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1.
Trials ; 23(1): 899, 2022 Oct 22.
Article in English | MEDLINE | ID: covidwho-2089229

ABSTRACT

BACKGROUND: The COVID-19 pandemic has had major impacts in many different spheres, including mental health. Children and adolescents are especially vulnerable because their central nervous system is still in development and they have fewer coping resources than do adults. Increases in the prevalence of depressive and anxiety symptomatology have been reported worldwide. However, access to mental health care is limited, especially for the paediatric population and in low- and middle-income countries. Therefore, we developed a brief internet-delivered cognitive-behavioural intervention for children and adolescents with symptoms of anxiety and depression. The aim of this proposed study is to test the efficacy of the intervention. METHODS: We will conduct a two-arm, parallel randomised controlled trial involving children and adolescents (8-11 and 12-17 years of age, respectively) with symptoms of anxiety, depression or both, according to the 25-item Revised Child Anxiety and Depression Scale (t-score > 70). A total of 280 participants will be randomised to the intervention group or the active control group, in a 1:1 ratio. Those in the intervention group will receive five weekly sessions of cognitive-behavioural therapy via teleconference. The sessions will focus on stress responses, family communication, diaphragmatic breathing, emotions, anger management, behavioural activation and cognitive restructuring. Participants in both groups will have access to 15 videos covering the same topics. Participant-guardian pairs will be expected to attend the sessions (intervention group), watch the videos (control group) or both (intervention group only). A blinded assessor will collect data on symptoms of anxiety, depression and irritability, at baseline, at the end of the intervention and 30 days thereafter. Adolescents with access to a smartphone will also be invited to participate in an ecological momentary assessment of emotional problems in the week before and the week after the intervention, as well as in passive data collection from existing smartphone sensors throughout the study. DISCUSSION: Internet-delivered interventions play a major role in increasing access to mental health care. A brief, manualised, internet-delivered intervention might help children and adolescents with anxiety or depressive symptomatology, even outside the context of the COVID-19 pandemic. TRIAL REGISTRATION: ClinicalTrials.gov NCT05139433. Registered prospectively in November 2021. Minor amendments made in July 2022.


Subject(s)
COVID-19 , Cognitive Behavioral Therapy , Internet-Based Intervention , Adolescent , Child , Humans , Anxiety/diagnosis , Anxiety/therapy , Cognition , Cognitive Behavioral Therapy/methods , Depression/diagnosis , Depression/therapy , Pandemics , Randomized Controlled Trials as Topic , Treatment Outcome
3.
BMC Psychiatry ; 22(1): 638, 2022 10 10.
Article in English | MEDLINE | ID: covidwho-2064763

ABSTRACT

BACKGROUND: The context of the COVID-19 pandemic has harmed the mental health of the population, increasing the incidence of mental health problems such as depression, especially in those who have had COVID-19. Our study puts forward an explanatory model of depressive symptoms based on subjective psychological factors in those hospitalized for COVID-19 with and without biological markers (i.e., inflammatory markers). Therefore, we aim to evaluate the hypotheses proposed in the model to predict the presence of depressive symptoms. METHOD: We conducted a cross-sectional study, using a simple random sampling. Data from 277 hospitalized patients with COVID-19 in Lima-Peru, were collected to assess mental health variables (i.e., depressive, anxiety, post-traumatic stress, and somatic symptoms), self-perception of COVID-19 related symptoms, and neutrophil/lymphocyte ratio (NLR) such as inflammatory marker. We performed a structural equation modeling analysis to evaluate a predictive model of depressive symptoms. RESULTS: The results showed a prevalence of depressive symptoms (11.2%), anxiety symptoms (7.9%), somatic symptoms (2.2%), and symptoms of post-traumatic stress (6.1%) in the overall sample. No association was found between the prevalence of these mental health problems among individuals with and without severe inflammatory response. The mental health indicators with the highest prevalence were sleep problems (48%), low energy (47.7%), nervousness (48.77%), worry (47.7%), irritability (43.7%) and back pain (52%) in the overall sample. The model proposed to explain depressive symptoms was able to explain more than 83.7% of the variance and presented good goodness-of-fit indices. Also, a different performance between the proposed model was found between those with and without severe inflammatory response. This difference was mainly found in the relationship between anxiety and post-traumatic stress symptoms, and between the perception of COVID-19 related symptoms and somatic symptoms. CONCLUSIONS: Results demonstrated that our model of mental health variables may explain depressive symptoms in hospitalized patients of COVID-19 from a third-level hospital in Peru. In the model, perception of symptoms influences somatic symptoms, which impact both anxiety symptoms and symptoms of post-traumatic stress. Thus, anxiety symptoms could directly influence depressive symptoms or through symptoms of post-traumatic stress. Our findings could be useful to decision-makers for the prevention of depression, used to inform the creation of screening tools (i.e., perception of symptoms, somatic and anxiety symptoms) to identify vulnerable patients to depression.


