Factors Associated with Medical Cannabis Use After Certification: A Three-Month Longitudinal Study.

Background: Over the past decade, there has been increased utilization of medical cannabis (MC) in the United States. Few studies have described sociodemographic and clinical factors associated with MC use after certification and more specifically, factors associated with use of MC products with different cannabinoid profiles. Methods: We conducted a longitudinal cohort study of adults (N=225) with chronic or severe pain on opioids who were newly certified for MC in New York State and enrolled in the study between November 2018 and January 2022. We collected data over participants' first 3 months in the study, from web-based assessment of MC use every 2 weeks (unit of analysis). We used generalized estimating equation models to examine associations of sociodemographic and clinical factors with (1) MC use (vs. no MC use) and (2) use of MC products with different cannabinoid profiles. Results: On average, 29% of the participants used predominantly high delta-9-tetrahydrocannabinol (THC) MC products within the first 3 months of follow-up, 30% used other MC products, and 41% did not use MC products. Non-Hispanic White race, pain at multiple sites, and past 30-day sedative use were associated with a higher likelihood of MC use (vs. no MC use). Current tobacco use, unregulated cannabis use, and enrollment in the study during the COVID-19 pandemic were associated with a lower likelihood of MC use (vs. no MC use). Among participants reporting MC use, female gender and older age were associated with a lower likelihood of using predominantly high-THC MC products (vs. other MC products). Conclusion: White individuals were more likely to use MC after certification, which may be owing to access and cost issues. The findings that sedative use was associated with greater MC use, but tobacco and unregulated cannabis were associated with less MC use, may imply synergism and substitution that warrant further research. From the policy perspective, additional measures are needed to ensure equitable availability of and access to MC. Health practitioners should check patients' history and current use of sedative, tobacco, and unregulated cannabis before providing an MC recommendation and counsel patients on safe cannabis use. clinicaltrials.gov (NCT03268551).

Isolated and Stressed? Examining the Effects of Management Communication in Alleviating Mental Health Symptoms during COVID-19.

The goal of this research was to assess the role of professional isolation on mental health symptoms via stress among employees working remotely due to COVID-19. Additionally, this research explored the interactive effect of management communication on the relationship between professional isolation and stress, and stress and mental health symptoms. In Study 1, behavior analysts who were working remotely as a result of the pandemic completed assessments of professional isolation, stress, and mental health symptoms at two points in time, separated by two weeks. Study 2 replicated and extended the findings from Study 1 in a sample of remote employees recruited from Amazon's Mechanical Turk using a three-wave design. Findings of both Study 1 and Study 2 suggested that stress mediated the relationship between professional isolation and mental health symptoms. Additionally, management communication buffered the association between stress and mental health symptoms in Study 2. Lastly, the indirect effect of professional isolation on mental health symptoms was stronger for those who received less communication from their management. The findings of these two studies expand our understanding of the mechanism and boundary condition through which professional isolation is related to mental health symptoms.

COVID-19-Related Stressors and Clinical Mental Health Symptoms in a Northeast US Sample.

Research has linked specific COVID-19-related stressors to the mental health burden, yet most previous studies have examined only a limited number of stressors and have paid little attention to their clinical significance. This study tested the hypothesis that individuals who reported greater COVID-19-related stressors would be more likely to have elevated levels of anxiety, posttraumatic stress symptoms, and serious psychological distress. METHODS: An online survey was administered to a convenience sample from 18 June to 19 July 2020, in US states that were most affected by COVID-19 infections and deaths at the time. Individuals who were 18 or older and residents of five Northeast US states were eligible to participate (N = 1079). In preregistered analyses, we used logistic regression models to test the associations of COVID-19 stressors with symptoms on the Generalized Anxiety Disorder-7 (GAD-7), Impact of Event Scale-Revised, and K6, adjusting for sociodemographic covariates. RESULTS: COVID-19-related stressors (i.e., essential worker status, worry about COVID-19 infection, knowing someone hospitalized by COVID-19, having children under 14 at home, loneliness, barriers to environmental rewards, food insecurity, loss of employment) were associated with meeting thresholds (i.e., positive screening) for anxiety, posttraumatic stress, and/or serious psychological distress. Loneliness and barriers to environmental rewards were associated with all mental health outcomes. LIMITATIONS: We used a non-probability sample and cannot assume temporal precedence of stressors with regard to development of mental health symptoms. CONCLUSIONS: These findings link specific stressors to the mental health burden of the COVID-19 pandemic.

