COVID-19 and women's mental health during a pandemic – A scoping review

The novel coronavirus disease (COVID-19) has infected more than 10 million people globally, and it caused more than 500 thousand deaths. Researchers have highlighted the need for early detection and intervention for psychological ill effect of the pandemic on various population subgroups. Women may be more vulnerable in such a crisis phase. This review addresses the mental health needs of women and the kind of interventions needed to cater to their various psychological issues. All existing literature was searched using PubMed, Google Scholar, and Medline databases for articles published on mental health aspects of women during COVID-19 pandemic. Only English language articles published till June 15, 2020, were considered for the review. Data were extracted by the authors from the selected articles, and the findings were synthesized in a narrative format. From the available literature, following themes were identified for further discussion: sexual health and contraception, pregnancy, lactation, domestic abuse, female healthcare workers, women with pre-existing mental illness, women with substance use disorders, homeless women, refugees, and professional sex workers. Studies have reported a higher burden of mental health issues in females than male counterparts and an increase in domestic violence and crises for those at-risk (such as refugees and women with pre-existing illnesses). Women mental health is compromised in many aspects due to COVID-19 pandemic. Findings stress upon the increased need for early detection and prompt intervention for women in the community to alleviate the long-term psychological consequences of this pandemic.

A cross-sectional questionnaire-based study to assess anxiety among healthcare professionals in india during COVID-19 pandemic

Background and Aims: Coronavirus has resulted in unique challenges to the healthcare professionals. The pandemic has affected the mental health of healthcare professionals, which may impact their ability to provide care to patients. We aimed to assess anxiety among healthcare professionals, and its relation to selected parameters. Methods: This online questionnaire-based study recruited Indian healthcare workers through convenience sampling. Anxiety was measured using the Generalized Anxiety Disorder 7 scale. The reasons of emotional distress were also ascertained. Results: The sample comprised of 677 healthcare professionals including resident doctors, consultants, interns, nursing personnel, and others. Moderate/severe anxiety was present in 24.4% of the respondents. Moderate/severe anxiety was more likely to occur among those who had a friend or family member affected by COVID-19 (odds ratio [OR] 2.74, 95% confidence intervals [CI] 1.61–4.69), or who themselves had a psychiatric disorder in the past (OR 2.44, 95% CI 1.36–4.38). Those who reported long working hours and inadequate sleep, fear of being infected by the virus, concerns about transmitting the virus to a family member, mob violence against doctors, and shortage of personal protective equipment had significantly higher odds of moderate/severe anxiety. Conclusion: A considerable proportion of healthcare professionals suffering from anxiety suggests the need for addressing their mental health concerns.

Psycho-social and behavioral impact of COVID-19 on middle-aged and elderly individuals: A qualitative study.

BACKGROUND: COVID-19 may seem to have an impact on middle-aged and elderly people. However, not much is known about the lived experiences of middle-aged and elderly people during this pandemic. The study aims to explore psychosocial and behavioral impact of COVID-19 on the lives of these individuals. MATERIALS AND METHODS: Three focus group discussions and seven in-depth interviews were conducted. A format to guide discussions and interviews was made to bring uniformity across groups and participants. Participants were recruited through purposive and snowball sampling techniques. Discussions were recorded and transcribed verbatim. Thematic analysis method was used to extract key conceptual themes. RESULTS: There were 12 male and 10 female participants included, with a mean age of 62.2 years. Five subcategories identified were: Fear and anxiety, household confinement, lifestyle modification, preventive practices, and coping strategies. These sub-categories formed three major categories-psychological, social, and behavioral which ultimately led to the emergence of the main theme that is, COVID-19 effects on the life of middle-aged and older individuals. CONCLUSION: Middle-aged and elderly people are affected in many ways due to COVID-19. Addressing the psycho-social and behavioral problems can help in the better adjustment to tide over the pandemic.

Association of Sociodemographic Parameters With Depression, Anxiety, Stress, Sleep Quality, Psychological Trauma, Mental Well-Being, and Resilience During the Second Wave of COVID-19 Pandemic: A Cross-Sectional Survey From India.

Objective This study was conducted to assess the traumatic impact of the second wave of coronavirus disease 2019 (COVID-19) pandemic on depression, anxiety, stress, sleep quality, mental well-being, and resilience among the general population of India. Methods An online cross-sectional survey was conducted in May-June, 2021 via Google Forms, which included adult individuals who were willing to participate in the study. The purposive and snowball sampling technique was used to ensure the principle of maximum diversity. Standardised tools [Depression Anxiety and Stress Scale (DASS), Pittsburgh Sleep Quality Index (PSQI), Impact of Event-Revised (IES-R), Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS), and the Brief Resilience Scale (BRS)] were used to collect data. Results A total of 1,109 responses were analysed for this study. Participants of different age groups (mean age: 32.98 ±14.72 years) and different sociodemographics were enrolled. The younger population group (18-34 years) was found to be the most affected among all the age groups. The findings revealed that 44.18% showed posttraumatic stress disorder (PTSD)-like symptoms. About 48.87%, 65.56%, and 22.09% of the participants had significant depression, anxiety, and stress symptoms respectively, and 11.27% had disturbed sleep patterns. Mental well-being was found to be disturbed for 74.75% of the study population, out of which only 4.15% showed high resilience capacity. Conclusion The associated collective psychological trauma mapped out by this paper is a pandemic in itself and needs to be addressed on a scale similar to the efforts being made to curb the physical symptoms of COVID-19.