Subject(s)
COVID-19 , Medically Unexplained Symptoms , Stress Disorders, Post-Traumatic , Anxiety/psychology , Biomarkers , COVID-19/complications , Cross-Sectional Studies , Depression/diagnosis , Depression/epidemiology , Depression/etiology , Humans , Pandemics , Perception , SARS-CoV-2 , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/etiology
4.
BMC Cardiovasc Disord ; 22(1): 427, 2022 09 28.
Article in English | MEDLINE | ID: covidwho-2053862

ABSTRACT

BACKGROUND: The large-scale changes in cardiac rehabilitation (CR) programme delivery in response to COVID-19 has led to diminished provision. The influence of these service changes on the depression symptoms of patients in CR programmes is unknown. Our study investigated the extent of depressive symptoms prior to and during the COVID-19 periods in patients with a previous history of depression at the start of CR. METHODS: Use of Registry routine practice data, National Audit of Cardiac Rehabilitation (NACR), from COVID-19 period Feb 2020 and Jan 2021, as well as pre COVID-19 period Feb 2019 and Jan 2020, was extracted. Depressive symptoms were defined according to Hospital Anxiety and Depression Score ≥ 8. Chi-square tests and independent samples t-tests were used to investigate baseline characteristics. Additionally, a binary logistic regression to examine the factors associated with high levels of depressive symptoms. RESULTS: In total 3661 patients with a history of depression were included in the analysis. Patients attending CR during COVID-19 were found to be 11% more likely to have high levels of acute depressive symptoms compared to patients attending CR prior to COVID-19. Physical inactivity, increased anxiety, a higher total number of comorbidities, increased weight, and living in the most deprived areas were statistically significant factors associated with high levels of acute depressive symptoms at the start of CR following multivariate adjustments. CONCLUSION: Our research suggests that following a cardiac event patients with prior history of depression have high levels of acute depressive symptoms at CR baseline assessment. This finding exists in both the pre Covid-19 and Covid-19 periods in patients with a history of depression.


Subject(s)
COVID-19 , Cardiac Rehabilitation , Anxiety/diagnosis , Anxiety/epidemiology , COVID-19/diagnosis , Comorbidity , Depression/diagnosis , Depression/epidemiology , Humans
5.
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
6.
Trials ; 23(1): 797, 2022 Sep 21.
Article in English | MEDLINE | ID: covidwho-2038855

ABSTRACT

BACKGROUND: Depression and anxiety are common among pregnant women. Internet-delivered psychological therapies such as cognitive behavioral therapy (iCBT) have been developed to increase accessibility and address common help-seeking barriers, especially during pandemic period. The objective of this trial is to evaluate the short-term and long-term effects of iCBT on reducing depressive symptoms among pregnant women during the COVID-19 pandemic with the overall goal of preventing depression recurrence in the first 12 months postpartum. METHODS: A multi-site randomized controlled trial will be conducted where 300 pregnant women early in their third trimester will be screened for depression symptoms using the Edinburgh Postnatal Depression Scale (EPDS) during a routine obstetrical visit. Eligible and consenting women with a score greater than 9 will be randomly allocated (1:1) to either intervention group or control group. ICBT involving the completion of 7 weekly online modules will be delivered via a well-designed perinatal mental healthcare app. The primary objective is to evaluate the effect of iCBT on reducing depression symptoms among pregnant Chinese women starting from their third trimester. The secondary objectives are to examine the effect of iCBT on anxiety, sleep quality, social support, parenting stress, co-parenting relationship, and infant development. DISCUSSION: This multi-center randomized controlled trial has been planned in accordance with best practices in behavioral trial design. The internet-based intervention addressed the needs of pregnant women during a major pandemic where face-to-face therapy is not preferable. The trial has a relatively large sample size with sufficient power to evaluate the efficacy of iCBT intervention for the primary and secondary outcomes. One year follow-up evaluation in the study is designed to determine the longer-term effect of the intervention on both maternal and infant outcomes. Although a limitation is the assessment of depression and anxiety using self-report measures, these easily incorporated and maternal-preferred assessments allow for real-life scalability if the intervention is proven to be effective. ETHICS AND DISSEMINATION: Ethics was approved by the institutional review board of International Peace Maternity and Child Health Hospital (GKLW2020-25). Dissemination of results will be published in peer-reviewed academic journals and presented at scientific conferences. TRIAL STATUS: The first patient was enrolled on 19 August 2020. To date, 203 participants have met eligibility requirements and been randomized to either the intervention group or control group. Data collection aims to be complete in September 2022. Date and version identifier: 2020715-version1.0. TRIAL REGISTRATION: ChiCTR2000033433. Registered 31 May 2020, http://www.chictr.org.cn/showproj.aspx?proj=54482 .


