Prevalence rates of anxiety, depressive, and eating pathology symptoms between the pre- and peri-COVID-19 eras: A meta-analysis

Trajectories of pain and depressive symptoms among people living with low back pain during the COVID-19 pandemic: a 24-month longitudinal study

Introduction: We explored trajectories of pain intensity and depressive symptoms over the first 24 months of the pandemic in people with low back pain. Methods: This longitudinal study was conducted alongside the Quebec Low Back Pain Study. Starting in April 2020 and every 3 months until July 2022, 291 participants completed an online survey. Group-based trajectory modeling was used to identify patterns of pain intensity and depressive symptoms. Onset outbreak characteristics were then put in relation with trajectory groups using multivariate logistic regression. Results: The analysis revealed 5 trajectories of pain intensity and depressive symptoms, respectively. The pain trajectories were stable mild (n = 17, 5.8%); stable moderate (n = 103, 35.4%); stable severe (n = 81, 27.8%); U-shape (n = 24, 8.3%), and inverted U-shape (n = 66, 22.7%). The trajectories of depressive symptoms were stable none (n = 58, 19.9%); stable very mild (n = 61, 21.0%); stable mild (n = 85, 29.2%); stable moderate (n = 59, 21.7%); and severe slightly improving (n = 24, 8.3%). Pre-COVID everyday/nearly everyday pain, average pain intensity, and widespread bodily pain were predictive of pain trajectory groups. Higher pre-COVID depression, acute stress disorder, and lockdown measures-related stress were associated with moderate/severe depressive trajectories. Discussion: Our findings indicated relative stability of pain and depressive symptoms among participants during the COVID-19 pandemic but also highlighted subgroups of people who experienced temporary deterioration or improvement over the first months of the pandemic that then reverted back to baseline levels. Modifiable risk factors were identified before the onset of the pandemic, which could give preventive measures in targeted populations.

Prospective exploration of the role of combined internalizing symptoms in self-reported memory among older adults during the COVID-19 pandemic

OBJECTIVES

A growing literature suggests depression and anxiety increase risk of cognitive decline. However, few studies have examined their combined effects on cognition, among older adults, especially during periods of high stress.

METHOD

Based on a sample of community dwelling older adults (N = 576), we evaluated the effects of pre-pandemic anxiety and depressive symptoms, obtained in September 2018, to changes in self-reported memory (SRM) assessed 3 months into the COVID-19 pandemic.

RESULTS

In separate models, we found participants with depression scores at least 1-SD above the mean and participants with anxiety scores at least 2-SD above the mean to report a significant decline in SRM. Moderation analyses revealed those with high depressive symptoms (at or above the mean) showed a decrease in SRM regardless of anxiety. The extent to which high pre-pandemic anxiety symptoms influenced SRM is dependent on whether pre-pandemic depression was at or above the mean.

CONCLUSIONS

Pre-pandemic depression predicted a decline in SRM regardless of anxiety. Moderation analyses revealed that the extent to which anxiety symptoms influenced SRM was dependent on depression being at or above the mean. Those with high anxiety and depression are at highest risk of experiencing cognitive consequences related to stressful exposures like COVID-19.

Quality of Life and Loneliness Among American Military Veterans

ABSTRACT

Quality of life and loneliness are closely associated with mental and physical health outcomes. This relationship is particularly important in Veterans who experience elevated rates of disabilities, comorbidities, and chronic health conditions as compared with non-Veterans. In the present project, we use data from the Military Health and Well-Being Project ( n = 1469, 67.2% men, 32.3% women, 0.5% transgender, nonbinary, prefer not to say) to investigate the link between five domains of quality of life ( i.e. , general quality of life, physical health, psychological health, social relationships, and environment) with loneliness in American Military Veterans. Findings indicated that every domain of quality of life was negatively and significantly associated with loneliness ( r 's < -0.45, p 's < 0.001), such that quality of life decreased as loneliness increased. We further found, using linear regression, that quality social relationships (β = -0.385, t = -13.23), psychological functioning (β = -0.196, t = -5.28), and physical health (β = -0.133, t = -4.174) were related to low levels of loneliness. Taken together, these findings indicate that in this sample of Veterans 1) general quality of life, physical health, psychological health, social relationships, and environment are all strongly connected with loneliness, and 2) of these, social relationships, psychological health, and physical health seem to protect most against loneliness, with large robust effect sizes. We recommend that intervention and policy researchers continue to investigate and develop feasible, acceptable, and cost-effective ways to promote social relationships, psychological health, and physical health among Veterans. Data were collected during the COVID-19 pandemic, which may limit generalizability of these findings.

Something, everything, and anything more than nothing: stories of school-based prevention of body image concerns and eating disorders in young people

Much work has been done to promote the development of positive body image in schools. This paper aims to tell some stories from the past 35 years of work in this field that illuminate important issues in developing, evaluating, and disseminating programs, and in removing policies and practices that could trigger weight stigma and body shame or disordered eating attitudes and behaviours. The need for, goals of, and approaches to body image programs, problematic activities we have 'good enough' evidence to avoid, and next steps for advocacy, research, and action are explored as we celebrate how far we've come and have hope for the future.

Socio-demographic variation in diagnosis of and prescribing for common mental illnesses among children and young people during the COVID-19 pandemic: time series analysis of primary care electronic health records

BACKGROUND

The impact of the COVID-19 pandemic on the mental health of children and young people (CYP) has been widely reported. Primary care electronic health records were utilised to examine trends in the diagnosing, recording and treating of these common mental disorders by ethnicity and social deprivation in Greater Manchester, England.

METHODS

Time-series analyses conducted using Greater Manchester Care Record (GMCR) data examined all diagnosed episodes of anxiety disorders and depression and prescribing of anxiolytics and antidepressants among patients aged 6-24 years. The 41-month observation period was split into three epochs: Pre-pandemic (1/2019-2/2020); Pandemic Phase 1 (3/2020-6/2021); Pandemic Phase 2 (7/2021-5/2022). Rate ratios for all CYP specific to sex, age, ethnicity, and neighbourhood-level Indices of Multiple Deprivation (IMD) quintile were modelled using negative binomial regression.

RESULTS

Depression and anxiety disorder rates were highest in females, CYP aged 19-24, and White and 'Other' ethnic groups. During Pandemic Phase 1, rates for these diagnoses fell in all demographic subgroups and then rose to similar levels as those recorded pre-pandemic. In Pandemic Phase 2, rates in Black and Mixed-ethnicity females rose to a significantly greater degree (by 54% and 62%, respectively) than those in White females. Prescribing rates increased throughout the study period, with significantly greater rises observed in non-White females and males. The temporal trends were mostly homogeneous across deprivation quintiles.

CONCLUSION

The observed fluctuations in frequency of recorded common mental illness diagnoses likely reflect service accessibility and patients' differential propensities to consult as well as changing levels of distress and psychopathology in the population. However, psychotropic medication prescribing increased throughout the observation period, possibly indicating a sustained decline in mental health among CYP, and also clinicians' responses to problems presented. The comparatively greater increases in frequencies of diagnosis recording and medication prescribing among ethnic minority groups warrants further investigation.

Sex-specific Impact of the first COVID-19 Lockdown on Age Structure and Case Acuity at Admission in a Patient Population in southwestern Germany: a retrospective comparative Study in Neuroradiology

OBJECTIVES

A hard lockdown was presumed to lead to delayed diagnosis and treatment of serious diseases, resulting in higher acuity at admission. This should be elaborated based on the estimated acuity of the cases, changes in findings during hospitalisation, age structure and biological sex.

DESIGN

Retrospective monocentric cross-sectional study.

SETTING

German Neuroradiology Department at a .

PARTICIPANTS

In 2019, n=1158 patients were admitted in contrast to n=884 during the first hard lockdown in 2020 (11th-13th week).

MAIN OUTCOME MEASURES

Three radiologists evaluated the initial case acuity, classified them into three groups (not acute, subacute and acute), and evaluated if there was a relevant clinical deterioration. The data analysis was conducted using non-parametric methods and multivariate regression analysis.

RESULTS

A 24% decrease in the number of examinations from 2019 to 2020 (p=0.025) was revealed. In women, the case acuity increased by 21% during the lockdown period (p=0.002). A 30% decrease in acute cases in men was observable (in women 5% decrease). Not acute cases decreased in both women and men (47%; 24%), while the subacute cases remained stable in men (0%) and decreased in women (28%). Regression analysis revealed the higher the age, the higher the acuity (p<0.001 in both sexes), particularly among women admitted during the lockdown period (p=0.006).

