Stress reactions and health problems in hospital personnel during the COVID-19 pandemic-A longitudinal, multicenter study

Background: The overarching aim of the study was to (1) investigate how working with COVID-19 patients has impacted work environment, and (2) to identify how factors in the work environment impact adverse health outcomes among hospital personnel (HP), throughout the four waves of the pandemic. Material(s) and Method(s): In a web-based survey altogether 2472 HP participated from four large university hospitals in Norway, whereof N = 680 in April-June 2020 (T1), N = 1073 in December-January 2020/2021 (T2), N = 818 in April-May 2021 (T3), and N = 972 in December 2021-February 2022 (T4). At each time point participants reported on pandemic related work tasks, work environment and adverse health outcomes. Somatic symptoms, psychological distress, posttraumatic stress symptoms and burnout served as outcomes of multivariable linear regression models. The percentage of responders involved in ICU treatment of COVID-19 patients varied between 21% and 40% from T1-T4. Result(s): Reported stressors altered in strength during the 4 waves. Preliminary results indicate that exposure to patients with COVID-19 was associated with more frequent experience of work environmental factors. Compared to colleagues not working with patients with COVID-19 HP reported challenges related to professional competency and training, predictability in teams and work environment, manageable workload, adequate help and support for work stress management, user-friendliness of Personal Protection Equipment and infection protection safety. Furthermore, these environmental factors were associated with symptoms of psychological unhealth on at least one timepoint. Conclusion(s): The results may help guide organizational efforts to maintain professional competency and to reduce stress more efficiently among hospital personnel at different stages in response to long-term crises.

Mental distress among healthcare workers due to COVID-19 during second wave in a tertiary care center of South Karnataka: A cross-sectional study

Background: Healthcare workers (HCWs) in India are facing physical and psychological pressure. The pandemic has significant psychological impacts. Hence, we wanted to assess the mental stress and social stress among HCWs during the second wave of COVID-19. Aim and Objectives: Assessment of the mental distress among HCWs of tertiary care level institution during second wave of COVID-19 with the following objectives: (1) To know the sociodemographic characteristics of the HCWs of tertiary care center and (2) to assess the psychological stress among healthcare workers of a tertiary health center. Material(s) and Method(s): It is a cross-sectional and observational study conducted in hospital setting, in a tertiary care setting. Data were collected from 196 HCWs of the institute. Institutional ethical clearance was taken before the study. Structured questionnaire included sociodemographic variables, work-related variables, and variables to assess social stress. We used hospital anxiety and depression scoring questionnaire to assess anxiety and depression. Data were collected through personal interviews and online through Google forms after taking informed consent. Descriptive statistics and Chi-square tests are used analyzed using Statistical Package for the Social Sciences Version 21 for Statistical analysis. Result(s): A total of 196 HCWs, 121 doctors, 74 nursing staff, and one ward staff participated in the study. Nursing staff were at higher risk for anxiety and depression, that is, 29% and 25% than others. Females were slightly more anxious (29%) and depressed (17%) than males. HCWs who are Muslim by religion were at more mental distress. Media exposure of more than 3 h had increased risk of mental distress. HCWs with other frontline COVID warrior as a partner were both anxious (40%) and depressed (20%). Anxiety (35%) was more among those who's family members got COVID positive. About 25% of them faced social stigma, 55% of them faced issue of isolation with in the community, and 14% of them faced acts of violence which is unacceptable. Conclusion(s): Although its second wave HCWs are still having psychological distress which needs to be addressed. Social stress that they are facing is significant and is associated with higher anxiety and depression, which has to be taken seriously.Copyright © 2023, Mr Bhawani Singh. 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.

