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1.
medrxiv; 2023.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2023.01.24.23284959

ABSTRACT

After the deleterious effects of the COVID-19 pandemic on healthcare worker mental health, we tested the effectiveness of an interactive chatbot, Vitalk, for improving wellbeing and resilience among healthcare workers in Malawi, a country with few mental health professionals. We conducted a randomized, controlled trial (RCT) to investigate our hypothesis that Vitalk is more effective in improving mental health and resilience outcomes than passive Internet resources. For our 2-arm, 8-week, parallel RCT (ISRCTN Registry: trial ID ISRCTN16378480 ), we recruited participants from 8 professional cadres from public and private healthcare facilities. The treatment arm used Vitalk; the control arm received links to Internet resources. Of 1,584 participants, 512 completed baseline and endline assessments. Six assessments provided outcome measures for: anxiety (GAD-7); depression (PHQ-9); burnout (OLBI); loneliness (ULCA); resilience (RS-14); and resilience-building activities. We analyzed effectiveness using mixed-effects linear models, effect size estimates, and reliable change in risk levels. Results from mixed-model analyses support our hypothesis. Difference-in-differences estimators showed that Vitalk reduced: depression (-0.68 [95% CI -1.15 to -0.21]); anxiety (-0.44 [95% CI -0.88 to 0.01]); and burnout (-0.58 [95% CI -1.32 to 0.15]). Changes in resilience (1.47 [95% CI 0.05 to 2.88]) and resilience-building activities (1.22 [95% CI 0.56 to 1.87]) were significantly greater in the treatment group. We observed no treatment effect on loneliness. Our RCT produced a medium effect size. This is the first RCT of a mental health app for healthcare workers during the pandemic in Southern Africa combining multiple mental wellbeing outcomes, and measuring resilience and resilience-building activities. A significant number of participants could have benefited from mental health support (1 in 8 reported anxiety and depression; 3 in 4 suffered burnout; and 1 in 4 had low resilience). Such help is not readily available in Malawi. Vitalk has the potential to fill this gap.


Subject(s)
Depressive Disorder , COVID-19 , Anxiety Disorders , Retinoschisis
2.
medrxiv; 2023.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2023.01.27.23285082

ABSTRACT

Background: New SARS-CoV-2 variants have emerged and COVID-19 is still a public health issue, especially for vulnerable groups such as people with chronic medical conditions. Objective: To investigate the impact of COVID-19-related burnout on COVID-19 vaccination intention in cardiac patients. Moreover, we investigated other possible demographic and psychological predictors of vaccination intention in cardiac patients. Methods: We conducted a cross-sectional study in Greece using a convenience sample. Data collection was performed from 20 November 2022 to 10 January 2023. We measured demographic data, COVID-19-related burnout, anxiety, depression, social support, and resilience. We used the following valid tools: COVID-19 burnout scale, Patient Health Questionnaire-4, Multidimensional Scale of Perceived Social Support, and Brief Resilience Scale. Results: Among patients, 45.8% were willing to accept a COVID-19 booster dose, 25.3% were hesitant, and 28.9% were unwilling. Patients experienced moderate levels of COVID-19-related burnout. After multivariable linear regression analysis, we found that increased age and decreased emotional exhaustion due to COVID-19 were associated with increased vaccination intention. Moreover, patients who have already received a booster dose had also a greater willingness to accept a new booster dose. Conclusions: Identification of factors that influence patients decision to accept a COVID-19 booster dose is crucial to maintain a high vaccination coverage rate among them in order to avoid COVID-19-related outcomes. Since a COVID-19 booster dose on an annual basis seems to be necessary policy makers should develop and implement vaccination programmes tailored for patients.


Subject(s)
Depressive Disorder , COVID-19 , Heat Exhaustion , Anxiety Disorders
3.
medrxiv; 2023.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2023.01.24.23284906

ABSTRACT

The present study analyzes the effects on depression levels of each containment phase of the first wave of COVID-19 in a cohort of adults with a history of major depressive disorder (MDD). This analysis is part of the Remote Assessment of Disease and Relapse-MDD (RADAR-MDD) study. Depression was evaluated with the Patient Health Questionnaire-8 (PHQ-8) and anxiety with the Generalized Anxiety Disorder-7 (GAD-7). A total of 121 participants from Catalonia were registered from November 1, 2019, to October 16, 2020. Levels of depression were explored across the phases (pre-lockdown, lockdown, four post-lockdown phases) of the restrictions imposed by the Spanish/Catalan governments. Then, a mixed model was fitted to estimate how depression varied over the phases. A significant rise in the depressive severity was found during the lockdown and phase 0 (early post-lockdown), as compared with pre-lockdown phase in this sample with a history of MDD. Those with low pre-lockdown depression experienced a higher increase in depression levels during the new-normality. We observed a significant decrease in the depression levels during the new-normality in those with high pre-lockdown depression, compared to the pre-lockdown period. These findings suggest that COVID-19 restrictions impacted on the depression of individuals diagnosed with MDD, depending on their pre-lockdown depression levels.


