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.

Anxiety disorders and sleep

Anxiety disorders are the most common psychiatric illnesses in the world. As defined by the DSM-5, the key manual for the diagnosis of mental illnesses in the United States, only two anxiety disorders have sleep-related problems as part of their diagnostic criteria: generalized anxiety disorder (GAD) and separation anxiety disorder. GAD and panic disorder are the two most studied anxiety disorders with regard to sleep problems. This article reviews the demographics of anxiety disorders and sleep problems and also touches on alternative cultural idioms of anxiety that include sleep disruptions. The article also reviews sleep findings for GAD and panic disorder and discusses neurobiological evidence and some proposed mechanisms of the relationship between anxiety and sleep. Neurotransmitters and genetics involved are highlighted. Treatment, including psychotherapy and standard pharmacotherapy are emphasized, as is the evidence for alternative therapies such as herbal remedies. The article also makes note of recent studies on the interplay of anxiety, sleep, and COVID-19. © 2023 Elsevier Inc. All rights reserved

Stigmatization, panic disorder, and death anxiety among patients of Covid-19: Fourth wave of pandemic in Pakistan.

BACKGROUND: In Pakistan, the fourth wave of COVID-19 is causing an increasing number of positive cases. This fourth wave may be a risky aspect of mental health issues for COVID-19 patients. This quantitative study is designed to understand the stigmatization, and panic disorder and to explore the mediating role of death anxiety among patients of COVID-19 during the fourth wave of novel coronavirus. METHODS: The study was conducted using a correlational research design. The survey was carried out by utilizing a questionnaire with a convenient sample technique. The sample of the study was comprised of 139 patients with COVID-19. Data were collected through Stigma Scale for Chronic Illnesses (SSCI), The Panic Disorder Severity Scale (PDSS), and Death Anxiety Inventory. RESULTS: Results show that stigma is significantly positively related to panic disorder and death anxiety. Furthermore, panic disorder is also significantly positively related to death anxiety. Results also indicate that stigmatization is a significant positive predictor for death anxiety and panic disorder. Moreover, results indicate that death anxiety has a mediating role in the relationship between stigmatization and panic disorder with age and gender as covariates. CONCLUSION: This study would be helpful for people around the world to understand this threatening contagious virus so they wouldn't stigmatize infected ones. Additional research is required for the sustainable improvement of anxiety over time.

Evaluation of Coronavirus Anxiety Levels and Coping Strategies of Major Depressive Disorder, Generalized Anxiety Disorder, and Panic Disorder Patients During the Covid-19 Pandemic.

Objectives: This study aims to compare patients with major depressive disorder (MDD), generalized anxiety disorder (GAD), and panic disorder (PD), whom we have frequently seen in our hospital practice during the pandemic, with healthy controls (HC) in terms of coronavirus anxiety levels and coping strategies. Methods: In this study, the Sociodemographic Data Form, Coronavirus Anxiety Scale (CAS), Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, and Coping Orientation to Problems Experienced (COPE) scale were applied to the participants. 30 MDD patients, 32 GAD patients, 31 PD patients and 38 HCs, totaling 131 participants, constituted the sample of the study. Results: Evaluation of the CAS scores of the participants revealed that HC scored 3.306 (p=0.002) points lower than GAD patients and 3.014 (p=0.005) points lower than PD patients, while HC and major depression patients were not statistically different in terms of CAS scores (p=0.880). In the comparison of coping strategies, HC scored 3.151 (p<0.001) points higher than MDD patients and 2.059 (p=0.004) points higher than GAD patients in terms of "active coping." In terms of "planning," HC scored 2.726 (p<0.001) points higher than MDD patients, 2.589 (p=0.001) points higher than GAD patients, and 2.171 (p=0.006) points higher than PD patients. Conclusion: This study found higher coronavirus anxiety levels in GAD and PD patients but no difference in MDD patients compared to HC during the COVID-19 pandemic, which may indicate that MDD patients can COPE better with coronavirus anxiety. Determining the coping strategies that individuals use to COPE with coronavirus anxiety during the COVID-19 pandemic may help mental health professionals to control disease-related stressors and contribute to the treatment process.

