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Fradelos EC, Boutlas S, Tsimitrea E, Sistou A, Tourlakopoulos K, Papathanasiou IV, Gourgoulianis KI. Perceived Symptoms, Mental Health and Quality of Life after Hospitalization in COVID-19 Patients. J Pers Med 2022; 12:jpm12050728. [PMID: 35629149 PMCID: PMC9147638 DOI: 10.3390/jpm12050728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 04/22/2022] [Accepted: 04/29/2022] [Indexed: 12/10/2022] Open
Abstract
Patients recovering from novel coronavirus are reporting a variety of symptoms such as cough, dyspnea, myalgia as well as psychological distress and poor quality of life. The aim of this study is to assess quality of life and psychological distress in COVID-19 survivors and the sociodemographic and clinical characteristics that affect COVID-19 survivors’ mental health status and quality of life. A quantitative study was conducted among COVID-19 survivors, who had previously been admitted to the University Hospital of Larissa, Greece. Data were collected via a questionnaire consisting of three-parts. The first part consisted of questions about the demographic characteristics. The second part was the SF-36 QoL index. The third part was the Symptom Checklist-90r (SCL 90-R). In addition, clinical information such as the length and the department of hospitalization, days since discharge and pulmonary function (spirometry values) were recorded. From a total of 145 patients, 60% were male, aged 59.72 ± 12.74 and 78.6% of them were married; the majority had completed secondary education, 35.9% were pensioners and 58.6 were living in urban areas. The most frequently reported symptoms were fatigue (67.6%) and pain (44.8%) and 11.7% were experiencing psychological distress. Pain, loss of smell, mandatory education, ICU admission, female gender and the experiencing of skin disturbance are associated with poor physical QoL among COVID-19 recovered patients. Greek COVID-19 previously hospitalized patients were reporting several symptoms associated with COVID-19. Good QoL and mental health were also reported. Physical pain, loss of smell and female gender were associated with poor QoL and psychological distress.
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Affiliation(s)
- Evangelos C. Fradelos
- Department of Nursing, University of Thessaly, 41500 Larissa, Greece; (E.T.); (I.V.P.)
- Correspondence: ; Tel.: +30-69462-28458
| | - Stylianos Boutlas
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece; (S.B.); (A.S.); (K.T.); (K.I.G.)
| | - Eleni Tsimitrea
- Department of Nursing, University of Thessaly, 41500 Larissa, Greece; (E.T.); (I.V.P.)
| | - Alexandra Sistou
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece; (S.B.); (A.S.); (K.T.); (K.I.G.)
| | - Konstantinos Tourlakopoulos
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece; (S.B.); (A.S.); (K.T.); (K.I.G.)
| | | | - Konstantinos I. Gourgoulianis
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece; (S.B.); (A.S.); (K.T.); (K.I.G.)
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52
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Wu Q, Zhuo L, Li H, Zheng L, Ma G, Tao H. Factors associated with the mental health of back-to-Wuhan university students based on quantile regression model during the COVID-19 period. BMC Psychiatry 2022; 22:284. [PMID: 35448992 PMCID: PMC9022609 DOI: 10.1186/s12888-022-03828-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 02/28/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic had brought the increased levels of depression and anxiety on people. Our study investigated the levels of mental health and influencing factors among back-to-Wuhan university students. METHODS A cross-sectional questionnaire survey was conducted from 31 August 2020, to 14 September 2020 by convenience sampling on the back-to-Wuhan university students, which included the Generalized Anxiety Disorder Scale (GAD-7), Patient Health Questionnaire-9 (PHQ-9), the Insomnia Severity Index-7 (ISI-7), the revised Impact of Event Scale (IES-R) scales, and the basic demographic characteristics. Moreover, quantile regression analysis was used to identify the key factors related to the mental health variables of the back-to-Wuhan university students during the COVID-19 period. RESULTS The results from 1017 participants suggested that the prevalence rates of the anxiety, depression, insomnia, and distress were 44%, 47.5%, 37.7%, 57.7%, respectively. Quantile regression showed that mental health scores were negatively associated to age, years from graduation, being discriminated against owing to the experience in Wuhan, and the attitude on the future of COVID-19, while was positively related to the education level (P < 0.05). Especially, the education level was highly related with anxiety (25th = 1.64, 50th = 2.54). CONCLUSION The finding showed that the respondents who were near graduation, discriminated owing to the experience in Wuhan, and worried about the future trend of COVID-19 had a higher risk of negative psychologic status, especially in the bottom and median quantile, and might require more psycho-social interventions or support.
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Affiliation(s)
- Qian Wu
- grid.33199.310000 0004 0368 7223School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Lijun Zhuo
- grid.33199.310000 0004 0368 7223School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Hao Li
- grid.33199.310000 0004 0368 7223School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Ling Zheng
- grid.33199.310000 0004 0368 7223School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Guoqing Ma
- grid.33199.310000 0004 0368 7223School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Hongbing Tao
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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53
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Ertl MM, Trapp SK, Alzueta E, Baker FC, Perrin PB, Caffarra S, Yüksel D, Ramos-Usuga D, Arango-Lasprilla JC. Trauma-Related Distress During the COVID-19 Pandemic In 59 Countries. COUNSELING PSYCHOLOGIST 2022; 50:306-334. [PMID: 37636332 PMCID: PMC10457097 DOI: 10.1177/00110000211068112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
The COVID-19 pandemic has upended life like few other events in modern history, with differential impacts on varying population groups. This study examined trauma-related distress among 6,882 adults ages 18 to 94 years old in 59 countries during April to May 2020. More than two-thirds of participants reported clinically significant trauma-related distress. Increased distress was associated with unemployment; identifying as transgender, nonbinary, or a cisgender woman; being from a higher income country; current symptoms and positive diagnosis of COVID-19; death of a loved one; restrictive government-imposed isolation; financial difficulties; and food insecurity. Other factors associated with distress included working with potentially infected individuals, care needs at home, a difficult transition to working from home, conflict in the home, separation from loved ones, and event restrictions. Latin American and Caribbean participants reported more trauma-related distress than participants from Europe and Central Asia. Findings inform treatment efforts and highlight the need to address trauma-related distress to avoid long-term mental health consequences.
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Affiliation(s)
- Melissa M. Ertl
- University at Albany-State University of New York, Albany, NY, USA
| | | | - Elisabet Alzueta
- Center for Health Sciences, SRI International, Menlo Park, CA 94025, USA
- Autonomous University of Madrid, Madrid, Spain
| | - Fiona C. Baker
- Center for Health Sciences, SRI International, Menlo Park, CA 94025, USA
- Department of Physiology, University of the Witwatersrand, Johannesburg, South Africa
| | - Paul B. Perrin
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Sendy Caffarra
- Basque Center on Cognition, Brain and Language, Donostia-San Sebastián, Spain
- Developmental Behavioral Pediatrics, Stanford University, Stanford, USA
| | | | - Daniela Ramos-Usuga
- BioCruces Health Research Institute, Cruces University Hospital, Barakaldo, Spain
- IKERBASQUE, Basque Foundation for Science, Bilbao, Spain
| | - Juan Carlos Arango-Lasprilla
- BioCruces Health Research Institute, Cruces University Hospital, Barakaldo, Spain
- IKERBASQUE, Basque Foundation for Science, Bilbao, Spain
- Department of Cell Biology and Histology, University of the Basque Country UPV/EHU, Leioa, Spain
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54
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Veazie S, Lafavor B, Vela K, Young S, Sayer NA, Carlson KF, O'Neil ME. Mental health outcomes of adults hospitalized for COVID-19: A systematic review. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022; 8:100312. [PMID: 35165670 PMCID: PMC8828444 DOI: 10.1016/j.jadr.2022.100312] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 12/23/2021] [Accepted: 02/05/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Patients hospitalized for COVID-19 may be at high risk of mental health (MH) disorders. This systematic review assesses MH outcomes among adults during and after hospitalization for COVID-19 and ascertains MH care utilization and resource needs. METHODS We searched multiple medical literature databases for studies published December 2019 to March 2021. Studies of ≥ 200 participants were synthesized. One reviewer completed article selection, data abstraction and assessed study quality and strength of evidence, with verification by a second. RESULTS Fifty articles met preliminary inclusion criteria; 19 articles that included ≥ 200 participants were synthesized. Evidence from these primarily fair-quality studies suggests many patients experience symptoms of depression (9-66%), anxiety (30-39%), and insomnia (24-40%) during and 3 months after hospitalization for COVID-19. However, patients infrequently receive a new MH disorder diagnosis 6 months after hospitalization (5% are diagnosed with a new mood disorder, 7% anxiety disorder, and 3% insomnia). Some hospitalized patients - including women and those with more severe COVID-19 - may be at higher risk of poor MH outcomes. Data on MH care utilization and resource needs are currently limited. LIMITATIONS Most included studies were small, did not report the proportion of participants with preexisting MH disorders, and did not use comparison groups. CONCLUSIONS While many patients experience MH symptoms after hospitalization for COVID-19, most do not go on to develop a new MH disorder. Future studies should report whether participants have preexisting MH disorders and compare patients hospitalized for COVID-19 to patients hospitalized for other causes.
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Affiliation(s)
- Stephanie Veazie
- Evidence Synthesis Program Coordinating Center, VA Portland Health Care System, United States
| | - Brenda Lafavor
- Primary Care Division, VA Portland Health Care System, United States
| | - Kathryn Vela
- Evidence Synthesis Program Coordinating Center, VA Portland Health Care System, United States
| | - Sarah Young
- Evidence Synthesis Program Coordinating Center, VA Portland Health Care System, United States
| | - Nina A Sayer
- Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, United States
- Departments of Medicine and Psychiatry, University of Minnesota, United States
| | - Kathleen F Carlson
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, United States
- School of Public Health, Oregon Health & Science University-Portland State University, United States
| | - Maya E O'Neil
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, United States
- Department of Psychiatry and Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, United States
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55
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Montani D, Savale L, Noel N, Meyrignac O, Colle R, Gasnier M, Corruble E, Beurnier A, Jutant EM, Pham T, Lecoq AL, Papon JF, Figueiredo S, Harrois A, Humbert M, Monnet X. Post-acute COVID-19 syndrome. Eur Respir Rev 2022; 31:31/163/210185. [PMID: 35264409 PMCID: PMC8924706 DOI: 10.1183/16000617.0185-2021] [Citation(s) in RCA: 95] [Impact Index Per Article: 47.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 11/27/2021] [Indexed: 01/08/2023] Open
Abstract
Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the coronavirus disease 2019 (COVID-19) pandemic that has resulted in millions of deaths and a major strain on health systems worldwide. Medical treatments for COVID-19 (anticoagulants, corticosteroids, anti-inflammatory drugs, oxygenation therapy and ventilation) and vaccination have improved patient outcomes. The majority of patients will recover spontaneously or after acute-phase management, but clinicians are now faced with long-term complications of COVID-19 including a large variety of symptoms, defined as "post-acute COVID-19 syndrome". Most studies have focused on patients hospitalised for severe COVID-19, but acute COVID-19 syndrome is not restricted to these patients and exists in outpatients. Given the diversity of symptoms and the high prevalence of persistent symptoms, the management of these patients requires a multidisciplinary team approach, which will result in the consumption of large amounts of health resources in the coming months. In this review, we discuss the presentation, prevalence, pathophysiology and evolution of respiratory complications and other organ-related injuries associated with post-acute COVID-19 syndrome.
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Affiliation(s)
- David Montani
- Université Paris-Saclay, AP-HP, Service de Pneumologie et Soins Intensifs Respiratoires, Hôpital de Bicêtre, DMU 5 Thorinno, Inserm UMR_S999, Le Kremlin-Bicêtre, France
| | - Laurent Savale
- Université Paris-Saclay, AP-HP, Service de Pneumologie et Soins Intensifs Respiratoires, Hôpital de Bicêtre, DMU 5 Thorinno, Inserm UMR_S999, Le Kremlin-Bicêtre, France
| | - Nicolas Noel
- Université Paris-Saclay, AP-HP, Service de Médecine Interne et Immunologie Clinique, Hôpital de Bicêtre, DMU 7 Endocrinologie-Immunités-Inflammations-Cancer-Urgences, Le Kremlin-Bicêtre, France
| | - Olivier Meyrignac
- Université Paris-Saclay, AP-HP, Service de Radiologie Diagnostique et Interventionnelle, Hôpital de Bicêtre, DMU 14 Smart Imaging, BioMaps, Le Kremlin-Bicêtre, France
| | - Romain Colle
- Université Paris-Saclay, AP-HP, Service de Psychiatrie, Hôpital de Bicêtre, DMU 11 Psychiatrie, Santé Mentale, Addictologie et Nutrition, Équipe MOODS, Inserm U1178, CESP (Centre de Recherche en Epidémiologie et Santé des Populations), Le Kremlin-Bicêtre, France
| | - Matthieu Gasnier
- Université Paris-Saclay, AP-HP, Service de Psychiatrie, Hôpital de Bicêtre, DMU 11 Psychiatrie, Santé Mentale, Addictologie et Nutrition, Équipe MOODS, Inserm U1178, CESP (Centre de Recherche en Epidémiologie et Santé des Populations), Le Kremlin-Bicêtre, France
| | - Emmanuelle Corruble
- Université Paris-Saclay, AP-HP, Service de Psychiatrie, Hôpital de Bicêtre, DMU 11 Psychiatrie, Santé Mentale, Addictologie et Nutrition, Équipe MOODS, Inserm U1178, CESP (Centre de Recherche en Epidémiologie et Santé des Populations), Le Kremlin-Bicêtre, France
| | - Antoine Beurnier
- Université Paris-Saclay, AP-HP, Service de Pneumologie et Soins Intensifs Respiratoires, Hôpital de Bicêtre, DMU 5 Thorinno, Inserm UMR_S999, Le Kremlin-Bicêtre, France
| | - Etienne-Marie Jutant
- Université Paris-Saclay, AP-HP, Service de Pneumologie et Soins Intensifs Respiratoires, Hôpital de Bicêtre, DMU 5 Thorinno, Inserm UMR_S999, Le Kremlin-Bicêtre, France.,Université de Poitiers, CHU de Poitiers, Service de Pneumologie, Inserm CIC 1402, Poitiers, France
| | - Tài Pham
- Université Paris-Saclay, AP-HP, Service de Médecine Intensive-Réanimation, Hôpital de Bicêtre, DMU 4 CORREVE Maladies du Dœur et des Vaisseaux, Inserm UMR_S999, FHU Sepsis, CARMAS, Le Kremlin-Bicêtre, France
| | - Anne-Lise Lecoq
- Université Paris-Saclay, AP-HP, Centre de Recherche Clinique Paris-Saclay, DMU 13 Santé Publique, Information Médicale, Appui à la Recherche Clinique, Le Kremlin-Bicêtre, France
| | - Jean-François Papon
- Université Paris-Saclay, AP-HP, Service d'ORL et de Chirurgie Cervico-faciale, DMU 9 Neurosciences, Inserm U955, E13, CNRS ERL7000, Le Kremlin-Bicêtre, France
| | - Samy Figueiredo
- Université Paris-Saclay, AP-HP, Service d'Anesthésie-Réanimation et Médecine Périopératoire, Hôpital de Bicêtre, DMU 12 Anesthésie, Réanimation, Douleur, Le Kremlin-Bicêtre, France
| | - Anatole Harrois
- Université Paris-Saclay, AP-HP, Service d'Anesthésie-Réanimation et Médecine Périopératoire, Hôpital de Bicêtre, DMU 12 Anesthésie, Réanimation, Douleur, Le Kremlin-Bicêtre, France
| | - Marc Humbert
- Université Paris-Saclay, AP-HP, Service de Pneumologie et Soins Intensifs Respiratoires, Hôpital de Bicêtre, DMU 5 Thorinno, Inserm UMR_S999, Le Kremlin-Bicêtre, France
| | - Xavier Monnet
- Université Paris-Saclay, AP-HP, Service de Médecine Intensive-Réanimation, Hôpital de Bicêtre, DMU 4 CORREVE Maladies du Dœur et des Vaisseaux, Inserm UMR_S999, FHU Sepsis, CARMAS, Le Kremlin-Bicêtre, France
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56
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Han JH, Womack KN, Tenforde MW, Files DC, Gibbs KW, Shapiro NI, Prekker ME, Erickson HL, Steingrub JS, Qadir N, Khan A, Hough CL, Johnson NJ, Ely EW, Rice TW, Casey JD, Lindsell CJ, Gong MN, Srinivasan V, Lewis NM, Patel MM, Self WH. Associations between persistent symptoms after mild COVID‐19 and long‐term health status, quality of life, and psychological distress. Influenza Other Respir Viruses 2022; 16:680-689. [PMID: 35347854 PMCID: PMC9111447 DOI: 10.1111/irv.12980] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 02/28/2022] [Accepted: 03/01/2022] [Indexed: 12/13/2022] Open
Abstract
Background We sought to assess whether persistent COVID‐19 symptoms beyond 6 months (Long‐COVID) among patients with mild COVID‐19 is associated with poorer health status, quality of life, and psychological distress. Methods This was a multicenter prospective cohort study that included adult outpatients with acute COVID‐19 from eight sites during 2‐week sampling periods from April 1 and July 28, 2020. Participants were contacted 6–11 months after their first positive SARS‐CoV‐2 to complete a survey, which collected information on the severity of eight COVID‐19 symptoms using a 4‐point scale ranging from 0 (not present) to 3 (severe) at 1 month before COVID‐19 (pre‐illness) and at follow‐up; the difference for each was calculated as an attributable persistent symptom severity score. A total attributable persistent COVID‐19 symptom burden score was calculated by summing the attributable persistent severity scores for all eight symptoms. Outcomes measured at long‐term follow‐up comprised overall health status (EuroQol visual analogue scale), quality of life (EQ‐5D‐5L), and psychological distress (Patient Health Questionnaire‐4). The association between the total attributable persistent COVID‐19 burden score and each outcome was analyzed using multivariable proportional odds regression. Results Of the 2092 outpatients with COVID‐19, 436 (21%) responded to the survey. The median (IQR) attributable persistent COVID‐19 symptom burden score was 2 (0, 4); higher scores were associated with lower overall health status (aOR 0.63; 95% CI: 0.57–0.69), lower quality of life (aOR: 0.65; 95%CI: 0.59–0.72), and higher psychological distress (aOR: 1.40; 95%CI, 1.28–1.54) after adjusting for age, race, ethnicity, education, and income. Conclusions In participants with mild acute COVID‐19, the burden of persistent symptoms was significantly associated with poorer long‐term health status, poorer quality of life, and psychological distress.
