Addiction to medical websites post COVID-19 pandemic: a predictor of illness anxiety disorder among Arabian youth

BackgroundThe coronavirus (COVID-19) pandemic has significantly impacted every region of the world. During these unprecedented times, college students have been experiencing severe mental health issues concerning excessive internet usage. On average, 42.9% of students in Egypt utilized the internet (Anwar et al. in J Public Health 30:1753–1762, 2022). Arabs quickly diagnose themselves online using medical websites. The issue is exacerbated by drugs bought without a prescription (Alghadeer et al. in Saudi Pharm J 26:719–724, 2018).MethodsThis study examined he relationship between addiction to medical websites and behaviors related to Illness Anxiety Disorder among a population of Arabic university students. A sample consisting of N = 368 youths was examined.ResultsBivariate linear regression, Z score, R2, t-test, ANOVA, mean, and standard deviation were used for statistical analysis. The findings of the study revealed a linear equation that predicts illness anxiety in adolescents. The correlation between medical website addiction and hypochondria was found to be 0.69. Furthermore, male participants were more addicted to medical websites than female participants.ConclusionsFindings supported the notion that addiction to medical websites significantly predicts hypochondria.

Nocturnal enuresis in an adolescent with anxiety disorder during the COVID-19 pandemic.

The case of an adolescent with nocturnal enuresis since childhood, and anxiety symptoms during adolescence, associated with psychosocial factors and family dynamics, is presented. During the COVID-19 pandemic, he presented intense symptoms of anxiety related to fears of dying and/or experiencing a serious illness, reasoned for which he was taken to the emergency room on several occasions. The patient responded favorably to antidepressant medications, and individual and family psychotherapy approaches. Nocturnal enuresis es an elimination disorder rarely seen in adolescence, and whose diagnosis and treatment are important due to its impact on the patient's psychosocial functioning and greater probabilities of comorbidity. The effects of the COVID-19 pandemic on adolescents and its higher risk of presenting anxiety, depression and stress associated with enuresis, are also discussed.Copyright © 2022 Authors.

A COVID-19-járvány miatt kialakult betegségszorongás és depresszió kezelése kognitív viselkedésterápiával egy emlorákos no esete kapcsán.

Cancer and the various medical treatments and tests are a major physical and psychological challenge for patients, their relatives and for the medical staff as well. Adherence and compliance become critical factors during prolonged oncological therapies. The mental health of people with malignant cancer, untreated psychological symptoms can affect survival by increasing distress and suffering, weakening quality of life and reducing adherence. Furthermore, they have a particularly high comorbidity with psychiatric disorders. The aim of this study is to introduce the tools of cognitive behavioural therapy and the therapeutic indications in the context of mental disorders associated with chronic somatic illness. Our study presents the case of a 66-year-old woman with breast cancer. She was diagnosed with mild depressive episodes and hypochondriasis based on psychodiagnostic assessment. Instead of interpreting the patient's symptoms as a serious organic illness, the goal of psychotherapy is to develop new, more adaptive attitudes and more comforting perspective of the symptoms, and to reduce secondary depression. The elements of the 16-session cognitive behavioural therapy included behavioural activation, analysis of symptomatic behaviour, diary management, development of new alternatives and behavioural experiments, conceptualisation, and summarising learned techniques and future planning. Orv Hetil. 2022; 163(23): 895-901.

Negative interpretation of ambiguous bodily symptoms among illness-anxious individuals: Exploring the role of developmental and maintenance constructs.

Background: Cognitive factors play an essential role in the development and maintenance of anxiety problems. Among individuals with illness anxiety problems, their interpretation of bodily symptoms is a crucial factor in the determination of their ability to regulate their emotions. The catastrophic interpretation of ambiguous bodily symptoms and changes, known as interpretation bias, in line with the failure to reappraise the symptoms in safer ways, is supposed to increase the levels of anxiety in illness-anxious individuals. Methods: This study aimed to address the statistical limitations of the direct (self-report) measure of interpretation bias, using an indirect (online interpretation bias task) measure for assessing biased interpretations of bodily symptoms. In addition, we examined the contribution of self-report anxiety sensitivity (AS), intolerance of uncertainty (IU), interpretation bias, and reappraisal to illness anxiety problems in a subclinical population and compared it with controls with low levels of illness anxiety. Findings: Illness-anxious individuals made more negative interpretations of ambiguous, potentially health-threatening information. They used less reappraisal to regulate their emotion. Among the measures, the physical subscale of AS and the reaction time to the safe resolution of ambiguous information were the best factors that could contribute to the differentiation between the illness-anxious individuals and non-anxious individuals. Conclusion: Our findings provided further support for the biased processing of information related to physical symptoms among individuals with illness anxiety. AS-physical and safe resolutions for ambiguous situations could differentiate the illness-anxious and the control groups better than other factors. These findings suggest that a change of interpretation of ambiguous bodily symptoms among individuals suffering from chronic conditions can be a possible intervention to target anxiety and improve patients' lives.

