The impact of COVID-19 stressors on psychological distress and suicidality in a nationwide community survey in Taiwan

A comprehensive examination of temporal-seasonal variations of PM1.0 and PM2.5 in taiwan before and during the COVID-19 lockdown

COVID-19 has been a significant global concern due to its contagious nature. In May 2021, Taiwan experienced a severe outbreak, leading the government to enforce strict Pandemic Alert Level 3 restrictions in order to curtail its spread. Although previous studies in Taiwan have examined the effects of these measures on air quality, further research is required to compare different time periods and assess the health implications of reducing particulate matter during the Level 3 lockdown. Herein, we analyzed the mass concentrations, chemical compositions, seasonal variations, sources, and potential health risks of PM1.0 and PM2.5 in Central Taiwan before and during the Level 3 lockdown. As a result, coal-fired boilers (47%) and traffic emissions (53%) were identified as the predominant sources of polycyclic aromatic hydrocarbons (PAHs) in PM1.0, while in PM2.5, the dominant sources of PAHs were coal-fired boilers (28%), traffic emissions (50%), and iron and steel sinter plants (22.1%). Before the pandemic, a greater value of 20.9 ± 6.92 μg/m3 was observed for PM2.5, which decreased to 15.3 ± 2.51 μg/m3 during the pandemic due to a reduction in industrial and anthropogenic emissions. Additionally, prior to the pandemic, PM1.0 had a contribution rate of 79% to PM2.5, which changed to 89% during the pandemic. Similarly, BaPeq values in PM2.5 exhibited a comparable trend, with PM1.0 contributing 86% and 65% respectively. In both periods, the OC/EC ratios for PM1.0 and PM2.5 were above 2, due to secondary organic compounds. The incremental lifetime cancer risk (ILCR) of PAHs in PM2.5 decreased by 4.03 × 10-5 during the pandemic, with PM1.0 contributing 73% due to reduced anthropogenic activities.

Understanding the mental health impacts of biological disasters: Lessons from Taiwan's experience with COVID-19

Biological disasters pose a growing challenge in the 21st century, significantly impacting global society. Taiwan has experienced such disasters, resulting in long-term consequences like loss of life, trauma, economic decline, and societal disruptions. Post-disaster, mental health issues such as fear, anxiety, depression, post-traumatic stress disorder (PTSD), and stress surge, accompanied by increased suicide rates. The Coronavirus disease 2019 (COVID-19) (also called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)) pandemic, recognized as a biological disaster, triggered lockdowns and quarantines in Taiwan, causing lifestyle changes, economic recession, and so on. These shifts may elevate uncertainty about the future, intensifying mental stress and leading to a rise in various mental illnesses. This article reviews mental health studies conducted in Taiwan during the pandemic, emphasizing the need to integrate this research for future preparedness and interventions regarding the mental health impacts of biological disasters, including COVID-19. Further research is essential to explore long-term effects, interventions, and generalizability.

Gender difference in emotional distress among nursing and health science college students: An online survey

This cross-sectional study investigates the self-reported emotional distress of medical, nursing, dental, pharmacy, and public health students and identifies gender-related differences through an online survey. The data of 364 students were analyzed using Pearson correlation coefficients and multiple logistic regression. Emotional distress was more prevalent among female respondents (11.7 %) than male (3.8 %) respondents. The stigma, isolation, and depression experienced by female respondents influenced their emotional distress, whereas only the depression of male respondents influenced their emotional distress. Our findings suggest that mental health professionals should consider gender-specific factors when developing interventions for the study population to minimize emotional distress.

COVID-19-related stress response among adult females: Relevance of sociodemographics, health-related behaviors and COVID-19 contact

Women were more affected than men during the COVID-19 pandemic. This study aimed to investigate COVID-19-related stress response in adult women and its association with the relevant socioeconomic, lifestyle and COVID-19-related factors. This research was carried out in eight randomly chosen cities from September 2020 to October 2021. To examine stress, we distributed the COVID Stress Scales (CSS) and the Perceived Stress Scale (PSS). Women also fulfilled a general socio-epidemiologic questionnaire. The study included 1,264 women. Most women were healthy, highly educated, employed, married, nonsmokers who consumed alcohol. The average total CSS score suggested a relatively low COVID-19 related stress), while 1.7% of women had CSS ≥ 100. The mean PSS was around the mid-point value of the scale. Older women, who were not in a relationship, didn't smoke, didn't drink alcohol, but used immune boosters, had chronic illnesses and reported losing money during the pandemic had higher CSS scores. A higher level of stress was also experienced by women exposed to the intense reporting about COVID-19, had contact with COVID-19 positive people or took care of COVID-19 positive family members. In this sample of predominantly highly educated women few women experienced very high stress level, probably due to the study timing (after the initial wave) when the pandemic saw attenuated stress levels. To relieve women from stress, structural organization and planning in terms of health care delivery, offsetting economic losses, controlled information dissemination and psychological support for women are needed.

