Prevalence and Predictors of Anxiety and Depression Symptoms during the COVID-19 Pandemic and Compliance with Precautionary Measures: Age and Sex Matter

Influence of the Demographic, Social, and Environmental Factors on the COVID-19 Pandemic-Analysis of the Local Variations Using Geographically Weighted Regression

As the COVID-19 pandemic continues, an increasing number of different research studies focusing on various aspects of the pandemic are emerging. Most of the studies focus on the medical aspects of the pandemic, as well as on the impact of COVID-19 on various areas of life; less emphasis is put on analyzing the influence of socio-environmental factors on the spread of the pandemic. In this paper, using the geographically weighted regression method, the extent to which demographic, social, and environmental factors explain the number of cases of SARS-CoV-2 is explored. The research was performed for the case-study area of Poland, considering the administrative division of the country into counties. The results showed that the demographic factors best explained the number of cases of SARS-CoV-2; the social factors explained it to a medium degree; and the environmental factors explained it to the lowest degree. Urban population and the associated higher amount and intensity of human contact are the most influential factors in the development of the COVID-19 pandemic. The analysis of the factors related to the areas burdened by social problems resulting primarily from the economic exclusion revealed that poverty-burdened areas are highly vulnerable to the development of the COVID-19 pandemic. Using maps of the local R2 it was possible to visualize how the relationships between the explanatory variables (for this research-demographic, social, and environmental factors) and the dependent variable (number of cases of SARS-CoV-2) vary across the study area. Through the GWR method, counties were identified as particularly vulnerable to the pandemic because of the problem of economic exclusion. Considering that the COVID-19 pandemic is still ongoing, the results obtained may be useful for local authorities in developing strategies to counter the pandemic.

The relationship between health worry, work distress, and affective symptoms during the COVID-19 pandemic: The mediating role of hopelessness and helplessness

OBJECTIVES

The COVID-19 pandemic presented both serious health threats and economic hardships, which were reflected in increased rates of mood and anxiety symptoms. We examined two separate distress domains, health worries and work distress, as predictors of mood and anxiety symptoms. Additionally, we considered whether these two domains might be uniquely associated with the development of dysfunctional beliefs, as a proposed mechanism to account for increased symptoms during the pandemic. Two separate models were considered to examine if associations remained stable through the first year of the pandemic.

METHODS

Participants (N = 2152) were a representative sample of Florida adults. They completed online surveys at three waves: Wave 1 (April-May 2020), Wave 2 (May-June 2020), and Wave 3 (December-February 2021). Participants completed measures of COVID-19 health worry and work distress, anxiety, and depression. They also reported their level of hopelessness and helplessness (indices of dysfunctional beliefs).

RESULTS

In an early pandemic model (Wave 1-Wave 2), health worry directly and indirectly predicted anxiety and depression via dysfunctional beliefs. In contrast, work distress only indirectly predicted both outcomes. In a longer-term model (Wave 2-Wave 3), health worry had direct and indirect effects on downstream anxiety but not depression. Pandemic work distress had no effect on depression or dysfunctional beliefs; however, it was associated with less anxiety.

CONCLUSIONS

Although health worry and work distress predicted later symptoms of anxiety and depression, they appeared to operate through different pathways. These findings provide guidance for the development of more effective interventions to reduce the impact of pandemics.

Behavioral compliance with preventive health measures for students with and without hearing disability during COVID-19 pandemic: A cross-sectional study

Background

Hearing loss affects over 1.5 billion individuals worldwide. Their disability and limited access to the coronavirus (COVID-19) pandemic information make them suffer a greater degree than ordinary people. However, the quantitative studies on the implementation of behavior compliance with preventive health measures for vulnerable groups such as people with hearing disability were limited. The purpose of this study was to explore the compliance with pandemic-related protective health measures among people with hearing disability.

Design

A cross-sectional survey, population-based cohort study of students aged 12-26 years with and without hearing disability was conducted. Behavioral compliance with preventive health measures was collected from the general education institutions and special education schools using an online questionnaire. Logistic regression and structural equation model were used to determine the associations among the demographic variables, different degrees of mental health status and psychological impacts, and preventive health behaviors.

Results

Among 1,589 participants, 485 (30.5%) students are with hearing disability (SHD), and 1,104 (69.5%) students with normal hearing (SNH). The SHD has a significantly lower degree of behavioral compliance with the preventive health measures than SNH has. Hearing disability and anxiety [odds ratio (OR) = 1.54-1.76, p < 0.05] are risk factors for avoiding sharing of utensils during mealtime. Hearing disability, male sex, father's education level, mother's profession, bedtime after 11:00 p.m., anxiety, and depression (OR = 1.45-2.95, p < 0.05) are risk factors for hand hygiene. Male sex (OR = 2.13, p < 0.001) is risk factor and being aged below 18 years old (OR = 0.62, p = 0.03) is protective factor for wearing masks. Exercise (OR = 0.32-0.70, p < 0.01) is the most protective factor for preventive health behaviors. Mediating effect of mental health status and psychological impacts between hearing level and the compliance with the preventive health measures was -0.044 (95% CI: -0.068 to -0.027).

Conclusions

To reduce the risk of contraction, update pandemic information, essential communication services, extra assistance, and support should be provided to these disabled persons who are more susceptible to a public health emergency.

Older adults' prevention and communication to beat anxiety: the diminishing utility of proactive coping actions

This study aims to investigate older adults' psychological reactions when facing changes in daily life caused by the COVID-19 pandemic and anti-epidemic measures. Specifically, this study investigated the impacts of communication types (i.e., electronic and face-to-face communication) and frequency during the pandemic and the kinds of proactive coping actions taken by older adults on their anxiety. A total of 43,019 respondents were included in this study by merging two longitudinal databases. One is the seventh wave of the Survey of Health, Ageing and Retirement in Europe (SHARE) conducted in 2017, and the other is the COVID-19 Survey of SHARE, which was conducted between June and August 2020. This study found that one third of older adults reported anxiety symptoms during the COVID-19 pandemic and one fifth reported increased anxiety than before the pandemic. Anxiety symptoms seem somewhat prevalent among older adults during the COVID-19 pandemic. During the pandemic, the more kinds of proactive coping actions taken by older adults, the more likely they felt anxious. As the pandemic continues and develops, taking proactive coping actions might no longer alleviate anxiety in older adults, showing a diminishing utility. In addition, face to face communication was found to decrease the likelihood of anxiety symptoms in older adults, whereas the opposite impact of electronic communication was found. For older adults, contacting others by electronic means may increase their anxiety feeling during the COVID-19 pandemic.

Mental health of the Slovak population during COVID-19 pandemic: A cross-sectional survey

BACKGROUND

Population’s mental health surveillance is essential for knowing the distribution of mental well-being and mental disorders in the society. This allows for the establishment, evaluation, and revision of preventive measures and curative services. The results of such monitoring should serve as a database for evidence-based mental health policy. Mental disorders are among the top ten causes of burden globally and crisis situations such as the pandemic increase the risk of mental health problems, as they cause constant fear of contagion and the implementation of restrictive measures. The impact of the coronavirus disease 2019 (COVID-19) pandemic on the general population of the Slovak Republic has not yet been studied. The hypothesis was that more than one fifth of the population (women to a greater extent) will have symptoms of anxiety and depression.

AIM

To assess the mental health of the general Slovak population aged 15 years and older in the summer of 2021 by determining the prevalence of depressive and anxiety symptoms.

METHODS

An anonymous cross-sectional survey was implemented in a sample of 1501 respondents in the summer of 2021 during the COVID-19 pandemic. The inclusion criteria were age of 15 years and older and ability to complete the survey questionnaire online or in a face-to-face interview. The survey assessed anxiety symptoms by the seven-item general anxiety disorder and depressive symptoms by the nine-item patient health questionnaire instruments. Recognized cut-off scores of 10 or greater were used for both.

RESULTS

Anxiety symptoms were present in 19.32% and depression in 24.65% of the sample. Symptoms of both disorders were more common in females: 15.00% of males and 24.00% of females experienced anxiety symptoms, and 19.00% of males and 30.00% of females experienced symptoms of depression. Symptoms of both disorders were the most common in the youngest age group (15-25 years old): One fifth of males (20.29%) and one third of females (35.32%) had symptoms of anxiety, and 26.09% males and 43.79% females had symptoms of depression. Mean score for anxiety was 5.44 [standard deviations (SD) = 4.96] for the overall sample, 6.15 (SD = 5.14) for females, and 4.67 (SD = 4.63) for males. The youngest females of the 15-25 years age group had the highest score (7.55, SD = 5.27) among all age groups, for both sexes. Mean score for depression was 6.74 for the overall sample (SD = 5.75), 7.43 for females (SD = 5.87), and 5.99 (SD = 5.52) for males. The highest depression score was observed in the youngest females of the 15-25 years age group (9.34, SD = 6.07). We found a significant association between anxiety or depressive symptoms and younger age [odds ratio (OR): 1.69, 95% confidence interval (CI): 1.16-2.45 and OR: 1.65, 95%CI: 1.17-2.34, respectively], being female (OR: 1.86, 95%CI: 1.42-2.42 and OR: 1.76, 95%CI: 0.20-0.29, respectively), and having primary education (OR: 1.66, 95%CI: 1.08-2.54 and OR: 1.65, 95%CI: 1.16-2.63, respectively).

