Health-related quality of life (HRQoL) and psychological impact of the COVID-19 pandemic on patients with myasthenia gravis.

The aim of this study was to compare the effects of the pandemic on health-related quality of life (HRQoL), anxious-depressive symptoms, feelings of loneliness, and fear of COVID-19 between people with myasthenia gravis (MG) and healthy controls. We also wanted to know in which group the variable fear of COVID-19 interfered the most with the results. This cross-sectional study involved 60 people with MG and 60 healthy controls. Participants using an online platform completed a sociodemographic questionnaire, the Short Form-36 Health Survey (SF-36), the Hospital Anxiety and Depression Scale (HADS), the revised UCLA Loneliness Scale and the Fear of COVID19 Scale (FCV- 19S). The MG group reported worse levels in HRQoL indicators (p = 0.043- <.001), more severe anxiety-depressive symptoms (p = 0.002), and greater fear of COVID-19 (p < 0.001), but there were no differences in feelings of loneliness (p = 0.002). Furthermore, after controlling for the effect of the fear of COVID-19 variable, the differences remained for physical health indicators, but not for the most of psychosocial indicators (Social Functioning p = 0.102, η2p = 0.023; Role Emotional p = 0.250, η2p = 0.011; and HADS Total p = 0.161, η2p = 0.017). The harmful effect of the COVID-19 pandemic was greater in the MG group, and the perceived fear of COVID-19 had also a greater impact among this group, which has increased its negative effect on their psychosocial health.

Socio-emotional strengths against psychopathology and suicidal ideation in fear of COVID-19.

Coronavirus disease (COVID-19) has caused a global health crisis. It also leads to different types of psychosocial problems in society as a result of preventive health measures and the disease itself. Among others, psychopathological symptoms and suicide behaviors have increased. The PsicorecurSOS COVID-19 online protocol was designed. At baseline, 1020 Spanish adults were assessed, during confinement, for sociodemographics, fear of COVID-19, anxious-depressive symptoms, covitality, and suicidal ideation. Reliability, descriptive, and frequency analyses were carried out, and the computer tool SPSS PROCESS was used to carry out a conditional process analysis (model 59). A total of 595 participants were included (58.30% response rate from baseline; mean age = 37.18 [SD = 13.30]; 72.44% female). Regarding suicidal ideation, 12% responded differently to "never," 19.3% exceeded the cutoff point on the anxiety scale, and 24% on the depression scale. Moderate mediation analysis explained 27% of the variance in suicidal ideation. In addition, the indirect effect of moderate mediation was significant (b = -.004, SE = .002 with the presence of covitality; and b = .01, SE = .003 absence of covitality). Sex and age did not influence the overall outcome of the model. The data from this study can serve as a starting point for generating social and health treatment initiatives based on self-examination of anxiety-depressive symptoms and increasing socio-emotional skills in order to prevent and alleviate the psychosocial effects of the pandemic.

Low Treatment Fidelity as an Indication to Switch Interventions: Pivoting From Child-Parent Psychotherapy to Parent-Child Interaction Therapy for Early Childhood Trauma

Young children who experience trauma and adverse experiences are at an increased risk of developing an insecure attachment style as well as negative physical and mental health problems. These can include internalizing and externalizing behavioral problems, developmental delay, emotional dysregulation, and aggression. Several evidence-based interventions exist to treat young children with symptoms related to trauma, each with different foundational theories. This article presents the case of a 4-year-old boy with posttraumatic stress disorder who was in the middle of a legal fight between caregivers and transitioning between caregivers' homes. Initially, therapy began with Child-Parent Psychotherapy to address caregivers' first concerns. Later, the therapeutical approach was switched to Parent-Child Interaction Therapy due to difficulty with treatment fidelity related to caregivers' symptoms and conflict. This case demonstrates great improvement in treatment fidelity and subsequently problem behaviors after switching to an intervention that allowed to address behavior management shortcomings in a family with ongoing conflict.Copyright © The Author(s) 2022.

