Background The mental health impacts of the COVID-19 pandemic remain a public health concern. High quality synthesis of extensive global literature is needed to quantify this impact and identify factors associated with adverse outcomes. Methods We conducted a rigorous umbrella review with meta-review and present (a) pooled prevalence of probable depression, anxiety, stress, psychological distress, and post-traumatic stress, (b) standardised mean difference in probable depression and anxiety pre-versus-during the pandemic period, and (c) comprehensive narrative synthesis of factors associated with poorer outcomes. Databases searched included Scopus, Embase, PsycINFO, and MEDLINE dated to March 2022. Eligibility criteria included systematic reviews and/or meta-analyses, published post-November 2019, reporting data in English on mental health outcomes during the COVID-19 pandemic. Findings Three hundred and thirty-eight systematic reviews were included, 158 of which incorporated meta-analyses. Meta-review prevalence of anxiety symptoms ranged from 24.4% (95%CI: 18–31%, I2: 99.98%) for general populations to 41.1% (95%CI: 23–61%, I2: 99.65%) in vulnerable populations. Prevalence of depressive symptoms ranged from 22.9% (95%CI: 17–30%, I2: 99.99%) for general populations to 32.5% (95%CI: 17–52%, I2: 99.35) in vulnerable populations. Prevalence of stress, psychological distress and PTSD/PTSS symptoms were 39.1% (95%CI: 34–44%; I2: 99.91%), 44.2% (95%CI: 32–58%; I2: 99.95%), and 18.8% (95%CI: 15–23%; I2: 99.87%), respectively. Meta-review comparing pre-COVID-19 to during COVID-19 prevalence of probable depression and probable anxiety revealed standard mean differences of 0.20 (95%CI = 0.07–0.33) and 0.29 (95%CI = 0.12–0.45), respectively. Conclusion This is the first meta-review to synthesise the longitudinal mental health impacts of the pandemic. Findings show that probable depression and anxiety were significantly higher than pre-COVID-19, and provide some evidence that that adolescents, pregnant and postpartum people, and those hospitalised with COVID-19 experienced heightened adverse mental health. Policymakers can modify future pandemic responses accordingly to mitigate the impact of such measures on public mental health.

/pdf/a-hidden-pandemic-an-umbrella-review-of-global-evidence-on-17mozo59.pdf

A hidden pandemic? An umbrella review of global evidence on mental health in the time of COVID-19

Internalizing conditions of psychopathology include depressive and anxiety disorders; they most often onset in adolescence, are relatively common, and contribute to significant population morbidity and mortality. In this research review, we present the evidence that internalizing conditions, including depression and anxiety, as well as psychological distress, suicidal thoughts and self-harm, and fatal suicide, are considerably increasing in adolescent populations across many countries. Evidence indicates that increases are currently greatest in female adolescents. We present an epidemiological framework for evaluating the causes of these increases, and synthesize research on whether several established risk factors (e.g., age of pubertal transition and stressful life events) and novel risk factors (e.g., digital technology and social media) meet conditions necessary to be plausible causes of increases in adolescent internalizing conditions. We conclude that there are a multitude of potential causes of increases in adolescent internalizing conditions, outline evidence gaps including the lack of research on nonbinary and gender nonconforming populations, and recommend necessary prevention and intervention foci from a clinical and public health perspective.

Annual Research Review: Sex, gender, and internalizing conditions among adolescents in the 21st century - trends, causes, consequences.

We review recent research on the epidemiology and etiology of suicide in the global context. We focus on data from low- and middle-income countries (LMIC), with the goal of highlighting findings from these under-researched, over-burdened settings.Prevalence of suicide in LMIC adults varies across region and country income-level, but is, on average, lower than in high-income countries. Recent gains in suicide reduction, however, have been smaller in LMIC compared to global rates. LMIC youth have much higher rates of suicide attempts than youth from high-income countries. Females as well as people with psychiatric disorders, those living with HIV, those who are LGBTQ + , and those with poor socioeconomic status are highly vulnerable populations in LMIC. Limited and low-quality data from LMIC hinder clear interpretation and comparison of results. A greater body of more rigorous research is needed to understand and prevent suicide in these settings. 

