Immediate Psychological Responses and Associated Factors during the Initial Stage of the 2019 Coronavirus Disease (COVID-19) Epidemic among the General Population in China. Int J Environ Res Public Health. 2020;17. [PMID: 32155789 PMCID: PMC7084952 DOI: 10.3390/ijerph17051729]

Health-related quality of life during the COVID-19 pandemic: The impact of restrictive measures using data from two Dutch population-based cohort studies

OBJECTIVES

We describe health-related quality of life during the COVID-19 pandemic in the general Dutch population and correlations with restrictive measures.

METHODS

Data were obtained from 18-85 year-old participants of two population-based cohort studies (February 2021-July 2022): PIENTER Corona (n = 8,019) and VASCO (n = 45,413). Per cohort, mean scores of mental and physical health and health utility from the SF-12 were calculated by age group, sex and presence of a medical risk condition. Spearman correlations with stringency of measures were calculated.

RESULTS

Both cohorts showed comparable results. Participants <30 years had lowest health utility and mental health score, and highest physical health score. Health utility and mental health score increased with age (up to 79 years), while physical health score decreased with age. Women and participants with a medical risk condition scored lower than their counterparts. Fluctuations were small over time but most pronounced among participants <60 years, and correlated weakly, but mostly positively with measure stringency.

CONCLUSIONS

During the Dutch COVID-19 epidemic, health utility and mental health scores were lower and fluctuated strongest among young adults compared to older adults. In our study population, age, sex and presence of a medical risk condition seemed to have more impact on health scores than stringency of COVID-19 non-pharmaceutical interventions.

Risk factors associated with depression and anxiety among the Chinese general population after retracting the dynamic zero-COVID policy: A network analysis

BACKGROUND

Recent studies have evidenced the negative psychological consequences of the COVID-19 pandemic and sociodemographic vulnerability among the general population, while limited information was available on which factors make the greatest contribution to psychological distress when these factors were considered concurrently. Herein, we aimed to investigate the pathways that underlie psychological distress in the context of retracting dynamic zero-COVID policy.

METHODS

We employed the mixed graphical model to construct the network of depression (PHQ-9), anxiety (GAD-7), and pandemic-related factors in a general population sample (N = 1610). Then, we re-examined the network by adding sociodemographic variables to further explore the influence of sociodemographic factors. Additionally, we repeated the analyses in the second sample (N = 620) collected in the same period to assess the replicability.

RESULTS

The relationships between the pandemic factors and anxiety and depressive symptoms exhibited a tendency to decrease after adding demographic variables, and income became the most important node and shared edge weights with all anxiety and depressive symptoms. These findings were replicable with the second sample. No significant difference in the network properties was detected between the two samples.

LIMITATIONS

The cross-sectional design limits the ability to observe longitudinal changes in these risk factors and their relationship with psychological distress.

CONCLUSIONS

Income level, rather than the pandemic-related factors, acted as a vital role in the psychological distress of the general population, implying that livelihood issues may be the critical intervention targets for mental health during the post-pandemic period.

A mixed method study on the impact of COVID-19 on mental healthcare in Ghana: rethinking mental health service delivery

BACKGROUND

Since its emergence, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has caused severe health, social and economic challenges. Mental healthcare has been significantly affected globally, and even worse in developing countries. An emerging economy like Ghana in West Africa was not spared its disruptive effects. This study aimed to elucidate the impact of the coronavirus disease 2019, the COVID-19 pandemic (caused by SARS-CoV-2), on Ghana's mental healthcare system.

METHODS

This is a mixed-method study using an emergent sequential exploratory design. A total of 15 front-line healthcare professionals were recruited from the three psychiatric hospitals, including the mental health department of a new teaching hospital in Ghana. Purposive sampling techniques and a semi-structured interview approach were used for recruitment and data collection. Quantitative data from hospital registries were collected and analysed to triangulate qualitative findings.

RESULTS

Fifteen mental health workers were enrolled in the study. The mean age of participants was (34.47 ± 4.07) years, average work experience of (6.23 ± 3.64) years and the majority as males (60%). This study found an average decline of 23% in hospital attendance and a 35% decline in admissions in all four facilities compared to the previous year, 2019. The lived experiences shared by mental healthcare providers were grouped under 3 main themes: Adjustments to workplace regulations, accessibility to mental healthcare, and psychological wellbeing of mental healthcare workers. The fear of contracting SARS-CoV-2 among healthcare workers, medication shortages, and logistical challenges were also reported to affect Mental Health services during the pandemic.

CONCLUSION

This study highlights the challenges in mental healthcare during the COVID-19 pandemic in Ghana. The experiences encountered present an opportunity to gain insights into future pandemic preparedness and establish a framework for optimal mental healthcare delivery in Ghana.

Loneliness and Subjective Wellbeing During the Covid-19 Pandemic: A Systematic Review

To prevent the transmission of COVID-19, unprecedented measures were implemented, such as community lockdowns. With limited social interactions, the problem of loneliness might have worsened. As loneliness is thought to have a detrimental effect on subjective wellbeing (SWB), the present systematic review aims to better investigate and summarize the existing evidence about the association of loneliness and SWB during the COVID-19 pandemic. A total of 18 articles were included. In all studies, independently of the component of wellbeing assessed or of the instrument used, a negative association between loneliness and SWB was found. The results show an increase in loneliness during times of restrictions on social contacts, with a subsequent association with lower SWB, and underscore the need for developing specific interventions to tackle loneliness and for promoting alternative forms of social interaction if further physical distancing measures are needed. However, the literature had several limitations, since most of the studies followed cross-sectional and descriptive methodologies.

Psychological status of residents at the onset of nationwide COVID-19 lockdown in low- and medium-risk areas of China

The coronavirus disease 2019 (COVID-19), a dual threat to public physical and mental health, prompted an investigation into the psychological well-being of residents in low- to medium-risk areas of China during the initial stages of the pandemic. We administered WeChat-based questionnaire surveys and employed chi-square tests and multiple logistic regression to analyze correlations between residents' age, gender, education, symptoms, COVID-19 close contact history, information sources, and anxiety, depression, and attitudes toward lockdown measures. We received 10,433 valid questionnaires, revealing 26% anxiety and 19.5% depression. Support for lockdown measures reached 98.2%. Factors such as female gender, self-diagnosed pneumonia symptoms, close contact history, and higher education levels increased anxiety risk. Having a doctorate posed a severe anxiety risk, at 4.5 times (P = .019, 95% CI 1.29-15.73). Older age acted as a protective factor, reducing severe anxiety risk to 0.98 and 0.22 times (P < .001, 95% CI 0.14-0.34). Females with a master degree or below and those receiving COVID-19 information from multiple channels faced higher depression risk. Pneumonia symptoms were a risk for all anxiety and depression degrees. Attitudes toward lockdown measures had no significant impact on psychological status, nor did any of the analyzed factors affect residents' overall attitude toward lockdown. Our findings underscore the need for increased psychological counseling, particularly for young females with lower educational backgrounds or self-suspected infection symptoms, to mitigate mild to moderate anxiety and depression in future epidemics or pandemics. The public, especially those of working age with doctorates or higher education, bears the highest risk of severe anxiety. Lockdown measures enjoy strong support in low- to medium-risk areas of China.

Assessing the impact of COVID-19 on self-reported levels of depression during the pandemic relative to pre-pandemic among Canadian adults

OBJECTIVES

This study aims to assess the impact of COVID-19 related risk factors on self-reported increases in depression among Canadian adults during the pandemic compared to pre-pandemic levels. We aim to investigate the interactive effects of stressors, including social isolation, financial stress, and fear of catching COVID-19, on mental health outcomes. Our study aims to provide insights for the development of prevention and intervention strategies to address the mental health effects of the pandemic by examining the psychological changes attributable to the pandemic and its impact.

METHODS

This study used data collected from the Mental Health Research Canada online survey during the third wave of COVID-19 (April 20-28, 2021). The study examined the impact of COVID-19 related factors, including social isolation, financial concerns, fear of catching COVID-19, and concerns about paying bills, on self-reported increases in depression. Multivariable logistic regression models were utilized to examine these associations, with adjustments made for potential confounding variables. All statistical analysis was performed using SAS V9.4 (SAS Institute Inc., Cary, NC, USA).

RESULTS

Participants reporting social isolation, financial concerns, and fear of catching COVID-19 were more likely to report increased depression. An interaction was observed between concerns for paying bills and catching COVID-19 in relation to depression (p = 0.0085). In other words, the effect of concerns about paying bills on depression was stronger for individuals who also had a fear of catching COVID-19, and vice versa. Young adults, females, patients with pre-existing depression, and residents of certain provinces reported higher levels of depression during COVID-19.

CONCLUSION

Our study underscores the significant impact of the COVID-19 pandemic on mental health, particularly among certain demographic groups. It emphasizes the need for depression screening and increased support for mental health during the pandemic, with a focus on mitigating financial burdens and reducing negative psychological impacts of social isolation. Our findings highlight the complex interplay between different stressors and the need to consider this when designing interventions to support mental health during times of crisis.