Gift of fantasy: investigating how fantasy in digital game impacts game brand immersion

PurposeThis research aims to extend brand relationship theory to the domain of online gaming by augmenting the understanding of the role played by fantasy state in digital game in impacting gamers' immersive relationships with digital game brands. In this quest, the research examines how fantasy state in game (FSG) creates game brand immersion (GBI) through the mediation of emotional game brand attachment (EGBA) and the roles of individual's need for escapism (NE) and anxious attachment style (AAS) in moderating the aforementioned relationships.Design/methodology/approachThe research employs a pre-test followed by two quantitative studies. Quantitative data were analyzed using the PROCESS macro.FindingsResults from Study 1 illustrate that perceived fantasy in game generates EGBA, which, in turn, predicts GBI. Further, Study 2 establishes that the effect of fantasy in game on EGBA is moderated by gamer's NE. The moderating effect of NE is moderated by individual's AAS.Originality/valueValue of the study lies in extending consumer–brand relationship theory to digital gaming domain which enhances the understanding of how fantasy state in digital game can lead to GBI and the roles played by individual personality characteristics like escapism motivation and AAS in the process.

Exploring factors associated with complete mental health of pregnant women during the COVID-19 pandemic.

OBJECTIVE: To explore a wide range of factors associated with complete mental health (i.e., positive mental health - the presence of flourishing, and the absence of mental illness - depressive and anxious symptoms) among Portuguese pregnant women, during the COVID-19 pandemic. DESIGN: Quantitative cross-sectional study. SETTING: Data were collected through an online survey placed on social media websites targeting pregnant Portuguese adult women between October 2020 and April 2021. PARTICIPANTS: The sample comprised 207 pregnant women. RESULTS: A multivariate logistic regression model showed that higher levels of self-compassion and higher engagement in mindful self-care practices increased the likelihood of reporting complete mental health during pregnancy. CONCLUSIONS: Promoting self-compassion and mindful self-care may be particularly important in pregnant women, as these psychological factors appear to contribute to complete mental health during COVID-19 pandemic. IMPLICATIONS FOR PRACTICE: The COVID-19 pandemic represented a demanding period for pregnant women. Our findings highlight that targeting the promotion of self-compassion and mindful self-care practices during stressful periods could significantly contribute to their overall mental health.

Potential risk factors for acute grief during the COVID-19 pandemic: The mediating role of avoidance processes.

Bereavement during the COVID-19 pandemic may have some unique characteristics that become potential risk factors (e.g., absence of grief rituals, no opportunity to say goodbye to the deceased and loneliness caused by social distancing) for acute grief. Avoidance processes could be significant mediators in the context of the pandemic. The current study aimed to investigate whether and how these COVID-19-related risk factors were related to acute grief severity. Bereaved adults (n = 319) who lost significant others during the COVID-19 pandemic completed a self-report questionnaire package measuring COVID-19-related factors, grief severity and depressive and anxious avoidance. Regression analyses suggested that among the three potential risk factors (loneliness, grief rituals and opportunity to say goodbye), loneliness was significantly associated with acute grief after controlling for basic demographic and loss-related information. Structural equation models suggested that depressive avoidance and anxious avoidance partially mediated the associations of loneliness with acute grief severity. The findings indicate that dealing with loss during the COVID-19 pandemic warrants further exploration concerning how potential environmental risk factors may impede adaptation to loss. Depressive and anxious avoidance processes may play important roles in grief interventions for isolated and lonely bereaved people.

Effects of physical exercise intervention on depressive and anxious moods of college students: A meta-analysis of randomized controlled trials

Background Due to the limitation of drug treatment and other adverse reactions, many psychological treatments always adopt rehabilitation training or non-drug intervention methods, while physical exercise is considered as an auxiliary way. A mass of literature has verified the therapeutic benefits of physical exercise to reduce depression and anxiety in clinical populations. However, little attention is paid to the mental health benefits of exercise for non-clinical populations. The purpose of this meta-analysis is to systematically aggregate and quantify findings of the effect of physical exercise on depression and anxiety in non-clinical populations, through which to evaluate whether physical exercise intervention as a non-drug means can effectively improve the depressive and anxious moods of college students. Significance This paper combines sport and psychotherapy and links kinesiology and psychology, which can deepen readers' understanding and stimulate their interest in the practice of sport and exercise psychology. The 2019 novel coronavirus disease (COVID-19) has swept the world, causing a global epidemic with serious physical and psychological consequences, and this study may help policymakers and health care professionals to make effective recommendations for psychological interventions for college students. Methods The study was based on five electronic databases: CNKI, Wan Fang Data, SinoMed, PubMed, and Web of Science. The quality of the selected articles was evaluated by the PEDro scale. The Meta-Analysis was performed using R-4.0.4, which computed pooled estimates of effect size and respective 95% confidence intervals (95% CI) for intervention. Bias and sensitivity analyses were calculated to explore the source of heterogeneity, and subgroup analyses were performed according to time, frequency, and event. Results Synthesizing all the trials, the results show that the study heterogeneity of physical exercise on the improvement of depressive mood in college students is relatively high (I2=63%, P<0.01), which has a medium effect (SMD=-0.63, 95% confidence interval=-0.80 to -0.46). The results reveal low heterogeneity in anxious mood (I2=36%, P = 0.04), with a medium effect (SMD=-0.58, 95% confidence interval=-0.71 to -0.44). Conclusion The Meta-Analysis confirms the effective and positive role of physical exercise in reducing depressive and anxious moods of college students. Physical exercise can be used as a non-medical method to improve the mental health state of college students and promote full development. Further research should evaluate the impact of various sports and specific exercise prescriptions on college students' negative emotions, so as to apply them to complementary and alternative therapies.

