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1.
Int J Environ Res Public Health ; 19(19)2022 Sep 28.
Article in English | MEDLINE | ID: covidwho-2065944

ABSTRACT

Chronic stress has been associated with a range of health disparities, but examination of occupational stress, especially in the wake of COVID-19, has been minimal for many careers. A novel methodology involving work stress diaries and collection of salivary cortisol was employed to determine correlations between occupations, occupational stressors, and how well these are related to the physiological response to stress exposure, the release of cortisol. While cortisol levels tended to follow typical circadian rhythm based on sampling times, cortisol levels also followed the subjective stress levels listed in the work stress diaries following linear regression analysis using the pooled study population data (p = 0.042). When comparing the stressors between the studied careers, participants who worked in the healthcare industry accounted for one-third of the total participants, but reported nearly half (42%) of the more severe occupational stressors listed in the diaries. Finally, the most commonly listed emotional reactions to exposures listed included feelings of stress, frustration, anger, anxiety, or overwhelm. As the workplace progresses from the pandemic, the opportunity to reduce occupational stress exposures in the workplace is at hand. Companies that work towards minimizing the stress faced by their workforce would have a healthier and more relaxed workforce.


Subject(s)
COVID-19 , Occupational Stress , COVID-19/epidemiology , Circadian Rhythm , Humans , Hydrocortisone/analysis , Occupational Stress/epidemiology , Occupational Stress/psychology , Saliva/chemistry , Stress, Psychological/diagnosis , Stress, Psychological/epidemiology , Workplace/psychology
2.
PLoS One ; 17(9): e0274298, 2022.
Article in English | MEDLINE | ID: covidwho-2021964

ABSTRACT

OBJECTIVE: To develop a machine learning algorithm utilizing heart rate variability (HRV) and salivary cortisol to detect the presence of acute stress among pregnant women that may be applied to future clinical research. METHODS: ECG signals and salivary cortisol were analyzed from 29 pregnant women as part of a crossover study involving a standardized acute psychological stress exposure and a control non-stress condition. A filter-based features selection method was used to identify the importance of different features [heart rate (HR), time- and frequency-domain HRV parameters and salivary cortisol] for stress assessment and reduce the computational complexity. Five machine learning algorithms were implemented to assess the presence of stress with and without salivary cortisol values. RESULTS: On graphical visualization, an obvious difference in heart rate (HR), HRV parameters and cortisol were evident among 17 participants between the two visits, which helped the stress assessment model to distinguish between stress and non-stress exposures with greater accuracy. Eight participants did not display a clear difference in HR and HRV parameters but displayed a large increase in cortisol following stress compared to the non-stress conditions. The remaining four participants did not demonstrate an obvious difference in any feature. Six out of nine features emerged from the feature selection method: cortisol, three time-domain HRV parameters, and two frequency-domain parameters. Cortisol was the strongest contributing feature, increasing the assessment accuracy by 10.3% on average across all five classifiers. The highest assessment accuracy achieved was 92.3%, and the highest average assessment accuracy was 76.5%. CONCLUSION: Salivary cortisol contributed a significant increase in accuracy of the assessment model compared to using a range of HRV parameters alone. Our machine learning model demonstrates acceptable accuracy in detection of acute stress among pregnant women when combining salivary cortisol with HR and HRV parameters.


Subject(s)
Hydrocortisone , Stress, Psychological , Cross-Over Studies , Female , Heart Rate/physiology , Humans , Machine Learning , Pregnancy , Stress, Psychological/diagnosis
3.
J Am Heart Assoc ; 11(9): e023516, 2022 05 03.
Article in English | MEDLINE | ID: covidwho-1807753

ABSTRACT

Background This study sought to better understand the experiences of adults with congenital heart disease throughout the pandemic. Objectives were to determine (1) psychological distress before and throughout the pandemic; (2) changes in day-to-day functioning; and (3) the percentage of adults with congenital heart disease who experienced COVID-19 related symptoms, underwent testing, and tested positive. Methods and Results This was a cross-sectional study paired with retrospective chart review. A web-based survey was distributed to patients between December 2020 and January 2021. Patients reported on psychological distress across 5 categories (Screening Tool for Psychological Distress; depression, anxiety, stress, anger, and lack of social support), whether they experienced symptoms of COVID-19 and/or sought testing, and changes to their work and social behavior. Five hundred seventy-nine survey responses were received, of which 555 were linked to clinical data. Patients were aged 45±15 years. The proportion of patients reporting above-threshold values for all Screening Tool for Psychological Distress items significantly increased during the early pandemic compared with before the pandemic. Stress returned to baseline in December 2020/January 2021, whereas all others remained elevated. Psychological distress decreased with age, and women reported persistently elevated stress and anxiety compared with men during the pandemic. A consistent trend was not observed with regard to American College of Cardiology/American Heart Association anatomic and physiologic classification. Fifty (9%) patients lost employment because of a COVID-19-related reason. COVID-19 symptoms were reported by 145 (25%) patients, 182 (31%) sought testing, and 10 (2%) tested positive. Conclusions A substantial proportion of adults with congenital heart disease reported clinically significant psychological distress during the pandemic.


