Efficacy of online psychoeducation and relaxation training program (OnPR) on mental health problems in COVID-19 patients: A randomized controlled trial.

Purpose: Prior studies found that the prevalence of anxiety, depression, stress and insomnia were relatively high in COVID-19 patients. This study aimed to explore the efficacy of OnPR on mental health outcomes in patients with asymptomatic or mildly symptomatic COVID-19. Patients and methods: We employed a randomized controlled trial following the CONSORT guidelines. The Thai Clinical Trials Registry identification number of this study is TCTR20220729003. We used a block of 4 randomizations generated by a computer program. The intervention group (n = 38) received the OnPR program, and the control group (n = 36) received care as usual. OnPR was an online psychological intervention comprising psychoeducation, sleep hygiene education and relaxation techniques. OnPR was provided by qualified therapists trained with a standard protocol. The primary outcomes were depression, anxiety, and stress, which were determined by the Depression Anxiety and Stress Scale-21 (DASS-21). Sleep quality was measured by the Pittsburgh Sleep Quality Index (PSQI). Outcomes were compared between groups at pre-intervention and post-intervention at 1, 4, and 12 weeks using paired t-test or Wilcoxon signed-rank test. In addition, a linear mixed model was employed to demonstrate the effect changes of OnPR over time. All analyses were two-tailed, with a significance level of 0.05. Results: Of 74 Thai participants, 89.2 % were female, and 11.8 % were male. The average age was 31 years. Participants' baseline characteristics were not statistically significant between the intervention and control groups except for depression and stress scores from DASS-21. OnPR resulted in significantly better improvement in depression, anxiety, stress, and sleep quality. The mean differences between groups of DASS-21 scores in depression, anxiety and stress at 7-day follow-up were -4.69, -3.29, and -5.50 respectively. The differences continue to be significant at 4-week and 12-week follow-ups. The mean difference between groups of PSQI at 7-day follow-up is -0.91. Conclusion: OnPR improved mental health outcomes, and the effect on depression, anxiety and stress lasted for at least a 12-week follow-up period. In addition, it could enhance sleep quality after the intervention.

Mental health among healthcare workers during COVID-19 pandemic in Thailand.

OBJECTIVES: This study aimed to measure the prevalence of burnout syndrome, anxiety, depression, and post-traumatic disorders (PTSD), as well as examine their associated factors among Thai healthcare workers (HCWs) during COVID-19 outbreak. METHOD: We employed a multiple-method design at a tertiary-care hospital in Bangkok between May 22, 2021 and June 30, 2021 by using an online survey. The information included demographic characteristics, work details, perceived support, PTSD symptoms, Maslach Burnout Inventory: General Survey (MBI-GS), General Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire (PHQ-2 and PHQ-9), and narrative response to an open-ended question. The associated factors of mental health problems were analysed by multiple logistic regression analyses. The qualitative data were analysed by the content analysis method. RESULTS: A total of 986 HCWs (89.1% female; mean age = 34.89 ± 11.05 years) responded to the survey. 16.3%,16%, and 53.5% of respondents had a high level of emotional exhaustion, depersonalisation, and diminished personal achievement, respectively. 33.1%, 13.8%, and 2.3% of respondents had anxiety, depression, and PTSD. Risk factors of emotional exhaustion were male sex (ORadj = 2.29), nurses (ORadj = 3.04), doctors (ORadj = 4.29), working at COVID-19 inpatient unit (ORadj = 2.97), and working at COVID-19 intensive care unit (ORadj = 3.00). Additionally, preexisting mental illness was associated with anxiety (ORadj = 2.89), depression (ORadj = 3.47), and PTSD (ORadj = 4.06). From qualitative analysis, participants reported that these factors would improve their mental health: supportive and respectful colleagues, appropriate financial compensation, reduced workload, clarity of policy and communication channel, and adequate personal protective equipment. CONCLUSIONS: Thai HCWs experienced negative mental health outcomes during the COVID-19 pandemic substantially. This issue needs attention and actions should be implemented to support them.

Factors Associated with Depressive Symptoms in Elderly Individuals Living in Urban Communities.

Background: Depression is one of the most significant mental illnesses in the elderly population. Societal and economic changes in the social structure, particularly in urban communities, have led to a tendency toward depression in the elderly. Therefore, understanding the factors associated with depression among the elderly living in urban areas in Thailand is important to prevent and mitigate depression. Objective: To investigate the proportion of depression and its associated factors in the elderly living in Bangkok. Materials and Methods: This was a cross-sectional descriptive study with a sample size of 888 people living in Thai urban communities, including those in slum, urban, suburban, and high-rise building areas. A two-parts questionnaire was used: 1) the Thai Geriatric Depression Scale (TGDS) to assess depression and 2) associated factors. Results: The overall percentage of depression in the sample population was 7.3%, and the proportion of depression was associated with community density (p = 0.031). The factors significantly associated with depression in the elderly included anxiety about an underlying disease [adjusted odds ratio (AOR) = 7.51; 95% CI 3.47-16.27], family conflict (AOR = 6.30; 95% CI 1.34-29.55), family history of psychiatric illness (AOR = 5.78; 95% CI 2.35-14.21), financial problems (AOR = 3.81; 95% CI 2.08-6.98), living separately from a spouse (AOR = 3.31; 95% CI 1.22-8.98), and less or no activity participation (AOR = 3.09; 95% CI 1.32-7.26 and AOR = 3.02; 95% CI 1.29-7.09). Conclusion: To mitigate depression in the elderly, attention should be given to any underlying medical disease. The community also should promote more activities accessible to the elderly, especially income-earning activities. These activities might promote better relationships or ease conflict among elderly and other family members.

