More Negative Emodiversity Is Associated With Worse Mental Illness During (but Not Before) COVID-19

Relations between negative emodiversity (NED; the variety and relative abundance of negative emotions) with depression and anxiety were examined before and during the COVID-19 pandemic. Forty-five individuals (ages 25-65) participated in two ecological momentary assessments (EMA): pre-pandemic and during-pandemic (Fall, 2020). Participants reported how much they felt 6 negative emotions several times each day for 10 days (resulting up to 91 EMA “events”). Each event’s NED was computed and then averaged using an adaptation of Shannon’s entropy. Participants with higher levels of average NED had higher levels of concurrent depression and anxiety. When adjusting for average levels of negative emotion and other covariates, NED was a significant predictor of depression and anxiety only during the pandemic. These findings, which did not vary by age, suggest that having more diverse negative emotions on a moment-to-moment basis may hold greater significance for mental illness outcomes during times of extreme chronic stress.

The Impact of Economic Recessions on Depression, Anxiety, and Trauma-Related Disorders and Illness Outcomes—A Scoping Review

In the wake of a global economic recession secondary to the COVID-19 pandemic, this scoping review seeks to summarize the current quantitative research on the impact of economic recessions on depression, anxiety, traumatic disorders, self-harm, and suicide. Seven research databases (PsycINFO, MEDLINE, Embase, Web of Science: Core Collection, National Library of Medicine PubMed, PubMed Central, and Google Scholar) were searched for keywords returning 3412 preliminary results published since 2008 in Organisation for Economic Coordination and Development (OECD)nations. These were screened by both authors for inclusion/exclusion criteria resulting in 127 included articles. Articles included were quantitative studies in OECD countries assessing select mental disorders (depression, anxiety, and trauma-/stress-related disorders) and illness outcomes (self-harm and suicide) during periods of economic recession. Articles were limited to publication from 2008 to 2020, available online in English, and utilizing outcome measures specific to the disorders and outcomes specified above. A significant relationship was found between periods of economic recession and increased depressive symptoms, self-harming behaviour, and suicide during and following periods of recession. Results suggest that existing models for mental health support and strategies for suicide prevention may be less effective than they are in non-recession times. It may be prudent to focus public education and medical treatments on raising awareness and access to supports for populations at higher risk, including those vulnerable to the impacts of job or income loss due to low socioeconomic status preceding the recession or high levels of financial strain, those supporting others financially, approaching retirement, and those in countries with limited social safety nets. Policy makers should be aware of the potential protective nature of unemployment safeguards and labour program investment in mitigating these negative impacts. Limited or inconclusive data were found on the relationship with traumatic disorders and symptoms of anxiety. In addition, research has focused primarily on the working-age adult population with limited data available on children, adolescents, and older adults, leaving room for further research in these areas.

EVALUATION OF A COVID-19 PATIENT ACCORDING TO MERLEY MISHEL'S UNCERTAINTY IN DISEASE THEORY: A CASE REPORT

The COVID-19 epidemic, which the World Health Organization regards as a "pandemic", continues to be perceived as a threat to survive for many people living in different parts of the world. The virus is a global epidemic; It affects everyone's lives negatively regardless of religion, language, race, gender, socioeconomic and sociocultural differences. Facing with a threat that develops suddenly, changes daily habits and can result in death is not a common situation for people, and the perception of threat and uncertainty it creates makes it difficult to cope with the situation. Uncertainty is an important part of the illness experience, and our response to uncertainty can significantly affect our illness outcomes. Mishel's Uncertainty Theory in Illness helps to find meaning in uncertainty again and to develop healthy coping mechanisms. The role of nurses in the management of uncertainty regarding illness; to facilitate the process and to adapt the patient to healthy reactions. In this case report; Within the scope of the Uncertainty in Illness Theory of Mishel, a 39-year-old nurse who was diagnosed with Covid 19 was planned to find a meaning in the disease again by planning the care process. It was stated that the theory can be applied in the acute illness as well as in the chronic illness.