The neurological decline and psychological factors caused by coronavirus disease 2019 may be predictors of erectile dysfunction

BACKGROUND

Since the outbreak of coronavirus disease 2019, it has had a serious impact on people's physical and mental health. However, in our clinical work, we have found that the erectile function of coronavirus disease 2019 patients with neurological decline was often seriously affected.

OBJECTIVES

To further explore the relationship between erectile dysfunction and neurological dysfunction caused by coronavirus disease 2019.

MATERIALS AND METHODS

We conducted a survey from August 2022 to February 2023 at the First Affiliated Hospital of Anhui Medical University and the Third People's Hospital of Linyi City. A total of 251 subjects with a history of coronavirus disease 2019 infection were included. Symptoms and changes in erectile function after the coronavirus disease 2019 infection were collected and assessed using the International Index of Erectile Function-5 scale and several targeted questions.

RESULTS

In this study, we found that in patients infected with novel coronavirus, the proportion of erectile dysfunction was higher in those with neurological manifestations such as olfactory and taste impairment or psychological symptoms such as anxiety.

DISCUSSION

We found that neurological decline and psychological factors were independent and significant risk factors for erectile dysfunction caused by coronavirus disease 2019.

CONCLUSION

Patients with neurological damage or psychiatric symptoms are more likely to have erectile dysfunction, suggesting that the 2019 novel coronavirus may affect erectile function by damaging nerves. This provides a new insight into the mechanism of erectile dysfunction.

To Study the Distress, Anxiety, Depression, and Sleep Effects of the COVID-19 Pandemic on Essential Workers

Essential care workers like police personnel, social workers, and office and administrative staff of health institutions are also at increased risk of coronavirus disease 2019 (COVID-19) exposure along with healthcare workers. The present study aims to estimate the distress, anxiety, depression, and sleep impact of COVID-19 pandemic on essential workers through an online survey. This cross-sectional study (included 369 participants) was conducted in Chandigarh through an online survey using three psychological scales: Peritraumatic Distress Inventory (PDI), Insomnia Severity Index, and Depression Anxiety Stress Scale. Three-hundred-sixty-nine frontline warriors from hospital and community settings were included in the study. The respondents include police personnel (274; 73.66%), office staff (24; 6.45%), social workers (53; 14.24%), and media staff (21; 5.65%). Maximum distress was reported by media/transport officials on duty (85.7%). The majority of them scored high (>14), and slightly less than one-fourth (23.8%) scored significantly abnormal (>23) on PDI. About 42.9% reported moderate insomnia, 52.4% exhibited severe anxiety, and 33.3% of media/transport participants reported severe depression. Psychological morbidity is high in media/transport and social workers working in the community during the COVID-19 pandemic.

Intolerance of Uncertainty and Worry Prospectively Predict COVID-19 Anxiety and Distress: A 4-Year Longitudinal Study

The COVID-19 pandemic precipitated an uptick in poor mental health outcomes, including coronavirus-related anxiety and distress. Preliminary research has shown that intolerance of uncertainty (IU) and worry proneness, two transdiagnostic risk factors for anxiety and related disorders, are associated cross-sectionally with pandemic-related fear and distress. However, the extent to which IU and worry proneness prospectively predict coronavirus-related anxiety and distress is unclear. Whether IU and worry may also interact in prospectively predicting coronavirus-related anxiety and distress is also unknown. To address this knowledge gap, the present study examined IU and trait worry as prospective predictors of the level and trajectory of coronavirus anxiety and COVID stress syndrome over time, as well as the extent to which worry moderated the relation between IU and pandemic-related outcomes. Participants (n = 310) who completed self-report measures of IU and trait worry in 2016 were contacted following the onset of COVID-19 in 2020 and completed biweekly measures of coronavirus anxiety and COVID stress syndrome for 30 weeks. Multilevel models revealed that IU assessed in 2016 significantly predicted the severity of both coronavirus anxiety and COVID stress syndrome throughout the study period in 2020. Worry also moderated the link between IU and coronavirus anxiety, such that individuals with high levels of trait worry and high IU in 2016 experienced the most coronavirus anxiety in 2020. Results suggest that IU and worry functioned as independent and interactive vulnerability factors for subsequent adverse psychological reactions to COVID-19. Clinical implications and future directions are discussed.

Fatalism, Emotional Regulation, and Suicide Risk in Colombian Adults During the SAR-Cov-2 Disease Epidemic

The current pandemic of Severe Acute Syndrome (SAR-CoV-2) is a public health problem with implications for mental health. The study aimed to determine the prevalence of suicide risk and its association with fatalism and emotional regulation during SARS-CoV-2 in Colombia's adult population. A cross-sectional study was designed, an online format was used, which evaluated sociodemographic variables, CES-D-SI, the Fatalism Questionnaire against COVID-19, and the Emotional Regulation Scale. 435 Colombian adults participated, aged between 18 and 79 years. A prevalence of suicide risk was found in 5.3%, and it was associated with the interaction between living in rural area and less education (OR = 5.60, 95%CI 1.28-24.53), emotional dysregulation (OR = 3.54, 95%CI 1.77-7.09), and fatalistic beliefs (OR = 3.09, 95%CI 1.53-6.27). 5.3% of the population presented an elevated suicide risk. It was associated with less education, rural areas, fatalistic beliefs, and emotional dysregulation in the Colombian population during mandatory confinement due to SAR-CoV-2.

Physical Activity and Psychological Wellbeing Among Healthcare Students During the COVID-19 Pandemic

INTRODUCTION

Regular physical activity (PA) contributes to physical and mental wellbeing. Due to coronavirus disease 2019 (COVID-19)-related lockdowns in 2020, regular PA had been adjusted. Furthermore, students became accustomed to studying at home. Students in the healthcare field, in particular, have a better understanding of the link between PA and mental health. This study aimed to assess the association between psychological wellbeing and PA among healthcare students at one public university in Saudi Arabia during the COVID-19 pandemic period.

METHODS

This was a cross-sectional study conducted between November 2021 and February 2022. Healthcare students at one public university in Saudi Arabia were invited to participate in an online survey, consisting of three sections. The first section contained questions about demographic data. The second section was the International Physical Activity-Short Form (IPAQ-SF), which is composed of seven questions designed to assess the level of PA. The third part is The Center for Epidemiological Studies Depression Scale (CES-D), which is a self-reported questionnaire comprising 20 questions that assessed depressive symptoms on a four-point scale. Descriptive statistics, Chi-square test, Mann-Whitney U test, and Kruskal Wallis test were used to analyze the collected data using IBM SPSS Statistics for Windows, Version 28.0 (Released 2021; IBM Corp., Armonk, New York, United States).

RESULTS

The total responses received were 197 (response rate=60%). The majority of students in this sample were performing inadequate PA and reported depressive symptoms. No association was found between the amount of PA practiced and psychological wellbeing. There was a significant difference between specialties in relation to PA.

CONCLUSION

The majority of students in this sample were performing inadequate PA and reported depressive symptoms during the COVID-19 lockdown. The importance of PA should be promoted among healthcare students.

Exposure to urban green spaces and mental health during the COVID-19 pandemic: evidence from two low and lower-middle-income countries

Introduction

The COVID-19 pandemic has had a significant impact on mental health globally, with limited access to mental health care affecting low- and middle-income countries (LMICs) the most. In response, alternative strategies to support mental health have been necessary, with access to green spaces being a potential solution. While studies have highlighted the role of green spaces in promoting mental health during pandemic lockdowns, few studies have focused on the role of green spaces in mental health recovery after lockdowns. This study investigated changes in green space access and associations with mental health recovery in Bangladesh and Egypt across the pandemic.

Methods

An online survey was conducted between January and April 2021 after the first lockdown was lifted in Bangladesh (n = 556) and Egypt (n = 660). We evaluated indoor and outdoor greenery, including the number of household plants, window views, and duration of outdoor visits. The quantity of greenness was estimated using the normalized difference vegetation index (NDVI). This index was estimated using satellite images with a resolution of 10x10m during the survey period (January-April 2021) with Sentinel-2 satellite in the Google Earth Engine platform. We calculated averages within 250m, 300m, 500m and 1000m buffers of the survey check-in locations using ArcGIS 10.3. Multiple linear regression models were used to evaluate relationships between changes in natural exposure and changes in mental health.

Results

The results showed that mental health improved in both countries after the lockdown period. People in both countries increased their time spent outdoors in green spaces after the lockdown period, and these increases in time outdoors were associated with improved mental health. Unexpectedly, changes in the number of indoor plants after the lockdown period were associated with contrasting mental health outcomes; more plants translated to increased anxiety and decreased depression. Refocusing lives after the pandemic on areas other than maintaining indoor plants may assist with worrying and feeling panicked. Still, indoor plants may assist with depressive symptoms for people remaining isolated.

