Epidemic of Depression and Anxiety in child and adolescent population during COVID-19 pandemic: A systematic review and meta analysis of the prevalence of depression and anxiety.

COVID-19 has caused mayhem in the life of people. It has disrupted the social fabric of life. The children and adolescent population has been particularly affected by its direct and indirect effects. This systematic review aims to find the prevalence of depression and anxiety in children and adolescent age groups. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for finding the prevalence of depression and anxiety. We found the total number of participants to be 71,016. A random effect model was used for conducting meta-analysis. The prevalence of depression was mentioned in 17 studies of 23 and the pooled prevalence was 27% [95% confidence interval: 21%-36%] and heterogeneity (I2 statistics; P <.00001) was 100%. The prevalence of anxiety was found in 20 studies of 23 and the pooled anxiety prevalence was 25% (95% confidence interval: 16%-41%) and heterogeneity (I2 statistics; P < .00001) was found to be 100%. The summary of the findings has been provided. Due to high heterogeneity, moderator analysis was performed separately for depression and anxiety subgroups. The study design consisted of cross-sectional studies and some studies conducted through online surveys. The age range varied considerably from 1 year to 19 years; 5 studies had participants aged more than 19 years, but the mean age of the total sample was less than 18 years. We conclude that indeed there is a mental health epidemic among the child and adolescent population. We recommend early intervention and tailored made strategies should for management. As the pandemic is enduring, rigorous monitoring should be done. This age group is under extra pressure owing to a large uncertainty about their studies as well their future.

Gender differences in depression, anxiety, stress and sleep disturbances among doctors combating COVID-19

COVID-19 has caused havoc in the lives of doctors. The doctors were faced with the Herculean task of managing a variety of patients, dealing with the queries of their loved ones, keeping up with the ever-changing guidelines, while balancing the worries of their own families, and facing the risk of contracting the infection themselves or transmitting it to their loved ones. Bearing this in mind, the present study was undertaken to assess the impact of gender in causing depression, anxiety, stress, and sleep disturbances between male and female doctors during COVID-19 pandemic. This cross-sectional, analytical, web-based study was conducted during September 2020, after obtaining approval of Institutional Ethics Committee. All participants gave informed consent. The participants completed basic socio demographic questionnaire, and two standardized questionnaires-Depression Anxiety Stress Scale 21 (DASS21) and Athens Insomnia Scale. Out of 143 doctors included in the study, 83 were females (58.04%), while 60 were males (41.96%). On DASS-21, depression and stress was significantly higher in female doctors as compared to male doctors. On the Athens Insomnia Scale, more female doctors suffered from insomnia as compared to male doctors, but the difference was not statistically significant. Female doctors have significantly higher depression and stress while dealing with COVID-19 compared to male doctors. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Neuro-Psychiatric Outcomes in Covid-19 Recovered Patients

Background: Viral infections of respiratory affects Central Nervous system (CNS), precipitating a spectrum of psychiatric and neurological disorders. Some patients with COVID-19 develop various CNS abnormalities with serious long term consequences. Aim: To study neuro-psychiatric manifestations in post COVID-19 RT-PCR positive patients. Materials and Methods: 100 consecutive patients of all age groups were taken as cases who were COVID-19 RT-PCR positive, in a duration of 12 months. The neurological symptoms, MRI findings and CSF findings of the cases were recorded. Subjects were assessed with scales Mini Mental State Examination (MMSE), Mental Health Inventory (MHI), Modified Fatigue Impact Scale -5- Item Version (MFIS-5). Results: On MHI scale, 28.6% of the cases were diagnosed as Depression and 16.32% of the cases were diagnosed as Anxiety. On MFIS-5 scale, 14.9% of the cases were found to have sleep disorders and Fatigue. Positive MRI Brain findings were present in 1.2% cases. No neuro- psychiatric manifestations were found in 38.98% cases after recovery from COVID. Conclusion: In the COVID-19 pandemic, the psychiatric manifestations are common and neurological findings are also found in some cases. Attention to neuropsychiatric consequences of COVID-19 might help in early identification and better management.

