Mental health status of college students during coronavirus disease 2019 epidemic

Objective: To investigate the psychological characteristics of college students during the outbreak of coronavirus disease 2019 (COVID-19), so as to provide a basis for psychological intervention. Methods: From May 17, 2020 to Jun. 17, 2020, the adjusted psychological questionnaires for emergent events of public health (PQEEPH) was surveyed among the college students of Beijing Union University. The questionnaire included 5 dimensions:depression, neurasthenia, fear, obsessive-compulsive anxiety, and hypochondriasis. Four grades were scored according to the degree and frequency of emotional responses:0 means no symptoms, 1 means mild symptoms, 2 means moderate symptoms, and 3 means severe symptoms. Results: A total of 3 019 valid questionnaires were collected. During the COVID-19 epidemic, the emotional responses of college students, from the most serious to the least, were fear, neurasthenia, depression, obsessive-compulsive anxiety, and hypochondriasis, with the incidences being 87.7% (2 648/3 019), 44.8% (1 353/3 019), 37.4% (1 129/3 019), 17.3% (522/3 019), and 11.6% (350/3 019), respectively. The fear scores of female students were higher than those of male students (P < 0.001), the fear scores of college students from towns/suburbs were higher than those from rural and urban areas (both P < 0.017), the scores of depression, neurasthenia and obsessivecompulsive anxiety of college students with confirmed COVID-19 cases around them or their relatives participated in the epidemic prevention and control as medical staff or logistics support personnel were higher than those without such conditions (all P < 0.017), and the scores of depression, obsessive-compulsive anxiety and hypochondriasis of college students with suspected COVID-19 cases around them were higher than those without such condition (all P < 0.017). Females were more likely to have moderate to severe fear than males (odds ratio[OR]=1.53, 95% confidence interval[CI] 1.25-1.88, P < 0.001), those with confirmed or suspected COVID-19 cases around them were more likely to have moderate to severe fear than those without such conditions (OR=2.03, 95% CI 1.29-3.20, P=0.002), and those living in towns/suburbs were more likely to have moderate to severe fear than those living in rural and urban areas (OR=0.72, 95% CI 0.56-0.94, P=0.015;OR=0.78, 95% CI 0.63-0.97, P=0.025). Conclusion: COVID-19 epidemic has impact on the psychology of college students. It is necessary to pay attention to the mental health of college students and provide targeted psychological counseling for them.

One-quarter of COVID-19 patients developed PTSD symptoms: a one-year longitudinal study

This study investigated the longitudinal development of PTSD symptoms and respiratory sequelae among COVID-19 patients one year after hospital discharge. The cumulative occurrence of probable PTSD in COVID-19 survivors (n=329) was 26.7%, which significantly decreased over the 12-month period (23.1% to 4.3%). Non-severe patients showed marked improvement in all four clusters of PTSD symptoms at 12 months compared to 3 months, while severe patients only showed improvements in re-experiencing and numbing symptoms. Moreover, being female and having respiratory sequelae increased the risk for chronic PTSD. Psychological interventions are required for COVID-19 patients during long-term convalescence.

One-quarter of COVID-19 patients developed PTSD symptoms: A one-year longitudinal study.

This study investigated the longitudinal development of PTSD symptoms and respiratory sequelae among COVID-19 patients one year after hospital discharge. The cumulative occurrence of probable PTSD in COVID-19 survivors (n = 329) was 26.7%, which significantly decreased over the 12-month period (23.1% to 4.3%). Non-severe patients showed marked improvement in all four clusters of PTSD symptoms at 12 months compared to 3 months, while severe patients only showed improvements in re-experiencing and numbing symptoms. Moreover, being female and having respiratory sequelae increased the risk for chronic PTSD. Psychological interventions are required for COVID-19 patients during long-term convalescence.

More Positive Emotion, Less Stress Perception?

