Acute mental health responses during the COVID-19 pandemic in Australia

Examining the psychological and financial impact of travel restrictions on citizens and permanent residents stranded abroad during the COVID-19 pandemic: international cross-sectional study

OBJECTIVES

This study aimed to evaluate the psychological and financial distress reported by citizens and permanent residents stranded abroad due to international travel restrictions introduced in response to the COVID-19 pandemic.

DESIGN

An international cross-sectional study.

SETTING

A primary analysis of data collected between July and September 2021 through an online survey targeting individuals stranded abroad and unable to return to their country of residence due to international travel restrictions.

RESPONDENTS

A total of 1054 individuals aged 18-84 years.

DATA ANALYSIS

Multivariable logistic regression models were used to explore the relationship between higher levels of depression, anxiety and stress and participant variables.

OUTCOME MEASURES

The survey answered questions regarding COVID-19 travel restriction-related impacts: personal stress, anxiety and depression (using the validated 21-item Depression, Anxiety and Stress Scale (DASS-21) tool), as well as impacts on housing and financial security and demographic data.

RESULTS

A total of 75.4% of respondents reported wanting to return to the Oceania region (75.4%), with 45% stranded in Europe. 64.2% reported financial distress while stranded abroad. 64.4% (x̄=9.43, SD=5.81) reported moderate-to-extremely severe (based on the DASS-21 classification) levels of depression, 41.7% for anxiety (x̄=5.46, SD=4.74), and 58.1% for stress (x̄=10.64, SD=5.26). Multivariable analysis indicated that financial stress, an employment change, being <30 years, having a high perceived risk of contracting COVID-19 abroad and being stranded for >2 months were significantly related to scores of moderate-to-extremely severe depression, anxiety and stress.

CONCLUSION

The study is among the first to explore the psychological and financial distress-related impacts associated with being stranded abroad due to COVID-19 travel restrictions. It highlights a range of unintended consequences that arise from pandemic-related travel restrictions, identifies the health and social needs of a particularly vulnerable population, and provides clues as to the types of support that may be adopted to best support them.

Relationships Between Resilience, Mental Well-Being, and COVID-19 Worries in Collegiate Student-Athletes

The onset of the COVID-19 pandemic was associated with robust declines in well-being for collegiate student-athletes. Worries about COVID-19 have frequently been associated with worsening well-being; therefore, it is important to examine protective factors against well-being decrements. Resilience, one's ability to respond to stress and adversity, may be one such factor. Despite this possible influence, resilience has not yet been studied in student-athletes in this context as the pandemic has progressed. Therefore, the purpose of this study was to examine the moderating role of resilience on the relationship between COVID-19 worries and well-being. In this cross-sectional design, National Collegiate Athletic Association Division III athletes (N = 91) at one university completed surveys on COVID-19 worries, resilience, and well-being between February and March 2021. All competitions had been postponed until the Spring 2021 semester. The findings revealed a negative correlation between COVID-19 worries and well-being (r = −0.21, p = 0.05) and a positive correlation between resilience and well-being (r = 0.44, p < 0.001). Additionally, multiple regression and simple slopes analyses showed that individuals with higher resilience endorsed greater scores of well-being, even when COVID-19 worries increased (β = 0.38, p = 0.02). In conclusion, our results suggest that resilience had a moderating effect on the relationship between COVID-19 worries and well-being.

A Group-Facilitated, Internet-Based Intervention to Promote Mental Health and Well-Being in a Vulnerable Population of University Students: Randomized Controlled Trial of the Be Well Plan Program

BACKGROUND

A growing literature supports the use of internet-based interventions to improve mental health outcomes. However, most programs target specific symptoms or participant groups and are not tailored to facilitate improvements in mental health and well-being or do not allow for needs and preferences of individual participants. The Be Well Plan, a 5-week group-facilitated, internet-based mental health and well-being group intervention addresses these gaps, allowing participants to select a range of activities that they can tailor to their specific characteristics, needs, and preferences.

OBJECTIVE

This study aims to test whether the Be Well Plan program was effective in improving primary outcomes of mental well-being, resilience, anxiety, and depression compared to a waitlist control group during the COVID-19 pandemic; secondary outcomes included self-efficacy, a sense of control, and cognitive flexibility. The study further seeks to examine participants' engagement and satisfaction with the program.

METHODS

A randomized controlled trial (RCT) was conducted with 2 parallel arms, an intervention and a waitlist control group. The intervention involved 5 weekly 2-hour sessions, which were facilitated in group format using Zoom videoconferencing software. University students were recruited via social media posts, lectures, emails, flyers, and posters.

RESULTS

Using an intentional randomization 2:1 allocation strategy, we recruited 215 participants to the trial (n=126, 58.6%, intervention group; n=89, 41.4%, waitlist control group). Of the 126 participants assigned to the intervention group, 75 (59.5%) commenced the program and were included in modified intention-to-treat (mITT) analyses. mITT intervention participants attended, on average, 3.41 sessions (SD 1.56, median 4); 55 (73.3%) attended at least 4 sessions, and 25 (33.3%) attended all 5 sessions. Of the 49 intervention group participants who completed the postintervention assessment, 47 (95.9%) were either very satisfied (n=31, 66%) or satisfied (n=16, 34%). The mITT analysis for well-being (F_1,162=9.65, P=.002, Cohen d=0.48) and resilience (F_1,162=7.85, P=.006, Cohen d=0.44) showed significant time × group interaction effects, suggesting that both groups improved over time, but the Be Well Plan (intervention) group showed significantly greater improvement compared to the waitlist control group. A similar pattern of results was observed for depression and anxiety (Cohen d=0.32 and 0.37, respectively), as well as the secondary outcomes (self-efficacy, Cohen d=0.50; sense of control, Cohen d=0.42; cognitive flexibility, Cohen d=0.65). Larger effect sizes were observed in the completer analyses. Reliable change analysis showed that the majority of mITT participants (58/75, 77.3%) demonstrated a significant reliable improvement in at least 1 of the primary outcomes.

CONCLUSIONS

The Be Well Plan program was effective in improving mental health and well-being, including mental well-being, resilience, depression, and anxiety. Participant satisfaction scores and attendance indicated a high degree of engagement and satisfaction with the program.

TRIAL REGISTRATION

Australian New Zealand Clinical Trial Registry ACTRN12621000180819; https://tinyurl.com/2p8da5sk.

Social activity promotes resilience against loneliness in depressed individuals: a study over 14-days of physical isolation during the COVID-19 pandemic in Australia

Loneliness is a subjectively perceived state of social isolation that is associated with negative emotional, cognitive, and physical health outcomes. Physical distancing and shelter-in-place public health responses designed to curb COVID-19 transmission has led to concerns over elevated risk of loneliness. Given that physical isolation does not necessitate social isolation in the age of digital communication, this study investigated the relationship between the frequency of social interaction and loneliness over a two-week period in people engaging in physical distancing and examined whether this relationship was moderated by physical isolation level, age, or depression. A self-selected sample of N = 469 individuals across Australia who were engaged in physically distanced living completed daily surveys for 14-days during April to June of 2020. Multilevel modelling showed that more frequent social interaction with close, but not intermediate or distant contacts, was uniquely associated with lower loneliness. In addition, being younger, more depressed, more anxious, or having a mental health condition diagnosis (past or present) were also independently associated with higher loneliness. Critically, depression was the only significant moderator of the relationship between social interaction and loneliness over time, where more frequent social interaction with close contacts buffered against loneliness over time in high depression individuals only. The findings suggest that encouraging social activity with close contacts may promote resilience against loneliness in individuals with elevated depression symptoms.

Differential Impacts of the COVID-19 Pandemic on Mental Health Symptoms and Working Conditions for Senior and Junior Doctors in Australian Hospitals

OBJECTIVE

This study investigated severity, prevalence, and predictors of workplace disruption and mental health symptoms in Australian junior and senior hospital medical staff during the COVID-19 pandemic.

METHODS

A cross-sectional survey collected data on demographics, workplace disruption, personal relationships, and mental health.

RESULTS

One thousand twenty-one (62.1%) senior and 745 (37.9%) junior medical staff, located primarily in Victoria, completed the survey. Work disruptions were common but varied by seniority, withjunior staff more frequently exposed to COVID- 19 (P < 0.001). Symptoms of anxiety, depression, post-traumatic stress disorder and burnout were common but significantly higher in junior doctors (P  = 0.011 to < 0.001). Common predictors for experiencing mental health symptoms were identified, including prior mental health diagnoses and worsening personal relationships.

