key: cord-0906408-hlx60qyr
authors: Pang, Peng; Mehman, Tanzeeb
title: 51.22 USING TELEPHONIC FOLLOW-UP TO ASSESS ADOLESCENT FUNCTIONING DURING THE COVID-19 SHUTDOWN IN HENAN, CHINA
date: 2020-10-31
journal: Journal of the American Academy of Child & Adolescent Psychiatry
DOI: 10.1016/j.jaac.2020.08.432
sha: 7db29548430d6e3d77bd5c36b7f2ba55eeebd562
doc_id: 906408
cord_uid: hlx60qyr

nan

Objectives: The outbreak of the COVID-19 pandemic has led to increased experiences of despair, isolation, and a growing uncertainty surrounding the future of our global health. The effects of the pandemic are evident in almost all aspects of daily life, from the risks to physical health to loss of employment and the ability to attend school. Emerging adults are among the many individuals facing increases in mental illness during this time. Acceptance is a well-researched emotion regulation strategy that has been associated with positive outcomes such as decreased negative affect and greater psychological health in young adults. This study investigated the hypothesis that acceptance use is a mediator in the relationship between the perceived impact of COVID-19 and symptoms of depression among emerging adults. Methods: Participants in this IRB-approved study were recruited via online flyers distributed through listservs and social media. The sample (n ¼303; 79% female; 8.8% Hispanic; M age ¼ 20.9 years) completed a series of online selfreport measures, assessing for current levels of depression, the perceived impact of the COVID-19 pandemic, and the use of acceptance. Results: A linear regression indicated that the COVID-19 impact is significantly associated with depression (b ¼ 0.77; p < 0.001). Further regression analyses were conducted using Hayes's PROCESS macro in SPSS. The overall model was significant (F 2,300 ¼ 107.7; p < 0.001; R 2 ¼ 0.42), accounting for 42% of the variance. The path between the COVID-19 impact and acceptance use was significant (b ¼ 0.71; p ¼ 0.26), indicating that higher levels of COVID-19 impact are associated with less acceptance use. The path between acceptance use and depression was also significant (b ¼ 0.44; p ¼ 0.0025), indicating that higher levels of acceptance use is related to lower levels of depression. The indirect path from COVID-19 impact to depression remained significant when acceptance use was included in the model (b ¼ 0.36; p < 0.001).

