The effect of age, gender, income, work, and physical activity on mental health during coronavirus disease (COVID-19) lockdown in Austria

Coping strategies and mental health during COVID-19 lockdown

BACKGROUND

COVID-19 pandemic lockdown measures changed the everyday lives of people around the world.

AIMS

To evaluate the effects of different coping strategies on mental health during COVID-19 lockdown.

METHODS

A representative sample for Austria was recruited through Qualtrics^® in a period of 4 weeks after the lockdown started. Measurements were coping inventory (SCI), psychological quality of life (WHO-QOL BREF, psychological domain), well-being (WHO-5), depression (PHQ-9), anxiety (GAD-7), stress (PSS-10), and insomnia (ISI). Regression analyses were performed with coping strategies as predictors and mental health measures as dependent variables.

RESULTS

The representative sample included N = 1,005 respondents (52.7% women). Positive thinking, active stress coping and social support were found to be positive predictors for psychological life quality, well-being, and negative predictors for perceived stress, depression, anxiety, and insomnia. Alcohol and cigarette consumption was a negative predictor for psychological life quality, and well-being, and a positive predictor for perceived stress, depression, anxiety, and insomnia. Support in faith was a positive predictor for perceived stress, depression, anxiety, and insomnia.

CONCLUSIONS

Coping strategies are significant predictors for mental health measures. Education about positive thinking, active coping, and social support could be beneficial for dealing with a decrease in mental health due to COVID-19 pandemic.

The Role of Coping in the Wellbeing and Work-Related Quality of Life of UK Health and Social Care Workers during COVID-19

The coronavirus disease 2019 (COVID-19) was declared a global pandemic in early 2020. Due to the rapid spread of the virus and limited availability of effective treatments, health and social care systems worldwide quickly became overwhelmed. Such stressful circumstances are likely to have negative impacts on health and social care workers' wellbeing. The current study examined the relationship between coping strategies and wellbeing and quality of working life in nurses, midwives, allied health professionals, social care workers and social workers who worked in health and social care in the UK during its first wave of COVID-19. Data were collected using an anonymous online survey (N = 3425), and regression analyses were used to examine the associations of coping strategies and demographic characteristics with staff wellbeing and quality of working life. The results showed that positive coping strategies, particularly active coping and help-seeking, were associated with higher wellbeing and better quality of working life. Negative coping strategies, such as avoidance, were risk factors for low wellbeing and worse quality of working life. The results point to the importance of organizational and management support during stressful times, which could include psycho-education and training about active coping and might take the form of workshops designed to equip staff with better coping skills.

The Impact of COVID-19 Pandemic and Lockdown Measures on Quality of Life among Italian General Population

The COVID-19 pandemic that has hit the world in the year 2020 has put a strain on our ability to cope with events and revolutionized our daily habits. On 9 March, Italy was forced to lockdown to prevent the spread of the infection, with measures including the mandatory closure of schools and nonessential activities, travel restrictions, and the obligation to spend entire weeks in the same physical space. The aim of this study was to assess the impact of the COVID-19 pandemic and lockdown measures on quality of life (QoL) in a large Italian sample, in order to investigate possible differences in QoL levels related to both demographic and pandemic-specific variables. A total of 2251 Italian adults (1665 women, mainly young and middle adults) were recruited via a snowball sampling strategy. Participants were requested to answer to an online survey, which included demographic and COVID-related information items, and the World Health Organization Quality of Life BREF questionnaire (WHOQOL-BREF). The results showed statistically significant differences in QoL depending on a number of variables, including sex, area of residence in Italy, and being diagnosed with a medical/psychiatric condition. To our knowledge, this is the first study to assess QoL during COVID-19 pandemic in Italy, therefore the present findings can offer guidelines regarding which social groups are more vulnerable of a decline in QoL and would benefit of psychological interventions.

[Online psychotherapy in times of the corona pandemic]

BACKGROUND

The prevalence of mental illnesses in the population has enormously increased during the corona pandemic due to the accompanying burdens and distress. Therefore, it is important to continue with the provision of psychotherapeutic treatment even in times of social distancing. As a result, psychotherapists were soon confronted with the need to expand their traditional treatment setting and offer remote treatment.

OBJECTIVE

Which digital treatment options are available to psychotherapists since the pandemic, also with respect to the legal regulations? To what extent and how did they use video-based or telephone-based psychotherapy? What is the current stage of research regarding the effectiveness of video(telephony)? How can therapeutic alliance be built into video(telephony) settings? How can psychotherapists successfully apply their personal therapeutic method to different patient groups (children, adolescents, adults) in the new digital setting?

METHODS

These questions are answered based on a literature search and clinical considerations.

RESULTS

The majority of psychotherapists have immediately adapted to remote treatment. This has been supported by the government by expanding existing regulations in order to continue treatment with current and new patients without physical contact during the pandemic crisis. Survey studies have shown that psychotherapists consider the effectiveness of digital treatment settings to be lower than the traditional setting.

CONCLUSION

Further training is necessary to educate psychotherapists in the theory, practice and self-awareness for quality assurance in the video(telephony) setting.

Examine the associations between perceived neighborhood conditions, physical activity, and mental health during the COVID-19 pandemic

This study examined how neighborhood conditions changed and how neighborhood conditions were associated with physical activity and mental health during the COVID-19 pandemic among Americans. The major outcomes were stratified by the neighborhood's poverty and regression models were used to assess the associations between neighborhood conditions and their change during the pandemic and the outcomes of physical activity and mental health. The results show that low-poverty neighborhoods had more health-promoting neighborhood conditions before the outbreak and more positive changes during the outbreak. Health-promoting neighborhood conditions were associated with higher physical activity and moderate physical activity and lack of negative neighborhood conditions such as crime/violence and traffic were associated with a lower risk of mental health problems including loneliness, depression, and anxiety. Mental health problems were also significantly associated with the COVID-19 infection and death and household income level. Our findings suggest that it is plausible that the disparities of physical activity and mental health by neighborhood exacerbate due to the pandemic and people who living in socioeconomically disadvantaged neighborhoods bear increasingly disproportionate burden.