CONCLUSIONS

COVID-19 has had significant but varied impacts on junior and senior doctors, with junior doctors particularly susceptible to harm to mental health. Interventions to safeguard hospital medical staff and prevent attrition of this important workforce are urgently needed.

Analyzing COVID-19's impact on the travel mobility of various social groups in China's Greater Bay Area via mobile phone big data

The COVID-19 outbreak has significantly impacted people's mobility in terms of travel, which is directly related to regional economic vitality and individuals' well-being. This study conducted research on the COVID-19 epidemic's impact on travel mobility in China's Greater Bay Area, utilizing mobile phone big data. The overall influence of COVID-19 was measured by investigating the impact between different income and migration groups in three core cities: Shenzhen, Guangzhou, and Foshan. Individuals' weekly travel frequency and activity space area between December 2019 and May 2020 were calculated, and the average values between the different cities and various social groups were compared. The results showed that travel mobility declined during the epidemic's peak, followed by a recovery based on the overall trend. The start and end of strict law enforcement had a significant impact on the initial decline and subsequent recovery of travel mobility in the core cities. COVID-19 had a larger impact on core cities than peripheral areas, and on non-commute travel frequency, compared to commute travel frequency. Compared to advantaged groups, socially disadvantaged groups experienced a steeper decline in travel mobility during the epidemic's peak, but a more significant recovery afterwards. These findings indicate that discretionary activities have not yet recovered and remain below the pre-epidemic level, and that disadvantaged social groups had limited access to superior precautionary measures for avoiding infection. Based on the findings, we provide several policy suggestions regarding the recovery of travel mobility.

Momentary social interactions and affect in later life varied across the early stages of the COVID-19 pandemic

The COVID-19 pandemic has impacted many different facets of life. The infectious nature of the disease has led to significant changes in social interactions in everyday life. The present study examined how older adults’ patterns of everyday momentary social interactions (i.e., with no one, partner, family, and friends) and their affect varied across the early stages of the pandemic and whether the magnitude of affective benefits associated with social interactions changed across time. A total of 188 adults aged 50 or above (M_age = 62.05) completed momentary assessments in early March, late March, May, and July 2020. Overall, older adults spent more time in solitude and less time interacting with their friends after the declaration of the pandemic. Further, negative affect (NA) spiked after the pandemic declaration and then returned to pre-pandemic level. Finally, momentary interactions with close social ties were consistently associated with higher positive affect (PA) and lower NA whereas momentary solitude was associated with lower PA, but not related to NA. The magnitude of associations between specific social interactions (or solitude) and affect varied across time, and the onset of the pandemic appeared associated with this variation. During the presumably most stressful period, solitude was not associated with lower PA and family interaction was not associated with higher PA as they were at other times. Further, interactions with friends seemed to have diminished affective benefits following the onset of the pandemic.

Fear of COVID-19 and Perceived Stress: The Mediating Roles of Neuroticism and Perceived Social Support

Background: Fear of COVID-19 leads to stress and may result in various kinds of mental health problems. Many factors are associated with an individual’s perception of stress, including neuroticism and perceived social support. This study aimed to examine the role of neuroticism and perceived social support as mediators of fear of COVID-19 on perceived stress. Methods: Data from 3299 participants aged ≥18 years from the HOME-COVID-19 survey in 2020 were used for analysis. Measurements used included the Fear of COVID-19 and Impact on Quality of Life Scale, the Perceived Stress Scale-10, the Neuroticism inventory and the Multidimensional Scale of Perceived Social Support-12. A parallel mediation model within a structural equation modeling framework with 5000 bootstrapping sampling was used to test the mediating effect. Results: Fear of COVID-19 had a direct effect on perceived stress (B  =  0.100, 95% CI = 0.080−0.121, p < 0.001), whereas neuroticism, but not perceived social support, partially mediated the relationship between fear of COVID-19 and perceived stress (B = 0.018, 95% CI = 0.000−0.036). Among all types of social support, only perceived support from friends was a significant mediator (B = 0.016, 95% CI = 0.006−0.025). Conclusions: Neuroticism and perceived support from friends are critical factors in the relationship between fear of COVID-19 and perceived stress.

Mental Health Outcomes in Australian Healthcare and Aged-Care Workers during the Second Year of the COVID-19 Pandemic

Objective: the COVID-19 pandemic has incurred psychological risks for healthcare workers (HCWs). We established a Victorian HCW cohort (the Coronavirus in Victorian Healthcare and Aged-Care Workers (COVIC-HA) cohort study) to examine COVID-19 impacts on HCWs and assess organisational responses over time. Methods: mixed-methods cohort study, with baseline data collected via an online survey (7 May–18 July 2021) across four healthcare settings: ambulance, hospitals, primary care, and residential aged-care. Outcomes included self-reported symptoms of depression, anxiety, post-traumatic stress (PTS), wellbeing, burnout, and resilience, measured using validated tools. Work and home-related COVID-19 impacts and perceptions of workplace responses were also captured. Results: among 984 HCWs, symptoms of clinically significant depression, anxiety, and PTS were reported by 22.5%, 14.0%, and 20.4%, respectively, highest among paramedics and nurses. Emotional exhaustion reflecting moderate–severe burnout was reported by 65.1%. Concerns about contracting COVID-19 at work and transmitting COVID-19 were common, but 91.2% felt well-informed on workplace changes and 78.3% reported that support services were available. Conclusions: Australian HCWs employed during 2021 experienced adverse mental health outcomes, with prevalence differences observed according to occupation. Longitudinal evidence is needed to inform workplace strategies that support the physical and mental wellbeing of HCWs at organisational and state policy levels.

The health impacts of a 4-month long community-wide COVID-19 lockdown: Findings from a prospective longitudinal study in the state of Victoria, Australia

OBJECTIVES

To determine health impacts during, and following, an extended community lockdown and COVID-19 outbreak in the Australian state of Victoria, compared with the rest of Australia.

METHODS

A national cohort of 898 working-age Australians enrolled in a longitudinal cohort study, completing surveys before, during, and after a 112-day community lockdown in Victoria (8 July- 27 October 2020). Outcomes included psychological distress, mental and physical health, work, social interactions and finances. Regression models examined health changes during and following lockdown.

RESULTS

The Victorian lockdown led to increased psychological distress. Health impacts coincided with greater social isolation and work loss. Following the extended lockdown, mental health, work and social interactions recovered to an extent whereby no significant long-lasting effects were identified in Victoria compared to the rest of Australia.

CONCLUSION

The Victorian community lockdown had adverse health consequences, which reversed upon release from lockdown. Governments should weigh all potential health impacts of lockdown. Services and programs to reduce the negative impacts of lockdown may include increases in mental health care, encouraging safe social interactions and supports to maintain employment relationships.

COVID-19 vaccination did not improve employee mental health: A prospective study in an early phase of vaccination in Japan

Objectives

This study aimed to examine the effectiveness of vaccination to improve mental health among employees in Japan based on a prospective study.

Methods

The data were retrieved from the Employee Cohort Study conducted during the COVID‐19 pandemic in Japan (E‐ COCO‐J) at T1 (4–10 February 2021) and T2 (22–29 June 2021). Psychological distress was measured by using an 18‐item scale of the Brief Job Stress Questionnaire (BJSQ). The analytic sample was limited to individuals employed at both T1 and T2 without missing covariates. Vaccination status was measured at T2. Statistical analysis was conducted to test the differential change in the psychological distress at T1 and T2 with the time × group interactions by using repeated ANOVA, adjusting for the covariates (gender, age, marital status, education, chronic disease, company size, industry, and occupation).

Results

Of the total sample (N = 948), 105 (11.1%) were vaccinated at least once at T2. The crude mean scores of psychological distress at T1 and T2 were 41.8 and 42.0 for vaccinated participants and 41.2 and 41.2 for nonvaccinated participants, respectively, with no significant effect of having been vaccinated (Cohen's d = 0.02, P = 0.833). After adjusting the covariates, there was no significance (P = 0.446).

Conclusions

The COVID‐19 vaccination was supposed to have a limited effect on mental health among Japanese employees in an early phase of vaccination. To keep providing mental health care for employees is important even after starting the vaccination program.

