The Post-traumatic Stress Disorder in COVID-19 Recovered Patients: A Cross-sectional Study

Objective Post-traumatic stress disorder (PTSD) is one of the anxiety disorders caused by a specific event, which can be catastrophic events (natural disasters, war, imprisonment in a forced labor camp) or everyday adversities (death of relatives, divorce, carrying bags). Since patients who have recovered from COVID-19 are exposed to such events, this research was conducted to determine the prevalence of PTSD in this group.Materials & Methods This study was cross-sectional. The statistical population included all patients who recovered from COVID-19 between November 2021 and February 2022 in Hamedan City, Iran;based on Krejcie and Morgan's sample size table, 185 patients were selected by simple random sampling method. The research tool was the demographic questionnaire and the Mississippi post -traumatic stress disorder questionnaire (Mississippi PTSD);the data were analyzed using the Mann -Whitney and Kruskal-Wallis tests.Results The results showed that the Mean +/- SD score of PTSD was 80.37 +/- 17.37 in the subjects who recovered from COVID-19. The relationship between the demographic variables of gender (P=0.01), education (P=0.039), occupation (P=0.24), marriage (P=0.62), age (P=0.048), weight (P=0.047), height (P=0.023) with PTSD were reported.Conclusion The results showed that 76.2% of people who recovered from COVID-19 were exposed to PTSD with moderate and high severity;therefore, techniques to reduce anxiety from the corona -virus are recommended.

Relationship between parental stress and post-traumatic stress disorder: The moderating effect of visitation restrictions in paediatric intensive care units during COVID-19.

BACKGROUND: Visitation restrictions due to COVID-19 kept parents from being with their children who were hospitalized in the PICU and from meeting with professional staff. AIM: This study examined the moderating effect of COVID-19-induced visitation restrictions on the relationship between stress and post-traumatic stress disorder in parents of children admitted to the paediatric intensive care unit. STUDY DESIGN: We conducted a descriptive, exploratory study involving 93 parents of children hospitalized in the paediatric intensive care unit using the Korean version of the Parental Stressor Scale: Paediatric Intensive Care Unit and the Revised Impact of Events Scale. Descriptive, Pearson's correlation, and logistic regression analyses were used to investigate the data. Self-reported survey questionnaires were provided for parents to complete in a separate area of the outpatient clinic when they visited for follow-up care after their children were discharged from the paediatric intensive care unit. RESULTS: Mothers showed significantly higher post-traumatic stress disorder scores than fathers. The relationship between all the sub-domains of perceived stress and post-traumatic stress disorder was statistically significant. Visitation restrictions because of the COVID-19 pandemic had significant moderating effects on the relationship between perceived parental stress and post-traumatic stress disorder. Moreover, the moderating effects of COVID-19 were exhibited when the two sub-domains-hyperarousal and intrusion-were investigated. CONCLUSIONS: Paediatric intensive care unit visitation may be an important intervention for parental post-traumatic stress disorder. Parental visitation should be enabled, and alternative interventions should be developed in situations where visitation is prohibited. RELEVANCE TO CLINICAL PRACTICE: It is necessary to develop and apply various and effective alternatives visitation that can prepare hospitals for visiting restrictions during pandemic situations which could emerge in the future.

Psychological Impact on Healthcare Workers of Past SARS and Current COVID-19 Outbreak: A Global Review

