Sleep duration during the COVID-19 pandemic in Bangladesh: A GIS-based large sample survey study.

Although several studies have been conducted in Bangladesh regarding sleep problems during the COVID-19 pandemic, none have utilized a large nationwide sample or presented their findings based on nationwide geographical distribution. Therefore, the aim of the present study was to explore the total sleep duration, night-time sleep, and daily naptime and their associated factors as well as geographic information system (GIS) distribution. A cross-sectional survey was carried out among 9730 people in April 2020, including questions relating to socio-demographic variables, behavioral and health factors, lockdown, depression, suicidal ideation, night sleep duration, and naptime duration. Descriptive and inferential statistics, both linear and multivariate regression, and spatial distribution were performed using Microsoft Excel, SPSS, Stata, and ArcGIS software. The results indicated that 64.7% reported sleeping 7-9 h a night, while 29.6% slept less than 7 h nightly, and 5.7% slept more than 9 h nightly. 43.7% reported 30-60 min of daily nap duration, whereas 20.9% napped for more than 1 h daily. Significant predictors of total daily sleep duration were being aged 18-25 years, being unemployed, being married, self-isolating 4 days or more, economic hardship, and depression. For nap duration, being aged 18-25 years, retired, a smoker, and a social media user were at relatively higher risk. The GIS distribution showed that regional division areas with high COVID-19 exposure had higher rates of non-normal sleep duration. Sleep duration showed a regional heterogeneity across the regional divisions of the country that exhibited significant associations with a multitude of socioeconomic and health factors.

Uncertainty stress and self-rated health during the early stage of the COVID-19 outbreak.

Objectives: The COVID-19 crisis caused unparalleled uncertainty stress and health-related symptoms among Chinese residents. This study aimed to characterize stress status during the early stage of the pandemic and explore the inner mechanism between uncertainty stress and self-rated health. Setting/participants: A cross-sectional design was conducted online from February 7 to 14, 2020. A total of 2534 Chinese participants were surveyed. Main outcome measures: Uncertainty stress, negative affect, sleep quality, and health status were measured by self-report. A sequential mediation model using bootstrapping method was applied to test these relationships. Results: Age, place of residence, marital status, occupation, household annual income, infection, and quarantine status significantly correlated with uncertainty stress. Higher uncertainty stress was negatively related with self-rated health (r = -0.256, p < 0.01) and positively associated with higher negative emotions (r = 0.646, p < 0.01). The sequential mediation model found total indirect effect (ß = -0.014, 95%C.I. = -0.017-0.010) and direct effect (ß = -0.010, 95%C.I. = -0.015-0.005) were significant in the relationship between uncertainty stress and self-rated health with mediating by negative affect and subjective sleep quality. Conclusions: Findings provided evidence-based information for stakeholders designing and implementing intervention strategies by providing psychological consultation services and public education to manage uncertainty stress and minimize the damage of negative affect and poor sleep.

Validation of the 4-Item and 10-Item Uncertainty Stress Scale in a Community-Based Sample of Chinese Adults.

Purpose: The objectives of this study were to examine the psychometric properties of the Uncertainty Stress Scale (USS) and to compare the usefulness of two versions of the scale (USS-4 and USS-10) among a large community-based sample of Chinese adults. Participants and Methods: The Uncertainty Stress Scale was validated in 904 community residents (mean age: 32.71 ± 10.99; male: 41.7%) through an online survey conducted in February 2020. Psychometric properties of reliability (Cronbach's alpha), construct validity (confirmatory factor analysis), and criterion validity (correlation and ROC curve analyses) were evaluated using established benchmarks. To validate the USS, we used the Chinese version of the Perceived Stress Scale (CPSS). In addition, sensitivity, specificity, and suitable cutoff values of the two versions of USS were determined. Results: Both versions of the USS had high internal consistency (USS-10: 0.941; USS-4: 0.851). Confirmatory factor analyses supported a one-factor structure for both measures. Both USS-4 and USS-10 scores were significantly positively correlated with CPSS scores, indicating acceptable criterion validity. Conclusion: The findings of the current study confirmed that the psychometric properties of two Chinese versions of USS are acceptable. Furthermore, the 4-item USS was as effective as the 10-item USS for the measurement of uncertainty stress in our community-based sample of Chinese adults suggesting that the USS-4 is a time-efficient alternative to the USS-10 which can be used when the circumstances require a time-efficient instrument (eg, in epidemiological studies with a large test battery).

