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1.
JAMA Netw Open ; 4(11): e2134803, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1516698

ABSTRACT

Importance: Infection with SARS-CoV-2 is associated with fatigue and sleep problems long after the acute phase of COVID-19. In addition, there are concerns of SARS-CoV-2 infection causing psychiatric illness; however, evidence of a direct effect is inconclusive. Objective: To assess risk of risk of incident or repeat psychiatric illness, fatigue, or sleep problems following SARS-CoV-2 infection and to analyze changes according to demographic subgroups. Design, Setting, and Participants: This cohort study assembled matched cohorts using the Clinical Practice Research Datalink Aurum, a UK primary care registry of 11 923 499 individuals aged 16 years or older. Patients were followed-up for up to 10 months, from February 1 to December 9, 2020. Individuals with less than 2 years of historical data or less than 1 week follow-up were excluded. Individuals with positive results on a SARS-CoV-2 test without prior mental illness or with anxiety or depression, psychosis, fatigue, or sleep problems were matched with up to 4 controls based on sex, general practice, and year of birth. Controls were individuals who had negative SARS-CoV-2 test results. Data were analyzed from January to July 2021. Exposure: SARS-CoV-2 infection, determined via polymerase chain reaction testing. Main Outcomes and Measures: Cox proportional hazard models estimated the association between a positive SARS-CoV-2 test result and subsequent psychiatric morbidity (depression, anxiety, psychosis, or self-harm), sleep problems, fatigue, or psychotropic prescribing. Models adjusted for comorbidities, ethnicity, smoking, and body mass index. Results: Of 11 923 105 eligible individuals (6 011 020 [50.4%] women and 5 912 085 [49.6%] men; median [IQR] age, 44 [30-61] years), 232 780 individuals (2.0%) had positive result on a SARS-CoV-2 test. After applying selection criteria, 86 922 individuals were in the matched cohort without prior mental illness, 19 020 individuals had prior anxiety or depression, 1036 individuals had psychosis, 4152 individuals had fatigue, and 4539 individuals had sleep problems. After adjusting for observed confounders, there was an association between positive SARS-CoV-2 test results and psychiatric morbidity (adjusted hazard ratio [aHR], 1.83; 95% CI, 1.66-2.02), fatigue (aHR, 5.98; 95% CI, 5.33-6.71), and sleep problems (aHR, 3.16; 95% CI, 2.64-3.78). However, there was a similar risk of incident psychiatric morbidity for those with a negative SARS-CoV-2 test results (aHR, 1.71; 95% CI, 1.65-1.77) and a larger increase associated with influenza (aHR, 2.98; 95% CI, 1.55-5.75). Conclusions and Relevance: In this cohort study of individuals registered at an English primary care practice during the pandemic, there was consistent evidence that SARS-CoV-2 infection was associated with increased risk of fatigue and sleep problems. However, the results from the negative control analysis suggest that unobserved confounding may be responsible for at least some of the positive association between COVID-19 and psychiatric morbidity.


Subject(s)
COVID-19/complications , Fatigue/etiology , Pandemics , Psychological Distress , Psychotropic Drugs/therapeutic use , Sleep Wake Disorders/etiology , Sleep , Adult , Anxiety/drug therapy , Anxiety/epidemiology , Anxiety/etiology , COVID-19/psychology , COVID-19/virology , Cohort Studies , Depression/drug therapy , Depression/epidemiology , Depression/etiology , England/epidemiology , Fatigue/epidemiology , Female , Humans , Male , Middle Aged , Prevalence , Primary Health Care , Psychotic Disorders/drug therapy , Psychotic Disorders/epidemiology , Psychotic Disorders/etiology , Risk Factors , SARS-CoV-2 , Sleep Wake Disorders/epidemiology , Stress, Psychological/etiology
2.
BMC Womens Health ; 21(1): 387, 2021 11 03.
Article in English | MEDLINE | ID: covidwho-1501998

ABSTRACT

BACKGROUND: Despite the abundance of clinical data available for Coronavirus Disease 2019 (COVID-19), little research on the psychological well-being of breast cancer survivors has been published. We investigate the extent to which self-compassion accounted for the association between psychological well-being (depression, anxiety) and death anxiety in breast cancer survivors. METHODS: A cross-sectional study design was applied. Participants were recruited from three departments of oncology in Zanjan, Iran. Data were collected from 210 breast cancer patients. Participants completed self-report measures. Pearson correlation coefficient was used to assess the relationship among the study variables. Bootstrapping analyses were used to test the significance of indirect effects. RESULTS: Correlational analyses revealed that depression and anxiety were significantly and positively related to death anxiety (r = 0.77, p < 0.01; r = 0.85, p < 0.01, respectively) and negatively to self-compassion (r = - 0.48, p < 0.01; r = - 0.53, p < 0.01, respectively). Bootstrapping analyses revealed significant indirect effects of depression (ß = 0.065, SE = 0.35, p < 0.03, 95% CI [LL = - 0.0083, UL: - 0.1654]) and anxiety (ß = 0.089, SE = 0.09, p < 0.04, 95% CI [LL = - 0.0247, UL: - 0.1987]) on death anxiety through self-compassion. CONCLUSIONS: Findings from this study indicate that self-compassion may be considered as one treatment strategy to improve psychological well-being of cancer patients in the new context of the COVID-19 pandemic.


