in Adults
- Felicia Forma, Ramya Pratiwadi, Fadoua El-Moustaid, Nathaniel Smith, Fulton Velez
-
- Journal:
- CNS Spectrums / Volume 27 / Issue 2 / April 2022
- Published online by Cambridge University Press:
- 28 April 2022, p. 237
-
- Article
-
- You have access Access
- Export citation
-
Introduction
Chronic insomnia affects the physical and mental health, quality of life, and productivity of 6 to 10% of the adult population (15-25 million U.S. adults). Available treatments include guideline-recommended first-line cognitive behavioral therapy for insomnia (CBT-I) and medications. However, limitations such as patient access to CBT-I and limited efficacy, the presence of significant side effects, as well as safety concerns about medications limit favorable outcomes. Somryst is an FDA-authorized prescription digital therapeutic for the treatment of chronic insomnia in adults. The purpose of this analysis is to compare the effectiveness of the digital therapeutic vs CBT-I and medications for primary insomnia.
MethodsChronic insomnia trials focused on digital therapeutic, CBT-I, or medication were identified in a systematic literature review. Studies using a comparator arm that cannot be considered clinically equivalent to other treatments in the network were excluded (eg, meaningfully different definition of placebo arm). A Bayesian network meta-analysis was performed in R on the mean change from baseline and the proportion of remitters using the insomnia severity index (ISI) endpoint with follow-up timepoints between 6 and 12 weeks. Mean change in ISI score from baseline was analyzed as a continuous endpoint while comparisons of the proportion of remitters were performed using odds ratios. The analysis used a random-effects model for the base case analysis. A surface under the cumulative ranking curve (SUCRA) analysis was performed to rank the treatments on each endpoint.
ResultsIn total, 13 studies reported ISI mean change from baseline data. Only the digital therapeutic and CBT-I were significantly different than placebo. The digital therapeutic had the greatest mean change from baseline in ISI from placebo (−5.77 points, 95% Credible Interval (CrI) [−8.53, −3.07]), followed by CBT-I (−4.3 points, 95% CrI [−6.32, −2.39]). In the SUCRA analysis, the digital therapeutic had the highest probability (56%) of being the most effective treatment based on ISI mean change from baseline. Only 8 studies reported the proportion of ISI remitters. Only the digital therapeutic showed a statistically significant difference in remission vs placebo and had the highest odds ratio for remission vs placebo (12.33 95% CrI [2.28, 155.91]). The odds ratio for remission vs placebo in CBT-I was not statistically significant (4.08 95% CrI [0.45, 45.58]). The digital therapeutic had the highest probability (64%) of being the most efficacious for inducing remission per ISI.
ConclusionsSomryst was projected to be the most effective therapy on both mean change in ISI and ISI remission within 6 to 12 weeks of treatment start vs either CBT-I or medications. Further investigation should be performed to demonstrate the long-term effectiveness of all chronic insomnia treatments.
FundingPear Therapeutics
Psychiatric Prescriber Attitudes, Experiences, and Proclivities Toward Digital Medicine and How They Influence Adoption of Digital Medicine Platforms
- Charles Ruetsch, Dawn Velligan, Delbert Robinson, Chris Jaeger, William Carpenter, Tigwa Davis, Joshua N. Liberman, Jennifer Clerie, Heidi Waters, Felicia Forma
-
- Journal:
- CNS Spectrums / Volume 26 / Issue 2 / April 2021
- Published online by Cambridge University Press:
- 10 May 2021, pp. 144-145
-
- Article
-
- You have access Access
- Export citation
-
Background
Psychiatric prescribers typically assess adherence by patient or caregiver self-report. A new digital medicine (DM) technology provides objective data on adherence by using an ingestible event monitoring (IEM) sensor embedded within oral medication to track ingestion. Despite likely clinical benefit, adoption by prescribers will in part depend on attitudes toward and experience with digital health technology, learning style preference (LSP), and how the technology s utility and value are described.
Objectiveis to identify attitudes, experiences, and proclivities toward DM platforms that may affect adoption of the IEM platform and provide direction on tailoring educational materials to maximize adoption. Methods A survey of prescribers treating seriously mentally ill patients was conducted to assess drivers/barriers to IEM adoption. Factor analysis was performed on 13 items representing prior experience with and attitudes toward DM. Factor scores were correlated with prescriber characteristics including attitude and experience with digital technologies, LSP, and level of focus on healthcare cost.
ResultsA total of 127 prescribers (56% female, 76% physicians, mean age 48.1yrs.) completed the survey. Over 90% agreed medication adherence is important, visits allow enough time to monitor adherence (84.1%), and tailoring treatment to level of adherence would be beneficial (92.9%). The majority (65.9%) preferred relying upon outcomes data as their learning style while 15.9% preferred opinion leader recommendations and 18.3% information about how the technology would affect practice efficiency. Factor analysis revealed four dimensions: Level of comfort with EHR; Concern over current ability to monitor medication adherence; Attitudes about value of DM applications; and Benefits vs cost of DM for payers. Women scored higher on attitudes about the value of digital applications (p<0.01). Providers who perceive non-adherence as costly, and those who believe DM could benefit providers and patients scored higher on the value of DM (p<.05). Those whose LSP focuses on improving efficiency and prescribers with a higher proportion of Medicaid/ uninsured patients displayed concern about their ability to monitor adherence (p<0.05). Willingness to be a Beta Test site for DM applications was positively correlated with concern about their ability to monitor adherence and attitudes about the value of DM (p <0.01).
ConclusionsPrescriber characteristics including LSP, focus on healthcare costs, and attitudes toward DM may be related to adoption of the IEM platform. Those with more Medicaid/ uninsured patients were more concerned about ability to monitor adherence while those focused-on cost and benefit to providers and patients viewed DM as part of a solution for managing outcomes and cost. Overall, LSP, patient panel size by payer type, and focus on healthcare cost containment should be considered when developing IEM provider training materials.
FundingOtsuka Pharmaceutical Development & Commercialization, Inc.
Does Economic Hardship Lead to Polarisation of Opinions towards the Welfare State?
- PAULI FORMA
-
- Journal:
- Journal of Social Policy / Volume 31 / Issue 2 / April 2002
- Published online by Cambridge University Press:
- 25 April 2002, pp. 187-206
- Print publication:
- April 2002
-
- Article
- Export citation
-
The main focus of this article is an analysis of whether the opinions of the best-off and worst-off diverge during an economic recession. According to previous studies, economic hardship affects the public's willingness to finance the welfare state but less is known about the kind of cleavages economic problems create between different categories of people. Because Finland suffered the deepest economic recession of the OECD countries during the 1990s it provides an excellent context for this kind of study. The willingness of the better-off to finance benefits important to worse-off people decreased during the research period. Recently many European countries have reformed their social policies to increase selectivism. However, results indicate that this kind of policy can create new, or strengthen existing, cleavages among the public.