A Cognitive Behavioral Therapy Chatbot (Otis) for Health Anxiety Management: Mixed Methods Pilot Study.

BACKGROUND: An increase in health anxiety was observed during the COVID-19 pandemic. However, due to physical distancing restrictions and a strained mental health system, people were unable to access support to manage health anxiety. Chatbots are emerging as an interactive means to deliver psychological interventions in a scalable manner and provide an opportunity for novel therapy delivery to large groups of people including those who might struggle to access traditional therapies. OBJECTIVE: The aim of this mixed methods pilot study was to investigate the feasibility, acceptability, engagement, and effectiveness of a cognitive behavioral therapy (CBT)-based chatbot (Otis) as an early health anxiety management intervention for adults in New Zealand during the COVID-19 pandemic. METHODS: Users were asked to complete a 14-day program run by Otis, a primarily decision tree-based chatbot on Facebook Messenger. Health anxiety, general anxiety, intolerance of uncertainty, personal well-being, and quality of life were measured pre-intervention, postintervention, and at a 12-week follow-up. Paired samples t tests and 1-way ANOVAs were conducted to investigate the associated changes in the outcomes over time. Semistructured interviews and written responses in the self-report questionnaires and Facebook Messenger were thematically analyzed. RESULTS: The trial was completed by 29 participants who provided outcome measures at both postintervention and follow-up. Although an average decrease in health anxiety did not reach significance at postintervention (P=.55) or follow-up (P=.08), qualitative analysis demonstrated that participants perceived benefiting from the intervention. Significant improvement in general anxiety, personal well-being, and quality of life was associated with the use of Otis at postintervention and follow-up. Anthropomorphism, Otis' appearance, and delivery of content facilitated the use of Otis. Technical difficulties and high performance and effort expectancy were, in contrast, barriers to acceptance and engagement of Otis. CONCLUSIONS: Otis may be a feasible, acceptable, and engaging means of delivering CBT to improve anxiety management, quality of life, and personal well-being but might not significantly reduce health anxiety.

Perinatal patients with symptoms of anxiety

This chapter provides descriptions, typical clinical presentations, and case reviews of perinatal anxiety and perinatal obsessive-compulsive disorder. The discussed anxiety disorders include generalized anxiety disorder, panic disorder, and illness anxiety disorder as encountered in the perinatal period including pregnancy and 12 months' postpartum. Suggestions for provider advocacy during increased rates of intimate partner violence during COVID-19 are provided. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Time trends in mental health indicators during the initial 16 months of the COVID-19 pandemic in Denmark

Background: The COVID-19 pandemic and its associated national lockdowns have been linked to deteriorations in mental health worldwide. A number of studies analysed changes in mental health indicators during the pandemic;however, these studies generally had a small number of timepoints, and focused on the initial months of the pandemic. Furthermore, most studies followed-up the same individuals, resulting in significant loss to follow-up and biased estimates of mental health and its change. Here we report on time trends in key mental health indicators amongst Danish adults over the course of the pandemic (March 2020-July 2021) focusing on subgroups defined by gender, age, and self-reported previously diagnosed chronic and/or mental illness. Methods: We used time-series data collected by Epinion (N=8,261) with 43 timepoints between 20 March 2020 and 22 July 2021. Using a repeated cross-sectional study design, independent sets of individuals were asked to respond to the Copenhagen Corona-Related Mental Health questionnaire at each timepoint, and data was weighted to population proportions. The six mental health indicators examined were loneliness, anxiety, social isolation, quality of life, COVID-19-related worries, and the mental health scale. Gender, age, and the presence of previously diagnosed mental and/or chronic illness were used to stratify the population into subgroups for comparisons. Results: Poorer mental health were observed during the strictest phases of the lockdowns, whereas better outcomes occurred during reopening phases. Women, young individuals (<34 yrs), and those with a mental- and/or chronic illness demonstrated poorer mean time-series than others. Those with a pre-existing mental illness further had a less reactive mental health time-series. The greatest differences between women/men and younger/older age groups were observed during the second lockdown. Conclusions: People with mental illness have reported disadvantageous but stable levels of mental health indicators during the pandemic thus far, and they seem to be less affected by the factors that result in fluctuating time-series in other subgroups. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Health anxiety is associated with fearful imagery of contracting COVID-19: An experimental study.

