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Mohlman J, Basch CH, Bartoszek G, Magee S. Is a diverse sample of college students motivated by compassionate, neutral, or fear-inducing language in COVID-19 crisis messages? JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:1941-1946. [PMID: 35834766 DOI: 10.1080/07448481.2022.2098032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 05/02/2022] [Accepted: 06/27/2022] [Indexed: 06/15/2023]
Abstract
Objective: During public health emergencies such as the ongoing COVID-19 illness pandemic, it is essential to rapidly disseminate crisis messages which often contain embedded health directives. This study investigated which of three variants of the same messages (neutral tone, positive/compassionate tone, negative/fear-inducing tone) were most likely to motivate readers to engage in the health behavior proscribed in the message. Participants: Participants were 87 female and 41 male undergraduates at an urban university in the northeast U.S. Methods: A survey with three versions of eight different COVID messages containing health directives was administered. Results: Those who indicated stronger influence of positive/compassionate crisis messages (i.e., had higher Crisis Messages Survey scores) had higher adaptive health engagement scores, lower worry scores, and were likely to have had a past diagnosis of COVID-19. Moreover, a regression model including COVID-19 status and worry scores accounted for a significant proportion of variance in Crisis Messages Survey scores. Conclusions: Findings indicate that the use of neutral and compassionate language is optimal in motivating health behaviors embedded in university crisis messages.
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Affiliation(s)
- Jan Mohlman
- Psychology, William Paterson University, Wayne, NJ, USA
- Public Health, William Paterson University, Wayne, NJ, USA
| | | | | | - Sofia Magee
- Psychology, William Paterson University, Wayne, NJ, USA
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Zainal NH, Newman MG. Examining the Effects of a Brief, Fully Self-Guided Mindfulness Ecological Momentary Intervention on Empathy and Theory-of-Mind for Generalized Anxiety Disorder: Randomized Controlled Trial. JMIR Ment Health 2024; 11:e54412. [PMID: 38787613 PMCID: PMC11161716 DOI: 10.2196/54412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/26/2023] [Accepted: 01/09/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND The utility of brief mindfulness ecological momentary interventions (EMIs) to improve empathy and theory-of-mind has been underinvestigated, particularly in generalized anxiety disorder (GAD). OBJECTIVE In this randomized controlled trial, we aimed to examine the efficacy of a 14-day, fully self-guided, mindfulness EMI on the empathy and theory-of-mind domains for GAD. METHODS Adults (aged ≥18 y) diagnosed with GAD were randomized to a mindfulness EMI (68/110, 61.8%) or self-monitoring app (42/110, 38.2%) arm. They completed the Interpersonal Reactivity Index self-report empathy measure and theory-of-mind test (Bell-Lysaker Emotion Recognition Task) at prerandomization, postintervention, and 1-month follow-up (1MFU) time points. Hierarchical linear modeling was conducted with the intent-to-treat principle to determine prerandomization to postintervention (pre-post intervention) and prerandomization to 1MFU (pre-1MFU) changes, comparing the mindfulness EMI to self-monitoring. RESULTS Observed effects were generally stronger from pre-1MFU than from pre-post intervention time points. From pre-post intervention time points, the mindfulness EMI was more efficacious than the self-monitoring app on fantasy (the ability to imagine being in others' shoes; between-intervention effect size: Cohen d=0.26, P=.007; within-intervention effect size: Cohen d=0.22, P=.02 for the mindfulness EMI and Cohen d=-0.16, P=.10 for the self-monitoring app). From pre-1MFU time points, the mindfulness EMI, but not the self-monitoring app, improved theory-of-mind (a window into others' thoughts and intentions through abstract, propositional knowledge about their mental states, encompassing the ability to decipher social cues) and the fantasy, personal distress (stress when witnessing others' negative experiences), and perspective-taking (understanding others' perspective) empathy domains. The effect sizes were small to moderate (Cohen d=0.15-0.36; P<.001 to P=.01) for significant between-intervention effects from pre-1MFU time points. Furthermore, the within-intervention effect sizes for these significant outcomes were stronger for the mindfulness EMI (Cohen d=0.30-0.43; P<.001 to P=.03) than the self-monitoring app (Cohen d=-0.12 to 0.21; P=.001 to P>.99) from pre-1MFU time points. No between-intervention and within-intervention effects on empathic concern (feeling affection, compassion, and care when observing others in distress, primarily attending to their emotional well-being) were observed from pre-post intervention and pre-1MFU time points. CONCLUSIONS The brief mindfulness EMI improved specific domains of empathy (eg, fantasy, personal distress, and perspective-taking) and theory-of-mind with small to moderate effect sizes in persons with GAD. Higher-intensity, self-guided or coach-facilitated, multicomponent mindfulness EMIs targeting the optimization of social relationships are likely necessary to improve the empathic concern domain in this population. TRIAL REGISTRATION ClinicalTrials.gov NCT04846777; https://clinicaltrials.gov/study/NCT04846777.
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Affiliation(s)
- Nur Hani Zainal
- Department of Health Care Policy, Harvard Medical School, Boston, MA, United States
- Department of Psychology, National University of Singapore, Singapore, Singapore
| | - Michelle G Newman
- Department of Psychology, The Pennsylvania State University, University Park, PA, United States
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Flynt S, Koscinski B, Accorso C, Knapp A, Gorka S, Suhr J, Austin M, Allan NP. A One-Arm Pilot Trial of a Telehealth CBT-Based Group Intervention Targeting Transdiagnostic Risk for Emotional Distress. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.04.23.24306218. [PMID: 38712129 PMCID: PMC11071586 DOI: 10.1101/2024.04.23.24306218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
The COVID-19 pandemic had a significant impact on mental health, straining an already overburdened healthcare system. A modular, transdiagnostic approach to treating psychopathology may be ideal to target common transdiagnostic risk factors for emotional distress and related disorders likely to be impacted by circumstances related to this once-in-a-lifetime environmental stressor. Anxiety sensitivity (AS), or fear of anxious arousal, intolerance of uncertainty (IU), or distress when confronted with uncertainty, and loneliness are three transdiagnostic risk factors impacted by the pandemic and robust predictors of emotional distress beyond that. We completed a pilot feasibility, acceptability, and utility trial of Coping Crew, our group, telehealth-delivered transdiagnostic treatment protocol in 17 participants who completed the intervention (M age = 22.00, SD = 4.46; 71% female). The intervention and study protocol were feasible to deliver and were rated as acceptable and useful to address intervention targets. Evidence was mixed regarding feasibility, acceptability, and usefulness of the mobile app component. Sixteen of 17 participants (94%) completed at least one survey a day on 80% of the days but only 6 participants (35%) completed at least 80% of the mobile app surveys delivered over the course of the intervention. Most participants rated use of the app as acceptable and relevant to psychological improvements made due to the intervention. Sizeable effect size reductions in transdiagnostic risk factors were found at post-intervention and maintained at 1- and 3-month follow-up, supporting next steps in the development of this modular transdiagnostic treatment.