The emergence of novel severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) in Wuhan, China during late 2019 spread quickly and creating international emergency and tremendous challenges for healthcare workers (HCWs) including dental and oral healthcare professionals. The brisk spread of this new viral disease forced HCWs to suffer from different types of stress including mortality and morbidity, delayed patient dealing, scarcity of complete personal protective equipment (PPE), and fear of being COVID-19 virus target and carriers to their family members. The dental and oral HCWs were also advised to apply mobility restrictions and social distancing measures. All of a sudden, most of the regular medical check-ups including dental clinic appointments were cancelled, reducing the number of patients flow. The abrupt cancellation of appointments put a sudden break on medical profession including dental practice. Different scales like progression of post-traumatic stress disorder (PTSD), Chinese Health Questionnaire-12 (CHd-12), Davidson Trauma Scale-Chinese (DTS-C), General Health Questionnaire (GHQ), Impact of Event Scale (IES), Perceived Stress Scale (PSS) etc. have been devised in different countries to assess the overall mental health status. The reports from earlier SARS outbreak in 2007 had also put a psychological impact on HCWs but least has been learned from this out break. The reports from previous Middle East respiratory syndrome (MERS) outbreaks and early COVID-19 pandemic have a considerable negative impact (short and long-term) on mental status of HCWs. Different types of negative impacts on mental health like depression, anxiety, sleep disorders and distress were reported in HCWs during COVID-19 pandemic. The current COVID-19 pandemic given a broader understanding of how much, how far and how fast an outbreak can occur and affect HCWs psychologically. In this review, authors summarize the impact of COVID-19 pandemic in the psychology of HCWs, as reported from different countries.Copyright © 2022, Anka Publishers. All rights reserved.

The prevalence of probable mental health disorders among hospital healthcare workers during COVID-19: A systematic review and meta-analysis.

OBJECTIVES: The mental health impacts of the COVID-19 pandemic continue to be documented worldwide with systematic reviews playing a pivotal role. Here we present updated findings from our systematic review and meta-analysis on the mental health impacts among hospital healthcare workers during COVID-19. METHODS: We searched MEDLINE, CINAHL, PsycINFO, Embase and Web Of Science Core Collection between 1st January 2000 to 17th February 2022 for studies using validated methods and reporting on the prevalence of diagnosed or probable mental health disorders in hospital healthcare workers during the COVID-19 pandemic. A meta-analysis of proportions and odds ratio was performed using a random effects model. Heterogeneity was investigated using test of subgroup differences and 95 % prediction intervals. RESULTS: The meta-analysis included 401 studies, representing 458,754 participants across 58 countries. Pooled prevalence of depression was 28.5 % (95 % CI: 26.3-30.7), anxiety was 28.7 % (95 % CI: 26.5-31.0), PTSD was 25.5 % (95 % CI: 22.5-28.5), alcohol and substance use disorder was 25.3 % (95 % CI: 13.3-39.6) and insomnia was 24.4 % (95 % CI: 19.4-29.9). Prevalence rates were stratified by physicians, nurses, allied health, support staff and healthcare students, which varied considerably. There were significantly higher odds of probable mental health disorders in women, those working in high-risk units and those providing direct care. LIMITATIONS: Majority of studies used self-report measures which reflected probable mental health disorders rather than actual diagnosis. CONCLUSIONS: These updated findings have enhanced our understanding of at-risk groups working in hospitals. Targeted support and research towards these differences in mental health risks are recommended to mitigate any long-term consequences.

The Impact of Event Scale-Revised: Examining Its Cutoff Scores among Arab Psychiatric Patients and Healthy Adults within the Context of COVID-19 as a Collective Traumatic Event.

The Impact of Event Scale-Revised (IES-R) is the most popular measure of post-traumatic stress disorder (PTSD). It has been recently validated in Arabic. This instrumental study aimed to determine optimal cutoff scores of the IES-R and its determined six subscales in Arab samples of psychiatric patients (N = 168, 70.8% females) and healthy adults (N = 992, 62.7% females) from Saudi Arabia during the COVID-19 pandemic as a probable ongoing collective traumatic event. Based on a cutoff score of 14 of the Depression Anxiety Stress Scale 8-items (DASS-8), receiver operator curve (ROC) analysis revealed two optimal points of 39.5 and 30.5 for the IES-R in the samples (area under the curve (AUC) = 0.86 & 0.91, p values = 0.001, 95% CI: 0.80-0.92 & 0.87-0.94, sensitivity = 0.85 & 0.87, specificity = 0.73 & 0.83, Youden index = 0.58 & 0.70, respectively). Different cutoffs were detected for the six subscales of the IES-R, with numbing and avoidance expressing the lowest predictivity for distress. Meanwhile, hyperarousal followed by pandemic-related irritability expressed a stronger predictive capacity for distress than all subscales in both samples. In path analysis, pandemic-related irritability/dysphoric mood evolved as a direct and indirect effect of key PTSD symptoms (intrusion, hyperarousal, and numbing). The irritability dimension of the IES-R directly predicted the traumatic symptoms of sleep disturbance in both samples while sleep disturbance did not predict irritability. The findings suggest the usefulness of the IES-R at a score of 30.5 for detecting adults prone to trauma related distress, with higher scores needed for screening in psychiatric patients. Various PTSD symptoms may induce dysphoric mood, which represents a considerable burden that may induce circadian misalignment and more noxious psychiatric problems/co-morbidities (e.g., sleep disturbance) in both healthy and diseased groups.