Adjunctive Pimavanserin in Patients with Major Depressive Disorder: Combined Results from Two Randomized, Double-Blind, Placebo-Controlled Phase 3 Studies.

Objective: In a phase 2 study, pimavanserin demonstrated efficacy as adjunctive treatment for major depressive disorder (MDD). Subsequently, two phase 3 studies (NCT03968159 in the US; NCT03999918 in Europe) were initiated to examine the efficacy and safety of adjunctive pimavanserin in subjects with MDD and inadequate response to antidepressant treatment. Studies were combined with a prespecified statistical analysis plan owing to recruitment challenges related to the COVID-19 pandemic. Experimental design: The randomized, double-blind studies enrolled 298 patients with MDD and inadequate response to current antidepressants. Patients were randomly assigned 1:1 to pimavanserin or placebo added to current antidepressant for 6 weeks. Primary endpoint was change from baseline to week 5 in the Hamilton Rating Scale for Depression, 17-item version (HAM-D-17). Principal observations: There was no effect of pimavanserin in change from baseline to week 5 in the HAM-D-17 (pimavanserin [n = 138]: least-squares mean [LSM] [standard error {SE}], -9.0 [0.58]; placebo [n = 135]: -8.1 [0.58]; mixed-effects model for repeated measures LSM [SE] difference, -0.9 [0.82], P = 0.2956). Nominal improvement with pimavanserin was observed on 2 secondary endpoints: Clinical Global Impressions-Severity scale, Karolinska Sleepiness Scale. Treatment-emergent adverse events occurred in 58.1% of pimavanserin-treated and 54.7% of placebo-treated patients. Conclusions: Adjunctive pimavanserin did not significantly improve depressive symptoms, although pimavanserin was well tolerated.

Saffron for mood improvement in children and adolescents: a narrative review

Depressive and anxious disorders could be experienced by children and adolescents worldwide and are associated with psychiatric syndromes diagnosed in adulthood. In this context, the COVID-19 outbreak and digital media arising use have worsened mental conditions in the pediatric population. Older adolescents, girls, and patients living with neurodiversity and/or chronic physical conditions are more likely to develop negative mental health outcomes. Crocus sativus L. (saffron) is a medicinal plant whose most biologically relevant components are two carotenoids (crocin and crocetin) and two apocarotenoids (picrocrocin and safranal). Crocin seems to inhibit the uptake of dopamine and norepinephrine, while safranal inhibits the serotonin reuptake;in vitro and in animal models, crocin also displayed neuroprotective abilities, increasing the intracellular levels of neurotrophic factors. Further studies are required to strengthen these results;however, multiple studies have already demonstrated significant positive effects of saffron on psychiatric disorders - including depression and anxiety in young patients. Saffron administration appears to reduce depression symptoms and to strengthen antidepressant effects of current drugs (fluoxetine), also lowering adverse events of these therapies. Consequently, saffron could have an important role as a complementary therapy for depressive and anxious disorders in children and teenagers.

Research on the Design Strategy of Healing Products for Anxious Users during COVID-19.