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Affiliation(s)
- Jin H. Han
- Vanderbilt University Medical Center Nashville Tennessee USA
- Geriatric Research, Education, and Clinical Center Tennessee Valley Healthcare System Nashville Tennessee USA
| | | | - Mark W. Tenforde
- CDC COVID‐19 Response Team Centers for Disease Control and Prevention Atlanta Georgia USA
| | - D. Clark Files
- Wake Forest University Baptist Medical Center Winston‐Salem North Carolina USA
| | - Kevin W. Gibbs
- Wake Forest University Baptist Medical Center Winston‐Salem North Carolina USA
| | | | | | | | | | - Nida Qadir
- UCLA Medical Center Los Angeles California USA
| | - Akram Khan
- Oregon Health & Sciences University Portland Oregon USA
| | | | | | - E. Wesley Ely
- Vanderbilt University Medical Center Nashville Tennessee USA
- Geriatric Research, Education, and Clinical Center Tennessee Valley Healthcare System Nashville Tennessee USA
| | - Todd W. Rice
- Vanderbilt University Medical Center Nashville Tennessee USA
| | | | | | | | | | - Nathaniel M. Lewis
- CDC COVID‐19 Response Team Centers for Disease Control and Prevention Atlanta Georgia USA
| | - Manish M. Patel
- CDC COVID‐19 Response Team Centers for Disease Control and Prevention Atlanta Georgia USA
| | - Wesley H. Self
- Vanderbilt University Medical Center Nashville Tennessee USA
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Szepietowska EM, Zawadzka E, Filipiak S. Symptoms of Post-Traumatic Stress Disorder and the Sense of Gains and Losses during the COVID-19 Pandemic: An International Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063504. [PMID: 35329192 PMCID: PMC8949522 DOI: 10.3390/ijerph19063504] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/10/2022] [Accepted: 03/12/2022] [Indexed: 12/23/2022]
Abstract
This study was primarily designed to investigate the perception of changes in selected areas of life experienced by adults of various nationalities in connection to the long-lasting COVID-19 pandemic. The second objective was to identify the factors increasing the risk of perception of negative changes in life during the pandemic. The tools applied in the study include a self-report questionnaire designed to measure sociodemographic data and health status of the subjects, COVID-19 Sense of Life Changes Questionnaire, as well as the Impact of Event Scale: Revised. The study involved over 600 adult subjects. With increased intensity of intrusions, the likelihood of negative perception of the changes emerging as a result of the pandemic was reduced by approximately 7%, whereas a higher intensity of hyperarousal increased that risk. Individuals reporting a sense of negative changes presented a greater degree of hyperarousal compared to those reporting positive changes. In the group of subjects perceiving the changes in a positive way, increasing the intensity of intrusion and/or hyperarousal corresponded to a growing conviction about a negative nature of life changes concerning the relationship with their partner and affecting their work as well as regarding a positive meaning of the changes in relations with their parents and in daily life. Generally, there was a prevailing sense of negative changes; however, there was also a group of subjects that perceived these as positive. Intrusions and hyperarousal in certain individuals may play a role in motivating them to take action in protecting against effects of the pandemic and, in others, may lead to frustration and anxiety.
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58
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Tang L, Gao Y, Qi S, Cui J, Zhou L, Feng Y. Prevalence of post-traumatic stress disorder symptoms among patients with mental disorder during the COVID-19 pandemic. BMC Psychiatry 2022; 22:156. [PMID: 35232421 PMCID: PMC8886345 DOI: 10.1186/s12888-022-03790-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 02/16/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The outbreak of the COVID-19 pandemic has caused extensive public health concerns, posing significant challenges to healthcare services. One particular area of concern is the mental health of patients with mental disorder, who are often a neglected group. The aim of this study was to investigate the prevalence of, and associated factors for symptoms of post-traumatic stress disorder (PTSD) among patients with mental disorder in China during the COVID-19 pandemic. METHODS Self-reported questionnaires were distributed to patients in four psychiatric hospitals in Beijing, China, between April 28th and May 30th, 2020. Information regarding sociodemographic characteristics, COVID-19 related factors, support, psychosomatic factors, and PTSD symptoms were collected using a series of scales, such as the Impact of Event Scale-Revised, the 7-item Generalized Anxiety Disorder Scale, the 9-item Patient Health Questionnaire depression scale, and so on. Multivariate regression was used to identify factors related to PTSD symptoms. RESULTS A total of 1,055 patients with mental disorder were included in the final sample. The prevalence of PTSD symptoms was 41.3%. Hierarchical linear regression demonstrated that fear of the pandemic and anxiety were shared associated factors for both symptoms of PTSD and their subscales. Additionally, age was an associated factor for the total PTSD (β = 0.12, p < 0.01), intrusion (β = 0.18, p < 0.001), and avoidance (β = 0.1, p < 0.05) symptoms; depression was an associated factor for the total PTSD (β = 0.13, p < 0.001), intrusion (β = 0.11, p < 0.01), and hyperarousal (β = 0.19, p < 0.001) symptoms. CONCLUSIONS The prevalence of PTSD symptoms was high among patients with mental disorder during the COVID-19 pandemic in China. This study found that age, fear of the pandemic, anxiety and depression are significant associated factors of PTSD symptoms in patients with mental disorder during the pandemic. We call for higher awareness and introduction of PTSD interventions to relieve the psychological stress in these patients.
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Affiliation(s)
- Lirong Tang
- grid.24696.3f0000 0004 0369 153XDepartment of Clinical Psychology Center, Beijing Anding Hospital, Capital Medical University, Beijing, China ,grid.24696.3f0000 0004 0369 153XThe National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Yue Gao
- grid.24696.3f0000 0004 0369 153XDepartment of Clinical Psychology Center, Beijing Anding Hospital, Capital Medical University, Beijing, China ,grid.24696.3f0000 0004 0369 153XThe National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Shuangyi Qi
- grid.24696.3f0000 0004 0369 153XDepartment of Clinical Psychology Center, Beijing Anding Hospital, Capital Medical University, Beijing, China ,grid.24696.3f0000 0004 0369 153XThe National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Jie Cui
- grid.24696.3f0000 0004 0369 153XDepartment of Clinical Psychology Center, Beijing Anding Hospital, Capital Medical University, Beijing, China ,grid.24696.3f0000 0004 0369 153XThe National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Li Zhou
- grid.24696.3f0000 0004 0369 153XDepartment of Clinical Psychology Center, Beijing Anding Hospital, Capital Medical University, Beijing, China ,grid.24696.3f0000 0004 0369 153XThe National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China ,grid.24696.3f0000 0004 0369 153XAdvanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yi Feng
- Mental Health Center, Central University of Finance and Economics, 39 South College Road, Haidian District, 100081, Beijing, China. .,Faculty of Psychology, Beijing Normal University, Beijing, China.
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59
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Huang F, Sun W, Zhang L, Lu H, Chen WT. Depressive symptoms mediate COVID-associated stigma and quality of life: Stigma instrument validation and path analysis. J Affect Disord 2022; 297:269-275. [PMID: 34699856 PMCID: PMC8541885 DOI: 10.1016/j.jad.2021.10.043] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 10/05/2021] [Accepted: 10/20/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND The aim of this study was to adapt and modify the HIV/AIDS Stigma Instrument-Patient to develop the COVID-19 Stigma Instrument-Patient (CSI-P) and validate its psychometric characteristics, as well as explore how affected individuals in China experienced COVID-related stigma and its associated variables, including depressive symptomology and quality of life (QOL). METHODS From September to October 2020, 151 COVID-19 survivors recruited in Shanghai, China, completed a set of measures of demographic characteristics, depression, stigma, and QOL. RESULTS The 15-item CSI-P-2 achieved a Cronbach's α of 0.67 to 0.91. The six-factor structure was obtained by exploratory factor analysis. The mean score for the CSI-P-2 in Chinese COVID survivors was 8.14 ± 9.98. Regression analysis showed that survivors' age, comorbid diseases, education levels, and loneliness level were the factors influencing their COVID-19 stigma, explaining 37.80% of the total variance (F = 19.25, p < 0.001). Also, stigma's effect on QOL was significant in direct and indirect paths mediated by depressive symptomology. LIMITATIONS First, this sample might limit the generalization of the findings to other Chinese-speaking regions. Second, future longitudinal or experimental studies are warranted for checking and further refinement of the scale. Finally, future studies are needed on the changing dynamics of stigma in different stages of the pandemic. CONCLUSIONS The 29-item CSI-P-2 with six domains is an instrument with sound psychometric properties that can be used to measure COVID-19 stigma during the COVID-19 outbreak and, later, for COVID-19 survivors. Future studies should explore how to integrate the significant demographic and psychological characteristics influencing the experience of stigma work on this study into the development of stigma-reducing interventions.
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Affiliation(s)
- Feifei Huang
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Wenxiu Sun
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Lin Zhang
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
| | - Hongzhou Lu
- Shenzhen Third People's Hospital, the Second Afflilated Hospital of Souterhn University of Science and Technology, Shenzhen, China
| | - Wei-Ti Chen
- School of Nursing, University of California Los Angeles, Los Angeles, CA, USA.
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60
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Kim GM, Lee JU, Jung HK, Nam SG, Sim SH, Chang SJ. [Types of Perception Toward Quarantine Measures among Patients Infected with COVID-19]. J Korean Acad Nurs 2022; 51:661-677. [PMID: 35023856 DOI: 10.4040/jkan.21141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/23/2021] [Accepted: 10/01/2021] [Indexed: 11/09/2022]
Abstract
PURPOSE This study was conducted to identify the types of perception toward quarantine measures at hospitals or community treatment centers among patients infected with COVID-19. METHODS This study applied Q-methodology. Two hundred and nineteen Q populations were constructed based on related literature and in-depth interviews with 5 adults infected with COVID-19 and who experienced quarantine and hospitalization. Interviews were performed from November 14 to 29, 2020. A total of 45 Q samples were extracted and Q sorting was performed using a 9-point scale for 30 adult subjects who experienced quarantine at hospitals and community treatment centers. The data were analyzed using the PC-QUANL program. RESULTS The perception of subjects toward quarantine measures was classified into the following six types: 'passive acceptance', 'social stigma perception', 'appreciation of daily life through awareness of the realities of illness', 'why me?', 'fearful perception', and 'positive meaning'. CONCLUSION The perception of quarantine measure among patients with COVID-19 is identified as six types with positive and negative emotional characteristics. This result will contribute to the development of individualized strategies to address psychosocial health problems among patients with infectious diseases.
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Affiliation(s)
- Geun Myun Kim
- Department of Nursing, Gangneung-Wonju National University, Wonju, Korea
| | - Jung Un Lee
- Department of Nursing, Gangneung-Wonju National University, Wonju, Korea
| | - Hae Kyung Jung
- Department of Nursing, Gangneung-Wonju National University, Wonju, Korea
| | - Soo Gyung Nam
- Department of Nursing, Gangneung-Wonju National University, Wonju, Korea
| | - So Hyeong Sim
- Department of Nursing, Gangneung-Wonju National University, Wonju, Korea
| | - Soo Jung Chang
- Department of Nursing, Gangneung-Wonju National University, Wonju, Korea.
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Psychological Symptoms in COVID-19 Patients: Insights into Pathophysiology and Risk Factors of Long COVID-19. BIOLOGY 2022; 11:biology11010061. [PMID: 35053059 PMCID: PMC8773222 DOI: 10.3390/biology11010061] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 12/26/2021] [Accepted: 12/27/2021] [Indexed: 12/17/2022]
Abstract
There is growing evidence of studies associating COVID-19 survivors with increased mental health consequences. Mental health implications related to a COVID-19 infection include both acute and long-term consequences. Here we discuss COVID-19-associated psychiatric sequelae, particularly anxiety, depression, and post-traumatic stress disorder (PTSD), drawing parallels to past coronavirus outbreaks. A literature search was completed across three databases, using keywords to search for relevant articles. The cause may directly correlate to the infection through both direct and indirect mechanisms, but the underlying etiology appears more complex and multifactorial, involving environmental, psychological, and biological factors. Although most risk factors and prevalence rates vary across various studies, being of the female gender and having a history of psychiatric disorders seem consistent. Several studies will be presented, demonstrating COVID-19 survivors presenting higher rates of mental health consequences than the general population. The possible mechanisms by which the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) enters the brain, affecting the central nervous system (CNS) and causing these psychiatric sequelae, will be discussed, particularly concerning the SARS-CoV-2 entry via the angiotensin-converting enzyme 2 (ACE-2) receptors and the implications of the immune inflammatory signaling on neuropsychiatric disorders. Some possible therapeutic options will also be considered.
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Ju N, Yang X, Ma X, Wang B, Fu L, Hu Y, Luo D, Xiao X, Zheng W, Xu H, Fang Y, Chan PSF, Xu Z, Chen P, He J, Zhu H, Tang H, Huang D, Hong Z, Xiao F, Sun F, Hao Y, Cai L, Yang J, Ye S, Chen YQ, Yuan J, Wang Z, Zou H. Hospitalization, interpersonal and personal factors of social anxiety among COVID-19 survivors at the six-month follow-up after hospital treatment: the minority stress model. Eur J Psychotraumatol 2022; 13:2019980. [PMID: 35111284 PMCID: PMC8803063 DOI: 10.1080/20008198.2021.2019980] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND As a highly infectious disease with human-to-human transmission characteristics, COVID-19 has caused panic in the general public. Those who have recovered from COVID-19 may experience discrimination and internalized stigma. They may be more likely to worry about social interaction and develop social anxiety. OBJECTIVES This study investigated the associations among hospitalization factors, social/interpersonal factors, personal factors, and social anxiety to reveal the mechanism of social anxiety in COVID-19 survivors. METHODS A cross-sectional, multicenter telephone survey was conducted from July to September 2020 in five Chinese cities (i.e. Wuhan, Nanning, Shenzhen, Zhuhai, and Dongguan); adult COVID-19 survivors were recruited 6 months after they were discharged from the hospital. Linear regressions and path analysis based on the minority stress model were conducted to test the relationships among hospitalization, social/interpersonal factors, personal factors, and social anxiety. RESULTS The response rate was 74.5% (N = 199, 55.3% females). Linear regression analyses showed that various hospitalization, social/interpersonal, and personal factors were statistically significantly associated with social anxiety. Path analysis showed that the proposed model fit the data well (χ2(df) = 3.196(3), p = .362, CFI = .999, NNFI = .996, RMSEA = .018). Internalized stigma fully mediated the association between perceived discrimination/social support and social anxiety, while it partially mediated the association between perceived affiliate stigma and social anxiety. CONCLUSIONS The results suggest that social/interpersonal and personal factors have a stronger association with social anxiety than hospitalization factors and highlight the importance of internalized stigma in understanding the mechanisms of these relationships. Clinical psychologists can refer to these modifiable psychosocial factors to develop efficient interventions for mental health promotion.