CONCLUSION

The lockdown led to a decrease in neuroradiological consultations, with delays in seeking medical care. In women, the number of most severe cases remained stable, whereas the mean case acuity and age increased. This could be due to greater pandemic-related anxiety among women, however, with severe symptoms they were seeking for medical help. In contrast in men, the absolute number of most severe cases decreased, whereas the mean acuity and age remained nearly unaffected. This could be attributable to a reduced willingness to seek for medical consultation.

The association between the sense of control and depression during the COVID-19 pandemic: a systematic review and meta-analysis

Introduction

High levels of depression and low sense of control have been reported during the COVID-19 pandemic. The removal of typical freedoms through public health restrictions may have played an important role. The aim of this review was to examine data collected during the pandemic and (1) estimate the strength of the association between sense of control and depression, (2) examine whether the different types of control measures affected the strength of the association, and (3) whether this changed as a function of pandemic indicators.

Methods

We conducted a systematic review and meta-analysis of studies published in English between December 2019 and November 2022. A total of 993 articles were identified, of which 20 were included in the review and 16 in the meta-analysis after conducting a quality assessment using the standard NIH tool.

Results

The control-depression association gave a bias-independent pooled effect size of r = .41, and grew stronger over the 130 weeks covered by this review but did not change as a function of local COVID incidence rates. Subgroup analyses showed that external and overall control were more strongly related to depression than internal control.

Discussion

These findings emphasize that external factors are important to the sense of control and the importance of preserving the sense of control in situations where the removal of personal freedoms is necessary, such as public health emergencies.

Paternal Prenatal and Lactation Exposure to a High-Calorie Diet Shapes Transgenerational Brain Macro- and Microstructure Defects, Impacting Anxiety-Like Behavior in Male Offspring Rats

Prenatal exposure to high-energy diets (HED) increases the susceptibility to behavioral alterations in the male offspring. We addressed whether prenatal HED primes the transgenerational inheritance of structural brain changes impacting anxiety/depression-like behavior in the offspring. For this, we used female Wistar rats exposed to a HED [cafeteria (CAF) diet, n = 6] or chow [control (CON) n = 6] during development. Anxiety and depression-like behavior were evaluated in filial 1 (F1), filial 2 (F2), and filial 3 (F3) male offspring using the open field (OFT), elevated plus maze, novelty suppressed feeding (NSFT), tail suspension (TST), and forced swimming tests. Structural brain changes were identified by deformation-based morphometry (DBM) and diffusion tensor imaging using ex vivo MRI. We found that the F1, F2, and F3 offspring exposed to CAF diet displayed higher anxious scores including longer feeding latency during the NSFT, and in the closed arms, only F1 offspring showed longer stay on edges during the OFT versus control offspring. DBM analysis revealed that CAF offspring exhibited altered volume in the cerebellum, hypothalamus, amygdala, and hippocampus preserved up to the F3 generation of anxious individuals. Also, F3 CAF anxious exhibited greater fractional anisotropy and axial diffusivity (AD) in the amygdala, greater apparent diffusion coefficient in the corpus callosum, and greater AD in the hippocampus with respect to the control. Our results suggest that prenatal and lactation exposure to HED programs the transgenerational inheritance of structural brain changes related to anxiety-like behavior in the male offspring.

A Qualitative Exploration of Prominent Factors Contributing to the Aetiology of Child and Adolescent Eating Disorder Presentations during the COVID-19 Pandemic: The Perspectives of Patients, Parents and Clinicians

AIM

The aim of this study was to explore the prominent factors that contributed to the development of child and adolescent eating disorder presentations during the COVID-19 pandemic.

METHODS

This was achieved through a qualitative analysis of interviews gathered from (1) adolescent patients diagnosed with an eating disorder (ED) during the COVID-19 pandemic (aged 13-18) (n = 4), (2) parents of patients attending an ED service (n = 7) and (3) clinicians working within a specialist child and adolescent ED support service (n = 7). Reflexive thematic analysis was used to analyse the data and establish the most prominent aetiological factors reported.

RESULTS

The most prominent aetiological factors reported were (1) the accumulation of risk factors; (2) seeking control amid increased anxiety, stress and uncertainty; (3) social isolation; (4) an increased focus on exercise and "healthy eating"; (5) increased social media use promoting unhelpful attention towards ED triggers; and (6) a lack of both awareness and support services.

CONCLUSION

During the COVID-19 pandemic, the quantity and severity of ED presentations increased. The current study uncovered six themes perceived by patients, parents and clinical staff that contributed to the aetiology of ED presentations during the COVID-19 pandemic. It is hoped that the insight gained through this research study into ED aetiology may act as a basis for further research and support ED awareness, prevention and intervention in the future.

The mechanisms of nature-based therapy on depression, anxiety, stress, and life satisfaction: examining mindfulness in a two-wave mediation model

Background

Nature-based therapy (NBT), which centers around engaging in activities within natural surroundings, has consistently demonstrated therapeutic benefits for mental health. While NBT highlights the potential of nature as a therapeutic resource for promoting mental health, there is limited knowledge regarding its underlying mechanisms.

Methods

Two hundred seventy-six Korean participants (204 women, mean age = 54.99 ± 23.25 years) participated in a 30-session gardening program held twice weekly for 15 weeks. Structural equation modeling with a two-wave autoregressive cross-lagged model was used to investigate the mediating effects of mindfulness.

Results

NBT significantly improved the mean scores of all psychological variables. The mediation model was partially confirmed, with mindfulness at post-intervention (T2) mediating the relationship between baseline (T1) depression and anxiety and post-intervention (T2) life satisfaction. However, no significant indirect effect was observed between the path from stress (T1) to life satisfaction (T2).

Conclusion

Mindfulness is a crucial component for improving mental health outcomes. This study underscores the need to prioritize and emphasize mindfulness practices in NBT.

How does COVID-19-related social media usage influence disordered eating? A daily diary study among Chinese adults during lockdown

BACKGROUND

Despite previous studies highlighting the benefits of social media use during the COVID-19 pandemic, particularly under lockdown, limited research has identified the potential detrimental consequences of social media use during lockdown. Therefore, the purpose of this study is to examine the effects of social media on mental health in particular situations and the mechanisms underlying these effects.

METHODS

A daily diary protocol was adopted. A total of 96 adults (Mage = 25.90 ± 8.32 years) were recruited from Xi'an, Shaanxi Province, China. COVID-19-related social media use, psychological distress, COVID-19-related stress and anxiety, and disordered eating were measured each day for a week. Multilevel path analyses for the nested data were conducted.

RESULTS

Daily COVID-19-related social media use was positively related to daily disordered eating (r = .13 p < .001). Furthermore, the multilevel path analysis showed that psychological distress and COVID-19-related stress and anxiety mediated the relationship between COVID-19-related social media use and disordered eating at the within-person level. However, only COVID-19-related-anxiety mediated the relationship at the between-person level.

CONCLUSIONS

Our findings contribute to the understanding of social media's impact during lockdown and provide implications for social media users, social media platform providers, mental health professionals, and governments regarding the correct and sustainable use of social media during the COVID-19 pandemic and in future public health emergencies.

The effectiveness of nature-based therapy for community psychological distress and well-being during COVID-19: a multi-site trial

During the COVID-19 pandemic, the world population faced various mental health challenges, highlighting a need for new community-based psychosocial interventions. This study aimed to investigate the effectiveness and feasibility of Nature-Based Therapy (NBT) for the community experiencing psychological distress during the pandemic. A multi-site trial comparing NBT and control groups was conducted in Korea with 291 participants exhibiting mild to severe depression or anxiety. A total of 192 participated in 30 sessions of therapeutic gardening, while 99 remained in the control group. Psychological distress and well-being were assessed using seven measures of depression, anxiety, daily activity, life satisfaction, mindfulness, stress, and loneliness. The effect sizes (Cohen's d) of NBT compared to the control group were medium to large: depression (0.583), anxiety (0.728), daily activity (1.002), life satisfaction (0.786), mindfulness (0.645), stress (0.903), and loneliness (0.695). Multilevel analysis revealed significant Time × Group interaction effects for all measures. Pearson correlation (r = - 0.28 to 0.71) showed that changes in all variables correlated significantly with each other, with small to large effect sizes. Therapeutic alliance at post-test positively moderated the intervention effects on the outcomes. We concluded that NBT is a promising psychosocial intervention for treating psychological distress for community dwellers.