Mental health problems of asymptomatic or mildly symptomatic COVID-19 patients in hospitel in Thailand: A cross-sectional study.

Background There is evidence that patients with COVID-19 have a higher prevalence of mental health problems than the normal population. This study aimed to investigate the prevalence of mental health problems and their associated factors in patients with asymptomatic or mildly symptomatic in the hospitel in Thailand. Methods Mental health problems were evaluated using the Depression, Anxiety, and Stress Scale - 21 items, and Patient Health Questionnaire-9. The prevalence of mental health problems was presented by frequency and percentage. McNemar's test was used to compare the prevalence of mental health problems between day 1 and day 7. Binary logistic regression was used to identify potential predictors of mental health problems. Results A total of 186 participants (68.3% female; mean age = 37.21 years (SD 13.66) were recruited. The depression, anxiety, and stress rate on day 1 of admission was 26.9%, 32.3% and 25.8%, respectively. Having mild COVID-19 symptoms was a significantly associated factor with anxiety (OR=2.69, 95%CI: 1.05-6.89) and stress (OR=4.53, 95%CI: 1.32-15.55). Conclusions There was a high rate of mental health problems in COVID-19 patients. Detecting and managing mental health problems should be considered standard care for COVID-19 patients.

Perceived Stress and Associated Factors Among Pregnant Women Attending Antenatal Care in Urban Thailand.

BACKGROUND: Perceived stress during pregnancy is associated with adverse obstetric outcomes. Antenatal perceived stress is still unaware and under-diagnosed during routine antenatal care. There has not yet been a study of prevalence and associated factors among pregnant women living in urban areas in Thailand. Understanding antenatal perceived stress is important to improve maternal and neonatal outcomes. OBJECTIVE: To identify the prevalence, associated factors, and predictive factors of perceived stress in pregnant women living in an urban area. MATERIALS AND METHODS: This cross-sectional study was conducted from December 1, 2019 to February 29, 2020 among pregnant women attending antenatal care at the Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Bangkok, Thailand. The participants were interviewed using a structured questionnaire which included demographic data, obstetric data, serious life event data, and a Thai language version of the 10-item Perceived Stress Scale (T-PSS-10) to assess perceived stress symptoms. RESULTS: Of a total 403 pregnant women, the prevalence of perceived stress symptoms in antenatal pregnant women was 23.6%. Perceived stress symptoms were significantly associated with divorce (p=0.001), separation from spouse (p=0.005), physical or psychological trauma from family (p=0.005), marital conflict (p<0.001), and family conflict (p<0.001). Results from multiple logistic regression found that significant predictive factors for perceived stress symptoms in pregnant women were marital conflict (AOR 3.10, 95% CI 1.74-5.52, p<0.001) and family conflict (AOR 3.24, 95% CI 1.59-6.60, p=0.001). CONCLUSION: This study demonstrated that the prevalence of perceived stress symptoms in pregnant women living in an urban area in Thailand was 23.6%. Perceived stress symptoms were significantly associated with divorce, separation from spouse, physical or psychological trauma from family, marital conflict, and family conflict. Predictive factors for perceived stress symptoms were marital conflict and family conflict.

Prevalence and Associated Factors of Antenatal Depressive Symptoms in Pregnant Women Living in an Urban Area of Thailand.

BACKGROUND: Depression is a major public health problem in middle- and low-income countries. Depression in pregnancy has adverse effects on obstetric outcomes. Maternal depression remains under-recognized, under-diagnosed and undertreated in Thailand. Antenatal screening of depression is an important strategy to improve maternal and neonatal outcomes. This problem has rarely been investigated in Thailand, especially in urban areas. OBJECTIVE: To discover the prevalence, associated factors, and predictive factors of depression in pregnant women living in an urban area. MATERIALS AND METHODS: This cross-sectional study of 402 pregnant women was conducted during antenatal care at the Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand, from 10 September to 31 November 2019. The participants were interviewed using a structured questionnaire that included a demographic profile, obstetric conditions, socio-cultural characteristics, and a Thai language version of the Center for Epidemiologic Studies-Depression Scale to assess depressive symptoms. RESULTS: Among a total 402 pregnant women, the prevalence of depressive symptoms in pregnant women in an urban area was 18.9%. Depressive symptoms in pregnant women were significantly associated with divorce (p < 0.001), low family income (p < 0.03), financial insufficiency (p < 0.001), extended family (p < 0.001), history of previous abortion (p = 0.033), history of previous pregnancy complications (p = 0.044), current alcohol use (p = 0.03), current tobacco use (p = 0.009), current substance abuse (p = 0.002), marital conflict (p < 0.001), and family conflict (p < 0.001). The significant factors predicting depression in pregnant women were extended family (AOR 3.0, 95% CI 1.59-5.51, p=0.001) and marital conflict (AOR 4.7, 95% CI 2.37-9.11, p<0.001). CONCLUSION: This study revealed that the prevalence of depressive symptoms in pregnant women living in an urban area in Thailand was 18.9%. The significant associated factors of depressive symptoms were divorce, low family income, financial insufficiency, extended family, previous abortion, previous pregnancy complications, current alcohol use, current tobacco use, current substance abuse, marital conflict, and family conflict. Extended family and marital conflict were significant predictive factors for antenatal depressive symptoms.