The COVID-19 pandemic has posed an enormous challenge to the mental health of the population with probable differentiated profiles for men and women, although not all studies are consistent. While women are likely to have endured greater loads of stress associated with an increased incidence of mental disorders such as depression, men have been able to abuse alcohol and other drugs more, in addition to complying with prevention recommendations to a lesser extent. As soon as the COVID pandemic began, we began a clinical trial to enhance first-line treatments with three complementary interventions with patients with Major Depression (MD), which has allowed us to analyze differences in response according to gender.

As a secondary analysis of a clinical trial, the aim of the current study was to address the relative different efficacy between genders of three psychotherapeutic approaches in the context of MD.

This study was a secondary analysis of a pragmatic parallel randomized controlled clinical trial that was composed of three arms (Minimal Lifestyle Intervention, Mindfulness-Based Cognitive Therapy, and Lifestyle Modification Program). We recruited 94 individuals (24 men and 70 women) from the Primary Healthcare Centers of the Balearic Islands region in Spain who were currently experiencing an episode of MD. Descriptive and univariate analyses were used to examine between-group differences in sociodemographic and clinical data between the two genders. General Linear Modelling (specifically, repeated measures ANOVA) was performed to compare the effect of gender on the evolution of depressive symptoms (measured by BDI-II).

Significant between-group differences were observed for the evolution of depressive symptoms after controlling for the intervention group and age. These results suggested that being a woman was significantly related to a worse evolution of depressive symptoms. This association implies a large effect size.

The COVID 19 pandemic has not only been able to predispose women to Depression to a greater extent, but it is also possible that it has negatively conditioned their response to antidepressant therapies compared to men. However, our data suggest the possibility that greater psychological support could help prevent this situation.

None Declared

Early COVID-19 research suggests a detrimental impact of the initial lockdown on young people's mental health.

We investigated mental health among university students and young adults after the first UK lockdown and changes in symptoms over 6 months.

In total, 895 university students and 547 young adults not in higher education completed an online survey at T1 (July–September 2020). A subset of 201 university students also completed a 6 month follow-up survey at T2 (January–March 2021). Anxiety, depression, insomnia, substance misuse and suicide risk were assessed.

At T1, approximately 40%, 25% and 33% of the participants reported moderate to severe anxiety and depression and substance misuse risk, clinically significant insomnia and suicidal risk. In participants reassessed at T2, reductions were observed in anxiety and depression but not in insomnia, substance misuse or suicidality. Student and non-student participants reported similar levels of mental health symptoms. Student status was not a significant marker of mental health symptoms, except for lower substance misuse risk.

Cross-sectionally, greater symptoms across measures were consistently associated with younger age, pre-existing mental health conditions, being a carer, worse financial status, increased sleep irregularity and difficulty since lockdown. Longitudinally, T2 symptoms were consistently associated with worse financial status and increased difficulty sleeping at T1. However, these associations were attenuated when baseline mental health symptoms were adjusted for in the models.

Mental health symptoms were prevalent in a large proportion of young people after the first UK lockdown. Risk factors identified may help characterise high-risk groups for enhanced support and inform interventions.

Depression is the most prevalent mental disorder in Primary Care (PC), with 60% of depressed patients receiving treatment in PC Units. Suicide is the most serious consequence of depression. The European Commission funded the European Alliance Against Depression (EAAD), a preventive program on depression and suicide that has been applied in 18 European countries. In Spain, this program has been implemented in Catalonia and the Balearic Islands (Majorca and Menorca).

To present the results obtained in the program implementation in Majorca.

This program was applied in June 2009 within the urban area of Palma (222,100 inhabitants). Phase 1 entailed data collection of suicide, suicide attempts and antidepressant consumption since 2006. Phase 2 implied the development of specific training courses for General Practitioners on suicide prevention in high-risk population, and the launch of a public advertising campaign with the collaboration of mass media.

Based on data collected since 2006, there are nearly 300 suicide attempts in the Balearic Islands every year. Within the area of intervention suicide attempts decreased a 24.8% between 2009 and 2010. Conversely, antidepressant prescription and consumption increased from a frequent 2–3% per year to a 5%.

Obtained results are consistent with findings in other areas where this program has been applied. Data available next years about number of suicides will help to assess the final impact of this program. It is important to continue designing and implementing preventive programs aimed to reduce suicide risk including specific training for health care providers.

Autism spectrum disorders (ASD) are characterized by deficits in social interaction and behavioral impairments. Several studies have reported differences in white matter generalized Fractional Anisotropy (gFA) in ASD.

We studied white matter microstructural integrity in individuals with ASD.

We conducted the first DWI-based whole brain tractography study to compare gFA in 22 deep white matter tracts in first-degree relatives of individuals with ASD to controls and individuals with ASD. Futhermore, we replicated our significants results in an independant sample.

Fifty-one first-degree relatives of individuals with ASD, 29 controls and 14 individuals with ASD participated.

We performed q-ball imaging whole-brain tractography based on 1.5 T diffusion weighted MRI over 32 non-colinear directions. Then, we computed mean gFA along 22 main deep white matter tracts. A linear mixed model using group, gender, age and IQ as fixed effects and family as a random effect was used and Bonferroni correction applied. We also recruited a replication sample comprising 23 individuals with ASD and 32 controls.