Subject(s)
Breast Neoplasms , COVID-19 , Cancer Survivors , Anxiety/epidemiology , Breast Neoplasms/complications , Cross-Sectional Studies , Depression/epidemiology , Depression/etiology , Empathy , Female , Humans , Pandemics , SARS-CoV-2 , Stress, Psychological , Surveys and Questionnaires
3.
Environ Health Prev Med ; 26(1): 107, 2021 Nov 02.
Article in English | MEDLINE | ID: covidwho-1501988

ABSTRACT

BACKGROUND: The 2019 novel coronavirus disease (COVID-19) emerges in China, which spreads rapidly and becomes a public health emergency of international concern. Chinese government has promptly taken quarantine measures to block the transmission of the COVID-19, which may cause deleterious consequences on everyone's behaviors and psychological health. Few studies have examined the associations between behavioral and mental health in different endemic areas. This study aimed to describe screen time (ST), physical activity (PA), and depressive symptoms, as well as their associations among Chinese college students according to different epidemic areas. METHODS: The study design is cross-sectional using online survey, from 4 to 12 February 2020, 14,789 college students accomplished this online study, participants who did not complete the questionnaire were excluded, and finally this study included 11,787 college students from China. RESULTS: The average age of participants was 20.51 ± 1.88 years. 57.1% of the college students were male. In total, 25.9% of college students reported depression symptoms. ST > 4 h/day was positively correlated with depressive symptoms (ß = 0.48, 95%CI 0.37-0.59). COVID-19ST > 1 h/day was positively correlated with depressive symptoms (ß = 0.54, 95%CI 0.43-0.65), compared with COVID-19ST ≤ 0.5 h/day. Compared with PA ≥ 3 day/week, PA < 3 day/week was positively associated with depression symptoms (ß = 0.01, 95%CI 0.008-0.012). Compared with low ST and high PA, there was an interaction association between high ST and low PA on depression (ß = 0.31, 95%CI 0.26-0.36). Compared with low COVID-19ST and high PA, there was an interaction association between high COVID-19ST and low PA on depression (ß = 0.37, 95%CI 0.32-0.43). There were also current residence areas differences. CONCLUSIONS: Our findings identified that high ST or low PA was positively associated with depressive symptoms independently, and there was also an interactive effect between ST and PA on depressive symptoms.


Subject(s)
COVID-19/psychology , Depression/epidemiology , Exercise , Mental Health/statistics & numerical data , Screen Time , Students/psychology , Adult , COVID-19/epidemiology , COVID-19/prevention & control , China/epidemiology , Cross-Sectional Studies , Depression/etiology , Female , Humans , Male , Time Factors , Universities , Young Adult
4.
PLoS One ; 16(11): e0259213, 2021.
Article in English | MEDLINE | ID: covidwho-1496532

ABSTRACT

Healthcare workers have had the longest and most direct exposure to COVID-19 and consequently may suffer from poor mental health. We conducted one of the first repeated multi-country analysis of the mental wellbeing of medical doctors (n = 5,275) at two timepoints during the COVID-19 pandemic (June 2020 and November/December 2020) to understand the prevalence of anxiety and depression, as well as associated risk factors. Rates of anxiety and depression were highest in Italy (24.6% and 20.1%, June 2020), second highest in Catalonia (15.9% and 17.4%, June 2020), and lowest in the UK (11.7% and 13.7%, June 2020). Across all countries, higher risk of anxiety and depression symptoms were found among women, individuals below 60 years old, those feeling vulnerable/exposed at work, and those reporting normal/below-normal health. We did not find systematic differences in mental health measures between the two rounds of data collection, hence we cannot discard that the mental health repercussions of the pandemic are persistent.


Subject(s)
Anxiety/etiology , COVID-19/psychology , Depression/etiology , Occupational Diseases/psychology , Physicians/psychology , Adult , Female , Health Personnel/psychology , Humans , Italy , Male , Middle Aged , Pandemics
5.
PLoS One ; 16(10): e0259012, 2021.
Article in English | MEDLINE | ID: covidwho-1480465

ABSTRACT

OBJECTIVES: This study aims to investigate the potential factors associated with mental health outcomes among Chinese adults during the Coronavirus disease 2019 (COVID-19) epidemic. METHODS: This is an online cross-sectional survey conducted among Chinese adults in February 2020. Outcome measurements included the three-item UCLA Loneliness Scale (UCLA-3), two-item Patient Health Questionnaire (PHQ-2), two-item Generalized Anxiety Disorder Questionnaire (GAD-2), and two items from the Clinician-Administered Post-traumatic Stress Disorder (PTSD) Scale. COVID-19 related factors, physical health, lifestyle, and self-efficacy were also measured. Univariable and multivariable logistic regressions were performed. RESULTS: This study included 1456 participants (age: 33.8±10.5 years; female: 59.1%). The prevalence of depressive symptoms, anxiety symptoms, loneliness, and PTSD symptoms were 11.3%, 7.6%, 38.7%, and 33.9%, respectively. In multivariable analysis, loneliness was associated with being single, separated/divorced/widowed, low level of education, current location, medication, more somatic symptoms, lower self-efficacy, and going out frequently. Depression was associated with fear of infection, binge drinking, more somatic symptoms, lower self-efficacy, and longer screen time. Anxiety was associated with more somatic symptoms and lower self-efficacy. PTSD symptoms were associated with more somatic symptoms, lower self-efficacy, higher perceived risk of infection, fear of infection, and self-rated more negative influence due to the epidemic (p<0.05). CONCLUSIONS: Mental health problems during the COVID-19 epidemic were associated with various biopsychosocial and COVID-19 related factors. Psychological interventions should be aware of these influencing factors and prioritize support for those people at higher risk.


