The impact of the COVID-19 pandemic on physical and mental health in the two largest economies in the world: a comparison between the United States and China

The relationship between COVID-19 stress and test anxiety in art students: the chain mediating roles of intolerance of uncertainty and sleep quality

BACKGROUND

The global spread of COVID-19 has brought immense physiological and psychological distress to students, such as test anxiety and poor sleep quality. This study aims to explore the relationship between COVID-19 stress and test anxiety and the mediating roles of intolerance of uncertainty and sleep quality between them.

METHODS

A study was conducted in China during the late stage of the pandemic. A total of 936 Chinese art students (age M = 18.51, SD = 2.11, 46.6% female) completed the Coronavirus Stress Measure (CSM), the 12-item Intolerance of Uncertainty (IUS-12), the Brief Version of the Pittsburgh Sleep Quality Index (B-PSQI), and the Test Anxiety Inventory (TAI). A chain mediation model analysis was conducted to examine the mediating effects of intolerance of uncertainty and sleep quality on the association with COVID-19 stress and test anxiety.

RESULTS

COVID-19 stress was positively associated with test anxiety (β = 0.50, p < 0.001). The intolerance of uncertainty and sleep quality partially and serially mediated the relationship between COVID-19 stress and test anxiety (β = 0.01, 95% CI = 0.01 to 0.02).

CONCLUSION

These findings suggest that art students' intolerance of uncertainty and sleep quality partially and serially mediate the relation between COVID-19 stress and test anxiety. The results have significant implications for the intervention and prevention of test anxiety, providing additional evidence for the relationship between COVID-19 stress and test anxiety.

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

Background

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

Methods

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

Results

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

Conclusion

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

A longitudinal study of the association between depression, anxiety and stress symptoms of university students in Serbia with excessive social media use before and during COVID-19 pandemic

Background

Besides the well known good side of social media, it cannot be denied some of its negative effects. This two-phase study aimed to find out whether the usage of social media during the COVID-19 pandemic showed some significant association with depression and anxiety symptoms, and levels of stress.

Methods

The study was based on the survey of 1,476 randomly selected students at the initial phase (December 2019 to February 2020), and 1,400 students of the same cohort at the follow up phase (December 2021-February 2022). The collected data included socio-demographics, social media usage aspects, and the ones concerning levels of depression, stress and anxiety symptoms. Standardized questionnaires - the Bergen Social Media Addiction Scale (BSMAS) was applied to measure the levels of social media addiction, and the Depression Anxiety Stress Scale (DASS 42) was administered to evaluate the symptoms of depression, anxiety and stress.

Results

The comparison of responses regarding the six components of online social media addiction, which constitute the BSMAS, between the two phases of the study showed significant difference (p < 0.01) in favor of the follow up phase in the raised scores of all but one component. The probable severe or extremely severe symptoms of depression, anxiety, and stress were notably enhanced during the peak of pandemic, and all three of them were positively correlated with all 6 BSMAS components (p < 0.01). The results also indicate that students, who consumed alcohol beverages and psychoactive substances more frequently in the pandemic, exhibited more noticeable symptoms of depression (p < 0.01, for both associations). Higher levels of anxiety symptoms in students were found to be associated with longer sleep during the night (p < 0.01), increased alcoholic beverages consumption (p < 0.01). Stress levels had the strongest correlations with consuming alcoholic beverages during the pandemic (r = 0.16, p < 0.01).

Conclusion

The comparison between two phases of this follow-up study revealed significant changes in the Internet usage characteristics, which may have had an essential influence on the investigated symptoms of depression, anxiety, and stress. However, other factors that may have influenced student's mental health during the COVID-19 pandemic should also be considered.

A comparison of anxiety levels before and during the COVID-19 pandemic

The COVID-19 Pandemic upended the lives of nearly everyone worldwide, and recent studies have reported higher rates of anxiety, depression, and other mental health problems. Using a repeated crosssectional design, the current study compares anxiety levels from a representative sample of college students prior-to and during the COVID-19 Pandemic. Additionally, differences in anxiety prior to and following U.S. approval for use of the Pfizer-BioNTtech COVID-19 vaccine were also compared. Findings indicate that state-anxiety levels did not differ significantly prior to and during the Pandemic as well as before the vaccine and during and after the vaccine (M = 43.01, 44.10, 44.77, respectively). Surprisingly, trait anxiety levels were significantly higher during the Pandemic than before (p = .003), and anxiety levels trend down after the approval of the vaccine, but not significantly (M = 45.10, 48.85, 47.58, respectively). Future research should continue to investigate and compare anxiety levels during the COVID-19 Pandemic.

The psychological impact of the COVID-19 pandemic and the role of resilience: cross cultural differences between Brazil, Italy, and the United States

OBJECTIVE

Restrictive measures consequent to the COVID-19 pandemic have had a significant psychological impact on everyday life in the general population, even though differences between countries remain poorly investigated. The present study sought to examine the different psychological impacts and resilience of the pandemic among three of the most heavily hit countries: Brazil, Italy, and the United States.

METHODS

This cross-sectional study separately involved three national community populations, namely the Brazilian, the Italian, and the American population. Participants aged 18 years or older were recruited through a shared online survey. Participants self-completed the Connor-Davidson Resilience Scale (CD-RISC-10) and the Center for Epidemiological Studies-Depression Scale (CES-D); post-traumatic stress was additionally assessed using the Impact of Event Scale-Revised (IES-R). Three separate Analyses of Covariance (ANCOVA) were performed in order to investigate differences in the levels of resilience, post-traumatic stress, and depression among the three populations.

RESULTS

The study included in total 734 participants (mean age = 27.60 ± 11.69 years; 77% of females). Results of ANCOVA comparisons showed significant differences between the three groups in the variable measuring resilience, post-traumatic stress symptoms, and depression. As for resilience, results of post-hoc tests showed significant differences between the groups from Brazil and Italy and between the groups from Brazil and USA. As for the post-traumatic stress symptoms, results showed significant differences between the USA and Brazil groups and between the USA and Italy groups. As for the depression symptoms, results showed significant differences between the USA and Brazil groups.

CONCLUSIONS

Overall, these findings may help to increase understanding of the psychological impact of COVID-19 in Brazil, Italy, and the USA. Interventions to prevent mental disorders among general populations should take into account these findings.

Evaluating the effectiveness of applying aroma seals to masks in reducing stress caused by wearing masks: A randomized controlled trial

During the COVID-19 pandemic, face masks on patients and healthy people have been recommended to prevent airborne transmission of the virus. This increased the number of people who felt stressed while wearing masks. In this study, we investigated the stress-relieving effects of attaching aroma seals to masks. A double-blind, randomized controlled trial was conducted involving 62 university students. The participants were randomly assigned to two groups and instructed to apply a seal to their masks once a day throughout the study period. The primary measure used was the Depression, Anxiety, and Stress Scale-21 (DASS-21), while the secondary measures included the assessment of breathlessness associated with mask-wearing and the World Health Organization Five Well-Being Index (WHO-5). The intervention group, referred to as the aroma-seal use group, utilized aroma seals infused with orange-lime essential oil with the expectation of experiencing the healing effects of citrus. On the other hand, the non-intervention group, known as the placebo-seal use group, utilized identical seals without any aroma. Results indicated that the aroma-seal use group exhibited significant improvements in both the total DASS-21 scores and depression scores compared to their baseline values by the second week of the intervention. Furthermore, the aroma-seal use group demonstrated a reduced occurrence of breathlessness while wearing masks compared to the placebo-seal group. Additionally, when assessing the item "I have felt calm and relaxed" from the WHO-5 questionnaire, the aroma-seal use group displayed significantly higher scores than the placebo group. Therefore, using aroma seals containing orange-lime essential oil could be beneficial in relieving mental stress and reducing breathlessness while wearing a mask, thus improving mental health.

Quantifying the heterogeneous impact of lockdown policies on different socioeconomic classes during the first COVID-19 wave in Colombia

In the absence of vaccines, the most widespread reaction to curb the COVID-19 pandemic worldwide was the implementation of lockdowns or stay-at-home policies. Despite the reported usefulness of such policies, their efficiency was highly constrained by socioeconomic factors determining their feasibility and their associated outcome in terms of mobility reduction and the subsequent limitation of social activity. Here we investigate the impact of lockdown policies on the mobility patterns of different socioeconomic classes in the three major cities of Colombia during the first wave of the COVID-19 pandemic. In global terms, we find a consistent positive correlation between the reduction in mobility levels and the socioeconomic stratum of the population in the three cities, implying that those with lower incomes were less capable of adopting the aforementioned policies. Our analysis also suggests a strong restructuring of the mobility network of lowest socioeconomic strata during COVID-19 lockdown, increasing their endogenous mixing while hampering their connections with wealthiest areas due to a sharp reduction in long-distance trips.