Sclareol exerts synergistic antidepressant effects with quercetin and caffeine, possibly suppressing GABAergic transmission in chicks

This study evaluated the effects of sclareol (SCL) with or without caffeine (CAF) and quercetin (QUR) using in-vivo and in-silico studies. For this, 5-day-old chicks weighing between 45 and 48 g were randomly divided into five groups and treated accordingly. The chicks were monitored to compare the occurrence, latency, and duration of sleep as well as the loss and gain of righting reflex in response to SCL-10 mg/kg, CAF-10 mg/kg, and QUR-50 mg/kg using a thiopental sodium (TS)-induced sleeping model. Data were analyzed by one-way ANOVA followed by t-Student-Newman-Keuls' as a posthoc test at 95% confidence intervals with multiple comparisons. An in-silico study was also performed to investigate the possible antidepressant mechanisms of the test and/or standard drugs with different subunits of GABAA receptors. In comparison to the SCL, CAF, and QUR individual groups, SCL+CAF+QUR significantly increased the latency while decreasing the length of sleep. The incidence of loss and gain of the righting reflex was also modulated in the combination group. SCL showed better interaction with GABAA (α2 and α5) subunits than QUR with α2, α3, and α5. All these compounds showed stronger interactions with the GABAA receptor subunits than the standard CAF. Taken together, SCL, CAF, and QUR reduced the TS-induced righting reflex and sleeping time in the combination group more than in the individual treatments. SCL may show its antidepressant effects, possibly through interactions with GABAA receptor subunits.

Veterans and Nonveterans Coping With Stress During 4 Months of COVID-19

PURPOSE

Identifying how people have been coping with stress during the COVID-19 pandemic allows us to anticipate how the population may react to similar stressors over time. In this study, we assessed patterns of coping styles among veterans and nonveterans, and stability and change in these strategies at 3 time points during the pandemic.

METHODS

Using an online survey platform, we circulated a questionnaire at 3 time points during the period when COVID-19 vaccines became widely available (December 2-27, 2020; January 21-February 6, 2021; and March 8-23, 2021). The questionnaire asked participants about their extent of use of 11 coping strategies, and symptoms of anxiety and depression.

RESULTS

A total of 2,085 participants (50.8% veterans) completed the questionnaire at 1 or more time points and 930 participants (62.8% veterans) completed it at all 3 time points. Cluster analysis identified 3 distinct coping styles: adaptive, distressed, and disengaged. Compared with nonveterans, veterans more commonly had adaptive and disengaged coping styles, and less commonly had a distressed coping style. The majority of the cohort (71.3%) changed coping style at least once during the study period. Participants who used the same coping style across all 3 time points reported lower levels of anxiety and depression.

CONCLUSIONS

Our data demonstrate a need to better understand the dynamic nature of coping with pandemic-level stressors across time. We did not find patterns of change in coping styles, but our findings point to potential advantages of stability in coping style. It is possible that less adaptive styles that are more stable may be advantageous for mental health. This research has implications for supporting patients dealing with stress in family medicine.

Recent advances in the neuroscience of spontaneous and off-task thought: implications for mental health

People spend a remarkable 30-50% of awake life thinking about something other than what they are currently doing. These experiences of being "off-task" can be described as spontaneous thought when mental dynamics are relatively flexible. Here we review recent neuroscience developments in this area and consider implications for mental wellbeing and illness. We provide updated overviews of the roles of the default mode network and large-scale network dynamics, and we discuss emerging candidate mechanisms involving hippocampal memory (sharp-wave ripples, replay) and neuromodulatory (noradrenergic and serotonergic) systems. We explore how distinct brain states can be associated with or give rise to adaptive and maladaptive forms of thought linked to distinguishable mental health outcomes. We conclude by outlining new directions in the neuroscience of spontaneous and off-task thought that may clarify mechanisms, lead to personalized biomarkers, and facilitate therapy developments toward the goals of better understanding and improving mental health.

Prevalence of fear of COVID-19, depression, and anxiety among undergraduate students during remote classes

BACKGROUND

During the coronavirus disease 2019 (COVID-19) pandemic, undergraduate students were exposed to symptoms of psychological suffering during remote classes. Therefore, it is important to investigate the factors that may be generated and be related to such outcomes.

OBJECTIVE

To investigate the association between fear of COVID-19, depression, anxiety, and related factors in undergraduate students during remote classes.

METHODS

This cross-sectional study included 218 undergraduate students (60.6% women and 39.4% men). Students answered a self-administered online questionnaire designed to gather personal information, pandemic exposure, physical activity level, fear of COVID-19 using the 'Fear of COVID-19 Scale', symptoms of depression using the Patient Health Questionnaire-9, and anxiety using General Anxiety Disorder-7.

RESULTS

Undergraduate students had a high prevalence of depression and anxiety (83.0% and 76.1%, respectively) but a low prevalence of fear of COVID-19 (28.9%) during remote classes. Multivariate analysis revealed that women who reported health status as neither good nor bad and who had lost a family member from COVID-19 had the highest levels of fear. For depression and anxiety, the main related factors found were female gender, bad health status, insufficiently active, and complete adherence to the restriction measures.

CONCLUSION

These findings may be used to develop actions to manage symptoms of anxiety and depression among students, with interventions through physical activity programmes to improve mental health.

Traumatic brain injury and suicidality among military veterans: The mediating role of social integration

Suicide is a widespread public health concern, including among military Veterans. Traumatic brain injuries (TBIs) and lack of social integration have both been shown to increase risk for suicidality, an outcome that includes, among other suicide-related variables, suicidal ideation, suicide attempts, and suicide death. Interestingly, TBIs have also been identified as a risk factor for social integration problems. In this cross-sectional study we investigated associations between TBI, social integration, and suicidality. Additionally, mediation analysis was used to test whether social integration mediated the association between TBI and suicidality. A sample of 1469 military Veterans (male, n = 1004, 67.2 %; female, n = 457, 32.3 %; transgender/non-binary/prefer not to say, n = 8, 0.5 %) completed an online survey as part of the Military Health and Well-Being Project. TBI was negatively associated with social integration (r = -0.084, p < .001) and positively with suicidality (r = 0.205, p < .001). Social integration was negatively associated with suicidality (r = -0.161, p < .001). Finally, social integration partially mediated the relationship between TBI and social integration (B = 0.121, 95 % CI [0.031-0.23]). This work shows that in the context of TBI, lack of social integration may promote suicidality. It provides support for many theories of suicide which propose social problems as a risk factor of suicide-related outcomes. It further highlights social integration as potential fodder for novel interventions for suicidality, an approach that would have transtheoretical support.

Happiness in pre-pandemic Europe: correlates of individual happiness prior to Covid

OBJECTIVE

To identify levels and key correlates of happiness across Europe in 2018, prior to the Covid-19 pandemic.

METHODS

We used data from the European Social Survey to determine levels of happiness in individuals (n = 49,419) from 29 European countries and identify associations between happiness and age, gender, satisfaction with income, employment status, community trust, satisfaction with health, satisfaction with democracy, religious belief and country of residence.

RESULTS

In 2018, self-rated happiness varied significantly across the 29 European countries, with individuals in Denmark reporting the highest levels of happiness (8.38 out of 10) and individuals in Bulgaria reporting the lowest (5.55). Ireland ranked 11th (7.7). Happiness had significant, independent associations with younger age, satisfaction with health, satisfaction with household income, community trust, satisfaction with democracy and religious belief. These factors accounted for 25.4% of the variance in happiness between individuals, and, once they were taken into account, country of residence was no longer significantly associated with happiness.

CONCLUSIONS

Self-rated happiness varied significantly across pre-pandemic. At individual level, happiness was more closely associated with certain variables than with country of residence. It is likely that the Covid-19 pandemic had significant impacts on some or all of these variables. This highlights the importance of further analysis of correlates of happiness in Europe over future years, when detailed happiness data from during and after the pandemic become available.

Exploring the reciprocal associations between body appreciation, body image flexibility, and body acceptance by others in the context of the COVID-19 pandemic in Germany: Results from cross-lagged panel analyses among women and men

The COVID-19 pandemic provided a context associated with negative consequences for body image and eating behavior. However, little is known about what factors helped to mitigate these consequences and build a positive body image. Previous research pointed to the significance of body image flexibility and perceived body acceptance by others in predicting body appreciation. However, as most of the studies have been cross-sectional, causal relationships are poorly understood. This longitudinal study tested the reciprocal association between body appreciation, body image flexibility, and perceived body acceptance by others during the COVID-19 pandemic in Germany. We analyzed data from a large community sample consisting of 1436 women and 704 men who were invited to complete the study measures (BAS-2, BI-AAQ-5, BAOS-2) at three time points, each approximately six months apart. Latent cross-lagged panel analyses revealed that greater T1 body appreciation predicted an increase in T2 body image flexibility among both genders, while for women, we additionally observed reciprocal effects between T2 and T3. Among both genders, we further found that greater body appreciation predicted increased perceived body acceptance by others over both measurement intervals (but not vice versa). Our findings are discussed in light of pandemical constraints during the studies' assessments.

