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Background: The outbreak of the COVID-19 pandemic, the constant transformation of the SARS-COV-2 virus form, exposure to substantial psychosocial stress, environmental change, and isolation have led to the inference that the overall population's mental health could be affected, resulting in an increase in cases of psychosis. Objective(s): We initiated a systematic review to determine the impact of the SARS-COV-2 virus and its long-term effects-in both symptomatic and asymptomatic cases-on people with or without psychosis. We envisioned that this would give us an insight into effective clinical intervention methods for patients with psychosis during and after the pandemic. Method(s): We selected fifteen papers that met our inclusion criteria, i.e., those that considered participants with or without psychiatric illness and exposed to SARS-COV-2 infection, for this review and were retrieved via Google, Google Scholar, MEDLINE, PubMed, and PsychINFO Database. Key Gap: There is a dearth of research in understanding how COVID-19 affects people with or without a prior personal history of psychosis. Result(s): The systematic review summary provides insight into the state of knowledge. Insights from the systematic review have also been reviewed from the salutogenesis model's perspec-tive. There is moderate evidence of new-onset psychosis during the COVID-19 pandemic in which some antipsychotics treated the psychotic symptoms of patients while treating for COVID-19. Suggestions and recommendations are made for preventive and promotive public health strategies. Conclusion(s): The Salutogenesis model and Positive Psychology Interventions (PPI) provide another preventive and promotive public health management approach.Copyright © 2023 Bentham Science Publishers.
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Objectives: To assess the psychological factors in undergraduate dental students towards e-learning in clinical skills education compared to traditional teaching methods and their relationship with performance during the COVID-19 pandemic. Method(s): In this study, survey conductedamong 494undergraduate dentalstudents of all four sessions from different dental universities within the Pakistan. Total 494 undergraduate dental students responded to a 28-question online survey to identify e- learning is more convenient and practicalthan traditional learning and to measure it 5- pointLikertScaleused. To measure level of psychological impact, Hamilton Anxiety Scale used due to e-learning among undergraduate dental students. Result(s): The majority of undergraduate dental student's responded e-learning is not convenient and practical than traditional learning system. The majority of undergraduate dentalstudents reportedveryseverelevelof psychologicalimpactdueto e-learning and closing of institutions during COVID-19 pandemic. Results are statistically significant and analyzed on IBM SPSS version 23. There are 82% students responded having problem with e-learning system and among them 58 % have very severe anxiety and 24% have severe anxiety. So the results shows increased percentage of anxiety due e-learning. Conclusion(s): Dental students expressed a higher level of comfort and effective learning in a recognizable, conventional classroom circumstance. Teaching with traditional system improvesstudent'scriticalthinkingskillsandformulatesopinionsorargumentsbyengaging in live discussions. This study reveals that students face challenges in using the e-learning resources because of incompetency in the IT skills, lack of motivation and access to proper internet. The most important issue identified by this study is maintaining an effective interaction with dental students in e-learning system of teaching to fill the gap between the teacher and students. There should be further flexibility workload and learning time to students to reduce the level of anxiety among the dental students.Copyright © 2020 Ubiquity Press. All rights reserved.
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Objective: To assess anxiety among dentists practicing in Cameroon during the coronavirus disease 2019 (COVID-19) pandemic. We conducted a cross-sectional web-based survey, and used the Hamilton Anxiety Rating Scale (HAM-A) to appraise anxiety symptoms and severity. Result(s): Overall, 82 questionnaires were fully completed and retained for analysis. The mean age (standard deviation) of participants was 30.2 (2.6) with 52 (62.2%) being male. The mean (standard deviation) HAM-A score was 10.5 (4.6), with minimum and maximum values of 4 and 26/56. We found that 13 (15.8%) had moderate to severe anxiety (with 11 having moderate symptoms and 2 having severe), and 69 (84.2%) had no, minimal or mild anxiety. Participants working in health facilities with more than one dentist, where less likely to have moderate/severe anxiety (OR: 0.22, 95% CI: 0.05;0.78).Copyright © 2021 The Author(s)
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Background: The COVID-19 pandemic caused by the novel Corona virus has impacted more than 200 countries.COVID-19 patients are frequently isolated and quarantined due to high infectivity thus adding to further mental stress in addition to physical symptoms, uncertainty, anger, stress and insecurity. It has given rise to various psychological problems such as anxiety, depression, fear of isolation, fear of dying, feeling of helplessness, insomnia and many more. The aim of this study is to investigate stress, anxiety, and depression in COVID-19 positive patients during the Corona pandemic in West Bengal. Aim(s): To study the prevalence of psychiatric comorbidities lie stress, anxiety, depression in moderate and severely affected COVID 19 patients admitted in a tertiary care hospital in West Bengal. Settings and Design: This cross sectional study was conducted at post COVID follow up clinic on 100 COVID-19 infected patients who were admitted in COVID ward of College of Medicine and Sagore Dutta Hospital, West Bengal. Subjects and Methods: those EWS score more than equals to 5 and gave consent were selected as subjects and data was collected on socio demographic parameters and SRQ 24 was applied followed by assessment was done using the HAM-D for depression, HAM-A for anxiety, and PSS for stress in post COVID-19 patients at post COVID follow up clinic in the hospital. Statistical Analysis Used: SPSS 27.0 version for Microsoft Windows. Result(s): 78% patients were suffering from moderate (N=78) and 22% from severe (N=22) COVID 19 infection. 57.0 % patients (N=57) were women and 43.0% (N=43) were men. The mean age of the patients was more in severe (50.6+/-12.8) compared to moderate (42.6+/-12.5) COVID-19 infection .Mean depression was more in severe (14.0+/-3.8) compared to moderate (5.57+/-2) (p<0.0001). Mean Anxiety was more in severe (16.72+/-11.6) compared to moderate (8.0+/-10.6.) (p=0.0014). Mean Stress was more in severe (20.18+/-3.36) compared moderate infection (19.0+/-3.2) (p=0.1397). Conclusion(s): out of 100 COVID-19 patients majority were women and suffered from moderate COVID infection. Higher the age more the infection was found. Depression, Anxiety, Stress were more associated with the severe infection, low educated, lower socioeconomic status. Severe infection was commonly found among female, less educated, higher age, from rural area, lower economic status.