Mental health outcome in hospitalized COVID-19 patients: An observational analysis from North Indian tertiary care hospital.

Aim: The study investigate the severity of perceived stress and wide domains of psychiatric symptoms reported on initial screening in hospitalized patients of COVID-19 with a second aim to determine the role of sociodemographic factors and coping styles in the hospitalized patients of COVID-19. Method: Total 224 patients of COVID-19 infection, hospitalized in various isolation facilities were assessed via web-based self-reported questionnaires on perceived stress scale, brief cope inventory, and DSM-5 crosscutting level-1 questionnaire. Results: Majority of the patients reported moderate level of stress followed by mild and severe. Depression and Anxiety symptoms were most common psychopathologies though the patients have reported greater severity in various domains of psychiatric symptoms. Coping styles explains most of variance (64.8%) of the perceived stress. Similarly total PSS scores, coping styles, COVID-19 status and sociodemographic factors contributed significantly to the variance of all psychiatric symptoms. Conclusion: Factors like female gender, being married, belonging to nuclear families, service class and urban domicile are the significant factors determining higher risk of stress and developing more psychopathologies. Furthermore, coping styles used by the patients have a greater moderating effect on mental health symptoms and their perceived stress which can be a major area for interventions to reduce the mental health morbidities.

Mental health symptom changes in pregnant individuals across the COVID-19 pandemic: a prospective longitudinal study.

BACKGROUND: Initial studies found that mental health symptoms increased in pregnant and postpartum individuals during the COVID-19 pandemic. Less research has focused on if these putative increases persist over time and what factors influence these changes. We examined the longitudinal change in mental health symptoms in pregnant and postpartum individuals and investigated moderation by maternal emotion dysregulation and the incidence of coronavirus. METHODS: Pregnant and postpartum individuals at the University of Utah were invited to join the COVID-19 and Perinatal Experiences (COPE) Study. Beginning on April 23, 2020 participants were sent a survey comprised of demographics, medical and social history, pregnancy information and self-assessments (Time 1). Participants were contacted 90 days later and invited to participate in a follow-up questionnaire (Time 2). Daily coronavirus case counts were accessed from the state of Utah and a 7-day moving average calculated. Within-subject change in mental health symptom scores, as measured by the Brief Symptom Inventory, was calculated. Linear mixed effects regression modeling adjusted for history of substance abuse and mental health disorders. RESULTS: 270 individuals responded between April 23rd, 2020 and July 15th, 2021. Mental health symptom scores improved by 1.36 points (0.7-2.0 p < 0.001). The decrease in mental health symptoms was not moderated by the prevalence of COVID-19 cases (p = 0.19) but was moderated by emotion dysregulation (p = 0.001) as defined by the Difficulties in Emotion Regulation Scale short form. Participants with higher emotion dysregulation also had higher mental health symptom scores. CONCLUSION: Mental health symptoms improved over the course of the pandemic in the same pregnant or postpartum participant. Our findings do not negate the importance of mental health care during the pandemic. Rather, we believe this identifies some aspect of resiliency and adaptability. Examining emotion dysregulation, or asking about a history of mental health, may be helpful in identifying persons at higher risk of heightened responses to stressors.

The Influence of COVID-19 Pandemic on the Frequent Use of E-Cigarettes and Its Association with Substance Use and Mental Health Symptoms.