Psychological Distress, Loneliness, and Boredom Among the General Population of Tyrol, Austria During the COVID-19 Pandemic

Background: COVID-19-related mental health problems are considered a public health challenge. The aim of this study was to investigate psychological distress, loneliness, and boredom among the general population of the federal state of Tyrol, Austria. Methods: Residents of Tyrol aged ≥ 18 years were recruited via dissemination of a link through social media and other advertisements and invited to complete an online survey from June 26th to August 20th, 2020. Next to the collection of sociodemographic and COVID-19 related variables the Brief Symptom Checklist (BSCL), the Three-Item Loneliness Scale (TILS), and the Multidimensional State Boredom Scale-Short Form (MSBS-SF) were used to assess psychological distress, loneliness, and boredom. Results: 961 participants took part in the survey (68.3% woman). Of these, 14.4% were burdened from psychological distress (BSCL), 22.6% reached a TILS score ≥ 7 and were therefore classified as severely lonely, and boredom levels lay by a mean of 25.9 ± 11.0 points in the MSBS-SF (range: 7-56). Women, singles, low-income people as well as those who were unemployed were significantly more often affected by all of the selected outcomes compared to the remaining sample and they had significantly more frequently consumed alcohol or other substances since the outbreak of the pandemic in order to feel better. In addition, young and middle-aged adults were particularly burdened by loneliness and boredom. Discussion: Our findings identify vulnerable groups and factors associated with higher psychological distress, loneliness, and boredom in the context of the pandemic. In order to prevent mental health problems it will be critical to identify options of maintaining social contacts and remaining active despite pandemic-related restrictions.

A Comparative Study on the Psychological Health of Frontline Health Workers in Wuhan Under and After the Lockdown

Background: The coronavirus disease-2019 (COVID-19) outbreak and a 3-month lockdown of Wuhan may have had a long-term impact on the mental health of frontline healthcare workers (HWs). However, there is still a lack of comparative studies on the mental health of front-line HWs in the initial phase of the lockdown and 1 month after the lifting of the lockdown. Methods: We recruited 1717 HWs during the initial phase of the lockdown and 2214 HWs 1 month after the lifting of the lockdown, and their baseline characteristics and psychiatric health in these two phases were compared. Furthermore, Pearson's Chi-square test and multivariate logistic regression analysis were used to determine the possible risk factors associated with depressive symptoms in the front-line HWs. Results: Compared with the initial phase of the lockdown, the proportion of HWs with anxiety symptoms and stress decreased, while the proportion of HWs with depressive symptoms increased a month after the lifting of the lockdown. Male sex, exercise habit, comorbidities, and having family members or relatives with suspected or confirmed COVID-19 infection were significantly related to the increased incidence of depressive symptoms during the initial phase of the lockdown. Comorbidities, negative effect of media coverage, working >4 days a week, lower annual household income, and deteriorating relationships with family members were associated with depressive symptoms a month after the lifting of the lockdown. Conclusion: The increased proportion of HWs with depressive symptoms 1 month after the lifting of the lockdown suggested that mental health of front-line HWs should be a top-priority issue, not only during, but also after the pandemic.

Depression and Health-Related Quality of Life Among Elderly Patients during the COVID-19 Pandemic in Israel: A Cross-sectional Study

AIM

This study aims to assess how optimism, social support, and perceived susceptibility are associated with depressive symptoms and health-related quality of life among elderly patients during the COVID-19 pandemic in Israel.

METHODS

In a cross-sectional study, 256 participants age 60 through 95 completed the following self-administered questionnaires: Perceived Susceptibility, Life Orientation Test (LOT-R), Multidimensional Scale of Perceived Social Support (MSPSS), Symptoms of Depression (CES-D) and health-related quality of life (SF-12v2 Health Survey). Data were collected from June to July 2020, 3 months after the COVID-19 state of emergency was declared in Israel. Participants were interviewed by family medicine residents via telephone. Statistical analyses included Pearson correlations, t-tests between groups, regression analyses, and Hayes' PROCESS to analyze a moderated mediation model.

RESULTS

Of the elderly participants, 37.5% were classified as having depression. Optimism, social support and health-related quality of life were positively associated. Higher optimism and social support were related to lower perceived susceptibility and lower depression. Results of a multivariate regression explained 29% of the variance in depression and 19% of the variance in health-related quality of life. The relationships assessed by 4 Process models were significant, such that higher optimism and social support were related to lower perceived susceptibility, which in turn was related to higher depression and lower health-related quality of life.

CONCLUSIONS

Optimism and social support may be effective in coping with challenges and buffering depression. Perceived susceptibility may mediate the association of optimism and social support with higher depression and lower health-related quality of life. The conclusions of this study underscore the need to treat depression among older adults during this period. Hence, healthcare providers should also support elderly patients living at home. In giving this type of help, healthcare providers should strive to increase social support and optimism among older adults.

The impact of lockdown during the COVID-19 pandemic on mental and social health of children and adolescents

PURPOSE

During the COVID-19 pandemic in the Netherlands, governmental regulations resulted in a lockdown for adults as well as children/adolescents. Schools were closed and contact with other people was limited. In this cross-sectional, population-based study, we aimed to investigate the mental/social health of children/adolescents during COVID-19 lockdown.

METHODS

Two representative samples of Dutch children/adolescents (8-18 years) before COVID-19 (2018, N = 2401) and during lockdown (April 2020, N = 844) were compared on the Patient-Reported Outcomes Measurement Information System (PROMIS) domains: global health, peer relationships, anxiety, depressive symptoms, anger, sleep-related impairment by linear mixed models and calculating relative risks (RR (95% CI)) for the proportion of severe scores. Variables associated with worse mental/social health during COVID-19 were explored through multivariable regression models. The impact of COVID-19 regulations on the daily life of children was qualitatively analyzed.

RESULTS

Participants reported worse PROMIS T-scores on all domains during COVID-19 lockdown compared to before (absolute mean difference range 2.1-7.1 (95% CI 1.3-7.9). During lockdown, more children reported severe Anxiety (RR = 1.95 (1.55-2.46) and Sleep-Related Impairment (RR = 1.89 (1.29-2.78) and fewer children reported poor Global Health (RR = 0.36 (0.20-0.65)). Associated factors with worse mental/social health were single-parent family, ≥ three children in the family, negative change in work situation of parents due to COVID-19 regulations, and a relative/friend infected with COVID-19. A large majority (> 90%) reported a negative impact of the COVID-19 regulations on daily life.

