Mental Health and Coping Strategies among University Staff during the COVID-19 Pandemic: A Cross–Sectional Analysis from Saudi Arabia

This study examined psychological health and coping strategies among faculty and staff at a Saudi Arabian university. A web-based self-administered survey was used to assess probable anxiety, depression, post-traumatic stress disorder (PTSD), and coping strategies by using the Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Impact of Event Scale-Revised (IES-R), and Brief-COPE scale, respectively. Of 502 participants (mean age 36.04 ± 10.32 years, male: 66.3%), 24.1% (GAD-7 ≥ 10) had probable anxiety. Anxiety score was significantly higher in females (p < 0.001), those with a history of COVID-19 infection (p = 0.036), and participants with less work experience (p = 0.019). Approximately 40% of participants met the criteria of probable depression, with females (p < 0.001) and participants with less experience having more depressive symptoms. Around one-fourth (27.7%) of study participants indicated probable PTSD (score ≥ 33), with higher symptoms in females (p <0.001), less experienced staff (p < 0.001), and academic staff (p = 0.006). Correlation analysis indicated a significant positive correlation between anxiety and depression (r = 0.844, p < 0.001), anxiety and PTSD (r = 0.650, p < 0.001), and depression and PTSD (r = 0.676, p < 0.001). Active coping, religious/spiritual coping, and acceptance were common coping strategies, while substance use was the least adopted coping method among the study participants. This study indicated a high prevalence of probable psychological ailments among university staff.

Prevalence of Post-traumatic Stress Disorder in People With a History of Hospitalization With COVID-19 and Its Relationship With Socio-economic Status

Background: COVID-19 has had many negative consequences in all aspects of human life, especially physical and mental health. This study aims to determine the prevalence of post-traumatic stress disorder (PTSD) in people with a history of hospitalization with COVID-19 and its relationship with socio-economic status (SES). Materials and Methods: The present study was a cross-sectional descriptive study and the statistical population of the study included all people with a history of being infected with COVID-19 and subsequent hospitalization in Shohada Hospital of Sarpol-e Zahab, Kermanshah Province, Iran. The sample members were randomly selected from the list of hospitalized patients. A total of 479 people were evaluated face to face using the PTSD Checklist Scale (PCL-S) questionnaire to examine PTSD, as well as the Ghodrat Nama et al.'s SES questionnaire to determine the SES. The data were analyzed using SPSS software, version 21 and by Chi-square test, one-way ANOVA, and Pearson correlation coefficient (P≤0.05). Results: The prevalence of PTSD was 31.10%. No significant relationship was observed between socioeconomic status and the prevalence of PTSD (P=0.97). Among the demographic variables, only gender had a significant relationship with the prevalence of this disorder (P=0.00) and the prevalence was higher in women than in men. Conclusion: The prevalence of PTSD is high in people with a history of hospitalization with COVID-19. Getting infected with COVID-19 and subsequent hospitalization hurts people's mental health. Maintaining the mental health of this group of people should be considered. © 2023, Negah Institute for Scientific Communication. All rights reserved.

Variations in circadian rhythmicity and students' gender-related psychological conditions during the COVID-19 lockdown

In the face of the COVID-19 pandemic experienced around the world, new student lifestyles have had an impact on their daily behavior. The purpose of this study was to examine post-traumatic stress associated with the initial COVID-19 crisis in students (N = 280) with a mean age of 13 +/- 1.70 and to determine the relationship between their reported daily behaviors in terms of their gender. The study was conducted primarily in Casablanca and Marrakech, the two cities most affected by the pandemic at the time of the study in Morocco in May 2020. Our sample consists of 133 high school students and 147 middle school students, 83.6% of whom are females. Students were asked to answer questions based on an Activity Biorhythm Questionnaire, the Post-Traumatic Stress Scale (Weathers et al., 1993), the Hamilton Scale (Hamilton, 1960), the Worry Domains Questionnaire (Tallis, Eyzenck, Mathews, 1992), and the Visual Analog Scale of Moods (VASM) (Stern et al., 1997). The results obtained confirm that there is a significant relationship between the circadian rhythm of some variables and gender in some activities such as academic study (p < 0.05) and TV and Internet use (p < 0.05) and was highly significant for physical activity (p = 0.001), while others are not significant in relation to other schedules of the same variables or in relation to others. Likewise, for the psychological conditions, significant relationships with mood states and depressive tendencies were confirmed. In lockdown, the students' daily lives underwent changes in circadian rhythm and lifestyle. Therefore, it is necessary to treat their current psychological problems and avoid future complications. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Relationship between social support and psychological resilience and post-traumatic stress disorder in college students