Stress and coping among elderly during the COVID-19 pandemic in Sulaimanya city in Kurdistan region of Iraq

This study aimed to find out the level of stress and coping methods among elderly in Sulaimanya city during the pandemic COVID-19. Through the snowballing sampling method, 394 elders were included to this study. After validation, two scales were used in this study;stress subscale from Depression, Anxiety and Stress Scale (DASS-21) and a culture-bound scale for determining coping methods. The results of this study showed that participants experienced a mild level of stress. Male participants, elders who live with their family, unvaccinated elders, physically passive elders have had higher stress level than female, elderly home, vaccinated, physical active elders. The findings also indicated that spiritual connection was the most common coping method used by the sample. Results of this study are the first and foremost way to share elder's unexpressed messages;it also can be a way for verbalizing their unspoken feelings. These results may also inform the elder's caregivers that elder's stress level and illness anxiety was not very high, strengthening their social support and spiritual connection may help them to reduce their distress into a lesser degree.

Assessment of adjustment disorder in people with COVID-19 infection

Objective: This study aimed to evaluate the development of adjustment disorder according to the ADNM-20 (Adjustment Disorder New Module-20) scale in participants who were followed up for Covid-19 infection. Methods: A cross-sectional survey was conducted from September to November 2020. After sample size calculation, we aimed to reach minimum 170 people out of 1290 people who applied to the hospital for Covid-19 disease treatment. Participants were selected from the patients admitted to the hospital using a simple stratified random sampling method. We reached 182 people after treating the patients who were followed up with Covid-19 infection in a University Hospital in Istanbul, Turkey. A questionnaire and the Adjustment Disorder New Module-20 scale were applied via phone / mail at the end of the 6th month after Covid-19 related hospital admission by researchers. Results: Adjustment disorder was found in 28.8% (n=42) of the participants disorder according to the ADNM-20 scale. While the rate of development of adjustment disorder due to Covid-19-related stress was 26.7% (n=39);the rate of development of adjustment disorder due to non-Covid-19 stress was found to be 2.1% (n=3). With the increase in stress load, the development of adjustment disorder increased significantly. The frequency of developing Covid-19-related stress-related adjustment disorder was statistically significantly increased with the duration of exposure to stress. Conclusion: We have found out that one out of every four people who apply to the hospital for healthcare services due to Covid-19 infection may develop an adjustment disorder. Assessment of the adjustment disorder more frequently and making early interventions may contribute to the prevention of progressive mental disorders.

Collective minds: Emotional support and counselling program using information and communications technologies

Aims: The counselling and support program of the Collective Minds Ecosystem [Mentes Colectivas] is a university-based program that aims to provide free and available counselling services in mental and sexual and reproductive health to people over 14 years in Colombia. Method(s): The program uses diverse information and communications technologies such as: traditional phone, SMS, and Internet mediated chat and video calls. Results and Conclusion(s): Since September 2020 to October 2022, 4873 users have been counselled, most of them are female (78.2%, n = 3809/4873), 46% of the users are between 18 to 29 years old. The program has served most of the Colombian territory, reaching 28/32 departments;as expected, the 4 remained are in the Amazon region, which is the area with the lowest internet connectivity. Most of the counselled (84%) had some type of psychological distress (measured with the Kessler-6 scale): 27% were classified as having mild psychological discomfort, 37% moderate and 20% severe. The most frequent topics in mental health include anxiety, depression, and relationship problems. In relation to sexual and reproductive health counselling, they were sexual education, anticonception, and pregnancy. By making use of diverse technologies, the Collective Minds program has managed to reach different parts of Colombia, providing free counselling and support to individuals in need. It has also assisted to mitigate the post-COVID-19 negative effects on mental and sexual and reproductive health by breaking down economic, geographic, and specialized human capital barriers.

Comparing the Effectiveness of Mindfulness and Aerobic Exercise on Psychological Factors and Sleep Quality Following Recovery from COVID-19.