Subject(s)
COVID-19 , Heart Defects, Congenital , Psychological Distress , Adult , COVID-19/epidemiology , Cross-Sectional Studies , Depression/psychology , Female , Heart Defects, Congenital/diagnosis , Heart Defects, Congenital/epidemiology , Humans , Male , Pandemics , Retrospective Studies , Stress, Psychological/diagnosis , Stress, Psychological/epidemiology , United States
4.
Cad Saude Publica ; 38(3): e00198321, 2022.
Article in Portuguese | MEDLINE | ID: covidwho-1745275

ABSTRACT

The objective was to analyze associations between perceived risk from COVID-19 and symptoms of depression, anxiety, and stress among workers in healthcare units. This was a cross-sectional study of workers from different professions who appeared voluntarily at one of the first COVID-19 Testing Centers in the municipality of Rio de Janeiro, Brazil. The workers were invited to answer an online questionnaire from May to August 2020. The COVID-19 Risk Perception Scale and the Depression, Anxiety, and Stress Scale (DASS-21) were used. Odds ratios (OR) and 95% confidence intervals were estimated. Of the total sample (N = 2,996), 81.5% were women, and mean age was 40.7 years. About half presented mild, moderate, or severe depression, anxiety, or stress, and the rates for workers with severe symptoms were 18.5%, 29.6%, and 21.5%, respectively. The associations between perceived risk and symptoms of depression, anxiety, and stress increased with the increase in each symptom's severity. Workers with higher perceived risk from COVID-19 showed higher OR for severe symptoms of depression (OR = 4.67), anxiety (OR = 4.35), and stress (OR = 4.97). The findings point to the demand for measures to protect workers' health and that should not be limited to personal protective equipment. It is essential for health system administrators to promote collective spaces for discussion and actions to favor workers' recovery in the context of a prolonged pandemic.


O objetivo foi analisar as associações entre a percepção de risco de adoecimento por COVID-19 e os sintomas de depressão, ansiedade e estresse em profissionais atuantes em unidades de saúde. Estudo transversal com trabalhadores de diversas categorias profissionais que buscaram voluntariamente um dos primeiros Centros de Referência em Testagem de COVID-19 no Município do Rio de Janeiro, Brasil. Os trabalhadores foram convidados a responder a um questionário online entre maio e agosto de 2020. Foram utilizadas a escala Percepção de Risco de Adoecimento por COVID-19 e a Escala de Depressão, Ansiedade e Estresse (DASS-21). Foram estimados razão de chance (OR) e intervalo de 95% de confiança. Do total (N = 2.996), 81,5% eram mulheres com idade média de 40,7 anos. Cerca da metade apresentava grau leve, moderado ou severo de depressão, ansiedade ou estresse, sendo a frequência de trabalhadores com sintomas severos, respectivamente, 18,5%, 29,6% e 21,5%. Observou-se que as associações entre a percepção de risco e os sintomas de depressão, ansiedade e estresse foram mais fortes à medida que aumentava a classificação de gravidade de cada sintoma. Os trabalhadores com alta percepção de risco de adoecimento por COVID-19 apresentaram OR mais elevadas para sintomas severos de depressão (OR = 4,67), ansiedade (OR = 4,35) e estresse (OR = 4,97). Os achados apontam a demanda por medidas de proteção à saúde dos trabalhadores, que não devem se restringir aos equipamentos de proteção individual. É essencial que os gestores promovam espaços coletivos de discussão e ações que favoreçam a recuperação dos trabalhadores em contexto pandêmico de longa duração.


El objetivo fue analizar las asociaciones entre la percepción de riesgo de enfermedad por COVID-19 y los síntomas de depresión, ansiedad y estrés en profesionales activos en unidades de salud. Estudio transversal con trabajadores de diversas categorías profesionales que buscaron voluntariamente uno de los primeros Centros de Referencia en Tests de COVID-19 en el municipio de Río de Janeiro, Brasil. Los trabajadores fueron invitados a responder a un cuestionario online entre mayo y agosto de 2020. Se utilizaron la escala Percepción de Riesgo de Enfermedad por COVID-19 y la Escala de Depresión, Ansiedad y Estrés (DASS-21). Se estimaron razón de oportunidad (OR) e intervalo de 95% de confianza. Del total (N = 2.996), un 81,5% eran mujeres con una edad media de 40,7 años. Cerca de la mitad presentaba grado leve, moderado o severo de depresión, ansiedad o estrés, siendo la frecuencia de trabajadores con síntomas severos, respectivamente, 18,5%, 29,6% y 21,5%. Se observó que las asociaciones entre la percepción de riesgo y los síntomas de depresión, ansiedad y estrés fueron más fuertes a medida que aumentaba la clasificación de la gravedad de cada síntoma. Los trabajadores con alta percepción de riesgo de enfermedad por COVID-19 presentaron OR más elevadas para síntomas severos de depresión (OR = 4,67), ansiedad (OR = 4,35) y estrés (OR = 4,97). Los resultados apuntan la demanda de medidas de protección a la salud de los trabajadores, que no se deben restringir a equipamientos de protección individual. Es esencial que los gestores promuevan espacios colectivos de discusión y acciones que favorezcan la recuperación de los trabajadores en un contexto pandémico de larga duración.


