Using implementation science in youth mental health workforce development: Adapting to the COVID-19 pandemic in Australia

Aims: Globally, mental illness and substance use disorders are the leading cause of disability and disease burden for young people. Orygen is an Australian youth mental health organization with a mission to reduce the impact of mental ill-health on young people, families and society, and one of only a few known research and clinical centres with a dedicated Knowledge Translation division. This paper provides a case study of the workforce development team within Orygen Knowledge Translation, outlining how implementation science informs their work and how the division has adapted its model of service support in the face of COVID-19. Method(s): Process data on training and resources developed and delivered by the workforce development team at Orygen over the period 2017-2021 was collated and synthesized with team reflections about the adaptations made by team in response to the COVID-19 pandemic. Results and Conclusion(s): Since 2017, the team has delivered training to more than 4000 youth mental health workers across Australia, on the topics of trauma, psychosis, mood and anxiety disorders, brief interventions, cognition and other areas of youth mental health. The COVID-19 pandemic generated abrupt and dramatic changes to the delivery of workforce and service development initiatives in Australia due to significant restrictions to travel and in-person events. It also placed major delivery demands on youth mental health services. The COVID-19 pandemic facilitated profound and rapid changes to service delivery and development in Australian youth mental health. Implementation science offers flexible models to support a changing system.

Mental disorders during the pandemic of a new coronavirus infection: causes and predisposing factors.

Objective: to study the causes and predictors of mental disorders during the COVID-19 epidemic in those who turned to psychiatrist for the first time, as well as in patients with already diagnosed mental illness. Patients and methods. We examined 100 patients who turned to a psychiatrist due to a deterioration in their mental state during the pandemic, 50 patients were newly diagnosed (Group 1) and 50 with previously diagnosed mental disorders (Group 2). The study was carried out by a clinical method using a specially designed map, followed by statistical processing of the obtained data. Results and discussion. Mental disorders caused by the COVID-19 pandemic more often occurred at a young age, in patients with higher and secondary specialized education, and in single patients. In the 1st group, as a result of exposure to psychogenic factors (the influence of the media, quarantine, economic changes), anxiety (36.8%) and depressive (21.1%) disorders occurred more often, and after the coronavirus infection, depressive disorders were in the first place (54.2%). The 2nd group mostly included patients with endogenous disorders (bipolar affective disorder - 24%, recurrent depressive disorder - 20%, schizophrenia - 20%), which were exacerbated more often as a result of COVID-19, to a lesser extent - psychogenic (experiences associated with a change in material status and illness of relatives). Obsessive-compulsive disorder, generalized anxiety disorder, somatoform disorders have been associated with epidemic factors. Conclusion. The results obtained indicate that there are differences between the mental disorders that first appeared during the pandemic and the exacerbations of the condition in mentally ill patients, which relate to the predictors, causes and clinical manifestations of these disorders.Copyright © 2022 Ima-Press Publishing House. All rights reserved.

HOLISTIC APPROACH IN THE ASSESSMENT OF THE RELAPSE OF DEPRESSIVE AND ANXIETY DISORDERS DURING COVID-19.

The aim of the current study was to assess the influence of the first wave of COVID-19 (March- June 2020) on individuals with depression and anxiety, evaluating the impact of different groups of factors in a complex (holistic) manner. Material(s) and Method(s): The study is cross-sectional, including outpatients with depressive and anxiety disorders in remission (n = 60), outpatients in relapse (n = 65), a group of healthy controls (n = 30), and a control group with relatives of the patients with depression and anxiety (n = 30) for the period July-October 2020. Socio-demographic factors, the presence of somatic comorbidity and risk factors related to it, and the need for medical care during the first COVID wave were analyzed. Result(s): Patients with deteriorated anxiety disorders have a significantly lower educational status (p < 0.001) in comparison to the other groups. Individuals with deteriorated major depressive disorder and controls-relatives have significantly more somatic comorbidity compared to healthy controls (p < 0.05). Individuals with anxiety disorders do not differ from healthy controls on this measure. Visits to medical specialists in those with worsening depression increased during the analyzed period but were comparable to the control groups. In persons with anxiety - worsened or in remission, there is a significant increase in this indicator compared to healthy controls (p < 0.05). Conclusion(s): In the conditions of the first COVIDwave, individuals with worsened depression, as well as relatives of anxious and depressed patients have significantly more somatic problems compared to healthy controls. However, individuals with anxiety but not depression seek significantly more healthcare consultations, despite the isolation. The holistic approach implies a complex assessment of somatic and mental comorbidity and the need for additional knowledge and resources in the service of persons with anxiety and depression, although there is relatively easy access to consultation care in our country.Copyright © 2023, Central Medical Library Medical University - Sofia. All rights reserved.

