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2.
BMC Pregnancy Childbirth ; 21(1): 828, 2021 Dec 13.
Article in English | MEDLINE | ID: covidwho-1571748

ABSTRACT

BACKGROUND: The early postpartum period is recognized cross-culturally as being important for recovery, with new parents receiving increased levels of community support. However, COVID-19-related lockdown measures may have disrupted these support systems, with possible implications for mental health. Here, we use a cross-sectional analysis among individuals who gave birth at different stages of the pandemic to test (i) if instrumental support access in the form of help with household tasks, newborn care, and care for older children has varied temporally across the pandemic, and (ii) whether access to these forms of instrumental support is associated with lower postpartum depression scores. METHODS: This study used data from the COVID-19 And Reproductive Effects (CARE) study, an online survey of pregnant persons in the United States. Participants completed postnatal surveys between April 30 - November 18, 2020 (n = 971). Logistic regression analysis tested whether birth timing during the pandemic was associated with odds of reported sustained instrumental support. Linear regression analyses assessed whether instrumental support was associated with lower depression scores as measured via the Edinburgh Postnatal Depression survey. RESULTS: Participants who gave birth later in the pandemic were more likely to report that the pandemic had not affected the help they received with household work and newborn care (p < 0.001), while access to childcare for older children appeared to vary non-linearly throughout the pandemic. Additionally, respondents who reported that the pandemic had not impacted their childcare access or help received around the house displayed significantly lower depression scores compared to participants who reported pandemic-related disruptions to these support types (p < 0.05). CONCLUSIONS: The maintenance of postpartum instrumental support during the pandemic appears to be associated with better maternal mental health. Healthcare providers should therefore consider disrupted support systems as a risk factor for postpartum depression and ask patients how the pandemic has affected support access. Policymakers seeking to improve parental wellbeing should design strategies that reduce disease transmission, while facilitating safe interactions within immediate social networks (e.g., through investment in COVID-19 testing and contact tracing). Cumulatively, postpartum instrumental support represents a potential tool to protect against depression, both during and after the COVID-19 pandemic.


Subject(s)
COVID-19 , Child Care , Depression, Postpartum , Physical Distancing , Stress, Psychological , Adult , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/psychology , Child , Child Care/methods , Child Care/psychology , Child Care/statistics & numerical data , Communicable Disease Control/methods , /trends , Cross-Sectional Studies , Depression, Postpartum/diagnosis , Depression, Postpartum/epidemiology , Depression, Postpartum/prevention & control , Depression, Postpartum/psychology , Female , Humans , Maternal-Child Health Services/organization & administration , Maternal-Child Health Services/trends , Needs Assessment , Psychiatric Status Rating Scales/statistics & numerical data , Risk Assessment , SARS-CoV-2 , Stress, Psychological/complications , Stress, Psychological/etiology , Stress, Psychological/physiopathology , United States/epidemiology
3.
BMC Pregnancy Childbirth ; 21(1): 826, 2021 Dec 13.
Article in English | MEDLINE | ID: covidwho-1571747

ABSTRACT

BACKGROUND: Postpartum depression affects a significant proportion of women of childbearing age. The birth of a newborn baby is normally considered a joyful event, inhibiting mothers from expressing their depressive feelings. If the condition is not well understood and managed, mothers with postpartum depression are likely to experience suicidal ideation or even commit suicide. This study explored lived experiences of women who had recovered from a clinical diagnosis of postpartum depression in southwestern Uganda. METHODS: This phenomenological study adopted the explorative approach through in-depth interviews as guided by the biopsychosocial model of depression. It was conducted in Mbarara Regional Referral Hospital, Bwizibwera Health Centre IV and Kinoni Health Centre IV located in Mbarara and Rwampara districts, southwestern Uganda. Data were collected from 30 postpartum mothers who were purposively selected, between 9th December 2019 and 25th September 2020. We analyzed this work using thematic data analysis and this was steered by the Colaizzi's six-step phenomenological approach of inquiry. RESULTS: The findings were summarized into five major themes: 1) somatic experiences including insomnia and headache, breast pain, poor breast milk production, weight loss and lack of energy; 2) difficulties in home and family life including overwhelming domestic chores, lack of social support from other family members, fighting at home and financial constraints due to COVID-19 pandemic; 3) negative emotions including anger, self-blame, despondency and feelings of loneliness and regrets of conceiving or marriage; 4) feelings of suicide, homicide and self-harm including suicidal ideation and attempt, homicidal ideations and attempt and feelings of self-harm and 5) coping with postpartum depression including spirituality, termination of or attempt to leave their marital relationships, acceptance, counselling and seeking medical treatment, perseverance. CONCLUSION AND RECOMMENDATIONS: Suicidal and homicidal thoughts are important parts of the postpartum depression experience, and these may put the lives of the mothers, their spouses and their babies at a great risk. Poor relationship quality, intimate partner violence and lack of financial resources contribute significantly to the negative emotional experiences of mothers with PPD.


