BACKGROUND: It remains unknown whether severe mental disorders contribute to fatally harmful effects of physical illness. AIMS: To investigate the risk of all-cause death and loss of life-years following the onset of a wide range of physical health conditions in people with severe mental disorders compared with matched counterparts who had only these physical health conditions, and to assess whether these associations can be fully explained by this patient group having more clinically recorded physical illness. METHOD: Using Czech national in-patient register data, we identified individuals with 28 physical health conditions recorded between 1999 and 2017, separately for each condition. In these people, we identified individuals who had severe mental disorders recorded before the physical health condition and exactly matched them with up to five counterparts who had no recorded prior severe mental disorders. We estimated the risk of all-cause death and lost life-years following each of the physical health conditions in people with pre-existing severe mental disorders compared with matched counterparts without severe mental disorders. RESULTS: People with severe mental disorders had an elevated risk of all-cause death following the onset of 7 out of 9 broadly defined and 14 out of 19 specific physical health conditions. People with severe mental disorders lost additional life-years following the onset of 8 out 9 broadly defined and 13 out of 19 specific physical health conditions. The vast majority of results remained robust after considering the potentially confounding role of somatic multimorbidity and other clinical and sociodemographic factors. CONCLUSIONS: A wide range of physical illnesses are more likely to result in all-cause death in people with pre-existing severe mental disorders. This premature mortality cannot be fully explained by having more clinically recorded physical illness, suggesting that physical disorders are more likely to be fatally harmful in this patient group.

• Keywords
• Psychotic disorders/schizophrenia, bipolar type I or II disorders, comorbidity, depressive disorders, mortality and morbidity,
• MeSH
• Adult MeSH
• Mental Disorders * epidemiology   MeSH
• Cohort Studies MeSH
• Comorbidity MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Cause of Death * MeSH
• Registries statistics & numerical data   MeSH
• Aged MeSH
• Health Status MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Czech Republic epidemiology   MeSH

The aim of the paper was to assess the differences in the mental distress of university students in the first and second waves of COVID-19, to compare these levels with that of the general population as well as to identify the risk factors associated with the changes in mental health. A total of 2,025 university students in core psychology courses in all years of study at the Faculty of Education at Palacký University Olomouc were approached via e-mail. Of this number of students, 800 students took part in the study, divided into two groups from the spring (N = 438) and autumn (N = 362) pandemic waves. The data were collected online via Google Forms using a battery of questionnaires and analyzed using the Wilcoxon-Mann-Whitney test, One-Sample Wilcoxon Signed Rank Test and binary logistic regression. The results showed a high prevalence of depressive symptoms (38.4 and 51.4%), significant anxiety (43.8 and 37%), and high stress (19.9 and 22.9%) among students in both waves of the pandemic. Depression and stress also increased significantly during the second wave compared with the first one (r = 0.18 [0.12, 0.25] and r = 0.08 [0.01, 0.14]). Finally, university students showed significantly higher levels of mental distress than the general population in all of the variables and in both waves (r = 0.42-0.86). A variety of factors influenced different aspects of mental distress in the spring and autumn pandemic waves. Emotion regulation emerged as the most significant and pervasive factor, both influencing all of the three indicators of mental distress and being a significant predictor in both waves.

• Keywords
• COVID-19, mental health, pandemic, risk factors, university setting,
• Publication type
• Journal Article MeSH

Recent reports suggest that the COVID-19 lockdown resulted in changes in mental health, however, potential age-related changes and risk factors remain unknown. We measured COVID-19 lockdown-induced stress levels and the severity of depressive symptoms prior to and during the COVID-19 lockdown in different age groups and then searched for potential risk factors in a well-characterized general population-based sample. A total of 715 participants were tested for mental distress and related risk factors at two time-points, baseline testing prior to COVID-19 and follow-up testing during COVID-19, using a battery of validated psychological tests including the Perceived Stress Scale and the Patient Health Questionnaire. Longitudinal measurements revealed that the prevalence of moderate to high stress and the severity of depressive symptoms increased 1.4- and 5.5-fold, respectively, during the COVID-19 lockdown. This surge in mental distress was more severe in women, but was present in all age groups with the older age group exhibiting, cross-sectionally, the lowest levels of mental distress prior to and during the lockdown. Illness perception, personality characteristics such as a feeling of loneliness, and several lifestyle components were found to be associated with a significant increase in mental distress. The observed changes in mental health and the identified potential risk factors underlying these changes provide critical data justifying timely and public emergency-tailored preventive, diagnostic, and therapeutic mental health interventions, which should be integrated into future public health policies globally.

• Keywords
• COVID-19, depressive symptoms, feeling of loneliness, risk factors, stress levels,
• Publication type
• Journal Article MeSH