The results indicate that acceptance partially explains the relationship between the perceived COVID-19 impact and current depression. This study highlights the importance of incorporating acceptance use within treatment interventions for young adults who have been heavily impacted by the COVID-19 pandemic and may be struggling with symptoms of depression. Objectives: The current outbreak of COVID-19 is an unprecedented event impacting people all around the world and leading to increased mental health concerns. Although research regarding the impact of the COVID-19 pandemic is limited, research indicates that it has led to increased levels of stress and anxiety. The lives of emerging adults in the United States were particularly disrupted due to unexpected changes, such as displacement and an abrupt switch to remote learning. Consequently, it is imperative to assess how COVID-19 has impacted this population and how it may relate to anxiety severity. Methods: The current study used self-report online measures to explore the relationship between COVID-19 life disruptions and anxiety severity in a sample of individuals aged 18 to 25 years (n ¼ 353; M age ¼ 21 years; 79% female; 95% college student). A logistic regression analysis was conducted in order to examine the likelihood of an individual having moderate-to-severe anxiety based on the number of life disruptions (eg, loss of employment, contracting COVID-19, difficulties accessing basic needs) they have experienced. Results: The logistic regression yielded significant results (c 2 [1] ¼ 13.479; p < 0.001; R 2 ¼ 0.046]. The overall model yielded 59% correct classification, with 84% correct classification for none-to-minimal anxiety. Examination of the ORs (OR ¼ 1.316; p < 0.001; 95% CI, 1.132-1.530) indicated that life disruptions in a higher (vs lower) number of domains increased the likelihood of experiencing clinical levels of anxiety. Further examination of specific life disruptions revealed that 3 of the 13 life disruptions listed were significant predictors for moderate-to-severe anxiety: 1) difficulties accessing basic needs(c 2 [1] ¼ 10.757; p < 0.01; R 2 ¼ 0.037; OR ¼ 2.377; 95% CI, 1.406-4.019); 2) difficulties working from home (c 2 [1] ¼ 8.335; p < 0.01; R 2 ¼ 0.029; OR ¼ 2.043; 95% CI, 1.253-3.330); and 3) difficulties transitioning to remote learning (c 2 [1] ¼ 6.002; p < 0.05; R 2 ¼ 0.021; OR ¼ 1.950; 95% CI, 1.131-3.364). Conclusions: These findings demonstrate the impact of COVID-19 life disruptions on anxiety severity. Given that the 3 life disruptions have been found to be significant predictors of anxiety, educational institutions should consider methods to ensure that students have access to basic needs and utilize strategies to enhance remote learning endeavors throughout the COVID-19 pandemic. in mobility and daily activities would lead to interpersonal conflicts in families, especially between children and those parents who worked away from home year-round. By using telephonic follow-up, we aimed to assess the impact of the outbreak on the patients' daily functioning and to reduce relapse rates. Methods: The Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) and the Children's Global Assessment Scale (CGAS) were administered to families of adolescents with recent mental health admissions at a participating hospital in Henan province, China. Interviews were conducted telephonically at 3 time points during the 3-month lockdown. Paired and unpaired t tests were employed to compare the functionality of children whose parents worked locally and lived with their children (G1) vs those whose parents worked outside the province and do not live in the home (G2). Results: The study cohort consists of 48 adolescent patients in G1 and 93 patients in G2. The re-hospitalization rate was 2.2% compared to 4.5% in 2019 during the same period. CGAS total scores did not show group differences at each of the time points. There were significant changes in emotional difficulty subscores of HoNOSCA between the 2 time points, T1-T3 (p ¼ 0.006) and T2-T3 (p < 0.0001), in group G2. The parent-child conflict scores in G2 between T1-T2 (p < 0.001) and T2-T3 (p ¼ 0.007) were different significantly. On the other hand, group G1 did not experience significant emotional difficulty, but their online learning behavior deteriorated over time, at T1-T2 (p < 0.0001) and T2-T3 (p < 0.0001). Intergroup differences were seen in learning difficulties at T1 between the G1 and G2 groups (p ¼ 0.016). Conclusions: In China, this is the first study providing telephonic intervention to a population of discharged adolescent patients who have no access to follow-up clinic visits. We found a significant change in adolescent emotional control, parent-child conflict, and online learning compliance in those adolescents whose parents left for work outside the province during the extended quarantine. This study can provide reference for future studies on COVID-19related adolescent mental health. Objectives: The objective of this presentation is to examine how visit completion rates were affected by the transformation of a large communitybased pragmatic clinical trial (entitled Metformin for overweight and OBese chILdren with bIpolar spectrum disorders Treated with second-generation antipsYchotics [MOBILITY] ) to remote follow-up visits with the use of telepsychiatry and virtual research methodology in light of a pandemic. Methods: MOBILITY is a Patient-Centered Outcome Research Institute (PCORI)-funded, large, randomized pragmatic clinical trial designed to examine the effectiveness of metformin and healthy lifestyle instruction vs healthy lifestyle instruction alone on BMI and other metabolic and clinically useful parameters. We examined visit completion rates of patients due for a study visit on April 1, 2020 performed in the remote care visit window (April 1, 2020 to May 31, 2020) by visit type (month 6, month 24, other visit) and institution type (community vs academic) to in-person visits from the coinciding preceding enrollment period (April 1, 2019 to May 31, 2019). Results: Of the total 603 patients in-window on April 1, 2020 for a visit, 180 patients (29.9%) had an in-window remote visit. Of the total 620 patients inwindow on April 1, 2019 for a visit, 159 patients (25.6%) had an in-window inperson visit. There were no significant time x type interaction effects for visit type (p ¼ 0.37) or institution type (p ¼ 0.26). However, there were significant main effects for visit type and institution type, with higher month-24 in-window visits for remote visits vs in-person visits (2020 ¼ 14.9% vs 2019 ¼ 9.4%; p < 0.01) and higher overall visits in academic vs nonacademic centers (2020 ¼ 34.4% vs 2019 ¼ 27.7%). Conclusions: Overall visit completion rates comparing the pre-COVID-19 enrollment period in 2019 to the same period in 2020 did not show significant changes in visit completion rates. Despite the shift to remote visits, visit completion rates for this large, pragmatic study that are linked to clinical care visits did not suffer. However, month-24 visit completion rates were significantly improved. Academic institutions were able to hold or improve visit completion rates more effectively than community-based ones. Making virtual visits available in clinical effectiveness research may be beneficial by decreasing patient and caregiver burden, improving data quality, and reducing cost, although this may be more easily accomplished in academic centers. PCS-1406-19276 

24 YOUTH SOCIAL MEDIA USE BEFORE AND DURING THE COVID-19 PANDEMIC

Olive View Psychiatry Residency Program, cguest1008@gmail.com

Olive View Psychiatry Residency Program, mahogata7@gmail.com

Social Media Initial Questionnaire (SMIQ) paper self-reports in 2019 are compared to the electronic Social Media Initial Questionnaire-Revised (SMIQ-r) modified to elicit reactions to the COVID-19 pandemic in 2020. This poster will emphasize changes in youth social media use in 2020 during social distancing and increased social isolation. Methods: A total of 66 mental health clinic patients aged 8 to 20 years

Youths also noted a preference for in-person friends compared to online during the COVID-19 pandemic, and expressed missing their friends and school as the most difficult change since the COVID-19 pandemic began. Additionally, 40% of youths reported an increase in sadness, and 34% of youths reported an increase in anxiety since the COVID-19 pandemic began. Conclusions: Our conclusions are as follows: 1) compared to 2019, youth in 2020 reported a stronger preference for, and more highly valued, in-person friends; 2) youth reported that life is harder in 2020 particularly due to missing both friends and school; 3) since online school, youth report more anxiety and sadness; 4) SMIQ-r electronic Google Forms survey format used by youth on cell phones proved to be user-friendly and efficient