Subject(s)
COVID-19 , Depression , Adult , Anxiety/epidemiology , Brazil/epidemiology , COVID-19 Testing , Cross-Sectional Studies , Delivery of Health Care , Depression/epidemiology , Female , Humans , Stress, Psychological/diagnosis , Stress, Psychological/epidemiology
5.
Psychother Psychosom Med Psychol ; 72(9-10): 445-451, 2022 Oct.
Article in German | MEDLINE | ID: covidwho-1740512

ABSTRACT

Parental stress has negative impact on parents and their children. Parental stress may be of special interest for family and child well-being due to Covid-19 pandemic. A reliable and valid assessment of parental stress would be beneficial both in research and clinical practice. The Parental Stress Scale (PSS) is internationally well established as an economic and psychometric valid assessment. It consists of 18 items. The study evaluated the factor structure of the German version of the PSS in a general population (n=386 parents with children<16 years) for the first time. The sample was part of a representative sample (n=2519). The confirmatory factor analysis did not confirm internationally previously reported models. Eliminating one item, the explorative factor analysis suggested a two factor structure with the dimensions "lack of confident" and "worries and strain". Both subscales showed a good internal consistence (McDonalds ω≥0,87). We observed correlations of the PSS-17 items with family dysfunction and elevated scores for depressive or anxiety symptoms, but not with sociodemographic factors. One conclusion is that the multidimensional construct of parental stress maybe is not comprehensively represented by the PSS. For the use in clinical practice and research this has to be taken into account. Albeit, the German version of the PSS is an economic, reliable and valid assessment.


Subject(s)
COVID-19 , Pandemics , Child , Humans , Psychometrics , Stress, Psychological/diagnosis , Parents , Factor Analysis, Statistical , Reproducibility of Results , Surveys and Questionnaires
6.
Afr Health Sci ; 21(4): 1533-1543, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1726491

ABSTRACT

Background: COVID19 pandemic forced most countries to lockdown, leading to the prolonged closure of many learning institutions. This dramatic shift led to increase of mental illness symptoms among university students. Objective: To determine the prevalence and factors associated with symptoms of depression, anxiety, and stress among Uganda's university students during the COVID-19 lockdown. Methods: We conducted a one-month online survey using the Depression Anxiety and Stress Scale (DASS-21). Results: Participants n=321 were enrolled with mean age, 24.8(SD=5.1) years and 198(61.7%) were males. The prevalence of mental health symptoms among participants was 80.7%, 98.4%, and 77.9% for depression, high levels of anxiety, and stress, respectively. Statistically significant association between mental health symptoms on multi-logistic regression was found with Males (depression=2.97[1.61-5.48] and stress=1.90[1.07-3.35]), engagement in leisure activity (depression= 1.87[1.01-3.49] and stress=1.98[1.10-3.56]), and being finalist (stress=0.55[0.31- 0.97]). Use of addictive substances seem to potentially alleviate symptoms of depression, anxiety and stress in the short term. Conclusions: The findings of this study suggest a high prevalence of symptoms of depression, anxiety and stress among university students during the COVID-19 lockdown. Students' mental health should be monitored by all stakeholders, especially as the pandemic progresses.


Subject(s)
COVID-19 , Adult , Anxiety/psychology , COVID-19/epidemiology , Communicable Disease Control , Cross-Sectional Studies , Depression/psychology , Humans , Male , SARS-CoV-2 , Stress, Psychological/diagnosis , Students , Uganda/epidemiology , Universities , Young Adult
7.
Endocr Metab Immune Disord Drug Targets ; 21(12): 2213-2219, 2021.
Article in English | MEDLINE | ID: covidwho-1714871

ABSTRACT

AIMS: To investigate the influence of body mass index (BMI) on the association between psychological stress and physical fitness. BACKGROUND: Both obesity and psychological stress reduce exercise performance. OBJECTIVE: It is unknown whether obesity may modify the relationship. METHODS: A population of 4,080 military subjects in Taiwan was divided to three groups according to the BMI ≥27.0 kg/m2 (obesity), 24.0-26.9 kg/m2 (overweight) and 18.5-23.9 kg/m2 (normal weight). Normal, slight, and great psychological stress was evaluated by the Brief Symptoms Rating Scale (BSRS-5) score ≤5, 6-9, and ≥10, respectively. Aerobic and anaerobic fitness were respectively evaluated by time for a 3000-meter run and numbers of 2-minute sit-ups and 2-minute push-ups. Analysis of covariance (ANCOVA) with adjustments for age and sex was used to determine the relationship. RESULTS: The mean time (sec) for a 3000-meter run (standard error) under slight and great stress differed from that under normal stress in the normal weight (881.0 (11.0) and 877.9 (5.8) vs. 862.2 (1.7), p=0.089 and 0.0088, respectively) and in the obesity (928.1 (16.8) and 921.8 (10.7) vs. 895.2 (1.6), p=0.054 and 0.016, respectively), while the differences were not significant in the overweight (877.1 (12.7) and 877.5 (7.1) vs. 867.1 (2.1), both p >0.5). The impacts of the BMI on 2-minute sit-ups had a similar pattern with that on a 3000-meter run whereas the impact of the BMI on 2-minute push-ups was insignificant. CONCLUSIONS: Mental stress may not affect physical fitness in overweight military personnel. The mechanism is not clear and should be further investigated.


