ABSTRACT
The lockdown due to the coronavirus disease 2019 (COVID-19) pandemic had a significant impact on daily routines and habits. New lifestyle behaviors contributed to the onset and course of mental diseases, including addictive problems. The objective of this work was to describe changes in health status during lockdown in the general population, including potentially addictive behaviors, and explore possible contributing factors. The analyzed data comprised a population-based sample of 240 individuals (73.3% women, mean age 43.8 years old). Assessments included sociodemographics and self-reports for health state and addictive behaviors. The risk of perceived worsening physical and psychological state was 21.7% and 20.0%, respectively, after the lockdown. The risk of requiring a new treatment for physical and psychological illnesses was 10.4% and 4.2%, respectively, while 2.5% of the participants started using illegal drugs and 9% initiated video game use. Finally, the statistical predictors of health worsening during the lockdown were the presence of anxiety symptoms, being unmarried, having low education levels, experiencing fears related to COVID-19 infection, and having family conflicts. This research identified vulnerability factors contributing to changes in physic and mental health, as well as those associated with addictive behaviors during lockdown. These results should be considered in further stressful situations to design personalized preventive and therapeutic plans. © Author(s).
ABSTRACT
The COVID-19 pandemic has the potential to worsen mental health problems in the general population, including increasing engagement in addictive behaviors. Here, we describe observations suggesting that the current crisis and its sequelae may worsen problem gambling. The current pandemic may impact financial and psychological well-being due to social isolation during spatial distancing, and these stressors in conjunction with substantial changes in gambling markets (land-based, online) during the pandemic may significantly influence gambling behaviors. This situation calls for rapid research initiatives in this area and preventive and regulatory measures by multiple stakeholders.Copyright © 2020 Lippincott Williams and Wilkins. All rights reserved.
ABSTRACT
Introduction: COVID19 lockdown is having a significant impact on mental health, patients with eating disorders (ED) are particularly vulnerable. Objective(s): 1) To explore changes in eating and other psychological features due to confinement in patients with ED from various European and Asian countries;and 2) to assess differences related to diagnostic subtypes, age and geography. Method(s): The sample comprised 829 participants, diagnosed with an ED according to DSM-5 criteria from specialized ED units in Europe and Asia. Participants were assessed using the COVID19 Isolation Scale (CIES). Result(s): On one hand, patients with Binge Eating Disorder experienced the highest impact on weight and ED symptoms due to confinement. Together with subjects diagnosed with Other Specified Feeding and Eating Disorders (OFSED), they also experienced a deterioration in general psychological state. On the other hand, there was less symptomatic impact on people with Bulimia Nervosa or Anorexia Nervosa and asian and younger individuals appeared to be more resilient in this situation. Conclusion(s): The impact of COVID varied by cultural context and individual variation in age and form of illness. Services may need to target preventive measures and adapting therapeutic approaches for the most vulnerable patients.
ABSTRACT
Introduction: Small subepithelial gastrointestinal lesions (SEL), often defined as submucosal tumours, or subepithelial tumours (SET) confirmed once characterized by endoscopic ultrasound (EUS), could generate anxiety and fear of cancer. Aims & Methods: The main aim was to assess the anxiety burden and cancerophobia in patients with a small-sized SEL diagnosis or SET in periodic EUS surveillance. Secondary aims: to evaluate possible factors or patients characteristics influencing on anxiety or fear of cancer degree. Methods: Observational prospective study. Consecutive inclusion of all patients with a small-sized SEL diagnosis (requiring an EUS performance), or patients with a previously catalogued SET under echoendoscopy surveillance. Evaluation of the anxiety-distress degree and fear of cancer using two specific designed and validated instruments-questionnaires: Hospital Anxiety and Depression Scale (HADS), anxiety and depression subscales [0-7 points normal;8-10 borderline;11-21 pathologic], and global-distress scale [0-10 points normal;11-17 borderline;18-42 pathologic];and Cancer Worry Scale (CWS) [6-10 points low;11-15 moderate;16-20 high;21- 24 very high]. ClinicalTrials.gov register: NCT04316000. Due to SARS-CoV2 (Covid-19) pandemia and its implications for outcomes bias, the study was prematurely suspended. Results: Two participating centres, 40 patients (inclusion period: September 2019-February 2020). Mean HADS-anxiety: 7.2 (+/- 4.3) [= borderline anxiety];HADS-distress: 11.4 (+/- 7.7) [= borderline distress];CWS: 11.0 (+/- 4.1) [= moderate concern]. Belief on probability of having GI cancer now: 20.7% (+/- 23.6);belief on probability of getting GI cancer in 10 years: 28.6% (+/- 24.3). Impact on quality of life: Yes 40% (16/40). Female sex (n- 26) vs. male (n-14) subanalysis: HADS-anxiety 8.0 vs. 5.9;HADS-distress 12.7 vs. 9.0;CWS 11.5 vs. 9.9. Family history of cancer YES (n-29) vs. NO (n- 11) subanalysis: HADS-anxiety 8.1 vs. 5.0;HADS-distress 12.7 vs. 8.0;CWS 11.7 vs. 9.1. Conclusion: Patients with SEL diagnosis or SET under EUS surveillance present a moderate anxiety-distress degree and a moderate concern about having cancer, partially affecting their quality of life. Family history of cancer and female gender are factors that can increase anxiety and cancerophobia degree. Modifying the submucosal tumour term use for subepithelial lesion in conventional endoscopy reports, and suggesting the SETs removal in case of significant anxiety-cancerophobia, could be measures to be adopted, providing a transversal approach to patients' health.