Subject(s)
COVID-19 , Cognitive Behavioral Therapy , Child , Cognitive Behavioral Therapy/methods , Depression/diagnosis , Depression/therapy , Female , Humans , Internet , Multicenter Studies as Topic , Pandemics , Pregnancy , Randomized Controlled Trials as Topic , Treatment Outcome
7.
BMJ Open ; 12(9): e056326, 2022 09 16.
Article in English | MEDLINE | ID: covidwho-2038297

ABSTRACT

OBJECTIVES: This study aims to assess the prevalence of depressive symptoms among healthcare workers and possible factors associated with this outcome (resilience, spirituality, social support, quality of life, among other individual variables). Our hypothesis is that some of these factors can have a protective effect on depressive symptoms. DESIGN: Web-based cross-sectional survey. SETTING: Participants were recruited online from 16 April to 23 April 2020. PARTICIPANTS: 1043 healthcare workers, predominantly Brazilians, aged 18 years or older. PRIMARY AND SECONDARY OUTCOME MEASURES: Depression was the primary outcome, measured using the Patient Health Questionnaire-9 (PHQ-9). Possible protective factors were measured in the following ways: social support was assessed by the modified Medical Outcomes Study Social Support Survey (mMOS-SS); spirituality, religiousness and personal beliefs (SRPB) were evaluated using the 9-item SRPB module of the brief WHO Quality of Life instrument (WHOQoL-SRPB-bref); quality of life was assessed using the brief EUROHIS instrument for Quality of Life (EUROHIS-QoL 8-item); resilience was assessed using the 10-item Connor-Davidson Resilience Scale (CD-RISC 10). RESULTS: 23% met the criteria for depression according to the PHQ-9 scale. Quality of life (B=-3.87 (-4.30 to -3.43), ß=-0.37, p<0.001), social support (B=-0.32 (-0.59 to -0.05), ß=-0.04, p=0.022), resilience (B=-0.19 (-0.23 to -0.15), ß=-0.20, p<0.001), SRPB (B=-0.03 (-0.05 to -0.02), ß=-0.01, p<0.001) and physical exercise (B=-0.95 (-1.40 to -0.51), ß=-0.08, p<0.001) demonstrated protective effects against depression. CONCLUSION: Healthcare workers have a high risk of developing depressive symptoms during the COVID-19 pandemic, especially those working in the front line. However, there are factors that seem to work as protective mechanisms against depression, notably perceived quality of life.


Subject(s)
COVID-19 , Quality of Life , Brazil/epidemiology , COVID-19/epidemiology , Cross-Sectional Studies , Depression/diagnosis , Depression/epidemiology , Depression/prevention & control , Health Personnel , Humans , Pandemics , Protective Factors , Surveys and Questionnaires
8.
Comput Biol Med ; 149: 105926, 2022 10.
Article in English | MEDLINE | ID: covidwho-2035907

ABSTRACT

This study proposes depression detection systems based on the i-vector framework for classifying speakers as depressed or healthy and predicting depression levels according to the Beck Depression Inventory-II (BDI-II). Linear and non-linear speech features are investigated as front-end features to i-vectors. To take advantage of the complementary effects of features, i-vector systems based on linear and non-linear features are combined through the decision-level fusion. Variability compensation techniques, such as Linear Discriminant Analysis (LDA) and Within-Class Covariance Normalization (WCCN), are widely used to reduce unwanted variabilities. A more generalizable technique than the LDA is required when limited training data are available. We employ a support vector discriminant analysis (SVDA) technique that uses the boundary of classes to find discriminatory directions to address this problem. Experiments conducted on the 2014 Audio-Visual Emotion Challenge and Workshop (AVEC 2014) depression database indicate that the best accuracy improvement obtained using SVDA is about 15.15% compared to the uncompensated i-vectors. In all cases, experimental results confirm that the decision-level fusion of i-vector systems based on three feature sets, TEO-CB-Auto-Env+Δ, Glottal+Δ, and MFCC+Δ+ΔΔ, achieves the best results. This fusion significantly improves classifying results, yielding an accuracy of 90%. The combination of SVDA-transformed BDI-II score prediction systems based on these three feature sets achieved RMSE and MAE of 8.899 and 6.991, respectively, which means 29.18% and 30.34% improvements in RMSE and MAE, respectively, over the baseline system on the test partition. Furthermore, this proposed combination outperforms other audio-based studies available in the literature using the AVEC 2014 database.


Subject(s)
Depression , Speech , Databases, Factual , Depression/diagnosis , Discriminant Analysis , Emotions
9.
JAMA Psychiatry ; 79(11): 1081-1091, 2022 Nov 01.
Article in English | MEDLINE | ID: covidwho-2013279