Subject(s)
Depressive Disorder , COVID-19 , Anxiety Disorders , Depressive Disorder, Major
4.
researchsquare; 2023.
Preprint in English | PREPRINT-RESEARCHSQUARE | ID: ppzbmed-10.21203.rs.3.rs-2506091.v1

ABSTRACT

Background: During the COVID-19 pandemic, individuals with pre-existing mental health problems may have experienced additional stress, which could worsen symptoms or trigger relapse. Objective: To investigate if the number of consultations with general practitioners (GPs) among individuals with a pre-existing common mental health problem during the pandemic differed from pre-pandemic years. Methods: Data on consultations with GPs among 18-65-year-olds registered with common mental health problems in 2017-2021 were retrieved from the Norwegian Control and Payment of Health Reimbursement register. Based on data from the pre-pandemic years (2017-2019), we predicted the number of consultations per week for depression, anxiety disorder, phobia/obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and eating disorders during the pandemic (March 2020-December 2021) among individuals with pre-existing mental health problems. The forecasted and observed trends in GP consultations per week during the pandemic were stratified by diagnosis, gender, and age groups. Results: The observed number of consultations for anxiety disorder, PTSD, and eating disorders were significantly higher than forecasted during extended periods of the two pandemic years. The differences were largest for PTSD (on average 37% higher in men and 47% higher in women during the pandemic), and for eating disorders among women (on average 87% higher during the pandemic). There were only minor differences between the predicted and observed number of consultations for depression and phobia/OCD. Conclusions: During the pandemic, individuals with a recent history of mental health problems were more likely to seek help for anxiety disorder, PTSD, and eating disorders, as compared to pre-pandemic years.


Subject(s)
Stress Disorders, Post-Traumatic , Obsessive-Compulsive Disorder , Feeding and Eating Disorders , COVID-19 , Stress Disorders, Traumatic , Depressive Disorder , Anxiety Disorders , Phobic Disorders
5.
researchsquare; 2023.
Preprint in English | PREPRINT-RESEARCHSQUARE | ID: ppzbmed-10.21203.rs.3.rs-2502382.v1

ABSTRACT

Objectives to assess the levels of anxiety, depression, stress and fear of COVID-19 in non-syndromic cleft lip and/or palate (NSCL/P) children parents and caregivers.Materials and Methods Cross-sectional case-control study conducted at a Craniofacial Anomalies Rehabilitation Center, Brazil. Non-probabilistic convenience sampling was used and data were collected between October 2021 and November 2022. Variables were assessed by Depression, Anxiety and Stress Scale (DASS-21) and Fear of COVID-19 Scale (FC-19S). Pearson's chi-square test and multivariate binary logistic regression model have been performed.Results Data were obtained of 80 NSCL/P parents group and 130 by control group. Severe symptoms were higher in NSCL/P parents indicated by rates (8.8% vs 69% to anxiety; 12.5% vs 8.5% to depression and 17.5% vs 10.0% to stress). As for the predilection in case group there was an association (p < 0.05) for manifestation of mild stress (OR: 4.09; 95%CI 1.28–13.06). Control group caregivers were more fear of COVID-19 (43.8% vs 28.7% p < 0.05).Conclusion There were no significant differences in anxiety, depression, and stress levels between groups. NSCL/P children parents and caregivers were less fear of COVID-19. There is a predilection for severe symptoms in the case group.Clinical Relevance: This is the first cross-sectional study analyzing fear of COVID-19 in NSCL/P children parents and caregivers. These people should receive greater attention by multiprofessional team due to the predisposition of illness in mental health.


