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1.
European Psychiatry ; 65(Supplement 1):S487-S488, 2022.
Article in English | EMBASE | ID: covidwho-2153966

ABSTRACT

Introduction: Psychological health problems, especially emotional disorders, have become an important topic of considerations for many scientists, because the epidemiology of these disorders is strongly influenced by stressful events, such as the SARS-CoV-2 coronavirus pandemic. Objective(s): The aim of this study was to evaluate selected parameters of psychosocial functioning as well as sociodemographic correlates of depression, anxiety, sleep disorders and perceived stress among the residents of the West Pomeranian Voivodeship. Method(s): An online questionnaire was completed by 323 participants, in whom the parameters of psychosocial functioning were assessed: symptoms of depression (PHQ-9), anxiety (GAD-7), severity of sleep disorders (AIS) and perceived stress (Perceived Stress Scale). Result(s): The majority of the respondents (75.2%) scored high on the Perceived Stress Scale, almost half of the respondents (47.1%) had sleep disorders and 26% of the participants had no depressive symptoms. Age statistically significantly correlated with the severity of depressive symptoms and sleep disorders. Parental status statistically significantly correlated with the severity of depressive symptoms. There was a strong correlation between the severity of depression and anxiety and a strong correlation between depression and sleep disorders. Conclusion(s): Age and parental status contributed to the severity of depressive symptoms and the occurrence of sleep disorders among the residents of the West Pomeranian Voivodeship during the SARS-CoV-2 pandemic. Some of the residents of the West Pomeranian Voivodeship showed high levels of stress or insomnia. The severity of depressive symptoms significantly influenced the levels of anxiety and perceived stress, as well as the occurrence of sleep disorders.

2.
JMIR Form Res ; 6(10): e36656, 2022 Oct 25.
Article in English | MEDLINE | ID: covidwho-2089627

ABSTRACT

BACKGROUND: Although the mental health impacts of COVID-19 on the general population have been well studied, studies of the long-term impacts of COVID-19 on infected individuals are relatively new. To date, depression, anxiety, and neurological symptoms associated with post-COVID-19 syndrome (PCS) have been observed in the months following COVID-19 recovery. Suicidal thoughts and behavior (STB) have also been preliminarily proposed as sequelae of COVID-19. OBJECTIVE: We asked 3 questions. First, do participants reporting a history of COVID-19 diagnosis or a close relative having severe COVID-19 symptoms score higher on depression (Patient Health Questionnaire-9 [PHQ-9]) or state anxiety (State Trait Anxiety Index) screens than those who do not? Second, do participants reporting a COVID-19 diagnosis score higher on PCS-related PHQ-9 items? Third, do participants reporting a COVID-19 diagnosis or a close relative having severe COVID-19 symptoms score higher in STB before, during, or after the first year of the pandemic? METHODS: This preliminary study analyzed responses to a COVID-19 and mental health questionnaire obtained from a US population sample, whose data were collected between February 2021 and March 2021. We used the Mann-Whitney U test to detect differences in the medians of the total PHQ-9 scores, PHQ-9 component scores, and several STB scores between participants claiming a past clinician diagnosis of COVID-19 and those denying one, as well as between participants claiming severe COVID-19 symptoms in a close relative and those denying them. Where significant differences existed, we created linear regression models to predict the scores based on COVID-19 response as well as demographics to identify potential confounding factors in the Mann-Whitney relationships. Moreover, for STB scores, which corresponded to 5 questions asking about 3 different time intervals (i.e., past 1 year or more, past 1 month to 1 year, and past 1 month), we developed repeated-measures ANOVAs to determine whether scores tended to vary over time. RESULTS: We found greater total depression (PHQ-9) and state anxiety (State Trait Anxiety Index) scores in those with COVID-19 history than those without (Bonferroni P=.001 and Bonferroni P=.004) despite a similar history of diagnosed depression and anxiety. Greater scores were noted for a subset of depression symptoms (PHQ-9 items) that overlapped with the symptoms of PCS (all Bonferroni Ps<.05). Moreover, we found greater overall STB scores in those with COVID-19 history, equally in time windows preceding, during, and proceeding infection (all Bonferroni Ps<.05). CONCLUSIONS: We confirm previous studies linking depression and anxiety diagnoses to COVID-19 recovery. Moreover, our findings suggest that depression diagnoses associated with COVID-19 history relate to PCS symptoms, and that STB associated with COVID-19 in some cases precede infection.

