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1.
BMJ Open ; 12(1): e047753, 2022 01 11.
Article in English | MEDLINE | ID: covidwho-1622052

ABSTRACT

OBJECTIVES: This study aimed to examine the prevalence of peritraumatic stress symptoms (PTSSs), perceived threat, social support and factors contributing to clinically significant PTSS among frontline COVID-19 healthcare workers (HCWs) in China. DESIGN AND SETTING: An online survey through self-administered questionnaires was conducted from 18 February to 4 March 2020, during the outbreak of COVID-19. OUTCOMES MEASURES: PTSS was assessed using the post-traumatic stress disorder (PTSD) self-rating scale. Demographic and socioeconomic characteristics, self-reported health, physical/psychological symptoms, perceived threat from frontline work and perceived social support were investigated. Multivariable line regression analysis distinguished factors associated with HCWs' PTSS scores. RESULTS: A total of 676 (58.1%) HCWs have shown clinically significant high levels of PTSS. Only 441 (37.9%) self-reported good health. Most had physical symptom(s) (915 (78.7%)), psychological symptom(s) (906 (77.9%)), inability to vent emotions (284 (24.4%)), emotional exhaustion (666 (57.3%)) and 1037 (89.2%) needed professional respect. Moreover, social support received was less than expected, and the receipt of psychological services/help scored the lowest (3.11±1.73). Combined psychological and physical symptoms, difficulty in releasing tension and venting emotions timely, fear of infection, emotional exhaustion and depersonalisation are significantly associated with PTSS scores among frontline HCWs. Working ≥8 hours, having the senior professional title, self-reported health, enjoying perfect protection and control measures, economic subsidy and control policy on reducing discriminatory practices are negatively correlated with PTSS scores. CONCLUSIONS: During the outbreak of COVID-19, frontline HCWs experienced clinically significant high levels of PTSS and heavy workload, and the emergency resulted in their inadequate psychosocial support. If this is left unchecked, HCWs have a higher risk of developing PTSD. Early detection, identification and person-directed, targeted multidisciplinary interventions should be undertaken to address various influencing factors. Comprehensive measures, including setting up emotional release channels, as well as providing psychological and social support intervention for HCWs globally, are highly recommended.


Subject(s)
COVID-19 , Stress Disorders, Post-Traumatic , China/epidemiology , Cross-Sectional Studies , Disease Outbreaks , Health Personnel , Humans , SARS-CoV-2 , Stress Disorders, Post-Traumatic/epidemiology
2.
BMJ Open ; 12(1): e055696, 2022 01 07.
Article in English | MEDLINE | ID: covidwho-1613009

ABSTRACT

BACKGROUND: A growing body of literature shows profound effects of the COVID-19 pandemic on mental health, among which increased rates of post-traumatic stress disorder (PTSD) and adjustment disorder (AD). However, current research efforts have largely been unilateral, focusing on psychopathology and not including well-being, and are dominated by examining average psychopathology levels or on disorder absence/presence, thereby ignoring individual differences in mental health. Knowledge on individual differences, as depicted by latent subgroups, in the full spectrum of mental health may provide valuable insights in how individuals transition between health states and factors that predict transitioning from resilient to symptomatic classes. Our aim is to (1) identify longitudinal classes (ie, subgroups of individuals) based on indicators of PTSD, AD and well-being in response to the pandemic and (2) examine predictors of transitioning between these subgroups. METHODS AND ANALYSIS: We will conduct a three-wave longitudinal online survey study of n≥2000 adults from the general Dutch population. The first measurement occasion takes place 6 months after the start of the pandemic, followed by two follow-up measurements with 6 months of intervals. Latent transition analysis will be used for data analysis. ETHICS AND DISSEMINATION: Ethical approval has been obtained from four Dutch universities. Longitudinal study designs are vital to monitor mental health (and predictors thereof) in the pandemic to develop preventive and curative mental health interventions. This study is carried out by researchers who are board members of the Dutch Society for Traumatic Stress Studies and is part of a pan-European study (initiated by the European Society for Traumatic Stress Studies) examining the impact of the pandemic in 11 countries. Results will be published in peer-reviewed journals and disseminated at conferences, via newsletters, and media appearance among (psychotrauma) professionals and the general public.


Subject(s)
COVID-19 , Stress Disorders, Post-Traumatic , Adjustment Disorders , Adult , Humans , Longitudinal Studies , Pandemics , SARS-CoV-2 , Stress Disorders, Post-Traumatic/epidemiology
3.
Epidemiol Prev ; 45: In press, 2021.
Article in English | MEDLINE | ID: covidwho-1597567

ABSTRACT

OBJECTIVES: to assess the prevalence of post-traumatic stress disorder (PTSD) symptoms in a sample of Italian citizens during the first COVID-19 pandemic wave and its association with sociodemographic characteristics, housing conditions, and lifestyles modifications. DESIGN: cross-sectional survey. SETTING AND PARTICIPANTS: between 21st April and 7th June 2020, a self-administered online questionnaire aiming at investigating mental well-being and lifestyle habits during the lockdown period was disseminated online. Respondents were recruited through a snowball sampling. MAIN OUTCOME MEASURES: PTSD symptoms were assessed using a validated screening tool, the SPAN (Startle, Physiological arousal, Anger, Numbness) questionnaire. RESULTS: the study population is composed of 6,687 participants, of whom 71.5% were females. The mean age of the sample was 48.7 years. Globally, 43.8% of the participants reported symptoms of PTSD, especially females. PTSD prevalence showed a decreasing trend across age groups. The likelihood of PTSD symptoms was higher among those who increased alcohol consumption, decreased physical activity, and experienced restless sleep. CONCLUSIONS: a high prevalence of PTSD symptoms emerged from this survey, especially among women and younger subjects. Preventive strategies should be implemented to protect the mental health of the most vulnerable citizens in a period of emergency.


