Mental Health and Access to Medical Care in Patients with Chronic Cardiovascular Conditions: An Analysis of the Behavior Risk Factor Surveillance System

Introduction. Poor mental health is associated with worse outcomes for chronic diseases. It is unclear whether mental illness predisposes to difficulties with healthcare access. Methods. Using a combined dataset of the 2016-2019 behavioral risk factor surveillance system, we included individuals who reported a chronic cardiovascular condition. Weighted multivariable logistic regression analyses were used to explore the association between domains of mental health and measures of healthcare access including delaying medical care, > 1 year since last routine checkup, lack of a primary care physician (PCP), and cost-related medication nonadherence (CRMNA). Results. Among 1,747, 397 participants, 27% had a chronic cardiovascular condition, 12% had clinical depression, and 12% had poor mental health. Those with poor mental health (OR 3.20 [3.08 – 3.33]) and clinical depression (OR 2.43 [2.35 – 2.52]) were more likely to report delays in medical care. Those with greater stress frequency (OR 8.47 [6.84 -10.49] stressed all of the time), lower levels of emotional support received (OR 3.07 [2.21 – 4.26] rarely get needed emotional support), and greater life dissatisfaction (6.66 [4.14 – 10.70] very dissatisfied) reported greater delays in medical care. Conclusions. Individuals with poor mental health have greater difficulty accessing medical care independent of socioeconomic variables.

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Cross-Sectional Online Study of the Psychological Status of Russian Doctors during the COVID-19 Pandemic

Background. COVID-19 outbreak resulted in an increased psychological and physical pressure on healthcare professionals worldwide. Doctors treating COVID-19 patients have turned out to be at higher risk of depression, anxiety, psychosomatic disorders. The data about the influence of the pandemic on psychological health of Russian doctors is still missing. Aims to evaluate a psychological status of Russian doctors during COVID-19 pandemic. Methods. This cross-sectional online-study was conducted among 133 doctors of different specialties aged 2570 (mean age 43.6 9.9), 112 (84.2%) of the them were females. We assessed the work conditions of the respondents during pandemic, the presence of psychosomatic disorders, depression and anxiety levels by HADS scale. Results. Almost two thirds (82; 61.7%) of the respondents reported an increased workload during the pandemic, 54.1% of them work more than 40 hours per week. The income has risen only in 25.6% of the doctors. Most of the respondents announced a manifestation of one or more psychosomatic disorders during the pandemic. The most frequent complaint was insomnia found in 72 (54.1%) of the doctors. Clinical anxiety was confirmed in 30 (22.6%), clinical depression in 15 (11.3%), moderate anxiety in 22 (16.5%), moderate depression in 31 (23.3%), both clinical anxiety and depression in 6% of the participants. Conclusions. During the pandemic Russian doctors continue to work under physical and psychological pressure and provide medical care even if they have clinical depression and anxiety that influences on patients and doctors wellbeing. Theres still a lack of psychological assistance to doctors and of other methods to prevent professional burn-out.