Subject(s)
Cardiorespiratory Fitness , Military Personnel , Body Mass Index , Hospitalization , Humans , Stress, Psychological/diagnosis , Stress, Psychological/epidemiology
8.
Int J Soc Psychiatry ; 66(8): 756-762, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-1638753

ABSTRACT

BACKGROUND: The severe outbreak of COVID-19 has affected the mental health of Indians. AIM: The objective of this article was to find the prevalence rates of depression, anxiety and stress and their socio-demographic correlates among Indian population during the lockdown to contain the spread of COVID-19. METHODS: A cross-sectional survey was conducted using an electronic questionnaire. A total of 354 participants were recruited through convenience sampling. Depression, anxiety and stress were measured using Depression Anxiety Stress Scale (DASS-21), a 21-item self-reported questionnaire. RESULTS: In total, 25%, 28% and 11.6% of the participants were moderate to extremely severely depressed, anxious and stressed, respectively. Binary logistic regressions indicated employment status (odds ratio (OR) = 1.91; 95% confidence interval (CI): 1.072-3.418) and binge drinking (OR = 2.03; 95% CI: 1.045-3.945) were significantly associated with depressive symptoms; gender (OR = 2.17; 95% CI: 1.317-3.589), employment status (OR = 1.77; 95% CI: 1.002-3.141) and binge drinking (OR = 2.62; 95% CI: 1.361-5.048) were significantly associated with anxiety symptoms; and binge drinking (OR = 3.42; 95% CI: 1.544-7.583) was significantly associated with stress symptoms. CONCLUSION: Depression, anxiety and stress among Indian population during the lockdown were prevalent. Along with other measures to contain the spread of COVID-19, mental health of citizens needs the urgent attention of the Indian government and mental health experts. Further large-scale studies should be conducted on different professions and communities such as health care professionals and migrant workers and incorporate other mental health indicators.


Subject(s)
Anxiety/epidemiology , Coronavirus Infections/psychology , Depression/epidemiology , Mental Health , Pneumonia, Viral/psychology , Stress, Psychological/epidemiology , Adolescent , Adult , Anxiety/diagnosis , Betacoronavirus , Binge Drinking/epidemiology , COVID-19 , Cross-Sectional Studies , Depression/diagnosis , Female , Humans , India/epidemiology , Logistic Models , Male , Middle Aged , Pandemics , Prevalence , Psychiatric Status Rating Scales , Quarantine/psychology , SARS-CoV-2 , Social Isolation/psychology , Stress, Psychological/diagnosis , Surveys and Questionnaires , Young Adult
9.
Nutrients ; 13(2)2021 Jan 25.
Article in English | MEDLINE | ID: covidwho-1575182

ABSTRACT

This study aimed to investigate the impact of food insecurity and poor nutrient intake on the psychological health of middle-aged and older adults during the COVID-19 pandemic. A sub-sample of 535 individuals aged 52 years and above, from the earlier cohort and interventional studies (n = 4) from four selected states in Peninsular Malaysia, were recruited during the COVID-19 outbreak (April to June 2020). Telephone interviews were conducted by trained interviewers with a health sciences background to obtain participants' information on health status, physical activity, food security, and psychological health (General Health Questionnaire-12; normal and psychological distress). Univariate analyses were performed for each variable, followed by a logistic regression analysis using SPSS Statistics version 25.0. Results revealed food insecurity (OR = 17.06, 95% CI: 8.24-35.32, p < 0.001), low protein (OR = 0.981, 95% CI: 0.965-0.998, p < 0.05), and fiber intakes (OR = 0.822, 95% CI: 0.695-0.972, p < 0.05) were found to be significant factors associated with the psychological distress group after adjusting for confounding factors. The findings suggested that food insecurity and insufficiencies of protein and fiber intakes heightened the psychological distress during the COVID-19 pandemic. Optimal nutrition is vital to ensure the physical and psychological health of the older population, specifically during the current pandemic.


Subject(s)
COVID-19/epidemiology , Nutritional Status , Pandemics , Psychological Distress , Stress, Psychological/epidemiology , Aged , COVID-19/economics , COVID-19/psychology , Cross-Sectional Studies , Female , Food Insecurity/economics , Humans , Independent Living/economics , Independent Living/psychology , Independent Living/statistics & numerical data , Malaysia/epidemiology , Male , Middle Aged , Patient Health Questionnaire/statistics & numerical data , Stress, Psychological/diagnosis , Stress, Psychological/economics , Stress, Psychological/psychology
11.
Epilepsy Behav ; 125: 108361, 2021 12.
Article in English | MEDLINE | ID: covidwho-1517512

