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1.
J Health Care Poor Underserved ; 33(4): 1844-1864, 2022.
Article in English | MEDLINE | ID: covidwho-2109264

ABSTRACT

In the United States, eight million people have disabilities related to self-care (having serious difficulty with bathing and dressing). Of these, approximately 2.3 million receive paid personal assistance services (PAS) to assist with activities of daily living. The National Survey on Health and Disability asked a series of questions about the impacts of COVID-19 for disabled people including disruptions in PAS. We used data from an open-ended question "How did you manage without the help you needed in your home?" to bring light to both the importance of, and vulnerabilities associated with, receipt of PAS. Themes from qualitative responses (n = 108) included (1) causes of unmet need, (2) consequences of unmet need, and (3) adaptations to overcome the loss of PAS. Results provide compelling evidence about the importance of the personal care attendant workforce and needed policies to address worker shortages to support community-based living options.


Subject(s)
COVID-19 , Disabled Persons , Humans , Activities of Daily Living , COVID-19/epidemiology , COVID-19/psychology , Self Care , United States/epidemiology
3.
Global Health ; 17(1): 106, 2021 09 16.
Article in English | MEDLINE | ID: covidwho-2098354

ABSTRACT

BACKGROUND: The severity of COVID-19, as well as the speed and scale of its spread, has posed a global challenge. Countries around the world have implemented stringent non-pharmaceutical interventions (NPI) to control transmission and prevent health systems from being overwhelmed. These NPI have had profound negative social and economic impacts. With the timeline to worldwide vaccine roll-out being uncertain, governments need to consider to what extent they need to implement and how to de-escalate these NPI. This rapid review collates de-escalation criteria reported in the literature to provide a guide to criteria that could be used as part of de-escalation strategies globally. METHODS: We reviewed literature published since 2000 relating to pandemics and infectious disease outbreaks. The searches included Embase.com (includes Embase and Medline), LitCovid, grey literature searching, reference harvesting and citation tracking. Over 1,700 documents were reviewed, with 39 documents reporting de-escalation criteria included in the final analysis. Concepts retrieved through a thematic analysis of the included documents were interlinked to build a conceptual dynamic de-escalation framework. RESULTS: We identified 52 de-escalation criteria, the most common of which were clustered under surveillance (cited by 43 documents, 10 criteria e.g. ability to actively monitor confirmed cases and contact tracing), health system capacity (cited by 30 documents, 11 criteria, e.g. ability to treat all patients within normal capacity) and epidemiology (cited by 28 documents, 7 criteria, e.g. number or changes in case numbers). De-escalation is a gradual and bi-directional process, and resurgence of infections or emergence of variants of concerns can lead to partial or full re-escalation(s) of response and control measures in place. Hence, it is crucial to rely on a robust public health surveillance system. CONCLUSIONS: This rapid review focusing on de-escalation within the context of COVID-19 provides a conceptual framework and a guide to criteria that countries can use to formulate de-escalation plans.


Subject(s)
COVID-19/prevention & control , Bibliometrics , COVID-19/psychology , Contact Tracing/methods , Humans , Quarantine/methods , Quarantine/psychology
4.
Infect Control Hosp Epidemiol ; 42(4): 490-491, 2021 04.
Article in English | MEDLINE | ID: covidwho-2096350
6.
Psychiatr Danub ; 34(3): 547-556, 2022.
Article in English | MEDLINE | ID: covidwho-2081402