Subject(s)
Craniofacial Abnormalities , COVID-19 , Depressive Disorder , Anxiety Disorders
6.
medrxiv; 2023.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2023.01.20.23284600

ABSTRACT

China was the first country affected by the COVID-19 virus and it reacted strongly in the first months of 2020. This paper presents new evidence on the deterioration in mental health in China between 2018 and 2020. Using two waves of the China Family Panel Studies (CFPS) we can follow the same individuals pre and during the pandemic periods. We find clear evidence of a moderate level of mental health deterioration between 2018 and 2020. The prevalence of severe cases of depression, measured using an eight-item version of the common CES-D scale, increased from 6.33% in 2018 to 7.54% in 2020; quantifiable as around a 19% increase. This deterioration is higher for individuals who are subject to strict lockdowns, about 0.3 symptoms more on average, and it is stronger among those who already reported symptoms of depression in the 2018 wave of data. The effects we find are larger for individuals with more open personalities: one standard deviation of the Openness trait corresponds to 0.08 more symptoms, while more Neurotic individuals do not seem to be more affected. Younger cohorts and individuals with lower levels of education are more affected. Males seem slightly more affected than females, although this difference is statistically non-significant.


Subject(s)
Depressive Disorder , COVID-19 , Neurotic Disorders
7.
medrxiv; 2023.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2023.01.13.23284501

ABSTRACT

This article is an examination of the acts of discriminiation and hate crimes against the Asian American community and how their mental health has been impacted. The historical examination of acts against the Asian American community stem from acts against the Asian American community during both the yellow peril and the Roosevelt Era. Alongside current day institutionalized policies that are propagated by the media, the resurrection of historical tropes further act to seclude Asian Americans from mainstream society. These acts of seclusion further drive mental health inequality in Asian American society that include, but are not limited to: anxiety, depression, and psychological stress. These mental health inequalities are further subdivided into different ethnic groups that worsen as data is collected from older generations. More recently, COVID-19 has brought forth an upsurge in hate crimes that has only worsened the ability of Asian American youth to fully develop a racial identity; the upsurge in hate crimes is also coupled with invalidation of interethnic differences and invalidation of their discriminatory experiences. The synthesis of current day research will aid in the understanding of the mental health inequality in the Asian American community and aid in further studies that can address these plights.


Subject(s)
COVID-19 , Depressive Disorder , Anxiety Disorders , Sexual Dysfunctions, Psychological
8.
biorxiv; 2023.
Preprint in English | bioRxiv | ID: ppzbmed-10.1101.2023.01.15.524078

ABSTRACT

Background: Depression and dysosmia have been regarded as the main neurological symptoms in COVID-19 patients, the mechanism of which remains unclear. Current studies have demonstrated that SARS-CoV-2 envelope protein served as a pro-inflammatory factor as sensed by Toll like receptor 2 (TLR2), suggesting the viral infection independent pathological feature of E protein. In this study, we aim to determine the role of E protein in depression, dysosmia and associated neuroinflammation in central nervous system (CNS). Methods: Depression and olfactory function were observed in both female and male mice as receiving intracisternal injection of envelope protein. Immunohistochemistry was applied in conjunction with RT-PCR to assess the glial activation, blood-brain barrier status and mediators synthesis in cortex, hippocampus and olfactory bulb. TLR2 was pharmacologically blocked to determine its role in E protein related depression and dysosmia. Results: Intracisternal injection of envelope protein evoked depression and dysosmia in both female and male mice. Immunohistochemistry suggested that envelope protein upregulated IBA1 and GFAP in cortex, hippocampus and olfactory bulb, while ZO-1 was downregulated. Moreover, IL-beta, TNF-alpha, IL-6, CCL2, MMP2 and CSF1 were upregulated in both cortex and hippocampus, whereas IL-beta, IL-6 and CCL2 were upregulated in olfactory bulb. Furtherly, inhibiting microglia, but not astrocyte, alleviated depression and dysosmia induced by envelope protein. Finally, RT-PCR and immunohistochemistry suggested that TLR2 was upregulated in cortex, hippocampus and olfactory bulb, the blocking of which mitigated depression and dysosmia induced by envelope protein. Conclusions: Our study demonstrates that envelope protein could directly induce depression and dysosmia together with obvious neuroinflammation in CNS. TLR2 mediated depression and dysosmia induced by envelope protein, which could serve as a promising therapeutic target for neurological manifestation in COVID-19 patients.