Associations between sedentary behavior and negative emotions in adolescents during home confinement: Mediating role of social support and sleep quality

Background Prolonged periods of sedentary behaviour, for instance, engendered by home confinement in Shenzhen city, has led to negative mental health consequences, especially in adolescents. Previous research suggests, in general, that sedentary behavior can increase negative emotions. However, the specific mechanism driving the relationship between sedentary behavior and negative emotions is still relatively unclear. Social support and sleep quality might partly explain the effect of sedentary behavior on negative emotions. Thus, the current study aimed to examine the associations between sedentary behavior and negative emotions, and to investigate if social support and sleep quality mediate such a relationship. Method During home confinement due to the COVID-19 Omicron variant outbreak, 1179 middle and high school students in Shenzhen were invited to voluntarily complete an e-questionnaire, including the 21-item Depression Anxiety Stress Scale (DASS-21), the short form of the International Physical Activity Questionnaire (IPAQ-SF), the Social Support Rating Scale (SSRS) and the Pittsburgh Sleep Quality Index (PSQI). Data from 1065 participants were included in the analysis. Results We observed significant sex-related and demografic-related differences in emotional (e.g., anxiety, stress and social support) and other outcome variables (e.g., sitting duration and PSQI score). Furthermore, sedentary behavior, social support, and sleep quality were associated with negative emotions (p < .01), even after controlling for sex, age, only-child case, body mass index, and metabolic equivalent level. In addition, social support and sleep quality partially mediated the association between sedentary behavior and negative emotions. Conclusion The findings of the current study suggest that social support and sleep quality partially mediate the relationship between sedentary behavior and negative emotions in middle and high school students during home confinement in Shenzhen city.

Association of social support with negative emotions among Chinese adolescents during Omicron-related lockdown of Shenzhen City: The roles of rumination and sleep quality.

Objective: Adolescents are likely to suffer from negative emotions such as depression and anxiety due to the rapid development of biological, cognitive and social changes. Previous studies have indicated possible risk (rumination) and protective (good social support and high sleep quality) factors for depression and anxiety among this age group. The present study is the first to investigate the association between social support and negative emotions during the Outbreak of Omicron variant, on this basis, to further determine the mediating role of rumination and sleep quality on this link. Method: A total of 1,065 Chinese middle- and high-school students (51.5% female, M age = 13.80, SD = 1.20) completed a psychosocial battery, including the Social Support Rating Scale (SSRS), the Pittsburgh Sleep Quality Index (PSQI), the Ruminative Responses Scale (RRS), the Depression Anxiety Stress Scale (DASS). Serial multiple mediation analysis was conducted using PROCESS macro based on SPSS. Results: Social support, rumination, and sleep quality were significantly negatively correlated with negative emotional states (Ps < 0.05). Further, rumination and sleep quality were found to partially mediate the relationship between social support and negative emotional states. Conclusions: For early detection and prevention of depression and anxiety, providing sufficient social support is necessary for adolescents, because rumination and sleep problems are reported during stressful periods, such as the COVID-19 pandemic.

Moving more and sitting less as healthy lifestyle behaviors are protective factors for insomnia, depression, and anxiety among adolescents during the COVID-19 pandemic

Purpose: This study aimed to investigate associations of physical activity time (PAT) and sitting time (ST) independently and jointly with insomnia, depressive and anxiety symptoms among Chinese adolescents in the context of COVID-19. Methods: A cross-sectional study including 965 adolescents (mean age = 15.26, SD = 0.46) was conducted in May 2020. PAT, ST and the symptoms of insomnia, depression and anxiety were assessed with the International Physical Activity Questionnaire Short Form, the Youth Self-Rating Insomnia Scales, the 9-item Patient Health Questionnaire and the Generalized Anxiety Disorder scale via an online survey platform. Logistic regression was used to analyze the association between COVID-19-related fear, PAT, ST and combinations of PAT and ST with insomnia, depressive and anxiety symptoms. Results: COVID-19-related fear was associated with higher odds of insomnia, depressive and anxiety symptoms. PAT was associated with lower odds of insomnia and depressive symptoms, while ST was associated with higher odds of these three symptoms. After combining PAT and ST, the group with both low PAT and high ST was set as the referent. For insomnia, groups with low ST reported significantly lower odds of symptoms. For depression, groups with high PAT and/or low ST reported lower odds of symptoms. Regarding anxiety, only the group with both high PAT and low ST reported lower odds of symptoms. Generally, group with both high PAT and low ST reported lower odds of the three symptoms than the referent. Conclusion: COVID-19-related fear was a risk factor for developing insomnia, depressive and anxiety symptoms among Chinese adolescents. Fortunately, moving more and sitting less were good for sleep and mental health in Chinese adolescents during the pandemic. Educators should help adolescents to be more physically active in their daily life in the primary prevention of adolescent insomnia, depression and anxiety. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Self-compassion and resilience mediate the relationship between childhood exposure to domestic violence and posttraumatic growth/stress disorder during COVID-19 pandemic.

