The Association between Smartphone Addiction, Depression and Anxiety among Medical Students in Jordan

Introduction: Awareness of psychological disorders such as smartphone addiction, anxiety, and depression is a trending research area in the scientific community that has further escalated with the impact of COVID-19. In this regard, young adults and medical students are already considered to be under a high level of stress academically and culturally. This study aimed to investigate the relationship between depression, anxiety, and smartphone addiction among medical students in Jordan. Method(s): A cross-sectional study was conducted using an online structured questionnaire. The survey was completed by 164 male and female medical students stratified by years one to three in the basic medical sciences. The survey consisted of items from the Generalized Anxiety Disorder (GAD-7), Patient Health Questionnaire (PHQ-9), and Smartphone Addiction Scale-Short Version (SAS-SV), in addition to two questions concerning the impact of the COVID-19 pandemic on smartphone addiction. Result(s): Among the students who participated, the mean age was 18.9, with almost half (47.2%) being first-year students. The results showed no significant difference in stress, anxiety or cell phone addiction based on gender or academic year. The logistic regression model was not statistically significant regarding the covariates, except for GAD, which had an OR=1.15 (CI: 1.06 -1.25). Furthermore, SAS-SV was positively correlated with GAD-7 and PHQ-9 scores (r=0.42, r=0.2, p< 0.000, p=0.029, respectively). Conclusion(s): The results of the study showed a statistically significant positive correlation between smartphone addiction, depression, and anxiety. These variables were not statistically different among medical students in terms of gender and academic year.Copyright © 2023 DSR Publishers / The University of Jordan. All Rights Reserved.

Effect of COVID-19-Induced Changes on Job Insecurity, Presenteeism, and Turnover Intention in the Workplace-An Investigation of Generalized Anxiety Disorder among Hotel Employees Using the GAD-7 Scale

In this study, we investigated COVID-19 ' s (coronavirus disease 2019's) effect on job insecurity, presenteeism, and turnover intention in hotel environments by measuring hotel staffs' generalized anxiety disorder (GAD-7) levels. We surveyed 351 hotel employees from the office, facilities, food and beverage, and cooking departments. Convenience sampling was performed from December 2021 to March 2022. Job insecurity was measured with seven items (easily annoyed, tension, anxiety, nervousness, a lot of worry, fear, uncontrollable worry, restlessness, and discomfort) and demonstrated a significantly positive effect on presenteeism and turnover intention in the high GAD-7 group compared with the low GAD-7 group. Our study contributes academic value to research on GAD-7 in the hotel industry. In addition, it provides a theoretical basis for the relationship between job insecurity and hotel employees' psychological response to the pandemic. Based on the findings, we recommend periodically implementing the GAD-7 scale for employee assessments. Consequently, hotel companies can create guidelines for human resource management post-COVID-19.

[The impact of lockdown on mental health in PhD students, a cohort study in a French university]. / Impact du confinement sur la santé mentale des doctorants, une étude de cohorte dans une université française.