Background and purpose: The COVID-19 pandemic have led to some psychological disorders and sleep problems that should be taken into account after recovery. After recovering from COVID-19 people are at risk of sleep disorders, depression, and low quality of life and there is paucity of information about this issue. The present study aimed to compare the effectiveness of mindfulness and aerobic exercise on depressive symptoms, perceived stress, and sleep quality in recovered COVID-19 patients. Material(s) and Method(s): An intervention field research was performed in 60 male and female patients (mean age: 39.52+/-5.82) recovered from COVID-19 in Kermanshah, Iran. Participants were randomly divided into four groups (n=15): 1) attending mindfulness-based stress reduction (MBSR) program, 2) aerobic exercise, 3) combination of MBSR and aerobic exercise, and 4) control group. The study was carried out at four stages: pretest, interventions, post-test, and follow-up test. Dependent variables included depressive symptoms, perceived stress, and sleep quality. Bonferroni Post hoc test in 4*3 mixed ANOVA was used for data analysis. Result(s): In this study, depression and perceived stress reduced in all experimental groups compared to the control group (P= 0.001). Also, sleep quality improved in these groups compared to the control group (P= 0.001). Post hoc tests showed the superiority of combination of MBSR and aerobic exercise compared to other interventions. Conclusion(s): According to current study, combination of MBSR and physical activity shows to be more helpful than mindfulness training and physical activity alone in improving psychological problems and sleep quality after recovering from COVID-19.Copyright © 2023, Mazandaran University of Medical Sciences. All rights reserved.

Fears and anxieties of pregnant women facing the pandemic

Pregnancy and the entire mothering process is always a very big challenge, which involves physical and emotional changes in women. Currently, with the numbers of cases confirmed by COVID-19 growing every day in our city, everything is uncertain. This whole scenario brought many anxieties, concerns and ques- tions. This is no different with pregnant women, on the contrary, their fears and anxieties have multiplied during this period. The project, through a field study, aimed to assess the emotional state of the pregnant woman in relation to the pandemic COVID-19. A quantitative research was carried out, with the application of a virtual questionnaire prepared by the author herself. 39 pregnant women who are monitoring their prenatal care at a clinic in the city of Tres Coracoes - MG were interviewed. The research appli- cation was released with an opinion embodied under the number of CAAE 39410820.9.0000.5158 and authorization from the res- ponsible nurse, where the contact phones of the pregnant women were noted so that the questionnaire could be applied in a virtual way, through the Google Forms platform, after the term agree- ment. It was found that psychological disorders appeared in 51.3% of the study population and 48.7% who already had some disorder such as anxiety and depression stated that their clinical condition worsened with the pandemic. This target audience is a group considered at risk by the World Health Organization. It should be given full support and support, through guidance on preventive measures and complete assistance by a multidiscipli- nary team.

What are the mental health issues of postpartum mothers during a pandemic? A scoping review

Background. Postpartum mothers' mental health has a significant role in mothers' well-being and child's growth and develop-ment. This issue is worsened during a pandemic when social restrictions are regulated, resulting in perceived stress, baby blues, postpartum depression, and other mental health issues. Objective. This study intends to investigate postpartum moth-ers' mental health during the COVID-19 pandemic. Methods. This study's methodology is a scoping review using the prism-ScR checklist, the Joanna Briggs Institute critical appraisal tool, and a population, exposure, outcome framework. It uses 4 databases: Pubmed, Willey, Proquest, and ScienceDirect;its inclusion criteria is original English articles that can be accessed in full text between 2020 and 2022. Results. Out of 190 publications, we found 7 that are pertinent to the research goals. Qualitative research, cross-sectional studies, and longitudinal studies make up the research. The mapping result includes 4 themes: the types of mental health problems experi-enced by postpartum moms during the Pandemic, risk and predic-tive factors, postpartum mothers' experiences, and the effects of mothers' mental health problems. Conclusion. After giving birth, most mothers experience stress, anxiety, and depression. Postpartum mental health concerns are influenced by isolation, social exclusion, and crises. The cre-ation of a customized plan for early assistance for a woman's mental health requirements, as well as the establishment of an accessi-ble mental health provider, including medical personnel and medical facilities, is advised for pregnant and postpartum women. only.Copyright © the Author(s), 2023.