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Affiliation(s)
- Sierra Flynt
- Department of Psychology, Ohio University, Athens, OH, USA
| | | | | | - Ashley Knapp
- Feinberg School of Medicine, Northwestern University, Evanston, IL, USA
| | - Stephanie Gorka
- Department of Psychiatry and Behavioral Health, Ohio State University, Columbus, OH, USA
| | | | | | - Nicholas P. Allan
- Department of Psychiatry and Behavioral Health, Ohio State University, Columbus, OH, USA
- VA Center of Excellence for Suicide Prevention, VA Finger Lakes Health Care System, United States
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Iyer CS, Schrock JM, Johnson A, Gorbach PM, Siminski S, Newcomb ME, McDade TW, Mustanski B. Infectious Illness Symptoms Are Associated with Elevated Anxiety in a Sample of Sexual and Gender Minority Young Adults During the COVID-19 Pandemic. Int J Behav Med 2024:10.1007/s12529-023-10251-5. [PMID: 38241000 PMCID: PMC11258203 DOI: 10.1007/s12529-023-10251-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2023] [Indexed: 07/20/2024]
Abstract
BACKGROUND To evaluate whether infectious illness symptoms (IIS) are associated with generalized anxiety symptoms during the COVID-19 pandemic in sexual/gender (SGM) minority young adults assigned male at birth (AMAB). METHOD Four hundred eighteen participants (median age = 25; range, 20-40) were recruited through RADAR, an ongoing Chicago-based cohort study of SGM-AMAB between September 2020 and February 2021. Participants completed online surveys. A subset (n = 145) provided dried blood spot samples to assess SARS-CoV-2 serostatus. RESULTS One hundred twenty participants (28.7%) had GAD-7 scores of 10 or greater, which indicates generalized anxiety symptoms that may be clinically significant. In a binomial logistic regression model adjusting age, gender identity, race/ethnicity, substance use, and HIV status, the authors found that having a higher IIS count since March 1, 2020, was associated with greater odds of having a GAD-7 score of 10 or greater (OR = 1.14; 95% CI, 1.04, 1.25; P = 0.007). This effect was more pronounced in a binomial logistic regression model adjusting for the same covariates but using current IIS count as the independent variable (OR = 1.39; 95% CI, 1.13, 1.74; P = 0.002). CONCLUSION Among SGM-AMAB young adults, those who experienced ISS reported higher scores on the GAD-7, a widely used and validated screening measure for generalized anxiety symptoms. These findings highlight the importance of screening for anxiety disorders when patients present with IIS in clinical settings and psychobehavioral health follow-ups when indicated.
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Affiliation(s)
- Chitra S Iyer
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N Michigan Ave, Suite 14, Chicago, IL, 60611, USA
| | - Joshua M Schrock
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N Michigan Ave, Suite 14, Chicago, IL, 60611, USA
- Department of Anthropology, Northwestern University, 1810 Hinman Avenue, Evanston, IL, 60208, USA
| | - Anthony Johnson
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N Michigan Ave, Suite 14, Chicago, IL, 60611, USA
| | - Pamina M Gorbach
- Department of Epidemiology, University of California, Los Angeles, 650 Charles E Young Dr S, Room 41-295, Los Angeles, CA, 90095, USA
| | - Sue Siminski
- Frontier Science, 4033 Maple Road, Amherst, NY, 14226, USA
| | - Michael E Newcomb
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N Michigan Ave, Suite 14, Chicago, IL, 60611, USA
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 633 N. St Clair Street, 19th Floor, Chicago, IL, 60611, USA
| | - Thomas W McDade
- Department of Anthropology, Northwestern University, 1810 Hinman Avenue, Evanston, IL, 60208, USA
- Institute for Policy Research, Northwestern University, 2040 Sheridan Road, Evanston, IL, 60208, USA
| | - Brian Mustanski
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N Michigan Ave, Suite 14, Chicago, IL, 60611, USA.
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 633 N. St Clair Street, 19th Floor, Chicago, IL, 60611, USA.
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Shrestha NR, Deason RG, Cordaro M, Howard K, Haskard-Zolnierek K. Evaluating the relationship of empathic concern to college students' responses to the COVID-19 pandemic. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-7. [PMID: 37437177 DOI: 10.1080/07448481.2023.2224432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 04/19/2023] [Accepted: 06/01/2023] [Indexed: 07/14/2023]
Abstract
Objective: Empathic concern (EC) for others may be related to COVID-19 pandemic responses. Participants and methods: The purpose of this survey study was to examine differences in pandemic responses in 1,778 college students rated as low (LE) versus high (HE) on the EC subscale of the Interpersonal Reactivity Index. Results: HE participants reported greater concerns in numerous pandemic-related domains, including acquiring COVID-19; access to COVID-19 treatment; number of COVID-19 cases, hospitalizations, and deaths reported; staying employed; and being isolated for long periods of time. Generalized anxiety symptoms, depressive symptoms, and perceived stress scores were significantly higher for individuals in the HE group compared to the LE group. The HE group reported being significantly more adherent to health and safety recommendations than the LE group. Conclusions: Empathic concern for others is important for promoting college student prosocial behavior but is associated with anxiety and depression symptomatology during times of traumatic stress.
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Affiliation(s)
- Neha R Shrestha
- Department of Psychology, Texas State University, San Marcos, Texas, USA
| | - Rebecca G Deason
- Department of Psychology, Texas State University, San Marcos, Texas, USA
| | - Millie Cordaro
- Department of Psychology, Texas State University, San Marcos, Texas, USA
| | - Krista Howard
- Department of Psychology, Texas State University, San Marcos, Texas, USA
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Schmiedehaus E, Snyder E, Perrotte J, Deason R, Howard K, Cordaro M. The Ongoing Mental Health Plight of Depressed College Students: Clinical Recommendations and the Importance of Early Screening and Detection. Issues Ment Health Nurs 2023:1-9. [PMID: 37279399 DOI: 10.1080/01612840.2023.2215866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The COVID-19 pandemic disrupted the lives of college students. The psychological distress from the pandemic increased risk for provisional rates of Major Depression Disorder (MDD) during an already crucial developmental period. Using an online survey, participants were assessed for a provisional diagnosis of MDD using a validated screening tool, along with Generalized Anxiety Disorder (GAD) and psychosocial correlates. Findings showed a significant increase in the prevalence of MDD, and significant differences in social support, loneliness, substance use, GAD and suicidality were identified. Early screening and detection for potential MDD symptoms can reduce the severity, duration, and reoccurrence of future MDD episodes for college students.