ABSTRACT

Importance: Few risk factors for long-lasting (≥4 weeks) COVID-19 symptoms have been identified. Objective: To determine whether high levels of psychological distress before SARS-CoV-2 infection, characterized by depression, anxiety, worry, perceived stress, and loneliness, are prospectively associated with increased risk of developing post-COVID-19 conditions (sometimes called long COVID). Design, Setting, and Participants: This prospective cohort study used data from 3 large ongoing, predominantly female cohorts: Nurses' Health Study II, Nurses' Health Study 3, and the Growing Up Today Study. Between April 2020 and November 2021, participants were followed up with periodic surveys. Participants were included if they reported no current or prior SARS-CoV-2 infection at the April 2020 baseline survey when distress was assessed and returned 1 or more follow-up questionnaires. Exposures: Depression, anxiety, worry about COVID-19, perceived stress, and loneliness were measured at study baseline early in the pandemic, before SARS-CoV-2 infection, using validated questionnaires. Main Outcomes and Measures: SARS-CoV-2 infection was self-reported during each of 6 monthly and then quarterly follow-up questionnaires. COVID-19-related symptoms lasting 4 weeks or longer and daily life impairment due to these symptoms were self-reported on the final questionnaire, 1 year after baseline. Results: Of 54 960 participants, 38.0% (n = 20 902) were active health care workers, and 96.6% (n = 53 107) were female; the mean (SD) age was 57.5 (13.8) years. Six percent (3193 participants) reported a positive SARS-CoV-2 test result during follow-up (1-47 weeks after baseline). Among these, probable depression (risk ratio [RR], 1.32; 95% CI = 1.12-1.55), probable anxiety (RR = 1.42; 95% CI, 1.23-1.65), worry about COVID-19 (RR, 1.37; 95% CI, 1.17-1.61), perceived stress (highest vs lowest quartile: RR, 1.46; 95% CI, 1.18-1.81), and loneliness (RR, 1.32; 95% CI, 1.08-1.61) were each associated with post-COVID-19 conditions (1403 cases) in generalized estimating equation models adjusted for sociodemographic factors, health behaviors, and comorbidities. Participants with 2 or more types of distress prior to infection were at nearly 50% increased risk for post-COVID-19 conditions (RR, 1.49; 95% CI, 1.23-1.80). All types of distress were associated with increased risk of daily life impairment (783 cases) among individuals with post-COVID-19 conditions (RR range, 1.15-1.51). Conclusions and Relevance: The findings of this study suggest that preinfection psychological distress may be a risk factor for post-COVID-19 conditions in individuals with SARS-CoV-2 infection. Future work should examine the biobehavioral mechanism linking psychological distress with persistent postinfection symptoms.


Subject(s)
COVID-19 , Female , Humans , Middle Aged , Male , COVID-19/epidemiology , Loneliness/psychology , SARS-CoV-2 , Depression/diagnosis , Prospective Studies , Anxiety/psychology , Stress, Psychological/epidemiology
10.
Alzheimers Res Ther ; 14(1): 126, 2022 Sep 06.
Article in English | MEDLINE | ID: covidwho-2009455

ABSTRACT

BACKGROUND: The COVID-19 pandemic may worsen the mental health of people reporting subjective cognitive decline (SCD) and therefore their clinical prognosis. We aimed to investigate the association between the intensity of SCD and anxious/depressive symptoms during confinement and the underlying mechanisms. METHODS: Two hundred fifty cognitively unimpaired participants completed the Hospital Anxiety and Depression Scale (HADS) and SCD-Questionnaire (SCD-Q) and underwent amyloid-ß positron emission tomography imaging with [18F] flutemetamol (N = 205) on average 2.4 (± 0.8) years before the COVID-19 confinement. During the confinement, participants completed the HADS, Perceived Stress Scale (PSS), Brief Resilience Scale (BRS), and an ad hoc questionnaire on worries (access to primary products, self-protection materials, economic situation) and lifestyle changes (sleep duration, sleep quality, eating habits). We investigated stress-related measurements, worries, and lifestyle changes in relation to SCD. We then conducted an analysis of covariance to investigate the association of SCD-Q with HADS scores during the confinement while controlling for pre-confinement anxiety/depression scores and demographics. Furthermore, we introduced amyloid-ß positivity, PSS, and BRS in the models and performed mediation analyses to explore the mechanisms explaining the association between SCD and anxiety/depression. RESULTS: In the whole sample, the average SCD-Q score was 4.1 (± 4.4); 70 (28%) participants were classified as SCD, and 26 (12.7%) were amyloid-ß-positive. During the confinement, participants reporting SCD showed higher PSS (p = 0.035) but not BRS scores (p = 0.65) than those that did not report SCD. No differences in worries or lifestyle changes were observed. Higher SCD-Q scores showed an association with greater anxiety/depression scores irrespective of pre-confinement anxiety/depression levels (p = 0.002). This association was not significant after introducing amyloid-ß positivity and stress-related variables in the model (p = 0.069). Amyloid-ß positivity and PSS were associated with greater HADS irrespective of pre-confinement anxiety/depression scores (p = 0.023; p < 0.001). The association of SCD-Q with HADS was mediated by PSS (p = 0.01). CONCLUSIONS: Higher intensity of SCD, amyloid-ß positivity, and stress perception showed independent associations with anxious/depressive symptoms during the COVID-19 confinement irrespective of pre-confinement anxiety/depression levels. The association of SCD intensity with anxiety/depression was mediated by stress perception, suggesting stress regulation as a potential intervention to reduce affective symptomatology in the SCD population in the face of stressors.