Purpose: Shanghai, a mega-city with a population of 25 million, was becoming the first city in mainland China to erupt in the Omicron pandemic. The pandemic and the quarantine measures of whole city static management brought out big challenges for the population. This study sought to examine the psychological impact of such quarantine measures. Methods: A cross-sectional study was conducted in China between April 8 to April 14, 2022. The survey contained inventories of stress perception, emotion states, duration of quarantine, and demographic characteristics. A total of 1,051 participants in Shanghai who were quarantined at home were included by random sampling. Results: We found moderate-to-mild perceived stress (3.248±1.936) and emotion states (3.453±2.094). Individuals with high negative emotions had high levels of perceived stress. Specifically, the population aged 30-49, female, with higher household income, staying with the elderly or children, were more likely to report high stress and negative emotion. Hierarchical regression and the further path analysis indicated that emotion states partially mediated the relationship between quarantined days at home and perceived stress. Conclusion: There was a moderate-to-mild level of perceived stress and emotion when quarantined at home for an average of 20 days in Shanghai. The present findings implicated more positive emotion then less stress perception at the same duration of quarantine. It was suggested to consider the measures taken to construct positive emotions for the public to overcome negativity and bring out a virtuous circle to thrive, if the quarantine has to be continued for preventing the pandemic.

Beneficial for mental health, exercise more or less?

Regular physical activity may improve mental health during the pandemic by reducing inflammatory responses. However, overtraining or prolonged exercise training may adversely affect mental health.

Stigmatization related COVID-19 and PTSD among Chinese graduates.

BACKGROUND: Since COVID-19 broke out worldwide, it had caused extensive public health concerns and psychological distress, including PTSD and stigmatization towards recovered patients and people from high-risk areas. However, the association between PTSD, stigmatization and certain related factors have not been confirmed. METHODS: Through cluster random sampling, 946 Chinese graduates were investigated from 5 universities in Shanghai at three months after China lifted its coronavirus lockdown. PTSD symptoms were evaluated with PCL-5. Demographic and disease-related characteristics including stigmatization, educational attainment and working position were collected to assess their association with PTSD. RESULTS: 12.4% graduates were reported significant PTSD symptoms in PCL-5 screening with a cut-off of 33. Graduates with a Master's degree (P = 0.02) or working position like "looking for a job" and "planning to go abroad" (P = 0.038) showed severer stigmatization related to COVID-19. Stigmatization towards both patients recovering from COVID-19 and people from high-risk areas had significant association with PTSD symptoms. Multivariate linear regression analysis showed that stigmatization can explain 5% of variation of PCL-5 scores after controlling gender, age, educational attainments and working position. CONCLUSION: Graduates who were looking for jobs or preparing to go abroad showed more stigmatization related to COVID-19. There was a positive correlation between stigma against COVID-19 and PTSD symptoms. More attention should be paid to the mental health status of graduates who are preparing to go abroad or looking for jobs.

The increase of PTSD in front-line health care workers during the COVID-19 pandemic and the mediating role of risk perception: a one-year follow-up study.

The long-term health consequences of the COVID-19 pandemic on health care workers (HCWs) are largely unclear. The purpose of the present study was to investigate the development of posttraumatic stress disorder (PTSD) in HCWs in a longitudinal manner. Additionally, we further explored the role of risk perception in the evolution of PTSD over time based on a one-year follow-up study. HCWs were recruited from hospitals in Guangdong, China. Demographic information, the PTSD checklist for DSM-5 (PCL-5) and the risk perception questionnaire were obtained online at two different time points: May to June 2020 (T1), with 317 eligible responses, and June 2021 (T2), with 403 eligible responses. Seventy-four HCWs participated in the survey at both T1 and T2. The results revealed that (1) the PTSD prevalence rate in the HCWs (cut-off = 33) increased from 10.73% at T1 to 20.84% at T2, and the HCWs reported significantly higher PTSD scores at T2 than at T1 (p < 0.001); (2) risk perception was positively correlated with PTSD (p < 0.001); and (3) PTSD at T1 could significantly positively predict PTSD at T2 (ß = 2.812, p < 0.01), and this longitudinal effect of PTSD at T1 on PTSD at T2 was mediated by risk perception at T2 (coefficient = 0.154, 95% CI = 0.023 to 0.297). Our data provide a snapshot of the worsening of HCWs' PTSD along with the repeated pandemic outbreaks and highlight the important role of risk perception in the development of PTSD symptoms in HCWs over time.

The Sleep Quality of the Frontline Healthcare Workers and the Improving Effect of Tai Chi.