ABSTRACT

BACKGROUND: Empathy is important for successful interactions. The aim of the present study was to determine whether the cognitive component (Perspective taking) and affective components (Empathic concern and Personal distress) of empathy in health professionals were related to the degree of perceived threat of coronavirus, difficulties in doing work, difficulties in getting along with people, the health condition (current or past coronavirus disease), as well as with some socio-demographic characteristics. Fantasy as the cognitive component of empathy was not the focus of the present study as more irrelevant to clinical practice. SUBJECTS AND METHODS: A study of 296 health care workers through the Interpersonal Reactivity Index and a survey on perceived coronavirus threat, difficulties in work and getting along with people found that perceiving coronavirus as a stronger threat reduced both the cognitive component of empathy Perspective taking and the affective component of empathy Personal distress. RESULTS: As the affective components of empathy Empathic concern and Personal distress increased, the reported work difficulties were reduced. As the cognitive component of empathy Perspective taking and the affective component of empathy Personal distress increased, the reported difficulties in having a good relationship with other people were reduced. Some socio-demographic differences in the components of empathy in health workers were also established. CONCLUSION: These findings revealed the importance of Personal Distress (experienced anxiety, worry, discomfort, and apprehension when observing another person's negative experiences), as well as the joint manifestation of several aspects of empathy for successful work and maintaining good relationships in health care. Emotionality is a normal part of human interactions, so manifestations of cognitive empathy should not be only considered as appropriate, and emotional empathy should not be ruled out as unnecessary in clinical practice during the coronavirus pandemic.


Subject(s)
COVID-19 , Empathy , Health Personnel , Humans , Delivery of Health Care , Emotions , Pandemics , COVID-19/epidemiology , COVID-19/psychology , SARS-CoV-2 , Health Personnel/psychology
9.
Psychiatr Danub ; 34(3): 578-586, 2022.
Article in English | MEDLINE | ID: covidwho-2081406

ABSTRACT

BACKGROUND: COVID-19 pandemic, which still continues to affect the whole world, has led to an increase in PTSD symptoms in societies, especially individuals who have been diagnosed with the disease and recovered are at significant risk for PTSD have been reported. Although it has been observed that PTSD symptoms of individuals who were infected in the past epidemics such as SARS and Ebola continued for a long time even after the epidemic, it is noteworthy that the studies conducted during the COVID-19 process do not focus enough on people who survived the COVID-19 disease. The purpose of this study is to determine the direct and indirect impact of positivity on PTSD symptoms of individuals who have recovered from COVID-19 and the role of rumination and fear of COVID-19 as potential mediators in this effect. SUBJECTS AND METHODS: In the study, the Impact of Event Scale-Revised, Ruminative Response Scale, Positivity Scale, and Fear of COVID-19 Scale were applied to 551 Turkish participants, who survived the COVID-19 disease. SEM-based mediation analysis was used to test hypothesized relationships. RESULTS: Mediating roles of fear of COVID-19 and rumination between positivity and PTSD were tested. Results indicated that rumination and fear of COVID-19 had a full mediating role in the relationship between positivity and PTSD. CONCLUSION: These findings pointed out that positivity might be an indirect protective disposition against COVID-19-related PTSD and might reduce risk factors associated with PTSD among COVID-19 survivors. Mental health practices for COVID-19 patients should aim to increase positive thinking, since they have ruminative thoughts about transmission of the virus and hospitalization process and these thoughts may lead to negative mental health conditions. In this sense, positive psychology-focused implementations can be organized for COVID-19 patients and survivors.


Subject(s)
COVID-19 , Stress Disorders, Post-Traumatic , Humans , COVID-19/psychology , Fear , Pandemics , Stress Disorders, Post-Traumatic/psychology , Survivors/psychology
10.
J Clin Psychiatry ; 82(4)2021 07 06.
Article in English | MEDLINE | ID: covidwho-2066794