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Affiliation(s)
- Niu Ju
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Xue Yang
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xiaojun Ma
- Guangdong Provincial People's Hospital, Guangzhou, China
| | - Bingyi Wang
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Leiwen Fu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Yuqing Hu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Dan Luo
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Xin Xiao
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China.,Center for Optometry and Visual Science, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Weiran Zheng
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Hui Xu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Yuan Fang
- Department of Early Childhood Education, The Education University of Hong Kong, Hong Kong SAR, China
| | - Paul Shing Fong Chan
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Zhijie Xu
- The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Ping Chen
- The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Jiaoling He
- The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Hongqiong Zhu
- The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Huiwen Tang
- The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Dixi Huang
- The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Zhongsi Hong
- The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Fei Xiao
- The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | | | - Yanrong Hao
- Department of Scientific Research, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Lianying Cai
- Department of Education, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Jianrong Yang
- Department of Hepatobiliary, Pancreas and Spleen Surgery, the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Shupei Ye
- Department of Emergency, SSL Central Hospital of Dongguan City, Dongguan, China
| | - Yao-Qing Chen
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Jianhui Yuan
- Shenzhen Nanshan District Center for Disease Control and Prevention, Shenzhen, China
| | - Zixin Wang
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Huachun Zou
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China.,School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shenzhen Center for Disease Control and Prevention, Shenzhen, China.,Kirby Institute, University of New South Wales, Sydney, Australia
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Cai W, Zhang K, Wang GT, Li J, Wei XY, Ma W, Li YJ, Wang B, Shen WD. Effects and safety of auricular acupressure on depression and anxiety in isolated COVID-19 patients: A single-blind randomized controlled trial. Front Psychiatry 2022; 13:1041829. [PMID: 36545041 PMCID: PMC9760812 DOI: 10.3389/fpsyt.2022.1041829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 11/18/2022] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Psychological distress such as depression and anxiety resulted from coronavirus disease 2019 (COVID-19) have attracted increasing attention. The aim of this randomized controlled trial is to evaluate the effects and safety of auricular acupressure on depression and anxiety in isolated COVID-19 patients. METHODS 68 participants diagnosed with COVID-19 pneumonia (18-80 years old, SDS ≥ 50, SAS ≥ 45) were recruited and randomly allocated to the auricular acupressure group and the sham auricular acupressure group by a computer-generated random number sequence from 9th June to 30th June 2022. The group allocation was only blinded to the participants. Those in the auricular acupressure group were attached magnetic beads against 4 auricular points Shenmen, Subcortex, Liver and Endocrine, while sham group used four irrelevant auricular points. Outcomes were measured by Zung Self-Rating Depression Scale (SDS) and Zung Self-Rating Depression Scale (SAS) before and after treatment in both groups through electronic questionnaire in mobile phones. RESULTS After treatment, statistically significant differences were found in scores of SAS in both groups (P < 0.001 in auricular acupressure group; P = 0.003 in sham group), and SDS scores reduced significantly in the auricular acupressure group (P = 0.002). Significant reduced SAS and SDS scores were achieved in the auricular acupressure group than that in the sham group (F = 4.008, P = 0.049, MD -7.70 95% CI: -9.00, -6.40, SMD -2.79 95% CI: -3.47, -2.11 in SDS; F = 10.186, P = 0.002, MD -14.00 95% CI: -15.47, -12.53, SMD -4.46 95% CI: -5.37, -3.56 in SAS). No adverse events were found in either group during the whole study. CONCLUSION Auricular acupressure is an effective and safe treatment for alleviating symptoms of depressive and anxiety in patients with COVID-19. CLINICAL TRIAL REGISTRATION https://www.chictr.org.cn//, identifier ChiCTR2200061351.
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Affiliation(s)
- Wa Cai
- Department of Acupuncture, Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Kun Zhang
- Department of Acupuncture, Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Guan-Tao Wang
- Department of Acupuncture, Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jin Li
- Department of Acupuncture, Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiang-Yu Wei
- Institute of Acupuncture and Anesthesia, Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wen Ma
- Department of Acupuncture, Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ya-Juan Li
- Department of Traditional Chinese Medicine, Lianyang Community Health Service Center, Shanghai, China
| | - Bo Wang
- Department of Acupuncture, Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wei-Dong Shen
- Department of Acupuncture, Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Institute of Acupuncture and Anesthesia, Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Belen H. Fear of COVID-19 and Mental Health: The Role of Mindfulness in During Times of Crisis. Int J Ment Health Addict 2022; 20:607-618. [PMID: 33935608 DOI: 10.21203/rs.3.rs-40529/v1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/15/2020] [Indexed: 05/21/2023] Open
Abstract
The novel coronavirus disease (COVID-19) has had a significant impact on all aspects of individuals' lives, particularly their mental health due to the fear associated with the pandemic. Thus, the current study explored the relationship between the fear of COVID-19 and aspects of mental health, namely anxiety and depression, and will consider whether this relationship can be mediated by mindfulness. Data were collected from a student sample of 355 participants (71.5% female and 28.5% male) ranging between 18 and 41 years of age (M = 22.41 ± 3.27), with participants completing a fear of COVID-19 scale (FCV-19S), Mindfulness Attention and Awareness Scale (MAAS), and the anxiety and depression subscale of the Symptom Checklist-90-Revised (SCL-90-R). In terms of the results, correlational analyses indicated that fear of COVID-19 is inversely associated with mindfulness, while positive correlations were found with anxiety and depression. Structural equation modeling analyses demonstrated that mindfulness mediated the relationship between fear of COVID-19 and depression and anxiety. Associated implications are further discussed.
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Affiliation(s)
- Hacer Belen
- Educational Sciences, Psychological Counseling and Guidance, Bursa Uludag University, Ozluce, Gorukle Campus, 16059 Nilüfer, Bursa Turkey
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65
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Satapathy S, Wundavalli L, Chadda R, Satpathy S, Tiwari S, Singh S, Singh A, Kumar Y, Barre V. Coronavirus phase and major influencing factors in determining anxiety, depression, and posttraumatic stress disorder in patients with COVID-19. TAIWANESE JOURNAL OF PSYCHIATRY 2022. [DOI: 10.4103/tpsy.tpsy_14_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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66
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Xiao X, Yang X, Zheng W, Wang B, Fu L, Luo D, Hu Y, Ju N, Xu H, Fang Y, Fong Chan PS, Xu Z, Chen P, He J, Zhu H, Tang H, Huang D, Hong Z, Hao Y, Cai L, Ye S, Yuan J, Xiao F, Yang J, Wang Z, Zou H. Depression, anxiety and post-traumatic growth among COVID-19 survivors six-month after discharge. Eur J Psychotraumatol 2022; 13:2055294. [PMID: 35401948 PMCID: PMC8986234 DOI: 10.1080/20008198.2022.2055294] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Pre-hospitalisation, hospitalisation and post-hospitalisation factors may significantly affect depression, anxiety and post-traumatic growth (PTG) among COVID-19 survivors. OBJECTIVE Our study investigated depression, anxiety and PTG and their correlates among COVID-19 survivors. METHOD A cross-sectional telephone survey recruited 199 COVID-19 patients (Mean age = 42.7; 53.3% females) at six-month follow-up after hospital discharge in five Chinese cities (i.e. Wuhan, Shenzhen, Zhuhai, Dongguan and Nanning). Their demographic information, clinical records and experiences during (e.g. severity of covid-19 symptoms, treatment and exposure to other patients' suffering) and after hospitalisation (e.g. perceived impact of covid-19, somatic symptoms after hospitalisation), and psychosocial factors (e.g. perceived discrimination, self-stigma, affiliate stigma, resilience and social support) were investigated. Depressive and anxiety symptoms were measured by the Patient Health Questionnaire (PHQ-9) and the Generalised anxiety disorder (GAD-7) scale, respectively. PTG was examined by the Post-traumatic Growth Inventory (PTGI) instrument. RESULTS The proportion of depressive symptoms <5, ≥5 and <10, ≥10 were 76.9%, 12.0% and 11.1%, respectively. The proportion of anxiety symptoms <5, ≥5 and <10, ≥10 were 77.4%, 15.1% and 7.5%, respectively. Multivariate logistic regression showed that receiving mental health care services during hospitalisation, somatic symptoms after discharge, perceived affiliate stigma and perceived impact of being infected with COVID-19 were significantly and positively associated with probable depression. Significant correlates of probable anxiety also included permanent residents of the city, somatic symptoms after discharge, perceived impact of being infected with COVID-19 and self-stigma. Social support, self-stigma and receiving mental health care services during hospitalisation were positively associated with PTG.Conclusions: The results suggest that post-hospitalisation and psychosocial factors had relatively stronger associations with depression, anxiety and PTG than pre-hospitalisation and hospitalisation factors. Promoting social support and social inclusion may be useful strategies to improve the mental health of COVID-19 survivors. HIGHLIGHTS • Post-hospitalisation and psychosocial factors had relatively stronger associations with depression, anxiety and PTG than pre-hospitalisation and hospitalisation factors, promoting social support and social inclusion may be useful strategies to improve mental health of COVID-19 survivors.
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Affiliation(s)
- Xin Xiao
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, People's Republic of China.,Center for Optometry and Visual Science, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, People's Republic of China
| | - Xue Yang
- Faculty of Medicine, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Weiran Zheng
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, People's Republic of China
| | - Bingyi Wang
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, People's Republic of China
| | - Leiwen Fu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, People's Republic of China
| | - Dan Luo
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, People's Republic of China
| | - Yuqing Hu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, People's Republic of China
| | - Niu Ju
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, People's Republic of China
| | - Hui Xu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, People's Republic of China
| | - Yuan Fang
- Department of Early Childhood Education, The Education University of Hong Kong, Hong Kong, People's Republic of China
| | - Paul Shing Fong Chan
- Faculty of Medicine, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Zhijie Xu
- The Fifth Affiliated Hospital of Sun Yat-sen University, 74 Zhongshan 2nd Road, Yuexiu District, Guangzhou, People's Republic of China
| | - Ping Chen
- The Fifth Affiliated Hospital of Sun Yat-sen University, 74 Zhongshan 2nd Road, Yuexiu District, Guangzhou, People's Republic of China
| | - Jiaoling He
- The Fifth Affiliated Hospital of Sun Yat-sen University, 74 Zhongshan 2nd Road, Yuexiu District, Guangzhou, People's Republic of China
| | - Hongqiong Zhu
- The Fifth Affiliated Hospital of Sun Yat-sen University, 74 Zhongshan 2nd Road, Yuexiu District, Guangzhou, People's Republic of China
| | - Huiwen Tang
- The Fifth Affiliated Hospital of Sun Yat-sen University, 74 Zhongshan 2nd Road, Yuexiu District, Guangzhou, People's Republic of China
| | - Dixi Huang
- The Fifth Affiliated Hospital of Sun Yat-sen University, 74 Zhongshan 2nd Road, Yuexiu District, Guangzhou, People's Republic of China
| | - Zhongsi Hong
- The Fifth Affiliated Hospital of Sun Yat-sen University, 74 Zhongshan 2nd Road, Yuexiu District, Guangzhou, People's Republic of China
| | - Yanrong Hao
- Department of scientific research, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, People's Republic of China
| | - Lianying Cai
- Department of education, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, People's Republic of China
| | - Shupei Ye
- Dongguan Songshan Lake Central Hospital, Dongguan, People's Republic of China
| | - Jianhui Yuan
- Shenzhen Nanshan District Center for Disease Control and Prevention, Shenzhen, People's Republic of China
| | - Fei Xiao
- The Fifth Affiliated Hospital of Sun Yat-sen University, 74 Zhongshan 2nd Road, Yuexiu District, Guangzhou, People's Republic of China
| | - Jianrong Yang
- Department of Hepatobiliary, Pancreas and Spleen Surgery, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, People's Republic of China
| | - Zixin Wang
- Faculty of Medicine, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Huachun Zou
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, People's Republic of China.,School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.,Shenzhen Center for Disease Control and Prevention, Shenzhen, People's Republic of China.,Kirby Institute, University of New South Wales, Sydney, NSW, Australia
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Gaur V, Salvi D, Gautam M, Sangwan V, Tambi T, Kalia A, Singh N. Psychiatric comorbidity in clinically stable COVID-19 patients. Indian J Psychiatry 2022; 64:89-92. [PMID: 35400739 PMCID: PMC8992745 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_312_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 11/16/2021] [Accepted: 12/14/2021] [Indexed: 11/30/2022] Open
Abstract
AIMS To identify prevalence of psychiatric comorbidity in clinically stable COVID-19 patients. MATERIALS AND METHODS A cross-sectional single point observational study was conducted among clinically stable 72 COVID-19 infected patients. Psychiatric comorbidity was assessed with the help of DSM-5 Self-Rated Level 1 CCSM-Adult scale. RESULTS The prevalence of psychiatric comorbidity was 76.4% (n = 55). Depression was the most common diagnosis in 44.44% (n = 32) followed by anxiety (34.72%, n = 25), somatic symptoms (26.39%, n = 19), sleep problems (23.61%, n = 17). Around 45 .83 % (n = 33) patients considered COVID-19 infection as potentially life-threatening and 23.62% (n=17) patients experienced discrimination and stigma after being diagnosed with COVID-19 infection. Using binary logistic regression, physical symptoms was identified as a risk factor for psychiatric comorbidity. CONCLUSION Our study provides evidence of a significant impact of COVID-19 infection on mental health in COVID-19 patients.
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Affiliation(s)
- Vikas Gaur
- Department of Psychiatry, Mahatma Gandhi Medical College, Jaipur, Rajasthan, India
| | - Deepak Salvi
- Department of Clinical Psychology, Mahatma Gandhi Medical College, Jaipur, Rajasthan, India
| | - Manaswi Gautam
- Gautam Hospital and Research Center, Jaipur, Rajasthan, India
| | - Vaundhra Sangwan
- Department of Psychiatry, Mahatma Gandhi Medical College, Jaipur, Rajasthan, India
| | - Tanushi Tambi
- Department of Medicine, Mahatma Gandhi Medical College, Jaipur, Rajasthan, India
| | - Anchin Kalia
- Department of Psychiatry, Mahatma Gandhi Medical College, Jaipur, Rajasthan, India
| | - Nishant Singh
- Department of Psychiatry, Mahatma Gandhi Medical College, Jaipur, Rajasthan, India
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Fagbamigbe AF, Tolba MF, Amankwaa EF, Mante PK, Sylverken AA, Zahouli JZB, Goonoo N, Mosi L, Oyebola K, Matoke-Muhia D, de Souza DK, Badu K, Dukhi N. Implications of WHO COVID-19 interim guideline 2020.5 on the comprehensive care for infected persons in Africa Before, during and after clinical management of cases. SCIENTIFIC AFRICAN 2021; 15:e01083. [PMID: 34957351 PMCID: PMC8683379 DOI: 10.1016/j.sciaf.2021.e01083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 11/11/2021] [Accepted: 12/16/2021] [Indexed: 01/08/2023] Open
Abstract
The novel coronavirus disease 2019 (COVID-19) is one of the biggest public health crises globally. Although Africa did not display the worst-case scenario compared to other continents, fears were still at its peak since Africa was already suffering from a heavy load of other life-threatening infectious diseases such as HIV/AIDS and malaria. Other factors that were anticipated to complicate Africa's outcomes include the lack of resources for diagnosis and contact tracing along with the low capacity of specialized management facilities per capita. The current review aims at assessing and generating discussions on the realities, and pros and cons of the WHO COVID-19 interim guidance 2020.5 considering the known peculiarities of the African continent. A comprehensive evaluation was done for COVID-19-related data published across PubMed and Google Scholar (date of the last search: August 17, 2020) with emphasis on clinical management and psychosocial aspects. Predefined filters were then applied in data screening as detailed in the methods. Specifically, we interrogated the WHO 2020.5 guideline viz-a-viz health priority and health financing in Africa, COVID-19 case contact tracing and risk assessment, clinical management of COVID-19 cases as well as strategies for tackling stigmatization and psychosocial challenges encountered by COVID-19 survivors. The outcomes of this work provide links between these vital sub-themes which may impact the containment and management of COVID-19 cases in Africa in the long-term. The chief recommendation of the current study is the necessity of prudent filtration of the global findings along with regional modelling of the global care guidelines for acting properly in response to this health threat on the regional level without exposing our populations to further unnecessary adversities.