Subject(s)
COVID-19 , Depression, Postpartum , Financial Stress , Marriage/psychology , Physical Distancing , Stress, Psychological , Suicidal Ideation , Adaptation, Psychological , Adult , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/psychology , Communicable Disease Control/methods , Depression, Postpartum/diagnosis , Depression, Postpartum/physiopathology , Depression, Postpartum/psychology , Female , Financial Stress/etiology , Financial Stress/psychology , Humans , Models, Biopsychosocial , Qualitative Research , SARS-CoV-2 , Social Support/psychology , Stress, Psychological/complications , Stress, Psychological/etiology , Stress, Psychological/physiopathology , Uganda/epidemiology
4.
PLoS One ; 16(10): e0259094, 2021.
Article in English | MEDLINE | ID: covidwho-1496528

ABSTRACT

INTRODUCTION: We read, see and hear news from various media sources every day. A large majority of the news is negative. A previous study from our laboratory showed that reading negative news is associated with both increased stress reactivity (measured via the stress hormone cortisol) and recall of the negative news segments in women. OBJECTIVES: The present study investigated the effects of positive news on cortisol stress reactivity, memory and affect using a methodology highly similar to the study on negative news that was previously used by our team. METHODS: Sixty-two healthy participants aged between 18 and 35 years (81% women) were randomly exposed to either positive or neutral news segments, followed by a laboratory stressor. We assessed participants' affect three times during the procedure and measured cortisol in saliva eight times (at 10-minute intervals). Twenty-four hours later, participants were contacted by phone to assess their recall of the news segments. RESULTS: Results showed that exposure to positive news, relative to neutral news, did not modulate participants' cortisol levels in response to the laboratory stressor. Positive news had no impact on memory recall of the news and did not change participants' positive or negative affect. Bayes factors suggested that these nonsignificant results are not attributable to low statistical power. CONCLUSION: Contrary to negative news, positive and neutral news do not modulate stress reactivity, memory and affect. These results suggest that people can stay informed without physiological and psychological costs when the news to which they are exposed adopt a positive or neutral approach.


Subject(s)
Cognition/physiology , Emotions/physiology , Hydrocortisone/analysis , Mass Media , Memory/physiology , Stress, Psychological/physiopathology , Adolescent , Adult , Female , Humans , Male , Saliva/chemistry , Young Adult
5.
Am J Med Genet A ; 188(1): 71-82, 2022 01.
Article in English | MEDLINE | ID: covidwho-1427048

ABSTRACT

The coronavirus pandemic increased anxiety and stress and prevented access to health care worldwide; it is unclear how COVID-19 affected adults with a multisystem genetic disorder such as neurofibromatosis (NF). An anonymous online survey was distributed through an international registry and foundations to adults with NF (June-August 2020) to assess the impact of the pandemic on mental health and NF health care. Six hundred and thirteen adults (18-81 years; M = 45.7) with NF1 (77.8%), NF2 (14.2%), and schwannomatosis (7.8%) provided complete responses. Respondents rated moderate-to-high amounts of worry about the impact of COVID-19 on their emotional (46.3%) and physical health (46.7%), and 54.8% endorsed moderate-to-high pandemic-related stress. Adults with diagnosed/suspected mental health disorders or moderate-to-severe NF symptom impact as well as females endorsed higher COVID-19 stress (ps < 0.01). Less than half who missed a doctor's appointment for their NF care (43.4%) used telehealth. Of these, 33.3% and 46.2% reported that telehealth met their needs to a moderate or high degree, respectively. Results indicated that subgroups of adults with NF experience higher COVID-19-related worries and stress and may need additional support. Furthermore, telehealth is under-utilized and could help NF providers connect with patients, although improved delivery and patient training may facilitate expanded use of these services.


Subject(s)
Anxiety/psychology , COVID-19/psychology , Mental Health/statistics & numerical data , Neurofibromatoses/psychology , Stress, Psychological/physiopathology , Telemedicine/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , Anxiety/physiopathology , COVID-19/epidemiology , Europe/epidemiology , Female , Humans , Male , Middle Aged , Neurofibromatoses/physiopathology , SARS-CoV-2/pathogenicity , Surveys and Questionnaires , United States/epidemiology
6.
PLoS One ; 16(7): e0255211, 2021.
Article in English | MEDLINE | ID: covidwho-1325442