Impact of Covid-19 on Mental Health among Medical Students

Background: The COVID-19 pandemic is a major health crisis affecting several nations. Such widespread outbreaks are associated with adverse mental health consequences. Objective(s): To conduct a survey-based assessment of mental health among medical students during the COVID-19 pandemic. Aimed at identifying severity levels of depression and anxiety, stressors related to the pandemic, and barriers students experienced in handling the pandemic-related stress. Method(s): An analytical cross-sectional study was chosen as the study design for this research to study the association between demographic social and mental health among medical students during the pandemic COVID-19. Result(s): The results of this study were collected by respondents through questionnaires as the respondents were needed to answer about 16 questions and the main question was asked mostly about their mental health condition during the pandemic COVID-19. 101 respondents participated in the study. Discussion(s): the impact of COVID-19 on mental health among medical students has been studied. Due to the long-lasting pandemic situation and numerous measures such as lockdown and stay-at-home orders, COVID-19 brings negative impacts on higher education of medical students, self and social isolation, disconnection from friends and teachers resulting in more medical students than ever experiencing feelings of helplessness, isolation, grief, anxiety and depression. The issue of mental health is not only relevant but crucial. Demand for health support services has increased exponentially as a result. Conclusion(s): In this study, severity levels of depression and anxiety, stressors related to the pandemic, and barriers students experienced in handling the pandemic-related stress have increased due to many factors such as social isolation, own health and the health of loved ones, financial difficulties, suicidal thoughts, depressive thoughts, class workload, changes in living environment, eating patterns and sleeping habits.Copyright © RJPT. All right reserved.

Role of nutrition in minimizing mental and health-related issues during COVID-19: a systematic literature review. (Special Issue: The relationship between nutrition and COVID-19.)

Purpose: This study aims to conduct a systematic literature review to investigate the mental health problems during COVID-19 and the role of nutrition in minimizing mental and health-related issues during COVID-19. Design/methodology/approach: A literature search was done electronically on April-May 2022 in the databases Google Scholar, PubMed and Cochrane Library, reviewing all the articles published in English. There were no limitations for the study (such as study design, region or any time frame). The quality assessment was done. The beginning database search picked out a total of 654 articles, 47 in PubMed, 575 in Google Scholar, 22 in Cochrane Library and 10 records from other sources. A total of 565 (duplicates found 89) were found after removing the duplicated articles, after reading the title and s were further decreased to 88 full-text articles. These 88 studies went for full-text analysis, which excluded 56 studies and generated a final 32 articles for systemic analysis. The quality of the included study for the systematic review was assessed in two ways: one is evidence-based and another one on the JBI checklist. Findings: People in social isolation and home quarantine suffer from severe anxiety, stress, depression, loneliness, anger and panic attack. During COVID-19, the vital role of diet and nutrients in mental health has been acknowledged and helps mitigate COVID-19 infection. Many studies showed stress and anxiety due to increased unhealthy eating and lifestyle practices. Originality/value: This review will explain the interlink between diet and mental health because what we eat and think is interconnected with the gut-brain axis. The dietary elements and psychobiotic help in improving the immune system and psychological distress during the pandemic. This paper describes the role of different nutrients, psychobiotics and phytochemicals, to minimize mental and health issues during the COVID-19 pandemic. This paper also contains a balanced diet plan to withstand COVID-19.

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.

Psychological Distress among Healthcare and Non-Healthcare Workers during the COVID-19 Pandemic: This Too Shall Pass

Objective: This study aimed to evaluate the psychological distress experienced by healthcare and non-healthcare professionals working in a hospital setting during the Coronavirus Disease 2019 (COVID-19) pandemic. Methodology: This survey-based cross-sectional study included 361 professionals (288 healthcare and 73 non-healthcare professionals) working at Ziauddin University Hospital, Karachi, Pakistan. Psychological distress was assessed using Depression Anxiety Stress Scale - 21 (DASS-21). Result(s): There was a higher prevalence of anxiety, depression, and stress among healthcare professionals as compared to the non-healthcare professionals, as indicated by the mean depression, anxiety, and stress scores on DASS-21 (p<0.05). The univariate logistic regression analysis showed that the odds of psychological distress were similar in both genders and individuals of all age groups. Healthcare professionals were twice more likely to be severely depressed and stressed as compared to non-healthcare professionals (p<0.05). Conclusion(s): This study concludes that psychological distress is more prevalent among healthcare workers than non-healthcare workers.Copyright © 2023 Lahore Medical And Dental College. All rights reserved.