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Affiliation(s)
- Evan Schmiedehaus
- Department of Philosophy, Texas State University, San Marcos, TX, USA
| | - Ethan Snyder
- Department of Biology, Texas State University, San Marcos, TX, USA
| | - Jessica Perrotte
- Department of Psychology, Texas State University, San Marcos, TX, USA
| | - Rebecca Deason
- Department of Psychology, Texas State University, San Marcos, TX, USA
| | - Krista Howard
- Department of Psychology, Texas State University, San Marcos, TX, USA
| | - Millie Cordaro
- Department of Psychology, Texas State University, San Marcos, TX, USA
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Tan HJ, Shahren AAH, Khoo CS, Ng CF, Zaidi WAW, Kori N, Periyasamy P, Eu CL, Payus AO, Hod R. Anxiety among hospitalized COVID-19 patients: a case-control study from a tertiary teaching hospital in Malaysia. Front Psychiatry 2023; 14:1148019. [PMID: 37275980 PMCID: PMC10232945 DOI: 10.3389/fpsyt.2023.1148019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 04/27/2023] [Indexed: 06/07/2023] Open
Abstract
Introduction Anxiety has been increasingly recognized as part of the psychosocial health issues in COVID-19 patients. However, the impact of this topic may be underestimated in low- and middle-income countries. This study aimed to estimate the prevalence of and risk factors of anxiety in COVID-19 patients compared to controls in a local tertiary teaching hospital in Malaysia. Methods In this case-control study, we analyzed data on adult patients aged 18 years and above hospitalized for COVID-19 infection with matched hospitalized controls. The demographic, clinical data and anxiety measures using the Generalized Anxiety Disorder-7 questionnaire were analyzed using univariate and multivariate analysis. Results 86.6% in the COVID-19 group had anxiety, significantly higher than 13.4% in the control group (p = 0.001). The COVID-19 group was significantly associated with the GAD-7 severity (p = 0.001). The number of COVID-19 patients in the mild, moderate, and severe anxiety groups was 48 (84.2%), 37 (86%), and 18 (94.7%), respectively. Multiple logistic regression showed significant predictors for anxiety, including COVID-19 diagnosis and neurological symptoms. Anxiety was found 36.92 times higher in the patients with COVID-19 compared to those without COVID-19 (OR 36.92;95% CI 17.09, 79.78, p = 0.001). Patients with neurological symptoms were at risk of having anxiety (OR 2.94; 95% CI 1.03, 8.41, p = 0.044). Discussion COVID-19 patients experience a significant disruption in psychosocial functioning due to hospitalization. The burden of anxiety is notably high, compounded by a diagnosis of COVID-19 itself and neurological symptomatology. Early psychiatric referrals are warranted for patients at risk of developing anxiety symptoms.
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Affiliation(s)
- Hui Jan Tan
- Department of Medicine, Faculty of Medicine, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Abdool Alleem Hj Shahren
- Department of Medicine, Faculty of Medicine, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Ching Soong Khoo
- Department of Medicine, Faculty of Medicine, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Chen Fei Ng
- Department of Medicine, Faculty of Medicine, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Wan Asyraf Wan Zaidi
- Department of Medicine, Faculty of Medicine, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Najma Kori
- Department of Medicine, Faculty of Medicine, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Petrick Periyasamy
- Department of Medicine, Faculty of Medicine, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Choon Leng Eu
- Department of Psychiatry, Faculty of Medicine, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Alvin Oliver Payus
- Department of Medicine, Faculty of Medicine, University Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Rozita Hod
- Department of Community Health, Faculty of Medicine, The National University of Malaysia, Kuala Lumpur, Malaysia
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Mathew AG, Kaye AJ, Patel SJ, Meyers SR, Saiganesh P, Wang W. Outcomes of Gastroparesis in Hospitalized Patients With Generalized Anxiety Disorder. Cureus 2023; 15:e35832. [PMID: 37033595 PMCID: PMC10075333 DOI: 10.7759/cureus.35832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2023] [Indexed: 03/08/2023] Open
Abstract
Background Gastroparesis is a common gastrointestinal pathology that has been increasing in prevalence and represents a significant cost to the United States healthcare system. Gastroparesis is associated with psychological dysfunction, including generalized anxiety disorder (GAD). GAD is known to be a prevalent and chronic manifestation of anxiety, which has been increasing in prevalence since the year 2020. Despite the association between gastroparesis and GAD, there has been limited research on the possible impact GAD may have on the morbidity and mortality of patients hospitalized for gastroparesis, which is further evaluated in this study. Methods Using the Nationwide Inpatient Sample from the year 2014, a retrospective study was conducted to assess the outcomes of hospitalized gastroparesis patients with and without a history of GAD. In this study, the analyzed outcomes included acute kidney injury (AKI), acute respiratory failure, sepsis, acute deep vein thrombosis, myocardial infarction, intestinal obstruction, and inpatient mortality. To assess whether GAD is an independent risk factor for the outcomes, a multivariate logistic regression analysis was used. Results There were 22,150 patients with gastroparesis assessed in this study; GAD was found to be a comorbid diagnosis in 4,196 of those patients. In the GAD cohort, there was an elevated risk for AKI (adjusted odds ratio 1.24, p < 0.001). The adjusted odds ratios for acute respiratory failure, sepsis, acute deep vein thrombosis, myocardial infarction, intestinal obstruction, and inpatient mortality did not meet the threshold for statistical significance. Conclusion In hospitalized gastroparesis patients, GAD is a risk factor for AKI. This finding may be attributed to prerenal azotemia due to an increased risk of nausea and vomiting associated with GAD, as well as the medications used to treat GAD such as escitalopram and duloxetine. In addition, the dual inflammatory states caused by the co-existence of both GAD and gastroparesis may also have a role in increasing the risk for AKI. The results of this study may become increasingly relevant given the increasing prevalence of GAD. .
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Grelle K, Shrestha N, Ximenes M, Perrotte J, Cordaro M, Deason RG, Howard K. The Generation Gap Revisited: Generational Differences in Mental Health, Maladaptive Coping Behaviors, and Pandemic-Related Concerns During the Initial COVID-19 Pandemic. JOURNAL OF ADULT DEVELOPMENT 2023; 30:1-12. [PMID: 36811122 PMCID: PMC9934502 DOI: 10.1007/s10804-023-09442-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2023] [Indexed: 02/18/2023]
Abstract
The purpose of this study was to assess differences in mental health symptoms, pandemic-related concerns, and maladaptive coping behaviors among adults in the United States across generations during the initial period of the COVID-19 pandemic. A social media campaign was used to recruit 2696 U.S. individuals to participate in an online survey in April 2020, assessing various validated psychosocial factors, including major depressive disorder, generalized anxiety disorder (GAD), perceived stress, loneliness, quality of life, and fatigue, along with pandemic-specific concerns and changes in alcohol use and substance use. Participants were grouped based on generation status (Gen Z, Millennial, Gen X, and Baby Boomer) and statistical comparisons were conducted based on demographics, psychosocial factors, pandemic-related concerns, and substance use. During the initial period of the COVID-19 pandemic, the younger cohorts (Gen Z and Millennials) rated significantly worse on mental health indices, including major depression, GAD, perceived stress, loneliness, quality of life, and fatigue. Further, the participants in the Gen Z and Millennial generational groups exhibited greater increase in maladaptive coping with substance use, specifically alcohol use and increased use of sleep aids. Our results indicate that during the initial period of the COVID-19 pandemic, members of the Gen Z and Millennial generational cohorts were considered a psychologically vulnerable population due to their mental health and maladaptive coping behaviors. Improving access to mental health resources during early stages of a pandemic is an emerging public health concern.