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BACKGROUND: About 10% of pregnant women worldwide experience emotional changes. Several alterations during the pandemic might induce anxiety, including in pregnant women. AIM: This study aimed to analyze factors associated with anxiety levels in pregnant women during the COVID-19 pandemic in Semarang, Indonesia. METHOD(S): This study was an observational study with a cross-sectional design. This study incorporates a cluster sampling technique involving 238 pregnant women as the study subjects. Moreover, the study variables include the mother's characteristics, hemoglobin level, nutrition and COVID-19-related knowledge, and anxiety. Anxiety levels were measured using the Hamilton Rating Scale for Anxiety questionnaire. The bivariate analysis was performed using Chi-square and independent t-test followed by multiple logistic regression for multivariate analysis. RESULT(S): This study showed that 20.2% (n = 48) of subjects had moderate-to-severe anxiety levels. The results of the multivariate analysis showed that subjects with low COVID-19 knowledge had higher odds of anxiety levels (OR 2.407;95% CI: 1.202-4.820;p = 0.042), and subjects with gravida in the 1st time or >=4th times had higher odds of anxiety levels (OR 2.366;95% CI 1.199-4.670;p = 0.013). CONCLUSION(S): Pregnant women with low COVID-19 knowledge and gravida for the 1st time or >=4th time are found to be associated with anxiety during the COVID-19 pandemic in Semarang, Indonesia. Copyright © 2022 Ani Margawati, Ahmad Syauqy, Aras Utami, Annisa Hananingtyas, Charysa Zaimatussoleha.
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Objective: To determine the prevalence of anxiety and depression among the COVID-19 infected patients. Study design: Descriptive cross-sectional study. Place and Duration of Study: Rawalpindi Medical University and Allied Hospitals Covid designated wards from 1stApril 2019 and 30thJune 2020 Methodology: Hundred patients of either gender presented with Covid-19 infection were enrolled. Detailed demographics and complete medical examination was done after taking informed written consent. Those patients who fulfil the clinical criteria Hamilton rating scale for anxiety (HAMA) and Hamilton rating scale for depression (HRSD) were applied to assess the severity of anxiety and/or depression. Result(s): There were 69 (69%) males and 31 (31%) females. Eighty two (82%) patients fall in the age range of 21 to 50 years with the mean of 38 years. There is high level of anxiety as well as depression among admitted patients suffering from COVID-19. Seventy five (75%) patients suffered from depression and 72 (72%) of patients suffered from anxiety ranging from mild to severe. Conclusion(s): It is concluded that patients suffering from Covid-19 disease had high prevalence of depression and anxiety. Copyright © 2022 Lahore Medical And Dental College. All rights reserved.