Multisite randomised controlled trial of trauma-focused cognitive behaviour therapy for psychosis to reduce post-traumatic stress symptoms in people with co-morbid post-traumatic stress disorder and psychosis, compared to treatment as usual: study protocol for the STAR (Study of Trauma And Recovery) trial.

BACKGROUND: People with psychosis have high rates of trauma, with a post-traumatic stress disorder (PTSD) prevalence rate of approximately 15%, which exacerbates psychotic symptoms such as delusions and hallucinations. Pilot studies have shown that trauma-focused (TF) psychological therapies can be safe and effective in such individuals. This trial, the largest to date, will evaluate the clinical effectiveness of a TF therapy integrated with cognitive behaviour therapy for psychosis (TF-CBTp) on post-traumatic stress symptoms in people with psychosis. The secondary aims are to compare groups on cost-effectiveness; ascertain whether TF-CBTp impacts on a range of other meaningful outcomes; determine whether therapy effects endure; and determine acceptability of the therapy in participants and therapists. METHODS: Rater-blind, parallel arm, pragmatic randomised controlled trial comparing TF-CBTp + treatment as usual (TAU) to TAU only. Adults (N = 300) with distressing post-traumatic stress and psychosis symptoms from five mental health Trusts (60 per site) will be randomised to the two groups. Therapy will be manualised, lasting 9 months (m) with trained therapists. We will assess PTSD symptom severity (primary outcome); percentage who show loss of PTSD diagnosis and clinically significant change; psychosis symptoms; emotional well-being; substance use; suicidal ideation; psychological recovery; social functioning; health-related quality of life; service use, a total of four times: before randomisation; 4 m (mid-therapy); 9 m (end of therapy; primary end point); 24 m (15 m after end of therapy) post-randomisation. Four 3-monthly phone calls will be made between 9 m and 24 m assessment points, to collect service use over the previous 3 months. Therapy acceptability will be assessed through qualitative interviews with participants (N = 35) and therapists (N = 5-10). An internal pilot will ensure integrity of trial recruitment and outcome data, as well as therapy protocol safety and adherence. Data will be analysed following intention-to-treat principles using generalised linear mixed models and reported according to Consolidated Standards of Reporting Trials-Social and Psychological Interventions Statement. DISCUSSION: The proposed intervention has the potential to provide significant patient benefit in terms of reductions in distressing symptoms of post-traumatic stress, psychosis, and emotional problems; enable clinicians to implement trauma-focused therapy confidently in this population; and be cost-effective compared to TAU through reduced service use. TRIAL REGISTRATION: ISRCTN93382525 (03/08/20).