Objective To investigate the characteristics of post-traumatic stress disorder (PTSD) in college students during the outbreak of COVID-19, and to explore the mediating role of psychological resilience between social support and PTSD. Methods By using direct selection method, 572 college students in Anhui and Shanghai were selected and administered with General Characteristics Questionnaire, the PTSD Checklist-Civilian Version(PCL-C), Psychological Resilience Scale(PRS) and Social Support Rating Scale(SSRS). Results Among the participants, 25.0% had moderate PTSD symptoms, 11.7% had obvious PTSD symptoms, and the positive rate of PTSD was 36.7%. The prevalence of PTSD in college students was higher in males than in females (X2=4.31, P < 0.05). The junior students were higher than other students (X2=16.81, P < 0.01). The scores of social support, psychological resilience and PTSD were (33.79+or-4.83), (92.17+or-13.39) and (35.50+or-11.39), respectively. The correlations of all variables were statistically significant(r=-0.49-0.76, P < 0.05);The mediation test showed that social support could not only negatively predict PTSD directly(direct effect was -0.35), but also indirectly affect PTSD through psychological resilience(indirect effect was -0.32). Conclusion More than one third of college students have PTSD symptoms, and psychological resilience plays a partial mediating role in the relationship between social support and PTSD, social support can both directly and negatively predict PTSD and indirectly affect PTSD by increasing an individual's psychological resilience.

Use of Living Systematic Reviews (LSRS) Beyond COVID-19

Objectives: A LSR is a systematic review that is continually updated, incorporating new evidence as it becomes available. They are conducted in research areas where new evidence is constantly emerging on diagnostic methods, treatments, and outcomes. The objective of this study was to understand the current application of LSRs across research areas. Method(s): Embase, MEDLINE, and the Cochrane Database of Systematic Reviews were searched to identify LSRs. Only the most recent update of a LSR was included. Data regarding the indication, intervention, methods, frequency of updates, and funding were extracted. Result(s): Of the 1,243 records identified, 126 LSRs were included for analysis. The first LSR was published in 2015, with a significant increase in the number of LSRs published starting in 2020, coinciding with the COVID-19 pandemic. The most common indication represented by LSRs was COVID-19 (72%), followed by oncology (10%). Other indications with LSRs included chronic pain, traumatic brain injury, and skin disorders, among others. While most oncology LSRs identified interventional randomized-controlled trials (RCTs) (85%), only 54% of COVID-19 LSRs were restricted to interventional studies, including a combination of RCTS and real-world observational studies. Oncology LSRs included common cancers such as prostate, renal, or multiple myeloma. Of the reviews that reported update frequency, 28% planned monthly, 12% yearly, and 12% weekly updates. Only 46% of LSRs were registered. The majority of LSRs were funded by government or research organizations. Objectives of LSRs varied, with most stating the need to maintain up-to-date databases;however, several studies used LSRs to facilitate network meta-analysis or mixed treatment comparisons. Conclusion(s): While LSRs were introduced over five years ago, their frequency increased during the COVID-19 pandemic. Apart from COVID-19, LSRs are commonly used in oncology settings. LSRs provide high-level, relevant, and up-to-date evidence, making them a useful tool for clinical and real-world research.Copyright © 2023