Conclusion

These findings have important implications for policymakers and urban planners in LMICs, highlighting the need to increase access to natural environments in urban areas to improve mental health and well-being in public health emergencies.

Perceived Epidemic Impacts and Mental Symptom Trajectories in Adolescents Back to School After COVID-19 Restriction: A Longitudinal Latent Class Analysis

PURPOSE

This study aimed to assess the impacts of COVID-19 epidemic on various life aspects and identify the trajectories of common mental symptoms among adolescents back to school after COVID-19 restriction. Furthermore, potential predictors associated with those trajectories were investigated.

METHODS

This longitudinal study, with five data collection points and a total follow-up of 68.4 days, was conducted among 1,393 junior high school students (mean age: 13.8 years; male, 53.3%) shortly after school reopened during the first COVID-19 outbreak in China. Questions on sociodemographics and perceived COVID-19 epidemic impacts were completed at the baseline while the Patient Health Questionnaire, Generalized Anxiety Disorder Scale, and Insomnia Severity Index were measured throughout the study for depression, anxiety, and insomnia symptoms, respectively. Trajectories of mental symptoms were classified by longitudinal latent class analysis, and the associated predictive factors were identified with multinomial regression modelling.

RESULTS

Our study revealed high but steadily declining prevalence of depression, anxiety, and insomnia symptoms (p trend < .001). Five distinctive trajectories were identified for both depression and anxiety ("resistance," "low symptom," "recovery," "chronic dysfunction," and "delayed dysfunction") and three for insomnia ("resistance," "low symptom," and "chronic dysfunction"). Besides the significant association between the mental symptom trajectories and students' perceived COVID-19 impacts on study practice, family income, and family relationship, female gender, lower school grade, and higher body mass index were found to be predictive of high severity trajectories.

DISCUSSION

Our findings may help locate the most psychologically vulnerable adolescents during the epidemic and foster better implementation of targeted intervention.

Screen Time and Child Behavioral Disorders During COVID-19 Pandemic: A Systematic Review

Background

The extensive use of various electronic games and communication devices, particularly among children and adolescents, has raised concerns, particularly during the COVID-19 pandemic. This study investigated the link between screen time and internalizing disorders, such as anxiety and depression, among individuals aged ≤18 during the global COVID-19 pandemic.

Methods

This systematic review aims to summarize scientific publications from 2019 to early 2022 by searching databases, including the Cochrane Library, PubMed, Web of Science, Scopus, and PsycINFO, to identify suitable studies. In each paper, we searched the following keywords and their synonyms: screen, child, high school, middle school, and psychiatric disorders. The quality of the selected papers was evaluated using a checklist recommended by the National Institutes of Health (NIH) for observational cohort studies.

Results

Out of 986 reports identified, we included 12 papers with 14,483 participants. The study revealed a negative correlation between screen time (TV, computer, video games, and mobile phones) and behavioral outcomes. Smartphones were the most frequently used devices, with video games being more prevalent among older participants for education, communication, and entertainment purposes. The prevalence of depression ranged between 10% and 25%. Furthermore, anxiety and depression were identified as predictors of increased screen usage. Some results displayed variation based on the type of screen exposure, the questionnaires used, and the age of the participants.

Conclusions

The findings imply an indirect association between increased screen time and depression and anxiety. It is crucial to consider limitations on screen time exposure and parental supervision as measures to prevent certain mental disorders.

Psychological Distress Associated with Enforced Hospital Isolation Due to COVID-19 during the "Flatten the Curve" Phase in Morocco: A Single-Center Cross-Sectional Study

(1) Background: although much research has highlighted the mental health challenges faced by patients in hospital isolation during the COVID-19 pandemic, data from low-middle-income countries, including Morocco, are lacking. The main objective of this study was to assess the psychological distress of patients undergoing enforced hospital isolation during the initial phase of the COVID-19 pandemic in Morocco. (2) Methods: we conducted a cross-sectional study between 1 April and 1 May 2020, among patients hospitalized in isolation for suspected or confirmed COVID-19 at the Ibn Sina University Hospital of Rabat, Morocco. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS). Binary logistic regression was performed to identify variables associated with anxiety and depression, with a cutoff of ≥8 used for both scales to create dichotomous variables. (3) Results: among 200 patients, 42.5% and 43% scored above the cut-off points for anxiety and depression, respectively. Multiple logistic regression identified female gender, a higher education level, a longer duration of isolation, and a poor understanding of the reasons for isolation as significant factors associated with anxiety. Conversely, female gender, chronic disease, a longer duration of isolation, and a poor understanding of the reasons for isolation were factors significantly associated with depression. (4) Conclusions: our study underscores high rates of anxiety and depression among patients forced into hospital isolation during the initial phase of COVID-19 in Morocco. We identified several factors associated with patients experiencing psychological distress that may inform future discussions on mental health and psychiatric crisis management.

Long-term psychological impact of the pandemic COVID-19: Identification of high-risk groups and assessment of precautionary measures five months after the first wave of restrictions was lifted

Critical facets of our lives have been disrupted by the COVID-19 outbreak for almost three years. During this time, there has been a lot of clinical and research interest in issues related to mental health. However, few have examined the pandemic's long-term psychological effects. The aims of the present study were to assess the long-term psychological impact of the pandemic COVID -19, five months after the first wave restriction measures were lifted, to identify high-risk groups and to address the use of precautionary measures (PM). Information about sociodemographic characteristics, mental health, coping mechanisms, and compliance with precautionary measures (PM) were all gathered in Cyprus through an anonymous online survey. The poll was completed by 1128 people (73% of whom were female). For the purposes of the present study, descriptive statistics and structural equation modeling were used. 32.3% of participants experienced moderate-to-severe anxiety symptoms, where 16.4% and 23% reported moderate-to-severe depression and post-traumatic stress symptoms respectively. Lower levels of anxiety, depression, and post-traumatic stress symptoms as well as greater compliance to PM were linked to higher levels of resilience. Additionally, subgroups of participants, at a higher risk for negative psychological effects were identified, such as women and young adults. Our findings demonstrate the long-lasting effects of the COVID-19 pandemic on mental health and provide guidance on how to deal with similar situations. It also raises questions about the concurrent effects on people with the long COVID syndrome.

Effects of internet-based exercise intervention on depression and anxiety: A systematic review and meta-analysis

BACKGROUND

While exercise is acknowledged for its positive effects on depression and anxiety symptoms, the benefits of internet-based exercise on mental health have not been extensively examined. This study seeks to systematically review and quantify the outcomes of high-quality randomized controlled trials (RCTs) that investigate the impact of internet-based exercise on depression and anxiety symptoms.

METHODS

Following the PRISMA 2020 guidelines, we conducted a comprehensive meta-analysis of RCTs. Databases, including Web of Science Core Collection, PubMed, PsycINFO, Medline, BIOSIS Previews, SPORTDiscus, and Education Source, were scoured through in September 2023. After quality assessment and data extraction, the analysis was performed using R. Using random effects models, effect sizes were determined and subsequently represented as standardized mean differences (SMD).

RESULTS

Our analysis incorporated data from 11 RCTs, involving a cohort of 1009 participants. We observed a modest yet significant reduction in depression and anxiety symptoms, with an SMD of -0.44 [95% confidence interval (CI) (-0.63, -0.26), I^2 = 79.3%, P < .01]. Interestingly, the effects were more pronounced in individuals diagnosed with depression, as indicated by an SMD of -0.96 [95% CI (-1.55, -0.37), I^2 = 82%, P < .01]. Furthermore, participants utilizing smartphone applications as part of their intervention reported a meaningful reduction in their symptoms, evidenced by an SMD of -0.52 [95% CI (-0.90, -0.14), I^2 = 87%, P < .01]. Additionally, short-term interventions, specifically those lasting <12 weeks, indicated a notable alleviation in depression symptoms, with an SMD of -0.76 [95% CI (-1.38, -0.14), I^2 = 86%, P < .01].

CONCLUSION

Internet-based exercise interventions yield significant amelioration in depression and anxiety symptoms, with heightened efficacy observed among individuals with depression. Notably, short-term interventions, specifically those under 12 weeks, demonstrate enhanced benefits for depression relief.

The mental burden of stay-at-home order extensions during COVID-19

This study evaluates the psychological impact of stay-at-home extension orders during COVID-19 and its relationship with individuals' expectations on the duration of the extensions. An online survey was administered to 1259 US adult residents to measure symptoms of post-traumatic stress disorder (PTSD), anxiety and stress induced by different stay-at-home order extensions using hypothetical length scenarios. We find that individuals exposed to two 2-week order extensions exhibit higher levels of stress and anxiety compared to those exposed to a single 4-week extension. We also find that subjects with longer expected extensions exhibit more signs of psychological damage than those with shorter expected extensions. Furthermore, we find that the negative psychological consequences of providing two shorter extensions is observed only among subjects with extension expectations of four weeks or less. Our results demonstrate that people's expectations affect the level of psychological damage caused by lockdown mandates. Our findings suggest that whenever lockdown extensions are necessary, reduced psychological distress may be possible by implementing a one-time restriction, rather than extending multiple smaller extensions perhaps due to manipulation of personal expectations.