Association of blood eicosapentaenoic acid levels with intracerebral hemorrhage during the COVID-19 pandemic: preliminary experience from a single-center in Japan

Background

The COVID-19 pandemic has forced lockdowns and declarations of states of emergency, resulting in marked changes to daily life such as dietary habits in many countries. Though serum omega-3 polyunsaturated fatty acids levels have been shown to be useful markers for recurrent vascular events or worse prognosis in cardiovascular diseases and ischemic stroke, the relationship between serum omega-3 PUFA levels and the occurrence of intracerebral hemorrhage has essentially been unknown. We explored the association of serum omega-3 polyunsaturated fatty acids with intracerebral hemorrhage during the COVID-19 pandemic.

Methods

Participants comprised patients admitted to Juntendo University Hospital (Tokyo, Japan) with intracerebral hemorrhage between January 1, 2016 and April 30, 2020. Clinical characteristics including serum omega-3 polyunsaturated fatty acid levels were compared between patients developing intracerebral hemorrhage during the period from January 1, 2016 to February 29, 2020, and the subsequent COVID-19 pandemic period (March 1 to April 30, 2020). Clinical characteristics independently related to intracerebral hemorrhage during the COVID-19 pandemic were analyzed by comparing these two cohorts of intracerebral hemorrhage patients in different periods.

Results

A total of 103 patients (age, 67.0 ± 13.9 years; 67 males) with intracerebral hemorrhage were enrolled. Intracerebral hemorrhage developed in 91 patients before and 12 patients during the COVID-19 pandemic. Monthly averages of intracerebral hemorrhage patients admitted to our hospital during and before the COVID-19 pandemic were 6 and 1.82, respectively. Serum eicosapentaenoic acid levels were significantly lower in intracerebral hemorrhage patients during the COVID-19 pandemic than before (31.87 ± 12.93 μg/ml vs. 63.74 ± 43.29 μg/ml, p = 0.007). Multiple logistic regression analysis showed that, compared to before the COVID-19 pandemic, dyslipidemia (odds ratio 0.163, 95% confidence interval 0.031–0.852; p = 0.032) and eicosapentaenoic acid levels (odds ratio 0.947, 95% confidence interval 0.901–0.994; p = 0.029) were associated with intracerebral hemorrhage during the COVID-19 pandemic.

Conclusions

From our preliminary results, low eicosapentaenoic acid levels were linked with intracerebral hemorrhage during the COVID-19 pandemic. Low levels of eicosapentaenoic acid might be an endogenous surrogate marker for intracerebral hemorrhage during the COVID-19 pandemic.

Self-reported wellbeing and health-related quality of life of Aboriginal and Torres Strait Islander people pre and post the first wave of the COVID-19 2020 pandemic

OBJECTIVE

Quantify change in wellbeing and health-related quality-of-life (HRQoL) in Aboriginal and Torres Strait Islander adults pre and post Australia's initial COVID-19 lockdown.

METHODS

Aboriginal and Torres Strait Islander adults completed an online survey at Time 1 (October-November 2019; before the initial Australian COVID-19 outbreak) and Time 2 (August-September 2020; after the first Australian lockdown). We assessed wellbeing using a visual analogue scale (VAS) and HRQoL using the Assessment of Quality of Life (AQoL-4D) instrument. Participants who completed both surveys (n=42) were included to quantify change in outcomes over time and by comorbidity and demographic factors.

RESULTS

Mean reduction in wellbeing over time was 6.4 points (95%CI -14.2 to 1.4) and was associated with age (18-54yo), financial instability and mental health comorbidity. Mean reduction in HRQoL over time was 0.06 (95%CI -0.12 to 0.01) and was associated with financial instability, high physical comorbidity level and mental health comorbidity.

CONCLUSIONS

Aboriginal and Torres Strait Islanders aged 18-54yo, who were financially unstable or had elevated comorbidity during COVID lockdowns experienced greater reductions in wellbeing and HRQoL.

IMPLICATIONS FOR PUBLIC HEALTH

As the COVID-19 pandemic continues in Australia, both urgent and forward planning is needed, especially for the priority groups identified.

The impact of the COVID lockdown on alcohol consumption in the Netherlands. The role of living arrangements and social isolation

BACKGROUND

The COVID-19 pandemic and the subsequent lockdown have a strong impact on health and health behaviours, such as alcohol consumption. Although there is some evidence of an overall decline in alcohol consumption during the lockdown, studies also show an increase in risky drinking patterns, e.g. solitary drinking, and differences between subgroups of individuals, e.g. depending on their living arrangement. Yet most studies rely on cross-sectional designs with retrospective questions, and small samples.

METHODS

A longitudinal study was conducted using 13 waves of the COVID-Questionnaire within the Lifelines cohort from the northern Netherlands (n = 63,194). The outcome was alcohol consumption (glasses per week) between April 2020 and July 2021. Linear fixed-effects models were fitted to analyse trends in alcohol consumption, and these were compared with pre-COVID drinking levels. Moreover, the role of living arrangement and feelings of social isolation as potential moderators was tested.

RESULTS

Alcohol consumption during the pandemic was lower than in previous years, and the seasonal pattern differed from the pre-COVID one, with levels being lower when lockdown measures were stricter. Moreover, the seasonal pattern differed by living arrangement: those living alone saw a relative increase in drinking throughout tight lockdown periods, whereas those living with children showed the strongest increase during the summer. Social isolation showed a weaker moderation effect.

CONCLUSIONS

Overall alcohol levels were down in the pandemic, and in particular during strict lockdowns. Those living on their own and those who felt more isolated reacted more strongly to the lockdown, the longer it lasted.

The effect of the COVID-19 pandemic on mental health in individuals with pre-existing mental illness

BACKGROUND

There is evidence that the COVID-19 pandemic has negatively affected mental health, but most studies have been conducted in the general population.

AIMS

To identify factors associated with mental health during the COVID-19 pandemic in individuals with pre-existing mental illness.

METHOD

Participants (N = 2869, 78% women, ages 18-94 years) from a UK cohort (the National Centre for Mental Health) with a history of mental illness completed a cross-sectional online survey in June to August 2020. Mental health assessments were the GAD-7 (anxiety), PHQ-9 (depression) and WHO-5 (well-being) questionnaires, and a self-report question on whether their mental health had changed during the pandemic. Regressions examined associations between mental health outcomes and hypothesised risk factors. Secondary analyses examined associations between specific mental health diagnoses and mental health.

RESULTS

A total of 60% of participants reported that mental health had worsened during the pandemic. Younger age, difficulty accessing mental health services, low income, income affected by COVID-19, worry about COVID-19, reduced sleep and increased alcohol/drug use were associated with increased depression and anxiety symptoms and reduced well-being. Feeling socially supported by friends/family/services was associated with better mental health and well-being. Participants with a history of anxiety, depression, post-traumatic stress disorder or eating disorder were more likely to report that mental health had worsened during the pandemic than individuals without a history of these diagnoses.

CONCLUSIONS

We identified factors associated with worse mental health during the COVID-19 pandemic in individuals with pre-existing mental illness, in addition to specific groups potentially at elevated risk of poor mental health during the pandemic.

'It's the economy, stupid': Lessons of a longitudinal study of depression in Argentina

BACKGROUND

On March 20, 2020, the Argentine Ministry of Health imposed a mandatory quarantine, which still persists.

AIM

The aim of this study is to determine the variation in the prevalence of depression since the beginning of the quarantine and the evolution of risk factors, with special emphasis on the population's concerns.

METHODS

A longitudinal study was carried out using a digital questionnaire disseminated in social networks. The first stage (T1) was carried out from March 29 to April 12 and the second stage (T2) from May 23 to June 12, 2020. The prevalence of depression was measured using the 9-item Patients Health Questionnaire (PHQ-9).

RESULTS

The prevalence of moderate/severe depression increased from 24.3% in T1 to 47.8% in T2 (p: 0.000). Risk factors increased significantly: age 18-27, female, primary and secondary school, smoking and having a poor sleep quality (p: 0.000). The concerns about 'a family member getting sick' (OR: 1.28; CI: 1.04-1.58; p: 0.016), 'changes at work' (OR: 2.24; CI: 1.79-2.81; p: 0.000), 'running out of money' (OR: 1.43; CI: 1.20-1.71; p: 0.000) and 'being unemployed' (OR: 2.99; CI: 2.55-3.52; p: 0.000) were risk factors for depression. On the other hand, the concern about 'getting the virus' (OR: 0.73; CI: 0.61-0.87; p: 0.001) was not a risk factor.

CONCLUSIONS

The extended quarantine in Argentina is associated with an increase in the prevalence of depression; the high impact of economic and social concerns on mental health must be considered in order to avoid long-term effects.