Relationship between attentional Bias, anxiety, depression and post-traumatic stress disorder in primary and middle school students

Objective: To investigate the relationship between negative attentional bias and post-traumatic stress disorder(PTSD) in the context of higher depression and anxiety symptoms after the outbreak of COVID-19, so as to provide scientific basis for mental health education in primary and secondary schools. Methods: From March to April 2021, a total of 708 students from primary school and junior high school (grade 6 through grade 9) in Beijing, Shanxi, Hunan, Shandong, Hebei, Hubei of China were selected. The Children's Revised Impact of Event Scale(CRIES), the Attention to Positive and Negative Information Scale (APNI)and Depression, Anxiety and Stress Scale-21(DASS-21) were used in a questionnaire survey. Results: A total of 242 students were diagnosed with PTSD, and the detection rate was 34.2%. The scores of intrusion and high arousal of boys(7.92+or-5.33, 8.60+or-5.41) were lower than those of girls(8.72+or-4.85, 9.50+or-4.76), and the difference was statistically significant (t=-2.04, -2.32, P < 0.05). There were statistically significant differences of negative attention bias, CRIES score, intrusion, debarb and high arousal among primary and middle school students of different grades (F=3.57, 5.99, 4.45, 4.60, 7.40, P < 0.05). Negative attention bias, anxiety, depression and post-traumatic stress symptoms were significantly positively correlated (r=0.27-0.84, P < 0.05). Logistic regression analysis showed that anxiety (OR=1.13, 95%CI=1.06-1.20) and negative attention bias (OR=1.10, 95%CI=1.07-1.12) were positively associated with PTSD symptoms in primary and middle school students(P < 0.01). Conclusion: Anxiety and depressive symptoms show impacts on negative attention bias and might exacerbate the symptoms of post-traumatic stress disorder. Therefore, emotional adjustments can help reduce the post-traumatic stress response in the post-epidemic period.

A Case Report on Heart Rate Variability Biofeedback and Postconcussion Syndrome: Healing the Autonomic Nervous System

Postconcussion syndrome is a devastating condition of the mind, body, and even personality. Mounting research demonstrates that heart rate variability biofeedback can help the concussed individual in three critical ways: (a) eliciting high amplitude oscillations in cardiovascular functions and thereby strengthening self-regulatory control mechanisms;(b) restoring autonomic balance;and (c) increasing the afferent impulse stream from the baroreceptors to restore balance between inhibitory and excitatory processes in the brain.

Organisational strategies to support NHS staff in response to the COVID-19 pandemic

