The impact of the COVID-19 pandemic on physical and mental health in the two largest economies in the world: a comparison between the United States and China

Levels and Predictors of Anxiety and Depression in Turkish Pregnant Woman During the Covid-19 Pandemic

OBJECTIVE

 In addition to being a medical phenomenon, pandemics affect the individual and society on several levels and lead to disruptions. In the pandemic process, different groups in the population, including pregnant women as a defenseless group, are subjected to psychological threat. The present study aimed to determine the levels of anxiety and depression and related factors in pregnant women during the the coronavirus disease 2019 (Covid-19) pandemic.

METHODS

 The present cross-sectional study was conducted with 269 pregnant women through face-to-face interviews held in Istanbul, Turkey. Regarding the data collection tools, the Cronbach α reliability coefficient was of 0.90 for the Beck Anxiety Inventory, and of 0.85 for the Beck Depression Inventory.

RESULTS

 Among the participating pregnant women, 30.5% had mild, 17.5% had moderate, and 5.9% had severe anxiety symptoms, whereas 35.3% had mild, 16.7% had moderate, and 2.2% had severe depression symptoms. We found that those who were concerned about their health had 5.36 times (p = 0.04) more risk of developing anxiety, and 4.82 times (p = 0.01) more risk of developing depression than those who were not concerned. Those who had a history of psychiatric disease had 3.92 times (p = 0.02) more risk of developing anxiety than those without it.

CONCLUSION

 We determined that about half of the pregnant women included in the study had some degree of anxiety and depression during the COVID-19 pandemic. The risk factors for anxiety and depression among the pregnant women were determined as smoking, concerns about health and getting infected with the coronavirus, history of psychiatric disease, and undergoing regular antenatal care.

RESEARCH ARTICLEPrevalence and associated factors of depression, anxiety and stress among coronavirus disease 2019 (COVID-19) patients in Heart, Afghanistan

Objectives

Coronavirus disease 2019 (COVID-19) pandemic has been associated with a great level of psychological distresses in people around the world. This study aims to assess the prevalence of depression, anxiety and stress among COVID-19 patients and identify the associated factors, in Herat Province of Afghanistan.

Methods

This cross-sectional study was conducted on 459 hospitalized patients between May and September 2021. Data was collected with a structured questionnaire on depression, anxiety and stress scale, which was the validated Dari-version. Chi-square test was adopted to analyze the associations of the prevalence of the mental disorders and the factors.

Results

The mean age of participants was 38.05; 51.9% (238/459) were male and 84.1% (386/459) were married. Median scores for depression, anxiety and stress were 5.0, 8.0, and 10.0, respectively. Gender, general health condition, nutritional status, COVID-19 clinical manifestation and concurrent comorbidities (except diabetes and hypertension) were significantly associated with mental disorders; while association between marital status and these psychological disorders was not significant. Moreover, a significant difference was observed in the level of anxiety between healthcare workers and other respondents.

Conclusion

This is the first study to report the high prevalence of depression, anxiety and stress among COVID-19 patients in Herat, which indicates the negative effect of mental health for COVID-19 patients globally and highlights the need for urgent and appropriate interventions to improve mental health of people during the pandemic.

Animated, video entertainment-education to improve vaccine confidence globally during the COVID-19 pandemic: an online randomized controlled experiment with 24,000 participants

Background

Science-driven storytelling and entertainment-education (E-E) media demonstrate potential for promoting improved attitudes and behavioral intent towards health-related practices. Months after the outbreak of coronavirus disease 2019 (COVID-19), emerging research highlights the essential role of interventions to improve public confidence in the COVID-19 vaccine. To improve vaccine confidence, we designed three short, animated videos employing three research-informed pedagogical strategies. These can be distributed globally through social media platforms, because of their wordless and culturally accessible design. However, the effectiveness of short, animated storytelling videos, deploying various pedagogic strategies, needs to be explored across different global regions.

Methods/design

The present study is a multi-site, parallel group, randomized controlled trial (RCT) comparing the effectiveness of (i) a storytelling-instructional-humor approach, (ii) a storytelling-analogy approach, (iii) a storytelling-emotion-focused approach, and (iv) no video. For our primary outcomes, we will measure vaccine hesitancy, and for secondary outcomes, we will measure behavioral intent to seek vaccination and hope. Using online platforms, we will recruit 12,000 participants (aged 18–59 years) from the USA and China, respectively, yielding a total sample size of 24,000.