A longitudinal examination of the protective effect of resilience against anxiety among older adults with high COVID-related worry

This longitudinal study of community dwelling older adults (N = 453) examined consequences of COVID-related worries on changes in anxiety symptoms before relative to during the pandemic. We further evaluated if pre-COVID psychological resilience (PR) buffered the impact of COVID-related worry. Pre-COVID data were collected in September 2018. COVID-related worry and COVID anxiety symptoms were collected in October 2020 (Wave 2). Controlling for pre-COVID anxiety symptoms, we examined if COVID-related worries (e.g. I'm worried that I might die from COVID-19) were associated with increased anxiety symptoms, and whether pre-COVID PR moderated the association between COVID-related worries and prospective increases in anxiety symptoms. COVID-related worries were associated with increased anxiety symptoms (β = 0.005, p < .01), whereas pre-COVID PR was associated with a decrease in anxiety symptoms (β = -0.029, p < .05). PR moderated the association; COVID-related worries were associated with greater increases in anxiety symptoms among those with low pre-COVID PR (Model η2 = 0.35). Thus, the extent to which COVID-related worries influenced psychological health was dependent on pre-COVID levels of PR. We conclude the combined vulnerabilities of low pre-COVID PR and high COVID-related worries significantly increased the psychological consequences of COVID-19 for our sample of older adults.

Mental health across two years of the COVID-19 pandemic: a 5-wave longitudinal study in Germany

The COVID-19 pandemic has been negatively associated with mental health. However, little is known about the temporal dynamics of mental health in the longer term of the pandemic. We aimed to investigate symptom levels and changes of depression, anxiety, posttraumatic stress, and loneliness spanning two years of the pandemic; and to examine associated risk factors. This five-wave, longitudinal online study from May 2020 to April 2022 included 636 adults (Mage = 39.5 years, SD = 16.11; 84.1% female) from the German general population who completed the international COVID-19 Mental Health Survey. Symptoms of anxiety (Generalized Anxiety Disorder-7; GAD-7), depression (Patient Health Questionnaire-9; PHQ-9), posttraumatic stress (PTSD Checklist for DSM-5; PCL-5), and loneliness ("Do you feel lonely?") were assessed using mixed-effects models. Associations with anxiety and depressive symptoms were examined with having children, student status, financial worries, contamination fear, and loneliness. PHQ-9, GAD-7, PCL-5, and loneliness scores overall decreased throughout the two-year period of the pandemic but exhibited an increase during two national lockdowns. Controlled for significant associations with female gender and younger age, increased PHQ-9 and GAD-7 scores were associated with contamination fear, financial worries, and loneliness. No associations were found with having children and student status. Symptoms of depression, anxiety, posttraumatic stress, and loneliness decreased over time but varied along with the dynamics of the pandemic. Longitudinal monitoring of mental health in vulnerable subgroups is required, especially those of younger age, females, and the financially insecure.

Effects of Locomotion Regulatory Mode on COVID-19 Anxiety: The Mediating Role of Resilience

The COVID-19 pandemic has exerted a significant impact on mental health globally. The uncertainty, fear, and stress associated with this crisis have contributed to a heightened prevalence of anxiety, depression, and various other mental health disorders. In this scenario, the present study aimed at investigating the relationship between locomotion regulatory mode, resilience, and COVID-19 anxiety. It is worth noting that previous extensive research has established a significant correlation between high levels of locomotion and diverse positive psychological conditions, such as optimism, reduced hopelessness, and a positive effect. A total of 243 participants completed measures of locomotion regulatory mode, resilience, and COVID-19 anxiety. In line with our hypotheses, individuals' locomotion regulatory mode was negatively, although non-significatively, associated with COVID-19 anxiety. Furthermore, resilience was found to mediate the relationship between the locomotion regulatory mode and COVID-19 anxiety, indicating that individuals displaying high locomotion may be better equipped to cope with the stress and uncertainty of the COVID-19 pandemic due to their greater levels of resilience. Taken together, these findings highlight the importance of considering both locomotion and resilience in managing anxiety related to COVID-19, and suggest that interventions aimed at enhancing resilience may be particularly beneficial for individuals with a low locomotion regulatory mode.

Substance use, psychiatric symptoms, personal mastery, and social support among COVID-19 long haulers: A compensatory model

BACKGROUND

Substance use has become a critical health concern during the COVID-19 pandemic, and emerging attention has been paid to people with the persistent symptoms of COVID-19 (COVID-19 long haulers) due to their high vulnerability. However, scant research has investigated their substance use and relevant psychosocial factors. The current study was to (1) examine substance use behaviors (i.e., legal drug use, illicit drug use, and non-medical use of prescription drugs); and (2) assessed their associations with psychiatric symptoms (i.e., depression, anxiety, and post-traumatic stress disorder) and psychosocial factors (i.e., personal mastery and social support) among COVID-19 long haulers.

METHODS

In January-March 2022, 460 COVID-19 long haulers (50% female), with an average age of 32, completed online surveys regarding their demographics, substance use, psychiatric symptoms, and psychosocial factors.

RESULTS

In the past three months, the most commonly used or non-medically used substances were tobacco (82%) for legal drugs, cocaine (53%) for illicit drugs, and prescription opioids (67%) for prescription drugs. Structural equation modeling suggested that psychiatric symptoms were positively associated with substance use behaviors (βs = 0.38 to .68, ps < 0.001), while psychosocial factors were negatively associated with substance use behaviors (βs = -0.61 to -0.43, ps < 0.001).

CONCLUSION

Substance use is common in COVID-19 long haulers and psychiatric symptoms are the risk factors. Personal mastery and social support appear to offer protection offsetting the psychiatric influences. Substance use prevention and mental health services for COVID-19 long haulers should attend to personal mastery and social support.

Factor structure of the patient health questionnaire-4 in adults with attention-deficit/hyperactivity disorder

Background

Persons with attention-deficit/hyperactivity disorder (ADHD) frequently experience symptoms of anxiety and depression. In this population, there is a need for validated brief self-report screening questionnaires to assess the severity of comorbid mental health problems. The Patient Health Questionnaire 4 (PHQ-4) is a self-report questionnaire that may contribute to this purpose as it can screen for both disorders efficiently. However, this will be the first study examining the factor structure of the PHQ-4 in samples of adults with ADHD, and also evaluating the validity of the Norwegian version of the PHQ-4.

Objectives

The aim of the current cross-sectional study was to examine the factor structure and validity of the Norwegian version of the PHQ-4 in a sample of adults who reported having been diagnosed with ADHD.

Methods

Of 496 invited, a total of 326 participants (66%) completed the PHQ-4, The World Health Organization Five Well-Being Index, the Oslo Social Support Scale and the 4-item Perceived Stress Scale electronically in a web-portal between the 9th and 30th of June 2020.

Results

Confirmatory factor analysis of the PHQ-4 supported a two-factor structure [RMSEA = 0.038 (90% CI 0.000-0.159), CFI = 1.00, TLI = 0.999, SRMR = 0.004], consisting of a depression factor and an anxiety factor. Standardized factor loadings were 0.79 to 0.97. The PHQ-4 was negatively correlated with well-being and social support and positively correlated with perceived level of stress.

Conclusion

This study indicates promising psychometric properties of the PHQ-4 as a measure of anxiety and depressive symptoms in adults with self-reported ADHD who are fluent in Norwegian. The questionnaire's brevity makes it a valuable resource in research and clinical settings. However, more studies are needed to test the instrument in a clinical sample.

Fear of COVID-19, insomnia, and eating disorder symptoms among Iranian college students

Objective

Eating disorders (EDs), fear of COVID-19, and insomnia have all increased during the COVID-19 pandemic in Western societies. Additionally, fear of COVID-19 and sleep disturbances relate to ED symptoms in Western societies. However, it is unknown whether fear of COVID-19 and insomnia relate to ED symptoms in non-Western countries, such as Iran. Thus, this study examined the relation between fear of COVID-19, insomnia, and ED symptoms among Iranian college students. Specifically, we hypothesized that insomnia and fear of COVID-19 would each uniquely relate to ED symptoms and the interaction between insomnia and fear of COVID-19 would also associate with increased ED symptoms.

Method

College students (N =1,043) filled out measures assessing fear of COVID-19, insomnia, and ED symptoms. We ran moderation analyses using linear regression for global ED symptoms and negative binomial regressions for binge eating and purging.

Results

Fear of COVID-19 and insomnia had unique effects on global ED symptoms and binge eating. Insomnia, but not fear of COVID-19, had a unique effect on purging. No significant interaction effect was found.

Discussion

This study was the first to examine the association between fear of COVID-19 and insomnia on ED symptoms in Iran. Fear of COVID-19 and insomnia should be incorporated into novel assessments and treatments for EDs.

Eating disorder symptoms among children and adolescents in Germany before and after the onset of the COVID-19 pandemic

Background

Disordered eating is highly prevalent among children and adolescents. Since the outbreak of the COVID-19 pandemic, hospitalizations due to eating disorders have peaked and overweight has risen. The aim of this study was to determine differences in the prevalence of eating disorder symptoms among children and adolescents in Germany before and after the onset of the COVID-19 pandemic and to identify associated factors.

