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Lasalvia A, Bodini L, Pace D, Colombi M, Caruson MM, Van Bortel T, Bonetto C. Experienced discrimination and internalized stigma among people infected with SARS-CoV-2 and surviving COVID-19: Association with anxiety, depression, and insomnia symptoms. JOURNAL OF COMMUNITY PSYCHOLOGY 2024; 52:910-928. [PMID: 39056479 DOI: 10.1002/jcop.23136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 07/03/2024] [Accepted: 07/16/2024] [Indexed: 07/28/2024]
Abstract
People surviving COVID-19 may experience social stigma related to their condition even after clinical recovery. This study aimed to: (1) investigate COVID-19-related experienced discrimination and internalized stigma, and (2) explore their association with symptoms of anxiety, depression, and insomnia. We conducted an online survey of people who survived COVID-19. Perception of stigma was assessed using the COVID-19 Experienced Discrimination Scale and the COVID-19 Internalized Stigma Scale. Depression, anxiety, and insomnia were assessed using, respectively, the Patient Health Questionnaire-9, the General Anxiety Disorder Scale-7, and the Insomnia Severity Index. Multivariable logistic regression analyses for each psychopathological domain were performed. A total of 579 participants participated in this study. Overall, 25% reported some degree of experienced discrimination, and 23% reported some degree of internalized stigma. Adjusted odds ratio showed that scoring higher on internalized stigma related significantly to higher symptoms of depression (2.14; 95% confidence interval [CI], 1.35-3.39), anxiety (2.30; 95% CI, 1.48-3.59), and insomnia (2.54; 95% CI, 1.64-3.95), whereas experienced discrimination was associated to anxiety (1.55; 95% CI, 1.06-2.28) and insomnia (1.82; 95% CI, 1.24-2.69). Experiences of social stigmatization are frequent among people surviving COVID-19 and seem to be associated with levels of psychological disturbances. Further research is required to elucidate the direction of these relationships to implement effective treatment strategies.
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Affiliation(s)
- Antonio Lasalvia
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
- UOC Psichiatria, Azienda Ospedaliera Universitaria Integrata (AOUI) di Verona, Verona, Italy
| | - Luca Bodini
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Davide Pace
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | | | | | - Tine Van Bortel
- Faculty of Health and Life Sciences, Leicester School of Allied Health Sciences, De Montfort University, Leicester, UK
- Department of Psychiatry, Cambridge Public Health Interdisciplinary Research Centre, University of Cambridge, Cambridge, UK
| | - Chiara Bonetto
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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Lathabhavan R, Hosseini Marznaki Z, Kaggwa MM, Darvishi M, Haghighi A, Yıldırım M. Exploring the relationship between peritraumatic dissociative experiences, post-traumatic stress disorder, stigma, and fear: A three-wave study during the COVID-19 pandemic. Arch Psychiatr Nurs 2024; 51:176-182. [PMID: 39034076 DOI: 10.1016/j.apnu.2024.06.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 11/09/2023] [Accepted: 06/30/2024] [Indexed: 07/23/2024]
Abstract
COVID-19 has emerged as a pervasive global challenge, giving rise to both significant public health concerns and a range of psychological experiences, such as fear, stigma, and post-traumatic stress disorder. Importantly, healthcare professionals have been subjected to immense mental health problems as they battle against this disease. This study aimed to investigate the mediating roles of perceived stigma, self-stigma related to COVID-19, and fear of COVID-19 in the associations between peritraumatic dissociative experiences and post-traumatic stress disorder during a three-wave COVID-19 pandemic (4th [T1], no wave [T2], and 5th [T3]) in Iran. Data were collected from healthcare professionals using the Peritraumatic Dissociative Experiences Questionnaire, Impact of Event Scale-6, Perceived Stigma Scale, Fear of COVID-19 Scale, and Self-Stigma Scale-Short. The results of structural equation modelling demonstrated positive associations between peritraumatic dissociative experiences, perceived stigma, self-stigma related to COVID-19, fear of COVID-19, and post-traumatic stress disorder across all survey waves. Moreover, the study revealed that perceived stigma, self-stigma related to COVID-19, and fear of COVID-19 acted as mediators in the association between peritraumatic dissociative experiences and post-traumatic stress disorder. The implications of these findings highlight the urgent need to address the mental health of healthcare professionals in the aftermath of a pandemic. Policy efforts should be directed towards providing adequate mental health resources and support to mitigate the psychological impact of pandemics on healthcare professionals.
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Affiliation(s)
- Remya Lathabhavan
- OB and HRM Area, Indian Institute of Management Bodh Gaya, Bihar, India
| | | | - Mark Mohan Kaggwa
- Department of Psychiatry and Behavioral Sciences, McMaster University, Ontario, Canada; Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Mohammad Darvishi
- Infectious Diseases & Tropical Medicine Research Center (IDTMRC), School of Aerospace and Subaquatic Medicine, AJA University of Medical Sciences, Tehran, Iran
| | - Abdullah Haghighi
- Imam Reza Hospital at Amol City, Mazandaran University of Medical Sciences, Sari, Iran
| | - Murat Yıldırım
- Department of Psychology, Agri Ibrahim Cecen University, Ağrı, Turkey; Department of Social and Educational Sciences, Lebanese American University, Beirut, Lebanon.
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Lu ML, Zhu JW, Wu JL, Lv LY, Liu L, Kong GQ, Ding CL, Yu Y, Pan L. Insomnia among coronavirus disease 2019 survivors: A single-center cross-sectional study. Medicine (Baltimore) 2024; 103:e37311. [PMID: 38363887 PMCID: PMC10869043 DOI: 10.1097/md.0000000000037311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 01/29/2024] [Indexed: 02/18/2024] Open
Abstract
Since the coronavirus disease 2019 (COVID-19) epidemic, insomnia has become one of the longer COVID-19 symptoms. This study aimed to investigate insomnia among COVID-19 survivors and explore the occurrence and influencing factors of insomnia. A cross-sectional study was performed from December 2022 to February 2023 through an online questionnaire star survey with 8 questions. The insomnia severity index scale (ISI) was used to assess the severity of insomnia. Univariate analysis was used to analyze the factors related to COVID-19 infection. A total of 564 participants (183 males and 381 females) were surveyed in the present study. The prevalence of insomnia was 63.12%. Among these insomnia patients, there were 202 (35.82%) with sub-threshold symptoms, 116 (20.57%) with moderate symptoms, and 38 (6.74%) with severe symptoms. Univariate analysis indicated that there were statistically significant differences in the prevalence of insomnia among COVID-19 survivors of different ages, occupations, and educational levels (P < .05). Of the 356 insomnia patients, 185 (51.97%) did not take any measures against insomnia, while those who took drugs only, physical exercise only, drugs and physical exercise, and other measures were 90 (25.28%), 42 (11.80%), 17 (4.78%), and 22 (6.18%), respectively. Additionally, of the 107 insomnia patients with drug therapy, 17 (15.89%) took estazolam, 16 (14.95%) took alprazolam, 39 (36.45%) took zopiclone, and 35 (32.71%) took other drugs to improve insomnia symptoms. The prevalence of insomnia symptoms remains high among COVID-19 survivors in China. Education level and occupation may be the influencing factors. Unfortunately, most patients with insomnia do not take corresponding treatment measures.
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Affiliation(s)
- Man-Lu Lu
- Department of Respiratory and Critical Care Medicine, Binzhou Medical University Hospital, Binzhou, China
| | - Ji-Wei Zhu
- Department of Respiratory and Critical Care Medicine, Binzhou Medical University Hospital, Binzhou, China
| | - Jing-Lin Wu
- Department of Respiratory and Critical Care Medicine, Binzhou Medical University Hospital, Binzhou, China
| | - Liang-Yan Lv
- Institute of Clinical Drug Trials, Binzhou Medical University Hospital, Binzhou, China
| | - Lu Liu
- Department of Respiratory and Critical Care Medicine, Binzhou Medical University Hospital, Binzhou, China
| | - Gui-Qing Kong
- Department of Respiratory and Critical Care Medicine, Binzhou Medical University Hospital, Binzhou, China
| | - Chang-Ling Ding
- Institute of Clinical Drug Trials, Binzhou Medical University Hospital, Binzhou, China
| | - Yan Yu
- Department of Respiratory and Critical Care Medicine, Binzhou Medical University Hospital, Binzhou, China
| | - Lei Pan
- Department of Respiratory and Critical Care Medicine, Binzhou Medical University Hospital, Binzhou, China
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Wang R, Wang Z, Shi D, Xu L, Liu Y, Liu S, Chen H, Chen Y, Xia D, Ge X, Xu H, Chen Y, Wang Z, Chang R, Hu F, Shen T, Wang Y, Cai Y. Evaluation of the psychometrics of the Social Impact Scale and its association with depression among asymptomatic COVID-19 carriers. BJPsych Open 2024; 10:e41. [PMID: 38297498 PMCID: PMC10897691 DOI: 10.1192/bjo.2023.651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND COVID-19 carriers experience psychological stresses and mental health issues such as varying degrees of stigma. The Social Impact Scale (SIS) can be used to measure the stigmatisation of COVID-19 carriers who experience such problems. AIMS To evaluate the reliability and validity of the Chinese version of the SIS, and the association between stigma and depression among asymptomatic COVID-19 carriers in Shanghai, China. METHOD A total of 1283 asymptomatic COVID-19 carriers from Shanghai Ruijin Jiahe Fangcang Shelter Hospital were recruited, with a mean age of 39.64 ± 11.14 years (59.6% male). Participants completed questionnaires, including baseline information and psychological measurements, the SIS and Self-Rating Depression Scale. The psychometrics of the SIS and its association with depression were examined through exploratory factor analysis, confirmatory factor analysis and receiver operating characteristic analysis. RESULTS The average participant SIS score was 42.66 ± 14.61 (range: 24-96) years. Analyses suggested the model had four factors: social rejection, financial insecurity, internalised shame and social isolation. The model fit statistics of the four-factor SIS were 0.913 for the comparative fit index, 0.902 for the Tucker-Lewis index and 0.088 for root-mean-square error of approximation. Standard estimated factor loadings ranged from 0.509 to 0.836. After controlling for demographic characteristics, the total score of the 23-item SIS predicted depression (odds ratio: 1.087, 95% CI 1.061-1.115; area under the curve: 0.84, 95% CI 0.788-0.892). CONCLUSIONS The Chinese version of the SIS showed good psychometric properties and can be used to assess the level of perceived stigma experienced by asymptomatic COVID-19 carriers.
