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      Saudi Arabia Mental Health Surveillance System (MHSS): mental health trends amid COVID-19 and comparison with pre-COVID-19 trends Translated title: Sistema de Vigilancia de Salud Mental de Arabia Saudita (MHSS): Tendencias de salud mental durante la pandemia COVID-19 y comparación con las tendencias pre COVID-19 Translated title: 沙特阿拉伯心理健康监测系统 (MHSS): COVID-19中的心理健康趋势以及与 COVID-19之前趋势的比较

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          ABSTRACT

          Background: The impact of the COVID-19 pandemic on populations’ mental health has started to emerge.

          Objectives: To describe the mental health trends of the risk of major depressive disorder (MDD) and generalized anxiety disorder (GAD) between May and August 2020. It also compares the results with pre-COVID-19 results and identifies risk factors associated with increased likelihood of being at risk of MDD and GAD.

          Method: This study utilizes repeated cross-sectional design, at national-level coverage of mental health screenings via computer-assisted phone interviews conducted in four waves monthly (between May and August 2020). Arabic-speaking adults from Saudi Arabia were recruited via a random phone list. The questionnaire includes the Arabic version of the Patient Health Questionnaire (PHQ-9) and the General Anxiety Disorder-7 (GAD-7). Pre-COVID-19 comparison was done using the PHQ-2 score to allow for comparison with a previous and similar national study conducted in 2018.

          Results: Across the four waves, 16,513 participants completed the interviews, with an overall response rate of 81.3%. The weighted national prevalence of people at risk of MDD was 14.9% overall, and 13.8%, 13.6%, 16.8%, and 15.3% in Waves 1, 2, 3, and 4, respectively. The weighted national prevalence of people at risk of GAD was 11.4%, overall, and 10.9%, 10.7%, 12.4%, and 11.7% in Waves 1, 2, 3, and 4, respectively. The weighted national proportion of individuals who were at risk of MDD and GAD at the same time was 7.4% overall. The risk of MDD on PHQ-2 increased by 71.2%, from 12.5% in 2018 to 21.4% in 2020.

          Conclusions: The risks of MDD and GAD in this study are relatively high. These results can help decision makers to understand the impact of the COVID-19 pandemic on the population’s mental health and the most-impacted subgroups.

          HIGHLIGHTS

          • In the first national study of COVID-19 impact on mental health form Saudi Arabia, the risk of depression in Saudi Arabia increased by 71.2% between May and August 2020 compared to 2018.

          Translated abstract

          Antecedentes: El impacto de la pandemia COVID-19 en la salud mental de la población ha comenzado a emerger.

          Objetivos: Describir las tendencias en salud mental del riesgo de tener un trastorno depresivo mayor (MDD por sus siglas en inglés) y un trastorno de ansiedad generalizado (GAD por sus siglas en inglés) entre Mayo y Agosto de 2020. También compara los resultados con los resultados pre COVID-19 e identifica factores de riesgo asociados con el aumento de la probabilidad de estar en riesgo de sufrir MDD y GAD

          Método: Este estudio utiliza un diseño transversal repetido, a un nivel de cobertura nacional de tamizaje sobre salud mental vía entrevistas telefónicas asistidas por computador, conducidas en 4 olas mensualmente (entre Mayo y agosto de 2020). Adultos que hablasen árabe de Arabia Saudita fueron reclutados mediante una lista aleatoria de teléfonos. El cuestionario incluía la versión árabe del Cuestionario de Salud del Paciente (PHQ-9) y de La Escala del Trastorno de Ansiedad Generalizada (GAD-7). Se hicieron comparaciones pre-COVID 19 usando el puntaje del PHQ-2 para permitir la comparación con un estudio previo nacional de características similares que fue realizado el 2018.

          Resultados: A través de las cuatro olas, 16.513 participantes completaron las entrevistas, con una tasa de respuesta promedio de 81.3%. La prevalencia nacional calculada de personas en riesgo para MDD fue de 14.9% en general y de 13.8%, 13.6%, 16.8% y 15.3% en Olas 1, 2, 3 y 4 respectivamente. La prevalencia nacional calculada de personas en riesgo para GAD fue 11.4% en general y 10.9%, 10.7%, 12.4% y 11.7% en Olas 1, 2, 3 y 4 respectivamente. La proporción nacional calculada de individuos que estaban en riesgo para MDD y GAD al mismo tiempo fue de 7.4% en general. El riesgo de MDD según el PHQ-2 aumentó en un 71.2%, de 12.5% en 2018 a 21.4% en 2020.