Subject(s)
COVID-19 , Cognitive Dysfunction , Amyloid beta-Peptides , Anxiety/diagnosis , Anxiety/epidemiology , Cognitive Dysfunction/diagnostic imaging , Cognitive Dysfunction/epidemiology , Depression/diagnosis , Depression/epidemiology , Humans , Pandemics , Perception
11.
J Affect Disord ; 318: 456-464, 2022 12 01.
Article in English | MEDLINE | ID: covidwho-2007794

ABSTRACT

BACKGROUND: Various populations have experienced significant increases in depression and decreased quality of life (QOL) during the coronavirus disease 2019 (COVID-19) pandemic. This network analysis study was designed to elucidate interconnections between particular depressive symptoms and different aspects of QOL and identify the most clinically important symptoms in this network among adults in Wuhan China, the initial epicenter of the COVID-19 pandemic. METHODS: This cross-sectional, convenience-sampling study (N = 2459) was conducted between May 25 to June 18, 2020, after the lockdown policy had been lifted in Wuhan. Depressive symptoms and QOL were measured with the Patient Health Questionnaire-9 (PHQ-9) and first two items of the World Health Organization Quality of Life Questionnaire - brief version (WHOQOL-BREF), respectively. A network structure was constructed from the extended Bayesian Information Criterion (EBIC) model. Network centrality strength and bridge strength were evaluated along with the stability of the derived network model. RESULTS: Loss of energy (DEP-4) and Guilt feelings (DEP-6) were the two central symptoms with the highest strength as well as the two most prominent bridge symptoms connecting the clusters of depression and quality of life (QOL) in tandem with the two nodes from the QOL cluster. Network structure and bridge strengths remained stable after randomly dropping 75 % of the sample. CONCLUSION: Interventions targeting "Loss of energy" and "Guilt feelings" should be evaluated as strategies for reducing depressive symptoms and promoting improved QOL in COVID-19-affected populations.


Subject(s)
COVID-19 , Quality of Life , Adult , Bayes Theorem , China/epidemiology , Communicable Disease Control , Cross-Sectional Studies , Depression/diagnosis , Depression/epidemiology , Humans , Pandemics
12.
J Affect Disord ; 317: 79-83, 2022 11 15.
Article in English | MEDLINE | ID: covidwho-2004179

ABSTRACT

BACKGROUND: Pregnant women themselves are at higher risk for psychological symptoms. The impact of ongoing COVID-19 may increase the risk. However, it is uncertain whether COVID-19 affects pregnant women's psychological symptoms directly or indirectly being mediated. METHODS: This survey was conducted in four obstetrics and gynecology hospitals in Beijing from February 28, 2020, to April 26, 2020. Pregnant women who visited the antenatal-care clinic were mobilized to finish the online questionnaires, including the Generalized Anxiety Disorder 7-Item Scale, Patient Health Questionnaire-9, Connor-Davidson resilience scale, and Insomnia Severity Index. RESULTS: A total of 828 pregnant women were included in the analysis. The estimated self-reported rates of anxiety, depression, insomnia, and any of the three were 12.2 %, 24.3 %, 13.3 %, and 33.1 %, respectively. Mediating effect analysis showed that pregnant women's response to COVID-19 was not directly associated with psychological symptoms but indirectly through the mediating effect of maternal concerns, which accounted for 32.35 % of the total effect. Stratified analysis by psychological resilience showed that women's attitude toward COVID-19 (OR, 2.68, 95 % CI: 1.16-6.18) was associated with a higher risk of psychological symptoms in those with poor psychological resilience. LIMITATIONS: The study was a non-probability sampling survey, and the causal relationship between maternal concerns and psychological symptoms could not be determined due to the study's design. CONCLUSIONS: Under public health emergencies such as COVID-19, routine antenatal care should still be prioritized, and concerns related to childbirth-related caused by such emergencies should also be addressed, especially for those with weak psychological resilience.


Subject(s)
COVID-19 , Sleep Initiation and Maintenance Disorders , Anxiety/diagnosis , COVID-19/epidemiology , Depression/diagnosis , Emergencies , Female , Humans , Pregnancy , Pregnant Women/psychology , SARS-CoV-2 , Stress, Psychological/etiology , Surveys and Questionnaires
13.
J Paediatr Child Health ; 58(11): 2051-2057, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-1997201

ABSTRACT

AIM: This paper aims to examine the maternal and child mental health and parenting outcomes in the context of COVID-19 pandemic conditions using a sample from Melbourne, Australia - a city exposed to one of the longest lockdowns world-wide in response to the pandemic. METHODS: This study utilises observational data from a prospective, pregnancy cohort, Mercy Pregnancy Emotional Wellbeing Study and includes 468 women and their children followed up in Melbourne to 3-4 years postpartum pre-COVID pandemic and compared to those followed up during the COVID-19 pandemic. RESULTS: When compared to mothers followed up at 3-4 years postpartum pre-pandemic, those followed up during the COVID-19 pandemic showed higher depressive symptoms with a steep incline in their symptom trajectory (EMMdifference  = 1.72, Bonferroni-corrected P < 0.01, d = 0.35) and had a three times higher risk of scoring 13 or above on the EPDS (aRR = 3.22, Bonferroni-corrected P < 0.01). Although this increase was not associated with the variation in the duration of exposure to pandemic conditions, the steep increase in depressive symptoms was more pronounced in those with pre-existing depressive disorders. There was no difference in parenting stress or adjusted childhood mental health symptoms or disorder. CONCLUSIONS: Our findings highlight the vulnerability of those with pre-existing clinical mental health disorders and the need for adequate clinical care for this vulnerable group. Equally, our study indicates the possibility that  parenting and early childhood mental health outcomes, at least in the short term, may be resilient.