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Affiliation(s)
- Rongxi Wang
- Public Health Department, Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, China; Department of Scientific Research and Disciplinary Development, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, China; and School of Public Health, Shanghai Jiao Tong University School of Medicine, China
| | - Zuxin Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, China
| | - Dake Shi
- School of Public Health, Shanghai Jiao Tong University School of Medicine, China; and Department of Infection Control, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China
| | - Liling Xu
- Public Health Department, Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, China
| | - Yujie Liu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, China
| | - Shangbin Liu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, China
| | - Hui Chen
- School of Public Health, Shanghai Jiao Tong University School of Medicine, China
| | - Yingjie Chen
- School of Public Health, Shanghai Jiao Tong University School of Medicine, China
| | - Danni Xia
- School of Public Health, Shanghai Jiao Tong University School of Medicine, China
| | - Xin Ge
- School of Public Health, Shanghai Jiao Tong University School of Medicine, China
| | - Huifang Xu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, China
| | - Yufei Chen
- School of Public Health, Shanghai Jiao Tong University School of Medicine, China
| | - Zhiqiang Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, China
| | - Ruijie Chang
- Public Health Department, Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, China; School of Public Health, Shanghai Jiao Tong University School of Medicine, China; and Center for Community Health Care, Hospital Development Institute Shanghai Jiao Tong University, China
| | - Fan Hu
- Public Health Department, Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, China; School of Public Health, Shanghai Jiao Tong University School of Medicine, China; and Center for Community Health Care, Hospital Development Institute Shanghai Jiao Tong University, China
| | - Tian Shen
- Public Health Department, Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, China; School of Public Health, Shanghai Jiao Tong University School of Medicine, China; and Center for Community Health Care, Hospital Development Institute Shanghai Jiao Tong University, China
| | - Ying Wang
- Public Health Department, Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, China; School of Public Health, Shanghai Jiao Tong University School of Medicine, China; and Center for Community Health Care, Hospital Development Institute Shanghai Jiao Tong University, China
| | - Yong Cai
- Public Health Department, Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, China; School of Public Health, Shanghai Jiao Tong University School of Medicine, China; and Center for Community Health Care, Hospital Development Institute Shanghai Jiao Tong University, China
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Farrell R, Dahler C, Pope R, Divoky E, Collart C. COVID testing hesitancy among pregnant patients: Lessons learned from the COVID-19 pandemic about the unique needs and challenges of medically complex populations. RESEARCH SQUARE 2024:rs.3.rs-3892181. [PMID: 38352470 PMCID: PMC10862955 DOI: 10.21203/rs.3.rs-3892181/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
Background Pregnant patients were a significant population to consider during the pandemic, given the impact of SARS-CoV-2 infection on obstetric outcomes. While COVID testing was a central pillar of infection control, it became apparent that a subset of the population declined to test. At the same time, data emerged about pregnant persons also declining to test. Yet, it was unknown why pregnant patients declined tests and if those reasons were similar or different from those of the general population. We conducted this study to explore pregnant patients' attitudes, access, and utilization of COVID-19 testing to support healthcare for infection prevention management for this unique and medically complex population. Methods We conducted a qualitative study of patients who were currently or recently pregnant during the early stages of the pandemic and received outpatient prenatal care at one of the participating study sites. An interview guide was used to conduct in-depth telephone interviews. Coding was performed using NVivo, and analysis was conducted using Grounded Theory. Results The average age of the participants (N = 37) was 32 (SD 4.21) years. Most were < 35 years of age (57%) and self-described as White (68%). Qualitative analysis identified themes related to barriers to COVID-19 testing access and use during pregnancy, including concerns about test accuracy, exposure to COVID-19 in testing facilities, isolation and separation during labor and delivery, and diminished healthcare quality and patient experience. Conclusions The implementation of widespread and universal COVID testing policies did not address the unique needs and challenges of pregnant patients as a medically complex population. It is important to understand the reasons and implications for pregnant patients who declined COVID testing during the current pandemic to inform strategies to prevent infection spread in future public health emergencies.
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Sales PMG, Greenfield MJ, Pinkhasov A, Viswanathan R, Saunders R, Huremović D. Drawing the Line Between Postacute Sequelae of COVID-19 and Functional Neurologic Disorders: A Daunting Clinical Overlap or Irrelevant Conundrum? J Nerv Ment Dis 2023; 211:882-889. [PMID: 38015183 DOI: 10.1097/nmd.0000000000001643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
ABSTRACT Coronavirus disease 2019 (COVID-19) is an acute infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in its multiple variants that classically presents with cough, fatigue, fever, headache, myalgias, and diarrhea. As vaccination becomes widely available and infection rates facilitate herd immunity across the globe, more attention has been given to long-term symptoms that may persist after the index infection, which include impairments in concentration, executive dysfunction, sensory disturbances, depression, anxiety, fatigue, and cough, among other symptoms classified under the umbrella term of postacute sequelae of SARS-CoV-2 infection (PASC).Functional neurologic disorder (FND), also known as conversion disorder and functional neurologic symptom disorder, refers to the presence of one or more symptoms of altered voluntary motor or sensory function that are incompatible with and not better explained by a known neurological or medical condition that causes significant distress and functional impairment. Although the diagnosis of FND may not require the identification of an underlying psychological stressor, being diagnosed with an FND can worsen stigma and shift attention and resources away from other medical concerns that should be concomitantly addressed.This review summarizes the literature on the overlapping nature and discrimination of PASC from FND in COVID-19 survivors. Based on this, we develop a treatment framework that targets unique domains of these complex overlapping presentations, following a multidisciplinary approach with an individualized treatment plan inclusive of physical and psychological interventions focused on functional rehabilitation.
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Affiliation(s)
- Paulo M G Sales
- Department of Psychiatry and Behavioral Neurobiology, The University of Alabama at Birmingham, Birmingham, Alabama
| | - Melissa J Greenfield
- Department of Psychiatry and Behavioral Neurobiology, The University of Alabama at Birmingham, Birmingham, Alabama
| | - Aaron Pinkhasov
- Department of Psychiatry, Department of Medicine, NYU Long Island School of Medicine, Mineola
| | - Ramaswamy Viswanathan
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, New York
| | - Ramotse Saunders
- Department of Psychiatry, University of California San Francisco Medical Center, San Francisco, California
| | - Damir Huremović
- Department of Psychiatry, North Shore University Hospital at Northwell Health, Manhasset, New York
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Li Q, Yang X, Wang X, Zhang H, Ding N, Zhao W, Tian W, He J, Du M, Hu H, Zhang G. COVID-19 symptoms, internet information seeking, and stigma influence post-lockdown health anxiety. Front Psychol 2023; 14:1228294. [PMID: 37637921 PMCID: PMC10448810 DOI: 10.3389/fpsyg.2023.1228294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 07/28/2023] [Indexed: 08/29/2023] Open
Abstract
Background With the lifting of Zero-COVID policies in China, rapid transmission of the virus has led to new challenges for patients' health anxiety. This study aimed to evaluate the relationship between COVID-19 symptoms and health anxiety, as well as the mediation paths between them in individuals infected with COVID-19. Method A cross-sectional study was conducted in December 2022, following the relaxation of anti-COVID measures in China. A validated online questionnaire was used to collect data from COVID-19 patients on the number and severity of symptoms, health anxiety, internet health information-seeking behavior (IHISB), and perceived stigma. Structural equation modeling was used to examine the mediation model in which COVID-19 symptoms would affect health anxiety via IHISB and perceived stigma. Results Overall, 1,132 participants (women, 67.6%) were included, with a mean (SD) age of 28.12 (10.07) years. Participants had an average of seven COVID-19 symptoms, with cough (91.3%), nasal congestion (89.1%) and fatigue (87.8%) being the most common. The number and severity of COVID-19 symptoms, IHISB, perceived stigma, and health anxiety were positively correlated with each other after adjusting for covariates (r ranging from 0.10 to 0.81, all p < 0.05). IHISB (effect = 0.14, p < 0.001) and perceived stigma (effect = 0.04, p < 0.001) fully mediated the relationship between COVID-19 symptoms and health anxiety. Conclusion Interventions for health anxiety reduction during and after pandemics should target improving the quality of online health information, enhancing individuals' online healthy literacy, and reducing stigma.
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Affiliation(s)
- Qian Li
- Faculty of Medicine, Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Xue Yang
- Faculty of Medicine, Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Xin Wang
- Faculty of Medicine, Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Han Zhang
- Faculty of Medicine, Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Ningning Ding
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Wenqian Zhao
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
- Zhejiang Provincial Clinical Research Center for Mental Disorders, The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou, China
| | - Wenwen Tian
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Jiankang He
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Mingxuan Du
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Haiyan Hu
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Guohua Zhang
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
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Jain L, Bhivandkar S, Baqir H, Shoib S, Nimavat N, Mohan A, Zubair AS, Jawad MY, Muhammed N, Ahmed R, Sachdeva V, Ahmed S. Beyond physical health: the role of psychosocial challenges and stigma in tackling the COVID-19 pandemic-A scoping review. Front Psychiatry 2023; 14:1180252. [PMID: 37496686 PMCID: PMC10366364 DOI: 10.3389/fpsyt.2023.1180252] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 05/30/2023] [Indexed: 07/28/2023] Open
Abstract
Background The socio-cultural response to the Coronavirus Disease 2019 (COVID-19) and the level of adherence to evidence-based guidelines played a crucial role in determining the morbidity and mortality outcomes during the pandemic. This review aims to evaluate the impact of stigma and psycho-socio-cultural challenges on efforts to control the COVID-19 pandemic and to identify ways to mitigate such challenges in future pandemics. Methods Using keywords including COVID-19, coronavirus, stigma, psychosocial challenges, and others, the authors searched seven major databases with a time limitation of July 2021, which yielded 2,038 results. Out of these, 15 papers were included in this review. Results The findings of the review indicated that several psychosocial, socio-economic, and ethno-cultural factors are linked to the transmission and control of COVID-19. The research revealed that stigma and related psychosocial challenges and others, such as anxiety, fear, and stigma-driven social isolation, have resulted in significant mental health problems. Discussion The review underscores the negative impact of stigma on COVID-19 patients, survivors, and the general population. Addressing stigma and psychosocial challenges is crucial to effectively manage the current pandemic and to prevent similar challenges during future public health crises.