INTRODUCTION: Few studies are available on the health status of doctoral students. This position at the border between university studies and a professional activity presents specific risk factors, especially in terms of psychosocial constraints. The lockdowns implemented worldwide to control the COVID-19 pandemic are potentially worsening factors. METHODS: At Lyon 1 University, a systematic medical follow-up of first year PhD students had been set up by the occupational health service in 2019. In the context of the lockdown during the COVID-19 pandemic, a telephonic interview was proposed to the same PhD students in order to assess the impact of the lockdown on working conditions and health and to provide possible assistance. During this interview, a standardized questionnaire was used to collect information about the conditions during the lockdown, doctoral work during this period and the consequences on research progress, as well as possible financial difficulties due to the lockdown. In addition, questions were asked about the perceived general health conditions and consultation with a health practitioner during this period. The Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder (GAD-7) were used to assess depression and anxiety. Questions on lifestyle during lockdown, changes in diet during the period, weight change, and changes in the quantity and quality of their sleep were also asked. Comparisons of perceived health status, the prevalence of anxiety and depression symptoms at baseline and during the follow-up survey were made by MacNemar Chi2 tests, as the data were repeated ones. The students were informed orally and in writing that their data would be entered anonymously into a computer and that they could have access to their data in accordance with the General Data Protection Regulation (GDPR). They were all informed by e-mail about the study results at the end of the study. The data collection process was registered with the National Institute for Health Data (INDS) and with the university's register under reference no. 2020/002 by the university's data protection officer in compliance with the French data protection laws (CNIL). The protocol was approved by the ethics committee of the Lyon University College of General Medicine (notification number: 2020-10-29-02). RESULTS: Of the 161 PhD students initially interviewed, 149 underwent a second interview. In total, 89.2% of the students assessed their health as good or very good. Regarding the answers to the GAD-7 questionnaire, 8.1% had a score equal to or higher than 10, corresponding to moderate to severe anxiety. Regarding the answers to PHQ-9, 19.6% of the PhD students had a score equal to or higher than 9 corresponding to moderate to severe depressive syndromes. The prevalence of an anxiety disorder was significantly associated with the absence of an outside private access in the place of residence during lockdown (75% vs. 37%), an increase in coffee consumption (33% vs. 5%), an increase in the quantity of food consumed (50% vs. 12%), weight gain (50% vs. 19%) and a deterioration in sleep quality (75% vs. 28%). The prevalence of a depressive symptom was significantly associated with lockdown in an urban area (89% vs. 70%), the occurrence of financial difficulties (7% vs. 1%), the consultation of a health professional during the period (34% vs. 15%), smoking cessation (14% vs. 1%), changes in the quantity (31% vs. 9%) and deterioration (59% vs. 25%) of the quality of sleep, and diet changes (66% vs. 43%). GAD-7 scores were unchanged for 90% of participants between the two surveys, but they were higher for 6.8% of doctoral students and lower for 2.7 % (P=0.1). A deterioration of the PHQ-9 scores, i.e. higher scores in the second survey compared to the first, was observed for 15.5% of the PhD students while an improvement of the scores was observed for 1.4% (P=0.0001). DISCUSSION: A number of studies have been published on the impact of lockdown on mental health, but few of them focused specifically on PhD students and even fewer were prospective studies. Their results are therefore difficult to compare with ours; they generally show GAD-7 and PHQ-9 scores that are similar to those of our population, or even higher. The impact of lockdown on the mental health of doctoral students highlighted in our study therefore justifies an appropriate follow-up of this population, particularly in the case of former psychiatric disorders.

Assessment of Mental Health in Medical and Dental College Students in Jazan Province to See the Delayed Psychological Impact of COVID-19 Pandemic: An Online Survey

Aim: The present study aimed to assess the depression and anxiety among medical and dental students of Jazan University, Jazan, Saudi Arabia, during the COVID-19 pandemic using the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder (GAD-7). Materials and methods: An online descriptive cross-sectional survey was conducted among 117 students of Jazan University. Depression and anxiety among the students were assessed using the PHQ-9 and GAD-7. Descriptive statistics were calculated. Association between independent variables and questionnaire scores was calculated using the Chi-square test. Statistical significance was considered at a p-value less than 0.05. Results: Eighty-one students (69.2%) and 72 (61.5%) who participated in the survey were suffering from depression and anxiety, respectively. The medical students had significantly more severe anxiety (p = 0.028) than dental students. No significant association of gender with the presence of depression and anxiety was observed (p > 0.05). Conclusion: Two-thirds of the participants were suffering from some form of depression or anxiety. Medical students reported higher levels of anxiety than dental students. No association was found between depression and anxiety with gender. Clinical significance: COVID-19 had an impact on the mental health of the students and proper counseling from time to time should be provided. © The Author(s). 2023.