Assessment of motivation for solitude, covid-19 related anxiety and resilience among medical students

Background: Covid-19 related lockdowns and restrictions have generated mixed reactions in people. For some, it is a time of agony, anxiety and despair but for others, it has brought the opportunity to spend time alone. People utilize aloneness with different motivations (self-determined versus not self-determined motivations for solitude) and this can determine one’s unique way to deal with life events. This study was designed to assess these motivations for solitude among medical students of a tertiary care centre and to find their relationship with Covid-19 related anxiety and resilience among these students. Materials and Methods: This was an analytical cross-sectional study where more than 300 medical students (age above 17, of either gender, from 1st year to final year of MBBS) of a tertiary care institute of Eastern India were enrolled after obtaining informed consent. The study was passed by the Institute’s Ethical Committee. Motivation for Solitude Scale – Short Form, COVID-19 Anxiety Scale, Connor-Davidson Resilience Scale-Abbreviated (CD-RISC2) were the principal tools to be applied. Results: The collected data is under being entered and will be analysed using the appropriate statistical tests. The obtained results and their discussion will be shared during the presentation. Conclusion: The outcome of the study, in terms of different motivations for solitude, is expected to influence the policymaking in assessments as well as psychosocial interventions for vulnerable students during a loneliness crisis like the Covid-19 pandemic.

Reliability and Psychometric Validity of the Marathi Version of Corona Anxiety Scale

Background: The COVID-19 Anxiety Scale (CAS) was developed and validated in 2020 as a psychometrically suitable measure of anxiety incurred by the COVID-19 pandemic. Availability in English language limits its utility in our setting where majority are Marathi speaking. Aim: To establish reliability and validity of the Marathi adaptation of CAS. Method: CAS was translated by bilingual experts, followed by forward and backward translation processes. Final version was used. Eighty volunteers, versed in both English and Marathi languages were included. The original English version of the scale was first applied, followed by the Marathi translation, after a hiatus of 14 days. Result: Mean score of the original English version was 2.95 (±2.79) and that of the Marathi version was 2.80 (±2.76), showing significant correlation (0.001 level) with Kendall’s tau-b of 0.830. The Marathi version of CAS has a high degree of internal consistency as demonstrated by a Cronbach’s-alpha of 0.809. The scale has significant concurrent validity and acceptable split-half reliability. A principal components analysis with varimax rotation was performed on the CAS responses of the participants, which yielded one factor with an eigen value greater than one, representing 58.51% of the total variance. CAS was found to be easily understandable and capable of adequately evaluating and measuring various aspects of Corona anxiety. Conclusion: The Marathi version of CAS is a valid and reliable instrument to assess anxiety due to Corona virus in the Marathi speaking population of India.

Comparative study of coping, anxiety, and resilience in doctors caring and not-caring for COVID 19 patients

BACKGROUND: Doctors are more vulnerable to the negative effects of the COVID 19 pandemic than the general population due to direct contact with patients causing an increase in levels of anxiety and compromising resilience by isolation and risk to family members. This study aims to explore the anxiety, resilience, and coping among health care professionals. AIM: To compare the coping strategies, anxiety, and resilience in doctors caring and not caring for COVID 19 patients. METHODS: A cross-sectional study was carried out in a tertiary care center from September 2020 to September 2021. A written informed consent was obtained for participation in the study from all doctors recruited for the study after explaining the purpose and design of the study. By purposive sampling a total of 100 doctors were recruited in the study after fulfilling the inclusion and exclusion criteria. RESULTS: The mean Coronavirus Anxiety Scale (CAS), Brief COPE, Connor – Davidson Resilience Scale scores in doctors treating COVID 19 patients was significantly more than the respective scores for doctors not treating COVID 19. CONCLUSION: The doctors treating COVID 19 patients had more anxiety as compared to doctors not treating COVID 19 patients, whereas doctors not treating COVID 19 patients had better coping and resilience as compared to doctors treating COVID19 patients.

Weaved around COVID-19: Case series of coronavirus thematic delusions.

Stressful situations such as the COVID-19 pandemic can serve as a niche for developing pathological mental state or influence the symptomatology of patients with psychiatric disorders. Here, we present four such cases. Three cases highlight the onset of psychosis precipitated by the immense stress posed by the pandemic. In the last case, psychopathology of a patient with preexisting mental illness getting influenced by the pandemic is highlighted. In all the four cases, it is interesting to note that delusional work is weaved around the COVID-19.