Cognitive-behavioral therapy for panic disorders.

This article discusses the treatment of panic disorder in terms of cognitive behavioral psychotherapy. Panic disorder is one of the most common anxiety disorders. The etiology of panic disorder assumes the coexistence of genetic and environmental factors. Panic attacks often accompany other mental and somatic diseases. The constant feeling of intense anxiety with a number of somatic symptoms affects the deterioration of everyday functioning, significantly reducing one's quality of life. The global situation caused by SARS-CoV-2 may correlate with the increase in the incidence of panic disorder. The introduction of appropriate therapeutic interventions at the earliest possible stage of the disease gives patients a chance for long-term remission. So far, it has been proven that the best results of pharmacological treatment are achieved thanks to the antidepressant and benzodiazepine drug groups. One of the non-pharmacological interventions with the highest clinical effectiveness is cognitive-behavioral psychotherapy. Compared to other trends, cognitive- behavioral therapy is characterized by the most reliable research proving its high effectiveness. Psychotherapy of panic disorders in the cognitive-behavioral approach includes a complete conceptualization of the patient's problem, taking into account individual theoretical models. Treatment of panic attacks is based on a protocol which takes into account both cognitive and behavioral interventions, e.g. psychoeducation, cognitive restructuring, breathing training, relaxation exercises and both interoceptive and in vivo exposures. Research results indicate that this therapy is an alternative form of treatment for panic disorders. Sources indicate that the effectiveness of interventions based on cognitive-behavioral therapy is comparable to that of pharmacotherapy.Copyright © 2022 Termedia Publishing House Ltd.. All rights reserved.

Differences in Functional Level and Central Symptom of Network Structures in the Patients Seeking Treatment for Panic Disorder Before and During the COVID-19 Pandemic.

OBJECTIVE: Mental health problems such as anxiety, panic, and depression have been exacerbated by the coronavirus disease-2019 (COVID-19). This study aimed to compare the symptom severities and overall function before and during the COVID-19 pandemic among patients with panic disorder (PD) seeking treatment compared to healthy controls (HCs). METHODS: Baseline data were collected from the two groups (patients with PD and HCs) in two separate periods: before COVID-19 (Jan 2016-Dec 2019) and during COVID-19 (Mar 2020-Jul 2022). A total 453 participants (before COVID-19: 246 [139 patients with PD and 107 HCs], during COVID-19: 207 [86 patients with PD and 121 HCs]) was included. Scales for panic and depressive symptoms and overall function were administered. Additionally, network analyses were performed to compare the two groups within the patients with PD. RESULTS: The results of two-way analysis of variance analyses showed that patients with PD enrolled during COVID-19 showed higher levels of interoceptive fear and lower overall functioning. In addition, a network comparison test revealed that a significantly high strength and expected influence for agoraphobia and avoidance in patients with PD during COVID-19. CONCLUSION: This study suggested that the overall function could have worsened, and the importance of agoraphobia and avoidance as a central symptom may have increased in patients with PD seeking treatment during COVID-19.

CBT treatment delivery formats for panic disorder: a systematic review and network meta-analysis of randomised controlled trials.