Discussion

This trial uses innovative online technology, reliable randomization algorithms, validated survey instruments, and list experiments to establish the effectiveness of three short, animated videos employing various research-informed pedagogical strategies. Results will be used to scientifically support the broader distribution of these short, animated video as well as informing the design of future videos for rapid, global public health communication.

Trial registration

German Clinical Trials Register DRKS #00023650. Date of registration: 2021/02/09.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13063-022-06067-5.

Online Mental Health Survey for Addressing Psychosocial Condition During the COVID-19 Pandemic in Indonesia: Instrument Evaluation

BACKGROUND

Regular monitoring of the pandemic's psychosocial impact could be conducted among the community but is limited through online media. This study aims to evaluate the self-rating questionnaire commonly used for online monitoring of the psychosocial implications of the coronavirus disease 2019 (COVID-19) pandemic.

METHODS

The data were taken from the online assessment results of two groups, with a total of 765 participants. The instruments studied were Self-Rating Questionnaire (SRQ-20), post-traumatic stress disorder (PTSD), and Center for Epidemiological Studies Depression Scale-10 (CESD-10), used in the online assessment. Data analysis used Rasch modeling and Winsteps applications. Validity and reliability were tested, and data were fit with the model, rating scale, and item fit analysis.

RESULTS

All the scales for outfit mean square (MnSq) were very close to the ideal value of 1.0, and the Chi-square test was significant. Item reliability was greater than 0.67, item separation was greater than 3, and Cronbach's alpha was greater than 0.60; all the instruments were considered very good. The raw variance explained by measures for the SRQ-20, PTSD, and CESD-10 was 30.7%, 41.6%, and 47.6%, respectively. The unexplained eigenvalue variances in the first contrast were 2.3, 1.6, and 2.0 for the SRQ-20, PTSD, and CESD-10, respectively. All items had positive point-measure correlations.

CONCLUSION

The internal consistency of all the instruments was reliable. Data were fit to the model as the items were productive for measurement and had a reasonable prediction. All the scales are functionally one-dimensional.

The Impacts of Psychological Distress on Life Satisfaction and Wellbeing of the Indian General Population During the First and Second Waves of COVID-19: A Comparative Study

The current study aims to understand the impact of psychological distress caused by the COVID-19 pandemic on life satisfaction and wellbeing, in the Indian context. The study also analyses the differences in these effects between the first and second waves of the pandemic. For this purpose, a survey was conducted during the two waves of the pandemic. Eight hundred eighty-four and 925 respondents participated in the first and second waves, respectively. The study showed that depression, anxiety, and stress negatively related to life satisfaction and wellbeing during both waves. The study also showed that the effects were stronger during the second wave compared to the first. Life satisfaction and wellbeing of women were found to be affected to a higher level than those of men, due to psychological distress. The study showed that a combined approach involving coping mechanisms and health care can help manage the psychological issues that arise with crisis situations such as the COVID-19 pandemic.

Prevalence of anxiety, depression, stress, and perceived stress and their relation with resilience during the COVID-19 pandemic, a cross-sectional study

Background and aims

Home quarantine and physical distancing at the time of coronavirus disease 2019 (COVID-19) had a severe effect on the mental health of the populations. Resilience has been reported previously to be a protective factor against anxiety, stress, and depression. This study evaluates the prevalence and severity of depression, anxiety, stress, and perceived stress and their relation with resilience associated with the COVID-19 pandemic among a sample of the general population in Southern Iran.

Methods

In this cross-sectional web-based survey, from April 12 to May 13, 2020, stress, anxiety, depression, perceived stress, and resilience were measured using the Persian version of Depression Anxiety and Stress Scale (DASS-21), Perceived Stress Scale (PSS-14), and Connor-Davidson Resilience Scale (CD-RISC). Statistical analyses were carried out using the IBM Statistical Package for Social Sciences. Mean ± standard deviation (SD) and frequencies were used to describe demographic data. Independent sample t-test, Spearman correlation, and the Pearson correlation coefficient were performed to examine anxiety, depression, stress, and resilience.

Results

Among a total of 538 participants, the overall prevalence of moderate-to-extremely severe depression, anxiety, and stress was found to be 26.1%, 33.2%, and 5.8%, respectively. The overall median PSS and resilience score were 30 and 70, respectively. There was a significant association between higher age and perceived stress. Male and high income were related to higher resilience scores. Perceived stress positively correlates with resilience, whereas depression significantly correlates with anxiety and stress. Individuals with underlying disease demonstrated significantly higher scores for depression and anxiety. Also, perceived stress had a significant but weak, positive correlation with age and the number of quarantine days.

