Adjustment disorder, traumatic stress, depression and anxiety in Poland during an early phase of the COVID-19 pandemic

Symptoms of Post-Traumatic Stress and Mental Health in a Sample of University Students: The Mediating Role of Resilience and Psychological Well-Being

The COVID-19 pandemic has been one of the most stressful events in recent times across the world. The long-term effect of these experiences raises several concerns, including the development of post-traumatic stress symptomatology. However, little is known about the psychological processes that mediate this association. The aim of this study was to explore the association of emotional exhaustion and anxiety in post-traumatic stress symptomatology, and the mediating role of resilience and psychological well-being in university students. A total of 526 university students of both sexes participated in this study, and they were aged between 17 and 62 years old. Symptoms of anxiety and emotional exhaustion were significantly higher in females, in contrast, males showed on average more resilience and psychological well-being. Additionally, participants with COVID-19 infection had higher levels of emotional exhaustion, anxiety, and PTSD. The results indicated that the variables were correlated with each other (p < 0.001). A conceptual model was confirmed that describes anxiety and emotional exhaustion as predictors, post-traumatic stress symptomatology as an outcome variable, and resilience and psychological well-being as mediators. Resilience and psychological well-being can be important protective factors for adaptive responses in stressful situations. The findings obtained in this study will provide a theoretical basis for designing targeted interventions to improve psychological health, whether for crisis intervention, the process of adapting to higher education, or for recovery plans from psychological trauma.

A longitudinal study of risk and protective factors for symptoms of adjustment disorder during the COVID-19 pandemic

Background: The COVID-19 pandemic caused multiple stressors that may lead to symptoms of adjustment disorder.Objective: We longitudinally examined relationships between risk and protective factors, pandemic-related stressors and symptoms of adjustment disorder during the COVID-19 pandemic, as well as whether these relationships differed by the time of assessment.Method: The European Society for Traumatic Stress Studies (ESTSS) ADJUST Study included N = 15,169 participants aged 18 years and above. Participants from 11 European countries were recruited and screened three times at 6-month intervals from June 2020 to January 2022. Associations between risk and protective factors (e.g. gender), stressors (e.g. fear of infection), and symptoms of adjustment disorder (AjD, ADNM-8) and their interaction with time of assessment were examined using mixed linear regression.Results: The following predictors were significantly associated with higher AjD symptom levels: female or diverse gender; older age; pandemic-related news consumption >30 min a day; a current or previous mental health disorder; trauma exposure before or during the pandemic; a good, satisfactory or poor health status (vs. very good); burden related to governmental crisis management and communication; fear of infection; restricted social contact; work-related problems; restricted activity; and difficult housing conditions. The following predictors were associated with lower AjD levels: self-employment or retirement; working in healthcare; and face-to-face contact ≥ once a week with loved ones or friends. The effects of the following predictors on AjD symptoms differed by the time of assessment in the course of the pandemic: a current or previous mental disorder; burden related to governmental crisis management; income reduction; and a current trauma exposure.Conclusions: We identified risk factors and stressors predicting AjD symptom levels at different stages of the pandemic. For some predictors, the effects on mental health may change at different stages of a pandemic.

Diagnostic certainty during in-person and telehealth autism evaluations

Background

Many diagnostic evaluations abruptly shifted to telehealth during the COVID-19 pandemic; however, little is known about the impact on diagnosis patterns for children evaluated for autism spectrum disorder (ASD). The purpose of this clinical research study was to examine (1) the frequency of diagnoses evaluated beyond ASD; (2) the frequency of diagnoses made, including ASD; and (3) clinician diagnostic certainty for all diagnoses evaluated for children who received an evaluation due to primary concerns about ASD via telehealth during the pandemic compared to those evaluated in person before the pandemic at an ASD specialty clinic.

Methods

The sample included 2192 children, 1-17 years (M = 6.5 years; SD = 3.9), evaluated by a physician/psychologist at an ASD specialty center. A total of 649 children were evaluated in-person September 1, 2019-March 13, 2020 (pre-pandemic) and 1543 were evaluated via telehealth March 14, 2020-July 26, 2021 (during pandemic). Upon completion of each evaluation, clinicians provided a final diagnostic determination (i.e., "Yes," "No," "Possible," or "Not Assessed") for the following DSM-5 conditions: ASD, attention-deficit/hyperactivity disorder (ADHD), intellectual developmental disorder (IDD), anxiety (ANX), depression (DEP), and behavioral disorder (BD). "Possible" indicated lower certainty and the diagnosis was not provided. "Not Assessed" indicated the disorder was not evaluated.

