The relationship among psychological distress, well-being and excessive social media use during the outbreak of Covid-19: A longitudinal investigation.

INTRODUCTION: The corona pandemic has been a life event causing negative consequences on mental health. Mental health consists of positive and negative dimensions. The present longitudinal study investigated how positive and negative dimensions changed over 15 months after the Covid-19 outbreak. Potential changes of excessive social media use (SMU) and its relationship with mental health were also investigated. METHOD: Data (N = 189) on distress (measured overall and as depression, anxiety, and stress), well-being and excessive SMU were collected at three time points (baseline, BL; 3-month follow-up, FU1; 15-month follow-up, FU2) via online surveys in Italy. Repeated analyses of variance were used to test differences among the three measurement time points. Mediational models were applied. RESULTS: Distress did not change over time, well-being decreased and excessive SMU increased significantly. The relationship between distress at BL and excessive SMU at FU2 was significant (total effect, c: p < .001). The relationship between distress at BL and well-being at FU1 (a: p < .001), and between well-being at FU1and excessive SMU at FU2 (b: p = .004) was significant. Including FU1 well-being in the model, the relationship between distress at BL and excessive SMU at FU2 was not significant (direct effect, c': p = .078). The indirect effect (ab) was significant. CONCLUSION: Well-being mediated the relationship between baseline stress and excessive SMU. Enhanced stress may reduce well-being which, in turn, increases the risk of excessive SMU. This emphasizes the urgency of programmes that foster well-being, especially during stressful events such as a pandemic.

Anxiety in the Medically Ill: A Systematic Review of the Literature.

Background: Although anxiety is highly represented in the medically ill and its occurrence has relevant clinical implications, it often remains undetected and not properly treated. This systematic review aimed to report on anxiety, either symptom or disorder, in patients who suffer from a medical illness. Methods: English-language papers reporting on anxiety in medically ill adults were evaluated. PubMed, PsycINFO, Web of Science, and Cochrane databases were systematically searched from inception to June 2021. Search term was "anxiety" combined using the Boolean "AND" operator with "medically ill/chronic illness/illness/disorder/disease." Risk of bias was assessed via the Joanna Briggs Institute (JBI) Critical Appraisal Tools-Checklist for Prevalence Studies. The PRISMA guidelines were followed. Results: Of 100,848 citations reviewed, 329 studies met inclusion criteria. Moderate or severe anxious symptoms were common among patients with cardiovascular, respiratory, central nervous system, gastrointestinal, genitourinary, endocrine, musculoskeletal system or connective tissue, dermatological diseases, cancer, AIDS and COVID-19 infections. The most common anxiety disorder was generalized anxiety disorder, observed among patients with cardiovascular, respiratory, central nervous system, dermatologic diseases, cancer, primary aldosteronism, amenorrhea, and COVID-19 infection. Panic disorder was described for cardiovascular, respiratory, dermatology diseases. Social anxiety was found for cardiovascular, respiratory, rheumatoid diseases. Specific phobias were relatively common in irritable bowel syndrome, gastroesophageal reflux, end-stage renal disease. Conclusion: Anxiety is a major challenge in medical settings. Recognition and proper assessment of anxiety in patients who suffer from a medical illness is necessary for an appropriate management. Future reviews are warranted in order also to clarify the causal and temporal relationship between anxiety and organic illness.

Impact of COVID-19 outbreak on Italian healthcare workers versus general population: Results from an online survey.