3.
American Journal of Transplantation ; 22(Supplement 3):405, 2022.
Article in English | EMBASE | ID: covidwho-2063339

ABSTRACT

Purpose: Post-acute sequelae of SARS-CoV-2 infection (PASC) is an increasingly recognized phenomenon manifested by long lasting cognitive, mental, and physical symptoms. We aimed to estimate the prevalence of PASC symptoms in solid organ transplant recipients (SOTRs) in the short (1- 6 months) and long-term (> 6 months) periods after SARS-CoV-2 infection. We also compared the prevalence of these symptoms between those with SARS-CoV-2 infection requiring hospitalization and those not requiring hospitalization. Method(s): We surveyed 111 SOTRs with self-reported SARS-CoV-2 infection diagnosed more than 4 weeks prior to survey administration. The survey consisted of 7 validated questionnaires ("Quick Dementia Rating System (QDRS)", "Patient Health Questionnaire (PHQ9)", "Generalized Anxiety Disorder 7 (GAD-7)", "Impact of Events Scale (IES-6)", "EuroQol- 5 Dimension (EQ-5D)", "PROMIS global physical health scale (GHS) "and "Breathlessness, Cough and Sputum Scale (BCSS)"). Result(s): Of the 111 survey participants, 32 (33%) had been hospitalized and 35 (36%) had SARS-CoV-2 infection >6 months ago. Median (IQR) age was 58 years (46, 65). Median time from SARS-CoV-2 diagnosis was 167 days (138, 221). Cognitive impairment, anxiety, depression, insomnia, feeling of trauma, fatigue, pain, breathing problems, cough, abnormal smell, abnormal taste, and diarrhea were reported by 40%, 23%, 36%, 55%, 53%, 41%, 19%, 33%, 33%, 21%, 22%, and 32% of patients respectively. Hospitalized patients had poorer scores in cognition (QDRS survey score of 2 versus 0.75, p=0.048) (Figure 1), quality of life (EQ-5D survey score of 2 versus 1, p=0.043), physical health (PROMIS GHS survey score of 10 versus 11, p=0.013), respiratory status (BCSS survey score of 1 versus 0, p=0.056), and pain (Pain score of 3 versus 0, p 0.006). Among patients who had SARS-CoV-2 infection >6 months ago, abnormal breathing, cough, abnormal smell, abnormal taste, and diarrhea continued to be reported by 31%, 31%, 29%, 32%, and 32% of patients respectively. Conclusion(s): After SARS-CoV-2 infection, SOTRs had a high prevalence of PASC symptoms. Some of the symptoms are more severe in patients who had required hospitalization and persist beyond 6 months. Further studies are needed to understand the long term sequalae of SARS-CoV-2 infection in SOTRs and to develop an evidence-based multidisciplinary approach for caring for these patients beyond the acute phase. (Table Presented).

4.
Investigative Ophthalmology and Visual Science ; 63(7):1631-A0126, 2022.
Article in English | EMBASE | ID: covidwho-2057724

ABSTRACT

Purpose : The mental health burden of the COVID-19 pandemic is thought to be substantial. Glaucoma patients are especially vulnerable considering prior reports of higher rates of anxiety and depression than the general population at baseline. In this study, we explore how measures of mental health and social support during the pandemic varied by gender among those diagnosed with glaucoma. Methods : We obtained a cohort of patients diagnosed with glaucoma (any type) from the NIH All of US Research Program. Answers from the latest COVID-19 Participant Experience (COPE) survey were used. Logistic regression was used to evaluate the association between reported depression (using Patient Health Questionnaire-9 (PHQ-9) scores), stress associated with social distancing, and measures of social support if one became sick with COVID-19 by self-reported gender (male, female, other). Multivariable models were adjusted for age, race/ethnicity, health insurance status, education, and income, with males as the reference group. Observations with missing values for covariates used in the models were dropped. Results : Of 3,675 glaucoma patients, 56.1% were female, 83.4% were non-Hispanic White, and 95.0% had insurance plans other than Medicaid or none. Many patients had a PHQ-9 score >4 (33.5%), indicating mild, moderate, or severe depression, and 74.4% experienced “a lot” or “some” stress during the pandemic from social distancing. After adjusting for covariates, females were more likely to report depression (OR: 1.40, 95% CI: 1.20-1.62) and stress associated with social distancing (OR: 1.34, 95% CI: 1.14-1.57) than males. Further, females were less likely to report having help if they were sick with COVID-19 and needed someone to prepare meals (OR: 0.78, 95% CI: 0.67-0.92) or help with daily chores (OR: 0.79, 95% CI: 0.67-0.91). Conclusions : Females with glaucoma were more likely to experience depression, stress due to social distancing, and were less likely to have social support if sick with COVID-19 than their male counterparts. As measures of mental wellbeing and social support are associated with better medication adherence and health outcomes, glaucoma patients identifying as female may represent an especially vulnerable population. Efforts should be made to identify glaucoma patients experiencing hardship during the COVID-19 pandemic.

5.
Journal of the Intensive Care Society ; 23(1):40, 2022.
Article in English | EMBASE | ID: covidwho-2042998

ABSTRACT

Introduction: Intensive care units (ICU) health care professionals working in a challenging environment during the Covid 19 pandemic.1 Expansion of ICU provision, working long shifts with limited resources with precarious infrastructure expose them to more stressful environments and potentially affect their mental health.2 Objectives: To identify the prevalence of psychological impact and assess the associated factors among ICU health care professionals (doctors and nurses) in five Sri Lankan hospitals from July to August 2021. Methods: It's a descriptive study carried out in five hospitals in Sri Lanka caring for covid 19 patients. Data were collected anonymously and voluntarily using web-based (Google form) and printed standardized questionnaires examining anxiety symptoms (Generalized Anxiety Disorder-7 (GAD-7)), depression (Patient Health Questionnaire (PHQ-9)), and symptoms of post-traumatic stress disorder (PTSD) (PTSD Checklist-Civilian Version (PCL-6)). Results: Overall, 233 health care professionals participated, compromising 54 (23.2%) doctors and 179 (76.8%) nurses. Prevalence of moderate to severe anxiety, depression, and PTSD was 42.1%, 51.5%, and 37.8% respectively. Sub-group analysis showed the risk of developing PTSD was more among nurses than doctors (p <0.05). Among doctors, moderate to severe depression prevalence was high (55.5%), while anxiety and PTSD were 31.45% and 24.07%, respectively. In nurses, moderate to severe depression, anxiety, and PTSD were 50.27%, 45.25, and 41.89%. Years of experience in patient care, working long shifts, inadequate personal protective equipment, inadequate staffing of ICU does not associate with significant psychological impact. Conclusion: A high prevalence of psychological impact was observed in the health care professionals in ICU during the COVID-19 pandemics. Efforts should be made to implement interventions for the mental well-being of the staff.