Influence of socio-demographic factors on perceived stress in outpatients with depression and anxiety in remission during the COVID-19 pandemic

Objective: The study aimed at identifying the influence of socio-demographic factors on perceived stress during the first and the second "waves" of the COVID-19 pandemic among patients with depression and anxiety in remission compared to controls. Method: The study was designed as case-control, cross-sectional and non-interventional, and included 60 outpatients with depressive and anxiety disorders in remission and 60 controls with or without family history of affective disorder. A self-assessment scale (Perceived Stress Scale, PSS-10) was used to evaluate perceived stress. The remission was objectified by the Clinical Global Impression scale (CGI-S 2) and a questionnaire about the socio-demographic features and clinical characteristics of the disorders was completed. Results: By using multiple logistic regression, it was found that the diagnostic category and/or the relevant family history did not predict higher levels of perceived stress during the COVID-19 pandemic (p > 0.05). Females were associated with higher risk of moderate or high stress (OR=2.613, p=0.017), as well as those working from home during the pandemic (OR=4.00, p=0.026). Conclusions: Addressing the COVID-19 effects on mental health in a biopsychosocial manner, the study shows the impact of socio-demographic factors such as gender and work environment in times of a psychosocial crisis. The lack of differences in stress perception by the patients in remission and healthy controls implicates the importance of adequate maintenance treatment and easy access to mental health services in times of crisis.

Scientific rationale of Indian AYUSH Ministry advisory for COVID-19 prevention, prophylaxis, and immunomodulation

The current outbreak of COVID-19 is caused by the SARS-CoV-2 virus that has affected > 210 countries. Various steps are taken by different countries to tackle the current war-like health situation. In India, the Ministry of AYUSH released a self-care advisory for immunomodulation measures during the COVID-19 and this review article discusses the detailed scientific rationale associated with this advisory. Authors have spotted and presented in-depth insight of advisory in terms of immunomodulatory, antiviral, antibacterial, co-morbidity associated actions, and their probable mechanism of action. Immunomodulatory actions of advised herbs with no significant adverse drug reaction/toxicity strongly support the extension of advisory for COVID-19 prevention, prophylaxis, mitigations, and rehabilitation capacities. This advisory also emphasized Dhyana (meditation) and Yogasanas as a holistic approach in enhancing immunity, mental health, and quality of life. The present review may open-up new meadows for research and can provide better conceptual leads for future researches in immunomodulation, antiviral-development, psychoneuroimmunology, especially for COVID-19.Copyright © 2021, Institute of Korean Medicine, Kyung Hee University.

Pandemic-related stress experiences, resources and depressive moods of students at the end of the online winter semester 2020/21

Background: Students worldwide belong to a vulnerable group with an above-average tendency towards depressive disorders. Empirical studies also show that depressive moods among students have increased significantly during the coronavirus disease 2019 (COVID-19) pandemic. Objectives: The aim of the article is to examine whether the stress experiences caused by the pandemic are related to the depressed mood of the students. In addition, it is analyzed whether resilience, coping and social support as resources are associated with the depressive moods of students. The aim is to clarify which resources can explain the connection between the stress experiences caused by the pandemic and the depressive mood of students as mediators. Methods: The study is based on an online survey of students at Magdeburg-Stendal University of Applied Sciences for the 2020/21 winter semester. The data of 621 students were evaluated. A mediation analysis was carried out. Results: Pandemic-related stress experiences are significantly related to the depressive moods of students. Resilience is also a significant factor influencing depressive moods and partially mediates the influence of pandemic-related stressful experiences on the depressed mood of the students. Coping and social support show no significant association with the depressed mood of the students. Conclusion: Starting points for reducing the depressive mood lie in reducing the stress caused by the pandemic and in strengthening the resilience of the students.