ContextThis case series aims to assess the organisational strategies utilised by two NHS trusts (trust A and B) in North West England in order to improve the well-being of their Healthcare workers (HW) during the time period from December 2019 to March 2021. In the context of existing clinical leadership theory, we investigated what organisational strategies leaders and managers in English hospitals can use to improve the well-being of HWs in response to the COVID-19 pandemic.Establish what strategies are being used by trusts to improve the mental well–being of healthcare workersAscertain which risk factors are associated with poor mental health during the COVID–19 pandemic in NHS healthcare workersExamine whether strategies can be designed using limited resources to meet the challenging mental healthIssue/ChallengeA higher prevalence of mental health issues (MHI) such as depression, burnout, post-traumatic stress disorder (PTSD) and anxiety is observed during epidemics and pandemics. In May 2020, during the COVID-19 Pandemic, Mental health Illnesses (MHI) accounted for 28.3% of all sickness leave in the UK NHS. The highest sickness absence rate (SAR) in the United Kingdom (UK) was reported in the North West England (NWE) at 4.9%;with MHI being consistently responsible for sickness absence, accounting for 31.8% of all sickness leave in June 2020, placing a huge strain on limited resources and patient safety and care.Assessment of issue and analysis of its causesFollowing written, informed consent, semi-structured, 60 minute interviews were conducted via video-conferencing with six participants (clinical managers or directors) of two NHS Trusts in NWE. Interviews were recorded and transcribed verbatim. The transcripts were then read, and Coding was done using NVivo software in an iterative process which used a leadership framework oriented around the interview questions.We also conducted a retrospective data collection on the average monthly percentage of Full Time Equivalent (FTE) days lost to mental health issues from the trusts' databases between 1st December 2019 and 1st March 2021 in order to triangulate strategies impact on sickness absence rate.ImpactTo date, there is no case study research on the strategies implemented in NHS trusts that address the consequences of the COVID-19 pandemic on HW's mental health and wellbeing which utilise absence data.InterventionTrust A had a higher Sickness absence rate versus Trust B, despite the greater funding and larger wellbeing team utilised in Trust A. Understanding early on, via surveys, the needs of HW in Trust B, contributed to their effective response and target of resources. The practical support offered by Trust B may have acted as preventative and proactive measure for poor mental health. Trusts psychological support approach may have only benefitted HW in later stages of MHI, such as PTSD. Nevertheless, Trust B is a significantly smaller trust, with fewer replacements, consequently, HW may feel less comfortable or less able to take sickness absence.The least engagement in wellbeing strategies was seen in both Trusts amongst Black And Minority Ethnic (BAME) groups. Raising concerns in Trust A and Trust B was aided with BAME ‘listening events' and a ‘BAME network' forum respectively. The latter formed part of the ‘governance structure' of Trust B, ensuring that official reports were acted upon. Trust A also introduced ‘outreach calls' for nursing staff off sick due to MHI to check in on them with referrals to the Greater Manchester resilience hub and did regular health checks for early prevention of unhealthy behavioural patterns.Both Trusts highlighted the importance of measuring the efficacy of strategies implemented. However, Trust B reported that due to the ‘fast-paced nature of the start of the pandemic, evaluation was not as important then. Contrarily, Trust A submits quarterly reports on engagement with services, outcomes and feedback as part of their service delivery which they are constantly amending.Key MessagesBoth NHS trusts in NWE identified similar risk factors for developing mental health issues and reported similar challenges in implementing wellbeing initiatives. Organisational strategies were dependent on each trust’s needs and outcomes. Our study suggests that practical support may be more effective for stress and fatigue management during the peaks of pandemics in contrast to psychological support which may be more suitable during recovery phases. Screening for psychological issues may highlight areas of support and may enhance engagement with services, particularly in vulnerable population groups (BAME). Ultimately, a whole-systems leadership approach involving the aforementioned systemic change to organisational culture is needed in order to meet the well-being needs of healthcare workers.Lessons learntAn organisational, rather than individual, approach to re-building team cohesion should be preferred. Furthermore, the focus of interventions in both trusts was individual psychotherapy, with minimal exploration of organisational cultural factors. Even though practical support was seen as superior to psychological interventions in Trust B, both wellbeing strategies may help improve overworked occupational culture.Self-care coping mechanisms were emphasised more during the peaks of the pandemic. Similarly, according to Avero et.al. 2003 wellbeing initiatives during the peaks of pandemics should help HW cope with stress and trauma, whereas during recovery phases of pandemics they should help with processing psychological trauma.Identifying common manifestations such as unhealthy eating, smoking and alcohol consumption may be more effective than relying on HW self-reporting. Nevertheless, this system relies on open and honest conversations with HW.

The effect of pandemic-related stress on the decision-making process for individual outdoor leisure activities

This study investigates the decision-making process for outdoor leisure activities of the Chinese people in the context of COVID-19. An online survey of residents of Heilongjiang Province was conducted in September and October 2020. In total, 441 questionnaires were returned for empirical analysis. The results reveal that fears of contamination and compulsory checking/reassurance-seeking have had a significant impact on the respondents' goal-directed behavior for nature-based outdoor leisure activities during the pandemic. The theoretical contribution is that extended goal-directed behavior expands with the inclusion of emotional variables and can be used to predict individual outdoor activity intention and decision-making process in the COVID-19 situation relating to leisure. This study provides useful insights for public health ministries and local governments in any country to encourage nature-based outdoor leisure activities as a public health policy for the mental health of the people.