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Key Words
- AFCOR, Africa Task Force for Novel Coronavirus
- AIDS, acquired immune deficiency syndrome
- ARDS, acute respiratory distress syndrome
- Africa
- C02, carbon dioxide
- COVID-19
- Clinical management
- Contact tracing
- ECMO, extracorporeal membrane oxygenation
- GGE, general government expenditure
- GGHE, general government health expenditure
- H2O, Hydrogen
- HIV, Human immunodeficiency virus
- MERS, Middle East Respiratory Syndrome
- NHS, national health services
- O2, Oxygen
- PCR, polymerase chain reaction
- PTSD, post-traumatic stress disorder
- RECOVERY, Randomized Evaluation of COVID-19 Therapy
- SARS, severe acute respiratory syndrome
- Stigmatization
- US-CDC, United States Centre for Disease Control
- WHO guidelines
- WHO, World Health Organization
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Affiliation(s)
- Adeniyi Francis Fagbamigbe
- The African Academy of Sciences, Nairobi, Kenya.,Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Nigeria
| | - Mai F Tolba
- The African Academy of Sciences, Nairobi, Kenya.,Department of Pharmacology and Toxicology, Faculty of Pharmacy and The Centre of Drug Discovery Research and Development, Ain Shams University, Cairo 11566, Egypt.,School of Life and Medical Sciences, University of Hertfordshire Hosted by Global Academic Foundation, New Capital City, Egypt
| | - Ebenezer F Amankwaa
- The African Academy of Sciences, Nairobi, Kenya.,Department of Geography and Resource Development, University of Ghana, Accra, Ghana
| | - Priscilla Kolibea Mante
- The African Academy of Sciences, Nairobi, Kenya.,Department of Pharmacology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Augustina Angelina Sylverken
- The African Academy of Sciences, Nairobi, Kenya.,Department of Theoretical and Applied Biology, Kwame Nkrumah University of Science and Technology, Ashanti, UPO/PMB, Kumasi, Ghana.,Kumasi Centre for Collaborative Research in Tropical Medicine, Kumasi, Ghana
| | - Julien Z B Zahouli
- The African Academy of Sciences, Nairobi, Kenya.,Centre d'Entomologie Médicale et Vétérinaire, Université Alassane Ouattara, Bouaké, Côte d'Ivoire
| | - Nowsheen Goonoo
- The African Academy of Sciences, Nairobi, Kenya.,Biomaterials, Drug Delivery and Nanotechnology Unit, Centre for Biomedical Biomaterials Research, University of Mauritius, Reduit, Mauritius
| | - Lydia Mosi
- The African Academy of Sciences, Nairobi, Kenya.,Department of Biochemistry Cell and Molecular Biology, University of Ghana, Ghana.,West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Ghana
| | - Kolapo Oyebola
- The African Academy of Sciences, Nairobi, Kenya.,Nigerian Institute of Medical Research, Lagos, Nigeria.,Department of Zoology, Faculty of Science, University of Lagos, Nigeria
| | - Damaris Matoke-Muhia
- The African Academy of Sciences, Nairobi, Kenya.,Centre for Biotechnology Research and Development, Kenya Medical Research Institute, Nairobi, Kenya
| | - Dziedzom K de Souza
- The African Academy of Sciences, Nairobi, Kenya.,Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Kingsley Badu
- The African Academy of Sciences, Nairobi, Kenya.,Department of Theoretical and Applied Biology, Kwame Nkrumah University of Science and Technology, Ashanti, UPO/PMB, Kumasi, Ghana.,Kumasi Centre for Collaborative Research in Tropical Medicine, Kumasi, Ghana
| | - Natisha Dukhi
- The African Academy of Sciences, Nairobi, Kenya.,Human and Social Capabilities Division, Human Sciences Research Council, 116-118 Buitengracht Street, Merchant House, 3rd floor, Cape Town, Western Cape 8001, South Africa
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69
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Badenoch JB, Rengasamy ER, Watson C, Jansen K, Chakraborty S, Sundaram RD, Hafeez D, Burchill E, Saini A, Thomas L, Cross B, Hunt CK, Conti I, Ralovska S, Hussain Z, Butler M, Pollak TA, Koychev I, Michael BD, Holling H, Nicholson TR, Rogers JP, Rooney AG. Persistent neuropsychiatric symptoms after COVID-19: a systematic review and meta-analysis. Brain Commun 2021; 4:fcab297. [PMID: 35169700 PMCID: PMC8833580 DOI: 10.1093/braincomms/fcab297] [Citation(s) in RCA: 112] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 09/10/2021] [Accepted: 12/15/2021] [Indexed: 12/21/2022] Open
Abstract
The nature and extent of persistent neuropsychiatric symptoms after COVID-19 are not established. To help inform mental health service planning in the pandemic recovery phase, we systematically determined the prevalence of neuropsychiatric symptoms in survivors of COVID-19. For this pre-registered systematic review and meta-analysis (PROSPERO ID CRD42021239750), we searched MEDLINE, EMBASE, CINAHL and PsycINFO to 20 February 2021, plus our own curated database. We included peer-reviewed studies reporting neuropsychiatric symptoms at post-acute or later time-points after COVID-19 infection and in control groups where available. For each study, a minimum of two authors extracted summary data. For each symptom, we calculated a pooled prevalence using generalized linear mixed models. Heterogeneity was measured with I 2. Subgroup analyses were conducted for COVID-19 hospitalization, severity and duration of follow-up. From 2844 unique titles, we included 51 studies (n = 18 917 patients). The mean duration of follow-up after COVID-19 was 77 days (range 14-182 days). Study quality was most commonly moderate. The most prevalent neuropsychiatric symptom was sleep disturbance [pooled prevalence = 27.4% (95% confidence interval 21.4-34.4%)], followed by fatigue [24.4% (17.5-32.9%)], objective cognitive impairment [20.2% (10.3-35.7%)], anxiety [19.1% (13.3-26.8%)] and post-traumatic stress [15.7% (9.9-24.1%)]. Only two studies reported symptoms in control groups, both reporting higher frequencies in COVID-19 survivors versus controls. Between-study heterogeneity was high (I 2 = 79.6-98.6%). There was little or no evidence of differential symptom prevalence based on hospitalization status, severity or follow-up duration. Neuropsychiatric symptoms are common and persistent after recovery from COVID-19. The literature on longer-term consequences is still maturing but indicates a particularly high prevalence of insomnia, fatigue, cognitive impairment and anxiety disorders in the first 6 months after infection.
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Affiliation(s)
- James B. Badenoch
- Barts Health NHS Trust, London, UK
- Queen Mary University of London, London, UK
| | - Emma R. Rengasamy
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Cameron Watson
- Barts Health NHS Trust, London, UK
- Preventive Neurology Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - Katrin Jansen
- Department of Psychology, University of Münster, Münster, Germany
| | - Stuti Chakraborty
- Department of Physical Medicine and Rehabilitation, Christian Medical College and Hospital, Vellore, India
- Occupational Therapy Unit, Department of Physical Medicine and Rehabilitation, Christian Medical College and Hospital, Vellore, India
| | | | - Danish Hafeez
- Homerton University Hospitals Foundation Trust, London, UK
| | - Ella Burchill
- Faculty of Medicine and Life Sciences, King’s College London, London, UK
| | - Aman Saini
- Medical School, University College London, London, UK
| | - Lucretia Thomas
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | | | | | - Isabella Conti
- School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
| | - Sylvia Ralovska
- Sofia University ‘St Kliment Ohridski’, bul, ‘Tsar Osvoboditel’ 15, Sofia, Bulgaria
| | - Zain Hussain
- Edinburgh Medical School, College of Medicine and Veterinary Medicine, University of Edinburgh, UK
- School of Medicine, University of Dundee, Dundee, UK
| | - Matthew Butler
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Thomas A. Pollak
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Ivan Koychev
- Department of Psychiatry, University of Oxford, Oxford, UK
- Department of Psychological Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Benedict D. Michael
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK
- National Institute for Health Research Health Protection Research Unit in Emerging and Zoonotic Infection, University of Liverpool, Liverpool, UK
- Clinical Infection Microbiology and Immunology, Institute of Infection, Veterinary, and Zoological Science, University of Liverpool, Liverpool, UK
| | - Heinz Holling
- Department of Psychology, University of Münster, Münster, Germany
| | - Timothy R. Nicholson
- Section of Cognitive Neuropsychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Jonathan P. Rogers
- Division of Psychiatry, University College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Alasdair G. Rooney
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
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70
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Dorri M, Mozafari Bazargany MH, Khodaparast Z, Bahrami S, Seifi Alan M, Rahimi F, Kamipoor Z, Niksima MM, Dehghan H, Rastad H. Psychological problems and reduced health-related quality of life in the COVID-19 survivors. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021; 6:100248. [PMID: 34642678 PMCID: PMC8495058 DOI: 10.1016/j.jadr.2021.100248] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 09/23/2021] [Accepted: 10/01/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND COVID-19 survivors are predicted to experience the long-term consequences, including pulmonary, neurologic, cardiovascular, and mental health sequelae. This systematic review and meta-analysis was performed on studies assessing the health-related quality of life (HRQoL) and psychiatric problems in COVID-19 survivors. METHODS A systematic search was performed on PubMed, Embase, and Google scholar databases using key terms COVID-19, PTSD, depression, anxiety, HRQoL, survivors. Pooled estimates were calculated using the random-effects models. RESULTS A total of 21 eligible articles were included. The pooled prevalence of PTSD, depression, and anxiety among COVID-19 survivors were 18% (95% CI: 13 to 23%, I2=88.23%), 12% (8 to 17%, I2=91.84%), and 17% (12 to 22%, I2=97.07%), respectively. COVID-19 survivors compared to pre-COVID-19 time and controls showed reduced HRQoL and a lower score in Social Functioning (SF) and Role Physical (RP), and Role Emotional (RE) health. Females compared to males had a higher risk of experiencing mental health problems. Also, patients with severe disease had a higher prevalence of depression and anxiety, but not PTSD. LIMITATIONS Regarding HRQoL, we were not able to perform a subgroup analysis due to a lack of data. Also, the included studies mainly used a self-rating scale to detect psychological problems in their study population. CONCLUSION A significant number of patients who survived from COVID-19 might suffer from PTSD, depression, and anxiety beyond one month. Our systematic review also found evidence of reduced HQOL and limited social role in these survivors.
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Affiliation(s)
- Mahya Dorri
- Cardiovascular Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | | | - Zeinab Khodaparast
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Soroush Bahrami
- Cardiovascular Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Mahnaz Seifi Alan
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Fariba Rahimi
- Cardiovascular Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Zeinab Kamipoor
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Mohammad Mahdi Niksima
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Hanieh Dehghan
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Hadis Rastad
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
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71
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Esmat S, Attia A, Elhabashi E. Prevalence and Predictors for Depression among Medical Students during Coronavirus Disease-19 Pandemic: A Cross-sectional Study. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Since the declaration of the World Health Organization of the coronavirus (SARS-COV-2) as a pandemic, several countries have locked down and quarantined their residents with restrictive procedures to control spread of the disease. Due to pandemic related stressors, concerns and worries have developed regarding negative psychological impact on the mental well-being of the general population, particularly those known to have higher levels of psychological impairment with high vulnerability to mental health diseases such as medical students.
AIM: The objectives of the study were to assess the prevalence of self-reported depression and to explore its predictors during the period of Coronavirus Disease 2019 first lock down among medical students.
METHODS: This was a cross-sectional study design. The study was conducted at Kasr Alainy Medical School, Faculty of Medicine, Cairo University, Egypt, in June 2020. A simple random sample was picked of one subgroup of 4th year medical students (No. = 300) at faculty of medicine during the academic year 2019–2020. Self-administered questionnaires including Beck’s Depression Inventory scoring were distributed using Google form through communication social media such as WhatsApp.
RESULTS: Out of the 300 participants, 238 responses were received with response rate 79.3%. Results indicated that 38.2% of the respondents were experiencing depression with different degrees with Beck’s Depression Inventory mean scores was 19.4 ± 11.6. Multiple logistic regression analysis point out that gender (odds ratio [OR] = 2.4 and p = 0.022) and “Good” grade level of academic performance (OR = 7.2 and p = 0.045) are significant predictors for developing depression among the participating medical students.
CONCLUSION: A significantly high prevalence of depression is detected among medical students during the first wave of the SARS-COV-2 pandemic. The prevalence of depression is more among females than males and more with medical students achieving “Good” grade level.
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72
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Fu L, Fang Y, Luo D, Wang B, Xiao X, Hu Y, Ju N, Zheng W, Xu H, Yang X, Chan PSF, Xu Z, Chen P, He J, Zhu H, Tang H, Huang D, Hong Z, Ma X, Hao Y, Cai L, Yang J, Ye S, Yuan J, Chen Y, Xiao F, Wang Z, Zou H. Pre-hospital, in-hospital and post-hospital factors associated with sleep quality among COVID-19 survivors 6 months after hospital discharge: cross-sectional survey in five cities in China. BJPsych Open 2021; 7:e191. [PMID: 34659795 PMCID: PMC8505817 DOI: 10.1192/bjo.2021.1008] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 08/11/2021] [Accepted: 08/30/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Understanding factors associated with post-discharge sleep quality among COVID-19 survivors is important for intervention development. AIMS This study investigated sleep quality and its correlates among COVID-19 patients 6 months after their most recent hospital discharge. METHOD Healthcare providers at hospitals located in five different Chinese cities contacted adult COVID-19 patients discharged between 1 February and 30 March 2020. A total of 199 eligible patients provided verbal informed consent and completed the interview. Using score on the single-item Sleep Quality Scale as the dependent variable, multiple linear regression models were fitted. RESULTS Among all participants, 10.1% reported terrible or poor sleep quality, and 26.6% reported fair sleep quality, 26.1% reported worse sleep quality when comparing their current status with the time before COVID-19, and 33.7% were bothered by a sleeping disorder in the past 2 weeks. After adjusting for significant background characteristics, factors associated with sleep quality included witnessing the suffering (adjusted B = -1.15, 95% CI = -1.70, -0.33) or death (adjusted B = -1.55, 95% CI = -2.62, -0.49) of other COVID-19 patients during hospital stay, depressive symptoms (adjusted B = -0.26, 95% CI = -0.31, -0.20), anxiety symptoms (adjusted B = -0.25, 95% CI = -0.33, -0.17), post-traumatic stress disorders (adjusted B = -0.16, 95% CI = -0.22, -0.10) and social support (adjusted B = 0.07, 95% CI = 0.04, 0.10). CONCLUSIONS COVID-19 survivors reported poor sleep quality. Interventions and support services to improve sleep quality should be provided to COVID-19 survivors during their hospital stay and after hospital discharge.
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Affiliation(s)
- Leiwen Fu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Yuan Fang
- Department of Early Childhood Education, The Education University of Hong Kong, Hong Kong SAR, China
| | - Dan Luo
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Bingyi Wang
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Xin Xiao
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China, and Center for Optometry and Visual Science, the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Yuqing Hu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Niu Ju
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Weiran Zheng
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Hui Xu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Xue Yang
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Paul Shing Fong Chan
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Zhijie Xu
- The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Ping Chen
- The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Jiaoling He
- The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Hongqiong Zhu
- The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Huiwen Tang
- The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Dixi Huang
- The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Zhongsi Hong
- The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Xiaojun Ma
- Guangdong Provincial People's Hospital, Guangzhou, China
| | - Yanrong Hao
- Department of Scientific Research, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Lianying Cai
- Department of Education, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Jianrong Yang
- Department of Hepatobiliary, Pancreas and Spleen Surgery, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Shupei Ye
- Department of emergency, SSL Central Hospital of Dongguan City, Dongguan, China
| | - Jianhui Yuan
- Shenzhen Nanshan District Center for Disease Control and Prevention, Shenzhen, China
| | - Yaoqing Chen
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Fei Xiao
- The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Zixin Wang
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Huachun Zou
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China; Kirby Institute, University of New South Wales, Sydney, Australia; Shenzhen Center for Disease Control and Prevention, Shenzhen, China; and School of Public Health, Shanghai Jiao Tong University, Shanghai, China
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73
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Hu B, Ruan Y, Liu K, Wei X, Wu Y, Feng H, Deng Z, Liu J, Wang T. A Mid-to-Long Term Comprehensive Evaluation of Psychological Distress and Erectile Function in COVID-19 Recovered Patients. J Sex Med 2021; 18:1863-1871. [PMID: 34600862 PMCID: PMC8387224 DOI: 10.1016/j.jsxm.2021.08.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 07/12/2021] [Accepted: 08/20/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND The psychological and sexual health of different populations are negatively affected during the coronavirus disease 2019 (COVID-19) pandemic. However, little is known about psychological distress and erectile function of male recovered patients with COVID-19 in the long term. AIM We aimed to evaluate psychological distress and erectile function of male recovered patients with COVID-19 in the mid-to-long terms. METHODS We recruited 67 eligible male recovered patients with COVID-19 and followed them up twice within approximately 6 months of recovery time. The psychological distress and erectile function were assessed by validated Chinese version of paper questionnaires. OUTCOMES The primary outcomes were Symptom Checklist 90 questionnaire for psychological distress and International Index of Erectile Function-5 for erectile function. RESULTS In the first visit, COVID-19 patients with a median recovery time of 80 days mainly presented the following positive symptoms: Obsessive-Compulsive, additional items (ADD), Hostility, Interpersonal Sensitivity, Depression, and Somatization; while the dimension scores in Somatization, Anxiety, ADD, and Phobia were higher than Chinese male norms. Besides, the prevalence of erectile dysfunction (ED) in the first-visit patients was significantly higher than Chinese controls. In the second visit, the primary psychological symptoms of COVID-19 patients with a median recovery time of 174 days were Obsessive-Compulsive, ADD, Interpersonal Sensitivity, and Hostility, while all dimensions scores of Symptom Checklist 90 were lower than Chinese male norms. Moreover, second-visit patients had no significant difference with Chinese controls in ED prevalence. In addition, it suggested that GSI was the independent risk factor for ED in the regression analysis for the first-visit patients. CLINICAL IMPLICATIONS The study showed the changes of psychological symptoms and erectile function in COVID-19 recovered patients, and provided reference on whether psychological and sexual supports are needed after a period of recovery. STRENGTHS AND LIMITATIONS To our knowledge, it is the first study to comprehensively evaluate the psychological distress and erectile function of COVID-19 recovered patients in the mid-to-long terms. The main limitations were the low number of analyzed participants, and the psychological distress and erectile function of healthy Chinese men over the same period were not evaluated, and the psychological and sexual related data of participants prior to COVID-19 were not available. Additionally, there was a selection bias in comparing COVID-19 patients with healthy controls. CONCLUSION With less impact of COVID-19 event, the impaired erectile function and psychological distress improved in COVID-19 recovered patients with a recovery time of nearly half a year. Hu B, Ruan Y, Liu K, et al. A Mid-to-Long Term Comprehensive Evaluation of Psychological Distress and Erectile Function in COVID-19 Recovered Patients. J Sex Med 2021;18:1863-1871.