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Introduction: Myriad of complications were observed in post Coronavirus Disease (COVID-19) survivors, psychiatric morbidities among one of them. Recent body of research has shown that significant number of patients developed psychological symptoms following COVID-19. Most of the Indian studies have assessed psychological morbidity among COVID-19 patients during admission. However, very few Indian studies have assessed the psychological impact of COVID-19 during the follow-up period, especially in rural India. Aim(s): The study aimed to determine the prevalence of depression and anxiety and evaluate related socio-demographic (age, gender, education, occupation and marital status) and clinical factors (severity of COVID-19, presence of medical co-morbidity, Oxygen requirement, Intensive Care Unit (ICU) referral, duration of admission) in patients post-COVID-19. Material(s) and Method(s): This was a cross-sectional study conducted at Hind Institute of Medical Sciences, Sitapur, Uttar Pradesh, India. among 96 patients post-COVID -19 after their discharge from the hospital. Data collection was done between July 2021 to September 2021, using a semi-structured proforma and a psychiatric diagnosis was made (based on International Classification of Diseases- 10th Edition Diagnostic Criteria for Research criteria and clinically approved by two qualified psychiatrists). Rating scales such as Hamilton Anxiety Rating Scale (HAM-A) and Hamilton Depression Rating Scale (HAM-D) were used for severity assessment. Data was analysed using Microsoft Statistical Package for Social Sciences (SPSS) version 20.0. A p-value of <0.05 was considered significant. Result(s): In 96 patients, 70 (72.91%) were males. 38 patients (39.58%) were of the age group 45-60 years. 36 (37.50%) patients had Depression. Anxiety was seen in 40 (41.66%) participants. Among the clinical variables, the severity of the COVID-19 infection (p-value<0.01), presence of co-morbidity (p-value<0.01), and ICU referral (p-value<0.01), were found to be associated significantly with the presence of depression in the participants. Among 36 depressive patients, mild depression was present in 17 (47%), moderate depression in 12 (33%), severe depression in 5 (14%) and very severe in 2 (6%) of the participants. Anxiety was associated significantly with the gender (p-value=0.02), co-morbidity (p-value<0.01), severity of illness (p-value<0.01), oxygen requirement (p-value=0.04) and ICU admission (p-value<0.01). Mild anxiety was observed in 18 (45%), moderate anxiety in 16 (40%) and severe anxiety in 6 (15%). Conclusion(s): The prevalence of depression and anxiety is high in patients post COVID-19. The severity of these disorders is significantly associated with presence of medical co-morbidity and severity of COVID-19. Hence, thorough evaluation and management of these disorders in post-COVID-19 patients can help in improving the overall outcome. Copyright © 2023 Journal of Clinical and Diagnostic Research. All rights reserved.
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Objective: To evaluate the impact of coronavirus disease-2019 (COVID-19) lockdown on the sexual lives of couples who live in Turkiye. Material(s) and Method(s): One hundred ninety-three sexually active participants. While sexual functions were evaluated with the international erectile function index-15 in men and the female sexual function index in women, Hamilton anxiety scale (HAM) was used to measure anxiety level. Married people filled out the Marriage adjustment test (MAT) questionnaire. The effects of the quarantine period on the relationship were evaluated with a questionnaire created specifically for this study. Result(s): Sexual improvement and worsening were observed in 8.8%, and 15%, respectively. It did not change for 76.2%. Sexually deteriorated subjects had a higher HAM score (p=0.003). The MAT score was lower in sexually deteriorated subjects (p=0.004). The rate of sexual worsening was higher in women than in men (28.6% vs. 12%, p=0.02). Women's HAM scores were higher (p=0.002). The MAT score was also found to be higher in women (p=0.0037). 58% of sexually deteriorated participants did not feel safe at home during the COVID-19 period, whereas all of those sexually improved participants felt safe at home. Conclusion(s): During the COVID-19 lockdown period, sexual deterioration was detected in 15% of sexually active people. This worsening was associated with the HAM score. Additionally, it was revealed that feeling safe at home is related to sexual life. While the relationship between sexually worsening and the MAT score was significant in men, it was revealed that the level of anxiety in women affected sexual life more significantly. © Copyright 2022 by the Association of Urological Surgery / Journal of Urological Surgery published by Galenos Publishing House.
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Objectives: Since 2016, the NYC Health + Hospitals Family Justice Center Mental Health Program (FJCMHP) has provided on-site psychiatric and therapeutic mental health services to intimate partner violence (IPV) survivors in each of the 5 Family Justice Centers in NYC. This is a novel program that meets families where they feel the safest. This study reports on the evaluation of the program. Method(s): A mixed-methods qualitative-quantitative assessment of the program that ascertained client usage, symptomatic, and relational change upon receipt of mental health services was conducted in July 2019 via: 1) an 18-item anonymous paper survey;and 2) 3 focus groups. From January 2020 to July 2021, 11 parents were interviewed for an individual summary of their experiences of pregnancy, childbirth, and parenting. Result(s): Of the 53 IPV survivors who completed the anonymous questionnaires, 47.2% identified as Hispanic or Latino, 47.2% were between the ages of 31 and 40 years, and 62.3% had never received mental health treatment prior to engaging in the collaboration. A total of 71% of the clients