Mental health during the COVID-19 pandemic and first lockdown in Lebanon: Risk factors and daily life difficulties in a multiple-crises setting

INTRODUCTION

Research from around the world shows important differences in the impact of the COVID-19 pandemic and lockdowns on mental health. This study examined the extent of mental health challenges (depressive and anxiety symptoms and daily life difficulties) and their associations with pandemic- and response-related factors during the first lockdown in Lebanon, which happened amid a severe economic crisis and socio-political turmoil.

METHODS

Data come from a cross-sectional internet-based survey (May-June 2020). Association of depressive (Patient Health Questionnaire (PHQ-9)) and anxiety symptoms (Generalized Anxiety Disorder (GAD-7)) with outbreak-related worries and knowledge, information sources, and confidence and satisfaction in response measures were estimated using logistic regression adjusted for sociodemographic and socioeconomic indicators.

RESULTS

Among 510 participants (mean age 36.1±11.3; 69.4% women), 32.3% had elevated depressive and 27.3% had elevated anxiety symptoms; younger age, unemployment, loss of employment, and lower income were related to more mental health symptoms. Most prevalent daily life challenges were feelings of uncertainty (74.5%) and financial (52.2%) and emotional (42.2%) difficulties; these and all other daily life difficulties (work-related, caregiving, and online learning) were significantly higher among participants with higher depressive and anxiety symptoms. Higher outbreak-related worries were associated with higher depressive (OR = 1.36, 95% CI = 1.20,1.53) and anxiety symptoms (OR = 1.47, 95% CI = 1.30,1.67). Higher pandemic-related knowledge, reliance on and trust in local health agencies and professionals' information, and satisfaction and confidence regarding governmental and health institutions' response were all related to lower mental health symptoms.

CONCLUSION

Results show that mental health burden in Lebanon during the first lockdown (when the COVID-19 outbreak was still minimal) is among the highest reported worldwide and highlight elevated emotional and financial tolls and widespread impact on daily life. In this high-burden and multiple-challenges context, results suggest an important role for the healthcare body, knowledge, and trust in the institutions managing the response.

A Lonelier World after COVID-19: Longitudinal Population-Based Study of Well-Being, Emotional and Social Loneliness, and Suicidal Behaviour in Slovenia

Background and Objectives: The impact of coronavirus disease 2019 (COVID-19) goes beyond the consequences of the infectious disease, especially as the measures taken to prevent the spread of the virus have had a very profound impact on people's social relationships and everyday lives. Several studies have investigated these effects, but there is a lack of longitudinal studies in Central Europe. Objective: The aim of our study was to observe changes in well-being, loneliness, and suicidal behaviour before, during, and after the COVID-19 pandemic using the same population-based cohort. Materials and Methods: A representative sample of 440 participants completed online questionnaires at four time points: 2019 (wave 0), 2021 (wave 1), 2022 (wave 2), and 2023 (wave 3). Results: The results show significant changes in the levels of well-being and loneliness over these periods. In particular, both social and emotional loneliness increased during the pandemic, while emotional loneliness increased to a greater extent without further decreases. Well-being appeared to increase after pandemic-related restrictions diminished but decreased again one year later. No significant changes concerning suicidal ideation were observed. Conclusions: Our study suggests that the COVID-19 pandemic changed the way in which people perceive their well-being and especially their relationships with others. From the data, we can conclude that people's worldview is now lonelier than before the pandemic.

Positive and negative emotions during the COVID-19 pandemic: A longitudinal survey study of the UK population

The COVID-19 pandemic has had a profound impact on society; it changed the way we work, learn, socialise, and move throughout the world. In the United Kingdom, policies such as business closures, travel restrictions, and social distance mandates were implemented to slow the spread of COVID-19 and implemented and relaxed intermittently throughout the response period. While negative emotions and feelings such as distress and anxiety during this time of crisis were to be expected, we also see the signs of human resilience, including positive feelings like determination, pride, and strength. A longitudinal study using online survey tools was conducted to assess people's changing moods during the pandemic in the UK. The Positive and Negative Affect Schedule (PANAS) was used to measure self-reported feelings and emotions throughout six periods (phases) of the study from March 2020 to July 2021. A total of 4,222 respondents participated in the survey, while a sub-group participated in each of the six study phases (n = 167). The results were analysed using a cross-sectional study design for the full group across each study phase, while prospective cohort analysis was used to assess the subset of participants who voluntarily answered the survey in each of the six study phases (n = 167). Gender, age and employment status were found to be most significant to PANAS score, with older people, retirees, and women generally reporting more positive moods, while young people and unemployed people generally reported lower positive scores and higher negative scores, indicating more negative emotions. Additionally, it was found that people generally reported higher positive feelings in the summer of 2021, which may be related to the relaxation of COVID-19-related policies in the UK as well as the introduction of vaccines for the general population. This study is an important investigation into what allows for positivity during a crisis and gives insights into periods or groups that may be vulnerable to increased negative states of emotions and feelings.

Psychological well-being of healthcare workers during COVID-19: Relationship with risk perception and fear in the context of health belief model

This study aimed to evaluate the extent of fear and risk perception related to COVID-19 and their impact on the psychological well-being of healthcare workers. Data were gathered through an online survey, incorporating questions about risk perception utilizing the health belief model, the Fear of COVID-19 Scale, and the General Health Questionnaire-12. A total of 364 HCWs participated in the survey, with 94% of participants identified as being in the high-risk category for mental disorders based on their General Health Questionnaire scores. The assessment of COVID-19-related risk perception within the Health Belief Model demonstrated significant correlations between perceived susceptibility, perceived severity, perceived barriers, and self-efficacy with both the fear scale and General Health Questionnaire scores. Linear regression was employed to identify factors influencing General Health Questionnaire scores, revealing that risk perception, Fear of COVID-19 scores, marital status, and perceived health were significantly associated with General Health Questionnaire scores. These findings underscore the importance of monitoring the psychological well-being of healthcare workers throughout all stages of pandemic preparedness and response.

A Longitudinal Study of the Influence of the COVID-19 Pandemic on Anxiety and Stress among Medical University Students

(1) Background: The COVID-19 pandemic was declared an international health emergency by the World Health Organization. The dramatic, widespread transmission of the virus, high mortality, and lack of specific drugs caused the development of panic attacks and anxiety. Healthcare professionals, including medical students, were challenged to provide medical care to patients in need, often exposing themselves to the virus. (2) Methods: This study aimed to assess anxiety and stress levels in medical students, both at the beginning and after the end of the COVID-19 pandemic. The STAI and PSS-10 questionnaires were used. (3) Results: This study showed a decrease in anxiety levels among medical students after the end of the COVID-19 pandemic. In both 2020 and 2022, female students were found to experience higher stress levels than male students. Anxiety levels were similar among students of different medical-related faculties. (4) Conclusions: The COVID-19 pandemic caused stress and anxiety among medical students, which decreased throughout the duration of the pandemic.

Determinants of Psychosocial Health Status in Pregnant and Postpartum Women Experiencing Earthquake in Turkey

OBJECTIVE

It is well known that natural disasters such as earthquakes negatively affect physical and mental health by exposing people to excessive stress. The aim of this study was to investigate determinants of psychosocial health status among the pregnant and postpartum women who experienced earthquake in Türkiye.

METHODS

Pregnant and postpartum women (n = 125) living in tent cities in the Kahramanmaraş region formed the study sample. Data were collected between February 20 and 26, 2023, through face-to-face interviews. The instruments used for data collection were the Introductory Form, the Depression Anxiety Stress Scale, the Traumatic Childbirth Perception Scale, and the Post-Traumatic Stress Disorder-Short Scale.

RESULTS

A moderate positive relationship was found between stress and posttraumatic stress and traumatic childbirth perception in pregnant and postpartum women, and a high positive relationship was found between anxiety and depression. A high level of relationship was found between anxiety and stress and depression.

CONCLUSIONS

It is seen that the psychosocial health of pregnant and postpartum women, who belong to the risk group in the earthquake zone, is at high risk. Psychological support is urgently needed to preserve and improve their psychosocial health.

Job loss and mental disorders: International evidence from the early stages of COVID-19 outbreak

Using a rich individual level dataset from six countries, we examine the relationship between job loss and mental disorders during the first phase of the COVID-19 pandemic. We consider four indicators of mental disorders based on their severity, viz. anxiety, insomnia, boredom, and loneliness. We draw our conclusions based on two groups of countries that differ by the timing of their peak infections count. Using a logit and a two-stage least squares (TSLS) regression methods, we find that the people who lost their jobs due to the pandemic are more likely to suffer from mental disorders, especially insomnia and loneliness. Additionally, people with financial liabilities, such as housing mortgages, are among those vulnerable to anxiety. Women, urban residents, youth, low-income groups, and tobacco users are more prone to mental disorders. The findings from this research have significant policy implications on infectious disease control measures and mental health conditions due to lockdowns and social distancing.