ABSTRACT

Objective: The conditions created by the COVID-19 pandemic could negatively affect maternal mental health and the mother-infant relationship. The aim of this study is to determine the impact of the COVID-19 pandemic on depression, anxiety, and mother-infant bonding among women seeking treatment for postpartum depression (PPD).Methods: Baseline data collected in two separate randomized controlled trials of a psychoeducational intervention for PPD in the same geographic region, one prior to COVID-19 (March 2019-March 2020) and one during the COVID-19 pandemic (April-October 2020), were compared. Eligible participants had an Edinburgh Postnatal Depression Scale (EPDS) score of ≥ 10, were ≥ 18 years of age, had an infant < 12 months old, and were fluent in English. Outcomes included PPD (EPDS), anxiety (Generalized Anxiety Disorder-7 [GAD-7]), and mother-infant relationship (Postpartum Bonding Questionnaire [PBQ]). All were measured continuously and dichotomized at accepted clinical cutoffs.Results: Of the 603 participants (305 pre-COVID-19; 298 during COVID-19), mothers enrolled during the COVID-19 pandemic reported higher levels of symptoms of PPD (B = 1.35; 95% CI, 0.64 to 2.06; Cohen d = 0.31) and anxiety (B = 1.52; 95% CI, 0.72 to 2.32; Cohen d = 0.30). During COVID-19, women had 65% higher odds of clinically significant levels of depression symptoms (OR = 1.65; 95% CI, 1.13 to 2.31) and 46% higher odds of clinically relevant anxiety symptoms (OR = 1.46; 95% CI, 1.05 to 2.05). However, there were no statistically significant differences in mother-infant bonding.Conclusions: The findings of this study suggest that rates and severity of PPD and anxiety symptoms among women seeking treatment for PPD have worsened in Canada during the COVID-19 pandemic. However, treatment-seeking mothers have consistently maintained good relationships with their infants. Considering the difficulties women with PPD face when accessing treatment, it is important that strategies are developed and disseminated to safely identify and manage PPD to mitigate potential long-term adverse consequences for mothers and their families.Trial Registration: ClinicalTrials.gov identifiers: NCT03654261 and NCT04485000.


Subject(s)
Anxiety/etiology , COVID-19/psychology , Depression, Postpartum/etiology , Mother-Child Relations/psychology , Mothers/psychology , Object Attachment , Pandemics , Adolescent , Adult , Anxiety/diagnosis , Anxiety/epidemiology , Anxiety/psychology , COVID-19/epidemiology , Depression, Postpartum/epidemiology , Depression, Postpartum/psychology , Female , Humans , Infant , Infant, Newborn , Ontario/epidemiology , Risk Factors , Self Report , Severity of Illness Index , Young Adult
11.
J Clin Psychiatry ; 82(3)2021 04 06.
Article in English | MEDLINE | ID: covidwho-2066783

ABSTRACT

OBJECTIVE: By forcing closure of schools, curtailing outpatient services, and imposing strict social distancing, the COVID-19 pandemic has abruptly affected the daily life of millions worldwide, with still unclear consequences for mental health. This study aimed to evaluate if and how child and adolescent psychiatric visits to hospital emergency departments (EDs) changed during the pandemic lockdown, which started in Italy on February 24, 2020. METHODS: We examined all ED visits by patients under 18 years of age in the 7 weeks prior to February 24, 2020, and in the subsequent 8 weeks of COVID-19 lockdown at two urban university hospitals, in Turin and Rome, Italy. ED visits during the corresponding periods of 2019 served as a comparison using Poisson regression modeling. The clinician's decision to hospitalize or discharge home the patient after the ED visit was examined as an index of clinical severity. RESULTS: During the COVID-19 lockdown, there was a 72.0% decrease in the number of all pediatric ED visits (3,395) compared with the corresponding period in 2019 (12,128), with a 46.2% decrease in psychiatric visits (50 vs 93). The mean age of psychiatric patients was higher in the COVID-19 period (15.7 vs 14.1 years). No significant changes were found in hospitalization rate or in the prevalence distribution of the primary reason for the psychiatric ED visit (suicidality, anxiety/mood disorders, agitation). CONCLUSIONS: In the first 8 weeks of the COVID-19-induced social lockdown, the number of child and adolescent psychiatric ED visits significantly decreased, with an increase in patient age. This decrease does not appear to be explained by severity-driven self-selection and might be due to a reduction in psychiatric emergencies or to the implementation of alternative ways of managing acute psychopathology.