Slovak Adaptation of the Coronavirus Anxiety Scale

This study examined the psychometric properties of the Slovak version of the Coronavirus Anxiety Scale (CAS-SK) in a sample of adult Slovaks (N = 743). The data were collected online during the second wave of the COVID-19 pandemic in Slovakia. Along with the Coronavirus Anxiety Scale, the Perceived Stress Scale, and the Well-Being Index were administered to the respondents. The results of the Confirmatory Factor Analysis show a stable uni-dimensional structure of the CAS-SK, good reliability, and adequate convergent validity. The Item Response Theory findings suggest that all items have good discrimination parameters, all thresholds increased monotonically across the rating scale, and that the CAS-SK is more informative in individuals with a high level of coronavirus anxiety. These results suggest that the CAS-SK is a valid and reliable tool for measuring coronavirus anxiety.

Developing a healthcare worker psychological preparedness support programme for the COVID-19 outbreak

Background

The coronavirus disease 2019 (COVID-19) outbreak caused worldwide disruptions to healthcare systems. The emerging evidence indicates that mental health problems have consequently become an occupational hazard in frontline healthcare workers.

Aim

We aimed to develop a psychological preparedness training (PPT) programme to support frontline health workers in three resource-limited hospitals in South Africa dealing with the COVID-19 outbreak and to evaluate its effectiveness using an audit tool. We established a theoretical framework and goals for a psychological preparedness programme to support healthcare workers at the study sites.

Setting

Data were collected at the Dora Nginza Hospital, Nelson Mandela Academic Hospital and Elizabeth Donkin Hospital.

Methods

We employed an observational, descriptive, and cross-sectional design. A group psychological intervention was developed and implemented at the three sites in South Africa, from mid-April 2020 over 20 weeks. We collected data using an audit tool to measure healthcare workers’ perceptions of the outbreak before and after the intervention. We analysed the data to test for a statistically significant difference between the pre-intervention and post-intervention audit tools.

Results

We supported 761 healthcare workers during the 20 weeks of the programme. Statistical analysis showed a significant positive change from pre- to post-intervention measures in perceptions of health worker about the outbreak, their anxiety associated with the outbreak, their ability to control reactions to stress and the perception of their ability to support others. Feedback comments indicated that the programme was beneficial for the majority of those who attended.

Conclusion

Health workers who attended the programme reported improvement in stress levels and in perceptions about their ability to cope with the outbreak, as well as in their perceptions of being able to support others.

COVID-19 Vaccination Intention Associated with Behaviors towards Protection and Perceptions Regarding the Pandemic

Background: The impressively rapid availability of different types of COVID-19 vaccines and, on the other hand, the degree of their effectiveness as opposed to the likelihood of serious or non-serious side effects place a fairly large percentage of the population at a crossroads regarding the choice to get vaccinated or not, hence threatening achievement of total immunization coverage and full immunity. This study aimed to assess COVID-19 vaccination intention in Greece regarding protection behaviors and perceptions of the pandemic. Methods: A total of 3753 participants completed a specially designed electronic questionnaire anonymously and voluntarily. The study population consisted of healthcare workers, students, members of professional societies, teachers, and professors. The questionnaire was composed of four parts pertaining to demographic data and possible changes in hygiene attitudes during the COVID-19 pandemic. Results: In total, 43.3% of the participants stated that SARS-CoV-2 poses a significant risk. The most widespread protection practice was avoiding crowded places (90.1%), followed by reducing the use of public transport (86.1%) and washing their hands with soap and water more often than usual (84.2%). Women undertook significantly more behavioral changes than men and participants of other nationalities. About half of the participants (44%) implemented seven behavioral changes. Lower personal and general perceived risk due to COVID-19 was significantly associated with lower intention to get vaccinated. Conclusion: Strong hesitancy was observed towards COVID-19 vaccination. There is a need for further studies to be conducted to investigate the benefits and safety of vaccines for the purpose of better informing the public. Healthcare personnel can and should play a key role in this process.

The anxiety of not knowing: Diagnosis uncertainty about COVID-19

The emergence and swift global spread of COVID-19 brought increased anxiety worldwide (Santabárbara et al. (Progress in Neuro-Psychopharmacology & Biological Psychiatry, 109, 110207, 2021)). Research regarding the COVID-19 outbreak addressed factors that contribute to anxiety people experienced as they tried to handle the changes in their lives associated with COVID-19 (Holmes et al. (The Lancet Psychiatry, 7(6), 547-560, 2020)). This paper focuses on diagnosis uncertainty as a particular source of anxiety. We use self-reported anxiety measures to understand how different stressors, and particularly how being sick or being unsure if one or one's close friends or relatives are sick, relate to overall anxiety levels. Five-hundred and thirty-three participants from a country with a stringent COVID-19 testing policy were surveyed in the spring of 2020 on various aspects of their anxiety and risk for depression, as well as on whether they or their friends or family had COVID-19. Analysis of survey results found that anxiety related to uncertainty regarding whether the survey responder or their friends or family were carrying COVID-19 may be even greater than fear of the virus itself. This paper discusses directional issues related to this finding and offers policy implications for decreasing anxiety during pandemics for certain types of communities. In addition to the main findings regarding diagnosis uncertainty and anxiety, this paper's results also indicate the importance of providing participants with an option for "not sure" in closed questions and imply the increased knowledge that can be gained by analyzing an unsure response independently of "yes" or "no".

Can physical activity foster mental health by preventing addictive social media use? – A longitudinal investigation during the COVID-19 pandemic in Germany

Introduction

The COVID-19 pandemic contributed to an increase of mental health problems like depression, anxiety, stress symptoms, and Internet-based addictive behaviors. Therefore, the present longitudinal study investigated whether physical activity might prevent addictive social media use (SMU) and thus foster positive mental health (PMH) and decrease negative mental health (NMH).

Methods

Data were assessed in a sample of 356 participants (Mage = 27.43, SDage = 6.59) from Germany via online surveys at two measurement time points in spring 2020 (baseline, BL) and one year later in spring 2021 (follow-up, FU). Moderated mediation analyses were conducted for the investigation of the relations.

Results

Analyses revealed that addictive SMU (BL) mediated the relationship between physical activity (BL) and PMH (FU) as well as symptoms of depression, anxiety, and stress (FU). Moreover, the association between physical activity and addictive SMU was moderated by the level of burden caused by COVID-19 (BL), i.e., it was significant for medium and high, but not for low burden.

Limitations

The mostly female and relatively young sample limit the generalizability of the current findings. Moreover, the relationships should be investigated in further countries to different time points.

Conclusions

The findings indicate positive effects of physical activity on PMH and NMH by the reduction of tendencies of addictive SMU. Especially people who experience high levels of burden by COVID-19 may benefit from regular physical activity. This could be a cost-effective, low-threshold prevention strategy for meeting the pandemic induced challenges for mental health.

COVID-19 Vaccination Uptake and Hesitancy in a National Sample of Australian Gay and Bisexual Men

Minority groups may face additional barriers to vaccination. In April-June 2021, we assessed the level of COVID-19 vaccination and willingness to be vaccinated in a national, online survey of 1280 gay and bisexual men in Australia. Over a quarter of the sample (28.0%) had been partially or fully vaccinated, and 80.0% of the unvaccinated were willing to be vaccinated. Vaccination was independently associated with older age, being university educated, and HIV status (with HIV-positive participants being more likely and untested participants less likely to be vaccinated). Willingness to be vaccinated was independently associated with living in a capital city and being university educated. Those who had lost income or their job due to COVID-19 were less willing to be vaccinated. Our results suggest encouraging COVID-19 vaccination among those with lower levels of health literacy and supporting those who have experienced financial stress because of the pandemic.