Prevalence of post-traumatic stress disorder, emotional impairments, and fear in COVID-19 surviving patients

Introduction: Among the different psychological sequelae of post-COVID syndrome are symptoms related to emotional impairment, mostly depression, anxiety, and post-traumatic stress disorder (PTSD). Objective: To describe and compare the prevalence and severity of PTSD, anxiety, depression, and fear of COVID-19 in survivors 3 months after discharge from the hospital. Methods: A cross-sectional descriptive study was conducted, a total of 227 survivors of COVID-19 participated;they were assessed 3 months after being discharged from the hospital. A psychological evaluation focused on anxiety, depression, PTSD, and fear was conducted. Statistical analysis through the t-test for independent samples was performed. Results: Of the patients, 64.5% were men, 60.9% required invasive mechanical ventilation (IMV) during hospitalization, and the average age was about 48.23 ± 14.33 years. Also, 40% showed symptoms associated with PTSD, 38.4% exhibited anxiety, 36.6% depression, and 36.12% exhibited fear of COVID-19. There were statistically significant differences between men and women, in PTSD (t = -3.414, df = 224, p = 0.001, x̅m = 5.10, x̅w = 6.32), depression (t = -4.680, df = 225, p = 0.000, x̅m = 3.64, x̅w = 7.18), anxiety (t = -3.427, df = 152.53, p = 0.001, x̅m = 3.78, x̅w = 6.20), and fear of COVID-19 (t = -3.400, df = 224, p = 0.001, x̅m = 11.88, x̅w = 15.19). Furthermore, there were also statistically significant differences between the type of treatment during hospitalization (IMV vs. without IMV), in PTSD (t = 2.482, df = 223, p = 0.014, x̅IMV = 5.21, x̅WIMV = 6.08) and anxiety (t = -2.006, df = 223, p = 0.046, x̅IMV = 4.05, x̅WIMV = 5.44). Conclusion: Survivors of COVID-19 experience a high prevalence of PTSD, anxiety, depression, and fear, even 3 months after discharge from the hospital. Females and patients who did not require IMV during hospitalization are the most affected population, presenting more severe symptoms of these psychological alterations. More research is required to know and observe the long-term evolution of these psychological alterations in this population. Copyright © 2022 Luna-Rodríguez, Peláez-Hernández, Orea-Tejeda, Ledesma-Ruíz, Casarín-López, Rosas-Trujillo, Domínguez-Trejo and Tepepa-Flores.

Post-Traumatic Stress Disorder among Frontline Nurses during the COVID-19 Pandemic and Its Relationship with Occupational Burnout.

Objective: This study aimed to determine the level of post-traumatic stress disorder (PTSD) among nurses and its relationship with occupational burnout. Method : This online cross-sectional survey was conducted from late November to early January 2020 in six hospitals in Iran. 309 frontline nurses in COVID-19 wards were selected via stratified random sampling and asked to complete a sociodemographic questionnaire, the Impact of Event Scale-revised version (IES-R), and the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) in an anonymous online survey. Data management and analysis were performed in SPSS 25.0 using descriptive and inferential statistics, including Pearson's correlation coefficient, independent samples t-test, ANOVA, and linear regression. Results: The majority of the participants were women (81.6%) with a mean ± SD age of 31.56 ± 6.42 years. The mean ± SD of the total PTSD score was 39.2 ± 16.44 years, indicating severe PTSD among nurses. The mean ± SD of the total occupational burnout score was 82.77 ± 19.38, expressing moderate burnout. The findings also demonstrated a significant moderate correlation between PTSD and occupational burnout (r = 0.363, P < 0.001). Univariate analysis revealed a significant relationship of occupational burnout with PTSD, work experience, number of night shifts per month, and employment status (P < 0.05). However, in multivariate analysis, only PTSD had a positive and significant relationship with occupational burnout (P < 0.001; R2 = 160; ß = 0.339) and was a predicting factor for it. Conclusion: We found that both PTSD and burnout are common among nurses. Given the role of PTSD especially as a predictor of burnout and the significant impact of these disorders on occupational and non-occupational activities, immediate and appropriate measures are necessary to monitor and reduce their effects on the nurses who are at the forefront of fighting the pandemic.

Rasch Modeling and Multilevel Confirmatory Factor Analysis for the Usability of the Impact of Event Scale-Revised (IES-R) during the COVID-19 Pandemic.