Background: A number of studies have documented that coronavirus disease 2019 (COVID-19) brought more negative impact on the physical and psychological functioning of frontline healthcare workers. Especially, sleep quality was focused. This study aimed to investigate the sleep quality of frontline healthcare workers, risk factors for sleep quality, and the effect of Tai Chi training. Methods: A total of 98 frontline healthcare workers were recruited, coming from the infection department, fever clinic, laboratory, and medical imaging department in a COVID-19-designated hospital in Shanghai. Of them, 50 participated in a 2-week intervention and were randomized to receive a Tai Chi training or relaxation training. Participants were assessed at baseline, 7 and 14 days after participation. Demographic information, sleep quality, and anxiety were measured by using the demographic questionnaire, Pittsburgh Sleep Quality Index (PSQI) and Beck Anxiety Inventory (BAI). Results: 13.3% participants were above the cut-off score (>10) for the PSQI. Regression analysis showed gender, age, working years, and job category had effect on sleep quality. Compared to the control group, participants in the Tai Chi training group had lower scores on both PSQI (p < 0.05) and BAI (p < 0.01) after the 2-week intervention. Conclusion: It was demonstrated that poor sleep quality existed in the frontline healthcare workers, which was related to gender, age, working years, and job category. Tai Chi training can dramatically improve their sleep quality and reduce anxiety symptoms.

Post-traumatic stress disorder in patients with rheumatic disease during the COVID-19 outbreak: a cross-sectional case-control study in China.

OBJECTIVE: The COVID-19 pandemic is not only a traumatic event, but a collective stressor unfolding over time, causing devastating implications for the mental health. This study aimed to shed light on the mental health status of patients with rheumatic disease (RD) during the massive outbreak of COVID-19 in China, especially the prevalence and severity of post-traumatic stress disorder (PTSD) compared with healthy individuals. METHODS: A total of 486 patients with RD and 486 age-matched and sex-matched healthy individuals were recruited into the study. For each participant, we collected demographic and clinical characteristics data. The PTSD Checklist for DSM-5 (PCL-5) and four items from the Pittsburgh Sleep Quality Index (PSQI) were used to investigate the prevalence and severity of PTSD and sleep quality, respectively. RESULTS: Compared with healthy control subjects (n=486), patients with RD (n=486) had a higher prevalence of PTSD (12.1% vs 4.1%; p<0.001). Higher total scores on the PCL-5 and on all four items from the PSQI (p≤0.001) were also observed. Female, old age, poor sleep quality, long duration of RD, poor subjective evaluation of the disease and pessimistic subjective perception of the epidemic were identified as risk factors of PTSD in patients with RD during the COVID-19 epidemic. CONCLUSION: During the COVID-19 outbreak, patients with RD presented a higher prevalence and severity of PTSD and showed more sleep disturbances. Our findings confirm the importance of psychological assessment and mental healthcare out of regular clinical care for patients with RD during the pandemic.

PTSD Symptoms and Sleep Quality of COVID-19 Patients During Hospitalization: An Observational Study from Two Centers.

BACKGROUND: The outbreak of COVID-19 has developed into a pandemic. Data are required that specifically address the psychological consequences in COVID-19 confirmed patients. This study mainly aimed to examine posttraumatic stress disorder (PTSD) symptoms and sleep quality among COVID-19 confirmed patients during hospitalization. METHODS: An observational study was conducted in two designated hospitals in Wuhan, China. Data were collected from 190 patients hospitalized with laboratory-confirmed COVID-19 infection between February 10, 2020 and March 13, 2020. RESULTS: The mean age of the 190 confirmed patients was 55.7 years (SD = 13.7), of which 96 (50.5%) were female and 88 (46.3%) had family members or acquaintances infected with COVID-19. Lymphocytopenia was presented in 62 (32.6%) patients and 25 (13.2%) patients showed oxygen desaturation. The prevalence of high PTSD symptoms was 22.6% among the 190 patients. The median time from symptom onset to first medical visit and hospitalization was 2 days (IQR, 1-5) and 16 days (IQR, 10-27), respectively. Patients' PTSD symptoms were positively related to the time from symptom onset to first medical visit (r = 0.156, p < 0.05) and hospitalization (r = 0.181, p < 0.01). There were significant correlations between sleep quality and PTSD symptoms (r = 0.312-0.547, p < 0.01). CONCLUSION: The prevalence of high PTSD symptoms was 22.6% among hospitalized COVID-19 patients. Early diagnosis and treatment of COVID-19 symptoms are beneficial to infected patients both physically and psychologically. With the recovery of physical symptoms, psychological intervention is desired to promote the trauma recovery in COVID-19 patients.