6.
Journal of the Intensive Care Society ; 23(1):91-92, 2022.
Article in English | EMBASE | ID: covidwho-2042992

ABSTRACT

Introduction: During theCOVID-19 pandemic we were faced with a large number of critical care discharges recovering from prolonged intensive care admission and severe lung injury at our 500 bed hospital in the South East of England. These patients often had complex rehabilitation needs and rehabilitation of these patients had been challenged by social distancing and the reconfiguration of many outpatient departments. Prior to the covid pandemic our rehabilitation pathway consisted of a nurse led follow up that focussed on psychological recovery and, following initial assessment, physiotherapy that included musculoskeletal therapy, 1:1 or small group exercises and respiratory physiotherapy. We developed a new pathway during the COVID-19 pandemic that united these above services into a one-stop multidisciplinary service that included clinician follow up and utilised smart watch technology from Fitbit watches to aid recovery of our ICU discharges. Method: Prior to discharge patients had a comprehensive set of assessments to identify physical and psychological needs. This included an incremental shuttlewalk test, oneminute sit-to-stand test, patient health questionnaire-9 (PHQ-9), generalized anxiety depression questionnaire -7 and Chelsea critical care physical assessment (CPAX). Patients were offered an exercise programme, depending on level of function, and referred to appropriate community services as required. Patients received Fitbit charge 3watches and were asked towear these as often as they felt able. At three months following discharge patients attended a multidisciplinary clinic consisting of an intensive care clinician, physiotherapist, and nursing staff. Outcome measures were re-assessed, and the patient had access to ongoing physio, nursing and medical input to support their recovery. Fitbit data was reviewed and incorporated into future goal setting. In addition, patients were invited to a relative and patient support group as an opportunity to meet other critical care survivors and for their relatives to share their experiences of recovery. They were also offered the chance to visit the ICU to aid physiological recovery. Results: The one-stop nature of the clinic allowed a resource efficient means for multi disciplinary care to be delivered to patients. The majority of patients found the support group extremely beneficial. Patients reported they found it helpful being able to share experiences, listen to others and see people at different stages in their recovery. Relatives also found the experience useful to deal with the traumatic experience of a critically ill loved one. Smart watches were well received by patients and over 80% of patients felt the watch aided their recovery. The watches also added a unique dimension to the MDT meeting, able to pick up changes in daily activity levels, rapidly alerting the clinician to a potential problem in that patient. Conclusion: The service is continually evolving. Future plans aim;to use smart watches for all ICU discharges with an integrated app to promote recovery and allow remote feedback, to use a Post-ICU Presentation Screen (PICUPS) and rehabilitation prescription to inform rehabilitation needs and to include a psychologist into the clinic to improve patient recovery after ICU admission.

7.
Journal of the Intensive Care Society ; 23(1):50-51, 2022.
Article in English | EMBASE | ID: covidwho-2042972

ABSTRACT

Introduction: The COVID-19 pandemic presents a unique set of stressors for healthcare professionals across the globe.1 The challenges facing intensive care workers in the United Kingdom (UK) have not previously been seen on this scale. There is a dearth of research establishing the psychological impact of the virus among intense care workers specifically, who may be at the greatest risk of adverse outcomes. Protecting the psychological wellbeing of healthcare workers caring for patients with COVID-19 is essential for the long-term capacity of the health workforce. Objectives: The objectives of this study were to establish the prevalence of anxiety, depression and post-traumatic stress disorder (PTSD) among a cohort of intensive care workers within the United Kingdom during the COVID-19 pandemic. Methods: An anonymous questionnaire was designed to incorporate validated screening tools for anxiety (Generalised Anxiety Disorder Scale, GAD-7),2 depression (Patient Health Questionnaire, PHQ-9)3 and post-traumatic stress disorder (Impact of Event Scale-Revised, IES-R).4 Participants were also asked to highlight any factors in particular that contributed significantly to their own perceived mental health status. Additionally, awareness of any available mental health support services was established. All intensive care workers at the Countess of Chester Hospital, UK, were eligible and data was collected over a three week period during the months of June and July 2020 Results: The majority of the 131 respondents were nurses (52.7% [69/131]) or doctors (32.8% [43/141]). Almost onethird (29.8% [39/131]) reported a significant or extreme impact of COVID-19 on their mental health. In total, 16% (21/131) had symptoms of moderate depression, 11.5% (15/131) moderately severe depression and 6.1% (8/131) severe depression. Females had a significantly higher mean PHQ-9 score than males (8.8 and 5.68 respectively, p=0.009). Furthermore, 18.3% (24/131) had moderate anxiety with 14.5% (19/131) having severe anxiety. Mean GAD-7 scores were higher among females than males (8.69 and 6.26 respectively, p=0.028). Additionally, 28.2% (37/ 131) had symptoms of PTSD (IES-R ≥33). The most commonly cited contributory factors to participants' selfrated impact on mental health, was the effect of COVID-19 on family (78.6% [103/131]) followed by being busier at work (60.3% [79/131]), the personal risk of contracting COVID-19 (56.5% 74/131]), change in working environment (51.1% [67/131]) and change in working hours (43.5% [57/131]). The majority (58% [76/131]) of participants were either unaware or only vaguely aware of available mental health support services. Surprisingly, only 3.1% (4/131) had accessed support services at the time of data collection. Conclusion: The psychological impact of COVID-19 on intensive care workers is significant. Healthcare systems are currently ill-prepared to cope with the increased demand for support5. Specific focus and attention must be directed accordingly in order to safeguard the mental health of this key sector of the workforce, who play a crucial role in the fight against COVID-19. Determining and acknowledging the scale of the problem is the first step towards achieving this.