CONCLUSION

This study showed that governmental regulations regarding lockdown pose a serious mental/social health threat on children/adolescents that should be brought to the forefront of political decision-making and mental healthcare policy, intervention, and prevention.

Civil unrest, COVID-19 stressors, anxiety, and depression in the acute phase of the pandemic: a population-based study in Hong Kong

PURPOSE

To examine the joint associations of civil unrest and COVID-19 with probable anxiety and depression during the first half of 2020 in Hong Kong. Associations were compared between persons with low or high assets.

METHODS

A population-representative sample of 4011 Hong Kong Chinese residents aged 15 years or older were recruited between February and May 2020. Respondents reported current anxiety and depressive symptoms, unrest stress, COVID-19 stress, assets (savings and home ownership), and demographics.

RESULTS

Stress due to unrest and COVID-19 was associated with higher prevalence of probable anxiety and depression; persons with both stressors had higher prevalence. This pattern was consistent among persons with low or high assets, but the probabilities of mental disorder were substantially higher among persons with fewer assets.

CONCLUSIONS

The effect of stressors on probable anxiety and depression are cumulative: persons with stress due to civil unrest and to COVID-19 reported more mental disorders than persons with stress due to only one, or none of these factors. Overall high assets appear to buffer the consequences of stressors, lowering the risk of mental disorder.

Mental health status and risk factors during Covid-19 pandemic in the Croatia's adult population

Background: The Covid-19 pandemic is associated with adverse mental health outcomes for people worldwide.Objective: The study aimed to assess mental health during the Covid-19 pandemic and the key risk factors from the human ecology perspective in Croatia's adult population.Method: An online panel survey with 1,201 adult participants (50.1% women) was done with a nationally representative sample in terms of gender, age, and country region four months after the nation lockdown began and two months after most of the restrictions were lifted. Indicators of mental health included symptoms of adjustment disorder (ADNM-8); depression, anxiety, and stress (DASS-21); symptoms of post-traumatic stress disorder (PC-PTSD-5); and well-being (WHO-5).Results: In the entire sample, 9.8% (95% confidence interval [CI]: 7.9%, 14.0%) of the participants were at risk of adjustment disorder, 7.7% (95% CI: 6.7%, 11.9%) were at risk of depression disorder, and 7.8% (95% CI: 5.3%, 10.3%) were at risk of anxiety disorder. In addition, 7.2% (95% CI: 5.3%, 10.2%) were experiencing high levels of stress. The average well-being score was 56.5 (SD = 21.91) on a scale from 0 to 100. Among the participants who have lifetime traumatic experience (n = 429), 14% (95% CI: 10.6%, 17.2%) were at risk for PTSD. Key risk factors for specific mental health outcomes differed, but the common ones included: current health status, previous mental health diagnosis, and psychological resilience. Being younger, having a below-average income, and excessively following news about Covid-19 were predictive for some of the mental health problems.Conclusions: Together, the key risk factors identified in this study indicate the need for public health interventions addressing the general population's mental health, but also for specific risk groups. Lower rates of mental health symptoms assessed soon after lifting quarantine measures that have been found in other studies may indicate human resilience capacity.

Disrupted rhythms of life, work and entertainment and their associations with psychological impacts under the stress of the COVID-19 pandemic: A survey in 5854 Chinese people with different sociodemographic backgrounds

BACKGROUND & AIM

The coronavirus disease 2019 (COVID-19) pandemic has affected the life and work of people worldwide. The present study aimed to evaluate the rhythm disruptions of life, work, and entertainment, and their associations with the psychological impacts during the initial phase of the COVID-19 pandemic.

METHOD

A cross-sectional study was conducted from the 10th to 17th March 2020 in China. A structured e-questionnaire containing general information, the Chinese version of Brief Social Rhythm Scale, and Zung's self-rating scales of depression and anxiety (SDS and SAS) was posted and collected online through a public media (i.e. EQxiu online questionnaire platform). Scores in sleeping, getting up, and socializing (SGS) rhythm and eating, physical practice, and entertainment (EPE) rhythm were compared among and between participants with different sociodemographic backgrounds including gender, age, education, current occupation, annual income, health status, and chronic disease status. Correlations of SDS and SAS with SGS-scale and EPE-scale were also analyzed.

RESULTS

Overall, 5854 participants were included. There were significant differences in the scores of SGS-scale and EPE-scale among people with different sociodemographic backgrounds. The scores were significantly higher in the groups with female gender, low education level, lower or higher than average income, poor health status, ages of 26-30 years or older than 61 years, nurses and subjects with divorce or widow status. There were also significant differences in SAS and SDS scores among people with different sociodemographic backgrounds (all P< 0.05). The overall prevalence of depression and anxiety was 24.3% and 12.6%, respectively, with nurses having the highest rates of depression (32.94%) and anxiety (18.98%) among the different occupational groups. SGS-scale was moderately correlated with SDS and SAS, and disruption of SGS rhythm was an independent risk factor for depression and anxiety.

CONCLUSION

Social rhythm disruption was independently associated with depression and anxiety. Interventions should be applied to people vulnerable to the rhythm disruption during the COVID-19 pandemic.

Coping With the COVID-19 Pandemic: Examining Gender Differences in Stress and Mental Health Among University Students

The COVID-19 pandemic has imposed a wide variety of unprecedented challenges, many of which appear to be disproportionately affecting the mental health and well-being of young adults. While there is evidence to suggest university students experience high rates of mental health disorders, less is known about the specific impacts of the COVID-19 pandemic on student mental health and how they are coping with this stress. To address this gap, we conducted an online study among undergraduate students (n = 366) to examine the impact of the COVID-19 pandemic on academics, social isolation, and mental health, as well as the extent to which they have been implementing a variety of coping strategies. The pandemic had a more pronounced negative effect on female students' academics, social isolation, stress and mental health compared to male counterparts. Moreover, for females, frequent use of social media as a coping mechanism was associated with greater perceived negative impacts on their academic performance and stress levels, compared to males. However, frequent social media use related to similar negative mental health effects for both males and females. While male and female students both reported using substances to cope, for males the use of cannabis was associated with greater negative impacts on academic outcomes, stress and mental health compared to females. These findings highlight the need for adequate student support services across the post-secondary sector, and point to the importance of gender informed interventions to address the impacts of the COVID-19 pandemic.

