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.

Level of General Stress in Doctors Community in Pre and Post Covid-19 Scenario in Different Hospitals of Pakistan

Objectives: To find out the level of stress among the doctor community before and during the COVID-19 pandemic in different public sector hospitals. Study Design: Cross-sectional study. Place and Duration of Study: Divisional Headquarters DHQ Teaching Hospital, Sahiwal Pakistan and two Public Sector Hospitals at Okara and Islamabad Pakistan, from Aug 2019 to Aug 2020. Methodology: A total of 320 doctors in two Groups were included in the study. Group-1 included 197 doctors in pre-COVID-19 time i-e from Aug 2019 to Jan 2020, while Group-2 included 123 doctors working in the COVID-19 scenario. The stress was assessed according to responses on a structured questionnaire and patient health questionnaire (PHQ-9) scores. Results: Three hundred and twenty doctors participated in the study, out of which 78(39.8%) doctors in the First Group and 49(40.4%) in Second Group developed depression during their duties. More female doctors participated in the study, most of whom were young doctors who were actively involved in COVID-19 patients. Conclusion: There is no significant rise in stress among the doctors working in the COVID-19 situation in public sector hospitals of Pakistan. © 2022, Army Medical College. All rights reserved.

Psychological impact of the COVID-19 pandemic on waitlisted pre-bariatric surgery patients in Saudi Arabia: A cross-sectional study.

Background: During the COVID-19 pandemic, the number of bariatric surgeries was decreased to ensure patient safety. This study aimed to evaluate the effect of such delays on the psychological status and weight management behaviors of waitlisted pre-bariatric surgery patients in Jeddah, Saudi Arabia. Materials and methods: A web-based cross-sectional survey was conducted. Results were then evaluated with simple descriptive statistics and inferential analyses through the Chi-square test, one-way ANOVA, and the general linear regression model. Results: Of 437 patients, 208 successfully completed the survey. Approximately half of the participants reported weight change (46.6%, n = 97), while other weight management behaviors remained unchanged. The mean Patient Health Questionnaire-9 (PHQ-9) total score of the respondents was 8.29 ± 6.3, indicating mild depression. Higher PHQ-9 scores were associated with being a student, unhealthy dietary habits, physical inactivity, worsened psychological status, and weight gain. Among these factors, being a student was the strongest predictor of the total PHQ-9 score. Conclusion: The COVID-19 pandemic significantly affected the psychological status of patients with obesity on the bariatric surgery waitlist. Since delays in bariatric surgeries could worsen patients' psychological status, as substantiated in this study, the provision of virtual care through telemedicine and the development of policies for reintroducing bariatric surgeries for future lockdowns are highly recommended.

The use of dietary supplements for mental health among the Saudi population: A cross-sectional survey.

Introduction: Despite limited evidence about the efficacy and safety of dietary supplements (DSs) for improving mental health, people with or without mental disorders often tend to use them, especially during the ongoing COVID-19 pandemic. Previous studies focused on DS use for maintaining or improving overall health; Therefore, this study aimed to assess the prevalence of DSs for mental health among the SA population and to determine the factors that affect their use. Methods: This cross-sectional study was based on an online survey of Saudi Arabian participants between July and August 2021 with an anonymous, self-completed questionnaire distributed using convenience sampling. The questionnaire included queries related to demographic information, DS use assessment, and mental health evaluation using the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Disorder 7-item (GAD-7), questionnaire, and the Insomnia Severity Index (ISI). Results: In total, 443 participants from various regions of Saudi Arabia completed the questionnaire. The prevalence of DS use in the Saudi population was 44%. Vitamin D (28%) and melatonin (20%) were the most commonly reported DSs used for mental health. The odds of DS use were three times higher in responders with previous mental health diagnoses (OR: 2.972; 95% CI: 1.602-5.515). Furthermore, the chances of using DSs almost doubled in patients with sub-threshold and moderate to severe insomnia (OR: 1.930; 95% CI: 1.191-3.126 and OR: 2.485; 95% CI: 1.247-4.954, respectively). Conclusion: Responders diagnosed by a specialist with psychiatric disorders or current insomnia had a higher chance of using DSs. Thus, healthcare providers must provide evidence-based information regarding DSs for mental health improvement and encourage the public to consult healthcare professionals before self-medicating for mental health problems.