Correlates of depression, anxiety, self-esteem, and suicidal ideas in COVID-associated mucormycosis patients and the effects of treatment.

AIM: The aim was to study the correlates of depression, anxiety, self-esteem, and suicidal ideas in patients of COVID-associated mucormycosis (CAM) and effects of treatment. MATERIALS AND METHODS: A cross-sectional, analytical study was performed in a tertiary care center in Western Maharashtra. By purposive sampling, 34 patients of CAM were included in the study with their informed consent and after obtaining ethical clearance. A self-made questionnaire to include demographic and clinical details was filled. Hospital Anxiety and Depression Scale (HADS), Rosenberg Self-Esteem Scale (RSES), and Suicidal Ideation Attributes Scale (SIDAS) were applied after initial diagnosis. The HADS, RSES, and SIDAS were reapplied after their operative treatment. RESULTS: A significant reduction in anxiety and depression scores postoperatively was seen. No significant difference was found in self-esteem or suicidal ideas postoperatively in the study population. However, patients who underwent orbital exenteration showed a significant reduction in level of self-esteem with anxiety and depression postoperatively. No specific correlation was found between the computed tomography score, family history, intensive care unit admission, or orbital exenteration with anxiety, depression, self-esteem, and suicidal ideas. CONCLUSION: Levels of anxiety and depression in patients of CAM reduced significantly after treatment, but self-esteem worsened in males more than females owing to disfigurement. There is a need of psychological counseling in patients of mucormycosis undergoing a debilitating surgery both pre- and postoperatively for a better outcome and recovery.

COVID-19 lockdown - Blessing or disaster?

Despite the dubious results of the nationwide lockdown in India state after state continue to clamp lockdowns indiscriminately and claim that it is a panacea for all their ills. Unverified claims abound and myths are perpetuated without any basis. It is time to take a close look at the hard data and come to logical conclusions regarding the utility of prolonged open-ended lockdowns. Unfortunately, the evidence does not support the use of prolonged lockdowns as a useful strategy to combat the COVID-19 pandemic.

Dangers of mRNA vaccines.

"Necessity is the mother of invention:" An adage was brought to life with the emergence of the mRNA vaccine against the backdrop of the foreboding and mercurial COVID-19 pandemic. Considering a negligible adverse-effect profile and a break-neck manufacturing speed, it shone bright as the ideal vaccine candidate. However, "all that glitters is not gold," as was evidenced by the significant reactogenicity, a host of multi-systemic side-effects, that are being reported by the vaccine recipients; which is palpably resulting in a shift of emotions for the vaccine, accounting for vaccine hesitancy. Anaphylaxis, antibody-dependent enhancements, and deaths, comprise the most serious side-effects, albeit occurring in sparing numbers. Storage and transportation require fastidious temperatures, rendering it substantially inaccessible to a country like India. The biggest jolt, however, was the unfolding of the biases in reporting vaccine efficacy, as only the attractively high numbers of the relatively equivocal relative risk reduction were reported while keeping at bay the meager numbers of the more forthright absolute risk reduction. Notwithstanding the fallacies, the mRNA vaccine still promises hope; and with the right precautions and finesse, can be potentiated, as "a watched pot never boils."

Quarantine: Psychological aspects.

Quarantine is an age old methods of preventing the spread of infection by restricting the movement of persons or goods. It has again come to global attention due to its widespread implementation during the COVID-19 pandemic. While the public health utility of quarantine is well established, it is associated with few psychological effects which are neither well known nor recognized. In this communication, the psychological side-effects of quarantine and their prevention are briefly discussed.

Stigma associated with COVID-19.

A number of incurable, deadly, and disfiguring diseases are associated with stigma which worsens the quality of life of the sufferer. Unfortunately, at the beginning of the COVID-19 pandemic, the disease was associated with severe stigma and extreme prejudice. Stigma of COVID-19 and its adverse effects are briefly discussed and solutions suggested.