Student mental health during the COVID-19 pandemic: Are international students more affected?

Background: The psychological well-being of students may be especially affected by the COVID-19 pandemic; international students can lack local support systems and represent a higher risk subgroup. Methods: Self-reported depressive symptoms, suicidal ideation, anxiety, post-traumatic stress disorder (PTSD), insomnia, alcohol use, academic stress, and loneliness were examined in two cohorts of university students (March 2020 n = 207, March 2021 n = 142). We investigated differences i) between 2020 and 2021, ii) between domestic and international students, and ii) whether differences between the two cohorts were moderated by student status. Results: More depressive symptoms, academic stress, and loneliness were reported in 2021. International students reported more depressive symptoms, suicidal ideation, anxiety, PTSD, academic stress, and loneliness. The main effect of cohort was not moderated by student status. Conclusions: International students had worse mental health outcomes overall, but were not affected more by the COVID-19 pandemic than domestic students.

A qualitative interview study exploring the psychological health impacts of the SPIN-CHAT program among people with systemic sclerosis at the onset of COVID-19: perceptions of trial participants and research team members

PURPOSE

Explore trial participants' and research team members' perceptions of the impact of the videoconference-based, supportive care program (SPIN-CHAT Program) during early COVID-19 for individuals with systemic sclerosis (SSc).

METHODS

Data were collected cross-sectionally. A social constructivist paradigm was adopted, and one-on-one videoconference-based, semi-structured interviews were conducted with SPIN-CHAT Trial participants and research team members. A hybrid inductive-deductive approach and reflexive thematic analysis were used.

RESULTS

Of the 40 SPIN-CHAT Trial participants and 28 research team members approached, 30 trial participants (Mean age = 54.9; SD = 13.0 years) and 22 research team members agreed to participate. Those who took part in interviews had similar characteristics to those who declined. Five themes were identified: (1) The SPIN-CHAT Program conferred a range of positive psychological health outcomes, (2) People who don't have SSc don't get it: The importance of SSc-specific programming, (3) The group-based format of the SPIN-CHAT Program created a safe space to connect and meet similar others, (4) The structure and schedule of the SPIN-CHAT Program reduced feelings of boredom and contributed to enhanced psychological health, (5) The necessity of knowledge, skills, and tools to self-manage SSc and navigate COVID-19.

CONCLUSION

Participants' and research team members' perspectives elucidated SPIN-CHAT Program benefits and how these benefits may have been realized. Results underscore the importance of social support from similar others, structure, and self-management to enhance psychological health during COVID-19.

TRIAL REGISTRATION

clinicaltrials.gov (NCT04335279)IMPLICATIONS FOR REHABILITATIONThe videoconference-based, supportive care SPIN-CHAT Program enhanced psychological health amongst individuals affected by systemic sclerosis.SPIN-CHAT Program participants and research team members shared that being around similar others, program structure, and self-management support were important and may have contributed to enhanced psychological health.Further efforts are required to explore experiences within supportive care programs to better understand if and how psychological health is impacted.

University students coping with COVID-19 challenges: Do they need help?

Objective: This study examined students' perceived levels of coping and need for help, and the relationship with their risks and protective factors during the early stages of the COVID-19 pandemic in Israel. Participants: A sample of 4,710 university students responded anonymously to an online questionnaire. Methods: The risk and protective factors assessed were: specific COVID-related functional difficulties, levels of social support, and trust in the university authorities and the government in handling the crisis. Results: The most frequent COVID-19 related difficulties were: worry for the health of family members (64.4%) and difficulties with online learning (63.2%). Almost half of the students (47.3%) reported that they needed at least a little help. Hierarchical regression analyses for coping and need for help showed that COVID-related difficulties predicted lower levels of perceived coping and a higher need for help. Conclusions: Universities need to build specific services for students to provide concrete support throughout this continuous health crisis.

Chronic kidney disease in the shadow of COVID-19: insights from the bibliometric analysis

OBJECTIVE

This study aims to present the current status and frontiers of research on COVID-19 in relation to chronic kidney disease through bibliometric analysis and visualization.

METHODS

Access to information through the Web of Science Core Collection, retrieved from December 2019 to May 2023. The bibliometric visualization of countries, institutions, and keywords was analyzed using VOSviewer.

RESULTS

A total of 1038 publications are included. The global scientific community showed a high level of collaborative consensus. The three countries with the most publications are the USA, China, and the UK. The institution with the most publications is Harvard Medical School. The research frontier for 2020 is thrombosis, for 2021 is telemedicine, for 2022 is depression, and for 2019-2023 is the COVID-19 vaccines.

CONCLUSIONS

This is the first bibliometric report to establish a link between COVID-19 and CKD. The USA, China, and some European countries and their institutions are major contributors to these publications. Thrombosis, telemedicine, depression, and COVID-19 vaccines are current hot topics in the field and have the potential to shape future research trends.

The Combined Outcomes of the COVID-19 Pandemic and a Collapsing Economy on Mental Well-Being: A Cross-Sectional Study

Objective: This study aimed to examine the outcomes of COVID-19 and a collapsing economy on the mental well-being (MWB) of the general Lebanese population. Methods: A cross-sectional study was conducted online in May 2020 and enrolled 502 adults. Results: Mental well-being had a mean of 14.80 (14.37; 15.24). A lower MWB was associated with female gender (beta=-1.533 [-2.324; -0.743]), university education (beta=-2.119 [-3.353;-0.885]), fear of COVID-19 (beta=-0.131 [-0.199; -0.063]), fear of poverty (beta=-0.232 [-0.402;-0.063]), verbal violence at home (beta=-3.464 [-5.137; -1.790]), and chronic disease (beta=-1.307 [-2.283; -0.330]). Better family satisfaction (beta=0.380 [0.235; 0.525]) and better financial situation (beta=0.029 [0.003; 0.055]) were significantly correlated with better MWB. In the subsample of workers/looking for a job, additional factors affected MWB: physical exercise (beta =1.318 [0.370; 2.265]) was associated with better QOL, while being a previous waterpipe smoker, being self-employed before the crisis (beta=-1.22 [-2.208;-0.231]), working from home since the economic crisis (-1.853 [-3.692; -0.013]), and worrying about the long-term effects of the crisis on one's employment status (beta=-0.433 [-0.650; -0.216]) were associated lower MWB. It is noteworthy that closure of the institution yielded a borderline result (B = -1.2; p = .094), while the fear of COVID-19 was not significantly associated with MWB (B = -0.054; p =0.192). Conclusion: This study showed that, during the pandemic, economic and other factors, directly or indirectly related to COVID-19, significantly affected quality of life. The fear of COVID-19 and fear of poverty mainly impacted the MWB of the general population. However, the fear of COVID-19 lost its significance among workers, who reported that factors negatively affecting their MWB are directly related to their employment and the already collapsing economy in Lebanon.

The flashbulb-like nature of memory for the first COVID-19 case and the impact of the emergency. A cross-national survey

Flashbulb memories (FBMs) refer to vivid and long-lasting autobiographical memories for the circumstances in which people learned of a shocking and consequential public event. A cross-national study across eleven countries aimed to investigate FBM formation following the first COVID-19 case news in each country and test the effect of pandemic-related variables on FBM. Participants had detailed memories of the date and others present when they heard the news, and had partially detailed memories of the place, activity, and news source. China had the highest FBM specificity. All countries considered the COVID-19 emergency as highly significant at both the individual and global level. The Classification and Regression Tree Analysis revealed that FBM specificity might be influenced by participants' age, subjective severity (assessment of COVID-19 impact in each country and relative to others), residing in an area with stringent COVID-19 protection measures, and expecting the pandemic effects. Hierarchical regression models demonstrated that age and subjective severity negatively predicted FBM specificity, whereas sex, pandemic impact expectedness, and rehearsal showed positive associations in the total sample. Subjective severity negatively affected FBM specificity in Turkey, whereas pandemic impact expectedness positively influenced FBM specificity in China and negatively in Denmark.

Short-Term and Long-Term Impact of COVID-19 on Quality of Life and Psychological Outcomes in Saudi Arabia: A Comparative Cross-Sectional Study

Background

Prior research has revealed notable declines in health-related quality of life (HRQoL) and substantial psychological impacts among individuals infected with COVID-19. However, there is a noticeable gap in studies addressing the enduring long-term effects of COVID-19 on HRQoL and psychological well-being.

Objective

The current study investigated and compared short and long-term effects of COVID-19 on HRQoL and psychological outcomes among the Saudi population.

Methods

The Arabic version of the SF-36 questionnaire was used to assess HRQoL while Anxiety and depression were evaluated by the Hamilton Anxiety (HAM-A) and Depression Scales (HDRS). Participants (n=292) were categorized into three groups: the "never-been-infected" group (n=134), the "one-year infected group" (n=43), and the "more than one year infected" group (n=115). Descriptive statistics were presented using numerical values and frequencies. To compare the groups, a one-way analysis of variance (ANOVA) test was used.