          Conclusiones: El riesgo de MDD y GAD encontrado en este estudio es relativamente alto. Estos resultados pueden ayudar a entender a las personas que toman decisiones del impacto de la pandemia COVID-19 en la salud mental de la población y en los subgrupos más impactados.

          背景: COVID-19疫情对人们心理健康的影响开始逐渐显现。

          目的: 描述2020年5月至8月期间重性抑郁障碍 (MDD) 和广泛性焦虑症 (GAD) 风险的心理健康趋势。还将这些结果与COVID-19之前的结果进行比较, 并确定患MDD和GAD可能性增加的相关风险因素。

          方法: 本研究利用重复的横断面设计, 通过2020年5月至8月每月进行的四次计算机辅助电话访谈, 在全国范围内进行心理健康筛查。通过随机电话列表招募了沙特阿拉伯中说阿拉伯语的成人。问卷包括阿拉伯语版的患者健康问卷 (PHQ-9) 和广泛性焦虑障碍量表 (GAD-7) 。与COVID-19之前的比较使用了PHQ-2评分, 以便与2018年进行的前人的类似国家研究进行比较。

          结果: 在这四次测量中, 16,513名参与者完成了访谈, 总回应率为81.3%。MDD风险人群的加权全国患病率总体上为14.9%, 在第1, 2, 3和4次测量中分别为13.8%, 13.6%, 16.8%和15.3%。GAD风险人群的加权全国患病率总体上为11.4%, 第1, 2, 3和4次分别为10.9%, 10.7%, 12.4%和11.7%。同时为MDD和GAD的风险人群的加权全国比例总体上为7.4%。 PHQ-2的MDD风险从2018年的12.5%增加到2020年的21.4%, 共增加了71.2%, 。

          结论: 本研究中MDD和GAD的风险较高。这些结果可以帮助决策者了解COVID-19疫情对人群心理健康和受影响最大亚群的影响。

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          A brief measure for assessing generalized anxiety disorder: the GAD-7.

          Generalized anxiety disorder (GAD) is one of the most common mental disorders; however, there is no brief clinical measure for assessing GAD. The objective of this study was to develop a brief self-report scale to identify probable cases of GAD and evaluate its reliability and validity. A criterion-standard study was performed in 15 primary care clinics in the United States from November 2004 through June 2005. Of a total of 2740 adult patients completing a study questionnaire, 965 patients had a telephone interview with a mental health professional within 1 week. For criterion and construct validity, GAD self-report scale diagnoses were compared with independent diagnoses made by mental health professionals; functional status measures; disability days; and health care use. A 7-item anxiety scale (GAD-7) had good reliability, as well as criterion, construct, factorial, and procedural validity. A cut point was identified that optimized sensitivity (89%) and specificity (82%). Increasing scores on the scale were strongly associated with multiple domains of functional impairment (all 6 Medical Outcomes Study Short-Form General Health Survey scales and disability days). Although GAD and depression symptoms frequently co-occurred, factor analysis confirmed them as distinct dimensions. Moreover, GAD and depression symptoms had differing but independent effects on functional impairment and disability. There was good agreement between self-report and interviewer-administered versions of the scale. The GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research.
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            The PHQ-9: validity of a brief depression severity measure.

            While considerable attention has focused on improving the detection of depression, assessment of severity is also important in guiding treatment decisions. Therefore, we examined the validity of a brief, new measure of depression severity. The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. The PHQ-9 is the depression module, which scores each of the 9 DSM-IV criteria as "0" (not at all) to "3" (nearly every day). The PHQ-9 was completed by 6,000 patients in 8 primary care clinics and 7 obstetrics-gynecology clinics. Construct validity was assessed using the 20-item Short-Form General Health Survey, self-reported sick days and clinic visits, and symptom-related difficulty. Criterion validity was assessed against an independent structured mental health professional (MHP) interview in a sample of 580 patients. As PHQ-9 depression severity increased, there was a substantial decrease in functional status on all 6 SF-20 subscales. Also, symptom-related difficulty, sick days, and health care utilization increased. Using the MHP reinterview as the criterion standard, a PHQ-9 score > or =10 had a sensitivity of 88% and a specificity of 88% for major depression. PHQ-9 scores of 5, 10, 15, and 20 represented mild, moderate, moderately severe, and severe depression, respectively. Results were similar in the primary care and obstetrics-gynecology samples. In addition to making criteria-based diagnoses of depressive disorders, the PHQ-9 is also a reliable and valid measure of depression severity. These characteristics plus its brevity make the PHQ-9 a useful clinical and research tool.
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              Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science