Psychiatric emergency visit trends and characteristics in a mental health epicenter in Istanbul during COVID-19 lockdown

BACKGROUND

We aimed to explore the impact of the preventive measures and partial lockdown to the psychiatric emergency department (PED) visits during COVID-19 pandemic in a mental health epicenter in Istanbul.

METHODS

A total of 5839 patients admitted to PED during the lockdown period (LP) between March 30 and May 31, 2020, were enrolled in this retrospective cohort study. Data of these patients were compared to those of patients in the same period in 2019 between April 1 and June 2, 2019 (non-LP). We also investigated the monthly number of PED visits and hospitalizations between March 1 and December 31, 2020, and compared it to the same period in 2019.

RESULTS

The volume of PED visits and hospitalizations in LP decreased by 12% and 41.6%, respectively. The rates of patients presenting anxiety and depressive disorders and bipolar disorders were found to significantly increase in LP than non-LP (p < 0.001; p < 0.001; p < 0.01, respectively). Depressive disorders, prior history of mental illness, and aggressive behavior were found to predict frequent PED visits while decrease in age and male gender found to predict hospitalizations. Regarding suicide attempt, younger patients and those with new-onset mental disorders were found to be at high risk in LP. Patients diagnosed with COVID-19 in PED visits were mostly with psychotic and bipolar disorders.

CONCLUSION

Policy-makers should focus on studies on mental health services to reorganize and enhance such services, which are crucial to prevent and manage adverse mental health consequences of the pandemic and congestion in PEDs.

The Psychological Impact of Coronavirus on University Students and its Socio-Economic Determinants in Malaysia

The objective of this article is to examine the impact of coronavirus disease 2019 (COVID-19) upon university students’ anxiety level and to find the factors associated with the anxiety level in Malaysia. We collected data from 958 students from 16 different universities using an originally designed questionnaire. The Generalized Anxiety Disorder Scale 7-item (GAD-7) was used to estimate the anxiety. Then we applied the ordered logit model to calculate the odds ratios (OR) and factors associated with the anxiety level. We find that 12.3% of students were normal, whereas 30.5% were experiencing mild anxiety, 31.1% moderate anxiety, and 26.1% severe anxiety. Surprisingly, only 37.2% of students were aware of mental health support that was provided by their universities. However, age above 20 years (OR = 1.30), ethnicity Chinese (OR = 1.72), having any other disease (OR = 2.0), decreased family income (OR = 1.71), more time spent on watching COVID-19-related news (OR = 1.52), and infected relative or friends (OR = 1.62) were risk factors for anxiety among students. We conclude that the government of Malaysia should monitor the mental health of the universities’ students more closely and universities should open online mental health support clinics to avoid the adverse impacts of anxiety.

Prevalence and Risk Factors Associated with Insomnia Symptoms Among the Chinese General Public After the Coronavirus Disease 2019 Epidemic Was Initially Controlled

INTRODUCTION

The prevalence rate and related factors of insomnia remained unknown after the COVID-19 epidemic had been under control. Therefore, we conducted this survey to investigate the prevalence rate and related factors of insomnia symptoms in the Chinese general public after the COVID-19 had been initially control.

METHODS

An online survey was conducted among Chinese citizens through the JD Health APP. The questionnaire was used for collecting demographic data and self-designed questions related to the COVID-19 outbreak. Insomnia Severity Index, Patient Health Questionnaire-9, Somatic Symptom Scale-8 and Impact of Events Scale-Revised were used for measuring psychological symptoms. To examine the associations of sociodemographic and psychological factors with insomnia symptoms, a binary logistic regression was used.

RESULTS

In total, there were 14,894 eligible participants, and 4601 (30.9%) participants were found to have insomnia symptoms. The regression model revealed that a higher risk of insomnia symptoms was associated with being over the age of 40 years, having history of psychiatric disorders, smoking, having infected friends or colleagues, having depressive or somatic symptoms, experiencing psychological distress and feeling estranged from family members. Meanwhile a lower risk of insomnia symptoms was associated with being female, having closer family relationships, not feeling alienated from others and being satisfied with the available information.

CONCLUSION

In our study, 30.9% of the participants in the general public reported insomnia symptoms after the COVID-19 epidemic had been initially controlled. When providing precise interventions for insomnia, extra attention should be paid to the individuals who are male, elderly and smokers, and those with psychiatric disorder history, with infected friends or colleagues, with psychological symptoms and with poor social support.

Sharp increase in depression and anxiety among Brazilian adults during the COVID-19 pandemic: findings from the PAMPA cohort

Objectives

We aimed to compare the prevalence of depression and anxiety symptoms before and during the pandemic and identify factors associated with aggravated mental health symptoms.

Study design

Retrospective cohort study.

Methods

We identified the proportion of normal, mild, moderate, and severe symptoms of depression and anxiety before and during the social distancing restrictions in adults from southern Brazil. An online, self-administered questionnaire was delivered for residents within the state of Rio Grande do Sul. Depressive and anxiety symptoms were examined by the Hospital Anxiety and Depression Scale.

Results

Most of the participants (n = 2314) aged between 31 and 59 years (54.2%), were women (76.6%), White (90.6%) with a university degree (66.6%). Moderate-to-severe symptoms of depression and anxiety were reported in 3.9% and 4.5% of participants, respectively, before COVID-19. During the pandemic (June–July, 2020), these proportions increased to 29.1% (6.6-fold increase) and 37.8% (7.4-fold increase), respectively. Higher rates of depressive and anxiety symptoms were observed among women, those aged 18–30 years, diagnosed with chronic disease and participants who had their income negatively affected by social restrictions. Remaining active or becoming physically active during social distancing restrictions reduced the probability of aggravated mental health disorders.

Conclusions

Depressive and anxiety symptoms had a 6.6- and 7.4-fold increase since the COVID-19 pandemic. Public policies such as physical activity promotion and strategies to reduce the economic strain caused by this pandemic are urgently needed to mitigate the impact of the pandemic on mental health.