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Affiliation(s)
- Kaitlin Grelle
- Department of Psychology, Texas State University, 601 University Drive, San Marcos, TX 78666 USA
| | - Neha Shrestha
- Department of Psychology, Texas State University, 601 University Drive, San Marcos, TX 78666 USA
| | - Megan Ximenes
- Department of Psychology, Texas State University, 601 University Drive, San Marcos, TX 78666 USA
| | - Jessica Perrotte
- Department of Psychology, Texas State University, 601 University Drive, San Marcos, TX 78666 USA
| | - Millie Cordaro
- Department of Psychology, Texas State University, 601 University Drive, San Marcos, TX 78666 USA
| | - Rebecca G. Deason
- Department of Psychology, Texas State University, 601 University Drive, San Marcos, TX 78666 USA
| | - Krista Howard
- Department of Psychology, Texas State University, 601 University Drive, San Marcos, TX 78666 USA
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Gabarrell-Pascuet A, García-Mieres H, Giné-Vázquez I, Moneta MV, Koyanagi A, Haro JM, Domènech-Abella J. The Association of Social Support and Loneliness with Symptoms of Depression, Anxiety, and Posttraumatic Stress during the COVID-19 Pandemic: A Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2765. [PMID: 36833463 PMCID: PMC9957328 DOI: 10.3390/ijerph20042765] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 01/30/2023] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Research suggests that changes in social support and loneliness have affected mental disorder symptoms during the COVID-19 pandemic. However, there are a lack of studies comparing the robustness of these associations. AIMS The aims were to estimate the strength of the associations of loneliness and social support with symptoms of depression, anxiety, and posttraumatic stress during the COVID-19 pandemic (2020-2022) in the general population. METHOD The method entailed a systematic review and random-effects meta-analysis of quantitative studies. RESULTS Seventy-three studies were included in the meta-analysis. The pooled correlations of the effect size of the association of loneliness with symptoms of depression, anxiety, and posttraumatic stress were 0.49, 0.40, and 0.38, respectively. The corresponding figures for social support were 0.29, 0.19, and 0.18, respectively. Subgroup analyses revealed that the strength of some associations could be influenced by the sociodemographic characteristics of the study samples, such as age, gender, region, and COVID-19 stringency index, and by methodological moderators, such as sample size, collection date, methodological quality, and the measurement scales. CONCLUSIONS Social support had a weak association with mental disorder symptoms during the COVID-19 pandemic while the association with loneliness was moderate. Strategies to address loneliness could be highly effective in reducing the impact of the pandemic on social relationships and mental health.
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Affiliation(s)
- Aina Gabarrell-Pascuet
- Epidemiology of Mental Health Disorders and Ageing Research Group, Sant Joan de Déu Research Institute, 08950 Esplugues de Llobregat, Spain
- Research, Teaching, and Innovation Unit, Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Medicine, Universitat de Barcelona, 08007 Barcelona, Spain
| | - Helena García-Mieres
- Health Services Research Unit, Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Iago Giné-Vázquez
- Epidemiology of Mental Health Disorders and Ageing Research Group, Sant Joan de Déu Research Institute, 08950 Esplugues de Llobregat, Spain
- Research, Teaching, and Innovation Unit, Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Maria Victoria Moneta
- Epidemiology of Mental Health Disorders and Ageing Research Group, Sant Joan de Déu Research Institute, 08950 Esplugues de Llobregat, Spain
- Research, Teaching, and Innovation Unit, Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Ai Koyanagi
- Epidemiology of Mental Health Disorders and Ageing Research Group, Sant Joan de Déu Research Institute, 08950 Esplugues de Llobregat, Spain
- Research, Teaching, and Innovation Unit, Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Institució Catalana de Recerca i Estudis Avançats (ICREA), 08010 Barcelona, Spain
| | - Josep Maria Haro
- Epidemiology of Mental Health Disorders and Ageing Research Group, Sant Joan de Déu Research Institute, 08950 Esplugues de Llobregat, Spain
- Research, Teaching, and Innovation Unit, Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Medicine, Universitat de Barcelona, 08007 Barcelona, Spain
| | - Joan Domènech-Abella
- Epidemiology of Mental Health Disorders and Ageing Research Group, Sant Joan de Déu Research Institute, 08950 Esplugues de Llobregat, Spain
- Research, Teaching, and Innovation Unit, Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain
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Monnig MA, Clark SE, Avila JC, Sokolovsky AW, Treloar Padovano H, Goodyear K, Aston ER, Haass-Koffler CL, Tidey JW, Ahluwalia JS, Monti PM. COVID-19-Related Stressors and Clinical Mental Health Symptoms in a Northeast US Sample. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1367. [PMID: 36674123 PMCID: PMC9858791 DOI: 10.3390/ijerph20021367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/30/2022] [Accepted: 01/06/2023] [Indexed: 06/17/2023]
Abstract
Research has linked specific COVID-19-related stressors to the mental health burden, yet most previous studies have examined only a limited number of stressors and have paid little attention to their clinical significance. This study tested the hypothesis that individuals who reported greater COVID-19-related stressors would be more likely to have elevated levels of anxiety, posttraumatic stress symptoms, and serious psychological distress. METHODS An online survey was administered to a convenience sample from 18 June to 19 July 2020, in US states that were most affected by COVID-19 infections and deaths at the time. Individuals who were 18 or older and residents of five Northeast US states were eligible to participate (N = 1079). In preregistered analyses, we used logistic regression models to test the associations of COVID-19 stressors with symptoms on the Generalized Anxiety Disorder-7 (GAD-7), Impact of Event Scale-Revised, and K6, adjusting for sociodemographic covariates. RESULTS COVID-19-related stressors (i.e., essential worker status, worry about COVID-19 infection, knowing someone hospitalized by COVID-19, having children under 14 at home, loneliness, barriers to environmental rewards, food insecurity, loss of employment) were associated with meeting thresholds (i.e., positive screening) for anxiety, posttraumatic stress, and/or serious psychological distress. Loneliness and barriers to environmental rewards were associated with all mental health outcomes. LIMITATIONS We used a non-probability sample and cannot assume temporal precedence of stressors with regard to development of mental health symptoms. CONCLUSIONS These findings link specific stressors to the mental health burden of the COVID-19 pandemic.