8.
Ann Med Surg (Lond) ; 82: 104767, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2041503

ABSTRACT

Background: During the COVID-19 pandemic, the number of bariatric surgeries was decreased to ensure patient safety. This study aimed to evaluate the effect of such delays on the psychological status and weight management behaviors of waitlisted pre-bariatric surgery patients in Jeddah, Saudi Arabia. Materials and methods: A web-based cross-sectional survey was conducted. Results were then evaluated with simple descriptive statistics and inferential analyses through the Chi-square test, one-way ANOVA, and the general linear regression model. Results: Of 437 patients, 208 successfully completed the survey. Approximately half of the participants reported weight change (46.6%, n = 97), while other weight management behaviors remained unchanged. The mean Patient Health Questionnaire-9 (PHQ-9) total score of the respondents was 8.29 ± 6.3, indicating mild depression. Higher PHQ-9 scores were associated with being a student, unhealthy dietary habits, physical inactivity, worsened psychological status, and weight gain. Among these factors, being a student was the strongest predictor of the total PHQ-9 score. Conclusion: The COVID-19 pandemic significantly affected the psychological status of patients with obesity on the bariatric surgery waitlist. Since delays in bariatric surgeries could worsen patients' psychological status, as substantiated in this study, the provision of virtual care through telemedicine and the development of policies for reintroducing bariatric surgeries for future lockdowns are highly recommended.

9.
Telemed J E Health ; 28(8): 1126-1133, 2022 08.
Article in English | MEDLINE | ID: covidwho-1577485

ABSTRACT

Introduction: Patient participation and clinical outcomes of a precoronavirus disease 2019 (COVID-19) office-based transdiagnostic psychiatric intensive outpatient program (IOP) were compared with those of telehealth IOP during COVID-19. Materials and Methods: Weeks of enrollment, Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) assessments, and sociodemographic and clinical factors (including group track and diagnosis) were collected during pre-COVID-19 (n = 191) and during COVID-19 (n = 200). Continuous and categorical measures of GAD-7 and PHQ-9 were analyzed; potential sociodemographic and clinical covariates to scores were also explored. Results: There were no statistically significant differences in participation between time periods. Associations were observed between PHQ-9/GAD-7 score improvement and number of assessments. Significant score reductions occurred in both periods, and differences in change scores were not significant. Sociodemographic and clinical factors were not significantly different between time periods. Patients with commercial insurance had significantly higher improvement in both mean and categorical PHQ-9 scores (t = 2.77, p = 0.006; χ2 = 10.47, df = 1, p = 0.001) and GAD-7 scores (t = 2.29, p = 0.023; χ2 = 8.58, df = 1, p = 0.003) than those with public insurance. Patients with anxiety disorders had significantly greater improvements (F = 4.49, p = 0.004; χ2 = 9.15, df = 3, p = 0.027) in GAD-7 during COVID-19. Discussion: Significant improvements in PHQ-9/GAD-7 scores and measures of participation were not significantly different between telehealth and office-based IOP, nor were they greatly influenced by clinical or sociodemographic factors. Further study is needed of possible care disparities for publicly insured patients. Conclusion: Despite some limitations, telehealth IOP appears to be a clinically appropriate option for a diverse sociodemographic and diagnostically heterogeneous psychiatric population.


Subject(s)
COVID-19 , Telemedicine , Anxiety Disorders/diagnosis , COVID-19/epidemiology , Humans , Outpatients , Patient Participation
10.
Clinical Practice and Epidemiology in Mental Health ; 18, 2022.
Article in English | EMBASE | ID: covidwho-2009793

ABSTRACT

Background: Quarantine measures during the COVID-19 lockdown had a negative impact on children’s psychology and development. In this study, we aimed to evaluate the psychological impact of quarantine on children due to the COVID-19 pandemic in Saudi Arabia and to assess types of reported child maltreatment before and after the pandemic. Methods: A cross-sectional survey among parents was performed along with a retrospective data review for anonymized data from the National Family Safety Program, Saudi Arabia. 436 children participated in this survey during June-November 2020. Results: The percentage of fathers with an organic or psychological illness in the children with elevated anxiety levels is 18.5% (p-value = 0.019). The anxiety level of the participants was assessed using the Generalized Anxiety Disorder Assessment (GAD-7). Based on the scores, 10.1% had severe anxiety. The depression level of the participants was assessed using Patient Health Questionnaire (PHQ-9). Based on the scores, 4.4% had severe depression. The anxiety level of the children was assessed using Spence Children’s Anxiety Scale – Parent (SCAS-Parent). Based on the overall score, 28.1% of the children had elevated anxiety levels. The anxiety level was elevated in a panic attack and agoraphobia for 36.8% of the kids, in separation anxiety for 26.8%, in physical injury fears for 35.1%, in social phobia for 19%, in obsessive-compulsive for 25.1%, and in generalized anxiety disorder/overanxious for 27.3%. Conclusion: Quarantine and lockdown during the period of the COVID-19 pandemic have had a negative impact and many adverse effects on the mental and intellectual development of children. These negative outcomes may be addressed via well-planned multilevel interventions.