Subject(s)
COVID-19 , Stress Disorders, Post-Traumatic , Communicable Disease Control , Cross-Sectional Studies , Female , Humans , Italy/epidemiology , Middle Aged , Pandemics , Prevalence , SARS-CoV-2 , Stress Disorders, Post-Traumatic/epidemiology
4.
Inquiry ; 58: 469580211059953, 2021.
Article in English | MEDLINE | ID: covidwho-1598094

ABSTRACT

BACKGROUND: College students are vulnerable and may experience high stress due to COVID-19, especially girls. This study aims to identify posttraumatic stress disorder (PTSD) and related factors among the target population during the initial phases of the COVID-19 pandemic. METHODS: In the initial phase of COVID-19 epidemic (February 23 to March 5, 2020), 2205 female college students from six provinces in mainland China were enrolled in this study and completed the online survey about the cognitive status of COVID-19, including the Impact of Event Scale-6, the Multidimensional Perceived Social Support Scale and a self-developed 10-item Perceived threat scale. Univariate and multivariate logistic regression were performed using SPSS software to explore the determinants of PTSD symptoms. RESULTS: PTSD symptoms were prevalent in female college students, and 34.20% met the cut-off for PTSD. Self-reported fair or poor health (AOR = 1.78, 95% CI: 1.22-2.59), high concern about COVID-19 (AOR = 1.66, 95% CI: 1.35-2.03), beliefs that "COVID-19 can cause a global outbreak" (AOR = 1.26, 95% CI: 1.02-1.56), the perception of "risk of infection" (AOR = 2.46, 95% CI: 2.16-2.81), beliefs that "closed management" and "COVID-19 as a public health emergency of international concern" would have an impact, and the fear of "impact on life planning" were all positively associated with PTSD (AOR = 1.37, 1.22, and 1.29, respectively); however, perceived social support from family (AOR = 0.81, 95% CI: 0.70-0.93) was negatively associated with PTSD. Among the significant variables at the bivariate level, multivariate logistic regression revealed that the greatest protector for PTSD was the high knowledge score (AOR = 0.73, 95% CI: 0.60-0.90), while had confirmed cases among relatives and friends (AOR = 7.70, 95% CI: 1.28-46.25) was the strongest predictor of PTSD. CONCLUSIONS: In summary, PTSD symptoms were prevalent among female college students in China during the COVID-19 epidemic. Targeting vulnerable populations to improve their knowledge about COVID-19 and create an atmosphere of social support would be beneficial. Moreover, the joint efforts from family, school administrators, and policymakers are essential to improve the mental health of the female students during the COVID-19 epidemic.


Subject(s)
COVID-19 , Stress Disorders, Post-Traumatic , Anxiety , China/epidemiology , Cross-Sectional Studies , Depression , Female , Humans , Pandemics , Prevalence , SARS-CoV-2 , Stress Disorders, Post-Traumatic/epidemiology , Students , Surveys and Questionnaires
5.
Int J Environ Res Public Health ; 19(1)2021 12 27.
Article in English | MEDLINE | ID: covidwho-1580808

ABSTRACT

BACKGROUND: Prevalence, incidence, and factors associated with posttraumatic stress disorder (PTSD) symptoms at follow-up among healthcare workers after the first wave of the COVID-19 pandemic are unknown. METHODS: A web survey invitation was sent to healthcare worker listservs at a NYC medical center (April, 2020). The Primary Care (PC)-PTSD questionnaire was used to screen for PTSD symptoms at baseline and then every 2 weeks for 10 weeks. Incidence and prevalence of PTSD symptoms were determined at each time point. Multivariable generalized estimating equation models were performed to investigate the factors associated with a positive PC-PTSD screen at follow-up. RESULTS: Median age (interquartile range) of N = 230 participants was 36 (31-48) years; 79.6% were women; 82.6% worked in COVID-19-focused settings. The prevalence of PTSD symptoms decreased from 55.2% at baseline to 25.0% at 10 weeks (p < 0.001). Among participants who had a baseline negative screen for PTSD symptoms, the incidence of PTSD at 10 weeks was 12.2% (p-trend 0.034). In multivariable-adjusted analyses, being a nurse (odds ratio [OR]: 1.70, 95% confidence interval [CI]: 1.06-2.71), female (OR: 3.00, 95% CI: 1.59, 5.72), and working in a COVID-19-focused location (OR: 1.51, 95% CI: 1.02, 2.21) were associated with increased odds of PTSD symptoms at 10-weeks. CONCLUSIONS: PTSD symptoms improved over 3 months following the first wave of the COVID-19 pandemic. However, one out of four NYC healthcare workers still had an increased risk for PTSD at 10-weeks. Screening healthcare workers for PTSD symptoms should be considered during the COVID-19 pandemic.