ABSTRACT

OBJECTIVE: To identify the risk factors for psychological distress in electroencephalography (EEG) technicians during the coronavirus disease 2019 (COVID-19) pandemic. METHOD: In this national-level cross-sectional survey initiated by Japan Young Epilepsy Section (YES-Japan), which is a national chapter of The Young Epilepsy Section of the International League Against Epilepsy (ILAE-YES), a questionnaire was administered to 173 technicians engaged in EEG at four clinics specializing in epilepsy care and 20 hospitals accredited as (quasi-) epilepsy centers or epilepsy training facilities in Japan from March 1 to April 30, 2021. We collected data on participants' profiles, information about work, and psychological distress outcome measurements, such as the K-6 and Tokyo Metropolitan Distress Scale for Pandemic (TMDP). Linear regression analysis was used to identify the risk factors for psychological distress. Factors that were significantly associated with psychological distress in the univariate analysis were subjected to multivariate analysis. RESULTS: Among the 142 respondents (response rate: 82%), 128 were included in the final analysis. As many as 35.2% of EEG technicians have been under psychological distress. In multivariate linear regression analysis for K-6, female sex, examination for patients (suspected) with COVID-19, and change in salary or bonus were independent associated factors for psychological distress. Contrastingly, in multivariate linear regression analysis for TMDP, female sex, presence of cohabitants who had to be separated from the respondent due to this pandemic, and change in salary or bonus were independent associated factors for psychological distress. CONCLUSION: We successfully identified the risk factors associated with psychological distress in EEG technicians during the COVID-19 pandemic. Our results may help in understanding the psychological stress in EEG technicians during the COVID-19 pandemic and improving the work environment, which is necessary to maintain the mental health of EEG technicians.


Subject(s)
COVID-19 , Psychological Distress , Cross-Sectional Studies , Electroencephalography , Female , Humans , Japan/epidemiology , Pandemics , Risk Factors , SARS-CoV-2 , Stress, Psychological/diagnosis , Stress, Psychological/epidemiology , Stress, Psychological/etiology
13.
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
14.
Eur Rev Med Pharmacol Sci ; 25(18): 5836-5842, 2021 09.
Article in English | MEDLINE | ID: covidwho-1451041

ABSTRACT

OBJECTIVE: Functional gastrointestinal disorders are common gastrointestinal diseases. The pathophysiology is multifactorial and psychosocial distress worsens symptoms severity. Since the end of 2019 the world has been facing COVID-19 pandemic. The associated control measures have affected the psychological health of people. The aim of the present study is to evaluate the impact of the COVID-19 pandemic on the prevalence of functional gastrointestinal disorders among Italian children and adolescents. PATIENTS AND METHODS: The study sample is composed of 407 patients (187 males, 220 females), aged from 10 to 17 years. The mean age is 14.27 ± 2.24 years. The study was conducted through the Italian version of the Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III Version.  The prevalence of each disorder has been calculated as the ratio of affected subjects for each disease and the total number of effective cases for that specific disease. RESULTS: The study demonstrates that the prevalence of Functional Gastrointestinal Disorder in Italian children, during the COVD-19 pandemic, is higher, compared with the one reported in the previous studies. The most frequent disorders are Abdominal Migraine and Irritable Bowel Syndrome. CONCLUSIONS: Our study is the first one which provides data of the prevalence of Functional gastrointestinal disorders in sample of Italian adolescents, during the COVID-19 pandemic. The study underlines the need to focus on stress management, in order to reduce the effects of the lockdown on the psychological wellness of the youngest.


Subject(s)
COVID-19/psychology , Gastrointestinal Diseases/etiology , Gastrointestinal Diseases/psychology , Quarantine/psychology , Social Isolation/psychology , Stress, Psychological/complications , Abdominal Pain/epidemiology , Abdominal Pain/etiology , Abdominal Pain/psychology , Adolescent , Aerophagy/epidemiology , Aerophagy/etiology , Aerophagy/psychology , COVID-19/epidemiology , COVID-19/prevention & control , Child , Constipation/epidemiology , Constipation/etiology , Constipation/psychology , Dyspepsia/epidemiology , Dyspepsia/etiology , Dyspepsia/psychology , Fecal Incontinence/epidemiology , Fecal Incontinence/etiology , Fecal Incontinence/psychology , Female , Gastrointestinal Diseases/diagnosis , Gastrointestinal Diseases/epidemiology , Humans , Irritable Bowel Syndrome/epidemiology , Irritable Bowel Syndrome/etiology , Irritable Bowel Syndrome/psychology , Italy , Male , Migraine Disorders/epidemiology , Migraine Disorders/etiology , Migraine Disorders/psychology , Prevalence , Rumination Syndrome/epidemiology , Rumination Syndrome/etiology , Rumination Syndrome/psychology , Stress, Psychological/diagnosis , Surveys and Questionnaires , Vomiting/epidemiology , Vomiting/etiology , Vomiting/psychology
15.
Int J Environ Res Public Health ; 18(19)2021 09 27.
Article in English | MEDLINE | ID: covidwho-1438622