Subject(s)
COVID-19 , Olfaction Disorders , Depressive Disorder
9.
medrxiv; 2023.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2023.01.09.23284380

ABSTRACT

Purpose: Lesbian, gay, bisexual, transgender, queer, and other persons outside of heteronormative and cisgender identities (LGBTQ+) and ethnic/racial minority populations are at heightened vulnerability amid the Covid-19 pandemic. Systemic marginalization and resulting adverse social determinants of health contribute to health disparities among these populations that result in more severe consequences due to Covid-19 and the public health measures to control it. We developed and tested a tailored online intervention (#SafeHandsSafeHearts) to support ethnoracially diverse LGBTQ+ individuals in Toronto, Canada amid the pandemic. Methods: We used a quasi-experimental pre-test post-test design to evaluate the effectiveness of a 3-session, peer-delivered eHealth intervention in reducing psychological distress and increasing Covid-19 knowledge and protective behaviors. Individuals [≥]18-years-old, resident in Toronto, and self-identified as sexual or gender minority were recruited online. Depressive and anxiety symptoms, Covid-19 knowledge and protective behaviors were assessed at baseline, 2-weeks postintervention, and 2-months follow-up. We used generalized estimating equations and zero-truncated Poisson models to evaluate the effectiveness of the intervention on the four primary outcomes. Results: From March to November 2021, 202 participants (median age, 27 years [Interquartile rage: 23-32]) were enrolled in #SafeHandsSafeHearts. Over half (54%, n=110) identified as cisgender lesbian or bisexual women or women who have sex with women, 26.2% (n=53) cisgender gay or bisexual men or men who have sex with men, and 19.3% (n=39) transgender or nonbinary individuals. The majority (75.7%, n=143) were Black and other people of color. The intervention led to statistically significant reductions in the prevalence of clinically significant depressive and anxiety symptoms, and increases in Covid-19 protective behaviors from baseline to postintervention. Conclusion: We demonstrated the effectiveness of a brief, peer-delivered eHealth intervention for ethnoracially diverse LGBTQ+ communities in reducing psychological distress and increasing protective behaviors amid the Covid-19 pandemic. Implementation through community-based health services with trained peer educators supports feasibility, acceptability, and the importance of engaging ethnoracially diverse LGBTQ+ communities in pandemic response preparedness. This trial is registered with ClinicalTrials.gov, number NCT04870723.


Subject(s)
Depressive Disorder , COVID-19 , Anxiety Disorders , Sexual Dysfunctions, Psychological
10.
medrxiv; 2023.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2023.01.10.23284300

ABSTRACT

Introduction: The Covid-19 pandemic brought forward unprecedented psycho-social challenges for the world. The devastating loss of human lives created a burden of grief throughout the world. The bereaved were put at a greater risk of grief complications with high death tolls, strict social isolation guidelines and a halt to communal funeral practices. Prolonged Grief Disorder is a young psychiatric condition which refers to an abnormal grief reaction that exceeds the normal cultural, social and religious norms. In this study, we assessed the prevalence of Prolonged Grief Disorder (PGD), as mentioned in ICD-11 in Pakistan, along with its correlation to anxiety, depression and psychological distress. Severity of grief reactions were compared with the place of death and relationship with the deceased. Methods: A cross sectional online survey was conducted during the month of October 2021. Sample size was calculated using OpenEpi and data was collected through non probability sampling. The questionnaire was validated and shared through multiple social forums. A total of 737 participants residing in Lahore Pakistan, who had lost a close one due to Covid-19 participated in the study. Demographics, loss related information, and self-reported symptoms measured by 13-item Prolonged Grief Disorder Scale, Patient Health Questionnaire-4 and Kessler-6 scales were obtained. Results:The prevalence of Prolonged Grief Disorder was found to be 15.4%. There was a significant correlation of grief intensity with depression and anxiety.Prolonged Grief Disorder puts individuals at greater risk of suffering from serious mental illnesses. People who were closely related to the deceased were more likely to experience severe Prolonged Grief Disorder symptoms. Conclusion: Early detection and treatment of high risk individuals is necessary to mitigate the burden of grief and associated risk of anxiety and depression. Overall we conclude that discussions pertaining to grief and measures to curb the psychological effects are crucial in the post-pandemic world.