With the spread of COVID-19 worldwide, various travel restrictions are becoming a significant trigger for anxiety. Although healing products could relieve anxiety, few scholars have proposed a practical design strategy. Therefore, we offer a design strategy for healing products that includes three phases: preparation, analysis, and verification. In Phase 1, 20 people with moderate or high anxiety are invited to rate 100 samples. Then, FCM is used to obtain representative samples. In Phase 2, a three-layer diagram (incl. the upper, middle, and lower layers) of healing products is obtained using the evaluation grid method. Subsequently, the middle layer is considered evaluation criteria. Additionally, 18 items in the lower layer are considered design guidelines. In Phase 3, we invite two teams to develop innovative designs based on design guidelines and personal experience, generating four alternatives. Finally, four alternatives and four healing commodities are evaluated using grey relation analysis and perceptual questionnaires. The consistency of both evaluations could confirm the validity of the evaluation criteria. The alternatives generated based on the design guidelines are better than other alternatives, demonstrating the effectiveness of the design guidelines. The design strategy is beneficial for developing and evaluating healing products to alleviate people's anxiety during COVID-19.

Temporal Unpredictability and Probabilistic Uncertainty Induced Anxiety in the Times of COVID-19 Pandemic

Human beings prefer a predictable and certain environment over an unpredictable and uncertain environment. No one predicted the coronavirus pandemic and it is not certain when the pandemic will come to an end. Pandemics not only affect the physical health but also the mental health of the public. An increase in anxiety and suicide rates has been reported during the previous pandemics and the same trend is also being observed in this current pandemic as well. Pandemics inevitably result in unpredictable and uncertain environments. Many studies have proven that unpredictability and uncertainty increase the levels of stress and anxiety in animals and humans. Coronavirus pandemic has caused many unpredictable and uncertain events resulting in increased confusion, frustration, stress and anxiety among the public. For instance, the institution of lockdowns was unpredictable and it was uncertain when the lockdowns will be unlocked. Similarly, events that unfolded around the initial touting of chloroquine and hydroxychloroquine as a possible therapeutic agent and later lack of evidence in support of these drugs resulted in extreme confusion and frustration. The uncertainty around if a vaccine for coronavirus will be developed and when it will become available for public use has also caused stress and anxiety. Current studies indicate that coronavirus is not just a respiratory virus but it also affects the kidneys, brain, heart and blood vessels. This unpredictable nature of the virus has caused further confusion and frustration. These unpredictable and uncertain events around the current pandemic might have increased the levels of stress and anxiety among the public.

Media exposure, attitude, anxiety and practices among university students during the COVID-19 pandemic

The coronavirus disease 2019 (COVID-19) pandemic, which originated from China, went global within weeks. At the time of writing, almost 300 million people around the world have been infected by this potent and fast-spreading disease, which in many cases has paralysed economies and normal daily activities. University students are among the people that have been badly affected by the pandemic, as the movement control order (MCO) has resulted in university closure. Hence, many students are unable to proceed with their regular studies and have to be extra vigilant in dealing with the pandemic. During the MCO period, they rely heavily on media for guidance and information. This study was conducted to examine media exposure, attitude, anxiety, and practices towards COVID-19 amongst the students of Universiti Pendidikan Sultan Idris (UPSI), Perak, Malaysia. A quantitative research design was used to achieve the research objective. A total of 505 respondents answered an online survey and the findings revealed that respondents were highly dependent on various media for updated information about the pandemic, with the majority of them anxious about their safety. These findings are useful for higher education institutions in developing a better learning environment for students and understand the impact of the pandemic on students. © 2022, Intelektual Pustaka Media Utama. All rights reserved.

Self-compassion and mindful parenting among postpartum mothers during the COVID-19 pandemic: The role of depressive and anxious symptoms.

Self-compassion is an important psychological skill that may facilitate the adoption of a mindful way of parenting, especially during the COVID-19 pandemic. However, the association between these constructs may be explained by several variables, such as maternal psychopathological symptoms, with a well-established interference in parenting. This study aimed to compare mothers who experienced and mothers who did not experience a negative emotional impact of the COVID-19 pandemic on self-compassion, mindful parenting, postpartum depressive symptoms (PPDS) and postpartum anxious symptoms (PPAS). We also explored whether mothers' self-compassion was associated with mindful parenting and whether this relationship may be mediated by PPDS and PPAS. A sample of 977 Portuguese mothers of infants aged between zero and six months completed an online survey between December 2020 and January 2021, a period of major pandemic-related restrictions. The survey included several self-report questionnaires that assessed sociodemographic, clinical, and COVID-19 information, self-compassion, mindful parenting, PPDS and PPAS. Mothers who reported having felt that the pandemic had a negative emotional impact during their postpartum period (79.5%) presented lower levels of self-compassion and mindful parenting, and higher levels of PPDS and PPAS. Regarding the mediation model, higher levels of self-compassion were related to higher levels of mindful parenting, and this association was mediated by lower levels of PPAS. These results highlight the relevance of mothers' self-compassion for helping them feel less anxious and to adopt a mindful way of parenting in the postpartum period, particularly during the pandemic. Compassion-based interventions may be particularly important in reducing PPAS and promoting mindful parenting and should be available to postpartum mothers, especially during, but also beyond the pandemic.