Results

Diagnostic certainty for ASD and ADHD was lower and clinicians evaluated for and made diagnoses of IDD less often during evaluations that occurred via telehealth during the pandemic versus in person before the pandemic. DEP and BD were diagnosed more frequently, diagnostic certainty of DEP was lower, and no differences in the frequency of ANX diagnoses emerged during evaluations conducted via telehealth during the pandemic compared to those conducted in person before the pandemic.

Conclusions

Differences emerged in the frequency of diagnoses evaluated and made and diagnostic certainty for evaluations conducted via telehealth during the pandemic compared to in person before the pandemic, which likely impacted patients and reflect real-word challenges. Future work should examine whether these patterns are generalizable and the mechanisms that contribute to these differences.

Post-what stress? A review of methods of research on posttraumatic stress during COVID-19

BACKGROUND

Post-traumatic stress (PTS) was extensively investigated during the COVID-19 pandemic. However, numerous researchers have raised concerns regarding the adherence of many of these studies to the diagnostic criteria for PTSD as outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the International Classification of Diseases (ICD). This review aimed to provide insight into the methodology of research on PTS during the COVID-19 pandemic.

METHODS

Two independent reviewers examined a total of 1129 studies published between 1/01/2020 and 1/07/2023. The investigation focused on the scales employed to assess PTS, the diagnostic framework used (DSM or ICD), whether there was referral to an index-event in the PTS measurement and country where data collection took place.

RESULTS

Among the 1129 studies, 70.0% did not provide any indication of an index-event to which PTS symptoms were attributed. Only 11.3% of the studies explicitly indicated an index-event associated with the PTS symptoms. Furthermore, 54.1% of the studies utilized scales based on DSM-IV criteria. Finally, the majority of PTS-studies had data collections in China, United States and Italy.

CONCLUSION

A limited number of studies conducted during the COVID-19 pandemic reported use of an index-event in their PTS measurement. Furthermore, most studies used scales based on a previous iteration of the most used diagnostical system, namely the DSM. This delay in the implementation of new diagnostic criteria, may impair the clinical relevance of scientific studies.

Mental health during the COVID-19 pandemic and first lockdown in Lebanon: Risk factors and daily life difficulties in a multiple-crises setting

INTRODUCTION

Research from around the world shows important differences in the impact of the COVID-19 pandemic and lockdowns on mental health. This study examined the extent of mental health challenges (depressive and anxiety symptoms and daily life difficulties) and their associations with pandemic- and response-related factors during the first lockdown in Lebanon, which happened amid a severe economic crisis and socio-political turmoil.

METHODS

Data come from a cross-sectional internet-based survey (May-June 2020). Association of depressive (Patient Health Questionnaire (PHQ-9)) and anxiety symptoms (Generalized Anxiety Disorder (GAD-7)) with outbreak-related worries and knowledge, information sources, and confidence and satisfaction in response measures were estimated using logistic regression adjusted for sociodemographic and socioeconomic indicators.

RESULTS

Among 510 participants (mean age 36.1±11.3; 69.4% women), 32.3% had elevated depressive and 27.3% had elevated anxiety symptoms; younger age, unemployment, loss of employment, and lower income were related to more mental health symptoms. Most prevalent daily life challenges were feelings of uncertainty (74.5%) and financial (52.2%) and emotional (42.2%) difficulties; these and all other daily life difficulties (work-related, caregiving, and online learning) were significantly higher among participants with higher depressive and anxiety symptoms. Higher outbreak-related worries were associated with higher depressive (OR = 1.36, 95% CI = 1.20,1.53) and anxiety symptoms (OR = 1.47, 95% CI = 1.30,1.67). Higher pandemic-related knowledge, reliance on and trust in local health agencies and professionals' information, and satisfaction and confidence regarding governmental and health institutions' response were all related to lower mental health symptoms.

CONCLUSION

Results show that mental health burden in Lebanon during the first lockdown (when the COVID-19 outbreak was still minimal) is among the highest reported worldwide and highlight elevated emotional and financial tolls and widespread impact on daily life. In this high-burden and multiple-challenges context, results suggest an important role for the healthcare body, knowledge, and trust in the institutions managing the response.