Materials and methods

Eating disorder symptoms and associated factors were examined in a sample of n = 1,001 participants of the nationwide population-based COPSY study in autumn 2021. Standardized and validated instruments were used to survey 11-17-year-olds along with a respective parent. To identify differences in prevalence rates, logistic regression was used to compare results with data from n = 997 participants of the prepandemic BELLA study. Multiple logistic regression analyses were performed to examine associations with relevant factors in the pandemic COPSY sample.

Results

Eating disorder symptoms were reported by 17.18% of females and 15.08% of males in the COPSY study. Prevalence rates were lower overall in the COPSY sample compared to before the pandemic. Male gender, anxiety, and depressive symptoms were associated with increased odds for eating disorder symptoms in the pandemic.

Conclusion

The pandemic underscores the importance of further research, but also prevention and intervention programs that address disordered eating in children and adolescents, with a focus on age - and gender-specific differences and developments. In addition, screening instruments for eating disorder symptoms in youths need to be adapted and validated.

Private renters in shared housing: investigating housing conditions and mental well-being in Australia during COVID-19

Lockdowns were the major policy response to COVID-19 containment in many countries, and subsequently many people spent abnormal amounts of time at home. Research has found that housing conditions affected more peoples' mental health during the COVID-19 crisis than prior to it, and vulnerable groups were especially affected. One group that may be particularly vulnerable is private renters in shared housing. Using a socio-economic lens, our research examined to what extent mental well-being outcomes were associated with housing conditions in shared housing under COVID-19 restrictions in Australia. Data about private renters were obtained from the Australian Rental Housing Conditions Dataset (n = 1908), collected in mid-2020 during the easing of the first lockdown restrictions. Respondents living in shared arrangements reported higher levels of worry and anxiety (8.5-13.2%) and loneliness and isolation (3.7-18.3%) compared to other household types. Binary logistic regressions showed that COVID-19-related mental and financial well-being variables were the main contributors in COVID-19-related worry/anxiety and loneliness/isolation models. Accumulated housing problems were the only housing condition measure that was significant in the worry/anxiety model. Participants who had more than two people living in a household felt 1.4 times lonelier/isolated compared to those who lived with four or more people. Males and participants who reported good mental health were less likely to feel COVID-19-related worry/anxiety and loneliness/isolation. Our analysis demonstrates the importance of measures for mental health and income during a pandemic and concludes with recommendations of support for shared housing renters during and beyond crisis events.

The anxiolytic and circadian regulatory effect of agarwood water extract and its effects on the next generation; zebrafish modelling

Anxiety is one of the most common psychiatric symptoms worldwide. Studies show that there is an increase of >25 % in the prevalence of anxiety with the onset of the COVID-19 pandemic process. Due to the various side effects of drugs used in the treatment of anxiety, interest in natural therapeutic alternatives has increased. Agarwood is a plant used as a natural therapeutic due to its sedative effect as well as many effects such as antioxidant and antibacterial. Although there are many studies with agarwood, comprehensive behavioral studies, including the next generation, are limited. In present study, zebrafish fed with diets containing 10-100 ppm water extract of Agarwood (AWE) for 3 and 8 weeks were exposed to predator stress using Oscar fish in order to test the potential anxiolytic effect of AWE. At the end of the period, zebrafish exposed to predator stress were subjected to anxiety and circadian tests. Histopathological evaluation and immunofluorescent analyzes of BDNF and 5HT4-R proteins were performed in the brains of zebrafish. The effects on the next generation were examined by taking offspring from zebrafish. According to the results, it was observed that AWE had a healing effect on anxiety-like behaviors and on the disrupted circadian rhythm triggered by the predatory stress it applied, especially in the 8 weeks 100 ppm group. Interestingly, it was also found to be effective in offspring of zebrafish fed diets with AWE.

Depressive symptoms and psychological pain experienced by Polish adults in the context of both the war in Ukraine and the COVID-19 pandemic

Background

This study sought to investigate the perceived influence of stressful events (i.e., the outbreak of the war in Ukraine, the political situation, and the COVID-19 pandemic) on the depressive symptoms and psychological pain experienced by Polish adults. The study also aimed to explore the association between experiential avoidance and emotional distress.

Method

110 Polish social media users aged 18-89 completed online the Patient Health Questionnaire-9, Psychache Scale and the Multidimensional Experiential Avoidance Questionnaire-30 and questions concerning perceived influence of stressful event on their emotional functioning.

Results

More than half of the participants (52.7%) reported experiencing a subjective increase in their depressive symptoms since the outbreak of the war in Ukraine. Interestingly, a larger percentage of participants associated their emotional distress with the outbreak of the war (44.6%) and the overall political situation (39.2%) than with the COVID-19 pandemic (27.2%). In addition, experiential avoidance was found to be associated with subjective increases in the participants' depressive symptoms and emotional distress.

Limitations

Cross-sectional character of the study, small sample size, and exclusive use of online data are main limitation of the study.

Conclusions

Findings of our study can help planning preventive and therapeutic interventions for at-risk individuals to reduce negative long-term outcomes of the recent stressful life events in Poland.

COVID-19 and common mental health symptoms in the early phase of the pandemic: An umbrella review of the evidence

BACKGROUND

There remains uncertainty about the impact of the Coronavirus Disease 2019 (COVID-19) pandemic on mental health. This umbrella review provides a comprehensive overview of the association between the pandemic and common mental disorders. We qualitatively summarized evidence from reviews with meta-analyses of individual study-data in the general population, healthcare workers, and specific at-risk populations.

METHODS AND FINDINGS

A systematic search was carried out in 5 databases for peer-reviewed systematic reviews with meta-analyses of prevalence of depression, anxiety, and post-traumatic stress disorder (PTSD) symptoms during the pandemic published between December 31, 2019 until August 12, 2022. We identified 123 reviews of which 7 provided standardized mean differences (SMDs) either from longitudinal pre- to during pandemic study-data or from cross-sectional study-data compared to matched pre-pandemic data. Methodological quality rated with the Assessment of Multiple Systematic Reviews checklist scores (AMSTAR 2) instrument was generally low to moderate. Small but significant increases of depression, anxiety, and/or general mental health symptoms were reported in the general population, in people with preexisting physical health conditions, and in children (3 reviews; SMDs ranged from 0.11 to 0.28). Mental health and depression symptoms significantly increased during periods of social restrictions (1 review; SMDs of 0.41 and 0.83, respectively) but anxiety symptoms did not (SMD: 0.26). Increases of depression symptoms were generally larger and longer-lasting during the pandemic (3 reviews; SMDs depression ranged from 0.16 to 0.23) than those of anxiety (2 reviews: SMDs 0.12 and 0.18). Females showed a significantly larger increase in anxiety symptoms than males (1 review: SMD 0.15). In healthcare workers, people with preexisting mental disorders, any patient group, children and adolescents, and in students, no significant differences from pre- to during pandemic were found (2 reviews; SMD's ranging from -0.16 to 0.48). In 116 reviews pooled cross-sectional prevalence rates of depression, anxiety, and PTSD symptoms ranged from 9% to 48% across populations. Although heterogeneity between studies was high and largely unexplained, assessment tools and cut-offs used, age, sex or gender, and COVID-19 exposure factors were found to be moderators in some reviews. The major limitations are the inability to quantify and explain the high heterogeneity across reviews included and the shortage of within-person data from multiple longitudinal studies.

CONCLUSIONS

A small but consistent deterioration of mental health and particularly depression during early pandemic and during social restrictions has been found in the general population and in people with chronic somatic disorders. Also, associations between mental health and the pandemic were stronger in females and younger age groups than in others. Explanatory individual-level, COVID-19 exposure, and time-course factors were scarce and showed inconsistencies across reviews. For policy and research, repeated assessments of mental health in population panels including vulnerable individuals are recommended to respond to current and future health crises.

Social support, distress and well-being in individuals experiencing Long-COVID: a cross-sectional survey study

OBJECTIVES

Increasingly attention of the COVID-19 pandemic is directed towards its long-term effects, also known as Long-COVID. So far, Long-COVID was examined mainly from a medical perspective, leaving psychosocial effects of Long-COVID understudied. The present study advances the current literature by examining social support in the context of Long-COVID. The study not only examines received support reported by individuals with Long-COVID, but also provided support reported by relatives of individuals with Long-COVID.

DESIGN

Cross-sectional study.

SETTING

The study was conducted from June to October 2021 in Austria, Germany and the German-speaking part of Switzerland.