Quarantine Anxiety: Governmentality Strategies for Anxious Subjects During the Covid-19 Pandemic

The numbers of mental disorders, such as pathological anxiety, almost doubled in the first months of the Covid-19 pandemic worldwide. This fact, in turn, demands specific medical-psychiatric intervention strategies, with digital technologies as the main means of therapeutic articulation. Paying attention to this scenario, this research seeks to investigate the modes of governmentality for the anxious subject in the Covid-19 pandemic, in 2020, in the Brazilian scenario. Methodologically, the archgenealogy bias of a qualitative nature is adopted, having as corpus three materialities, one from Canal Drauzio Varela and two from Vittude Blog, analyzed in the light of Foucault’s postulates. In short, social media offers a virtual environment that, even in the midst of isolation, articulates the government of itself and the other through information publications, online therapies, among others. © 2021, Universidade Federal de Minas Gerais, Faculdade de Letras. All rights reserved.

Children and Adolescents' Psychological Well-Being Became Worse in Heavily Hit Chinese Provinces during the COVID-19 Epidemic.

In light of the novel coronavirus's (COVID-19's) threat to public health worldwide, we sought to elucidate COVID-19's impacts on the mental health of children and adolescents in China. Through online self-report questionnaires, we aimed to discover the psychological effects of the pandemic and its associated risk factors for developing mental health symptoms in young people. We disseminated a mental health survey through online social media, WeChat, and QQ in the five Chinese provinces with the most confirmed cases of COVID-19 during the late stage of the country-wide lockdown. We used a self-made questionnaire that queried children and adolescents aged 6 to 18 on demographic information, psychological status, and other lifestyle and COVID-related variables. A total of 17,740 children and adolescents with valid survey data participated in the study. 10,022 (56.5%), 11,611 (65.5%), 10,697 (60.3%), 6868 (38.7%), and 6225 (35.1%) participants presented, respectively, more depressive, anxious, compulsive, inattentive, and sleep-related problems compared to before the outbreak of COVID-19. High school students reported a greater change in depression and anxiety than did middle school and primary school students. Despite the fact that very few children (0.1%) or their family members (0.1%) contracted the virus in this study, the psychological impact of the pandemic was clearly profound. Fathers' anxiety appeared to have the strongest influence on a children's psychological symptoms, explaining about 33% of variation in the child's overall symptoms. Other factors only explained less than 2% of the variance in symptoms once parents' anxiety was accounted for. The spread of COVID-19 significantly influenced the psychological state of children and adolescents in participants' view. It is clear that children and adolescents, particularly older adolescents, need mental health support during the pandemic. The risk factors we uncovered suggest that reducing fathers' anxiety is particularly critical to addressing young people's mental health disorders in this time.

Pre-Pandemic Peer Relations Predict Adolescents' Internalizing Response to Covid-19.

The goal of the current longitudinal study was to investigate the role of adolescents' peer victimization and aggression prior to COVID-19 on the change in their depressive and anxious symptoms from pre- to mid-pandemic. We hypothesized that, although adolescents overall would display an increase in internalizing symptoms from pre- to mid-pandemic, this response would be weakened or perhaps even reversed when adolescents experienced high levels of victimization or aggression prior to the pandemic. Participants included 96 racially/ethnically diverse adolescents (42 males, 53 females; 1 other) with an average age of 16.79 years (SD = 0.60). At Time 1 (T1; June 2019 through February 2020; pre-pandemic), adolescents completed self-report measures of their peer relations (aggression, victimization) and internalizing symptoms (depressive, anxious). At Time 2 (T2; May through July 2020; mid-pandemic), adolescents completed self-report measures of their internalizing symptoms (depressive, anxious). On average, adolescents' anxious and depressive symptoms increased from T1 to T2, although they exhibited substantial variability, with reports ranging from decreasing symptoms to increasing symptoms. Although on average adolescents reported increases in anxious symptoms from T1 to T2, adolescents with higher T1 peer victimization reported less positive change in anxious symptoms. Similarly, although on average adolescents reported increases in depressive symptoms from T1 to T2, adolescents with higher levels of T1 aggression reported less positive change in depressive symptoms from T1 to T2. Discussion focused on restrictions on in-person peer interactions necessitated by COVID-19 that may reduce adolescents' distress when their pre-pandemic daily lives were characterized by negative peer relations.