Incidence and Persistence of Post-COVID-19 Conditions in the Year Following Initial Diagnosis

Objectives: Long-COVID, the persistence of various symptoms after COVID-19 infection, is still not fully understood. This study evaluated the incidence and chronicity of post-COVID-19 conditions using administrative claims, which provide a large, generalizable sample, to provide insight into the scope of long-COVID in the United States. Method(s): Patients newly diagnosed with COVID-19 from 4/1/2020-3/31/2021 were identified in the MerativeTM MarketScan Commercial and Medicare databases. The first COVID-19 diagnosis served as the index date and patients were continuously eligible for 12-months pre- and post-index. Incident conditions were defined as a new diagnosis (no pre-period diagnoses) for one of 17 conditions of interest in the first 60-days of the post-period. Among patients with an incident condition, chronicity of the condition was assessed over the remaining post-period (long-term conditions). Result(s): The sample included 503,742 patients;mean+/-SD age was 39.5+/-16.5 and 46% were male. The most common incident conditions were respiratory symptoms (24.1%), fatigue (7.3%), muscle pain (6.0%), and headache (5.9%). Among patients with each of these conditions, long-term persistence was observed in 21.9% for respiratory symptoms, 36.8% for muscle pain, 18.3% for fatigue, and 16.0% for headache. Fewer than 5% patients evidenced incident anxiety, mood disorders, myocarditis, sleep disorders, or pulmonary embolism;however, among these patients, over 40% had long-term persistence of the condition. Among patients with long-term conditions, sleep disorders (248+/-98 days), mood disorders (239+/-96 days), anxiety (236+/-95 days), respiratory symptoms (233+/-92 days), and asthma (230+/-93 days) had the longest average durations of persistence, evidenced by continued claims over the post-period. Conclusion(s): With the continued presence of COVID-19 an understanding of the risk of long-term symptoms is needed to help manage patients both during and following infection. These findings provide some initial insight into the incidence and tenure of various conditions that are affecting patients diagnosed with COVID-19.Copyright © 2023

Persistent Work Limitations in Long COVID: A Cross-Sectional Analysis of Employed US Respondents to the 2022 National Health and Wellness Survey

Objectives: Many Americans experience continued symptoms after SARS-CoV-2 infection. In addition to people who leave the workforce after experiencing COVID, those who remain employed may experience loss of productivity from short-term absences (absenteeism) and reduced productivity while working (presenteeism). We examined reported losses of work productivity among adults who reported physician-identified Long COVID. Method(s): We conducted a retrospective, cross-sectional analysis of data from National Health and Wellness Survey (May-Aug 2022) respondents. We included employed adults who reported having experienced COVID in the past (no date specified), said their physician identified them as having Long COVID or COVID syndrome, and reported symptoms at the time of survey. Respondents were stratified by their magnitude of activity limitations reported on the Work Productivity and Activity Impairment questionnaire;we describe responses for the lowest (LT) and highest tertiles (HT). Work productivity (absenteeism, presenteeism, overall work limitations from either absenteeism or presenteeism), and mental health (anxiety via General Anxiety Disorder-7 questionnaire, depression via Patient Health Questionnaire-9), were compared across tertiles. Result(s): Among 1036 Long COVID respondents meeting inclusion criteria, presenteeism ranged from 24.2% of LT respondents (n=291) to 92.8% of HT respondents (n=304), and absenteeism ranged from 12.7% (LT respondents) to 47.3% (HT respondents). Almost all (99.7%) HT respondents reported their overall work productivity was reduced by 50% or more while 26.7% of LT respondents reported the same. The prevalence of moderate-to-severe depression (92.4% vs. 37.8%) and moderate-to-severe anxiety (84.2% vs. 26.1%) was higher among HT relative to LT (all p<.001). Conclusion(s): Adults with Long COVID exhibit substantial heterogeneity in activity limitations;however, work limitations were substantial in all groups. Our results suggest significant economic impacts of Long COVID through lower productivity among those who remain employed. Further work with a comparison group is important to understand Long COVID-related work impairments, limitations, and disability.Copyright © 2023