Psychometric properties and psychological correlates of the COVID-19 Anxiety Syndrome Scale: A comprehensive systematic review and meta-analysis

Coronavirus disease-19 (COVID-19) has led to the demise of millions of people worldwide; additionally, it has resulted in a significant economic and mental health burden. Since the onset of the COVID-19 pandemic, various measures have been constructed to evaluate pandemic-related fear and anxiety. The COVID-19 Anxiety Syndrome Scale (C-19ASS) is a promising measure that assesses coping strategies (e.g., avoidance, checking, worrying and threat monitoring), termed 'COVID-19 Anxiety Syndrome', in response to COVID-19 fear and anxiety. The measure has been broadly welcomed, leading to its use in Brazil (Portuguese), China, Greece, Indonesia, the Philippines, Iran (Farsi), Italy, Saudi Arabia (Arabic), Turkey, the United Kingdom and the United States. To gain a better understanding of the relevance of the COVID-19 Anxiety Syndrome, we conducted a systematic review and meta-analysis to explore the psychological correlates and psychometric properties of the C-19ASS. Through the analysis of a total of 17,789 individuals (age range 19-70; female = 33%-85%), the C-19ASS demonstrated a consistent factor structure, measurement invariance across gender and acceptable reliabilities. Furthermore, a significant association with COVID-19 anxiety, depressive symptoms, generalized anxiety, health anxiety, psychological distress and functional impairment (work and social adjustment) during the COVID-19 pandemic was observed. When considering the Big Five personality traits, the C-19ASS and its subscales were only significantly and negatively associated with extraversion; only the total score on the measure was associated with neuroticism. The observed effect sizes ranged from very small to medium. Given that all included studies (K = 24) were cross-sectional, and due to the nature of the COVID-19 Anxiety Syndrome, which may well persist after the pandemic ends, it is recommended to continue screening society for the persistence of this syndrome.

Refraining from interaction can decrease fear of physical closeness during COVID-19

Perception of peripersonal space (PPS) and interpersonal distance (IPD) has been shown to be modified by external factors such as perceived danger, the use of tools, and social factors. Especially in times of social distancing in the context of the COVID-19 pandemic, it is vital to study factors that modify PPS and IPD. The present work addresses the question of whether wearing a face mask as a protection tool and social interaction impact the perception of IPD. We tested estimated IPD in pictures at three distances: 50 cm, 90 cm, and 150 cm in both social interaction (shaking hands) and without interaction and when the two people in the pictures wore a face mask or not. Data from 60 subjects were analyzed in a linear mixed model (on both difference in distance estimation to the depicted distance and in absolute distance estimation) and in a 3 (distance: 50, 90, 150) × 2 (interaction: no interaction, shake hands), × 2 face mask (no mask, mask) rmANOVA on distance estimation difference. All analyses showed that at a distance of 50 and 90 cm, participants generally underestimated the IPD while at an IPD of 150 cm, participants overestimated the distance. This could be grounded in perceived danger and avoidance behavior at closer distances, while the wider distance between persons was not perceived as dangerous. Our findings at an IPD of 90 cm show that social interaction has the largest effect at the border of our PPS, while the face mask did not affect social interaction at either distance. In addition, the ANOVA results indicate that when no social interaction was displayed, participants felt less unsafe when depicted persons wore a face mask at distances of 90 and 150 cm. This shows that participants are on the one hand aware of the given safety measures and internalized them; on the other hand, that refraining from physical social interaction helps to get close to other persons.

Levels and predictors of postpartum depression and anxiety during the first year of the COVID-19 pandemic in a confined cross-border city

Pregnancy and/or the puerperium involve social, physiological and psychological changes that make women more vulnerable to mental disorders such as anxiety and depression, even more so if these develop in stressful contexts such as the pandemic. The aim of this study is to identify factors associated with the risk of postpartum anxiety and depression during the COVID-19 pandemic. A cross-sectional study was conducted among postpartum women (n = 69) who gave birth between March 2020 and March 2021 in Melilla, a Spanish cross-border city with Morocco whose borders were closed, making it a confined city. The scales used were the State-Trait Anxiety Inventory and the Edinburgh Postnatal Depression Scale. Results reported an elevated risk of depression (85.5%) and anxiety (63.8%), with severe anxiety reaching 40.6% of cases. Predictors of postpartum depression comprised a personal history of mood disorders (β = 8.421; CI95% = 4.863/11.978) and having been diagnosed with COVID-19 during pregnancy or postpartum (β = 4.488; CI95% = 1.331/7.646). As regards anxiety, it is predicted on the basis of mood antecedents (β = 14.175; CI95% = 7.870/20.479), the fact of having been diagnosed with COVID-19 during pregnancy or postpartum (β = 8.781; CI95% = 2.970/14.592) and the fact of being a multipara (β = 5.513; CI95% = 0.706/10.321). In conclusion, special attention should be paid to women with a history of mood disorders and a positive diagnosis of COVID-19 during pregnancy or postpartum, even more so in the case of multiparous women, because of its impact on mental health during the postpartum period.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-023-04719-6.

Effects of psychological distress and life satisfaction on COVID-related traumatic stress: An international, cross-sectional study

BACKGROUND

This study examines the individual impacts of psychological distress (i.e., depression and anxiety) and life satisfaction on COVID-related traumatic stress in an international sample of heterosexual versus LGBQ+ adults.

METHOD

Between July and August 2020, a cross-sectional electronic survey (n = 2482) was launched in five countries (India, Italy, Saudi Arabia, Spain, and United States) assessing sociodemographic characteristics as well as psychological, behavioral, and social factors related to health outcomes during the COVID-19 pandemic.

RESULTS

Significant differences between LGBQ+ participants and heterosexual participants were found for depression (p < .001) and anxiety (p < .001). Depression was associated with COVID-related traumatic stress among heterosexual participants (p < .001) but not LGBQ+ participants. Both anxiety (p < .001) and life satisfaction (p = .003) were also associated with COVID-related traumatic stress in both groups. Hierarchical regression models demonstrated significant effects of COVID-related traumatic stress for adults outside the United States (p < .001); less than full-time employment (p = .012); and for greater levels of anxiety, depression, and life satisfaction, respectively (all ps < .001).

LIMITATIONS

Given the stigma of being LGBQ+ that remains in many countries, participants in may have been reluctant to identify as a sexual minority and therefore indicated a heterosexual sexual orientation.

CONCLUSION

The impact of sexual minority stress among LGBQ+ may play a role in COVID-related post-traumatic stress. Large-scale global disasters such as pandemics, contribute to disparities in psychological distress among LGBQ+ individual, however, sociodemographic factors such as country and urbanicity may play mediating or moderating roles.

Predicting depression and anxiety of Chinese population during COVID-19 in psychological evaluation data by XGBoost

BACKGROUND

Due to the onset of sudden stress, COVID-19 has greatly impacted the incidence of depression and anxiety. However, challenges still exist in identifying high-risk groups for depression and anxiety during COVID-19. Studies have identified how resilience and social support can be employed as effective predictors of depression and anxiety. This study aims to select the best combination of variables from measures of resilience, social support, and alexithymia for predicting depression and anxiety.

METHODS

The eXtreme Gradient Boosting (XGBoost¹) model was applied to a dataset including data on 29,841 participants that was collected during the COVID-19 pandemic. Discriminant analyses on groups of participants with depression (DE²), anxiety (AN³), comorbid depression and anxiety (DA⁴), and healthy controls (HC⁵), were performed. All variables were selected according to their importance for classification. Further, analyses were performed with selected features to determine the best variable combination.

RESULTS

The mean accuracies achieved by three classification tasks, DE vs HC, AN vs HC, and DA vs HC, were 0.78, 0.77, and 0.89. Further, the combination of 19 selected features almost exhibited the same performance as all 56 variables (accuracies = 0.75, 0.75, and 0.86).

CONCLUSIONS

Resilience, social support, and some demographic data can accurately distinguish DE, AN, and DA from HC. The results can be used to inform screening practices for depression and anxiety. Additionally, the model performance of a limited scale including only 19 features indicates that using a simplified scale is feasible.

The Effect of COVID-19 Vaccine Acceptance, Intention, and/or Hesitancy and Its Association with Our Health and/or Important Areas of Functioning

The emergence of coronavirus 2019 (COVID-19) has had a significant negative impact on the world, with its effect noted in various areas, such as commerce [...].