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Affiliation(s)
- Mollie A. Monnig
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI 02912, USA
- Center for Addiction and Disease Risk Exacerbation, Brown University, Providence, RI 02912, USA
| | - Samantha E. Clark
- Center for Addiction and Disease Risk Exacerbation, Brown University, Providence, RI 02912, USA
| | - Jaqueline C. Avila
- Center for Addiction and Disease Risk Exacerbation, Brown University, Providence, RI 02912, USA
| | - Alexander W. Sokolovsky
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI 02912, USA
- Center for Addiction and Disease Risk Exacerbation, Brown University, Providence, RI 02912, USA
| | - Hayley Treloar Padovano
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI 02912, USA
- Center for Addiction and Disease Risk Exacerbation, Brown University, Providence, RI 02912, USA
- Center for Alcohol and Addiction Studies, Department of Psychiatry and Human Behavior, Brown University, Providence, RI 02912, USA
| | - Kimberly Goodyear
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI 02912, USA
- Center for Addiction and Disease Risk Exacerbation, Brown University, Providence, RI 02912, USA
- Center for Alcohol and Addiction Studies, Department of Psychiatry and Human Behavior, Brown University, Providence, RI 02912, USA
| | - Elizabeth R. Aston
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI 02912, USA
- Center for Addiction and Disease Risk Exacerbation, Brown University, Providence, RI 02912, USA
| | - Carolina L. Haass-Koffler
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI 02912, USA
- Center for Addiction and Disease Risk Exacerbation, Brown University, Providence, RI 02912, USA
- Center for Alcohol and Addiction Studies, Department of Psychiatry and Human Behavior, Brown University, Providence, RI 02912, USA
| | - Jennifer W. Tidey
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI 02912, USA
- Center for Addiction and Disease Risk Exacerbation, Brown University, Providence, RI 02912, USA
- Center for Alcohol and Addiction Studies, Department of Psychiatry and Human Behavior, Brown University, Providence, RI 02912, USA
| | - Jasjit S. Ahluwalia
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI 02912, USA
- Center for Addiction and Disease Risk Exacerbation, Brown University, Providence, RI 02912, USA
| | - Peter M. Monti
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI 02912, USA
- Center for Addiction and Disease Risk Exacerbation, Brown University, Providence, RI 02912, USA
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12
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Li M, Liu X, Ye X, Zhuang L. Efficacy of acupuncture for generalized anxiety disorder: A PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e30076. [PMID: 36626458 PMCID: PMC9750622 DOI: 10.1097/md.0000000000030076] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Generalized anxiety disorder (GAD) tightly traps modern people. Its incidence shows an increased peak during the 2019 novel coronavirus (COVID-19) epidemic. Acupuncture is regarded as an effective way to relieve anxiety symptoms. However, there are still controversies. This study aimed to systematically evaluate the clinical efficacy of acupuncture in patients with GAD. METHODS Four English and 3 Chinese databases were searched from their inception to January 2022. Only randomized controlled trials (RCTs) in which acupuncture was the main intervention were included. The literature was independently screened and extracted by two investigators. The Cochrane Bias Risk Assessment Tool was used for quality evaluation. Analyses were conducted by RevMan 5.3.0 and STATA 15.0 software. The primary outcome was the Hamilton Anxiety Scale (HAMA). The secondary indicators were the total effective rate, the Self-Rating Anxiety Scale (SAS), and the Treatment Emergent Symptom Scale (TESS). RESULTS Twenty-seven studies were included with a total of 1782 participants. The risk of performance bias or reporting bias for most of the included trials was unclear. Combined results showed the acupuncture group had better outcomes in the HAMA score [MD = -0.78, 95%CI (-1.09, -0.46)], the total effective rate [RR = 1.14, 95%CI (1.09, 1.19)], the SAS score [MD = -2.55, 95%CI (-3.31, -1.80)] compared with the control group. Regarding the number of adverse events, the acupuncture group was safer than the control group and scored less grade in the TESS score [MD = -1.54, 95%CI (-1.92, -1.17)]. CONCLUSIONS Acupuncture can effectively relieve the anxiety symptoms of generalized anxiety disorder patients with fewer side effects, but randomized controlled trials with large sample size and high quality are also required to support the result.
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Affiliation(s)
- Meichen Li
- Acupuncture and rehabilitation clinical collage of Guangzhou University of Chinese Medicine
| | - Xin Liu
- Acupuncture and rehabilitation clinical collage of Guangzhou University of Chinese Medicine
| | - Xinyi Ye
- Dongguan Traditional Chinese Medicine Hospital
| | - Lixing Zhuang
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine
- *Correspondence: Lixing Zhuang, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China (e-mail: )
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13
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Delpino FM, da Silva CN, Jerônimo JS, Mulling ES, da Cunha LL, Weymar MK, Alt R, Caputo EL, Feter N. Prevalence of anxiety during the COVID-19 pandemic: A systematic review and meta-analysis of over 2 million people. J Affect Disord 2022; 318:272-282. [PMID: 36096370 PMCID: PMC9462928 DOI: 10.1016/j.jad.2022.09.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 08/28/2022] [Accepted: 09/05/2022] [Indexed: 12/02/2022]
Abstract
INTRODUCTION Uncertainty, disruptions in daily routines, and concerns for the health and well-being during the COVID-19 pandemic are likely associated with increases in generalized anxiety. The present study aimed to systematically review the literature in order to identify the update prevalence of anxiety in the general population during the COVID-19 pandemic. METHODS A systematic review and meta-analysis. It included studies that assessed the prevalence of anxiety among the general population during the COVID-19 pandemic. RESULTS In total, we included 194 studies. The general prevalence of anxiety was 35.1 %, affecting approximately 851,000 participants. The prevalence in low and middle-income countries (35.1 %; 95%CI: 29.5 % to 41.0 %) was similar compared to high-income countries (34.7 %; 95%CI: 29.6 % to 40.1 %). In studies that provided the proportion of cases in each level of anxiety disorder, mild-to-moderate anxiety affected one quarter of the participants. One in ten cases with anxiety during the COVID-19 may be living with severe or extremely anxiety disorder. Most instruments estimated similar prevalence of anxiety disorders with notable difference in the prevalence estimated by the Generalized Anxiety Disorder 2-item (GAD-2), Zung Self-Rating Anxiety Scale (SAS), and State-Trait Anxiety Inventory (STAI). CONCLUSION One in three adults were living with anxiety disorder during the COVID-19 pandemic worldwide.
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Affiliation(s)
- Felipe Mendes Delpino
- Postgraduate Program in Nursing, Federal University of Pelotas, Rio Grande do Sul, Brazil.
| | | | - Jeferson Santos Jerônimo
- Postgraduate Program in Physical Education, Federal University of Pelotas, Rio Grande do Sul, Brazil
| | - Eliete Stark Mulling
- Postgraduate Program in Physical Education, Federal University of Pelotas, Rio Grande do Sul, Brazil
| | - Larissa Leal da Cunha
- Postgraduate Program in Physical Education, Federal University of Pelotas, Rio Grande do Sul, Brazil
| | - Marina Krause Weymar
- Postgraduate Program in Physical Education, Federal University of Pelotas, Rio Grande do Sul, Brazil
| | - Ricardo Alt
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rio Grande do Sul, Brazil
| | - Eduardo L. Caputo
- Postgraduate Program in Physical Education, Federal University of Pelotas, Rio Grande do Sul, Brazil
| | - Natan Feter
- Postgraduate Program in Epidemiology, Federal University of Rio Grande do Sul, Rio Grande do Sul, Brazil
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14
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Howard KJ, Leong C, Chambless S, Grigsby TJ, Cordaro M, Perrotte JK, Howard JT. Major Depression in Postpartum Women during the COVID-19 Pandemic: Can Social Support Buffer Psychosocial Risks and Substance Use? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15748. [PMID: 36497822 PMCID: PMC9738345 DOI: 10.3390/ijerph192315748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 11/22/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
Rates of mood disorders and substance use increased during the COVID-19 pandemic for postpartum women. The present study's aims were to: (1) examine the prevalence of major depressive disorder (MDD) in postpartum women during the COVID-19 pandemic, and (2) evaluate whether social support can buffer the associations between MDD, psychosocial factors (perceived stress, generalized anxiety, and intimate partner violence) and substance use (alcohol and drug use). A nationwide survey included 593 postpartum mothers (within 12 months from birth). Participants were assessed for a provisional diagnosis of MDD, and provided responses on validated instruments measuring stress, intimate partner violence, suicidal ideation, generalized anxiety, social support, and substance use. A hierarchical logistic regression model assessed the association of psychosocial factors and substance use with MDD. The final model shows that social support attenuates the association of MDD with perceived stress, alcohol use, and drug use, but does not buffer the relationship of MDD with anxiety or intimate partner violence. Social support was shown to significantly attenuate the effects of stress, alcohol use, and drug use on MDD, suggesting that the presence of a strong, supportive social network should be an area of increased focus for public health and healthcare professionals when caring for postpartum women.