BACKGROUND: Several instruments are currently used to assess Coronavirus Disease 2019 (COVID-19) -induced psychological distress, including the 22-item Impact of Event Scale-Revised (IES-R). The IES-R is a self-administered scale used to assess post-traumatic stress disorder (PTSD). The current study aimed to examine the construct validity of the IES-R, based on the Rasch model, with COVID-19-related data, as well as to test the multilevel construct validity of the IES-R within and among countries during the pandemic crisis. METHODS: A multi-country web-based cross-sectional survey was conducted utilizing the 22-item IES-R. A total of 1020 participants enrolled in our survey, of whom 999 were included in the analyses. Data were analyzed using Rasch modeling and multilevel confirmatory factor analysis (MCFA). RESULTS: The Rasch modeling results of the IES-R demonstrated that the IES-R is a satisfactory instrument with the five-point Likert scale, asserting that its 22 items are significant contributors to assessing PTSD as a unidimensional construct covered by the items of the IES-R. The MCFA confirmed that the 22-item IES-R, with its three factors, including intrusion, avoidance, and hyperarousal, demonstrates adequate construct validity at the within- and among-country levels. However, the results of the Akaike information criterion (AIC) model determined that the 16-item IES-R is better than the 22-item IES-R. CONCLUSION: The results suggested that the 22-item IES-R is a reliable screening instrument for measuring PTSD related to the COVID-19 pandemic, and can be utilized to provide timely psychological health support, when needed, based on the screening results.

Post-pandemic stress of COVID-19 among high-risk groups: A systematic review and meta-analysis.

BACKGROUND: Post-Traumatic Stress Disorder (PTSD) is considered as a prevalent outcome of the COVID-19 pandemic. This study aimed to present a global picture of the prevalence of PTSD in high-risk groups for COVID-19 (HRGs-COVID19) and determine its risk factors. METHODS: Cross-sectional studies published between March 11, 2020, and October 11, 2021, in English, were searched in seven databases on the prevalence of PTSD in HRGs-COVID19. After screening the retrieved records, their quality was assessed, and the required data were extracted. R-4.1.3 software and random effect model with 95 % confidence interval (CI) were used to synthesize and analyze the data. RESULTS: The pooled prevalence of PTSD in HRGs-COVID19 was 30 % (95 % CI: 21-39 %). The pooled prevalence of PTSD was significantly different in terms of the variables of data collection during the lockdown, gender, and data collection season (P < 0.05). Subgroup analyses could not identify sources of heterogeneity. LIMITATIONS: The included studies did not cover all HRGs-COVID19 such as smokers and the elderly. CONCLUSION: Considering the higher pooled prevalence of PTSD in HRGs-COVID19 than the general population, COVID-19 patients, and health care workers, prioritizing this subgroup for prevention and treatment of psychological outcomes is highly recommended. Predicting and implementing psychological interventions early in the pandemic is more critical when applying restrictive measures and among HRGs-COVID19 women.

The course and determinants of post-traumatic stress over 12 months after hospitalization for COVID-19.

Objective: To assess the trajectory of symptoms and symptom-defined post-traumatic stress disorder (PTSD) from 1.5 to 12 months after hospitalization for COVID-19 and determine risk factors for persistent symptoms and PTSD. Methods: This was a prospective cohort study of consecutive patients discharged after hospitalization for COVID-19 before 1 June 2020 in six hospitals in Southern Norway. Symptom-defined PTSD was assessed by the post-traumatic stress disorder (PTSD) checklist for DSM-5 (PCL-5) at 1.5, 3 and/or 12 months after hospitalization, using DSM-5 criteria. Changes in PCL-5 symptom score and the prevalence of PTSD were analyzed with multivariable mixed models. Results: In total, 388 patients were discharged alive, and 251 (65%) participated. Respondents had a mean (SD) age of 58.4 (14.2) years, and 142 (57%) were males. The prevalence of symptom-defined PTSD was 14, 8, and 9% at 1.5, 3, and 12 months, respectively. WHO disease severity for COVID-19 was not associated with PCL-5 scores. Female sex, lower age and non-Norwegian origin were associated with higher PCL-5 scores. The odds ratio (OR) (95%CI) for PTSD was 0.32 (0.12 to 0.83, p = 0.019) at 3 months and 0.38 (0.15 to 0.95, p = 0.039) at 12 months compared to 1.5 months. There was no association between PTSD and WHO severity rating. Conclusions: The level of PTSD symptoms decreased from 1.5 to 3 months after hospitalization, but did not decrease further to 12 months, and there was no association between PTSD symptoms and COVID-19 disease severity.