BACKGROUND: Although several studies examined the association between e-cigarettes, substance use, and mental health conditions, there is limited research on whether COVID-19-related stress and health outcomes, mental health symptoms, and substance use differ by the frequency of e-cigarette use during the COVID-19 pandemic. We assessed the association of past 30-day frequent use of e-cigarettes with alcohol, cannabis, anxiety/depression, and COVID-19 impact. METHODS: We conducted a national online cross-sectional survey among a random sample of US adults aged 18 years or older (N = 5065) between 13 May 2021, and 9 January 2022. A multinomial logistic regression analysis was performed to assess the study aims. RESULTS: Of the participants, 7.17% reported once to several times per month (OSTPM), 6.95% reported once to several times per week (OSTPW), and 6.57% reported every day to several times per day (ESTPD) use of e-cigarettes in the past month. Alcohol and cannabis use ESTPD and once to several times per week/month (OSTPW/M) were associated with a higher likelihood of e-cigarette use ESTPD and OSTPW/M, respectively. Anxiety/depression was associated with e-cigarette use ESTPD and OSTPW. Individuals who considered social distancing to be stressful were more likely to use e-cigarettes ESTPD and OSTPW/M compared to those that considered social distancing as not stressful. CONCLUSION: Individuals who engaged in the frequent use of alcohol or cannabis, had depression/anxiety, and considered social distancing to be stressful were more likely to engage in frequent e-cigarette use. Improving efforts geared toward reducing the use of substances may help decrease the health risks associated with e-cigarette use.

Under or out of Government Control? The Effects of Individual Mental Health and Political Views on the Attribution of Responsibility for COVID-19 Incidence Rates

The paper shows the role of mental health and political views in attributing responsibility for COVID-19 incidence rates to the government and factors beyond government control. Authors' hypotheses draw on the classic and new versions of attribution theories, on literature from political psychology about the process of blaming the government for natural catastrophes, and also on local socio-political specifics (political polarization). The empirical data used in the article come from the survey carried out on-line via a professional research panel at the turn of May and June 2020, after about three months of lockdown, and during the presidential election campaign. The research sample included 850 Polish adults (aged 18 to 84) fully diversified in terms of gender, age, and education (the sample was representative for the Polish population in terms of respondents' place of residence and the country's region). To measure attribution of responsibility, the authors developed an 8-item instrument. Half of the instrument’s items indicate government and state institutions' responsibility and half describe circumstances not related to the government. The results showed that the respondents tended to attribute more responsibility for COVID-19 effects to the government than other ("non-government") factors. In explaining the government's responsibility, political views and party preferences play an incomparably more significant role than mental health symptoms. The authors interpret these results as the effect of attitudinal and affective political polarization of Polish society. © 2022 Turk Deprem Arastirma Dergisi. All rights reserved.

Gender differences in the experience of burnout and its correlates among Chinese psychiatric nurses during the COVID-19 pandemic: A large-sample nationwide survey.

Psychiatric nurses often experience burnout and other mental health symptoms. However, few studies have examined these phenomena and gender-specific associated factors during the COVID-19 pandemic. We surveyed a national sample of psychiatric nurses (N = 8971) from 41 tertiary psychiatric hospitals in China as part of a large national survey conducted during the pandemic. The Maslach Burnout Inventory-Human Service Survey was used to assess burnout and the Depression, Anxiety, and Stress Scale-21 was used to assess mental health symptoms. Binary logistic regression analyses were used to explore factors associated with burnout in the entire sample and separately by gender. The overall prevalence of burnout was 27.27%, with the rate in male psychiatric nurses (32.24%) being significantly higher than that in female psychiatric nurses (25.97%). Many key demographic factors (such as the male gender and marital status), work-related variables (such as a mid-level professional title, having an administrative position, longer working hours, more monthly night shifts, and the perceived negative impact of the COVID-19 pandemic on medical work) were significantly associated with burnout in the whole sample. Moreover, burnout was associated with depression, anxiety, and stress symptoms in the whole sample. Gender-specific factors associated with burnout were also identified: burnout was associated with night shifts in male psychiatric nurses, whereas it was associated with single or married marital status, a mid-level professional title, and having an administrative position among female psychiatric nurses. The high rates of burnout and mental health symptoms in psychiatric nurses need attention from hospital administrators. While mental health symptoms, longer working hours, and the perceived impact of COVID-19 are associated with burnout in both genders, gender-specific factors also warrant special attention when developing gender-specific interventions.

Screening Tool for Mental Health Problems During COVID-19 Pandemic: Psychometrics and Associations With Sex, Grieving, Contagion, and Seeking Psychological Care.