reported improved sleep, and 87% reported improved mood. Of those who reported suicidal ideation, 84% reported a decrease in self-harm thoughts, and 77% reported enhanced social support. Of those with children, 92.3% reported improvement in their relationships with their children. Of the 11 interviewees in the smaller subset, nearly 60% were parents of children 0 to 18 years old with 30% having children under 5 years of age with a mean adverse childhood experiences (ACEs) score of 9.2 (SD = 3.89). The Hamilton Depression Rating Scale (HAM-D) and Hamilton Anxiety Rating Scale (HAM-A) scores were classified as moderate depression (M = 21.52;SD = 22.52) and moderate anxiety (M = 21.37;SD = 19.94). There was no statistical difference between the HAM-D or HAM-A scores comparing those in the FJCMHP and those not in the program (p =.56 for HAM-D;p =.49 for HAM-A). All (100%) of them reported satisfaction with the FJCMHP with qualitative themes of postpartum depression and new outlook on parenting. Conclusion(s): A collaborative mental health program in a nonmedical setting is attainable and leads to subjective symptom and relational improvements. Limitations of this evaluation include the difficulty of recruiting child interviewees into the study, and the effect of COVID-19 that limited long-term follow-up data. Future directions apply to what specific interventions lead to reductions in mental health outcomes. CC, SP, TRA Copyright © 2022
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Purpose: The coronavirus disease 2019 (COVID-19) is the largest pandemic of our times. Pandemics are severe stressors to vulnerable groups (such as patients with chronic diseases) and this highly contagious disease exerts considerable impacts on mental health. We wanted to investigate the possible impact of COVID-19 pandemic on the quality of life (QoL) of myasthenia gravis (MG) patients and potential changes during the period of one year. Methods: Data on the epidemiological and clinical characteristics of MG was collected. We used a selfdesigned questionnaire (consisting of 12 questions), a revised 15-item Myasthenia Gravis Quality of Life Questionnaire (MGQOL15r), a 36-item health survey of the Medical Outcomes Study Short Form (SF36), Hamilton scales for the assessment of anxiety (HAM-A) and depression (HAMD) were used. The actual severity of the clinical manifestation was estimated using MG activities of daily life (MGADL). We reassessed patients in April and May 2021, who were tested during April 2020 using the same questionnaires. Results: The study included 57 adult MG patients. We noticed a statistically significant difference between the results obtained at these two time points regarding scores on MGQOL15r (p<0.05). The obtained scores were significantly better in 2021. Some scores on SF-36 subscales were also better in 2021 than in 2020 (such as social functioning, emotional well-being, role limitation due to emotional problems) (p<0.05). MGQOL15r and SF36 scores correlate with severe clinical manifestation, high scores on HAM-A and HAM-D (p<0.01). Higher scores on HAM-D and fear that MG symptoms will be worse if the patient gets an upper respiratory infection were independent predictors of the lower SF36 scores. Regarding MGQOL15r independent predictors of the higher score were higher scores on HAM-D. Conclusions: QoL of myasthenia gravis patients improved during the pandemic. It is important for healthcare workers to provide professional therapeutic advice and psychosocial support for this population of patients during the pandemic. eP01.04.07 COVID Spike Antibodies in Neuromuscular Conditions: A KU Experience Pasnoor M1, Tajuddin A1, Jawdat O1, Farmakidis C1, Jabari D1, Heim A1, Higgs K1, Dimachkie M1 1The University of Kansas Medical Center, Kansas City, United States Background: Little is known about the immune response to COVID vaccination in immune suppressed neuromusuclar patients. Multiple studies showed variable data regarding the effect of immunosuppression on the immune response to the vaccination. Objective: To evaluate the COVID spike antibody levels in patients with various neuromuscular conditions who received vaccination and assess the effect of immunosuppressive therapies on antibody levels. Method: We performed a retrospective chart review of patients in neuromuscular clinic who had COVID antibody testing. We collected demographic, clinical, diagnostic and treatment information. Descriptive statistics was performed on the data obtained. Results: The total number of patients enrolled in the study were129, 64 male and 65 female . The mean age of the patients enrolled was 64.82 ±14.50 and the mean duration of antibody acquisition since date of last vaccination dose was 172 days. The number of patients on immunosuppressive therapies was 88(68.2%), 47(53.41%) had high antibody titer (>250), 31(35.23%) had low antibody titer (0.4- 250), 9(10.23%) had undetected antibody titer (<0.4) and 1 (1.1%) had detected unmeasured titer. Immunosuppressive therapies included steroids, methotrexate, azathioprine, myophenolate mofetil, eculizumab, efgartigimod, intravenous immunoglobulin and rituximab. The other group of patients who were not on immunosuppressive medication were 41 (31.8%) , 28 (68.29%) showed high antibody titer (>250), 9(21.95%) showed low antibody titer (0.4-250) , 1(2.44%) showed undetected titer (>0.4) and 3(7.32%) had detected unmeasured titer. 50% of patient who were on rituximab showed undetected antibody titer and 60% of patients who received eculizumab had low antibody titer. 4 % of patients on immunosuppressive drugs did not develop adequate spike antibodies levels to vaccination, compared to 24% on no immunosuppressive therapies. Conclusions: Our study reveals modest impact of immunosuppression on COVID spike antibody titer. While this finding is limited by small number of patients and heterogeneity in therapies, age and interval between vaccination and antibody testing, our finding supports the importance of booster vaccine in this patient population.