Psychological responses of hospital-based nurses working during the COVID-19 pandemic in the United States: A cross-sectional study

Studies show decreased well-being during the COVID-19 pandemic, especially for healthcare providers from Asia. Less is known about the psychological responses of working during the pandemic on hospital-based registered nurses (RNs) in the United States (US). Therefore, the purpose of this paper is to report the well-being of U.S.-based hospital RNs working during the initial acute phase of COVID-19 and compare it with well-being among healthcare workers described in two global meta-analyses. We conducted a cross-sectional survey in May–June 2020 (N = 467). Well-being was measured using the following tools: Generalized Anxiety Disorder-7, Patient Health Questionnaire-2 for depressive symptoms, Impact of Events Scale-Revised for traumatic stress, and the Insomnia Severity Index. Compared with global rates from two meta-analyses, US-based RNs reported significantly more traumatic stress (54.6% vs. 11.4% and 21.5%; p < .001) and depressive symptoms (54.6% vs. 31.8% and 21.7%; p < .001). Rates of insomnia were also higher in U.S.-based RNs than in the meta-analysis that reported insomnia (32.4% vs 27.8%; p < .033). Rates of anxiety symptoms among US-based RNs did not differ from that reported in one meta-analysis (37.3% vs. 34.4%), while it was significantly higher in the other (37.3% vs. 22.1%; p < .001). Hospital-based RNs from the US exhibited over twice the rates of trauma and nearly double the rates of depressive symptoms than shown in reports from hospital workers globally during the acute phase of the COVID-19 pandemic. The lasting effects of this distress are unknown and warrant ongoing evaluation and solutions to better support emotional well-being and prevent burnout in the workplace.

'This bloody rona!': using the digital story completion method and thematic analysis to explore the mental health impacts of COVID-19 in Australia

OBJECTIVE

To use the digital story completion method to prompt participants to describe thoughts, fears and mental health experiences in response to a story stem about COVID-19, to capture a specific sociohistoric moment.

DESIGN

We used digital story completion, a qualitative research method, to gather narratives from Australians coping with physical distancing and social restriction measures. Our reflexive thematic analysis of the data was underpinned by a constructionist approach to reflect the importance of social context in understanding health experiences.

SETTING

Australia.

PARTICIPANTS

52 people living in Australia (aged 18 years and over).

RESULTS

Four meta-themes were prevalent across 52 stories submitted: (1) expressions of mental distress linked to COVID-19; (2) various coping strategies offered by characters in stories; (3) narratives outlining social support offered to alleviate distress; and (4) specialised COVID-19 vocabulary.

CONCLUSION

We cautiously propose that points of convergence across stories indicate a level of shared experience among participants relating to COVID-19 in Australia. We suggest this is due to intensive media coverage of the pandemic, persistent public health messaging, engagement with social media and instant messaging technologies, and extended lockdowns that impacted the mental health of vast numbers of Australians.

Daily uplifts during the COVID-19 pandemic: what is considered helpful in everyday life?

Background

Knowledge of what is uplifting and helpful during pandemics could inform the design of sustainable pandemic recommendations in the future. We have explored individuals’ views on helpful and uplifting aspects of everyday life during the coronavirus disease 2019 (COVID-19) pandemic.

Methods

Participants answered a brief, daily survey via text messages during 14 consecutive days in July–August, 2020. The survey included the question: “During the past 24 hours, is there anything that has made you feel good or helped you in your life?” We used content analysis to compile responses from 693 participants, who provided 4,490 free-text answers, which resulted in 24 categories subsumed under 7 themes.

Results

Positive aspects during the COVID-19 pandemic primarily related to social interactions, in real life or digitally, with family, friends and others. Other important aspects concerning work, colleagues and maintaining everyday life routines. One theme concerning vacations, going on excursions and being in nature. Leisure and recreation activities, such as hobbies and physical exercise, also emerged as important, as did health-related factors. Bodily sensations, thoughts, feelings and activities that benefited well-being were mentioned frequently. Lastly, people commented on the government strategies for containing COVID-19, and whether to comply with restrictions.

Conclusions

To summarize, daily uplifts and helpful aspects of everyday life centered around social relationships. To comply with recommendations on physical distancing, people found creative ways to maintain social connections both digitally and face-to-face. Social interaction, maintenance of everyday life routines, hobbies and physical activity appeared to be important for well-being.

A Bibliometric Analysis on Global Psychological and Behavioral Research Landscape on COVID-19 Pandemic

The COVID-19 pandemic outbreak in December 2019 has spread globally. The ongoing psychological and behavioral effects of the COVID-19 pandemic, which poses a major challenge to humanity, are of concern to researchers. To understand the academic community’s attention, focus and research collaboration on psychological and behavioral research during the COVID-19 pandemic, we conducted a macro analysis using a bibliometric approach. Using the topic selection strategy of TS = (“COVID-19” OR “coronavirus disease 2019” OR “SARS-CoV-2” OR “2019-nCoV”) AND TS = (“behavio*”) AND TS = (“psycholog*”), 2096 high-quality research articles and reviews were downloaded as data from the Web of Science core collection on 16 November 2021. Through analysis and visualization, the following conclusions are drawn in this study: (1) The popularity and importance of psychological and behavioral research under COVID-19 has increased significantly and needs further attention; (2). Related research focuses on eight hotspots, with quarantine, health care workers, the elderly, students, pregnant women, family, consumers, social media and emergency preparedness knowledge as the focus of the research object; and (3) Research collaboration is relatively high at the author, organizational and national levels. However, low-income countries need to get more attention. Furthermore, this article would help researchers make decisions for the research of psychological and behavioral issues under COVID-19 and planning for future prospects to contribute to academic development and applied methodology.

Western Australian adolescent emotional wellbeing during the COVID-19 pandemic in 2020

BACKGROUND

The impacts of the COVID-19 pandemic have been vast and are not limited to physical health. Many adolescents have experienced disruptions to daily life, including changes in their school routine and family's financial or emotional security, potentially impacting their emotional wellbeing. In low COVID-19 prevalence settings, the impact of isolation has been mitigated for most young people through continued face-to-face schooling, yet there may still be significant impacts on their wellbeing that could be attributed to the pandemic.

METHODS

We report on data from 32,849 surveys from Year 7-12 students in 40 schools over two 2020 survey cycles (June/July: 19,240; October: 13,609), drawn from a study of 79 primary and secondary schools across Western Australia, Australia. The Child Health Utility Index (CHU9D) was used to measure difficulties and distress in responding secondary school students only. Using comparable Australian data collected six years prior to the pandemic, the CHU9D was calibrated against the Kessler-10 to establish a reliable threshold for CHU9D-rated distress.

RESULTS

Compared to 14% of responding 12-18-year-olds in 2013/2014, in both 2020 survey cycles almost 40% of secondary students returned a CHU9D score above a threshold indicative of elevated difficulties and distress. Student distress increased significantly between June and October 2020. Female students, those in older Grades, those with few friendships or perceived poor quality friendships, and those with poor connectedness to school were more likely to score above the threshold.

CONCLUSIONS

In a large dataset collected during the first year of the COVID-19 pandemic, the proportion of secondary school students with scores indicative of difficulties and distress was substantially higher than a 2013/2014 benchmark, and distress increased as the pandemic progressed, despite the low local prevalence of COVID-19. This may indicate a general decline in social and emotional wellbeing exacerbated by the events of the pandemic.

TRIAL REGISTRATION

ANZCTRN (ACTRN12620000922976). Retrospectively registered 17/08/2020. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380429&isReview=true .

Psychological Distress During COVID-19 Curfews and Social Distancing in Saudi Arabia: A Cross-Sectional Study

Background: Coronavirus disease 2019 (COVID-19) has spread to over 150 countries worldwide. Since the first case of COVID-19 was confirmed in Saudi Arabia, cases have continued to escalate exponentially. The COVID-19 outbreak has had a negative effect on mental health and well-being. The study aimed to investigate the effects of the strict national regulations associated with the COVID-19 pandemic on mental health. Methods: This was a cross-sectional study of a convenience sample of Saudi residents. Saudi residents aged 18 years or older were invited to complete an online questionnaire after one month of a nationwide 24-h curfew between May 6, 2020 and May 13, 2020. We measured psychological distress using the Depression, Anxiety, and Stress Scale-21 (DASS-21). We ran binary logistic regression analyses to detect variables that significantly predicted DASS-21 scores. Results: A sample of 2252 participants was recruited from the general population of Saudi Arabia. The DASS-21 score means and standard deviations for depression and anxiety for the whole sample (10.73 ± 10.29 and 6.98 ± 8.30, respectively) were in the range of mild depression and anxiety. In contrast, the mean DASS-21 stress score was within the normal range (11.97 ± 10.80). The mean stress score for healthcare workers was within the normal range (13.70 ± 10.68) but was significantly higher than the mean score for the public (11.56 ± 10.89; P = 0.0006). Several variables (e.g., age, gender, and history of contact with confirmed COVID-19 cases) were significantly associated with higher DASS-21 scores. Conclusions: The COVID-19 pandemic has created a psychological burden. Therefore, there is an urgent need to implement emergency public health interventions that ameliorate the risk perception of COVID-19 through the dissemination of adequate and targeted health information that could be a successful measure to mitigate the psychological impact of the Covid-19 pandemic.

