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Mental Health and Substance Use Disorders during the COVID-19 Pandemic

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: closed (28 February 2023) | Viewed by 15326

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Special Issue Editors

Dr. Cristina Crocamo

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Guest Editor

Department of Medicine and Surgery, University of Milano Bicocca, via Cadore 48, 20900 Monza, Italy
Interests: public mental health; public health; digital health; psychiatric epidemiology; addiction; young people

Dr. Ashley Elizabeth Muller

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Guest Editor

Norwegian Institute of Public Health, PO Box 222 Skøyen, 0213 Oslo, Norway
Interests: evidence synthesis; opioid dependence; machine learning; substance use disorders

Dr. Ilaria Riboldi

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Assistant Guest Editor

Department of Medicine and Surgery, University of Milano-Bicocca, via Cadore 48, 20900 Monza, Italy
Interests: social psychiatry; youth mental health; eating disorders; psychiatric epidemiology

Special Issue Information

Dear Colleagues,

The COVID-19 pandemic and the measures adopted to tackle it may be risk factors for the development, exacerbation, and relapse of a range of mental disorders, especially among the most vulnerable groups. Worldwide, healthcare systems and public health policies have been challenged to develop and scale up novel treatment and prevention strategies. Numerous cross-sectional studies have pointed to healthcare professionals, who have been committed to treating COVID-19 patients during the different stages of the pandemic, as likely at risk of developing psychological distress and mental health problems, including acute traumatic stress, depression, anxiety, problematic alcohol use, and insomnia. Concurrently, a significant detrimental impact to those suffering from ongoing mental health conditions is likely due to decreased access to support and resources. Furthermore, this public health emergency had a key role also considering unhealthy behaviors such as alcohol and substance misuse. Those with substance use disorders are more likely to report COVID-19 and experience worse COVID-19-related outcomes, including higher risk of hospitalization and mortality. On the other hand, although there is limited scientific evidence, the impact of the COVID-19 pandemic might lead to substantial modifications in substance use patterns and settings.

In addition to changing mental health burdens, substance use patterns, and access to and provision of care, the COVID-19 pandemic has significantly influenced traditional mental health and substance use research settings, timelines, and resources. What are the innovations, methodological lessons, and pitfalls experienced that we could use to improve mental health management and research during the post-pandemic period?

We invite qualitative, quantitative, and theoretical submissions related to the impact of the pandemic on mental health and substance use disorder treatment and research:

Implications of COVID-19 for the present and the future of mental health care and substance use disorder (SUD) treatment, considering also special populations and vulnerable groups;
Promising and transformative approaches to mental health service delivery;
Changes in mental health research methodologies during the pandemic, from statistical and machine-learning-related to qualitative and participatory approaches;
Innovative digital resources development, such as large mental health and SUD administrative data sets, digital health and machine learning algorithms, and national symptom registries.

Dr. Cristina Crocamo
Dr. Ashley Elizabeth Muller
Dr. Ilaria Riboldi
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

COVID-19;

mental health;

substance use disorders;

healthcare workers;

research;

public health;

novel strategies;

digital resources

Published Papers (7 papers)

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Research

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15 pages, 1227 KiB

Open AccessArticle

Psychosocial Impacts of the COVID-19 Pandemic on Women with Spinal Cord Injury

by Heather B. Taylor, Rosemary B. Hughes, Diana Gonzalez, Muna Bhattarai and Susan Robinson-Whelen

Int. J. Environ. Res. Public Health 2023, 20(14), 6387; https://doi.org/10.3390/ijerph20146387 - 18 Jul 2023

Viewed by 1210

Abstract

This study represents the first known research addressing the impact of the COVID-19 pandemic on women with spinal cord injury (SCI) in the United States. Women in this population face unique barriers that put them at elevated risk for compromised quality of life, risk that was magnified by physical and social restrictions imposed during the pandemic. This qualitative study examined the perceptions of women with SCI and the effect of the pandemic on their lives. The predominantly White and relatively well-educated sample of 105 women with traumatic SCI was diverse in age, injury characteristics, and geographic representation. Recruited across the USA, participants in an online psychological health intervention trial were asked to respond to the item, “Please tell us how COVID-19 has affected you and your life”, administered May–October, 2020. An overall sentiment rating of impact was coded as well as the impact of COVID-19 on eight individual themes: Physical Health, Mental Health, Social Health, Activities of Daily Living, Exercise, Work, Activities Outside the Home, and Activities at Home. Sentiment responses were rated as positive, negative, a mixture of positive and negative impacts, or neutral impact. Participants described the overall impact of COVID-19 as negative (54%), positive (10%), mixed (21%) or neutral (15%). Sentiment ratings to individual themes were also described. Our findings highlight the importance of providing access to disability-sensitive and affordable support, resources, and interventions for women with SCI, especially during a public health crisis. Full article