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Objective: To evaluate the covid-19 pandemic related anxiety in obstetrics patients admitted in tertiary care centre in suspected covid wards by using WSAS and HAM-A scales. Methods: A cross-sectional survey of women accessing maternity services was carried out at the local peak of the pandemic. Background data including relevant demographic details, pregnancy and mental health history, concerns, as well as helpful stress-reducing factors reported by women was collected. Depression and anxiety symptomatology was studied using the WSAS and HAM-A scales. Results: The survey results revealed a high prevalence of anxiety and Depressive symptomatology (34.4 and 39.2% respectively), based on WSAS and HAM-A scales. These rates appeared much higher than the reported pre-pandemic prevalence and were not affected by occupation, previous mental health problems or pregnancy complications. Women’s most commonly reported concerns as well as coping factors. Conclusion: Marked increase in anxiety and depressive symptoms during the COVID-19 pandemic, among pregnant and puerperal individuals, who constitute a vulnerable group with respect to mental health morbidity.
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BACKGROUND: The outbreak of coronavirus disease 2019 (COVID-19) has increased the burden of psychological stress. AIM: This study aims to determine the relationship between the length of isolation, the results of the COVID-19 polymerase chain reaction swab test, the time of reporting, and the level of knowledge with the degree of depression and anxiety in patients with swab results confirmed by SARS-CoV-2. METHODS: This study is an analytical observational study with a cross-sectional design. After the data were collected, a bivariate statistical analysis was carried out for the Kruskal–Wallis and Spearman Test. RESULTS: A total of 25 patients with a diagnosis of COVID-19 were included in this study. CONCLUSION: The study found that the length of isolation, frequency of swab, the time spent focusing on COVID-19, and level of knowledge were not related to the degree of depression and anxiety. However, mental attention and appropriate intervention are an important part of clinical care for those at risk.
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BACKGROUND: Adjustment disorders are now primary diagnoses in the trauma and stressrelated disorders section of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Adjustment disorder with anxiety (AjDA) is the development of emotional or behavioral symptoms considered excessive in response to stressful events, significantly impairing a person's ability to function in social, occupational, and/ or other situations. Traumatic experiences related to the COVID-19 pandemic may have increased rates of adjustment disorders, especially among those whose life routines were disrupted by pandemic-associated stress and anxiety. PH94B (3b-hydroxy-androsta-4,16-dien-ol) has shown rapid-onset efficacy in the treatment of social anxiety disorder (Liebowitz et al. Am J Psychiatry. 2014). PH94B is a neuroactive steroid administered as a nasal spray that engages olfactory chemosensory neurons, activating subsets of olfactory bulb neurons that project directly to the limbic amygdala regulating fear and anxiety circuits. OBJECTIVE: To assess the efficacy, safety, and tolerability of PH94B in adults with AjDA. METHODS: This is an exploratory, phase 2A, randomized, double-blind, 4-week, placebo-controlled, 2-arm study in adults with AjDA. The primary outcome is change from baseline to week 4 in the Hamilton Anxiety Rating Scale (HAM-A) total score after intranasal administration of PH49B 4 times daily vs placebo. Patients with a DSM-5 diagnosis of AjDA confirmed by the Mini-International Neuropsychiatric Interview (MINI) with Adjustment Disorders Module and a clinician-rated HAM-A score of ≥20 at screening (Visit 1), with ≤15% decrease at baseline (Visit 2, randomization) are eligible for inclusion. Secondary outcomes include change from baseline to week 4 in the Adjustment Disorder New Module Scale (ADNM), the International Adjustment Disorder Questionnaire (IADQ), the Clinical Global Impression of Improvement (CGI-I), and the Patient Global Impression of Change (PGI-C). Change from baseline in the Hamilton Depression Rating Scale (HAM-D) was exploratory. RESULTS: A total of 40 patients will be randomized (1:1 drug to placebo). The study design features the use of the ADNM and IADQ, newly developed according to ICD-11 criteria for evaluation of AjDA. While both are validated, neither has been tested in placebo-controlled clinical trials. Both scales begin with a list of stressors (18 for ADNM and 9 for IADQ);a yes answer to any 1 stressor triggers a series of questions about the frequency and duration of a patient's reaction to the stressor (ADNM) or quantifies symptoms in response to the stressor (IADQ). CONCLUSIONS: Anxiety disorders are the most prevalent psychiatric disorders and a leading cause of disability. Anxiety and impaired functioning are increasing, particularly in response to the COVID-19 pandemic, and no pharmacologic treatment is currently approved by the FDA for AjDA. PH94B, an investigational pherine nasal spray, is also being studied for treatment of other anxiety-related disorders.
