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Background: The COVID-19 pandemic has had a significant impact on the mental health of healthcare workers (HCWs) particularly in low and middle-income countries (LMICs). This scoping review provides a summary of current evidence on the mental health consequences of COVID on HCWs. Methods: A scoping review was conducted searching PubMed and Embase for articles relevant to mental health conditions among HCWs during COVID-19. Relevant articles were screened and extracted to summarize key outcomes and findings. Results: A total of fifty-one studies were included in this review. Depressive symptoms, anxiety symptoms, psychological trauma, insomnia and sleep quality, workplace burnout and fatigue, and distress were the main outcomes reviewed. Most studies found a high number of symptoms endorsed for depression, anxiety, and other conditions. We found differences in symptoms by sex, age, and HCW role, with female, younger-aged, frontline workers, and non-physician workers being affected more than other subgroups. Conclusion: This review highlights the existing burden of mental health conditions reported by HCWs during COVID-19. It also demonstrates emerging disparities among affected HCW subgroups. This scoping review emphasizes the importance of generating high quality evidence and developing informed interventions for HCW mental health with a focus on LMICs.

Purpose: Attention-deficit/hyperactivity disorder (ADHD), conduct disorder (CD), and oppositional defiant disorder (ODD) are common externalizing disorders of childhood. The common effects of these disorders on substance abuse need further investigation. The current study investigated the joint clusters of childhood/adolescence ADHD, CD, and ODD, and their influence on substance abuse/dependence in a population-based sample of adults. Methods: The data were drawn from the PsyCoLaus study (n=3,720) conducted in Lausanne, Switzerland. The population-based sample included 238 subjects meeting criteria for ADHD/ODD/CD diagnoses before the age of 15. Latent class analyses (LCA) were performed to derive comorbidity subtypes, which were subsequently characterized with respect to psychosocial correlates and substance use. Results: The best fit in LCAs was achieved with three latent classes: an ADHD subtype (35.7%); an externalizing multimorbid subtype (33.6%) involving ODD, ADHD, and CD; and a third subtype with CD (30.7%). The CD subtype showed the highest association with substance use. Apart from this, the externalizing multimorbid subtype was also significantly linked to substance use. The ADHD subtype had only elevated frequencies for alcohol dependence in comparison with subjects that had no history of ADHD, ODD, and CD during childhood or adolescence. Finally, important interactions between subtypes and sex were observed with regard to substance use. Conclusions: This study provides evidence showing that subtyping the externalizing disorders, ADHD, ODD and CD, along their comorbidity patterns leads to important differences regarding substance use. This could have implications for the etiology, prevention, and treatment of substance use disorders.

Although dyspareunia has a major impact on sexual and general wellbeing, there are few data on the longitudinal development of its prevalence in representative study groups. Therefore, it was the aim of the present study to fill this gap by evaluating the prevalence of dyspareunia in a representative sample at age 30, 35, 41, and 50. Additional aims were to determine the association between dyspareunia, psychopathological covariates, personality characteristics, and coping resources. Semi-structured interviews with single-item questions on sexual problems in general as well as dyspareunia were used to gain information on 1-year as well as long-time prevalence rates. Psychopathological covariates were explored with the SCL-90-R. The Freiburger Personality Inventory (Freiburger Persönlichkeits Inventar, FPI) assessed personality characteristics. Scales of sense of mastery and self-esteem were used to investigate coping resources. Twelve months prevalence of dyspareunia varied between 4.5 and 6.4% with a mean of 5.6% and a long-time risk of 19.3%. No relation between age and the prevalence rates was found. Dyspareunia was related to psychopathological covariates, especially depression. With respect to personality traits as measured with the FPI only nervousness showed a significant association with dyspareunia, whereas coping resources were unrelated. As dyspareunia is experienced by about 20% of all women, it represents a frequent sexual problem. Therefore, assessment of dyspareunia should be integrated into primary care of women at any age and diagnostic as well as therapeutic strategies should be based on physiological and psychological factors.