CONCLUSION

Results of our study indicate that anxiety and depression are frequent in the Slovak Republic during the COVID-19 pandemic. This important observation should serve as an information basis for the development of effective mental health policies, consisting of preventive programs, and early detection and effective treatment services. The study results provide strong argument for the necessity of mental health reform that is currently being shaped in the Slovak Republic.

The effect of the COVID-19 pandemic on the health-related quality of life in home-based patients with spinal cord injuries in Japan

CONTEXT

The COVID-19 pandemic has forced people to maintain social distance and to refrain from going out. As a result, home-based patients with spinal cord injuries (SCI) are not only less able to go out, but they may have difficulty in easily receiving long-term care services. There are concerns that their health-related quality of life (HRQOL) may have deteriorated. We aimed to clarify the effect of the COVID-19 pandemic on HRQOL in home-based patients with SCI.In June 2020, when the COVID-19 pandemic was finally settling down in Japan, we conducted a mail survey of 266 patients with SCI regarding changes in the frequency of going out, the long-term care services, and their HRQOL due to the COVID-19 pandemic. They had all been discharged from our hospital (Rehabilitation medical center) by 2019, and were expected to be living at home. We received answers from 135 patients about their HRQOL.

FINDINGS

Respondent characteristics indicated that many of them were elderly (74.1% were over 60 years of age) and many had cervical SCI (70.5%). Worsened HRQOL since the impact of the COVID-19 pandemic was reported by 40% of respondents. The most commonly reported dimension was pain/discomfort. Significantly, many had been injured comparatively recently and had reduced frequency of going out and receiving home-visit nursing or rehabilitation services than patients whose HRQOL was unchanged.

CONCLUSION/ CLINICAL RELEVANCE

This study clarifies the negative effect of the COVID-19 pandemic on HRQOL in home-based patients with SCI. Many respondents had worsened HRQOL, in particular pain/discomfort. It was suggested that the decrease in the frequency of going out may be one of the factors that affected the deterioration of their HRQOL.

Anxiety, Distress and Stress among Patients with Diabetes during COVID-19 Pandemic: A Systematic Review and Meta-Analysis

The prevalence of mental health disorders has increased during the COVID-19 pandemic. Patients with chronic diseases, such as diabetes, are a particularly vulnerable risk group. This study aims to assess the levels and prevalence of anxiety, distress, and stress in patients with diabetes during the COVID-19 pandemic. A systematic review was conducted in CINAHL, Cochrane, LILACS, Medline, SciELO, and Scopus in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Thirty-seven articles with a total of 13,932 diabetic patients were included. Five meta-analyses were performed. The prevalence of anxiety was 23% (95% CI = 19–28) in T1DM and 20% (95% CI = 6–40) in T2DM patients. For diabetes distress it was 41% (95% CI = 24–60) for T1DM and 36% in T2DM patients (95% CI = 2–84). For stress, the prevalence was 79% (95% CI = 49–98) in T1DM patients. People with diabetes have significant psychiatric comorbidity as well as psychological factors that negatively affect disease management, increasing their vulnerability in an emergency situation. To establish comprehensive care in diabetic patients addressing mental health is essential, as well as including specific policy interventions to reduce the potential psychological harm of the COVID-19 pandemic.

COVID-19 Vaccination and Mental Health Outcomes among Greek Adults in 2021: Preliminary Evidence

Existing research on the association between COVID-19 vaccination and quantitatively measured mental health outcomes is scarce. We conducted a cross-sectional telephone survey on a random sample of 1039 adult Greek citizens in June 2021. Among the participants, 39.6% were vaccinated with two doses, 23.1% with one dose, 21.4% were planning to become vaccinated later, and 8.1% refused vaccination. Compared to those fully vaccinated, those against vaccination ("deniers") and those who planned to do so later on ("not vaccinated yet") had significantly higher scores across three stress, anxiety, and depression construct scales. Our findings suggest an association between COVID-19 vaccination status and mental health.

I hate you when I am anxious: Anxiety during the COVID-19 epidemic and ideological hostility

Most previous studies that examined the effect of anxiety on hostility towards a distinct group have focused on cases in which we hate those we are afraid of. The current study, on the other hand, examines the relationship between anxiety in one domain and hostility towards a distinct group that is not the source of that anxiety. We focus here on symptoms of anxiety during the COVID-19 pandemic, which have become increasingly frequent, and show that the implications of such mental difficulties are far-reaching, posing a threat to relationships between ideological groups. In two studies conducted in both Israel and the United States, we found that high levels of anxiety during the COVID-19 epidemic are associated with higher levels of hatred towards ordinary people from the respective political outgroups, lower levels of willingness to sustain interpersonal relations with these people (i.e., greater social distancing), and greater willingness to socially exclude them. This relationship was mediated by the perception of threat posed by the political outgroup. This study is the first to show that mental difficulty driven by an external threat can be a fundamental factor that explains levels of intergroup hostility.

A Path Model for Subjective Well-Being during the Second Wave of the COVID-19 Pandemic: A Comparative Study among Polish and Ukrainian University Students

Background: Previous studies showed several associations between physical and mental health dimensions and well-being. This study aims to examine a complex path model explaining the life satisfaction of university students from Poland and Ukraine during the second wave of the COVID-19 pandemic. Methods: The cross-sectional web-based study was performed in November 2020 using Google Forms. The conventional sample of 3230 university students from Poland (n = 1581) and Ukraine (n = 1649), aged 18–59 (M = 21.40, SD = 3.46), with 59% women, participated in the study. We used standardized questionnaires to measure life satisfaction (SWLS), self-reported physical health (GSRH), perceived stress (PSS-10), coronavirus-related PTSD (PCL-S), anxiety (GAD-7), and depression (PHQ-9). We also developed some questions to assess the exposure to the COVID-19 pandemic, positive effects of the pandemic, religiosity, and physical activity (PA). Results: We found a high prevalence of stress, coronavirus-related PTSD, anxiety, and depression and a low level of life satisfaction and physical health. Polish students, women, and those with insufficient PA levels reported worse physical and mental health than Ukrainians, men, and those who exercised sufficiently during the pandemic. Low perceived stress can directly predict life satisfaction, anxiety, and depression. Low stress also leads to better physical health, sufficient PA levels, high religiosity, and more perceived positive effects of the pandemic. Several indirect effects between particular variables and life satisfaction were also found in the path model. Conclusions: The target group for campus prevention programs is Polish university students, women, and people with insufficient PA levels. Intervention and prevention programs should focus on coping strategies and techniques for improving mental and physical health.

Psychopathic traits predict lower adherence to COVID-19 containment measures

Countries worldwide have implemented measures to contain the spread of COVID-19, and it is vital to understand which factors influence compliance to these measures. This study investigated whether psychopathic traits predict adherence to containment measures imposed by the UK government. 156 university students (Mage=21 years) completed an online survey measuring psychopathic traits (the Triarchic Psychopathy Measure), demographic variables, and participants' living situations, underlying health risks, contact with vulnerable people and fear of COVID-19. Hierarchical multiple regression indicated that higher psychopathic traits (particularly disinhibition) predicted lower adherence to containment measures when controlling for other variables. A mixed-model ANOVA analysing longitudinal data, collected during the second (n=156) and third (n=118) lockdowns, showed that this relationship was stable over time. Additionally, fear of COVID-19 predicted adherence and mediated the relationship between psychopathic traits and adherence. These findings highlight the relevance of psychopathic traits for understanding COVID-19-related behaviours, with implications for public health communication.

Closed doors: Predictors of stress, anxiety, depression, and PTSD during the onset of COVID-19 pandemic in Brazil

BACKGROUND

The rise in mental health problems in the population directly or indirectly because of the coronavirus disease 2019 (COVID-19) pandemic is a major concern. The aim of this study was to investigate and compare independent predictors of symptoms of stress, anxiety, depression, and posttraumatic stress disorder (PTSD) in Brazilians one month after the implementation of measures of social distancing.

METHODS

This cross-sectional study was performed using a web-based survey. The Depression, Anxiety, and Stress Scale (DASS-21) and PTSD Checklist for DSM-5 (PCL-5) were the outcomes. Data were gathered regarding demographics, social distancing, economic problems, exposure to the news of the pandemic, psychiatric history, sleep disturbances, traumatic situations, and substance use. The Alcohol Use Disorders Identification Test - Consumption (AUDIT-C) was also administered. The predictors of the symptoms were investigated using hierarchical multiple linear regression.