The Nasopharynx Swab Test for Coronavirus Disease-2019 Is Mild and Will Not Cause Significant Pain and Anxiety: A Cross-Sectional Study Based on Psychiatrists.

Background: Laboratory viral nucleic acid testing (NAT), such as the nasopharyngeal swab test, is now recommended as the gold standard for the diagnosis of Coronavirus disease-2019 (COVID-19). However, the nasopharyngeal swab testing process may cause some discomfort. Objective: To investigate the influence of nasopharyngeal swab tests on the anxiety and pain felt by psychiatric medical staff. Methods: A total of 174 psychiatric medical staff (namely 97 doctors, 68 nurses, and nine administrators) and 27 controls were included in the current study. A self-designed questionnaire was used to collect their general demographic information (age, gender, marriage, occupation, profession, smoking history, alcohol consumption history, tea drinking history, previous history of anxiety and depression) as well as their subjective experience, such as nausea, vomiting, coughing, worry, fear, etc, during nasopharyngeal swab collection. The Numerical Rating Scale (NRS) and the State-Trait Anxiety Inventory (STAI) were used to assess the subjects' pain and state anxiety, respectively. Results: There were no statistical differences (p>0.05) in age, marriage, smoking history, a history of anxiety and depression, pain scores, and anxiety scores between different professions and genders. The results of partial correlation analysis (controlled for gender and history of depression or anxiety) indicated that the male gender was negatively correlated with being anxious (r=-0.148, p=0.037) and nervous (r=-0.171 p=0.016), although there was no significant difference in pain and anxiety between men and women. In addition, marriage might help women resist negative emotions. Conclusions: 1) There will be mild discomfort during nucleic acid testing, but not enough to cause pain and anxiety; 2) women are more likely to be anxious and nervous during the nucleic acid testing.

Suicidality and Its Associated Factors Among Students in Rural China During COVID-19 Pandemic: A Comparative Study of Left-Behind and Non-Left-Behind Children.

Introduction: The coronavirus disease 2019 (COVID-19) has rapidly spread worldwide. The harmful impact of COVID-19 is beyond just physical health concern. The unprecedented public health crisis has also taken its toll on the mental health of adolescents. The present study aims to estimate the prevalence of suicidal ideation and attempts and investigate the similarities and differences in the influential factors for suicidal ideation and attempts among left-behind children (LBC) and non-left-behind children (NLBC) in rural China during the COVID-19 pandemic. Method: A total of 761 rural Chinese students, of whom 468 were left behind, completed the cross-sectional questionnaires including demographic data, Cognitive Emotion Regulation Questionnaire, nine-item Patient Health Questionnaire, seven-item Generalized Anxiety Disorder Scale, suicidal ideation, and suicidal attempts. Chi-square test, independent-sample t-test, and logistic regression were performed in the statistical analysis. Results: Overall, 36.4 and 10.4% of rural Chinese students reported suicidal ideation (37.8% for LBC vs. 34.1% for NLBC) and attempts (11.3% for LBC vs. 8.9% for NLBC) during the COVID-19 pandemic. Among LBC, parental educational level (adjusted odds ratio, Adj. OR = 1.60), maladaptive strategies (Adj. OR = 1.04), anxious symptoms (Adj. OR = 2.61), and depressive symptoms (Adj. OR = 3.85) were significantly associated with suicidal ideation, while age (Adj. OR = 0.56), maladaptive strategies (Adj. OR = 1.08), symptoms of anxiety (Adj. OR = 3.85), and symptoms of depression (Adj. OR = 2.68) were significantly related to suicidal attempts during the COVID-19 outbreak. Among NLBC, gender (Adj. OR = 2.20), parental educational level (Adj. OR = 1.77), perceived family economic status (Adj. OR = 0.39), anxious symptoms (Adj. OR = 2.38), and depressive symptoms (Adj. OR = 2.77) were significantly associated with suicidal ideation, whereas only anxious symptom (Adj. OR = 5.85) was significantly related to suicidal attempts. Conclusion: Suicidal ideation and attempts are prevalent among students in rural China during the COVID-19 outbreak. Our findings also revealed the shared and unique factors for suicidal ideation and attempts among LBC and NLBC during the COVID-19 epidemic. With regard to the differences between LBC and NLBC, the use of maladaptive strategies and age might be vital factors for suicide prevention measures directed specifically toward LBC, whereas interventions sensitive to gender and perceived social economic status should be specifically designed for NLBC amid the COVID-19 pandemic.