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Affiliation(s)
- Krista J. Howard
- Department of Psychology, Texas State University, 601 University Dr., San Marcos, TX 78666, USA
| | - Caleb Leong
- Department of Public Health, University of Texas at San Antonio, One UTSA Circle, San Antonio, TX 78249, USA
- Consequences of Trauma Working Group, The Center for Community-Based and Applied Health Research, University of Texas at San Antonio, One UTSA Circle, San Antonio, TX 78249, USA
| | - Sidney Chambless
- Department of Psychology, Texas State University, 601 University Dr., San Marcos, TX 78666, USA
| | - Timothy J. Grigsby
- Department of Social and Behavioral Health, University of Nevada, Las Vegas, NV 89119, USA
| | - Millie Cordaro
- Department of Psychology, Texas State University, 601 University Dr., San Marcos, TX 78666, USA
| | - Jessica K. Perrotte
- Department of Psychology, Texas State University, 601 University Dr., San Marcos, TX 78666, USA
| | - Jeffrey T. Howard
- Department of Public Health, University of Texas at San Antonio, One UTSA Circle, San Antonio, TX 78249, USA
- Consequences of Trauma Working Group, The Center for Community-Based and Applied Health Research, University of Texas at San Antonio, One UTSA Circle, San Antonio, TX 78249, USA
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15
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Liu CH, Koire A, Feldman N, Erdei C, Mittal L. COVID-19-related health worries and generalized anxiety symptoms: Higher risks in perinatal women without a pre-existing generalized anxiety diagnosis. Psychiatry Res 2022; 317:114918. [PMID: 37732861 PMCID: PMC9584754 DOI: 10.1016/j.psychres.2022.114918] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 10/17/2022] [Accepted: 10/19/2022] [Indexed: 11/24/2022]
Abstract
The perinatal period has been well-established as a time of vulnerability to anxiety, as has the COVID-19 pandemic. Perinatal women with a prior diagnosis of Generalized Anxiety Disorder (GAD) may be anticipated to be at particular risk for elevated symptom burden when facing the overlay of these stressors. This study examined whether pre-existing anxiety exacerbates COVID-19-related health worries on anxiety symptom severity among a sample of women who entered perinatal status during the COVID-19 pandemic. We assessed COVID-19-related health worries, past diagnosis of GAD, and current generalized anxiety symptoms cross-sectionally in 1,587 perinatal U.S. women during the COVID-19 pandemic (May 21, 2020 to June 24, 2021). Among perinatal women who reported high levels of COVID-19-related health worries, those with a pre-existing GAD diagnosis were 3.56 times more likely to score at clinically significant levels of generalized anxiety, while those without a pre-existing GAD diagnosis were 6.51 times more likely. COVID-19-related health worries posed a larger risk for elevated anxiety symptoms among those without a pre-existing diagnosis of GAD. Greater access to treatment and psychoeducation for such individuals may be warranted for individuals without a pre-existing mental health diagnosis.
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Affiliation(s)
- Cindy H Liu
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, 221 Longwood Ave. Boston, MA, USA 02115; Department of Psychiatry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, USA 02115; Harvard Medical School, 25 Shattuck Street, Boston, MA, USA 02115.
| | - Amanda Koire
- Department of Psychiatry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, USA 02115; Harvard Medical School, 25 Shattuck Street, Boston, MA, USA 02115
| | - Natalie Feldman
- Department of Psychiatry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, USA 02115; Harvard Medical School, 25 Shattuck Street, Boston, MA, USA 02115
| | - Carmina Erdei
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, 221 Longwood Ave. Boston, MA, USA 02115; Harvard Medical School, 25 Shattuck Street, Boston, MA, USA 02115
| | - Leena Mittal
- Department of Psychiatry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, USA 02115; Harvard Medical School, 25 Shattuck Street, Boston, MA, USA 02115
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16
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Triastuti NJ, Herawati E. Demographic characteristics and anxiety in the educational setting during the COVID-19 pandemic in Indonesia: A cross-sectional study. Health Sci Rep 2022; 5:e792. [PMID: 36000080 PMCID: PMC9387899 DOI: 10.1002/hsr2.792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 07/01/2022] [Accepted: 08/01/2022] [Indexed: 12/04/2022] Open
Abstract
Background and Aims This study aims to analyze the relationship between gender, age, occupation, residence, and anxiety in the education environment during the coronavirus disease 2019 (COVID-19) pandemic. Methods This study used a descriptive-analytic cross-sectional design to determine anxiety using the DASS 42 questionnaire given to 181 respondents. The sampling technique used was purposive sampling, and the data analysis used was the Chi-square test and multivariate analysis. Results It was found that 66.7% of teenagers experienced anxiety, while 33.3% of adults experienced anxiety. In addition, the school-age community (86.2%) experienced higher anxiety compared with the working-age community (13.8%) who experienced anxiety. Women experienced more significant anxiety (66.7%) compared with men (33.3%). People living on the island of Java (74.7%) have a greater incidence of anxiety compared with people living outside Java (25.3%). Conclusion There is a significant relationship between the type of occupation and the incidence of anxiety with p < 0.05 (OR = 0.341). A significant correlation was found between age with the incidence of anxiety with p < 0.05 (OR = 0.489). The demographic factors altogether had significant relationships with the anxiety in the educational environment during the COVID-19 pandemic with a p value < 0.05 and R Square of 0.069. There is a strong relationship between the demographic factors and the incidence of anxiety in the community's educational environment during the COVID-19 pandemic with p < 0.05. It is suggested that women, school-age communities, or the un-employment community need to be supported to alleviate the impact of COVID-19 on anxiety through several programs.
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Affiliation(s)
- N Juni Triastuti
- Department of Medical Education Universitas Muhammadiyah Surakarta Indonesia
| | - Erna Herawati
- Department of Psychiatry Universitas Muhammadiyah Surakarta Indonesia
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17
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Kaye AJ, Patel SJ, Meyers SR, Ahlawat S. Outcomes of Inflammatory Bowel Disease in Hospitalized Patients With Generalized Anxiety Disorder. Cureus 2022; 14:e27656. [PMID: 36072180 PMCID: PMC9439936 DOI: 10.7759/cureus.27656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2022] [Indexed: 11/28/2022] Open
Abstract
Background The development of inflammatory bowel disease (IBD), which encompasses ulcerative colitis and Crohn’s disease, is multifactorial. Stress from anxiety is a risk factor for IBD. Generalized anxiety disorder (GAD) is twice as likely in IBD patients. This study explores the outcomes of patients hospitalized for IBD with comorbid GAD. Methods A retrospective analysis utilizing the 2014 USA National Inpatient Sample database was performed to assess the outcomes of hospitalized IBD patients with and without GAD. The outcomes analyzed were sepsis, acute hepatic failure, hypotension/shock, acute respiratory failure, acute deep vein thrombosis, acute renal failure, intestinal obstruction, myocardial infarction, ileus, inpatient mortality, colectomy, intestinal abscess, intestinal perforation, and megacolon. A multivariate logistic regression analysis was employed to explore whether GAD is a risk factor for these outcomes. Results Among 28,173 IBD hospitalized patients in the study, GAD was a comorbid diagnosis in 3,400 of those patients. IBD patients with coexisting GAD were found to be at increased risk for acute hepatic failure (adjusted odds ratio (aOR) 1.80, p = 0.006), sepsis (aOR 1.33, p < 0.001), acute respiratory failure (aOR 1.24, p = 0.018), inpatient mortality (aOR 1.87, p < 0.001), intestinal abscess (aOR 2.35, p = 0.013), and intestinal perforation (aOR 1.44, p = 0.019). The aORs for the remaining outcomes were not statistically significant. Conclusions In hospitalized IBD patients, GAD is a risk factor for sepsis, acute hepatic failure, acute respiratory failure, intestinal abscess, intestinal perforation, and inpatient mortality. IBD and GAD are becoming increasingly common, which will likely lead to a larger number of complications among inpatients with these comorbidities.