Subject(s)
COVID-19 , Depression , Loneliness , SARS-CoV-2 , Stress Disorders, Post-Traumatic , Adult , COVID-19/epidemiology , COVID-19/psychology , China/epidemiology , Cross-Sectional Studies , Depression/epidemiology , Depression/etiology , Depression/psychology , Female , Humans , Male , Prevalence , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/etiology , Stress Disorders, Post-Traumatic/psychology
6.
Hisp Health Care Int ; 19(4): 230-238, 2021 12.
Article in English | MEDLINE | ID: covidwho-1473601

ABSTRACT

The purpose of the current study was to determine the influence of moral injury and Light Triad (LT) personality traits on anxiety and depression symptoms of health-care personnel during the coronavirus-2019 pandemic. A quantitative, cross-sectional research design was used, the study included a sample of 169 health-care workers from Honduras. Data was gathered through the Moral Injury Symptom Scale for Health Professionals (MISS-HP), Light Triad Scale (LTS), the Generalized Anxiety Disorder-7, and the Patient-Health Questionnaire-9. Results suggest that almost 9 out of 10 respondents experienced at least one potentially morally injurious event, 45.6% were at significant risk of impairment related to moral injury. Working with limited staff and resources, and the implications of it, was the most common potentially morally injurious situation reported by the respondents. Results suggest that MISS-HP Mistrust has significant negative correlations with LT traits. A hierarchical regression model determined that Moral Injury, but not LT traits, significantly affected depression symptoms. On the other hand, anxiety symptoms were significantly predicted by Moral Injury, as did LTS-Humanism. The results were discussed according to their implications for public health policy in Latin America.


Subject(s)
COVID-19 , Stress Disorders, Post-Traumatic , Anxiety/epidemiology , Anxiety/etiology , Anxiety Disorders/epidemiology , Anxiety Disorders/etiology , Cross-Sectional Studies , Depression/epidemiology , Depression/etiology , Health Personnel , Honduras/epidemiology , Humans , Pandemics , Surveys and Questionnaires
7.
PLoS One ; 16(3): e0249098, 2021.
Article in English | MEDLINE | ID: covidwho-1477519

ABSTRACT

BACKGROUND: Nursing homes (NH) for the elderly have been particularly affected by the Covid-19 pandemic mainly due to their hosted vulnerable populations and poor outbreak preparedness. In Belgium, the medical humanitarian organization Médecins Sans Frontières (MSF) implemented a support project for NH including training on infection prevention and control (IPC), (re)-organization of care, and psychosocial support for NH staff. As psychosocial and mental health needs of NH residents in times of Covid-19 are poorly understood and addressed, this study aimed to better understand these needs and how staff could respond accordingly. METHODS: A qualitative study adopting thematic content analysis. Eight focus group discussions with direct caring staff and 56 in-depth interviews with residents were conducted in eight purposively and conveniently selected NHs in Brussels, Belgium, June 2020. RESULTS: NH residents experienced losses of freedom, social life, autonomy, and recreational activities that deprived them of their basic psychological needs. This had a massive impact on their mental well-being expressed in feeling depressed, anxious, and frustrated as well as decreased meaning and quality of life. Staff felt unprepared for the challenges posed by the pandemic; lacking guidelines, personal protective equipment and clarity around organization of care. They were confronted with professional and ethical dilemmas, feeling 'trapped' between IPC and the residents' wellbeing. They witnessed the detrimental effects of the measures imposed on their residents. CONCLUSION: This study revealed the insights of residents' and NH staff at the height of the early Covid-19 pandemic. Clearer outbreak plans, including psychosocial support, could have prevented the aggravated mental health conditions of both residents and staff. A holistic approach is needed in NHs in which tailor-made essential restrictive IPC measures are combined with psychosocial support measures to reduce the impact on residents' mental health impact and to enhance their quality of life.


Subject(s)
COVID-19/pathology , Nursing Staff/psychology , Quality of Life , Vulnerable Populations/psychology , Aged , Aged, 80 and over , Anxiety/etiology , COVID-19/virology , Depression/etiology , Female , Focus Groups , Humans , Interviews as Topic , Male , Middle Aged , Nursing Homes , Personal Autonomy , Protective Devices/supply & distribution , Quarantine , SARS-CoV-2
8.
Int J Clin Pract ; 75(11): e14880, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1476236

ABSTRACT

INTRODUCTION: Outbreaks of infectious diseases have negative effects on mental health. Currently, there is very little information about the psychological effects of the COVID-19 pandemic on adolescents and associated factors affecting their mental health. The aim of the present study is to determine the severity of anxiety, depression and post-traumatic stress disorder (PTSD) symptoms in adolescents during the COVID-19 outbreak, and to investigate the associated factors with these symptoms. METHODS: The present study was conducted with a total of 447 adolescents. Psychiatric symptoms were evaluated by the use of DSM-5 Level 2 Anxiety Scale, DSM-5 Level 2 Depression Scale and National Stressful Events Survey PTSD Short Scale. The association between age, gender, residential area, presence of COVID-19 in the participant, presence of COVID-19 in the family or environment and psychiatric symptoms were evaluated with linear regression analysis. RESULTS: The mean age of participants was 15.06, and 38.3% of the participants were men and 61.7% were women. The rate of participants with moderate or high levels of anxiety, depression and PTSD symptoms was 28%, 37.6% and 28.5%, respectively. High age and living in an urban area were associated with increased anxiety, depression and PTSD symptoms. In addition, female gender was associated with increased depression symptoms, and the presence of COVID-19 in the family or environment was associated with increased anxiety symptoms. CONCLUSION: The present study shows that adolescents have serious levels of anxiety, depression and PTSD symptoms during the COVID-19 pandemic. These results emphasise the need for mental health interventions that are appropriate for the characteristics of this age group.