Subject(s)
COVID-19 , Stress Disorders, Post-Traumatic , Cross-Sectional Studies , Female , Follow-Up Studies , Health Personnel , Humans , Incidence , New York City/epidemiology , Pandemics , Prevalence , SARS-CoV-2 , Stress Disorders, Post-Traumatic/epidemiology
6.
Int J Environ Res Public Health ; 19(1)2021 Dec 29.
Article in English | MEDLINE | ID: covidwho-1580791

ABSTRACT

The aim of the study is to investigate the changes in the maternal healthcare system during the pandemic and their associations with maternal mental health in Russia. A sample of Russian women who gave birth during the first year of the COVID-19 pandemic (n = 1645) and matched controls, i.e., women who gave birth before the COVID-19 pandemic (n = 611), completed an anonymous Internet survey about recent childbirth. They were assessed for childbirth-related posttraumatic stress disorder (PTSD) and postpartum depression (PPD). Clinically relevant symptoms of PPD and PTSD were high before the pandemic and showed no significant change during the pandemic (p = 0.48 and p = 0.64, respectively). We found a notable increase in the frequency of obstetric violence (p = 0.015) during the pandemic, which, in turn, has a strong correlation with birth-related PTSD and PPD. The problem of ethical communication with patients among maternal healthcare professionals is acute in Russia, and it has been exacerbated by the pandemic. Family and doula support during labor can be a potential protective factor against obstetric violence.


Subject(s)
COVID-19 , Stress Disorders, Post-Traumatic , Depression/epidemiology , Female , Humans , Pandemics , Parturition , Postpartum Period , Pregnancy , SARS-CoV-2 , Stress Disorders, Post-Traumatic/epidemiology
7.
Int J Environ Res Public Health ; 19(1)2021 12 31.
Article in English | MEDLINE | ID: covidwho-1580773

ABSTRACT

BACKGROUND: Fort McMurray, a city in northern Alberta, Canada, has experienced multiple traumas in the last five years, including the 2016 wildfire, the 2020 floods, and the COVID-19 pandemic. Eighteen months after the wildfire, major depressive disorder (MDD), generalized anxiety disorder (GAD), and Post Traumatic Stress Disorder (PTSD) symptoms were elevated among school board employees in the city. OBJECTIVE: This study aimed to compare employees of the school board and other employees of Fort McMurray in respect to the impact the 2016 wildfires, the 2019 COVID pandemic, and the 2020 floods had on their mental health. METHODOLOGY: A quantitative cross-sectional survey was conducted in Fort McMurray from 24 April to 2 June 2021. Online questionnaires were administered through REDCap and were designed to capture socio-demographic characteristics, clinical as well as wildfire, COVID-19, and flooding-related variables. Mental health outcome variables were captured using self-reported standardized assessment scales. Data were analysed with descriptive statistics, Chi-square/Fisher's Exact tests, and binary regression analysis. RESULTS: Of the 249 residents who accessed the online survey, 186 completed the survey, giving a response rate of 74.7%. Of these respondents, 93.5% (174) indicated their employment status and were included in the Chi-square analysis. Most of the respondents were female (86.2%, (150)), above 40 years (53.4%, (93)), and were in a relationship (71.3%, (124)). The prevalence values for MDD, GAD and PTSD among respondents were 42.4%, 41.0, and 36.8%, respectively. There was a statistically significant difference between employees of the school board and other employees with respect to likely PTSD prevalence (28% vs. 45%, respectively, p < 0.05), although with other factors controlled for, in a binary logistic regression model, employer type did not significantly predict likely PTSD. CONCLUSIONS: The study has established that likely PTSD symptoms were significantly higher in other employees compared to those of school board employees. Greater exposure to the traumatic events and a greater perceived lack of support from other employers might have contributed to the significantly higher prevalence of PTSD in other employees.


Subject(s)
COVID-19 , Depressive Disorder, Major , Stress Disorders, Post-Traumatic , Wildfires , Alberta/epidemiology , Cross-Sectional Studies , Depression , Female , Floods , Humans , Mental Health , Pandemics , SARS-CoV-2 , Schools , Stress Disorders, Post-Traumatic/epidemiology
8.
Ital J Pediatr ; 47(1): 176, 2021 Aug 26.
Article in English | MEDLINE | ID: covidwho-1561998

ABSTRACT

INTRODUCTION: The Post-traumatic Stress Disorder (PTSD) is a group of persistent psychological and physiological symptoms due to a traumatic, severe, event. Only few studies focused on the effects of Covid-19 on psychosocial outcomes in children with Type 1 Diabetes (T1D) and their parents. AIM OF THE STUDY: The aim of this study was to evaluate the presence PTSD in parents of children with T1D during COVID-19 pandemic lockdown. PATIENTS AND METHODS: In the period between March and May 2020 we submitted the "Impact of Event Scale - Revised" (IES-R) questionnaire to the parents of 34 children with Type 1 Diabetes, asking them to express their emotions about the ongoing Covid-19 pandemic. RESULTS: A total of thirty mothers (mean age 43.0 ± 4.2 years) and 25 fathers (mean age 45.6 ± 5.9 years) participated in the survey and completed the questionnaires. 29.1% of parents had a score that allows to define a clinically relevant level of PTSD; ten mothers and 6 fathers had a PTSD clinically relevant score, corresponding, respectively, to 28.4 and 24% of total mothers and fathers. Finally, mothers and fathers, both express PTSD symptoms mainly in the form of intrusion and hyperarousal. CONCLUSIONS: The present study confirms a high prevalence symptoms related to PTSD in mothers and fathers of children with Type 1 Diabetes. We believe that psychosocial outcomes of the COVID-19 pandemic should be taken into account in the planning of the next future assistance for children with T1D.


