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Two years of COVID-19: persistently reduced well-being and increases in global psychopathology during the pandemic in a representative Austrian population-sample within the COH-FIT study

IntroductionThe COVID-19 pandemic worsened well-being and mental health worldwide, but effects have diminished over time. However, prospective national data within representative samples remain scarce. We aimed to examine the change in well-being and psychopathology from pre-pandemic to intra-pandemic times in an Austrian representative general population sample, to identify vulnerable subgroups, and explore most effective coping strategies to mitigate the impact of COVID-19.MethodsData were collected in Austria as part of the Collaborative Outcomes Study on Health and Functioning During Infection Times (COH-FIT) survey, an international, multilingual, anonymous online survey assessing mental health indicators during COVID-19. Adults ≥18 years old participated through nationally representative sampling across three waves from 05/2020-04/2022. Outcomes included the WHO well-being index (WHO-5) and a global psychopathology score (‘P-score’), alongside 12 predefined risk factors and 16 coping strategies.ResultsAcross 4,148 adults, the mean WHO-5 well-being score decreased by 7.5 ± 17.7 points from the pre-pandemic baseline (73.2 ± 19.7) to the intra-pandemic average (65.7 ± 24.1) (p<.001). Participants with female sex, pre-existing mental or physical health conditions, and unemployment experienced greater declines. The proportion of individuals scoring <50, indicating depression, increased from 12.6% pre-pandemic baseline to 25.1% intra-pandemic, and the proportion scoring <29, indicating major depression, increased from 3.3% to 9.7% (both p<.001). The ‘P-score’ increased by 9.6 ± 15.0 points from 24.1 ± 19.5 pre-pandemic baseline to 33.7 ± 22.4 intra-pandemic (p<.001) with the same risk groups (except female sex). Although the greatest deterioration in both outcomes occurred during the mid-pandemic period (04/2021), neither well-being nor ‘P-score’ levels returned to pre-pandemic baseline values by 04/2022, nor to values from 05/2020 (Wave 1). Greater deterioration in WHO-5 and the P-score were associated with female sex, unemployment, pre-existing mental or physical disorders, and COVID-19 infection. The most commonly reported helpful coping strategies included internet use, physical activity, media consumption, social media and remote interaction, and meaningful hobbies.DiscussionCOVID-19 had a persistent negative impact on well-being and mental health in Austria. Vulnerable subgroups – including those with prior health conditions and unemployment – were particularly affected. The findings underscore the importance of implementing public health measures together with targeted interventions, preventive measures, and long-term psychosocial support, especially for risk populations.
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The efficacy of acupuncture for depression-associated chronic pain: a systematic review and meta-analysis

ObjectiveThe comorbidity of pain and depression is prevalent, adding difficulty to the treatment of depression. This systematic review with meta-analysis aims to determine the efficacy and safety of acupuncture in treating depression-associated chronic pain (DACP).MethodsA comprehensive search was conducted across four international databases, namely PubMed, Embase, Web of Science, and the Cochrane Library, along with four regional databases, including Wanfang Data, CNKI, VIP database, and SinoMed, from inception to March 2025. The Cochrane Risk of Bias 2 tool was utilized to assess risk of bias in the included research articles, and the Grading of Recommendations Assessment, Development, and Evaluations system was employed to evaluate the certainty of evidence. Meta-regression analysis was performed to explore the influence of patient age and treatment duration on the study results, and sensitivity analysis was used to verify the stability of the results. The publication bias was evaluated when the number of included studies exceeded ten. All data analyses were completed using Stata15.1.ResultsTen randomized controlled trials involving 761 participants were included. Acupuncture combined with conventional medications was more effective than medication alone in improving depressive symptoms (standardized mean difference (SMD): -0.72; 95% confidence interval (CI): -0.91 to -0.53; P < 0.01) and reducing pain (SMD: -0.85; 95% CI: -1.36 to -0.34; P < 0.01). Head-to-head comparisons revealed that acupuncture is similar to medication in improving the Hamilton Depression Rating Scale scores (SMD: -0.05; 95% CI: -0.61 to 0.51; P > 0.05) and the Visual Analogue Scale scores (SMD: -0.33; 95% CI: -0.94 to 0.29; P > 0.05), suggesting no statistically significant difference between the two treatments. In contrast, acupuncture was associated with a better safety profile (relative risk: 0.40; 95% CI: 0.27 to 0.60). Further subgroup analysis found the advantage of a 4-week acupuncture treatment in improving depressive symptoms, while longer-term treatment tended to be more effective in relieving pain.ConclusionsAcupuncture appears to have comparable antidepressant and analgesic effects to conventional oral medications. When applied as an adjuvant therapy, acupuncture may enhance the clinical efficacy of monotherapy for DACP. Regarding treatment duration, a 4-week acupuncture intervention may be superior to a longer cycle (> 4 weeks) in alleviating depressive symptoms, while long-term acupuncture treatment may provide greater benefits in analgesia.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO, identifier CRD420251026454.
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Wearable low-level laser therapy (laser acupuncture) versus manual acupuncture for chronic insomnia: protocol for a randomized, assessor-blinded, superiority trial

BackgroundChronic insomnia is a prevalent and disabling condition associated with impaired daytime functioning, psychiatric comorbidity, and autonomic dysregulation. Although cognitive behavioral therapy for insomnia (CBT-I) is recommended as the first-line treatment, access is limited. Acupuncture has demonstrated therapeutic benefits for insomnia but requires trained practitioners and repeated clinic visits. Low-level laser therapy (LLLT), an acupoint-targeted form of photobiomodulation that is also referred to as laser acupuncture when applied to acupuncture points, offers a non-invasive and standardized modality that may serve as a practical alternative.MethodsThis single-center, parallel-group, assessor-blinded, superiority randomized controlled trial will compare wearable LLLT with manual acupuncture in 106 adults with chronic insomnia. Participants aged 18–65 years who meet DSM-5 criteria for chronic insomnia and have an Insomnia Severity Index (ISI) score between 8 and 21 will be randomly allocated (1:1) to the LLLT group or acupuncture group. Both interventions will target bilateral HT7, PC6 and SP6 (six acupoints in total) for 30 minutes per session, three times per week, over two weeks (six sessions total). In the LLLT group, 650-nm laser irradiation will be delivered simultaneously to all six acupoints. The primary outcome is the change in ISI score from baseline to week 2. Secondary outcomes include sleep quality (Pittsburgh Sleep Quality Index, PSQI), fatigue (Fatigue Severity Scale, FSS), depressive symptoms (Patient Health Questionnaire-9, PHQ-9), anxiety (Generalized Anxiety Disorder-7, GAD-7) and heart rate variability (HRV) indices. The ISI will be assessed at baseline, post-treatment (week 2), and follow-up (week 6). Secondary outcomes, including PSQI, FSS, PHQ-9, GAD-7, and HRV indices, will be assessed at baseline and week 2. Analyses will follow the intention-to-treat principle using analysis of covariance and prespecified longitudinal or repeated-measures models where appropriate.DiscussionThis trial will provide comparative evidence on the short-term efficacy and safety of wearable LLLT versus manual acupuncture for chronic insomnia. By directly comparing an established acupuncture protocol with a non-invasive intervention that has potential for future home-based implementation, the study aims to clarify the clinical value of LLLT as a less invasive alternative within the framework of complementary and integrative sleep medicine.Clinical trial registrationhttps://itmctr.ccebtcm.org.cn/Home/ProjectView?pid=d0e46c39-0647-4cbd-ba40-e2b02830fd28, identifier ITMCTR2025000977.