Health Promotion Among Individuals Facing Chronic Illness: The Unique Contribution of the Bodyknowledging Program

This chapter offers an oversight of the concept of chronic illness and the meaning of health promotion in this context. Bodyknowledging is a theory describing patients’ process of health promotion in chronic illness that has been used as a theoretical frame for a new health intervention; the Bodyknowledging Program (BKP). This program is outlined as the aim of BKP is to activate and strengthen patients’ resources for health in chronic illness. Outcomes for patients and implications for practice are discussed.

The Scale-Up of Diabetes and Hypertension Care (SCUBY) - large-scale evaluation using routine health information systems

The SCUBY project aims to (1) change the organization of primary health care for diabetes and hypertension in order to (2) improve the outcome of chronic care in three countries (Belgium-Slovenia-Cambodia). These two aims require two types of data, namely data on the organization of care and data on the chronic illness outcomes. It can however be challenging to (1) gather all these data (from various sources) on both the organization and outcomes and (2) create cross-culturally valid datasets. The presentation will present the strategy of SCUBY to gather data and discuss the issues of cross-cultural validity.

Microbiota-Orientated Treatments for Major Depression and Schizophrenia

Background and significance. There is a need to develop new hypothesis-driven treatment for both both major depression (MD) and schizophrenia in which the risk of depression is 5 times higher than the general population. Major depression has been also associated with poor illness outcomes including pain, metabolic disturbances, and less adherence. Conventional antidepressants are partly effective, and 44% of the subjects remain unremitted under treatment. Improving MD treatment efficacy is thus needed to improve the SZ prognosis. Microbiota-orientated treatments are currently one of the most promising tracks. Method. This work is a systematic review synthetizing data of arguments to develop microbiota-orientated treatments (including fecal microbiota transplantation (FMT)) in major depression and schizophrenia. Results. The effectiveness of probiotic administration in MD constitutes a strong evidence for developing microbiota-orientated treatments. Probiotics have yielded medium-to-large significant effects on depressive symptoms, but it is still unclear if the effect is maintained following probiotic discontinuation. Several factors may limit MD improvement when using probiotics, including the small number of bacterial strains administered in probiotic complementary agents, as well as the presence of a disturbed gut microbiota that probably limits the probiotics’ impact. FMT is a safe technique enabling to improve microbiota in several gut disorders. The benefit/risk ratio of FMT has been discussed and has been recently improved by capsule administration. Conclusion. Cleaning up the gut microbiota by transplanting a totally new human gut microbiota in one shot, which is referred to as FMT, is likely to strongly improve the efficacy of microbiota-orientated treatments in MD and schizophrenia and maintain the effect over time. This hypothesis should be tested in future clinical trials.

The Common Sense Model of Illness Self-Regulation: Conceptual Review and Proposal of an Extended Model

The common sense model of illness self-regulation outlines the dynamic processes by which individuals perceive, interpret, respond, and adjust, psychologically and behaviorally, to health threats and illness-related information. An extended version of the model is presented, which formally operationalizes existing processes in the model and specifies additional constructs and processes to explain how lay perceptions of health threats and illnesses impact coping responses and health-related outcomes. The extended model provides detail on: (a) the mediating process by which individuals’ illness representations relate to illness outcomes through adoption of coping strategies; (b) representations of health threats and illnesses as schematically organized and activated by presentation of health-threatening stimuli; (c) behavioral and treatment beliefs as determinants of coping responses and illness outcomes independent of illness representations; and (d) effects of salient moderators (e.g., optimism, perfectionism, trait negative affectivity, emotional representations) of relations between cognitive representations, coping responses, and illness outcomes. The extended model is intended to set an agenda for future research that addresses knowledge gaps regarding how individuals represent and cope with illnesses and health threats, and augments the evidence base that may inform effective and optimally-efficient illness-management interventions. We also identify the specific kinds of research required to provide robust evidence for the revised model propositions. We call for research paradigms that employ incipient illness samples, utilize designs that better capture dynamic processes in the model such as cross-lagged panel and intervention designs, and adopt illness-specific measures of coping behaviors and self-management actions rather than reliance on generic instruments.