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Affiliation(s)
- Lakshit Jain
- Connecticut Valley Hospital, Middletown, CT, United States
- Department of Psychiatry, University of Connecticut, Farmington, CT, United States
| | - Siddhi Bhivandkar
- Department of Psychiatry, St. Elizabeth’s Medical Center, Boston University, Boston, MA, United States
| | - Huma Baqir
- Department of Psychiatry, University at Buffalo, Buffalo, NY, United States
| | - Sheikh Shoib
- Department of Psychiatry, Jawahar Lal Nehru Memorial Hospital, Srinagar, India
| | - Nirav Nimavat
- Dr. Kiran C. Patel Medical College and Research Institute, Bharuch, India
| | - Anmol Mohan
- Department of Medicine, Karachi Medical and Dental College, Karachi, Pakistan
| | | | | | - Nazar Muhammed
- Department of Psychiatry, Cornerstone Family Healthcare, New York, NY, United States
| | - Rizwan Ahmed
- Liaquat College of Medicine and Dentistry, Karachi, Pakistan
| | - Vishi Sachdeva
- Adesh Institute of Medical Sciences and Research, Bathinda, India
| | - Saeed Ahmed
- Addiction Psychiatry, Rutland Regional Medical Center, Rutland, VT, United States
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Zhang JJ, Sun R, Guo S, Zhang H. Melatonin effects on sleep quality of COVID-19 patients: a protocol for systematic review and meta-analysis of randomised controlled trials with trial sequential analysis. BMJ Open 2023; 13:e068345. [PMID: 37349103 PMCID: PMC10314484 DOI: 10.1136/bmjopen-2022-068345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 05/31/2023] [Indexed: 06/24/2023] Open
Abstract
INTRODUCTION Sleep disturbance is one of the common complaints of patients with COVID-19 infection. Melatonin is a physiological indoleamine involved in circadian rhythm regulation and it is currently used for secondary sleep disorders caused by various diseases. Some clinical randomised controlled trials (RCTs) have obtained a small amount of evidence and controversial results in support of their therapeutic effect on sleep disorders, but no studies have summarised and evaluated RCTs in all current databases to obtain conclusive results. Therefore, the aim of this systematic review and meta-analysis was to determine the efficacy and safety of melatonin in the treatment of sleep disturbances in patients with COVID-19. METHODS AND ANALYSIS We will search for RCT-type studies of melatonin in the treatment of sleep disturbances in patients with COVID-19. From inception to October 2022 will be available on PubMed/MEDLINE, Web of Science, Embase, CINAHL, PsycINFO, LILACS, SCOPUS, Cochrane Central Register of Controlled Trials, ICTRP, Wanfang Data, VIP database and CNKI, VIP database, China Biomedical Literature Database to search for eligible studies. There are no language and geographical restrictions. Two authors will independently screen and select eligible studies, assess methodological quality and perform data extraction. Two additional authors will independently extract data from each study. Then, meta-analysis will then be carried out using a fixed-effects or random-effects model, using the mean difference for continuous outcomes and the relative risk for dichotomous outcomes. Risk of bias assessment will be assessed using the Cochrane risk-of-bias tool. Heterogeneity between studies was assessed by Cochrane Q-test and I2. The quality of evidence for each outcome will be assessed using the Grading of Recommendations Assessment, Development and Evaluation methodology. Funnel plots, Begg's test and Egger's test will be used to assess the risk of publication bias. Subgroup analysis, data synthesis, meta-analysis and overall incidence of adverse events will be performed using Review Manager V.5.4 software and Stata software. Trial sequential analysis will be performed if appropriate. ETHICS AND DISSEMINATION This study is an extraction review of data from existing studies, and thus it is unnecessary to obtain ethical approval. The results of this systematic review will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42022359221.
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Affiliation(s)
- Juan Juan Zhang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ran Sun
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Sha Guo
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Hong Zhang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Xiao W, Liu X, Wang H, Huang Y, Dai Z, Si M, Fu J, Chen X, Jia M, Leng Z, Cui D, Mak WWS, Su X. Prevalence and risk for symptoms of PTSD among survivors of a COVID-19 infection. Psychiatry Res 2023; 326:115304. [PMID: 37352746 PMCID: PMC10275658 DOI: 10.1016/j.psychres.2023.115304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 06/09/2023] [Accepted: 06/10/2023] [Indexed: 06/25/2023]
Abstract
COVID-19 pandemic has profound psychological effects worldwide and the psychological sequelae will persist for a long time among COVID-19 survivors. This cross-sectional study aimed to explore the prevalence of PTSD and its associated risk factors in COVID-19 survivors of the first wave pandemic. Demographics questionnaire, the Impact of Events Scale-Revised, the Pittsburgh Sleep Quality Index, the Fatigue Scale-14, the Resilience Style Questionnaire, the Short Version of COVID-19 Stigma Scale, the Peace of Mind Scale, and the Perceived Social Support Questionnaire were used to collect relevant information of the participants. The propensity score-matching (PSM) method was employed to adjust covariate or confounding variables in order to derive more accurate conclusions. After PSM, adjusted odds ratios and 95% confidence intervals were determined by binary conditional logistic regression. A total of 1541 COVID-19 survivors were included firstly and 15.2% reported PTSD symptoms, 1108 participants left after PSM. Four risk factors were identified: higher severity of COVID-19 infection, fatigue, COVID-19 related stigma and poor sleep quality. When designing psychological interventions to alleviate PTSD symptoms of COVID-19 survivors, reducing stigma and fatigue, and improve their sleep quality are suggested.
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Affiliation(s)
- Weijun Xiao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
| | - Xiaoyang Liu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
| | - Hao Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yiman Huang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Zhenwei Dai
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Mingyu Si
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jiaqi Fu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xu Chen
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Mengmeng Jia
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Zhiwei Leng
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Dan Cui
- Department of Pulmonary and Critical Care Medicine, National Center for Respiratory Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China; Department of Pulmonary and Critical Care Medicine, The 2nd Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, China
| | - Winnie W S Mak
- Diversity and Well-Being Laboratory, Department of Psychology, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Xiaoyou Su
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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11
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Komaroff AL, Lipkin WI. ME/CFS and Long COVID share similar symptoms and biological abnormalities: road map to the literature. Front Med (Lausanne) 2023; 10:1187163. [PMID: 37342500 PMCID: PMC10278546 DOI: 10.3389/fmed.2023.1187163] [Citation(s) in RCA: 69] [Impact Index Per Article: 69.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 05/09/2023] [Indexed: 06/23/2023] Open
Abstract
Some patients remain unwell for months after "recovering" from acute COVID-19. They develop persistent fatigue, cognitive problems, headaches, disrupted sleep, myalgias and arthralgias, post-exertional malaise, orthostatic intolerance and other symptoms that greatly interfere with their ability to function and that can leave some people housebound and disabled. The illness (Long COVID) is similar to myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) as well as to persisting illnesses that can follow a wide variety of other infectious agents and following major traumatic injury. Together, these illnesses are projected to cost the U.S. trillions of dollars. In this review, we first compare the symptoms of ME/CFS and Long COVID, noting the considerable similarities and the few differences. We then compare in extensive detail the underlying pathophysiology of these two conditions, focusing on abnormalities of the central and autonomic nervous system, lungs, heart, vasculature, immune system, gut microbiome, energy metabolism and redox balance. This comparison highlights how strong the evidence is for each abnormality, in each illness, and helps to set priorities for future investigation. The review provides a current road map to the extensive literature on the underlying biology of both illnesses.
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Affiliation(s)
- Anthony L. Komaroff
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - W. Ian Lipkin
- Center for Infection and Immunity, Mailman School of Public Health, Vagelos College of Physicians and Surgeons of Columbia University, New York, NY, United States
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12
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Shaik L, Boike S, Ramar K, Subramanian S, Surani S. COVID-19 and Sleep Disturbances: A Literature Review of Clinical Evidence. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59050818. [PMID: 37241050 DOI: 10.3390/medicina59050818] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/05/2023] [Accepted: 04/10/2023] [Indexed: 05/28/2023]
Abstract
The need for adequate good quality sleep to optimally function is well known. Over years, various physical, psychological, biological, and social factors have been investigated to understand their impact on sleep. However, understanding the etiological processes that are involved in causing sleep disturbances (SD) as impacted by stressful phases such as pandemics has not been well studied. Many such etiological and management strategies have surfaced during the latest "coronavirus disease of 2019 (COVID-19) pandemic. The occurrence of these SD in the infected and uninfected individuals poses a need to investigate factors linked to such occurrence during this phase. Some of such factors include stressful practices such as social distancing, masking, vaccines, and medications availability, changes in routines, and lifestyles. As the status of infection improved, a collective term for all the prolonged effects of COVID-19 after the resolution of the primary infection called the post-COVID-19 syndrome (PCS) surfaced. Apart from impacting sleep during the infectious phase, the aftereffects of this virus left an even greater impact during the PCS. Various mechanisms have been hypothesized to be linked to such SD during the PCS, but the available data are inconclusive. Further, the varied patterns of incidence of these SDs differed by many factors, such as age, gender, and geographical location, making clinical management even more challenging. This review elucidates the impact of coronavirus 2 (SARS-CoV-2) (COVID) disease on sleep health during the various phases of the COVID-19 pandemic. We also investigate different causal relationships, management strategies, and knowledge gaps related to SD during the COVID-19 pandemic.
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Affiliation(s)
- Likhita Shaik
- Department of Family Medicine, Hennepin Healthcare, Minneapolis, MN 55415, USA
| | - Sydney Boike
- Department of Medicine, University of Minnesota Medical School, Minneapolis, MN 55455, USA
| | | | | | - Salim Surani
- Department of Pulmonary, Critical Care and Sleep Medicine, Texas A&M University, College Station, TX 77843, USA
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13
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Xiao W, Liu X, Wang H, Huang Y, Dai Z, Si M, Fu J, Chen X, Jia M, Leng Z, Cui D, Mak WWS, Dong L, Su X. Mediating role of resilience in the relationship between COVID-19 related stigma and mental health among COVID-19 survivors: a cross-sectional study. Infect Dis Poverty 2023; 12:27. [PMID: 36978095 PMCID: PMC10043530 DOI: 10.1186/s40249-023-01074-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 02/28/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND The global coronavirus disease 2019 (COVID-19) has caused many negative effects on physical and mental health of patients who have survived COVID-19. Apart from some long-lasting physical sequelae, those COVID-19 survivors are also suffering stigma and discrimination at different levels around the world. The current study aims to assess the role resilience played in stigma and mental disorders among COVID-19 survivors. METHODS The cross-sectional study was carried out among former COVID-19 patients in Jianghan District (Wuhan, China) from June 10 to July 25, 2021. The demographic questions, the Impact of Events Scale-Revised, the Generalized Anxiety Disorder Questionnaire, the Patient Health Questionnaire, the Resilience Style Questionnaire and the Short Version of COVID-19 Stigma Scale of 12 items were used to collect relevant information of the participants. Descriptive analyses, Pearson correlation analysis and Structural Equation Modeling were used to make data description and analysis. RESULTS A total of 1541 out of 1601 COVID-19 survivors (887 females and 654 males) were included in the analysis. Perceived stigma of those COVID-19 survivors correlates significantly with anxiety (r = 0.335, P < 0.001), depression (r = 0.325, P < 0.001) and post-traumatic stress disorder (PTSD) (r = 0.384, P < 0.001). It has a direct effect on COVID-19 survivors' anxiety (β = 0.326, P < 0.001), depression (β = 0.314, P < 0.001), PTSD (β = 0.385, P < 0.001) and their resilience (β = - 0.114, P < 0.01). Resilience partially mediated the association between perceived stigma and anxiety (β = 0.020, P < 0.01), depression (β = 0.020, P < 0.01), and PTSD (β = 0.014, P < 0.01) among COVID-19 survivors. CONCLUSION Stigma has a significant negative impact on mental health, while resilience plays a mediator role in the relationship between stigma and mental health among COVID-19 survivors. Based on our study, we suggested that when designing psychological interventions for COVID-19 survivors, consideration should be taken into account to reduce stigma and improve resilience.
