Eligible intervention studies include randomized and non-randomized controlled trials of the effects of any intervention designed to im-prove any aspect of mental health during the COVID-19 pandemic. Only studies initiated after China’s initial declaration to the WHO on December 31, 2019, will be eligible. Eligible trials must target mental health, and mental health must be the primary trial outcome if a primary outcome is stated. Eligible interventions must be: 1) done to improve mental health with people with COVID-19; or 2) designed to specifically target COVID-19 related mental health concerns in people not identified as having COVID-19; interventions in this group that are not described as addressing mental health symptoms from COVID-19 or that are not tailored to address COVID-19 challenges will be excluded.
Please note that we have identified eleven non-randomized intervention trials. Because of small-scale population, poor reporting, and risk of bias concerns, we removed them from the current tables.
About Eligible Registered Trials
We have identified 83 registrations for trials that appear to be eligible once completed. Of the 83 trial registrations, 31 target the general population, 17 target medical staff, 2 target patients infected with COVID-19, 12 target people with pre-existing mental health conditions, 6 target people with pre-existing medical conditions, 1 targets university students, 2 target close contacts of COVID-19 patients, 1 targets US veterans, and 1 targets police personnel.
Registered trials are from Australia (N = 7), Brazil (N=3), Belgium (N=2), Canada (N = 9), China (N = 5), Denmark (N = 1), France (N = 2), Germany (N = 4), Honduras (N=1), Hungary (N=1), India (N=3), Israel (N=1), Iran (N = 7), Malaysia (N=1), Mexico (N=1), Oman (N=1), Spain (N = 5), Sweden (N = 4), Switzdrland (N=1), Turkey (N = 3), the United Kingdom (N=3), and the United States (N=16).
About Eligible Completed Trials
We have identified and extracted data from 67 eligible completed trials. The majority of identified completed trials that have reported results have not provided results that can be meaningfully interpreted due to small sample sizes, poor reporting, and risk of bias concerns. Additionally, most trials use standard interventions not adapted for COVID-19 (e.g., exercise, standard psychotherapy) which limits their potential to inform health policy during the pandemic. However, some trials (e.g. 101948) do provide evidence for feasibly implemented COVID-19 tailored interventions that may be relevant to the general population. And, trial 200001 examines that multi-faceted interventions like SPIN-CHAT have potential to address mental health needs in vulnerable groups during COVID-19, yet uncertainty remains about effectiveness.
RESEARCH QUESTION 3:
Effects of Interventions on Mental Health Symptoms
Manzoni GM, Pagnini F, Castelnuovo G, et al. Relaxation training for anxiety: a ten-years systematic review with meta-analysis. BMC Psychiatry. 2008;8:41.
Kim HS, Kim EJ. Effects of relaxation therapy on anxiety disorders: a systematic review and meta-analysis. Arch Psychiatr Nurs. 2018;32:278-284.
RESULTS VISUALIZATION-COMPLETED TRIALS
Country of participants: Among 67 eligible completed trials, Australia (N=1), Austria (N=1), Canada (N=1), China (N=55), France (N=1), Germany (N=1), Iran (N=1), Malaysia (N=1), Mexico (N=1), Oman (N=1), Serbia (N=1), Spain (N=2), Sweden (N=1), Turkey (N=1), UK (N=1), USA (N=2), not specified (N=1)
REGISTERED TRIAL CHARACTERISTICS
*Abbreviations: ACQ= Anxiety Control Questionnaire; aMBI-HSS= Abbreviated Maslach Burnout Inventory- Human Services Survey; ASI-3= Anxiety Sensitivity Index; BAI= Beck Anxiety Inventory; BBQ= Brunnsviken Brief Quality of Life Scale; BDI= Beck Depression Inventory; BHS= Beck Hopelessness Scale; BRS= Brief Resilience Scale; BVK= Berner Verbitterungsinventar Kurzversion; CAS= Coronavirus Anxiety Scale; CD-RISC= Connor-Davidson Resilience Scale; CES-D= Center for Epidemiologic Studies Depression Scale; CRISIS= CoRonavIruS Health Impact Survey; DASS-21= Depression, Anxiety; DTS= Davidson Trauma Scale; Stress; EPDS= Edinburgh Postnatal Depression Scale; EQ-5D-5L= Quality