The impact of physical conditions on the incidence of major depressive disorder in Chinese university students: Results from a longitudinal study.

BACKGROUND: Major depressive disorder (MDD) is prevalent, and highly comorbid with physical illnesses. Few longitudinal studies have investigated the relationship between physical health conditions and MDD. The objectives of this study were to investigate the comorbid relationship between physical conditions and MDD, and the association between physical conditions and the 2-year risk of MDD. METHODS: A study was conducted in first-year Chinese university students (n = 8,079) over two and half years, using a longitudinal design. An adapted version of the Composite International Diagnostic Interview (CIDI - 3.0) was used to assess for MDD. The presence of physician diagnosed physical conditions was assessed using ten self-report questions. Cross-sectional and longitudinal associations between self-reported physical conditions and MDD were estimated, adjusting for possible confounders. RESULTS: The most frequently reported physical conditions were migraines, chronic rhinitis, and gastritis. We found that migraines, gastritis, and stomach ulcers were associated with a significantly higher lifetime prevalence of MDD than those without any physical health conditions. In those without a lifetime MDD, migraines, gastritis and stomach ulcers were also found to be significant predictors for 2-year risk of new onset MDD. LIMITATIONS: Recall and selection biases are possible when using self-reporting measures. Additionally, the COVID-19 outbreak impacted the response rate at the second follow-up assessment. Lastly, the severity of the physical conditions was not measured. CONCLUSIONS: Physical conditions and MDD are highly prevalent and comorbid in university students. Migraines, gastritis and stomach ulcers are associated with the risk of developing MDD. Future studies should further investigate how this information can be used to prevent MDD.

Internet-based cognitive behavioral therapy for psychological distress in older adults without cognitive impairment living in nursing homes during the COVID-19 pandemic: A feasibility study.

BACKGROUND: The COVID-19 pandemic has had a detrimental effect on the mental health of older adults living in nursing homes. Very few studies have examined the effects of Internet-based Cognitive Behavioral Therapy (ICBT) on older adults living in nursing homes during the pandemic. We conducted a feasibility study using a single-group design, to explore the effectiveness of ICBT on psychological distress in 137 older adults (without cognitive impairment) from 8 nursing homes in 4 southeast cities in China, between January and March 2020. METHODS: Symptoms of depression, anxiety, general psychological distress, and functional disability were measured at baseline, post-treatment (5 weeks) and at a 1-month follow-up. Mixed-effects model was used to assess the effects of ICBT. RESULTS: Statistically significant changes with large effect sizes were observed from pre- to post-treatment on the PHQ-9 (p < .001, Cohen's d = 1.74), GAD-7 (p < .001, d = 1.71), GDS (p < .001, d = 1.30), K-10 (p < .001, d = 1.93), and SDS (p < .001, d = 2.03). Furthermore, improvements in treatment outcomes were sustained at 1-month follow-up, and high levels of adherence and satisfaction were indicated. CONCLUSION: ICBT was effective in reducing psychological distress in older adults without cognitive impairments living in nursing homes during the COVID-19 pandemic. Thus, it could be applied in improving the mental health of this vulnerable group during the pandemic.

Dismantling internet-based cognitive behavioral therapy for tinnitus. The contribution of applied relaxation: A randomized controlled trial.