(This article belongs to the Special Issue Mental Health and Substance Use Disorders during the COVID-19 Pandemic)

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18 pages, 708 KiB

Open AccessArticle

Mental Health and COVID-19 in University Students: Findings from a Qualitative, Comparative Study in Italy and the UK

by Ilaria Riboldi, Chiara Alessandra Capogrosso, Susanna Piacenti, Angela Calabrese, Susanna Lucini Paioni, Francesco Bartoli, Cristina Crocamo, Giuseppe Carrà, Jo Armes and Cath Taylor

Int. J. Environ. Res. Public Health 2023, 20(5), 4071; https://doi.org/10.3390/ijerph20054071 - 24 Feb 2023

Cited by 12 | Viewed by 3490

Abstract

Introduction: COVID-19 restrictions introduced several changes in university academic and social experience. Self-isolation and online teaching have amplified students’ mental health vulnerability. Thus, we aimed to explore feelings and perspectives about the impact of the pandemic on mental health, comparing students from Italy and the UK. Methods: Data were collected from the qualitative portion of “the CAMPUS study”, longitudinally assessing mental health of students at the University of Milano-Bicocca (Italy) and the University of Surrey (UK). We conducted in-depth interviews and thematically analysed the transcripts. Results: The explanatory model was developed from four themes identified across 33 interviews: anxiety exacerbated by COVID-19; putative mechanisms leading to poor mental health; the most vulnerable subgroups; and coping strategies. Generalised and social anxiety resulted from COVID-19 restrictions by being associated with loneliness, excessive time online, unhealthy management of time and space and poor communication with the university. Freshers, international students, and people on the extremes of the introversion/extroversion spectrum, were identified as vulnerable, while effective coping strategies included taking advantage of free time, connection with family and mental health support. The impact of COVID-19 was mostly related to academic issues by students from Italy, whereas to the drastic loss of social connectedness by the UK sample. Conclusions: Mental health support for students has an essential role, and measures that encourage communication and social connectedness are likely to be beneficial. Full article

(This article belongs to the Special Issue Mental Health and Substance Use Disorders during the COVID-19 Pandemic)

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16 pages, 918 KiB

Open AccessArticle

Change in Alcohol Use during the Prolonged COVID-19 Pandemic and Its Psychosocial Factors: A One-Year Longitudinal Study in Japan

by Nagisa Sugaya, Tetsuya Yamamoto, Naho Suzuki and Chigusa Uchiumi

Int. J. Environ. Res. Public Health 2023, 20(5), 3871; https://doi.org/10.3390/ijerph20053871 - 22 Feb 2023

Cited by 2 | Viewed by 1602

Abstract

This study investigated changes in alcohol use and its related psychosocial factors during the COVID-19 pandemic in Japan. Two online surveys were completed by participants between 15 and 20 June 2021 (phase 1) and 13 and 30 May 2022 (phase 2). A total of 9614 individuals participated in both phases (46% women, mean age = 50.0 ± 13.1 years) and a repeated three-way analysis of variance and multinomial logistic regression analysis were conducted. These data analyses showed that the presence of hazardous alcohol use at phase 2 was predicted by being male and unmarried, having a higher annual household income and age, having a larger social network, and displaying fewer COVID-19 prevention behaviors at phase 1. Further, the presence of potential alcoholism at phase 2 was predicted by being male, being more anxious, having a larger social network, exercising more, showing a deterioration of economic status, having more difficulties owing to a lack of daily necessities, having less healthy eating habits, and showing fewer COVID-19 prevention behaviors at phase 1. These findings suggest that psychological problems and increased work (or academic) and economic difficulties were associated with severe alcohol problems during a later stage of the COVID-19 pandemic. Full article