Use of virtual meeting and survey technology to assess Covid-19-related mental well-being of healthcare workers

Background and aims

Healthcare workers (HCWs) throughout the world have been exposed to economic and existential stress during the Covid-19 pandemic. The American Medical Association (AMA) has documented that increased healthcare burden correlates with increased stress, burnout, and psychological burden in HCWs. However, limits on personnel, time, and in person interactions make it challenging to assess mental health outcomes during a pandemic. This pilot study used virtual technology to efficiently assess these outcomes.

Setting

Data were collected based on voluntary participation in the Coping with Covid-19 for Caregivers Survey created by AMA. The survey was sent out to approximately 300 participants who included local physicians, medical residents, medical students, and allied health professionals and students who attended a virtual Mental Health Summit.

Methods

The AMA developed survey included questions about demographics, overall stress, fear of infection and transmission of the virus, perceived anxiety or depression due to Covid-19, work overload, childcare issues, and sense of meaning and purpose. The AMA allows for up to five additional questions to be added to their survey, therefore five questions regarding support service utilization, perseverance, and resilience during the Covid-19 pandemic, and two items to further understand students' areas of medical interest. The survey was administered using an online platform through the AMA. The data were analyzed using descriptive statistics.

Results

There were 81 survey respondents. Based on the results of the survey, "high stress" was found in 52 (64%) participants. 66 (81%) were afraid (moderately or to a great extent) of exposure or transmission, 61 (75%) described high levels of anxiety or depression, and 67 (84%) noted work overload. Despite this increase in stress, most respondents (77%) said they were not likely to reduce their devoted hours to clinical care or research in the next 12 months, and 81% answered that they would not leave their practice or research within two years.

Conclusion

Covid-19 has negatively affected the well-being of HCWs. This is a similar trend seen during other times of healthcare strain. Mental health support, work modulation, and various provisions should be explored as means to reduce Covid-19-related negative impacts. The use of an online summit and online data collection methods were appropriate for collecting data on the impact of the Covid-19 pandemic on mental health. This pilot study supports the larger scale implementation of this technology for health informatics research.

Coping with Symptoms of Mental Health Disorders among University Students during the COVID-19 Pandemic in Relation to Their Lifestyle Habits

Background and Objectives: The time of the pandemic brought great difficulties, both in state and interstate systems, industry, trade, and with individuals themselves. In addition, numerous studies have shown a drastic increase in mental disorders in people around the world. Therefore, the basic idea of our study was to investigate these disorders in university students in relation to their different lifestyles. Materials and Methods: The cross-sectional study was carried out at the University of Niš (Serbia) from December 2021 to February 2022. All of the participants were assessed by using appropriate questionnaires. The study included 1400 randomly selected students (692 females and 708 males). The statistical analysis of the data included the application of multiple regression analyses and correlation tests. Results: Statistical analysis indicates that extremely severe levels of depression symptoms were reported by 232 students (16.6%). Severe and extremely severe anxiety symptoms were reported by 480 students (34.3%). Multiple linear regression analysis found that for the increased depressive symptoms, the “most deserving” parameters were related to the consumption of alcoholic beverages and psychoactive substances (β = 0.10, and 0.11, respectively), compared to the period before the COVID-19 pandemic. For anxiety symptoms, the main role was played by alcohol consumption (β = 0.11) but also by the use of social networks as an adequate substitute for deprived content during the pandemic (β = 0.13). Alcohol consumption was the most “responsible” for elevated stress levels compared to the period before the pandemic (β = 0.19). Conclusions: Due to the COVID-19 pandemic, symptoms of depression, anxiety, and stress were drastically increased in the university students. There was significantly more frequent consumption of alcoholic beverages and psychoactive substances among them. That is why social support from a close environment is the most important strategy in coping with mental health issues during emergency situations.

The impact of the COVID-19 pandemic on undergraduate and postgraduate students: A cross-sectional survey

BACKGROUND

The COVID-19 pandemic has impacted many facets of life. This study focuses on undergraduate and postgraduate students in China to explore how the pandemic has affected health status, daily life, learning situations, graduation-related situations, and their studies or work planning.

METHODS

This study sent online questionnaires to 2,395 participants to investigate the extent to which they were affected by the epidemic in the various aspects mentioned above and to understand what help they tend to get in the face of these effects.

RESULTS

A total of 2,000 valid questionnaires were collected. The physical health of 82.90% of the respondents was affected to varying degrees, with male students, non-medical students, and graduates being more affected than female students, students with medical majors, and non-graduates, respectively. The proportion of students affected by mental health, the total amount of physical exercise, emotional life, and interpersonal communication was 86.35, 88.65, 80.15, and 90.15%, respectively. Compared with medical students and non-graduates, non-medical students and graduates were more affected. In addition, students' learning and graduation conditions have also been affected to a certain extent: 13.07% of students may not be able to graduate on time, and the proportion of postgraduate students' graduations affected was higher than that of undergraduate students.

CONCLUSION

The COVID-19 pandemic has affected the health status of students, their daily lives, learning situations, and so on to varying degrees. We need to pay attention to the issues, provide practical solutions, and provide a basis for better responses to similar epidemics in the future.

COVID-19 cases with a contact history: A modeling study of contact history-stratified data in Japan

The purpose of the present study was to develop a transmission model of COVID-19 cases with and without a contact history to understand the meaning of the proportion of infected individuals with a contact history over time. We extracted epidemiological information regarding the proportion of coronavirus disease 2019 (COVID-19) cases with a contact history and analyzed incidence data stratified by the presence of a contact history in Osaka from January 15 to June 30, 2020. To clarify the relationship between transmission dynamics and cases with a contact history, we used a bivariate renewal process model to describe transmission among cases with and without a contact history. We quantified the next-generation matrix as a function of time; thus, the instantaneous (effective) reproduction number was calculated for different periods of the epidemic wave. We objectively interpreted the estimated next-generation matrix and replicated the proportion of cases with a contact p(t) over time, and we examined the relevance to the reproduction number. We found that p(t) does not take either the maximum or minimum value at a threshold level of transmission with R(t)=1.0. With R(t) < 1 (subcritical level), p(t) was a decreasing function of R(t). Qualitatively, the minimum p(t) was seen in the domain with R(t) > 1. An important future implication for use of the proposed model is to monitor the success of ongoing contact tracing practice. A decreasing signal of p(t) reflects the increasing difficulty of contact tracing. The present study findings indicate that monitoring p(t) would be a useful addition to surveillance.

Effect of face masks on salivary parameters and halitosis: Randomized controlled crossover trial

BACKGROUND

Face masking is associated with self-perceived dry mouth and halitosis. Aim of the study was to measure the effect of different face masks on salivary parameters and halitosis.

METHODS

The randomized controlled crossover clinical trial with four periods included 40 oral healthy participants using different face masks (cloth mask, surgical mask, filtering facepiece 2 [FFP2] mask) or no mask (control) for 4 h in random order. Unstimulated salivary flow rate (primary outcome) and stimulated salivary flow rate, salivary pH and buffer capacity of stimulated and unstimulated saliva (secondary outcomes, blinded), and volatile sulfur compounds (secondary outcome) were measured before and after the 4-h periods. Statistical analysis was performed by repeated measures ANOVA (p < 0.05).

RESULTS

Of 40 randomized participants, 39 completed the study. Unstimulated salivary flow rate prior to face masking amounted to 0.6 ± 0.3 ml/min. Face masking had no significant effect on unstimulated salivary flow (p = 0.550). Face masking had also no significant effect on the other salivary parameters (p ≥ 0.518). The concentration of volatile sulfur compounds (VSC) prior to face masking amounted to 157.3 ± 59.7 ppb. After face masking, the concentration of VSC increased slightly, but not significantly (p = 0.055): 168.1 ± 76.3 ppb (control), 199.3 ± 132.7 ppb (cloth masks), 188.5 ± 101.1 ppb (surgical masks), and 189.7 ± 90.1 ppb (FFP2 masks).

CONCLUSION

Four hours of face masking did not change the salivary flow rate, pH, and buffer capacity, and had no significant effect on VSC's levels. Wearing face masks does not seem to result in measurable side-effects on salivary parameters such as a reduced salivary flow rate or VSC's levels.

CLINICAL TRIAL REGISTRATION

The protocol was prospectively registered at ClinicalTrials.gov (NCT04914208) on June 4, 2021.