Results

Most SF-36 domains exhibited lower values while HAM-A and HDRS values were higher in individuals infected during last year compared to those who never infected. Social functioning subscale of the SF-36 showed a significant difference between the groups (F (2.289) = 6.094, p = 0.01) and the effect size was d = 0.95. Pairwise comparison showed a significant reduction in the social functioning component of SF-36 in "one-year group" compared to both groups "never-been-infected" group (mean difference -13.58 (4.40-22.76) p < 0.01) and "more than one year infected" group (mean difference -10.80 (1.44-20.16) p = 0.02). HAM-A and HDRS scores showed mild levels of anxiety (<17 score) and depression (8 to 16 score) in all groups.

Conclusion

The influence of COVID-19 on psychological well-being and HRQoL is significant regardless of whether individuals infected with the virus. Overall, the consistent presence of mild anxiety and depression across all groups highlights the need for a holistic approach to mental health.

The experiences and impact on wellness among international students in the United States during the COVID-19 pandemic

Objective Assessing experiences and impact on wellness among international students during the COVID-19 pandemic. Participants: 405 undergraduate and graduate international students from 65 countries studying at a large public university. Methods: An online, voluntary and anonymous survey consisting of 50 quantitative and qualitative questions was conducted through Qualtrics. Descriptive and frequency analyses were used. Results: 27% of the students had concerns about the changes in student visa status that could seriously disrupt their studies in the U.S. 66.2% of them reported a moderate level, 18.8% reported a high level of stress related to the pandemic. Students identified the highest confidence in getting tested for infection but the lowest confidence in getting treatment if infected. They preferred telehealth for mental health services. Conclusions: Universities can best help international students by assisting with student visa and international travel issues, access to treatment for COVID-19 infection and developing telehealth for mental health services.

Assessment of lifestyle changes related to quarantine among Saudi population during the early COVID-19 pandemic: pre- and post-analysis

BACKGROUND

The escalating emergence of the COVID-19 pandemic interrupted human life due to the ever-increasing morbidity, containment measures, and the associated emotional distress. This study examined the influence of COVID-19-related measures on the lifestyle behaviors of adults living in the Kingdom of Saudi Arabia (KSA).

METHODS

The study recruited 638 participants through convenience sampling in Jeddah and Taif cities, Saudi Arabia. Demographic characteristics and COVID-19-related information were collected through an anonymous self-reported electronic questionnaire. Lifestyle behaviors were assessed before and during the quarantine using the Healthy Dietary Habits Index (HDHI)-A and the International Physical Activity Questionnaire (IPAQ-SF).

RESULTS

The study revealed significant changes in the dietary pattern: a reduction in fish intake and increased consumption of French fries and candies. Vegetables and fruit intake increased significantly. Sedentary time > 6 h per day increased from 36.7% pre to 60.8% during the pandemic. Healthy dietary index score and physical activity MET-minutes/week values were respectively 3.5% and 37.9% significantly higher before compared to the full quarantine period.

CONCLUSION

The pandemic detrimentally influenced eating habits and physical activity levels that led to weight gain, and hence higher vulnerability to COVID-19 infection and negative outcomes. This analysis provides public health agencies with data to tailor nutrition interventions that mitigate the observed adverse lifestyle behaviors.

Australian adults cooked more and tried new recipes during COVID-19 restrictions and lockdowns

The lockdowns and restrictions due to COVID-19 caused changes in both food accessibility and availability for people around the globe resulting in changes in food habits and behaviours. To enable a better public health response to the next pandemic, lessons must be learnt from this most recent emergency. This study aimed to examine self-reported changes in food habits and behaviours, of Australian adults during COVID-19 restrictions in 2020. A cross-sectional, convenience, Australia-wide survey, with open-ended and closed-ended questions was conducted online. Respondents were asked to report their demographic characteristics, positive food habit development, worst food-related experiences, changes in food habits and behaviours and cooking and food preparation practices during the COVID-19 restriction period. Adult Australian residents, recruited through social media advertising of the survey. Respondents (n = 764) were mostly female (86%), over 55 years of age (57%, mean age (SD) 53.4 (18.1) years), and half (51%) were not in paid employment. Nearly two-thirds (63%) developed positive food habits, including trying new recipes (54%), eating less take-away (53%) and cooking from scratch (46%) during the COVID-19 restrictions. Furthermore, respondents reported including family members in food preparation and eating together as a family. Negative experiences included being unable to buy certain foods (due to lack of stock and store limits), cooking at home, and being unable to access some food outlets. Australians experienced both positive and negative food experiences during the COVID-19 pandemic and associated lockdown periods, with most experiencing positive changes such as cooking at home from scratch and trying new recipes and relying on less take-away. Females and those who experienced a change in employment status were more likely to develop positive new food habits.

Prevalence and factors for anxiety and depression among secondary school teachers from Sfax city of Tunisia in times of the coronavirus disease 2019 pandemic: a cross-sectional study

Introduction

teachers have to adapt during the coronavirus disease 2019 (COVID-19) pandemic to many changes that could potentially make them more vulnerable to psychological distress. We aimed to assess anxiety and depression in Tunisian secondary school teachers during the COVID-19 pandemic and to explore their associated factors.

Methods

we conducted a cross-sectional survey concerning Tunisian secondary school teachers between May 1st, 2021, and June 30th, 2021, using an online survey platform via Google Forms. Participants were asked to fill in a form including two psychometric tests: the General Anxiety Disorder 7 (GAD-7) and the Patient Health Questionnaire 9 (PHQ-9). We performed both univariable and multivariable logistic regression analyses.

Results

a total of 170 secondary school teachers were included, of whom 22.4% (n=38) were males and 77.6% (n=132) were females. The median age was 45.5 years (Q1=39, Q3=49). The overall anxiety prevalence was 34.7% (n=59) while it was 41.7% (n=71) for depression. In multivariable analysis, anxiety was strongly associated with sleep disturbances (aOR: 5.1; 95% CI: 1.80-14.45; p=0.002) and depression (aOR: 33.91; 95% CI: 12.32-93.33; p<0.001) while depression was strongly associated with dissatisfaction with working conditions (aOR: 3.99; 95% CI: 1.49-10.65; p=0.006), the irregular wearing of protective masks (aOR: 3.94; 95% CI: 1.33-11.66; p=0.013) and anxiety (aOR=51.63; 95% CI: 17.74-150.25; p<0.001).

Conclusion

secondary school teachers in Tunisia are characterized by a high rate of anxiety and depressive disorders which are related to personal and professional factors on which we can act by supplying of educational institutions by protective masks, the implementation of programs for adjusting working conditions and the practice of non-pharmacological interventions for insomnia management.

Isolating unique variance in mental health outcomes attributable to personality variables and childhood emotional abuse

Introduction

University students are at high risk for anxiety and depression. Our main objective was to tease apart variance in symptom severity that was uniquely attributable to four associated variables that are frequently confounded: exposure to childhood emotional abuse, alexithymia, sensory processing sensitivity (SPS), and anxiety sensitivity (AS).

Methods

University students (N = 410) completed an online survey designed to measure our four key study variables along with several other potentially relevant variables including sex, physical activity levels, and perceived COVID-19 impacts.

Results

Over half of the participants reported moderate to extremely severe symptoms of anxiety and depression. Females reported stronger signs of SPS and AS and were more likely than males to have increased their moderate/vigorous exercise since the pandemic began. After controlling for the other variables, the best predictors of perceived COVID-19 impacts were SPS, childhood emotional abuse, and current levels of physical activity. Whereas all three personality variables and childhood emotional abuse emerged as significant predictors of both depression and anxiety, neither COVID-19 impacts nor physical activity levels accounted for unique variance in either model. Unexpectedly, male sex emerged as an additional risk factor for depression, raising the possibility that males experience unique stressors and societal pressures that increase their risk of depression.

Discussion

These findings help to clarify the links between childhood emotional abuse, personality traits implicated in emotional awareness and self-regulation, and mental health. They may have important implications for the development and implementation of individualized treatments for common mental disorders.