Subject(s)
COVID-19 , Parenting , Pregnancy , Child , Female , Child, Preschool , Humans , Parenting/psychology , Pandemics , Mental Health , Depression/epidemiology , Depression/diagnosis , COVID-19/epidemiology , Prospective Studies , Communicable Disease Control , Mothers/psychology
14.
J Affect Disord ; 317: 84-90, 2022 11 15.
Article in English | MEDLINE | ID: covidwho-1996304

ABSTRACT

BACKGROUND: Since COVID-19 outbreak, clinical experience on its management during the acute phase has rapidly grown, including potential effects on the psychopathological dimension. However, still few data are available regarding the impact on survivors' mental health over the long-term. METHODS: A sample of 1457 COVID-19 patients underwent a multidisciplinary follow-up protocol, approximately 3 months after hospital discharge, including a psychological evaluation. The primary outcomes were anxiety, depression, resilience, post-traumatic symptoms, and health-related quality of life. Furthermore, we examined the potential role of hospitalization and delay in the follow-up assessment on the increased burden of illness. RESULTS: Although a general high level of resilience emerged, suggesting most patients relied on their individual and interpersonal resources to face difficulties related to the pandemic, almost one third of the sample reported signs of psychological distress over time, especially post-traumatic symptoms, with anxiety being more represented than depression. Furthermore, hospitalization - regardless of the setting of care - and promptness in follow-up evaluation were found to play a protective role on patients' recovery and mental wellbeing. LIMITATIONS: Selection bias of patients exclusively admitted to the hospital; absence of a control group; psychological assessment relying on self-reported instruments. CONCLUSIONS: The current crisis demands resilience and adjustment resources, either in the acute and post-acute phase. Thus, the clinical effort should aim at relieving the traumatic impact of such condition through timely interventions. Further investigation may address potential predictors of developing a traumatic stress response, in order to identify and promptly treat at-risk subpopulations.


Subject(s)
COVID-19 , Stress Disorders, Post-Traumatic , Anxiety/diagnosis , Anxiety/epidemiology , Depression/diagnosis , Depression/epidemiology , Follow-Up Studies , Hospitals , Humans , Patient Discharge , Quality of Life , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/psychology , Stress Disorders, Post-Traumatic/therapy
15.
J Athl Train ; 57(6): 592-598, 2022 Jun 01.
Article in English | MEDLINE | ID: covidwho-1994284

ABSTRACT

CONTEXT: Depression is among the most common mental health disorders in youth, results in significant impairment, and is associated with a higher risk of suicide. Screening is essential, but assessment tools may not account for the complex interrelatedness of various demographic factors, such as sex, socioeconomic status, and race. OBJECTIVES: To determine the (1) the factor structure of the Patient Health Questionnaire-Adolescent (PHQ-A) for measuring depression in a group of adolescent athletes and (2) measurement invariance between Black and White patients on the PHQ-A. DESIGN: Retrospective cohort design. SETTING: Data were obtained from a secure database collected at a free, comprehensive, mass preparticipation physical examination event hosted by a large health care system. PATIENTS OR OTHER PARTICIPANTS: Participants were 683 high school athletes (Black = 416, White = 267). The independent variables were somatic and affective factors contributing to the construct of depression measured by the PHQ-A and participant race (Black or White). MAIN OUTCOME MEASURE(S): (1) Factors upon which the construct of depression is measured and (2) measurement invariance between Black and White participants. RESULTS: A 2-factor model, involving affective and somatic components, was specified and exhibited adequate fit to the data (comparative fit index >0.90). All items exhibited moderate to high squared multiple correlation values (R2 = 0.10-0.65), suggesting that these items resonated relatively well with participants. The 2-factor model demonstrated noninvariance between Black and White participants (root mean square error of approximation = 0.06-0.08). CONCLUSIONS: Overall, the structure of the PHQ-A was supported by a 2-factor model in adolescent athletes, measuring both affective and somatic symptoms of depression. However, a 2-factor PHQ-A structure was not fully invariant for the adolescents sampled across participant groups, indicating that the model functioned differently between the Black and White participants sampled.