Subject(s)
COVID-19 , Stress Disorders, Post-Traumatic , Adolescent , Anxiety/epidemiology , Anxiety/etiology , Cross-Sectional Studies , Depression/epidemiology , Depression/etiology , Disease Outbreaks , Female , Humans , Male , Pandemics , SARS-CoV-2 , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/etiology , Stress, Psychological
9.
Rev Colomb Psiquiatr (Engl Ed) ; 50(3): 189-198, 2021.
Article in English, Spanish | MEDLINE | ID: covidwho-1466864

ABSTRACT

BACKGROUND: The aim of the study is to compare the emotional effects of COVID-19 among three different groups, namely: health personnel, medical students, and a sample of the general population. METHODS: 375 participants were recruited for this study, of which 125 were medical students (preclinical studies, 59; clinical studies, 66), 125 were health personnel (COVID-19 frontline personnel, 59; personnel not related with COVID-19, 66), and 125 belonged to the general population. The PHQ-9, GAD-7, and CPDI scales were used to assess the emotional impact. A multinomial logistic regression was performed to measure differences between groups, considering potential confounding factors. RESULTS: Regarding CPDI values, all other groups showed reduced values compared to COVID-19 frontline personnel. However, the general population, preclinical and clinical medical students showed increased PHQ-9 values compared to COVID-19 frontline personnel. Finally, confounding factors, gender and age correlated negatively with higher CPDI and PHQ-9 scores. CONCLUSIONS: Being frontline personnel is associated with increased COVID-19-related stress. Depression is associated, however, with other groups not directly involved with the treatment of COVID-19 patients. Female gender and younger age correlated with COVID-19-related depression and stress.


Subject(s)
Anxiety/etiology , COVID-19/psychology , Depression/etiology , Health Personnel/psychology , Stress, Psychological/etiology , Students, Medical/psychology , Adolescent , Adult , Aged , Aged, 80 and over , Anxiety/diagnosis , Anxiety/epidemiology , COVID-19/prevention & control , Depression/diagnosis , Depression/epidemiology , Female , Health Surveys , Humans , Logistic Models , Male , Middle Aged , Peru/epidemiology , Psychological Tests , Risk Factors , Stress, Psychological/diagnosis , Stress, Psychological/epidemiology , Young Adult
10.
BMC Geriatr ; 21(1): 537, 2021 10 10.
Article in English | MEDLINE | ID: covidwho-1463233

ABSTRACT

BACKGROUND: Patients with hip fracture and depression are less likely to recover functional ability. This review sought to identify prognostic factors of depression or depressive symptoms up to 1 year after hip fracture surgery in adults. This review also sought to describe proposed underlying mechanisms for their association with depression or depressive symptoms. METHODS: We searched for published (MEDLINE, Embase, PsychInfo, CINAHL and Web of Science Core Collection) and unpublished (OpenGrey, Greynet, BASE, conference proceedings) studies. We did not impose any date, geographical, or language limitations. Screening (Covidence), extraction (Checklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies, adapted for use with prognostic factors studies Checklist), and quality appraisal (Quality in Prognosis Studies tool) were completed in duplicate. Results were summarised narratively. RESULTS: In total, 37 prognostic factors were identified from 12 studies included in this review. The quality of the underlying evidence was poor, with all studies at high risk of bias in at least one domain. Most factors did not have a proposed mechanism for the association. Where factors were investigated by more than one study, the evidence was often conflicting. CONCLUSION: Due to conflicting and low quality of available evidence it is not possible to make clinical recommendations based on factors prognostic of depression or depressive symptoms after hip fracture. Further high-quality research investigating prognostic factors is warranted to inform future intervention and/or stratified approaches to care after hip fracture. TRIAL REGISTRATION: Prospero registration: CRD42019138690 .


Subject(s)
Depression , Hip Fractures , Depression/diagnosis , Depression/epidemiology , Depression/etiology , Hip Fractures/diagnosis , Hip Fractures/epidemiology , Hip Fractures/surgery , Humans , Prognosis , Systematic Reviews as Topic
11.
Rev Colomb Psiquiatr (Engl Ed) ; 50(3): 214-224, 2021.
Article in English, Spanish | MEDLINE | ID: covidwho-1433767

ABSTRACT

INTRODUCTION: The current SARS-CoV-2 pandemic has caused feelings of anxiety, confusion, and panic among the world population. Due to these psychological changes resulting from the stress produced by the disease, we sought to investigate the psychological impact of the pandemic on the university student community. MATERIAL AND METHODS: 1,283 students were surveyed, of which 1,149 students were selected. The majority of the subjects were female, and the overall average age was of 20 years. They were provided with an 82-question online questionnaire divided into four sections; looking for the prevalence of significant symptomatology of major depression and generalised anxiety using the PHQ-9 and GAD-7 scales; and factors that potentially affect the mental health of our university population. RESULTS: We found a high prevalence of significant depression (47.08%) and anxiety (27.06%) symptomatology, considering a score of 10 or more as cut-off point. There was no significant difference in depression and anxiety symptomatology between the health-care students and non-health-care students. CONCLUSIONS: Our results, together with what is observed in the literature, allow us to conclude that the college student population has a high risk of mental illness, and these should be taken into consideration for the search of effective strategies for detection and control of mental health illnesses. Undoubtedly, the COVID-19 pandemic is a red flag that shows the need to upgrade mental health programmes in universities and to validate virtual instruments.