Burnout and resilience in doctors in clinical and preclinical departments in a tertiary care teaching and dedicated COVID-19 hospital.

BACKGROUND: The worldwide COVID-19 pandemic has significantly altered our life. Doctors more so than the general public because of their involvement in managing the COVID-infected individuals, some of them 24/7 end in burnout. Burnout in doctors can lead to reduced care of patients, increased medical errors, and poor health. Burnout among frontline health-care workers has become a major problem in this ongoing epidemic. On the other hand, doctors in preclinical department have a lack of interaction with patients, with not much nonclinical professional work to boot, find the profession less gratifying which perhaps increase their stress level. AIM: The aim was to study the prevalence of burnout and measure resilience in doctors in clinical and in preclinical departments. MATERIALS AND METHODS: This observational, cross-sectional, comparative study was carried out in a tertiary care teaching hospital and COVID care center. By purposive sampling 60 preclinical and 60 clinical doctors in a tertiary health care center were included in the study. After obtaining the Institutional Ethics Committee approval and informed consent, the doctors were administered a self made socio-demographic questionnaire, the Copenhagen Burnout Inventory, and the Connor-Davidson Resilience Scale. Doctors were given a self-made questionnaire, the Copenhagen Burnout Inventory, and the Connor-Davidson Resilience Scale. RESULTS: The prevalence of burnout was seen more in clinical doctors (55.47) and the resilience was observed more in preclinical doctors (88.9). DISCUSSION: Resident doctors are a major force to combat COVID-19 as frontline health workers; hence, one can visualize burnout amongst them. On an individual basis, the work-related burnout was severely high in the clinical group owing to the workload which has been corresponding to a number of western studies. Nonclinical department doctors from pathology, community medicine, and microbiology did show burnout but showed a greater score in resilience. Psychological resilience has been identified as a component in preventing burnout. CONCLUSION: Therapy sessions can be used in clinical doctors facing burnout to build up their resilience.

Impact of COVID-19 pandemic on mental health of health-care workers in a tertiary care teaching and dedicated COVID-19 hospital.

AIM: We aimed to assess the consequences of dealing with patients during the COVID-19 pandemic lockdown period on the mental state of health-care workers. MATERIALS AND METHODS: An anonymous online survey was conducted with 353 participants using a self-made questionnaire comparing the prevalence of low mood, apprehension, tension, and coping skills used and the Depression, Anxiety, and Stress Scale-21. The data were analyzed to compare the mental health of male and female doctors. To identify predictors of mental health outcomes, a multivariate logistic regression was carried out. RESULTS: Both men and women were almost equally affected in terms of developing features of low mood, with easy physical and mental exhaustion. While the feeling of being isolated and irritability was slightly higher in females, both sexes were equally affected by the media. It was observed that the prevalence of smoking (tobacco/marijuana, etc.) had increased in both with slightly higher percentage in males as compared to females while there was a considerable increase in caffeine and alcohol consumption in males. The sleeping pattern and appetite were equally affected in both sexes. The sexual drive was also altered in both male and female residents, but the change was considerably more in males. The significant predictors of anxiety were age, depression, mental exhaustion, burden of increased quantity of work, and feeling of having no choice but to work due to obligation. CONCLUSION: Both male and female doctors working during the COVID-19 pandemic developed anxiety and depression. While substance use and altered sexual drive were more in males, exhaustion and stress were more in females.

Efficacy of psychological intervention in patients with post-COVID-19 anxiety.

BACKGROUND: Individuals who suffered from COVID-19 remain stressed and worried about anxiety issues for significant changes in daily living activities, causing strong emotional distress. AIM: The aim of this study was to assess the efficacy of psychological intervention in patients with post-COVID-19 anxiety. MATERIALS AND METHODS: Thirty patients recovered from COVID-19 were selected for the study of age group 20-45 years of both the sexes. Initially, sociodemographic data sheet was filled, and after that, Mental Health Inventory (MHI) was administered. The patients who scored less on MHI were taken for the study, and psychoeducation, relaxation exercises, and activity scheduling were given to them. The goal of intervention was to prepare the patients to learn, interpret, and react to physical and psychological symptoms related after recovering from COVID-19 infection. The intervention was done for 30 min twice a week for 1 month, after that again postassessment was done to see the efficacy of psychological intervention. RESULTS: Result reveals a significant improvement in mental health-related issues after psychological intervention as assessed by the MHI. CONCLUSION: Psychological intervention resulted in significant improvement of post-COVID-19 anxiety and related mental health issues.