Subject(s)
Depression , Patient Health Questionnaire , Adolescent , Depression/diagnosis , Humans , Mass Screening , Psychometrics , Reproducibility of Results , Retrospective Studies , Schools , Surveys and Questionnaires
16.
BMC Public Health ; 22(1): 1563, 2022 08 17.
Article in English | MEDLINE | ID: covidwho-1993347

ABSTRACT

BACKGROUND: Understanding how pandemics differentially impact on the socio-protective and psychological outcomes of males and females is important to develop more equitable public health policies. We assessed whether males and females differed on measures of major depression and generalized anxiety during the COVID-19 the pandemic, and if so, which sociodemographic, pandemic, and psychological variables may affect sex differences in depression and anxiety. METHODS: Participants were a nationally representative sample of Irish adults (N = 1,032) assessed between April 30th to May 19th, 2020, during Ireland's first COVID-19 nationwide quarantine. Participants completed self-report measures of anxiety (GAD-7) and depression (PHQ-9), as well as 23 sociodemographic pandemic-related, and psychological variables. Sex differences on measures of depression and anxiety were assessed using binary logistic regression analysis and differences in sociodemographic, pandemic, and psychological variables assessed using chi-square tests of independence and independent samples t-tests. RESULTS: Females were significantly more likely than males to screen positive for major depressive disorder (30.6% vs. 20.7%; χ2 (1) = 13.26, p < .001, OR = 1.69 [95% CI = 1.27, 2.25]), and generalised anxiety disorder (23.3% vs. 14.4%; χ2 (1) = 13.42, p < .001, OR = 1.81 [95% CI = 1.31, 2.49]). When adjusted for all other sex-varying covariates however, sex was no longer significantly associated with screening positive for depression (AOR = 0.80, 95% CI = 0.51, 1.25) or GAD (AOR = 0.97, 95% CI = 0.60, 1.57). CONCLUSION: Observed sex-differences in depression and anxiety during the COVID-19 pandemic in the Republic of Ireland are best explained by psychosocial factors of COVID-19 related anxiety, trait neuroticism, lower sleep quality, higher levels of loneliness, greater somatic problems, and, in the case of depression, increases in childcaring responsibilities and lower trait consciousnesses. Implications of these findings for public health policy and interventions are discussed.


Subject(s)
COVID-19 , Depressive Disorder, Major , Adult , Anxiety/diagnosis , Anxiety/epidemiology , COVID-19/epidemiology , Depression/diagnosis , Depression/epidemiology , Depressive Disorder, Major/epidemiology , Female , Humans , Male , Mental Health , Pandemics/prevention & control , SARS-CoV-2 , Sex Characteristics
17.
BMC Geriatr ; 22(1): 662, 2022 08 12.
Article in English | MEDLINE | ID: covidwho-1993329

ABSTRACT

BACKGROUND: Family and friend caregivers play significant roles in advocating for and ensuring quality health and social care of residents in Assisted Living (AL) homes. However, little is known about how the COVID-19 pandemic and related visitor restrictions affected their health and mental well-being. We examined the prevalence and correlates of anxiety and depressive symptoms among caregivers of AL residents during the initial wave of COVID-19 in two Canadian provinces. METHODS: A cross-sectional web-based survey was conducted among family/friend caregivers of AL residents in Alberta and British Columbia (Oct 28, 2020-Mar 31, 2021) to collect data on their sociodemographic, health and caregiving characteristics, as well as concerns about residents' health and social care before and during the first wave of the pandemic. A clinically significant anxiety disorder and depressive symptoms were assessed with the GAD-7 and CES-D10 instruments, respectively. Separate multivariable (modified) Poisson regression models identified caregiver correlates of each mental health condition. RESULTS: Among the 673 caregivers completing the survey (81% for Alberta residents), most were women (77%), white (90%) and aged ≥ 55 years (81%). Clinically significant anxiety and depression were present in 28.6% and 38.8% of caregivers respectively. Both personal stressors (comorbidity level, income reduction, low social support) and caregiving stressors exacerbated by the pandemic were independently associated with caregiver anxiety and depression. The latter included increased concern about the care recipients' depression (adjusted risk ratio [adjRR] = 1.84, 95% confidence interval [CI] 1.19-2.85 for caregiver anxiety and adjRR = 1.75, 95% CI 1.26-2.44 for caregiver depressive symptoms) and reported intention to withdraw the resident from AL because of COVID-19 (adjRR = 1.24, 95%CI 0.95-1.63 for caregiver anxiety and adjRR = 1.37, 95%CI 1.13-1.67 for caregiver depressive symptoms). CONCLUSIONS: Caregivers of residents in AL homes reported significant personal and caregiving-related stressors during the initial wave of COVID-19 that were independently associated with an increased likelihood of experiencing clinically significant anxiety and depressive symptoms. Healthcare providers and AL staff should be aware of the prevalence and varied correlates of caregivers' mental health during public health crises so that appropriate screening and support may identified and implemented.


Subject(s)
COVID-19 , Caregivers , Alberta , Anxiety/diagnosis , Anxiety/epidemiology , Anxiety Disorders/epidemiology , COVID-19/epidemiology , Caregivers/psychology , Cross-Sectional Studies , Depression/diagnosis , Depression/epidemiology , Female , Humans , Male , Pandemics , Prevalence
18.
Sci Rep ; 12(1): 14042, 2022 08 18.
Article in English | MEDLINE | ID: covidwho-1991677