Subject(s)
COVID-19/prevention & control , Communicable Disease Control , Diabetes Mellitus, Type 1/psychology , Fathers/psychology , Mothers/psychology , Stress Disorders, Post-Traumatic/epidemiology , Adult , COVID-19/epidemiology , COVID-19/psychology , Child , Cohort Studies , Female , Humans , Italy , Male , Middle Aged , Prevalence , Surveys and Questionnaires , Symptom Assessment
9.
Nursing ; 51(7): 52-56, 2021 Jul 01.
Article in English | MEDLINE | ID: covidwho-1561264

ABSTRACT

ABSTRACT: Little is known about the psychological impact of trauma from pandemics such as the COVID-19 pandemic. This article explores a descriptive study on the impact of COVID-19 and the prevalence of posttraumatic stress disorder among RNs caring for patients with COVID-19.


Subject(s)
COVID-19/nursing , Nurses/psychology , Pandemics , Stress Disorders, Post-Traumatic/epidemiology , COVID-19/epidemiology , COVID-19/psychology , Cross-Sectional Studies , Female , Humans , Male , Nurses/statistics & numerical data , Prevalence , Self Report
10.
Eur J Psychotraumatol ; 12(1): 1997181, 2021.
Article in English | MEDLINE | ID: covidwho-1559184

ABSTRACT

Background and Objectives: Prevalent Post-traumatic Stress Disorder (PTSD) negatively affected individuals during the COVID-19 pandemic. Using network analyses, this study explored the construct of PTSD symptoms during the COVID-19 pandemic in China to identify similarities and differences in PTSD symptom network connectivity between the general Chinese population and individuals reporting PTSD. Methods: We conducted an online survey recruiting 2858 Chinese adults. PTSD symptoms were measured using the PCL-5 and PTSD was determined according to the DSM-5 criteria. Results: In the general population, self-destructive/reckless behaviours were on average the most strongly connected to other PTSD symptoms in the network. The five strongest positive connections were found between 1) avoidance of thoughts and avoidance of reminders, 2) concentration difficulties and sleep disturbance, 3) negative beliefs and negative trauma-related emotions, 4) irritability/anger and self-destructive/reckless behaviours, and 5) hypervigilance and exaggerated startle responses. Besides, negative connections were found between intrusive thoughts and trauma-related amnesia and between intrusive thoughts and self-destructive/reckless behaviours. Among individuals reporting PTSD, symptoms such as flashbacks and self-destructive/reckless behaviours were on average most strongly connected to other PTSD symptoms in the network. The five strongest positive connections were found between 1) concentration difficulty and sleep disturbance, 2) intrusive thoughts and emotional cue reactivity, 3) negative beliefs and negative trauma-related emotions, 4) irritability/anger and self-destructive/reckless behaviour, and 5) detachment and restricted affect. In addition, a negative connection was found between intrusive thoughts and self-destructive/reckless behaviours. Conclusion: Our results indicate similarly positive connections between concentration difficulty and sleep disturbance, negative beliefs and negative trauma-related emotions, and irritability/anger and self-destructive/reckless behaviours in the general and PTSD-reported populations. We argue that self-destructive/reckless behaviours are a core symptom of COVID-19 related PTSD, worthy of more attention in future psychiatric programmers.


Antecedentes y Objetivos: El Trastorno de Estrés Postraumático (TEPT) prevalente afectó negativamente a los individuos durante la pandemia del COVID-19. Usando análisis de redes, este estudio exploró el constructo de síntomas de TEPT durante la pandemia de COVID-19 en China para identificar las similitudes y diferencias en la conectividad de red de síntomas de TEPT entre la población general china y los individuos que reportan TEPT.Métodos: Realizamos una encuesta en línea que reclutó 2.858 adultos chinos. Los síntomas de TEPT se midieron usando el PCL-5 y el TEPT se determinó de acuerdo a los criterios del DSM-5.Resultados: En la población general, las conductas autodestructivas/ imprudentes fueron, en promedio, las más fuertemente conectadas con otros síntomas de TEPT en la red. Las cinco conexiones positivas más fuertes se encontraron entre 1) evitación de pensamientos y evitación de recordatorios, 2) dificultades en la concentración y trastornos del sueño, 3) creencias negativas y emociones negativas relacionadas con el trauma, 4) irritabilidad/ ira y conductas autodestructivas/ imprudentes y 5) hipervigilancia y respuestas de sobresalto exageradas. Además, se encontraron conexiones negativas entre pensamientos intrusivos y amnesia relacionada con el trauma y entre pensamientos intrusivos y conductas autodestructivas/ imprudentes. Entre los individuos que reportaron TEPT, los síntomas como flashbacks y conductas autodestructivas/ imprudentes estuvieron, en promedio, más fuertemente conectadas con otros síntomas de TEPT en la red. Las cinco conexiones positivas más fuertes se encontraron entre 1) dificultades en la concentración y trastornos del sueño, 2) pensamientos intrusivos y reactividad emocional a ciertas señales, 3) creencias negativas y emociones negativas relacionadas con el trauma, 4) irritabilidad/ ira y conductas autodestructivas/ imprudentes, y 5) desapego y afecto restringido. Además, se encontró una conexión negativa entre pensamientos intrusivos y conductas autodestructivas/ imprudentes.Conclusión: Nuestros resultados indican conexiones igualmente positivas entre dificultades en la concentración y trastornos del sueño, creencias negativas y emociones negativas relacionadas con el trauma, e irritabilidad/ ira y conductas autodestructivas/ imprudentes en la población general y la que reporto TEPT. Argumentamos que las conductas autodestructivas/imprudentes son un síntoma central de TEPT relacionado con COVID-19, que merece más atención en futuros programas psiquiátricos.