Functional movement disorders during the COVID-19 pandemic

Functional movement disorders (FMDs) are a heterogenous group of movement abnormalities that greatly affect the quality of life of patients. They usually manifest as a result of underlying psychological or psychiatric illnesses without any known structural or neurochemical diseases. Various neurological disorders such as encephalitis, stroke, demyelination, seizures, and neuropathy have been reported by otherwise healthy individuals during the ongoing coronavirus disease 2019 (COVID-19) pandemic. Here, we describe the case of a 27-year-old woman who presented to our outpatient department with episodes of deviation of angle of mouth with variability and distractibility. Following thorough clinical evaluation and appropriate investigation, the underlying etiology was identified as FMD secondary to the restrictions imposed during the COVID-19 pandemic to contain the transmission of the virus. The lockdown, isolation, financial strain, and other pandemic-related issues are stressors that may contribute to psychogenic disorders in people.Copyright © 2021 Annals of Movement Disorders Published by Wolters Kluwer - Medknow.

Association Between COVID-19 Pandemic and Serious Mental Illness: Systematic Review within Salutogenesis Model for Public Health Management

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.

Social disability and impairment in childhood anxiety

This chapter discusses social disability and impairment in childhood anxiety. The chapter starts with a discussion of clinical characteristics of the condition. Approaches to evidence-based assessment and cognitive-behavioral treatment are discussed. Future directions are highlighted. © Springer Nature Switzerland AG 2011, 2023. All rights reserved.

Screening adolescents for psychosocial concerns

Psychosocial issues are cen-'tral to the care of adolescent patients. Pediatricians routinely discuss substance use, sexual health, and accident prevention with adolescents and are likely to see specific mental health concerns in about 20% of their patients. In light of rising suicide rates and the likely consequences of COVID-19, depression is an increasingly common concern. With limited access to mental health clinicians, individual pediatricians must manage patients' mental health needs by enhancing their own skills, collocating mental health personnel in their practices, and building trusted referral networks. Because psychosocial screening is now an expected part of pediatric primary care,1 this article focuses on screening adolescent patients, including choice of tools and follow-up of positive results.

Association of health behaviors with mental health problems in adolescents during COVID-19

Aim: Adolescents have experienced disruption in their daily routines, including changes in health behaviors such as an increased sedentary behavior and increased smartphone usage. The aim of this study was to assess the association of health behaviors with mental health problems. Method(s): Five cross-sectional surveys (February 2021 to May 2022) were performed during the pandemic assessing physical activity, smartphone usage, depressive symptoms (Patient Health Questionaire-9 (PHQ-9)), anxiety symptoms (Generalized Anxiety Disorder Scale 7 (GAD-7)), sleep quality (Insomnia Severity Index 7 (ISI-7)), and stress (Perceived Stress Scale 10 (PSS-10)). In total, N = 7201 adolescents (age: 14-20 years ((MW +/- SD): 16.63 +/- 1.49 years);70.2% female, 18.8% migration background) participated. Result(s): A strong increase in mobile phone usage as well as a decrease in physical activity as compared to pre-pandemic data were observed (p < 0.001). Compared to the lowest smartphone user group (<1 h/d), the adjusted odds ratios (aOR) for depressive symptoms increased with increasing smartphone usage to 1.98 (3-4 h/d), 3.30 (5-6 h/d), 4.96 (7-8 h/d), and 6.79 (>8 h/d). High utilizers (>8 h/d) were also more likely to experience clinically relevant anxiety, insomnia, or stress symptoms (aORs 3.23-5.75) compared to those using the smartphone less than 1 h/d. Conclusion(s): Results highlight the need for measures to promote responsible smartphone usage as well as to increase physical activity, so as to promote mental health in adolescence.Copyright © 2023

Mental health status of college students during coronavirus disease 2019 epidemic.