Change in Physical Activity, Sleep Quality, and Psychosocial Variables during COVID-19 Lockdown: Evidence from the Lothian Birth Cohort 1936

(1) Objectives: The COVID-19 pandemic has disproportionately affected the lives of older people. In this study, we examine changes in physical activity, sleep quality, and psychosocial variables among older people during COVID-19 lockdown. We build on cross-sectional studies on this topic by assessing change longitudinally. We also examined whether participant characteristics including demographic, cognitive, personality, and health variables were related to more positive or negative changes during lockdown. (2) Methods: 137 older participants (mean age 84 years) from the Lothian Birth Cohort 1936 study were included in the analysis. They completed the same questionnaires assessing physical activity, sleep quality, mental wellbeing, social support, loneliness, neighbourhood cohesion, and memory problems before (mostly 2 years earlier) and again during national lockdown. (3) Results: On average, levels of physical activity were reduced (those doing minimal physical activity increased from 10% to 19%) and perceived social support increased during lockdown (effect size drm = 0.178). More positive change in the psychosocial and behavioural outcome variables during lockdown was associated with personality traits (greater intellect, emotional stability, and extraversion) and having a higher general cognitive ability. Participants with a history of cardiovascular disease, more symptoms of anxiety, or who lived alone were more likely to experience negative changes in the outcome variables during lockdown. (4) Discussion: These results provide further insight into the experiences of older people during the COVID-19 pandemic and could help to identify those at greatest risk of negative psychosocial or behavioural changes during this time.

Differential effect of gender, marital status, religion, ethnicity, education and employment status on mental health during COVID-19 lockdown in Nigeria

We examine the differential effect of gender, marital status, ethnicity, religion, education and employment status on mental health indicators (successful coping, stress & self-esteem) during COVID-19 lockdown in Nigeria. Applying a cross sectional approach, we administered an anonymised online questionnaire to select 353 individuals (mean age = 34.84, SD = 11.19) from 17 April to 24 May 2020. Married individuals coped better, were less stressed and reported high self-esteem. Christians were less stressed and have high self-esteem. Yoruba ethnic group coped better and were high in self-esteem, while Igbo ethnic group was less stressed. Also, postgraduate degree holders coped well; secondary education holders were highly stressed; while first degree holders were high in self-esteem. Self-employed respondents successfully coped, while the unemployed were high in stress and low in self-esteem. Marital status and employment status directly and interactively affected overall mental health. Officially employed persons reported higher self-esteem and less stress. Married females, single males and self-employed males coped better, while self-employed singles recorded highest stress. No gender difference was observed in mental health indicators. The degree of differences in Nigerians' mental health indicators according to socio-demographics and the importance in improving mental health during and post COVID-19 pandemic are highlighted.

Psychological Health and Physical Activity Levels during the COVID-19 Pandemic: A Systematic Review

The coronavirus disease (COVID-19) pandemic has been devastating in all senses, particularly psychologically. Physical activity (PA) is known to aid psychological well-being, and it is worth investigating whether PA has been a coping strategy during this pandemic. The objective of this literature review is to analyze the extent to which engaging in PA during the COVID-19 pandemic impacts psychological health in the adult population. The literature was searched in all databases from the EBSCOhost Research Database-MEDLINE, APA PsycArticles, between others-published between 1 January 2019 and 15 July 2020. From 180 articles found, 15 were eligible. The reviewed articles showed an association between mental health distress-e.g., stress, anxiety, depressive symptoms, social isolation, psychological distress-and PA. This research concludes that the COVID-19 pandemic and the lockdown measures caused psychological distress. Those studies that analyzed PA showed that, during quarantine, adults increased their sedentary time and reduced their PA levels, showing controversial psychological outcomes. This review discusses whether PA is an effective strategy to face the COVID-19 pandemic psychological effects contributing to a further putative increase in the prevalence of psychiatric disorders.

Psychological Impact of Corona Lockdown in Germany: Changes in Need Satisfaction, Well-Being, Anxiety, and Depression

All over the world; measures have been implemented to contain the novel Sars-CoV-2 virus since its outbreak in the beginning of 2020. These measures-among which social distancing and contact restrictions were most prominent-may have an overall effect on people's psychological well-being. The present study seeks to examine whether lockdown measures affected people's well-being; anxiety; depressive symptoms during the lockdown and whether these effects could be explained by reduced satisfaction of the basic psychological needs of autonomy and relatedness. N = 1086 participants of different ages and educational levels from all over Germany reported strong declines in autonomy and well-being; small declines in relatedness satisfaction; moderate increases in anxiety and depressive symptoms. These effects were stronger for people with moderate to bad subjective overall health. Latent change modeling revealed that, especially, decreases in autonomy satisfaction led to stronger decreases in well-being as well as stronger increases in anxiety and depressive symptoms; whereas decreases in relatedness had much weaker effects. Our results imply differential effects depending on individual preconditions; but also more generally that peoples' need for autonomy was most strongly affected by the lockdown measures, which should be considered as important information in planning future lockdowns.

A Longitudinal Investigation of the Effects of the COVID-19 Pandemic on the Mental Health of Individuals with Pre-existing Severe Mental Illnesses

OBJECTIVE

Individuals with severe mental illnesses (SMI), including schizophrenia spectrum illnesses and affective disorders, may be at increased risk for negative mental health outcomes related to the COVID-19 pandemic. This study compared the severity of pre-pandemic symptoms and affective experiences to current symptoms to evaluate this possibility.

METHODS

148 individuals with SMI (92 with schizophrenia spectrum illnesses and 56 with affective disorders) were recruited from ongoing ecological momentary assessment studies that sampled day-to-day experiences and symptom severity prior to the pandemic. Participants completed a one-time phone survey that queried these same experiences/symptoms between April and June of 2020.

RESULTS

Severity of affective experiences and psychotic symptoms remained stable across time, as did sleep duration. Well-being and the number of substances used increased during the early months of the pandemic. Increases in well-being were associated with being female and spending less time alone pre-pandemic. Patterns of stability/change did not differ according to diagnostic category.

CONCLUSIONS

At this relatively early stage, individuals with SMI are not reporting a worsening of symptoms or affective experiences and instead appear to be resilient in the face of the pandemic. Continued assessment is needed to determine whether this resilience will persist as the pandemic progresses.