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Affiliation(s)
- Weijun Xiao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, 31 BeiJiGe San Tiao, Dongcheng District, Beijing, China
| | - Xiaoyang Liu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, 31 BeiJiGe San Tiao, Dongcheng District, Beijing, China
| | - Hao Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, 31 BeiJiGe San Tiao, Dongcheng District, Beijing, China
| | - Yiman Huang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, 31 BeiJiGe San Tiao, Dongcheng District, Beijing, China
| | - Zhenwei Dai
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, 31 BeiJiGe San Tiao, Dongcheng District, Beijing, China
| | - Mingyu Si
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, 31 BeiJiGe San Tiao, Dongcheng District, Beijing, China
| | - Jiaqi Fu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, 31 BeiJiGe San Tiao, Dongcheng District, Beijing, China
| | - Xu Chen
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, 31 BeiJiGe San Tiao, Dongcheng District, Beijing, China
| | - Mengmeng Jia
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, 31 BeiJiGe San Tiao, Dongcheng District, Beijing, China
| | - Zhiwei Leng
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, 31 BeiJiGe San Tiao, Dongcheng District, Beijing, China
| | - Dan Cui
- Department of Pulmonary and Critical Care Medicine, National Center for Respiratory Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
- Department of Pulmonary and Critical Care Medicine, The 2nd Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, China
| | - Winnie W S Mak
- Diversity and Well-Being Laboratory, Department of Psychology, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Liming Dong
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, 31 BeiJiGe San Tiao, Dongcheng District, Beijing, China.
| | - Xiaoyou Su
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, 31 BeiJiGe San Tiao, Dongcheng District, Beijing, China.
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14
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Sattler DN, Bishkhorloo B, Lawley KA, Hackler R, Byambajav C, Munkhbat M, Smith-Galeno B. Stigma, Post-traumatic Stress, and COVID-19 Vaccination Intent in Mongolia, India, and the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2084. [PMID: 36767449 PMCID: PMC9915119 DOI: 10.3390/ijerph20032084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/20/2023] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
Background: Stigma and discrimination during the coronavirus (COVID-19) pandemic have increased precipitously worldwide. This multinational study examines how stigma, blaming groups for virus spread, concern regarding contracting the virus, resource loss, life satisfaction, and protective behaviors that help control the spread of COVID-19 are associated with post-traumatic stress and vaccine intent in Mongolia, India, and the United States. Method: 1429 people in Mongolia, India, and the United States completed measures assessing stigma during the COVID-19 pandemic, post-traumatic stress, blame, protective behaviors, and vaccine intent. Results: Mean post-traumatic stress scores in all three countries exceeded the cut-off that is commonly used to determine probable post-traumatic stress. Post-traumatic stress was associated with COVID-19 stigma experience, personal behavior change due to COVID-19 stigma, blaming groups for the spread of COVID-19, fear of COVID-19, and resource loss. In India and the United States, personal behavior change due to COVID-19 stigma, anger at individuals spreading COVID-19, and perceived susceptibility to illness were positively associated with vaccine intent. Conclusions: Stigma is a collateral stressor during the pandemic. The findings underscore the importance of prompt action to address stigma as a deleterious consequence of the pandemic. The findings illuminate potential barriers to receiving the vaccine and provide direction for future research to address barriers.
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Affiliation(s)
- David N. Sattler
- Department of Psychology, Western Washington University, Bellingham, WA 98225-9172, USA
| | - Boldsuren Bishkhorloo
- Department of Education and Psychology, National University of Mongolia, Ulaanbaatar 14200, Mongolia
| | - Kendall A. Lawley
- Global Center for Integrated Health of Women, Adolescents, and Children, University of Washington, Seattle, WA 98195, USA
| | - Ruth Hackler
- Department of Psychology, Western Washington University, Bellingham, WA 98225-9172, USA
| | - Chuluunbileg Byambajav
- Department of Education and Psychology, National University of Mongolia, Ulaanbaatar 14200, Mongolia
| | - Michidmaa Munkhbat
- Department of Education and Psychology, National University of Mongolia, Ulaanbaatar 14200, Mongolia
| | - Brooklyn Smith-Galeno
- Department of Psychology, Western Washington University, Bellingham, WA 98225-9172, USA
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15
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Tedjasukmana R, Budikayanti A, Islamiyah WR, Witjaksono AMAL, Hakim M. Sleep disturbance in post COVID-19 conditions: Prevalence and quality of life. Front Neurol 2023; 13:1095606. [PMID: 36698905 PMCID: PMC9869804 DOI: 10.3389/fneur.2022.1095606] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 12/02/2022] [Indexed: 01/12/2023] Open
Abstract
Post COVID-19 conditions are complaints and symptoms in patients with a history of probable or confirmed COVID-19 after 3 months of the onset of COVID-19 and last at least 2 months. About 10-20% of people may experience post COVID-19 conditions, one of which is sleep disturbance. There is a wide range of prevalence of sleep disturbances from 6% to more than 70%. An online survey of the post COVID-19 conditions in various countries showed that 78.58% of subjects had sleep disturbances, including insomnia, sleep-disordered breathing, central disorders of hypersomnolence, circadian rhythm sleep-wake disorders, parasomnias, and sleep-related movement disorders. Sleep disturbance can be found starting from 2 weeks until 48 weeks or more after discharge or after having a negative COVID-19 test results. Women aged < 50 years old with severe COVID-19 infection reported a worse outcome. Several mechanisms may cause sleep disturbance in post COVID-19 condition, namely persistent viral infection and inflammation, immunity dysregulation, and mitochondrial dysfunction. Several studies discovered sleep disturbance was a major problem that affected different domains of QoL in post COVID-19 conditions. Significant correlation was found between several dimensions of SF-36 with moderate-to-severe insomnia in post COVID-19 conditions. Therefore, sleep disturbance is a major problem in post COVID-19 conditions and may affect patients' QoL, and the existence of sleep disturbance should be a concern in post COVID-19 conditions period. Further research is required to determine the prevalence based on agreed definition as well as methods to assess this condition and its impact on QoL.
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Affiliation(s)
| | - Astri Budikayanti
- Department of Neurology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- Department of Neurology, Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Wardah Rahmatul Islamiyah
- Department of Neurology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Department of Neurology, Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Anastasia Melissa Ayu Larasati Witjaksono
- Department of Neurology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- Department of Neurology, Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Manfaluthy Hakim
- Department of Neurology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- Department of Neurology, Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
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16
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Bisenius S, Treml J, Hanschmidt F, Kersting A. Stigmatization profiles and psychological distress in people at high risk of infection with COVID-19 -A study conducted in Germany from March to August 2021. PLoS One 2023; 18:e0285788. [PMID: 37200379 DOI: 10.1371/journal.pone.0285788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 04/29/2023] [Indexed: 05/20/2023] Open
Abstract
COVID-19-related stigmatization of affected people or people at risk of infection has been shown to enhance the reluctance of affected individuals to use health services and reduce their mental health. It is thus highly important to gain a thorough understanding of COVID-19-related stigmatization. The present study's first aim was to explore stigmatization profiles of experienced stigmatization (anticipated stigmatization, internalized stigmatization, enacted stigmatization, disclosure concerns) and stigmatization practices in 371 German people at high risk of infection using latent class analyses. The second aim was to investigate the relationship between stigmatization profiles and psychological distress via multiple regression analysis taking into account other possible negative and positive risk factors. Our results showed two stigmatization profiles: "high stigmatization group" and "low stigmatization group". Belonging to the "high stigmatization group" was significantly correlated with higher levels of psychological distress. Other risk factors significantly related to psychological distress were mental health disorders in the past, exposure to COVID-19, fear related to COVID-19, perceived risk of being infected, lower perceived self-efficacy, and lower subjective knowledge about COVID-19.
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Affiliation(s)
- Sandrine Bisenius
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Leipzig, Saxony, Germany
| | - Julia Treml
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Leipzig, Saxony, Germany
| | - Franz Hanschmidt
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Leipzig, Saxony, Germany
| | - Anette Kersting
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Leipzig, Saxony, Germany
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17
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Zhao YJ, Zhang C, Guo T, Sha S, Su Z, Cheung T, Jackson T, An FR, Xiang YT. Associations between post-traumatic stress symptoms and quality of life among psychiatric healthcare personnel in China during the COVID-19 pandemic: A network approach. Front Psychiatry 2023; 14:975443. [PMID: 36873200 PMCID: PMC9975756 DOI: 10.3389/fpsyt.2023.975443] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 01/10/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Post-traumatic stress symptoms (PTSS) are commonly reported by psychiatric healthcare personnel during the coronavirus disease 2019 (COVID-19) pandemic and negatively affect quality of life (QOL). However, associations between PTSS and QOL at symptom level are not clear. This study examined the network structure of PTSS and its connection with QOL in psychiatric healthcare personnel during the COVID-19 pandemic. METHODS This cross-sectional study was carried out between March 15 and March 20, 2020 based on convenience sampling. Self-report measures including the 17-item Post-Traumatic Stress Disorder Checklist - Civilian version (PCL-C) and World Health Organization Quality of Life Questionnaire - Brief Version (WHOQOL-BREF) were used to measure PTSS and global QOL, respectively. Network analysis was used to investigate the central symptoms of PTSS and pattern of connections between PTSS and QOL. An undirected network was constructed using an extended Bayesian Information Criterion (EBIC) model, while a directed network was established based on the Triangulated Maximally Filtered Graph (TMFG) method. RESULTS Altogether, 10,516 psychiatric healthcare personnel completed the assessment. "Avoidance of thoughts" (PTSS-6), "Avoidance of reminders" (PTSS-7), and "emotionally numb" (PTSS-11) were the most central symptoms in the PTSS community, all of which were in the Avoidance and Numbing domain. Key bridge symptoms connecting PTSS and QOL were "Sleep disturbances" (PTSS-13), "Irritability" (PTSS-14) and "Difficulty concentrating" (PTSS-15), all of which were within the Hyperarousal domain. CONCLUSION In this sample, the most prominent PTSS symptoms reflected avoidance while symptoms of hyper-arousal had the strongest links with QOL. As such, these symptom clusters are potentially useful targets for interventions to improve PTSS and QOL among healthcare personnel at work under pandemic conditions.