Is Higher Subjective Fear Predictive of Post-Traumatic Stress Symptoms in a Sample of the Chinese General Public?

Background: COVID-19 has taken a huge toll on medical resources and the economy and will inevitably have an impact on public mental health. Post-traumatic stress disorder (PTSD), as the most common mental illness after an epidemic, must be seriously addressed. This study aimed to investigate the subjective fear of the Chinese general public during COVID-19 and to explore how it affected the development of PTSD. Methods: An online questionnaire survey was conducted among 1,009 people from January 30 to February 14, 2020 (about 1 month after the COVID-19 outbreak). The subjective fear was measured by a self-reported single-choice question. Four items from the Pittsburgh Sleep Quality Index (PSQI) were selected to measure the subjects' sleep quality. Their post-traumatic stress symptoms (PTSS) were measured by the PTSD Checklist for DSM-5 (PCL-5). Pearson correlation, hierarchical multivariate regression analysis, multiple mediator model, and bootstrapping were used in statistical analyses. Results: Different people showed different levels of subjective fear in response to the outbreak. There was a significant positive correlation between subjective fear and the total score of PCL-5 (R = 0.513, P < 0.01), meaning that the higher the degree of subjective fear, the more severe the symptoms of post-traumatic stress are. Subjective fear was an important predictor of PTSS, accounting for 24.3% of the variance. The total effect of subjective fear on PCL-5 scores was significant (total effect = 7.426, SE = 0.405, 95% CI = 6.631-8.221). The total indirect effect of subjective fear on PCL-5 scores through sleep quality was also significant (total indirect effect = 1.945, SE = 0.258, 95% CI = 1.436-2.470). Conclusions: Subjective fear has an important predictive effect on PTSS. In addition to the direct effect, our findings firstly demonstrate the mediating role of sleep quality in the relationship between subjective fear and PTSS.

The influence of risk perception for COVID-19 pandemic on posttraumatic stress disorder in healthcare workers: A survey from four designated hospitals.

The aim of current study was to investigate risk perception of COVID-19 pandemic, sleep quality and time change of leisure activity and their correlations with posttraumatic stress disorder (PTSD) in healthcare workers (HCWs) from four designated hospitals in China. Medical staffs (n = 317) from three designated hospitals in Guangdong Province and one designated hospital in Guangxi Province were surveyed on their demographic information, sleep quality and time change of leisure activity, risk perception of pandemic and PTSD symptoms (by using PTSD checklist for DSM-5 (PCL-5)). Hierarchical regression and structural equation model (SEM) were used to examine the correlated factors of PTSD. The prevalence of high level of PTSD symptoms (PCL-5 > =33, a probable diagnosis of PTSD) was 10.7%. Regression analysis found that risk perception (dread: ß = 0.142, p < 0.01; familiarity: ß = 0.203, p < 0.01), sleep quality (ß = 0.250, p < 0.001), time change of leisure activity (ß = -0.179, p < 0.01), were independently correlated with PTSD severity, which was further confirmed by SEM. Locations of COVID-19-related hazards were significant different in cognitive map of risk perception between groups with high and low levels of PTSD symptoms. Risk perception of COVID-19 pandemic influenced PTSD symptoms in HCWs. Adequate time for leisure activity and good sleep quality protected some HCWs against PTSD symptoms under the influence of pandemic. More researches were warranted to understand the path from pre-factors of risk perception to its psychological consequences among HCWs.

Prevalence and risk factors for acute posttraumatic stress disorder during the COVID-19 outbreak.

BACKGROUND: To examine the prevalence of and risk factors for acute posttraumatic stress disorder (PTSD) shortly after the massive outbreak of COVID-19 in China. METHODS: An online anonymous survey was conducted between 30 January and 3 February, 2020. The survey included two self-administered questionnaires: one collected personal information (gender, age, education background), current location, recent epidemic area contact history, the classification of population, and subjective sleep quality; the other was the PTSD Checklist for DSM-5 (PCL-5). RESULTS: A total of 2091 Chinese participated in the current study. The prevalence of PTSD among the Chinese public one month after the COVID-19 outbreak was 4.6%. Multiple linear regression analysis revealed that gender (p < 0.001), epidemic area contact history (p = 0.047), classification of population (p < 0.001), and subjective sleep quality (p < 0.001) could be regarded as predictors for PTSD. LIMITATIONS: First, the majority of participants in this study were the general public, with confirmed or suspected patients being a small part. Second, the measurement of PTSD in this study might be vulnerable to selection bias because of an online self-report study, such as participants' recruitment. Third, the prevalence of PTSD in this study was estimated by an online questionnaire rather than a clinical interview. CONCLUSIONS: The results suggested that some Chinese showed acute PTSD during the COVID-19 outbreak. Therefore, comprehensive psychological intervention needs further implementation. Furthermore, females, people who had recent epidemic area contact history, those at high risk of infection or with poor sleep quality deserve special attention.