Several in-person and remote delivery formats of cognitive-behavioural therapy (CBT) for panic disorder are available, but up-to-date and comprehensive evidence on their comparative efficacy and acceptability is lacking. Our aim was to evaluate the comparative efficacy and acceptability of all CBT delivery formats to treat panic disorder. To answer our question we performed a systematic review and network meta-analysis of randomised controlled trials. We searched MEDLINE, Embase, PsycINFO, and CENTRAL, from inception to 1st January 2022. Pairwise and network meta-analyses were conducted using a random-effects model. Confidence in the evidence was assessed using Confidence in Network Meta-Analysis (CINeMA). The protocol was published in a peer-reviewed journal and in PROSPERO. We found a total of 74 trials with 6699 participants. Evidence suggests that face-to-face group [standardised mean differences (s.m.d.) -0.47, 95% confidence interval (CI) -0.87 to -0.07; CINeMA = moderate], face-to-face individual (s.m.d. -0.43, 95% CI -0.70 to -0.15; CINeMA = Moderate), and guided self-help (SMD -0.42, 95% CI -0.77 to -0.07; CINeMA = low), are superior to treatment as usual in terms of efficacy, whilst unguided self-help is not (SMD -0.21, 95% CI -0.58 to -0.16; CINeMA = low). In terms of acceptability (i.e. all-cause discontinuation from the trial) CBT delivery formats did not differ significantly from each other. Our findings are clear in that there are no efficacy differences between CBT delivered as guided self-help, or in the face-to-face individual or group format in the treatment of panic disorder. No CBT delivery format provided high confidence in the evidence at the CINeMA evaluation.

Emotional Disorders During the COVID-19 Outbreak in Spain: The Role of Sociodemographic Risk Factors and Cognitive Emotion Regulation Strategies.

BACKGROUND: Cognitive emotion regulation strategies (CERS) play a transdiagnostic role in emotional disorders, but the role of these strategies in coping with emotions during the coronavirus disease 2019 (COVID-19) pandemic remains poorly understood. AIMS: To assess the presence of emotional disorders in Spain and the association to sociodemographic characteristics and CERS during the COVID-19 outbreak. METHOD: Cross-sectional survey administered through an online platform. Sociodemographic variables and CERS (CERQ-Short) were collected and possible diagnoses of generalized anxiety disorder (GAD, GAD-7), major depression disorder (MDD; Patient Health Questionnaire-9 [PHQ-9]), panic attacks (PA; PHQ-PD), and panic disorders (PD; PHQ-PD) were assessed. Sociodemographic risk factors and CERS association to the possible diagnosis of emotional disorders were reported with hierarchical multivariate logistic regression analyses. RESULTS: A total of 1,753 respondents completed the questionnaire in Spain. Of these, most (76.8%) were female, with a mean (SD) age of 40.4 years (12.9). A high proportion of participants met diagnostic criteria for emotional disorders: 15.3% for GAD, 12.2% for MDD, 17.2% for PD, and 25.7% had experienced a PA. The contribution of sociodemographic variables to diagnoses of emotional disorders was modest, explaining from 3.1% to 5.7% of the variance; however, when CERS were added, the combination of sociodemographic and CERS explained from 15% to 29% of the variance. Rumination and catastrophizing were the most transdiagnostic maladaptive strategies and positive refocusing was another adaptive strategy. DISCUSSION: Although results from convenience samples should be handled with caution, the high prevalence of emotional disorders in this study suggests that the demand of mental health interventions will probably increase in Spain. Also, CERS play a clear role in the presence of these disorders. CONCLUSION: Intervention programs should focus on training CERS in populations at high risk, focusing on the reduction of maladaptive CERS and the reinforce of other more adaptive CERS.

Developing A Smartphone-Based Application for the Behavioral Cognitive Therapy of Panic Disorder

Introduction: Even though cognitive behavior therapy is proven to be an effective treatment for panic disorder, the scarcity of psychiatrists cause many patients not to get a sufficient therapy. E-mental health applications are being developed to address this shortage, especially after the COVID-19 pandemic. However, none of the e-mental health applications developed so far has offered a structured cognitive behavioral therapy. Objective(s): We are developing a mobile application which will integrate with psychiatric interventions that aims to make cognitive behavioral therapy more accessible. Method(s): Our algorithm consists of multiple choice questions and answers to determine the progression of the algorithm. The first three sessions consist of psycho-education of the application and the cognitive therapy model of panic mostly. During the psychoeducation sessions, patients' symptoms during panic attacks and their catastrophic thoughts will be questioned to be used in following sessions. After the panic log has been introduced in the third session, patients will enter the details of their panic attacks right after they experience it and this information will be investigated in the following sessions. Progress for the cognitive restructuring will be monitored as the sessions proceed. Later session will also include in-session symptom induction exercises. Result(s): We are still on the development phase of the mobile application. Hence we do not have any data to present at the moment. Conclusion(s): Our main purpose is to develop a mobile application which will integrate with structured cognitive behavioral therapy process, reduce the workload of the therapist and is easily accessible through the smart phones.