Subject(s)
COVID-19/psychology , Pandemics , Stress Disorders, Post-Traumatic/epidemiology , Adolescent , Adult , Aged , COVID-19/epidemiology , China/epidemiology , Diagnostic and Statistical Manual of Mental Disorders , Female , Humans , Male , Middle Aged , Self-Injurious Behavior/psychology , Surveys and Questionnaires , Young Adult
11.
J Clin Neurosci ; 95: 27-30, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1536920

ABSTRACT

BACKGROUND: Since February 2020, many governments of the world ordered strict social distancing rules to try to contain the COVID-19 pandemic, with a reported consequent increase in levels of stress, anxiety and depression in the general population. Aim of this study was to assess the prevalence of the aforementioned psychiatric symptoms across a sample of individuals with High Functioning Autism Spectrum Disorders (HF-ASDs) with respect to a group of neurotypical adults (NA), during the first two months of COVID-19 pandemic in Italy. METHOD: 45 adults with HF-ASDs and 45NA completed a structured online questionnaire, including; the Depression, Anxiety and Stress Scale - 21 items (DASS-21); the Impact of Event Scale-Revised (IES-R); the Perceived Stress Scale (PSS). We also explored some specific aspects of participants' psychological well-being through an ad-hoc questionnaire. RESULTS: Subjects with HF-ASDs scored significantly higher than NA at the DASS-21, the IES-R Total Score and the PSS; NA reported a higher perceived change of their lifestyle during the lockdown than individuals with HF-ASDs, and subjects with HF-ASDs reported to feel more comfortable and less tired during the lockdown period, in relation to the social distancing measures adopted by Italian authorities. CONCLUSIONS: Adults with HF-ASDs presented higher rates of depression, anxiety, stress and PTSD-related symptoms than NA during the first two months of COVID-19 pandemic. However, they also reported to feel subjectively more comfortable and less tired during the lockdown than before, in relation to the social distancing measures.


Subject(s)
Autism Spectrum Disorder , COVID-19 , Stress Disorders, Post-Traumatic , Adult , Anxiety/epidemiology , Autism Spectrum Disorder/epidemiology , Communicable Disease Control , Depression/epidemiology , Humans , Pandemics , SARS-CoV-2 , Stress Disorders, Post-Traumatic/epidemiology , Stress, Psychological/epidemiology
12.
Depress Anxiety ; 38(10): 1007-1017, 2021 10.
Article in English | MEDLINE | ID: covidwho-1525429

ABSTRACT

INTRODUCTION: Little is known about the relationship between moral distress and mental health problems. We examined moral distress in 2579 frontline healthcare workers (FHCWs) caring for coronavirus disease 2019 (COVID-19) patients during the height of the spring 2020 pandemic surge in New York City. The goals of the study were to identify common dimensions of COVID-19 moral distress; and to examine the relationship between moral distress, and positive screen for COVID-19-related posttraumatic stress disorder (PTSD) symptoms, burnout, and work and interpersonal functional difficulties. METHOD: Data were collected in spring 2020, through an anonymous survey delivered to a purposively-selected sample of 6026 FHCWs at Mount Sinai Hospital; 2579 endorsed treating COVID-19 patients and provided complete survey responses. Physicians, house staff, nurses, physician assistants, social workers, chaplains, and clinical dietitians comprised the sample. RESULTS: The majority of the sample (52.7%-87.8%) endorsed moral distress. Factor analyses revealed three dimensions of COVID-19 moral distress: negative impact on family, fear of infecting others, and work-related concerns. All three factors were significantly associated with severity and positive screen for COVID-19-related PTSD symptoms, burnout, and work and interpersonal difficulties. Relative importance analyses revealed that concerns about work competencies and personal relationships were most strongly related to all outcomes. CONCLUSION: Moral distress is prevalent in FHCWs and includes family-, infection-, and work-related concerns. Prevention and treatment efforts to address moral distress during the acute phase of potentially morally injurious events may help mitigate risk for PTSD, burnout, and functional difficulties.