The psychological impact of the COVID-19 pandemic in remote learning in higher education

Stressful events can cause a significant impact on education;however, it is not yet clear how the interplay between anxiety, work, and social dysfunction relates to learning impairments. In this study, we investigated the impact of the COVID-19 pandemic on students' learning and mental health. This study was conducted during four modules of a remote Psychopharmacology course between 5 October and 20 December 2020. We collected data from 28 Psychology undergraduate students at the University of Sao Paulo, Brazil. We used pre- and post-test multiple-choice questions to obtain a quantitative measure of learning. Students completed an online survey to report demographic information, functional impairment (Work and Social Adjustment scale;WSAS), generalized anxiety (Generalized Anxiety Disorder scale;GAD-7), coronavirus anxiety (Brazilian adapted version of the Coronavirus Anxiety Scale;CAS-BR), and self-perception with the remote lectures' methodology. In our sample, 42.9% of respondents experienced symptoms of generalized anxiety disorders (GAD-7 >= 15), and 53.6% had moderate to severe functional impairment (WSAS > 20). We also observed an overlapping profile of highly anxious and dysfunctional students. A chi-square test of independence revealed a relation between pairs of multiple-choice questions answers and GAD-7 scores, indicating that less anxious students were more likely to perform better in pairs of pre- and post-tests. Intriguingly, the correlational analysis suggested that students with moderate to severe functional impairment (WSAS scores > 20) were less likely to change from an incorrect to a correct answer to pairs of pre- and post-tests. This data suggests that psychological distress and anxiety states might influence students' ability to coordinate social and work activities and performance during remote learning. Although this study evaluated a small sample of students, our data highlights the importance of investigating anxiety and functional impairment measures as part of the remote-learning curriculum. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Validation of Generalized Anxiety Disorder 6 (GAD-6)-A Modified Structure of Screening for Anxiety in the Adolescent French Population.

Anxiety disorders remain underdiagnosed and undertreated, especially in child and adolescent populations. This study aimed to examine the construct validity of the Generalized Anxiety Disorder Scale 7 (GAD-7) in a sample of French adolescents by combining the Classical Test Theory (CTT) and the Item Response Theory (IRT) and to assess the invariance of items. A total of 284 adolescents enrolled in school in the Lorraine region were randomly selected to participate in a cross-sectional study. A psychometric evaluation was performed using a combination of CTT and IRT analyses. The study of psychometric properties of GAD-7 revealed poor adequation to the sample population, and engendered the deletion of one item (#7) and the merger of two response modalities (#2 and #3). These modifications generated the new GAD-6 scale, which had a good internal consistency reliability (Cronbach α = 0.85; PSI = 0.83), acceptable goodness-of-fit indices (χ2 = 28.89, df = 9, P = 0.001; RMSEA (90% CI) = 0.088 [0.054; 0.125]; SRMR = 0.063; CFI = 0.857), and an acceptable convergent validity (r = -0.62). Only one item (#5) had a consistent Differential Item Functioning (DIF) by gender. This study evaluated the structure of the GAD-7 scale, which was essentially intended at discriminating adolescent patients with high levels of anxiety, and adapted it to a population of adolescents from the general population. The GAD-6 scale presents better psychometric properties in this general population than the original GAD-7 version.

The Effect of COVID-19 Pandemic on Anxiety Disorders among Workers in a Hospital in Balikpapan, East Kalimantan