Airborne transmission risks of tuberculosis and COVID-19 in schools in South Africa, Switzerland, and Tanzania: Modeling of environmental data

The COVID-19 pandemic renewed interest in airborne transmission of respiratory infections, particularly in congregate indoor settings, such as schools. We modeled transmission risks of tuberculosis (caused by Mycobacterium tuberculosis, Mtb) and COVID-19 (caused by SARS-CoV-2) in South African, Swiss and Tanzanian secondary schools. We estimated the risks of infection with the Wells-Riley equation, expressed as the median with 2.5% and 97.5% quantiles (credible interval [CrI]), based on the ventilation rate and the duration of exposure to infectious doses (so-called quanta). We computed the air change rate (ventilation) using carbon dioxide (CO2) as a tracer gas and modeled the quanta generation rate based on reported estimates from the literature. The share of infectious students in the classroom is determined by country-specific estimates of pulmonary TB. For SARS-CoV-2, the number of infectious students was estimated based on excess mortality to mitigate the bias from country-specific reporting and testing. Average CO2 concentration (parts per million [ppm]) was 1,610 ppm in South Africa, 1,757 ppm in Switzerland, and 648 ppm in Tanzania. The annual risk of infection for Mtb was 22.1% (interquartile range [IQR] 2.7%-89.5%) in South Africa, 0.7% (IQR 0.1%-6.4%) in Switzerland, and 0.5% (IQR 0.0%-3.9%) in Tanzania. For SARS-CoV-2, the monthly risk of infection was 6.8% (IQR 0.8%-43.8%) in South Africa, 1.2% (IQR 0.1%-8.8%) in Switzerland, and 0.9% (IQR 0.1%-6.6%) in Tanzania. The differences in transmission risks primarily reflect a higher incidence of SARS-CoV-2 and particularly prevalence of TB in South Africa, but also higher air change rates due to better natural ventilation of the classrooms in Tanzania. Global comparisons of the modeled risk of infectious disease transmission in classrooms can provide high-level information for policy-making regarding appropriate infection control strategies.

A comparison of rate and methods of probable suicide for 2 years pre and post the onset of the COVID-19 pandemic

OBJECTIVES

To examine and compare rates and methods of probable suicide in a Western region of Ireland during a 24 month period since the onset of the COVID-19 pandemic compared with a similar period immediately prior to the pandemic onset.

METHODS

Post-mortem reports between March 1st 2018 and February 29th 2020 were reviewed and compared with data from March 1st 2020 to February 28th 2022. Relevant demographic data, rates and methods of probable suicide and lifetime engagement with mental health services were compared across the two time points.

RESULTS

Identical rates of probable suicide (85 individuals at both time points) were demonstrated with no difference evident in the utilisation of violent compared to non-violent methods.

CONCLUSIONS

This study demonstrates that despite previous reports of increased rates of self-harm and some evidence of increased mental distress since the onset of the COVID-19 pandemic, no change in rates of or methods employed by individuals who died by probable suicide were evident in this geographical region.

Urban green space visitation and mental health wellbeing during COVID-19 in Bangkok, Thailand

Urban green spaces offer numerous benefits, and their role in supporting mental health, particularly during global crises such as the COVID-19 pandemic, is of growing interest to researchers and policymakers. This study explored the relationship between urban green space visitation and mental health well-being during the COVID-19 pandemic in Bangkok, Thailand. This cross-sectional study, conducted in Bangkok during the COVID-19 lockdown, used a telephone survey of 579 respondents. A logistic regression model was employed to examine the association between urban green space visitation and the WHO-5 mental health well-being score, considering various factors such as socioeconomic variables, healthy behaviors, and COVID-19-related experiences. The findings revealed a significant association between urban green space visitation during the lockdown and higher mental health well-being. Socioeconomic variables and healthy behaviors of respondents were also notably linked to higher WHO-5 mental health well-being scores. These findings collectively indicate that urban greenspace visitation serves as a crucial determinant of mental health and well-being, especially during the COVID-19 pandemic.

Relationship between health literacy and generalized anxiety disorder during the COVID-19 pandemic in Khuzestan province, Iran

Introduction

During the COVID-19 pandemic, many changes occurred in various cultural, social, and economic fields, leading to the creation of psychological effects, especially anxiety, in the community. Fear and anxiety about emerging diseases (COVID-19) and less participation in preventive behaviors reduce individual resistance and ultimately lower one's quality of life. Therefore, we aimed to investigate the relationship between health literacy and generalized anxiety disorder during the COVID-19 pandemic in Khuzestan province, Iran.

Methods

This was a descriptive-analytical (cross-sectional) study conducted among participants aged 18-65 in Khuzestan province during the years 2020-2021 through online sampling. Due to the prevalence of COVID-19 and the impossibility of face-to-face communication, the questionnaire was designed on the Porseline Survey website and the questionnaire link was provided to participants through WhatsApp and Telegram. The data collection tool includes the Iranian Health Literacy Questionnaire, which includes 33 items, and the Generalized Anxiety Disorder-7 scale, which has 7 items based on a Likert scale. Data analysis was performed using STATA14 software and descriptive and analytical statistical tests at a significant level less than 0.05.

Results

The mean (standard deviation) score for health literacy was 52.9 ± 9.3 and for generalized anxiety disorder was 5.2 ± 3.1. A significant negative correlation was found between the mean of anxiety disorder and health literacy (p < 0.05). The frequency of health literacy in individuals included 427 (37.8%) with inadequate health literacy, 628 (55.6%) with marginal health literacy, and 75 (6.6%) with sufficient health literacy. There was a statistically significant difference between the mean of generalized anxiety disorder among individuals with different levels of health literacy (p < 0.05).

Conclusion

As the level of health literacy increases, the prevalence of generalized anxiety disorder caused by fear of COVID-19 decreases. Therefore, increasing awareness and health literacy about this virus, its transmission, and prevention methods is very effective in managing anxiety and stress caused by COVID-19. Paying attention to the issue of health literacy and generalized anxiety disorder, and promoting preventive behaviors can be effective tools for planners, health officials, and policymakers to promote health literacy for any type of disease.

Students' mental health during the pandemic: results of the observational cross-sectional COVID-19 MEntal health inTernational for university Students (COMET-S) study

Introduction

The aim of the study was to search rates of depression and mental health in university students, during the COVID-19 pandemic.

Materials and methods

This is an observational cross-sectional study. A protocol gathering sociodemographic variables as well as depression, anxiety and suicidality and conspiracism was assembled, and data were collected anonymously and online from April 2020 through March 2021. The sample included 12,488 subjects from 11 countries, of whom 9,026 were females (72.2%; aged 21.11 ± 2.53), 3,329 males (26.65%; aged 21.61 ± 2.81) and 133 "non-binary gender" (1.06%; aged 21.02 ± 2.98). The analysis included chi-square tests, correlation analysis, ANCOVA, multiple forward stepwise linear regression analysis and Relative Risk ratios.

Results

Dysphoria was present in 15.66% and probable depression in 25.81% of the total study sample. More than half reported increase in anxiety and depression and 6.34% in suicidality, while lifestyle changes were significant. The model developed explained 18.4% of the development of depression. Believing in conspiracy theories manifested a complex effect. Close to 25% was believing that the vaccines include a chip and almost 40% suggested that facemask wearing could be a method of socio-political control. Conspiracism was related to current depression but not to history of mental disorders.

Discussion

The current study reports that students are at high risk for depression during the COVID-19 pandemic and identified specific risk factors. It also suggested a role of believing in conspiracy theories. Further research is important, as it is targeted intervention in students' groups that are vulnerable both concerning mental health and conspiracism.

Prevalence of post-traumatic stress disorder risk post-COVID-19 in 12 countries in Latin America: a cross-sectional survey

Introduction

Latin America was the region most affected by COVID-19 in the second quarter of 2020, and consequently, the impact on mental health requires evaluation. The aim of this study was to assess the risk of post-traumatic stress disorder (PTSD) caused by bereavement due to COVID-19 in 12 countries in Latin America.

Methods

The current study was an analytical cross-sectional study. Validated tests were applied for PTSD, depression, anxiety, and stress (DASS-21), questions about the respondent's condition or their environment, and demographic questions, as well as the length of the mourning period of suffering.

Results

The outcomes demonstrated that the PTSD risk increased for women (p < 0.001), when a friend or acquaintance had COVID-19 (p = 0.002), when a close relative died from COVID-19 (p = 0.010), having severe depression (p <0.001), severe anxiety (p  <0.001), severe stress (p  <0.001), residing in Chile (p  <0.001), Paraguay (p  <0.001), Bolivia (p  <0.001), Costa Rica (p  <0.001) or El Salvador (p  = 0.005). On the other hand, there was less risk of PTSD at an older age (p  <0.001) or if respondents had a sentimental partner (p  = 0.025). In the case of severe PTSD, there was a greater gender risk for women (p  <0.001), a close relative dying from COVID-19 (p  = 0.017), having severe depression (p  <0.001), severe anxiety (p  <0.001), severe stress (p  <0.001), residing in Chile (p  <0.001), Paraguay (p  <0.001), Bolivia (p  <0.001) and Costa Rica (p  = 0.002). It was also observed that there was less risk of severe PTSD at an older age demographic (p  <0.001).

Discussion

It can be concluded that the percentages of PTSD are high in its clinical presentation as severe, especially among Latin American women.