ABSTRACT

Despite extensive investigations of the Depression Anxiety Stress Scales-21 (DASS-21) since its development in 1995, its factor structure and other psychometric properties still need to be firmly established, with several calls for revising its item structure. Employing confirmatory factor analysis (CFA), this study examined the factor structure of the DASS-21 and five shortened versions of the DASS-21 among psychiatric patients (N = 168) and the general public (N = 992) during the COVID-19 confinement period in Saudi Arabia. Multigroup CFA, Mann Whitney W test, Spearman's correlation, and coefficient alpha were used to examine the shortened versions of the DASS-21 (DASS-13, DASS-12, DASS-9 (two versions), and DASS-8) for invariance across age and gender groups, discriminant validity, predictive validity, item coverage, and internal consistency, respectively. Compared with the DASS-21, all three-factor structures of the shortened versions expressed good fit, with the DASS-8 demonstrating the best fit and highest item loadings on the corresponding factors in both samples (χ2(16, 15) = 16.5, 67.0; p = 0.420, 0.001; CFI = 1.000, 0.998; TLI = 0.999, 0.997; RMSEA = 0.013, 0.059, SRMR = 0.0186, 0.0203). The DASS-8 expressed configural, metric, and scalar invariance across age and gender groups. Its internal consistency was comparable to other versions (α = 0.94). Strong positive correlations of the DASS-8 and its subscales with the DASS-21 and its subscales (r = 0.97 to 0.81) suggest adequate item coverage and good predictive validity of this version. The DASS-8 and its subscales distinguished the clinical sample from the general public at the same level of significance expressed by the DASS-21 and other shortened versions, supporting its discriminant validity. Neither the DASS-21 nor the shortened versions distinguished patients diagnosed with depression and anxiety from each other or from other psychiatric conditions. The DASS-8 represents a valid short version of the DASS-21, which may be useful in research and clinical practice for quick identification of individuals with potential psychopathologies. Diagnosing depression/anxiety disorders may be further confirmed in a next step by clinician-facilitated examinations. Brevity of the DASS-21 would save time and effort used for filling the questionnaire and support comprehensive assessments by allowing the inclusion of more measures on test batteries.


Subject(s)
COVID-19 , Depression , Anxiety/diagnosis , Depression/diagnosis , Factor Analysis, Statistical , Humans , Mental Health , Psychometrics , Reproducibility of Results , SARS-CoV-2 , Stress, Psychological/diagnosis , Surveys and Questionnaires
16.
Allergy Asthma Proc ; 42(4): e107-e115, 2021 07 01.
Article in English | MEDLINE | ID: covidwho-1435924

ABSTRACT

Background: The impact of coronavirus disease 2019 (COVID-19) related mental health status on chronic spontaneous urticaria (CSU) has not been addressed before. Objective: The aim of this study was to evaluate the depression, anxiety and stress levels, and the fear of COVID-19 in patients with mild-to-moderate CSU and to determine their impact on urticaria activity during the pandemic. Methods: A total of 509 patients with mild-to-moderate CSU were prospectively evaluated with validated scales, the Depression Anxiety Stress Scale 21 (DASS-21) and the Fear of COVID-19 Scale (FCV-19S) during the lockdown period (LP) and the return to normal period (RTNP). CSU activity was determined with the urticaria activity score summed over 7 days (UAS7) and medication scores (MS). UAS7 and MS before the pandemic were retrospectively collected from medical records. Results: The median UAS7 and MS were both significantly higher in the LP than in the median of related scores during the prepandemic period (p < 0.0001) and the RTNP (p < 0.0001). The mean FCV-19S and DASS-21 scores were both significantly higher in the LP than in the RTNP (p < 0.0001). The FCV-19S and the DASS-21 anxiety and stress subscales were significantly higher in women. The UAS7s were positively correlated with the FCV-19S and depression, anxiety, and stress subscale scores. Conclusion: Fear of COVID-19, anxiety, depression, and stress during the COVID-19 pandemic, especially when strict isolation measures are taken, have a significant impact on mental health and urticaria activity in patients with mild-to-moderate CSU, even though they are not infected. Psychological support for patients with CSU seems to be important to control disease activity during the pandemic.


Subject(s)
COVID-19/psychology , Chronic Urticaria/psychology , Cost of Illness , Mental Health , Adult , Anxiety/diagnosis , Anxiety/epidemiology , Anxiety/psychology , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/therapy , Chronic Urticaria/diagnosis , Chronic Urticaria/epidemiology , Chronic Urticaria/therapy , Cross-Sectional Studies , Depression/diagnosis , Depression/epidemiology , Depression/psychology , Fear , Female , Humans , Longitudinal Studies , Male , Middle Aged , Prospective Studies , Psychiatric Status Rating Scales , Retrospective Studies , Risk Factors , Stress, Psychological/diagnosis , Stress, Psychological/epidemiology , Stress, Psychological/psychology , Time Factors , Turkey/epidemiology , Young Adult
17.
Metabolism ; 123: 154845, 2021 10.
Article in English | MEDLINE | ID: covidwho-1340768

ABSTRACT

PURPOSE: Individuals with diabetes/stress hyperglycemia carry an increased risk for adverse clinical outcome in case of SARS-CoV-2 infection. The purpose of this study was to evaluate whether this risk is, at least in part, modulated by an increase of thromboembolic complications. METHODS: We prospectively followed 180 hospitalized patients with confirmed COVID-19 pneumonia admitted to the Internal Medicine Units of San Raffaele Hospital. Data from 11 out of 180 patients were considered incomplete and excluded from the analysis. We analysed inflammation, tissue damage biomarkers, hemostatic parameters, thrombotic events (TEs) and clinical outcome according to the presence of diabetes/stress hyperglycemia. RESULTS: Among 169 patients, 51 (30.2%) had diabetes/stress hyperglycemia. Diabetes/stress hyperglycemia and fasting blood glucose (FBG) were associated with increased inflammation and tissue damage circulating markers, higher D-dimer levels, increased prothrombin time and lower antithrombin III activity. Forty-eight venous and 10 arterial TEs were identified in 49 (29%) patients. Diabetes/stress hyperglycemia (HR 2.71, p = 0.001), fasting blood glucose (HR 4.32, p < 0.001) and glucose variability (HR 1.6, p < 0.009) were all associated with an increased risk of thromboembolic complication. TEs significantly increased the risk for an adverse clinical outcome only in the presence of diabetes/stress hyperglycemia (HR 3.05, p = 0.010) or fasting blood glucose ≥7 mmol/L (HR 3.07, p = 0.015). CONCLUSIONS: Thromboembolism risk is higher among patients with diabetes/stress hyperglycemia and COVID-19 pneumonia and is associated to poor clinical outcome. In case of SARS-Cov-2 infection patients with diabetes/stress hyperglycemia could be considered for a more intensive prophylactic anticoagulation regimen.