The Post-traumatic Stress Disorder in COVID-19 Recovered Patients: A Cross-sectional Study

Objective Post-traumatic stress disorder (PTSD) is one of the anxiety disorders caused by a specific event, which can be catastrophic events (natural disasters, war, imprisonment in a forced labor camp) or everyday adversities (death of relatives, divorce, carrying bags). Since patients who have recovered from COVID-19 are exposed to such events, this research was conducted to determine the prevalence of PTSD in this group.Materials & Methods This study was cross-sectional. The statistical population included all patients who recovered from COVID-19 between November 2021 and February 2022 in Hamedan City, Iran;based on Krejcie and Morgan's sample size table, 185 patients were selected by simple random sampling method. The research tool was the demographic questionnaire and the Mississippi post -traumatic stress disorder questionnaire (Mississippi PTSD);the data were analyzed using the Mann -Whitney and Kruskal-Wallis tests.Results The results showed that the Mean +/- SD score of PTSD was 80.37 +/- 17.37 in the subjects who recovered from COVID-19. The relationship between the demographic variables of gender (P=0.01), education (P=0.039), occupation (P=0.24), marriage (P=0.62), age (P=0.048), weight (P=0.047), height (P=0.023) with PTSD were reported.Conclusion The results showed that 76.2% of people who recovered from COVID-19 were exposed to PTSD with moderate and high severity;therefore, techniques to reduce anxiety from the corona -virus are recommended.

The role of the COVID-19 pandemic and economic crisis in insomnia and post-traumatic stress symptoms in the Lebanese population: A cross-sectional assessment

Based on an online cross-sectional survey, this study aimed to evaluate the role of the coronavirus disease 2019 (COVID-19) pandemic and economy-related factors in post-traumatic stress symptoms (PTSSs) and sleep in a sample of the general Lebanese population using the post-traumatic stress disorder checklist. The online survey was conducted between May 10, and May 20, 2020, and 502 Lebanese adults who have access to the internet were enrolled. Results highlighted that positive correlates of PTSS were fear of COVID-19, female gender, and waterpipe smoking;negative correlates were higher family satisfaction, higher financial wellness, older age, having access to healthcare, and never having to work. When including insomnia as an independent variable to explain PTSS, the model did not substantially change. Positive correlates of insomnia included fear of poverty, fear of COVID-19, violence at home, the number of dependent children, having a job, and having a chronic disease. Conversely, higher family satisfaction and financial wellness were associated with lower likelihood of insomnia. When entering PTSS, insomnia remained positively associated with fear of poverty, PTSS, and violence at home. However, fear of COVID-19 was no longer associated with insomnia. We concluded that both the fear of COVID-19 and the economic crisis are correlated with PTSS and insomnia. © 2023 Author(s).

Current Evidence of Cannabidiol's Potential as an Anxiolytic Agent

This article will summarize the current knowledge and scientific evidence regarding cannabidiol as a possible pharmacological tool for anxiety disorders. Although the use of this substance in medical practice is gaining momentum, gaps can still be found in the current knowledge regarding its molecular targets, drug-to-drug interactions, efficacy in different populations, adequate dosage, duration of treatment, and correct formulation. Moreover, current evidence is still preliminary, lacking robust, blinded, and placebo-controlled clinical trials in many areas of investigation. After reading this article, readers should have a thorough understanding of the current scientific evidence regarding the use of CBD as an anxiolytic drug. [Psychiatr Ann. 2023;53(6):242–246.]

