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      A pilot randomized controlled trial of a group intervention via Zoom to relieve loneliness and depressive symptoms among older persons during the COVID-19 outbreak

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          Abstract

          While effective in reducing infections, social distancing during the COVID-19 outbreak may carry ill effects on the mental health of older adults. The present study explored the efficacy of a short-term digital group intervention aimed at providing seniors with the tools and skills necessary for improving their coping ability during these stressful times. A total of 82 community-dwelling adults aged between 65 aged 90 (M age = 72 years, SD = 5.63) were randomized to either an intervention group ( n = 64) or a wait-list control group ( n = 18). The intervention comprised online guided sessions in small groups in which behavioral and cognitive techniques were learned and practiced via the ZOOM videoconferencing platform. Loneliness and depression levels were measured pre- and post-participation. The results demonstrated a significant improvement in the intervention group in terms of both loneliness and depressive symptoms, compared with the control group. Results of mixed effect models indicated a medium ameliorative effect on loneliness ( d = 0.58), while that for depressive symptoms was only marginally significant and smaller in size ( d = 0.43). Our intervention presents a relatively simple and effective technique that can be efficiently utilized to support older adults both during emergencies such as the COVID-19 outbreak, as well as in more routine times for older adults who live alone or reside in remote areas.

          Highlights

          • Digital group interventions can support older people's mental health during crises.

          • Results demonstrated significant improvement in loneliness and depressive symptoms.

          • This tool can also be utilized for people who live alone or reside in remote areas.

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          Most cited references44

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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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            COVID-19 and mental health: A review of the existing literature

            Highlights • Subsyndromal mental health concerns are a common response to the COVID-19 outbreak. • These responses affect both the general public and healthcare workers. • Depressive and anxiety symptoms have been reported in 16–28% of subjects screened. • Novel methods of consultation, such as online services, can be helpful for these patients. • There is a need for further long-term research in this area, especially from other countries
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              A Short Scale for Measuring Loneliness in Large Surveys: Results From Two Population-Based Studies.

              Most studies of social relationships in later life focus on the amount of social contact, not on individuals' perceptions of social isolation. However, loneliness is likely to be an important aspect of aging. A major limiting factor in studying loneliness has been the lack of a measure suitable for large-scale social surveys. This article describes a short loneliness scale developed specifically for use on a telephone survey. The scale has three items and a simplified set of response categories but appears to measure overall loneliness quite well. The authors also document the relationship between loneliness and several commonly used measures of objective social isolation. As expected, they find that objective and subjective isolation are related. However, the relationship is relatively modest, indicating that the quantitative and qualitative aspects of social relationships are distinct. This result suggests the importance of studying both dimensions of social relationships in the aging process.
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                Author and article information

                Contributors
                Journal
                Internet Interv
                Internet Interv
                Internet Interventions
                Elsevier
                2214-7829
                27 January 2021
                April 2021
                27 January 2021
                : 24
                : 100368
                Affiliations
                [a ]School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, P.O. Box 653, Beer Sheva, Israel
                [b ]PREPARD Center for Emergency Response Research, Ben Gurion University of the Negev, P.O. Box 653, Beer Sheva, Israel
                [c ]Department of Communication Studies, Faculty of Humanities and Social Sciences, Ben Gurion University of the Negev, P.O. Box 653, Beer Sheva, Israel
                [d ]The Department of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, P.O. Box 653, Beer Sheva, Israel
                [e ]The Spitzer Department of Social Work, Faculty of Humanities and Social Sciences, Ben Gurion University of the Negev, P.O. Box 653, Beer Sheva, Israel
                [f ]Medical School for International Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O. Box 653, Beer Sheva, Israel
                [g ]The Department of Geriatrics, McGill University, Montreal, QC, Canada
                Author notes
                [* ]Corresponding author. stavshap@ 123456bgu.ac.il
                Article
                S2214-7829(21)00008-7 100368
                10.1016/j.invent.2021.100368
                7839498
                33527072
                b1a430ef-df35-443d-9f07-b97c806e0570
                © 2021 The Author(s)

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 12 August 2020
                : 13 January 2021
                : 13 January 2021
                Categories
                Full length Article

                covid-19,older adults,mental health effects,digital group intervention,cognitive-behavioral skills,randomized controlled trial

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