The mediation role of sleep quality in the association between the incidence of unhealthy movement behaviors during the COVID-19 quarantine and mental health

BACKGROUND

Our aim was to investigate the mediating role of worsening sleep quality in the association of the incidence of physical inactivity, high TV-viewing, and high computer/tablet use with loneliness, sadness, and anxiety.

METHODS

Data of 45,161 Brazilian adults from a nationwide behavior survey, conducted between April 24th and May 24th (2020), were used. Participants reported physical inactivity (PI; <150 min/week), high TV-viewing (TV; ≥4 h/day), and high computer/tablet use (PC; ≥4 h/day) before and during COVID-19 quarantine (exposures). For incidence indicators, we only considered participants without the risk behavior before quarantine. Changes in sleep quality during the quarantine period (maintained/got better or worsened) were treated as a mediator. Elevated frequencies of feelings of loneliness, sadness (feel sad, crestfallen, or depressed), and anxiety (feel worried, anxious, or nervous) during the pandemic period were the study outcomes. Analyses were adjusted for sex, age group, highest academic achievement, working status during quarantine, skin color, previous diagnosis of depression, and adherence to quarantine. Mediation models were created using the Karlson Holm Breen method.

RESULTS

The incidence of PI, high TV, and high PC use were associated with loneliness, sadness, and anxiety feelings. Worsening sleep quality partly mediated the association of the incidence of PI, high TV, and high PC use with loneliness (PI:30.9%; TV:19.6%; PC: 30.5%), sadness (PI:29.8%; TV:29.3%; PC: 39.1%), and anxiety (PI:21.9%; TV:30.0%; PC:38.5%).

CONCLUSION

The association of the incidence of physical inactivity and sedentary behaviors with mental health indicators is partly mediated by worsening sleep quality during the COVID-19 pandemic quarantine.

Forced Cohabitation during Coronavirus Lockdown in Italy: A Study on Coping, Stress and Emotions among Different Family Patterns

Background: At the beginning of 2020, a pandemic caused by a new strain of coronavirus occurred. On March 9th, the Italian population was forced to lockdown to prevent the spread of this new virus. This event forced families and cohabitants to spend their entire days and weeks in the same physical space, interacting with partners and children with a very different degree of intimacy than in the earlier situation. The present study investigated the effects of being forced to live together on different family patterns, on various dimensions such as stress, coping strategies, time perception and quality evaluation of cohabitation. Method: A total sample consisting of 1750 individuals was recruited through a random sample of probability across the Italian country. Due to the lockdown condition, an online questionnaire was set up; several validated scales were chosen, and some open-ended items were included for the thoughts of the participants. Results: The results showed statistically significant differences between the three family patterns examined. Conclusion: During the forced period of living together, a positive effect could be inferred as given by the presence of children and the collaborative coping strategies that have been adopted; the results have been discussed according to the literature on the topic.

Workplace Stress, Presenteeism, Absenteeism, and Resilience Amongst University Staff and Students in the COVID-19 Lockdown

Background: This study explored how the COVID-19 outbreak and arrangements such as remote working and furlough affect work or study stress levels and functioning in staff and students at the University of York, UK. Methods: An invitation to participate in an online survey was sent to all University of York staff and students in May-June 2020. We measured stress levels [VAS-scale, Perceived Stress Questionnaire (PSQ)], mental health [anxiety (GAD-7), depression (PHQ-9)], physical health (PHQ-15, chronic medical conditions checklist), presenteeism, and absenteeism levels (iPCQ). We explored demographic and other characteristics as factors which may contribute to resilience and vulnerability for the impact of COVID-19 on stress. Results: One thousand and fifty five staff and nine hundred and twenty five students completed the survey. Ninety-eight per cent of staff and seventy-eight per cent of students worked or studied remotely. 7% of staff and 10% of students reported sickness absence. 26% of staff and 40% of the students experienced presenteeism. 22-24% of staff reported clinical-level anxiety and depression scores, and 37.2 and 46.5% of students. Staff experienced high stress levels due to COVID-19 (66.2%, labeled vulnerable) and 33.8% experienced low stress levels (labeled resilient). Students were 71.7% resilient vs. 28.3% non-resilient. Predictors of vulnerability in staff were having children [OR = 2.23; CI (95) = 1.63-3.04] and social isolation [OR = 1.97; CI (95) = 1.39-2.79] and in students, being female [OR = 1.62; CI (95) = 1.14-2.28], having children [OR = 2.04; CI (95) = 1.11-3.72], and social isolation [OR = 1.78; CI (95) = 1.25-2.52]. Resilience was predicted by exercise in staff [OR = 0.83; CI (95) = 0.73-0.94] and in students [OR = 0.85; CI (95) = 0.75-0.97]. Discussion: University staff and students reported high psychological distress, presenteeism and absenteeism. However, 33.8% of staff and 71.7% of the students were resilient. Amongst others, female gender, having children, and having to self-isolate contributed to vulnerability. Exercise contributed to resilience. Conclusion: Resilience occurred much more often in students than in staff, although psychological distress was much higher in students. This suggests that predictors of resilience may differ from psychological distress per se. Hence, interventions to improve resilience should not only address psychological distress but may also address other factors.

The influence of COVID-19 measures in the United Kingdom on physical activity levels, perceived physical function and mood in older adults: A survey-based observational study

In March 2020, the spreading Coronavirus (COVID-19) prompted the United Kingdom government to introduce a societal shutdown, accompanied by self-isolation and social-distancing measures to reduce virus transmission. In doing so, opportunities for physical activity were likely reduced, potentially causing detrimental effects to older adults. Therefore, the present study investigated the influence of the initial six weeks of lockdown on physical activity levels, perceived physical function and mood in older adults. A cross-sectional, mixed-methods, observational study was conducted using self-administered, fortnightly online surveys throughout the UK between 21^st March-4 May 2020. A total of 117 participants (52 males [age: 76 ± 4 years] and 65 females [age: 76 ± 4 years]) completed all surveys. Despite lockdown restrictions, this group of older adults maintained their pre-lockdown physical activity levels, but also increased their self-reported sedentary time. Subsequently, perception of physical function was maintained across lockdown. With regards to mood; the only strong evidence for an increase in depression was for males (ps = 95.35%; >0.3 AU), although self-reported levels of depression were similar between sexes at week six. Given the link between sedentary behaviour and negative health outcomes in older adults, strategies to reduce sedentariness during the COVID-19 pandemic are required.