BACKGROUND: Studies have indicated that childhood exposure to domestic violence is a common factor in posttraumatic growth (PTG) and posttraumatic stress disorder (PTSD), but it is unclear whether PTG and PTSD share a common/different underlying mechanism. AIM: To explore the common/different underlying mechanism of PTG and PTSD. METHODS: Between February 12 and 17, 2020, a nationwide cross-sectional online survey was conducted in China among 2038 university students, and a self-administered questionnaire was used for the data collection. The data included demographic characteristics, such as age, gender, and subjective social economic status, and childhood exposure to domestic violence scale that was selected from the Chinese version of revised Adverse Childhood Experiences Question, Self-compassion Scale, Connor-Davidson Resilience Scale, Posttraumatic Growth Inventory, and the Abbreviated PTSD Checklist-Civilian version. A structural equation model was used to test the hypotheses. RESULTS: Exposure to domestic violence was significantly associated with PTG and PTSD via a 1-step indirect path of self-compassion (PTG: ß = -0.023, 95%CI: -0.44 to -0.007; PTSD: ß = 0.008, 95%CI: 0.002, 0.014) and via a 2-step indirect path from self-compassion to resilience (PTG: ß = -0.008, 95%CI: -0.018 to -0.002; PTSD: ß = 0.013, 95%CI: 0.004-0.024). However, resilience did not mediate the relationship between exposure to domestic violence and PTG and PTSD. CONCLUSION: PTG and PTSD are common results of childhood exposure to domestic violence, which may be influenced by self-compassion and resilience.

Prevalence and Associated Factors of Problematic Smartphone Use During the COVID-19 Pandemic: A Bangladeshi Study.

BACKGROUND: Problematic smartphone use (PSU) has been increasing hastily in recent decades, and it has become inseparable during the COVID-19 pandemic, especially among the students who are at risk of problematic smartphone use. Therefore, the present study aimed to investigate the prevalence and associated factors of PSU during the COVID-19 pandemic among the Bangladeshi students. METHODS: A total of 601 Bangladeshi students were recruited through an online-based cross-sectional survey that was conducted between October 7 and November 2, 2020. The survey collected information related to socio-demographics, behavioral health, internet use behaviors, depression, anxiety, and PSU. Independent samples t-test and one-way ANOVA were performed to present the relationship between the studied variables and PSU. Multiple linear regression analysis was also used for investigating the explanatory power of the predictive models for PSU. RESULTS: Surprisingly, about 86.9% of the students scored to be problematic smartphone users (≥21 out of a total 36 based on the Smartphone Application-Based Addiction Scale). In addition, medical students, engaging in a relationship, performing less physical activity, longer duration of internet use, some sorts of internet use purpose (eg, messaging, watching videos, using social media), depression, and anxiety were significantly associated with higher scores of PSU. After adjusting all the studied variables, the final model explained a 31.3% variance predicting PSU. CONCLUSION: The present study is one of the first approaches to assess the prevalence of PSU among the Bangladeshi students during the COVID-19 pandemic, whereas the addiction level was superfluous (and this may be due to more online engagement related to the pandemic). Thus, the study recommended strategies or policies related to the students' risk-reducing and healthy use of smartphones.

Psychometric Evaluation of the Fear of COVID-19 Scale Among Chinese Population.

Fear is a negative emotional reaction to or persistent worry over an imminent public health event like COVID-19. The COVID-Fear Scale was developed in many countries, but not in China. The current study aims to examine the psychometric properties of Chinese version of the Fear of COVID-19 Scale. Translation into Chinese and back-translation into English were conducted firstly. Item analysis and exploratory factor analysis were conducted in Sample 1, followed by validity tests in Sample 2. Likely, test-retest reliability was conducted in sample 3. A bifactor structure of Chinese version of FCV-19S with a general fear factor and two orthogonal group factors with fear thoughts and physical response was confirmed. Besides, it has good internal consistency reliability (α = .92), composite reliability (CR = .92), and validity correlation validity. The results of the present study confirmed that the Chinese version of FCV-19S has good psychometric properties in the Chinese communities. Supplementary Information: The online version contains supplementary material available at 10.1007/s11469-020-00441-7.

Mental health problems among Chinese adolescents during the COVID-19: The importance of nutrition and physical activity.