(This article belongs to the Special Issue Mental Health and Substance Use Disorders during the COVID-19 Pandemic)

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13 pages, 1805 KiB

Open AccessArticle

The Impact of COVID-19 on Opioid-Related Overdose Deaths in Texas

by Karima Lalani, Christine Bakos-Block, Marylou Cardenas-Turanzas, Sarah Cohen, Bhanumathi Gopal and Tiffany Champagne-Langabeer

Int. J. Environ. Res. Public Health 2022, 19(21), 13796; https://doi.org/10.3390/ijerph192113796 - 24 Oct 2022

Cited by 4 | Viewed by 1800

Abstract

Prior to the COVID-19 pandemic, the United States was facing an epidemic of opioid overdose deaths, clouding accurate inferences about the impact of the pandemic at the population level. We sought to determine the existence of increases in the trends of opioid-related overdose (ORO) deaths in the Greater Houston metropolitan area from January 2015 through December 2021, and to describe the social vulnerability present in the geographic location of these deaths. We merged records from the county medical examiner’s office with social vulnerability indexes (SVIs) for the region and present geospatial locations of the aggregated ORO deaths. Time series analyses were conducted to determine trends in the deaths, with a specific focus on the years 2019 to 2021. A total of 2660 deaths were included in the study and the mean (standard deviation, SD) age at death was 41.04 (13.60) years. Heroin and fentanyl were the most frequent opioids detected, present in 1153 (43.35%) and 1023 (38.46%) ORO deaths. We found that ORO deaths increased during the years 2019 to 2021 (p-value ≤ 0.001) when compared with 2015. Compared to the year 2019, ORO deaths increased for the years 2020 and 2021 (p-value ≤ 0.001). The geographic locations of ORO deaths were not associated with differences in the SVI. The COVID-19 pandemic had an impact on increasing ORO deaths in the metropolitan Houston area; however, identifying the determinants to guide targeted interventions in the areas of greatest need may require other factors, in addition to community-level social vulnerability parameters. Full article

(This article belongs to the Special Issue Mental Health and Substance Use Disorders during the COVID-19 Pandemic)

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10 pages, 288 KiB

Open AccessArticle

A COVID-19 Survey among People Who Use Drugs in Norway

by Gabrielle K. Welle-Strand, Linn Gjersing, Ida K. Olsen and Thomas Clausen

Int. J. Environ. Res. Public Health 2022, 19(12), 7002; https://doi.org/10.3390/ijerph19127002 - 8 Jun 2022

Cited by 2 | Viewed by 1624

Abstract

Background: to combat the COVID-19 pandemic, adherence to COVID-19 recommendations and vaccination against COVID-19 have been important. Among people who use drugs (PWUD), little is known regarding compliance towards COVID-19 recommendations, COVID-19 testing, or attitudes towards COVID-19 vaccination. We aimed to examine these issues in a sample of PWUD. Methods: a cross-sectional study was conducted between January and March 2021. Through users’ organizations and different low-threshold services for substance users, we recruited former drug users and professionals to include participants and perform the interviews. Participants completed an interviewer-administered questionnaire. Any person above 16 years of age who used substances were recruited. Results: 477 Norwegian PWUD participated in the study. The mean age was 43.8 (SD 12.8) years and 77% were males. Thirty-four percent had injected drugs the past four weeks. Alcohol (41%) and cannabis (41%) were the most common drugs used the past four weeks, followed by tranquilizers (37%), central stimulants (35%) and opioids (30%). The majority (90%) had washed their hands frequently, used alcohol sanitizer during the past two weeks, had used face masks, kept one-meter distance to other people and stayed at home if feeling unwell. Fifty-four percent had been COVID-19 tested. More than half the sample (58%) had positive attitudes to COVID-19 vaccination, while 26% were fairly or very unlikely to accept vaccination. Those older (OR = 0.96, 95% CI 0.94; 0.98) and using face masks (OR = 0.49, 95% CI 0.30; 0.79) were more likely to have positive attitudes towards vaccination, while those reporting low life-satisfaction (OR = 3.86, 95% CI 1.43; 10.40), using opioids (OR = 2.97, 95% CI 1.43; 6.18) or almost never staying at home when feeling unwell (OR = 2.76, 95% 1.39; 5.45) expressed more negative attitudes towards vaccination. Conclusion: there was generally a high compliance towards COVID-19 recommendations, but one quarter of the sample was sceptical towards COVID-19 vaccination. This indicates a need for targeted and tailored information and well-designed vaccination roll-out programs to reach all PWUD. Full article