11.
Annals of the Rheumatic Diseases ; 81:1677, 2022.
Article in English | EMBASE | ID: covidwho-2008970

ABSTRACT

Background: The COVID-19 pandemic has raised concerns about its psychological effects. Sleep disturbances, anxiety and/or depressive symptoms, post-traumatic stress symptoms have been reported in general population. Patients with chronic rheumatism, systemic autoimmune disease or auto-infam-matory disease, due to immunosuppression, are at risk of severe forms of infection. Currently, there is little information on psychological impact of the pandemic on the mental health of these more vulnerable patients. Objectives: To compare psychological assessment between patients with chronic rheumatic, autoimmune and/or autoinfammatory diseases who presented with COVID-19 infection between March and September 2020, frst wave of French pandemic, and patients with same diseases who did not presented with infection to date. Methods: The MentCOVRMD study was a multicenter descriptive study. Cases were patients with chronic rheumatic, autoimmune and/or autoinfammatory diseases from the French RMD cohort who presented COVID-19 infection between March and September 2020. Controls were patients with same diseases who did not develop infection. The study is registered in Clinical Trials under number 2020-A02058-31. For participants, following criteria were collected: demographics (age, gender, smoking status);psychological assessment questionnaires: Insomnia Severity Index (ISI);Post-traumatic stress disorder (PTSD) checklist;Patient Health Questionnaire (PHQ9) Depression;Generalized Anxiety Disorder (GAD7) Anxiety;Patient Health Questionnaire-15 (PHQ-15) and Somatic Symptom Disorder (SSD)-12. Results: Between February and December 2021, 60 cases (46 (76.7%) women), median age 52.0 (39.0;63.0) were included, of which 15 (25%) had been hospitalized during infection, and 169 controls (148 (87.6%) women), median age of 52.0 (38.0;63.0). There were more smokers in the group of cases 12 (20%) than controls 14 (9.1%) (p=0.028) as well as more cases on ARA2 treatment (8 (13.3%)) than controls (7 (4.5%)) (p=0.035) with no statistically signifcant difference in others comorbidities or treatments. There was no statistically difference concerning the ISI scores between cases (11.83 ± 7.31) of which 60% had sleep disorders and controls (11.64 ± 6.82) of which 70.4% had sleep disorders. There was no statistically significant difference in PTSD scores of 15.5 (5.0 to 28.0) for cases and 18.0 (8.0 to 35.0) for controls, of which respectively 12 (20%) had values indicating possible PTSD for cases and 50 (29.6%) for controls. There was no statistically significant difference in PHQ-9 scores (5.5 (1.5 to 11.0)) of which 50% had depressive symptoms and controls (6.0 (2.0 to 11.0)) of which 54.5% had symptoms. There was no statistically significant difference in GAD-7 scores (3.5 (0.0 to 8.0)) of which 40% had anxiety symptoms and controls (4.0 (0.0 to 8.0)) of which 43.2% had symptoms. There was no statistically significant difference in PHQ-15 scores (11.4 ± 6.7), 85% of whom reported presence of symptoms, and controls (10.9 ± 6.2), 82.3% of whom reported symptoms. There was no statistically significant difference in SSD scores between cases (17.7 ± 10.9) and controls (18.4 ± 10.9). There was a statistically signifcant difference in reported VAS scores of pain related to infammatory rheumatism in cases with a median of 4.5 (3.0 to 6. 0) compared to controls with a median of 4.0 (1.0 to 6.0) (p=0.011). There was no statistically signifcant difference in any of the psychological assessment scores between the inpatient and outpatient COVID cases. Conclusion: There was no statistically signifcant difference between COVID cases and controls in the evaluation of these psychological parameters. Prevalence of all these variables were high in the whole study population, testifying to the need to manage these psychological aspects for patients with chronic rheumatisms, autoimmune and/or autoinfammatory diseases.

12.
Annals of the Rheumatic Diseases ; 81:1092, 2022.
Article in English | EMBASE | ID: covidwho-2008940

ABSTRACT

Background: Mental disorders constitute a serious and underestimated problem in Latin America and they could have worse features in comparison with Europe or North America (1);that was the case even before the COVID-19 epidemic ensued in 2020. Objectives: The objective of this study was to determine the factors associated with the occurrence of mental health disorders (MHD) in patients with autoimmune rheumatic disease (ARD) from Perú, a high COVID-19 incidence country. Methods: Patients with ARD from a single center (Hospital Guillermo Almenara-EsSalud, Lima-Perú) were included during the frst and second waves of the COVID-19 pandemic (March to November 2020). Interviews, medical records reviews, and an electronic survey were performed. MHD explored were depression (assessed with the Patient Health Questionnaire 9: PHQ-9), anxiety (ascertained with the Generalized Anxiety Disorder-7: GAD-7) and post-traumatic stress disorder: PTSD (evaluated with the Event Scale-Revised: IES-R). Variables examined were sociodemographic (age, gender, educational level, marital status, living alone, job status, religiosity), previous diagnosis and treatment for mental disorders, living with a COVID-19 patient, COVID-19 diagnosis (current or past), fear of COVID-19 (assessed with the COVID-19 Scale: FCV-19S) and the ARD type. Multivariable logistic regression models using backward elimination procedure were performed to determine the variables associated with depression, anxiety, and PTSD. (See Table 1). Results: Nine hundred and thirteen ARD patients were evaluated. The most frequent diagnosis was rheumatoid arthritis in 446(48.8%) patients followed by systemic lupus erythematosus in 279 (30.6%). Depression, anxiety, and PTSD were observed in 128 (14.0%), 112 (12.30%) and 485 (53.1%) patients, respectively. In the multivariable analyses, previous treatment for mental disorders and fear of COVID-19 were associated with depression: OR=2.35 (95% CI 1.37-4.03;p=0.002) and OR=1.07 (95% CI 1.05-1.10;p<0.001) respectively;also with anxiety: OR= 2.42 (95% CI 1.37-4.26;p=0.002) and OR=1.09 (95% CI 1.06-1.12;p <0.01) and with PSTD: OR=2.42 (95% CI 1.39-4.21;p=0.002) and OR=1.41 (95% CI=1.11-1.17;p<0.001). A diagnosis of COVID-19 was associated with PTSD: OR=1.75 (95% CI 1.06-2.89, p=0.028), while being single was associated with a decreased probability of PTSD occurrence: OR=0.57 (95% CI=0.35-0.96;p=0.03). Finally, having a high educational level was associated with less anxiety: OR=0.43 (95% CI=0.82-0.21;p=0.009), for university/postgraduate studies and OR=0.52 (CI 95%=0.28-0.95;p=0.032) for secondary studies. Conclusion: Fear of COVID-19 and previous treatment for mental disorder were associated with all MHD explored on our ARD patients during the COVID-19 pandemic.