Subject(s)
Mental Disorders , Pregnancy, Prolonged , Congenital, Hereditary, and Neonatal Diseases and Abnormalities , COVID-19 , Depressive Disorder , Anxiety Disorders , Death
11.
medrxiv; 2023.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2023.01.06.23284202

ABSTRACT

BACKGROUND: Long Covid is a widely recognised consequence of COVID-19 infection, but little is known about the burden of symptoms that patients present with in primary care, as these are typically recorded only in free text clinical notes. Our objectives were to compare symptoms in patients with and without a history of COVID-19, and investigate symptoms associated with a Long Covid diagnosis. METHODS: We used primary care electronic health record data from The Health Improvement Network (THIN), a Cegedim database. We included adults registered with participating practices in England, Scotland or Wales. We extracted information about 89 symptoms and 'Long Covid' diagnoses from free text using natural language processing. We calculated hazard ratios (adjusted for age, sex, baseline medical conditions and prior symptoms) for each symptom from 12 weeks after the COVID-19 diagnosis. FINDINGS: We compared 11,015 patients with confirmed COVID-19 and 18,098 unexposed controls. Only 20% of symptom records were coded, with 80% in free text. A wide range of symptoms were associated with COVID-19 at least 12 weeks post-infection, with strongest associations for fatigue (adjusted hazard ratio (aHR) 3.99, 95% confidence interval (CI) 3.59, 4.44), shortness of breath (aHR 3.14, 95% CI 2.88, 3.42), palpitations (aHR 2.75, 95% CI 2.28, 3.32), and phlegm (aHR 2.88, 95% CI 2.30, 3.61). However, a limited subset of symptoms were recorded within 7 days prior to a Long Covid diagnosis in more than 20% of cases: shortness of breath, chest pain, pain, fatigue, cough, and anxiety / depression. INTERPRETATION: Numerous symptoms are reported to primary care at least 12 weeks after COVID-19 infection, but only a subset are commonly associated with a GP diagnosis of Long Covid.


Subject(s)
Chest Pain , COVID-19 , Pain , Dyspnea , Depressive Disorder , Anxiety Disorders , Fatigue
12.
medrxiv; 2023.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2023.01.06.23284199

ABSTRACT

As the coronavirus (COVID-19) pandemic approaches the three-year mark and the number of confirmed COVID-19 cases now exceeds 100 million cases in the United States and continues to climb, there have been increasing concerns raised over the future public health and economic burden of long COVID including disability and concomitant declines in labor force participation. Only a handful of US studies have explored sociodemographic and socioeconomic characteristics that may put people at risk of long COVID or have investigated the possible mental health and socioeconomic sequelae of long COVID. In this paper, I report findings from the largest multivariable analysis to date using US nationally-representative population-based data on 152,812 adults including 19,871 adults with long COVID to explore key predictors and sequelae of long COVID. An estimated 14.0% of US adults aged 18-84 years (34.55 million adults; 95% CI = 33.63 to 35.47 million adults) and 15.4% of US working-aged adults aged 18-64 years (31.14 million adults; 95% CI = 30.26 to 32.02 million adults) had developed long COVID by November 2022. I identify several sociodemographic and socioeconomic factors as predictors of long COVID including lower household income levels, being Hispanic, female, gay/lesbian or bisexual, and divorced or separated. Even after accounting for such factors, having long COVID was linked to higher risks of recent unemployment, financial hardship, and anxiety and depressive symptomatology, with evidence of dose-response relationships. Overall, an estimated 27.3 million US adults with long COVID were at risk of adverse socioeconomic and health outcomes including anxiety and depression. These preliminary estimates highlight the substantial public health and economic implications of long COVID among Americans and should prompt further inquiry and intervention.


Subject(s)
Depressive Disorder , COVID-19 , Labor Pain , Anxiety Disorders
13.
researchsquare; 2023.
Preprint in English | PREPRINT-RESEARCHSQUARE | ID: ppzbmed-10.21203.rs.3.rs-2454273.v1

ABSTRACT

Purpose The present study was designed to evaluate the risk perception of being infected by SARS-CoV-2 in elderly people, what preventive measures they took and to examine the role of perceived risk in preventive behaviors toward COVID-19 in this population.Methods Data was collected by telephone interviews, April 15th to April 30th, 2020 during the first COVID-19 outbreak in Portugal. Participants were asked their opinion about the level of risk they thought they were exposed to regarding infection with SARS-CoV-2 and what preventive measures they took to protect themselves. Spearman's correlation was used to assess the relationship between risk perception and number of preventive measures taken.Results Our sample consisted of 85 participants from the “Covilhã Aging Study” with a mean age of 79.54 years (SD = 5.04). 36.5% of our participants reported their perception of risk as being “ high or very high”, and men more often than women perceived this risk as “high or very high”. Risk perception is positively associated with age (rS=0.289, p = 0.004), depression (rS=0.281, p = 0.005) and number of preventive measures taken (rS=0.178, p = 0.05). Most participants (94.1%) reported that they stayed at home as much as possible, 49.4% wore a facemask, 55.3% washed hands and 17.6% weared gloves. 55.3% considered age as a vulnerability factor.Conclusion Risk perception could contribute to explain the adoption of preventive measures in elderly people. The capacity to assume preventive measures in this group suggests that they are able to take care of themselves, and that forceful confinements may not be needed. The results of this study can be used by health policy makers to focus on effective risk communication, especially for vulnerable groups such as the elderly.