Effect of Repeated Home Quarantine on Anxiety, Depression, and PTSD Symptoms in a Chinese Population During the COVID-19 Pandemic: A Cross-sectional Study.

Background: Strict quarantines can prevent the spread of the COVID-19 pandemic, but also increase the risk of mental illness. This study examined whether the people who have experienced repeated home quarantine performance more negative emotions such as anxiety, depression, and post-traumatic stress disorder (PTSD) in a Chinese population. Methods: We collected data from 2,514 participants in Pi County, Chengdu City, and stratified them into two groups. Group 1 comprised 1,214 individuals who were quarantined only once in early 2020, while Group 2 comprised 1,300 individuals who were quarantined in early 2020 and again in late 2020. Both groups were from the same community. The GAD-7, PHQ-9, and PCL-C scales were used to assess symptoms of anxiety, depression, and PTSD between the two groups. Results: Analyses showed that total PHQ-9 scores were significantly higher in Group 2 than in Group 1 (p < 0.001) and the quarantine times and age are independent predictors of symptoms of depression (p < 0.001). The two groups did not differ significantly in total GAD-7 or PCL-C scores. Conclusion: Increasing quarantine times was associated with moderate to severe depression symptoms, but not with an increase in symptoms of anxiety or PTSD.

Pushing the frontiers of military medical excellence: updates, progress and future needs.

Since its establishment in 2014, Military Medical Research has come a long way in becoming a premier journal for scientific articles from various different specialties, with a special emphasis on topics with military relevance. The field of military medicine may be obscure, and may not be readily encountered by the typical clinician on a day-to-day basis. This journal aims not only to pursue excellence in military research, but also keep current with the latest advancements on general medical topics from each and every specialty. This editorial serves to recap and synthesize the existing progress, updates and future needs of military medical excellence, discussing foremostly the unique traits of literature published in this journal, and subsequently presenting the discourse regarding wartime and peacetime medicine, the role of the military in a public health emergency, as well as wound healing and organ regeneration. Special attention have been devoted to military topics to shed light on the effects of Chemical, Biological, Radiological and Explosive (CBRE) warfare, environmental medicine and military psychiatry, topics which rarely have a chance to be discussed elsewhere. The interconnectedness between military combat and soldier physical and mental well-being is intricate, and has been distorted by pandemics such as coronavirus disease 2019 (COVID-19). This journal has come a long way since its first article was published, steadily contributing to the existing knowledge pool on general medical topics with a military slant. Only with continuous research and sharing, can we build upon the work of the scientific community, with hopes for the betterment of patient care.

Post-Pandemic Stress Disorder as an Effect of the Epidemiological Situation Related to the COVID-19 Pandemic.

According to many experts in the fields of psychology and psychiatry, the destabilization resulting from the coronavirus pandemic may not be as noticeable now as it will be after the pandemic period is over. Undoubtedly, the fact that the surrounding reality is standardized and normalized by many at present contributes to this. In the opinion of many researchers, the scale and degree of trauma experienced by society will only be noticed by many once the pandemic is over. Many also suggest that we will experience post-pandemic stress disorder. This literature review aims to bring together in one place the information that speaks to the nature of the problem, which is post-pandemic stress disorder. The main sections of the paper deal with exposure to the disorder in the general population and a review of the current literature on the subject. The second section deals with a group of medical personnel who are on the direct frontline in the fight against the COVID-19 pandemic; it is assumed here that they are those who are at much higher risk of developing post-pandemic stress disorder.