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Affiliation(s)
- Bintao Hu
- Department of Urology, Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yajun Ruan
- Department of Urology, Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Kang Liu
- Department of Urology, Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xian Wei
- Department of Urology, Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yue Wu
- Department of Urology, Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Huan Feng
- Department of Urology, Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhiyao Deng
- Department of Urology, Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jihong Liu
- Department of Urology, Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Tao Wang
- Department of Urology, Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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Th’ng F, Rao KA, Ge L, Mao D, Neo HN, Molina JAD, Seow E. A One-Year Longitudinal Study: Changes in Depression and Anxiety in Frontline Emergency Department Healthcare Workers in the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111228. [PMID: 34769750 PMCID: PMC8583330 DOI: 10.3390/ijerph182111228] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/19/2021] [Accepted: 10/22/2021] [Indexed: 02/04/2023]
Abstract
Frontline healthcare workers (HCWs) fighting COVID-19 have been associated with depression and anxiety, but there is limited data to illustrate these changes over time. We aim to quantify the changes in depression and anxiety amongst Emergency Department (ED) HCWs over one year and examine the factors associated with these changes. In this longitudinal single-centre study in Singapore, all ED HCWs were prospectively recruited face-to-face. Paper-based surveys were administered in June 2020 and June 2021. Depression and anxiety were measured using DASS-21. The results of 241 HCWs who had completed both surveys were matched. There was significant improvement in anxiety amongst all HCWs (Mean: 2020: 2.85 (±3.19) vs. 2021: 2.54 (±3.11); Median: 2020: 2 (0–4) vs. 2021: 2 (0–4), p = 0.045). HCWs living with elderly and with concerns about infection risk had higher odds of anxiety; those living with young children had lower odds of anxiety. There was significant worsening depression amongst doctors (Mean: 2020: 2.71 (±4.18) vs. 2021: 3.60 (±4.50); Median: 2020: 1 (0–3) vs. 2021: 3 (0–5), p = 0.018). HCWs ≥ 41 years, living with elderly and with greater concerns about workload had higher odds of depression. HCWs who perceived better workplace support and better social connectedness had lower odds of depression. In summary, our study showed significant improvement in anxiety amongst ED HCWs and significant worsening depression amongst ED doctors over one year. Age, living with elderly, and concerns about workload and infection risk were associated with higher odds of depression and anxiety.
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Affiliation(s)
- Francesca Th’ng
- Acute & Emergency Care Department, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore 768828, Singapore; (K.A.R.); (D.M.); (H.N.N.); (E.S.)
- Correspondence: ; Tel.: +65-98821657
| | - Kailing Adriel Rao
- Acute & Emergency Care Department, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore 768828, Singapore; (K.A.R.); (D.M.); (H.N.N.); (E.S.)
| | - Lixia Ge
- Health Services and Outcomes Research, National Healthcare Group, 3 Fusionopolis Link, Singapore 138543, Singapore; (L.G.); (J.A.D.M.)
| | - Desmond Mao
- Acute & Emergency Care Department, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore 768828, Singapore; (K.A.R.); (D.M.); (H.N.N.); (E.S.)
| | - Hwee Nah Neo
- Acute & Emergency Care Department, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore 768828, Singapore; (K.A.R.); (D.M.); (H.N.N.); (E.S.)
| | - Joseph Antonio De Molina
- Health Services and Outcomes Research, National Healthcare Group, 3 Fusionopolis Link, Singapore 138543, Singapore; (L.G.); (J.A.D.M.)
| | - Eillyne Seow
- Acute & Emergency Care Department, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore 768828, Singapore; (K.A.R.); (D.M.); (H.N.N.); (E.S.)
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CANSEL N, KARACA Y, YAĞIN FH. Evaluation of Coronavirus Phobia and Depression in Patients With Cardiovascular Disease. KAHRAMANMARAŞ SÜTÇÜ İMAM ÜNIVERSITESI TIP FAKÜLTESI DERGISI 2021. [DOI: 10.17517/ksutfd.994994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Dong F, Liu HL, Dai N, Yang M, Liu JP. A living systematic review of the psychological problems in people suffering from COVID-19. J Affect Disord 2021; 292:172-188. [PMID: 34126309 PMCID: PMC8169237 DOI: 10.1016/j.jad.2021.05.060] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 05/26/2021] [Accepted: 05/28/2021] [Indexed: 12/23/2022]
Abstract
OBJECTIVES We aimed to investigate the psychological problems on people infected with SARS-CoV-2 during the pandemic. METHODS In this living systematic review and meta-analyses, we searched seven electronic databases for cross-sectional studies and longitudinal studies on psychological problems on COVID-19 patients from Jan 1, 2020 to Oct 7, 2020. The primary outcome was prevalence of various psychological problems such as anxiety, depression, stress, insomnia, somatization, and fear. We pooled data for prevalence with their 95% confidence interval (CI) using random effect models and assessed the study quality based on the 11-item checklist recommended by the Agency for Healthcare Research and Quality. RESULTS Fourty-four studies, including studies from China(35), Italy(2), Iran(2), India(1), Korea(1), Ecuador(1), Switzerland(1), Germany(1), were identified by comprising a total of 8587 completed questionnaires and 38 studies for meta-analyses. The prevalence of anxiety, depression, post-traumatic stress disorder(PTSD), insomnia, somatization, and fear in patients with COVID-19 was 16.6% (10.1%-23.1%), 37.7% (29.3%-46.2%), 41.5% (9.3%-73.7%), 68.3% (48.6%-88.0%), 36.5% (20.2%-52.8%), 47.6% (9.4%-85.7%), respectively. The prevalence of anxiety, depression, and insomnia in severe COVID-19 patients (intensive care unit inpatients) was higher than mild or clinically stable COVID-19 patients. LIMITATIONS A significant degree of heterogeneity in terms of populations, sampling methods, scales was noted across studies. CONCLUSIONS There existed high proportions of COVID-19 patients with psychological problem. The prevalence of psychological problems was closely related to the patients themselves, their surroundings and social support. It is imperative to provide ontime psychological care service for COVID-19 patients and to follow-up them for a longer period.
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Affiliation(s)
- Fei Dong
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China; School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Hong-Liang Liu
- Gastroenterology Department, Guang'anmen Hospital, China Academy of Chinese Medicine Sciences, Beijing, China
| | - Ning Dai
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China; School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Ming Yang
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China; School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Jian-Ping Liu
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China; Institute for Excellence in Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.
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The relationship between Dietary Inflammatory Index and disease severity and inflammatory status: a case-control study of COVID-19 patients. Br J Nutr 2021; 127:773-781. [PMID: 34420546 PMCID: PMC8446593 DOI: 10.1017/s0007114521003214] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Numerous studies have revealed strong relationships between COVID-19 and inflammation. However, the imminent link between diet-related inflammation and the COVID-19 risk has not been addressed before. So, we explored the capability of the Energy-Adjusted Dietary Inflammatory Index (E-DII) to predict the inflammatory markers, incidence and severity of COVID-19. We conducted a case-control study consisting of 120 adults; they had been admitted for COVID-19 at hospital during June and July, 2020. The E-DII score was calculated based on the dietary intake, which was evaluated by a 138-item semi-quantitative food frequency questionnaire. Serum levels of inflammatory markers including the Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and White blood cells (WBCs) differential were measured. Severity of disease was assessed by chest radiology criteria. Patients with the maximum pro-inflammatory energy adjusted E-DII score had 7·26 times greater odds of developing COVID-19, as compared to those in tertiles 1 (E-DII T3v. E-DII T1: OR = 7·26; 95 % CI 2·64 to 9·94, P < 0·001). Also, a positive association between E-DII and C-reactive protein (CRP) was observed (BE-DII = 1·37, 95 % CI 0·72, 2·02), such that with each unit increase in E-E-DII, the CRP levels were increased by 1·37 units. Furthermore, a significant association was found between E-DII and the severity of disease (BE-DII = 0·03, 95 % CI 0·01, 0·06. 0·024). Patients consuming a diet with a higher pro-inflammatory potential were at a greater risk of COVID-19 occurrence; also, the severity of disease was elevated with a high score inflammatory diet.
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Qiu D, Li Y, Li L, He J, Ouyang F, Xiao S. Infectious Disease Outbreak and Post-Traumatic Stress Symptoms: A Systematic Review and Meta-Analysis. Front Psychol 2021; 12:668784. [PMID: 34421723 PMCID: PMC8376538 DOI: 10.3389/fpsyg.2021.668784] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 07/05/2021] [Indexed: 12/23/2022] Open
Abstract
Background: As one of the most widely researched consequence of traumatic events, the prevalence of post-traumatic stress symptoms (PTSS) among people exposed to the trauma resulting from infectious disease outbreak varies greatly across studies. This review aimed at examining the pooled prevalence of PTSS among people exposed to the trauma resulting from infectious disease outbreak, summarizing the possible causes of the inconsistencies in the current estimates. Methods: Systematic searches of databases were conducted for literature published on PubMed, EMBASE, Web of Science, the Cochrane Library, PsycArticles, and Chinese National Knowledge Infrastructure (CNKI) until 14 October 2020. Statistical analyses were performed using R software (registration number: CRD42020182366). Results: About 106 studies were included. The results showed that the pooled prevalence of PTSS among the general population exposed to the trauma resulting from infectious disease outbreak was 24.20% (95% CI: 18.54-30.53%), the pooled prevalence of PTSS among healthcare workers was 24.35% (95% CI: 18.38-1.51%), the pooled prevalence of PTSS among patients with infectious disease was 28.83% (95% CI: 18.53-44.86%), and the pooled prevalence of PTSS among suspected cases of infectious disease was 25.04% (95% CI: 18.05-34.73%). Mortality rate was a significant contributor to heterogeneity. Conclusions: Evidence suggests that PTSS were very common among people exposed to the trauma resulting from infectious disease outbreak. Health policymakers should consider both short-term and long-term preventive strategy of PTSS.
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Affiliation(s)
- Dan Qiu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Yilu Li
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Ling Li
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Jun He
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Feiyun Ouyang
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Shuiyuan Xiao
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
- Mental Health Institute, Second Xiangya Hospital, Central South University, Changsha, China
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79
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Shanbehzadeh S, Tavahomi M, Zanjari N, Ebrahimi-Takamjani I, Amiri-arimi S. Physical and mental health complications post-COVID-19: Scoping review. J Psychosom Res 2021; 147:110525. [PMID: 34051516 PMCID: PMC8133797 DOI: 10.1016/j.jpsychores.2021.110525] [Citation(s) in RCA: 136] [Impact Index Per Article: 45.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 05/16/2021] [Accepted: 05/17/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Several long-lasting health complications have been reported in previous coronavirus infections. Therefore, the aim of this study was to review studies that evaluated physical and mental health problems post-COVID-19. METHODS Articles for inclusion in this scoping review were identified by searching the PubMed, Scopus, Web of Science and Google Scholar databases for items dated from 1 January to 7 November 2020. Observational studies evaluating physical health (musculoskeletal symptoms, functional status) or mental health status with a follow-up period longer than 1 month after discharge or after the onset of symptoms were included. RESULTS This scoping review included 34 studies with follow-up periods of up to 3 months post-COVID-19. The most commonly reported physical health problems were fatigue (range 28% to 87%), pain (myalgia 4.5% to 36%), arthralgia (6.0% to 27%), reduced physical capacity (six-minute walking test range 180 to 561 m), and declines in physical role functioning, usual care and daily activities (reduced in 15% to 54% of patients). Common mental health problems were anxiety (range 6.5% to 63%), depression (4% to 31%) and post-traumatic stress disorder (12.1% to 46.9%). Greater fatigue, pain, anxiety and depression were reported in female patients and individuals admitted to intensive care. An overall lower quality of life was seen up to 3 months post-COVID-19. CONCLUSIONS This review highlights the presence of several physical and mental health problems up to 3 months post-COVID-19. The findings point to the need for comprehensive evaluation and rehabilitation post-COVID-19 to promote quality of life.
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Affiliation(s)
- Sanaz Shanbehzadeh
- Rehabilitation Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Tavahomi
- Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Nasibeh Zanjari
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Ismail Ebrahimi-Takamjani
- Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Somayeh Amiri-arimi
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Abstract
Since its emergence in Wuhan, China, covid-19 has spread and had a profound effect on the lives and health of people around the globe. As of 4 July 2021, more than 183 million confirmed cases of covid-19 had been recorded worldwide, and 3.97 million deaths. Recent evidence has shown that a range of persistent symptoms can remain long after the acute SARS-CoV-2 infection, and this condition is now coined long covid by recognized research institutes. Studies have shown that long covid can affect the whole spectrum of people with covid-19, from those with very mild acute disease to the most severe forms. Like acute covid-19, long covid can involve multiple organs and can affect many systems including, but not limited to, the respiratory, cardiovascular, neurological, gastrointestinal, and musculoskeletal systems. The symptoms of long covid include fatigue, dyspnea, cardiac abnormalities, cognitive impairment, sleep disturbances, symptoms of post-traumatic stress disorder, muscle pain, concentration problems, and headache. This review summarizes studies of the long term effects of covid-19 in hospitalized and non-hospitalized patients and describes the persistent symptoms they endure. Risk factors for acute covid-19 and long covid and possible therapeutic options are also discussed.
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Affiliation(s)
- Harry Crook
- Faculty of Medicine, Imperial College London, London, UK
| | - Sanara Raza
- Faculty of Medicine, Imperial College London, London, UK
| | - Joseph Nowell
- Faculty of Medicine, Imperial College London, London, UK
| | - Megan Young
- Faculty of Medicine, Imperial College London, London, UK
| | - Paul Edison
- Faculty of Medicine, Imperial College London, London, UK
- Cardiff University, Cardiff, UK
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Saevarsdóttir KS, Hilmarsdóttir HÝ, Magnúsdóttir I, Hauksdóttir A, Thordardottir EB, Gudjónsdóttir ÁB, Tomasson G, Rúnarsdóttir H, Jónsdóttir HL, Gudmundsdóttir B, Pétursdóttir G, Petersen PH, Kristinsson SY, Love TJ, Hansdóttir S, Hardardóttir H, Gudmundsson G, Eythorsson E, Gudmundsdóttir DG, Sigbjörnsdóttir H, Haraldsdóttir S, Möller AD, Palsson R, Jakobsdóttir J, Aspelund T, Valdimarsdottir U. Illness severity and risk of mental morbidities among patients recovering from COVID-19: a cross-sectional study in the Icelandic population. BMJ Open 2021; 11:e049967. [PMID: 34301663 PMCID: PMC8313306 DOI: 10.1136/bmjopen-2021-049967] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To test if patients recovering from COVID-19 are at increased risk of mental morbidities and to what extent such risk is exacerbated by illness severity. DESIGN Population-based cross-sectional study. SETTING Iceland. PARTICIPANTS A total of 22 861 individuals were recruited through invitations to existing nationwide cohorts and a social media campaign from 24 April to 22 July 2020, of which 373 were patients recovering from COVID-19. MAIN OUTCOME MEASURES Symptoms of depression (Patient Health Questionnaire), anxiety (General Anxiety Disorder Scale) and posttraumatic stress disorder (PTSD; modified Primary Care PTSD Screen for DSM-5) above screening thresholds. Adjusting for multiple covariates and comorbidities, multivariable Poisson regression was used to assess the association between COVID-19 severity and mental morbidities. RESULTS Compared with individuals without a diagnosis of COVID-19, patients recovering from COVID-19 had increased risk of depression (22.1% vs 16.2%; adjusted relative risk (aRR) 1.48, 95% CI 1.20 to 1.82) and PTSD (19.5% vs 15.6%; aRR 1.38, 95% CI 1.09 to 1.75) but not anxiety (13.1% vs 11.3%; aRR 1.24, 95% CI 0.93 to 1.64). Elevated relative risks were limited to patients recovering from COVID-19 that were 40 years or older and were particularly high among individuals with university education. Among patients recovering from COVID-19, symptoms of depression were particularly common among those in the highest, compared with the lowest tertile of influenza-like symptom burden (47.1% vs 5.8%; aRR 6.42, 95% CI 2.77 to 14.87), among patients confined to bed for 7 days or longer compared with those never confined to bed (33.3% vs 10.9%; aRR 3.67, 95% CI 1.97 to 6.86) and among patients hospitalised for COVID-19 compared with those never admitted to hospital (48.1% vs 19.9%; aRR 2.72, 95% CI 1.67 to 4.44). CONCLUSIONS Severe disease course is associated with increased risk of depression and PTSD among patients recovering from COVID-19.