Socio-economic factors associated with mental health outcomes during the COVID-19 pandemic in South Korea

Background

Individuals are at an increased risk of adverse mental health outcomes during the COVID-19 pandemic. To reduce the impact on mental health outcomes that were induced by national-level policies, which may influence an individual at the community level, exploring the comprehensive relations between individual and environmental factors are needed. The aim is to examine socio-ecological factors associated with mental health outcomes, including depressive and anxiety symptoms, with the perspective of support to provide interventions that help the community during future disease outbreaks.

Method

From 5 November to 20 November 2020, a cross-sectional and population-based study was conducted to assess the socio-ecological factors of mental health outcomes during the COVID-19 pandemic. A total of 1,000 participants, aged 20-69 years, in Chungnam Region, South Korea, were included in this study. Multiple linear regression models were used to examine the association between socio-ecological factors and mental health outcomes. The primary outcomes were individuals' mental health outcomes which are measured by PHQ-9 and GAD-7 scores.

Results

Of the 1,000 participants, the average PHQ-9 was 4.39, and GAD-7 was 3.21 during the COVID-19 pandemic. Specifically, the participants with moderate or severe levels of PHQ-9 and GAD-7 were 12.6 and 6.8%, respectively. Higher levels of depressive and anxiety symptoms were associated with participants who were single, reported a lower household income, had decreased support from friends or family, and increased stress from the workplace or home. In subgroup analyses by age, gender, and household income, a similar trend was reported in individual and interpersonal-level factors. There were significant associations between regional-level factors, including gross regional domestic product (GRDP), mental health institutions, psychiatrists, nurse-to-population ratios, and individuals' mental health outcomes.

Conclusion

The management of depressive and anxiety symptoms of individuals during the pandemic was better explained by individual and interpersonal characteristics rather than regional-level factors, highlighting the need for more policies aimed at these lower levels.

Meaning in life and health behavior habits during the COVID-19 pandemic: Mediating role of health values and moderating role of conscientiousness

An increasing number of studies have explored health behavior changes since the COVID-19 outbreak, however, the potential mechanism leading to the acquisition of COVID-19-related health behavior habits remains largely underexplored. The current study aimed to investigate how meaning in life contributed to the Chinese general public's acquisition of COVID-19-related health behavior habits, and whether health values would play a mediating role and conscientiousness would play a further moderating role in this relation. A total of 1024 Chinese participants (age range = 17-63 years; 67.29% females) were recruited by posting flyers on an open-access web forum. All participants voluntarily completed a series of online anonymous questionnaires assessing conscientiousness, meaning in life, health values and health behavior habits. Results showed that (1) the majority of the respondents reported the acquisition of COVID-19-related health behavior habits, and meaning in life positively predicted COVID-19-related health behavior habits; (2) health values mediated the link between meaning in life and health behavior habits; and (3) conscientiousness moderated the indirect effect, such that the indirect effect was stronger among individuals with low conscientiousness. These findings have important implications for revealing the reconstruction of the Chinese public's health behavior habits and its potential mechanism that meaning in life influences health behavior habits through health values during the COVID-19 pandemic, particularly for individuals with low conscientiousness.

Reliability and factor analysis of Hindi version of IES-R scale: Effect of Rajyoga meditation on perceiving the impact of COVID-19

The purpose of this study is to present the Hindi translation and validation of the Impact of Event Scale-Revised and to evaluate psychometric qualities of this scale in a sample of regular Rajyoga meditators to examine the psychological impact of Coronavirus on them. The convenience sampling method was used to collect the data from 801 Rajyoga meditators through online survey. Data were analysed using SPSS 26.0. The Hindi version of IES-R demonstrated good internal consistency with the value of alpha coefficient being 0.91 for the scale and ranging between 0.81 to 0.83 for the subscales. The correlations between the subscales varied between 0.55 and 0.66. Principal components analysis using Varimax rotation was run with three-factor solution based on eigen value greater than one. This solution explained 54 percent of the total variance. It generated mainly two factors, an intrusion hyperarousal factor and an avoidance factor and third factor with one item only. Only 4.7 percent of the meditators rated the outbreak's psychological impact as moderate or severe. The mean score of IES-R was 10.01 (with an S.D. of 11.107). Significant positive correlations were found among IES-R scores and the presence of COVID symptoms. Thus, in clinical and research contexts, the scale appears to be a valid measure of post-trauma occurrences. The present study was conducted to generate a validated Hindi version of the IES-R that is easier and more compatible for use in the Indian population.

Stress and the impact of stressful events are lesser among raja yoga meditators – A cross sectional study during COVID-19 pandemic from India

This research work presents a study on the relationship between stress & related events with meditation practice and other socio-demographic variables during COVID 19 pandemic among healthy adults. In this cross-sectional survey design, healthy adults with and without practice of Raja yoga meditation completed stress, anxiety & depression related questions (Depression Anxiety & stress Scale, DASS 21) and its impact (Impact of Event Scale-Revised, IES-R) along with other socio-demographic including COVID infection or contact related information. Data was assessed for difference in DASS 21 scores and IES-R scores between Raja yoga meditators (n = 802) & non-meditators (n = 357). An analysis was performed to study the predictors of DASS 21 and IES-R scores. We conclude that healthy Raja yoga meditation practitioners differ from non-meditators in terms of stress/anxiety/depression and its impact during COVID 19 pandemic and meditation practice predicts mental health better along with other sociodemographic variables.

Evaluation of psychological impact of COVID-19 on anesthesiology residents in the United States

The aim of our study was to evaluate the impact of COVID-19 on the mental health of in-training anesthesiology residents in the United States. A link containing validated survey tools including the Depression-Anxiety-Stress-Scale (DASS-21), the Abbreviated Maslach Burnout Inventory (aMBI), and the Brief Resilient Coping Scale (BRCS) along with questions related to work environment, and additional personal factors were emailed to 159 Anesthesiology residency programs across the US. 143 responses were received of which 111 were complete. The prevalence of depression, anxiety, stress and burnout was 42%, 24%, 31% and 71% respectively. Emotional exhaustion, depersonalization, and reduced feelings of personal accomplishment were experienced by 80%, 53%, and 65% of respondents, respectively. The BRCS scale showed 33% of respondents with low, 44% with moderate and 22% with high coping scales. Logistic regression analyses indicated those with a prior mental health diagnosis were 3 times more likely to have a non-normal DASS depression score, 4 times more likely to have a non-normal DASS anxiety score, and 11.74 times more prone to emotional exhaustion. Increased work hours and higher training levels were associated with increased levels of stress. In our survey, prior mental health illness, gender and increased work hours were the main drivers of increased risk .

Non-Pathological Psychological Distress among Mainland Chinese in Canada and Its Sociodemographic Risk Factors amidst the Pandemic

The COVID-19 pandemic has exacerbated health inequalities, with a potentially heightened mental health risk for Mainland Chinese in Canada, given the rising anti-Chinese discrimination, and barriers in assessing health services. In this context, this study aimed to assess non-pathological psychological distress towards COVID-19 and identify its sociodemographic risk factors among Mainland Chinese in Canada at the early stages of the pandemic. Methods: A sample of 731 Mainland Chinese aged 16 or older completed an on-line survey to examine their attitudes, behavioural, and psychological responses towards COVID-19. Non-pathological psychological distress was assessed with a 7-item self-report scale to capture common emotional reactions towards COVID-19. Results: A factor analysis revealed a single-factor structure of the 7-item COVID-19 psychological distress scale (Eigen λ = 3.79). A composite psychological distress index (PDI) score was calculated from these items and used as the outcome variable. Multivariate regression models identified age, financial satisfaction, health status, and perceived/experienced discrimination as significant predictors of psychological distress (ps ≤ 0.05). Conclusions: Mainland Chinese in Canada who were over 25, in poor financial/health status, or with perceived/experienced discrimination were at a higher risk for COVID-19-related psychological distress. The health inequity across these factors would inform the services to mitigate mental health risk in minority groups.

Predictors of Psychological Distress across Three Time Periods during the COVID-19 Pandemic in Poland

BACKGROUND

Since the onset of COVID-19, public health policies and public opinions changed from stringent preventive measures against spread of COVID-19 to policies accommodating life with continued, diminished risk for contracting COVID-19. Poland is a country that demonstrated severe psychological impact and negative mental health. The study aims to examine psychological impact and changes in levels of depression, anxiety, and stress among three cross-sectional samples of Polish people and COVID-19-related factors associated with adverse mental health.

