Pregnant Women Are More Vulnerable to Mental Health Problems Due to the COVID-19 Pandemic
What’s New Pregnant and postpartum women in 64 countries, including the United States, have been experiencing a higher level of symptoms of post-traumatic stress, depression, anxiety, and loneliness as a result of the ongoing COVID-19 pandemic, according to a study published in April 2021 in PLOS One. Factors that put women at the greatest risk were worrying about their children and medical care, as well as seeking information about the pandemic at least five times a day from any source, whether online searches or talking to others. Research Details Nearly 6,900 pregnant and postpartum women from around the world participated in an online survey advertised on social media and online parenting forums. The survey found that 43 percent of women demonstrated higher levels of post-traumatic stress, 31 percent of women experienced more symptoms of depression and anxiety, and 53 percent of women had high levels of loneliness. Other key findings:
86 percent of women were worried about COVID-19.59 percent were concerned that their families couldn’t visit after the baby was born.59 percent worried that their baby would come down with COVID-19.55 percent feared not having someone to support them when they gave birth.41 percent worried that COVID-19 would lead to changes in their delivery plans.
Why It Matters Psychological distress during pregnancy and after birth can negatively impact both mothers’ and their children’s health. “We know that maternal mental health has adverse effects on a range of outcomes for the offspring — for example, infant outcomes, mother-infant bonding, and later offspring physical and behavioral health,” says study author Karestan Koenen, PhD, a professor of psychiatric epidemiology at the Harvard T.H. Chan School of Public Health in Boston, adding that helpful ways to care for mental health could include:
Limiting exposure to COVID-19-related newsEating well and fitting in some exerciseGetting enough sleepLeaning on loved ones for social support
Mental health screening among pregnant and postpartum women is also key, but efforts shouldn’t stop there, says study author Archana Basu, PhD, a research scientist at the Harvard T.H. Chan School of Public Health. “In addition to screening and monitoring mental health symptoms, addressing potentially modifiable factors such as excessive information seeking and women’s worries about access to medical care and their children’s well-being, and developing strategies to target loneliness such as online support groups, should be part of intervention efforts for perinatal women,” says Dr. Basu. RELATED: What It’s Like to Give Birth During the Coronavirus Pandemic Research Details The study included 103 children who received either online cognitive behavioral therapy or online supportive therapy for 10 weeks. CBT strategies used included educating the participants about social anxiety disorder, training them in social skills, gradually exposing them to different social situations, and having a plan for preventing a relapse. Supportive therapy entailed teaching participants about social anxiety disorder and emphasizing the importance of friendships, healthy habits such as exercise, and finding strategies to overcome difficult social situations. The researchers found that online CBT was much more effective than online supportive therapy, noting that CBT was linked to lower medication use and costs, as well as increased productivity in school. Why It Matters “Internet-delivered cognitive behavioral therapy has the potential to overcome common treatment barriers and increase availability of evidence-based psychological treatments for this patient group,” the authors write. RELATED: What Are Common Symptoms of Anxiety Disorders?