BACKGROUND: Aversive mental images of contracting or having a severe disease are assumed to contribute to the development and maintenance of health anxiety (HA) via the elicitation of fear, arousal and defensive mobilization. The current COVID-19 pandemic is known to trigger fears of contracting COVID-19. METHODS: In this study, we used an experimental approach to investigate whether COVID-19-related mental images lead to a fearful response and whether this is associated with levels of HA. 139 participants vividly imagined neutral, standard fear and COVID-19 related narrative scenes. RESULTS: Standard fear and COVID-19 scripts prompted higher anxiety, arousal, displeasure and avoidance tendencies as compared to neutral scripts. HA was associated with higher anxiety, arousal, displeasure, imagery vividness and stronger avoidance tendencies during imagery of COVID-19 scenes. No associations were found for anxiety sensitivity, trait anxiety as well as depressive and anxiety symptoms. Moreover, there was no association of HA with emotional responses during imagery of standard fear scenes. LIMITATIONS: Fear responses were assessed via verbal reports. Future studies should also assess behavioral and physiological correlates of fear. CONCLUSIONS: The present results indicate that individuals with high levels of HA are prone to fearful mental imagery of contracting COVID-19 which might be crucial factor contributing to the exacerbation and chronicity of excessive HA in times of a pandemic.

Anxiety, depression, and health anxiety in undergraduate students living in initial US outbreak "hotspot" during COVID-19 pandemic.

Evidence of the psychological distress associated with the COVID-19 pandemic, including depression, anxiety, and health anxiety, has been documented globally. College students are a unique sub-set of the population with consistently elevated psychological distress associated with the pandemic, and well-informed intervention is urgently needed. The current study is the first, to our knowledge, to document the effects of the COVID-19 pandemic on the mental health of undergraduates in a heavily impacted area in the United States. Cross-sectional, self-report data on psychological distress and COVID-19 exposure were collected from a racially and ethnically diverse sample of 641 undergraduates between April 7-9 May 2020. Nearly half of the students reported elevated psychological distress, including health anxiety, general anxiety, and depression. Heightened risk of psychological distress was associated with female sex, a COVID-19 case in one's immediate social network, underlying medical vulnerabilities, and recent experience of ≥3 viral symptoms. Vigilance to viral symptoms and worry about coronavirus were also factors associated with more severe psychological distress. The current study highlights some of the factors associated with a greater risk of developing psychological distress due to COVID-19 and can be used to inform the dissemination of psychological interventions.

On the Nature of Fear and Anxiety Triggered by COVID-19.

Emergencies that occur during natural disasters, such as avalanches, earthquakes, and floods, tend to be sudden, unexpected, and ephemeral and recruit defensive responses, similar to the ones recruited when faced with dangerous animals. Defensive behaviors are triggered by activity in survival circuits that detects imminent threats and fear is the conscious emotion of that follows immediately. But this particular threat (COVID-19) is useable and mysterious, triggering anxieties much more than fear. We conducted a literature search on May 1, 2020 in Google Scholar, PsychInfo, and PubMed with search terms related to COVID-19 fears and found 28 relevant articles. We categorized the papers into six groups based on the content and implications: fear of the unknown, social isolation, hypochondriasis, disgust, information-driven fears, and compliance. Considering the nature of fear and anxiety, combined with the characteristics of the present COVID-19 situation, we contemplate that physicians and other health care workers of several specialties, as well as police officers, fire-fighters, and rescue personnel, and first responders might be more able to deal with COVID-19 if they have (a) some tolerance of the unknown, (b) low illness anxiety disorder, (c) tolerance to social isolation; (d) low levels of disgust sensitivity; (e) be granted financial support, (f) have priority if needed medical assistance (g) use caution relatively to the COVID-19 media coverage and (h) be trained to have high levels of efficacy. Possibilities for preventive and therapeutic interventions that can help both health care personnel and the general population are also discussed.

An analysis on the panic during COVID-19 pandemic through an online form.

With the rapid spread of global pandemic coronavirus disease 2019 (COVID-19), people around the world express panic in various behaviors. This affects the economy of the county, social values, and psychological stress of the people involved regardless of the directness of contact with the infected. This study aims to analyze the panic responses of the people as well as the perception on the global issue through an online survey. The researchers used Health Anxiety Inventory and open ended questions regarding the feelings, thoughts and actions of people during the enhanced community quarantine. Quantitative and qualitative data were both analyzed and interpreted interactively. Results also show that there is a significant difference (p = 0.028) in the Avoidance behavior between locations. Furthermore, a significant difference (p = 0.000) also shows on the Symptoms of Hypochondriasis between exposure to COVID-19. COVID-19 Panic Framework were also conceptualized with the following themes arranged from negative to positive behaviors: Indifference, Annihilation, Nihilism, Paranoia, Sadness, Fear, Transmission of Virus, Shock, Government Blaming, Anxiety, Relating to Past Pandemics, Worry on Self/Family/Others, Information Dissemination, Composure, Compliance, Protection, Cautiousness, Optimism, and Health Consciousness. In conclusion, levels of health anxiety were consistent regardless of location and exposure to COVID-19 patients. Lastly, spectrum of panic consequences due to COVID-19 pandemic were constructed.