METHODS

In total, 2324 Polish persons participated in repeated cross-sectional studies across three surveys: Survey 1 (22 to 26 March 2020), Survey 2 (21 October to 3 December 2020), and Survey 3 (3 November to 10 December 2021). Participants completed an online survey, including Impact of Event Scale-Revised (IES-R), Depression, Anxiety, and Stress Scale (DASS-21), demographics, knowledge, and concerns of COVID-19 and precautionary measures.

RESULTS

A significant reduction of IES-R scores was seen across surveys, while DASS-21 scores were significantly higher in Survey 2. There was significant reduction in the frequency of following COVID-19 news, recent COVID-19 testing, and home isolation from Survey 1 to 3. Being emale was significantly associated with higher IES-R and DASS-21 scores in Surveys 1 and 2. Student status was significantly associated with higher DASS-21 across surveys. Chills, myalgia, and fatigue were significantly associated with high IES-R or DASS-21 scores across surveys. Frequency of wearing masks and perception that mask could reduce risk of COVID-19 were significantly associated with higher IES-R and DASS-21 scores.

CONCLUSION

Conclusions: The aforementioned findings indicate a reduction in the level of the measured subjective distress andin the frequency of checking COVID-19 news-related information across three periods during the pandemic in Poland.

Social Work and the Next Frontier of Racial Justice: Using COVID-19 as a Vehicle for Healing

The COVID-19 pandemic has put the United States and the world into a state of uncertainty. Before the onset of the coronavirus, awareness of health disparities across cities in the United States was questionable at best. As the world continues to grapple with the fallout of the pandemic and the response to it, several states and developed and developing countries created and implemented response efforts that were used as a guide, which social workers are most qualified to address but have not been a focus on a national nor international stage. This commentary focuses on two American states - Texas and Ohio as well as other global countries, and their responses that gained worldwide attention related to healthcare accessibility, service provision, and the role social workers should play moving forward and beyond the pandemic.

Development and cross-national investigation of a model explaining participation in WHO-recommended and placebo behaviours to prevent COVID-19 infection

To protect themselves from COVID-19, people follow the recommendations of the authorities, but they also resort to placebos. To stop the virus, it is important to understand the factors underlying both types of preventive behaviour. This study examined whether our model (developed based on the Health Belief Model and the Transactional Model of Stress) can explain participation in WHO-recommended and placebo actions during the pandemic. Model was tested on a sample of 3346 participants from Italy, Japan, Poland, Korea, Sweden, and the US. It was broadly supported: objective risk and cues to action showed both direct and indirect (through perceived threat) associations with preventive behaviours. Moreover, locus of control, decision balance, health anxiety and preventive coping moderated these relationships. Numerous differences were also found between countries. We conclude that beliefs about control over health and perceived benefits of actions are critical to the development of interventions to improve adherence to recommendations.

A multidimensional approach to the resilience in older adults despite COVID-19

Researchers have mainly focused on aging risk factors and COVID-19 consequences. However, older adults have proved their ability to overcome adversities along their life. Resilience is a protective variable that dampens the impact of stress. Based on MacLeod’s et al. (2016) approach, we aimed to analyze the relationship between older adults’ resilience and COVID-19 related-stressors as well as their physical, mental, and social characteristics. Eight hundred eighty-nine people aged 60 and over participated in this study. Older participants, women, having better perceived health and not losing a loved one because of the virus were associated with more resilience. Moreover, higher levels of gratitude, personal growth, life purpose and lower levels of depression were associated with greater scores in resilience. This study offers a change of perspective in which aging is perceived from a positive viewpoint by focusing on easily accessible resources that may help older adults to cope with adverse situations.

New symptoms and prevalence of postacute COVID-19 syndrome among nonhospitalized COVID-19 survivors

The aim of this study was to assess postacute coronavirus disease 2019 (COVID-19) syndrome (PACS) symptoms according to the onset of the infection while evaluating the effect of COVID-19 vaccination on the symptoms of PACS. We conducted a retrospective single-center cohort study in which nonhospitalized COVID-19 survivors and healthy controls were compared for the occurrence of PACS. The total number of patients in this study was 472. At 6-12 and > 12 months after the infection, COVID-19 survivors had a significantly higher incidence of posttraumatic stress disorder (PTSD) and anxiety than the non-COVID-19 cohort. Furthermore, depression, cognitive deficit, tics, impaired quality of life and general health impairment were significantly more prevalent among COVID-19 survivors at < 6 months, 6-12 months and > 12 months than in the non-COVID-19 cohort. However, respiratory symptoms were significantly more prevalent among COVID-19 survivors only in the first 6 months after infection. In addition, cognitive deficit (OR = 0.15; 95% CI 0.03-0.87) and impaired quality of life (B = - 2.11; 95% CI - 4.21 to - 0.20) were significantly less prevalent among vaccinated COVID-19 survivors than among nonvaccinated survivors. Longitudinal studies are needed to establish the time that should elapse after COVID-19 infection for the symptoms of PACS to appear. Randomized clinical trials are needed to assess the possibility that COVID-19 vaccines might relieve PACS symptoms.

The emotional state of young people in northern Spain after one year and a half of the COVID-19 pandemic

BACKGROUND AND OBJECTIVES

: Since the beginning of the COVID-19 pandemic, the young population has been suffering from an accumulation of psychological symptoms in northern Spain. The main objectives of this study were (1) to assess whether psychological symptoms persisted after one year and a half of the COVID-19 pandemic in northern Spain sample of young people, and (2) to analyze whether pandemic-specific variables (having a chronic illness, living with a person who has a chronic illness, having been infected with COVID-19, having a close person who has died or believing that people are respecting the measures imposed) are related to psychological symptomatology.

METHODS

: Symptoms of stress, anxiety, and depression were measured using the Depression and Stress Anxiety Scale-21 (DASS-21). An ad hoc online questionnaire was used to collect socio-demographical information related to chronic illnesses of the participants, living with a chronically ill person, contact with a person diagnosed with COVID-19, having people close to them who have died of COVID-19, and their perception of whether or not people respect the health measures.

RESULTS

: Young people have suffered higher stress, anxiety, and depression levels than at the beginning of the pandemic.

CONCLUSIONS

: The present study highlights the importance of addressing young people's mental health, and ensure that future adults emerge from the COVID-19 pandemic in a psychologically strong state.

Study protocol for a randomized controlled trial evaluating the effectiveness of an internet-based self-help intervention to cope with psychological distress due to COVID-19 in the Italian general population: the RinasciMENTE project

BACKGROUND

This study aims to evaluate the feasibility and effectiveness of the RinasciMENTE program, an Internet-based self-help intervention based on cognitive behavioral therapy (CBT) principles and techniques in supporting individuals experiencing psychological impairments during the COVID-19 pandemic. A randomized controlled trial (RCT) design with random allocation at the level of individual will be conducted to compare the impact of the RinasciMENTE program with a waiting list control in improving the psychological functioning of the general population during the COVID-19 pandemic.

METHODS

A minimum sample of 128 participants experiencing mild/subthreshold levels of psychological symptoms during the COVID-19 pandemic will be recruited. After the initial screening, participants will be randomly assigned to either the experimental group or the control condition. The program will last 2 months, during which participants will receive 8 weekly CBT treatment modules. The impact of the RinasciMENTE program on selected primary and secondary psychological outcomes will be tested at the end of the intervention (2 months) and 6- and 12-month follow-ups.

DISCUSSION

We expect people to show an increased level of psychological functioning and to acquire the skills and self-confidence necessary to deal with the psychological consequences of the COVID-19 outbreak and its related social isolation during and following the pandemic.

TRIAL REGISTRATION

ClinicalTrials.gov NCT0497903 Registered on 28 May 2021.

Depression, anxiety and stress among people infected with COVID-19 in Dhaka and Chittagong cities

Background

Covid-19 is an acute respiratory infectious disease caused by novel coronavirus 2019. Many individuals have suffered or are experiencing psychological symptoms due to feelings of isolation, insecurity and instability triggered by Covid-19. This study aimed to explore the perceived psychological distress and associated factors among people infected with Covid-19 in Dhaka and Chittagong cities.

Methods

Using the face-to-face interview method, a survey was conducted from 23 April to 22 May 2021 on a questionnaire on depression, anxiety and stress scale (DASS-21), socio-demographic, economic and health factors. Among those who had ever been infected with Covid-19, a total of 2092 respondents (1180 from Dhaka and 912 from Chittagong) were randomly selected and interviewed. χ2 test for independence of attributes was employed to observe the association of various socioeconomic, cultural, demographic and health factors with psychological distress. Moreover, multinomial logistic regression analysis was performed to explore the factors that contributed to psychological distress.