Introduction. During the global COVID-19 pandemic, health workers were found to have a higher prevalence of anxiety disorder compared to non-health workers. Anxiety disorder that occurs chronically have a 25% chance to become a major depression disorder. Objective. The aim of this study is to understand the anxiety condition and related risk factors among workers in a Balikpapan hospital during the COVID-19 pandemic. Method. The design of this research used a cross sectional method that involved 279 respondents who are workers in a Balikpapan hospital. The study used SPSS version 20.0, using the chi square and Fisher's Exact test for the bivariate analysis, and the logistic regression with enter method for the multivariate analysis. Results. The study shows that using the General Anxiety Disorder 7 (GAD-7) questionnaire from 279 hospital workers, there were 10.8% with mild-, 1.45% with moderate-, and 0.4% with severe anxiety disorder. A significant relation was found between anxiety disorder and risk factors such as being a health worker with p=0.001 and a 4.8 ORadj (95% CI: 1.9-12.3), working in areas with high risk of transmitting COVID-19 with p=0.04 and a 5.1 ORadj (95% CI: 1.0-24.2), and workers who are being quarantined with p=0.001 a 10.5 ORadj (2.6-42.3) after being adjusted by age and gender variables. Conclusion. Significant relations were found between anxiety disorder among hospital workers with risk factors such as being health workers, working in areas with high risk of transmitting COVID-19, and workers who are being quarantined. Researchers strongly advise health providers to do regular monitoring and seek moral support especially for workers who have higher risk of anxiety disorder. © 2022 University of the Philippines Manila. All rights reserved.

Response to the coronavirus disease 2019 pandemic of dental hygienists in South Korea-Part II: Fear and anxiety.

OBJECTIVES: The purpose of this cross-sectional study was to evaluate the mental fear and anxiety about coronavirus disease 2019 (COVID-19) among Korean clinical dental hygienists and to investigate factors influencing the anxiety felt after the outbreak of COVID-19. METHODS: A questionnaire on mental fear (Fear-C) and anxiety for COVID-19 was conducted among 500 clinical dental hygienists in South Korea. Fear-C was identified with eight questions. The General Anxiety Disorder-7 (GAD-7) questionnaire was scored for the pre-COVID-19 situation (GADBefore ) and the current situation going through the pandemic (GADAfter ). The scores for the responses to the questionnaire were 0 points for strong negative and 3 points for strong positive. Higher scores indicate higher levels of fear and anxiety. All data were analysed using IBM SPSS Statistics, and the statistical significance was set at α = 0.05. RESULTS: The average Fear-C was 16.11 ± 3.89 out of 24.00. There were significant differences in Fear-C when the type of work organization and symptoms related to COVID-19 (Sx-C) differed. Significant differences were confirmed in GADBefore according to age range, systemic diseases, and Sx-C (p < 0.05). There was no difference in GADAfter for all general characteristics, except Sx-C (p > 0.05). In the regression model of GADAfter , Sx-C (ß = 0.526), Fear-C (ß = 0.358), and GADBefore (ß = 0.515) were positively related to GADAfter (p < 0.001), respectively. CONCLUSIONS: Most dental hygienists complained of Fear-C. GADAfter was significantly higher than GADBefore . The factor that had the greatest impact on GADAfter was Sx-C.

Analysis of the anxiety level and influencing factors during the coronavirus disease 2019 epidemic among the parents of students in China.

Background: Due to the outbreak of Coronavirus Disease 2019, there has been a significant impact on the mental health of parents. However, no detailed study on the mental health status of parents has been conducted to date. Methods: This study was a cross-sectional used a whole-group random sampling method to conduct an online questionnaire survey with 102,883 parents in Guangdong Province, China, April 25, 2020 and May 14, 2020. Anxiety was assessed by using the Generalized Anxiety Disorder tool (GAD-7). Potential factors of anxiety were estimated using univariate analysis and multivariate logistic regression analysis by SPSS 22.0 statistical software. Results: Among the total 94,705 parents who have completed the questionnaire survey (92.05% response rate). The incidence of anxiety was 23.77%. Parents' anxiety symptoms are more likely to be caused by female family roles, higher levels of education, unemployed or jobless employment status, children not being an only child, and children having negative attitudes toward online courses. Conclusions: Our research shows that most parents experienced mild anxiety during the Coronavirus Disease 2019 epidemic. Our findings provide strong evidence for investigating and focusing on the mental health of this population during the COVID-19 epidemic. Therefore, governments and healthcare departments at all levels should actively provide psychological counseling services to relieve their anxiety symptoms.