Objective To investigate the psychological characteristics of college students during the outbreak of coronavirus disease 2019 (COVID-19), so as to provide a basis for psychological intervention. Methods From May 17, 2020 to Jun. 17, 2020, the adjusted psychological questionnaires for emergent events of public health (PQEEPH) was surveyed among the college students of Beijing Union University. The questionnaire included 5 dimensions: depression, neurasthenia, fear, obsessive-compulsive anxiety, and hypochondriasis. Four grades were scored according to the degree and frequency of emotional responses: 0 means no symptoms, 1 means mild symptoms, 2 means moderate symptoms, and 3 means severe symptoms. Results A total of 3 019 valid questionnaires were collected. During the COVID-19 epidemic, the emotional responses of college students, from the most serious to the least, were fear, neurasthenia, depression, obsessive-compulsive anxiety, and hypochondriasis, with the incidences being 87.7% (2 648/3 019), 44.8% (1 353/3 019), 37.4% (1 129/3 019), 17.3% (522/3 019), and 11.6% (350/3 019), respectively. The fear scores of female students were higher than those of male students (P<0.001), the fear scores of college students from towns/suburbs were higher than those from rural and urban areas (both P<0.017), the scores of depression, neurasthenia and obsessive-compulsive anxiety of college students with confirmed COVID-19 cases around them or their relatives participated in the epidemic prevention and control as medical staff or logistics support personnel were higher than those without such conditions (all P<0.017), and the scores of depression, obsessive-compulsive anxiety and hypochondriasis of college students with suspected COVID-19 cases around them were higher than those without such condition (all P<0.017). Females were more likely to have moderate to severe fear than males (odds ratioOR=1.53, 95% confidence intervalCI1.25-1.88, P<0.001), those with confirmed or suspected COVID-19 cases around them were more likely to have moderate to severe fear than those without such conditions (OR=2.03, 95% CI 1.29-3.20, P=0.002), and those living in towns/suburbs were more likely to have moderate to severe fear than those living in rural and urban areas (OR=0.72, 95% CI 0.56-0.94, P=0.015;OR=0.78, 95% CI 0.63-0.97, P=0.025). Conclusion COVID-19 epidemic has impact on the psychology of college students. It is necessary to pay attention to the mental health of college students and provide targeted psychological counseling for them.Copyright © 2022, Second Military Medical University Press. All rights reserved.

The Earthquake Disaster in Turkiye: A Review from Child and Adolescent Psychiatry Perspective

The earthquake has long-lasting various mental and behavioral effects on children and adolescents. The aim of this review was to discuss the nature and extent of psychiatric problems, management options, and the process of organizing psychological interventions for affected children. Individuals show a range of physically, emotionally, and cognitively healthy responses that can help them cope with the aftermath of a disaster. Psychiatric symptoms such as acute stress reactions, post-traumatic stress disorder, depression, anxiety disorder, increased risk of suicide, sleep disorders, substance use disorders, and psychotic disorders may develop in some children. Comorbidities and sub-clinical syndromes are also common. There are many risk factors and protective factors in the development of mental disorders. Close follow-up of children at high risk and interventions for psychosocial support may prevent the development of mental disorders. It is very important to start the intervention at the earliest period. The psychological impacts of young disaster victims can be addressed by skilled local volunteers, medical professionals, and educators in primary health care programs. With the nation's overall social and economic recovery, children can recover more quickly from traumatic experiences.Copyright © 2023, Duzce University Medical School. All rights reserved.