Results

Among participants from Dhaka, of three mental health conditions, the prevalence was higher for anxiety (80.0%), followed by stress (64.2%) and depression (59.8%), respectively. Anxiety was also more prevalent (57.3) among respondents in Chittagong, followed by depression (47.7%) and stress (39.5%). As the coexistence of symptoms, 52.8% of respondents in Dhaka, 34.4% in Chittagong experienced depression, anxiety and stress simultaneously. Moreover, in both Dhaka and Chittagong, all three psychological symptoms were strongly correlated in pairs. Multivariate analysis revealed that the most consistent factors associated with mild to moderate (MM), and severe to extremely severe (SES) depression were respondents from Chittagong who were illiterate or primary educated (OR = 0.166, CI: 0.076–0.364 for MM and OR = 0.041, CI: 0.013–0.131 for SES), male (OR = 0.999, CI: 0.666–1.496 for MM and OR = 0.395, CI: 0.249–0.625 for SES), single (OR = 0.393, CI: 0.157–0.982 for MM and OR = 0.121, CI: 0.049–0.303 for SES) and married (OR = 0.403, CI: 0.177–0.916 for MM and OR = 0.075, CI: 0.033–0.167 for SES), had a family of size ≤ 4 (OR = 0.253, CI: 0.140–0.458 for MM and OR = 0.114, CI: 0.059–0.218 for SES) and a family of size 5–6 (OR = 0.151, CI: 0.084–0.272), and no family members at risk being infected with Covid-19 (OR = 0.699, CI: 0.487–1.002 for MM and OR = 0.332, CI: 0.199–0.522 for SES). The analysis yielded similar findings for the other two mental health subscales, such as anxiety and stress. For respondents in Dhaka, the effect of factors other than sex on psychological distress was the opposite in Chittagong. Overall, psychological distress during the outbreak was greater among respondents in Dhaka than in Chittagong if respondents were not classified based on various characteristics.

Conclusion

This study showed that in both Dhaka and Chittagong, a substantially large portion of Covid-19-infected respondents experienced all three psychological distress (e.g., depression, anxiety and stress). Regardless of the dissimilarity between the results in Dhaka and Chittagong, better mental health support was needed for women in both cities.

Psychosocial factors associated with mental health and quality of life during the COVID-19 pandemic among low-income urban dwellers in Peninsular Malaysia

Background and aims

Mental well-being among low-income urban populations is arguably challenged more than any other population amid the COVID-19 pandemic. This study investigates factors associated with depression and anxiety symptoms and quality of life among Malaysia’s multi-ethnic urban lower-income communities.

Methods

This is a community-based house-to-house survey conducted from September to November 2020 at the Petaling district in Selangor, Malaysia. Five hundred and four households were identified using random sampling, and heads of eligible households were recruited. Inclusion criteria were age ≥18 years with a monthly household income ≤RM6960 (estimated $1600) without acute psychiatric illness. The PHQ-9, GAD-7 and EQ-5D were used for depression, anxiety, and quality of life, respectively. Multivariable logistic regression was performed for the final analysis.

Results

A total of 432 (85.7%) respondents with a mean age of 43.1 years completed the survey. Mild to severe depression was detected in 29.6%, mild to severe anxiety in 14.7%, and problematic quality of life in 27.8% of respondents. Factors associated with mild to severe depression were younger age, chronic health conditions, past stressful events, lack of communication gadgets and lack of assets or commercial property. While respiratory diseases, marital status, workplace issues, financial constraints, absence of investments, substance use and lack of rental income were associated with mild to severe anxiety. Attributing poverty to structural issues, help-seeking from professionals, and self-stigma were barriers, while resiliency facilitated good psychological health. Problematic quality of life was associated with depression, older age, unemployment, cash shortage, hypertension, diabetes, stressful life events and low health literacy.

Conclusions

A high proportion of the sampled urban poor population reported mild to severe anxiety and depression symptoms. The psychosocial determinants should inform policymakers and shape future work within this underserved population.

Psychological impacts of COVID-19 pandemic in cancer patients on active treatment

Introduction

Although cancer patients have a high risk of exposing COVID-19 and developing severe complications, they have to receive active treatment. We aimed to determine the psychological conditions of cancer patients and shed light on the establishment of early psychological intervention and intervention policies by making specific recommendations.

Method

We consecutively evaluated 385 cancer patients under treatment. Post-traumatic stress disorder (PTSD) symptoms, depression, anxiety, stress, and associated sociodemographic/clinical characteristics were investigated. In addition, we applied depression-anxiety-stress-scale-21 (DASS-21) for the mental states of patients and Impact of Event-Scale-Revised (IES-R) for the psychological effects of Covid-19.

Results

The mean age was 58 (18-88). 47.2% were psychologically distressful per DASS-21, and 39.3% were traumatic per IES-R scores. 71.9% stated the risk of getting COVID-19 was high since they had cancer, and 82% stated serious complications would develop if they had COVID-19 infection. Patients diagnosed for more than one year were more stressed, anxious, and depressive (p-value = 0.001,0.003,0.049, respectively). Singles were more stressed, depressed, and traumatized than couples (p-value = 0.001, 0.011, 0.001). In multivariate analysis, a significant correlation with being under psychiatric treatment before the pandemic was found for depression (OR: 3.743, 95 %CI: 1.790-7.827) anxiety (OR: 3.776-95 %CI: 1.945-7.332) and stress levels (OR: 4.129, 95 %CI: 1.728-9.866). Having relatives who died or received treatment for COVID-19(OR: 0.515,0.296-0.895) and being unmarried (OR: 2.445-95% CI: 1.260-4.747) predicts PTSD development.

Conclusions

When the psychological effects of the COVID-19 pandemic are manifesting strongly, cancer patients' anxiety and exposure levels are high. It is of great importance that clinicians understand needs, recognize psychological distress, and direct them to relevant departments for supportive care.

COVID-19 Burnout Subject to the Dynamic Zero-COVID Policy in Hong Kong: Development and Psychometric Evaluation of the COVID-19 Burnout Frequency Scale

We sought to develop and validate a self-assessment burnout scale of the Chinese general population during the COVID-19 pandemic in the context of a dynamic zero-COVID policy. Factors relevant to individuals’ burnout during the prolonged COVID-19 pandemic were identified in the literature and through the reviews of an expert panel. A convenience sample of 1087 was randomly divided into two subsamples and the scale’s psychometric properties were assessed. Findings suggested that the COVID-19 BFS has adequate reliability (α = 0.90) along with factorial, concurrent, and convergent validity. Results of confirmatory factor analysis (CFA) supported the one-factor structure of the scale. Concurrent validity results indicate a significant positive correlation between COVID-19 BFS and the Fear of COVID-19 Scale (r = 0.131, p < 0.001), suggesting that individuals with higher levels of burnout may also have higher levels of fear of COVID, or vice versa. The scale was also correlated positively with being against the dynamic zero-COVID strategy (r = 0.340, p < 0.001), indicating that a higher level of burnout may be associated with individuals who are against the dynamic zero-COVID strategy. The results suggest the five-item COVID-19 BFS is a valid and reliable scale for the measurement of burnout frequency of the Chinese general population in relation to the prolonged COVID-19 pandemic in a dynamic zero-COVID policy context.

Anxiety and psychological needs of high school students: COVID-19 period

The study aims to examine the relationship between anxiety and psychological needs of high school students during the COVID-19 pandemic period. The fact that the COVID-19 virus poses a threat to mental health as well as physical health, the effects of the pandemic period on the psychological needs and anxiety level of adolescents, especially in a critical developmental stage, and the scarcity of studies concerning adolescent mental health in this period, constituted the purpose of the current study. The quantitative (N = 502) and qualitative data (N = 29) of the study, in which triangulation design was used, were collected from high school students studying in the Southeast of Turkey. In the quantitative part of the research Multiple Linear Regression was implemented and content analysis was used in the qualitative part. The results indicate that love, belonging and power, which are subdimensions of basic psychological needs, are significant predictors of anxiety level. Additionally, it is seen that the need for freedom subdimension is the least predictive variable for the anxiety level. It is concluded that there are moderate negative and significant relationships between the general and subdimensions of basic psychological needs and the level of state anxiety. In this sense, it has been found that the level of anxiety tends to decrease as the level of the satisfaction of basic psychological needs increases. The results in the qualitative analysis part largely overlap with the results in the quantitative part. Suggestions based on the findings of the study are made to researchers.

