Objectives
To estimate the population prevalence of clinically significant symptoms of depression, generalised anxiety, thoughts of being better off dead, irritability, and high optimism about the ...future, and of direct experience of COVID‐19, loss of employment caused by COVID‐19 restrictions, worry about contracting COVID‐19, or major disadvantage because of the restrictions; to examine the relationship between these experiences and reporting mental symptoms.
Design, setting, participants
Anonymous online survey of adult Australian residents, 3 April – 2 May 2020.
Main outcome measures
Self‐reported psychological status during the preceding fortnight assessed with the Patient Health Questionnaire 9 (PHQ‐9; symptoms of depression) and the Generalised Anxiety Disorder Scale (GAD‐7). Optimism about the future was assessed with a 10‐point study‐specific visual analogue scale.
Results
13 829 respondents contributed complete response data. The estimated prevalence of clinically significant symptoms of depression (PHQ‐9 ≥ 10) was 27.6% (95% CI, 26.1–29.1%) and of clinically significant symptoms of anxiety (GAD‐7 ≥ 10) 21.0% (95% CI, 19.6–22.4%); 14.6% of respondents (95% CI, 13.5–16.0%) reported thoughts of being better off dead or self‐harm (PHQ‐9, item 9) on at least some days and 59.2% (95% CI, 57.6–60.7%) that they were more irritable (GAD‐7, item 6). An estimated 28.3% of respondents (95% CI, 27.1–29.6%) reported great optimism about the future (score ≥ 8). People who had lost jobs, were worried about contracting COVID‐19, or for whom the restrictions had a highly adverse impact on daily life were more likely to report symptoms of depression or anxiety, and less likely to report high optimism than people without these experiences.
Conclusions
Mental health problems were widespread among Australians during the first month of the stage two COVID‐19 restrictions; in addition, about one‐quarter of respondents reported mild to moderate symptoms of depression or anxiety. A public mental health response that includes universal, selective and indicated clinical interventions is needed.
Violence against women perpetrated by an intimate partner (IPV) is prevalent in low- and middle-income countries (LAMIC). The aim was to describe the attitudes of women and men towards perpetration ...of physical violence to women by an intimate partner, in a large group of low- and middle-income countries.
We used data from Round Four of the UNICEF Multiple Indicator Cluster Surveys. Attitudes towards IPV against women were assessed by a study-specific scale asking if 'wife beating' is justified in any of five circumstances. Overall, data from 39 countries (all had data from women and 13 countries also had data from men) were included in the analyses. The proportions of women who held attitudes that 'wife-beating' was justified in any of the five circumstances varied widely among countries from 2.0% (95% CI 1.7;2.3) in Argentina to 90.2% (95% CI 88.9;91.5) in Afghanistan. Similarly, among men it varied from 5.0% (95% CI 4.0;6.0) in Belarus to 74.5% (95% CI 72.5;76.4) in the Central African Republic. The belief that 'wife-beating' is acceptable was most common in Africa and South Asia, and least common in Central and Eastern Europe and Latin America and the Caribbean. In general this belief was more common among people in disadvantaged circumstances, including being a member of a family in the lowest household wealth quintile, living in a rural area and having limited formal education. Young adults were more likely to accept physical abuse by a man of his intimate partner than those who were older, but people who had never partnered were less likely to have these attitudes.
Violence against women is an international priority and requires a multicomponent response. These data provide evidence that strategies should include major public education programs to change attitudes about the acceptability of IPV against women, and that these should be addressed to women and girls as well as to boys and men.
Research concerning the psychosocial aspects of infertility and infertility treatment focuses more often on women than men. The aim of this review was to synthesize the English-language evidence ...related to the psychological and social aspects of infertility in men and discuss the implications of these reports for clinical care and future research. A structured search identified 73 studies that reported data concerning the desire for fatherhood and the psychological and social aspects of diagnosis, assisted reproductive technology (ART) treatment and unsuccessful treatment among men with fertility difficulties. The studies are diverse in conceptualisation, design, setting and data collection, but the findings were reasonably consistent. These studies indicated that fertile and infertile childless men of reproductive age have desires to experience parenthood that are similar to those of their female counterparts; in addition, diagnosis and initiation of treatment are associated with elevated infertility-specific anxiety, and unsuccessful treatment can lead to a state of lasting sadness. However, rates of clinically significant mental health problems among this patient population are no higher than in the general population. Infertile men who are socially isolated, have an avoidant coping style and appraise stressful events as overwhelming, are more vulnerable to severe anxiety than men without these characteristics. Men prefer oral to written treatment information and prefer to receive emotional support from infertility clinicians rather than from mental health professionals, self-help support groups or friends. Nevertheless, structured, facilitated psycho-educational groups that are didactic but permit informal sharing of experiences might be beneficial. There are gaps in knowledge about factors governing seeking, persisting with and deciding to cease treatment; experiences of invasive procedures; parenting after assisted conception; adoption and infertility-related grief and shame among men. Few resource-constrained countries have any data concerning male experiences of infertility.