The Impact of Prenatal Maternal Mental Health during the COVID-19 Pandemic on Birth Outcomes: A Study within CONCEPTION Cohort

Background: External natural events, such as hurricanes, floods, and the COVID-19 pandemic can contribute to increased populational stress, especially for pregnant persons. Exposure to crises can produce short- and longterm health effects on pregnant persons and their offspring. There has been much interest in the association between maternal depression, anxiety, and stress during pregnancy and perinatal outcomes such as preterm birth (PTB) and low birth weight (LBW), before and since the COVID-19 pandemic, however results are controversial. Objective(s): Assess the association between prenatal mental health during the COVID-19 pandemic and preterm birth (delivery <37 weeks gestation) and low birthweight (<2,500 grams). Method(s): Pregnant individuals, >18 years, were recruited in Canada and provided data through a web-based questionnaire. We analyzed data on persons recruited between 06/2020-08/2021 who completed questionnaires while pregnant and two months post-partum. Data on maternal sociodemographics, comorbidities, medication use, mental health (Edinburgh Postnatal Depression Scale, General Anxiety Disorder-7, stress), pandemic hardship (CONCEPTION - Assessment of Stress from COVID-19), and on gestational age at delivery and birth weight, were selfreported. Crude and adjusted relative risks (aRR) with 95% confidence interval (95%CI) were calculated to quantify the association between PTB/LBW and maternal mental health. Result(s): A total of 1,265 and 1,233 participants were included in the analyses of PTB and LBW, respectively. No associations between PTB and prenatal mental health (depression [aRR 1.01, 95%CI 0.91-1.11], anxiety [aRR 1.04, 95%CI 0.93-1.17], stress [aRR 0.88, 95%CI 0.71-1.10], nor hardship [aRR 1.00, 95%CI 0.96-1.04]) after adjusting for potential confounders. The risk of PTB was increased with nonwhite ethnicity/race (aRR 3.85, 95%CI 1.35-11.00), consistently with the literature. Similar findings were observed for LBW (depression [aRR 1.03, 95%CI 0.96- 1.13], anxiety [aRR 1.05, 95%CI 0.95-1.17], COVID stress [aRR 0.92, 95%CI 0.77-1.09], or overall hardship [aRR 0.97, 95%CI 0.94-1.01]). Conclusion(s): No association was found between prenatal mental health nor hardship during the COVID-19 pandemic and the risk of PTB or LBW. However, it is imperative to continue the follow-up of mothers and their offspring to detect long-term health problems early.

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.]

Psychopharmacological assessment of antidepressant-like, anxiolytic, and sedative-hypnotic effects of tilia platyphyllos scop. Extract using experimental animal models

The prevalence of psychiatric disorders namely depression, anxiety, and sleep disturbances has been increased worldwide, particularly during the COVID-19 pandemic. In this regard, the interest of recent investigations is moved toward phytomedicines and bioactive substances derived from natural sources. Although Tilia platyphyllos Scop. contains high amounts of phenolic compounds such as quercetin, kaempferol, and catechin, there is no study on the possible effects of its extract on psychological disorders. The present study was carried out to determine the antidepressant-like, anxiolytic, and sedative-hypnotic effects of the hydroethanolic extract of T. platyphyllos leaves using forced swimming test (FST), tail suspension test (TST), elevated plus maze test (EPMT), pentobarbital-induced loss of righting reflex test and open field test (OFT). Following the ethanolic extraction of T. platyphyllos leaves, the extraction yield was 14% and the total phenolic and total flavonoid contents were found to be 135.23 +/- 0.14 mg gallic acid equivalent/g dry extract and 19.02 +/- 0.03 mg rutin equivalent/g dry extract, respectively. Both FTS and TST revealed a significant antidepressant-like activity for the tested extract at 400 mg/kg compared to the control group. In addition, the anxiolytic activity of the extract was proven through OFT and EPMT in the same dose. Finally, T. platyphyllos extract at 200 mg/kg and 400 mg/kg significantly increased the sleeping time when compared to the control group reflecting its potential hypnotic activity. Co-administration of T. platyphyllos extract at 400 mg/kg and flumazenil as the GABA-A receptor antagonist decreased the sleeping time but the observed effect was not statistically significant. Therefore, we cannot completely rule out the GABA-A receptor's involvement in the hypnotic activity of the extract. The biological results presented here led us to conclude that T. platyphyllos extract can be a prominent source of antidepressant, anxiolytic and hypnotic agents. Probably, the main phenolic compounds of T. platyphyllos such as quercetin, kaempferol, and catechin are involved in the observed effects. However, there is still a great need for additional investigations on the exact mechanisms.Copyright © 2022, Iranian Association of Pharmaceutical Scientists. All rights reserved.