Background: The COVID-19 pandemic has created a public mental health crisis. Brief, valid electronic tools are required to evaluate mental health status, identify specific risk factors, and offer treatment when needed. Objective: To determine the construct validity, reliability, and measurement invariance of a brief screening tool for mental health symptoms by sex, loss of loved ones, personal COVID-19 status, and psychological care-seeking during the COVID-19 pandemic. Furthermore, the aim involved establishing a predictive pattern between the mental health variables. Method: A total sample of 27,320 Mexican participants, with a mean age of 32 years (SD = 12.24, range = 18-80), 67% women (n = 18,308), 23.10% with a loss of loved ones (n = 6,308), 18.3% with COVID-19 status (n = 5,005), and 18.40% seeking psychological care (n = 5,026), completed a questionnaire through a WebApp, containing socio-demographic data (sex, loss of loved ones, COVID-19 status, and psychological care-seeking) and the dimensions from the Posttraumatic Checklist, Depression-Generalized Anxiety Questionnaires, and Health Anxiety-Somatization scales. We used the confirmatory factor analysis (CFA: through maximum likelihood to continuous variable data, as an estimation method), the invariance measurement, and the structural equational modeling (SEM) to provide evidence of the construct validity of the scale and the valid path between variables. We analyzed the measurement invariance for each dimension by comparison groups to examine the extent to which the items showed comparable psychometric properties. Findings: The tool included eight dimensions: four posttraumatic stress symptoms -intrusion, avoidance, hyperactivation, and numbing, as well as depression, generalized anxiety, health anxiety, and somatization The tool's multidimensionality, was confirmed through the CFA and SEM. The participants' characteristics made it possible to describe the measurement invariance of scales because of the participants' attributes. Additionally, our findings indicated that women reported high generalized anxiety, hyperactivation, and depression. Those who lost loved ones reported elevated levels of intrusion and health anxiety symptoms. Participants who reported having COVID-19 presented with high levels of generalized anxiety symptoms. Those who sought psychological care reported high levels of generalized anxiety, intrusion, hyperactivation, and health anxiety symptoms. Our findings also show that intrusion was predicted by the avoidance dimension, while health anxiety was predicted by the intrusion dimension. Generalized anxiety was predicted by the health anxiety and hyperactivation dimensions, and hyperactivation was predicted by the depression one. Depression and somatization were predicted by the health anxiety dimension. Last, numbing was predicted by the depression and avoidance dimensions. Discussion and Outlook: Our findings indicate that it was possible to validate the factor structure of posttraumatic stress symptoms and their relationship with depression, anxiety, and somatization, describing the specific bias as a function of sociodemographic COVID-19-related variables. We also describe the predictive pattern between the mental health variables. These mental health problems were identified in the community and primary health care scenarios through the CFA and the SEM, considering the PCL, depression, generalized anxiety, health anxiety, and somatization scales adapted during the COVID-19 pandemic. Therefore, future studies should describe the diagnosis of mental health disorders, assessing the cut-off points in the tool to discriminate between the presence and absence of conditions and mental health cut-off points. Community and primary care screening will lead to effective early interventions to reduce the mental health risks associated with the current pandemic. Limitations: Future studies should follow up on the results of this study and assess consistency with diagnoses of mental health disorders and evaluate the effect of remote psychological help. Moreover, in the future, researchers should monitor the process and the time that has elapsed between the occurrence of traumatic events and the development of posttraumatic stress and other mental health risks through brief electronic measurement tools such as those used in this study.

Longitudinal associations between multiple mental health problems and suicidal ideation among university students during the COVID-19 pandemic.

BACKGROUND: Recent research suggested that COVID-19-related multiple mental health problems were associated with an increased risk for suicidal ideations (SIs), but population-based data demonstrating these associations are scarce. This study aimed to estimate the cumulative effects of psychological risk factors on SIs during the outbreak and remission periods of COVID-19 using a cumulative risk model, as well as sex differences. METHODS: A total of 68,685 college students in China participated in the survey during two phases of the pandemic (T1 and T2). Mental health risks (acute stress, depression, anxiety, insomnia, and obsessive-compulsive symptoms) and sociodemographic characteristics were measured at T1, and SIs were assessed at T1 and T2. Hierarchical regression analysis was used to determine the combined effect of multiple mental health problems on SIs at T1 and T2. RESULTS: The prevalence of SIs increased from the early periods of the COVID-19 pandemic (7.6%) to the later periods (10.0%). Depression was a powerful risk factor for SIs during the COVID-19 pandemic. Individuals with >3 mental risks would be most likely to experience rapidly increasing SIs during the early periods of the COVID-19 pandemic. Sex exerted different effects on the cumulative risk model of SIs. CONCLUSIONS: Interventions, such as mental health education and improving utilization of student support services, should be implemented. There is a crucial need for early intervention and prevention efforts aimed at males with greater than three mental health problems.