Subject(s)
Anxiety/etiology , COVID-19/psychology , Depression/etiology , Students/psychology , Anxiety/diagnosis , Anxiety/epidemiology , COVID-19/prevention & control , Cross-Sectional Studies , Depression/diagnosis , Depression/epidemiology , Female , Health Occupations/education , Health Surveys , Humans , Logistic Models , Male , Mexico/epidemiology , Prevalence , Psychological Tests , Social Determinants of Health , Universities , Young Adult
12.
JMIR Public Health Surveill ; 7(9): e31052, 2021 09 16.
Article in English | MEDLINE | ID: covidwho-1394691

ABSTRACT

BACKGROUND: The outbreak of the COVID-19 pandemic has caused great panic among the public, with many people suffering from adverse stress reactions. To control the spread of the pandemic, governments in many countries have imposed lockdown policies. In this unique pandemic context, people can obtain information about pandemic dynamics on the internet. However, searching for health-related information on the internet frequently increases the possibility of individuals being troubled by the information that they find, and consequently, experiencing symptoms of cyberchondria. OBJECTIVE: We aimed to examine the relationships between people's perceived severity of the COVID-19 pandemic and their depression, anxiety, and stress to explore the role of cyberchondria, which, in these relationship mechanisms, is closely related to using the internet. In addition, we also examined the moderating role of lockdown experiences. METHODS: In February 2020, a total of 486 participants were recruited through a web-based platform from areas in China with a large number of infections. We used questionnaires to measure participants' perceived severity of the COVID-19 pandemic, to measure the severity of their cyberchondria, depression, anxiety, and stress symptoms, and to assess their lockdown experiences. Confirmatory factor analysis, exploratory factor analysis, common method bias, descriptive statistical analysis, and correlation analysis were performed, and moderated mediation models were examined. RESULTS: There was a positive association between perceived severity of the COVID-19 pandemic and depression (ß=0.36, t=8.51, P<.001), anxiety (ß=0.41, t=9.84, P<.001), and stress (ß=0.46, t=11.45, P<.001), which were mediated by cyberchondria (ß=0.36, t=8.59, P<.001). The direct effects of perceived severity of the COVID-19 pandemic on anxiety (ß=0.07, t=2.01, P=.045) and stress (ß=0.09, t=2.75, P=.006) and the indirect effects of cyberchondria on depression (ß=0.10, t=2.59, P=.009) and anxiety (ß=0.10, t=2.50, P=.01) were moderated by lockdown experience. CONCLUSIONS: The higher the perceived severity of the COVID-19 pandemic, the more serious individuals' symptoms of depression, anxiety, and stress. In addition, the associations were partially mediated by cyberchondria. Individuals with higher perceived severity of the COVID-19 pandemic were more likely to develop cyberchondria, which aggravated individuals' depression, anxiety, and stress symptoms. Negative lockdown experiences exacerbated the COVID-19 pandemic's impact on mental health.


Subject(s)
COVID-19/psychology , Perception , Quarantine/psychology , Stress, Psychological/complications , Adolescent , Adult , Anxiety/etiology , Anxiety/psychology , COVID-19/epidemiology , COVID-19/prevention & control , China/epidemiology , Cross-Sectional Studies , Depression/etiology , Depression/psychology , Female , Humans , Male , Middle Aged , Quarantine/standards , Social Media/standards , Social Media/statistics & numerical data , Stress, Psychological/psychology
13.
J Korean Med Sci ; 36(25): e168, 2021 Jun 28.
Article in English | MEDLINE | ID: covidwho-1389140

ABSTRACT

This study explored the psychometric properties of the Arabic version of the Stress and Anxiety to Viral Epidemics-6 items (SAVE-6) scale for assessing people's anxiety in response to the viral epidemic in Lebanon. The 406 participants responded voluntarily to the online survey that included the SAVE-6, Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9) tools. The single-structure SAVE-6 model showed good internal consistency (Cronbach's α = 0.773). The SAVE-6 scale also showed good convergent validity with the GAD-7 (Spearman's ρ = 0.42, P < 0.001) and PHQ-9 (ρ = 0.38, P < 0.001). Receiver operating characteristic (ROC) analysis revealed an Arabic SAVE-6 cut-off score of 12 points (area under the curve [AUC] = 0.753; sensitivity = 62.74%; specificity = 78.26%) for an at least mild degree of anxiety (GAD-7 score ≥ 5). The Arabic version of the SAVE-6 was a reliable, valid, and solely usable scale for measuring the anxiety response of the general population to the viral epidemic.


Subject(s)
Anxiety Disorders/epidemiology , Anxiety/epidemiology , COVID-19/psychology , Pandemics , Psychiatric Status Rating Scales , SARS-CoV-2 , Stress, Psychological/epidemiology , Adolescent , Adult , Aged , Anxiety/etiology , Anxiety Disorders/etiology , Area Under Curve , COVID-19/epidemiology , Depression/epidemiology , Depression/etiology , Depressive Disorder/epidemiology , Depressive Disorder/etiology , Diagnostic Self Evaluation , Factor Analysis, Statistical , Female , Humans , Lebanon/epidemiology , Male , Middle Aged , Patient Health Questionnaire , Psychometrics , Quarantine/psychology , ROC Curve , Reproducibility of Results , Sensitivity and Specificity , Surveys and Questionnaires , Translations , Young Adult
14.
Lancet ; 398(10302): 747-758, 2021 08 28.
Article in English | MEDLINE | ID: covidwho-1376121