The American Psychological Association's (APA's) Ethical Principles of Psychologists and Code of Conduct (American Psychological Association, 2017b; hereinafter referred to as the Ethics Code) does ...not contain an enforceable standard regarding psychologists' role in either honoring or protecting the free speech of others, or ensuring that their own free speech is protected, including an important corollary of free speech, the protection of academic freedom. Illiberal acts illegitimately restrict civil liberties. We argue that the ethics of illiberal acts have not been adequately scrutinized in the Ethics Code. Psychologists require free speech to properly enact their roles as scientists as well as professionals who wish to advocate for their clients and students to enhance social justice. This article delineates criteria for what ought to be included in the Ethics Code, argues that ethical issues regarding the protection of free speech rights meet these criteria, and proposes language to be added to the Ethics Code.
Public Significance Statement
Freedom of speech is a fundamental civil right and currently has come under threat. Psychologists can only perform their duties as scientists, educators, or practitioners if they are not censored or fear censorship. The American Psychological Association's (APA's) Ethics Code contains no enforceable ethical standard to protect freedom of speech for psychologists. This article examines the ethics of free speech and argues for amending the APA Ethics Code to more clearly delineate psychologists' rights and duties regarding free speech. This article argues that such protection is an ethical matter and for specific language to be included in the Ethics Code.
Depression and anxiety are recognised increasingly as serious public health problems among women in low- and lower-middle income countries. The aim of this study was to validate the 21-item ...Depression Anxiety and Stress Scale (DASS21) for use in screening for these common mental disorders among rural women with young children in the North of Vietnam.
The DASS-21 was translated from English to Vietnamese, culturally verified, back-translated and administered to women who also completed, separately, a psychiatrist-administered Structured Clinical Interview for DSM IV Axis 1 diagnoses of depressive and anxiety disorders. The sample was a community-based representative cohort of adult women with young children living in Ha Nam Province in northern Viet Nam. Cronbach's alpha, Exploratory Factor Analyses (EFA) and Receiver Operating Characteristic (ROC) analyses were performed to identify the psychometric properties of the Depression, Anxiety, and Stress subscales and the overall scale.
Complete data were available for 221 women. The internal consistency (Cronbach's alpha) of each sub-scale and the overall scale were high, ranging from 0.70 for the Stress subscale to 0.88 for the overall scale, but EFA indicated that the 21 items all loaded on one factor. Scores on each of the three sub-scales, and the combinations of two or three of them were able to detect the common mental disorders of depression and anxiety in women with a sensitivity of 79.1% and a specificity of 77.0% at the optimal cut off of >33. However, they did not distinguish between those experiencing only depression or only anxiety.
The total score of the 21 items of the DASS21-Vietnamese validation appears to be comprehensible and sensitive to detecting common mental disorders in women with young children in primary health care in rural northern Vietnam and therefore might also be useful to screen for these conditions in other resource-constrained settings.
We aimed to estimate the population prevalence of people with changes in their usual patterns of alcohol use during the early stages of the novel coronavirus pandemic of 2020 (COVID-19) pandemic in ...Australia; assess the association between mental health status and changes in alcohol use during the pandemic; and examine if the associations were modified by gender and age.
This study was an anonymously-completed online self-report survey. Changes in alcohol use were assessed using a single fixed-choice study-specific question. Mental health was assessed using the Patient Health Questionnaire 9 and the Generalized Anxiety Disorder Scale.
A total of 13,829 people contributed complete data and were included in the analysis. Overall, about one in five adults reported that they had been drinking more alcohol since the COVID-19 pandemic began than they used to. People were more likely to be drinking alcohol more than they used to if they had more severe symptoms of depression or anxiety. The associations between depressive and anxiety symptoms and increased alcohol use since the COVID-19 pandemic began were consistent between females and males.
Online surveys are less accessible to some groups of people. The data are self-report and not diagnostic. Cross-sectional data can identify associations, not causal relationships. The study was limited to participants from Australia.
These data indicate that there is a need for public policies focused on alcohol use during the COVID-19 pandemic and the strategies should include specific consideration of the needs of people with mental health problems.