Mental health problems are common among adolescents and greatly influenced by stressful events. This study sought to assess the prevalence and correlates of insomnia, depressive and anxiety symptoms among Chinese adolescents during the COVID-19. METHOD: Cross-sectional study (N = 1,794 adolescents, mean age = 15.26) was conducted in May 2020. An online survey was used to collect socio-demographic data, COVID-related fear (COVID-fear), nutrition, physical activity (PA) level and the symptoms of insomnia, depression and anxiety. RESULTS: The prevalence of insomnia, depressive and anxiety symptoms was 37.80%, 48.20% and 36.70%, respectively, among Chinese adolescents during the pandemic. Generalized linear models revealed that female, left behind children, and students with greater COVID-fear tended to report symptoms of insomnia, depression and anxiety concurrently. After adjusting for socio-demographic factors and COVID-fear, better nutritional status and moderately active PA were both associated with lower levels of depressive and anxiety symptoms, while highly active PA was associated with lower levels of insomnia, depressive and anxiety symptoms. CONCLUSIONS: These findings suggest that more attention should be paid to psychological health among adolescents while combating COVID-19. To promote adolescents' mental health, educators should help adolescents develop a healthy lifestyle with balanced diet and regular exercise.

Los problemas de salud mental son comunes en adolescentes y están influenciados por eventos estresantes. Se evaluó prevalencia y correlatos de síntomas de insomnio, depresión y ansiedad en adolescentes chinos durante el COVID-19. Método: En mayo de 2020 se realizó un estudio transversal (N = 1.794 adolescentes, edad media = 15,26) mediante una encuesta en línea para recopilar datos sociodemográficos, miedo relacionado con COVID-19, nutrición, actividad física (AF) y síntomas de insomnio, depresión y ansiedad. Resultados: La prevalencia de síntomas de insomnio, depresión y ansiedad fue del 37,80%, 48,20% y 36,70%, respectivamente. Modelos lineales generalizados revelaron que mujeres, niños abandonados y estudiantes con más miedo al COVID-19 tendían a informar síntomas de insomnio, depresión y ansiedad simultaneamente. Después de ajustar los factores sociodemográficos y el miedo al COVID-19, mejor estado nutricional y AF moderadamente activa se asociaron con niveles más bajos de síntomas de depresión y ansiedad, mientras que AF muy activa se asoció con niveles más bajos de insomnio, síntomas depresivos y de ansiedad. Conclusiones: Se debe prestar más atención a la salud psicológica de los adolescentes mientras se combate el COVID-19. Para promover su salud mental, los educadores deben ayudarles a desarrollar un estilo de vida saludable con una dieta equilibrada y ejercicio regular.

Depression is Associated with Moderate-Intensity Physical Activity Among College Students During the COVID-19 Pandemic: Differs by Activity Level, Gender and Gender Role.

PURPOSE: The novel coronavirus disease (COVID-19) pandemic and associated restrictive measures have implications for depressive symptoms (henceforth depression) of young people and risk may be associated with their reduced physical activity (PA) level. Therefore, we aimed to examine the association between depressive symptoms and PA among college students with different gender and gender role (masculinity traits and femininity traits) during the COVID-19 pandemic. PARTICIPANTS AND METHODS: Cross-sectional study included 628 healthy college students from nineteen different locations. The Center for Epidemiological Studies Depression Scales (CES-D), the International Physical Activity Questionnaire - Short Form (IPAQ-SF), and the 50-item Chinese Sex-Role Inventory (CSRI-50) were used to measure depressive symptoms, PA continuous (weekly metabolic equivalent minutes, MET-minutes/week) and categorical indicators (activity level category) and gender role, respectively. The statistical analyses were used in partial correlation analysis, t-test, one-way ANOVA, moderation model tests, and linear regression model tests. RESULTS: Total of 34.72% participants had clinically relevant depression (16, CES-D scale). Total of 58.6% participants were classified as a "low" activity level for spending less time on PA. Depression significantly negatively correlated with MET-minutes/week in moderate-intensity PA but not vigorous and walking scores. Of note, the depression-PA association was only moderated by the "low" activity level group in terms of categorical scores across gender groups. Participants with higher masculinity traits were less likely to have depression among all participants. Moreover, more recovered cases and fewer deaths could also predict the lower depression risk in the "high" activity level group. CONCLUSION: Moderate-intensity PA is beneficial for reducing depression risk among college students at a low activity level. College students with fewer masculinity traits (regardless of gender) are highly vulnerable to depression during the outbreak of COVID-19. Effective control of the COVID-19 pandemic seems critical to alleviating the burden of mental disorders of the public including depression.