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Affiliation(s)
- Yan-Jie Zhao
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, The National Clinical Research Center for Mental Disorders, The Advanced Innovation Center for Human Brain Protection, School of Mental Health, Capital Medical University, Beijing, China
| | - Cheng Zhang
- Yong Ding Lu Outpatient Department, Jingnan Medical Area, Chinese PLA General Hospital, Beijing, China
| | - Tong Guo
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, The National Clinical Research Center for Mental Disorders, The Advanced Innovation Center for Human Brain Protection, School of Mental Health, Capital Medical University, Beijing, China
| | - Sha Sha
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, The National Clinical Research Center for Mental Disorders, The Advanced Innovation Center for Human Brain Protection, School of Mental Health, Capital Medical University, Beijing, China
| | - Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
| | - Todd Jackson
- Department of Psychology, University of Macau, Taipa, Macao SAR, China
| | - Feng-Rong An
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, The National Clinical Research Center for Mental Disorders, The Advanced Innovation Center for Human Brain Protection, School of Mental Health, Capital Medical University, Beijing, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Taipa, Macao SAR, China.,Centre for Cognitive and Brain Sciences, University of Macau, Taipa, Macao SAR, China
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18
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Hazumi M, Okazaki E, Usuda K, Kataoka M, Nishi D. Relationship between attitudes toward COVID-19 infection, depression and anxiety: a cross-sectional survey in Japan. BMC Psychiatry 2022; 22:798. [PMID: 36536342 PMCID: PMC9761043 DOI: 10.1186/s12888-022-04474-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Although negative attitudes are known to develop with experiences of COVID-19 infection, it remains unclear whether such attitudes contribute to depression and anxiety as sequelae of COVID-19. We aimed to investigate the relationships between attitude towards COVID-19 infection and post-COVID-19 depression and anxiety. METHODS A cross-sectional survey of COVID-19 recovered patients was conducted from July to September 2021 in Japan. Outcome variables, depression and anxiety were assessed using the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7); scores of 10 and above were identified as having symptoms of depression and anxiety, respectively. Exposure variables were whether participants were experiencing the following attitude strongly: threat to life due to COVID-19 infection, helplessness regarding COVID-19 infection, blaming a third party who did not restrain from going outside, blaming themselves for their COVID-19 infection, worry about spreading the infection to others, and self-stigma (Self-Stigma Scale-Short). Modified Poisson regression analyses were performed to analyze the findings. RESULTS A total of 6016 responses were included in the analyses. The proportion of depression was 19.88%, and anxiety was 11.47%. The threat of life due to COVID-19 infection, helplessness regarding COVID-19 infection, blaming oneself for their COVID-19 infection, and self-stigma were significantly associated with depression and anxiety after adjusting covariates. Blaming the third party who did not restrain from going outside was associated with anxiety. There was no association between the worry about spreading infection to others and depression or anxiety. CONCLUSION Negative attitudes, including self-stigma with the experience of COVID-19 infection, were related to depression and anxiety. Further studies confirming whether countermeasures for preventing or decreasing the negative attitude towards COVID-19 infection mitigate these symptoms are needed.
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Affiliation(s)
- Megumi Hazumi
- grid.419280.60000 0004 1763 8916Department of Public Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo Japan ,grid.419280.60000 0004 1763 8916Department of Sleep-Wake Disorder, National Center of Neurology and Psychiatry, Kodaira, Tokyo Japan
| | - Emi Okazaki
- grid.419280.60000 0004 1763 8916Department of Public Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo Japan
| | - Kentaro Usuda
- grid.419280.60000 0004 1763 8916Department of Public Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo Japan
| | - Mayumi Kataoka
- grid.419280.60000 0004 1763 8916Department of Public Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo Japan ,grid.26999.3d0000 0001 2151 536XDepartment of Mental Health, Graduate School of Medicine, The University of Tokyo, Bunkyo, Tokyo Japan
| | - Daisuke Nishi
- Department of Public Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan. .,Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Bunkyo, Tokyo, Japan.
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19
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Zhou X, Chen C, Yao Y, Xia J, Cao L, Qin X. The scar that takes time to heal: A systematic review of COVID-19-related stigma targets, antecedents, and outcomes. Front Psychol 2022; 13:1026712. [PMID: 36533056 PMCID: PMC9752089 DOI: 10.3389/fpsyg.2022.1026712] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 11/14/2022] [Indexed: 09/19/2023] Open
Abstract
COVID-19, as a crucial public health crisis, has affected our lives in nearly every aspect. Besides its major health threats, COVID-19 brings severe secondary impacts, one of which is the rise of social stigma. Although numerous studies have examined the antecedents and outcomes of COVID-19-related stigma, we still lack a systematic understanding of who is being stigmatized during the COVID-19 pandemic, what exacerbates COVID-19-related stigma, and what impacts COVID-19-related stigma has on victims. Therefore, this review aims to provide a systematic overview of COVID-19-related stigma. With 93 papers conducted with 126,371 individuals in more than 150 countries and territories spanning five continents, we identify three targets that have received the most research: Chinese/Asian people, (suspected) patients and survivors, and healthcare workers. Furthermore, we find that for each stigma target, characteristics of the stigmatized, stigmatizer, and context contribute to COVID-19-related stigma and that this stigma negatively influences victims' health and non-health outcomes. We call for future research to provide a more integrative, balanced, and rigorous picture of COVID-19-related stigma via conducting research on neglected topics (e.g., contextual factors that contribute to stigma toward HCWs) and stigma interventions and using a longitudinal design. In practice, we urge governments and institutions (e.g., ministries of public health, hospitals) to pay close attention to stigma issues and to promote safe and inclusive societies.
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Affiliation(s)
- Xiang Zhou
- Department of Business Administration, Sun Yat-sen University, Guangzhou, China
| | - Chen Chen
- Department of Business Administration, Sun Yat-sen University, Guangzhou, China
| | - Yuewei Yao
- Department of Business Administration, Sun Yat-sen University, Guangzhou, China
| | - Jingtian Xia
- Department of Business Administration, Sun Yat-sen University, Guangzhou, China
| | - Limei Cao
- Department of Business Administration, Sun Yat-sen University, Guangzhou, China
| | - Xin Qin
- Department of Business Administration, Sun Yat-sen University, Guangzhou, China
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Long COVID and rheumatology: Clinical, diagnostic, and therapeutic implications. Best Pract Res Clin Rheumatol 2022; 36:101794. [PMID: 36369208 PMCID: PMC9641578 DOI: 10.1016/j.berh.2022.101794] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
As of this writing, it is estimated that there have been nearly 600 million cases of coronavirus disease 2019 (COVID-19) around the world with over six million deaths. While shocking, these figures do not fully illustrate the morbidity associated with this disease. It is also estimated that between 10% and 30% of those who survive COVID-19 develop persistent symptoms after the acute infection has passed. These individuals, who most often experienced initial infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) considered mild to moderate in severity, often display a broad array of symptoms. Collectively, this disorder or syndrome is now referred to as Long COVID (among other designations), and it represents a national/international health crisis. The most frequently reported symptoms associated with Long COVID include chronic fatigue with post exertional features, neurocognitive dysfunction, breathlessness, and somatic pain. Long COVID can range in severity from mild to severely debilitating, with resultant loss of quality of life and productivity. For now, there are many unanswered questions surrounding Long COVID: how can it be best defined, what is needed for accurate diagnosis, what is causing it, and how should it be best managed. How rheumatologists will engage in the Long COVID pandemic is another question; at the minimum, we will be called upon to evaluate and manage our own patients with immune-mediated inflammatory diseases who have developed it. This review focuses on addressing the disease essentials, providing both declarative and procedural knowledge to prepare rheumatologists for how to address Long COVID: understanding its origins, its current case definitions, epidemiology, pathobiology and clinical manifestations. Finally, it will provide an outline on how to clinically approach patients with possible Long COVID and initiate treatment and/or guide them on how to best manage it.
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Mchunu GG, Harris O, Nxumalo CT. Exploring primary healthcare practitioners' experiences regarding the coronavirus disease 2019 (COVID-19) pandemic in KwaZulu-Natal, South Africa. Prim Health Care Res Dev 2022; 23:e67. [PMID: 36330843 PMCID: PMC9641673 DOI: 10.1017/s1463423622000536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 06/23/2022] [Accepted: 09/03/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) has spread rapidly around the world since the initial outbreak in Wuhan, China. With the emergence of the Omicron variant, South Africa is presently the epicentre of the COVID-19 pandemic in sub-Saharan Africa. Healthcare workers have been at the forefront of the pandemic in terms of screening, early detection and clinical management of suspected and confirmed COVID-19 cases. Since the beginning of the outbreak, little has been reported on how healthcare workers have experienced the COVID-19 pandemic in South Africa, particularly within a low-income, rural primary care context. METHODS The purpose of the present qualitative study design was to explore primary healthcare practitioners' experiences regarding the COVID-19 pandemic at two selected primary healthcare facilities within a low-income rural context in KwaZulu-Natal, South Africa. Data were collected from a purposive sample of 15 participants, which consisted of nurses, physiotherapists, pharmacists, community caregivers, social workers and clinical associates. The participants were both men and women who were all above the age of 20. Data were collected through individual, in-depth face-to-face interviews using a semi-structured interview guide. Audio recordings were transcribed verbatim. Data were analysed manually by thematic analysis following Tech's steps of data analysis. RESULTS Participants reported personal, occupational and community-related experiences related to the COVID-19 pandemic in South Africa. Personal experiences of COVID-19 yielded superordinate themes of psychological distress, self-stigma, disruption of the social norm, Epiphany and conflict of interest. Occupational experiences yielded superordinate themes of staff infections, COVID-19-related courtesy stigma, resource constraints and poor dissemination of information. Community-related experiences were related to struggles with societal issues, clinician-patient relations and COVID-19 mismanagement of patients. CONCLUSION The findings of this study suggest that primary healthcare practitioners' experiences around COVID-19 are attributed to the catastrophic effects of the COVID-19 pandemic with the multitude of psychosocial consequences forming the essence of these experiences. Ensuring availability of reliable sources of information regarding the pandemic as well as psychosocial support could be valuable in helping healthcare workers cope with living and working during the pandemic.