Subject(s)
Burnout, Professional , COVID-19 , Stress Disorders, Post-Traumatic , Burnout, Professional/epidemiology , Health Personnel , Humans , Morals , Pandemics , Psychosocial Functioning , SARS-CoV-2 , Stress Disorders, Post-Traumatic/epidemiology , United States/epidemiology
13.
BMC Psychiatry ; 21(1): 572, 2021 11 15.
Article in English | MEDLINE | ID: covidwho-1518263

ABSTRACT

BACKGROUND: The COVID-19 pandemic has posed significant threats to both the physical and psychological health of healthcare workers working in the front-line combating COVID-19. However, studies regarding the medium to long term impact of COVID-19 on mental health among healthcare workers are limited. Therefore, we conducted this cross-sectional survey to investigate the prevalence, factors and impact of post-traumatic stress disorder (PTSD) in healthcare workers exposed to COVID-19 8 months after the end of the outbreak in Wuhan, China. METHODS: A web-based questionnaire was delivered as a link via the communication application WeChat to those healthcare workers who worked at several COVID-19 units during the outbreak (from December 2019 to April 2020) in Wuhan, China. The questionnaire included questions on social-demographic data, the post-traumatic stress disorder checklist-5 (PCL-5), the family care index questionnaire (Adaptation, Partnership, Growth, Affection and Resolve, APGAR), and the quality-of-life scale (QOL). The prevalence, risk and protective factors, and impact of PTSD on healthcare workers were subsequently analyzed. RESULTS: Among the 659 participants, 90 healthcare workers were still suffering from PTSD 8 months after the end of the outbreak of COVID-19 in Wuhan, in which avoidance and negative impact were the most affected dimensions. Suffering from chronic disease, experiencing social isolation, and job dissatisfaction came up as independent risk factors for PTSD, while obtaining COVID-19 related information at an appropriate frequency, good family function, and working in well-prepared mobile cabin hospitals served as protective factors. The impact of PTSD on COVID-19 exposed healthcare workers was apparent by shortened sleeping time, feeling of loneliness, poorer quality of life and intention to resign. CONCLUSIONS: Eight months after the end of the COVID-19 outbreak in Wuhan, the level of PTSD in healthcare workers exposed to COVID-19 was still high. Apart from the commonly recognized risk factors, comorbid chronic disease was identified as a new independent risk factor for developing PTSD. For countries where the pandemic is still ongoing or in case of future outbreaks of new communicable diseases, this study may contribute to preventing cases of PTSD in healthcare workers exposed to infectious diseases under such circumstances.


Subject(s)
COVID-19 , Stress Disorders, Post-Traumatic , China/epidemiology , Cross-Sectional Studies , Health Personnel , Humans , Pandemics , Prevalence , Quality of Life , SARS-CoV-2 , Stress Disorders, Post-Traumatic/epidemiology
14.
PLoS One ; 16(11): e0260033, 2021.
Article in English | MEDLINE | ID: covidwho-1511836

ABSTRACT

Medical leaders have warned of the potential public health burden of a "parallel pandemic" faced by healthcare workers during the COVID-19 pandemic. These individuals may have experienced scenarios in which their moral code was violated resulting in potentially morally injurious events (PMIEs). In the present study, hierarchical linear modeling was utilized to examine the role of PMIEs on COVID-19 pandemic-related difficulties in psychosocial functioning among 211 healthcare providers (83% female, 89% White, and an average of 11.30 years in their healthcare profession [9.31]) over a 10-month span (May 2020 -March 2021). Reported exposure to PMIEs was associated with statistically significant poorer self-reported psychosocial functioning at baseline and over the course of 10-months of data collection. Within exploratory examinations of PMIE type, perceptions of transgressions by self or others (e.g., "I acted in ways that violated my own moral code or values"), but not perceived betrayal (e.g., "I feel betrayed by leaders who I once trusted"), was associated with poorer COVID-19 related psychosocial functioning (e.g., feeling connected to others, relationship with spouse or partner). Findings from this study speak to the importance of investing in intervention and prevention efforts to mitigate the consequences of exposure to PMIEs among healthcare providers. Interventions for healthcare providers targeting psychosocial functioning in the context of moral injury is an important area for future research.


Subject(s)
COVID-19/psychology , Health Personnel/psychology , Pandemics , Stress Disorders, Post-Traumatic/epidemiology , Adult , COVID-19/epidemiology , COVID-19/virology , Female , Humans , Male , Middle Aged , Military Personnel/psychology , Psychosocial Functioning , Public Health , SARS-CoV-2/pathogenicity , Stress Disorders, Post-Traumatic/psychology , Veterans/psychology
15.
BMC Psychiatry ; 21(1): 545, 2021 11 04.
Article in English | MEDLINE | ID: covidwho-1504277

ABSTRACT

BACKGROUND: The Coronavirus Disease 2019 (COVID-19) pandemic has rapidly spread across the whole world and brought strong psychological impact. This study aimed to evaluate the prevalence of post-traumatic stress disorders (PTSD) in the general people of southwestern China and associated factors 1 month after the outbreak of the COVID-19. METHODS: This study was started on 4-10 Feb 2020 based on online survey. The present work was carried out in the provinces of southeastern China, including Sichuan Province, Guizhou Province, Yunnan Province, and Chongqing City.1593 respondents aged 18 years and above administered to this study. Data on whether they have experienced confirmed or suspected COVID-19 of themselves/family members/acquaintances were also collected, and based on 'yes' answers, the number of affected individuals (via COVID-19) were categorized into four exposure levels i.e., non-affected, less, moderately, or significantly affected. The civilian version of the PTSD checklist and the self-reported information about COVID-19 were used. RESULTS: The prevalence of PTSD was approximately 25.2%(n = 401/1593). The chances of developing PTSD were 6.053(OR = 6.053, 95% CI 1.394 to 26.280) or 3.673(OR = 3.673, 95% CI 1.738 to 7.765) times higher among respondents who had been significantly and moderately affected than those who had not been affected, accordingly. Male (OR = 1.484, 95% CI 1.147 to 1.920),younger age individuals (40 ~ 49 age group/<30 age group, OR = 0.395, 95% CI 0.258 to 0.606) and health care workers (OR = 1.788, 95% CI 1.155 to 2.277) were at higher risk of developing PTSD. CONCLUSION: Our findings highlight that a positive correlation between the pandemic and PTSD. It is urgent to establish a screening and prevention systems for the population who are significantly exposed to COVID-19,and provide different psychological intervention strategies for different groups.