The impact of COVID-19 pandemic on psychopathological symptoms in mothers and their school-age children before, during and after the COVID-19 pandemic peak

The COVID-19 pandemic had an impact on children's and caregivers' mental health. We investigated psychopathological symptoms in a group of non-at-risk and a group of at-risk mothers and their school-age children from the pre-pandemic period to the lockdown period and to the post-lockdown period. We used the SCL-90/R to assess mothers' psychological symptoms, the CBCL 1½-5, and the CBCL 6-18 for the perceived children's emotional-behavioral functioning. Analysis of variance was conducted to assess significant differences in the groups over the three assessment points. Linear regressions were run to investigate the effect of maternal psychological symptoms on their children's functioning. In the non-at-risk group, maternal psychopathological symptoms significantly varied during the pandemic. Children's Aggression scores decreased after the lockdown, while Depression scores significantly increased during lockdown and after. The mothers in the at- risk group presented overall decreasing scores over the three assessment points. Children's Aggression scores did not increase during lockdown. Depression scores did not show significant changes over the three assessment points. Overall, our results showed that mothers' psychopathological risk did not influence specific areas of children's emotional/behavioral functioning, but it had an effect on the general offspring psychological well-being.

Establishment of primary health information in the COVID-19 outbreak: A cross-sectional study of population awareness of self-testing

The global pandemic of the Corona Virus Disease 2019 is a severe threat to human health. This paper aims to investigate the status of mass health self-examination awareness and its influencing factors during the COVID-19 epidemic and establish complete health information to intervene in the prevention and control of the COVID-19 epidemic. The study used a simple random sampling method to survey permanent residents (9761 people) aged 15–70 years in a region of Jiangsu Province, China. The survey collected data using a questionnaire with acceptable reliability and validity. The data were entered into SPSS 26, and the data were analyzed using the chi-square test, ANOVA, and logistic regression. The differences in the status of mass health self-examination during COVID-19 were statistically significant (P < 0.05) in terms of the literacy level of the grassroots population, ease of access to medical care, primary medical and health conditions, the situation of medical examination programs, and the construction of primary health information technology. The establishment of comprehensive and systematic primary health information can effectively assist in raising people's awareness of health self-examination and promoting health behaviors, which is essential for enhancing COVID-19 prevention and intervention.

Pandemic-activated psychological growth: significance of extraversion, self-consciousness and COVID-19 related anxiety

BACKGROUND

The sense of threat to health and life in the face of a pandemic, accompanied by difficulties imposed by lockdown, may trigger a serious crisis. Among possible consequences of such a crisis may paradoxically be the phenomenon of psychological growth. The aim of this article is to identify predictors of pandemic-activated psychological growth (PPG). The relationships between extraversion, reflective and ruminative self-consciousness and PPG were the subject of our inquiry. Additionally, a question was posed about the indirect effect of self-consciousness on PPG through anxiety.

PARTICIPANTS AND PROCEDURE

The study involved 1206 participants aged 18 to 26 years, who declared that the pandemic situation significantly threatened their important life goals. Procedure: cross-sectional design. Four online short questionnaire-measures were used: the Ten-Item Personality Inventory (TIPI), the Rumination-Reflection Questionnaire (RRQ), the Current Self-disposition Scale (CSS), and the Post-traumatic Growth Inventory (PTGI).

RESULTS

Extraversion and reflective self-consciousness were direct predictors of higher PPG, whereas ruminative self-consciousness was directly related to a lower PPG. There was an indirect effect of ruminative self-consciousness on PPG through COVID-19 related anxiety.

CONCLUSIONS

Although the results do not confirm the permanence of a growth effect, finding PPG predictors considered as beneficial resources for coping with difficult pandemic circumstances appears to be valuable in the current state of affairs.

Stressful Life Events and Depression During the Recurrent Outbreak of COVID-19 in China: The Mediating Role of Grit and the Moderating Role of Gratitude

Purpose

COVID-19 has been exerting tremendous influence on an individual’s physical behavior and mental health. In China, prolonged isolation may lead to depression among college students during the recurrent outbreak of COVID-19. We conducted this study to explore the relationship among stressful life events, grit, gratitude, and depression in college students during the recurrent outbreak of COVID-19.

Methods

We investigated 953 college students from across China, with an average age of 20.38 (SD=1.39) years. Participants completed four scales (Stressful Life Events Scale, Oviedo Grit Scale, Gratitude Questionnaire, and Patients’ Health Questionnaire Depression Scale-9 item).

Results

The present study found that (1) stressful life events were positively correlated with depression in college students; (2) grit mediated the positive relationship between stressful life events and depression; (3) gratitude moderated the relationship between grit and depression, and such that there was a stronger association between grit and depression for college students with high gratitude.

Conclusion

This study was of great significance for studying the relationship between stressful life events and depression in Chinese college students during the recurrent outbreak of COVID-19. Results indicated that grit and gratitude of college students may be the main targets of depression prevention and intervention. The research conclusion has theoretical and reference value for solving and preventing depression in college students during the recurrent outbreak of COVID-19.

Fear of COVID-19, psychological distress, well-being and life satisfaction: A comparative study on first and second waves of COVID-19 among college students in India

The aim of the study is to examine the relationship of fear of COVID-19 with well-being and life satisfaction through psychological distress among the college students in India. The study was conducted in two waves of the pandemic-during first and second waves of the COVID-19 among college students. A survey was conducted among 768 and 884 students in first and second waves of COVID-19 respectively for this purpose. Structural equation modeling was used to analyze the data. The study found out that the fear of COVID-19 positively related to psychological distress and negatively to well-being and life satisfaction and the effects were stronger in second wave. Also, the psychological distress mediates the relationship between fear of COVID-19 with well-being and life satisfaction, and the relationships were stronger during second wave. Proper coping strategies and mechanisms can be helpful to overcome the difficulties of such situation.

Negative emotional symptoms during COVID19 confinement: The relationship with reading habits

Background

Coronavirus disease (COVID19) is an ongoing pandemic, which forced governments across the globe to implement confinement measures to limit the spread of the disease. These measures have impacted the daily life and psychological status of people. However, no studies have examined the relationship between changes in psychological status with reading habits during the COVID19 pandemic.

Objectives

The study aims at examining the relationship between changes in reading habits and negative emotional states.

Method

The psychological status was measured using the Depression, Anxiety, Stress Scales (DASS). In addition, the participants reported changes in four types of reading experiences during COVID19 confinement. These reading types are specialized, general knowledge, story/novels, and religious material. An internet-based survey was used to collect the data among adults.

Results

A total of 1711 individuals participated in the study. About 60.0%, 55.1%, 60.5% and 61.0% reported participating in scientific, religious, general, and novel reading, respectively. Additionally, the ANOVA revealed differences (p < 0.05) in DASS scores according to the changes in scientific, religious, newspaper, and novel/story reading. Subgroup post hoc comparisons showed that DASS scores were associated with a no-change or increase in all types of reading habits indicating a main effect of emotional state on all types of reading.

Conclusions

Current results might suggest that the participants who experienced greater negative emotions, tended to either not change or increase their reading habits. Additionally, individuals with lower negative emotion scores reported a decrease in reading during the COVID19 pandemic.

The effect of cyberchondria on anxiety, depression and quality of life during COVID-19: the mediational role of obsessive-compulsive symptoms and Internet addiction

Since the global pandemic of the coronavirus disease 2019 (COVID-19), online health information-seeking behaviors have notably increased. Cyberchondria can be a vulnerability factor for the worsening of anxiety-depressive symptoms and quality of life. The current study aims to understand the predictive effect of cyberchondria on health anxiety, anxiety, depression and quality of life considering the mediating effect of obsessive-compulsive symptoms and Internet addiction and the moderating effect of COVID anxiety. 572 Italian participants (66% female; Mean age = 34; SD = 15) took part in a cross-sectional online survey involving CSS-12, MOCQ-R, IAT, SHAI, HADS, WHOQoL-BREF and CAS. Mediation and moderation analyses were conducted. Obsessive-compulsive symptoms and Internet addiction were found to partially mediate the cyberchondria-health anxiety and the cyberchondria-anxiety links and to totally mediate the cyberchondria-depression and the cyberchondria-quality of life links. COVID anxiety was found to moderate the relationship between cyberchondria and anxiety. The findings suggest that compulsivity may have a key role in the explanation of the underlying mechanisms of cyberchondria. Healthcare practitioners should provide additional support for individuals with cyberchondria. As such, cyberchondria is a contributing factor to the exacerbation of anxiety-depressive disorders and may impact on the quality of life.