BACKGROUND: Internet-based cognitive behavioral therapy (ICBT) for tinnitus is an evidence-based intervention. The components of ICBT for tinnitus have, however, not been dismantled and thus the effectiveness of the different therapeutic components is unknown. It is, furthermore, not known if heterogeneous tinnitus subgroups respond differently to ICBT. AIMS: This dismantling study aimed to explore the contribution of applied relaxation within ICBT for reducing tinnitus distress and comorbidities associated with tinnitus. A secondary aim was to assess whether outcomes varied for three tinnitus subgroups, namely those with significant tinnitus severity, those with low tinnitus severity, and those with significant depression. METHODS: A parallel randomized controlled trial design (n = 126) was used to compare audiologist-guided applied relaxation with the full ICBT intervention. Recruitment was online and via the intervention platform. Assessments were completed at four-time points including a 2-month follow-up period. The primary outcome was tinnitus severity as measured by the Tinnitus Functional Index. Secondary outcomes were included for anxiety, depression, insomnia, negative tinnitus cognitions, health-related quality of life, hearing disability, and hyperacusis. Treatment engagement variables including the number of logins, number of modules opened, and the number of messages sent. Both an intention-to-treat analysis and completer's only analysis were undertaken. RESULTS: Engagement was low which compromised results as the full intervention was undertaken by few participants. Both the ICBT and applied relaxation resulted in large reduction of tinnitus severity (within-group effect sizes d = 0.87 and 0.68, respectively for completers only analysis), which were maintained, or further improved at follow-up. These reductions in tinnitus distress were greater for the ICBT group, with a small effect size differences (between-group d = 0.15 in favor of ICBT for completers only analysis). Tinnitus distress decreased the most at post-intervention for those with significant depression at baseline. Both ICBT and applied relaxation contributed to significant reductions on most secondary outcome measures, with no group differences, except for a greater reduction of hyperacusis in the ICBT group. CONCLUSION: Due to poor compliance partly attributed to the COVID-19 pandemic results were compromised. Further studies employing strategies to improve compliance and engagement are required. The intervention's effectiveness increased with initial level of tinnitus distress; those with the highest scores at intake experienced the most substantial changes on the outcome measures. This may suggest tailoring of interventions according to tinnitus severity. Larger samples are needed to confirm this.

Anxiety and depression and the related factors in nurses of Guilan University of Medical Sciences hospitals during COVID-19: A web-based cross-sectional study.

BACKGROUND: The outbreak of COVID-19 is an unprecedented challenge to the health systems in Iran. We aimed to assess the psychological impact of this outbreak on nurses in the hospitals of Guilan University of Medical Sciences that is one of the top provinces of incidence of COVID-19. METHODS: In a web-based cross-sectional study, 441 nurses working were selected from the hospitals, from 7 to 12 April 2020. Anxiety and depression were measured using the Generalized Anxiety Disorder-7 and the Patient Health Questionnaire-9, respectively. Simple and multiple logistic regression models were used to identify the factors related to anxiety and depression. RESULTS: The majority were in contact with suspected or confirmed COVID-19 cases (93.4%) and their relatives had been infected with COVID-19 (42%). The mean of anxiety-7 and depression total scores were 8.64 ± 5.60 and 8.48 ± 6.19, respectively. Female (OR = 3.27, 95% CI = 1.01-10.64), working in COVID-19 designated hospital (OR = 1.82, 95% CI = 1.13-2.93), being suspected with COVID-19 infection (OR = 2.01, 95% CI = 1.25-3.26), and insufficient personal protective equipment (OR = 2.61, 95% CI = 1.68-4.06) were associated with anxiety. Depression was significantly associated with female sex (OR = 4.62, %95 CI = 1.24-17.16), having chronic disease (OR = 2.12, 95% CI = 1.20-3.74), being suspected or confirmed with COVID-19 infection (OR = 3.44, 95% CI = 2.11-5.59, and OR = 2.21, 95% CI = 1.04-4.70, respectively), and insufficient personal protective equipment (OR = 1.86, 95% CI = 1.19-2.91). CONCLUSION: The finding declares healthcare workers are at high risk for mental illness. Continuous supervision of the psychological consequences following infectious diseases outbreaks should be a part of the preparedness efforts of health care systems.