Savoring mediates the mental health benefits of positive coping processes: A prospective population-based analysis

Positive coping (e.g., self-efficacy and positive reappraisal) and savoring could bear mental health implications under large-scale disasters such as COVID-19. The integrative affect-regulation framework of psychological resilience proposes that evaluative efforts regulate affect, which then predicts positive short-term consequences and better mental health. This two-wave study was done during the prolonged, intensive COVID-19 control rules in Hong Kong and examined (1) the prospective associations of positive coping processes (i.e., self-efficacy and positive reappraisal) (T1, March-August 2021) with subsequent psychiatric symptoms (T2, September 2021-February 2022) and (2) the mediating effect of T2 savoring in the associations. Path analyses revealed that T1 self-efficacy and positive reappraisal were inversely related to T2 psychiatric symptoms. T2 savoring partially mediated the effect of T1 self-efficacy but fully mediated the effect of T1 positive reappraisal. Self-efficacy could have more sustainable direct positive associations with mental health, whereas the benefit of positive reappraisal might need to be catalyzed by savoring over time. Our study offered concrete illustrations of the conceptual tenets of the affect-regulation framework.

[Efficacy and safety of Aviandr in the treatment of anxiety in patients with adjustment disorders after COVID-19]

OBJECTIVE

To investigate the efficacy and safety of Aviandr in the treatment of anxiety in patients with adjustment disorders after COVID-19.

MATERIAL AND METHODS

A multicenter prospective open-label study included 109 patients of both sexes aged 18 to 65 years (70 women, 39 men, average age - 41.4±13.18 years) with a leading complaint of anxiety (Hamilton scale score, HAM-A ≥18 - ≤24), which arose after acute coronavirus infections. Clinical manifestations had to meet the diagnostic criteria F43.2 ICD-10. The drug Aviander was prescribed 20 mg 2 times a day for 4 weeks. At the end of taking the drug, patients were monitored for another 1 week (a delayed follow-up visit). Psychopathological, statistical and parametric research methods were used using standardized HAM-A, Montgomery-Asberg scales (MADRS), visual analog asthenia scale (VASH-A), Sheehan Disability Scale (SDS), digital character substitution test (DSST), general clinical impression scale (CGI).

RESULTS

Data from 109\110 patients were analyzed to evaluate efficacy\safety. Aviandr was administered 20 mg 2 times daily for 4 weeks. Patients were followed for 1 week (delayed follow-up visit) at the end of treatment. Reducing the intensity of anxiety on the HAM-A scale was - 14.2±4.92 or 69.4±22.66% by the end of treatment. The response rate to therapy (responders are patients with a decrease in the total score on the HAM-A ≥50%) was 83.49%. Remission was achieved (sum of HAM-A scores ≤7) by the end of treatment 68.81% of patients, and 79.8% of patients at the follow-up visit. Significant changes were obtained on the MADRS, VAS-A, SDS and DSST scales. According CGI 45.9% of patients had «much improved» and 43.1% of patients had «very much improved» by the end of treatment; 58.7% of patients had «much improved» and of 33.9% patients had «very much improved» at the follow-up visit. 38 adverse events were reported in 27 (24.55%) patients during the study. A definite association with study drug was reported between 5 mild adverse events in 4 (3.64%) patients. No subjects withdrew from the study due to an adverse event. Positive dynamics (reduction of anxiety symptoms, decrease in asthenia) persisted after discontinuation of the study drug. No cases of withdrawal syndrome were observed.

CONCLUSION

According to the results of the study, the anxiolytic, antidepressant, antiasthenic and pro-cognitive effects of Aviandr were observed. An increase in the social activity of patients was observed.

On the path to recovery: traumatic stress research during the COVID-19 pandemic 2021-2023

This Special Issue of the European Journal of Psychotraumatology (EJPT) presents 51 articles published between 2021 and 2023 and follows the Special Issue on pandemic-related traumatic stress research published in 2021 (O'Donnell, M. L., & Greene, T. [2021]. Understanding the mental health impacts of COVID-19 through a trauma lens. European Journal of Psychotraumatology, 12(1), 1982502). Research on traumatic stress during the pandemic has cast the spotlight on vulnerable populations and groups, notably front-line healthcare workers; people faced with major losses including the deaths of loved ones; those who personally survived debilitating and often life-threatening viral infection; and students who were isolated and experienced profound delays in their education, relationships, and emerging independence. The papers in this collection underscore the associations between COVID-19 related stressors and a plethora of adverse mental health sequelae, including posttraumatic stress reactions, and draw attention to the ubiquity of grief and moral injury and their wide-ranging and detrimental impact. Currently, there is a paucity of evidence on interventions to enhance resources, self-efficacy, and hope for affected groups and individuals through societal, organisational, and healthcare systems; however early research on the prevention of COVID-related traumatic stress disorders provides a basis for both hope and preparedness for the future.