ABSTRACT

INTRODUCTION: The COVID-19 pandemic resulted in severe detrimental effects on the mental well-being of health care workers (HCW). Consequently, there has been a need to identify health-promoting resources in order to mitigate the psychological impact of the pandemic on HCW. OBJECTIVE: Our objective was to investigate the association of sense of coherence (SOC), social support and religiosity with self-reported mental symptoms and increase of subjective burden during the COVID-19 pandemic in HCW. METHODS: Our sample comprised 4324 HCW of four professions (physicians, nurses, medical technical assistants (MTA) and pastoral workers) who completed an online survey from 20 April to 5 July 2020. Health-promoting resources were assessed using the Sense of Coherence Scale Short Form (SOC-3), the ENRICHD Social Support Inventory (ESSI) and one item on religiosity derived from the Scale of Transpersonal Trust (TPV). Anxiety and depression symptoms were measured with the PHQ-2 and GAD-2. The increase of subjective burden due to the pandemic was assessed as the retrospective difference between burden during the pandemic and before the pandemic. RESULTS: In multiple regressions, higher SOC was strongly associated with fewer anxiety and depression symptoms. Higher social support was also related to less severe mental symptoms, but with a smaller effect size, while religiosity showed minimal to no correlation with anxiety or depression. In professional group analysis, SOC was negatively associated with mental symptoms in all groups, while social support only correlated significantly with mental health outcomes in physicians and MTA. In the total sample and among subgroups, an increase of subjective burden was meaningfully associated only with a weaker SOC. CONCLUSION: Perceived social support and especially higher SOC appeared to be beneficial for mental health of HCW during the COVID-19 pandemic. However, the different importance of the resources in the respective occupations requires further research to identify possible reasons.


Subject(s)
Anxiety/psychology , COVID-19/psychology , Depression/psychology , Pandemics , Sense of Coherence , Social Support , Stress, Psychological/epidemiology , Adolescent , Adult , Anxiety/epidemiology , COVID-19/epidemiology , Cross-Sectional Studies , Depression/epidemiology , Female , Germany/epidemiology , Health Personnel , Health Promotion/statistics & numerical data , Humans , Logistic Models , Male , Mental Health , Middle Aged , Religion , SARS-CoV-2/pathogenicity , Stress, Psychological/physiopathology , Surveys and Questionnaires
7.
PLoS One ; 16(7): e0255158, 2021.
Article in English | MEDLINE | ID: covidwho-1325441

ABSTRACT

BACKGROUND: The outbreak of the COVID-19 epidemic lead to high levels of morbidity and mortality around the globe. Consequences of this outbreak and possible associated infection are an increase in mental health disorders and an increased likelihood of internalizing problems, particularly depression. However, to date few studies have tested this hypothesis while taking into account individuals' preexisting mental health difficulties. METHODS: We used longitudinal data collected among 729 persons in the context of the French TEMPO cohort between March and June 2020 (7 waves of data collection). COVID-19-like symptoms as well as anxiety/depression (assessed by the Adult Self Report), were reported at each wave of data collection. To study the relationship between COVID-19-like symptoms and anxiety/depression, we used generalized estimation equation (GEE) models controlled for socio-demographic and health-related characteristics, including anxiety/depression prior to 2020. RESULTS: Overall, 27.2% of study participants reported anxiety/depression during lockdown. 17.1% of participants reported COVID-19-like symptoms during the course of follow-up, 7.3% after the beginning of lockdown, with an average number of 2.7 symptoms, and 3.6% reported respiratory distress. In multivariate analyses, nearly all the considered indicators of COVID-19-like symptoms were associated with higher odds of symptoms of anxiety/depression (symptoms Yes/No: OR = 1.66, 95% CI = 1.08-2.55; symptoms after the beginning of lockdown: OR = 1.91, 95% CI = 1.03-3.52; number of symptoms: OR for each additional symptom = 1.19, 95% CI = 1.02-1.39. This relationship exists after taking into account prior symptoms of anxiety/depression, which are associated with a 5-fold increased likelihood of psychological distress. And this impact is stronger among men than women. CONCLUSIONS: Our study shows higher risk of anxiety/depression among persons who experienced COVID-19-like symptoms, even after accounting for prior mental health difficulties. COVID-19 infection could have both a direct and indirect impact on the occurrence of psychological difficulties, and this association should be studied in greater detail.