              Summary The coronavirus disease 2019 (COVID-19) pandemic is having a profound effect on all aspects of society, including mental health and physical health. We explore the psychological, social, and neuroscientific effects of COVID-19 and set out the immediate priorities and longer-term strategies for mental health science research. These priorities were informed by surveys of the public and an expert panel convened by the UK Academy of Medical Sciences and the mental health research charity, MQ: Transforming Mental Health, in the first weeks of the pandemic in the UK in March, 2020. We urge UK research funding agencies to work with researchers, people with lived experience, and others to establish a high level coordination group to ensure that these research priorities are addressed, and to allow new ones to be identified over time. The need to maintain high-quality research standards is imperative. International collaboration and a global perspective will be beneficial. An immediate priority is collecting high-quality data on the mental health effects of the COVID-19 pandemic across the whole population and vulnerable groups, and on brain function, cognition, and mental health of patients with COVID-19. There is an urgent need for research to address how mental health consequences for vulnerable groups can be mitigated under pandemic conditions, and on the impact of repeated media consumption and health messaging around COVID-19. Discovery, evaluation, and refinement of mechanistically driven interventions to address the psychological, social, and neuroscientific aspects of the pandemic are required. Rising to this challenge will require integration across disciplines and sectors, and should be done together with people with lived experience. New funding will be required to meet these priorities, and it can be efficiently leveraged by the UK's world-leading infrastructure. This Position Paper provides a strategy that may be both adapted for, and integrated with, research efforts in other countries.
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                Author and article information

                Journal
                Eur J Psychotraumatol
                Eur J Psychotraumatol
                European Journal of Psychotraumatology
                Taylor & Francis
                2000-8198
                2000-8066
                22 February 2021
                2021
                : 12
                : 1
                : 1875642
                Affiliations
                [a ]Scientific Affairs Department, Sharik Association for Health Research; , Riyadh, Saudi Arabia
                [b ]CEO Office, Saudi Food and Drug Authority; , Riyadh, Saudi Arabia
                [c ]Public Health Department, College of Medicine, Alfaisal University; , Riyadh, Saudi Arabia
                [d ]Small and medium enterprises Department, Ministry of Health; , Riyadh, Saudi Arabia
                [e ]Department of Clinical Neurosciences, College of Medicine, Al-Imam Mohammad Ibn Saud Islamic University (IMSIU); , Riyadh, Saudi Arabia
                [f ]Population Health Department, King Abdulah International Medical Research Center (KAIMRC); , Riyadh, Saudi Arabia
                [g ]Public Health Research and Health Statistics Department, The National Center for Disease Prevention and Control (Weqaya); , Riyadh, Saudi Arabia
                [h ]Research and Studies Department, Saudi Health Council; , Riyadh, Saudi Arabia
                [i ]Mental Health Department, King Fahd Specialist Hospital; , Dammam, Saudi Arabia
                Author notes
                CONTACT Nasser F. BinDhim nd@ 123456nasserdhim.com Sharik Association for Health Research; , Riyadh, Saudi Arabia
                Author information
                https://orcid.org/0000-0001-8117-1044
                https://orcid.org/0000-0002-8215-6097
                https://orcid.org/0000-0002-8905-8641
                https://orcid.org/0000-0003-4885-9036
                https://orcid.org/0000-0001-5817-0481
                https://orcid.org/0000-0002-3193-2586
                https://orcid.org/0000-0002-0501-5610
                https://orcid.org/0000-0003-1808-2596
                https://orcid.org/0000-0001-5583-131X
                Article
                1875642
                10.1080/20008198.2021.1875642
                8128114
                34025918
                2fd4b6b1-234b-4545-ab5b-0b41745a99c0
                © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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                Figures: 0, Tables: 4, References: 40, Pages: 11
                Categories
                Research Article
                Clinical Research Article

                Clinical Psychology & Psychiatry
                mental health,depression,anxiety,screening,surveillance,covid-19,salud mental,depresión,ansiedad,tamizaje,vigilancia,心理健康,抑郁,焦虑,筛查,监测

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