13.
Annals of the Rheumatic Diseases ; 81:927, 2022.
Article in English | EMBASE | ID: covidwho-2008832

ABSTRACT

Background: Vaccine trials of the SARS-CoV-2 mRNA vaccines were encouraging but excluded most patients with rheumatic diseases (RD) and patients treated with immunosuppressive therapy. However, reports of a more severe COVID-19 disease course in patients with RDs prompted strategies for expediting vaccination of RD patients in most countries. In addition to the impact experienced by most people of the pandemic, patients with RDs were adversely impacted by the potential risk of severe COVID-19 due to their disease and immunosuppressive treatment. Fear of COVID-19 led to disproportionate anxiety, self-isolation, and shielding behavior for many RD patients at the beginning of the pandemic. Objectives: We investigated antibody levels in serum against SARS-CoV-2 after a two-dose vaccination with an mRNA vaccine in patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Further, we examined the association between reactogenicity and immunogenicity and how vaccination influenced patient behavior concerning fear of COVID-19 and shielding. Methods: Patients with SLE or RA from the COPANARD (Corona PANdemic Autoimmune Rheumatic Disease)1 cohort received two doses of an mRNA vaccine between January and August 2021 and had total antibodies against SARS-CoV-2 measured before vaccination and 2 and 9 weeks after the second vaccination. In addition, patients answered an electronic questionnaire before and eight weeks after vaccination concerning behavior, anxiety, and symptoms of depression (PHQ-9). Results: Three-hundred-and-three patients and 44 blood donors (healthy controls) were included. Signifcantly fewer patients (90%) had measurable antibodies against SARS-CoV-2 compared to blood donors (100%) after the second vaccination (p<0.001) (Figure 1). Treatment with Rituximab was the strongest predictor of unfavorable vaccine response, as only 27% were seropositive after vaccination. We found a negative effect of prednisone and methotrexate but no effect of age, comorbidity, or pausing medication on seroconversion. Patients experienced signifcant improvement after vaccination in 10 out of 12 questions regarding behavior and fear of COVID-19, but no change was observed in symptoms of depression (p=0.62) or anxiety (p=0.46). Conclusion: The majority of patients with SLE or RA had a measurable sero-logical response to the COVID-19 mRNA vaccine after two doses. Treatment with Rituximab was the strongest predictor of no seroconversion. Our fndings warrant encouragement of vaccination against COVID-19 for patients with RD, as most patients benefts with both a serological immune response and reduced isolation and shielding behavior.

14.
Annals of the Rheumatic Diseases ; 81:1663, 2022.
Article in English | EMBASE | ID: covidwho-2008817

ABSTRACT

Background: The Coronavirus-2019 (COVID-19) pandemic increased psychosocial distress in the general population and in patients with rheumatic disease. Limited data exists on the impact of COVID-19 in rheumatology patients living in Africa. Objectives: To describe COVID-19 related illness and psychosocial impact in Ethiopian (ET) rheumatology patients attending the only public rheumatology clinic in Ethiopia (Tikur Anbessa Specialized Hospital (TAH) in Addis Ababa). To compare fndings in ET with fndings in Canadian (CA) rheumatology patients. Methods: Between May 1 and Oct 31 2021, 130 patients attending the TAH rheumatology clinic answered questions related to COVID-19 infection, symptoms and testing, and psychosocial impacts of the COVID-19 pandemic. We assessed depression (Patient Health Questionnaire-9), anxiety (General Anxiety Disorder-7;GAD7), COVID-19 stress factors and coping measures, Resilience (Brief Resilience Scale-BRS) and medication compliance (Morisky medication adherence scale-4 item;MAS4). Rheumatic disease severity was assessed with the Routine Assessment of Patient Index Data-3 (RAPID-3). Questionnaires were translated to Amharic. Descriptive statistics are reported [mean (standard deviation), median (25%, 75%) number and percent.)] and compared to data of 97 CA patients with rheumatoid arthritis (RA) and lupus patients from Quebec1. Results: ET patients were mainly female (71%) with a mean (SD) age of 47 (16), and resided in the capital city (Addis Ababa) (72%). Half had RA or lupus. A quarter of patients had moderate to severe rheumatic disease severity desite good medication adherence [MAS4 score of 3(2,4)]. Most (89%) reported no COVID-19 symptoms since the beginning of the pandemic, were not tested for COVID-19 and reported few risk factors for COVID-19 exposure. Eight (6%) ETs were diagnosed with COVID-19;2 required hospitalization. Diagnosed patients reported a median of 2 COVID-19 symptoms (range 0-8;mainly cough, fever and malaise). Within the entire cohort, depression (PHQ9= 10 or above) and anxiety (GAD7=10 or above) were more frequent in ETs than CAs (depression 30% vs 3%;anxiety 16% vs 1%) yet nearly half (47%) of ETs had normal or high resilience levels. The most common COVID-19 stressors were risk of contracting COVID illness personally [ETs vs CAs risk ratio(95% confdence limits-CL);0.67 (0.5, 0.99)] or of loved one [0.56 (0.36, 0.86)]. More ETs reported COVID-19 related stress related to difficulty obtaining food, medicine or other essentials [1.74, (1.00-3.0)], and getting needed supports [1.97 (1.03, 3.77)] (Table 1). CAs and ETs used similar levels of problem solving [median (25%,75%) CA 3.3 (2.8, 3.3), ET 3.5 (3.0, 3.7)] and emotion-focus [CA 2.5 (2.2, 3.1);ET 3.3 (2.8, 3.7)] coping strategies. Conclusion: During the COVID-19 pandemic, depression was more common in ETs compared to CAs with rheumatic disease. COVID-19-related stressors due to insecurity in obtaining the basic essentials and support were more pronounced in ETs. Differences between ETs and CA in these stressors may refect local public health and economic supports. There were no differences in coping strategies.