Subject(s)
Anxiety/psychology , COVID-19/psychology , Depression/psychology , Social Isolation/psychology , Stress, Psychological/epidemiology , Adult , Anxiety/epidemiology , COVID-19/epidemiology , Depression/epidemiology , Female , France/epidemiology , Humans , Longitudinal Studies , Male , Mental Health/statistics & numerical data , Physical Distancing , SARS-CoV-2/pathogenicity , Sex Factors , Stress, Psychological/physiopathology
8.
PLoS One ; 16(7): e0254825, 2021.
Article in English | MEDLINE | ID: covidwho-1325437

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) has affected all age groups worldwide, but older adults have been affected greatly with an increased risk of severe illness and mortality. Nepal is struggling with the COVID-19 pandemic. The normal life of older adults, one of the vulnerable populations to COVID-19 infection, has been primarily impacted. The current evidence shows that the COVID-19 virus strains are deadly, and non-compliance to standard protocols can have serious consequences, increasing fear among older adults. This study assessed the perceived fear of COVID-19 and associated factors among older adults in eastern Nepal. METHODS: A cross-sectional study was conducted between July and September 2020 among 847 older adults (≥60 years) residing in three districts of eastern Nepal. Perceived fear of COVID-19 was measured using the seven-item Fear of COVID-19 Scale (FCV-19S). Multivariate logistic regression identified the factors associated with COVID-19 fear. RESULTS: The mean score of the FCV-19S was 18.1 (SD = 5.2), and a sizeable proportion of older adults, ranging between 12%-34%, agreed with the seven items of the fear scale. Increasing age, Dalit ethnicity, remoteness to the health facility, and being concerned or overwhelmed with the COVID-19 were associated with greater fear of COVID-19. In contrast, preexisting health conditions were inversely associated with fear. CONCLUSION: Greater fear of the COVID-19 among the older adults in eastern Nepal suggests that during unprecedented times such as the current pandemic, the psychological needs of older adults should be prioritized. Establishing and integrating community-level mental health support as a part of the COVID-19 preparedness and response plan might help to combat COVID-19 fear among them.


Subject(s)
COVID-19/epidemiology , COVID-19/psychology , Fear/psychology , Pandemics , Stress, Psychological/epidemiology , Acute Disease , Aged , Aged, 80 and over , Cross-Sectional Studies , Female , Health Services Accessibility/statistics & numerical data , Humans , Logistic Models , Male , Middle Aged , Nepal/epidemiology , SARS-CoV-2/pathogenicity , Stress, Psychological/physiopathology
9.
Sci Prog ; 104(2): 368504211026409, 2021.
Article in English | MEDLINE | ID: covidwho-1282203

ABSTRACT

The COVID-19 has been spreading across the world since December 2019. The pandemic has created tremendous fear of death from infection and awful psychological pressure on healthcare professionals (HCPs). The measures of psychological effects of the COVID-19 outbreak on the Bangladeshi HCPs are unknown. The present study aimed to assess the mental health outcomes of Bangladeshi HCPs and associated risk factors. We conducted this cross-sectional study from July 15 to September 20, 2020. A total of 355 HCPs aged between 20 and 60 years residing in Bangladesh participated in this study. All the participants completed a self-administered questionnaire through Google Forms consisting of socio-demographic characteristics and mental health outcomes. We measure loneliness, depression, anxiety, and sleep disturbance using the UCLA loneliness scale-8, patient health questionnaire-9, 7-item generalized anxiety disorder scale, Pittsburgh sleep quality index. The present study observed the prevalence of loneliness, depression, anxiety, and sleep disturbance among HCPs were 89%, 44%, 78%, and 87%, respectively. The factors significantly associated with the development of mental health problems among HCPs were working environment, economic condition, education level, area of residence, marital status, gender differences, professional category, body mass index, and smoking habit. Moreover, we have seen significant correlations among the different mental health outcomes. In Bangladesh, a large portion of HCPs reported mental health issues during the COVID-19 pandemic. COVID-19 pandemic incredibly impacted the psychological health of Bangladeshi healthcare professionals. Appropriate supportive programs and interventional initiatives might help the HCPs with mental health problems during and after this pandemic.


Subject(s)
Anxiety/epidemiology , COVID-19/epidemiology , Depression/epidemiology , Health Personnel/psychology , Pandemics , Sleep Initiation and Maintenance Disorders/epidemiology , Stress, Psychological/epidemiology , Adult , Anxiety/physiopathology , Anxiety/psychology , Bangladesh/epidemiology , COVID-19/psychology , Cross-Sectional Studies , Depression/physiopathology , Depression/psychology , Female , Humans , Loneliness/psychology , Male , Mental Health/statistics & numerical data , Middle Aged , Occupational Health/statistics & numerical data , SARS-CoV-2/pathogenicity , Sleep Initiation and Maintenance Disorders/physiopathology , Sleep Initiation and Maintenance Disorders/psychology , Stress, Psychological/physiopathology , Surveys and Questionnaires
10.
Sci Prog ; 104(2): 368504211026121, 2021.
Article in English | MEDLINE | ID: covidwho-1277844