Stress and emotion in a locked campus: the moderating effects of resilience and loneliness

The aim of this study is to investigate the dynamic relationship between Chinese students' emotions and stress during a strict lockdown period in a university setting and the context of a global pandemic. Dynamic structural equation modeling was used to investigate the moderating role of resilience and loneliness in this relationship. The participants consisted of 112 students. Based on loneliness and resilience measures and the intensive tracking of emotional stress over a 21-day period, the results of data analysis indicated that the students' overall levels of positive emotions were low and relatively independent of negative emotions. Negative emotions were significantly autoregressive and their baseline was closely related to the individual's overall feelings of stress and loneliness levels, fluctuating with feelings of stress. The results confirm the hypothesis that resilience helps to stabilize emotions. Individuals with low resilience may be more emotionally sensitive in confined environments, while receiving social support may help to alleviate low moods.

Prevalence of depression, anxiety in China during the COVID-19 pandemic: an updated systematic review and meta-analysis

Background

Mental health risks associated with the aftermath of the COVID-19 pandemic are often overlooked by the public. The aim of this study was to investigate the effects of the COVID-19 pandemic on depression and anxiety disorders in China.

Methods

Studies were analyzed and extracted in accordance with the PRISMA 2020 flowchart. The studies were screened and extracted using electronic databases including PubMed, Web of Science, Embase, Cochrane Library, and ClinicalTrials.gov according to the predefined eligibility criteria. The Cochrane Review Manager software 5.3.1 was used for data analysis and the risk of bias assessment.

Results

As of 2023, a total of 9,212,751 Chinese have been diagnosed with COVID-19 infection. A total of 913,036 participants in 44 studies were selected following the eligibility criteria, the statistical information of which was collected for meta-analysis. The pooled prevalence of depression and anxiety were 0.31 (95% CI: 0.28, 0.35; I2 = 100.0%, p < 0.001) and 0.29 (95% CI: 0.23, 0.36; I2 = 100.0%, p < 0.001), respectively. After performing a subgroup analysis, the prevalence of depression among women, healthcare workers, students, and adolescents was 0.31 (95% CI: 0.22, 0.41), 0.33 (95% CI: 0.26, 0.44), 0.32 (95% CI: 0.26, 0.39), and 0.37 (95% CI: 0.31, 0.44), respectively.

Conclusion

The prevalence of depression and anxiety among the Chinese was overall high. Monitoring and surveillance of the mental health status of the population during crises such as sudden global pandemics are imperative.

Systematic review registration

https://clinicaltrials.gov/, identifier [CRD42023402190].

The emergence of COVID-19 over-concern immediately after the cancelation of the measures adopted by the dynamic zero-COVID policy in China

Background

This study aimed to report the prevalence of COVID-19 over-concern and its associated factors after the relaxation of the health-protective measures in China.

Methods

A team of seven experts in psychiatry and psychology specializing in COVID-19 mental health research from China, Hong Kong, and overseas reached a consensus on the diagnostic criteria for COVID-19 over-concern. Individuals had to meet at least five of the following criteria: (1) at least five physical symptoms; (2) stocking up at least five items related to protecting oneself during the COVID-19 pandemic; (3) obsessive-compulsive symptoms related to the COVID-19 pandemic; (4) illness anxiety related to the COVID-19 pandemic; (5) post-traumatic stress symptoms; (6) depression; (7) anxiety; (8) stress and (9) insomnia. An online survey using snowball sampling collected data on demographics, medical history, views on COVID-19 policies, and symptoms of COVID-19 over-concern. Multivariate linear regression was performed using significant variables from the previous regressions as independent variables against the presence of COVID-19 over-concern as the dependent variable. Breush-Pagan test was used to assess each regression model for heteroskedasticity of residuals.

Results

1,332 respondents from 31 regions in China participated in the study for 2 weeks from December 25 to 27, 2022, after major changes in the zero-COVID policy. After canceling measures associated with the dynamic zero-COVID policy, 21.2% of respondents fulfilled the diagnostic criteria for COVID-19 over-concern. Factors significantly associated with COVID-19 over-concern were poor self-rated health status (β = 0.07, p < 0.001), concerns about family members getting COVID-19 (β = 0.06, p < 0.001), perceived usefulness of COVID-19 vaccine (β = 0.03, p = 0.012), impact on incomes, employment and studies (β = 0.045, p < 0.001) and impact on families (β = 0.03, p = 0.01).

Conclusion

After removing measures associated with the dynamic zero-COVID policy in China, approximately one-fifth of respondents met the diagnostic criteria for COVID-19 over-concern.

Evaluation of Sexual Function According to Gender and Sexual Orientation during the COVID-19 Pandemic in Turkey: A National Online Survey Study

OBJECTIVE

Coronavirus Diseases-19 (COVID-19) pandemic that has caused the death of thousands of people affected negatively not only people's physical wellbeing but also their mental health. The aim of this study was to evaluate the sexual function, depression, anxiety and stress, and fear of COVID-19 of individuals according to gender and sexual orientation during the COVID-19 pandemic.

METHOD

The questionnaire form included sociodemographic data form, the Arizona Sexual Experiences Scale (ASEX), the Depression, Anxiety and Stress Scale-Short Form (DASS-21), and the Fear of COVID-19 Scale (FCV-19S). The form was distributed on social media platforms.

RESULTS

1593 sexually active participants were included in the study. 47.5% of the participants were females and 52.5% were males. 86.9% of them were heterosexuals and 13.1% were lesbian, gay, and bisexual (LGB) individuals. ASEX, DASS-21 Depression, Anxiety, and Stress, and FCV-19S scores were significantly higher in females than males (p<0.001). When anxiety, depression, stress, and fear of COVID-19 were controlled, level of sexual dysfunction continued to be higher in women. We found that while the ASEX and FCV-19S scores were similar between the heterosexuals and LGBs (respectively p=0.66 and p=0.31), the DASS-21 Depression, Anxiety, and Stress scores were higher in LGBs (p<0.001).

CONCLUSION

Our results reveal the effect of the pandemic period on female sexual functions and the importance of addressing this topic in clinical practice and research.

Mental Health Among Healthcare Workers During the COVID-19 Pandemic in Vietnam

OBJECTIVES

The objective of this study was to characterize mental health issues among Vietnamese healthcare workers (HCWs) and to identify related factors.

METHODS

A cross-sectional study was conducted with 990 HCWs in 2021. Their mental health status was measured using the Depression, Anxiety, and Stress Scale.

RESULTS

In total, 49.9%, 52.3%, and 29.8% of respondents were found to have depression, anxiety, and stress, respectively. The multivariable linear regression model revealed that factors associated with increased anxiety scores included depression scores (β, 0.45; 95% confidence interval [CI], 0.39 to 0.51) and stress scores (β, 0.46; 95% CI, 0.41 to 0.52). Factors associated with increased depression scores included being frontline HCWs (β, 0.57; 95% CI, 0.10 to 1.10), stress scores (β, 0.50; 95% CI, 0.45 to 0.56), and anxiety scores (β, 0.41; 95% CI, 0.36 to 0.47), while working experience was associated with reduced depression scores (β, -0.08; 95% CI, -0.16 to -0.01). Factors associated with increased stress scores included working experience (β, 0.08; 95% CI, 0.00 to 0.16), personal protective equipment interference with daily activities (β, 0.55; 95% CI, 0.07 to 1.00), depression scores (β, 0.54; 95% CI, 0.48 to 0.59), and anxiety scores (β, 0.45; 95% CI, 0.39 to 0.50), while age was associated with reduced stress scores (β, -0.12; 95% CI, -0.20 to -0.05).

CONCLUSIONS

Specific interventions are necessary to enhance and promote the mental health of HCWs so they can successfully cope with the circumstances of the pandemic.

Effects of Anxiety, Stress and Perceived Social Support on Depression and Loneliness Among Older People During the COVID-19 Pandemic: A Cross-Sectional Path Analysis

During the COVID-19 pandemic, older people were exposed to high levels of anxiety and stress leading to loneliness and depressive disorders. The purpose of the present study was to investigate the effects of anxiety, positive coping, perceived social support, and perceived stress on depression and loneliness among older people during the COVID-19 pandemic. This was a cross-sectional online/telephone survey. A non-probability convenience sampling method was used. Participants were 112 people aged 60 years and above, without cognitive impairment, who experienced confinement (from March 2020 onward) and had access to the internet or telephone. A path analysis model showed a direct significant effect of anxiety on both, depression (β = .68, P < .001) and perceived stress (β = .65, P < .001), as well as an indirect effect of anxiety on loneliness via perceived stress (β = .65) * (β = .40); and social support (β = -.21) * (β = -.20). The model showed adequate fit χ2(df = 4) =5.972, P = .201; RMSEA = 0.066 (0.000, 0.169), CFI = 0.992; TLI = 0.970. Anxiety had a significant effect on depressive symptoms as well as on loneliness via perceived social support and perceived stress. According to our findings, in order to reduce depressive symptoms and perceived loneliness, it is essential to develop timely interventions that decrease levels of anxiety and stress and increase levels of perceived social support in older people, particularly when there are any restrictions, physical or contextual, that prevent face-to-face contact. This can be achieved by implementing preventive community-based programs, enhancing accessibility to mental health services, and collaborating with local support groups, among others.