RESULTS

Of a sample of 3587 participants, approximately two-thirds considered that their mental health worsened after the beginning of the social restriction measures. The most important predictors of the symptoms investigated were the intensity of the distress related to the news of the pandemic, younger age, current psychiatric diagnosis, trouble sleeping, emotional abuse or violence, and economic problems.

CONCLUSIONS

These results confirmed the hypothesis that the pandemic impacted the mental health of the population and indicated that the level of distress related to the news was the most important predictor of psychological suffering.

First-onset major depression during the COVID-19 pandemic: A predictive machine learning model

BACKGROUND

This study longitudinally evaluated first-onset major depression rates during the pandemic in Italian adults without any current clinician-diagnosed psychiatric disorder and created a predictive machine learning model (MLM) to evaluate subsequent independent samples.

METHODS

An online, self-reported survey was released during two pandemic periods (May to June and September to October 2020). Provisional diagnoses of major depressive disorder (PMDD) were determined using a diagnostic algorithm based on the DSM criteria of the Patient Health Questionnaire-9 to maximize specificity. Gradient-boosted decision trees and the SHapley Additive exPlanations technique created the MLM and estimated each variable's predictive contribution.

RESULTS

There were 3532 participants in the study. The final sample included 633 participants in the first wave (FW) survey and 290 in the second (SW). First-onset PMDD was found in 7.4% of FW participants and 7.2% of the SW. The final MLM, trained on the FW, displayed a sensitivity of 76.5% and a specificity of 77.8% when tested on the SW. The main factors identified in the MLM were low resilience, being an undergraduate student, being stressed by pandemic-related conditions, and low satisfaction with usual sleep before the pandemic and support from relatives. Current smoking and taking medication for medical conditions also contributed, albeit to a lesser extent.

LIMITATIONS

Small sample size; self-report assessment; data covering 2020 only.

CONCLUSIONS

Rates of first-onset PMDD among Italians during the first phases of the pandemic were considerable. Our MLM displayed a good predictive performance, suggesting potential goals for depression-preventive interventions during public health crises.

A prospective study revealing a compounded burden of COVID-19, sex, and clinical diagnosis of alcohol use disorder and HIV infection on quality of life, anxiety, and alcohol use

The COVID-19 pandemic led to unprecedented restrictions to mitigate disease spread, leading to consequences affecting mental health. Many studies examining COVID-19 pandemic effects on well-being and mental health initiated inquiry after the pandemic onset, whereas we used self-report questionnaires obtained before the pandemic to re-assess the same functions during the pandemic. Participants were drawn from our ongoing longitudinal studies of people with HIV infection, alcohol use disorder (AUD), HIV + AUD comorbidity, and controls. We used phone or mail contact to invite all to participate in our COVID phone survey, which included three self-report questionnaires: Health-related Quality of Life (QoL), State-Trait Anxiety Inventory (STAI), and Alcohol Use Disorder Identification Test (AUDIT). Of 218 eligible participants, 86 responded (July 2020-March 2021): clinical (29 men, 23 women; 17 AUD, 21 HIV, 14 HIV + AUD); control (17 men, 17 women). QoL scores declined, and anxiety symptoms increased from pre-COVID surveys in all groups; clinical women reported greater negative changes than the other groups. QoL subscales revealed COVID-related declines in emotional well-being in all groups, with clinical women reporting additional declines in energy, physical and social functioning, health, and pain increase. Clinical men also reported health declines. Although AUDIT scores were stable in all groups between assessments, changes in AUDIT scores were inversely correlated with QoL scores in clinical women; in clinical men, changes in STAI scores were inversely correlated with QoL scores. Although all groups were adversely affected by the pandemic, the negative effects were greater in the clinical group regardless of diagnosis and greatest in clinical women.

Motivations and Limits for COVID-19 Policy Compliance in Germany and Switzerland

BACKGROUND

In contrast to neighboring countries, German and Swiss authorities refrained from general curfews during the first pandemic wave in spring 2020, calling for solidarity and personal responsibility instead. Using a qualitative methodology, this study aims to explore why people in Germany and Switzerland were motivated to comply with policy measures during the first wave of the coronavirus disease 2019 (COVID-19) pandemic, and what factors hindered or limited their motivation. While quantitative surveys can measure the level of compliance, or broadly ask what motives people had for compliance, we here strive to explain why and how these motives lead to compliance.

METHODS

This publication has been made possible by the joint work of the members of the "Solidarity in times of pandemics" (SolPan) research commons. Seventy-seven semi-structured qualitative interviews were conducted with members of the general public in Germany (n = 46) and the German-speaking part of Switzerland (n = 31) in April 2020. Interviews were transcribed and analyzed following a grounded theory approach.

RESULTS

Three themes were identified that summarize factors contributing to compliant or noncompliant behavior. (1) Social cohesion was, on the one hand, an important motivator for compliance, but at the same time related to conflicting needs, illustrating the limits of compliance. (2) Consequences were considered on both the individual level (eg, consequences of individual infection) and societal level (eg, the societal and economic consequences of restrictions). (3) While for some participants following the rules was perceived as a matter of principle, others stressed the importance of making their own risk assessment, which was often associated with with a need for evidence on the effectiveness and reasons behind measures.

CONCLUSION

A variety of motives contribute to COVID-19 related compliance. Authorities should seek to address these multi-faceted aspects to support motivation for compliance in a large proportion of the population.

Health-Related Behaviors and Perceived Addictions: Predictors of Depression During the COVID Lockdown

ABSTRACT

The COVID-19 pandemic led to a worldwide implementation of measures to contain the virus from spreading, and social isolation was one of those measures. Social isolation is associated with increased susceptibility to various neuropsychiatric disorders, including depression. Because this risk varies between populations and their respective habits, understanding which behaviors play a positive or harmful role is fundamental for people with depression under these conditions. This study aims to 1) compare health-related behaviors (HRBs) and perceived addictions between healthy individuals and individuals who reported having a depressive disorder at the time of the first outbreak of the COVID-19 pandemic in Portugal, and 2) test which HRB and perceived addictions are associated with depression. Participants were a matched for age and sex and comprised 968 adults divided into two groups: healthy (484, 50%) and depressed (484, 50%). They completed online self-report questionnaires, and the data were analyzed in SPSS. Logistic regressions showed that being a health professional, getting up in a later time during weekends, and a higher consumption of soft drinks increased the risk for depression. In contrast, higher education and higher intensity of physical activity decreased this risk. Perceived addictions to TV, social networking, and gaming increased the risk for depression. HRBs and the identified addictions associated with depression during the confinement should be targeted in clinical and community interventions.

Gender difference in working from home and psychological distress - A national survey of U.S. employees during the COVID-19 pandemic

The COVID-19 pandemic has precipitated broad and extensive changes in the way people live and work. While the general subject of working from home has recently drawn increased attention, few studies have assessed gender differences in vulnerability to the potential mental health effects of working from home. Using data from 1,585 workers who participated in the Health, Ethnicity, and Pandemic (HEAP) study, a national survey conducted in the U.S. during the COVID-19 pandemic in October 2020, associations of working from home with psychological distress were examined with weighted logistic regression among 1,585 workers and stratified by gender. It was found that workers who worked from home had higher odds of psychological distress (aOR and 95% CI = 2.62 [1.46, 4.70]) compared to workers who did not work from home, adjusting for demographic factors, socioeconomic status, and health behaviors. In gender-stratified analyses, this positive association between working from home and psychological distress was significant in women (aOR and 95% CI = 3.68 [1.68, 8.09]) but not in men. These results have implications for female workers' mental health in the transition towards working from home in the COVID-19 pandemic era.

Health inequities as measured by the EQ-5D-5L during COVID-19: Results from New York in healthy and diseased persons

INTRODUCTION

The effects of the COVID-19 pandemic caused considerable psychological and physical effects in healthy and diseased New Yorkers aside from the effects in those who were infected. We investigated the relationship between known risk-enhancing and health-promoting factors (social and medical), comorbidity indicators, and, as the primary outcome, health-related quality of life (HRQoL).

METHODS

Between April 22 and May 5, 2020, a market research agency (Dynata) administered a digital survey including the EQ-5D-5L and items related to individual characteristics, social position, occupational and insurance status, living situation, exposures (smoking and COVID-19), detailed chronic conditions, and experienced access to care to an existing internet panel representative of New Yorkers.