ABSTRACT

The COVID-19 pandemic has affected the psychological well-being of healthcare professionals, among them, on medical and nursing occupational specialists. This study describes the psychological distress that this group has suffered, analyzing the effect that the sense of coherence related with the history of contact with infected people has generated in their mental health. Cross-sectional descriptive study using online questionnaires. Data were collected on a sample of 499 subjects, representing 42.0% and 38.8% of the associations of specialists in Occupational Medicine and Nursing, respectively. A univariate data analysis, independence test, and the CHAID multivariate method were carried out. The percentage of workers with high psychological distress was higher among women than among men; this was also higher in public sector workers than in the private sector. No differences have been observed regarding psychological distress and educational level, coexistence, having children, working away from home, having a pet, or between being a physician or nurse. The most efficient measure to prevent psychological distress was acting regarding the comprehensibility dimension of the sense of coherence. Sex, contact with any infected person, age, living as a couple, working in public or private centers, the availability of diagnostic tests, and the correlation with the manageability dimension were modulating factors. Sense of coherence is an effective measure to prevent psychological distress due to contact with people affected by COVID-19 in Occupational Health professionals.


Subject(s)
Anxiety/epidemiology , COVID-19/epidemiology , Health Personnel/psychology , Pandemics , Psychological Distress , Sense of Coherence , Stress, Psychological/epidemiology , Adult , Anxiety/physiopathology , Anxiety/psychology , COVID-19/psychology , Cross-Sectional Studies , Female , Humans , Male , Mental Health/statistics & numerical data , Middle Aged , Occupational Health/statistics & numerical data , SARS-CoV-2/pathogenicity , Spain/epidemiology , Stress, Psychological/physiopathology , Surveys and Questionnaires
11.
Sci Prog ; 104(2): 368504211025873, 2021.
Article in English | MEDLINE | ID: covidwho-1277843

ABSTRACT

The coronavirus 2019 (COVID-19) pandemic has caused dramatic changes in the daily lives of Romanians, affecting their mental health. The COVID-19 pandemic has evolved at three significant peaks, which sequentially occurred on: April 29, 2020; September 18, 2020; and the third wave registered the highest severity on November 27, 2020. Little is known about the mental health changes during this phase of this pandemic. This study evaluated mental health levels in Romania at the end of the first wave of the pandemic and amidst the third and most severe wave. We administered a two-phase internet-based survey among 543 and 583 participants, respectively, recruited through snowball sampling at a 6-month interval. The IPAT Anxiety Scale measured anxiety, the Beck's Depression Inventory measured depression, and the Dissociative Experiences Scale measured dissociation. We observed no statistically significant differences in the number of participants with clinically relevant scores at either time point. In the first survey, 23.8%, 19.2%, and 32.6% reported being clinically anxious, clinically depressed, and showed clinical dissociation, respectively. Binary logistic regressions indicated that age, education level, and previous traumatic events were significantly associated with clinical levels of anxiety and depression. Moreover, multiple linear regression analysis reported a collective significant effect of gender, age, psychological impact, traumatic events, and dissociation on predicting high levels of anxiety and depression. Romanian adults' mental health status was affected during the COVID-19 pandemic, and it did not change 6 months after the first lockdown.


Subject(s)
Anxiety/epidemiology , COVID-19/epidemiology , Depression/epidemiology , Pandemics , Stress, Psychological/epidemiology , Adolescent , Adult , Age Factors , Aged , Anxiety/physiopathology , Anxiety/psychology , COVID-19/psychology , Cross-Sectional Studies , Depression/physiopathology , Depression/psychology , Educational Status , Female , Humans , Logistic Models , Male , Manifest Anxiety Scale , Mental Health/statistics & numerical data , Middle Aged , Romania/epidemiology , SARS-CoV-2/pathogenicity , Sex Factors , Stress, Psychological/physiopathology
12.
Psychoneuroendocrinology ; 129: 105269, 2021 07.
Article in English | MEDLINE | ID: covidwho-1230717

ABSTRACT

OBJECTIVE: This study aimed to examine the relationship between competitive anxiety, fear/anxiety of COVID-19, and autonomic and endocrine stress responses in professional football players after returning to competition during the COVID-19 pandemic. METHODS: Ninety male professional football players (age: 26.33 ± 2.48 yr) volunteered to participate in this study, which included an official competition. Psychophysiological responses, including the Fear of COVID-19 Scale, the Coronavirus Anxiety Scale, and the Competitive State Anxiety Inventory-2 Revised, were collected 30 min before the competition. In addition, salivary alpha-amylase (sAA) and salivary cortisol (sCort) were collected at 8 a.m. and 15 min before the competition. RESULTS: The main findings, based on the Pearson correlation, showed significant positive correlations between COVID-19 anxiety and somatic competitive anxiety (p = 0.01), cognitive competitive anxiety (p = 0.01), and competition response of sCort and sAA (p = 0.01). Moreover, fear of COVID-19 was positively correlated with COVID-19 anxiety (p = 0.01). On the contrary, the awakening response of sCort and sAA was not found to be correlated with psychological parameters (all p > 0.05). The analysis also indicated that there was no significant correlation between self-confidence with other psychological and physiological variables (all p > 0.05). The regression analysis showed that cognitive anxiety was a relevant predictor for the competition response of sCort and sAA (p < 0.05). Moreover, COVID-19 anxiety was the only predictor of somatic and cognitive anxiety (p < 0.05). CONCLUSIONS: The present study provides the first preliminary evidence that COVID-19 anxiety and competitive anxiety might pose a negative impact on the athletic performance of professional football players during COVID-19 pandemic competitions. Thus, research is needed to build a strategy to reduce the psychophysiological stress related to COVID-19 and competition response.