Evaluation of Psychological Impact of COVID-19 on Health-Care Workers.

BACKGROUND: Little information is available from India about the psychological impact of COVID-19 on helath-care workers. AIM: The current study aimed to evaluate the psychological issues among the health-care workers (HCW) during the COVID-19 pandemic. MATERIALS AND METHODS: An online survey using Survey Monkey® platform was carried out to evaluate depression (using Patient Health Questionnaire-9), anxiety (using Generalized Anxiety Disorder Questionnaire-7), and other psychological issues (using a self-designed questionnaire). RESULTS: The study sample comprised 303 participants with a mean age of 41.2 (standard deviation: 11.1) years. A majority of them were male (69%) and married (79.9%). Nearly half (46.2%) of the participants had either anxiety disorder or depression or both and 12.9% of HCW had suicidal behavior. Higher level of anxiety and depression scores were associated with being female, having undergone quarantine, directly involved in the care of COVID-19 patients, and younger age (<30 years). Higher prevalence of depression and anxiety disorder was seen in younger (<30 years) age group, being a doctor (compared to paramedics). In addition, higher prevalence of depression was seen in those who were directly involved in the care of patients with COVID-19 infection. CONCLUSION: About half of the HCWs are suffering from psychiatric morbidity, specifically anxiety, in the wake of the COVID-19 pandemic. There is a need to assess all the HCWs for psychiatric morbidity and provide them with psychological support.

Socio-behavioural impact of COVID-19 on general population: A cross-sectional survey of one thousand seventy-nine participants across India between the first and the second wave of pandemic.

BACKGROUND AND AIMS: COVID-19 is expected to have a significant impact on the socio-behavioural aspect of citizens' lives, although the effects are expected to manifest differently in different population groups. The current study was conducted to assess the socio-behavioural impact of COVID-19 among the general population across India between the first and the second wave of pandemic. METHODS: A web-based cross-sectional study was conducted from 15th March -25th March 2021 using a pre-validated validated questionnaire upon the general population using e-survey, telephonic and face-to-face interview. The participants were recruited from the different regions of India by the purposive and snowball sampling technique following the principle of maximum diversity. Appropriate statistical tests were applied to study the association between the various sociodemographic variables and different behaviours. RESULTS: A total of 1079 responses were analysed for the study. Almost half of the participants feared contracting the COVID-19 infection. Overall, female participants, elderly people (more than 60 years of age) and urban dwellers reported a greater fear in the survey. More than half of the participants (53.39%) reported significant difficulties due to home confinement. People have become more inclined to adopt healthy lifestyles. There are mixed responses in the area of following preventive practices. CONCLUSION: People have a significant amount of fear and anxiety related to the pandemic, leading to several social and behavioural changes that might have a considerable impact on their everyday lives.

Tools for the evaluation of the psychological impact of COVID-19: A practical guide for Family physicians and Primary Care Practitioners.

The COVID-19 pandemic has affected the global population significantly and has resulted in physiological, psychological, social, and behavioral changes among the individuals. The prominent mental health effects of COVID-19 on the general and clinical populations have been well recognized. The family physicians and primary care practitioners from various disciplines are likely to encounter patients who are experiencing psychological distress manifested in the form of anxiety, depression, stress, insomnia, increased substance use, or other symptoms. This narrative review is aimed to present a bird's eye view of the psychological impact of COVID-19 on the general population and the various tools that are used to evaluate them. Besides, we intend to suggest a set of tools/questionnaires that can be used by the family physicians and primary care practitioners for generating data on the psychological impact of this pandemic.

Development and validation of a questionnaire to assess socio-behavioural impact of COVID-19 on the general population.

BACKGROUND AND AIM: The aim of the study is to develop a valid and reliable tool to assess sociobehavioural changes due to COVID among the general population. METHODS: This mixed method study has two phases. Phase I for questionnaire development (literature review, focus group discussion, expert evaluation and pilot testing). Phase II for establishing construct validity via factor analysis and internal consistency via Cronbach's ɑ by administering the questionnaire on 179 participants. RESULTS: A questionnaire comprising 33 questions and five domains was developed having Cronbach's α of 0·82. CONCLUSION: The developed questionnaire is a concise, easy to administer and valid tool to assess socio-behavioural changes.

Psycho-social and behavioural impact of COVID 19 on young adults: Qualitative research comprising focused group discussion and in-depth interviews.