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Background: Concerns of hydroxychloroquine (HCQ) shortage for patients with rheumatic diseases are growing during the era of COVID-19 pandemic as it was assigned in some treatment protocols. Its nonavailability may impact the disease management especially in patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). Objectives: To evaluate the shortage of HCQ in patients with RA and SLE and its impact on patients anxiety and disease activity. Methods: 219 RA patients (according to 2010 ACR/EULAR criteria) and 200 SLE patients (according to 2012 SLICC criteria) were recruited in the study. Demographic and clinical features of the patients together with the current disease activity parameters (CDAI and SELENA/SLEADI) were prospectively collected. previous disease activity measures were collected from the patients records before hydroxychloroquine shortage. Patient's anxiety was measured using Hamilton anxiety rating scale. Results: A total of 419 patients divided into two groups, Group (1);219 RA patients with mean age 45.6±9.6 years, disease duration 45.5±32.8 months with female predominance (63 %). Group (2): 200 SLE patients with mean age 33.8±7.9 years, disease duration 61.2±39.2 months with female predominance (84%). 168 (76.7%) of the RA patients and 128 (64%) of SLE patients reduced or stopped the dose of HCQ due to unavailability. Despite HCQ shortage, there was no signifcant change in disease activity in RA or SLE patients (P=0.063 and 0.064 respectively). All participants suffered from different levels of anxiety which was positively correlated with HCQ shortage (p= 0.001 and 0.005 for RA and SLE respectively). Conclusion: COVID 19 pandemic caused hydroxychloroquine shortage in the majority of patients with RA and SLE with no signifcant impact on their disease activity. Anxiety was found correlating to HCQ shortage in both diseases more signifcantly in SLE patients.
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The COVID-19 outbreak has caused an impervious financial and psychological burden. Health care professionals, including oral health care workers, have been risking fighting the pandemic. The chief objective of the current study was to estimate the rates of prevalence of depression, stress, and anxiety among the oral health care professionals in Jammu and Udaipur city. The study was delineated as an online cross-sectional questionnaire-based research. It was mailed to different practitioners between May and July 2020, particularly those offered their services in COVID centers. The participants were to fill the self report questionnaires. Then, the parameters were measured using depression, anxiety, and stress scale 21(DASS 21) and Hamilton anxiety rating scale (HARS) to measure the degrees of depression, stress, and fear among the volunteers. The target population was divided into age groups between 23 to 28 years and over 28 years. Four hundred ninety responses were received and were considered for the study. The acquired data were analysed using IBM SPSSsoftware (windows version 23). The mean and standard deviations were calculated for stress, anxiety, depression using mentioned scale. The results were compared based on gender and age group. A statistically significant variance in stress level was found between male and female groups (p=0.002) and for the two age groups (p=0.001). Using the Hamilton anxiety rating scale, no statistically significant divergence could be seen among male and female participants. The current study showed stress, anxiety, and depressions were prevalent among health care workers working in COVID pandemic situations. Therefore, mental health status must be addressed, and issues must be resolved. © 2022, DESIDOC.
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Background - COVID 19 illness is associated with psychological impairments. Whether this impairment is due to illness itself or inpatient stay also contributes to it needs to be ascertained. Present study was done to assess the change in severity of stress, depression and anxiety in COVID-19 patients on the day of hospital admission and on the day of discharge and its association with clinical variables. Methods - A cross sectional study design with sample of 104 patients admitted in the COVID wards. Socio-demographic and COVID related clinical variables and laboratory parameters were recorded. The severity of stress (PSS scale), anxiety (HAM-A scale) and depression (HAM-D scale) was assessed on the day of hospital admission &on the day of discharge. Association between change in severity of these and other variables was assessed. Results-Significant increase in severity of stress, anxiety and depression was found during indoor stay of Covid-19 patients. Severity increased despite improvement in physical status of subjects. There was no significant association of increased severity of stress, anxiety, depression with demographic variables and laboratory parameters. Conclusion - There was a significant increase in level of stress, anxiety and depression during the inpatient stay despite improvement in clinical symptoms, with minimal association with demographic and clinical variables.
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Introduction: Although isolation and quarantine are important measures to curb the exponential growth of the prevailing Coronavirus disease 2019 (COVID-19) pandemic, but at same time this can impose psychological issues among the affected population and also to their family members. Aims: To evaluate the mental health problems, their severity and associated factors in quarantined population during the COVID-19 pandemic. Materials and Methods: This cross-sectional study was conducted among 207 quarantined subjects at different quarantine centres of Ajmer, associated with JLN Medical College, Ajmer, from August 2020 to October 2020,after getting approval from ethics committee of the centre. All the consenting quarantined subjects who were of age 18 years and above, irrespective of their gender were enrolled in the study. For the assessment of psychiatric morbidity, participants were screened using Mini-International Neuropsychiatric Interview (MINI) 6.0.0. Finally, the relevant psychiatric assessment tools like Hamilton Rating Scale for Depression (HAM-D),Hamilton Anxiety Rating Scale (HAM-A) and Yale-Brown Obsessive Compulsive Scale were applied to assess the severity of the disorders. Pearson correlation analysis was used to evaluate the relationship among various clinical variables.The level of significance was considered at p-value lt;0.05. Results: Majority 85 (41%) subjects belonged to the age group 31-40 years of age. Around 116 (77.3%) participants were male. Around 51 (24.6%) presented moderate depression and 25 (12%) presented with severe depression. Also 182 (87.9%) presented with moderate anxiety. The study showed a statistically significant association between depression/anxiety and substance abuse, insomnia, co-morbidities, suicidal ideation/attempts. Conclusion: The findings of the present study concluded that a significant proportion of the quarantined population suffered from psychological issues. So, the psychological impact of a mandatory quarantine should be weighed more thoughtful and in an evidence based manner.
