Swine flu increase mental health problems, study finds

Mental health problems worsened among young people as the virus spread, although it didn’t kill, an Oxford University study says

It caused more young people to fall into a mental health crisis as the pandemic spread, even though it didn’t kill, says the latest study to examine how its impact impacted on people’s psychological wellbeing.

Between 1980 and 1981, the H1N1 (swine flu) virus generated outbreaks that caused 1 million epidemics in Mexico, 230 million worldwide, and killed 286,000, according to the study published in the British Medical Journal.

The study, which explored data from a review of 1,550 studies on influenza and mortality among populations, found that the disease impacted the health of people aged between two and 84 years more. These patients had higher rates of psychiatric disorders, decreased self-esteem, increased depression symptoms and were more likely to have experienced suicidal thoughts than people unaffected by the pandemic.

The analysis, led by Dr Sarah-Jane Batten, a lecturer in epidemiology at Oxford University, examined the findings of more than 10,000 studies and more than 74,000 people.

Batten said: “Our findings suggest that … two decades of epidemic illness in children and young people has resulted in an increased rate of mental health disorders, and have therefore increased the burden of mental health illness on children, young people and families.”

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The H1N1 virus emerged in Mexico in April 2009. It was airborne and it killed 23 people in the country and 143 worldwide, according to the World Health Organisation.

It triggered a rash of cases of severe acute respiratory syndrome (Sars) disease in both Australia and Asia. But its impact on people’s mental health was minimised, owing to advances in medicine and immunity.

“They died of viral pneumonia, but they died of a whole range of problems and most of them died within a few weeks,” she said. “That’s the kind of climate we should be recognising.”

Despite the threat, people weren’t panicking and were only given an aspirin to treat the flu, she said.

The death rates are similar to other common viral illnesses, said Batten. “The only difference is that in those cases the children’s mental health disorders are so much worse than normal.”

“In the last couple of decades, there have been over 50 years’ worth of research to try and improve our understanding of environmental and situational factors affecting mental health,” she said. “The links between obesity, stress, alcohol and youth risk of suicide have led to a number of campaigns around the world to try and reduce these problems. But there’s still a problem.”

There are lessons to be learned for politicians, added Batten. “How they can step in, this is one thing that needs to be clear to government ministers. It’s a talking point but the problem hasn’t gone away,” she said.

The study also highlighted one mistake in the healthcare system that had exacerbated mental health problems in the population: young people with flu were better off to be seen in hospital for ventilator treatment, rather than in ambulances after being transferred from the community, like many patients with pneumonia.

“That was seen as a comforting thing to do – they wouldn’t suffer psychiatric symptoms – but the negative effects of the two being on top of each other was that the young patient was really severely ill, but the ones in the ambulance were only slightly worse,” said Batten.

There needs to be more research on how we could intervene and prevent such outbreaks, she said.

“It’s really important that we don’t draw these conclusions to say we’re facing a mental health crisis, but [the evidence] suggests there’s an increased risk of mental health problems in the population as a whole, and that’s not a level of risk that is going to be borne without intervention.”

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