Subject(s)
Anxiety , Athletes , COVID-19 , Competitive Behavior , Fear , Soccer , Stress, Psychological , Adult , Anxiety/metabolism , Anxiety/physiopathology , Anxiety/psychology , Athletes/psychology , Fear/physiology , Fear/psychology , Humans , Hydrocortisone/metabolism , Male , Saliva , Salivary alpha-Amylases/metabolism , Soccer/physiology , Soccer/psychology , Stress, Psychological/metabolism , Stress, Psychological/physiopathology , Stress, Psychological/psychology , Young Adult
13.
Psychosom Med ; 83(4): 351-357, 2021 05 01.
Article in English | MEDLINE | ID: covidwho-1218020

ABSTRACT

OBJECTIVE: Increased autonomic arousal is a proposed risk factor for posttraumatic stress disorder (PTSD). Few studies have prospectively examined the association between physiological responses to acute psychological stress before a traumatic event and later PTSD symptoms. The present prospective study examined whether cardiovascular responses to an acute psychological stress task before the COVID-19 global pandemic predicted PTSD symptoms related to the ongoing pandemic. METHODS: Participants (n = 120) were a subsample of an ongoing research study. Phase 1 consisted of a 10-minute baseline and 4-minute acute psychological stress task with blood pressure and heart rate recorded throughout. Phase 2 was initiated 2 weeks after the COVID-19 pandemic declaration. Participants completed the Impact of Event Scale-Revised (IES-R) with respect to the ongoing pandemic. Hierarchical linear regression analyses were used to examine whether cardiovascular stress reactivity predicted COVID-19 PTSD symptoms. RESULTS: Heart rate reactivity significantly predicted IES intrusion (ß = -0.208, t = -2.28, p = .025, ΔR2 = 0.041, confidence interval = -0.021 to -0.001) and IES hyperarousal (ß = -0.224, t = -2.54, p = .012, ΔR2 = 0.047, confidence interval = -0.22 to - 0.003), but not IES avoidance (p = .077). These results remained statistically significant after adjustment for sex, socioeconomic status, baseline cardiovascular activity, neuroticism, race, ethnicity, body mass index, and adverse childhood experiences. There were no statistically significant associations between blood pressure and any of the Impact of Event Scale-Revised subscales (p values > .12). CONCLUSIONS: Diminished heart rate responses (i.e., lower physiological arousal) to acute psychological stress before the COVID-19 pandemic significantly predicted reported PTSD symptoms during the crisis.


Subject(s)
COVID-19/psychology , Heart Rate/physiology , Stress Disorders, Post-Traumatic/etiology , Stress, Psychological/etiology , COVID-19/complications , Female , Humans , Male , Pandemics/statistics & numerical data , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/physiopathology , Stress, Psychological/epidemiology , Stress, Psychological/physiopathology , Surveys and Questionnaires , Texas/epidemiology , Young Adult
14.
Transl Psychiatry ; 11(1): 268, 2021 05 04.
Article in English | MEDLINE | ID: covidwho-1216450

ABSTRACT

Maternal stress has debilitating implications for both mother and child, including increased risk for anxiety. The current COVID-19 pandemic escalates these phenomena, thus, urging the need to further explore and validate feasible therapeutic options. Unlike the protracted nature of clinical studies, animal models could offer swift evidence. Prominent candidates for treatment are selective serotonin reuptake inhibitors (SSRIs) to the mother, that putatively accommodate maternal functioning, and, thereby, also protect the child. However, SSRIs might have deleterious effects. It is important to assess whether SSRIs and other pharmacotherapies can moderate the transference of anxiety by soothing maternal anxiety and to examine the extent of offspring's exposure to the drugs via lactation. To our knowledge, the possibility that antenatal stress exacerbates lactation-driven exposure to SSRIs has not been tested yet. Thirty ICR-outbred female mice were exposed to stress during gestation and subsequently administered with either the SSRI, escitalopram, or the novel herbal candidate, shan-zha, during lactation. Upon weaning, both dams' and pups' anxiety-like behavior and serum escitalopram levels were assessed. The major findings of the current study show that both agents moderated the antenatal stress-induced transgenerational transference of anxiety by ameliorating dams' anxiety. Interestingly though, pups' exposure to escitalopram via lactation was exacerbated by antenatal stress. The latter finding provides a significant insight into the mechanism of lactation-driven exposure to xenobiotics and calls for a further consideration vis-à-vis the administration of other drugs during breastfeeding.