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Introduction. The Covid 19 has probably altered the epidemiology of mental disorders worldwide, with their incidence which is likely to have increased during the pandemic [1,2]. It is possible that it has impacted response to drug treatment in psychiatric conditions, resulting in differential hospitalisation rates. Hence, we compared the responses to three different antidepressant drugs in outpatients with a major depressive episode (MDE) in the course of Major Depressive Disorder (MDD) and Bipolar Disorder (BD) during two time periods, i.e., prior to suffering Covid-19–related trauma and after suffering such trauma. Methods. We conducted an observational study on outpatients with MDE during their course of MDD (N=58) or BD (N=84)who were clinically stabilised for at least 6 months and treated with antidepressants, antipsychotics or mood stabilisers according to recent treatment guidelines [3,4]. Outpatients, of whom we had baseline assessments of Montgomery-Åsberg Rating Scale (MADRS) and Hamilton Anxiety Rating Scale (Ham-A), were recruited at the time they suffered Covid-19–related traumas, defined as developing Covid-19 infection or witnessing Covid-19 infection in a close person, death of a loved one, domestic violence, or job loss. Fifty patients were being treated with 15 mg/day oral vortioxetine, 46 with 450 mg/day oral extended-release trazodone (ERT), and 46 with 150 mg/day oral sertraline. We compared their scores on the MADRS, Ham-A, and WHOQOL-2.0-BREF drug-wise and gender-wise. We used Student's t test for continuous variables and the χ2 test for categorical variables. Results. The sample consisted of 142 outpatients (age, mean 39.63 ± 16.84;70 men and 72 women);women were older than men (mean age 43.18 ± 17.61 vs. 35.98 ± 15.30;p=0.01). The two genders did not differ on other variables). There was a main effect of time for MADRS scores (F(1.000,130.000)=147.292, p<0.001, η2=0.531;from 13.75 ± 4.60 to 20.38 ± 7.06) and Ham-A scores (F(1.000,130.000)=100.260, p<0.001, η2=0.435;from 13.41±7.14 to 20.61±7.99) and an interaction effect, i.e., a Time × Treatment effect (F(2.000,130.000)=10.376, p<0.001, η2=0.138) for MADRS and (F(2.000,130.000)=6.836, p=0.002, η2=0.095) for Ham-A, with a lower impairment for the vortioxetine group (from 14.20±3.60 to 17.26±5.44) than sertraline (from 13.56±4.29 to 22.44±6.59) and trazodone (from 13.57±5.85 to 21.68±7.06) for MADRS and for Ham-A (vortioxetine from 13.96±6.26 to 17.78±7.09 better than sertraline, from 13.79 ±8.36 to 22.77±7.62 and trazodone, from 12.39±6.69 to 21.48±8.55) from the pre-Covid-19 to the post-Covid-19–related trauma period. Improved QoL from the Covid-19–related trauma period to 1 month post-trauma was shown for trazodone (from 62.16±15.44 to 67.90±13.74), but not vortioxetine (from 61.56±13.89 to 63.50±15.60) or sertraline (from 63.89±13.37 to 62.08±15.10). The vortioxetine group showed a lower hospitalisation rate (24%) than sertraline (35.4%) and trazodone (38.6%), but this was not significant (p=0.27). Conclusion. We found all drugs to improve depression and anxiety scores with vortioxetine showing a small advantage over the others in patients with and MDE during the course of MDD or BD. Trazodone improved QoL faster than other drugs. No differences between vortioxetine, sertraline and trazodone were found as concerns the need for hospitalisation. No conflict of interest
ABSTRACT
Introduction: SARS-CoV-2 infection causes a pulmonary disease (COVID-19) which spread worldwide in 2020, leading the World Health Organization (WHO) to declare a pandemic [1] and the Italian government firstly to declare a state of emergency, then to impose restrictive measures lasting about two months. COVID-19 pandemic generated fear, anxiety, depression and post-traumatic symptoms in the general population [2,3] as well as among subjects affected by mental disorders [4]. Little is known about which different psychopathological changes the pandemic caused among individuals affected by different psychiatric disorders. Aims: To investigate potential psychopathological changes over time during the first wave of COVID-19 pandemic comparing different psychiatric disorders. Methods: Data about demographic/clinical variables and psychopathological status were retrospectively collected. Specific psychometric scales were administered at three time points: T0 as outbreak of pandemic, T1 as lockdown period, T2 as reopening. Primary outcomes: Brief Psychiatry Rating Scale (BPRS), Clinical Global Impression (CGI), Hamilton Anxiety Rating Scale (HAM-A). Secondary outcomes: Disability Scale (DISS), Positive and Negative Syndrome Scale (PANSS), Hamilton Depression Rating Scale (HAM-D), Montgomery and Åsberg Depression Rating Scale (MADRS), Young Mania Rating Scale (YMRS), Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Descriptive analyses and linear regression models were performed. Summary