We demonstrated a significantly reduced mean gFA along the left IFOF in first-degree relatives of individuals with ASD and individuals with ASD compared with controls and replicated this finding in an independant sample of patients. A decrease in mean gFA was also observed in the left CST when we compared first-degree relatives of individuals with ASD to controls (no such decrease was present in patients).

Our work suggests that structural fronto-occipital disconnectivity may be an endophenotype of ASD.

Chronic non-malignant pain (CNMP) is defined as pain lasting a minimum of three months. In general, chronic pain affects 20% adult worldwide population. Moreover, pain is more common in patients with depression, anxiety, and substance-use disorders and with low socioeconomic status. We aimed to better understand the influence of pain on substance use and treatment use patterns of individuals who experienced clinically recognized pain and have substance use disorder.

Patients with pain disturbances were identified in Electronic Health Records (EHR) through ICD-9 code 338*, medical written diagnoses, or diagnoses of fibromyalgia. A patient was considered to have a substance use disorder if he received treatment for illicit drug or alcohol abuse or dependence. We combined 2010–2012 (EHR) data from primary care and specialty mental health setting in a Boston healthcare system (n = 131,966 person-years) and a specialty mental health care setting in Madrid, Spain (n = 43,309 person-years).

We identified that 35.3% of individuals with clinically recognized pain also report substance use disorder, compared to only 10.6% of individuals without clinically recognized pain (P < 0.01). Those with co-morbid pain and substance use disorder were significantly more likely than their specialty care counterparts without co-morbid pain and substance disorders to be seen in the emergency room (56.5% vs. 36.6%, respectively, P < 0.01).

The findings suggest that CNMP is associated with an increase risk of substance abuse disorder.

The authors have not supplied their declaration of competing interest.

Neighbourhood greenness or vegetative presence has been associated with indicators of health and well-being, but its relationship to depression in older adults has been less studied. Understanding the role of environmental factors in depression may inform and complement traditional depression interventions, including both prevention and treatment.

This study examines the relationship between neighbourhood greenness and depression diagnoses among older adults in Miami-Dade County, Florida, USA.

Analyses examined 249 405 beneficiaries enrolled in Medicare, a USA federal health insurance programme for older adults. Participants were 65 years and older, living in the same Miami location across 2 years (2010–2011). Multilevel analyses assessed the relationship between neighbourhood greenness, assessed by average block-level normalised difference vegetative index via satellite imagery, and depression diagnosis using USA Medicare claims data. Covariates were individual age, gender, race/ethnicity, number of comorbid health conditions and neighbourhood median household income.

Over 9% of beneficiaries had a depression diagnosis. Higher levels of greenness were associated with lower odds of depression, even after adjusting for demographics and health comorbidities. When compared with individuals residing in the lowest tertile of greenness, individuals from the middle tertile (medium greenness) had 8% lower odds of depression (odds ratio 0.92; 95% CI 0.88, 0.96; P = 0.0004) and those from the high tertile (high greenness) had 16% lower odds of depression (odds ratio 0.84; 95% CI 0.79, 0.88; P < 0.0001).

Higher levels of greenness may reduce depression odds among older adults. Increasing greenery – even to moderate levels – may enhance individual-level approaches to promoting wellness.

None.

In the foothills of the Cumberland Mountains, in central Appalachia (a region that spans 13 states in the US), sits an economically distressed and rural community of the United States. Once a thriving coal-mining area, this region now is reported as one of the hardest places to live in the US. Southeastern Kentucky, located in a remote, rocky, mountainous area surrounded by rivers and valleys and prone to flooding, experienced a major flood in Spring 2013 causing significant damage to homes and critical infrastructure.

Aims of the study were to: (1) identify and better understand the contextual variables compounding the impact of a disaster event that occurred in Spring 2013; (2) identify ways participants managed antecedent circumstances, risk, and protective factors to cope with disaster up to 12 months post-event; and (3) further determine implications for community-focused interventions that may enhance recovery for vulnerable populations to promote greater outcomes of adaptation, wellness, and readiness.

Using an ethnographic mixed-methods approach, an inter-collaborative team conducted face-to-face interviews with (N=12) Appalachian residents about their disaster experience, documented observations and visual assessment of need on an observation tool, and used photography depicting structural and environmental conditions. A Health and Emergency Preparedness Assessment Survey Tool was used to collect demographic, health, housing, environment, and disaster readiness assessment data. Community stakeholders facilitated purposeful sampling through coordination of scheduled home visits.

Triangulation of all data sources provided evidence that the community had unique coping strategies related to faith and spirituality, cultural values and heritage, and social support to manage antecedent circumstances, risk, and protective factors during times of adversity that, in turn, enhanced resilience up to 12 months post-disaster. The community was found to have an innate capacity to persevere and utilize resources to manage and transcend adversity and restore equilibrium, which reflected components of resilience that deserve greater recognition and appreciation.

Resilience is a foundational concept for disaster science. A model of resilience for the rural Appalachia community was developed to visually depict the encompassing element of community-based interventions that may enhance coping strategies, mitigate risk factors, integrate protective factors, and strengthen access. Community-based interventions are recommended to strengthen resilience, yielding improved outcomes of adaptation, health and wellness, and disaster readiness.

BanksLH , DavenportLA , HayesMH , McArthurMA , ToroSN , KingCE , VaziraniHM . Disaster Impact on Impoverished Area of US: An Inter-Professional Mixed Method Study. Prehosp Disaster Med. 2016;31(6):583–592.