15.
Indian Journal of Critical Care Medicine ; 26:S67-S68, 2022.
Article in English | EMBASE | ID: covidwho-2006357

ABSTRACT

The COVID-19 pandemic has ravaged populations across the globe. The toll taken is unprecedented in the modern age. Aside from this obvious morbidity and mortality, there is an under-appreciated pandemic of mental illness that is sweeping across the world. Mental health issues in health care professionals have long since been identified to be a significant problem. Our experiences during previous similar epidemics have shown that such situations take a huge toll on the physical as well as mental health of personnel affected, either directly by infection or indirectly by the social and economic consequences of the pandemic. The health care worker may find him/herself in a very challenging situation, dealing simultaneously with multiple sources of stress in an ever-changing environment. These manifest in the form of serious mental issues such as depression, anxiety, stress, sleep disturbances, and posttraumatic stress disorder, to name a few. These can have a longlasting impact on the psychological makeup of the victims. We conducted this survey-based study to assess the prevalence of depression and anxiety among a wide range of personnel involved in health care, in different settings, working in the front line and nonfront line scenarios. Aims and objectives: To assess the prevalence of developing anxiety and depression among health care workers during the COVID-19 pandemic and to compare the prevalence thereof based on various factors such as occupation, pre-existing health issues, level of work, social background, working directly with infected patients. Materials and methods: Survey-based, prospective, observational cohort study including data collection over 1 month. The online survey was circulated as a Google Form and made available to all healthcare workers pan India. The study included the Patient Health Questionnaire-9 (PHQ-9) and the General Anxiety Disorder-7 (GAD-7) scale along with other personal information, gathered anonymously. The paired t-test and Mann- Whitney U-test were used to determine the statistical significance. Results: The mean age of the population was 39.9 years, with equal distribution among the sexes. 70% of subjects were married and 76% lived with their families. The commonest co-morbidities were hypertension (n = 66), obesity (n = 61), diabetes (n = 37). 60.4% had PG qualifications, 69.3% were treating physicians, and 49.4% were consultants. 90.3% worked in urban settings, 65.5% worked at the tertiary level. 37.4% worked directly with COVID-19 patients. 24.4% of respondents worked in ICU, 14.7% in OPD, 12% in ward settings. Gross prevalence of depression was 43% (mild: 22.6%, moderate 11.2%, moderate-severe 5.1%, severe: 3.9%). Prevalence of anxiety was 47% (mild 26%, moderate 13%, severe 7%). Depression was commoner among men (p = 0.04), those in a relationship (p = 0.00), those with children (p = 0.00) in older age groups, with higher positions and educational qualifications, and those with co-morbidities (p = 0.0). It was less prevalent in front-line workers, including physicians (p = 0.00). Among the front-line workers, depression and anxiety were more prevalent among physicians (p = 0.01). Depression was commoner in OPD and ED settings (p = 0.00), and less for people getting quarantine period (p = 0.00). Conclusion: Our survey shows a higher than average prevalence of anxiety and depression among health care workers in India as compared to non-pandemic periods. We have also identified groups that are at higher risk for mental health issues .

16.
Journal of Clinical Oncology ; 40(16), 2022.
Article in English | EMBASE | ID: covidwho-2005715

ABSTRACT

Background: To direct limited specialized palliative care resources to patients in greatest need, we developed STEP (Symptom screening with Targeted Early Palliative care). STEP entails symptom screening (ESAS-r) at each oncology clinic visit and triggered alerts (for moderate-high physical and psychological symptoms) to a nurse who calls the patient to offer a palliative care clinic (PCC) visit. We conducted a phase III RCT to assess the impact of STEP versus usual care on quality of life and other patient-reported outcomes (PROs). Methods: Adults with advanced cancer were recruited from medical oncology clinics at the Princess Margaret Cancer Centre, Toronto, Canada. Consenting patients with oncologist-assessed ECOG 0-2 and estimated survival of 6-36 months were enrolled and block randomized (stratified by tumour site and symptom severity) to STEP or usual care. Participants completed measures of quality of life (FACT-G7), depression (PHQ-9), symptom control (ESASr-CS), and satisfaction with care (FAMCARE-P16) at baseline, 2, 4 and 6 months. The primary outcome was FACT-G7 at 6 months, with a planned sample size of 261/arm. Results: From 8/2019 to 3/2020, 69 patients were enrolled: 33 randomized to STEP and 36 to usual care. The trial was then halted permanently due to the COVID-19 pandemic, owing to substantial changes to elements of STEP (shift to virtual symptom screening and palliative care) and usual care (shift to virtual oncology care). Median age was 64 years (range 25-87) and 62% (43/69) were women;study arms were balanced at baseline except gender, with more women randomized to STEP. Within the STEP arm, 20 (61%) participants triggered a nurse's call to offer a PCC visit, of whom 13 attended the clinic at least once. All outcomes tended to be better in the STEP arm compared to usual care, particularly depression and satisfaction with care at 6 months;however, results were not statistically significant (Table). Conclusions: STEP holds promise for improving quality of life and other PROs in patients with advanced cancer and effectively directing early palliative care towards those who need it most. In response to the pandemic, an online version of STEP has been developed and a further trial is in progress.