ABSTRACT

BACKGROUND: The full range of long-term health consequences of COVID-19 in patients who are discharged from hospital is largely unclear. The aim of our study was to comprehensively compare consequences between 6 months and 12 months after symptom onset among hospital survivors with COVID-19. METHODS: We undertook an ambidirectional cohort study of COVID-19 survivors who had been discharged from Jin Yin-tan Hospital (Wuhan, China) between Jan 7 and May 29, 2020. At 6-month and 12-month follow-up visit, survivors were interviewed with questionnaires on symptoms and health-related quality of life (HRQoL), and received a physical examination, a 6-min walking test, and laboratory tests. They were required to report their health-care use after discharge and work status at the 12-month visit. Survivors who had completed pulmonary function tests or had lung radiographic abnormality at 6 months were given the corresponding tests at 12 months. Non-COVID-19 participants (controls) matched for age, sex, and comorbidities were interviewed and completed questionnaires to assess prevalent symptoms and HRQoL. The primary outcomes were symptoms, modified British Medical Research Council (mMRC) score, HRQoL, and distance walked in 6 min (6MWD). Multivariable adjusted logistic regression models were used to evaluate the risk factors of 12-month outcomes. FINDINGS: 1276 COVID-19 survivors completed both visits. The median age of patients was 59·0 years (IQR 49·0-67·0) and 681 (53%) were men. The median follow-up time was 185·0 days (IQR 175·0-198·0) for the 6-month visit and 349·0 days (337·0-361·0) for the 12-month visit after symptom onset. The proportion of patients with at least one sequelae symptom decreased from 68% (831/1227) at 6 months to 49% (620/1272) at 12 months (p<0·0001). The proportion of patients with dyspnoea, characterised by mMRC score of 1 or more, slightly increased from 26% (313/1185) at 6-month visit to 30% (380/1271) at 12-month visit (p=0·014). Additionally, more patients had anxiety or depression at 12-month visit (26% [331/1271] at 12-month visit vs 23% [274/1187] at 6-month visit; p=0·015). No significant difference on 6MWD was observed between 6 months and 12 months. 88% (422/479) of patients who were employed before COVID-19 had returned to their original work at 12 months. Compared with men, women had an odds ratio of 1·43 (95% CI 1·04-1·96) for fatigue or muscle weakness, 2·00 (1·48-2·69) for anxiety or depression, and 2·97 (1·50-5·88) for diffusion impairment. Matched COVID-19 survivors at 12 months had more problems with mobility, pain or discomfort, and anxiety or depression, and had more prevalent symptoms than did controls. INTERPRETATION: Most COVID-19 survivors had a good physical and functional recovery during 1-year follow-up, and had returned to their original work and life. The health status in our cohort of COVID-19 survivors at 12 months was still lower than that in the control population. FUNDING: Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences, the National Natural Science Foundation of China, the National Key Research and Development Program of China, Major Projects of National Science and Technology on New Drug Creation and Development of Pulmonary Tuberculosis, the China Evergrande Group, Jack Ma Foundation, Sino Biopharmaceutical, Ping An Insurance (Group), and New Sunshine Charity Foundation.


Subject(s)
COVID-19/complications , Survivors , Aged , Anxiety/etiology , COVID-19/physiopathology , COVID-19/psychology , Depression/etiology , Exercise Tolerance , Fatigue/etiology , Female , Follow-Up Studies , Humans , Longitudinal Studies , Lung/physiopathology , Male , Middle Aged , Muscle Weakness/etiology , Quality of Life , SARS-CoV-2 , Walk Test
15.
JAMA Netw Open ; 4(8): e2121934, 2021 08 02.
Article in English | MEDLINE | ID: covidwho-1370361

ABSTRACT

Importance: The COVID-19 pandemic and resulting conditions may negatively affect adolescents. Objective: To examine aspects of self-reported mental and physical health among adolescents in Norway before and during the pandemic, including the role of pandemic-associated anxiety. Design, Setting, and Participants: This cohort study examined a diverse nationwide sample of grade 11 students from the longitudinal MyLife study in Norway. The original study recruitment of all 8th, 9th, and 10th graders from the same middle schools facilitated identification of 2 sociodemographically comparable cohorts assessed in October to December 2018 and 2019, before the COVID-19 pandemic, and October to December 2020, during the pandemic. School entry and enrollment in Norway is determined by the birth year, and students usually start high school (11th grade) during the fall of the year of their 16th birthday. Data were analyzed from March to June 2021. Exposures: The COVID-19 pandemic and associated conditions in Norway. Main Outcomes and Measures: In grades 10 and 11, adolescents reported their depression symptoms using the Patient Health Questionnaire-9 (cutoff scores for moderate/severe depression, ≥15), number of close friends, physical health, and organized sports participation. Cohort differences were examined with a set of nested regression models, incrementally controlling for sociodemographic covariates and grade 10 outcomes. Results: A sample of 2536 adolescents (1505 [59.4%] girls) was analyzed, including 1621 adolescents before the pandemic and 915 adolescents during the pandemic, of whom 158 adolescents (17.3%) reported high pandemic anxiety. The only significant difference in outcomes between the COVID-19 cohort and the pre-COVID-19 cohort were lower odds of organized sports participation (adjusted odds ratio [aOR], 0.69; 95% CI, 0.56-0.87). However, in subanalyses comparing adolescents with high anxiety during the COVID-19 pandemic with adolescents in the pre-COVID-19 cohort, adolescents with high pandemic anxiety were more likely to experience clinical-level depression symptoms (aOR, 2.17; 95% CI, 1.39-3.37) and poor physical health (aOR, 1.53; 95% CI, 1.01-2.31). Conclusions and Relevance: In this cohort study of Norwegian adolescents, adolescents who started high school during the pandemic year had lower odds of organized sports participation in late 2020, but were otherwise comparable in terms of self-reported mental and physical health with their pre-COVID-19 counterparts. However, adolescents in the COVID-19 cohort experiencing high pandemic-related anxiety had significantly greater odds of poorer mental and physical health than adolescents in the pre-COVID-19 cohort. Strategies aiming to mitigate the impact of COVID-19 may benefit from identifying youth disproportionally affected by the pandemic conditions.