Conclusion

The occurring COVID-19 pandemic could be the culprit of psychological distress, anxiety, and depression of large population quantities. Our results showed a subordinate overall resilience in the general Iranian population during the COVID-19 pandemic.

Differentiating the stress buffering functions of perceived versus received social support

Drawing upon the stress buffering model of social support, this study investigated how perceived social support (PSS), defined as the amount of support individuals think they can mobilize from their network, and received social support (RSS), defined as the level of support individuals have received, moderated the direct and indirect relationships between COVID-19 news exposure (i.e., stressor) and stress via social trust. An online survey from six major cities in China (N = 636) revealed that PSS rather than RSS moderated the direct relationship between COVID-19 news exposure and stress such that this relationship was stronger at a low level of PSS than a high level. Additionally, RSS rather than PSS moderated the relationship between COVID-19 news exposure and social trust such that this relationship was stronger at a low level of RSS than a high level. These findings reveal the differential mechanisms by which PSS and RSS function to buffer against stress.

Psychosocial responses to COVID-19 among nurses in two hospitals: a mixed method study at Eastern Nepal

BACKGROUND

Most documented studies have focused on mental health status of health care workers during the pandemic but there are very few studies, focusing on mitigation of mental health problems among nurses.

AIM

To study psychosocial responses to COVID-19 and the effectiveness of intervention among nurses.

MATERIALS AND METHODS

A mixed-method study was conducted, including 278 nurses from two COVID-19 hospitals of the province by purposive sampling. Depression, anxiety and stress and a composite measure of personal financial burden scales for quantitative; and interview guide for qualitative data were used. A psychosocial strengthening session was introduced and the effectiveness of the program was assessed after 4-5 weeks of intervention.

RESULTS

Mild, moderate and severe depression was found among 13.7%, 9.4% and 1.1% of the participants correspondingly. Mild, moderate, severe and extremely severe anxiety was found among 21.2%, 8.6%, 3.2% and 2.2% of the participants respectively. Stress was mild among 9% and moderate in 1.4% of the participants. Lack of PPE and fear of transmitting infection were found as frequent causes of problems. Mean scores of depression, anxiety and stress were significantly decreased after the psychosocial strengthening program.

CONCLUSION

Depression, anxiety and stress are common issues of nurses. Common causes of problems were lack of resources, fear of being infected and fear of transmitting to family members. The psychosocial strengthening program was effective in reducing the problems.

Demographic and Psychosocial Factors associated with Internet Addiction among the Pakistani Population during COVID-19: A Web-Based Survey

This study aims to determine the burden of COVID19-induced internet addiction and related psychosocial factors among the Pakistani sample. A web-based cross-sectional survey was conducted from January to March 2021. An analytical cross-sectional survey was broadcast on the internet via a Google form completed by 1145 Pakistanis. Individuals aged 13 years and above with competency to comprehend English or Urdu language, currently residing in any province of Pakistan, having access to the questionnaire, and willing to participate were eligible to participate. Overseas Pakistanis were excluded from the study. The outcome is COVID19-induced internet addiction was measured using the validated tool Young’s Internet Addiction Test (IAT). In addition, symptoms of depression, anxiety, stress, and other psychosocial factors were assessed using the validated tool Depression, Anxiety, and Stress Scale-21 (DASS-21). Adjusted odds ratios with a 95% confidence interval were reported using multinomial logistic regression. Most participants were females and youth (between 20 and 24 years). The prevalence of problematic internet users (PIU) and addictive internet users (AIU) was 27.3% and 11.3%, respectively. The odds of extremely severe anxiety among AIU were approximately three times (Adj OR: 2.6 (1.1-7.1), followed by the odds of having extremely severe stress being about five times higher among AIU (Adj OR: 5.4 (1.6-17.6)) as compared to normal internet users (NIU). Amid COVID-19, the burden of internet addiction has surged among the Pakistani populace. This study identified that gender, marital status, depression, stress, anxiety, work situation, and mood changes during the COVID-19 pandemic are significantly correlated with problematic and addictive internet use. Preventative measures against the addictive use of the internet are needed to avoid or mitigate any serious mental health problems.