Subject(s)
COVID-19/epidemiology , Diabetes Mellitus/epidemiology , Hyperglycemia/epidemiology , Thromboembolism/etiology , Aged , Aged, 80 and over , COVID-19/complications , COVID-19/diagnosis , COVID-19/therapy , Diabetes Complications/diagnosis , Diabetes Complications/epidemiology , Diabetes Complications/therapy , Diabetes Mellitus/blood , Diabetes Mellitus/diagnosis , Diabetes Mellitus/therapy , Female , Follow-Up Studies , Hospitalization/statistics & numerical data , Humans , Hyperglycemia/diagnosis , Hyperglycemia/etiology , Hyperglycemia/therapy , Inflammation/complications , Inflammation/diagnosis , Inflammation/epidemiology , Inflammation/therapy , Italy/epidemiology , Male , Middle Aged , Mortality , Prognosis , Risk Factors , Stress, Psychological/complications , Stress, Psychological/diagnosis , Stress, Psychological/epidemiology , Thromboembolism/diagnosis , Thromboembolism/epidemiology , Treatment Outcome
18.
J Formos Med Assoc ; 120(8): 1602-1610, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1317715

ABSTRACT

BACKGROUND: Global pandemic resulted from the coronavirus disease-19 (COVID-19) demands mental health concerns on the affected population. We examine the time-course shift of psychological burden among suspected and confirmed COVID-19 patients. METHODS: Participants with suspected or confirmed COVID-19 were included in the cohort. Consecutive surveys were conducted upon hospital admission, discharge, and during outpatient follow-up by adapting the 5-item brief symptom rating scale (BSRS-5) assessing psychological symptoms including anxiety, depression, hostility, interpersonal sensitivity, and insomnia. The sixth measure to observe suicidal ideation was also included. RESULTS: A total of 109 eligible patients participated in the study, in which 83.49% reported no distress upon hospital admission, while 2.75%, 3.66%, and 10.1% patients were assessed as being with severe, moderate and mild psychological distress, respectively. Overall, age, sex, and history of contact did not significantly differ between patients with and without psychological distress. Multivariate logistic regression revealed that patients admitted during April-May (OR: 7.66, 95% CI: 1.46-40.28) and presented with symptoms including sore throat (OR: 4.24, 95% CI: 1.17-15.29) and malaise (OR: 5.24, 95% CI: 1.21-22.77) showed significantly higher risk of psychological distress. Cough symptom interestingly showed lower risk of emotional distress (OR: 0.25, 95% CI: 0.08-0.81). Subsequent surveys upon hospital discharge and during outpatient follow-up revealed steadily declining distress among all cohort. CONCLUSION: At least 16.5% of our cohort reported psychological distress upon hospital admission, with distinct time-dependent decline. Access to mental health support, alongside with promoting positive activities for good mental health are pivotal for those directly affected.


Subject(s)
COVID-19 , Psychological Distress , Anxiety , Cohort Studies , Cross-Sectional Studies , Depression , Humans , SARS-CoV-2 , Stress, Psychological/diagnosis , Stress, Psychological/epidemiology , Surveys and Questionnaires
19.
J Sports Sci Med ; 20(3): 421-430, 2021 09.
Article in English | MEDLINE | ID: covidwho-1316068

ABSTRACT

The aim of the study was to identify coherence, hope for success and coping strategies as predictors of mood among this year's Olympians in the context of coronavirus events. The relationships between the above variables and the mood of athletes were analysed. The study group consisted of 57 athletes - women (29) and men (28) between 18 and 39 years of age - representing various sports disciplines who were preparing for the Tokyo Olympics. The research was conducted in the period of April 7-28, 2020 during the first threat of COVID-19 pandemic, following the decision to move the Summer Olympics to the year 2021. It was time of the greatest national restrictions and information about the postponement of the games had been received. As a result of the step regression analysis, three predictors of vigour were established: sense of meaningfulness, coping with stress through positive reframing, and not using the self-blaming strategy. A positive predictor of anger was the use of substances. Confusion was predicted based on the frequency of behavioral disengagement. Behavioral disengagement predicted the severity of depression. Predictors of fatigue were the sense of meaningfulness, and the strategies of positive reframing and self-blaming. The results obtained emphasize the importance of positive reframing as a factor contributing to maintaining a positive mood state. In contrast, behavioral disengagement and self-blaming were strategies that lowered the mood of elite athletes. The results confirm the importance of factors included in the salutogenic model (sense of coherence, coping strategies) as predictors of athletes' mood during a pandemic.