OBJECTIVE: COVID-19 pandemic has been a stressful condition. We explored life changes and health-related consequences of COVID-19 outbreak in Italian healthcare workers in comparison to the general population. METHODS: A total of 593 subjects participated to the online CoRonavIruS Health Impact Survey. Life events and changes, physical health and worries were evaluated referring to 2 weeks prior to the survey. Mood states and daily behaviour were retrospectively evaluated referring to 3 months before COVID-19 (T1) and 2 weeks prior to the survey (T2). Student t test, Mann-Whitney test and multivariate logistic regression analyses were run. RESULTS: Five hundred and twenty-one subjects were analysed (healthcare workers: n = 163, 31.84%; general population: n = 349, 68.16%). Healthcare workers were more likely to report fatigue and have spent more time outside home during the 2 weeks prior to the survey than the general population (χ2 (df) = 266.03(17) , p < 0.001, R2 = 0.57). From T1 to T2, healthcare workers had a significant increase in negative mood, worry, restlessness, loneliness and a decrease in happiness, while subjects from the general population had a statistically significant increase in negative mood, worry, attention, concentration difficulties and a decrease in happiness, pleasure related to daily activities, time spent outdoors and alcohol use. CONCLUSION: In the framework of a growing literature on healthcare workers' status during the COVID-19 pandemic, the present study allowed to identify fatigue and loneliness as psychosomatic modifiable variables in need of being monitored and, possibly managed, to ameliorate the health status of healthcare workers.

Expert opinion in anxiety disorder: Corona-phobia, the new face of anxiety

The Covid-19 pandemic changed our lives quickly and abruptly. This occurred in a radical and, often, unexpected way. During 2020, in favor of social distance, restrictions on leaving home, participating in social activities, and even working impacted our lives. The health agenda in the face of the pandemic encompasses a huge range of areas that must be covered, but it is necessary to draw the attention to the general population mental health, which gives worrying evidence. The pandemic has been described by epidemiologists in terms of waves of infection. The world is now facing the second wave of infection and the experts already worry for the third one. However, another wave has occurred in between and within the waves of infection;it is the wave of mental health problems caused directly by the infection or by its secondary consequences.

The association between depression symptoms, psychological burden caused by Covid-19 and physical activity: An investigation in Germany, Italy, Russia, and Spain.

The outbreak of Covid-19 required the re-organization of everyday life. While some people accepted this challenge, other experienced the current situation as a heavy burden that impedes the adaptation to the new life conditions. The present study investigated factors that can impact the level of burden caused by Covid-19. Burden, depression symptoms and frequency of physical activity (e.g., jogging, cycling) were assessed via online surveys in overall 1,931 people from four countries (Germany: N = 625; Italy: N = 936; Russia: N = 230; Spain: N = 140). Similar result patterns were found in all country-specific samples. Burden by Covid-19 was significantly positively associated with depression symptoms, while it was significantly negatively linked to physical activity. Moreover, physical activity buffered the association between depression symptoms and burden. The present cross-national findings emphasize the protective effect of physical activity specifically in times of Covid-19. This issue should be addressed in governmental programs to longitudinally protect mental and physical health and to enhance the willingness to adhere to the anti-Covid-19 measures among the population.

Post-COVID-19 Epidemic: Allostatic Load among Medical and Nonmedical Workers in China.

BACKGROUND: As the fight against the COVID-19 epidemic continues, medical workers may have allostatic load. OBJECTIVE: During the reopening of society, medical and nonmedical workers were compared in terms of allostatic load. METHODS: An online study was performed; 3,590 Chinese subjects were analyzed. Socio-demographic variables, allostatic load, stress, abnormal illness behavior, global well-being, mental status, and social support were assessed. RESULTS: There was no difference in allostatic load in medical workers compared to nonmedical workers (15.8 vs. 17.8%; p = 0.22). Multivariate conditional logistic regression revealed that anxiety (OR = 1.24; 95% CI 1.18-1.31; p < 0.01), depression (OR = 1.23; 95% CI 1.17-1.29; p < 0.01), somatization (OR = 1.20; 95% CI 1.14-1.25; p < 0.01), hostility (OR = 1.24; 95% CI 1.18-1.30; p < 0.01), and abnormal illness behavior (OR = 1.49; 95% CI 1.34-1.66; p < 0.01) were positively associated with allostatic load, while objective support (OR = 0.84; 95% CI 0.78-0.89; p < 0.01), subjective support (OR = 0.84; 95% CI 0.80-0.88; p < 0.01), utilization of support (OR = 0.80; 95% CI 0.72-0.88; p < 0.01), social support (OR = 0.90; 95% CI 0.87-0.93; p < 0.01), and global well-being (OR = 0.30; 95% CI 0.22-0.41; p < 0.01) were negatively associated. CONCLUSIONS: In the post-COVID-19 epidemic time, medical and nonmedical workers had similar allostatic load. Psychological distress and abnormal illness behavior were risk factors for it, while social support could relieve it.