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Affiliation(s)
- Karen Sól Saevarsdóttir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, School of Health Sciences, Reykjavik, Iceland
| | - Hildur Ýr Hilmarsdóttir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, School of Health Sciences, Reykjavik, Iceland
| | - Ingibjörg Magnúsdóttir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, School of Health Sciences, Reykjavik, Iceland
| | - Arna Hauksdóttir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, School of Health Sciences, Reykjavik, Iceland
| | - Edda Bjork Thordardottir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, School of Health Sciences, Reykjavik, Iceland
| | - Ásdís Braga Gudjónsdóttir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, School of Health Sciences, Reykjavik, Iceland
| | - Gunnar Tomasson
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, School of Health Sciences, Reykjavik, Iceland
- Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland
| | - Harpa Rúnarsdóttir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, School of Health Sciences, Reykjavik, Iceland
| | - Harpa Lind Jónsdóttir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, School of Health Sciences, Reykjavik, Iceland
- Faculty of Psychology, University of Iceland School of Health Sciences, Reykjavik, Iceland
| | | | - Gudrún Pétursdóttir
- Institute for Sustainability Studies, University of Iceland, Reykjavik, Iceland
| | - Pétur Henry Petersen
- Faculty of Medicine, University of Iceland School of Health Sciences, Reykjavik, Iceland
| | - Sigurdur Yngvi Kristinsson
- Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland
- Faculty of Medicine, University of Iceland School of Health Sciences, Reykjavik, Iceland
| | - Thorvardur Jon Love
- Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland
- Faculty of Medicine, University of Iceland School of Health Sciences, Reykjavik, Iceland
| | - Sif Hansdóttir
- Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland
| | - Hrönn Hardardóttir
- Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland
| | - Gunnar Gudmundsson
- Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland
- Faculty of Medicine, University of Iceland School of Health Sciences, Reykjavik, Iceland
| | - Elias Eythorsson
- Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland
| | | | | | | | | | - Runolfur Palsson
- Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland
- Faculty of Medicine, University of Iceland School of Health Sciences, Reykjavik, Iceland
| | - Jóhanna Jakobsdóttir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, School of Health Sciences, Reykjavik, Iceland
| | - Thor Aspelund
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, School of Health Sciences, Reykjavik, Iceland
- Icelandic Heart Association, Kopavogur, Iceland
| | - Unnur Valdimarsdottir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, School of Health Sciences, Reykjavik, Iceland
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
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Murphy JK, Khan A, Sun Q, Minas H, Hatcher S, Ng CH, Withers M, Greenshaw A, Michalak EE, Chakraborty PA, Sandanasamy KS, Ibrahim N, Ravindran A, Chen J, Nguyen VC, Lam RW. Needs, gaps and opportunities for standard and e-mental health care among at-risk populations in the Asia Pacific in the context of COVID-19: a rapid scoping review. Int J Equity Health 2021; 20:161. [PMID: 34253198 PMCID: PMC8274266 DOI: 10.1186/s12939-021-01484-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 05/28/2021] [Indexed: 12/23/2022] Open
Abstract
Background The COVID-19 pandemic is expected to have profound mental health impact, including in the Asia Pacific Economic Cooperation (APEC) region. Some populations might be at higher risk of experiencing negative mental health impacts and may encounter increased barriers to accessing mental health care. The pandemic and related restrictions have led to changes in care delivery, including a rapid shift to the use of e-mental health and digital technologies. It is therefore essential to consider needs and opportunities for equitable mental health care delivery to the most at-risk populations. This rapid scoping review: 1) identifies populations in the APEC region that are at higher risk of the negative mental health impacts of COVID-19, 2) identifies needs and gaps in access to standard and e-mental health care among these populations, and 3) explores the potential of e-mental health to address these needs. Methods We conducted a rapid scoping review following the PRISMA Extension for Scoping Reviews (PRISMA-ScR). We searched Medline, Embase and PsychInfo databases and Google Scholar using a search strategy developed in consultation with a biomedical librarian. We included records related to mental health or psychosocial risk factors and COVID-19 among at-risk groups; that referred to one or more APEC member economies or had a global, thus generalizable, scope; English language papers, and papers with full text available. Results A total of 132 records published between December 2019 and August 2020 were included in the final analysis. Several priority at-risk populations, risk factors, challenges and recommendations for standard and e-mental health care were identified. Results demonstrate that e-mental health care can be a viable option for care delivery but that specific accessibility and acceptability considerations must be considered. Options for in-person, hybrid or “low-tech” care must also remain available. Conclusions The COVID-19 pandemic has highlighted the urgent need for equitable standard and e-mental health care. It has also highlighted the persistent social and structural inequities that contribute to poor mental health. The APEC region is vast and diverse; findings from the region can guide policy and practice in the delivery of equitable mental health care in the region and beyond.
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Affiliation(s)
- Jill K Murphy
- Department of Psychiatry, Faculty of Medicine; APEC Digital Hub for Mental Health, University of British Columbia, 2255 Wesbrook Mall, Vancouver, BC, V6T 2A1, Canada.
| | - Amna Khan
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, 2255 Westbrook Mall, Vancouver, BC, V6T 2A1, Canada
| | - Qiumeng Sun
- Sol Price School of Public Policy, University of Southern California, 650 Childs Way, Los Angeles, CA, 90089, USA
| | - Harry Minas
- Global and Cultural Mental Health, Level 4, 207 Bouverie Street, Melbourne, Australia.,The University of Melbourne, Melbourne School of Population and Global Health, Carlton, Victoria, 3010, Australia
| | - Simon Hatcher
- Department of Psychiatry, Faculty of Medicine, University of Ottawa, Roger Guindon Hall, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada
| | - Chee H Ng
- Healthscope Chair of Psychiatry, Department of Psychiatry, The University of Melbourne, Carlton, Victoria, 3010, Australia
| | - Mellissa Withers
- USC Keck School of Medicine, USC Institute on Inequalities in Global Health, Los Angeles, USA.,APRU Global Health Program, 2001 N Soto Street SSB 318G, Los Angeles, CA, 90089, USA
| | - Andrew Greenshaw
- Department of Psychiatry, Scientific Director, APEC Digital Hub for Mental Health, Faculty of Medicine & Dentistry, 4-142M Katz Group Centre for Pharmacy and Health Research, University of Alberta, Edmonton, Alberta, T6G 2B7, Canada
| | - Erin E Michalak
- APEC Digital Hub for Mental Health, University of British Columbia, 420-5950 University Boulevard, Vancouver, BC, V6T 1Z3, Canada
| | - Promit Ananyo Chakraborty
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Karen Sharmini Sandanasamy
- Mental Health, Substance Abuse and Violence Injury Prevention, Non-Communicable Disease Section, Disease Control Division, Ministry of Health, Level 2, Block E3, Putrajaya, Malaysia.,Precinct 1, Federal Government Administrative Complex, 62590, Putrajaya, Malaysia
| | - Nurashikin Ibrahim
- Mental Health, Substance Abuse and Violence Injury Prevention, Non-Communicable Disease Section, Disease Control Division, Ministry of Health, Level 2, Block E3, Putrajaya, Malaysia.,Precinct 1, Federal Government Administrative Complex, 62590, Putrajaya, Malaysia
| | - Arun Ravindran
- Global Mental Health Affairs & The Office of Fellowship Training, Department of Psychiatry, Graduate Faculty, Institute of Medical Sciences, University of Toronto, Toronto, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 100 Stokes St, Toronto, ON, M6J 1H4, Canada
| | - Jun Chen
- Office for Clinical Research Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Rd, Xuhui District, Shanghai, China
| | - Vu Cong Nguyen
- Institute of Population, Health and Development, ICON4 Tower, 243a Đường La Thành, Láng Thượng, Đống Đa, Hà Nội, 117222, Vietnam
| | - Raymond W Lam
- Department of Psychiatry, University of British Columbia, Vancouver, Canada.,Mood Disorders Centre, Djavad Mowafaghian Centre for Brain Health, Vancouver, Canada.,APEC Digital Hub for Mental Health, 2255 Wesbrook Mall, Vancouver, BC, V6T 2A1, Canada
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83
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Lee Y, Lui LM, Chen-Li D, Liao Y, Mansur RB, Brietzke E, Rosenblat JD, Ho R, Rodrigues NB, Lipsitz O, Nasri F, Cao B, Subramaniapillai M, Gill H, Lu C, McIntyre RS. Government response moderates the mental health impact of COVID-19: A systematic review and meta-analysis of depression outcomes across countries. J Affect Disord 2021; 290:364-377. [PMID: 34052584 PMCID: PMC8159271 DOI: 10.1016/j.jad.2021.04.050] [Citation(s) in RCA: 135] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 03/08/2021] [Accepted: 04/23/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND The COVID-19 pandemic represents a public health, economic and mental health crisis. We hypothesized that timely government implementation of stringent measures to reduce viral transmission would benefit mental health, as evidenced by reduced rates of depressive symptoms (i.e., Patient Health Questionnaire [PHQ]-9≥10, PHQ-2≥3). METHODS The systematic review herein (PROSPERO CRD42020200647) evaluated to what extent differences in government-imposed stringency and timeliness of response to COVID-19 moderate the prevalence of depressive symptoms across 33 countries (k=114, N=640,037). We included data from six lower-middle-income countries, nine upper-middle-income countries, and 18 higher-income countries. Government-imposed stringency and timeliness in response were operationalized using the Oxford COVID-19 Government Response ("Stringency") Index. RESULTS The overall proportion of study participants with clinically significant depressive symptoms was 21.39% (95% CI 19.37-23.47). The prevalence of clinically significant depressive symptoms was significantly lower in countries wherein governments implemented stringent policies promptly. The moderating effect of government response remained significant after including the national frequency of COVID cases at the time of study commencement, Healthcare Access and Quality index, and the inclusion of COVID patients in the study. LIMITATIONS Factors that may have confounded our results include, for example, differences in lockdown duration, lack of study participant and outcome assessor blinding, and retrospective assessment of depressive symptom severity. CONCLUSIONS Governments that enacted stringent measures to contain the spread of COVID-19 benefited not only the physical, but also the mental health of their population.
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Affiliation(s)
- Yena Lee
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, Toronto, ON, Canada M5T 2S8; Institute of Medical Science, University of Toronto, Toronto, ON, Canada M5S 1A8.
| | - Leanna M.W. Lui
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, Toronto, ON, Canada M5T 2S8
| | - David Chen-Li
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, Toronto, ON, Canada M5T 2S8
| | - Yuhua Liao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, People's Republic of China,Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, People's Republic of China
| | - Rodrigo B. Mansur
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, Toronto, ON, Canada M5T 2S8,Department of Psychiatry, University of Toronto, Toronto, ON, Canada M5S 1A8
| | - Elisa Brietzke
- Department of Psychiatry, Queen's University School of Medicine, Kingston, ON, Canada; Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Joshua D. Rosenblat
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, Toronto, ON, Canada M5T 2S8,Department of Psychiatry, University of Toronto, Toronto, ON, Canada M5S 1A8
| | - Roger Ho
- Department of Psychological Medicine, National University of Singapore, Singapore, 119228, Singapore
| | - Nelson B. Rodrigues
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, Toronto, ON, Canada M5T 2S8
| | - Orly Lipsitz
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, Toronto, ON, Canada M5T 2S8
| | - Flora Nasri
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, Toronto, ON, Canada M5T 2S8
| | - Bing Cao
- Key Laboratory of Cognition and Personality (SWU), Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, 400715, People's Republic of China
| | - Mehala Subramaniapillai
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, Toronto, ON, Canada M5T 2S8
| | - Hartej Gill
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, Toronto, ON, Canada M5T 2S8
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Roger S. McIntyre
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, Toronto, ON, Canada M5T 2S8,Institute of Medical Science, University of Toronto, Toronto, ON, Canada M5S 1A8,Department of Psychiatry, University of Toronto, Toronto, ON, Canada M5S 1A8,Department of Pharmacology, University of Toronto, Toronto, ON, Canada M5S 1A8
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84
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Vanderlind WM, Rabinovitz BB, Miao IY, Oberlin LE, Bueno-Castellano C, Fridman C, Jaywant A, Kanellopoulos D. A systematic review of neuropsychological and psychiatric sequalae of COVID-19: implications for treatment. Curr Opin Psychiatry 2021; 34:420-433. [PMID: 34016818 PMCID: PMC8183238 DOI: 10.1097/yco.0000000000000713] [Citation(s) in RCA: 84] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW COVID-19 impacts multiple organ systems and is associated with high rates of morbidity and mortality. Pathogenesis of viral infection, co-morbidities, medical treatments, and psychosocial factors may contribute to COVID-19 related neuropsychological and psychiatric sequelae. This systematic review aims to synthesize available literature on psychiatric and cognitive characteristics of community-dwelling survivors of COVID-19 infection. RECENT FINDINGS Thirty-three studies met inclusion/exclusion criteria for review. Emerging findings link COVID-19 to cognitive deficits, particularly attention, executive function, and memory. Psychiatric symptoms occur at high rates in COVID-19 survivors, including anxiety, depression, fatigue, sleep disruption, and to a lesser extent posttraumatic stress. Symptoms appear to endure, and severity of acute illness is not directly predictive of severity of cognitive or mental health issues. The course of cognitive and psychiatric sequelae is limited by lack of longitudinal data at this time. Although heterogeneity of study design and sociocultural differences limit definitive conclusions, emerging risk factors for psychiatric symptoms include female sex, perceived stigma related to COVID-19, infection of a family member, social isolation, and prior psychiatry history. SUMMARY The extant literature elucidates treatment targets for cognitive and psychosocial interventions. Research using longitudinal, prospective study designs is needed to characterize cognitive and psychiatric functioning of COVID-19 survivors over the course of illness and across illness severity. Emphasis on delineating the unique contributions of premorbid functioning, viral infection, co-morbidities, treatments, and psychosocial factors to cognitive and psychiatric sequelae of COVID-19 is warranted.
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Affiliation(s)
- William Michael Vanderlind
- Department of Psychiatry, Weill Cornell Medicine
- NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York
| | - Beth B. Rabinovitz
- Department of Psychiatry, Weill Cornell Medicine
- NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York
- NewYork-Presbyterian Hospital/Westchester Behavioral Health Center, White Plains
| | - Iris Yi Miao
- Department of Psychology, New School for Social Research
| | - Lauren E. Oberlin
- Department of Psychiatry, Weill Cornell Medicine
- NewYork-Presbyterian Hospital/Westchester Behavioral Health Center, White Plains
| | - Christina Bueno-Castellano
- Department of Psychiatry, Weill Cornell Medicine
- NewYork-Presbyterian Hospital/Westchester Behavioral Health Center, White Plains
| | - Chaya Fridman
- Department of Psychiatry, Weill Cornell Medicine
- NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York
| | - Abhishek Jaywant
- Department of Psychiatry, Weill Cornell Medicine
- NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York
- Department of Rehabilitation Medicine, Weill Cornell Medicine, New York, New York, USA
| | - Dora Kanellopoulos
- Department of Psychiatry, Weill Cornell Medicine
- NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York
- NewYork-Presbyterian Hospital/Westchester Behavioral Health Center, White Plains
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85
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Chen PJ, Pusica Y, Sohaei D, Prassas I, Diamandis EP. An overview of mental health during the COVID-19 pandemic. ACTA ACUST UNITED AC 2021; 8:403-412. [PMID: 34214386 DOI: 10.1515/dx-2021-0046] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 05/26/2021] [Indexed: 02/06/2023]
Abstract
Since its initial outbreak in late 2019, the COVID-19 pandemic has profoundly affected the global community. In addition to the negative health consequences of contracting COVID-19, the implementation of strict quarantine and lockdown measures has also disrupted social networks and devastated the global economy. As a result, there is rising concern that the pandemic has taken a toll on the mental health of the general population. To better understand its impact, an increasing number of studies examined the effects of the pandemic on mental health and psychosocial implications of enforced quarantine and lockdown. In this article, we aim to review and summarize the findings from a variety of studies that have explored the psychosociological effects of the pandemic and its impact on the mental well-being of the general population. We will also examine how various demographic groups, such as the elderly and youth, can be more susceptible or resilient to the pandemic's mental health effects. We hope to provide a broader understanding of the underlying causes of mental health issues triggered by the pandemic and provide recommendations that may be employed to address mental health issues in the population over the long-term.