Mutually exclusive disorder-dependent hearing discomfort in first-episode psychosis and panic disorder: two experiments using the same auditory stimulus set and two similar musical sequences.

We investigated the level of hearing tolerance in patients with first-episode psychosis (FEP) and panic disorder (PD) as compared to two different groups of healthy controls (HC, HC2), one for each experiment, because we used two distinct psychophysical paradigms. We evaluated auditory discomfort of 28 volunteers (14 with FEP and 14 HC) in the first study and of 42 volunteers (21 with PD and 21 HC2) in the second study. We presented 20 sounds: 16 pure-tone frequency sweeps (specially designed for use with FEP) and 11 s or 13 s musical sequences from the very beginning of the music "Play the Game" (PLAY) from Queen and its reverses. The first procedure used a Likert-like 0-10 scale ranging from "nothing bad" to "too bad" where volunteers made vertical marks along a horizontal line according to their discomfort. The second procedure involved subjective magnitude estimation online due to the SARS-COV-19 pandemic. Sounds were placed online and played by PD and HC2 volunteers themselves after having listened to the standard (the first 8 s from RADIO, "Radio Ga Ga" by Queen). Then, PD and HC2 volunteers were asked to assign values equal to, or multiples of 10 that felt like, or proportional to, their hearing "discomfort" in comparison with Sound 00 (RADIO). Our findings showed that FEP volunteers assign more discomfort to the 16 specially designed frequency sweep stimuli that appear not to affect HC, HC2, and PD. On the other hand, musical sequences from PLAY caused strong discomfort to PD in the reverse mode, but did not seem to affect HC, HC2, and FEP. Further experiments using the exact same paradigm with FEP and PD are needed to explore these findings.

Analysis of COVID-19-related psychiatric disorders - clinical manifestations and therapeutic considerations

During the COVID-19 pandemic, neuropsychiatric disorders have been diagnosed both in the acute phase, and in the aftermath of this disease. Inpatients, as well as outpatients recently diagnosed with mild, moderate or severe forms of Coronavirus infection have reported neuropsychiatric manifestations with variable duration, symptoms that could be directly or indirectly related to the viral pathogenic agent. Patients who are recovering from the acute phase of COVID- 19 also may exhibit various psychopathological manifestations, during the so-called "post-COVID-19 syndrome" or "long COVID-19 syndrome". Explanations regarding the onset of this type of clinical manifestations and the SARS-CoV-2 infection are extremely diverse, ranging from biological factors (e.g., direct central nervous system viral activity, cerebral hypooxygenation, high level of inflammatory response) to psycho-social stressors (e.g., isolation, fear of death, anxiety related to possible somatic complications or sequelae). Objectives: The primary objective of this article was to analyze psychiatric manifestations in patients with acute COVID-19 disease and in patients during post-COVID-19 phase. The secondary objective was to propose a conceptual framework for the evaluation and treatment of these patients. Methods: Patients included in this analysis were screened positive for COVID-19 infection in the last 6 months before their first psychiatric examination. These patients were further evaluated to detect any personal history of psychiatric disorders, somatic comorbidities, or significant concomitant pharmacological treatments. Specific scales for the measurement of symptoms severity and functional impairment were administered in all patients. Results: Five patients were included in this analysis, one during the acute phase of COVID-19 infection, and four patients were evaluated after the complete remission of this disease. Hyperactive delirium, mild neurocognitive disorder, major depressive episode, panic disorder with agoraphobia, or acute psychotic disorder were the main diagnoses in these patients. All patients received adequate treatment and they were monitored using psychological scales until symptoms remission or stabilisation. Conclusions: Psychosocial stressors, neurobiological changes, systemic inflammatory reaction, and individual vulnerability factors may contribute to a diathesisstress model for psychiatric disorders onset within the acute phase or after the remission of acute manifestations in COVID-19-diagnosed patients.