THE ASSOCIATION OF GRIEF WITH MENTAL HEALTH AND THE ROLE OF LONELINESS DURING THE COVID-19 PANDEMIC

In this study, we aimed to gauge the effects of the process of bereavement on mental health in the context of the COVID-19 pandemic and to explore the mediating role of loneliness on the relationship between grief and mental health alterations by surveying a representative sample of 2000 Spanish adults interviewed by phone during the pandemic (February-March 2021). There has also been an increase in death rates from other causes during the pandemic, sometimes attributed to treatment for other life-threatening diseases being postponed or health care visits being avoided to prevent infection (Stroebe & Schut, 2021). By contrast, a group of bereaved (10 % after natural death and 50% after death due to unnatural causes) experience intense grief that persists longer than what would normally be expected (Djelantik et al., 2020), characterized by an enduring and overwhelming sense of yearning or preoccupation with the deceased and significant emotional suffering that causes functional impairment in daily life. Some authors have stated that researchers studying mental health in relation to the pandemic should include grief as a potential contributory factor (Bertuccio & Runion, 2020).

Evaluating Take 5: Virtual Learning Sessions on Trauma Informed Care for Healthcare Staff During COVID-19

In 2018, CAI, an organization that provides national level training and capacity-building developed a TIC implementation model, now delivered in HIV and primary care agencies throughout the United States to integrate TIC into their culture, environment, and service delivery. In 2018, an organization that provides national level training and capacity-building, Cicatelli Associates, Inc. (CAI), developed a TIC implementation model, now delivered in HIV and primary care agencies throughout the United States to integrate TIC into their culture, environment, and service delivery. PWH who have experienced trauma are 58% less likely to adhere to their antiretroviral treatment compared to PHW who have not experienced trauma (Brown. Since 2018, CAI, a national training and technical assistance organization, has developed and implemented a TIC implementation model to build the capacity of primary care agencies and their healthcare staff to integrate TIC throughout their cultures, environments, and service delivery. The motivation for this model is based on the understanding that primary care providers play a critical role in identifying and addressing past trauma with clients, as opposed to simply relying on referrals to external mental health services to support these needs. CAI technical assistance providers offer capacity building and training to staff at these agencies to implement components of the model to ensure successful integration of TIC into agency culture, environment, and service delivery.

STRESS IN THE ELDERLY IN THE CONTEXT OF THE COVID-19 PANDEMIC AND ITS ASSOCIATED FACTORS

Objective: To identify stress in the elderly living in the city of Lima and its association with demographic factors, infodemics, the presence of physical and psychological symptoms, and the use of illicit substances in the context of the Covid-19 pandemic. Method: Quantitative, transversal, and analytical study through the web-based survey with 384 elderly from the city of Lima-Peru between April and August 2021. The instruments of demographic profile, Perceived Stress Scale, and self-reported symptoms were used for the study. The Multiple logistic regression was used, considering the significance level of 5%. Results: 62% were women, and the age ranged between 60 and 95 years with a mean of 70.5. The stress average was 26.8 points. Stress was associated with fear of relatives dying and concern for the elderly. Conclusions: it is important for health professionals trained to identify changes in mood in the elderly and to create individualized care plans. © 2023, Universidade Federal do Parana. All rights reserved.

Influence of a Stay-At-Home Order on Trauma Volume and Injury Patterns at a Level I Trauma Center in Ohio.

BACKGROUND: Changes in injury patterns during the COVID pandemic have been reported in other states. The objective was to explore changes to trauma service volume and admission characteristics at a trauma center in northeast Ohio during a stay-at-home order (SAHO) and compare the 2020 data to historic trauma census data. METHODS: Retrospective chart review of adult trauma patients admitted to a level I trauma center in northeast Ohio. Trauma admissions from January 21 to July 21, 2020 (COVID period) were compared to date-matched cohorts of trauma admissions from 2018 to 2019 (historic period). The COVID period was further categorized as pre-SAHO, active-SAHO, and post-SAHO. RESULTS: The SAHO was associated with a reduction in trauma center admissions that increased after the SAHO (P = .0033). Only outdoor recreational vehicle (ORV) injuries (P = .0221) and self-inflicted hanging (P = .0028) mechanisms were increased during the COVID period and had substantial effect sizes. Glasgow Coma Scores were lower during the COVID period (P = .0286) with a negligible effect size. Violence-related injuries, injury severity, mortality, and admission characteristics including alcohol and drug testing and positivity were similar in the COVID and historic periods. DISCUSSION: The SAHO resulted in a temporary decrease in trauma center admissions. Although ORV and hanging mechanisms were increased, other mechanisms such as alcohol and toxicology proportions, injury severity, length of stay, and mortality were unchanged.