Psychosocial and financial well-being mediated the effects of COVID-19 distress on suicidality: a serial mediation model among Hong Kong young adults

PURPOSE

The COVID-19 pandemic has brought significant distress on not only the physical health but also mental health of individuals. The present study investigated the direct and indirect effects from COVID-19 distress to suicidality via psychosocial and financial well-being among young people.

METHODS

This cross-sectional survey recruited 1472 Hong Kong young people via random sampling in 2021. The respondents completed a phone survey on COVID-19 distress, the four-item Patient Health Questionnaire and items on social well-being, financial well-being, and suicidality. Structural equation modeling (SEM) was conducted to examine the direct and indirect effects of COVID-19 distress on suicidality via psychosocial and financial well-being.

RESULTS

The direct effect of COVID-19 distress on suicidality was not significant (β = 0.022, 95% CI  - 0.097-0.156). The total indirect effect from COVID-19 distress to suicidality was significant and positive (αβγ = 0.150, 95% CI = 0.085-0.245) and accounted for 87% of the total effect (B = 0.172, 95% CI = 0.043-0.341). There were significant specific indirect effects via social well-being and psychological distress, and financial well-being and psychological distress.

CONCLUSION

The present findings support different pathways from COVID-19 distress to suicidality via functioning in different domains among young people in Hong Kong. Measures are needed to ameliorate the impact on their social and financial well-being to reduce their psychological distress and suicidality.

The Impact of the COVID-19 Pandemic on Calls to a National Suicide Prevention Hotline in Taiwan: An Analysis of Time Trend and Characteristics of Calls

We investigated the impact of the COVID-19 pandemic on call volumes and call characteristics using data from a national crisis helpline. Data were extracted for 215,066 calls to Taiwan's national suicide prevention hotline (January 2018-May 2020). We used negative binomial regression to investigate changes in the weekly number of calls during the early period of the COVID-19 outbreak (January 21, 2020-May 25, 2020), relative to that expected according to the pre-pandemic trend. The call characteristics during the pandemic period (February 18, 2020-May 31, 2020) were compared between COVID-19 related vs unrelated calls. Higher-than-expected call volumes started from the 6th week of the pandemic and reached a peak in the 14th week, which was 38% (rate ratio = 1.38, 95% confidence interval 1.26-1.51) higher than that expected based on the pre-pandemic trend. The higher-than-expected call volumes were mainly attributable to higher-than-expected calls from non-suicidal and male callers. Calls in which COVID-19 was mentioned (13.2%) were more likely to be from male and first-time callers, occur outside 12 am-6 am, last less than 5 min, and were less likely to be from callers who had previous suicide attempts, recent suicidal ideation or suicide plans or actions than COVID-19 unrelated calls. Callers who made COVID-19 related calls were more likely to request information than other callers. Crisis helplines should strategically adapt to the increased need and callers' specific concerns related to the outbreak.

Relationship between self-esteem and suicidal ideation before and during COVID-19 in a non-clinical sample: mediating effects of psychological distress and hopelessness

Introduction

Several studies have highlighted the impact of the novel coronavirus disease (COVID-19) pandemic on suicide. Accordingly, investigating the risk factors of suicide during this crisis is important. Based on the escape theory of suicide, the current study examined the serial mediating roles of psychological distress and hopelessness in the relationship between self-esteem and suicidal ideation. It also aimed to explore whether or not the COVID-19 pandemic changed the mediation effect in any way.

Methods

Data were collected from 645 university students before and during the pandemic. The study employed mediation and multi-group analyses to test the hypotheses.

Results

The results demonstrated that individuals with low self-esteem reported high psychological distress, which further lead to hopelessness and eventually heightened suicidal ideation. Multi-group analysis revealed that psychological distress exerted a greater impact on suicidal ideation during COVID-19.

Discussion

The finding suggested that self-esteem, hopelessness, and psychological distress could help elucidate the development of suicidal ideation. Clinicians may target these factors in suicide prevention programs, particularly in the settings of the COVID-19 pandemic or future crisis.