17.
Surgery for Obesity and Related Diseases ; 18(8):S30-S31, 2022.
Article in English | EMBASE | ID: covidwho-2004508

ABSTRACT

Samantha Leung Toronto1, Sanjeev Sockalingam Toronto2, Clement Ma Toronto2, Raed Hawa Toronto1, Susan Wnuk Toronto1, Satya Dash 1, Timothy Jackson Toronto1, Stephanie Cassin Toronto3 University Health Network1 Centre for Addiction and Mental Health2 Ryerson University3 Background: Patients undergoing bariatric surgery have high rates of psychiatric comorbidity, which may increase their vulnerability to COVID-19-related mental health distress. Exacerbation of mental health distress and disordered eating could have significant negative effects on long-term weight management and quality of life for these patients if untreated. Objective: To determine the efficacy of a telephone-based cognitive behavioural therapy (Tele-CBT) intervention in improving depressive, anxiety and disordered eating symptoms during COVID-19. Methods: Participants were recruited as part of a larger randomized controlled trial study (clinicaltrials.gov ID: NCT03315247) between March 2020 and March 2021 and randomized 1:1 to receive Tele-CBT or standard bariatric care. Outcomes of Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Emotional Eating Scale (EES), and Binge Eating Scale (BES) were measured at baseline, immediately post-intervention, and 3-months post-intervention. Linear mixed models were used to test the effect of intervention group, time, and group-by-time interaction for each outcome. Results: Eighty-one patients were included in the intention-to-treat analysis. Mean (SD) age of participants was 47.68 (9.36) years and 80.2% were female. There were significant group-by-time interactions for all outcomes and significant differences between groups across time. There were significant decreases in mean GAD-7 (p=0.001), PHQ-9 (p<0.001), EES-Total (p=0.001), EES-Anger (p=0.003), EES-Anxiety (p<0.001), EES-Depression (p<0.001) and BES (p=0.002) scores for the Tele-CBT group at post-intervention and follow-up when compared to baseline and the control group. Conclusion: Tele-CBT is a feasible and effective treatment for improving psychological distress and disordered eating among post-operative bariatric surgery patients during the COVID-19 pandemic.

18.
Terapia Psicologica ; 40(1):93-109, 2022.
Article in Spanish | EMBASE | ID: covidwho-1997912

ABSTRACT

Background: Female university students from socioeconomically vulnerable groups is a high-risk group for the development of mental health problems in the covid-19 pandemic. Objective: To evaluate the moderating role of teacher support on emotional regulation strategies (ERS) in the relationship between academic stressors (AS) and depressive symptoms in female university students from socioeconomically vulnerable groups. Method: 371 women between 18 and 29 years old who were in higher education completed a survey where depressive symptoms were evaluated through the PHQ-9 and the ERD through CERQ. To assess academic stressors and perception of teacher support, specific questions were designed. Results: Two indirect effect models were identified that showed that low teacher support moderated the moderation of low and medium levels of ERS planning in the relationship of “quality of online learning” and “concern for academic performance” with depressive symptoms. Conclusions: The role of ERS that points to metacognitive aspects and teaching support as protective factors for this specific group against AS, mainly linked to academic performance is discussed at the end.

19.
Journal of Cystic Fibrosis ; 21:S134-S135, 2022.
Article in English | EMBASE | ID: covidwho-1996793

ABSTRACT

Objectives: Research has shown that patients with CF and their families have an increased risk of anxiety and/or depression. This substudy, part of a multicentre observational trial, investigated the psychosocial impact of 6 months of treatment with Symkevi® in adult CF patients. Methods: The Cystic Fibrosis Questionnaire (CFQ-R), Patients Health Questionnaire (PHQ-9) and General Anxiety Disorder Questionnaire (GAD-7) were completed at baseline and after 6 months of treatment with Symkevi®. Results: Of 42 subjects (median age: 29.3 years;28M/14F) included in the initial trial, 21 patients completed the CFQ-R and 25 patients completedthe GAD-7 and PHQ-9. The scores in the GAD-7 and PHQ-9 were not significantly different between baseline and 6 months (p = 0.55;p = 0.51, resp.). No significant differences were observed between the CFQ-R domains except for "social functioning." For this domain, the median scores improved from median 55.56% (IQR: 50.00%;73.61%) to 72.22% (IQR: 65.28%;83.33%) (p = 0.001). Patients with an increased social functioning also had an increased FEV1 after 6 months (p = 0.02). Conclusion: These findings indicate that 6 months of treatment with Symkevi® improves social functioning among adult CF patients.We did not see a difference in anxiety or depression. Further research is required to investigate whether longer treatment with Symkevi® will have an influence on anxiety and/or depression. In addition, the current results did not account for a possible impact of local COVID-19 restrictions

20.
Journal of Cystic Fibrosis ; 21:S5, 2022.
Article in English | EMBASE | ID: covidwho-1996739

ABSTRACT

As new therapies emerge for cystic fibrosis (CF), it is important to understand their psychiatric implications. Studies have shown cystic fibrosis transmembrane conductance regulator (CFTR) modulators to be associated with worsening of depression and anxiety symptoms. Trikafta® (elexacaftor/tezacaftor/ivacaftor) is a newly-approved CFTR modulator that significantly improves lung function, decreases pulmonary exacerbations, and improves the quality of life. Further studies are needed to evaluate the effects of Trikafta® on anxiety and depression. Objectives: To evaluate the effects of Trikafta® on PHQ-9 (depression screening questionnaire) and GAD-7 (anxiety screening questionnaire), scores in adult patients with CF seen at an academic health centre in the Southeastern United States. Methods:We conducted a retrospective chart review of 127 adult patients with CF who initiated Trikafta® between (11/2019 to 08/2021). We gathered data, including demographic information (age, sex, race, CF mutation), annual PHQ-9 and GAD-7 scores, corresponding FEV1 percent predicted, BMI, mental health diagnoses, counseling/psychotherapy use, psychiatric medication use, prescriber of those medications, number of psychiatric emergency department visits and psychiatric admissions, and sleep disturbances. We then ran linear mixed models examining the effect of Trikafta® on PHQ- 9 and GAD-7 scores after controlling for timing with respect to the COVID- 19 pandemic. Results: Of the 127 adult patient charts reviewed,100were included. These patients yielded 562 PHQ-9 and 562 GAD-7 scores taken from 01/2015–01/ 2022. No change in PHQ-9 scores was found after initiating Trikafta® or after the beginning of COVID (designated as March 15, 2020). Similarly, GAD-7 scores showed no significant change after Trikafta® or COVID. Table 1. Patient demographics: N = 100 (Table Presented) Conclusion: There is no significant change in PHQ-9 and GAD-7 scores of patients with CF after initiating Trikafta®

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