Subject(s)
COVID-19 , Stress Disorders, Post-Traumatic , Anxiety , China/epidemiology , Cross-Sectional Studies , Depression , Disease Outbreaks , Humans , Male , Prevalence , SARS-CoV-2 , Stress Disorders, Post-Traumatic/epidemiology
16.
BMC Psychiatry ; 21(1): 546, 2021 11 05.
Article in English | MEDLINE | ID: covidwho-1503533

ABSTRACT

BACKGROUND: Emerging cross-sectional data indicate that healthcare workers (HCWs) in the COVID-19 era face particular mental health risks. Moral injury - a betrayal of one's values and beliefs, is a potential concern for HCWs who witness the devastating impact of acute COVID-19 illness while too often feeling helpless to respond. This study longitudinally examined rates of depression, generalized anxiety disorder (GAD), posttraumatic stress disorder (PTSD), and moral injury among United States HCWs in the COVID-19 era. We anticipated finding high levels of clinical symptoms and moral injury that would remain stable over time. We also expected to find positive correlations between clinical symptoms and moral injury. METHODS: This three-wave study assessed clinical symptoms and moral injury among 350 HCWs at baseline, 30, and 90 days between September and December 2020. Anxiety, depression, PTSD, and moral injury were measured using the Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Primary Care PTSD Screen (PC-PTSD), and Moral Injury Events Scale (MIES). RESULTS: Of the 350 HCWs, 72% reported probable anxiety, depression, and/or PTSD disorders at baseline, 62% at day 30, and 64% at day 90. High level of moral injury was associated with a range of psychopathology including suicidal ideation, especially among healthcare workers self-reporting COVID-19 exposure. CONCLUSIONS: Findings demonstrate broad, persisting, and diverse mental health consequences of the COVID-19 pandemic among United States HCWs. This study is the first to longitudinally examine the relationships between moral injury and psychopathology among HCWs, emphasizing the need to increase HCWs' access to mental healthcare.


Subject(s)
COVID-19 , Stress Disorders, Post-Traumatic , Cross-Sectional Studies , Health Personnel , Humans , Pandemics , SARS-CoV-2 , Stress Disorders, Post-Traumatic/epidemiology
17.
Tohoku J Exp Med ; 255(1): 71-77, 2021 09.
Article in English | MEDLINE | ID: covidwho-1496650

ABSTRACT

COVID-19 has caused an unprecedented global pandemic. Premenstrual symptoms include mood-related, behavioral, and physical symptoms that are limited to the luteal phase of the menstrual cycle. Psychosocial stress is a risk factor for premenstrual symptoms. The aim of this study was to examine the association between premenstrual symptoms and stress caused by COVID-19. We analyzed data from 871 students with regular menstrual cycles who completed the Premenstrual Symptoms Questionnaire (PSQ), Fear of COVID-19 Scale, and Impact of Event Scale-Revised version (IES-R). The total PSQ score was significantly higher in women with COVID-19-induced posttraumatic stress symptoms (PTSS) than in non-PTSS groups. Compared with pre-pandemic data (2019), the total PSQ score did not change in non-PTSS, but increased in PTSS groups. All symptoms were more severe in PTSS groups than in non-PTSS groups. Compared with 2019, PTSS groups had more severe symptoms for all symptoms except 'physical symptoms' and 'decreased social activity', and non-PTSS groups only exhibited improvements in the 'decreased social activity'. Multiple regression analysis revealed that the IES-R score was a significant exacerbation factor of the total PSQ score, along with age and menstrual pain. This study revealed the association between pandemic-associated PTSS and the severity of premenstrual symptoms.


Subject(s)
COVID-19/complications , Premenstrual Syndrome/etiology , SARS-CoV-2 , Stress Disorders, Post-Traumatic/etiology , Adolescent , COVID-19/epidemiology , COVID-19/psychology , Cross-Sectional Studies , Fear , Female , Humans , Japan/epidemiology , Menstrual Cycle , Pandemics , Premenstrual Syndrome/epidemiology , Risk Factors , Severity of Illness Index , Stress Disorders, Post-Traumatic/epidemiology , Students , Surveys and Questionnaires
18.
Psychosom Med ; 83(4): 338-344, 2021 05 01.
Article in English | MEDLINE | ID: covidwho-1494128