Subject(s)
Anxiety/drug therapy , Anxiety/physiopathology , Lactation/metabolism , Prenatal Exposure Delayed Effects/prevention & control , Serotonin Uptake Inhibitors/administration & dosage , Serotonin Uptake Inhibitors/therapeutic use , Stress, Psychological/physiopathology , Animals , COVID-19 , Citalopram/administration & dosage , Citalopram/pharmacology , Citalopram/therapeutic use , Crataegus , Disease Models, Animal , Drugs, Chinese Herbal , Female , Male , Mice , Mice, Inbred ICR , Pandemics , Pregnancy , Serotonin Uptake Inhibitors/pharmacology , Xenobiotics/metabolism
15.
Mayo Clin Proc ; 95(11): 2487-2498, 2020 11.
Article in English | MEDLINE | ID: covidwho-1071751

ABSTRACT

In light of the coronavirus disease 2019 pandemic, we explore the role of stress, fear, and the impact of positive and negative emotions on health and disease. We then introduce strategies to help mitigate stress within the health care team, and provide a rationale for their efficacy. Additionally, we identify strategies to optimize patient care and explain their heightened importance in today's environment.


Subject(s)
Coronavirus Infections/psychology , Fear/psychology , Health Personnel/psychology , Pneumonia, Viral/psychology , Professional-Patient Relations , Stress, Psychological/etiology , Adaptation, Psychological , Anxiety/etiology , Anxiety/physiopathology , Anxiety/prevention & control , COVID-19 , Critical Illness , Fear/physiology , Global Health , Humans , Interpersonal Relations , Mental Health , Occupational Health , Pandemics , Resilience, Psychological , Stress, Psychological/physiopathology , Stress, Psychological/prevention & control
16.
Health Informatics J ; 26(4): 3201-3214, 2020 12.
Article in English | MEDLINE | ID: covidwho-1067149

ABSTRACT

Rates of PTSD remain elevated among U.S. Veterans, highlighting a need for innovative management tools. Previous studies have shown mobile apps to have positive effects on PTSD symptoms, but few apps have been examined systematically. This pilot study evaluated the perceived effectiveness and usability of Mindset, a novel mobile app that monitors user stress level via heart rate to encourage e-therapy use. The study sample included 30 community-residing Veterans who completed baseline assessments. They used the Mindset app and associated smartwatch until their approximate 1-month follow-up. Self-reported assessments included pre- and post-deployment experiences; experience with Mindset; and standard screeners for PTSD (PCL-M), anxiety (GAD-7), depression (PHQ-9), and alcohol use problems (AUDIT). Among the 24 participants who completed follow-up interviews, a significant decrease (p < 0.05) was found in PCL-M, PHQ-9, and modified AUDIT scores. Respondents reported moderate to high acceptance and satisfaction with Mindset features, though considerable frustration with the associated smartwatch. These findings highlight mHealth apps such as Mindset as potentially useful tools for PTSD and depression symptom management. These findings are also encouraging in the context of the current COVID-19 pandemic, which may accelerate further innovation and implementation of mHealth technologies to improve mental health self-care.


Subject(s)
Mental Health , Mobile Applications , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/therapy , Telemedicine/methods , Veterans/psychology , Adult , Alcoholism/epidemiology , Alcoholism/therapy , Anxiety/epidemiology , Anxiety/therapy , COVID-19/epidemiology , Depression/epidemiology , Depression/therapy , Female , Heart Rate/physiology , Humans , Male , Pandemics , Patient Satisfaction , Pilot Projects , SARS-CoV-2 , Stress, Psychological/epidemiology , Stress, Psychological/physiopathology
17.
Encephale ; 46(3S): S93-S98, 2020 Jun.
Article in French | MEDLINE | ID: covidwho-1065058