Increased severity of mental health symptoms among adolescent inpatients during COVID-19.

OBJECTIVE: Prior research suggests that the COVID-19 pandemic has been detrimental to adolescent mental health. However, no research has examined whether the pandemic is associated with increased symptom severity among high-risk youth, such as those hospitalized for a psychiatric crisis. METHOD: Over a four-year period, upon admission to an adolescent psychiatric inpatient unit, youth completed measures of depression (Center for Epidemiologic Studies Depression Scale), feeling like a burden and lack of belongingness (Interpersonal Needs Questionnaire), trauma-related symptoms (Child Trauma Screen), suicidal thoughts and behaviors (Self-Injurious Thoughts and Behaviors Interview Self-Report Version). We compared the severity of these symptoms for patients admitted during the pandemic to the severity for patients admitted to the same unit in the three years before the pandemic. RESULTS: Across most symptoms, youth hospitalized during the pandemic reported increased severity compared to those hospitalized before the pandemic. CONCLUSIONS: Adolescents requiring psychiatric hospitalization during the pandemic reported increased symptom severity compared to adolescents hospitalized on the same inpatient unit in the three years prior to the pandemic.

The Associations Between Parental Burnout and Mental Health Symptoms Among Chinese Parents With Young Children During the COVID-19 Pandemic.

The Coronavirus Disease 2019 (COVID-19) pandemic has caused numerous unexpected changes for families and societies, which have likely contributed to higher amounts of stress for most parents. This study aimed to examine the relationship between burnout and mental health among parents during the COVID-19. Pandemic exposure and household factors (e.g., family structure, family function) were examined as moderators. An online cross-sectional survey recruiting 1,209 adults was conducted from April 21st to April 28th, 2020 during the COVID-19 lockdown in China. The multivariable linear regression analysis was employed to test the association between burnout, household factors, and mental health among parents. Findings suggested that for parents with a young child, poorer mental health was related to a higher level of burnout (ß = 0.220, P < 0.001) and greater exposure to the pandemic. Mothers of a single and/or young child had considerably poorer mental health. Moreover, the relationship between mental health and burnout among parents was significantly moderated by epidemic exposure (ß = 2.561, P < 0.001), family structure (number of children: ß = -1.257, P < 0.001; first child age: ß=-1.116, P < 0.001) and family function (ß = -0.574, P < 0.05). This study indicated that burnout symptoms were significantly associated with worse mental health among parents in China. Besides, exposure to the pandemic, family structure, and family function was found to moderate the association between burnout and mental health among parents. Therefore, the present study stressed enhanced access to mental health resources and emotional supports for parents during a public crisis to reduce the deleterious effects of burnout.

The effect of spiritual fortitude on mental health symptoms amidst the COVID-19 pandemic

The COVID-19 pandemic is a global traumatic stressor affecting millions of individuals worldwide. Traumatic events often cause significant resource loss and negatively affect mental health and emotional well-being. In the wake of trauma, many people draw on religious or spiritual faith to cope with adversity and suffering. One construct that has received increased attention within the field of religious/spiritual coping is spiritual fortitude (SF), which is one's ability to consistently draw on spiritual and religious resources to cope with negative emotions in the face of stressors (Van Tongeren et al., 2018). In this paper, we present data from 255 participants who completed measures of resource loss related to the ongoing COVID-19 pandemic, SF, depression, anxiety, and post-traumatic stress disorder (PTSD) symptoms. SF buffered the deleterious relationship between resource loss and mental health symptoms. Specifically, for individuals high in SF, the relationship between resource loss and mental health symptoms was weaker than for individuals low in SF. We conclude by discussing limitations of the current study, areas for future research, and implications for practice. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

The Effects of Severe Acute Respiratory Syndrome Coronavirus 2 on the Reported Mental Health Symptoms of Nonprofessional Carers: An Analysis Across Europe.