COVID-19 Related Knowledge and Mental Health: Case of Croatia

Background and Aims: The COVID-19 pandemic has led to radical and unexpected changes in everyday life, and it is plausible that people's psychophysical health has been affected. This study examined the relationship between COVID-19 related knowledge and mental health in a Croatian sample of participants.

METHODS

An online survey was conducted from March 18 until March 23, 2020, and a total of 1244 participant responses were collected (85.5% were women and 58.4% completed secondary education). Measures included eight questions regarding biological features of the virus, symptoms, and prevention, the Hospital Anxiety and Depression Scale, and Optimism-Pessimism Scale. According to the answers given on the questions on COVID-19 related knowledge, participants were divided in two groups: (1) informed and (2) uninformed on each question. They were then compared in the expressed levels of anxiety, depression, pessimism, and optimism. Full vs. partial mediation models with optimism/pessimism as a mediator in the relationship between anxiety/depression and the accuracy of responses for questions about handwashing and ways of transmission were estimated.

RESULTS

Participants who responded correctly on the question about handwashing had higher levels of anxiety, depression, and pessimism than those participants whose answer was incorrect, while participants who answered correctly on the question about the percentage of patients who develop serious breathing problems had higher levels of depression than those who answered incorrectly. Lower levels of anxiety and pessimism were observed in the participants who answered correctly about ways of transmission. Higher levels of pessimism were found in participants who scored incorrectly on questions about the efficiency of antibiotics, most common symptoms, and the possibility of being infected by asymptomatic carriers. Higher levels of knowledge about handwashing were predicted by higher levels of anxiety and pessimism. Higher levels of knowledge about ways of transmission were predicted by lower levels of anxiety and lower levels of pessimism. The examined relationships between anxiety/depression and knowledge were mediated by pessimism.

CONCLUSION

The findings of this study suggest that knowledge about COVID-19 may be useful to reduce anxiety and depression, but it must be directed to the promotion of health behaviors and to the recognition of fake news.

How the COVID-19 Pandemic Changes the Subjective Perception of Meaning Related to Different Areas of Life in Austrian Psychotherapists and Patients

We assessed psychotherapists' and patients' ratings of their subjective perception of meaning related to different areas of life before the COVID-19 pandemic as compared to the time during the COVID-19 pandemic. In a quantitative cross-sectional study, Austrian psychotherapists (N = 222) were recruited by e-mail, who in turn recruited their patients (N = 139). Therapists and patients were asked to rate the meaning of different areas of life before as well as during the COVID-19 crisis. The psychotherapists showed an overall higher rating of the importance of areas of life compared to their patients (p < 0.001). The rating of the importance of the domains of living was differently affected by the COVID-19 situation (p < 0.001). While the meaning of physical and mental health during COVID-19 was rated higher than before, the opposite was observed for work (p < 0.001). No differences were found for relationships and friends, as well as for hobbies. As no interactions between perspective (therapists vs. patients), area of life, and time point (before vs. during COVID-19) were observed, it can be concluded that the COVID-19 situation changed the subjective attribution of meaning concerning different aspects of life similarly in therapists as well as patients. While mental and physical health gained subjective importance, the opposite was observed for work.

Psychotherapy via the Internet: What Programs Do Psychotherapists Use, How Well-Informed Do They Feel, and What Are Their Wishes for Continuous Education?

The outbreak of the COVID-19 pandemic has caused changes in the provision of psychotherapy around the world. The common format of delivering in-person psychotherapy is replaced by psychotherapy via the Internet to a great extent. This study examined how well Austrian psychotherapists feel informed about the use of the Internet in psychotherapy, where additional information needs exist, and which software is used. A link to an online survey was sent to all psychotherapists providing a valid email address in the official list of licensed psychotherapists at the start of the COVID-19 lockdown in Austria. A total of 1547 people took part in the survey. The results show that psychotherapy via the Internet was primarily offered via Skype and Zoom during the COVID-19 pandemic and that the majority of the therapists felt well-informed about psychotherapy via the Internet; however, several therapists stated that they wish to have further information on data protection and security. Overall, the study shows that Austrian psychotherapists coped well with the rapid change from the provision of psychotherapy through personal contact to psychotherapy via the Internet. Security and data protection aspects of therapy via the Internet should be addressed in training and further education of psychotherapists. As this study was conducted online, it might have caused some respondent bias towards a higher participation of psychotherapists with higher preference for new technologies.

Studies of Physical Activity and COVID-19 During the Pandemic: A Scoping Review

BACKGROUND

This scoping review aimed to identify the available evidence related to physical activity (PA) and the coronavirus disease (COVID-19) pandemic.

METHODS

A search in 6 databases (PubMed, Embase, SPORTDiscus, Scopus, Web of Science, and CINAHL) was conducted on July 23, 2020. Medical subject headings and keywords related to PA and COVID-19 were combined to conduct the online search, which covered the period from January to July 2020.

RESULTS

Overall, 1784 articles were retrieved. After duplicate removal and title, abstract, and full-text screening, 41 articles were included. Most of the included studies were quantitative and collected data through online interviews/questionnaires, with sample sizes larger than 100 and composed by adults and older adults. Changes in PA levels due to the COVID-19 pandemic were the most assessed outcome, followed by the association between mental health issues and PA. Only 2 studies assessed the direct effects of PA on COVID-19.

CONCLUSION

Most of the evidence identified a decrease in PA levels due to social distancing measures and that PA might help to decrease the mental health burden related to the COVID-19 outbreak.

Validation of the Pandemic Emotional Impact Scale

Objective

The COVID-19 pandemic represents the most universal shared stressor for the general United States (U.S) population in many decades. Due to the unprecedented circumstances of COVID-19, no existing questionnaires can comprehensively measure the multi-faceted psychological effects attributable to this health crisis. This study aimed to validate a measure for that purpose.

Methods

A 16-item questionnaire, the Pandemic Emotional Impact Scale (PEIS), was designed and subjected to initial validation in an internet survey completed by a nationally representative sample of 1500 adults living in the U.S. This survey was completed between May 18 and May 30, 2020, during the height of the pandemic’s impact on society.