PARTICIPANTS

We examined 256 individuals with Long-COVID (M_Age=45.05 years, 90.2% women) and 50 relatives of individuals with Long-COVID (M_Age=48.34 years, 66.1% female) in two separate online surveys, assessing social support, well-being and distress.

PRIMARY OUTCOME MEASURES

Primary outcomes were positive and negative affect, anxiety and depressive symptoms and perceived stress.

RESULTS

For individuals with Long-COVID, receiving emotional support was related to higher well-being (positive affect: b=0.29, p<0.01; negative affect: b=-0.31, p<0.05) and less distress (anxiety: b=-1.45, p<0.01; depressive symptoms: b=-1.04, p<0.05; perceived stress: b=-0.21, p<0.05) but no effects emerged for receiving practical support. For relatives of individuals with Long-COVID, providing emotional support was only related to lower depressive symptoms (b=-2.57, p<0.05). Again, provided practical support was unrelated to the outcomes considered.

CONCLUSIONS

Emotional support is likely to play an important role in well-being and distress of patients and relatives, whereas practical support does not seem to make a difference. Future research should clarify under what conditions different kinds of support unfold their positive effects on well-being and distress in the context of Long-COVID.

Exploring the impact of the COVID-19 pandemic on perceptual disturbances and dysfunctional eating attitudes and behaviors: A review of the literature

From the outbreak of the novel coronavirus 2019 (COVID-19) a new physical and social distancing environment has changed our lives and, more particularly, the way of perceiving oneself, as well as eating attitudes and behaviors. An increasing number of studies have highlighted a risky scenario in terms of negative perceptions of one’s body as well as disordered eating and eating disorder patterns in both clinical and general population. With regard to this postulate, this literature review posits two main concepts—perceptual disturbances and dysfunctional eating attitudes and behaviors—in the general and (sub-)clinical populations, to provide an understanding of these phenomena during the COVID-19 pandemic. The main objective of this article is to provide a comprehensive and critical review of published scientific literature about perceptual disturbances (i.e., negative body image, body image disturbances, low body esteem) and dysfunctional eating attitudes and behaviors, including disordered eating (e.g., restrictive eating, binge-eating episodes, overeating, emotional eating) and eating disorders features in community (i.e., general population) and clinical and sub-clinical samples worldwide during the COVID-19 pandemic. The PubMed, ScienceDirect, Ebsco, and Google Scholar databases were searched. The initial search produced 42 references. Scientific publications from March 2020 to April 2022 were included, and among the works compiled, only published research articles have been retained. Purely theoretical papers were also excluded. The final selection consisted of 21 studies, covering both community, clinical (i.e., eating disorder population), and sub-clinical samples. The details of the results are discussed taking into consideration the potential impact of changes in the way we perceive ourselves and interact with others (e.g., the popularity of videoconferencing and the over-use of social network sites due to social isolation) as well as changes in eating attitudes and behaviors, physical activity and exercise (e.g., as an emotional response to the insecurity generated by the pandemic context), in community and (sub-)clinical samples. The discussion sheds light on two outcomes: (1) a summary of findings with methodological considerations; (2) an intervention continuum to deal with the consequences of the COVID-19 pandemic; (3) and a final conclusion.

A longitudinal study on college students' depressive symptoms during the COVID-19 pandemic: The trajectories, antecedents, and outcomes

The ongoing COVID-19 pandemic is not only an immediate hazard but also a long-term risk to the development of depressive symptoms. However, it remains unclear how people's depressive symptoms change with the process of COVID-19. Further, there is also a paucity of research on the underlying antecedents and outcomes of depressive symptoms during this global health crisis. In this study, a longitudinal study was conducted in China and the data of 559 participants were collected from the outbreak period to the normalization period of the pandemic through self-report questionnaires. Depressive symptoms were longitudinally analyzed using Patient Health Questionnaire-9. Core variables involving society, family, individual cognition, and behaviors were studied as determinants or consequences. Latent growth curve model analyses indicated that college students had mild depressive symptoms at the initial stage of COVID-19 with a subsequent decreasing linear slope. Depressive symptoms were significantly predicted by college students' risk perception of COVID-19, social support, family functioning, and smartphone addiction tendency. Further, their depressive symptoms predicted the changes in smartphone addiction tendency and levels of hope. In conclusion, current findings can provide implications for future prevention and intervention of mental disorders to assist college students through such challenging times.

Enhanced Recovery After Surgery Is Still Powerful for Colorectal Cancer Patients in COVID-19 Era

Purpose: To figure out whether enhanced recovery after surgery (ERAS) could effectively improve the prognosis of colorectal cancer (CRC) patients and reduce hospitalization expenses under the shadow of COVID-19, furthermore to alleviate the current situation of medical resource for the whole society. Methods: Patients who underwent CRC surgery in the department of gastrointestinal surgery of the First Affiliated Hospital from January 2020 to March 2022 were retrospectively enrolled. According to protocol adherence, all patients were divided into the ERAS group and the non-ERAS group. Short-term outcomes were compared between the two groups. Results: A total of 918 patients were enrolled in the study. Based on protocol adherence ≥70%, 265 patients were classified into the ERAS group and the other 653 patients were classified into the non-ERAS group. Patients in the ERAS group had shorter operation time (P < .01), less intraoperative blood loss (P < .01), shorter overall hospital stay (P < .01) and postoperative hospital stay (P < .01), less hospital costs (P < .01), earlier first flatus (P < .01), earlier first stool (P < .01), earlier food tolerance (P < .01), and lower postoperative complications (P < .01). Univariate and multivariate logistic regression analysis manifested that ERAS and cerebrovascular disease were predictive factors of postoperative overall complications. In univariate analyses, cerebrovascular disease (P = .033, OR = 2.225, 95% CI = 1.066-4.748), time of the surgery (P = .026, OR = 1.417, 95% CI = 1.043-1.925), and ERAS (P < .01, OR = 0.450, 95% CI = 0.307-0.661) were predictive factors. Furthermore, in the multivariate analysis, ERAS (P < .01, OR = 0.440, 95% CI = 0.295-0.656) and cerebrovascular disease (P = .016, OR = 2.575, 95% CI = 1.190-5.575) were independent predictive factors of postoperative overall complications. Conclusion: In summary, under the impact of the COVID-19 pandemic, ERAS could still reduce the financial burden of patients and reduce the incidence of short-term postoperative complications. However, whether the effects of ERAS were enhanced after the pandemic and the long-term outcomes of CRC obey ERAS remained to be further explored.

The Role of Family Resilience and Pandemic Burnout on Mental Health: A Two-Wave Study in China

Family resilience refers to the processes through which a family adapts to and bounces back from adversities. Pandemic burnout refers to feeling emotionally exhausted, cynical, and lack of accomplishment during the pandemic and/or toward various preventive polices and measures. This two-wave, region-wide, longitudinal study included 796 adult participants residing in mainland China. Participants completed online surveys at two time points during the COVID-19 pandemic. Time 1 (T1) survey was conducted when the number of new infected cases in China stabilized, while Time 2 (T2) was conducted 5 months later when there was a sudden surge of new infected cases. Results of a hierarchical regression analysis revealed that the interaction and main effects of pandemic burnout and family resilience at T2 showed significant incremental prediction of depression and anxiety at T2, after controlling for demographic as well as individual and family resilience at T1. These results supported the hypotheses that current family resilience functions as a protective factor, whereas pandemic burnout functions as a risk factor of mental health during successive waves of pandemic outbreaks. In particular, family resilience at T2 mitigated the negative impact of high pandemic burnout on anxiety and depression at T2.

Learner Experience of an Online Co-Learning Model to Support Mental Health during the COVID-19 Pandemic: A Qualitative Study

The COVID-19 pandemic has had a negative impact on the mental health of the population such as increased levels of anxiety, psychological distress, isolation, etc. Access to mental health services has been limited due to the "overflow" of demands. The Recovery College (RC) model, an education-based approach, has addressed this challenge and provided online well-being and mental health courses to at-risk populations. The RC model proposes a co-learning space in an adult education program where learners from diverse backgrounds collectively learn and empower themselves to better address psychological well-being and mental health issues. The aim of this study was to document the experience of learners who participated in online RC courses during the COVID-19 pandemic and the perceived impact of these courses on their mental health. A qualitative interpretative descriptive study design was employed, and Miles and Huberman's stepwise content analysis method was used to mine the data for themes. Fourteen structured online interviews were conducted with a sample representative of the diversity of learners. Five categories of themes emerged: (1) updating and validating your mental health knowledge, (2) taking care of yourself and your mental health, (3) improving and modifying your behaviors and practices, (4) changing how you look at yourself and others, and (5) interacting and connecting with others. Results suggest that online RC courses can be an effective strategy for supporting individual self-regulation and empowerment, breaking social isolation, and reducing the effects of stress in times of social confinement measures and limited access to care.