Anxiety Among Correctional/Detention Health Professionals and Associated Risk Factors During the Coronavirus Disease 2019 Pandemic.

Correctional health professionals are vulnerable to the negative mental health outcomes associated with the coronavirus disease 2019 (COVID-19) pandemic. A cross-sectional survey was conducted to assess anxiety symptoms in health professionals who work in correctional/detention facilities and identify associated risk factors. Data were collected from 192 health professionals from March 23 to June 30, 2021. The prevalence and degree of anxiety symptoms were assessed by the Generalized Anxiety Disorder (GAD) scale. Chi square, Mann-Whitney U, and Pearson's correlation were used to assess the associations among anxiety scores and demographic data, COVID-19 exposures, medical and psychological history, and isolation practices. Of the sample, 27.1% had at least moderate levels of anxiety (GAD-7 score >10), which is highly suggestive of a diagnosis for GAD. Main factors associated with higher levels of anxiety included female gender, younger age, type of facility, less access to personal protective equipment, and a history of chronic medical problems. The psychological burden of COVID-19 on correctional/detention health professionals is significant, and behavioral health interventions should be considered for this unique population.

Perceived Risk of COVID-19 and Anxiety in Syrian Refugees in Turkey.

Pandemics are amongst the most destructive disasters to have afflicted humankind through history. These disasters entail a disproportionate effect on refugee populations, who are already in a state of high vulnerability. This study aims to assess the perception of risk of COVID-19 in the refugee populations in Turkey, in addition to evaluating anxiety levels during the pandemic. The participants of this study were refugees enrolled in a local nonprofit organization in Istanbul. They were asked to complete questionnaires which asked about COVID-19 and any self-protection measures. The questionnaire also incorporated the General Anxiety Disorder-7 screening test. In this young, male and mostly unemployed population, knowing someone who experienced COVID-19 was associated with a greater likelihood of compliance with hygiene and physical distancing measures. Anxiety levels were above 29%, and the highest scores were in the age group between 25 and 55 years. We argue that comprehensive public health measures against COVID-19 should include focused interventions for refugee populations that take the extra vulnerability (health, financial, and other) into account.

Anxiety level among students of different college and universities in India during lock down in connection to the COVID-19 pandemic.

OBJECTIVES: COVID-19 incidence became a pandemic immediately after its origin and spread. Apart from death because of coronavirus infection, the pandemic brought unbearable psychological pressure to all. We assessed the psychological pressure on college and university students in India through cluster sampling. METHODS: The students responded (n = 209) to an online questionnaire following the Generalized Anxiety Disorder Scale (GAD-7) and Hamilton Anxiety Rating Scale (HAM-A) with some other basic information. RESULTS: According to GAD-7 scoring, we found the respondent students had severe anxiety (1.44%), moderately severe anxiety (14.35%), moderate anxiety (36.36%) and mild anxiety (47.85%). Following HAM-A scoring, anxiety level among the students could be scaled as severe (0.96%), high (4.31%), moderate (13.40%) and mild anxiety (34.93%) level. Age of the students was a confounding factor (p = 0.049, HAM-A) of experiencing anxiety, students <20 years of age were more anxious. We found female students to be more anxious than the males following the HAM-A scoring tool. Academic delays (R2 = 0.996, p = 0.036) and impact on daily life (R2 = 0.996, p = 0.117) were positively associated with anxiety symptoms, while social support was marginally correlated (R2 = 0.726, p = 0.069) with the anxiety level. CONCLUSIONS: As the study found almost all the students are experiencing anxiety because of the current pandemic situation, continuous observation of psychological health for all is recommended as well as establishing psychological intervention during the preparedness phase.