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Affiliation(s)
- Gugu Gladness Mchunu
- Faculty of Health Sciences, Durban University of Technology, Durban, South Africa
| | - Orlando Harris
- Department of Community Health Systems, School of Nursing, University of California San Francisco, San Fransisco, CA, USA
| | - Celenkosini Thembelenkosini Nxumalo
- Faculty of Health Sciences, Durban University of Technology, Durban, South Africa
- College of Health Sciences, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
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Huang PC, Hung CH, Chen GW, Cashin C, Griffiths MD, Yang WC, Wang HW, Lin CY, Ko NY. COVID-19-Related Self-Stigma, Post-Traumatic Stress Disorder, Insomnia, and Smartphone Addiction Among Frontline Government Workers with COVID-19 Pandemic Control Duties. Psychol Res Behav Manag 2022; 15:3069-3080. [PMID: 36281271 PMCID: PMC9587721 DOI: 10.2147/prbm.s383842] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 09/27/2022] [Indexed: 11/22/2022] Open
Abstract
Purpose The duties related to COVID-19 control and prevention may have caused psychological stress for the individuals in charge (eg, frontline government workers) and have reportedly led to mental health issues, such as insomnia and post-traumatic stress disorder (PTSD). However, the prevalence of these COVID-19-related disorders and their associated factors remain unclear. Therefore, the purpose of the present study was to investigate the prevalence rates of insomnia, PTSD, COVID-19-related self-stigma, and smartphone addiction, along with the identification of risk factors and protective factors for Taiwan frontline government workers with COVID-19 pandemic control duties. Methods The survey was carried out with 151 participants between September and October 2021. All participants completed the Fear of COVID-19 Scale (assessing fear of COVID-19), Self-Stigma Scale (assessing self-stigma during the COVID-19 pandemic), Smartphone Application-Based Addiction Scale (assessing the risk of smartphone addiction), Insomnia Severity Index (assessing insomnia), Impacts of Event Scale-6 (assessing PTSD), and a self-designed set of questions assessing trait resilience. Results The results showed that the prevalence rate was 31.1% for insomnia and 33.8% for PTSD. Furthermore, service duration (adjusted odds ratio [AOR] = 0.93; 95% confidence interval [CI] = 0.86, 0.999) and trait resilience (AOR = 0.19; 95% CI = 0.08, 0.46) were protective factors and fear of COVID-19 (AOR = 1.91; 95% CI = 1.02, 3.57) was a risk factor for insomnia. Fear of COVID-19 (AOR = 2.63; 95% CI = 1.35, 5.14), self-stigma (AOR = 3.62; 95% CI = 1.19, 11.02), and smartphone addiction (AOR = 1.09, 95% CI = 1.001, 1.19) were risk factors, and trait resilience was a protective factor (AOR = 0.58; 95% CI = 0.29, 1.17) for PTSD. Conclusion The findings demonstrated a high prevalence of insomnia and PTSD. Risk-reducing strategies and protective factor promotion strategies are recommended to help reduce the symptoms of insomnia and PTSD among Taiwan frontline government workers.
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Affiliation(s)
- Po-Ching Huang
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ching-Hsia Hung
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Guan-Wei Chen
- Department of Hydraulic and Ocean Engineering, College of Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Ciaran Cashin
- Department of Hydraulic and Ocean Engineering, College of Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Wen-Chi Yang
- Division of Hematology and Medical Oncology, Department of Internal Medicine, E-DA Hospital, Kaohsiung, Taiwan
- Faculty of School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Hsiao-Wen Wang
- Department of Hydraulic and Ocean Engineering, College of Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Nai-Ying Ko
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Liang L, Yuan T, Guo X, Meng C, Lv J, Fei J, Mei S. The path of depression among frontline nurses during COVID-19 pandemic: A fuzzy-set qualitative comparative analysis. Int J Ment Health Nurs 2022; 31:1239-1248. [PMID: 35727700 PMCID: PMC9350022 DOI: 10.1111/inm.13033] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/22/2022] [Indexed: 12/23/2022]
Abstract
This study aimed to explore the combination of different conditional variables that led to depressive symptoms among frontline nurses who were fought against COVID-19 during the outbreak in Wuhan City, Hubei Province of China. The study was conducted in August 2020, which included 331 frontline clinical nurses who supported Wuhan's fight against COVID-19. The age range was 21-57 years and included 315 female nurses and 16 male nurses. This study used the fuzzy-set qualitative comparative analysis research method to explore the path of depression among frontline nurses. This study generated nine different configurations for the path of depression among frontline nurses, and had a detailed demonstration for each configuration. Each configuration distinguishes the different effects of influencing factors. For example, in the first configuration, gender, sleep disorder and PTSD exist as core conditions, while social support exists as a core condition lack. This study was presented results which was different what linear regression model reports. It takes into consideration the combined effect of each conditional variable on the development of depression. Nurse managers should pay attention to the combination of multiple influencing factors, instead of focus on single factors.
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Affiliation(s)
- Leilei Liang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Tongshuang Yuan
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Xinmeng Guo
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Cuicui Meng
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Jianping Lv
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Junsong Fei
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Songli Mei
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
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Hazumi M, Usuda K, Okazaki E, Kataoka M, Nishi D. Differences in the Course of Depression and Anxiety after COVID-19 Infection between Recovered Patients with and without a Psychiatric History: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811316. [PMID: 36141588 PMCID: PMC9517442 DOI: 10.3390/ijerph191811316] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/05/2022] [Accepted: 09/06/2022] [Indexed: 05/03/2023]
Abstract
BACKGROUND This study aimed to examine the course of depression and anxiety in COVID-19 survivors with a psychiatric history compared with those without a psychiatric history. METHODS A web-based cross-sectional survey for COVID-19 survivors was conducted from July to September 2021. A total of 6016 COVID-19 survivors, the accuracy of whose responses was determined to be assured, were included in analyses. Exposures included psychiatric history and time since COVID-19 infection, and the main outcomes and measures included severity of depression and anxiety, as assessed using the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), respectively. RESULTS Mean severity of PHQ-9 and GAD-7 were significantly higher in participants with a psychiatric history than in those without a psychiatric history. Two-way analysis of covariance for PHQ-9 showed a significant main effect of the presence of psychiatric history and a significant interaction effect of psychiatric history × time since infection. Two-way analysis of covariance for the GAD-7 score revealed a significant main effect of the presence of psychiatric history and time since COVID-19 infection and the interaction effect of these factors. CONCLUSIONS The course of depression and anxiety was more severe in COVID-19 survivors with a psychiatric history than in those without a psychiatric history.
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Affiliation(s)
- Megumi Hazumi
- Department of Public Mental Health Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan
- Department of Sleep-Wake Disorder, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan
| | - Kentaro Usuda
- Department of Public Mental Health Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan
| | - Emi Okazaki
- Department of Public Mental Health Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan
| | - Mayumi Kataoka
- Department of Public Mental Health Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8654, Japan
| | - Daisuke Nishi
- Department of Public Mental Health Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8654, Japan
- Correspondence:
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Insomnia and Post-traumatic Stress Disorder: A Meta-analysis on Interrelated Association (n=57,618) and Prevalence (n=573,665). Neurosci Biobehav Rev 2022; 141:104850. [DOI: 10.1016/j.neubiorev.2022.104850] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/27/2022] [Accepted: 08/27/2022] [Indexed: 12/14/2022]
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Development and psychometric validation of new questionnaires assessing experienced discrimination and internalised stigma among people with Covid-19. Epidemiol Psychiatr Sci 2022; 31:e37. [PMID: 35616053 PMCID: PMC9158394 DOI: 10.1017/s204579602200021x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
AIMS To develop and validate two new standardised measures assessing, respectively, experienced discrimination (Covid-19 Experienced DISCrimination scale, CEDISC) and internalised stigma (COvid-19 INternalised Stigma scale, COINS) in people who had been infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or had developed coronavirus disease 2019 (Covid-19) disease. METHODS Both the CEDISC and the COINS were developed in Italian and tested for ease of use, comprehension, acceptability, the relevance of items and response options within a focus group session. Online cross-sectional validation survey was conducted among adults infected with SARS-CoV-2 or who developed Covid-19 disease, members of a closed Facebook discussion group in Italy. Exploratory factor analysis (EFA) with Promax oblique rotation; the Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy and the Bartlett's test of sphericity were used to assess the suitability of the sample for factor analysis. Reliability was assessed as internal consistency using Cronbach's alpha and as test-retest reliability using weighted kappa and intraclass correlation coefficient (ICC). Precision was examined by Kendall's tau-b coefficient. RESULTS Overall, 579 participants completed the CEDISC, 519 also completed the COINS, 155 completed the retest for both scales after two weeks. The 12 items of the CEDISC converged over a 2-factor solution ('social life' and 'close relations') accounting for 49.2% of the variance (KMO = 0.894; Bartlett's test p < 0.001); the 13 items of the COINS converged over a 3-factor solution ('self-perception', 'close relations' and 'social life') accounting for 67.7% (KMO = 0.827; Bartlett's test p < 0.001). Cronbach's α was 0.848 for the CEDISC, and 0.837 for the COINS. The CEDISC showed three items (25%) with kappa between 0.61 and 0.80 and seven (58.4%) between 0.41 and 0.60, with only two items scoring 0.21 and 0.40; the COINS had ten items (76.9%) with kappa ranging from 0.41 to 0.60, and three items below 0.31. ICC was 0.906 (95% CI, 0.871-0.932) for the, CEDISC and 0.860 (95% CI, 0.808-0.898) for the COINS. Kendall's tau-b ranged from 0.360 to 0.556 (p < 0.001) for the CEDISC and from 0.290 to 0.606 (p < 0.001) for the COINS. CONCLUSIONS Both the CEDISC and the COINS are two valid and reliable scales to be used in studies examining the role of stigma and discrimination of people infected with SARS-CoV-2 and Covid-19 patients, and in research evaluating interventions designed to mitigate stigma in this population.
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Chandran N, Vinuprasad V G, Sreedevi C, Sathiadevan S, Deepak K S. COVID-19-related Stigma Among the Affected Individuals: A Cross-Sectional Study From Kerala, India. Indian J Psychol Med 2022; 44:279-284. [PMID: 35656434 PMCID: PMC9125476 DOI: 10.1177/02537176221086983] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND The studies and case reports from various parts of the world are showing discrimination and stigma associated with COVID-19. Stigma can directly worsen the mental health of people and also worsen physical health indirectly. This study is aimed to assess the anticipatory and experienced stigma associated with COVID-19 in affected individuals. METHODS This was a cross-sectional study conducted at Palakkad District in Kerala. Study participants were patients diagnosed with COVID-19. The sampling method was convenience sampling and snowball sampling. COVID-19 Related Stigma Survey Questionnaire was prepared by experts from the field of Psychiatry and Community Medicine. The responses were collected via an online survey and telephonic interview. RESULTS Among the total participants (N=303) 119 participants (39.3%) wanted to keep the illness a secret. Eighty-one participants (26.7%) had fear of discrimination from others. Eighty-nine participants (29.4%) had experienced stigma related to their COVID-19 infection. Seventy-five (24.8%) participants' family members had experienced stigma. Few stigma parameters were significantly higher among the younger people. The participants belonging to the below poverty line category and the participants with lesser education showed significantly more worry about rejoining society after the isolation. Below poverty line category also had significantly more worry about discrimination towards their family members. Participants with lower education had significantly more worry about affecting their job due to the illness. Health care workers had significantly high worry regarding others attitudes towards them. CONCLUSION There is a high level of stigma associated with COVID-19 in society. Definite measures need to be taken to reduce the stigma related to COVID-19 infection.