The longitudinal association between internet addiction and depressive and anxiety symptoms among Chinese adolescents before and during the COVID-19 pandemic

Background

The COVID-19 pandemic and related prevention policies, such as home quarantine or online courses, could increase the risks of experiencing internet addiction and mental health problems among Chinese adolescents. There is a lack of longitudinal evidence to show the association between internet addiction symptoms and psychological consequences (e.g., depressive and anxiety symptoms).

Objective

This study aimed to explore the association between internet addiction and depressive and anxiety symptoms before and during the coronavirus disease 2019 (COVID-19) pandemic.

Methods

An effective sample of 7,958 Chinese adolescents was recruited for this two-wave longitudinal survey conducted over a six-month interval. All participants completed two-wave surveys before and during the COVID-19 pandemic. A longitudinal cross-lagged path model was used to analyze the associations between internet addiction and depressive and anxiety symptoms after controlling for four covariates (i.e., age, sex, minority, and COVID-19 influence).

Results

Higher depressive and anxiety symptoms before COVID-19 significantly predicted severe internet addiction during COVID-19. Results showed a significant bidirectional relationship between internet addiction and depressive symptoms. Furthermore, the prevalence of internet addiction displayed an increasing trend over the two waves. Conversely, a reduced prevalence of anxiety and depressive symptoms was observed over the two waves.

Conclusion

This current study provided valuable evidence that psychological problems and internet addiction significantly influenced each other before and during the COVID-19 outbreak. Consequently, the presence of psychological problems before and during the COVID-19 outbreak could indicate internet addiction. Thus, depression- and anxiety-related psychotherapies should be developed to prevent internet addiction among Chinese adolescents.

I'm judging you! Influence of depression on moral judgments of COVID-19 infection control behaviors and policies

Health officials recommended a number of COVID-19 infection control measures, such as social distancing and face covering. This study explores whether depression influences individuals' moral judgments regarding COVID-19 infection control behaviors and policies. In this study, participants (N = 340) were US residents, recruited via Amazon Mechanical Turk in March of 2020. Participants completed several questionnaires, such as demographics, including political affiliation, a depression screener, and a series of questions designed to capture individuals' moral judgments of infection control behaviors and policies. ANCOVA analyses indicated that, controlling for demographics, political affiliation, and the degree of news following, depression symptom level was consistently inversely related to the likelihood of judging infection control in moral terms. Depression symptom level was also inversely related to sensitivity to manipulation of moral judgments for personal behaviors, but not for policies. Individuals with higher levels of depression symptoms may be less willing to advocate for higher personal safety measures, which could lead to a higher likelihood of disease transmission. Outside of the pandemic, the lower propensity for moral judgment could translate into greater acceptance of morally questionable acts and behaviors from others.

Targeting the Arginine Vasopressin V1b Receptor System and Stress Response in Depression and Other Neuropsychiatric Disorders

A healthy stress response is critical for good mental and overall health and promotes neuronal growth and adaptation, but the intricately balanced biological mechanisms that facilitate a stress response can also result in predisposition to disease when that equilibrium is disrupted. The hypothalamic-pituitary-adrenal (HPA) axis neuroendocrine system plays a critical role in the body's response and adaptation to stress, and vasopressinergic regulation of the HPA axis is critical to maintaining system responsiveness during chronic stress. However, exposure to repeated or excessive physical or emotional stress or trauma can shift the body's stress response equilibrium to a "new normal" underpinned by enduring changes in HPA axis function. Exposure to early life stress due to adverse childhood experiences can also lead to lasting neurobiological changes, including in HPA axis function. HPA axis impairment in patients with depression is considered among the most reliable findings in biological psychiatry, and chronic stress has been shown to play a major role in the pathogenesis and onset of depression and other neuropsychiatric disorders. Modulating HPA axis activity, for example via targeted antagonism of the vasopressin V_1b receptor, is a promising approach for patients with depression and other neuropsychiatric disorders associated with HPA axis impairment. Despite favorable preclinical indications in animal models, demonstration of clinical efficacy for the treatment of depressive disorders by targeting HPA axis dysfunction has been challenging, possibly due to the heterogeneity and syndromal nature of depressive disorders. Measures of HPA axis function, such as elevated cortisol levels, may be useful biomarkers for identifying patients who may benefit from treatments that modulate HPA axis activity. Utilizing clinical biomarkers to identify subsets of patients with impaired HPA axis function who may benefit is a promising next step in fine-tuning HPA axis activity via targeted antagonism of the V_1b receptor.

Pandemieassoziierte Konsequenzen und Unterstützungsbedarf

Hintergrund

Die COVID-19-Pandemie geht potenziell mit zahlreichen Veränderungen im Leben der Allgemeinbevölkerung einher. Dennoch gibt es bisher kaum Befunde dazu, welche Auswirkungen als besonders gravierend und negativ erlebt wurden, wie sich diese Auswirkungen und ihre Bewertungen im Verlauf der Pandemie änderten, und welche Unterstützungswünsche in diesem Kontext entstanden.

Methode

Längsschnittliche Daten einer Onlinestudie mit 10 Messzeitpunkten über die ersten 2 Jahre der Pandemie (März 2020 bis April 2022) wurden in einer Mixed-methods-Analyse betrachtet. Die Stichprobe aus 8337 Erwachsenen der Allgemeinbevölkerung in Deutschland beantwortete qualitative Freitextfragen zu den gravierendsten Konsequenzen der Pandemie auf ihr Leben sowie Unterstützungswünschen. Quantitativ wurden zudem die Bewertung der Konsequenzen im Pandemieverlauf und ihre Assoziationen mit psychischer Belastung betrachtet.

Ergebnisse

Die erlebten Konsequenzen und insbesondere ihre Bewertung veränderten sich im Pandemieverlauf. Sozial-gesellschaftliche und das allgemeine Leben betreffende Konsequenzen wurden im Schnitt besonders gravierend und negativ erlebt. Negativer erlebte Konsequenzen waren quer- und teilweise auch längsschnittlich mit stärkeren Angst- und depressiven Symptomen assoziiert. Psychotherapeutische sowie evaluativ-kommunikative Unterstützung wurde im Pandemiekontext besonders häufig erbeten.

Schlussfolgerungen

Subjektiv negativ erlebte Konsequenzen sollten möglichst durch adäquate Maßnahmen abgemildert werden. Die dynamischen Veränderungen der Konsequenzen und damit auch des Unterstützungsbedarfs im Pandemieverlauf sollten berücksichtigt werden. Die Unterstützungsmöglichkeiten reichen von sehr niedrigschwelligen Angeboten (z. B. Tipps online) bis hin zu einer Psychotherapie.

A repeated cross-sectional and longitudinal study of mental health and wellbeing during COVID-19 lockdowns in Victoria, Australia

BACKGROUND

Population surveys across the world have examined the impact of the COVID-19 pandemic on mental health. However, few have simultaneously examined independent cross-sectional data with longitudinal data, each of which have different strengths and weaknesses and facilitate the investigation of distinct research questions. This study aimed to investigate psychological distress and life satisfaction during the first and second lockdowns in the state of Victoria, Australia, and the social factors that may be affected by lockdowns and could affect mental health.

METHODS

The VicHealth Victorian Coronavirus Wellbeing Impact Study included two 20-min opt-in online panel surveys conducted in May and September 2020 in Victoria, each with a sample of 2000 adults aged 18 + . A two-part study design was used: a repeated cross-sectional study of respondents who participated in Survey One and Survey Two, followed by a longitudinal nested cohort study. The primary exposures were social solidarity, social connectedness and staying connected with family and friends. Using logistic regression modelling, we explored the associations between our exposures and primary outcomes of psychological distress and life satisfaction with and without adjustment for covariates, both cross-sectionally and longitudinally. The results from the multivariable models were summarised using adjusted Odds Ratios (aOR), 95% Confidence Intervals (CI).

RESULTS

Cross-sectional results indicated that the percentage of participants with low life satisfaction was significantly higher in the second survey sample (53%) compared to the first (47%). The percentage of participants with high psychological distress was higher but not significantly different between the two survey samples (14% first survey vs 16% second survey). Longitudinal study results indicated that lower social connectedness was significantly associated with higher psychological distress (aOR:3.3; 95% CI: 1.3-8.4) and lower life satisfaction (aOR:0.2; 95% CI: 0.1-0.4). Younger adults had higher psychological distress compared to older adults (aOR:6.8; 95% CI:1.5-31.1). Unemployment at the time of the first survey was significantly associated with lower life satisfaction at the second survey (aOR:0.5; 95% CI: 0.3-0.9).

CONCLUSION

This study supports the findings of other international studies. It also highlights the need to promote increased social connection and maintain it at times of isolation and separation, particularly amongst younger adults.