Determining Anxiety Disorder in Health Workers who have received COVID-19 Vaccines: A Cross-Sectional Study at Public Health Centers in Tegal District, Indonesia

BACKGROUND: The COVID-19 pandemic has a major impact on health workers' mental health. Health workers in Indonesia have received COVID-19 vaccines to get protection against COVID-19 infection and reduce anxiety while on duty. AIM: This study aims to determine anxiety disorder in health workers at public health centers who have received COVID-19 vaccines. METHOD(S): A cross-sectional study was conducted at six public health centers in Tegal district, Indonesia. Data were collected using questionnaire that given to health workers who had vaccinated COVID-19. Anxiety disorder was determined with generalized anxiety disorder-7 (GAD-7) questionnaire. RESULT(S): There were 137 samples who participated in this study, consisted of 83.2% of women and 16.8% of men. The majority of the samples were 30-39 years old (41.6%), married (93.4%), and midwife (44.5%). There were 6.6% of samples had mild anxiety and others were normal (93.4%). CONCLUSION(S): COVID-19 vaccination program for health workers can reduce anxiety when providing health services. However, assistance is still needed for health workers who have mild anxiety disorder to prevent prolonged symptoms and more severe mental health condition. Copyright © The Authors.

Status of mental health among college and university students during first and second wave of COVID-19 outbreak in India: A cross-sectional study.

Background: India has been badly affected by Covid-19 not only in terms of human lives but also has a long-term effect on mental health of the population. This paper is an attempt to understand the psychological effects of the pandemic on the college and university students in India after the second wave of COVID-19 outbreak and its associated factors. Method: A web-based survey was conducted to collect information from the students both at individual and household level. The study applied binary and multivariate logistic regression to estimate the adjusted and unadjusted marginal effects of the predictor variables. Result: Results show a significant increase in mental health concerns during the second wave of the pandemic, as compared to the first year. The key factors contributing to the higher prevalence of depression, anxiety, and stress are the difficulties faced in the adaptation to the new way of learning, fear of discontinuation of education due to financial constraints faced by household, limited physical interaction, and prolonged screen-time during the pandemic. Limitation: The study has some limitations regarding selection of the sample as the survey was web-based. Also, the mental health situation of the students is self-reported and the study does not consider the prevailing mental health issues before the pandemic. Conclusion: The study recommends initiatives like offering counselling classes and strategies to cope up with mental health disorders. Further, there is a need to conduct follow-up studies to assess the long-term impacts of prolonged home quarantine on the mental health of the students.

Impact of COVID-19 on the mental health of medical students: a meta-analysis

The aim of this work was to estimate the overall proportion of anxiety in medical students during the COVID-19 pandemic. A systematic search of articles published up to January 6, 2021 in Medline reporting prevalence of anxiety (according to GAD-7) in medical students during the COVID-19 pandemic was performed. Ten studies were included in the meta-analysis, yielding an estimated overall prevalence of anxiety in medical students of 42. This finding suggests the need to assess anxious symptomatology among medical students during the COVID-19 pandemic and establish appropriate psychological support programs. © GKA Ediciones, authors. Creative Commons Reconocimiento-NoComercial-SinObraDerivada.

Generalized anxiety disorder in Berlin school children after the third COVID-19 wave in Germany: a cohort study between June and September 2021.