A qualitative study comprising eight focus group discussions and two in-depth interviews were conducted to explore the social and behavioural changes in young adults during COVID pandemic. Common themes identified were changes in interpersonal and intrapersonal relationships, changes in health-related behaviour, lifestyle modifications and impact on academic and professional life.

Data Handling for E-Mental Health Professionals.

Digital psychiatry and e-mental health have proliferated and permeated vastly in the current landscape of mental health care provision. The COVID-19 crisis has accelerated this digital transformation, and changes that usually take many years to translate into clinical practice have been implemented in a matter of weeks. These have outpaced the checks and balances that would typically accompany such changes, which has brought into focus a need to have a proper approach for digital data handling. Health care data is sensitive, and is prone to hacking due to the lack of stringent protocols regarding its storage and access. Mental health care data need to be more secure due to the stigma associated with having a mental health condition. Thus, there is a need to emphasize proper data handling by mental health professionals, and policies to ensure safeguarding patient's privacy are required. The aim of useful, free, and fair use of mental health care data for clinical, business, and research purposes should be balanced with the need to ensure the data is accessible to only those who are authorized. Systems and policies should be in place to ensure that data storage, access, and disposal are systematic and conform to data safety norms.

Treatment experience for opioid use disorder during COVID-19 in India: Learning from patients.

The COVID-19 pandemic and its containment strategies have presented unique challenges to India's healthcare infrastructure. While a national lockdown initially resulted in the closure of all licensed liquor shops, it also made healthcare facilities dedicated to the treatment of substance use disorders challenging to access. Addiction treatment services have been functioning at limited capacity with a lack of consensus on operating procedures. In this article, we present actual case scenarios where lockdown affected substance use and the treatment process, and discuss the policy implications and considerations for both.

Changes in sleep pattern and sleep quality during COVID-19 lockdown.

INTRODUCTION: To mitigate the spread of the pandemic coronavirus infection (COVID-19), governments across the world have adopted "lockdowns" which have confined many individuals to their homes. This disrupts normal life routines, elements of which are important circadian cues. The pandemic is also associated with new stressors, altered roles, and uncertainties about health and economic security, which are also likely to affect sleep. The current study is an online survey of sleep experience, routines, physical activity, and symptoms of anxiety and depression, to study the alterations associated with the lockdown. MATERIALS AND METHODS: The survey was conducted in early May 2020 using a questionnaire circulated through social media platforms. Questions related to demographic characteristics, current and previous sleep schedules, routine, and working patterns. Insomnia (Insomnia Severity Index - 4), Stress (Perceived Stress Scale - 4), anxiety and depressive symptoms (Patient Health Questionnaire - 4) and physical activity (International Physical Activities Questionnaire) were assessed using standardized instruments. RESULTS: A total of 958 valid responses were received. Compared to the prelockdown period, there was a shift to a later bedtime and waking time, with a reduction in night-time sleep and an increase in day-time napping. These effects were visible across occupational groups, but mostly affected working individuals except health professionals. Sleep quality deteriorated across groups. Reductions in sleep duration were associated with depressive symptoms. CONCLUSIONS: The COVID-19 lockdown is associated with changes in sleep schedule and in the quantity and quality of night-time sleep. Although these changes are associated with elevated rates of emotional symptoms, it is unclear from these cross-sectional results, whether sleep deterioration produces psychological distress, or vice versa.

Psychological impact of COVID-19 lockdown: An online survey from India.

BACKGROUND: The COVID-19 pandemic has led to a complete shut-down of the entire world and almost all the countries are presently in a "lockdown" mode. While the lockdown strategy is an essential step to curb the exponential rise of COVID-19 cases, the impact of the same on mental health is not well known. AIM: This study aimed to evaluate the psychological impact of lockdown due to COVID-19 pandemic on the general public with an objective to assess the prevalence of depression, anxiety, perceived stress, well-being, and other psychological issues. MATERIALS AND METHODS: It was an online survey conducted under the aegis of the Indian Psychiatry Society. Using the Survey Monkey platform, a survey link was circulated using the Whatsapp. The survey questionnaire included perceived stress scale, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Warwick-Edinburgh Mental Well-being Scale to assess perceived stress, anxiety, depression, and mental well-being, respectively. The survey link was circulated starting from April 6, 2020 and was closed on April 24, 2020. RESULTS: During the survey, a total of 1871 responses were collected, of which 1685 (90.05%) responses were analyzed. About two-fifth (38.2%) had anxiety and 10.5% of the participants had depression. Overall, 40.5% of the participants had either anxiety or depression. Moderate level of stress was reported by about three-fourth (74.1%) of the participants and 71.7% reported poor well-being. CONCLUSIONS: The present survey suggests that more than two-fifths of the people are experiencing common mental disorders, due to lockdown and the prevailing COVID-19 pandemic. This finding suggests that there is a need for expanding mental health services to everyone in the society during this pandemic situation.