Individual changes in stress, depression, anxiety, pathological worry, posttraumatic stress, and health anxiety from before to during the COVID-19 pandemic in adults from Southeastern Germany.

BACKGROUND: Many studies have previously compared the prevalence or sample means of distress and mental health problems from before to during the COVID-19 pandemic, while results on changes at the individual-level, and regarding multiple outcome measures are demanded. METHODS: This online study investigated individual changes in stress and mental health from before the COVID-19 pandemic to the first lockdown in adults from Southeastern Germany. This region was selected as it was where SARS-CoV-2 was first documented in Germany, and also due to the implementation of strict stay-at-home orders and social contact prohibitions. From April 10-27, 2020, we collected state measures and their clinical relevance for the subareas of perceived stress: worries, tension, joy, and demands. We also collected information regarding the following mental health problems: depression, anxiety, pathological worry, posttraumatic stress disorder (PTSD), and health anxiety; as well as retrospective measures of how participants felt they have changed in comparison to before the pandemic, ranging from worse to better. RESULTS: The analytical sample comprised 396 adult participants. On average, participants experienced increases in worries, tension, and lack of joy, and increases in mental health problems, but a decrease in demands. Perceived increases in symptoms of depression (26.0%) and PTSD (25.5%) were significantly more frequent than in symptoms of anxiety (particularly acute fear and panic) (5.6%), pathological worry (9.8%), and health anxiety (7.3%) (ps<.001). One per 10 participants (10.4%) reported an increase in depressive symptoms, and nearly two per 10 (18.4%) an increase in PTSD symptoms and additionally showed a clinically relevant symptom strain during lockdown. Interestingly, mainly non-specific PTSD symptoms associated with a general stress reaction were experienced to be increased. CONCLUSION: The findings suggest a dissociation of perceived changes in subareas of stress and mental health with a particular experience of increases in depressive and general stress symptoms and a decrease in external demands. This points to a need for a more differentiated view on the impact of the COVID-19 pandemic on stress and mental health, and for targeted interventions for mental health problems arising frequently during the pandemic.

Face-to-face versus Video Teleconference Group Cognitive Behavioural Therapy for Anxiety and Related Disorders: A Preliminary Comparison.

OBJECTIVE: Telehealth is being increasingly incorporated into the delivery of mental health care and has received widespread attention during the COVID-19 pandemic for its ability to facilitate care during physical distancing restrictions. Videoconferencing is a common telehealth modality for delivering psychotherapy and has demonstrated similar outcomes to those of face-to-face therapy. Cognitive behavioural therapy (CBT) is the most common psychotherapy evaluated across various telehealth modalities; however, studies on CBT delivered via videoconference, particularly in a group therapy format, are lacking. Further, little research exists on videoconference group CBT for anxiety disorders. Accordingly, the present study compared the outcomes of group CBT for anxiety and related disorders delivered via videoconference versus face-to-face. METHOD: Using a non-randomized design, data on attendance, dropout, clinical outcomes, and functional impairment were collected from 413 adult outpatients of a tertiary care anxiety disorders clinic who attended a CBT group for panic disorder/agoraphobia, social anxiety disorder, generalized anxiety disorder (GAD), or obsessive-compulsive disorder delivered either face-to-face (pre-COVID-19 pandemic) or via videoconference (since the onset of COVID-19 pandemic). Outcomes were assessed using well-validated self-report measures. Data were collected pre-treatment, across 12 weekly sessions, and post-treatment. Intent-to-treat analyses were applied to symptom outcome measures. RESULTS: Face-to-face CBT conferred only a slight benefit over videoconference CBT for symptom outcomes across all groups, but when assessed individually, only the GAD group showed greater symptom improvement in the face-to-face format. Effect sizes for significant differences between the delivery formats were small. Participants in videoconference groups tended to have slightly higher attendance rates in some instances, whereas functional improvement and treatment dropout were comparable across the delivery formats. CONCLUSIONS: Results provide preliminary evidence that videoconference group CBT for anxiety and related disorders may be a promising and effective alternative to face-to-face CBT. Additional research is needed to establish equivalence between these delivery formats.