Subject(s)
Adaptation, Psychological , Athletes/psychology , COVID-19/psychology , Sense of Coherence , Adult , Affect , Cross-Sectional Studies , Female , Humans , Male , Pandemics , Poland , SARS-CoV-2 , Stress, Psychological/diagnosis , Surveys and Questionnaires , Tokyo , Young Adult
20.
PLoS Med ; 18(6): e1003621, 2021 06.
Article in English | MEDLINE | ID: covidwho-1315878

ABSTRACT

BACKGROUND: Globally, 235 million people are impacted by humanitarian emergencies worldwide, presenting increased risk of experiencing a mental disorder. Our objective was to test the effectiveness of a brief group psychological treatment delivered by trained facilitators without prior professional mental health training in a disaster-prone setting. METHODS AND FINDINGS: We conducted a cluster randomized controlled trial (cRCT) from November 25, 2018 through September 30, 2019. Participants in both arms were assessed at baseline, midline (7 weeks post-baseline, which was approximately 1 week after treatment in the experimental arm), and endline (20 weeks post-baseline, which was approximately 3 months posttreatment). The intervention was Group Problem Management Plus (PM+), a psychological treatment of 5 weekly sessions, which was compared with enhanced usual care (EUC) consisting of a family psychoeducation meeting with a referral option to primary care providers trained in mental healthcare. The setting was 72 wards (geographic unit of clustering) in eastern Nepal, with 1 PM+ group per ward in the treatment arm. Wards were eligible if they were in disaster-prone regions and residents spoke Nepali. Wards were assigned to study arms based on covariate constrained randomization. Eligible participants were adult women and men 18 years of age and older who met screening criteria for psychological distress and functional impairment. Outcomes were measured at the participant level, with assessors blinded to group assignment. The primary outcome was psychological distress assessed with the General Health Questionnaire (GHQ-12). Secondary outcomes included depression symptoms, posttraumatic stress disorder (PTSD) symptoms, "heart-mind" problems, social support, somatic symptoms, and functional impairment. The hypothesized mediator was skill use aligned with the treatment's mechanisms of action. A total of 324 participants were enrolled in the control arm (36 wards) and 319 in the Group PM+ arm (36 wards). The overall sample (N = 611) had a median age of 45 years (range 18-91 years), 82% of participants were female, 50% had recently experienced a natural disaster, and 31% had a chronic physical illness. Endline assessments were completed by 302 participants in the control arm (36 wards) and 303 participants in the Group PM+ arm (36 wards). At the midline assessment (immediately after Group PM+ in the experimental arm), mean GHQ-12 total score was 2.7 units lower in Group PM+ compared to control (95% CI: 1.7, 3.7, p < 0.001), with standardized mean difference (SMD) of -0.4 (95% CI: -0.5, -0.2). At 3 months posttreatment (primary endpoint), mean GHQ-12 total score was 1.4 units lower in Group PM+ compared to control (95% CI: 0.3, 2.5, p = 0.014), with SMD of -0.2 (95% CI: -0.4, 0.0). Among the secondary outcomes, Group PM+ was associated with endline with a larger proportion attaining more than 50% reduction in depression symptoms (29.9% of Group PM+ arm versus 17.3% of control arm, risk ratio = 1.7, 95% CI: 1.2, 2.4, p = 0.002). Fewer participants in the Group PM+ arm continued to have "heart-mind" problems at endline (58.8%) compared to the control arm (69.4%), risk ratio = 0.8 (95% CI, 0.7, 1.0, p = 0.042). Group PM+ was not associated with lower PTSD symptoms or functional impairment. Use of psychosocial skills at midline was estimated to explain 31% of the PM+ effect on endline GHQ-12 scores. Adverse events in the control arm included 1 suicide death and 1 reportable incidence of domestic violence; in the Group PM+ arm, there was 1 death due to physical illness. Study limitations include lack of power to evaluate gender-specific effects, lack of long-term outcomes (e.g., 12 months posttreatment), and lack of cost-effectiveness information. CONCLUSIONS: In this study, we found that a 5-session group psychological treatment delivered by nonspecialists modestly reduced psychological distress and depression symptoms in a setting prone to humanitarian emergencies. Benefits were partly explained by the degree of psychosocial skill use in daily life. To improve the treatment benefit, future implementation should focus on approaches to enhance skill use by PM+ participants. TRIAL REGISTRATION: ClinicalTrials.gov NCT03747055.


Subject(s)
Depression/therapy , Mental Health , Natural Disasters , Problem Solving , Psychotherapy, Brief , Psychotherapy, Group , Relief Work , Stress Disorders, Post-Traumatic/therapy , Stress, Psychological/therapy , Adaptation, Psychological , Adolescent , Adult , Aged , Aged, 80 and over , Depression/diagnosis , Depression/etiology , Depression/psychology , Female , Functional Status , Humans , Male , Middle Aged , Nepal , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/etiology , Stress Disorders, Post-Traumatic/psychology , Stress, Psychological/diagnosis , Stress, Psychological/etiology , Stress, Psychological/psychology , Time Factors , Treatment Outcome , Young Adult
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