ABSTRACT

To investigate the relationships between communicative and critical health literacy (CCHL) and anxiety and depressive symptoms (ADs) in pregnant women during the coronavirus disease 2019 (COVID-19) pandemic. A cross-sectional study was conducted and 5466 pregnant women responded in Japan in September 2020. A Kessler 6 scale (K6) score ≥ 10, an Edinburgh Postnatal Depression Scale (EPDS) score ≥ 13, and four CCHL groups were analyzed using a logistic regression model and trend test. The proportions of pregnant women with a K6 score ≥ 10 and EPDS score ≥ 13 were 13.5 and 15.4%, respectively. In comparisons with the low CCHL group, the adjusted odds ratio (95% CI) for anxiety symptoms was 0.770 (0.604-0.982) in the high CCHL group, while those for depressive symptoms were 0.777 (0.639-0.946), 0.665 (0.537-0.824), and 0.666 (0.529-0.838) in the lower, higher, and high CCHL groups (all p < 0.05), respectively, after adjustments for potential confounding factors, such as age, weeks of gestation, complications, history, number of children, marital status, education, employment, and income. Higher CCHL was associated with significantly lower adjusted odds ratios for anxiety (p for trend = 0.019) and depressive symptoms (p for trend < 0.001). These results suggest a relationship between CCHL and ADs in pregnant women during the COVID-19 pandemic.


Subject(s)
COVID-19 , Health Literacy , Anxiety/diagnosis , Anxiety/epidemiology , COVID-19/epidemiology , Child , Cross-Sectional Studies , Depression/diagnosis , Depression/epidemiology , Female , Humans , Japan/epidemiology , Pandemics , Pregnancy , Pregnant Women
19.
Rev Esp Geriatr Gerontol ; 57(5): 273-277, 2022.
Article in Spanish | MEDLINE | ID: covidwho-1991246

ABSTRACT

BACKGROUND: The health risks faced by older adults are diverse; however, little has been explored about the use and abuse of psychoactive substances in this population. The seclusion imposed by the situation that prevails due to SARS-CoV-2 has increased the feelings of loneliness, isolation and sadness associated with this age, which makes them a risk factor for drug use. OBJECTIVE: To analyze the consumption of legal and illegal drugs in people over 60 years of age who are Facebook users and its relationship with symptoms of depression during the SARS-CoV-2 pandemic. MATERIAL AND METHODS: Study carried out on 380 elderly people, Facebook users, who answered a questionnaire published online, which inquired about: sociodemographic data, frequency and amount of legal and illegal drug use, and depressive symptomatology. RESULTS: 50.26% were women; the average age was 66.79 years (SD=5.81); 31.05% consumed alcohol in the last 30 days, 22.63% tobacco, tranquilizers without medical prescription 16.05% and marijuana 7.89%. The consumption of other illegal drugs did not exceed 2.6% of the population. When comparing between users and non-users, it turned out that consumption in the last 30 days was slightly higher in women, in single people and no differences were observed depending on the level of schooling. Mild and severe depressive symptoms were found to be associated with all drugs except tobacco and opiates. DISCUSSION AND CONCLUSIONS: The results obtained demonstrate the need to make drug use visible among older adults and to develop strategies that reduce the mood disorders they may be experiencing, such as fear, anguish and depression. When comparing between users and non-users, it turned out that consumption in the last 30 days was slightly higher in women, in single people and no differences were observed depending on the level of schooling.


Subject(s)
COVID-19 , Illicit Drugs , Opiate Alkaloids , Substance-Related Disorders , Female , Humans , Middle Aged , Aged , Male , Pandemics , SARS-CoV-2 , Depression/epidemiology , Depression/diagnosis , Mexico/epidemiology , COVID-19/epidemiology , Substance-Related Disorders/epidemiology
20.
J Nepal Health Res Counc ; 20(1): 166-172, 2022 Jun 02.
Article in English | MEDLINE | ID: covidwho-1988990

ABSTRACT

BACKGROUND: Psychological problems increased during the period of COVID-19. Lockdown" is adopted in many countries of the world. It has also been seen that COVID-19 has led not only to an increase of infection and death but also vast change in the lifestyles of every individual especially in young adults causing various mental health issues. However, in Nepal, there are limited studies to address this issue. The main objective of this study is to generate evidence on the prevalence of symptoms of post-traumatic stress disorder, anxiety, and depression among young adults and the factors contributing to these outcomes in Nepal. METHODS: Cross-sectional methods were employed using an online structured questionnaire in January 2021, among 1229 participants. Three logistic regression models were performed to examine the significant COVID-19 factors. RESULTS: The prevalence of Depression, Anxiety and post-traumatic stress disorder related symptoms in this study were 255(20.4%), 240(19.2%)and 162(13.2%) respectively relate.COVID-19 diagnosis, COVID-related stress and exposure was significantly related to depression. Similarly, COVID-19 diagnosis, change in income during COVID-19, being exposed to 4 or more exposure factors had high chances of getting anxiety. Also, income change during COVID-19 and stressors during COVID-19 were related to post-traumatic stress disorder. CONCLUSIONS: This research shows that various COVID-19 related factors have contributed to the high prevalence of these outcomes.


Subject(s)
COVID-19 , COVID-19/epidemiology , COVID-19 Testing , Communicable Disease Control , Cross-Sectional Studies , Depression/diagnosis , Humans , Nepal/epidemiology , Pandemics , SARS-CoV-2 , Stress, Psychological/epidemiology , Young Adult
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