of results: A total of 166 outpatients were included. Overall, psychometric scores showed a significant worsening at T1 with a mild improvement at T2 (p<0.05). Only psychotic and OC symptoms did not significantly improve at T2. Primary outcomes: time had a significant effect on the change of BPRS (F=26.56;p<0.001), CGI-severity (F=8.29;p<0.001), CGI-improvement (F=41.88;p<0.001) and HAM-A (F=33.63;p<0.001) scores. BPRS and CGI-S scores were higher among subjects affected by personality disorders (PDs) than in the depressed (MDD) and anxiety/obsessive-compulsive (OC) groups (p<0.05). PD patients also showed higher HAM-A scores than schizophrenia (SKZ) ones (p=0.02). Secondary outcomes: Time had a significant effect on the change of DISS-stress (F=40.80;p<0.001), DISS-support (F=9.26;p<0.001), HAM-D (F=9.50;p<0.001) and MADRS (F=9.40;p<0.001) scores. The time effect was not significant for DISS-disability (F=1.23;p=0.29), PANSS (F=1.37;p=0.26), YMRS (F=2.84;p=0.06) and Y-BOCS (F=0.55;p=0.59) scores. DISS-disability scores were higher in the PD group with respect to bipolar disorder (BD) (p=0.009), MDD (p<0.001) and anxiety/OCD (p=0.03) groups;SKZ and BD patients had lower DISS-stress scores than PD ones (both p values = 0.02). Conclusions: Patients affected by PDs showed to be particularly affected by the negative effects of outbreaks on mental health and perhaps they require specific clinical attention in case of traumatic events such as pandemics. Moreover, although SKZ patients reported lower anxiety levels than PD ones, the worsening of psychotic and OC symptoms should be strictly monitored by clinicians, as these aspects did not improve with the end of lockdown measures. Further studies on larger samples would allow an in-depth comparison of the psychopathological impact of pandemics between the different psychiatric diagnoses. The study has been registered on ClinicalTrials.gov with the following ID number: NCT04694482 No conflict of interest
ABSTRACT
Background: COVID-19 (C-19) infection can acutely cause organ dysfunctions, especially cardiorespiratory, even with a long recovery period, inducing a significant functional deficit. Aim of the study was to evaluate the impact of a holistic hospital intensive rehabilitation program, based on CR, on C-19 patients (P), after acute care, to improve their fitness, in order to return to their life in the best conditions. Methods: In the period april-august 2020, 30 P (mean age 73 years, 60% male) were admitted to the rehabilitation centre at a mean distance of 31±11 days from the onset of C-19;34% of them had undergone prolonged invasive ventilation, 34% non invasive ventilation and 32% required high flow oxygen. Comorbidities were: hypertension (77%), diabetes (13%) and chronic coronary syndrome (10%);18 P were unable to stand, and 12 showed impaired trunk control. No P had impaired LVEF or significant valvular disease. Initially, the program focused on training for trunk and sitting control;then on exercises for straightening the upper and lower limbs. From the second week, started a CR training on the cycle ergometer 10- 20 minutes a day for 6 days a week, similar protocol to that used in P with heart failure. The aerobic training was of moderate intensity, not exceeding 40-60% of the maximum heart rate, Borg scale 10-12, starting with zero load, gradually increasing by 10-15 watts and up to a minimum target of 25-30 watts. The impact of the protocol on motor functions [MRC Muscle Strenght Scale, Short Physical Performance Battery (SPPB)] on functional capacity [6 Minutes Walking Test (6MWT)] on anxiety (A) and depression (D) [Hamilton Anxiety Rating scale (HAMA) and Hamilton Depression Rating scale (HAMD)] and on basic activities of daily life [Barthel Index (BI)] were evaluated. The assessment was done on the admission (T0), at the discharge (T1, on average after 31 days) and after a follow-up of 55 days (T3). Results: The results are shown in the table below. Only 4 P were able to perform the 6MWT at T0. The motor function improves rapidly and then reaches a plateau and its trend is reflected in the BI. Functional capacity, on the other hand, improves significantly even at a distance. A and D decreased rapidly but increased over time. Conclusions: A rehabilitation protocol, centered on CR, induces a rapid increase in motor capacity, even in severely compromised subjects such as C-19. The improvement in fitness over time, as demonstrated by the 6MWT, probably is due to the severe muscle deconditioning, for the long stay in acute care. The long-term worsening of A and D may depend on various causes: no longer living in a “protected and safe” place, the fear of relapse, returning home and discovering new deaths and mournings. A program, CR-like, can counteract many of the negative consequences of C-19;however these P deserve an outpatient rehabilitation to maintain and consolidate the positive results over time. (Figure Presented).