Subject(s)
Ambulatory Care/statistics & numerical data , COVID-19 , Emergencies/epidemiology , Emergency Services, Psychiatric , Hospitalization/statistics & numerical data , Mental Disorders , Physical Distancing , Adolescent , Age Factors , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/psychology , Child , Communicable Disease Control/methods , Education, Distance , Emergency Services, Psychiatric/organization & administration , Emergency Services, Psychiatric/statistics & numerical data , Female , Humans , Italy/epidemiology , Male , Mental Disorders/epidemiology , Mental Disorders/psychology , Mental Disorders/therapy , Mental Health/statistics & numerical data , Organizational Innovation , SARS-CoV-2
12.
J Clin Psychiatry ; 82(1)2020 12 08.
Article in English | MEDLINE | ID: covidwho-2066784

ABSTRACT

OBJECTIVE: To assess the prevalence of and risk factors for posttraumatic stress disorder (PTSD) in patients with COVID-19. METHODS: We conducted a cohort study between March and May 2020 at the Lille University Hospital (France), including all patients with laboratory-confirmed COVID-19. Psychological distress symptoms were measured 3 weeks after onset of COVID-19 symptoms using the Impact of Event Scale-6 items (IES-6). The evaluation of PTSD symptoms using the PTSD Checklist for DSM-5 (PCL-5) took place 1 month later. Bivariate analyses were performed to analyze the relationship between PCL-5 scores and the demographic and health variables. The significant variables were then introduced into a multivariable linear regression analysis to establish their relative contributions to the severity of PTSD symptoms. RESULTS: 180 patients were included in this study, and 138 patients completed the 2 evaluations. Among the 180 patients, 70.4% patients required hospitalization, and 30.7% were admitted to the intensive care unit. The prevalence of PTSD was 6.5%, and the predictive factors of PTSD included psychological distress at the onset of the illness and a stay in an intensive care unit. CONCLUSIONS: The prevalence of PTSD in patients with COVID-19 is not as high as that reported among patients during previous epidemics. Initial psychological responses were predictive of a PTSD diagnosis, even though most patients showing acute psychological distress (33.5% of the sample) improved in the following weeks. PTSD symptoms also increased following a stay in an intensive care unit. Future studies should assess the long-term consequences of COVID-19 on patients' mental health.


Subject(s)
COVID-19 , Hospitalization/statistics & numerical data , Intensive Care Units/statistics & numerical data , Psychological Distress , Stress Disorders, Post-Traumatic , Acute Disease , Adult , Aged , Aged, 80 and over , COVID-19/complications , COVID-19/epidemiology , COVID-19/psychology , COVID-19/therapy , Female , Follow-Up Studies , France/epidemiology , Humans , Male , Middle Aged , Prevalence , Severity of Illness Index , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/etiology
13.
Ann Emerg Med ; 79(3): 313-314, 2022 03.
Article in English | MEDLINE | ID: covidwho-1689394
14.
G Ital Cardiol (Rome) ; 23(9): 651-662, 2022 Sep.
Article in Italian | MEDLINE | ID: covidwho-2065242

ABSTRACT

Recent evidence shows that a range of persistent or new symptoms can manifest after 4-12 weeks in a subset of patients who have recovered from acute SARS-CoV-2 infection, and this condition has been coined long COVID by COVID-19 survivors among social support groups. Long COVID can affect the whole spectrum of people with COVID-19, from those with very mild acute disease to the most severe forms. Like the acute form, long COVID has multisystemic aspects. Patients can manifest with a very heterogeneous multitude of symptoms, including fatigue, post-exertional malaise, dyspnea, cognitive impairment, sleep disturbances, anxiety and depression, muscle pain, brain fog, anosmia/dysgeusia, headache, and limitation of functional capacity, which impact their quality of life. Because of the extreme clinical heterogeneity, and also due to the lack of a shared, specific definition, it is very difficult to know the real prevalence and incidence of this condition. Risk factors for developing long COVID would be female sex, initial severity, and comorbidities. Globally, with the re-emergence of new waves, the population of people infected with SARS-CoV-2 continues to expand rapidly, necessitating a more thorough understanding of potential sequelae of COVID-19. This review summarizes up to date definitions and epidemiological aspects of long COVID.