Epidemic area contact history and sleep quality associated with posttraumatic stress symptoms in the first phase of COVID-19 outbreak in China.

The impact of 2019 coronavirus disease (COVID-19) outbreak on mental health was of widespread concern recently. The present study aimed to exam sleep quality and posttraumatic stress symptoms (PTSS) and potential influence factors in the first phases of COVID-19 massive outbreak in China. A snowball sampling technique was used and a total of 2027 Chinese participated in the present study. Demographic information, epidemic area contact history, sleep quality and PTSS data were collected with an internet-based cross-sectional survey. Results suggested that 59.7% participants were not fully satisfied with their sleep quality, and 50.9% participants had various degrees of short sleep duration problems. 44.1% and 33.0% participants had sleep disturbance and sleep onset latency problems. Also, the prevalence of PTSS reached 4.7% in the self-rating survey. Epidemic area contact history affected PTSS and latency onset of sleep under the influence of COVID-19. Epidemic area contact history and sleep quality had interaction effects on PTSS. The present study was one of the first to evaluate acute psychological responses and possible risk factors during the peak of COVID-19 in China and results indicate that keeping good sleep quality in individuals with pandemic exposure experiences is a way to prevent PTSS.

Coronavirus disease 2019-related mental health: research progress

Coronavirus disease 2019 (COVID-19) was first reported in late December 2019, and then erupted in China. COVID-19 is characterized by strong infectivity and a high mortality rate. The public and medical staff are under great psychological pressure. Scholars at home and abroad have carried out researches on mental health during the outbreak of COVID-19. This article summarizes the current researches on mental health related to COVID-19 from three aspects: mental health policy, mental intervention measures and mental health of key population.

Posttraumatic stress symptoms of health care workers during the corona virus disease 2019

Corona virus disease 2019 (COVID-19) outbreak has attracted worldwide attention. The COVID-19 outbreak is unique in its rapid transmission and results in heavy stress for the front-line health care workers (HCWs). The current study aimed to exam posttraumatic stress symptoms (PTSSs) of HCWs fighting for the COVID-19 and to evaluate their sleep quality after 1-month stressful suffering. Three hundred seventy-seven HCWs working in different provinces of China participated in the survey between February 1 and 5. The demographic information was collected first. Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5) and the Pittsburgh Sleep Quality Index (PSQI) were selected to measure PTSSs and sleep quality. Results showed that 1 month after the outbreak, the prevalence of PTSSs was 3.8% in HCWs. Female HCWs were more vulnerable to PTSSs with hazard ratio of 2.136 (95% CI = 1.388-3.286). HCWs with higher exposure level also significantly rated more hyperarousal symptoms (hazard ratio = 4.026, 95% CI = 1.233-13.140). There was a significant difference of sleep quality between participants with and without PTSSs (z value = 6.014, p < .001) and among different groups with various contact frequencies (chi-square = 7.307, p = .026). Path analysis showed that there was a significant indirect effect from exposure level to PTSSs through sleep quality (coefficient = 1.750, 95% CI of Boostroop test = 0.543-2.998). In summary, targeted interventions on sleep contribute to the mental recovery during the outbreak of COVID-19. Understanding the mental health response after a public health emergency might help HCWs and communities prepare for a population's response to disaster.

China experience from COVID-19: Mental health in mandatory quarantine zones urgently requires intervention.

The study investigated the quarantine of COVID-19 and its impact on mental health. The results showed that there was a significant difference in PTSD Checklist for DSM-5 scores between the quarantine group and the non-quarantine group. As a result, the mental health of residents in mandatory quarantine zones urgently requires intervention. (PsycInfo Database Record (c) 2020 APA, all rights reserved).