of Life Measure; FCOR= Fear of Coronavirus; FCV-19S= Fear of COVID-19 Scale; FFMQ= Five-Facet Mindfulness Questionnaire; FS= Psychological Flourishing Scale; GAD-7= Generalized Anxiety Disorder; GBQ= Goldard Burnout Questionnaire; GDS= Geriatric Depression Scale; GHQ= General Health Questionnaire; HADS= Hospital Anxiety and Depression Scale; HADS-A= Hospital Anxiety and Depression Scale-Anxiety; HADS-D= Hospital Anxiety and Depression Scale-Depression; HAM-A= Hamilton Anxiety Rating Scale; HAM-D= Hamilton Rating Scale for Depression; HAQ= Health Anxiety Questionnaire; IES-R= Impact of Events Scale Revised; K10= Kessler Psychological Distress Scale; LOT-R= Revised Life Orientation Test; MADRS= Montgomery-Asberg Depression Rating Scale; MASQ= Mood and Anxiety Symptom Questionnaire; MBI= Maslach Burnout Inventory; NR= Not Reported; NRS= Non-Random controlled intervention Study; OASIS= Overall Anxiety Severity and Impairment Scale; ODSIS= Overall Depression Severity and Impairment Scale; OSI-R= Occupational Stress Inventory-Revised; PCL-5= PTSD Checklist; PC-PTSD= Primary Care PTSD Screen for DSM-5; PDQ= Parkinson’s Disease Quality of Life Scale; PHQ-8= Patient Health Questionnaire-8; PHQ-9= Patient Health Questionnaire; PROMIS= Patient-Reported Outcomes Measurement Information System; PS = Parenting Stress Scale; PSS/PSS-10= Perceived Stress Scale; PSWQ= Penn State Worry Questionnaire; PTSS= Post-Traumatic Stress Symptoms Subscale; Q-LES-Q= The Quality of Life Enjoyment and Satisfaction Questionnaire; QWL= Quality of Work Life; RCT= Randomized Controlled Trial; RS= Resilience Scale; SBQ-R= Suicide Behavior Questionnaire Revised; SEK-27= Emotion regulation skills; SF-12= Short Form Health Survey; SF-36= Short-Form-36 (SF-36) Health Survey - Mental Health Component; SHS= Subjective Happiness Scale; SPTSMY= Scale of Post-traumatic Stress Traits in Mexican Youth Exposed to Social Violence; SRS-13= Smith Relaxation State Inventory; STAI= State Anxiety Inventory; S-STS= Sheehan Suicidality Tracking Scale; SUD= Subjective Units of Distress Scale; SUPPH= Strategies Used by People to Promote Health Questionnaire; SWE= Skala zur Allgemeinen Selbstwirksamkeit; UCLA-8= University of California Los Angeles Loneliness Scale; ULS= UCLA Loneliness Scale (Döring & Bortz, 1993); VAS= Visual Analogue Scale; VLA= Valued Life Assessment; WE-MWBS= Warwick Edinburgh Mental Wellbeing Scale; WFS= Widespread Fear Scale; WHO-5= WHO (Five) Wellbeing Index; WHOQOL-BREF= World Health Organization Quality of Life Questionnaire Bref; ZSAS= Zung Self-rating Anxiety Scale; ZSDS= Zung Self-rating Depression Scale
*Pregnant women were coded under the pre-existing medical condition population; All hospital staff are coded as medical staff.
*Funding: Some registries do not discriminate between funder and sponsor. If only the researcher’s institution was listed as a sponsor, funder was coded as NR.
COMPLETED TRIAL CHARACTERISTICS
COMPLETED TRIAL OUTCOMES
*Abbreviations: BM= Burnout Measure Scale; DASS-21= Depression, Anxiety, and Stress Scale; DJGLS= De Jong Loneliness Scale; FCV-19S= Fear of COVID-19 Scale; GAD-7= Generalized Anxiety Disorder; HADS= Hospital Anxiety and Depression Scale; IDA= Irritability, Depression, Anxiety Scale; MADRS= Montgomery Åsberg Depression Rating Scale; MBI= Maslach Burnout Inventory; NR= Not Reported; PANAS= Positive and Negative Affect Schedule; PHQ-9= Patient Health Questionnaire; PROMIS= Patient-Reported Outcomes Measurement Information System; POMS= The Profile of Mood States; PSS= Perceived Stress Scale; RCT = Randomized Controlled Trial; SCL-25= Symptom Check List; SF-12= Short Form Health Survey; SF-36= Short-Form-36 Health Survey - Mental Health Component; SSS-8= Somatic Symptom Scale; STAI= State Anxiety Inventory; SUD= Subjective Units of Distress Scale; SWLS= Satisfaction With Life Scale ; ULS= University of California, Los Angeles (UCLA) Loneliness Scale; WE-MWBS= Warwick Edinburgh Mental Wellbeing Scale; WHO-QOL= World Health Organization- Quality of Life; ZSAS= Zung Self-Rating Anxiety Scale; ZSDS= Zung Self-Rating Depression Scale
*A positive effect size indicates that the effect favored the intervention