Investigation of changes in ankylosing spondylitis disease activity through 2021 COVID-19 wave in Taiwan by using electronic medical record management system

We aim to investigate the alteration in disease activity of ankylosing spondylitis (AS) individuals before, during, and after the COVID-19 wave in Taiwan by using electronic medical-record management system (EMRMS). We identified 126 AS individuals from the single center, and gathered data of the three disease activities (Bath Ankylosing Spondylitis Disease Activity Index [BASDAI], Ankylosing Spondylitis Disease Activity Score with erythrocyte sedimentation rate [ASDAS-ESR], and Ankylosing Spondylitis Disease Activity Score with C-Reactive Protein [ASDAS-CRP]) by using EMRMS before (7 February to 1 May, 2021), during (2 May to 24 July, 2021), and after the COVID-19 wave (25 July to 16 October, 2021). We compared the disease activity measures of the three phases through a paired t test. Among the 126 individuals, CRP was significantly higher during the COVID-19 wave (0.2 (0.1, 0.5) mg/dl, p = 0.001) than before the wave (0.2 (0.1, 0.4) mg/dl), ESR (8.0 (4.0, 15.0) mm/h, p = 0.003) and ASDAS-ESR (1.4 (1.0, 1.9), p = 0.032) were significantly higher after the wave than during the wave (6.0 (3.0, 12.0) mm/h and 1.2 (0.9, 1.8) mm/h) e. ESR, CRP, ASDAS-ESR and ASDAS-CRP were all significant higher after COVID-19 wave than before. The disease activities of AS individuals in Taiwan worsened after 2021 COVID-19 wave in Taiwan.

Perceived COVID-19-related stress drives home gardening intentions and improves human health in Taiwan

The COVID-19 pandemic has added a layer of mental health problems and perceived stress. Home gardening is considered a good method to reduce perceived stress. The current research evidence is insufficient to understand the relationship and influencing factors between the intentions, behaviors, and benefits of home gardening during short-term COVID-19 events. Although the duration from the onset to stabilization of the outbreak lasted for only 1.5 months from May to June 2021 throughout Taiwan, the significant pandemic changes might have affected the perceived stress along with the intentions, behaviors, and benefits of home gardening. This study explored the relationship between pandemic stress and home gardening through online snowball sampling because of the strict social distancing regulations. A total of 1455 non-follow-up and internet questionnaires throughout Taiwan were collected during the wave onset, peak, easing, and stabilization stages. The questionnaire included questions on personal information, perceived pandemic stress, gardening intentions, gardening behaviors, and gardening benefits. This study showed that perceived stress increased from the pandemic onset to its peak, and decreased from the peak to stabilization stages. Home gardening intentions and behaviors also revealed similar trends. Higher pandemic-perceived stress directly increased home-gardening intentions and indirectly promoted home-gardening behaviors and benefits. Our findings indicated that home gardening is a positive element in reducing perceived stress. Lower gardening intentions and behaviors were observed when the high perceived stress was removed. This study suggests that home gardening was a valuable strategy for staying close to nature and obtaining multiple benefits during the peak pandemic period. Providing small-scale gardening activities and spaces is appropriate for obtaining gardening benefits and avoiding space abandonment after the pandemic. Providing seeds, seedlings, tools, knowledge, online home gardening programs, and small residential and food gardens is a valuable strategy for obtaining multiple benefits during the peak of the pandemic.

Has the COVID-19 pandemic affected the psychological state of arab cancer patients?

The Covid-19 pandemic has increased the vulnerability of cancer patients to psychological symptoms, in addition to treatment modality issues. The present study has aimed to determine the psychological state of Arab cancer patients during the COVID-19 pandemic and to explore the contributing factors. A cross-sectional, descriptive, correlational design with the Hospital Anxiety and Depression Scale (HADS), Insomnia Severity Index (ISI), Functional Assessment of Cancer Therapy-Fatigue subscale (FACT-F), and the Functional Assessment of Cancer Therapy-General (FACT-G) were used to collect the data. Out of 291 participants, 60.5% were female; 22.7% were 51-60 years; 31.6% were diagnosed with breast cancer; 44.3% with stage 2 cancer; 23% had contracted COVID-19; and 43.3% had received their first dose of the vaccine. The main study findings are: 74.9% had anxiety, 64.3% experienced depression, 68% suffered from insomnia, and 69.8% had fatigue. Quality of life (QoL) was low among cancer patients who had marked anxiety, depression, insomnia, or fatigue, and these findings were statistically significant (p < 0.05). Predictive factors showed males were 5.09 times more likely to report depression; gynecological cancer patients were 40.4 times more likely to experience insomnia, and patients who had COVID-19 were 5.13 times more likely to report fatigue. The study findings reveal that the COVID-19 pandemic affected the psychological state of cancer patients and had a significant effect on their quality of life. Hence, there is a need to develop a holistic cancer health care approach, which is often limited in Arab countries, to help patients manage these symptoms effectively and to decrease the prevalence of mental health morbidity.