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Affiliation(s)
- Nimmy Chandran
- Dept. of Psychiatry, Government Medical College, Palakkad, Kerala, India
| | - Vinuprasad V G
- Dept. of Psychiatry, Government Medical College, Palakkad, Kerala, India
| | - Sreedevi C
- Dept. of Community Medicine, Government Medical College, Palakkad, Kerala, India
| | - Sajal Sathiadevan
- Dept. of Psychiatry, Government Medical College, Palakkad, Kerala, India
| | - Deepak K S
- Dept. of Community Medicine, Government Medical College, Palakkad, Kerala, India
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Mohsen F, Bakkar B, Khadem alsrouji S, Abbas E, Najjar A, Marrawi M, Latifeh Y. Fear among Syrians: A Proposed Cutoff Score for the Arabic Fear of COVID-19 Scale. PLoS One 2022; 17:e0264257. [PMID: 35275930 PMCID: PMC8916619 DOI: 10.1371/journal.pone.0264257] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 02/07/2022] [Indexed: 12/23/2022] Open
Abstract
COVID-19 pandemic has led to psychological health issues one of which is fear. This study validates the Arabic version of the fear of COVID-19 scale and suggests a new cutoff score to measure fear of COVID-19 among the Syrian Population. A total of 3989 participants filled an online survey consisting of socio-demographic information, the fear of COVID-19 scale, the patient health questionnaire 9-item, and the generalized anxiety disorder 7-item. Receiver operating characteristic analysis was used to define cutoff scores for the fear of COVID-19 scale in relation to generalized anxiety disorder 7-item and the patient health questionnaire 9-item. The Cronbach α value of the Arabic fear of COVID-19 scale was 0.896, revealing good stability and internal consistency. The inter-item correlations were between [0.420–0.868] and the corrected item-total correlations were between [0.614–0.768]. A cutoff point of 17.5 was deduced from the analysis. According to the deduced cutoff point, 2111(52.9%) were categorized as extreme fear cases. This cutoff score deduced from this study can be used for screening purposes to distinguish community members that may be prone to developing extreme fear of COVID-19. Therefore, early preventive and supportive measures can then be delivered.
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Affiliation(s)
- Fatema Mohsen
- Faculty of Medicine, Syrian Private University, Damascus, Syria
- * E-mail:
| | - Batoul Bakkar
- Faculty of Medicine, Syrian Private University, Damascus, Syria
| | | | - Esraa Abbas
- Faculty of Medicine, Syrian Private University, Damascus, Syria
| | - Alma Najjar
- Faculty of Medicine, Syrian Private University, Damascus, Syria
| | - Marah Marrawi
- Department of Statistics, Syrian Private University, Damascus, Syria
| | - Youssef Latifeh
- Faculty of Medicine, Department of Psychiatry, Syrian Private University, Damascus, Syria
- Faculty of Medicine, Department of Psychiatry, Damascus University, Damascus, Syria
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Ye Y, Yang X, Zhou X. Attention to negative information and PTSSs during the COVID-19: A moderated mediational model. CURRENT PSYCHOLOGY 2022:1-8. [PMID: 35283612 PMCID: PMC8902846 DOI: 10.1007/s12144-022-02877-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2022] [Indexed: 11/19/2022]
Abstract
Post-traumatic stress symptoms (PTSSs) have been a common negative psychological response during the COVID-19 pandemic. Previous theories emphasized the unique effects of cognitive and family factors on PTSSs and overlooked their combined role, which suggested that the mechanisms underlying PTSSs were not fully understood. To fill this gap, this study aimed to examine the associations between attention to negative information, blaming others, parent-child relationship and PTSSs, as well as the combined role of these factors on PTSSs. During the COVID-19 pandemic, 1153 college students completed self-report questionnaires. Results indicated that attention to negative information increased PTSSs, both directly and via blaming others. Moreover, parent-child relationship buffered both the exacerbating effect of attention to negative information on blaming others and the effect of blaming others on worsening PTSSs. The current study integrates existing theories, expands the field of trauma research through considering the effect of cognitive and family factors on PTSSs, and provides theoretical support for interventions to relieve PTSSs.
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Affiliation(s)
- Yingying Ye
- Department of Psychology and Behavioral Sciences, Zhejiang University, No. 148 Tianmushan Street, Hangzhou, 310028 China
| | - Xima Yang
- Department of Psychology and Behavioral Sciences, Zhejiang University, No. 148 Tianmushan Street, Hangzhou, 310028 China
| | - Xiao Zhou
- Department of Psychology and Behavioral Sciences, Zhejiang University, No. 148 Tianmushan Street, Hangzhou, 310028 China
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Psychological Symptoms in COVID-19 Patients: Insights into Pathophysiology and Risk Factors of Long COVID-19. BIOLOGY 2022; 11:biology11010061. [PMID: 35053059 PMCID: PMC8773222 DOI: 10.3390/biology11010061] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 12/26/2021] [Accepted: 12/27/2021] [Indexed: 12/17/2022]
Abstract
There is growing evidence of studies associating COVID-19 survivors with increased mental health consequences. Mental health implications related to a COVID-19 infection include both acute and long-term consequences. Here we discuss COVID-19-associated psychiatric sequelae, particularly anxiety, depression, and post-traumatic stress disorder (PTSD), drawing parallels to past coronavirus outbreaks. A literature search was completed across three databases, using keywords to search for relevant articles. The cause may directly correlate to the infection through both direct and indirect mechanisms, but the underlying etiology appears more complex and multifactorial, involving environmental, psychological, and biological factors. Although most risk factors and prevalence rates vary across various studies, being of the female gender and having a history of psychiatric disorders seem consistent. Several studies will be presented, demonstrating COVID-19 survivors presenting higher rates of mental health consequences than the general population. The possible mechanisms by which the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) enters the brain, affecting the central nervous system (CNS) and causing these psychiatric sequelae, will be discussed, particularly concerning the SARS-CoV-2 entry via the angiotensin-converting enzyme 2 (ACE-2) receptors and the implications of the immune inflammatory signaling on neuropsychiatric disorders. Some possible therapeutic options will also be considered.
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Pedrozo-Pupo JC, Caballero-Domínguez CC, Campo-Arias A. Prevalence and variables associated with insomnia among COVID-19 survivors in Colombia. ACTA BIO-MEDICA : ATENEI PARMENSIS 2022; 93:e2022019. [PMID: 35315399 PMCID: PMC8972847 DOI: 10.23750/abm.v93i1.12132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 09/19/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIM OF THE WORK The prevalence of insomnia is higher in COVID-19 survivors. However, there is little information about his associated variables. The aimed to know the prevalence and variables associated with insomnia among COVID-19 survivors in Colombian adults. METHOD Three hundred and thirty COVID-19 survivors participated in a cross-sectional study. Insomnia was quantified with the Athens Insomnia Scale (cut-off score ≤ 6, Cronbach's alpha of 0.90). RESULTS COVID-19 survivors were between 18 and 89 years (Mean = 47.7, SD = 15.2); the majority were women (61.5%), university-educated (62.4%), low income (71.2%), married or free union (66.1%), not healthcare workers (85.8%), without comorbidities (63.0%), asymptomatic or mild COVID-19 (66.1%), duration of COVID-19 symptoms in less than three weeks (80.0%) and remission of symptoms less two months by the day of study participation (73.0%). Scores on the Athens Insomnia Scale were observed between 0 and 24 (M = 7.3, SD = 5.1, Me = 7, IQR = 3 - 10), 60% presented insomnia. Insomnia was associated with post-traumatic stress symptoms (OR = 8.8, 95%CI 2.7 - 29.5), COVID-19 symptoms for more than three weeks (OR = 2.1, 95%CI 1.1 - 3.9), female gender (OR = 1.9, 95%CI 1.2 - 3.2) and married or free union marital status (OR = 1.8, 95%CI 1.1 - 3.0). CONCLUSION The frequency of insomnia in COVID-19 survivors is high and mainly related to post-traumatic stress, symptoms of COVID-19 for more than three weeks, and the female gender. It is necessary to implement follow-up studies over time to evaluate the persistence of insomnia.
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Xiao X, Yang X, Zheng W, Wang B, Fu L, Luo D, Hu Y, Ju N, Xu H, Fang Y, Fong Chan PS, Xu Z, Chen P, He J, Zhu H, Tang H, Huang D, Hong Z, Hao Y, Cai L, Ye S, Yuan J, Xiao F, Yang J, Wang Z, Zou H. Depression, anxiety and post-traumatic growth among COVID-19 survivors six-month after discharge. Eur J Psychotraumatol 2022; 13:2055294. [PMID: 35401948 PMCID: PMC8986234 DOI: 10.1080/20008198.2022.2055294] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Pre-hospitalisation, hospitalisation and post-hospitalisation factors may significantly affect depression, anxiety and post-traumatic growth (PTG) among COVID-19 survivors. OBJECTIVE Our study investigated depression, anxiety and PTG and their correlates among COVID-19 survivors. METHOD A cross-sectional telephone survey recruited 199 COVID-19 patients (Mean age = 42.7; 53.3% females) at six-month follow-up after hospital discharge in five Chinese cities (i.e. Wuhan, Shenzhen, Zhuhai, Dongguan and Nanning). Their demographic information, clinical records and experiences during (e.g. severity of covid-19 symptoms, treatment and exposure to other patients' suffering) and after hospitalisation (e.g. perceived impact of covid-19, somatic symptoms after hospitalisation), and psychosocial factors (e.g. perceived discrimination, self-stigma, affiliate stigma, resilience and social support) were investigated. Depressive and anxiety symptoms were measured by the Patient Health Questionnaire (PHQ-9) and the Generalised anxiety disorder (GAD-7) scale, respectively. PTG was examined by the Post-traumatic Growth Inventory (PTGI) instrument. RESULTS The proportion of depressive symptoms <5, ≥5 and <10, ≥10 were 76.9%, 12.0% and 11.1%, respectively. The proportion of anxiety symptoms <5, ≥5 and <10, ≥10 were 77.4%, 15.1% and 7.5%, respectively. Multivariate logistic regression showed that receiving mental health care services during hospitalisation, somatic symptoms after discharge, perceived affiliate stigma and perceived impact of being infected with COVID-19 were significantly and positively associated with probable depression. Significant correlates of probable anxiety also included permanent residents of the city, somatic symptoms after discharge, perceived impact of being infected with COVID-19 and self-stigma. Social support, self-stigma and receiving mental health care services during hospitalisation were positively associated with PTG.Conclusions: The results suggest that post-hospitalisation and psychosocial factors had relatively stronger associations with depression, anxiety and PTG than pre-hospitalisation and hospitalisation factors. Promoting social support and social inclusion may be useful strategies to improve the mental health of COVID-19 survivors. HIGHLIGHTS • Post-hospitalisation and psychosocial factors had relatively stronger associations with depression, anxiety and PTG than pre-hospitalisation and hospitalisation factors, promoting social support and social inclusion may be useful strategies to improve mental health of COVID-19 survivors.