Factors associated with anxiety and post-traumatic stress symptomatology during the COVID-19 pandemic in Turkey: A comparison of youths and adults

Objective: The aim of this study was to investigate anxiety and post-traumatic stress symptoms (PTSS) and their possible associated factors among youths, comparing to their older adult counterparts. Patients and Methods: This cross-sectional online study assessed 1493 participants in Turkey. Beck Anxiety Inventory (BAI) and the Post-traumatic Stress Disorder (PTSD) Checklist for DSM-5 (PCL-5) were used. Results: The Youths (15-24 years) reported to experience more anxiety and PTSS than Adults (25-59 years). There were weak correlations between BAI, PCL-5 scores and duration of recovery and isolation in Adults infected with corona virus disease 19 (COVID-19), but not in Youths. Younger age and lower economic status were common factors for severe anxiety and PTSS, additionally history of mental health needs and loss of an acquaintance due to COVID-19 were specific predictors for anxiety, and having a medical condition was predictor for PTSS in Youths. In Adults, female, lower economic status, having a medical condition, history of mental health needs, and loss of an acquaintance due to COVID-19 were common factors for worsening both PTSS and anxiety, additionally younger age for PISS and being infected by COVID-19 for anxiety were specific predictors. Conclusion: Pandemic might have a greater impact on mental well-being of youths than adults. Identification of risk factors can shed light on planning, prevention and intervention strategies.

Mental Health Symptoms among General Practitioners Facing the Acute Phase of the COVID-19 Pandemic: Detecting Different Reaction Groups.

During the 2020 first wave of the COVID-19 pandemic, general practitioners (GPs) represented the first line of primary care and were highly exposed to the pandemic risks, with a consequent risk of developing a wide range of mental health symptoms. However, scant data are still available on factors associated with a worse outcome. The aim of the present study was to investigate mental health symptoms in 139 GPs in the aftermath of the first COVID-19 national lockdown in Italy, detecting groups of subjects with different depressive, anxiety, and post-traumatic stress symptom severity. The impact of the mental health symptoms on quality of life and individual functioning were also evaluated. A cluster analysis identified three groups with mild (44.6%), moderate (35.3%), and severe psychopathological burden (20.1%). Higher symptom severity was related to younger age, fewer years in service as GPs, working in a high incidence area for the pandemic, having a relative at risk of medical complications due to COVID-19, besides more severe global functioning impairment, burnout, and secondary traumatic stress. The present findings showed that GPs, forced to perform their professional activity in extremely stressful conditions during the COVID-19 pandemic, were at high risk of developing mental health problems and a worse quality of life.

Factors Associated With Post-traumatic Stress Disorder Among Nurses During COVID-19.

OBJECTIVE: To investigate post-traumatic stress disorder (PTSD), perceived professional benefits and post-traumatic growth (PTG) status among Chinese nurses in the context of the COVID-19 pandemic and to compare the differences between nurses working inside and outside Hubei. METHODS: From February 18 to February 25, 2020, the authors constructed the questionnaire using the Questionnaire Star platform, and convenience sampling was used to distribute the questionnaire via WeChat. Nurses who worked at the hospital during the COVID-19 pandemic were the research subjects. RESULTS: A total of 3,419 questionnaires were received, of which 2,860 nurses were working outside Hubei Province and 559 nurses were working inside Hubei Province. Both groups were exposed to COVID-19. The results indicated that gender, job title, department, average monthly income, the number of night shifts per month, hospital classification, specialization, and previous experience with assisting during disasters were statistically significant. The t-test results showed that the difference in perceived professional benefits scores between the two groups was not statistically significant, and the differences in PTG scores and PTSD scores between the two groups were statistically significant. The chi-square test indicated that the difference in PTSD prevalence between nurses working outside and inside Hubei Province was statistically significant and that the PTSD prevalence of nurses working outside Hubei Province was higher than that of nurses working inside Hubei Province. One-way ANOVA and independent sample t-test results showed that age, job title, job assignment, length of service, average monthly income, number of night shifts per month, number of children, and the Nurses' Perceived Professional Benefits Scale (NPPBS) and post-traumatic growth inventory (PTGI) scores influenced the prevalence of PTSD. Logistic regression showed that the occurrence of PTSD was associated with average monthly income, length of service, number of children, and the PTGI and NPPBS scores. CONCLUSION: During the COVID-19 pandemic, nurses working outside Hubei Province reported greater PTSD than those working inside Hubei Province. The occurrence of PTSD was related to average monthly income, length of service, number of children, and the PTGI and NPPBS scores.