ABSTRACT

OBJECTIVE: Persistent somatic symptoms, such as pain and fatigue, have been referred to as somatization. Somatization is commonly associated with histories of trauma and posttraumatic stress disorder (PTSD). Although previous research has demonstrated that PTSD can predict somatic problems, there has been no examination of this at the level of PTSD symptom clusters and multidimensional assessment of somatic symptoms. We examined the association between the three International Classification of Disease (11th Edition) PTSD symptom clusters (reexperiencing in the here and now, avoidance, and sense of threat), measured in relation to the COVID-19 pandemic as the stressor, and somatic symptoms while statistically adjusting for confounding variables. METHODS: Participants were a nationally representative sample of 1041 adults from the general population of the Republic of Ireland. Physical health problems across the domains of pain, gastrointestinal, cardiopulmonary, and fatigue were assessed by the Patient Health Questionnaire, and PTSD symptoms were assessed using the International Trauma Questionnaire. RESULTS: Sense of threat was associated with the presence of pain (ß = 0.254), fatigue (ß = 0.332), gastrointestinal (ß = 0.234), and cardiovascular symptoms (ß = 0.239). Avoidance was associated with pain (ß = 0.347). Reexperiencing was not associated with any physical health variable. CONCLUSIONS: In the context of COVID-19, the sense of threat symptoms in PTSD is most strongly related to somatic problems. Findings suggest that interventions addressing sense of threat symptoms might provide relief from somatization.


Subject(s)
COVID-19/psychology , Fear/psychology , Medically Unexplained Symptoms , Stress Disorders, Post-Traumatic/etiology , Adolescent , Adult , Aged , COVID-19/complications , Female , Humans , Ireland/epidemiology , Male , Middle Aged , Pandemics , Stress Disorders, Post-Traumatic/epidemiology , Surveys and Questionnaires , Young Adult
19.
Ann Med ; 53(1): 1924-1934, 2021 12.
Article in English | MEDLINE | ID: covidwho-1493393

ABSTRACT

INTRODUCTION: The SARS-CoV-2 pandemic has forced healthcare providers to reorganize their activities to protect the population from infection, postponing or suspending many medical procedures. Patients affected by chronic conditions were among the most affected. In the case of catastrophes, women have a higher lifetime prevalence of post-traumatic stress disorder (PTSD), and those with endometriosis have higher anxiety levels, making them fragile in such circumstances. MATERIALS AND METHODS: In this cross-sectional study, conducted in May 2020, we considered all women aged ≥18 years, followed up at our referral centre for endometriosis. Patients were sent an anonymous 6-section questionnaire via email, containing different validated tools for the evaluation of anxiety levels and the risk of PTSD. A multivariable linear regression was performed to assess the impact of patients' characteristics on the distress caused by the SARS-COV-2 pandemic. RESULTS: Among the 468 women recruited, 68.8% were quite-to-extremely worried about not being able to access gynaecologic care, with almost one-third of them scoring ≥33 on the IES-R. Older age and increased levels of anxiety were associated with higher risks of PTSD (age: b = 0.28, 95% CI = 0.12 - 0.44; GAD-7: b = 1.71, 95% CI = 1.38 - 2.05), with up to 71.8% of patients with severe anxiety (GAD-7 > 15) having an IES-R score ≥33 suggestive for PTSD. Women who could leave home to work showed lower levels of PTSD (b = -4.79, 95% CI = -8.44 to - 1.15, ref. unemployed women). The implementation of telemedicine in routine clinical practice was favourably viewed by 75.6% of women. DISCUSSION: Women with endometriosis are particularly exposed to the risk of PTSD during the SARS-CoV-2 pandemic, especially if they are older or have higher levels of anxiety. Gynaecologists should resort to additional strategies, and telemedicine could represent a feasible tool to help patients cope with this situation.KEY MESSAGESThe COVID-19 pandemic significantly impacted the lives of women with endometriosis, who appeared to have a considerable risk of PTSD.Older age, higher anxiety levels and unemployment were independently associated with the risk of developing PTSD.Clinicians should develop successful alternative strategies to help patients cope with this situation, and telemedicine might represent an applicable and acceptable solution.


Subject(s)
Anxiety/epidemiology , COVID-19/prevention & control , Endometriosis/therapy , Health Services Accessibility/standards , Stress Disorders, Post-Traumatic/epidemiology , Adult , Age Factors , Anxiety/diagnosis , Anxiety/etiology , Anxiety/psychology , COVID-19/epidemiology , COVID-19/transmission , Communicable Disease Control/standards , Cross-Sectional Studies , Endometriosis/psychology , Female , Health Services Accessibility/organization & administration , Humans , Internet/statistics & numerical data , Male , Middle Aged , Pandemics/prevention & control , Prevalence , Risk Management , SARS-CoV-2/pathogenicity , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/etiology , Stress Disorders, Post-Traumatic/psychology , Surveys and Questionnaires/statistics & numerical data , Telemedicine/organization & administration , Telemedicine/standards , Young Adult
20.
Int J Environ Res Public Health ; 18(21)2021 10 30.
Article in English | MEDLINE | ID: covidwho-1488588

ABSTRACT

During the COVID-19 pandemic, journalists reporting on the crisis in the UK were classed as keyworkers [...].


Subject(s)
COVID-19 , Stress Disorders, Post-Traumatic , Humans , Pandemics , Public Health , SARS-CoV-2 , Stress Disorders, Post-Traumatic/epidemiology
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