Sociodemographic and COVID-Related Predictors for Mental Health Condition of Mainland Chinese in Canada Amidst the Pandemic

The current study investigates the mental health condition of Mainland Chinese in Canada and identifies the associated sociodemographic and COVID-19-related predictors. A sample of 471 Mainland Chinese aged 18 or older completed an online survey that collected information on demographics, experience, cognition, and behaviours related to the COVID-19 pandemic and mental health condition. Mental health condition was assessed with the Depression, Anxiety, and Stress Scale-21 (DASS-21) for the depression, anxiety, and stress levels of Mainland Chinese during the pandemic. Moderate to severe depression, anxiety, and stress levels were respectively reported by 11.30%, 10.83%, and 5.10% of respondents. Univariate analysis of variance models (ANOVAs) were conducted to assess mental health condition variance as stratified by independent sociodemographic- or COVID-19-related explanatory variables, to identify possible predictors to be entered into the subsequent regression models. The regression models identified age, income level, health status, and perceived discrimination as significant sociodemographic predictors (absolute value of βs = 1.19–7.11, ps < 0.05), whereas self-infection worry, attitude towards Canadian measures, information confusion, food/goods stocking, and room cleaning/sanitizing were identified as significant COVID-19-reltaed predictors (absolute value of βs = 1.33–3.45, ps < 0.05) for mental health outcomes. The results shed light on our understanding of the major factors associated with the mental health condition of Mainland Chinese in Canada during the COVID-19 pandemic.

The relationship between anxiety, stress, spiritual health, and mindfulness among patients undergoing hemodialysis: A survey during the COVID-19 outbreak in Southeast Iran

BACKGROUND AND AIMS

Hemodialysis patients are prone to high stress and anxiety related to the acute coronavirus epidemic. Mindfulness and spiritual health are among the factors associated with stressful and anxious situations. The current study aimed to investigate the relationship between mindfulness, spiritual health, and coronavirus stress/anxiety in patients undergoing hemodialysis.

METHODS

One hundred and forty-four patients underwent hemodialysis participated in this cross-sectional study. Patients completed the Demographic and Clinical Characteristics Form, Corona Disease Anxiety Scale (CDAS), stress subscale of DASS-21, The Freiburg Mindfulness Inventory- Short Form (FMI-SF), and Spiritual Health Scale.

RESULTS

The results showed that 28.5% of the participants had moderate to severe anxiety. According to the psychological symptom subscale (CDAS), 54.2% of the participants had moderate to severe anxiety. According to the physical symptom subscale, 41.7% of the participants had moderate to severe anxiety. Sixteen percent of the patients believed that the coronavirus disease 2019 (COVID-19) outbreak and lockdown influenced their course of treatment. A significant association was found between coronavirus disease anxiety and mindfulness (r = -0.20, P < .05). No significant association was found between stress and mindfulness/spiritual health (P > .05).

CONCLUSION

The results of this study showed that coronavirus anxiety and stress are common in hemodialysis patients. Mindfulness may be effective in reducing coronavirus anxiety in hemodialysis patients. Therefore, interventions are suggested to increase the level of mindfulness and empower hemodialysis patients to cope with anxiety caused by crises such as the coronavirus outbreak.

Prevalence and risk factors of anxiety, depression and sleeping disturbances in china during the COVID-19 outbreak: a web-based cross-sectional study

The rapid development of the coronavirus disease 2019 (COVID-19) outbreak has brought great harm to physical and mental health of the public. This study aims to investigate the psychological status and sleep quality of the Chinese public during the outbreak of the COVID-19 and its related factors. The survey was conducted from February 17^th to February 26^th, 2020 in southwestern China. The snowball sampling method was used to invite subjects. Demographic data were collected, and mental status and sleep quality were assessed by the Generalized Anxiety Disorder-7 Scale (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), and the Pittsburgh Sleep Quality Index (PSQI). Descriptive, univariate, and correlation analyses were used to investigate risk factors for psychological status and sleep patterns. A total of 1509 adults (713 males and 796 females) were enrolled in this study. The overall prevalence of anxiety, depression, and decreased sleep quality were 22.3%, 32.2% and 35.4%, respectively. Compared with females, male population has witnessed a higher prevalence of anxiety symptoms (25.1% vs 20.4%, P= 0.007) and depressive symptoms (34.6% vs 30.0%, P= 0.027). In addition, age, marital status, living situation, involvement in anti-pandemic work, basic health status and work status were significant risk factors for anxiety or depression (P< 0.05). During the COVID-19 outbreak, psychological problems and sleep disorders were prevalent among the Chinese public. More attention should be paid to males, the elderly, the solitary, the unemployed, front-line workers in pandemic prevention, and patients with chronic diseases.