Subject(s)
Depressive Disorder , COVID-19
14.
researchsquare; 2023.
Preprint in English | PREPRINT-RESEARCHSQUARE | ID: ppzbmed-10.21203.rs.3.rs-2452500.v1

ABSTRACT

Background: Strict quarantine is an effective measure to prevent the spread of the Coronavirus disease (COVID-19) pandemic, but it probably increases the risk of anxiety and depression. We aimed to evaluate the anxiety and depression among quarantined college students at school during the COVID-19 pandemic and investigate whether gastrointestinal discomfort related-factors and skipping breakfast lead to increased risk of anxiety and depression. Methods: 384 quarantined college students in Shanghai China were recruited in this cross-sectional study from April 5th to May 29th, 2022. Generalized Anxiety Disorder (GAD-7) and Patient Health Questionnaire (PHQ-9) were used to assess anxiety and depression, respectively.Results: The prevalence of anxiety and depression were 56.8% and 62.8%, respectively. Longer quarantine duration, higher education level, skipping breakfast, stomachache or abdominal pain, and nausea or dyspepsia were the risk factors for anxiety. Moreover, longer quarantine duration, being woman, skipping breakfast, stomachache or abdominal pain, and nausea or dyspepsia increased the risk of depression. Notably, regularly physical exercising and taking positive attitude towards COVID-19 can reduce the risk of anxiety and depression. Conclusions: More attention should be paid to anxiety and depression of quarantined college students and universities should provide timely psychological monitoring and intervention services to mitigate the impact of negative emotions on students. And effectively relieving gastrointestinal symptoms, insisting on eat breakfast, regularly exercising, and taking a positive attitude towards to COVID-19 might contribute to preventing the anxiety and depression for those college students experiencing a long-term quarantine.


Subject(s)
Signs and Symptoms, Digestive , Coronavirus Infections , COVID-19 , Abdominal Pain , Depressive Disorder , Anxiety Disorders , Dyspepsia , Nausea
15.
researchsquare; 2023.
Preprint in English | PREPRINT-RESEARCHSQUARE | ID: ppzbmed-10.21203.rs.3.rs-2440390.v1

ABSTRACT

Background:The COVID-19 pandemic has had a widespread impact on sleep quality, yet little is known about the prevalence of sleep disturbance and its impact on self-management of chronic conditions during the ongoing pandemic. Objective: To evaluate trajectories of sleep disturbance, and their associations with one’s capacity to self-manage chronic conditions. Design: A longitudinal cohort study linked to 3 active clinical trials and 2 cohort studies with 5 time points of sleep data collection (July 15, 2020 – May 23, 2022). Participants: Adults living with chronic conditions who completed sleep questionnaires for two or more time points. Exposure: Trajectories of self-reported sleep disturbance across 5 time points. Main Outcomes: 3 self-reported measures of self-management capacity, including subjective cognitive decline, medication adherence, and self-efficacy for managing chronic disease. Results: 549 adults aged 23 to 91 years were included in the analysis. Two thirds had 3 or more chronic conditions; 42.4% of participants followed a trajectory of moderate or high likelihood of persistent sleep disturbance across the study period. Moderate or high likelihood of sleep disturbance was associated with older age (RR 1.57, 95% CI 1.09, 2.26, P<.05), persistent stress (RR 1.54, 95% CI 1.16, 2.06, P=.003), poorer physical function (RR 1.57, 95% CI 1.17, 2.13, P=.003), greater anxiety (RR 1.40, 95% CI 1.04, 1.87, P=.03) and depression (RR 1.63, 95% CI 1.20, 2.22, P=.002). Moderate or high likelihood of sleep disturbance was also independently associated with subjective cognitive decline, poorer medication adherence, and worse self-efficacy for managing chronic diseases (all P<.001). Conclusions: Persistent sleep disturbance during the pandemic may be an important risk factor for inadequate chronic disease self-management and potentially poor health outcomes in adults living with chronic conditions. Public health and health system strategies might consider monitoring sleep quality in adults with chronic conditions to optimize health outcomes.