Subject(s)
Adolescent Health , Anxiety/epidemiology , COVID-19 , Depression/epidemiology , Health Status , Mental Health , Pandemics , Adolescent , Anxiety/etiology , COVID-19/psychology , Depression/etiology , Depressive Disorder/epidemiology , Depressive Disorder/etiology , Female , Humans , Male , Norway/epidemiology , Odds Ratio , SARS-CoV-2 , Self Report , Sports
16.
Malawi Med J ; 33(1): 54-58, 2021 03.
Article in English | MEDLINE | ID: covidwho-1369850

ABSTRACT

Background: Several studies have been published on the topic of COVID-19 and pregnancy over recent months. However, few studies have evaluated the impact of this pandemic on maternal mental health, particularly in low-resource settings. Aim: To determine the prevalence and predictors of COVID-19-related depression, anxiety and stress symptoms among pregnant women. Methods: This was a cross-sectional study that involved 456 pregnant women attending prenatal care at Abakaliki, Nigeria, during the COVID-19 lockdown. These patients were screened for psychological morbidities using the Depression Anxiety and Stress Scale-21 (DASS-21). Results: Severe and extremely severe depression were reported in 7.2% (n=33) and 6.4% (n=29) of participants, respectively. Analysis also revealed that 3.3% (n=15) and 7.7% (n=35) of women had severe and extremely severe anxiety, respectively. In total, 23% (n=105) of the participating women had severe stress while 16.7% (n=76) reported extremely severe stress. Multiparity (2-4) and occupation, such as trading and farming, were predictors of depression whereas grand-multiparity, urban residence, and trading, were identified as predictors of anxiety and stress. Conclusion: Symptoms of depression, anxiety and stress were relatively common among pregnant women during the COVID-19 lockdown in Abakaliki, Nigeria. There is a clear need to integrate screening for depression, anxiety and stress, in existing antenatal care programs so as to identify and prevent long-term adverse psychological outcomes related to the COVID-19 pandemic.


Subject(s)
Anxiety Disorders/epidemiology , COVID-19/epidemiology , Depression/epidemiology , Maternal Health , Pregnancy Complications/epidemiology , Quarantine , Stress, Psychological/epidemiology , Adult , Anxiety Disorders/etiology , COVID-19/complications , Cross-Sectional Studies , Depression/etiology , Female , Humans , Nigeria/epidemiology , Pandemics , Pregnancy , Prevalence , Psychiatric Status Rating Scales , Retrospective Studies , SARS-CoV-2 , Stress, Psychological/etiology
17.
PLoS One ; 16(8): e0256041, 2021.
Article in English | MEDLINE | ID: covidwho-1362088

ABSTRACT

Despite the severe psychological impact of the COVID-19 pandemic, some individuals do not develop high levels of psychological distress and can be termed resilient. Using the ecological resilience model, we examined factors promoting or hindering resilience in the COVID-19 pandemic. Of the 1034 participants (49.9±16.2 years; females 51.2%) from Italian general population, 70% displayed resilient outcomes and 30% reported moderate-severe anxiety and/or depression. A binary regression model revealed that factors promoting resilience were mostly psychological (e.g., trait resilience, conscientiousness) together with social distancing. Conversely, factors hindering resilience included COVID-19-anxiety, COVID-19-related PTSD symptoms, intolerance of uncertainty, loneliness, living with children, higher education, and living in regions where the virus was starting to spread. In conclusion, the ecological resilience model in the COVID-19 pandemic explained 64% of the variance and identified factors promoting or hindering resilient outcomes. Critically, these findings can inform psychological interventions supporting individuals by strengthening factors associated with resilience.


Subject(s)
Anxiety/epidemiology , COVID-19/psychology , Depression/epidemiology , Resilience, Psychological , Adult , Aged , Anxiety/etiology , Cross-Sectional Studies , Depression/etiology , Female , Humans , Italy , Male , Middle Aged , Models, Psychological , Physical Distancing , Risk Factors
18.
PLoS One ; 16(8): e0255774, 2021.
Article in English | MEDLINE | ID: covidwho-1352706

ABSTRACT

INTRODUCTION: Illnesses requiring hospitalization are known to negatively impact psychological well-being and health-related quality of life (HRQoL) after discharge. The impact of hospitalization during the Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) pandemic on psychological well-being and health-related quality of life is expected to be higher due to the exceptional circumstances within and outside the hospital during the pandemic surge. The objective of this study was to quantify psychological distress up to three months after discharge in patients hospitalized during the first coronavirus disease 2019 (COVID-19) pandemic wave. We also aimed to determine HRQoL, to explore predictors for psychological distress and HRQoL, and to examine whether psychological distress was higher in COVID-19 confirmed patients, and in those treated in Intensive Care Units (ICUs). METHODS: In this single-center, observational cohort study, adult patients hospitalized with symptoms suggestive of COVID-19 between March 16 and April 28, 2020, were enrolled. Patients were stratified in analyses based on SARS-CoV-2 PCR results and the necessity for ICU treatment. The primary outcome was psychological distress, expressed as symptoms of post-traumatic stress disorder (PTSD), anxiety, and depression, up to three months post-discharge. Health-related quality of life (HRQoL) was the secondary outcome. Exploratory outcomes comprised predictors for psychological distress and HRQoL. RESULTS: 294 of 622 eligible patients participated in this study (median age 64 years, 36% female). 16% and 13% of these patients reported probable PTSD, 29% and 20% probable anxiety, and 32% and 24% probabledepression at one and three months after hospital discharge, respectively. ICU patients reported less frequently probable depression, but no differences were found in PTSD, anxiety, or overall HRQoL. COVID-19 patients had a worse physical quality of life one month after discharge, and ICU patients reported a better mental quality of life three months after discharge. PTSD severity was predicted by time after discharge and being Caucasian. Severity of anxiety was predicted by time after discharge and being Caucasian. Depression severity was predicted by time after discharge and educational level. CONCLUSION: COVID-19 suspected patients hospitalized during the pandemic frequently suffer from psychological distress and poor health-related quality of life after hospital discharge. Non-COVID-19 and non-ICU patients appear to be at least as affected as COVID-19 and ICU patients, underscoring that (post-)hospital pandemic care should not predominantly focus on COVID-19 infected patients.