The times, they are a-changin': tracking shifts in mental health signals from early phase to later phase of the COVID-19 pandemic in Australia

INTRODUCTION

Widespread problems of psychological distress have been observed in many countries following the outbreak of COVID-19, including Australia. What is lacking from current scholarship is a national-scale assessment that tracks the shifts in mental health during the pandemic timeline and across geographic contexts.

METHODS

Drawing on 244 406 geotagged tweets in Australia from 1 January 2020 to 31 May 2021, we employed machine learning and spatial mapping techniques to classify, measure and map changes in the Australian public's mental health signals, and track their change across the different phases of the pandemic in eight Australian capital cities.

RESULTS

Australians' mental health signals, quantified by sentiment scores, have a shift from pessimistic (early pandemic) to optimistic (middle pandemic), reflected by a 174.1% (95% CI 154.8 to 194.5) increase in sentiment scores. However, the signals progressively recessed towards a more pessimistic outlook (later pandemic) with a decrease in sentiment scores by 48.8% (95% CI 34.7 to 64.9). Such changes in mental health signals vary across capital cities.

CONCLUSION

We set out a novel empirical framework using social media to systematically classify, measure, map and track the mental health of a nation. Our approach is designed in a manner that can readily be augmented into an ongoing monitoring capacity and extended to other nations. Tracking locales where people are displaying elevated levels of pessimistic mental health signals provide important information for the smart deployment of finite mental health services. This is especially critical in a time of crisis during which resources are stretched beyond normal bounds.

The Mediating Role of Teacher Identification in the Relationship Between Psychological Distress and Teacher Satisfaction During COVID-19

The current study examines the potential mediating role of professional identification of school teachers in the relationship between psychological distress and teaching satisfaction. Professional identification is the extent to which an individual identifies with a professional group, including the values, beliefs, and commitment the individual has in relation to the professional group. Professional identification has been linked to negative work outcomes, such as job performance and turnover intentions, as well as to adverse mental health outcomes. In the context of education, professional identification is the extent to which teachers identify with the teaching profession. Participants (N = 355) were school teachers in South Africa who completed the Center for Epidemiological Depression Scale, the Beck Hopelessness Scale, the Professional Identification Scale, and the Teaching Satisfaction Scale. Structural equation analysis showed that professional identification plays a fully mediational role in the relationship between psychological distress and teaching satisfaction. Interventions that strengthen teachers’ identification with the teaching profession should be considered a priority.

The impact of COVID-19 on the lives and mental health of Australian adolescents

There has been significant disruption to the lives and mental health of adolescents during the COVID-19 pandemic. The purpose of this study was to assess the psychological and lifestyle impact of the pandemic on Australian adolescents, using an online survey, administered during the outbreak. Self-report surveys were administered online to a sample of 760 Australian adolescents aged 12-18 years assessing impact on a range of domains including behaviour, education, relationships, lifestyle factors (exercise, technology use, and sleep), and mental health outcomes (psychological distress, loneliness, health anxiety and well-being). Results showed that three quarters of the sample experienced a worsening in mental health, since the pandemic began, with negative impacts reported on learning, friendships and family relationships. There were also high higher levels of sleep disturbance, psychological distress and health anxiety, relative to normative samples. Effects on mental health were worse among those who reported a previous diagnosis of depression and/or anxiety relative to those without no such history. Adolescents are already vulnerable to the onset of mental illness at this developmental stage, and the current research underscores the need to find rapid and accessible ways to support adolescent mental health during times of crisis.

COVID-19 Daily Realities for Families: A South African Sample

The COVID-19 pandemic affected families globally. Empirical research has been explored to understand the impact of COVID-19 on families across countries, however, there are limited findings of how COVID-19 has affected the daily realities of families in South Africa. This study used an exploratory qualitative research approach to explore the experiences of COVID-19 for South African families. Findings suggest that the negative outcomes of COVID-19 experienced by South African families included a shift in the daily routines, restrictions on family events, lack of socialization and loss of connections, family conflicts, financial constraints as well as psychological impacts. On the contrary, the positive outcomes included increased family time and communication, cleanliness, and good health status, and improved financial management. Implications for future research should include research focused on the health impacts of COVID-19 on diverse family structures, family compositions, and family dynamics. In-depth research and findings can assist in developing policies and interventions for families.

The Relationships among Anxiety, Subjective Well-Being, Media Consumption, and Safety-Seeking Behaviors during the COVID-19 Epidemic

The COVID-19 epidemic has been confirmed as the largest scale outbreak of atypical pneumonia since the outbreak of severe acute respiratory syndrome (SARS) in 2003 and it has become a public health emergency of international concern. It exacerbated public confusion and anxiety, and the impact of COVID-19 on people needs to be better understood. Indeed, prior studies that conducted meta-analysis of longitudinal cohort research compared mental health before versus during the COVID-19 pandemic and proved that public health polices (e.g., city lockdowns, quarantines, avoiding gatherings, etc.) and COVID-19-related information that circulates on new media platforms directly affected citizen’s mental health and well-being. Hence, this research aims to explore Taiwanese people’s health status, anxiety, media sources for obtaining COVID-19 information, subjective well-being, and safety-seeking behavior during the COVID-19 epidemic and how they are associated. Online surveys were conducted through new media platforms, and 342 responses were included in the analysis. The research results indicate that the participants experienced different aspects of COVID-19 anxiety, including COVID-19 worry and perceived COVID-19 risk. Among the given media sources, the more participants searched for COVID-19 information on new media, the greater they worried about COVID-19. Furthermore, COVID-19 worry was positively related to safety-seeking behavior, while perceived COVID-19 risk was negatively related to subjective well-being. This paper concludes by offering some suggestions for future studies and pointing out limitations of the present study.

The effect of resilience on the relationship between perceived stress and change in alcohol consumption during the COVID-19 pandemic in Queensland, Australia

The COVID-19 pandemic has led to increased levels of stress and alcohol consumption. This study examined the effect of resilience on the relationship between stress and changes in alcohol consumption in the context of the COVID-19 pandemic in early 2020. A cross-sectional survey of 502 adults in Queensland, Australia (mean age = 45.68 (16.61)), found 23.9% of individuals had increased their alcohol consumption since the start of the pandemic. Regression modelling demonstrated a significant association between perceived stress and change in alcohol consumption. The study also revealed resilience was a moderating factor, where high levels of resilience buffered against increases in alcohol consumption associated with stress during the COVID-19 pandemic.

Predictors of Psychological Distress and Coronavirus Fears in the First Recovery Phase of the Coronavirus Disease 2019 Pandemic in Germany

Objectives: While previous research has mainly focused on the impact of the first acute phase of the COVID-19 pandemic on mental health, little empirical knowledge exists about depression, anxiety, and somatic symptom levels and possible predictors of symptom levels in the pandemic's recovery phase. The present study aimed to analyze the mental burden of a convenience ample of the general German population during the first recovery phase of the pandemic and to identify significant predictors of symptom levels. Methods: Standardized measures of anxiety (GAD-2), depression (PHQ-2), somatic symptoms (PHQ-15), and health anxiety, as well as measures of COVID-19 fears and possible vulnerability factors, were administered through a national, cross-sectional online survey (n = 2160, mean age 42.7 years, 75% female), asking participants for their current symptom levels and their symptom levels prior to the COVID-19 pandemic. Results: Our findings show significantly elevated levels of depression, anxiety, somatic symptoms, and health anxiety in the recovery period compared to before the pandemic. The current prevalence rates based on self-reporting were 26.7% for depression, 24.5% for anxiety, and 29% for somatization. The strongest predictors of these symptom reports included domain-specific pre-existing symptom levels, neuroticism, biological COVID-19 risk factors, avoidance of illness information, and younger age. The most important predictors of COVID-19 fears were subjective COVID-19 risk perception, followed by pre-existing health anxiety, the number of biological COVID-19 risk factors, older age, neuroticism, avoidance of illness information and female gender. Discussion: These findings indicate the need for specific psychological programs to help individuals with enhanced psychological and biological vulnerability to cope better with the mental distress experienced during all phases of the ongoing COVID-19 crisis.

Alcohol use among young Australian adults in May-June 2020 during the COVID-19 pandemic: a prospective cohort study

AIMS

To estimate change in young people's alcohol consumption during COVID-19 restrictions in Australia in early-mid 2020, and test whether those changes were consistent by gender and level of consumption prior to the pandemic.