Young Adults With Schizophrenia Face Higher Risk of Suicide
What’s New A large study published in May 2021 in JAMA Psychiatry showed that people with schizophrenia who are on Medicare, especially those between age 18 and 34, have an increased risk of dying by suicide. Factors found to elevate the risk of suicide in young adults were recent suicide attempts or self-harm, thoughts of suicide, and having a substance use disorder. Research Details For the study, researchers assessed nearly 669,000 people with schizophrenia who had Medicare coverage, of whom 2,218 died by suicide. Risk of suicide was studied by age group: 18 to 34, 35 to 44, 45 to 54, 55 to 64, and 65 or older. The results showed that people with schizophrenia who are on Medicare have a 4.5 times higher risk of dying by suicide than the general U.S. population, but also that suicide risk decreased over time with age. Why It Matters For adults being treated for schizophrenia, having a trusting relationship with their treatment team is key to effective suicide screening and prevention, says study author Mark Olfson, MD, MPH, who is a professor of psychiatry, medicine, and law at Columbia University Irving Medical Center in New York City. “Because they may have received involuntary inpatient treatment at some point in their lives, which is often an aversive experience, they may be reluctant to confide their suicidal thoughts or plans to their clinicians.” According to Dr. Olfson and his colleagues, their findings indicate the importance of taking steps to prevent suicide among people with schizophrenia, especially those who are young adults. These steps could potentially lower risk:
Increased access to Clozaril (clozapine), a drug treatment used to reduce suicide risk in people with schizophreniaReceiving treatment for any drug use disordersAccess to detection programs for early psychosis, which the National Alliance on Mental Illness defines as thoughts or perceptions that make it hard for someone to recognize what is and is not realUndergoing screening for suicide risk in inpatient settingsReceiving cognitive behavioral therapy to address hallucinations and suicidal thoughts or behaviors
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Virtual Eating Disorder Treatment Not Favored By Patients
What’s New A preliminary study published in March 2021 in the Journal of Eating Disorders suggests that virtual treatment for eating disorders, which abruptly became the norm during the COVID-19 pandemic, was not considered as desirable as face-to-face treatment by the majority of patients included in the study. Research Details The authors of the study created a scale containing six statements aimed toward measuring 63 patients’ perceptions of online treatment, whether patients felt online treatment positively or negatively affected the quality of their care, and whether they would like to continue virtual treatment instead of traditional face-to-face treatment. Patients receiving treatment also completed questionnaires about their eating disorder symptoms, anxiety related to COVID-19, and feelings toward telemedicine, among other factors. The results showed that 68 percent of participants would not continue online treatment if given the choice. The researchers note that establishing and strengthening a new relationship with a therapist remotely was difficult for patients in their recovery process. Other key findings:
40 percent of participants felt that transitioning to virtual treatment negatively impacted the quality and effectiveness of their treatment.54 participants said they would not recommend virtual treatment to their loved ones.
Why It Matters The study’s authors say that their findings align with experiences described by healthcare professionals who treat eating disorders, adding that “previous face-to-face engagement with a therapist was found to allow for a smoother transition to distant [eating disorder] protocol-based treatment during the pandemic, whereas initiating the program distantly was greeted by difficulty in building a collaborative relationship.” RELATED: The Best Telemedicine Apps to Use During the Coronavirus Pandemic
FDA Okays Marketing of Autism Diagnostic Aid
What’s New The Food and Drug Administration (FDA) has given a green light to the Cognoa ASD Diagnosis Aid, a device that can help diagnose autism spectrum disorder (ASD) among children ages 18 months to 5 years old. Research Details The Cognoa ASD Diagnosis Aid was evaluated in a study of 425 patients with possible symptoms of autism. Researchers compared the device’s ability to diagnose autism against a panel of experts who used the existing standard diagnostic process. According to the results of the study, the Cognoa ASD Diagnosis Aid helped make a diagnosis in 32 percent of patients. The device’s results matched the panel’s decisions in 81 percent of patients who had a positive for ASD result and 98 percent of patients with a negative for ASD result. The device was accurate in more than 98 percent of patients with autism and nearly 79 percent of patients without autism. But the device yielded a false positive result in 15 out of 303 patients without autism and one false negative result among 122 patients who did have autism. Why It Matters Approximately 1 in 54 children in the United States has autism, according to the Centers for Disease Control and Prevention. “Autism spectrum disorder can delay a child’s physical, cognitive, and social development, including motor skill development, learning, communication, and interacting with others. The earlier ASD can be diagnosed, the more quickly intervention strategies and appropriate therapies can begin,” Jeff Shuren, MD, director of the Center for Devices and Radiological Health, says in the FDA’s press release. The Cognoa ASD Diagnosis Aid is another tool that can help identify this condition in young children, he adds. RELATED: 5 Things People With Autism and Their Caregivers Should Know About COVID-19 Vaccines