Peripartum Covid 19 admissions in an intensive care unit - Case series

Introduction: Peripartum women are at increased risk for severe illness with coronavirus disease (Covid-19) infection. Recent medical literature has drawn attention to the possible influence of COVID-19 on the course of pregnancies and its long-term effects.1-5 Objective: This case series aimed to observe the clinical course of peripartum women with confirmed Covid-19 admitted to a critical care unit in the North-west of England. Method(s): Since the start of the pandemic, all pregnant women with Covid-19 infection admitted to the critical care unit were monitored and followed up. Demographic profile, medical co-morbidities, treatment received, respiratory support and vaccination status were noted. Result(s): From March 2020 until February 2022, 8 women in our practice were shifted to the critical care unit post-partum in view of worsening work of breathing & increasing oxygen requirement after initial management in the delivery suite. All admissions were during the 3rd wave of the pandemic in the UK, between June to October 2021. 5 patients underwent Caesarean section under spinal anesthesia & 3 were shifted post normal vaginal delivery. Mean age in the study population was 33.25 years (SD +/- 3.99) and mean length of stay in the ICU was 6.62 days (SD +/- 3.99). Only one woman required intubation & mechanical ventilation for 10 days and the rest were managed on High Flow Nasal Cannula (HFNC) or Continuous Positive Airway Pressure (CPAP) hood and self-proning manoeuvres. 50% of the patients received Tocilizumab. All women were discharged home and there were no maternal deaths. Pre- admission none of the women were vaccinated, but on follow up 5 out of the 8 had completed their vaccination. All women were emotionally distraught due to being isolated from their family and new born. When reviewed at 12 weeks, one patient experienced post traumatic stress disorder (PTSD) and one had features of long Covid syndrome. On follow up, all new born babies were doing well. Conclusion(s): From the limited amount of data available, psychological stress was common to all patients. Being isolated from their new-born and family was the most difficult emotional aspect for the mothers in addition to finding it difficult to breathe and uncertainty about the future. Most mothers and new-born babies were discharged from the hospital without any serious complications. However, further observation and long term follow up is imperative. Use of guidelines in peripartum patients will aid in appropriate escalation of care. Key words: COVID-19, Pregnancy, Peri-partum, Long Covid syndrome.

Towards gold standard care for peripartum women admitted to general intensive care units

Introduction: Critically-ill obstetric patients admitted to general intensive care units (ICU) are a rare and unique population for whom excellent care is essential to prevent devastating physical and psychological morbidity. Admissions are often unanticipated and can present challenges to obstetric and intensive care MDTs. 2018 Enhanced Maternal Care (EMC) Guidelines provide standards for caring for these women, and the 2022 Ockenden review exposed the association of peripartum ICU admission with undertreated psychological trauma and a desire for individualised debriefing [1,2]. We audited the care of obstetric admissions to general ICUs in our quaternary centre. We sought evidence of psychological morbidity to improve follow-up pathways in line with 2022 Ockenden actions. Method(s): Retrospective online case note review of maternity admissions to general ICUs between 1/1/2021-1/1/2022 compared to EMC audit standards. Exclusion criteria: <22/40 gestation, >6/52 postpartum and admissions to our level 2 labour ward high dependency unit. Result(s): 25 patients were admitted to general ICUs over 12 months. Median age was 35-39 years, mean parity was 1. The commonest indication was obstetric haemorrhage (n = 10). 15 of 25 patients required level 3 care, median length of stay was 1.5 days. Documentation of daily obstetric MDT ward round was variable, as was mother-baby contact. 0 of 25 women were seen in obstetric anaesthesia clinic after discharge, only 1 received outpatient ICU follow-up. 50% of postnatal admissions (n = 14) had documentation of significant psychological distress. In response a local checklist was developed with key colleagues to support collaborative working and standardise quality care. It includes automatic referral into obstetric anaesthesia clinic and access to a novel perinatal mental health service. Discussion(s): A peripartum admission to ICU is highly likely to be experienced as traumatic [2]. The incidence of obstetric ICU admissions may increase in the context of greater clinical complexity of the UK pregnant population and COVID-19, whilst the non-anaesthetic ICU workforce may have little obstetric training. Obstetric anaesthetists are therefore uniquely skilled to facilitate quality resuscitation and referral to ICU, but gold-standard holistic care extends beyond admission. We believe regular audit and dedicated local care pathways which incorporate proactive debriefing and psychological health can improve the care of this important group of women.Copyright © 2023 Elsevier Ltd