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Affiliation(s)
- Xin Xiao
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, People's Republic of China.,Center for Optometry and Visual Science, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, People's Republic of China
| | - Xue Yang
- Faculty of Medicine, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Weiran Zheng
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, People's Republic of China
| | - Bingyi Wang
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, People's Republic of China
| | - Leiwen Fu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, People's Republic of China
| | - Dan Luo
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, People's Republic of China
| | - Yuqing Hu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, People's Republic of China
| | - Niu Ju
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, People's Republic of China
| | - Hui Xu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, People's Republic of China
| | - Yuan Fang
- Department of Early Childhood Education, The Education University of Hong Kong, Hong Kong, People's Republic of China
| | - Paul Shing Fong Chan
- Faculty of Medicine, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Zhijie Xu
- The Fifth Affiliated Hospital of Sun Yat-sen University, 74 Zhongshan 2nd Road, Yuexiu District, Guangzhou, People's Republic of China
| | - Ping Chen
- The Fifth Affiliated Hospital of Sun Yat-sen University, 74 Zhongshan 2nd Road, Yuexiu District, Guangzhou, People's Republic of China
| | - Jiaoling He
- The Fifth Affiliated Hospital of Sun Yat-sen University, 74 Zhongshan 2nd Road, Yuexiu District, Guangzhou, People's Republic of China
| | - Hongqiong Zhu
- The Fifth Affiliated Hospital of Sun Yat-sen University, 74 Zhongshan 2nd Road, Yuexiu District, Guangzhou, People's Republic of China
| | - Huiwen Tang
- The Fifth Affiliated Hospital of Sun Yat-sen University, 74 Zhongshan 2nd Road, Yuexiu District, Guangzhou, People's Republic of China
| | - Dixi Huang
- The Fifth Affiliated Hospital of Sun Yat-sen University, 74 Zhongshan 2nd Road, Yuexiu District, Guangzhou, People's Republic of China
| | - Zhongsi Hong
- The Fifth Affiliated Hospital of Sun Yat-sen University, 74 Zhongshan 2nd Road, Yuexiu District, Guangzhou, People's Republic of China
| | - Yanrong Hao
- Department of scientific research, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, People's Republic of China
| | - Lianying Cai
- Department of education, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, People's Republic of China
| | - Shupei Ye
- Dongguan Songshan Lake Central Hospital, Dongguan, People's Republic of China
| | - Jianhui Yuan
- Shenzhen Nanshan District Center for Disease Control and Prevention, Shenzhen, People's Republic of China
| | - Fei Xiao
- The Fifth Affiliated Hospital of Sun Yat-sen University, 74 Zhongshan 2nd Road, Yuexiu District, Guangzhou, People's Republic of China
| | - Jianrong Yang
- Department of Hepatobiliary, Pancreas and Spleen Surgery, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, People's Republic of China
| | - Zixin Wang
- Faculty of Medicine, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Huachun Zou
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, People's Republic of China.,School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.,Shenzhen Center for Disease Control and Prevention, Shenzhen, People's Republic of China.,Kirby Institute, University of New South Wales, Sydney, NSW, Australia
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Bozan Ö, Atiş ŞE, Çekmen B, Şentürk M, Kalkan A. Healthcare workers' sleep quality after COVID-19 infection: A cross-sectional study. Int J Clin Pract 2021; 75:e14772. [PMID: 34473889 PMCID: PMC8646889 DOI: 10.1111/ijcp.14772] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 07/31/2021] [Accepted: 08/30/2021] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION The COVID-19 pandemic not only affected physical health but also caused high levels of mental health problems including sleep disturbances, depression and post-traumatic stress symptoms. The aim of this study was to examine the sleep parameters of healthcare workers before COVID-19 infection and after recovery. MATERIALS AND METHODS Healthcare workers who were infected with COVID-19 and whose treatment was completed at least 30 days ago were included in the study. A web-based cross-sectional survey was conducted on the participants. RESULTS The median PSQI score increased significantly after COVID-19 infection (7.0) compared with the level before COVID-19 infection (5.0). The increases in median scores for subjective sleep quality, sleep latency, sleep duration, sleep efficiency, sleep disturbance, use of sleeping medication and daytime dysfunction were all significant. CONCLUSION Sleep quality decreased during the convalescence period from COVID-19 infection as compared with the pre-COVID-19 period.
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Affiliation(s)
- Öner Bozan
- Department of Emergency MedicineProf. Dr Cemil Taşcıoğlu City HospitalIstanbulTurkey
| | - Şeref Emre Atiş
- Department of Emergency MedicineMersin City HospitalMersinTurkey
| | - Bora Çekmen
- Department of Emergency MedicineFaculty of MedicineKarabuk UniversityKarabükTurkey
| | - Mücahit Şentürk
- Department of Emergency MedicineProf. Dr Cemil Taşcıoğlu City HospitalIstanbulTurkey
| | - Asım Kalkan
- Department of Emergency MedicineProf. Dr Cemil Taşcıoğlu City HospitalIstanbulTurkey
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Mahmoudi H, Saffari M, Movahedi M, Sanaeinasab H, Rashidi-Jahan H, Pourgholami M, Poorebrahim A, Barshan J, Ghiami M, Khoshmanesh S, Potenza MN, Lin CY, Pakpour AH. A mediating role for mental health in associations between COVID-19-related self-stigma, PTSD, quality of life, and insomnia among patients recovered from COVID-19. Brain Behav 2021; 11:e02138. [PMID: 33811451 PMCID: PMC8119851 DOI: 10.1002/brb3.2138] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 02/07/2021] [Accepted: 03/16/2021] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Patients with COVID-19 often suffer from psychological problems such as post-traumatic stress disorder (PTSD) and self-stigmatization that may negatively impact their quality of life and sleep. This study examined mental health as a potential mediating factor linking self-stigmatization and PTSD to quality of life and sleep. METHODS Using a cross-sectional design, 844 people who had recovered from COVID-19 were called and interviewed. Data were collected using structured scales. Structural equation modeling was applied to assess fitness of a mediation model including self-stigma and PTSD as independent factors and quality of life and insomnia as dependent variables. RESULTS Mental health, COVID-19-related self-stigma, and mental quality of life were associated. Insomnia, PTSD, and COVID-19-related self-stigma displayed significant direct associations (r = .334 to 0.454; p < .01). A mediation model indicated satisfactory goodness of fit (CFI = 0.968, TLI = 0.950, SRMR = 0.071, RMSEA = 0.068). Mental health as a mediator had negative relationships with COVID-19-related self-stigma, PTSD, and insomnia and positive associations with quality of life. CONCLUSION Mental health may mediate effects of COVID-19-related self-stigma and PTSD on quality of life and insomnia. Designing programs to improve mental health among patients with COVID-19 may include efforts to reduce negative effects of PTSD and COVID-19-related self-stigma on quality of life and insomnia.
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Affiliation(s)
- Hosein Mahmoudi
- Trauma Research Center and Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mohsen Saffari
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.,Health Education Department, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mahmoud Movahedi
- Behavioral Sciences Research Center and Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Hormoz Sanaeinasab
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.,Health Education Department, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Hojat Rashidi-Jahan
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Morteza Pourgholami
- Health Education and Health Promotion unit, Rasht Health Center,Guilan University of Medical Sciences, Rasht, Iran
| | - Ali Poorebrahim
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Jalal Barshan
- Rasht Health Center,Guilan University of Medical Sciences, Rasht, Iran
| | - Milad Ghiami
- Health, Safety and Environment Management, Expert of Occupational Health of Health Center, Rasht, Iran
| | - Saman Khoshmanesh
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Marc N Potenza
- Departments of Psychiatry and Neuroscience and the Child Study Center, School of Medicine, Yale University, New Haven, CT, USA
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, Department of Occupational Therapy, Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Amir H Pakpour
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.,Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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35
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El Sayed S, Gomaa S, Shokry D, Kabil A, Eissa A. Sleep in post-COVID-19 recovery period and its impact on different domains of quality of life. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2021; 57:172. [PMID: 34924750 PMCID: PMC8669420 DOI: 10.1186/s41983-021-00429-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 11/30/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND COVID-19 pandemic became a global health problem affecting the life of millions of people all over the world. The effects of this pandemic were not only on the physical and medical aspects but also on the psychological issues including anxiety disorders, depressive manifestations, sleep problems and others. Sleep disorders were very commonly reported during the novel Coronavirus-19 pandemic either in the acute phase of COVID-19 infection or after recovery. These sleep problems might have a drastic burden on the recovered patients' life. This study aimed to investigate the sleep in the post-Coronavirus-19 period and if has an impact on the different items of patients' quality of life. This cross-sectional observational study investigated the sleep problems in 500 patients in the post recovery period using Insomnia Severity Index and Pittsburgh sleep quality index (PSQI), their relation to this critical period and their impact on different domains of Quality of Life which was assessed by the SF36 Health Survey. RESULTS Socio-demographic characteristics of 500 post-Coronavirus-19 patients were collected; the insomnia severity index and Pittsburgh sleep quality index evaluated the sleep pattern. The quality of life was investigated using Short Form 36 scale. The study revealed high scores of insomnia severity index (13.01 ± 4.9), Pittsburgh sleep quality index (15.37 ± 4.43), also high scores of different items of scale of quality of life in the studied group. CONCLUSION Post-COVID-19 sleep disturbances were commonly reported in the recovery period, also these sleep deficits had an impact on the physical and mental aspects of quality of life, so these sleep problems must be managed properly especially in this critical pandemic era.
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Affiliation(s)
- Samir El Sayed
- grid.10251.370000000103426662Department of Psychiatry, Faculty of Medicine, Mansoura University, Mansoura, 35516 Egypt
| | - Sarah Gomaa
- grid.10251.370000000103426662Mansoura University Students’ Hospital, Mansoura University, Mansoura, Egypt
| | - Doaa Shokry
- grid.10251.370000000103426662Department Community Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Ahmed Kabil
- grid.411303.40000 0001 2155 6022Department of Chest Medicine, Faculty of Medicine, Al Azhar University, Cairo, Egypt ,Department of Pulmonology Medicine, Hayat National Hospital, Riyadh, Kingdom of Saudi Arabia
| | - Ahmed Eissa
- grid.440879.60000 0004 0578 4430Department of Neuropsychiatry, Faculty of Medicine, Port Said University, Port Said, Egypt
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