Results

The PEIS demonstrated excellent internal consistency (Cronbach’s α ​= ​0.94) and Guttman split-half reliability (0.95). Exploratory factor analysis suggested two sub-scales -- emotional impact and pragmatic worries -- but these were highly correlated with the overall scale score suggesting that the total score can be used in most cases. The PEIS demonstrated good concurrent validity via robust positive correlations with anxiety, depression and stress, and negative correlations with quality of life and happiness. Criterion validity was supported by the finding that individuals who reported employment loss or loss of income due to the pandemic, had experienced COVID-19 infection in their household, or knew somebody personally who died from the pandemic, had elevated scores on the PEIS.

Conclusions

The PEIS questionnaire is a reliable and valid instrument that addresses a significant unmet need for a research instrument that can comprehensively measure pandemic-related effects on the emotional wellbeing of individuals in the U.S population.

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This study demonstrates excellent validity and reliability of the Pandemic Emotional Impact Scale.

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Data were from a nationally representative sample of 1500 adults living in the US.

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The PEIS can be used to assess the emotional effects of this and future pandemics.

Behavioral and sociodemographic predictors of anxiety and depression in patients under epidemiological surveillance for COVID-19 in Ecuador

Ecuador has been one of the most affected countries by the Corona Virus Disease 19 (COVID-19) pandemic, by April 2020 this country presented the highest rates of mortality in Latin America. The purpose of the present study was to identify behaviors during confinement and sociodemographic variables associated with the mental health status of confirmed or suspected COVID-19 patients who were part of the epidemiological surveillance program in Ecuador that included mandatory confinement and self-isolation. A cross-sectional study was performed from March 22th to April 18th, 2020 using an online survey. The survey collected socio-demographic information and severity of depressive symptoms using the Patient Health Questionnaire-9 and anxiety symptoms through the Generalized Anxiety Disorder-7. A total of 759 patients completed the questionnaire, 20.3% presented moderate to severe symptoms of depression and 22.5% moderate to severe symptoms of anxiety. Being a woman and from the Coastal region were risk factors. Exercising, maintaining daily routines, and keeping informed about the COVID-19 but limiting to an hour was associated with better mental health. Regression analysis indicated that the mentioned behaviors explained approximately 17% of the variance for depression sum scores and 11.8% of the variance for anxiety sum scores while controlling for gender and region. Understanding the association between sociodemographic variables and psychological states in patients with COVID-19 is relevant to tackle future public mental health problems and to implement health policies that are intended to palliate further psychiatric complications. Promotion of modifiable behaviors such as exercising, maintaining daily routines, and keeping informed about the COVID-19 but limiting to less than an hour is recommended.

Analysis of Self-Concept in Adolescents before and during COVID-19 Lockdown: Differences by Gender and Sports Activity

An appeal has been issued to the scientific community to investigate physical, mental and emotional states, and pro-social behaviours during the COVID-19 pandemic. Hence, this study aims to investigate adolescents’ self-concept before and during a lockdown period in relation to gender and type/amount of physical activity or sports. The pre-lockdown sample of 366 adolescents were aged 13–17 years (M = 15.51 ± 0.65), of whom 192 (52.5%) were females and 174 (47.5%) were males. During the lockdown, the age range of the sample was 13–17 years (M = 14.57 ± 1.47), of whom 82 (60.3%) were females, and 54 (39.7%) were males. The Form-5 Self-concept Questionnaire (AF-5) was used to measure adolescents’ self-concept. There was a reduction in adolescents’ overall self-concept during the COVID-19 pandemic, which was positively associated with emotional well-being, with family and peers being essential factors in the development of an appropriate self-concept. Furthermore, girls’ self-concept, especially academic self-concept, was higher than that of boys during the lockdown. However, both physical and emotional self-concept were higher for boys than girls before the COVID-19 lockdown, although no differences were found during the lockdown. The findings reveal that physical activity was positively correlated to self-concept before and during the COVID-19 lockdown.

Practical tips for prevention of cardiovascular disease in women after quarantine for COVID-19 disease

To contain the spread of CoV-19 / SARS-CoV-2 infection, several governments have imposed collective quarantine on the population. All of these restrictions have influenced women’s health and induced an unhealthy lifestyle that, in some cases, could persist after the lockdown. The present commentary briefly analyzes the effects of quarantine on women’s lifestyle. Quarantine is associated with stress and depression, which lead to unhealthy nutrition and reduced physical activity, particularly in women. Unhealthy diet is usually poor in fruit and vegetables, with a consequent low intake of antioxidants and vitamins. However, vitamins have recently been identified as a weapon in the fight against the Covid-19. Some reports suggest that Vitamin D could exert a protective effect on such infection. In addition, women are less likely to engage in regular physical activity and have increased sitting time and sedentary behaviors during quarantine, which have led to weight gain. During quarantine strategies to increase home-based physical activity and to encourage adherence to a healthy diet have been implemented. Following quarantine, a global action supporting healthy Diet and physical activity is mandatory to encourage women to return to a good lifestyle routine. (www.actabiomedica.it)

The Impact of Age on Negative Emotional Reactions, Compliance With Health Guidelines, and Knowledge About the Virus During the COVID-19 Epidemic: A Longitudinal Study From Israel

In a longitudinal study we examined the impact of age on negative emotional reactions, compliance with health guidelines and knowledge about the virus during the COVID-19 epidemic. A total of 2509 people participated in a two-phase study: 1424 participants in the first phase (March 12-21) and 1085 participants in the second phase (April 23 to May 5). Age was categorized into 4 groups: age 18 to 30, age 31 to 40, age 41 to 50, and age 51 and over. In the first and second phase, compliance with health guidelines was highest among participants over the age of 50. Knowledge was significantly higher in the second phase than in the first among participants over age 50 and those between the ages of 40 and 50. In the second phase, knowledge did not differ by age group. Negative emotional reactions were significantly higher in the first phase than in the second. Moreover, negative emotional reactions were higher among participants up to age 30 than among all other participants. Perceived susceptibility did not differ by phase or by age group. The paper underscores the impact of age during the COVID-19 epidemic and points to the necessity of taking the needs of different age groups into consideration.