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18
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Kaye AJ, Baker B, Meyers S, Ahlawat S. Outcomes of Upper Gastrointestinal Bleeding in Hospitalized Patients With Generalized Anxiety Disorder. Cureus 2022; 14:e25059. [PMID: 35719822 PMCID: PMC9200930 DOI: 10.7759/cureus.25059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2022] [Indexed: 11/05/2022] Open
Abstract
Background Upper gastrointestinal bleeding (UGIB) has a high morbidity and mortality. Social deprivation is a risk factor for UGIB and is associated with anxiety. The primary pharmaceutical therapeutic agents for anxiety are selective serotonin reuptake inhibitors. Anxiety is prevalent in the general population and generalized anxiety disorder (GAD) is a common form of anxiety. This study explores the impact of GAD on the outcomes of adult patients hospitalized with UGIB. Methods Adult UGIB patients were selected utilizing the National (Nationwide) Inpatient Sample database from year 2014 and International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. The outcomes of UGIB patients with and without GAD were investigated. The outcomes explored include inpatient mortality, hypotension/shock, acute renal failure, acute hepatic failure, acute respiratory failure and acute myocardial infarction. A multivariate logistic regression analysis was used to determine if GAD is an independent predictor of the outcomes. Results Among 19,850 UGIB patients studied, 2357 had comorbid GAD. GAD was identified as a risk factor for acute renal failure (adjusted odds ratio [aOR] 1.37, 95% confidence interval [CI] 1.30-1.57, p < 0.05) and inpatient mortality (aOR 1.50, 95% CI 1.01-2.06, p < 0.05). The aORs of hypotension/shock, acute hepatic failure, acute respiratory failure and acute myocardial infarction were not statistically significant. Conclusion UGIB patients with comorbid GAD are at elevated risk of inpatient mortality and acute renal failure. These results may gain increasing relevance as GAD prevalence has increased since the start of the coronavirus disease 2019 (COVID-19) pandemic.
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19
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Uwadiale A, Cordaro M, Brunett K, Stern M, Howard K. Lessons Learned about the Need for Early Screening for Depression during the First Months of the COVID-19 Pandemic in the United States. Issues Ment Health Nurs 2022; 43:272-281. [PMID: 34529543 DOI: 10.1080/01612840.2021.1975333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
A nationwide survey assessed the prevalence and pandemic-related risk factors of major depressive disorder (MDD) at the initial onset of the COVID-19 pandemic. Findings showed a significant increase in the prevalence of MDD (22.7%) compared to the pre-pandemic 12-month estimate (10.4%). Specific pandemic-related concerns, along with significant increases in stress, loneliness, fatigue, and substance use behaviors are noted for those with the provisional diagnosis of MDD. Early screening and detection for potential MDD cases can reduce the severity and duration of maladaptive symptoms, decreasing the risk for future depression episodes and the potential loss of quality of life and productivity.
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Affiliation(s)
- Akuekegbe Uwadiale
- Department of Psychology, Texas State University, San Marcos, Texas, USA
| | - Millie Cordaro
- Department of Psychology, Texas State University, San Marcos, Texas, USA
| | - Kaitlin Brunett
- Department of Psychology, Texas State University, San Marcos, Texas, USA
| | - Mark Stern
- Department of Educational Psychology, University of Texas, Austin, Texas, USA
| | - Krista Howard
- Department of Psychology, Texas State University, San Marcos, Texas, USA
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20
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Rudenstine S, Schulder T, Ettman C, Galea S. Perceived coping mitigates anxiety symptoms in the context of COVID-19 stress in an urban university student sample. Psychol Rep 2022:332941221074038. [PMID: 35084273 PMCID: PMC8894909 DOI: 10.1177/00332941221074038] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Perceived coping and its two subprocesses, trauma-focused coping (finding meaning in the details and memory of a potential trauma or stressor) and forward-focused coping (focusing on planning for the future) have been shown to be important in the context of potentially traumatic events. The COVID-19 pandemic and its associated stressors have negatively impacted population mental health, and preliminary investigations have demonstrated the importance of perceived abilities to cope during the pandemic. The current study sought to examine the potentially moderating role of each subprocess on the relationship between stress and anxiety symptoms in a low-income student sample during COVID-19 (N = 2364). We computed two hierarchical multiple linear regressions to assess for significant interactions between stress and perceived coping subprocess scores on anxiety outcomes. Our results demonstrated that both trauma-focused coping and forward-focused coping served as effect modifiers in the relationship between COVID-19related stress and anxiety. Such findings highlight the importance of interventions that incorporate both forms of coping for low-income students during a chronic stressor.
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21
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Thomas SP. Finding Hope in 2022. Issues Ment Health Nurs 2022; 43:1-2. [PMID: 35080995 DOI: 10.1080/01612840.2022.2026186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Sandra P Thomas
- College of Nursing, University of Tennessee Knoxville, Knoxville, Tennessee, USA
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22
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Lee HA, Ahn MH, Byun S, Lee HK, Kweon YS, Chung S, Shin YW, Lee KU. How COVID-19 Affected Healthcare Workers in the Hospital Locked Down due to Early COVID-19 Cases in Korea. J Korean Med Sci 2021; 36:e325. [PMID: 34873888 PMCID: PMC8648608 DOI: 10.3346/jkms.2021.36.e325] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 11/08/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The healthcare workers (HCWs) were exposed to never-experienced psychological distress during the early stage of the coronavirus disease 2019 (COVID-19) pandemic. The aim of this study was to investigate how the COVID-19 pandemic affected the mental health of HCWs during the hospital lockdown period due to mass healthcare-associated infection during the early spread of COVID-19. METHODS A real-time online survey was conducted between April 14-18, 2020 among HCWs who worked at the university hospital where COVID-19 was confirmed in a patient, and the hospital was shut down for 3 weeks. Along with demographic variables and work-related information, psychological distress was measured using the Generalized Anxiety Disorder-7 (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), the Maslach Burnout Inventory-General Survey scale, and the Stress and Anxiety to Viral Epidemics-9. RESULTS The HCWs working in the cohort ward and those who have experienced social discrimination had significantly higher level of depression (PHQ-9 score; 5.24 ± 4.48 vs. 4.15 ± 4.38; P < 0.01 and 5.89 ± 4.78 vs. 3.25 ± 3.77; P < 0.001, respectively) and anxiety (GAD-7 score; 3.69 ± 3.68 vs. 2.87 ± 3.73; P < 0.05 and 4.20 ± 4.22 vs. 2.17 ± 3.06; P < 0.001, respectively) compared to other HCWs. Worries regarding the peer relationship and the skepticism about job were associated with depression (odds ratio [OR], 1.39; 95% confidence interval [CI], 1.07-1.79; P < 0.05 and OR, 1.69; 95% CI, 1.31-2.17; P < 0.001, respectively) and anxiety (OR, 1.73; 95% CI, 1.21-2.49; P < 0.01 and OR, 1.54; 95% CI, 1.09-2.17; P < 0.05, respectively), while fear of infection or worsening of health was not. Path analysis showed that work-related stress associated with the viral epidemic rather than anxiety about the viral epidemic mainly contributed to depression. CONCLUSION The present observational study indicates that mental health problems of HCWs exposed to COVID-19 are associated with distress in work and social relationship. Early intervention programs focusing on these factors are necessary.