Internet psychotherapeutic interventions for anxiety disorders - a critical evaluation.

BACKGROUND: During the COVID-19 pandemic, internet-delivered psychotherapeutic interventions (IPI) move increasingly into the focus of attention. METHOD: We reviewed 39 randomized controlled studies of IPIs with 97 study arms (n = 4122 patients) for anxiety disorders (panic disorder/agoraphobia, generalized anxiety disorder, and social anxiety disorder) and performed a meta-analysis. Most studies were conducted with cognitive behavioural approaches (iCBT). Results were compared with a previous meta-analysis examining medications and face-to-face (F2F) psychotherapy. RESULTS: In direct comparisons, IPIs were as effective as F2F-CBT and superior to waitlist controls. Programs with more intensive therapist contact yielded higher effect sizes (ES). We compared the obtained ES with a previous comprehensive meta-analysis of 234 studies. In this comparison, iCBT was less effective than individual F2F-CBT and medications, not different from pill placebos, and more effective than psychological placebo and waitlist (p > .0001 for all comparisons). ES of IPIs may be overestimated. Treatments were only compared to waitlist, which is not a sufficient control condition. 97% of the studies were not blinded with regard to the main outcome measure. 32% of the participants received antianxiety drugs during the trials. In 89%, participants were recruited by advertisements rather than from clinical settings, and 63% of the participants had an academic background (students or university employees) which might affect the generalizability of the findings. Remote diagnoses were often made by students without completed training in psychotherapy. In only 15% of the studies, diagnoses were made in personal contact with a psychiatrist or psychologist. In 44% of the studies, the 'therapists' maintaining remote contact with the participants were mostly students without completed psychotherapy education. CONCLUSIONS: IPIs may be a useful tool when face-to-face psychotherapy is not easily available, or as an add-on to standard psychotherapeutic or psychopharmacological treatments but should perhaps not be used as monotherapy. We have suggested standards for future research and the practical use of IPIs.

Changes in the Mean of and Variance in Psychological Disease Incidences before and during the COVID-19 Pandemic in the Korean Adult Population.

The coronavirus disease 2019 (COVID-19) pandemic has been suggested to increase the risk of depression and anxiety disorders. This study expanded upon previous findings by estimating the changes in medical visits for various psychological disorders during the COVID-19 pandemic compared to before COVID-19. The entire Korean population ≥ 20 years old (~42.3 million) was included. The first COVID-19 case in Korea was reported on 20 January 2020. Thus, the period from January 2018 through to February 2020 was classified as "before COVID-19", and the period from March 2020 through to May 2021 was classified as "during COVID-19". Monthly medical visits due to the following 13 psychological disorders were evaluated: depressive disorder, bipolar disorder, primary insomnia, schizophrenia, panic disorder, hypochondriasis, posttraumatic stress disorder (PTSD), anxiety disorder, anorexia nervosa, addephagia, alcoholism, nicotine dependency, and gambling addiction were evaluated. The differences in the number of medical visits and the variance of diseases before and during the COVID-19 pandemic were analyzed using the Mann-Whitney U test and Levene's test. Subgroup analyses were conducted according to age and sex. The frequencies of medical visits for depressive disorder, bipolar disorder, primary insomnia, panic disorder, hypochondriasis, PTSD, anxiety disorder, anorexia nervosa, addephagia, and gambling addiction were higher during COVID-19 than before COVID-19 (all p < 0.001). However, the frequencies of medical visits for schizophrenia, alcoholism, and nicotine dependency were lower during the COVID-19 pandemic than before the COVID-19 pandemic (all p < 0.001). The psychological disorders with a higher frequency of medical visits during COVID-19 were consistent in all age and sex subgroups. In the old age group, the number of medical visits due to schizophrenia was also higher during COVID-19 than before COVID-19 (p < 0.001). Many psychological disorders, including depressive disorder, bipolar disorder, primary insomnia, panic disorder, hypochondriasis, PTSD, anxiety disorder, anorexia nervosa, addephagia, and gambling addiction, had a higher number of related medical visits, while disorders such as schizophrenia, alcoholism, and nicotine dependency had a lower number of related medical visits during COVID-19 among Korean adults.