Effects of media exposure on PTSD symptoms in college students during the COVID-19 outbreak.

Objective: We aimed to investigate the influence of media on college students' mental health during the COVID-19 pandemic. Methods: After the COVID-19 outbreak, we used cross-sectional surveys through online questionnaires to investigate the mental health of college students in lockdown at home. We identified the influencing factors of PTSD symptoms using the Chi-Square test and ordinal logistic regression analysis. Results: In 10,989 valid questionnaires, 9,906 college students with no PTSD symptoms, 947 college students with subclinical PTSD symptoms (1-3 items), and 136 college students with four or more PTSD symptoms were screened out. The results showed that media content impacted the mental health of college students in lockdown at home. Positive media content was negatively correlated with PTSD symptoms among college students. PTSD symptoms were not associated with sources of information. Moreover, College students with PTSD symptoms would reduce their willingness to learn and could not complete online learning efficiently. Conclusion: PTSD symptoms are related to media exposure and excessive information involvement of COVID-19 in college students, which influences the willingness to attend online classes.

A multi-country study of the associations between HIV vulnerability status, perception of COVID-19 related stigma and post-traumatic stress symptoms during the first wave of the pandemic.

BACKGROUND: This study investigated the associations between COVID-19 related stigma and post-traumatic stress symptoms (PTSS); and the associations between PTSS and COVID-19 related stigma, HIV status, COVID-19 status and key HIV population status. METHODS: This was a secondary analysis of data of 12,355 study participants generated through an online survey that recruited adults from 152 countries between July and December 2020. The dependent variables were COVID-19-related stigma and PTSS. The independent variables were HIV status (positive/negative), transaction sex (yes/no), use of psychoactive drugs (yes/no), and vulnerability status (transaction sex workers, people who use psychoactive drugs, living with HIV, and COVID-19 status). The confounding variables were age, sex at birth (male/female), level of education, sexual minority individuals (yes/no) and country income level. Multivariable logistic regression analyses were conducted to determine associations between the dependent and independent variables after adjusting for confounders. RESULTS: There were 835 (6.8%) participants who experienced COVID-19 related stigma during the pandemic and 3,824 (31.0%) participants reported PTSS. Respondents who were living with HIV (AOR: 1.979; 95%CI: 1.522-2.573), tested positive for COVID-19 (AOR: 3.369; 95%CI: 2.692-4.217), engaged in transactional sex (AOR: 1.428; 95%CI: 1.060-1.922) and used psychoactive drugs (AOR: 1.364; 95%CI: 1.053-1.767) had significantly higher odds of experiencing COVID-19 related stigma. Individuals with vulnerability status (AOR:4.610; 95%CI: 1.590-13.368) and who experienced COVID-19 related stigma (AOR: 2.218; 95%CI: 1.920-2.561) had significantly higher odds of PTSS. CONCLUSION: Individuals with vulnerability status may be at increased risk for COVID-19 related stigma. Key and vulnerable populations who were living with HIV and who experienced stigma may be at a higher risk of experiencing PTSS. Populations at risk for PTSS should be routinely screened and provided adequate support when they contract COVID-19 to reduce the risk for poor mental health during COVID-19 outbreaks and during future health crisis with similar magnitude as the COVID-19 pandemic.

Dublin hospital workers' mental health during the peak of Ireland's COVID-19 pandemic.