Subject(s)
Ossification of Posterior Longitudinal Ligament , Chronic Disease , Cognition Disorders , Sleep Wake Disorders , COVID-19 , Depressive Disorder , Anxiety Disorders
16.
preprints.org; 2022.
Preprint in English | PREPRINT-PREPRINTS.ORG | ID: ppzbmed-10.20944.preprints202212.0578.v1

ABSTRACT

Background: The global prevalence of anxiety and depressive symptoms in adolescents has increased considerably during the COVID-19 pandemic. Mental health problems may compromise glycemic control in young people with type 1 diabetes; however, evidence of improved glycemic control in adolescents with T1D appeared early during the pandemic. This qualitative study aimed to provide a more in-depth understanding of how the COVID-19 pandemic affected adolescents with type 1 diabetes routines, experiences, T1D management, behaviors, and mental health. Methods: 24 adolescents, aged 15-18 years, with DM1, joined the discussion of focus groups in the context of the summer camp for diabetes. Word frequency and thematic analysis were conducted on adolescents’ narratives. Results: The word Frequency Analysis identified 'friends', 'family', and 'home' as the most frequent terms. Seven themes were identified: (1) COVID-19 and T1D; (2) emotional reactions to the COVID-19 pandemic; (3) changes in daily life; (4) feelings of loss; (5) coping with the COVID-19 pandemic; (6) the COVID-19 pandemic as an opportunity; (7) return to (new) normality. Conclusions The COVID-19 pandemic may have represented a more stressful condition for adolescents with DM1, facing additional challenges compared to their healthy peers. The results offer directions to the diabetes care team for a customized intervention while the consequences of the pandemic on adolescents’ health continue.


Subject(s)
COVID-19 , Memory Disorders , Depressive Disorder , Anxiety Disorders , Diabetes Mellitus
17.
medrxiv; 2022.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2022.12.28.22284012

ABSTRACT

Background An increase in mental health problems has been reported since the beginning of the COVID-19 pandemic. However, little is known about the prevalence of depressive and anxiety disorders, and how recent COVID-19 diagnosis may influence risk of these conditions especially in low-income settings. In this study, we assessed the association between recent COVID-19 diagnosis and depressive and anxiety symptoms among residents in an urban slum setting in Uganda. Methods A cross-sectional study was conducted among 284 individuals in a slum settlement in Kampala, Uganda between April and May 2022. We assessed generalized anxiety and depression symptoms using two validated questionnaires. We collected data on sociodemographic characteristics, and self-reported recent COVID-19 diagnosis (in the previous 30 days). Using a modified Poisson regression, adjusted for age, sex, gender and household income, we separately provided prevalence ratios and 95% confidence intervals for the associations between recent COVID-19 diagnosis and depressive and anxiety symptoms. Results Overall, 33.8% and 13.4% of the participants met the depression and generalized anxiety screening criteria respectively. People with recent COVID-19 diagnosis were more likely to be depressed (53.1%) than those with no recent diagnosis (31.4%). Participants who were recently diagnosed with COVID-19 reported higher prevalence of anxiety (34.4%) compared to those with no recent diagnosis of COVID-19 (10.7%). After adjusting for confounding, recent diagnosis with COVID-19 was associated with depression (PR= 1.60, 95% CI 1.09 - 2.34) and anxiety (PR = 2.83, 95% CI 1.50 - 5.31) . Conclusion This study suggests an increased risk of depressive symptoms and GAD in adults following a COVID-19 diagnosis. We recommend additional mental health support for recently diagnosed persons. The long-term of COVID-19 on mental health effects also need to be investigated.


Subject(s)
Depressive Disorder , COVID-19 , Anxiety Disorders
18.
researchsquare; 2022.
Preprint in English | PREPRINT-RESEARCHSQUARE | ID: ppzbmed-10.21203.rs.3.rs-2423920.v1

ABSTRACT

Background COVID-19 infection continues all over the world, causing serious physical and psychological impacts to patients. Patients with COVID-19 infection suffer from various negative emotional experiences such as anxiety, depression, mania, and alienation, which seriously affect their normal life and is detrimental to the prognosis. Our study is aimed to investigate the effect of psychological capital on alienation among patients with COVID-19 and the mediating role of social support in this relationship.Methods The data were collected in China by the convenient sampling method. A sample of 259 COVID-19 patients completed the psychological capital, social support and social alienation scale and the structural equation model was adopted to verify the research hypotheses.Results Psychological capital was significantly and negatively related to the COVID-19 patients’ social alienation (p < .01). And social support partially mediated the association between psychological capital and patients’ social alienation (p < .01).Conclusion Psychological capital is critical to predicting COVID-19 patients’ social alienation. Social support plays an intermediary role and explains how psychological capital alleviates the sense of social alienation among patients with COVID-19 infection.