OBJECTIVES: This study tries to analyze how the crisis generated by severe acute respiratory syndrome coronavirus 2 has affected the reported mental health symptoms of informal caregivers in different European countries. METHODS: The Survey of Health, Ageing and Retirement in Europe-COVID-19 was used, collecting information from the beginning of June 2020 to August 2020 about individuals' state of health and the care they received. Several probit regression models were used to analyze the differences in the probability of (1) being sad or depressed, (2) being anxious or nervous, (3) having difficulty sleeping, and (4) feeling lonely, between individuals who provided informal care and individuals who did not. Several subanalyses by geographic area, mortality rates due to coronavirus disease 2019 (COVID-19), and long-term care expenditure were also performed. RESULTS: Since the outbreak of COVID-19, informal caregivers have had a higher probability of being sad or depressed of 8 percentage points (p.p.), a 7.1 p.p. higher probability of being anxious or nervous, and a 5.9 p.p. higher probability of having difficulty sleeping than non-caregivers. Informal caregivers in Southern Europe have had an 8 p.p. higher probability of being sad or depressed than non-caregivers. In Eastern Europe, this difference in probability reaches 9.7 p.p. Finally, in countries with higher mortality rates due to COVID-19, there have been greater differences in terms of being sad or depressed between caregivers and non-caregivers, regardless of expenditure on long-term care. CONCLUSIONS: Since the outbreak of COVID-19, informal caregivers in Europe have had a higher probability of reporting mental health symptoms than non-caregivers.

Impact of the COVID-19 pandemic on the psychological health of individuals with mental health conditions: A mixed methods study.

OBJECTIVES: This study explored how the coronavirus disease 2019 (COVID-19) pandemic has affected individuals with mental health conditions. METHODS: Participants were 477 adults (82% female) who reported a past-year mental health condition. They completed an online survey that included an open-ended question. Mixed methods analysis was conducted. RESULTS: While all mental health conditions were moderately impacted by the COVID-19 pandemic, self-reported impact on anxiety disorder and obsessive-compulsive disorder symptoms was greater than for all other mental health symptoms. Thematic analysis revealed five themes: (1) the contribution of the pandemic to worsening mental health; (2) life interruptions due to the pandemic; (3) increased loneliness/isolation; (4) upsides of the pandemic; and (5) normalization of the anxieties previously experienced by those with mental health conditions. CONCLUSION: Individuals with pre-existing mental health conditions reported a worsening of symptoms during the COVID-19 pandemic. Governments and organizations must focus on supporting and increasing access to treatment for this population.

Mental Health Symptoms, Binge Drinking, and the Experience of Abuse During the COVID-19 Lockdown in Mexico.

Background: The health crisis associated with the COVID-19 pandemic is causally linked to negative mental health symptoms in the same way as other diseases such as Ebola. Objective: The purpose of this paper is to describe the relationship between mental health symptoms, binge drinking, and the experience of abuse during the COVID-19 lockdown. Method: We surveyed 9,361 participants, all Mexican, with an average age of 33 years old (SD = 10.86). In this group of people, we found out that 59% were single (5,523), 71% were women (6,693). Forty-six percentage were complying with lockdown procedures (4,286), 50% were partially complying (4,682), and 4% were not complying at all (393). The invitation to participate was open from April 24th to April 30th during the second stage of the pandemic in Mexico, in 2020, characterized by voluntary complete lockdown staying at home. Thus, we used a cross-sectional online survey design to assess mental health risk factors related to the COVID-19 pandemic. The survey was available on a WebApp designed by Linux®, PHP®, HTML®, CSS®, and JavaScript®. We calculated descriptive and inferential analysis to describe the mental health average distribution as a function of the lockdown, binge drinking, and experience of abuse. To calculate the reliability and validation of the subscales, we used Cronbach's Alpha and Factor Loading. We run the confirmatory factor loading analysis, and we described the relationship between each latent variable and its item factor load, obtained through structural modeling equations, derived from 179 iterations and 207 parameters (t[1,171] = 28,079.418, p < 0.001). We got a CFI of 0.947, a TLC of 0.940, an RMSEA of 0.049 (0.049-0.050), and an SRMR of 0.048. Findings: The results indicated that reported attitudes such as avoidance, sadness, withdrawal, anger, and anxiety were associated with acute stress, which was linked to an anxiety condition caused by uncertainty about achieving or maintaining overall good health. Discussion and Prospects: People in lockdown mentioned a sudden increase in alcohol consumption. They lived episodes of physical and emotional abuse, in contrast with those who stated that they did not go into lockdown or consume alcohol, or experienced abuse. Limitations: Further studies should diagnose mental health conditions as part of the impact of COVID-19, ensure their follow-up, and assess the effect of providing remote psychological care. There is a need to explore methods to curb the increase in the number of people affected by post-traumatic stress disorder.