(This article belongs to the Special Issue Mental Health and Substance Use Disorders during the COVID-19 Pandemic)

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9 pages, 319 KiB

Open AccessBrief Report

Patient Experiences after Physical Trauma: The Negative Effect of the COVID-19 Pandemic on Recovery

by Jeanette Finstad, Thomas Clausen, Leiv Arne Rosseland, Olav Røise and Ingrid A. Havnes

Int. J. Environ. Res. Public Health 2022, 19(19), 12258; https://doi.org/10.3390/ijerph191912258 - 27 Sep 2022

Cited by 1 | Viewed by 1946

Abstract

The coronavirus disease 2019 (COVID-19) pandemic generated a crisis within the healthcare system, during which acute, COVID-19-related health needs were prioritized over less urgent needs, including vulnerable subgroups. This study explored experiences of recovery among survivors of physical injuries associated with severe pain during the COVID-19 pandemic in Norway. In-depth interviews were conducted among 13 participants. Findings generated by a thematic analysis revealed that the pandemic, including the contagion control measures and interrupted healthcare, were of negative consequence for the participants’ recovery experiences and mental and physical health. Despite experiencing severe pain and perceived needs for support, the participants experienced being deprioritized by the healthcare system. They experienced a reduced capacity to cope with pandemic-related stress and to perform everyday tasks, which they perceived as generating an additional burden for their loved ones. Alcohol was reported to be used in an effort to relieve the associated mental distress. As suggested by this study, injury survivors constitute a vulnerable subgroup for whom the continuity of rehabilitation services during a national crisis, as well as the integration of mental health support, can be essential for mitigating the negative impact of the crisis on recovery and for promoting optimal long-term health outcomes. Full article

(This article belongs to the Special Issue Mental Health and Substance Use Disorders during the COVID-19 Pandemic)

8 pages, 441 KiB

Open AccessCase Report

Trazodone Prolonged-Release Monotherapy in Cannabis Dependent Patients during Lockdown Due to COVID-19 Pandemic: A Case Series

by Marianna Mazza, Emanuele Caroppo, Giuseppe Marano, Georgios D. Kotzalidis, Carla Avallone, Giovanni Camardese, Delfina Janiri, Lorenzo Moccia, Alessio Simonetti, Luigi Janiri and Gabriele Sani

Int. J. Environ. Res. Public Health 2022, 19(12), 7397; https://doi.org/10.3390/ijerph19127397 - 16 Jun 2022

Cited by 1 | Viewed by 2402

Abstract

(1) Background: During the SARS-CoV-2 (COVID-19) pandemic, cannabis use increased relative to pre-pandemic levels, while forced home confinement frequently caused sleep/wake cycle disruptions, psychological distress, and maladaptive coping strategies with the consequent appearance of anxiety symptoms and their potential impact on substance use problems. (2) Aim: Long-acting trazodone (150 mg or 300 mg daily) has a potential benefit as monotherapy in patients with cannabis use disorder. The present work aims to investigate the effectiveness of trazodone in optimizing the condition of people with cannabis dependence under pandemic conditions. (3) Methods: All cases with cannabis use disorder were uniformly treated with long-acting trazodone 150 mg or 300 mg/day; their craving and clinical status were monitored through appropriate psychometric scales. Side effects were recorded as they were reported by patients. We described the cases of three young patients—one man and two women—who were affected by chronic cannabis use disorder and who experienced lockdown-related psychological distress and sought psychiatric help. (4) Results: The described cases highlight that the once-a-day formulation of trazodone seems to have a therapeutic role in patients with cannabis use disorder and to guarantee tolerability and efficacy over time. No significant side effects emerged. (5) Conclusions: The use of long-acting trazodone (150 mg or 300 mg daily) has a potential benefit as monotherapy in patients with cannabis use disorder. Trazodone deserves to be studied in terms of its efficacy for cannabis use disorder. Full article

(This article belongs to the Special Issue Mental Health and Substance Use Disorders during the COVID-19 Pandemic)

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