ABSTRACT

Although the "panic" word has been abundantly linked to the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) pandemic in the press, in the scientific literature very few studies have considered whether the current epidemic could predispose to the onset or the aggravation of panic attacks or panic disorder. Indeed, most studies thus far have focused on the risk of increase and aggravation of other psychiatric disorders as a consequence of the SARS-CoV-2 epidemic, such as obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and generalized anxiety disorder (GAD). Yet, risk of onset or aggravation of panic disorder, especially the subtype with prominent respiratory symptoms, which is characterized by a fear response conditioning to interoceptive sensations (e.g., respiratory), and hypervigilance to these interoceptive signals, could be expected in the current situation. Indeed, respiratory symptoms, such as coughs and dyspnea, are among the most commonly associated with the SARS-CoV-2 (59-82% and 31-55%, respectively), and respiratory symptoms are associated with a poor illness prognosis. Hence given that some etiological and maintenance factors associated with panic disorder - i.e., fear conditioning to abnormal breathing patterns attributable or not to the COVID-19 (coronavirus disease 2019), as well as hypervigilance towards breathing abnormalities - are supposedly more prevalent, one could expect an increased risk of panic disorder onset or aggravation following the COVID-19 epidemic in people who were affected by the virus, but also those who were not. In people with the comorbidity (i.e., panic disorder or panic attacks and the COVID-19), it is particularly important to be aware of the risk of hypokalemia in specific at-risk situations or prescriptions. For instance, in the case of salbutamol prescription, which might be overly used in patients with anxiety disorders and COVID-19, or in patients presenting with diarrhea and vomiting. Hypokalemia is associated with an increased risk of torsade de pointe, thus caution is required when prescribing specific psychotropic drugs, such as the antidepressants citalopram and escitalopram, which are first-line treatments for panic disorder, but also hydroxyzine, aiming at anxiety reduction. The results reviewed here highlight the importance of considering and further investigating the impact of the current pandemic on the diagnosis and treatment of panic disorder (alone or comorbid with the COVID-19).


Subject(s)
Betacoronavirus , Coronavirus Infections/psychology , Pandemics , Panic Disorder/psychology , Pneumonia, Viral/psychology , Anxiety/etiology , Anxiety/psychology , Anxiety Disorders/drug therapy , Anxiety Disorders/epidemiology , Anxiety Disorders/physiopathology , Anxiety Disorders/psychology , COVID-19 , Catastrophization , Comorbidity , Coronavirus Infections/epidemiology , Dyspnea/etiology , Dyspnea/psychology , Female , Humans , Hypokalemia/etiology , Male , Panic Disorder/drug therapy , Panic Disorder/epidemiology , Panic Disorder/physiopathology , Pneumonia, Viral/epidemiology , Psychotropic Drugs/adverse effects , Psychotropic Drugs/therapeutic use , Renin-Angiotensin System/physiology , Respiration/drug effects , SARS-CoV-2 , Stress, Psychological/etiology , Stress, Psychological/physiopathology , Terminology as Topic , Torsades de Pointes/chemically induced , Torsades de Pointes/etiology
20.
Neurourol Urodyn ; 40(1): 397-403, 2021 01.
Article in English | MEDLINE | ID: covidwho-1023302

ABSTRACT

AIMS: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic poses a challenge to treatment of patients with urologic chronic pelvic pain (UCPP), who are at risk to be postponed in the priority of care. We investigated pain, catastrophizing, and psychological status in UCPP patients during SARS-CoV-2 by means of Skype telephone calls. METHODS: A total of 28 UCPP patients underwent Skype video consultations. Pain intensity was assessed with Pain Numerical Rating Scale (PNRS). Pain Catastrophizing Scale (PCS) and Depression Anxiety Stress Scales (DASS-21) were used to assess catastrophizing and psychological status. RESULTS: During SARS-CoV-2, UCPP patients showed higher intensity of pain than before (mean ± SD PNRS score: 7.25 ± 0.9 vs. 5.4 ± 0.7; p < .0001), with pain exacerbation in 75%; they showed higher PCS and DASS-21 scores as compared to before the pandemic (mean ± SD PCS total score: 32.4 ± 1.2 vs. 23.7 ± 3.5; mean ± SD DASS-21 total score: 42.03 ± 4.5 vs. 34.4 ± 2.2; p < .001 and p < .001, respectively). CONCLUSION: During SARS-CoV-2 pandemic UCPP patients presented with high intensity of pain, marked catastrophizing thoughts and severe alteration of the psychological status. These observations impose the need not to postpone assessment and treatment of these patients during the pandemic. Remote visits with video telephone calls are a simple way of continuing care in UCPP patients.


Subject(s)
Anxiety/psychology , Catastrophization/physiopathology , Chronic Pain/physiopathology , Depression/psychology , Pelvic Pain/physiopathology , Telemedicine , Adult , COVID-19 , Catastrophization/psychology , Chronic Pain/psychology , Chronic Pain/therapy , Continuity of Patient Care , Delivery of Health Care , Female , Humans , Male , Middle Aged , Pain Measurement , Pandemics , Pelvic Pain/psychology , Pelvic Pain/therapy , SARS-CoV-2 , Stress, Psychological/physiopathology , Stress, Psychological/psychology , Urology , Videoconferencing
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