PMC:7573458 / 7291-14136 JSONTXT

{"target":"http://pubannotation.org/docs/sourcedb/PMC/sourceid/7573458","sourcedb":"PMC","sourceid":"7573458","source_url":"https://www.ncbi.nlm.nih.gov/pmc/7573458","text":"Method\n\nSetting\nTo assess the prevalence of current mental disorders in the Czech adult non-institutionalised population during the COVID-19 pandemic, we utilised data collected between 6th and 20th May 2020. In Czechia, the COVID-19-related nationwide state of emergency lasted from 12th March to the 17th of May, greatly impacting businesses and workers. During this period, services considered as non-essential by the Government of the Czech Republic were limited and citizens were under stay-at-home orders implemented on 16th March. Restrictions were gradually lifted, with businesses opening in waves according to their size and purpose (see the following reference for detailed introduction and easing of restrictions as well as for a list of essential services: Government of the Czech Republic, 2020). Since the psycho-diagnostic instrument used in this study assess whether the examined symptoms occurred in the period of last 2 weeks or more (see ‘Measurement’ for details), the obtained data reflect the period of the peak of COVID-19-related national emergency and the most severe associated restrictions within Czechia. This was the period immediately following the first peak of COVID-19 in CZ when stay-at-home orders were not in place anymore.\n\nData and participants\nSince face-to-face data collection was not feasible during the state of emergency, we utilised a combination of computer-assisted telephone interviewing (CATI) and computer-assisted web interviewing (CAWI). Individuals aged 18 years and older were eligible to participate. Participants were sampled via randomly emailing (CAWI) or telephoning (CATI) to individuals registered in the online database of a data collection agency, while respecting the distribution of the Czech non-institutionalised adult population. While we obtained data from 3021 respondents, 907 of them were interviewed using CATI (response rate = 43%) and 2114 completed CAWI (response rate = 93%); each of these subsamples were representative for the Czech non-institutionalised adult population in terms of gender, age, education, size and region of residence. As the representativeness was established according to the last census that was conducted in 2011, we asked the data-collecting agency to adjust the sample to be in-line with the more recent distribution of population as per the latest Demographic Yearbook of the Czech Republic (CZSO, 2019). Thus, post-stratification weights were applied to the sample. All respondents provided oral informed consent and, at the end of the interview, they were informed about the emergency hotline providing psychological aid to Czech residents during the COVID-19 pandemic. This study was approved by the Ethics Committee of the National Institute of Mental Health, Czech Republic (registration number 127/20).\nFor our baseline analysis, we used data from the 2017 Czech Mental Health Study (CZEMS), which is described in detail elsewhere (Winkler et al., 2018a; Formánek et al., 2019). Briefly, eligibility criteria were the same as in 2020 survey, but the data were collected using the PAPI method and two-staged sampling, with a random sample of participants being selected from a random group of voting districts. The response rate was 75% and the final sample of 3306 respondents was representative of the Czech general population in terms of age, gender, education and region of residence. The description of the 2017 sample is provided in online Supplementary Table 1.\n\nMeasurement\nIn both the 2017 and 2020 surveys, we assessed the presence of mental disorders via the fifth version of the Mini International Neuropsychiatric Interview (M.I.N.I.), a psycho-diagnostic instrument which has demonstrated a high concordance with clinician-assessed diagnosis of mental disorders (Sheehan et al., 1997, 1998). We focused on the prevalence of current (as opposed to life-time) mental disorders; i.e. the presence of examined symptoms within the past 2 weeks for major depressive episode; the past month for panic, posttraumatic stress disorder, social phobia and suicide risk (low, medium or high risk); the past 6 months for generalised anxiety disorder (GAD); and the past 12 months for alcohol use disorders. For agoraphobia, no specific periods are specified in the M.I.N.I.\nSince the diagnosis of alcohol use disorders require social dis-functioning (such as not going to work because of alcohol use), the chance of which is limited due to restrictions imposed during the lockdown, we measured also, usual consumption of alcohol (expressed in number of glasses per drinking session and examined separately for beer, wine and spirits) and the frequency of occurrence of binge drinking (at least five glasses of beer, wine or spirits per drinking session) in the last 12 months.\nIn addition, we assessed the following: consumption of prescription drugs (pain killers, sleeping pills, tranquilisers and stimulants) expressed as the number of drug categories consumed on daily basis; professional (i.e. psychiatrist/psychologist/general practitioner) mental health help-seeking in the last 12 months; COVID-19 health and economic-related worries (direct and indirect, see online Supplementary Appendix for details), expressed as the number of items with strong worries (min 0, max 2), and the presence of COVID-19 symptoms. All items were self-reported. The exact wording of COVID-19-related questions and the distribution of responses on these questions is provided in online Supplementary Table 2.\n\nStatistical analysis\nFirst, we calculated descriptive statistics for the sample, expressed as counts and percentages (%) for non-continuous variables, and as means with standard deviations (SD) for continuous variables. Second, we calculated the prevalence of mental disorders for 2017 and 2020. We expressed prevalence as weighted means with 95% confidence intervals (95% CIs) estimated via bootstrap method with 10 000 replicates. To address the slightly higher proportion (approximately 2%) of women in the 2017 sample, we employed post-stratification weights for the 2017 dataset.\nFinally, we performed logistic regression to assess whether COVID-19-related worries and the self-reported presence of COVID-19 symptoms were associated with the presence of (1) any mental disorder, (2) major depressive episode, (3) suicidality, (4) anxiety disorders and (5) alcohol use disorders in our 2020 sample. We controlled for age, gender, level of education, work status, marital status, size of residence and prescription drugs use in all models. We report results as odds ratios (ORs) with 95% CI, considering associations with p \u003c 0.05 as statistically significant. We report the crude models adjusted for age and gender in online Supplementary Table 3. All analyses were performed using R statistical programming language (version 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