BACKGROUND: During the COVID-19 pandemic, children and adolescents worldwide have disproportionally been affected in their psychological health and wellbeing. We conducted a cohort study among German school children, aiming at assessing levels of general anxiety disorder (GAD) and identifying associated factors in the second pandemic year. METHODS: A cohort of 660 students from 24 Berlin schools was recruited to fill in questionnaires including the GAD-7 tool on anxiety symptoms at three time points between June and September 2021. To adjust for non-random attrition, we applied inverse probability weighting. We describe reported GAD levels stratified by time point, sex, and school type and report odds ratios from univariate logistic regression. RESULTS: In total, 551 participants (83%) filled in at least one questionnaire at any time point. At the first time point in June 2021, 25% of the children and adolescents reported anxiety symptoms with a GAD-7 score ≥ 5, decreasing to 16% in August 2021 directly after the summer holidays and rising again to 26% in September 2021. The majority of reported anxiety levels belonged to the least severe category. Being female, attending secondary school, coming from a household with lower education or with lower income level, and being vaccinated against COVID-19 were significantly linked with reporting anxiety symptoms. Preceding COVID-19 infection and anxiety were negatively associated. CONCLUSION: Overall, anxiety in school children was lower in mid-2021 than in the first pandemic year, but still double compared to pre-pandemic data. Reporting of anxiety symptoms during the second pandemic year was especially high in females and in secondary school students. Policy makers should pay additional attention to the mental health status of school children, even as the pandemic situation might stabilize.

Socio-economic factors associated with mental health outcomes during the COVID-19 pandemic in South Korea.

Background: Individuals are at an increased risk of adverse mental health outcomes during the COVID-19 pandemic. To reduce the impact on mental health outcomes that were induced by national-level policies, which may influence an individual at the community level, exploring the comprehensive relations between individual and environmental factors are needed. The aim is to examine socio-ecological factors associated with mental health outcomes, including depressive and anxiety symptoms, with the perspective of support to provide interventions that help the community during future disease outbreaks. Method: From 5 November to 20 November 2020, a cross-sectional and population-based study was conducted to assess the socio-ecological factors of mental health outcomes during the COVID-19 pandemic. A total of 1,000 participants, aged 20-69 years, in Chungnam Region, South Korea, were included in this study. Multiple linear regression models were used to examine the association between socio-ecological factors and mental health outcomes. The primary outcomes were individuals' mental health outcomes which are measured by PHQ-9 and GAD-7 scores. Results: Of the 1,000 participants, the average PHQ-9 was 4.39, and GAD-7 was 3.21 during the COVID-19 pandemic. Specifically, the participants with moderate or severe levels of PHQ-9 and GAD-7 were 12.6 and 6.8%, respectively. Higher levels of depressive and anxiety symptoms were associated with participants who were single, reported a lower household income, had decreased support from friends or family, and increased stress from the workplace or home. In subgroup analyses by age, gender, and household income, a similar trend was reported in individual and interpersonal-level factors. There were significant associations between regional-level factors, including gross regional domestic product (GRDP), mental health institutions, psychiatrists, nurse-to-population ratios, and individuals' mental health outcomes. Conclusion: The management of depressive and anxiety symptoms of individuals during the pandemic was better explained by individual and interpersonal characteristics rather than regional-level factors, highlighting the need for more policies aimed at these lower levels.

COVID-19 lockdown and its impact on mental health in various population groups in Greece: A crosssectional study

Introduction: COVID-19 pandemic and lockdown has brought a serious impact on physical and mental health. Objective(s): The purpose of the present study was to estimate the impact of the first lockdown in Greece, on both quality of life and anxiety levels in different occupational groups. Method(s): A cross-sectional on- line survey was conducted from 20th of April to 4th of May 2020. A 24-item anonymous questionnaire was administered to collect basic demographic and socioeconomic data. The 5-item WHO Well-Being Index (WHO-5, 0-100%, cut-off 52%) and the Generalized Anxiety Disorder Assessment (GAD-7) tools were used to assess well-being and anxiety, respectively. Statistical analysis was performed with SPSS for Windows v.24.0 Statistical Package. Result(s): A total of 575 participated in the study, 62.8% females, 48.5% aged between 40 to 59 years. 32.5% were employed in education sector, 32.5% in health sector and 20.3% as season workers in tourism sector. Males showed slightly higher levels of wellbeing (52.1 vs. 47.3, p=0.023) and lower levels of anxiety (7.1 vs. 8.2, p=0.023) compared to females. Factors associated with higher wellbeing and lower anxiety were higher education and income level, optimism, taking less protection measures, and being seasonal worker. Furthermore, participants with comorbidities and symptoms like headache, musculoskeletal pain, as well as feeling depressed or stressed revealed lower wellbeing and higher anxiety scores. Conclusion(s): Our study revealed an overall poor wellbeing and mild to moderate levels of anxiety during the lockdown. Actions should be taken to address and to prevent its serious impact on mental health.