Common phobias among Egyptian primary schoolchildren: an emergency trigger for panic disorder due to corona pandemic. (Special Issue: Coronavirus disease (COVID-19).)

BACKGROUND: In the wake of the adverse situation we are currently facing globally due to the coronavirus pandemic outbreak, it is normal to feel stressed, confused, and scared but what is abnormal is to turn this to panic. Phobias are more pronounced than fears. They develop when a person has an exaggerated or unrealistic sense of danger that may be evolved to experience panic attacks. AIM: Our objective was to identify the prevalence of most common phobias as well as panic disorder (PD) due to the coronavirus pandemic among Egyptian primary schoolchildren and their determinants. METHODS: A cross-sectional study was conducted among 2015 schoolchildren from 3 to 6 grades in three governorates of Egypt. Seven types of phobias were investigated: Agoraphobia, phobias from darkness, animal, untreatable illness (mainly coronavirus), insects, height, and social phobia. The child's self-reported PD symptoms were assessed using DSM-IV with psychiatric diagnoses. RESULTS: Almost two-thirds of the surveyed primary schoolchildren have phobias of the low score (<9) versus one-third who had high phobias score (61.% vs. 35%, respectively) with highly significant difference (p < 0.001). The most prevalent phobias were from heights (66.5%) followed by darkness (60.0%). The important predictors of phobias were: Being a male child, living in an urban area, and studying at governmental school at fifth or sixth-grade residence. The prevalence of PD due to the corona epidemic is very high, it is reported by almost half of the surveyed primary schoolchildren. Fear of losing any of their family members, especially grandparents, was reported to be the highest PD symptom (97%). CONCLUSION AND RECOMMENDATION: Phobia from heights and darkness was the most common. The prevalence of PD due to the coronavirus epidemic is reported to be very high. Calming down children who might be experienced with a phobia that is triggering their PD is recommended.

Anxiety, depression, worry, and stress-related perceptions among antenatal women during the COVID-19 pandemic: Single group repeated measures design.

Background: Coronavirus disease 2019 (COVID-19) has rapidly spread across the globe, which has affected the health of all populations including antenatal women. Aims: The aim of the study was to evaluate the levels of anxiety, depression, stress, and worry in antenatal women during COVID-19 compared with the pre-COVID-19 levels and to evaluate the associations between the sociodemographic factors of antenatal women and Hospital Anxiety Depression Scale (HADS)-D, HADS-A, Generalized Anxiety Disorder (GAD)-7, Perceived Stress Scale (PSS), and Brief Measure of Worry Severity (BMWS) scores. Materials and Methods: This single group repeated measures design was conducted on 101 antenatal women who were referred to outpatient antenatal clinics from January 2020 (pre-COVID-19) to April 2020 (during the COVID-19 pandemic). Data were collected using four questionnaires including the HADS, GAD-7 scale, PSS, and BMWS. Results: Antenatal women (n = 101, Mage = 32.73 years, standard deviation = 5.67) during COVID-19 demonstrated significantly increased (P < 0.001) levels of anxiety, depression, stress, and worry compared with pre-COVID-19 levels. Multiple regression analysis indicated that panic disorder was significantly associated with HADS, PSS, and BMWS scores; pregnancy complications were significantly associated with HADS scores; associated health problems were significantly associated with PSS and BMWS scores; and current anxiety, depression, stress, and worry were significantly associated with HADS, GAD-7, and BMWS scores in antenatal women during COVID-19. Conclusion: Increased attention should be paid to the psychological health of antenatal women during this COVID-19 pandemic. Proper management of this current catastrophe is likely to result in global changes in social experiences, and interventions are necessary to address associated changes in mental health, especially among antenatal women.