DESIGN

Prospective longitudinal cohort.

SETTING

Secondary schools in New South Wales, Tasmania and Western Australia.

PARTICIPANTS

Subsample of a cohort (n = 443) recruited in the first year of secondary school in 2010-11. Analysis data included three waves collected in September 2017-July 2018, September 2018-May 2019 and August 2019-January 2020), and in May-June 2020.

MEASUREMENTS

The primary predictors were time, gender and level of consumption prior to the pandemic. Outcome variables, analysed by mixed-effects models, included frequency and typical quantity of alcohol consumption, binge drinking, peak consumption, alcohol-related harm and drinking contexts.

FINDINGS

Overall consumption (frequency × quantity) during the restrictions declined by 17% [incidence rate ratio (IRR) = 0.83; 95% confidence interval (CI) = 0.73, 0.95] compared to February 2020, and there was a 35% decline in the rate of alcohol-related harms in the same period (IRR = 0.66; 95% CI = 0.54, 0.79). Changes in alcohol consumption were largely consistent by gender.

CONCLUSIONS

From a survey of secondary school students in Australia, there is evidence for a reduction in overall consumption and related harms during the COVID-19 restrictions.

An investigation of COVID-19 related worry in a United States population sample

BACKGROUND

Although general anxiety has increased markedly since the onset of the COVID-19 pandemic, little has been reported about the demographic distribution of COVID-19 related worry, its relationship with psychological features, and its association with depression symptoms in the United States (US).

METHODS

2117 participants, selected to represent the age, gender, and race/ethnic distributions of the US population, completed an online survey. Analysis of variance and correlation analyses were used to assess relationships between the COVID-19 related worry score and demographic characteristics, past psychiatric diagnoses, personality dimensions, and current psychological symptoms. Logistic regression was used to evaluate the association between the COVID-19 worry score and depression symptoms.

RESULTS

The COVID-19 worry score was markedly higher in younger (18-49 year-olds) than older participants, and moderately higher in men, those who were married or cohabiting, with post-college education, and/or living in large urban areas. The COVID-19 worry score also was markedly higher in those who reported having been diagnosed with a psychiatric disorder. The COVID-19 worry score correlated with neuroticism, current psychological symptoms, and COVID-19 risk and COVID-19 behavior scores. The COVID-19 worry score was associated with current depression symptoms (OR = 1.10, 95% CI = 1.09-1.11; p < 0.001) in univariable models and remained significant after adjustment for other correlates of depression, including COVID-19 risk.

CONCLUSIONS

In this US sample, the COVID-19 worry score was inversely related to age, strongly related to psychological symptoms, and independently associated with depression symptoms. These findings have implications for the community mental health response to the COVID-19 pandemic in the US.

Impact of Covid-19 on field and office workforce in construction industry

The COVID-19 outbreak is the greatest global health crisis in many years. It has had a dramatic effect on workforces and workplaces all around the world, as it has spawned a massive change in the working atmosphere and raised the level of employees’ concerns about their mental health and physical wellbeing. The construction industry has been significantly affected by the COVID-19 pandemic and has been challenged to improve the safety and wellbeing of its workforce. The objectives of this study are to identify the health and safety issues that construction workers have encountered during the pandemic and to recommend management strategies to combat them. A thorough literature search on recently published literature, industry experiences, reports, and other related documents was performed to collect and categorize the required data. Seventeen COVID-19 challenges were identified and classified into five categories, and the results revealed that the lack of a safe environment in the workplace, heavy workloads, home situations, and concerns about job stability often contribute to anxiety, depression, and even suicide. Eleven strategies were identified to overcome these challenges, and the results demonstrated that redefining worksite safety by placing signs, ensuring a safe distance between workers, providing sanitizers and washing stations in the fields, and utilizing effective technologies would enhance project productivity while keeping workers safe. The findings of this study will help the project managers and authorities in the construction industry understand the challenges of the pandemic and adopt effective strategies that will improve the health and safety of their workforce.

Community service sector resilience and responsiveness during the COVID-19 pandemic: The Australian experience

The COVID-19 pandemic is a public health, economic and social crisis that is likely to have lasting consequences, including increased rates of financial hardship, housing insecurity, mental health problems, substance abuse and domestic violence. Workers in the community service sector have continued to support some of the most vulnerable and disadvantaged Australians during the pandemic, while also delivering services to new groups experiencing the economic impacts of virus suppression strategies. We surveyed community service sector workers from across Australia in three snapshots during April-May 2020 and found that perceptions of acute needs and organisational pressure points shifted even through this short period. While the sector faced significant challenges, it responded to the initial phase of the pandemic with flexibility, a strongly client-centred approach and a re-emphasis on collaboration between services. The community service sector's demonstrated capacity for agility and rapid adaptation suggests it is well placed to provide critical supports to those affected by crisis situations and everyday disadvantage. However, the sector's capacity to perform this role effectively depends on strong, stable government supports for all Australians in need.

Alcohol and other substance use during the COVID-19 pandemic: A systematic review

BACKGROUND

Although evidence suggests substance and alcohol use may change during the Covid-19 pandemic there has been no full review of the evidence around this.

METHODS

A systematic review of all available evidence was carried out to document and interpret the frequency and severity of alcohol and other substance use during the Covid-19 pandemic and their relationship to demographic and mental health variables that may suggest further clinical implications. Peer reviewed articles in MEDLINE, Embase, PsycINFO, CINAHL complete and Sociological Abstracts were searched from December 2019 until November 2020.

RESULTS

The search and screening identified 45 articles from 513 deduplicated records. The evidence suggests a mixed picture for alcohol use. Overall, there was a trend towards increased alcohol consumption. The proportion of people consuming alcohol during the pandemic ranged from 21.7% to 72.9% in general population samples. Unlike alcohol use, there was a clear trend towards increased use of other substances use during the COVID-19 pandemic. The proportion of people consuming other substances during the pandemic ranged from 3.6% to 17.5% in the general population. Mental health factors were the most common correlates or triggers for increased use of both alcohol and other substances.

CONCLUSION

There is an increased need for treatment for alcohol and other substance use related problems during the pandemic. Increased targeting and evidence-based interventions will also be important in the period which follows this pandemic, to improve the quality of life for individuals and families, but also to prevent additional costs to society and health systems.

Do patients with pathological health anxiety fear COVID-19? A time-course analysis of 12 single cases during the "first wave" of the COVID-19 pandemic in Germany

OBJECTIVE

Pre-existing health anxiety is associated with an intensified affective response to the novel COVID-19 pandemic in the general population. Still, results on the reaction of people with a diagnosis of pathological health anxiety (i.e., hypochondriasis) are scarce.

METHODS

In the present study, we investigated the course of (health) anxiety related to SARS-CoV-2/COVID-19 in comparison to (health) anxiety related to other severe diseases (e.g., cancer) in a sample of 12 patients with the diagnosis of pathological health anxiety during the "first wave" of the COVID-19 pandemic in Germany. Both SARS-CoV-2 related anxiety and anxiety related to other severe diseases were assessed weekly over 16 measurement points (30.03.-19.07.2020) and primarily analyzed with fixed effects regression analyses.

RESULTS

Unexpectedly, SARS-CoV-2 related anxiety was on average significantly lower than anxiety related to other severe diseases (d = -0.54, p < .001) and not significantly associated with anxiety related to other severe diseases or pre-COVID-19 health anxiety.

CONCLUSION

It therefore appears premature to assume that SARS-CoV-2 related anxiety and other health worries are necessarily strongly interrelated and comparably high in people with pathological health anxiety.

The uptake and outcomes of Internet-based cognitive behavioural therapy for health anxiety symptoms during the COVID-19 pandemic

BACKGROUND

Internet cognitive behavioural therapy (iCBT) for health anxiety has demonstrated efficacy but has not been evaluated during the COVID-19 pandemic. This study presents the first evaluation of the uptake and outcomes of iCBT for health anxiety during the COVID-19 pandemic.

METHODS

THIS WAY UP is an Australian digital mental health service which delivers iCBT interventions to community members. We compared the uptake of THIS WAY UP's iCBT course for health anxiety in an Australian adult sample who started the course before the pandemic (12th September 2019-11 th March 2020) to during the pandemic (12th March to 11th June 2020). The course was accessible to Australian adults over 18 years old, with no inclusion criteria. Outcomes included course registrations and commencements, lesson and course completion, and self-reported health anxiety (Short Health Anxiety Inventory), depression (Patient Health Questionnaire 9-item) and distress (Kessler-10).