Status of yoga and mental health among Brazilian practitioners during COVID-19: An internet-based cross-sectional survey

This study aimed to describe yoga practice and verify its association with depression, anxiety, and stress during the COVID-19 pandemic among Brazilian practitioners. A cross-sectional anonymous online survey was conducted in all regions of Brazil using a snowball sampling strategy among yoga practitioners. A total of 860 participants (87% female, aged: 19–82 years) completed the survey. Sociodemographic data, lifestyle factors, yoga practice during the pandemic, and the Depression Anxiety and Stress Scale (DASS-21) scores were collected between July 9 and July 15, 2021. Overall, 9.5%, 9.3%, and 5.6% of participants exhibited some traits (mild to severe) of depression, anxiety, and stress, respectively. Hatha yoga (48%) was the most commonly practiced yoga style. In the adjusted analysis, a higher yoga experience (> 5 years) was associated with better anxiety (odds ratio; bootstrap 95% confidence interval: 2.42; 1.32, 4.49) and stress status (1.80; 1.06, 3.00) than beginners (< 1 year). Practitioners who reported higher time and days of yoga practice during the study period were more likely to show normal levels of depression (odds ratio: 2.56–6.49; p ​< ​0.05), anxiety (odds ratio: 3.68–8.84; p ​< ​0.05), and stress (odds ratio: 2.15–5.21; p ​< ​0.05). Moreover, the maintenance of practice frequency during the pandemic was associated with higher odds of normal levels of depression (2.27; 1.39–3.79), anxiety (1.97; 1.25–3.10), and stress (1.97; 1.32–2.96). In conclusion, our findings indicated that a higher level of yoga practice was associated with better mental health levels during the COVID-19 pandemic.

The impact of impulsivity and school attendance on COVID-19 spread: A web-based cross-sectional questionnaire

Some personal and social decisions can be influential in the spread of COVID-19. There are no studies examining school attendance, impulsivity, COVID-19 phobia, and psychological resilience together while the effect of some individual and social measures on COVID-19 has been frequently investigated. In this study 360 participants were evaluated through an online questionnaire method during the peak of the COVID-19 pandemic. Sociodemographic data form prepared by the researchers, COVID-19 Phobia Scale, Barratt Impulsivity Scale, and Brief Resilience Scale were used in the study. In all, 20.6% (n = 74) of participants had previously experienced COVID-19. The rate of individuals who experienced the death of any of their relatives due to COVID-19 was 17.8%. Only 65.8% of respondents fully complied with government-implemented measures for the outbreak. School attendance (OR = 1.983, p = .033) and impulsivity (OR = 1.115, p < .001) were found to be positively correlated with COVID-19. The presence of a significantly higher psychiatric disease admission history in patients with COVID-19 in binary comparisons did not reach the level of significance in regression analysis. Our results suggest that high school attendance and impulsivity scores are positively correlated with COVID-19 in young people. Government strategies related to schools need to be carefully reviewed for this reason.

Depression, stress, anxiety among jordanian people during COVID-19 pandemic: A survey-based study

COVID-19 pandemic is associated with negative impacts on mental health. The study investigated mental health measures that include depression, stress, and anxiety, and their correlation with gender and age among Jordanians in the COVID-19 era. This investigation adopted a quantitative, cross-sectional, and descriptive design and included 1587 subjects recruited through a convenient sampling approach. Jordanians (≥18 years old) were recruited in the study. The total DASS score of the whole sample was 32.7 ± 0.67. The DASS scale showed significantly high scores for stress, anxiety, and depression in the groups that perceived a moderate-high probability of infection with COVID-19 (P < 0.05). The stress score was greater (P < 0.001) in the men (11.39 ± 0.469) compared to the women (10.74 ± 0.33). On the other hand, anxiety and depression scores were higher in women than men (8.13 ± 0.25, and 12.71 ± 0.30 respectively). Finally, DASS total score significantly decreased with the increasing age of the participants (P < 0.001). Many Jordanians experienced moderate to severe depression, stress, and anxiety during the COVID-19 era. Such experience was associated with the sex and age of subjects. The results of this study will benefit decision-makers in establishing a plan to prevent the consequences of these mental disorders during pandemics.

Psychological Well-Being During the Second Wave of COVID-19 Pandemic: The Mediation Role of Generalized Anxiety

Introduction

The outbreak of the COVID-19 has largely impacted individuals’ health and lifestyles. This study aimed to investigate people’s psychological well-being during the second phase of the COVID-19 pandemic.

Methods

We selected six indicators of psychological well-being: fear of COVID-19, loneliness, social interaction anxiety, generalized anxiety, PTSD, and depression. A sample of 231 Italian participants (56.3% women), with a mean age of 32.7 (SD=12.61), completed an online survey from February to March 2021, during the so called “second wave”. It included the Fear of COVID-19 Scale (FCV-19S), the UCLA Loneliness Scale- Version 3, the Generalized Anxiety Disorder 7-item Scale (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), the Impact of Event Scale–Revised (IES-R), and the Social Interaction Anxiety Scale (SIAS).

Results

Apart from loneliness, women reported lower levels of psychological well-being than men. Fairly good associations between all the detected variables were found. Based on a mediation model evaluation (in which generalized anxiety was introduced as a mediator in the relationship between fear of COVID-19, PTSD, loneliness, social interaction anxiety, and depression), except for social interaction anxiety, total and partial mediation effects suggested that generalized anxiety played a crucial role in exacerbating depressive symptoms during the pandemic.

Conclusion

Our outcomes may expand the knowledge about the psychological well-being during the pandemic experience, with a focus on the mediating role of generalized anxiety.

Levels and Predictors of Anxiety and Depression in Turkish Pregnant Woman During the Covid-19 Pandemic

OBJECTIVE

 In addition to being a medical phenomenon, pandemics affect the individual and society on several levels and lead to disruptions. In the pandemic process, different groups in the population, including pregnant women as a defenseless group, are subjected to psychological threat. The present study aimed to determine the levels of anxiety and depression and related factors in pregnant women during the the coronavirus disease 2019 (Covid-19) pandemic.

METHODS

 The present cross-sectional study was conducted with 269 pregnant women through face-to-face interviews held in Istanbul, Turkey. Regarding the data collection tools, the Cronbach α reliability coefficient was of 0.90 for the Beck Anxiety Inventory, and of 0.85 for the Beck Depression Inventory.

RESULTS

 Among the participating pregnant women, 30.5% had mild, 17.5% had moderate, and 5.9% had severe anxiety symptoms, whereas 35.3% had mild, 16.7% had moderate, and 2.2% had severe depression symptoms. We found that those who were concerned about their health had 5.36 times (p = 0.04) more risk of developing anxiety, and 4.82 times (p = 0.01) more risk of developing depression than those who were not concerned. Those who had a history of psychiatric disease had 3.92 times (p = 0.02) more risk of developing anxiety than those without it.

CONCLUSION

 We determined that about half of the pregnant women included in the study had some degree of anxiety and depression during the COVID-19 pandemic. The risk factors for anxiety and depression among the pregnant women were determined as smoking, concerns about health and getting infected with the coronavirus, history of psychiatric disease, and undergoing regular antenatal care.

RESEARCH ARTICLEPrevalence and associated factors of depression, anxiety and stress among coronavirus disease 2019 (COVID-19) patients in Heart, Afghanistan

Objectives

Coronavirus disease 2019 (COVID-19) pandemic has been associated with a great level of psychological distresses in people around the world. This study aims to assess the prevalence of depression, anxiety and stress among COVID-19 patients and identify the associated factors, in Herat Province of Afghanistan.

Methods

This cross-sectional study was conducted on 459 hospitalized patients between May and September 2021. Data was collected with a structured questionnaire on depression, anxiety and stress scale, which was the validated Dari-version. Chi-square test was adopted to analyze the associations of the prevalence of the mental disorders and the factors.

Results

The mean age of participants was 38.05; 51.9% (238/459) were male and 84.1% (386/459) were married. Median scores for depression, anxiety and stress were 5.0, 8.0, and 10.0, respectively. Gender, general health condition, nutritional status, COVID-19 clinical manifestation and concurrent comorbidities (except diabetes and hypertension) were significantly associated with mental disorders; while association between marital status and these psychological disorders was not significant. Moreover, a significant difference was observed in the level of anxiety between healthcare workers and other respondents.

Conclusion

This is the first study to report the high prevalence of depression, anxiety and stress among COVID-19 patients in Herat, which indicates the negative effect of mental health for COVID-19 patients globally and highlights the need for urgent and appropriate interventions to improve mental health of people during the pandemic.