Effectiveness of a scalable, remotely delivered stepped-care intervention to reduce symptoms of psychological distress among Polish migrant workers in the Netherlands: study protocol for the RESPOND randomised controlled trial

BACKGROUND

The COVID-19 pandemic has negatively affected the mental health of international migrant workers (IMWs). IMWs experience multiple barriers to accessing mental health care. Two scalable interventions developed by the World Health Organization (WHO) were adapted to address some of these barriers: Doing What Matters in times of stress (DWM), a guided self-help web application, and Problem Management Plus (PM +), a brief facilitator-led program to enhance coping skills. This study examines whether DWM and PM + remotely delivered as a stepped-care programme (DWM/PM +) is effective and cost-effective in reducing psychological distress, among Polish migrant workers with psychological distress living in the Netherlands.

METHODS

The stepped-care DWM/PM + intervention will be tested in a two-arm, parallel-group, randomized controlled trial (RCT) among adult Polish migrant workers with self-reported psychological distress (Kessler Psychological Distress Scale; K10 > 15.9). Participants (n = 212) will be randomized into either the intervention group that receives DWM/PM + with psychological first aid (PFA) and care-as-usual (enhanced care-as-usual or eCAU), or into the control group that receives PFA and eCAU-only (1:1 allocation ratio). Baseline, 1-week post-DWM (week 7), 1-week post-PM + (week 13), and follow-up (week 21) self-reported assessments will be conducted. The primary outcome is psychological distress, assessed with the Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS). Secondary outcomes are self-reported symptoms of depression, anxiety, posttraumatic stress disorder (PTSD), resilience, quality of life, and cost-effectiveness. In a process evaluation, stakeholders' views on barriers and facilitators to the implementation of DWM/PM + will be evaluated.

DISCUSSION

To our knowledge, this is one of the first RCTs that combines two scalable, psychosocial WHO interventions into a stepped-care programme for migrant populations. If proven to be effective, this may bridge the mental health treatment gap IMWs experience.

TRIAL REGISTRATION

Dutch trial register NL9630, 20/07/2021, https://www.onderzoekmetmensen.nl/en/trial/27052.

Predictors of pretraumatic stress during the COVID-19 pandemic in Poland

BACKGROUND

Pretraumatic stress has the same symptoms as post-traumatic stress but instead pertains to anticipated threats. There is evidence that pretraumatic stress occurs among soldiers and pregnant people.

OBJECTIVE

We analyzed correlates of pretraumatic stress concerning the threat of COVID-19 infection.

METHOD

Our pilot study was cross-sectional (N = 74); our main study was longitudinal and consisted of three waves (N = 1067, N = 894, and N = 752 for Waves 1, 2, and 3, respectively). Our pilot study used correlation and multiple linear regression. Our main study used quadratic regression and a random intercept cross-lagged panel model.

RESULTS

The pilot study found that pretraumatic stress was positively correlated with agreeableness (r = .24, p < .01) and negatively correlated with emotional stability (r = -.30, p < .01) and intellect/imagination (r = -.37, p < .01). The main study demonstrated that pretraumatic stress was positively correlated with other measures of mental health problems during the COVID-19 pandemic and with perceived positive aspects of the pandemic (r = .11, p < .01). There is evidence of a U-shaped relationship between pretraumatic stress and perceived positive aspects of the pandemic. A random intercept cross-lagged panel model analysis demonstrated that pretraumatic stress in Wave 2 was negatively predicted by levels of prosocial behavior in Wave 1 (B = -1.130, p < .01).

CONCLUSION

Mental health professionals should take into account pretraumatic stress, not only as a possible consequence of the COVID-19 pandemic outbreak but more generally as a risk in situations that are new, difficult, and challenging for people.

Did Cognitive Attentional Syndrome Symptoms Predict Stress- and Trauma-Related Symptoms in the Initial Phase of the COVID-19 Pandemic? Results from a Two-Wave Study on a Sample of Polish Internet Users

BACKGROUND

According to metacognitive theory, Cognitive Attentional Syndrome (CAS) is a transdiagnostic factor and a main mechanism of psychopathology maintenance. The main goal of this study is to examine whether CAS predicted stress- and trauma-related symptomatology in the first months of the COVID-19 pandemic and three months later.

METHODS

Initially, 1792 participants were recruited online via social media; the data were collected at two time points. The measures included the Cognitive Attentional Syndrome Questionnaire, the Adjustment Disorder-New Module 20, the International Trauma Questionnaire, and additional measures.

RESULTS

Structural equation modeling was conducted in order to determine the relations between the reported stressors, CAS, and symptomatology. At both time points, CAS was a significant mediator between the stressors and symptoms of adjustment disorder. Despite the decrease in the intensity of adjustment disorder symptoms between waves, it was a significant predictor of other psychopathologies at both time points, except for traumatic stress.