Effect of COVID-19 and sociocultural milieu on the psychopathology of mental health disorders: A hospital-based study.

BACKGROUND: Coronavirus disease (COVID-19) has posed a remarkable threat to mental health all around the world. This pandemic has increased the incidence of common as well as severe mental illness (SMI) all around the world. MATERIALS AND METHODS: We report 10 cases presenting to the psychiatric outpatient department (OPD) of Institute of Medical Sciences, Banaras Hindu University, from August to October 2020. They were either referred by other departments (3 patients) or came primarily to psychiatric OPD (7). RESULTS: Five out of these 10 cases presented with predominant psychotic features; 3 cases had predominant obsessive-compulsive features; and 1 case was of dissociative trance possession. CONCLUSION: COVID-19 can affect the psychopathology of both types of patients either with preexisting mental illness as well as new-onset SMI.

Depression, anxiety, stress, and sleep disturbances in doctors and general population during COVID-19 pandemic.

AIM: The aim of the study is to assess and compare depression, anxiety, stress, and sleep disturbances among doctors and general population during COVID-19 pandemic. MATERIALS AND METHODS: This cross-sectional, analytical, case-control, web-based study was conducted during September 2020 to examine the impact of pandemic on mental health. The participants completed basic sociodemographic questionnaire, Depression Anxiety Stress Scale-21 (DASS-21), and Athens Insomnia Scale (AIS). RESULTS: Of the 321 participants, 320 provided basic data, 22 were on psychotropics. Out of the 298, 286 were matched for age and sex and were included. On DASS-21, 41.27% of doctors and 30.76% of general population reported depression; 40.56% doctors and 26.57% general population had anxiety; 38.46% of the doctors and 24.48% of general population reported stress. Statistical analysis revealed that doctors had significantly higher levels of anxiety and stress as compared to general population. On the AIS, more doctors (48.25%) suffered from insomnia compared to the general population (37.06%), but the difference was not statistically significant. CONCLUSION: Physicians have significantly higher anxiety and stress while dealing with COVID-19 compared to general population.

Exploring cyberchondria and its associations in dental students amid COVID-19 infodemic.

BACKGROUND: Adverse psychological effect of pandemic includes not only increased levels of stress, anxiety, and depression but also cyberchondria - the problematic online health research behavior. It is thought that the distress and uncertainty of pandemic clubbed with information overload and its ambiguity have paved the way for cyberchondria. Students being the vulnerable population, the present study was an effort at understanding cyberchondria in students. AIM: The aim of the study is to assess cyberchondria and its association with depression, anxiety, stress, and quality of life (QOL) in dental students during the pandemic. MATERIALS AND METHODS: An online questionnaire-based survey was carried out on dental students. The survey tool comprised a semi-structured pro forma, General Health Questionnaire-12, Depression Anxiety and Stress Scale 21, Cyberchondria Severity Scale 15, and European Health Interview Survey QOL 8. RESULTS: The study revealed that 98.7% of the students were affected by one of the constructs of cyberchondria, viz., "excessiveness" (93.7%), followed by "distress" (84.3%) and "reassurance"-seeking behavior (83.7%). Cyberchondria affected girls more than boys and shared robust positive correlation with depression, anxiety, and stress but not QOL. Factors such as stress, anxiety, QOL, and changes in appetite were associated with higher severity of depression. Family financial losses, preexisting psychiatric illness, and media adverse effect shared robust positive associations with severity of depression, anxiety, and stress and an inverse association with QOL. 76.0% of the students expressed excessive worries regarding missing out on clinical exposure, and nearly half of the students were dissatisfied with eLearning. 78.3% of the students experienced changes in sleep; 68.7% had changes in appetite; and 89.0% reported reduction in the level of physical activity. CONCLUSION: Cyberchondria is affecting the large majority of students. Educational institutions must put efforts to sensitize students about cyberchondria.