/pdf/suicide-in-global-mental-health-1q9562gq.pdf

Suicide in Global Mental Health

We are reviewing the current state of knowledge on the virological and immunological correlates of long COVID, focusing on recent evidence for the possible association between the increasing number of SARS-CoV-2 reinfections and the parallel pandemic of long COVID. The severity of reinfections largely depends on the severity of the initial episode; in turn, this is determined both by a combination of genetic factors, particularly related to the innate immune response, and by the pathogenicity of the specific variant, especially its ability to infect and induce syncytia formation at the lower respiratory tract. The cumulative risk of long COVID as well as of various cardiac, pulmonary, or neurological complications increases proportionally to the number of SARS-CoV-2 infections, primarily in the elderly. Therefore, the number of long COVID cases is expected to remain high in the future. Reinfections apparently increase the likelihood of long COVID, but less so if they are mild or asymptomatic as in children and adolescents. Strategies to prevent SARS-CoV-2 reinfections are urgently needed, primarily among older adults who have a higher burden of comorbidities. Follow-up studies using an established case definition and precise diagnostic criteria of long COVID in people with or without reinfection may further elucidate the contribution of SARS-CoV-2 reinfections to the long COVID burden. Although accumulating evidence supports vaccination, both before and after the SARS-CoV-2 infection, as a preventive strategy to reduce the risk of long COVID, more robust comparative observational studies, including randomized trials, are needed to provide conclusive evidence of the effectiveness of vaccination in preventing or mitigating long COVID in all age groups. Thankfully, answers not only on the prevention, but also on treatment options and rates of recovery from long COVID are gradually starting to emerge.

SARS-CoV-2 Reinfections and Long COVID in the Post-Omicron Phase of the Pandemic

Depressive disorders (DDs) are an increasingly common health problem that affects all age groups. DDs pathogenesis is multifactorial. However, it was proven that stress is one of the most important environmental factors contributing to the development of these conditions. In recent years, there has been growing interest in the role of the glutamatergic system in the context of pharmacotherapy of DDs. Thus, it has become increasingly important to explore the functioning of excitatory synapses in pathogenesis and pharmacological treatment of psychiatric disorders (including DDs). This knowledge may lead to the description of new mechanisms of depression and indicate new potential targets for the pharmacotherapy of illness. An excitatory synapse is a highly complex and very dynamic structure, containing a vast number of proteins. This review aimed to discuss in detail the role of the key postsynaptic proteins (e.g., NMDAR, AMPAR, mGluR5, PSD-95, Homer, NOS etc.) in the excitatory synapse and to systematize the knowledge about changes that occur in the clinical course of depression and after antidepressant treatment. In addition, a discussion on the potential use of ligands and/or modulators of postsynaptic proteins at the excitatory synapse has been presented.

/pdf/postsynaptic-proteins-at-excitatory-synapses-in-the-brain-2vpldjcc.pdf

Postsynaptic Proteins at Excitatory Synapses in the Brain—Relationship with Depressive Disorders

Mental health problems among children and adolescents are increasingly reported amidst the coronavirus disease (COVID-19) pandemic. In this umbrella review, we aimed to synthesize global evidence on the epidemiologic burden and correlates of child and adolescent mental health (CAMH) problems during this pandemic from existing systematic reviews and meta-analyses. Adopting the Joanna Briggs Institute (JBI) methodology, we evaluated 422 citations and identified 17 eligible reviews with medium to high methodological quality. Most of the reviews reported a high prevalence of anxiety, depression, sleep disorders, suicidal behavior, stress-related disorders, attention-deficit/hyperactivity disorder, and other mental health problems. Also, factors associated with CAMH such as age, gender, place of residence, educational attainment, household income, sedentary lifestyle, social media and internet use, comorbidities, family relationships, parents' psychosocial conditions, COVID-19 related experiences, closure of schools, online learning, and social support were reported across reviews. As most studies were cross-sectional and used nonrepresentative samples, future research on representative samples adopting longitudinal and intervention designs is needed. Lastly, multipronged psychosocial care services, policies, and programs are needed to alleviate the burden of CAMH problems during and after this pandemic. 

https://doi.org/10.1016/j.psychres.2022.114814

Global burden of mental health problems among children and adolescents during COVID-19 pandemic: An umbrella review

Mental health problems among children and adolescents are increasingly reported amidst the coronavirus disease (COVID-19) pandemic. In this umbrella review, we aimed to synthesize global evidence on the epidemiologic burden and correlates of child and adolescent mental health (CAMH) problems during this pandemic from existing systematic reviews and meta-analyses. We evaluated 422 citations and identified 17 eligible reviews on the epidemiology of CAMH in the context of COVID-19. Most of the reviews reported a high prevalence of anxiety, depression, sleep disorders, suicidal behavior, stress-related disorders, attention-deficit/hyperactivity disorder, and other mental health problems. Also, factors associated with CAMH such as age, gender, place of residence, educational attainment, household income, sedentary lifestyle, social media and internet use, comorbidities, family relationships, parents' psychosocial conditions, COVID-19 related experiences, closure of schools, online learning, and social support were reported across reviews. As most studies were cross-sectional and used nonrepresentative samples, future research on representative samples adopting longitudinal and intervention designs is needed. Lastly, multipronged psychosocial care services, policies, and programs are needed to alleviate the burden of CAMH problems during and after this pandemic.