Epidemiology of mental health problems in COVID-19: a review.

The novel coronavirus disease 2019 (COVID-19) has become a pandemic affecting health and wellbeing globally. In addition to the physical health, economic, and social implications, the psychological impacts of this pandemic are increasingly being reported in the scientific literature. This narrative review reflected on scholarly articles on the epidemiology of mental health problems in COVID-19. The current literature suggests that people affected by COVID-19 may have a high burden of mental health problems, including depression, anxiety disorders, stress, panic attack, irrational anger, impulsivity, somatization disorder, sleep disorders, emotional disturbance, posttraumatic stress symptoms, and suicidal behavior. Moreover, several factors associated with mental health problems in COVID-19 are found, which include age, gender, marital status, education, occupation, income, place of living, close contact with people with COVID-19, comorbid physical and mental health problems, exposure to COVID-19 related news and social media, coping styles, stigma, psychosocial support, health communication, confidence in health services, personal protective measures, risk of contracting COVID-19, and perceived likelihood of survival. Furthermore, the epidemiological distribution of mental health problems and associated factors were heterogeneous among the general public, COVID-19 patients, and healthcare providers. The current evidence suggests that a psychiatric epidemic is cooccurring with the COVID-19 pandemic, which necessitates the attention of the global health community. Future epidemiological studies should emphasize on psychopathological variations and temporality of mental health problems in different populations. Nonetheless, multipronged interventions should be developed and adopted to address the existing psychosocial challenges and promote mental health amid the COVID-19 pandemic.

COVID-19, physical (in-)activity, and dementia prevention.

Physical inactivity is one major modifiable risk factor for dementia (especially Alzheimer's disease). Due to contact restrictions and isolation measures in response to the current COVID-19 (coronavirus disease 2019) pandemic, physical inactivity levels have increased by up to 30%, which will likely have adverse consequences for primary and secondary dementia prevention. Therefore, new interdisciplinary prevention approaches (eg, outdoor exercise; app-based exercise with online partners) are urgently needed that account for the suspected long-term lifestyle changes that the current-and upcoming-pandemics are likely to entail (increased use of home office, social isolation, avoidance of fitness centers and club sports, and so on).

Prevalence and Psychosocial Correlates of Mental Health Outcomes Among Chinese College Students During the Coronavirus Disease (COVID-19) Pandemic.

OBJECTIVES: To investigate the prevalence and risk factors for poor mental health of Chinese university students during the Corona Virus Disease 2019 (COVID-19) pandemic. METHOD: Chinese nation-wide on-line cross-sectional survey on university students, collected between February 12th and 17th, 2020. Primary outcome was prevalence of clinically-relevant posttraumatic stress disorder symptoms. Secondary outcomes on poor mental health included prevalence of clinically-relevant anxiety and depressive symptoms, while posttraumatic growth was considered as indicator of effective coping reaction. RESULTS: Of 2,500 invited Chinese university students, 2,038 completed the survey. Prevalence of clinically-relevant PTSD, anxiety, and depressive symptoms, and post traumatic growth (PTG) was 30.8, 15.5, 23.3, and 66.9% respectively. Older age, knowing people who had been isolated, more ACEs, higher level of anxious attachment, and lower level of resilience all predicted primary outcome (all p < 0.01). CONCLUSIONS: A significant proportion of young adults exhibit clinically relevant posttraumatic stress disorder (PTSD), anxious or depressive symptoms, but a larger portion of individuals showed to effectively cope with COVID-19 pandemic. Interventions promoting resilience should be provided, even remotely, to those subjects with specific risk factors to develop poor mental health during COVID-19 or other pandemics with social isolation.

Use of Corticosteroids in Coronavirus Disease 2019 Pneumonia: A Systematic Review of the Literature.

The aim was to investigate the effectiveness of glucocorticoid therapy in patients with COVID-19. A systematic search of the literature across nine databases was conducted from inception until 15th March 2020, following the PRISMA guidelines. Patients with a validated diagnosis of COVID-19 and using corticosteroids were included, considering all health outcomes. Four studies with 542 Chinese participants were included. Two studies reported negative findings regarding the use of corticosteroids in patients with COVID-19, i.e., corticosteroids had a detrimental impact on clinical outcomes. One study reported no significant association between the use of corticosteroids and clinical outcomes. However, one study, on 201 participants with different stages of pneumonia due to COVID-19, found that in more severe forms, the administration of methylprednisolone significantly reduced the risk of death by 62%. The literature to date does not fully support the routine use of corticosteroids in COVID-19, but some findings suggest that methylprednisolone could lower mortality rate in more severe forms of the condition.