The Arab COVID-19 Anxiety Syndrome Scale (C-19ASS): COVID-19 anxiety syndrome and psychological symptoms in the Saudi Arabian population.

INTRODUCTION: The COVID-19 Anxiety Syndrome Scale (C-19ASS) is a reliable scale assessing dysfunctional coping strategies activated in response to COVID-19 fear and threat. The present study aimed to provide a validation of the Arabic version of the C-19ASS and to explore the association between the C-19ASS and psychological symptoms syndrome. METHOD: In Study 1, a community sample of 404 participants completed the Arabic version of the C-19ASS and results were subjected to an exploratory factor analysis. In Study 2, a community sample of 903 participants completed the Arabic version of the C-19ASS and a series of measures assessing depressed mood and anhedonia, generalized anxiety and health anxiety. Internal consistency, construct validity and incremental validity were assessed. Associations between C-19ASS and psychological symptoms were assessed. RESULTS: Factor analysis identified a two-factor solution (i.e., C-19ASS-Perseveration and C-19ASS-Avoidance), and confirmatory factor analysis suggested a two-factor model best fits the data. The Arabic version of the C-19ASS showed good internal consistency, good construct and incremental validity. COVID-19 anxiety syndrome was associated with more severe anxiety symptoms, depressive symptoms and health anxiety. Females had higher levels of COVID-19 anxiety syndrome than males. Participants diagnosed with COVID-19, and those who had experienced loss as a consequence of COVID-19, had higher levels of COVID-19 anxiety syndrome (Perseveration). CONCLUSIONS: The Arabic version of the C-19ASS appears to be a reliable and valid measure of the COVID-19 anxiety syndrome. The COVID-19 anxiety syndrome could be a suitable therapeutic target to improve psychological recovery during the COVID-19 pandemic among Arabs.

Diabetes self-management during the COVID-19 pandemic and its associations with COVID-19 anxiety syndrome, depression and health anxiety.

INTRODUCTION: The effects of the COVID-19 pandemic on mental health have been profound. Mental health and diabetes self-care are inter-related. We examined whether COVID-19 anxiety, depressive symptoms and health anxiety were associated with domains of diabetes self-management and investigated whether greater COVID-19 anxiety syndrome would independently contribute to suboptimal diabetes self-care. RESEARCH DESIGN AND METHODS: Surveys were sent to people attending diabetes clinics of three London hospitals. Participants completed the Diabetes Self-Management Questionnaire (DSMQ), the COVID-19 Anxiety Syndrome Scale (C-19 ASS), which measures perseveration and avoidant maladaptive coping behaviour, assessed with measures of co-existent depressive symptoms and anxiety, controlling for age, gender and social deprivation. Clinical data, including pre- and post-lockdown HbA1c measures, were obtained from hospital records for 369 respondents, a response rate of 12.8%. RESULTS: Depressive symptom scores were high. Both pre-existing health anxiety and depressive symptoms were independently linked to improvable measures of diabetes care, as was lower socio-economic rank. However, avoidant COVID-19 anxiety responses were independently associated with higher diabetes self-care scores. HbA1c levels improved modestly over the year of UK lockdown in this cohort. CONCLUSION: During the height of lockdown, avoidant coping behaviours characteristic of the COVID-19 anxiety syndrome may in fact work to improve diabetes self-care, at least in the short term. We recommend screening for depressive symptoms and being aware of the significant minority of people with COVID-19 anxiety syndrome who may now find it difficult to re-engage with face-to-face clinic opportunities.