/pdf/global-burden-of-mental-health-problems-among-children-and-2txh38a3.pdf

Global burden of mental health problems among children and adolescents during COVID-19 pandemic: A systematic umbrella review

Mentorship of international students is an enriching experience because international students studying in the United States enhance inclusion and diversity within the university environment by contributing their unique cultural and societal experiences and perspectives. International students have unique needs regardless of their country of origin and exposure. This paper provides the perspectives of international students on recommendations and strategies that mentors could employ to meet some of the identified needs of international students. 

/pdf/meeting-the-mentorship-needs-of-international-students-in-2c96l3l6.pdf

Meeting The Mentorship Needs Of International Students In The United States

We read the umbrella review on the impact of COVID19 on the mental health of children and young people by Bevilacqua et al with great interest, as this work provides an updated synthesis of evidence after our previously published umbrella review on that topic. The inclusion of more recent reviews and PROSPERO registration are notable advances in this work. However, a few concerns about this review should be addressed for scientific clarity and evidencebased decisionmaking on the mental health of children and young people globally. First, this work ‘was conducted following the Preferred Reporting Items for Systematic Reviews and MetaAnalyses (PRISMA) guidelines,’ whereas the PRISMA statement states that ‘PRISMA 2020 is not intended to guide systematic review conduct, for which comprehensive resources are available.’ For umbrella reviews, specific methodological guidance is available from the Joanna Briggs Institute) working group, which can facilitate evidence synthesis using this approach. Second, six reviews (2nd, 5th, 6th, 9th, 13th and 18th reviews in authors’ online supplemental table 1) with inappropriate populations or outcomes conflict with the review criteria. Notably, umbrella reviews examine evidence at the ‘review level’ rather than the ‘study level’ 4 requiring all reviews to present studies with similar objectives rather than reviews with multiobjective studies. This inclusion of ‘partial evidence’ from those mixedstudies reviews lacks methodological justification. Lastly, the authors included several reviews that did not compare mental health problems ‘before versus during the COVID19 pandemic,’ as mentioned in the review criteria. For example, Bussières et al included 43 crosssectional that lacked comparisons with prepandemic data. Similarly, another review by Chai et al included 12 crosssectional studies in their metaanalysis, which did not have such comparisons with prepandemic data. This conflict is critical for the credibility of this umbrella review and its findings. Without quantitative comparisons between prepandemic and pandemic or postpandemic data, it would be inappropriate to call any mental health burden the ‘impact’ of this pandemic alone. For this reason, the title of the current umbrella review may not be justified as the true mental impact of COVID19 on children and adolescents is not accurately synthesised and reported here. These concerns and further discourses on the same may help the readers better understand the current umbrella review and future research. Systematic evidence synthesis is necessary for timely and effective policymaking and practice; therefore, enthusiastic scholars must conduct evidence synthesis with optimal rigour and transparency that benefit science and society.

Impact of COVID-19 on the mental health of children and young people: perspectives on evidence synthesis

CONTEXT.—
The tissue diagnosis of amyloidosis is traditionally suggested by hematoxylin-eosin stain and confirmed by Congo red stain, both examined by routine light microscopy. Both false-positive and false-negative congophilia are well documented, limiting the sensitivity and specificity of the Congo red stain for the diagnosis of amyloidosis. Examination of Congo red-stained tissue by Texas Red-filtered fluorescence microscopy (TRFM) is known to enhance the amyloid-specific congophilia, thus increasing the diagnostic sensitivity.


OBJECTIVE.—
To determine whether TRFM can mitigate the false positivity and thus improve the diagnostic specificity of the Congo red stain.


DESIGN.—
Ninety-two tissue samples were categorized into 3 groups. Group I included 15 samples with tissue deposition of amyloid. Group II consisted of 63 samples in which amorphous eosinophilic structures reminiscent of amyloid were seen on hematoxylin-eosin-stained tissue sections. Group III included 14 samples in which amyloid and amyloid-like tissue were seen side by side. The final diagnosis of presence or absence of amyloidosis in each case was established by clinicopathologic correlation. The congophilic areas in each case were identified by light microscopy. The same areas were then examined by TRFM.


RESULTS.—
TRFM enhanced congophilia, confirming the diagnosis of amyloidosis in all cases of group I. Enhancement was not seen in 52 of the 63 cases in group II. For group III cases, TRFM enhanced the amyloid-specific congophilia, but not the nonspecific congophilia, in all cases.


CONCLUSIONS.—
TRFM increases the diagnostic yield and specificity of Congo red-stained tissue sections for detection of amyloid.

Increased Diagnostic Specificity of Congo Red Stain for Amyloid.

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