Mental consequences of the COVID-19 pandemic: a comparative study

In this comparative study pursuing the objective of researching the mental consequences seen one year after the beginning of the pandemic in individuals who had COVID-19, and also in those who had not been affected by this illness, we carry out the analysis of the data obtained in an anonymous online survey with the use of the HADS and IES-R psychometric scales. Statistically significant differences in the symptoms of post-traumatic stress disorder, anxiety and depression were revealed in those who were ill and those who were not ill with COVID-19. The intensity of these mental disorders and the continuing negative impact of the COVID-19 pandemic are the grounds for conducting relevant studies in dynamics. Special attention should be paid to the organization of therapeutic and preventive measures aimed at preserving the mental health of the population. © 2021, V. Serbsky National Medical Research Centre for Psychiatry and Narcology. All rights reserved.

Telepsychiatry for Patients with Post-traumatic Stress Disorder During the COVID-19 Outbreak.

Purpose: The novel coronavirus, SARS-CoV-2, emerged from Wuhan, China, causing a pandemic. Access to outpatient psychiatric care was limited. We conducted a pilot study of telepsychiatry during a national shutdown. Adult patients with post-traumatic stress disorder (PTSD) participated via Zoom. Patient preference comparing televisits to face-to-face visits was assessed. Recent findings: Telemedicine has emerged as new technological tool in the evolution of the patient-physician relationship, changing the way we interact. Physicians and patients now have access to the electronic medical record, remote point-of-care testing, and each other. The present epidemic allows us to test the limits of technology in combating limited access to care for patients with psychiatric illness. Summary: Twenty (90% male) patients with PTSD participated. Most (90 %) were moderately to severely depressed, and 50% used medical cannabis and increased their dosage during the study period. Patients preferred face-to-face meetings for its ease of use (p < .01) and general satisfaction from therapy (p < .01). However, given continued outbreak-limiting access to care, most patients stated they would continue with telepsychiatry. While most patients preferred face-to-face visits, telepsychiatry can be used during times of outbreak-limiting access to care. Future research and development should be directed at improving technological ease of use.

Implementation of a Psychiatric Consultation for Healthcare Workers during First Wave of COVID-19 Outbreak.

BACKGROUND: Prevention and management strategies of mental suffering in healthcare workers appeared as important challenges during the COVID-19 pandemic. This article aims to: (1) show how potential psychiatric disorders for healthcare workers (HCW) during the first wave of the COVID-19 outbreak were identified; (2) present an activity report of this consultation; and (3) analyze and learn from this experience for the future. METHODS: We performed a retrospective quantitative analysis of socio-demographic and clinical data, in addition to psychiatric scales scores for the main potential psychiatric risks (PDI, PDEQ, PCL-5, HADS, MBI-HSS) and post-hoc qualitative analysis of written interviews. RESULTS: Twenty-five healthcare workers consulted between 19 March 2020 and 12 June 2020. We found 78.57% presented high peritraumatic dissociation and peritraumatic distress, 68.75% had severe anxiety symptoms, and 31.25% had severe depression symptoms. Concerning burnout, we found that 23.53% had a high level of emotional exhaustion. In the qualitative analysis of the written interview, we found a direct link between stress and the COVID-19 pandemic, primarily concerning traumatic stressors, and secondarily with work-related stress. CONCLUSIONS: Early detection of traumatic reactions, valorization of individual effort, and limitations on work overload appear like potential key preventive measures to prevent psychiatric complications for healthcare workers in the context of the COVID-19 pandemic.