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Affiliation(s)
- Hyeon-Ah Lee
- Department of Psychiatry, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Myung Hee Ahn
- Division of Psychiatry, Health Screening and Promotion Center, Asan Medical Center, Seoul, Korea
| | - Seonjeong Byun
- Department of Psychiatry, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hae-Kook Lee
- Department of Psychiatry, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yong-Sil Kweon
- Department of Psychiatry, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seockhoon Chung
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yong-Wook Shin
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
| | - Kyoung-Uk Lee
- Department of Psychiatry, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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23
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Volken T, Zysset A, Amendola S, von Wyl A, Dratva J. Generalized Anxiety among Swiss Health Professions and Non-Health Professions Students: An Open Cohort Study over 14 Months in the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010833. [PMID: 34682579 PMCID: PMC8535743 DOI: 10.3390/ijerph182010833] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 11/28/2022]
Abstract
To date, little is known about the long-term trajectory of generalized anxiety disorder (GAD) symptoms in health professions (HP) students over the course of the pandemic. Like health professionals in general, HP students may have a significantly greater susceptibility to GAD symptoms due to their involvement in the health care system and the associated specific stressors and risks during the COVID-19 pandemic. The HEalth in Students during the Corona pandemic study (HES-C) provided the opportunity to investigate the long-term course of GAD symptoms with eight measurement points over 14 months in 9380 HP and non-HP students in Switzerland between March 2020 and June 2021. We employed logistic regression models with clustered sandwich standard errors to estimate unadjusted and adjusted prevalence of GAD symptoms. In the full model, we adjusted for age, gender, nationality, social status, social support, self-efficacy, and COVID-19 symptoms in the past 4 weeks. At baseline, the estimated adjusted GAD symptom prevalence was 17.6% (95% CI = 14.4–20.7) in HP students and 24.4% (95% CI = 22.3–26.5) in their peers. With the peak of the second SARS-CoV-2 infection wave in October/November 2020, GAD symptom prevalence substantially increased and then remained stable over time, despite changes in the epidemiological situation and its associated containment measures. At the last follow-up in June 2021, GAD symptom prevalence in HP and non-HP students was 22.9% (95% CI = 16.3–29.5) and 36.9% (95% CI = 32.9–40.9), respectively. Absolute differences in GAD symptom prevalence between student groups over all eight measurement points ranged from 6.2% to 14.9% (all p < 0.05). Non-HP students are identified as a specifically vulnerable group. Accordingly, target group-specific public health campaigns and interventions should be developed with the aim to strengthen their resources, reducing GAD symptoms, and preventing chronification.
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Affiliation(s)
- Thomas Volken
- Institute of Health Sciences, ZHAW Zurich University of Applied Sciences, 8401 Winterthur, Switzerland; (A.Z.); (J.D.)
- Correspondence:
| | - Annina Zysset
- Institute of Health Sciences, ZHAW Zurich University of Applied Sciences, 8401 Winterthur, Switzerland; (A.Z.); (J.D.)
| | - Simone Amendola
- Faculty of Medicine and Psychology, Sapienza University of Rome, 00185 Rome, Italy;
| | - Agnes von Wyl
- School of Applied Psychology, ZHAW Zurich University of Applied Sciences, 8005 Zurich, Switzerland;
| | - Julia Dratva
- Institute of Health Sciences, ZHAW Zurich University of Applied Sciences, 8401 Winterthur, Switzerland; (A.Z.); (J.D.)
- Medical Faculty, University of Basel, 4056 Basel, Switzerland
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24
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Wolters PL, Reda S, Martin S, Al Ghriwati N, Baker M, Berg D, Erickson G, Franklin B, Merker VL, Oberlander B, Reeve S, Rohl C, Rosser T, Toledo-Tamula MA, Vranceanu AM. Impact of the coronavirus pandemic on mental health and health care in adults with neurofibromatosis: Patient perspectives from an online survey. Am J Med Genet A 2021; 188:71-82. [PMID: 34536052 PMCID: PMC8652613 DOI: 10.1002/ajmg.a.62490] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 07/19/2021] [Accepted: 08/10/2021] [Indexed: 01/25/2023]
Abstract
The coronavirus pandemic increased anxiety and stress and prevented access to health care worldwide; it is unclear how COVID-19 affected adults with a multisystem genetic disorder such as neurofibromatosis (NF). An anonymous online survey was distributed through an international registry and foundations to adults with NF (June-August 2020) to assess the impact of the pandemic on mental health and NF health care. Six hundred and thirteen adults (18-81 years; M = 45.7) with NF1 (77.8%), NF2 (14.2%), and schwannomatosis (7.8%) provided complete responses. Respondents rated moderate-to-high amounts of worry about the impact of COVID-19 on their emotional (46.3%) and physical health (46.7%), and 54.8% endorsed moderate-to-high pandemic-related stress. Adults with diagnosed/suspected mental health disorders or moderate-to-severe NF symptom impact as well as females endorsed higher COVID-19 stress (ps < 0.01). Less than half who missed a doctor's appointment for their NF care (43.4%) used telehealth. Of these, 33.3% and 46.2% reported that telehealth met their needs to a moderate or high degree, respectively. Results indicated that subgroups of adults with NF experience higher COVID-19-related worries and stress and may need additional support. Furthermore, telehealth is under-utilized and could help NF providers connect with patients, although improved delivery and patient training may facilitate expanded use of these services.
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Affiliation(s)
- Pamela L Wolters
- Pediatric Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Stephanie Reda
- Pediatric Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Staci Martin
- Pediatric Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Nour Al Ghriwati
- Pediatric Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Melissa Baker
- Pediatric Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Dale Berg
- Response Evaluation in Neurofibromatosis and Schwannomatosis (REiNS) International Collaboration
| | - Gregg Erickson
- Response Evaluation in Neurofibromatosis and Schwannomatosis (REiNS) International Collaboration.,NF Network, Wheaton, Illinois, USA
| | - Barbara Franklin
- Response Evaluation in Neurofibromatosis and Schwannomatosis (REiNS) International Collaboration
| | - Vanessa L Merker
- Department of Neurology and Cancer Center, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Beverly Oberlander
- Response Evaluation in Neurofibromatosis and Schwannomatosis (REiNS) International Collaboration.,NF Network, Wheaton, Illinois, USA
| | - Stephanie Reeve
- Response Evaluation in Neurofibromatosis and Schwannomatosis (REiNS) International Collaboration
| | - Claas Rohl
- Response Evaluation in Neurofibromatosis and Schwannomatosis (REiNS) International Collaboration.,NF Kinder, NF Patients United, Vienna, Austria
| | - Tena Rosser
- Division of Neurology, Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Mary Anne Toledo-Tamula
- Clinical Research Directorate (CRD), Frederick National Laboratory for Cancer Research, Frederick, Maryland, USA
| | - Ana-Maria Vranceanu
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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