RESULTS

From March to June 2020, we observed significant increases in course registrations (N = 238 vs N = 1057); and course commencements (N = 126 vs. N = 778). Large, significant improvements in health anxiety (g = 0.89), and distress (K10: g = 0.91), and medium improvements in depression (g = 0.55) were found. Course completion during COVID was 30.5%.

CONCLUSIONS

iCBT improved health anxiety during the COVID-19 pandemic, and provides scalable intervention that can address increased demands for mental health services in the community.

The Interaction between Lockdown-Specific Conditions and Family-Specific Variables Explains the Presence of Child Insomnia during COVID-19: A Key Response to the Current Debate

It is still debated whether lockdown conditions in response to the coronavirus disease 2019 (COVID-19) health crisis seriously affected children’s sleep. For young children, some studies identified more insomnia, while others only transient disturbances, or even no effect. Based on the premise of mother–child synchrony, a well-known dynamic established in child development research, we hypothesized that principally, the children whose mothers perceived the lockdown as stressful and/or responded maladaptively, suffered sleep disturbances. The main objective of this study was to identify the family profiles, variables, and lockdown responses most linked to insomnia in young children. The sample consisted of 165 mothers, French vs. Swiss origin (accounting for different lockdown severities), of children 6 months to 5 years old. Validated sleep, stress, and behavior scales were used. Multiple regression, age-matched clustering, and structural equation modeling analyses provided evidence that insomnia in young children is indeed strongly linked to the mother’s reaction to the pandemic and lockdown. Specifically, reactions such as COVID-19 fear/anxiety and obsessive COVID-19 information seeking coincide with heightened vigilance, cascading into reduced child social contact, outings, and increased screen viewing, ultimately culminating in child insomnia and behavioral problems. Mother education level and child day care quality (e.g., home-schooling) were also identified as strong insomnia predictors.

Symptoms of anxiety, depression and fear in healthcare workers and non-healthcare workers undergoing outpatient COVID-19 testing in an urban Australian setting

This study assessed symptoms of anxiety, depression and fear of COVID-19 in members of the general community and healthcare workers (HCWs) attending for COVID testing. This cross-sectional study was conducted in a public hospital COVID-19 testing clinic (June-September 2020) using self-administered questionnaires (i.e. the Hospital Anxiety and Depression Scale (HADS) and the Fear of COVID-19 Scale). In all, 430 participants who met the criteria for COVID-19 testing with nasopharyngeal and throat swabs completed the questionnaires. The mean (±s.d.) age of participants was 37.6 ± 12.6 years. HCWs made up 35.1% of the sample. Overall, the mean (±s.d.) score for anxiety was 6.09 ± 4.41 and 'case' prevalence (any severity) was 151/430 (35.1%), higher than normative population scores. Higher anxiety was found in women (P = 0.001) and in clients who had previously been tested for coronavirus (P = 0.03). HCWs had lower anxiety scores than members of the general community (P = 0.001). For depression, the mean (±s.d.) score was 4.18 ± 3.60, with a 'case' prevalence (any severity) of 82/430 (19.1%), similar to normative population scores. Women reported a higher level of COVID-19 fear (P = 0.001), as did people with a lower education level (P = 0.001). A greater psychological impact of COVID-19 was observed in women, people undergoing repeat testing and participants reporting lower levels of educational attainment. HCWs had fewer symptoms of anxiety and depression than non-HCWs attending the same clinic for COVID-19 testing. This information can be used to plan mental health interventions in primary care and testing settings during this and future pandemics.

Who Is Suffering from the "Corona Blues"? An Analysis of the Impacts of the COVID-19 Pandemic on Depression and Its Implications for Health Policy

COVID-19 is tremendously affecting not only social structures but also people's psychological states. In particular, COVID-19 is negatively affecting psychological health, in particular, the depression. When individuals are experiencing the depression, there is increase in the suicide rate and occurrence of serious social problems. This study therefore examines factors affecting depression by using hypothesis testing. Previous studies have limitations in that they focus only on demographic variables or other specific variables. In contrast, this study focuses on the influences of four non-pandemic and seven pandemic-related variables on people's depression. We analyze data from a social survey (N = 1525) in Korea which adopted the stratified quota sampling method. Results show that, first, among the demographic variables, young people experience depression to a greater extent than older people do. Second, among the non-pandemic variables, individuals with more social support, good health, optimism, and self-efficacy exhibit lower levels of depression. Third, among the factors related to COVID-19, fear of infection, financial instability, personal lifestyle changes, and poor health status increase depression.

The influence of sex, gender, age, and ethnicity on psychosocial factors and substance use throughout phases of the COVID-19 pandemic

OBJECTIVES

The SARS-CoV-2 (COVID-19) pandemic has had profound physical and mental health effects on populations around the world. Limited empirical research has used a gender-based lens to evaluate the mental health impacts of the pandemic, overlooking the impact of public health measures on marginalized groups, such as women, and the gender diverse community. This study used a gender-based analysis to determine the prevalence of psychosocial symptoms and substance use (alcohol and cannabis use in particular) by age, ethnicity, income, rurality, education level, Indigenous status, and sexual orientation.

METHODS

Participants in the study were recruited from previously established cohorts as a part of the COVID-19 Rapid Evidence Study of a Provincial Population-Based Cohort for Gender and Sex (RESPPONSE) study. Those who agreed to participate were asked to self-report symptoms of depression, anxiety, pandemic stress, loneliness, alcohol use, and cannabis use across five phases of the pandemic as well as retrospectively before the pandemic.

RESULTS

For all psychosocial outcomes, there was a significant effect of time with all five phases of the pandemic being associated with more symptoms of depression, anxiety, stress, and loneliness relative to pre-COVID levels (p < .0001). Gender was significantly associated with all outcomes (p < .0001) with men exhibiting lower scores (i.e., fewer symptoms) than women and gender diverse participants, and women exhibiting lower scores than the gender diverse group. Other significant predictors were age (younger populations experiencing more symptoms, p < .0001), ethnicity (Chinese/Taiwanese individuals experiencing fewer symptoms, p = .005), and Indigenous status (Indigenous individuals experiencing more symptoms, p < .0001). Alcohol use and cannabis use increased relative to pre-pandemic levels, and women reported a greater increase in cannabis use than men (p < .0001).

CONCLUSIONS

Our findings highlight the need for policy makers and leaders to prioritize women, gender-diverse individuals, and young people when tailoring public health measures for future pandemics.

Evaluation of Sleep Habits, Generalized Anxiety, Perceived Stress, and Research Outputs Among Postgraduate Research Students in Hong Kong During the Coronavirus (COVID-19) Pandemic

Purpose

The current study aimed to evaluate the impact of coronavirus (COVID-19) pandemic on sleep hygiene, anxiety levels, perceived stress, and research output among postgraduate research students in Hong Kong.

Methods

An online survey was developed and distributed to Hong Kong postgraduate research students. The sleep hygiene, anxiety levels, and perceived stress during the outbreak of COVID-19 were assessed. Questions about COVID-19’s impact on research outputs were asked.

Results

A total of 108 (response rate, 72%) full-time postgraduate students (PhD, 64%; M Phil, 8%; and Masters, 28%) participated. Approximately 83% of students reported poor sleep hygiene. Similarly, nearly 76% of students reported mild to severe levels of self-perceived anxiety levels. Most of the respondents (89%) expressed a moderate level of perceived stress. Sleep hygiene scores were moderately associated with anxiety levels (r = 0.384, p < 0.01) and perceived stress scores (r = 0.423, p < 0.01). Perceived stress was strongly correlated with anxiety levels (r = 0.601, p < 0.01). A hierarchical regression analysis revealed a significant association between respondents’ ethnicity (B = −0.923, p = 0.003), past medical history (such as hypertension, diabetes, and musculoskeletal disorders) (B = 1.112, p = 0.005), or poor sleep hygiene (B = 0.259, p = 0.000) and high levels of perceived stress. Additionally, prior medical history (such as hypertension, diabetes, and musculoskeletal disorders) (B = 1.957, p = 0.001) and poor sleep hygiene (B = 0.312, p = 0.000) were found to be strongly related to anxiety levels among postgraduate research students.

Conclusion

This is the first study that highlights poor sleep hygiene, moderate-to-severe levels of anxiety, and perceived stress during the COVID-19 pandemic in postgraduate research students in Hong Kong. These findings will help educators to prepare strategies to alleviate the stress and psychological problems in postgraduate students.