Subject(s)
COVID-19 , COVID-19/complications , COVID-19/epidemiology , COVID-19/physiopathology , COVID-19/psychology , Humans , Quality of Life , Risk Factors , SARS-CoV-2/pathogenicity , Survivors
15.
PLoS One ; 17(9): e0274542, 2022.
Article in English | MEDLINE | ID: covidwho-2054342

ABSTRACT

Five-factor model personality traits (neuroticism, extraversion, openness, agreeableness, conscientiousness) are thought to be relatively impervious to environmental demands in adulthood. The coronavirus pandemic is an unprecedented opportunity to examine whether personality changed during a stressful global event. Surprisingly, two previous studies found that neuroticism decreased early in the pandemic, whereas there was less evidence for change in the other four traits during this period. The present research used longitudinal assessments of personality from the Understanding America Study (N = 7,109; 18,623 assessments) to examine personality changes relatively earlier (2020) and later (2021-2022) in the pandemic compared to pre-pandemic levels. Replicating the two previous studies, neuroticism declined very slightly in 2020 compared to pre-pandemic levels; there were no changes in the other four traits. When personality was measured in 2021-2022, however, there was no significant change in neuroticism compared to pre-pandemic levels, but there were significant small declines in extraversion, openness, agreeableness, and conscientiousness. The changes were about one-tenth of a standard deviation, which is equivalent to about one decade of normative personality change. These changes were moderated by age and Hispanic/Latino ethnicity, but not race or education. Strikingly, younger adults showed disrupted maturity in that they increased in neuroticism and declined in agreeableness and conscientiousness. Current evidence suggests the slight decrease in neuroticism early in the pandemic was short-lived and detrimental changes in the other traits emerged over time. If these changes are enduring, this evidence suggests population-wide stressful events can slightly bend the trajectory of personality, especially in younger adults.


Subject(s)
COVID-19 , Pandemics , Personality Disorders , Adult , COVID-19/epidemiology , COVID-19/psychology , Humans , Longitudinal Studies , Neuroticism , Personality , Personality Disorders/epidemiology , United States/epidemiology , Young Adult
16.
Proc Natl Acad Sci U S A ; 119(39): e2214564119, 2022 09 27.
Article in English | MEDLINE | ID: covidwho-2050732
17.
Int Clin Psychopharmacol ; 36(4): 221-223, 2021 07 01.
Article in English | MEDLINE | ID: covidwho-2051818

ABSTRACT

This article reports on the treatment of a patient with nightmares who was treated with doxazosin of an alpha 1-adrenergic antagonists. A 71-year-old Japanese major depressive disorder (MDD) woman experienced nightmares after the coronavirus disease 2019 pandemic. She had nightmares about being chased by a coronavirus and catching the corona virus. After adding doxazosin 1 mg daily in the morning, her nightmares led to remission without side effects. We also had a rechallenge regimen with doxazosin. The nightmares ceased on the second night of the rechallenge and did not return with continued treatment. This case report suggests that doxazosin may be a useful therapeutic option to target nightmares in individuals with MDD.


Subject(s)
Adrenergic alpha-1 Receptor Antagonists/therapeutic use , COVID-19/psychology , Depressive Disorder, Major/drug therapy , Doxazosin/therapeutic use , Dreams/drug effects , Aged , Female , Humans , SARS-CoV-2
18.
Psychiatr Danub ; 34(Suppl 8): 81-89, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-2046923

ABSTRACT

BACKGROUND: The COVID-19 pandemic brought along a new situation for the population worldwide. The most important safety measures and lockdown expected extreme adaptability and flexibility impacting mental well-being. The aim of our study was to identify associations between changes in lifestyle and circadian rhythm and depression during the pandemic. SUBJECTS AND METHODS: Our analysis has been carried out on the Hungarian data set of the COMET-G study including information on lifestyle and circadian rhythm-associated factors and severity of depression and its 3 symptom clusters. Associations were assessed using linear regression models adjusted for age and sex. RESULTS: All variables reflecting changes in quality and quantity of sleep showed significant associations with overall depression scores and the three distinct symptom cluster scores. All variables reflecting importance and changes in physical activity during the pandemic were similarly significantly associated with all depression measures. However, only changes in quality of diet, but not quantity was associated with depression scores. CONCLUSIONS: Our results may confirm the association of circadian rhythm and lifestyle-related environmental factors in deterioration of mental health during COVID and help devise prevention and intervention methods and targets for similar situations.