Subject(s)
COVID-19/diagnosis , Psychological Distress , Quality of Life , Adult , Aged , Aged, 80 and over , Anxiety/etiology , COVID-19/complications , COVID-19/epidemiology , COVID-19/virology , Cohort Studies , Depression/etiology , Female , Hospitalization , Humans , Intensive Care Units , Male , Middle Aged , Pandemics , Patient Discharge , SARS-CoV-2/genetics , SARS-CoV-2/isolation & purification , Stress Disorders, Post-Traumatic/etiology
19.
PLoS One ; 16(8): e0255183, 2021.
Article in English | MEDLINE | ID: covidwho-1346328

ABSTRACT

BACKGROUND: The 2019 coronavirus disease (COVID-19) pandemic resulted in the closure of businesses and schools, the remote provision of services and the disruption of the services of professional childminders. These disruptions resulted in a significant increase in parental responsibility for childcare. Such a substantial increase in time requirements for childcare domestically has potential mental health consequences. We therefore ascertained the relationship between childcare and depression in South Africa during the pandemic. METHODS: Data came from the National Income Dynamics Study-Coronavirus Rapid Mobile Survey, a longitudinal telephonic survey conducted during the COVID-19 pandemic in South Africa. The outcome was a depression index obtained from the two-item Patient Health Questionnaire while the main covariate was the average number of hours spent in taking care of children per weekday. We employed the ordered logit model. FINDINGS: We found a positive relationship between spending more hours on childcare and worse depressive health for caregivers in both periods analyzed. Childcare responsibilities preventing/mitigating the ability of caregivers to work as well as preventing caregivers from searching for jobs moderated the depression-childcare relationship. CONCLUSION: These findings highlight the need to carefully consider policy responses aimed at containing the pandemic. We advocate a multi-stakeholder approach to mitigating the mental health impact of COVID-19 by encouraging more collaboration between government, school authorities, employers and parents/guardians.


Subject(s)
COVID-19 , Child Care , Depression/etiology , Adolescent , Adult , COVID-19/epidemiology , Caregivers , Child , Child, Preschool , Female , Humans , Infant , Male , Pandemics , South Africa/epidemiology
20.
Eur J Gen Pract ; 27(1): 184-190, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1334099

ABSTRACT

BACKGROUND: Healthcare professionals (HCPs) in family medicine (FM) in Croatia work in a demanding environment caused by the SARS-CoV-2 pandemic. Besides particular circumstances in healthcare, an unknown virus, social distancing, and homeschooling, the capital was hit with the earthquake during the lockdown. OBJECTIVES: To assess the prevalence of stress, anxiety, depression, posttraumatic stress disorder (PTSD) and the influence of demographic characteristics, professional differences, medical history, and specific stressors on the psychological outcomes. METHODS: A cross-sectional study with the online questionnaire containing the Depression, Anxiety and Stress Scale (DASS-21) and the Impact of Event Scale-Revised (IES-R) was conducted from 1st to 15 May 2020 in FM. RESULTS: HCPs (534, 35% response rate), predominantly female (84.5%), participated in the research. High prevalence of stress (30.9%), anxiety (33.1%), depression (30.7%), and PTSD (33.0%) were found. Female participants had higher results in the anxiety subscale of DASS-21 and IES-R scores. Pre-existing conditions were associated with higher levels of stress, anxiety, depression, and PTSD. The IES-R score for PTSD showed borderline correlation (p = 0.053) with working in regions with the highest incidence of COVID-19. Having schoolchildren made a difference on a stress subscale in DASS-21 (p < 0.043), but the earthquake did not have an impact. CONCLUSION: Family physicians and nurses in FM in Croatia are under a great mental load during the COVID-19 outbreak. Results suggest that HCPs of the female sex, with pre-existing chronic conditions, work in regions with a high incidence of SARS-CoV-2 or have schoolchildren at greater risk of the poor psychological outcome.


Subject(s)
Anxiety/etiology , COVID-19/psychology , Depression/etiology , Nurses/psychology , Occupational Stress/etiology , Physicians, Family/psychology , Stress Disorders, Post-Traumatic/etiology , Adolescent , Adult , Anxiety/diagnosis , Anxiety/epidemiology , COVID-19/epidemiology , COVID-19/prevention & control , Croatia/epidemiology , Cross-Sectional Studies , Depression/diagnosis , Depression/epidemiology , Disasters , Disease Outbreaks/prevention & control , Earthquakes , Female , Health Surveys , Humans , Logistic Models , Male , Middle Aged , Occupational Stress/diagnosis , Occupational Stress/epidemiology , Prevalence , Psychological Tests , Risk Factors , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/epidemiology , Young Adult
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