Subject(s)
Tooth, Impacted , Bipolar Disorder , COVID-19 , Depressive Disorder , Anxiety Disorders
19.
medrxiv; 2022.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2022.12.23.22283884

ABSTRACT

Background: Some studies have identified declines in mental health over the course of the COVID-19 pandemic across the world and in different age groups, including older people. As anxiety and depression are common neuropsychiatric symptoms among people with dementia or mild cognitive impairment, the mental health experiences of older people during the pandemic should therefore take cognitive function into consideration. This should also be examined using quantitative measures that were assessed prior to the pandemic. This study addresses such gaps in the evidence base on depression and anxiety among older people with cognitive impairment before and throughout the COVID-19 pandemic. Methods and Findings: Using data from the English Longitudinal Study of Ageing (ELSA) collected from 2018/19 to Nov/Dec 2020, we estimated changes in depression and anxiety for people aged 50+ in England across three cognitive function groups: no impairment, mild cognitive impairment, and dementia. We found that depression (measured with CES-D score) worsened from 2018/19 to Nov/Dec 2020 for people with mild cognitive impairment (1.39 (95%CI: 1.29-1.49) to 2.16 (2.02-2.30)) or no impairment (1.17 (95%CI: 1.12-1.22) to 2.03 (1.96-2.10)). Anxiety, using a single-item rating of 0-10 also worsened among those with mild cognitive impairment (2.48 (2.30-2.66) to 3.14 (2.95-3.33)) or no impairment (2.20 (2.11-2.28) to 2.85 (2.77-2.95)). No statistically significant increases were found for those with dementia. Using a clinical cutoff for likely depression (CES-D>=4), we found statistically significant increases in the probability of likely clinical depression between 2018/19 and Nov/Dec 2020 for those with no impairment (0.110 (0.099-0.120) to 0.206 (0.191-0.222)) and those with mild impairment (0.139 (0.120-0.159) to 0.234 (0.204-0.263)). We also found that differences according to cognitive function that existed before the pandemic were no longer present by June/July 2020, and there were no statistically significant differences in depression or anxiety among cognitive groups in Nov/Dec 2020. Conclusions: Our findings on measures collected before and during the pandemic suggest a convergence in mental health across cognitive function groups during the pandemic. This suggests mental health services will need to meet an increased demand that will come from older adults, especially those not living with cognitive impairment or dementia. We also found little significant change in mental health outcomes among those with dementia; as their existing need for support will remain, policymakers and care practitioners will need to ensure this group continues to have equitable access to support for their mental health.


Subject(s)
Cognition Disorders , COVID-19 , Depressive Disorder , Anxiety Disorders , Dementia , Pulmonary Disease, Chronic Obstructive
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researchsquare; 2022.
Preprint in English | PREPRINT-RESEARCHSQUARE | ID: ppzbmed-10.21203.rs.3.rs-2405792.v1

ABSTRACT

In earlier survey research, we observed a severe impact of the first peak of the COVID-19 pandemic on the subjective wellbeing, sleep and activity of adults aged 65 years or older in Flanders, Belgium. The impact on subjective cognitive functioning, however, was limited. Since then, periods of lockdown and periods with less strict regulations alternated, but social distancing remained, especially for older adults. To study the longer-term impact of the pandemic on wellbeing and cognitive functioning, we re-assessed the older adults from the first measurement moment (n = 371) in a second (June-July 2020) and third (December 2020) wave of the survey. Results indicated that wellbeing fluctuated with the severity of the pandemic. Results for self-reported cognitive functioning were mixed. While participants indicated a slightly better general cognitive functioning at the end of the study, experienced problems with most cognitive subdomains significantly increased over time. The presence of depressive and anxiety symptoms influenced the longer-term impact of the pandemic on wellbeing and cognitive functioning. Our study shows the long-lasting impact of the pandemic on the wellbeing and cognitive functioning of older adults, without full recovery from the first wave.


Subject(s)
Depressive Disorder , COVID-19 , Anxiety Disorders
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