RESULTS

2684 persons completed the questionnaire. The median age was 48 years old, and most respondents were non-Hispanic white (74%) and reported at least higher vocational training or a university education (83%). During COVID-19, mean HRQoL scores were 0.82 for the EQ-5D-5L index and 79.3 for the EQ VAS. Scores varied for healthy and diseased respondents differently by the above determinants. Lower age, impaired occupational status, loss of health insurance, and limited access to care exerted more influence on EQ-5D-5L scores of diseased persons compared to healthy persons. Among diseased persons, the number of chronic conditions and limited access to health care had the strongest association with EQ-5D-5L scores. While EQ-5D-5L scores improved with increasing age, gender had no noticeable effect. Deprivation factors showed moderate effects, which largely disappeared in (stratified) multivariable analysis, suggesting mediation through excess chronic morbidity and poor healthcare access. Generally, modifying effects were larger in the EQ-5D-5L as compared to the EQ VAS.

CONCLUSIONS

Almost all factors relating to a disadvantaged position showed a negative association with HRQoL. In diseased respondents, pre-existing chronic comorbidity and experienced access to health care are key factors.

Families in quarantine for COVID-19 in Italy. Resilience as a buffer of parental distress and problematic children's emotions and behaviors

The pandemic of Covid-19 has had a high impact on people's lives and especially on families. In Italy, in 2020, the several forced closures led families to live indoors to manage anxiety and distress. It was considered appropriate to investigate which protective factors, like parental resilience, can mitigate the negative impact of pandemic-related distress on family life. We have conducted two online surveys during different national lockdowns for Covid-19. The first survey was conducted immediately after the disruption of the virus and the second one after nine months. We measured parental resilience and distress, anxiety, problematic behaviors, and somatization of their children (as assessed by the parents). The aim was to investigate the protective role of parental resilience in mitigating parental distress and in turn problematic emotional states and behavior of their children. Mediation analyses confirmed the hypothesis that parental resilience lowers parental distress and consequently the anxiety and behavioral disorders of their children in both acute distress (first study) and chronic distress (second study) situations. Such results suggest that the improvement of parents' resilience can buffer the negative impact of pandemic-related parental distress and children's behavioral problems on both occasions. The need for focused interventions and treatments aimed to reinforce parental resilience is discussed. Targeted prevention and support strategies are needed now, and early in case of future health crises.

Mental health impact of COVID-19 pandemic on therapists at an inpatient rehabilitation facility

BACKGROUND

Healthcare workers have faced extraordinary work-related stress in the face of the COVID-19 pandemic. Physical therapy, occupational therapy, and speech-language pathology providers at inpatient rehabilitation facilities may represent a distinct at-risk subgroup for work-related stress during the pandemic due to the usual nature of their job duties, including close physical contact and extended treatment times.

OBJECTIVE

To evaluate the impact of the COVID-19 pandemic on work-related stress and occurrence of depression and anxiety in physical therapists, occupational therapists, and speech-language pathologists during the first surge of COVID-19 hospitalizations.

DESIGN

Cross-sectional survey.

SETTING

Academic, freestanding inpatient rehabilitation facility.

PARTICIPANTS

Survey responses were collected from 38 therapists.

INTERVENTION

A 26-item electronic questionnaire containing a mix of multiple-choice and open-ended questions.

MAIN OUTCOME MEASURES

Positive screens for depression or anxiety as measured by the Patient Health Questionnaire-9 (PHQ-9) and the General Anxiety Disorder 7-item (GAD-7) scale, respectively.

RESULTS

Seven individuals (19%) scored at or above the clinically significant cutoff of 10 on each the PHQ-9 and GAD-7, corresponding to increased risk for depression and anxiety. Therapists younger than 30 years old had significantly higher GAD-7 scores compared to therapists between 30-39 years old (p < .05). Occupational stress was attributed to a number of causes including concerns for health and safety, unpredictable changes in hospital protocols and work assignments, acquisition of additional work duties, concerns about the ability to provide high-quality patient care in a restricted environment, and the psychological toll of caring for patients with or recovering from COVID-19.

CONCLUSION

This cross-sectional survey highlights the impact of the COVID-19 pandemic on occupational stress and mental health of therapists working at an inpatient rehabilitation facility during the first surge of COVID-19 hospitalizations. This research may help institutions identify at-risk individuals who may benefit from support and guide policy changes to resolve potentially modifiable factors at a systems level.

Impact of COVID-19 on dental practice and anxiety among increased risk group dentists: A cross-sectional study

BACKGROUND: The likelihood of infection with SARS-COV-2 (COVID-19) in the dental office is considered high. OBJECTIVES: Assessing the impact of the COVID-19 on dental practices and anxiety levels in risk group Brazilian dentists. METHODS: A cross-sectional study was performed using an online questionnaire. The data obtained were analyzed using the IBM SPSS 25.0 software (Pearson’s Chi-square association test, multivariate logistic regression, and Poisson multiple regression), with subsequent calculation of the odds ratio at a 95% confidence interval, with a significance level of 5%. RESULTS: Responses of 578 dentists distributed in all regions of Brazil were collected. Most of the dentists were female, with an average age of 35. Of the participants, 23.4% were part of the increased risk group for COVID-19. The professionals who belonged to the increased risk group had a greater chance of not feeling prepared to perform consultations (OR = 1.67) and were not performing any procedures during the pandemic (OR = 2.03). Belonging to the increased risk group did not influence anxiety levels among the dentists. The factors associated with increased anxiety were being female, being younger, working in the southeastern region of the country, being afraid of contracting COVID-19 while working, and being concerned for one’s professional future. CONCLUSIONS: The pandemic has had a negative impact on the professional practice of individuals at risk, but the level of anxiety was like professionals who were not part of the increased risk group for COVID-19.

A five-nation study of the impact of political leaning and perception of crisis severity on the preference for female and minority leaders during the COVID-19 pandemic

Research on underrepresented groups in leadership has shown that women and ethnic minorities are preferred as leaders during a crisis. In the present study, we investigated factors that shape voter preferences for minority political leaders in the COVID-19 crisis. We examined participant perceptions of the severity of the COVID-19 crisis in health, social, and economic domains and self-reported political leaning, and their impact on preference for a female (vs male) or minority political leader. We collected survey data in autumn 2020 using online platforms in France, Japan, the United Kingdom, the United States, and a snowball sample in Germany (total N = 1,259). Results showed that female leaders were generally more preferred by politically left- than right-leaning participants independent of severity perceptions of the social or economic crisis. In addition, we found that preference for female leaders amongst right-leaning participants increased when their current regional leader's actions were judged insufficient to manage the health crisis, an effect primarily driven by participants in Germany and the United Kingdom. Left-leaning political orientation also predicted the preference for minority leaders across countries. Moreover, a more severe perception of the social aspects of the crisis increased minority preference, as expected, but mostly in Germany and the United States. We discuss cross-country variation of our results. Overall, our findings affirm and expand prior research showing the importance of political leaning and changing leadership demands in a crisis and their impact on the preference for minority leaders.

Affective States During the First Wave of the COVID-19 Pandemic: Progression of Intensity and Relation With Public Health Compliance Behavior

The COVID-19 pandemic was expected to cause intense affective reactions. This situation provided a unique opportunity to examine the characteristics and correlates of emotions in a real-world context with great significance. Our study aimed to describe the progression of positive and negative affective states during the pandemic, and to investigate which affective states predicted compliance with public health measures. We undertook a survey of affective states in the province of Quebec at the beginning, the peak, and the aftermath of the first wave of the COVID-19 pandemic. We recruited 530 responders; 154 responded to all three surveys. We used self-report scales to measure affective states and compliance with public health measures. We then computed separate linear regressions for the three phases of our study, with compliance with health measures as the dependent variable. Affective states were generally most intense at the beginning of the pandemic. Fear-related pandemic-related affective states reliably predicted compliance with public health measures in the three phases of our study. Positively valenced affective states related to the societal response also contributed predictive value, but only at the peak of the first wave.

Returning to work at school during the COVID -19 pandemic, is it stressful for schoolteachers? Assessment of immediate psychological effects: a cross sectional study

Background: The adoption of remote classes for students has been in vogue since the onset of the pandemic. Schools reopened in a phased manner after the second wave of coronavirus disease 2019 (COVID-19) in India. Reverting to the regular face-to-face teaching for students became a challenge to the teachers and students, especially at times when there was an impending third wave on the way. The study aimed to assess the presence of symptoms of depression, anxiety, and stress in teachers who attended reopened schools in the scenario of face-to-face classes. In addition, we studied the association of psychological symptoms with teachers' age groups, gender, school boards, and school institution type. Methods: A cross-sectional study was conducted between October to December 2021 after schools had reopened. Data was collected using Google Form questionnaires in 124 schoolteachers. The Depression, Anxiety, and Stress Scale - 21 Items (DASS-21) questionnaire assessed the psychological symptoms. Results: Of 124 schoolteachers, 108(87.1%) were female, 112 (90.3%) were from private institutions, and 70(56.5%) were from Central Board of Secondary Education (CBSE) school boards. The prevalence of depression, anxiety, and stress in teachers was 30.6%, 45.2%, and 20.2%, respectively. Nearly 80% of the female teachers expressed depression, anxiety, and stress symptoms. Amongst all the age groups, symptoms were higher in 40-49 group. We found anxiety to be statistically significant when compared with gender (p-0.042). We found no statistically significant differences concerning age groups, school boards, or school institutions with any psychological symptoms. Conclusions: The prevalence of psychological symptoms was high among schoolteachers after schools reopened for regular face-to-face teaching. Gender was associated with anxiety in teachers. We agree that identifying teachers' symptoms and providing adequate psychological counseling/support would improve their mental health status and thereby the quality of teaching to students.

