During the onset of the COVID-19 pandemic, the COVIDiSTRESS Consortium launched an open-access global survey to understand and improve individuals’ experiences related to the crisis. A year later, we extended this line of research by launching a new survey to address the dynamic landscape of the pandemic. This survey was released with the goal of addressing diversity, equity, and inclusion by working with over 150 researchers across the globe who collected data in 48 languages and dialects across 137 countries. The resulting cleaned dataset described here includes 15,740 of over 20,000 responses. The dataset allows cross-cultural study of psychological wellbeing and behaviours a year into the pandemic. It includes measures of stress, resilience, vaccine attitudes, trust in government and scientists, compliance, and information acquisition and misperceptions regarding COVID-19. Open-access raw and cleaned datasets with computed scores are available. Just as our initial COVIDiSTRESS dataset has facilitated government policy decisions regarding health crises, this dataset can be used by researchers and policy makers to inform research, decisions, and policy.

BackgroundBoth stroke and psychosis are independently associated with high levels of disability. However, psychosis in the context of stroke has received remarkably little interest from clinicians and researchers. To date there are currently no population studies on their joint prevalence and association.MethodsWe estimated the prevalence of i) probable psychosis in stroke and, ii) stroke in probable psychosis using four nationally representative cross-sectional psychiatric epidemiological studies: two from high-income countries (United Kingdom and United States) and two from middle-income countries (Chile and Colombia) and, subsequently, a combined dataset from all four countries. We also tested the statistical association between stroke and psychosis using single and multi-level regression models to estimate the unadjusted association between stroke and psychosis, and the association adjusted for potential demographic confounders.ResultsThe prevalence of probable psychosis in stroke ranged from 1.05% [95% CIs 0.03 - 5.73] in Chile, to 13.92% [95% CIs 7.16 - 23.55] in Colombia, with the prevalence from the combined countries dataset estimated at 3.81% [95% CIs 2.34 - 5.82]. Stroke in probable psychosis ranged from 2.18% [95% CIs 1.09 - 3.86] in Colombia, to 16.67% [95% CIs 6.37 - 32.81] in the US, with the combined countries prevalence estimated at 3.15% [95% CIs 1.94 - 4.83]. Estimates for the adjusted association between stroke and probable psychosis ranged from an OR = 1.11 [95% CIs 0.15 - 8.26] in the UK to an OR = 6.22 in the US [95% CIs 2.52 - 15.35] with the adjusted association from the combined dataset estimated at OR = 3.32 [95% CIs 2.05 - 5.38]. Larger prevalences and associations were associated with larger confidence intervals and we suggest the smaller estimates are likely to be more accurate. We also examined the association between stroke and paranoia, hallucinated voices, and thought passivity delusion, and although we found significant variation in the reliability and strength of association across countries, all three psychotic symptoms were associated with stroke in the unadjusted and adjusted analyses in the combined countries dataset.ConclusionsThere are high rates of association between psychosis and stroke, meaning there is likely a high clinical need group who are under-researched and may be poorly served by existing services. Notably, stroke is a known risk factor for psychosis, and psychosis and antipsychotic treatment for psychosis are known risk factors for stroke, meaning causality is likely to be bidirectional and treatment pathways should be integrated across traditional service boundaries.

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Background Both stroke and psychosis are independently associated with high levels of disability. However, psychosis in the context of stroke has been under-researched. To date, there are no general population studies on their joint prevalence and association. Aims To estimate the joint prevalence of stroke and psychosis and their statistical association using nationally representative psychiatric epidemiology studies from two high-income countries (the UK and the USA) and two middle-income countries (Chile and Colombia) and, subsequently, in a combined-countries data-set. Method Prevalences were calculated with 95% confidence intervals. Statistical associations between stroke and psychosis and between stroke and psychotic symptoms were tested using regression models. Overall estimates were calculated using an individual participant level meta-analysis on the combined-countries data-set. The analysis is available online as a computational notebook. Results The overall prevalence of probable psychosis in stroke was 3.81% (95% CI 2.34–5.82) and that of stroke in probable psychosis was 3.15% (95% CI 1.94–4.83). The odds ratio of the adjusted association between stroke and probable psychosis was 3.32 (95% CI 2.05–5.38). On the individual symptom level, paranoia, hallucinated voices and thought passivity delusion were associated with stroke in the unadjusted and adjusted analyses. Conclusions Rates of association between psychosis and stroke suggest there is likely to be a high clinical need group who are under-researched and may be poorly served by existing services.