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Affiliation(s)
- Patrick J Chen
- Department of Clinical Biochemistry, University Health Network, Toronto, Canada
| | - Yanna Pusica
- Department of Clinical Biochemistry, University Health Network, Toronto, Canada
| | - Dorsa Sohaei
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
| | - Ioannis Prassas
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Canada.,Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada
| | - Eleftherios P Diamandis
- Department of Clinical Biochemistry, University Health Network, Toronto, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada.,Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Canada.,Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada
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86
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Liu D, Liu W, Rodriguez M, Zhang J, Zhang F. The Mental Health Impacts of COVID-19 on Pediatric Patients Following Recovery. Front Psychol 2021; 12:628707. [PMID: 34267693 PMCID: PMC8276779 DOI: 10.3389/fpsyg.2021.628707] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 03/24/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Dong Liu
- Department of Communication, Renmin University of China, Beijing, China
| | - Wenjun Liu
- Department of Communication, Renmin University of China, Beijing, China
| | - Marcus Rodriguez
- Pitzer College, Claremont, CA, United States.,Boston Child Study Center, Los Angeles, CA, United States
| | - Jie Zhang
- Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fuhai Zhang
- School of Education, Hebei Normal University, Shijiazhuang, China
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87
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Gramaglia C, Gambaro E, Bellan M, Balbo PE, Baricich A, Sainaghi PP, Pirisi M, Baldon G, Battistini S, Binda V, Feggi A, Gai M, Gattoni E, Jona A, Lorenzini L, Marangon D, Martelli M, Prosperini P, Zeppegno P. Mid-term Psychiatric Outcomes of Patients Recovered From COVID-19 From an Italian Cohort of Hospitalized Patients. Front Psychiatry 2021; 12:667385. [PMID: 34177656 PMCID: PMC8222628 DOI: 10.3389/fpsyt.2021.667385] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 05/05/2021] [Indexed: 12/11/2022] Open
Abstract
Background: Although the usual primary clinical manifestation of Coronavirus disease (COVID-19) is respiratory, several non-respiratory symptoms have been described, including neuropsychiatric ones. The aim of this study was to investigate the mid-term mental health outcomes in patients recovered from COVID-19, 3-4 months after discharge from the University Hospital Maggiore della Carità, Novara, Italy. Furthermore, we investigated the possible association of the mid-term mental health consequences of the COVID-19 infection with patients' clinical current status, persistent physical impairment and severity of acute phase of the disease. Methods: Prospective study involving 238 individuals recovered from COVID-19. In the context of a multi-disciplinary approach, patients' assessment included both a clinical interview performed by an experienced psychiatrist, trained in the use of the Mini-International Neuropsychiatric Interview to assess the presence of anxiety and depressive symptoms and self-administered questionnaires: Beck Anxiety Inventory (BAI), Beck Depression Inventory-II (BDI-II), Resilience Scale for Adults (RSA), Impact of Event Scale (IES). Results: At the psychiatric assessment 32.9 and 29.5% of participants showed anxiety and depressive symptoms, respectively. Changes in appetite and sleep patterns emerged for 15.6 and 31.2% of patients. According to the self-administered questionnaires, 7.1% of participants had moderate-severe anxiety levels (BAI), while 10.5% had mild to severe depression (BDI-II). Twenty-six (11%) participants were referred to further psychiatric consultation. Psychiatric symptoms showed no correlation with acute COVID-19 severity; in our sample patients with depressive symptoms at the clinical interview, as well as those with mild to severe levels of depression according to BDI-II scores, had lower forced expiratory volume in the 1st second (FEV1) values than those without and greater odds for persistent, poor tolerance for physical efforts. Conclusions: As could be expected, an approach including both a psychiatric interview and the use of self-administered questionnaires is likely to capture the psychiatric outcome of patients recovered from COVID-19 better than questionnaires alone. Anxiety and depressive symptoms at follow-up had no correlation with the severity of COVID acute manifestations, but rather with ongoing and persistent physical symptoms. Further studies and longer follow-up duration will allow a better understanding of the complex relationship between residual physical symptoms, quality of life and psychological health.
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Affiliation(s)
- Carla Gramaglia
- Dipartimento di Medicina Traslazionale, Università del Piemonte Orientale UPO, Novara, Italy
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Eleonora Gambaro
- Dipartimento di Medicina Traslazionale, Università del Piemonte Orientale UPO, Novara, Italy
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Mattia Bellan
- Dipartimento di Medicina Traslazionale, Università del Piemonte Orientale UPO, Novara, Italy
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | | | - Alessio Baricich
- Dipartimento di Medicina Traslazionale, Università del Piemonte Orientale UPO, Novara, Italy
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Pier Paolo Sainaghi
- Dipartimento di Medicina Traslazionale, Università del Piemonte Orientale UPO, Novara, Italy
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Mario Pirisi
- Dipartimento di Medicina Traslazionale, Università del Piemonte Orientale UPO, Novara, Italy
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Giulia Baldon
- Dipartimento di Medicina Traslazionale, Università del Piemonte Orientale UPO, Novara, Italy
| | - Sofia Battistini
- Dipartimento di Medicina Traslazionale, Università del Piemonte Orientale UPO, Novara, Italy
| | - Valeria Binda
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Alessandro Feggi
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Martina Gai
- Dipartimento di Medicina Traslazionale, Università del Piemonte Orientale UPO, Novara, Italy
| | - Eleonora Gattoni
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Amalia Jona
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Luca Lorenzini
- Dipartimento di Medicina Traslazionale, Università del Piemonte Orientale UPO, Novara, Italy
| | - Debora Marangon
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Maria Martelli
- Dipartimento di Medicina Traslazionale, Università del Piemonte Orientale UPO, Novara, Italy
| | | | - Patrizia Zeppegno
- Dipartimento di Medicina Traslazionale, Università del Piemonte Orientale UPO, Novara, Italy
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
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88
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Richter K, Kellner S, Hillemacher T, Golubnitschaja O. Sleep quality and COVID-19 outcomes: the evidence-based lessons in the framework of predictive, preventive and personalised (3P) medicine. EPMA J 2021; 12:221-241. [PMID: 34122671 PMCID: PMC8185312 DOI: 10.1007/s13167-021-00245-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 05/12/2021] [Indexed: 01/08/2023]
Abstract
Sleep quality and duration play a pivotal role in maintaining physical and mental health. In turn, sleep shortage, deprivation and disorders are per evidence the risk factors and facilitators of a broad spectrum of disorders, amongst others including depression, stroke, chronic inflammation, cancers, immune defence insufficiency and individual predisposition to infection diseases with poor outcomes, for example, related to the COVID-19 pandemic. Keeping in mind that COVID-19-related global infection distribution is neither the first nor the last pandemic severely affecting societies around the globe to the costs of human lives accompanied with enormous economic burden, lessons by predictive, preventive and personalised (3P) medical approach are essential to learn and to follow being better prepared to defend against global pandemics. To this end, under extreme conditions such as the current COVID-19 pandemic, the reciprocal interrelationship between the sleep quality and individual outcomes becomes evident, namely, at the levels of disease predisposition, severe versus mild disease progression, development of disease complications, poor outcomes and related mortality for both - population and healthcare givers. The latter is the prominent example clearly demonstrating the causality of severe outcomes, when the long-lasting work overload and shift work rhythm evidently lead to the sleep shortage and/or deprivation that in turn causes immune response insufficiency and strong predisposition to the acute infection with complications. This article highlights and provides an in-depth analysis of the concerted risk factors related to the sleep disturbances under the COVID-19 pandemic followed by the evidence-based recommendations in the framework of predictive, preventive and personalised medical approach.
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Affiliation(s)
- Kneginja Richter
- Outpatient Clinic for Sleep Disorders, University Clinic for Psychiatry and Psychotherapy, Paracelsus Medical University Nuremberg, 90419 Nuremberg, Germany
- Faculty for Social Work, Technical University of Applied Sciences Nuremberg Georg Simon Ohm, 90489 Nuremberg, Germany
- Faculty for Medical Sciences, University Goce Delcev Stip, 2000 Stip, North Macedonia
| | - Stefanie Kellner
- Faculty for Social Work, Technical University of Applied Sciences Nuremberg Georg Simon Ohm, 90489 Nuremberg, Germany
| | - Thomas Hillemacher
- Outpatient Clinic for Sleep Disorders, University Clinic for Psychiatry and Psychotherapy, Paracelsus Medical University Nuremberg, 90419 Nuremberg, Germany
| | - Olga Golubnitschaja
- Predictive, Preventive and Personalised (3P) Medicine, Department of Radiation Oncology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, 53127 Bonn, Germany
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89
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Htun YM, Thiha K, Aung A, Aung NM, Oo TW, Win PS, Sint NH, Naing KM, Min AK, Tun KM, Hlaing K. Assessment of depressive symptoms in patients with COVID-19 during the second wave of epidemic in Myanmar: A cross-sectional single-center study. PLoS One 2021; 16:e0252189. [PMID: 34086722 PMCID: PMC8177551 DOI: 10.1371/journal.pone.0252189] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 05/11/2021] [Indexed: 12/02/2022] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) pandemic has had a great impact on every aspect of society. All countries launched preventive measures such as quarantine, lockdown, and physical distancing to control the disease spread. These restrictions might effect on daily life and mental health. This study aimed to assess the prevalence and associated factors of depressive symptoms in patients with COVID-19 at the Treatment Center. Methods A cross-sectional telephone survey was carried out at Hmawbi COVID-19 Treatment Center, Myanmar from December 2020 to January 2021. A total of 142 patients with COVID-19 who met the criteria were invited to participate in the study. A pre-tested Center for Epidemiologic Studies Depression Scale (CES-D) was used as a tool for depressive symptoms assessment. Data were analyzed by using binary logistic regression to identify associated factors of depressive symptoms. Adjusted odds ratio (AOR) with a 95% confidence interval (CI) was computed to determine the level of significance with a p < 0.05. Results The prevalence of depressive symptoms in patients with COVID-19 was 38.7%, with the means (± standard deviation, SD) subscale of somatic symptom, negative effect, and anhedonia were 4.64 (±2.53), 2.51 (± 2.12), and 5.01 (± 3.26), respectively. The patients with 40 years and older (AOR: 2.99, 95% CI: 1.36–6.59), < 4 of household size (AOR: 3.45, 95% CI: 1.46–8.15), ≤ 400,000 kyats of monthly family income (AOR: 2.38, 95% CI: 1.02–5.54) and infection to family members (AOR: 4.18, 95% CI: 1.74–10.07) were significant associated factors of depressive symptoms. Conclusion The high prevalence of depressive symptoms, approximately 40%, was found in patients with COVID-19 in the Treatment Center. Establishments of psychosocial supports, providing psychoeducation, enhancing the social contact with family and friends, and using credible source of information related COVID-19 would be integral parts of mental health services in COVID-19 pandemic situation.
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Affiliation(s)
- Ye Minn Htun
- Department of Prevention and Research Development of Hepatitis, AIDS and Other Viral Diseases, Health and Disease Control Unit, Nay Pyi Taw, Myanmar
- * E-mail:
| | - Kyaw Thiha
- Department of Mental Health, Defence Services Medical Academy, Yangon, Myanmar
| | - Aung Aung
- Department of Research and Development, Defence Services Medical School, Yangon, Myanmar
| | - Nay Myo Aung
- Department of Chest Medicine, Defence Services Medical Academy, Yangon, Myanmar
| | - Thet Wai Oo
- Special Operation Medical Research Department, Defence Services Medical Research Centre, Nay Pyi Taw, Myanmar
| | - Pyae Sone Win
- Special Operation Medical Research Department, Defence Services Medical Research Centre, Nay Pyi Taw, Myanmar
| | - Nay Hein Sint
- Department of Preventive and Social Medicine, Defence Services Medical Academy, Yangon, Myanmar
| | - Kaung Myat Naing
- Department of Preventive and Social Medicine, Defence Services Medical Academy, Yangon, Myanmar
| | - Aung Khant Min
- Department of Prevention and Research Development of Hepatitis, AIDS and Other Viral Diseases, Health and Disease Control Unit, Nay Pyi Taw, Myanmar
| | - Kyaw Myo Tun
- Department of Preventive and Social Medicine, Defence Services Medical Academy, Yangon, Myanmar
| | - Kyaw Hlaing
- Department of Prevention and Research Development of Hepatitis, AIDS and Other Viral Diseases, Health and Disease Control Unit, Nay Pyi Taw, Myanmar
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90
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Lima Y, Denerel N, Öz ND, Senisik S. The psychological impact of COVID-19 infection on athletes: example of professional male football players. SCI MED FOOTBALL 2021; 5:53-61. [DOI: 10.1080/24733938.2021.1933156] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Yavuz Lima
- Sports Medicine Clinic, Balıkesir Ataturk City Hospital, Balıkesir, Turkey
| | - Nevzad Denerel
- Health Team Sports Medicine Clinic, Nicosia/Turkish Republic of Northern, Cyprus
| | - Nazli Deniz Öz
- Recreation Department, Selcuk University Faculty of Sports Science, Konya, Turkey
| | - Seckin Senisik
- Sports Medicine Department, Ege University Faculty of Medicine, Izmir, Turkey
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91
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Aksoy Poyraz C, Faruk Demirel Ö, Çağrı Poyraz B, M. Dursun S. A Multi-Dimensional Psychiatric Perspective on the Impact of the COVID-19 Pandemic. PSYCHIAT CLIN PSYCH 2021; 31:219-225. [PMID: 38765226 PMCID: PMC11079654 DOI: 10.5152/pcp.2021.21222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 04/03/2021] [Indexed: 05/21/2024] Open
Abstract
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) arose in Wuhan, China in December 2019 and spread worldwide rapidly, and was declared a global pandemic by the World Health Organization as of March 2020. As the SARS-CoV-2 pandemic has spread worldwide, its impact is increasingly being recognized among vulnerable groups and also by the public in general. Recent findings indicate that patients with mental health disorders are among the groups most vulnerable to psychological stress and social hardships related to the current pandemic. Studies also indicate an increased risk of infection by SARS-CoV-2 in subjects with psychiatric disorders. Patients affected by SARS-CoV-2 may present to the psychiatrist with delirium, psychotic symptoms, depression, anxiety, post-traumatic stress disorder, and insomnia. Some patients will develop persistent somatic symptoms such as fatigue after the acute infection. In this article, we summarize the preliminary findings related to the effects of the SARS-CoV-2 pandemic on patients with mental health disorders, as well as recent research on psychiatric presentations in patients affected by SARS-CoV-2.
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Affiliation(s)
- Cana Aksoy Poyraz
- Department of Psychiatry, İstanbul University- Cerrahpaşa School of Medicine, Istanbul, Turkey
| | - Ömer Faruk Demirel
- Department of Psychiatry, İstanbul University- Cerrahpaşa School of Medicine, Istanbul, Turkey
| | - Burç Çağrı Poyraz
- Department of Psychiatry, İstanbul University- Cerrahpaşa School of Medicine, Istanbul, Turkey
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92
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Uzunova G, Pallanti S, Hollander E. Presentation and management of anxiety in individuals with acute symptomatic or asymptomatic COVID-19 infection, and in the post-COVID-19 recovery phase. Int J Psychiatry Clin Pract 2021; 25:115-131. [PMID: 33635172 DOI: 10.1080/13651501.2021.1887264] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
COVID-19 is associated with neuropsychiatric complications, the most frequent one being anxiety. Multiple biological and psychosocial factors contribute to anxiety in COVID-19. Among the biological factors, stress, genetics, gender, immune system, resilience, anosmia, hypogeusia, and central nervous system infection with SARS-CoV-2 are key. Anxiety is a complication of COVID-19 that may exacerbate the infection course, and the infection may exacerbate anxiety. We present the mechanisms of anxiety in symptomatic or asymptomatic COVID-19. We discuss the presentation of anxiety in patients without or with prior psychiatric illness, and with co-morbidities. Timely diagnosis and management of anxiety in COVID-19 patients is important. Given the frequent complication of COVID-19 with Acute Respiratory Distress Syndrome and Intensive Care Unit stay, anxiety may be a long-term complication. We review the diagnostic tools for anxiety in COVID-19, and summarise pharmacologic and non-pharmacologic treatments. We provide recommendations for diagnosis, treatment, prevention and follow up of anxiety in COVID-19.Key pointsPatients with COVID-19 (symptomatic or asymptomatic) exhibit a high frequency of neuropsychiatric complications with highest percentage attributed to anxiety.Multiple biological and psychosocial risk factors for anxiety exist in COVID-19-ill individuals. Biological risk factors include stress, resilience, genetics, gender, age, immune system, direct infection of the central nervous system (CNS) with SARS-CoV-2, comorbid psychiatric and general medical illnesses, ARDS and ICU stay. Anosmia and hypogeusia are COVID-19-specific anxiety risk factors. Knowledge of the anxiety risk factors is essential to focus on timely interventions, because anxiety may be a complication of and exacerbate the COVID-19 course.An inverse correlation exists between resilience and anxiety because of COVID-19, and therefore efforts should be made to increase resilience in COVID-19 patients.In COVID-19, important anxiety mechanism is neuroinflammation resulting from activation of the immune system and an ensuing cytokine storm.The general approach to management of anxiety in COVID-19 should be compassionate, similar to that during trauma or disaster, with efforts focussed on instilling a sense of hope and resilience.In selecting pharmacological treatment of anxiety, the stress response and immune system effects should be key. Medications with cardio-respiratory adverse effects should be avoided in patients with respiratory problems.Anxiety is a disorder that will require for long-term follow up at least one month after COVID-19.