Returning to work at school during the COVID -19 pandemic, is it stressful for schoolteachers? Assessment of immediate psychological effects: a cross sectional study

Background: The adoption of remote classes for students has been in vogue since the onset of the pandemic. Schools reopened in a phased manner after the second wave of coronavirus disease 2019 (COVID-19) in India. Reverting to the regular face-to-face teaching for students became a challenge to the teachers and students, especially at times when there was an impending third wave on the way. The study aimed to assess the presence of symptoms of depression, anxiety, and stress in teachers who attended reopened schools in the scenario of face-to-face classes. In addition, we studied the association of psychological symptoms with teachers' age groups, gender, school boards, and school institution type. Methods: A cross-sectional study was conducted between October to December 2021 after schools had reopened. Data was collected using Google Form questionnaires in 124 schoolteachers. The Depression, Anxiety, and Stress Scale - 21 Items (DASS-21) questionnaire assessed the psychological symptoms. Results: Of 124 schoolteachers, 108(87.1%) were female, 112 (90.3%) were from private institutions, and 70(56.5%) were from Central Board of Secondary Education (CBSE) school boards. The prevalence of depression, anxiety, and stress in teachers was 30.6%, 45.2%, and 20.2%, respectively. Nearly 80% of the female teachers expressed depression, anxiety, and stress symptoms. Amongst all the age groups, symptoms were higher in 40-49 group. We found anxiety to be statistically significant when compared with gender (p-0.042). We found no statistically significant differences concerning age groups, school boards, or school institutions with any psychological symptoms. Conclusions: The prevalence of psychological symptoms was high among schoolteachers after schools reopened for regular face-to-face teaching. Gender was associated with anxiety in teachers. We agree that identifying teachers' symptoms and providing adequate psychological counseling/support would improve their mental health status and thereby the quality of teaching to students.

Role of social determinants in anxiety and depression symptoms during COVID-19: A longitudinal study of adults in North Carolina and Massachusetts

Trajectory studies of the COVID-19 pandemic have described patterns of symptoms over time. Yet, few have examined whether social determinants of health predict the progression of depression and anxiety symptoms during COVID-19 or identified which social determinants worsen symptom trajectories. Using a racially, ethnically, and linguistically diverse sample of adults participating in a randomized clinical trial with pre-existing moderate to severe depression and/or anxiety symptoms, we compare symptom patterns before and during COVID-19; characterize symptom trajectories over a 20-week follow-up period; and evaluate whether social determinants are associated with within- and between- person differences in symptom trajectories. Data were collected before and during COVID-19 in Massachusetts and North Carolina. On average, depression and anxiety symptoms did not seem to worsen during the pandemic compared to pre-pandemic. During COVID-19, anxiety scores at follow-up were higher for participants with baseline food insecurity (vs no food insecurity). Depression scores at follow-up were higher for participants with food insecurity and for those with utilities insecurity (vs no insecurity). Participants with child or family care responsibilities at baseline had depression symptoms decreasing at a slower rate than those without these responsibilities. We discuss the important implications of these findings.

COVID-19 and stress: An evaluation using Beck's depression and anxiety inventory among college students and faculty members of Jouf University

BACKGROUND

Individuals might suffer emotional, psychological, and even bodily challenges as a result of any pandemic. The impact of the COVID-19 outbreak on Saudi Arabian University students and faculty members has received little attention.

OBJECTIVE

To assess stress during the COVID-19 pandemic among university college students and faculty members of Jouf University, KSA and evaluate the impact of socio- demographic factors on anxiety and depression levels.

METHODS

Two hundred and seventeen participants from Jouf University completed an anonymous web-based survey that includes questionnaires about anxiety and depression symptoms. Beck's anxiety inventory (BAI) was used to assess the anxiety levels, and Beck's depression inventory (BDI) was used to determine the depression levels due to COVID 19 pandemic. The research was carried out between April 1, 2020, and June 30, 2020. An ordinal logistic regression analysis was performed to explain the odds of observing anxiety and depression.

RESULTS

For "moderate anxiety" (22-35), the most frequently observed category of age, nationality, gender, duration spent in lockdown and profession was 20-30 years (n = 15, 65%), Saudis (n = 14, 61%), female (n = 15, 65%),>3 months (n = 17, 74%), and students (n = 15, 65%) respectively. For "moderate depression" (21-30), the most frequently observed category of age, nationality, gender, duration spent in lockdown and profession was 20-30 years (n = 10, 50%), Saudi (n = 15, 65%), female (n = 26, 65%).>3 months (n = 13, 65%), and both students and faculty members, each with an observed frequency of 10 (50%) respectively. Ordinal logistic regression analysis suggested that the observed effects of nationality, gender, and duration spent in lockdown period influenced the anxiety levels among participants.

CONCLUSIONS

The impact of the lockdown duration was more significant in students than in faculty members and females than in males. Authors recommend the critical need for intervention and prevention strategies to address college students' mental health.

Second Wave of COVID-19 Pandemic in Argentinian Population: Vaccination Is Associated With a Decrease in Depressive Symptoms

Background

Since the irruption of the coronavirus disease 2019 (COVID-19) the planet has submerged in a time of concern and uncertainty, with a direct impact on people's mental health. Moreover, the recurrent outbreaks that periodically harry different regions of the world constantly refocus people's concerns to the pandemic. Yet, each new wave heats the diverse countries in different situations, including the advances in their vaccination campaigns. In this research, we studied the levels of the general anxiety disorder (GAD) and depression in the Argentine population across the first and second waves of infections that occurred in our country.

Methods

We conducted an on-line survey, within each peak of the pandemic. People were asked to self-report GAD and depression symptoms using the GAD-7 and PHQ-9 questioners, inform their vaccination status, the frequency they performed physical activity as well as working condition and modality. Here, we identified the more vulnerable groups and evaluated factors that could mitigate the rise of these mental disorders, focusing on vaccination.

Results

Our data shows that reported GAD and depression levels were higher during the second wave than during the first one. More importantly, vaccinated people were less depressed than non-vaccinated people, while GAD levels remained equivalent in both groups. Other factors directly associated with lower GAD and depression levels were performing frequent physical activity and being employed, regardless of the employment modality. These observations were replicated in different age ranges and genders.

Conclusion

This work evidences GAD and depression in different pandemic waves in Argentina, as well the factors that may contribute to reducing the magnitude of these disorders, including vaccination.

Level of Depression during the COVID-19 Pandemic in Poland-A Cross-Sectional Study

OBJECTIVES

The aim of this study was to assess the level of depression during the COVID-19 pandemic in Poland.

METHODS

The online survey was conducted among Polish adult citizens (204 respondents) with a positive SARS-CoV-2 test result. The level of depression was assessed by the Beck Depression Inventory in Polish.

RESULTS

Depressive symptoms of moderate or severe degree appeared in about every fourth person. Women were characterised with higher mean depression scores. In the group of men, significant correlations were found between mental condition and age-the higher the age, the higher the values of depression measures. Those who were asymptomatic with SARS-CoV-2 had the best results-a lack of depression, while those who were fully symptomatic had the worst results-major depressive disorder.

CONCLUSIONS

There is a need for further research and monitoring of mental health in specific population groups. It is necessary to plan preventive measures to prevent the negative effects of the pandemic, especially in women. Specialist support should be implemented during and after the pandemic.

Determinants of Anxiety in the General Latvian Population During the COVID-19 State of Emergency

Background

The COVID-19 pandemic and its restrictive public health measures have seriously affected mental health of society. Social, psychological, and health-related factors have been linked to anxiety in the general population.

Aim

We investigate the association of various sociopsychological and health-related determinants of anxiety and identify the predicting factors for anxiety in the general population during the COVID-19 state of emergency from in Latvia.

Methods

We conducted an online survey using a randomized stratified sample of the general adult population in July 2020 for 3 weeks. Anxiety symptoms were measured using the State-Trait Anxiety Inventory (STAI-S). Sociodemographic, health-related, sociopsychological characteristics and suicidality were identified using the structured questionnaire. The statistical analysis included Pearson's chi-square test, post hoc analysis, and binomial logistic regression.