Subject(s)
COVID-19 , Circadian Rhythm , Depression , Life Style , Pandemics , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/psychology , Circadian Rhythm/physiology , Communicable Disease Control , Depression/epidemiology , Depression/physiopathology , Depression/psychology , Female , Humans , Male , Pandemics/prevention & control , Risk Factors
19.
Psychiatr Danub ; 34(Suppl 8): 246-255, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-2046764

ABSTRACT

BACKGROUND: During the COVID-19 pandemic healthcare workers have been under pressure of high workload and an increased risk of contracting the SARS-Cov-2 virus, while confronting the most tragic and devastating aspects of the pandemic-related medical realities. These factors could lead to severe distress with potential consequences for productivity in performing professional duties, and substantially increased risk for affective reactions, including clinical states of anxiety, depression and suicidality as compared to the general population. Thus, we aimed to investigate the changes in rates of anxiety, depression and suicidality in response to the pandemic among medical staff as compared to a sample of the general population and to the period of prepandemic time. SUBJECTS AND METHODS: This study is part of the large-scale, international multicentre COMET-G project. We assessed the extents of anxiety, depression and suicidality risks using the Stait-Trait Anxiety Inventory (STAI) with a cut-off score 39/40, Center for Epidemiologic Studies Depression Scale (CES-D) with a cut-off score 23/24, and the Risk Assessment Suicidality Scale (RASS) with a cut-off score 499/500, respectively, in samples of Russian healthcare workers and the general population. RESULTS: Among 7777 respondents participating in the study, responses to a query about occupation indicated 1216 healthcare workers. 45.8% of medical staff vs 40.4% of non-medical staff (χ2=12.42, p<0.001) reported the increased anxiety, in excess of the clinical anxiety state threshold score of 39 according to the STAI. High suicidality risks, according to a RASS score > 500, were reported by 8.2% of medical professionals vs 10.6% of non-medical personnel (χ2=6.35, p=0.012). The increase in depression rates, including cases of clinical depression according to the threshold of CES-D ≥ 24, did not differ between the groups. CONCLUSIONS: A larger proportion of healthcare system staff, as compared to the general population, reported a significant increase in anxiety in response to the pandemic. Compared to medical doctors, other healthcare system workers had a significantly higher prevalence of depression and suicidality rates. Exploratory analysis suggested that it was not the occupation per se, but rather the burden of meaningful working duties that could be associated with psychological defense mechanisms against depression and suicidality among medical staff.


Subject(s)
COVID-19 , Health Personnel , Anxiety/epidemiology , COVID-19/epidemiology , COVID-19/psychology , Depression/epidemiology , Health Personnel/psychology , Humans , Pandemics , Suicide
20.
Psychiatr Danub ; 34(Suppl 8): 262-264, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-2046183

ABSTRACT

In this study, with a psychodiagnostic survey, we wanted to evaluate the possible presence of depressive symptoms in patients diagnosed with type 2 diabetes. The sample of 106 type 2 diabetic patients consisted of three groups. Group A of 80 patients interviewed in 2017 at the Olbia clinic, group A-1 (a subgroup of A), of 41 patients with a follow-up after 5 years from the first examination in 2017 and group B of 26 new type 2 diabetic patients examined for the first time in 2022. All subject underwent an interview and and have completed the following validated questionnaires: Questionnaire for Mood Disorders (MDQ), Hamilton Psychiatric Rating Scale for Depression (HAM-D), Montgomery-Asberg Scale for Depression (MADRS), Hamilton Anxiety Scale (HAR -S) and Clinical Global Impression (CGI). The objective of the follow-up was to evaluate the possible emotional impact of the COVID-19 pandemic. The aim of the research is to evaluate the correlation between any depressive symptoms and diabetes.


Subject(s)
Depression , Diabetes Mellitus, Type 2 , COVID-19/epidemiology , COVID-19/psychology , Depression/diagnosis , Depression/epidemiology , Diabetes Mellitus, Type 2/diagnosis , Diabetes Mellitus, Type 2/epidemiology , Humans , Pandemics , Psychiatric Status Rating Scales
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