BACKGROUND: Hospital-based healthcare workers have experienced significant psychological stressors during the COVID-19 pandemic. AIM: To evaluate the mental health of hospital workers during the third wave of the COVID-19 pandemic in Dublin, Ireland. METHODS: Cross-sectional anonymous online survey of hospital workers (n = 377; 181 doctors (48.0%), 166 nurses (44.0%), 30 radiographers (8.0%)), collecting demographic information, COVID-19 exposure history and mental health measures. RESULTS: There were significant differences between profession groups in gender, experience, COVID-19 infection history, exposure to COVID-19 positive acquaintances, and work areas. Moderate-severe post-traumatic stress disorder (PTSD) symptoms were found in 45.1% (95% CI 40.1-50.1%) of all participants; significantly fewer doctors reported moderate-severe PTSD symptoms (26%; 95% CI 22-36%). A World Health Organisation-5 Wellbeing Index (WHO-5) score ≤ 32, indicating low mood, was reported by 52% (95% CI 47-57%) of participants; significantly fewer doctors reported low mood (46%; 95% CI 39-53%). One-week suicidal ideation and planning were reported respectively by 13% (95% CI 10-16%) and 5% (95% CI 3-7%) of participants with no between-group differences. Doctors reported significantly less moral injury than other groups. There were no significant between-group differences regarding coping styles. Work ability was insufficient in 39% (95% CI 34-44%) of staff; no between-group differences. CONCLUSIONS: Dublin hospital workers reported high levels of PTSD symptoms, mood disturbance, and moral injury during the COVID-19 pandemic. Concerning levels of suicidal ideation and planning existed in this cohort. Differences in degrees of post-traumatic stress, moral injury, and wellbeing were found between profession groups, which should be considered when planning any supports.

Longitudinal assessment and determinants of short-term and longer-term psychological distress in a sample of healthcare workers during the COVID-19 pandemic in Quebec, Canada.

Introduction: Previous research has demonstrated the negative impact of the COVID-19 pandemic emergency on the wellbeing of healthcare workers. However, few research contributions reported a longitudinal evaluation of psychological distress and examined determinants of its duration and course over time. The present study aims to explore the impact of the pandemic emergency on HCWs mental health by adopting a longitudinal design and assessing mental health as combination of overlapping clinical symptoms (post-traumatic stress disorder, depression and anxiety). Methods: Data were collected weekly through a mobile application during and after the first wave of COVID-19 in the province of Quebec, Canada, in 2020. Analysis was conducted on a final sample of 382 participants. Participants were grouped into "resilient" (RES) if they did not manifest clinical-level psychological distress during monitoring, "short-term distress" (STD) if distress exceeded the clinical threshold for 1-3 weeks, and longer-term distress (LTD) if it occurred for four or more weeks, even if not consecutively. Descriptive statistics for all variables were computed for each subgroup (RES, STD and LTD), and pairwise comparisons between each group for every descriptive variable were made using chi square statistics for categorical variables and t-test for continuous variables. Predictors of distress groups (STD and LTD vs RES) were assessed running multinomial hierarchical logistic regression models. Results: In our sample, almost two third (59.4%) HCWs did not manifest moderate or severe distress during the monitoring time. Short-term distress, mostly post-traumatic symptoms that lasted for less than 4 weeks, were the most common distress response, affecting almost one third of participants. Longer psychological distress occurred only in a smaller percentage (12.6%) of cases, as a combination of severe posttraumatic, depressive and anxiety symptoms. Perceived occupational stress was the most significant risk factor; moreover individual, peritraumatic work and family risk and protective factors, were likely to significantly affect the stress response. Discussion: Results tend to provide a more complex and resiliency-oriented representation of psychological distress compared to previous cross-sectional studies, but are in line with stress response studies. Findings allow us to better describe the profiles of distress response in STD and LTD groups. Participants that manifest short term distress experience acute stress reaction in which the interplay between personal, family and professional life events is associated with the stress response. Conversely, longer term distress response in HCWs presents a more complex mental health condition with an higher level of impairment and support needs compared to participants with short-term distress.