Results

The weighted study sample included 2,608 participants. The mean STAY-S score of the total sample was 22.88 ± 12.25. In the total sample, 15.2% (n = 398) of participants were classified as having anxiety. The odds ratio (OR) of having anxiety was higher in females (OR = 2.44; 95% CI 1.75-3.33) and people who had experienced mental health problems in the past (OR = 1.45; 95% CI 1.03-2.04), had suicide attempt in the past (OR = 1.68; 95% CI 1.08-2.59), were worried about their health status due to COVID-19 (OR = 1.64; 95% CI 1.36-1.16), were worried about stigmatization from others if infected with COVID-19 (OR = 1.18; 95% CI 1.03-1.35), were worried about information regarding COVID-19 from the Internet (OR = 1.24; 95% CI 1.08-1.43), persons who were lonely (OR = 1.90; 95% CI 1.54-2.34), and persons with negative problem orientation (OR = 1.26; 95% CI 1.06-1.51). Protective factors were identified as having good self-rated general health (OR = 0.68, 95 % CI 0.58-0.81), maintaining a daily routine (OR = 0.74, 95 % CI 0.61-0.90), having financial stability (OR = 0.66, 95 % CI 0.55-0.79), and having good psychological resilience (OR = 0.90, 95 % CI 0.87-0.94).

Conclusions

This is the first study to report a prevalence of anxiety in the general population of Latvia. Certain factors that predict anxiety, as well as protective factors were identified.

Gender differences in mental distress and affect balance during the first wave of COVID-19 pandemic in Spain

The COVID-19 pandemic is a major threat to the health and well-being of people around the world that has impacted freedom of movement, social interaction and the economy. The aim of the present work was twofold: first, to study the presence of mental distress, positive and negative experiences and affect balance in women and men in Spain in two different phases of the COVID-19 pandemic, the initial "first state of alarm" phase, characterized by maximum restrictions, and in the "new normal" phase with minimal restrictions, and second, to study the protective role of age, educational level, self-esteem, marital status and social support against mental distress, and as factors that increase the affect balance of women and men in the above mentioned phases of the first wave of the COVID- 19 pandemic in Spain. The study sample consisted of 652 women and 652 men from the general population, aged between 18 and 88 years, who were evaluated through self-reports. Results show greater mental distress in women than men but, strikingly, the magnitude of such differences were greater in the "new normal" phase than in the maximum restriction phase. In addition, in this last phase, women also experienced more negative feelings and less affect balance than men. High self-esteem and social support were also found to be protective factors for mental health, both in women and men, during the two phases of the pandemic studied. In conclusion, our study shows that the COVID-19 pandemic has especially impacted the well-being of women.

Mental health during the first wave of COVID-19 in Canada, the USA, Brazil and Italy

BACKGROUND

The mental health (MH) burden on healthcare practitioners (HCPs) is emerging as a significant cost of the pandemic, although few studies have compared the MH of HCPs in different countries.

METHODS

A link to an online survey was posted in the Spring of 2020 which included questions regarding perceived impact of the pandemic; current MH symptom severity and impairment was evaluated using validated scales.

RESULTS

Overall, 1315 individuals (74% female, mean age: 42.9 + 16.4) in Canada, the United States, Brazil and Italy completed the survey. Nearly 26% met diagnostic thresholds for GAD and MDD; Italian respondents reported the lowest rates of disorder. Except for Canada, non-HCPs in each country reported higher symptom severity than HCPs. Amongst the HCPs, Canadian HCPs reported the highest rates of anxiety and depression as well as increases in alcohol and cannabis use, lower levels of perceived emotional support and more worry about themselves or their loved ones contracting COVID-19.

CONCLUSION

Despite key infrastructural and COVID-19 mortality differences between the countries, the MH effects appeared to be quite similar. HCPs, with the exception of Canada, reported less impact on their mental health compared to the general population, suggesting resilience in the face of adversity.Key pointsRates of current mental health disorders were similar across Canada, the USA and Brazil but lower in Italy, yet much higher than pre-pandemic ratesNon-Healthcare Practitioners (HCPs) reported significantly higher severity on all MH scales in the overall sample. This was consistent within the USA, Brazil and Italy, however in Canada, HCPs reported higher anxiety, depression and stress symptom severity compared to Canadian non-HCPs.Canadian HCPs reported significantly higher anxiety and depression symptom severity than all other countriesCanadian HCPs also reported significantly greater increases in alcohol and cannabis use, lower levels of perceived emotional support and more worry about themselves or their loved ones contracting COVID-19 compared to HCPs in the other countries.

What has changed in the experiences of people with mental health problems during the COVID-19 pandemic: a coproduced, qualitative interview study

PURPOSE

We sought to understand how the experiences of people in the UK with pre-existing mental health conditions had developed during the course of the COVID-19 pandemic.

METHODS

In September-October 2020, we interviewed adults with mental health conditions pre-dating the pandemic, whom we had previously interviewed 3 months earlier. Participants had been recruited through online advertising and voluntary sector community organisations. Semi-structured qualitative interviews were conducted by telephone or video-conference by researchers with lived experience of mental health difficulties, and, following principles of thematic analysis, were analysed to explore changes over time in people's experience of the pandemic.

RESULTS

We interviewed 44 people, achieving diversity of demographic characteristics (73% female, 54% White British, aged 18-75) and a range of mental health conditions and service use among our sample. Three overarching themes were derived from interviews. The first theme "spectrum of adaptation" describes how participants reacted to reduced access to formal and informal support through personal coping responses or seeking new sources of help, with varying degrees of success. The second theme describes "accumulating pressures" from pandemic-related anxieties and sustained disruption to social contact and support, and to mental health treatment. The third theme "feeling overlooked" reflects participants' feeling of people with mental health conditions being ignored during the pandemic by policy-makers at all levels, which was compounded for people from ethnic minority communities or with physical health problems.

CONCLUSION

In line with previous research, our study highlights the need to support marginalised groups who are at risk of increased inequalities, and to maintain crucial mental and physical healthcare and social care for people with existing mental health conditions, notwithstanding challenges of the pandemic.

Using what we know about threat reactivity models to understand mental health during the COVID-19 pandemic

The COVID-19 pandemic has been accompanied by unprecedented levels of stress and threats in a variety of domains (e.g., health, livelihood). Individual differences in threat reactivity may explain why some individuals are at elevated risk for the development or maintenance of psychopathology during the COVID-19 pandemic. This article describes several prominent models, mechanisms, and components of threat reactivity (e.g., appraisals, intolerance of uncertainty, avoidance) and discusses how they might help improve understanding of changes in psychopathology during and following the COVID-19 pandemic.

Impact of the Covid-19 Pandemic on Children and Families in PICU Follow-Up Clinic

The novel coronavirus disease 2019 (COVID-19) pandemic disrupted the lives of many families, especially those of children with chronic health problems. Little is known about the impact of this pandemic on the health and well-being of critically ill children and their families after their discharge from pediatric intensive care unit (PICU) hospitalization. This study describes the repercussions of the COVID-19-related lockdown on the physical and psychological wellbeing, quality of life, and access to resources of PICU survivors and their families. This was a prospective cohort study of children and families followed at the Centre Hospitalier Universitaire Ste-Justine PICU follow-up clinic from October 2018 to February 2020. Families were contacted by phone to complete validated questionnaires (Pediatric Quality of Life Inventory, Hospital Anxiety and Depression Scale) and to evaluate the impact of the COVID-19 pandemic on their access to medical care and extrafamilial support. Fifty-five families were contacted between November and December 2020. Quality of life scores were 88.1 ± 16.9 and 83.8 ± 13.9 for physical and psychosocial aspects, respectively. Symptoms of anxiety and depression were detected in 23.6 and 3.6% of respondent parents, respectively. A significant proportion of families reported canceled or delayed health care appointments (65.5%) and difficulty with medication access (12.7%). Twenty-five families (45.5%) reported a significant decrease in income. We could not identify any statistically significant predictors for lower quality of life scores. Difficulty accessing medical care was associated with higher symptoms of anxiety and/or depression in parents on multivariate analysis (p = 0.02). In conclusion, the COVID-19 pandemic has had a significant negative impact on PICU survivors' access to medical resources and extrafamilial support.