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Affiliation(s)
- Genoveva Uzunova
- Psychiatric Research Institute at Montefiore-Einstein, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Stefano Pallanti
- Istituto di Neuroscienze, Firenze, Italy.,Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Eric Hollander
- Autism and Obsessive Compulsive Spectrum Program, Department of Psychiatry and Behavioral Sciences, Psychiatric Research Institute at Montefiore-Einstein, Albert Einstein College of Medicine, Bronx, NY, USA
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93
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Iqbal FM, Lam K, Sounderajah V, Clarke JM, Ashrafian H, Darzi A. Characteristics and predictors of acute and chronic post-COVID syndrome: A systematic review and meta-analysis. EClinicalMedicine 2021; 36:100899. [PMID: 34036253 PMCID: PMC8141371 DOI: 10.1016/j.eclinm.2021.100899] [Citation(s) in RCA: 184] [Impact Index Per Article: 61.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 04/21/2021] [Accepted: 04/26/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND A significant proportion of individuals experience lingering and debilitating symptoms following acute COVID-19 infection. The National Institute for Health and Care Excellence (NICE) have coined the persistent cluster of symptoms as post-COVID syndrome. This has been further sub-categorised into acute post-COVID syndrome for symptoms persisting three weeks beyond initial infection and chronic post-COVID syndrome for symptoms persisting beyond twelve weeks. The aim of this review was to detail the prevalence of clinical features and identify potential predictors for acute and chronic post-COVID syndrome. METHODS A systematic literature search, with no language restrictions, was performed to identify studies detailing characteristics and outcomes related to survivorship of post-COVID syndrome. The last search was performed on 6 March 2021 and all pre-dating published articles included. A means of proportion meta-analysis was performed to quantify characteristics of acute and chronic post-COVID syndrome. Study quality was assessed with a specific risk of bias tool. PROSPERO Registration: CRD42020222855. FINDINGS A total of 43 studies met the eligibility criteria; of which, 38 allowed for meta-analysis. Fatigue and dyspnoea were the most prevalent symptoms in acute post-COVID (0·37 and 0·35) and fatigue and sleep disturbance in chronic post-COVID syndrome (0·48 and 0·44), respectively. The available evidence is generally of poor quality, with considerable risk of bias, and are of observational design. INTERPRETATION In conclusion, this review highlights that flaws in data capture and interpretation, noted in the uncertainty within our meta-analysis, affect the applicability of current knowledge. Policy makers and researchers must focus on understanding the impact of this condition on individuals and society with appropriate funding initiatives and global collaborative research.
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Affiliation(s)
- Fahad M Iqbal
- Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, London W2 1NY, UK
- Institute of Global Health Innovation, Faculty Building, South Kensington Campus, Kensington SW7 2AZ, London, UK
| | - Kyle Lam
- Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, London W2 1NY, UK
- Institute of Global Health Innovation, Faculty Building, South Kensington Campus, Kensington SW7 2AZ, London, UK
| | - Viknesh Sounderajah
- Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, London W2 1NY, UK
- Institute of Global Health Innovation, Faculty Building, South Kensington Campus, Kensington SW7 2AZ, London, UK
| | - Jonathan M Clarke
- Institute of Global Health Innovation, Faculty Building, South Kensington Campus, Kensington SW7 2AZ, London, UK
- EPSRC Centre for Mathematics of Precision Healthcare, Imperial College London, London SW7 2AZ, UK
| | - Hutan Ashrafian
- Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, London W2 1NY, UK
- Institute of Global Health Innovation, Faculty Building, South Kensington Campus, Kensington SW7 2AZ, London, UK
| | - Ara Darzi
- Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, London W2 1NY, UK
- Institute of Global Health Innovation, Faculty Building, South Kensington Campus, Kensington SW7 2AZ, London, UK
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94
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Effects of COVID-19 pandemic on the mental health of pregnant women. JOURNAL OF CONTEMPORARY MEDICINE 2021. [DOI: 10.16899/jcm.923295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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95
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Prevalence of and factors associated with post-traumatic stress disorder among French university students 1 month after the COVID-19 lockdown. Transl Psychiatry 2021; 11:327. [PMID: 34045442 PMCID: PMC8157529 DOI: 10.1038/s41398-021-01438-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 05/05/2021] [Accepted: 05/12/2021] [Indexed: 01/05/2023] Open
Abstract
The COVID-19 pandemic and quarantine measures have sparked debate regarding their traumatic nature. This cross-sectional study reports the prevalence rate of probable post-traumatic stress syndrome (PTSD) and associated factors among French university students. A total of 22,883 students completed the online questionnaire. The prevalence rate of probable PTSD, assessed using the PTSD Checklist for DSM-5, was 19.5% [19.0-20.0]. Female (1.32 [1.21-1.45]) or non-binary gender (1.76 [1.35-2.31]), exposure to a non-COVID-19-related traumatic event (3.37 [3.08-3.67]), having lived through quarantine alone (1.22 [1.09-1.37]), poor quality of social ties (2.38 [2.15-2.62]), loss of income (1.20 [1.09-1.31]), poor quality housing (1.90 [1.59-2.26]), low-quality of the information received (1.50 [1.35-1.66]) and a high level of exposure to COVID-19 (from 1.38 [1.24-1.54] to 10.82 [2.33-76.57] depending on the score) were associated with PTSD. Quarantine was considered potentially traumatic by 78.8% of the students with probable PTSD. These findings suggest the pandemic context and lockdown measures could have post-traumatic consequences, stimulating debate on the nosography of PTSD.
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96
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Beck K, Vincent A, Becker C, Keller A, Cam H, Schaefert R, Reinhardt T, Sutter R, Tisljar K, Bassetti S, Schuetz P, Hunziker S. Prevalence and factors associated with psychological burden in COVID-19 patients and their relatives: A prospective observational cohort study. PLoS One 2021; 16:e0250590. [PMID: 33951085 PMCID: PMC8099094 DOI: 10.1371/journal.pone.0250590] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 04/11/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Due to the dramatic measures accompanying isolation and the general uncertainty and fear associated with COVID-19, patients and relatives may be at high risk for adverse psychological outcomes. Until now there has been limited research focusing on the prevalence of psychological distress and associated factors in COVID-19 patients and their relatives. The objective of our study was to assess psychological distress in COVID-19 patients and their relatives 30 days after hospital discharge. METHODS In this prospective observational cohort study at two Swiss tertiary-care hospitals we included consecutive adult patients hospitalized between March and June 2020 for a proven COVID-19 and their relatives. Psychological distress was defined as symptoms of anxiety and/or depression measured with the Hospital Anxiety and Depression Scale (HADS), i.e., a score of ≥8 on the depression and/or anxiety subscale. We further evaluated symptoms of post-traumatic stress disorder (PTSD), defined as a score of ≥1.5 on the Impact of Event Scale-Revised (IES-R). RESULTS Among 126 included patients, 24 (19.1%) had psychological distress and 10 (8.7%) had symptoms of PTSD 30 days after hospital discharge. In multivariate logistic regression analyses three factors were independently associated with psychological distress in patients: resilience (OR 0.82; 95%CI 0.71 to 0.94; p = 0.005), high levels of perceived stress (OR 1.21; 95%CI 1.06 to 1.38; p = 0.006) and low frequency of contact with relatives (OR 7.67; 95%CI 1.42 to 41.58; p = 0.018). The model showed good discrimination, with an area under the receiver-operating characteristic curve (AUC) of 0.92. Among 153 relatives, 35 (22.9%) showed symptoms of psychological distress, and 3 (2%) of PTSD. For relatives, resilience was negatively associated (OR 0.85; 95%CI 0.75 to 0.96; p = 0.007), whereas perceived overall burden caused by COVID-19 was positively associated with psychological distress (OR 1.72; 95%CI 1.31 to 2.25; p<0.001). The overall model also had good discrimination, with an AUC of 0.87. CONCLUSION A relevant number of COVID-19 patients as well as their relatives exhibited psychological distress 30 days after hospital discharge. These results might aid in development of strategies to prevent psychological distress in COVID-19 patients and their relatives.
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Affiliation(s)
- Katharina Beck
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
| | - Alessia Vincent
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
- Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Basel, Switzerland
| | - Christoph Becker
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
- Emergency Department, University Hospital Basel, Basel, Switzerland
| | - Annalena Keller
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
| | - Hasret Cam
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
| | - Rainer Schaefert
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
- Department for Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
- Medical Faculty of the University of Basel, Basel, Switzerland
| | - Thomas Reinhardt
- Human Resources & Leadership Development, University Hospital Basel, Basel, Switzerland
| | - Raoul Sutter
- Medical Faculty of the University of Basel, Basel, Switzerland
- Intensive Care Unit, University Hospital Basel, Basel, Switzerland
- Department of Clinical Research, University Hospital Basel, Basel, Switzerland
| | - Kai Tisljar
- Intensive Care Unit, University Hospital Basel, Basel, Switzerland
| | - Stefano Bassetti
- Medical Faculty of the University of Basel, Basel, Switzerland
- Division of Internal Medicine, University Hospital Basel, Basel, Switzerland
| | - Philipp Schuetz
- Medical Faculty of the University of Basel, Basel, Switzerland
- Division of Internal Medicine, Kantonsspital Aarau, Aarau, Switzerland
| | - Sabina Hunziker
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
- Department for Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
- Medical Faculty of the University of Basel, Basel, Switzerland
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97
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Liu D, Baumeister RF, Zhou Y. Mental health outcomes of coronavirus infection survivors: A rapid meta-analysis. J Psychiatr Res 2021; 137:542-553. [PMID: 33436263 PMCID: PMC7576143 DOI: 10.1016/j.jpsychires.2020.10.015] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/05/2020] [Accepted: 10/12/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND The current COVID pandemic is happening while the long-term effects of coronavirus infection remain poorly understood. The present article meta-analyzed mental health outcomes (anxiety, depression, etc.) from a previous coronavirus outbreak in China (2002). METHOD CNKI, Wanfang, PubMed/Medline, Scopus, Web of Science, Baidu Scholar, and Google Scholar were searched up to early June 2020 for articles in English or Chinese reporting mental illness symptoms of SARS patients. Main outcome measures include SCL-90, SAS, SDS, and IES-R scales. 29 papers met the inclusion criteria. The longest follow-up time included in the analysis was 46 months. FINDINGS The systematic meta-analysis indicated that mental health problems were most serious before or at hospital discharge and declined significantly during the first 12 months after hospital discharge. Nevertheless, average symptom levels remained above healthy norms even at 12 months and continued to improve, albeit slowly, thereafter. INTERPRETATION The adverse mental health impact of being hospitalized with coronavirus infection long outlasts the physical illness. Mental health issues were the most serious for coronavirus infected patients before (including) hospital discharge and improved continuously during the first 12 months after hospital discharge. If COVID-19 infected patients follow a similar course of mental health development, most patients should recover to normal after 12 months of hospital discharge.
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Affiliation(s)
- Dong Liu
- School of Journalism, Renmin University of China, China
| | - Roy F. Baumeister
- Department of Psychology, Florida State University, FL, USA,School of Psychology, University of Queensland, Brisbane, Australia
| | - Yong Zhou
- School of Journalism, Renmin University of China, China.
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98
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Mahmoudi H, Saffari M, Movahedi M, Sanaeinasab H, Rashidi-Jahan H, Pourgholami M, Poorebrahim A, Barshan J, Ghiami M, Khoshmanesh S, Potenza MN, Lin CY, Pakpour AH. A mediating role for mental health in associations between COVID-19-related self-stigma, PTSD, quality of life, and insomnia among patients recovered from COVID-19. Brain Behav 2021; 11:e02138. [PMID: 33811451 PMCID: PMC8119851 DOI: 10.1002/brb3.2138] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 02/07/2021] [Accepted: 03/16/2021] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Patients with COVID-19 often suffer from psychological problems such as post-traumatic stress disorder (PTSD) and self-stigmatization that may negatively impact their quality of life and sleep. This study examined mental health as a potential mediating factor linking self-stigmatization and PTSD to quality of life and sleep. METHODS Using a cross-sectional design, 844 people who had recovered from COVID-19 were called and interviewed. Data were collected using structured scales. Structural equation modeling was applied to assess fitness of a mediation model including self-stigma and PTSD as independent factors and quality of life and insomnia as dependent variables. RESULTS Mental health, COVID-19-related self-stigma, and mental quality of life were associated. Insomnia, PTSD, and COVID-19-related self-stigma displayed significant direct associations (r = .334 to 0.454; p < .01). A mediation model indicated satisfactory goodness of fit (CFI = 0.968, TLI = 0.950, SRMR = 0.071, RMSEA = 0.068). Mental health as a mediator had negative relationships with COVID-19-related self-stigma, PTSD, and insomnia and positive associations with quality of life. CONCLUSION Mental health may mediate effects of COVID-19-related self-stigma and PTSD on quality of life and insomnia. Designing programs to improve mental health among patients with COVID-19 may include efforts to reduce negative effects of PTSD and COVID-19-related self-stigma on quality of life and insomnia.
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Affiliation(s)
- Hosein Mahmoudi
- Trauma Research Center and Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mohsen Saffari
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.,Health Education Department, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mahmoud Movahedi
- Behavioral Sciences Research Center and Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Hormoz Sanaeinasab
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.,Health Education Department, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Hojat Rashidi-Jahan
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Morteza Pourgholami
- Health Education and Health Promotion unit, Rasht Health Center,Guilan University of Medical Sciences, Rasht, Iran
| | - Ali Poorebrahim
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Jalal Barshan
- Rasht Health Center,Guilan University of Medical Sciences, Rasht, Iran
| | - Milad Ghiami
- Health, Safety and Environment Management, Expert of Occupational Health of Health Center, Rasht, Iran
| | - Saman Khoshmanesh
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Marc N Potenza
- Departments of Psychiatry and Neuroscience and the Child Study Center, School of Medicine, Yale University, New Haven, CT, USA
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, Department of Occupational Therapy, Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Amir H Pakpour
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.,Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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99
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Tortella GR, Seabra AB, Padrão J, Díaz-San Juan R. Mindfulness and Other Simple Neuroscience-Based Proposals to Promote the Learning Performance and Mental Health of Students during the COVID-19 Pandemic. Brain Sci 2021; 11:552. [PMID: 33925627 PMCID: PMC8145019 DOI: 10.3390/brainsci11050552] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 03/31/2021] [Accepted: 04/13/2021] [Indexed: 12/12/2022] Open
Abstract
The COVID-19 pandemic has had a negative impact on education. The restrictions imposed have undoubtedly led to impairment of the psychological well-being of both teachers and students, and of the way they experience interpersonal relationships. As reported previously in the literature, adverse effects such as loneliness, anxiety, and stress have resulted in a decrease in the cognitive performance of school and higher education students. Therefore, the objective of this work is to present a general overview of the reported adverse effects of the COVID-19 pandemic which may potentially influence the learning performance of students. Some neuroscientific findings related to memory and cognition, such as neuroplasticity and long-term potentiation, are also shown. We also discuss the positive effects of the practice of mindfulness, as well as other simple recommendations based on neuroscientific findings such as restful sleep, physical activity, and nutrition, which can act on memory and cognition. Finally, we propose some practical recommendations on how to achieve more effective student learning in the context of the pandemic. The aim of this review is to provide some assistance in this changing and uncertain situation in which we all find ourselves, and we hope that some of the information could serve as a starting point for hypotheses to be tested in educational research and their association with neuroscience.
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Affiliation(s)
- Gonzalo R. Tortella
- Center of Excellence (CIBAMA-BIOREN), Universidad de La Frontera, Temuco 4811230, Chile
- PhD Program in Natural Resource Sciences, Universidad de La Frontera, Temuco 4811230, Chile
| | - Amedea B. Seabra
- Center for Natural and Human Sciences (CCNH), Federal University of ABC (UFABC), Av. dos Estados, 5001-Bangú, Santo André 09210-580, SP, Brazil;
| | - Jorge Padrão
- Centre for Textile Science and Technology (2C2T), University of Minho, 4800-058 Guimarães, Portugal;
| | - Rodrigo Díaz-San Juan
- Educational Neurosciences and Psychology Department, Centenario School, Temuco 4810936, Chile;
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100
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Fear of COVID-19 and Mental Health: The Role of Mindfulness in During Times of Crisis. Int J Ment Health Addict 2021; 20:607-618. [PMID: 33935608 PMCID: PMC8075278 DOI: 10.1007/s11469-020-00470-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/15/2020] [Indexed: 12/21/2022] Open
Abstract
The novel coronavirus disease (COVID-19) has had a significant impact on all aspects of individuals' lives, particularly their mental health due to the fear associated with the pandemic. Thus, the current study explored the relationship between the fear of COVID-19 and aspects of mental health, namely anxiety and depression, and will consider whether this relationship can be mediated by mindfulness. Data were collected from a student sample of 355 participants (71.5% female and 28.5% male) ranging between 18 and 41 years of age (M = 22.41 ± 3.27), with participants completing a fear of COVID-19 scale (FCV-19S), Mindfulness Attention and Awareness Scale (MAAS), and the anxiety and depression subscale of the Symptom Checklist-90-Revised (SCL-90-R). In terms of the results, correlational analyses indicated that fear of COVID-19 is inversely associated with mindfulness, while positive correlations were found with anxiety and depression. Structural equation modeling analyses demonstrated that mindfulness mediated the relationship between fear of COVID-19 and depression and anxiety. Associated implications are further discussed.
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