A Comparative Study of Peripartum Mental Health Disorders between COVID-19-infected and Non-infected during the Pandemic

Introduction: This study was done to compare the prevalence of mental health disorders between COVID-19-infected and non-infected mothers during the COVID-19 pandemic. The secondary objective was to find out the risk factors and long-term outcome of peripartum depression (PPD). Material(s) and Method(s): This was an observational and comparative study using a questionnaire-based direct interview, conducted in a tertiary hospital. After judging the inclusion and exclusion criteria, 842 subjects were selected between September 2020 to December 2020. The Edinburgh postnatal depression scale (EPDS) and COVID-19 anxiety scale (CAS) was used for evaluation of the mental health. Subjects with PPD were followed up for a year. Result(s): The mean age of the subjects was 24.8 +/- 3.9 years, 142 (16.8%) were confirmed COVID-19 positive. Overall, 317 (37.6%) had possible PPD (EPDS >=14) and 763 (90.6%) had peripartum anxiety (EPDS anxiety subscore >=4). While there was no significant difference in the prevalence of PPD (32.6% vs 39%, p = 0.12), peripartum anxiety was higher among COVID non-infected subjects (91.6% vs 86.6%, p = 0.04). Furthermore, COVID-19-related anxiety was higher among COVID-19-infected compared to the non-infected [17 (10-28) vs 15 (8-25), p = 0.00]. In multivariate analysis, medical comorbidities (p = 0.000), history of psychiatric illness (p = 0.002), domestic violence (p = 0.032) and obstetric complications (p = 0.000) were significant risk factors for PPD. Among the subjects who had PPD, only 35% still had depression after a year. Conclusion(s): This study provides an in-depth analysis of PPD and anxiety during the COVID-19 pandemic, the risk factors, and the long-term effects. Clinical significance: It highlights the importance of routine screening for perinatal mental health disorders and early psychiatric consultation when required.Copyright © The Author(s).

Perceived stress negatively affects diet quality and life satisfaction during the COVID-19 lockdown period, in Greece. (Special Issue: The relationship between nutrition and COVID-19.)

Purpose: The pandemic of COVID-19 led to considerable challenges with respect to people's health, dietary behavior and satisfaction with life. This study aims to investigate perceived stress levels, in relation to diet quality and life satisfaction in Greek adults, during the COVID-19 lockdown. Design/methodology/approach: This is a cross-sectional study which took place in Greece in the course of the strict lockdown period, in the third COVID-19 wave. A sample of 2,029 adults aged 18 years and above participated in an online survey. The questionnaire consisted of questions on sociodemographic and anthropometric characteristics. The Perceived Stress Scale, the Satisfaction with Life Scale and the Mediterranean Diet Assessment Tool were also used. Findings: Linear regression has shown that women (p < 0.0001), younger individuals (p < 0.0001), obese individuals (p = 0.047), those with lower levels of satisfaction with life (p < 0.0001) and lower adherence to Mediterranean diet (p = 0.0001) were positively associated with higher levels of stress. Originality/value: To the best of the authors' knowledge, this is the first study conducted in Greece aiming at investigating concurrently, levels of perceived stress, with respect to levels of satisfaction with life and diet quality in adults, during the lockdown period of the COVID-19 pandemic.