The Needs of School Professionals for Eating Disorder Prevention in Australian Schools: A Mixed-Methods Survey

(1) Background: School professionals such as teachers and counsellors are uniquely positioned to facilitate discussion around disordered eating and body image; however, little is known about the needs of school professionals with respect to eating disorder prevention. This study aimed to explore the needs and perceptions of Australian school professionals regarding eating disorder prevention. (2) Methods: School professionals were recruited to a mixed-methods online cross-sectional survey. The survey assessed demographics and perceived needs and attitudes to eating disorder prevention. (3) Results: Most participants (92%) were willing to participate in eating disorder prevention; however, only 61% reported good knowledge and 41% reported feeling confident in implementing eating disorder prevention. Those who had received training in eating disorders (24%) reported higher confidence (p = 0.02) and knowledge (p = 0.04). Only 66% of respondents reported that all teachers should be involved in eating disorder prevention while barriers including workload, knowledge, and resources were commonly highlighted. Fewer respondents working in primary school settings reported the need for prevention approaches (p = 0.046). (4) Conclusions: Despite a willingness to be involved in the prevention of eating disorders, there are inconsistencies in attitudes regarding the role of school professionals in eating disorder prevention. The findings of this study reinforce that understanding professional roles, school settings, and personal attitudes is critical in the development of more efficacious school professional training and prevention interventions.

1.5 years pandemic - Psychological burden over the course of the COVID-19 pandemic in Germany: A nine-wave longitudinal community study

BACKGROUND

The dynamic COVID-19 pandemic has been associated with mental strain. However, most studies focused primarily on the beginning of the pandemic and rarely took into account the long-term course. The aim of this prospective-longitudinal study was to investigate levels and changes of pandemic-related fears, unspecific anxiety, depressive symptoms, and psychosocial-behavioral factors over the first 1.5 years of the pandemic.

METHODS

We conducted a nine-wave longitudinal online-survey from March 2020 to October 2021 with a total of 8148 participants of the adult general population in Germany. Descriptive examination and multilevel analysis were carried out to assess psychological burden, risk-bearing and protective psychosocial-behavioral factors, and associations with sociodemographics and the pandemic's duration and severity over the course of the pandemic.

RESULTS

Symptoms of mental strain fluctuated across the pandemic and displayed a relative maximum at the pandemic's early beginning and during the second and third COVID-19 waves. Most participants (approximately 67.4 %-82.1 %) reported mild and transient symptoms, but a substantial portion (approximately 17.9 %-32.6 %) experienced pronounced mental health problems during the pandemic. Symptom severity was negatively associated with the duration of the pandemic and positively associated with the rate of new infections.

LIMITATIONS

The observational study design, non-probability-sampling methods, and online self-report assessments limit the generalizability of our results.

CONCLUSIONS

The fluctuating course of psychological burden during the pandemic emphasizes the relevance of continuous monitoring during this challenging time. Particularly individuals with pronounced subclinical symptoms or manifesting mental disorders should be targeted with adequate prevention and early intervention programs.

Body perceptions, occupations, eating attitudes, and behaviors emerged during the pandemic: An exploratory cluster analysis of eaters profiles

Introduction

COVID-19 pandemic negatively impacted people's mental and physical health. Three areas have been significantly impacted, among others: eating-related behaviors, occupational balance, and exposure to self-image due to videoconferencing. This study aims to explore and document eaters profiles that were reported during the pandemic in the general Canadian population using a holistic perspective, including body perceptions, attitudes, and eating behaviors (i.e., body image, behaviors, attitudes, and motivations regarding food), and occupations (i.e., physical activity and cooking).

Methods

This cross-sectional study was conducted from May to September 2020. Two hundred and seventy-three Canada's residents, French speaking of 18 years of age and older, participated in an online survey on behaviors, attitudes, and motivations regarding food and eating as well as body image and occupations during the COVID-19 pandemic. A hierarchical cluster analysis was used to determine the eaters profiles. One-way ANOVA and Chi-square test were conducted to differentiate occupational characteristics between eaters profiles.

Results

Three distinctive profiles were found during the COVID-19 pandemic and could be placed on a continuum: the Congruent-driven eater is at the functional pole of the continuum, whereas the Incongruent-driven eater is at the dysfunctional pole of the eaters continuum. In the middle of the continuum, the Incongruent-perceptual eater is at a critical crossing point. Significant differences were reported between eaters profiles.

Discussion

The empirical results based on an eaters continuum conceptualization highlight the importance of understanding how people perceive their body to assess and promote food well-being.

Mental health symptoms 1 year after the COVID-19 outbreak in Spain: The role of pre-existing mental disorders and their type

BACKGROUND

The type of pre-existing disorder might determine changes in mental health symptoms (i.e., anxiety, depression) during the COVID-19 pandemic and influence the effect of psychological factors (e.g., social support, resilience, stress) on such symptoms.

METHODS

Longitudinal data from two assessments (June-2020 and February/March-2021) collected through telephone interviews (Spanish general population) were analysed. Outcome variables included anxiety (GAD-7) and depressive symptoms (PHQ-8). Psychological factors included COVID-perceived stress (adapted COVID-perceived risk scale), social support (OSSS-3), and resilience (CD-RISC). Pre-existing mental conditions (3 groups: mood, anxiety, and comorbid depression+anxiety) were assessed using the CIDI checklist. Changes in anxiety and depressive symptoms between baseline and follow-up were assessed with the paired samples Wilcoxon test. Tobit regression and interaction models were conducted to test associations between psychological factors and these symptoms in follow-up.

RESULTS

Final sample included 1942 participants (mean age 49.6 yrs., ±16.7; 51.7 % females). Anxiety symptoms increased in all groups except for those with pre-existing mood conditions. Depressive symptoms only increased in those without pre-existing mental disorders and in those with pre-existing anxiety. Higher baseline resilience, increases in social support, and decreases in COVID-perceived stress were associated with lower anxiety and depressive symptoms. The type of pre-existing mental disorder did not modify these associations.

LIMITATIONS

Lack of pre-pandemic data and the limited number of pre-existing mental conditions.

CONCLUSIONS

Having pre-pandemic mental disorders is associated with different patterns of anxiety and depressive symptoms during the pandemic. COVID-related stress, social support, and resilience are key factors in improving mental health regardless of the mental diagnosis.

Resilience and Wellbeing Strategies for Pandemic Fatigue in Times of Covid-19

The COVID-19 pandemic is truly one of the greatest collective health crises in history which have altered our life and living. For years, people have felt fatigued from following public health directives such as social distancing, wearing masks, washing hands frequently, and working or studying remotely without in-person interactions. In this paper, we explore strategies for resilience and wellbeing which can mitigate pandemic-caused stress and behavioural fatigue. We start with individual level strategies including reworking stress appraisals, the importance of psychological flexibility, reducing loneliness through adaptive online platform use, optimizing familial relationships when living in close quarters for a prolonged period, reducing symptoms of burnout and using adaptive distractions, using specific evidence-based resilience strategies. We discuss specific considerations which tap on our shared identities and shared responsibilities which can enhance a sense of community, especially for individuals from marginalized backgrounds and how suicide risks can be minimized.

Factorial Validity, Reliability, Measurement Invariance and the Graded Response Model for the COVID-19 Anxiety Scale in a Sample of Ecuadorians

The aims of the research are to evaluate the factorial validity, internal consistency, measurement invariance, discrimination, and difficulty of the Covid-19 Anxiety Scale (CAS) applied to a sample of Ecuadorian adults (N = 451). The study is based on an instrumental design with Classical Test Theory (CTT) and Item Response Theory (IRT) technics. The results confirmed the validity of the CAS single-factor structure, with measurement invariance across gender and high internal consistency. Additionally, all CAS items displayed adequate discrimination indexes and proper ordering of the difficulty thresholds. In a conclusion, the CAS is a valid measurement scale for Ecuadorian adults.

Coping strategies and mental health: A web-based survey among the Italian population dealing with COVID-19

Coronavirus disease (COVID-19) continues to be a highly stressful event with a major impact on psychological mental health worldwide. The use of different coping strategies may change the perception of psychological well-being during the pandemic. The present study aims to explore psychological mental health in relation to sociodemographic variables and to analyze the coping strategies of the Italian population in dealing with COVID-19. Implications for clinical interventions are reported. A total of 537 individuals (>18) participated in the survey completing measures of sociodemographic data, general psychological well-being, and coping strategies. Results found that females, students, and unmarried people reported the lowest levels of well-being. Specifically, the coping strategy called positive attitude was positively correlated with psychological well-being, whereas avoidance and social support strategies negatively influenced well-being. Understanding beneficial coping strategies is central to optimally manage the long-lasting of the current COVID-19 situation and may be useful for mental health professionals in treating patients suffering psychologically from the pandemic.