Trends in Postpartum Depression before and during the COVID-19 Pandemic and Correlates of Treatment Choices: A Population-Based Retrospective Cohort Study

Objectives: COVID-19-related stressors - including social distancing, material hardship, increased intimate partner violence, and loss of childcare, among others - may result in a higher prevalence of depression among postpartum individuals. This study examines trends in postpartum depression in the US from 2018 to 2022, as well as correlates of treatment choices among women with postpartum depression. Method(s): 1,108,874 women aged 14-64 in the Komodo Healthcare Map with 1+ live birth between April 2018 and December 2021 and had continuous enrollment 2+ years before and 4+ months after the delivery date were included. Prevalence of depression during postpartum (within 3 months after delivery) was calculated before (April 2018-March 2020) and during (April 2020-March 2022) COVID-19. Multinomial logistic regression was used to investigate correlates of treatment choices (no treatment, medication-only, psychotherapy-only, or both). Result(s): The prevalence of postpartum depression increased from 9.7% pre-pandemic to 12.0% during the pandemic (p < 0.001). Among 119,788 women with postpartum depression in 2018-2022, 47.0% received no treatment, 35.0% received medication-only, 10.0% received psychotherapy-only, and 7.4% received both within one month following their first depression diagnosis. Factors associated with an increase in the odds of receiving medication-psychotherapy treatment (vs. no treatment) included older ages;commercial insurance coverage;lower social vulnerability index;history of anxiety or mood disorder during and before pregnancy;and being diagnosed by a nurse practitioner, physician assistant, or behavioral care practitioner (vs. physician). Similar patterns were observed for medication-only and psychotherapy-only treatments. Conclusion(s): In this large, nationally representative sample of US insured population, the prevalence of postpartum depression increased significantly by 2.3 percentage-points during the pandemic (or a relative increase of 23.7%). Nonetheless, almost half of women with postpartum depression received no treatment, and only 7.5% received both medication and psychotherapy. The study highlighted potential socioeconomic and provider variation in postpartum depression treatment.Copyright © 2023

KAP Study Regarding COVID-19 Amongst Pregnant Women, in Central India

Objectives: To assess the knowledge, attitude and practices of preventive measures against COVID-19 infection among pregnant women. It is our understanding that assessing healthcare needs and healthcare education form the pillars for better healthcare thereby this study was conducted. Methodology: An observational cross-sectional study was conducted in which 150 antenatal women were included. Face-to-face interview was conducted by using a self-developed internally validated semi-structured questionnaire based on 3 major domains, Knowledge (10), Attitude (10) and Practice (4), with close ended questions. Each response-correct was allotted score 1 & incorrect allotted score of 0. The responses were described as frequencies and percentages. Scoring system-Poor score<60%, Fair score 60-75%, Good score > 75% of total score in each domain. Result(s): 103(68.7%) had good knowledge and 121(80.7%) had poor attitude, regarding COVID affecting their pregnancy, antenatal visits and unborn baby. 113(75.3%) were practicing preventive habits. Conclusion(s): Our study showed the anxiety and fear related to Covid-19 affected mental health of women and their adherence to antenatal care which needs to be addressed in providing antenatal care services.Copyright © 2023, Dr Yashwant Research Labs Pvt Ltd. All rights reserved.