The aim of this study was to evaluate an intervention programme for people with severe mental illness that targets the reduction in compulsory psychiatric admissions. In the current study, we examine the feasibility of retaining patients in this programme and compare outcomes over the first 12months to those after treatment as usual (TAU). Study participants were recruited in four psychiatric hospitals in the Canton of Zurich, Switzerland. Patients were eligible if they had at least one compulsory admission during the past 24months. Participants were assigned at random to the intervention or to the TAU group. The intervention programme consists of individualised psycho-education focusing on behaviours prior to illness-related crisis, crisis cards and, after discharge from the psychiatric hospital, a 24-month preventive monitoring. In total, 238 (of 756 approached) inpatients were included in the trial. After 12months, 80 (67.2%) in the intervention group and 102 (85.7%) in the TAU group were still participating in the trial. Of these, 22.5% in the intervention group (35.3% TAU) had been compulsorily readmitted to psychiatry; results suggest a significantly lower number of compulsory readmissions per patient (0.3 intervention; 0.7 TAU). Dropouts are characterised by younger age and unemployment. This interim analysis suggests beneficial effects of this intervention for targeted psychiatric patients.

The possible link between work strain and subsequent mental disorders has attracted public attention in many European countries. Burnout has become a favored concept within this context. Most burnout research has concentrated on various professional groups and less so on ordinary community samples. We analyzed the data collected from a 30-year community sample during seven measuring occasions, beginning in 1978. In the last assessment (2008), we included for the first time the Maslach Burnout Inventory (MBI). Making the diagnosis of a lifetime mental disorder a predictor for burnout required us to compile the cumulative prevalence rate over all seven occasions. We also evaluated various psycho-social predictors of burnout over the life cycle of our sample. Concurrent associations of the MBI with subscales from the SCL-90-R were also investigated. The relationship of burnout with several SCL-90-R subscales demonstrated that, in all dimensions, burnout is associated with significant psychopathology. Persons with a lifetime mood disorder, and especially those with a combination of mood and anxiety disorders, had a higher risk for subsequent burnout. Various partnership problems were another predictor for burnout. In conclusion, the role of mental disorder as an occupational illness remains controversial. Various forms of such disorders as well as some psycho-social predictors can predispose to burnout. By contrast, work-related predictors appear to be less important.

Due to its heterogeneous phenomenology, obsessive-compulsive disorder (OCD) has been subtyped. However, these subtypes are not mutually exclusive. This study presents an alternative subtyping approach by deriving non-overlapping OCD subtypes. A pure compulsive and a mixed obsessive-compulsive subtype (including subjects manifesting obsessions with/without compulsions) were analyzed with respect to a broad pattern of psychosocial risk factors and comorbid syndromes/diagnoses in three representative Swiss community samples: the Zurich Study (n=591), the ZInEP sample (n=1500), and the PsyCoLaus sample (n=3720). A selection of comorbidities was examined in a pooled database. Odds ratios were derived from logistic regressions and, in the analysis of pooled data, multilevel models. The pure compulsive subtype showed a lower age of onset and was characterized by few associations with psychosocial risk factors. The higher social popularity of the pure compulsive subjects and their families was remarkable. Comorbidities within the pure compulsive subtype were mainly restricted to phobias. In contrast, the mixed obsessive-compulsive subtype had a higher prevalence and was associated with various childhood adversities, more familial burden, and numerous comorbid disorders, including disorders characterized by high impulsivity. The current comparison study across three representative community surveys presented two basic, distinct OCD subtypes associated with differing psychosocial impairment. Such highly specific subtypes offer the opportunity to learn about pathophysiological mechanisms specifically involved in OCD.

OBJECTIVE To assess the influence of migration on the psychopathological presentation of individuals at ultra-high risk for psychosis (UHR) in São Paulo, Brazil. METHODS This study is part of the Subclinical Symptoms and Prodromal Psychosis (SSAPP) project, a cohort study in São Paulo, Brazil, designed to follow individuals at UHR. After screening with the Prodromal Questionnaire (PQ) and a clinical interview, the Global Assessment of Functioning (GAF) was administered, a neuropsychological assessment was performed, sociodemographic and migration data were obtained. We then analyzed UHR individuals who had migration data to see if migration had any effect on their cognition and psychopathology. Chi-square tests were used for categorical variables, and Student's t test or analysis of variance (ANOVA) were used for nonparametric and parametric distributions, respectively. RESULTS The sample was composed of 42 at-risk subjects, of whom 5 had a migration history in the past two generations. Those with migration history showed significantly more formal thought disturbances (p = 0.012) and sleeping problems (p = 0.033) compared to those without. CONCLUSIONS Our data reinforce migration as a risk factor for psychosis in developing countries as well, and highlights the importance of studying the specific effect of this factor in UHR psychopathology.