The Lingering Effects: Examining Mental Health in India during a Period of Covid-19 Regression

PURPOSE: COVID-19 has been recognized as a contagious disease which can cause serious health problems, even proving to be fatal in some cases. The swift spread of COVID-19 epidemic shook the world which led to lockdowns, isolation, and social distancing for the general population so as to curb and contain the spread. This was found to lead to mental health disorders amongst people. This study examines the prevalence and severity of anxiety, stress perception, and well-being levels among the people at the time when the COVID-19 was in regression (decline) in India.METHODS: In this cross-sectional study, 374 respondents' mental health was evaluated using three standardized questionnaires: Generalized Anxiety Disorder [GAD-7], Perceived Stress Scale [PSS-4], and Five Wellbeing Index [WHO-5].RESULTS: The study revealed that almost 82% of respondents had moderate to severe levels of stress while 66% of respondents had mild to moderate levels of anxiety. Overall, 60% of respondents had poor (low) mental well-being. A strong negative correlation was found between mental well-being and perceived stress, and mental well-being and level of anxiety, in comparison to the correlation between anxiety and perceived stress was positive and statistically significant.CONCLUSIONS: This study identified several long-term psychological effects of COVID. The presence of stress and anxiety and poorer mental well-being even at the time of decline in COVID-19 cases, highlights the need for serious attention to be given to psychological and psychiatric help and support throughout the duration and regression of such diseases. Health policymakers must ensure coherent and consistent plans for screening the mental health of the general population are in place to provide the required support in managing the long-term psychological and psychiatric effects of COVID.

The Impact of COVID-19 on Maternal Mental Health during Pregnancy: A Comparison between Canada and China within the CONCEPTION Cohort.

The effect of the COVID-19 pandemic on maternal mental health has been described in Canada and China but no study has compared the two countries using the same standardized and validated instruments. In this study, we aimed to evaluate and compare the impact of COVID-19 public health policies on maternal mental health between Canada and China, as we hypothesize that geographical factors and different COVID-19 policies are likely to influence maternal mental health. Pregnant persons >18 years old were recruited in Canada and China using a web-based strategy. All participants recruited between 26 June 2020 and 16 February 2021 were analyzed. Self-reported data included sociodemographic variables, COVID-19 experience and maternal mental health assessments (Edinburgh Perinatal Depression Scale (EPDS), Generalized Anxiety Disorders (GAD-7) scale, stress and satisfaction with life). Analyses were stratified by recruitment cohort, namely: Canada 1 (26 June 2020-10 October 2020), Canada 2 and China (11 October 2020-16 February 2021). Overall, 2423 participants were recruited, with 1804 participants within Canada 1, 135 within Canada 2 and 484 in China. The mean EDPS scores were 8.1 (SD, 5.1) in Canada 1, 8.1 (SD, 5.2) in Canada 2 and 7.7 (SD, 4.9) in China (p-value Canada 2/China: p = 0.005). The mean GAD-7 scores were 2.6 (SD, 2.9) in China, 4.3 (SD, 3.8) in Canada 1 (p < 0.001) and 5.8 (SD, 5.2) in Canada 2 (p < 0.001). When adjusting for stress and anxiety, being part of the Chinese cohort significantly increased the chances of having maternal depression by over threefold (adjusted OR 3.20, 95%CI 1.77-5.78). Canadian and Chinese participants reported depressive scores nearly double those of other crises and non-pandemic periods. Lockdowns and reopening periods have an important impact on levels of depression and anxiety among pregnant persons.