Mental health status of military healthcare workers in shelter hospitals in Shanghai during the epidemic caused by severe acute respiratory syndrome coronavirus 2 omicron variant and its influencing factors.

Objective To investigate the mental health status of military healthcare workers in shelter hospitals in Shanghai during the epidemic caused by severe acute respiratory syndrome coronavirus 2 omicron variant and its influencing factors. Methods A total of 540 military healthcare workers in shelter hospitals in Shanghai were investigated with patient health questionnaire-9 (PHQ-9), generalized anxiety disorder-7 (GAD-7) and Athens insomnia scale (AIS) to explore their mental health status, and logistic regression was used to analyze the influencing factors. Results A total of 536 valid questionnaires were collected, with an effective rate of 99.3% (536/540). The incidence of depression, anxiety and insomnia among military healthcare workers in shelter hospitals in Shanghai was 45.5% (244/536), 26.1% (140/536) and 59.5% (319/536), respectively. Logistic regression analysis showed that whether people resided in Shanghai, the proportion of negative information in daily browsing information and diet status in shelter hospitals were the influencing factors of depression, anxiety and insomnia (all P<0.05);age and confidence in the future of Shanghai were the influencing factors of depression and insomnia (all P<0.05);and the time spent daily on epidemic-related information was an influencing factor of insomnia (P=0.021). Conclusion The incidence of depressive, anxiety and insomnia among military healthcare workers in shelter hospitals in Shanghai is high during the epidemic caused by severe acute respiratory syndrome coronavirus 2 omicron variant. Psychological consequences of the epidemic should be monitored regularly and continuously to promote the mental health of military healthcare workers.Copyright © 2022, Second Military Medical University Press. All rights reserved.

Maternal Mental Health during the COVID-19 Pandemic and Its Impact on Child Cognitive Development

Introduction: The COVID-19 pandemic has had a significant impact on pregnant persons' mental health. Prepandemic data reports an impact of depression, anxiety, and stress on the emotional and behavioral development of the child. Objective(s): We aimed to evaluate the impact of gestational maternal depression, anxiety, and stress during the COVID-19 pandemic on the child's cognitive development at 18 months. Method(s): The CONCEPTION study is a prospective mother-child cohort, established since June 23, 2020, during the COVID-19 pandemic. Depression and anxiety were assessed during pregnancy using validated tools in French and English (Edinburgh Postnatal Depression Scale [EPDS] and General Anxiety Disorder-7 [GAD-7]) as well as stress and antidepressant consumption. The child's cognitive development was reported by the mother using the third edition of Ages and stages questionnaires (ASQ-3) at 18 months of age. Data on other covariates were collected electronically. Multivariate linear regression models were built to assess the association between prenatal maternal depression, anxiety, stress, and child development across domains: communication, gross motor, fine motor, problem solving, and personal-social domains while adjusting for covariates. In addition, sensitivity analyses have been added like COVID-19 diagnosis. Result(s): Overall, 445 mother-child dyads were included in analyses (mean gestational age at delivery 39.2 weeks +/-1.8). Mean gestational scores were, for depression (EDPS, 7.8+/-5.4), anxiety (GAD-7, 4.4+/-4.0), and stress (4.3+/-2.1). Adjusting for potential confounders, as well as for maternal depression and anxiety during pregnancy, maternal prenatal stress was associated with communication skills (adjusted beta = 1.5, CI 95 % (0.34, 2.7)) and fine motor skills (adjusted beta = 1.06, CI 95 % (0.02, 2.6)) at 18 months age. Gestational depression, anxiety, and antidepressants use were not associated with any of the ASQ-3's domains. In addition, no significant association was found in stratified analysis for COVID-19 diagnosis. Conclusion(s): During the COVID-19 pandemic, gestational maternal stress was associated with some aspects of childhood cognitive problems, including communication and fine motor skills. Our results highlight the need to continue following-up on children until kindergarten to better understand the impact of maternal mental health during pregnancy on the child's cognitive development in the era of COVID-19.