Prevalence and Factors Associated with Mental and Emotional Health Outcomes among Africans during the COVID-19 Lockdown Period-A Web-based Cross-Sectional Study.

Mental health and emotional responses to the effects of COVID-19 lockdown in sub-Saharan Africa (SSA) are of serious public health concern and may negatively affect the mental health status of people. Hence, this study assessed the prevalence of mental health symptoms as well as emotional reactions among sub-Saharan Africans (SSAs) and associated factors among SSAs during the COVID-19 lockdown period. This was a web-based cross-sectional study on mental health and emotional features from 2005 respondents in seven SSA countries. This study was conducted between 17 April and 17 May 2020 corresponding to the lockdown period in most SSA countries. Respondents aged 18 years and above and the self-reported symptoms were feeling anxious, being worried, angry, bored and frustrated. These were the main outcomes and were treated as dichotomous variables. Univariate and multivariate logistic regression analyses were used to identify the factors associated with these symptoms. We found that over half (52.2%) of the participants reported any of the mental health symptoms and the prevalence of feeling bored was 70.5% followed by feeling anxious (59.1%), being worried (57.5%), frustrated (51.5%) and angry (22.3%) during the COVID-19 pandemic. Multivariate analysis revealed that males, those aged >28 years, those who lived in Central and Southern Africa, those who were not married, the unemployed, those living with more than six persons in a household, had higher odds of mental health and emotional symptoms. Similarly, people who perceived low risk of contracting the infection, and those who thought the pandemic would not continue after the lockdown had higher odds of mental health and emotional symptoms. Health care workers had lower odds for feeling angry than non-healthcare workers. During the COVID-19 lockdown periods in SSA, about one in two participants reported mental health and emotional symptoms. Public health measures can be effectively used to identify target groups for prevention and treatment of mental health and emotional symptoms. Such interventions should be an integral component of SSA governments' response and recovery strategies of any future pandemic.

Anxiety and Leisure-Domain Physical Activity Frequency, Duration, and Intensity During Covid-19 Pandemic.

This study investigated relationships between state anxiety and leisure-domain physical activity levels during Covid-19 pandemic. We used frequency, duration, and intensity as key variables of physical activity. Trait anxiety, state anxiety before pandemic, age, gender, and education level were also included in the analysis. Our general hypothesis was that participants who declared doing more physical activity levels would exhibit lower levels of anxiety during the Covid-19 pandemic. A convenient sample of 571 volunteer adults (mean age 39 ± 14 years) was drawn mainly from São Paulo State (89.2% of the sample), the epicenter of Covid-19 pandemic in Brazil. To obtain the participants' levels of anxiety (trait, state before pandemic, and state during pandemic) we used a validated short-version of the State and Trait Anxiety Inventory. Levels of physical activity were measured via questions from VIGITEL, a validated questionnaire about the individual's habits on risk factors. Answers were given regarding the first week of March 2020 (before pandemic) and at the very moment the participant was filling in the electronic form (June 2020). Data analyses were conducted through descriptive and inferential techniques, with the use of non-parametric tests and linear regression models. Overall, participants' responses indicate that anxiety levels were higher during the pandemic compared to the period that preceded the pandemic, and that frequent and long physical activity in the leisure-domain reduced anxiety, regardless its intensity. The regression models revealed an inverse relationship between physical activity and anxiety (the more physical activity, the less anxiety) and independent of gender, age, education level, trait anxiety, and physical activity before pandemic.