The Psychological Benefits of COVID-19 Vaccination

This study evaluates the extent to which COVID-19 vaccination affects population mental health. Exploiting the within-state and within-survey week variation in the number fully vaccinated per 10 million people, I uncover the favorable effects of vaccination on individuals’ psychological well-being. Particularly, a 100% increase in the number fully vaccinated per 10 million people makes individuals 0.24, 0.23, 0.12, and 0.14 percentage points less likely to experience anxiety, worry, displeasure, and depression on a daily basis, respectively. The probability of having at least one of the four symptoms (anxiety, worry, displeasure, and depression) every day also reduces by 0.27 percentage points. The study calls for the expansion of vaccine coverage, especially for disproportionately affected communities.

Associations Between the Perceived Severity of the COVID-19 Pandemic, Cyberchondria, Depression, Anxiety, Stress, and Lockdown Experience: Cross-sectional Survey Study

Background

The outbreak of the COVID-19 pandemic has caused great panic among the public, with many people suffering from adverse stress reactions. To control the spread of the pandemic, governments in many countries have imposed lockdown policies. In this unique pandemic context, people can obtain information about pandemic dynamics on the internet. However, searching for health-related information on the internet frequently increases the possibility of individuals being troubled by the information that they find, and consequently, experiencing symptoms of cyberchondria.

Objective

We aimed to examine the relationships between people’s perceived severity of the COVID-19 pandemic and their depression, anxiety, and stress to explore the role of cyberchondria, which, in these relationship mechanisms, is closely related to using the internet. In addition, we also examined the moderating role of lockdown experiences.

Methods

In February 2020, a total of 486 participants were recruited through a web-based platform from areas in China with a large number of infections. We used questionnaires to measure participants’ perceived severity of the COVID-19 pandemic, to measure the severity of their cyberchondria, depression, anxiety, and stress symptoms, and to assess their lockdown experiences. Confirmatory factor analysis, exploratory factor analysis, common method bias, descriptive statistical analysis, and correlation analysis were performed, and moderated mediation models were examined.

Results

There was a positive association between perceived severity of the COVID-19 pandemic and depression (β=0.36, t=8.51, P<.001), anxiety (β=0.41, t=9.84, P<.001), and stress (β=0.46, t=11.45, P<.001), which were mediated by cyberchondria (β=0.36, t=8.59, P<.001). The direct effects of perceived severity of the COVID-19 pandemic on anxiety (β=0.07, t=2.01, P=.045) and stress (β=0.09, t=2.75, P=.006) and the indirect effects of cyberchondria on depression (β=0.10, t=2.59, P=.009) and anxiety (β=0.10, t=2.50, P=.01) were moderated by lockdown experience.

Conclusions

The higher the perceived severity of the COVID-19 pandemic, the more serious individuals’ symptoms of depression, anxiety, and stress. In addition, the associations were partially mediated by cyberchondria. Individuals with higher perceived severity of the COVID-19 pandemic were more likely to develop cyberchondria, which aggravated individuals’ depression, anxiety, and stress symptoms. Negative lockdown experiences exacerbated the COVID-19 pandemic’s impact on mental health.

The relationship between the stress experienced by parents and cyberchondria during the pandemic process

Purpose

The purpose of this paper is to examine the relationship between the stress experienced by parents during the pandemic and their cyberchondria. The research was carried out in a descriptive and cross-sectional manner.

Design/methodology/approach

The sample of the research: living in Turkey and has created 432 parents with at least one child between the ages of 6 and 15. Participant information form, parental stress scale and cyberchondria scale were used in the study. Data were collected through online surveys between July 1, 2020, and August 31, 2020.

Findings

In the study, when the scores obtained from the Parental Stress Scale and the Cyberchondria Scale were compared with the demographic characteristics, a significant difference was found between gender, age, marital status, education level, economic status, number of children and presence of chronic diseases (p < 0.05). It was determined that there is a significant difference between the responses of the parents regarding the pandemic process and the Parental Stress Scale and the Cyberchondria Scale (p < 0.05). A positive significant correlation was found between the Parental Stress Scale and the total and subdimensions of the Cyberchondria Scale (p < 0.05).

Research limitations/implications

The research was carried out with only parents with children between the ages of 6 and 15, but it reveals the stress and cyberchondria of the parents during the pandemic.

Originality/value

The results obtained reflect the factors affecting the stress and cyberchondria levels experienced by parents during the pandemic process. Also, as the stress of the parent's increases, it has seen that the level of cyberchondria increases in parallel.