Prevalence and risk factors for mental health symptoms in community epidemic prevention workers during the postpandemic era of COVID-19 in China.

Few people have paid attention to community epidemic prevention workers in the postpandemic era of COVID-19. This study aimed to explore the prevalence and risk factors for mental health symptoms in community epidemic prevention workers during the postpandemic era. Mental health status was evaluated by the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Chinese Perceived Stress Scale, Insomnia Severity Index, and Maslach Burnout Inventory-General Survey. The results showed that a considerable proportion of community epidemic prevention workers reported symptoms of depression (39.7%), anxiety (29.5%), high stress (51.1%), insomnia (30.8%), and burnout (53.3%). The prevalence of depression and anxiety in community epidemic prevention workers was higher than in community residents. Among community epidemic prevention workers, short sleep duration was a risk factor for depression, anxiety, high stress and insomnia. Concurrent engagement in work unrelated to epidemic prevention and current use of hypnotics were risk factors for depression, anxiety and insomnia. Our study suggests that during the postpandemic era, the mental health problems of community epidemic prevention workers are more serious than those of community residents. Several variables, such as short sleep duration and concurrent engagement in work unrelated to epidemic prevention, are associated with mental health among community epidemic prevention workers.

Preventive Behaviors and Mental Health-Related Symptoms Among Immunocompromised Adults During the COVID-19 Pandemic: An Analysis of the COVID Impact Survey.

The COVID-19 pandemic has disrupted the continuity of care of U.S. adults living with chronic diseases, including immunocompromised adults. Disruption in care may be a barrier to identifying COVID-19 associated sequelae, such as mental health symptoms, among the immunocompromised. Our objectives were to evaluate COVID-19-related preventive behaviors, with a focus on canceling doctor's appointments as a proxy for continuity of care, and to compare COVID-19-related mental health symptoms among the immunocompromised with the general population. We used nationally-representative data of 10,760 U.S. adults from the publicly-available COVID-19 Household Impact Survey. We defined immunocompromised as adults with a self-reported diagnosis of "a compromised immune system" (n = 854, 7.6%). We adherence to self-reported COVID-19 preventive behaviors among immunocompromised adults to others using χ2-tests. We focused on continuity of care and estimated determinants of canceling doctor's appointments among the immunocompromised using multivariable Poisson regression to estimate adjusted prevalence ratios (aPRs) with 95% confidence intervals (95% CIs). We evaluated associations of mental health symptoms with being immunocompromised using multinomial logistic regression and estimated conditional odds ratios (cOR) with 95% CIs. Immunocompromised adults were more likely to adhere to recommended COVID-19 preventive behaviors, including washing or sanitizing hands (96.3% vs. 89.8%, χ2 <0.001), maintaining social distance (91.9% vs. 83.7%, χ2 <0.001), and canceling a doctor's appointment (47.1% vs. 29.7%, χ2 <0.001). Hispanic immunocompromised adults (aPR: 1.47, 95% CI: 1.12-1.92) and immunocompromised women (aPR: 1.25, 95% CI: 1.00-1.56) were more likely to cancel doctor's appointments compared to non-Hispanic White immunocompromised adults and men, respectively. Immunocompromised adults reported higher odds of feeling nervous/anxious/on edge (cOR: 1.89, 95% CI: 1.44-2.51), depressed (cOR: 2.81, 95% CI: 2.17-3.64), lonely (cOR: 2.28, 95% CI: 1.74-2.98), and hopeless (cOR: 2.86, 95% CI: 2.21-3.69) 3-7 days in the last week. Immunocompromised adults were more likely to cancel their doctor's appointments and report COVID19-related mental health symptoms. The continuity of care of immunocompromised adults should be prioritized through alternative interventions, such as telehealth.