Social inequality and change in psychological distress during the Covid-19 pandemic in Norway

Abstract Background Emerging research findings suggest that the Covid-19 pandemic may have affected various social groups differently. Using follow-up health data from Norway, the aim of this study was to investigate whether change in psychological distress in adolescents during the Covid-19 pandemic differed across socioeconomic position (SEP). Methods Data consisted of 1254 Norwegian adolescents who participated in Young-HUNT4 (2017-19) and Young-HUNT COVID (spring 2021). Psychological distress (PD) was assessed by the Symptom Checklist-10, using a cut-off point of ≥ 1.85 to identify adolescents with high PD. Based on the adolescents PD score prior to and during the Covid-19 pandemic, four groups were identified: persistent low PD, improved PD, worsened PD, and persistent high PD. Adolescents reported their parents’ education level which was used as an indicator for SEP. SEP was dichotomized separating low and high SEP, where having at least one parent with a higher education was defined as high SEP. Multinomial logistic regression models were used to investigate if the likelihood of the outcome groups varied across SEP, adjusted for age and sex. Results Compared to the persistent low PD group, no statistically significant difference was found between low and high SEP in the improved PD and worsened PD group (RR 1.33 95% CI 0.77 - 2.31, RR 1.22 95% CI 0.82 - 1.81, respectively). However, adolescents of low SEP had a higher likelihood to be in the persistent high PD group compared with the high SEP group (RR 1.93 95% CI 1.30 - 2.87). Conclusions These preliminary findings suggest that the pandemic may not have led to greater social inequality in mental health among Norwegian adolescents. However, the results showed that social inequality that existed prior to the pandemic has persisted, as adolescents of lower SEP had a higher likelihood of reporting high PD that persisted from prior to and throughout the Covid-19 pandemic. Key messages • Social inequality in psychological distress among Norwegian adolescents has persisted prior to and during the Covid-19 pandemic. • The Covid-19 pandemic does not seem to have increased existing social inequalities in psychological distress among Norwegian adolescents.


Background:
University life can be a particularly challenging phase in the development of young adults. Current research shows that mental disorders occur more frequently in students compared to workers of the same age. The coronavirus pandemic has exacerbated the problem. The TUDo! Study, done in cooperation with the FU Berlin, aimed to assess the health status of students at TU Dresden, with a focus on mental health.

Methods:
In 2020/2021 students at TU Dresden (excluding students in the medical school) completed an online-based questionnaire. Validated questionnaires, e.g. the PHQ 4 (depressive disorder and generalized anxiety disorder) and the ERI student (student gratification crisis) were used. We evaluated descriptively and analytically, according to the questionnaire-specific specifications.

Results:
A total of 2,683 students (12.3%) at the TU Dresden took part in the survey. The majority of study participants were female (n = 1,507; 56.7%) and had an average age of 22.9 years (SD = 4.3). 32.8% (n = 856/2,611) of the participating students reported a depressive syndrome and 32.5% (n = 848/2,612) a generalized anxiety disorder. Almost half of participating students (40,0%; n = 515/1,310) indicated an imbalance between effort (E) and reward (R) (ER ratio>1). 51.23% (n = 693/1,50) of respondents reported a decline of mental well-being because of the coronavirus pandemic.

Discussion:
Unlike similar studies, this study shows that TU Dresden students were particularly affected with regards to perceived psychological stress and complaints. The existing differences seem to be partly due to the coronavirus pandemic. These results indicate that universities should regularly check their studying conditions and provide appropriate preventive measures. Key messages: Students are at higher risk than workers of the same age for mental health problems. Students reported a decline in mental well-being due to the coronavirus pandemic.
Abstract citation ID: ckac131.489 The effectiveness of interventions to prevent loneliness in the community-dwelling elderly population

Background:
Loneliness and social isolation have comparable health effects to widely acknowledged and established risk factors. Although the elderly are particularly affected, the effectiveness of interventions to prevent and/or mitigate social isolation and loneliness in the community-dwelling elderly is unclear. The aim of this review of reviews was to pool the findings of systematic reviews addressing the question of effectiveness.

Methods:
Ovid MEDLINE Õ , Health Evidence, Epistemonikos and Global Health (EBSCO) were searched from January 2017 to November 2021. Two reviewers independently assessed each systematic review in two consecutive steps based on previously defined eligibility criteria and appraised the methodological quality using AMSTAR 2. One author extracted data from both systematic reviews and eligible studies; another checked this. We conducted meta-analyses to pool the study results. We report the results of the random-effects and common-effect models.

Results:
We identified 5 systematic reviews containing a total of 30 eligible studies, 16 with a low or moderate risk of bias. Our random-effects meta-analysis indicates an overall SMD effect of 0.63 [95% CI: -0.10; 1.36] for loneliness and was unable to detect an overall effect of the interventions on social support [SMD: 0.00; 95% CI: -0.11; 0.12].

Discussion:
The results show interventions can potentially reduce loneliness in the non-institutionalised, community-dwelling elderly population living at home. As confidence in the evidence is low, rigorous evaluation is recommended.

Key messages:
The meta-analysis indicates that psychosocial interventions have the potential to reduce loneliness in the communitydwelling elderly population. As confidence in the evidence is low, healthcare providers should only implement interventions that are, firstly, based on a sound theory of change and, secondly, subject to rigorous evaluation.

Background:
Emerging research findings suggest that the Covid-19 pandemic may have affected various social groups differently. Using follow-up health data from Norway, the aim of this study was to investigate whether change in psychological distress in adolescents during the Covid-19 pandemic differed across socioeconomic position (SEP).

Methods:
Data consisted of 1254 Norwegian adolescents who participated in Young-HUNT4 (2017-19) and Young-HUNT COVID (spring 2021). Psychological distress (PD) was assessed by the Symptom Checklist-10, using a cut-off point of 1.85 to identify adolescents with high PD. Based on the adolescents PD score prior to and during the Covid-19 pandemic, four groups were identified: persistent low PD, improved PD, worsened PD, and persistent high PD. Adolescents reported their parents' education level which was used as an indicator for SEP. SEP was dichotomized separating low and high SEP, where having at least one parent with a higher education was defined as high SEP. Multinomial logistic regression models were used to investigate if the likelihood of the outcome groups varied across SEP, adjusted for age and sex.

Results:
Compared to the persistent low PD group, no statistically significant difference was found between low and high SEP in the improved PD and worsened PD group (RR 1.33 95% CI 0.77 -2.31, RR 1.22 95% CI 0.82 -1.81, respectively). However, adolescents of low SEP had a higher likelihood to be in the persistent high PD group compared with the high SEP group (RR 1.93 95% CI 1.30 -2.87).

Conclusions:
These preliminary findings suggest that the pandemic may not have led to greater social inequality in mental health among Norwegian adolescents. However, the results showed that social inequality that existed prior to the pandemic has persisted, as adolescents of lower SEP had a higher likelihood of reporting high PD that persisted from prior to and throughout the Covid-19 pandemic. Key messages: Social inequality in psychological distress among Norwegian adolescents has persisted prior to and during the Covid-19 pandemic. The Covid-19 pandemic does not seem to have increased existing social inequalities in psychological distress among Norwegian adolescents.