COVID-19 pandemic: study on simple, easy, and practical relaxation techniques while wearing medical protective equipment.

BACKGROUND: No studies have reported on how to relieve distress or relax in medical health workers while wearing medical protective equipment in coronavirus disease 2019 (COVID-19) pandemic. The study aimed to establish which relaxation technique, among six, is the most feasible in first-line medical health workers wearing medical protective equipment. METHODS: This was a two-step study collecting data with online surveys. Step 1: 15 first-line medical health workers were trained to use six different relaxation techniques and reported the two most feasible techniques while wearing medical protective equipment. Step 2: the most two feasible relaxation techniques revealed by step 1 were quantitatively tested in a sample of 65 medical health workers in terms of efficacy, no space limitation, no time limitation, no body position requirement, no environment limitation to be done, easiness to learn, simplicity, convenience, practicality, and acceptance. RESULTS: Kegel exercise and autogenic relaxation were the most feasible techniques according to step 1. In step 2, Kegel exercise outperformed autogenic relaxation on all the 10 dimensions among the 65 participants while wearing medical protective equipment (efficacy: 24 v. 15, no space limitation: 30 v. 4, no time limitation: 31 v. 4, no body position requirement: 26 v. 4, no environment limitation: 30 v. 11, easiness to learn: 28 v. 5, simplicity: 29 v. 7, convenience: 29 v. 4, practicality: 30 v. 14, acceptance: 32 v. 6). CONCLUSION: Kegel exercise seems a promising self-relaxation technique for first-line medical health workers while wearing medical protective equipment among COVID-19 pandemic.

Mental Health and Psychosocial Problems of Medical Health Workers during the COVID-19 Epidemic in China.

OBJECTIVE: We explored whether medical health workers had more psychosocial problems than nonmedical health workers during the COVID-19 outbreak. METHODS: An online survey was run from February 19 to March 6, 2020; a total of 2,182 Chinese subjects participated. Mental health variables were assessed via the Insomnia Severity Index (ISI), the Symptom Check List-revised (SCL-90-R), and the Patient Health Questionnaire-4 (PHQ-4), which included a 2-item anxiety scale and a 2-item depression scale (PHQ-2). RESULTS: Compared with nonmedical health workers (n = 1,255), medical health workers (n = 927) had a higher prevalence of insomnia (38.4 vs. 30.5%, p < 0.01), anxiety (13.0 vs. 8.5%, p < 0.01), depression (12.2 vs. 9.5%; p< 0.04), somatization (1.6 vs. 0.4%; p < 0.01), and obsessive-compulsive symptoms (5.3 vs. 2.2%; p < 0.01). They also had higher total scores of ISI, GAD-2, PHQ-2, and SCL-90-R obsessive-compulsive symptoms (p ≤ 0.01). Among medical health workers, having organic disease was an independent factor for insomnia, anxiety, depression, somatization, and obsessive-compulsive symptoms (p < 0.05 or 0.01). Living in rural areas, being female, and being at risk of contact with COVID-19 patients were the most common risk factors for insomnia, anxiety, obsessive-compulsive symptoms, and depression (p < 0.01 or 0.05). Among nonmedical health workers, having organic disease was a risk factor for insomnia, depression, and obsessive-compulsive symptoms (p < 0.01 or 0.05). CONCLUSIONS: During the COVID-19 outbreak, medical health workers had psychosocial problems and risk factors for developing them. They were in need of attention and recovery programs.