Endometriosis is a chronic, inflammatory condition. The aim was to describe the self-reported disease characteristics and factors associated with the use of different treatment modalities among women ...with surgically diagnosed endometriosis.
A cross-sectional online survey featuring 58 fixed-response items measuring disease characteristics, self-efficacy, health service usage, and treatment approaches was conducted. Logistic regression was used to explore the factors associated with different treatment modalities.
Complete data were available from 620 respondents. Average delay to diagnosis was 6.4 years. Despite medical and surgical intervention, 65.8% reported dysmenorrhea and 61.1% reported dyspareunia, and 82.7% reported chronic pelvic pain in the last 3 months. Respondents had consulted an average of three different health practitioner specialties in the previous 12 months for their endometriosis.
A chronic disease management plan (CDMP) may be a useful mechanism to coordinate multidisciplinary care among women who experience ongoing symptoms.
The ethically proper response to problematic speech is more speech and not censorship. To the extent that Jackson (2022) and Smith (2022) advocate for all to be able to criticize all, for example, ...for unempowered undergraduates to criticize privileged White male professors or for anyone to criticize racist or hate speech, we are in agreement. The speech involved in criticism can be risky and hence ought to be protected by the Ethical Principles of Psychologists and Code of Conduct (American Psychological Association, 2017). However, except in very circumscribed circumstances, to the extent that Jackson or Smith advocate for acts such as the suppression, censorship, or punishment of speech, we are in disagreement.
Universal interventions to prevent postnatal mental disorders in women have had limited success, perhaps because they were insufficiently theorized, not gender-informed and overlooked relevant risk ...factors. This study aimed to determine whether an innovative brief psycho-educational program for mothers, fathers and first newborns, which addressed salient learning needs about infant behaviour management and adjustment tasks in the intimate partner relationship, prevented postpartum mental health problems in primiparous women.
A before and after controlled study was conducted in primary care in seven local government areas in Victoria, Australia. English-speaking couples with one-week old infants were invited consecutively to participate by the maternal and child health nurse at the universal first home visit. Two groups were recruited and followed sequentially: both completed telephone interviews at four weeks and six months postpartum and received standard health care. Intervention group participants were also invited to attend a half-day program with up to five couples and one month old infants, facilitated by trained, supervised nurses. The main outcome was any Composite International Diagnostic Interview (CIDI) diagnosis of Depression or Anxiety or Adjustment Disorder with Depressed Mood, Anxiety, or Mixed Anxiety and Depressed Mood in the first six months postpartum. Factors associated with the outcome were established by logistic regression controlling for potential confounders and analysis was by intention to treat.
In total 399/646 (62%) women were recruited; 210 received only standard care and 189 were also offered the intervention; 364 (91%) were retained at follow up six months postpartum. In women without a psychiatric history (232/364; 64%), 36/125 (29%) were diagnosed with Depression or Anxiety or Adjustment Disorder with Depressed Mood, Anxiety, or Mixed Anxiety and Depressed Mood in the control group, compared with 16/107 (15%) in the intervention group. In those without a psychiatric history, the adjusted odds ratio for diagnosis of a common postpartum mental disorder was 0.43 (95% CI 0.21, 0.89) in the intervention group compared to the control group.
A universal, brief psycho-educational group program for English-speaking first time parents and babies in primary care reduces de novo postpartum mental disorders in women. A universal approach supplemented by an additional program may improve effectiveness for women with a psychiatric history.
ACTRN 12605000567628.
Endometriosis is a chronic condition where endometrial-like cells proliferate outside the uterus causing pain and disability. Limited treatments are available but symptom management is essential for ...social and economic participation. The aim was to compare women's and health professionals' perceptions of quality of endometriosis health care and opportunities for improvements.
Women participated in closed moderated online discussion groups and health professionals in semi-structured telephone interviews. Discussion group text and interview transcripts were thematically analyzed using the Framework Analysis approach.
Forty-six women, 12 general practitioners (GPs), and 1 gynecologist participated. Endometriosis can have debilitating consequences. However, women reported that healthcare providers may dismiss symptoms, lack essential knowledge and provide inconsistent advice; treatments are seldom successful or without adverse side-effects. Health professionals acknowledged limitations in expertise, persistent myths, and challenges in achieving best practice. Enhancing collaborative care skills, individualized treatment plans, and local referral pathways to multi-disciplinary care may improve satisfaction with endometriosis care-giving and receiving.
This is the first comparison of patient and practitioner perceptions of endometriosis in primary healthcare. Models of multi-disciplinary, collaborative care need to be developed and evaluated against consumer-informed measures of women's wellbeing, quality of life and satisfaction with symptom management and health care.
PDF
