Research in Mental Health During the COVID-19 Pandemic Quality versus quantity Sultan Qaboos University Med J, November 2020, Vol. 20, Iss. 4, pp. e406–407, Epub. 21 Dec 20 Submitted 8 Jun 20 Revision Req. 29 Jul 20; Revision Recd. 13 Aug 20 Accepted 26 Aug 20 This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License. https://doi.org/10.18295/squmj.2020.20.04.024 LETTER TO THE EDITOR البحث يف الصحة العقلية أثناء جائحة كوفيد-19 اجلودة ِإزاء الكمية Dear Editor, Over the last several months, COVID-19 has significantly influenced everyday living globally. The pandemic has resulted in limitations to the lifestyles of most individuals. It has also significantly influenced medical research. According to the publications on PubMed® (National Library of Medicine, Bethesda, Maryland, USA), the number of articles found using the search-term “COVID-19” was 18,170 by 2 June 2020. Out of these, 18,161 (99.95%) articles were published in 2020. By 7 August 2020, a total of 38,522 articles were found (2.12 times increase in 66 days). When searching for articles related to mental health associated with COVID-19, 655 (3.66%) articles were found by 2 June and 1,662 (9.15%) articles by 7 August 2020. All the articles related to mental healthcare in the context of COVID-19 were published during 2020. Up to 7 August 2020, the total number of articles related to mental health in PubMed was 371,520. Over the past year, 37,365 articles were published with 4.45% being related to COVID-19 and mental health. Reports suggest that researchers are confined to COVID-19 research and all other dimensions of healthcare have been put aside.1,2 Knowledge related to COVID-19 has been ubiquitously disseminating during the current pandemic raising everybody’s concern, with researchers being no exception.3 Recently, publications on the role of hydroxycholoquine in COVID-19 management have been retracted from reputed journals due to uncertainty of data and evidence, which influenced decision-making worldwide.4 There are several reasons behind the shifting of focus towards COVID-19 research during the current pandemic which resulted in a healthcare crisis. During this period, multiple domains of healthcare were adversely affected directly or indirectly.5 Lockdown protocols during this pandemic have reduced accessibility to healthcare services with mental illness being no exception.6–8 This is a major contributor to the increased focus on COVID-19 research which became a priority for every affected nation as well as its healthcare professionals. Governments and international bodies are encouraging research of COVID-19 for its effective control.9 This heightened attention by researchers worldwide resulted in a significant increase COVID-19-based research. As there is a constant flow of new information related to COVID-19 (e.g. pathogenesis or management) and the fact that researchers of the 21st century never witnessed a pandemic of such extent, researchers were encouraged to gather evidence through intensive research to understand COVID-19 better. Fast-tracked approval by ethics committees, fast-tracked publication by publishing houses and calls for COVID-19-related papers for special issues of various national and international journals attracted researchers to a relatively easy and rapid publication process. It has been reported that the increased focus on COVID-19 by researchers has resulted in proliferation of COVID-19-related research, not all of which is impactful.7 When many studies attempt to measure similar phenomenon in a similar population at the same time period, not all of them may add to the existing information/ evidence. It is important to explore the research gaps and evaluate the unexplored domains that may give a meaningful conclusion. Furthermore, the focus on COVID-19 must not suppress the funding of ongoing research into other medical conditions of public health significance such as malnutrition and tuberculosis, which kills more people every year than COVID-19.5,10 To date, most of the available research has explored the epidemiology of mental health issues during COVID-19 and the association of COVID-19 with brain changes and the mental health of children, caregivers and healthcare professionals.11,12 It has been noticed that there is a global shortage of mental healthcare professionals and an even greater shortage of researchers. As publishing houses receive a large number of submissions and many fast-track their review process, they run the risk of not receiving high-quality feedback resulting in publication of poor- https://creativecommons.org/licenses/by-nd/4.0/ Sujita K. Kar, Vikas Menon, S. M. Yasir Arafat and Russell Kabir Letter to the Editor | e407 quality research. A large number of publications/submissions on COVID-19 were retracted or withdrawn due to poor quality and ethical concerns.9 Study methodology and design as well as the tools used to measure different mental health constructs also determine the quality of research. Unfortunately, most of the mental health research during the COVID-19 pandemic does not meet the desired quality.13,14 Futhermore, dynamics of the pandemic are rapidly changing as are public health priorities. Considering the rapidly evolving scenario of health priorities, recommendations may need constant updating.15,16 The generalisability of research findings also requires cautious interpretation. The significant increase in COVID-19-related research has caused a strain on precious researcher time and resources. Researchers should refrain from poor-quality research, study duplications and irrational trials.17 Any type of public tragedy or catastrophe is connected to major social, economic and political disturbances. Therefore, knowing the mental health determinants during such a crisis is crucial for resilience-building and mitigating anxiety and psychological distress. Sujita K. Kar,1 Vikas Menon,2 S. M. Yasir Arafat,3 *Russell Kabir4 1Department of Psychiatry, King George's Medical University, Lucknow India; 2Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India; 3Department of Psychiatry, Enam Medical College and Hospital, Dhaka, Bangladesh; 4School of Allied Health, Faculty of Health, Education, Medicine, and Social Care, Anglia Ruskin University, Chelmsford, United Kingdom. Corresponding Author’s e-mail: russell.kabir@anglia.ac.uk References 1. Brainard J. Scientists are drowning in COVID-19 papers. Can new tools keep them afloat? From: https://www.sciencemag.org/ news/2020/05/scientists-are-drowning-covid-19-papers-can-new-tools-keep-them-afloat Accessed: Aug 2020. 2. Nature Index. Coronavirus research publishing: The rise and rise of COVID-19 clinical trials. From: https://www.natureindex.com/news- blog/the-top-coronavirus-research-articles-by-metrics Accessed: Aug 2020. 3. Lee SA. How much “Thinking” about COVID-19 is clinically dysfunctional? Brain Behav Immun 2020; 87:97–98. https://doi.org/10.1016/j. bbi.2020.04.067. 4. Mehra MR, Ruschitzka F, Patel AN. Retraction—Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: A multinational registry analysis. The Lancet 2020; 395:1820. https://doi.org/10.1016/S0140-6736(20)31324-6. 5. Andrade C. COVID-19: Humanitarian and Health Care Crisis in a Third World Country. J Clin Psychiatry 2020; 81:20com13383. https:// doi.org/10.4088/JCP.20com13383. 6. Kumar A, Rajasekharan Nayar K, Koya SF. COVID-19: Challenges and its consequences for rural health care in India. Public Health Pract 2020; 1:100009. https://doi.org/10.1016/j.puhip.2020.100009. 7. eijt M, de Kort Y, Bongers I, Bierbooms J, Westerink J, IJsselsteijn W. Mental Health Care Goes Online: Practitioners’ Experiences of Providing Mental Health Care During the COVID-19 Pandemic. Cyberpsychol Behav Soc Netw 2020. https://doi.org/10.1089/cyber.2020.0370. 8. Siedner MJ, Kraemer JD, Meyer MJ, Harling G, Mngomezulu T, Gabela P, et al. Access to primary healthcare during lockdown measures for COVID-19 in rural South Africa: An interrupted series analysis. BMJ Open 2020; 10:e043763. https://doi.org/10.1101/2020.05.15.20103226. 9. World Health Organization (2020) Global research on coronavirus disease (COVID-19). From: https://www.who.int/emergencies/diseases/ novel-coronavirus-2019/global-research-on-novel-coronavirus-2019-ncov Accessed: Aug 2020. 10. Bhargava A, Shewade HD. The potential impact of the COVID-19 response related lockdown on TB incidence and mortality in India. Indian J Tuberc 2020 In press. https://doi.org/10.1016/j.ijtb.2020.07.004. 11. Xiong J, Lipsitz O, Nasri F, Lui LMW, Gill H, Phan L, et al. Impact of COVID-19 pandemic on mental health in the general population: A systematic review. J Affect Disord 2020; 277:55–64. https://doi.org/10.1016/j.jad.2020.08.001. 12. Vindegaard N, Benros ME. COVID-19 pandemic and mental health consequences: Systematic review of the current evidence. Brain Behav Immun 2020; 89:531–42. https://doi.org/10.1016/j.bbi.2020.05.048. 13. Nieto I, Navas JF, Vázquez C. The quality of research on mental health related to the COVID-19 pandemic: A note of caution after a systematic review. Brain Behav Immun Health 2020; 7:100123. https://doi.org/10.1016/j.bbih.2020.100123. 14. Dobler CC. Poor quality research and clinical practice during COVID-19. Breathe (Sheff.) 2020; 16:200112. https://doi. org/10.1183/20734735.0112-2020. 15. De Sousa A, Mohandas E, Javed A. 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