Psychosocial Factors Associated With Adherence to COVID-19 Preventive Measures in Low-Middle- Income Countries, December 2020 to February 2021

Objectives: To investigate psychosocial factors associated with adherence to COVID-19 preventive measures in low- and middle-income countries (LMICs). Methods: This online cross-sectional survey included 10,183 adults (median age 45 years) from nine LMICs. Participants were asked about adhering to four COVID-19 preventive measures (physical distancing, wearing a face mask, hand, and cough hygiene); a composite adherence score was calculated, ranging from 0-4 positive responses. Psychosocial measures included worry, anxiety, depression, social and demographic, and COVID-19 related factors. Results: Factors associated with adherence to more preventive measures included being a participant from Malaysia or Bangladesh, older age, higher education, belonging to the healthcare sector (either as or worker), having health personnel as a trusted source of COVID-19 information/advice, possessing correct COVID-19 knowledge, worry or fear about being (re)infected with COVID-19, and screening negative for general anxiety symptoms. Conclusion: Moderate to high adherence to COVID-19 preventive measures was found, with significant variations across countries. Psychosocial factors (worry, anxiety, knowledge, education, age, and country) seemed determinant in predicting the number of measures to which participants adhered.

Estimating and explaining cross-country variation in the effectiveness of non-pharmaceutical interventions during COVID-19

To control the COVID-19 pandemic, countries around the world have implemented non-pharmaceutical interventions (NPIs), such as school closures or stay-at-home orders. Previous work has estimated the effectiveness of NPIs, yet without examining variation in NPI effectiveness across countries. Based on data from the first epidemic wave of [Formula: see text] countries, we estimate country-specific differences in the effectiveness of NPIs via a semi-mechanistic Bayesian hierarchical model. Our estimates reveal substantial variation between countries, indicating that NPIs have been more effective in some countries (e. g. Switzerland, New Zealand, and Iceland) as compared to others (e. g. Singapore, South Africa, and France). We then explain differences in the effectiveness of NPIs through 12 country characteristics (e. g. population age, urbanization, employment, etc.). A positive association with country-specific effectiveness of NPIs was found for government effectiveness, gross domestic product (GDP) per capita, population ages 65+, and health expenditures. Conversely, a negative association with effectiveness of NPIs was found for the share of informal employment, average household size and population density. Overall, the wealth and demographic structure of a country can explain variation in the effectiveness of NPIs.

Analysis of the Effects of Lockdown on Staff and Students at Universities in Spain and Colombia Using Natural Language Processing Techniques

The aim of this study is to analyze the effects of lockdown using natural language processing techniques, particularly sentiment analysis methods applied at large scale. Further, our work searches to analyze the impact of COVID-19 on the university community, jointly on staff and students, and with a multi-country perspective. The main findings of this work show that the most often related words were "family", "anxiety", "house", and "life". Besides this finding, we also have shown that staff have a slightly less negative perception of the consequences of COVID-19 in their daily life. We have used artificial intelligence models such as swivel embedding and a multilayer perceptron as classification algorithms. The performance that was reached in terms of accuracy metrics was 88.8% and 88.5% for students and staff, respectively. The main conclusion of our study is that higher education institutions and policymakers around the world may benefit from these findings while formulating policy recommendations and strategies to support students during this and any future pandemics.

Spirituality as a protective factor for chronic and acute anxiety in Brazilian healthcare workers during the COVID-19 outbreak

Background

Anxiety symptoms (AS) are exacerbated in healthcare workers (HCWs) during the COVID-19 pandemic. Spirituality is known to protect against AS in the general population and it is a construct that differs from religion. It can be assessed using structured questionnaires. A validated questionnaire disclosed three spirituality dimensions: peace, meaning, and faith. In HCWs we investigated the predictors of chronic anxiety (pre-COVID-19 and during the pandemic) and acute anxiety (only during the pandemic), including spirituality in the model. Then, we verified which spirituality dimensions predicted chronic and acute anxiety. Lastly, we studied group differences between the mean scores of these spirituality dimensions.

Material and methods

The study was carried out in a Brazilian Hospital. HCWs (n = 118) were assessed for spirituality at a single time-point. They were also asked about AS that had started pre-COVID-19 and persisted during the pandemic (chronic anxiety), and AS that had started only during the pandemic (acute anxiety). The subjects without chronic anxiety were subdivided into two other groups: acute anxiety and without chronic and acute anxiety. Forward stepwise logistic regressions were used to find the significant AS predictors. First, the model considered sex, age, religious affiliation, and spirituality. Then, the analysis were performed considering only the three spirituality dimensions. Group means differences in the spirituality dimensions were compared using univariate ANCOVAS followed by T-tests.

Results

Spirituality was the most realible predictor of chronic (OR = 0.818; 95%CI:0.752–0.890; p<0.001) and acute anxiety (OR = 0.727; 95%CI:0.601–0.881; p = 0.001). Peace alone predicted chronic anxiety (OR = 0.619; 95%CI:0.516–0.744; p<0.001) while for acute anxiety both peace (OR:0.517; 95%CI:0.340–0.787; p = 0.002), and faith (OR:0.674; 95%CI:0.509–0.892; p = 0.006) significantly contributed to the model. Faith was significantly higher in subjects without AS.

Conclusion

Higher spirituality protected against chronic and acute anxiety. Faith and peace spirituality dimensions conferred protection against acute anxiety during the pandemic.

Mental health and well-being of LGBTQ+ people during the COVID-19 pandemic

The COVID-19 pandemic has had a profound negative impact on the mental health of the general population. The COVID-19 pandemic and its related containment measures have increased structural disadvantages faced by marginalized communities, such as LGBTQ+ people. LGBTQ+ is an acronym used to identify lesbian, gay, bisexual, transgender and queer people plus all community members using different terms to describe their sexual orientation or gender identity. It is likely that the COVID-19 pandemic has exposed them to increased minority stress, which can also affect their physical health. Since the beginning of the pandemic, the few available studies on the mental health of LGBTQ+ have reported frequent worries about the future, negative emotions, and feelings of uncertainty. Moreover, they have faced further difficulties such as undertaking hormone therapy, accessing to health facilities or living with family members not accepting their condition. The COVID-19 pandemic has added a significant burden to the well-being of LGBTQ+ people, and therefore there is the need to provide them with dedicated supportive interventions in order to promote the early detection of mental health problems or of full-blown mental disorders.

Determinants of anxiety and depression among Bangladeshi adults during COVID-19 lockdown: An online survey

Background

Human health and well-being are adversely affected by the effects of COVID-19. This study examined the prevalence of anxiety and depression during COVID-19 lockdown in Bangladesh, and their association with some less explored factors like perceived and relative health status, having elderly members in the family, fear for own and family future, and others from the Asian context.

Methods

Using an online survey, data were collected from the population aged 18 years and above, on socio-demographic and economic attributes, and two separate standardized twelve-item scales were used to assess the level of anxiety and depression. Both descriptive and multivariate linear regression were used to analyze the factors associated with anxiety and depression scores.

Results

The respondents had an average anxiety score of 21.74 (SD = 8.20) on a scale ranging from 12 to 60 and an average depression score of 24.39 (SD = 10.30) on the same scale. The study findings revealed that respondents' concern for future well-being, perceived physical health status compared to others in the same cohort, and perceived physical health status during the survey compared to prior COVID-19 were significantly associated with anxiety and depression scores during COVID-19 lockdown. In addition, the anxiety score was significantly higher (p = 0.046) for women respondents than men. Moreover, respondents aged 18-24 years had significantly higher (p < 0.001) depression than others.

Conclusions

The increased level of anxiety and depression during COVID-19 of adult people in Bangladesh are associated with several factors of which their greater concern about the future of their own and family members and health-related attributes are important. These findings may lead to developing interventions to reduce the psychological crisis during the pandemic in Bangladesh.

Psychological Health and Sleep Quality of Medical Graduates During the Second Wave of COVID-19 Pandemic in Post-epidemic Era

Recently, a COVID-19 virus variant spread rapidly in Guangzhou, China, causing public panic. This study aimed to understand the psychological and sleep-related consequences of the secondary outbreak of the pandemic on medical students. In this cross-sectional survey-based study, participants anonymously completed structured questionnaires online from June 8–22, 2021. We collected participants' demographic and general information. Anxiety, depression, and sleep quality were measured using the Zung Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and Pittsburgh Sleep Quality Index (PSQI), respectively. Protective factors were assessed using the Coping Style Questionnaire (CSQ). Uni- and multivariate logistic regression analyses were performed examining factors associated with mental health and sleep quality problems. During the second wave of the pandemic in local outbreak areas in Guangzhou, China, more than one-third of medical students' mental health and sleep quality were affected. The prevalence of anxiety, depression, and poor sleep quality were 27.54%, 27.58%, and 18.19%, respectively. Students belonging to the Class of 2019, aged over 29 years, those with siblings, and those whose hometowns were in other provinces were more prone to the three health problems. Factors associated with an increased risk of mental health problems were vaccination status (adjusted odds ratio 1.603–1.839) and diet status (adjusted odds ratio 1.62–1.929). Positive coping styles served as protective factors (p < 0.05). We discovered that completed vaccination status, good diet, and positive coping styles were related to good mental health and sleep quality.