A case-control study on the severity postpartum depression among COVID19 positive mother.

BACKGROUND: COVID19 pandemic has caused a variety of psychological problems including panic disorder, anxiety and depression. It is also associated with adverse psychological outcomes in pregnant women. The aim of this study was to compare the severity of postpartum depression in pregnant women with and without COVID-19 during the coronavirus epidemic. METHODS: This case-control study was performed on 102 pregnant women referred to the hospitals of (XXX). Using questionnaire, consisting of demographic and maternal data (age, number of pregnancies, type of delivery, history of any disease, history of drug use, breastfeeding experience, separation of mother from infant due to coronavirus) and score from Edinburgh postnatal depression scale (EPDS) score data from all the participants obtained and analyzed statistically using SPSSv23. RESULTS: The results showed that the mean EPDS score in COVID-positive mothers was 26.64 and in COVID-negative mothers was 24.76, which was statistically significant, p < 0.001. The score did not vary among the two group with respect to age group and type of delivery method. The score was significantly higher among the women with 3-4 pregnancies. CONCLUSION: COVID-positive status is associated with increased postnatal depression among women. Perinatal and postnatal psychological consultancy is required in such patients along with monitoring of maternal and neonate physical and mental health.

CCWORK protocol: a longitudinal study of Canadian Correctional Workers' Well-being, Organizations, Roles and Knowledge.

INTRODUCTION: Knowledge about the factors that contribute to the correctional officer's (CO) mental health and well-being, or best practices for improving the mental health and well-being of COs, have been hampered by the dearth of rigorous longitudinal studies. In the current protocol, we share the approach used in the Canadian Correctional Workers' Well-being, Organizations, Roles and Knowledge study (CCWORK), designed to investigate several determinants of health and well-being among COs working in Canada's federal prison system. METHODS AND ANALYSIS: CCWORK is a multiyear longitudinal cohort design (2018-2023, with a 5-year renewal) to study 500 COs working in 43 Canadian federal prisons. We use quantitative and qualitative data collection instruments (ie, surveys, interviews and clinical assessments) to assess participants' mental health, correctional work experiences, correctional training experiences, views and perceptions of prison and prisoners, and career aspirations. Our baseline instruments comprise two surveys, one interview and a clinical assessment, which we administer when participants are still recruits in training. Our follow-up instruments refer to a survey, an interview and a clinical assessment, which are conducted yearly when participants have become COs, that is, in annual 'waves'. ETHICS AND DISSEMINATION: CCWORK has received approval from the Research Ethics Board of the Memorial University of Newfoundland (File No. 20190481). Participation is voluntary, and we will keep all responses confidential. We will disseminate our research findings through presentations, meetings and publications (e.g., journal articles and reports). Among CCWORK's expected scientific contributions, we highlight a detailed view of the operational, organizational and environmental stressors impacting CO mental health and well-being, and recommendations to prison administrators for improving CO well-being.

COVID-19-Related Financial Hardship, Job Loss, and Mental Health Symptoms: Findings from a Cross-Sectional Study in a Rural Agrarian Community in India.

Several countries, including India, imposed mandatory social distancing, quarantine, and lockdowns to stop the spread of the SARS-CoV-2 virus. Although these measures were effective in curbing the spread of the virus, prolonged social distancing, quarantine, and the resultant economic disruption led to an increase in financial stress and mental health concerns. Prior studies established a link between the first lockdown and an increase in mental health issues. However, few studies investigated the association between post-lockdown financial hardship, job loss, and mental health. In this study, we examined the association between COVID-19-related financial hardship, job loss, and mental health symptoms approximately nine months after the end of the first nationwide lockdown in India. Job loss was associated with higher reporting of mental health symptoms among men (aIRR = 1.16) while financial hardship was associated with poor mental health symptoms among women (aIRR = 1.29). Conversely, social support and government aid were associated with better mental health symptoms among women. Our findings highlight the need for financial assistance and job creation programs to aid families in the recovery process. There is also an urgent need for improving the availability and affordability of mental health services in rural areas.