The Health Impacts and Life Challenges Caused by the COVID-19 Pandemic on Hong Kong Chinese Women

The COVID-19 pandemic has caused a massive global crisis. The adverse impacts on Asian women, including Hong Kong Chinese women, have been considerable. The pressure on Hong Kong women is immense due to cultural, social, familial, and personal responsibilities. This study aims to illustrate the health impacts and life challenges for Hong Kong Chinese Women during the pandemic. An interpretive phenomenological approach with purposive sampling was adopted. Semi-structured, face-to-face, in-depth interviews were conducted from August 2020 to January 2021. Twenty-five women participated in the interviews, lasting an average of 48 min. The transcribed interviews were analyzed using interpretative phenomenological analysis. The core theme identified was "Perceived family caregiving as paramount self-obligation in times of the pandemic", in the context of the role of daughter, wife, or mother (or a combination). Three interconnected themes have been identified in individual, relational, and external contexts: deterioration of personal health, unfavorable to family relationships, and adaptation to social challenges. Eight subthemes have emerged related to health impacts and life challenges. The pandemic has increased women's perception of their caregiver roles in the family, but it has diminished their quality of life. The promotion of strategies and activities that could enhance women's physical, psychological, emotional and social quality of life is recommended.

Association between work situation and life satisfaction during the COVID-19 pandemic: prospective cohort study in Norway

OBJECTIVES

To estimate the impact of being laid off from work, having to work from home or having been diagnosed with COVID-19 on self-reported satisfaction with life.

DESIGN

Nationwide population-based cohort study.

SETTING

Norway.

PARTICIPANTS

We followed more than 80 000 participants in an ongoing cohort study, the Norwegian Mother, Father and Child Cohort Study (MoBa), during the COVID-19 pandemic. We analysed current life satisfaction in April and again in September/October 2020 for subjects whose work situation and infection status had changed.

MAIN OUTCOME MEASURES

Self-reported satisfaction with life, using a scale from 0 (worst) to 10 (best). We analysed the scale both continuously and as a binary variable (

RESULTS

Temporary and permanent layoffs, working from a home-based office, and getting a COVID-19 diagnosis were all associated with modestly, but significantly lower concurrent life satisfaction, both in the total on a population level and for subjects experiencing a change in job status between spring and autumn. The associations with change in work situation were stronger for men. For men with permanent job loss, the adjusted odds ratio (OR) for low life satisfaction (<6) was 3.2 (95% CI 2.4 to 4.2) in April and 4.9 (95% CI 3.5 to 6.9) in autumn. Among all, a suspected or confirmed COVID-19 diagnosis was associated with an adjusted OR for low life satisfaction of 1.9 (95% CI 1.6 to 2.3) in spring. The strength of associations between work situation and life satisfaction did not vary much across socio-economic strata, but layoffs were more common among those with low education.

CONCLUSION

Layoffs, home office and infection status had clear impact on the quality of life as measured with a global life satisfaction scale. These findings suggest that social differentials in quality of life, are increasing during the pandemic.

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Key Words

• COVID-19
• epidemiology
• mental health

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MESH Headings

• Adult
• COVID-19/epidemiology
• COVID-19 Testing
• Cohort Studies
• Female
• Humans
• Male
• Norway/epidemiology
• Pandemics
• Personal Satisfaction
• Prospective Studies
• Quality of Life

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Grants

• Norges Forskningsråd
• Norwegian Institute of Public Health (NIPH)

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Affiliation(s)

Ellen Øen Carlsen Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
Ida H Caspersen Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
Helga Ask Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway
Ragnhild Eek Brandlistuen Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
Lill Trogstad Department of Infectious Disease Epidemiology and Modelling, Norwegian Institute of Public Health, Oslo, Norway
Per Magnus Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway

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The role of covid‐19 anxiety and intolerance of uncertainty in predicting resilience

Resilience is one of the protective factors for mental health. The aim of this study is to reveal the role of COVID‐19 anxiety and intolerance of uncertainty in predicting resilience in adulthood. To this end, data were collected from 533 adults (359 women‐174 men). A hierarchical regression analysis was performed, controlling for the effects of gender and presence of a chronic disease on the prediction of resilience. Results showed that intolerance of uncertainty and COVID‐19 anxiety were statistically significant predictors of resilience. Gender and presence of a chronic disease were not statistically significant in predicting resilience. These results indicate that intolerance of uncertainty plays an important role in explaining resilience.

Emerging adults’ cultural values, prosocial behaviors, and mental health in 14 countries during the COVID-19 pandemic

Evidence suggests an impact of the COVID-19 pandemic on mental health, particularly among emerging adults. However, theories on altruism born of suffering or adversarial growth suggest that we might also see prosocial behavior as a function of the pandemic, which may protect against mental health challenges. Because cultural values are central in determining prosocial behavior, the current study explored how cultural values were differentially associated with adaptive prosocial behaviors that might protect against mental health challenges. Participants for the current study included 5,682 young people aged 18–25 years from 14 different countries around the world (68% female, 62% college students). Path analyses suggested that there were few differences in patterns as a function of culture, but revealed that horizontal individualism and horizontal and vertical collectivism were indirectly associated with lower levels of depression via prosocial behavior toward family members. Discussion focuses on the importance of coping by strengthening family relationships via prosocial behavior during the pandemic.

Anxiety, Depression, and Concern About Employment Status of Hotel Housekeepers in the Balearic Islands During the COVID-19 Pandemic: A Longitudinal Study

Tourism is a crucial economic sector in the Balearic Islands (Spain). COVID-19 pandemic might severely impact hotel housekeepers (HHs) due to their already precarious employment situation. The purpose is to assess the evolution of the concern about employment status, anxiety, and depression of HHs. This is a longitudinal study conducted with a subset of participants from a primary care, health promotion intervention study. Two additional visits were added (March-April and October-December 2020) for the purpose of this study. We recruited 290 HHs in March-April 2020; 237 were again interviewed during October-December 2020. In the first visit, high level of concern about employment was associated with age under 50, temporary contracts and external locus of control (LOC). Moderate-severe anxiety was associated with low social support and external LOC; moderate-severe depression was associated with low social support. Regarding the second visit, age, years working as HH, type of contract, social support, and LOC were not associated with concern about employment status, anxiety, and depression. There was a larger proportion of HHs with moderate-severe anxiety and depression among HHs with high degree of concern. Concern increased significantly among HHs: over 50 years of age; with more than 15 years in the job, a recurring seasonal contract and normal social support. After adjusting by age, type of contract, LOC, and social support, we found a statistically significant increase (12.0%) of HHs highly concerned about their job situation: compared to the first visit, HHs were 2.3 more likely to have a high degree of concern in December 2020. In contrast, increases in moderate-severe anxiety (0.3%) and depression (4.3%) between the two periods were not significant. In HHs, the COVID-19 pandemic has caused significant concern about employment status and symptoms of depression and anxiety. In the uncertain times of the pandemic, mental wellbeing benefits from variables that confer stability, such as internal LOC, perception of social support, and a stable job. Longitudinal results point at long lasting effects of the COVID-19 pandemic on mental health. It is crucial to allocate additional resources in primary care to adequately address the anticipated influx of needs.

Impact of the COVID-19 lockdown on psychological health and nutritional habits in Italy: results from the #PRESTOinsieme study

OBJECTIVES

The present work aims to present the results of the 'PRESTOinsieme' (which is 'we will be together soon' in English). The web-based survey (www.prestoinsieme.com) describes changes in lifestyle habits and symptoms of psychological discomfort in the Italian population during the COVID-19 lockdown.

DESIGN

Cross-sectional online survey disseminated by messaging apps (ie, WhatsApp and Telegram) and social networks (ie, Instagram, Facebook and LinkedIn).

SETTING

Italy.

PARTICIPANTS

Italian population older than 16 years of age.

EXPOSURE

COVID-19 lockdown.

MAIN OUTCOMES AND MEASURES

Survey respondents filled out a set of validated questionnaires aimed at assessing lifestyle habits and psychological health, that is, the General Health Questionnaire (GHQ-12) to screen for psychological distress, the Impact of Event Scale-Revised (IES-R) to screen for post-traumatic stress and the Center for Epidemiologic Studies Depression Scale (CES-D).

RESULTS

Survey respondents totalled 5008. Moderate or severe psychological distress was reported in 25.5% and 22% of survey respondents, respectively. Lower age, female gender, being unemployed (OR 1.57, 95% CI 1.22 to 2.02) or being a student (OR 1.73, 95% CI 1.31 to 2.28) were predictors of more severe depressive symptoms.

CONCLUSIONS

The present study is one of the largest population-based surveys conducted in Italy during the first COVID-19 lockdown, providing valuable data about the Italian population's psychological health. Further studies should be conducted to understand whether psychological distress persists after the end of the lockdown.