CONCLUSIONS

The findings confirm the assumption that CAS is a transdiagnostic factor of psychopathology and has a mediating role in the relationship between stressors and adjustment disorder and co-occurring symptomatology. The effect was particularly significant in the initial phase of the pandemic, which was highly stressful for many people.

A predictive model of perceived stress during the first wave of the COVID-19 pandemic in university students Ecuadorians

Background and objectives

The situation caused by the confinement due to the COVID-19 pandemic and the mobility restriction implemented by governments worldwide had a significant impact on people's routines. Stressors are known to increase emotional imbalance, uncertainty, and frustration in the general population. This study explores the factors that predispose to the risk of perceived stress from COVID-19 and determines the underlying mediating mechanisms in the Ecuadorian population.

Method

The cross-sectional study an incidental non-probabilistic sample of n = 977 participating student volunteers from the four regions of the Republic of Ecuador (68.6% women and 31.4% men). Data on emotional regulation (ERQ), perceived stress (PSS), active procrastination (APS), diagnosis and symptoms related to COVID-19, social isolation, coexistence, and a sociodemographic questionnaire (biological sex, marital status, and age) were recruited. Statistical analysis was based on a structural equation model.

Results

The risk of suffering perceived stress in the COVID-19 pandemic was higher for single women who have lived longer in social isolation, have lived with more people, have poor emotional regulation and high rates of procrastination. This structural model is similar in all Ecuadorian regions χ² = 21.54 (p = 0.760), RMSEA = 0.001 (95%CI, 0.00-0.02), CFI = 0.998; TLI = 0.999; SRMR = 0.020.

Discussion

Although our findings are consistent and revealing for the scientific community, the lack of discrimination of the data due to strict isolation measures, taken at different periods by the Ecuadorian government against positive cases of COVID-19, is discussed. The research was applied to the university population, it would be representative to extend the study to schools and colleges.

Conclusion

We consider this work as a starting point for the creation of preventive models against perceived stress in the university environment in the event of health emergencies.

Networks of pandemic-specific stressors, risk factors, and clinical symptoms: A comparison between women and men during the early phase of the COVID-19 pandemic

BACKGROUND

During the COVID-19 pandemic, female gender was a robust factor associated with mental health problems. This study aimed to investigate associations between pandemic-related risk factors, stressors, and clinical symptoms, with special reference to gender and possible differential gender effects.

METHODS

Participants were recruited from June to September 2020 through an online survey (ESTSS ADJUST study). Women (N = 796) and men (N = 796) were matched on age, education, income, and living community. Symptoms of depression (PHQ-9), anxiety (PHQ-4), adjustment disorder (ADNM-8), and PTSD (PC-PTSD-5) and different risk factors including pandemic-specific stressors (PaSS) were assessed. Separate network analyses for men and women were conducted and compared followed by a joint network analysis including gender.

RESULTS

The networks of women and men did not differ in their structure (M = 0.14, p = .174) or strength of associations (S = 1.22, p = .126). Few relationships differed significantly between genders e.g., the connection between burden through work-related problems and anxiety was stronger in women. In the joint network, single factors were related to gender e.g., men felt more burdened through work-related problems and women through conflicts at home.

LIMITATIONS

We cannot imply causal relationships due to the cross-sectional data of our study. The findings cannot be generalized as the sample is not representative.

CONCLUSION

Men and women seem to show comparable networks of risk factors, stressors, and clinical symptoms, although differences in individual connections and in levels of clinical symptoms and burdens were found.

Emotional control and factors differentiating it in the adult population of Poland during the COVID-19 pandemic

Introduction

The public health crisis related to the COVID-19 pandemic has had a negative impact on the mental health of both individuals and entire populations. The source of stress was not only the fear of getting sick, but also the restrictions introduced, such as: mass lockdown, the need to maintain social distance, quarantine or the mandatory use of personal protective equipment. Their introduction and maintenance caused various emotional reactions which often resulted in undesirable behavior leading to infections spreading.

The aim of the study

The aim of the study was to analyze the level of emotional control depending on selected factors related to the pandemic and the introduced restrictions.

Materials and methods

The study covered 594 adult Poles. To evaluate knowledge about COVID-19 and attitudes toward the implemented restrictions, the questionnaire prepared by the authors was used. To determine the level of control of anger, depression and anxiety the Courtauld Emotional Control Scale (CECS) was used, and to estimate the level of perceived stress the Perceived Stress Scale (PSS-10) was applied.

Results

In the entire analyzed group, the general level of emotional control was 51.82 ± 12.26, with anxiety being the most suppressed emotion (17.95 ± 4.99), whereas the least suppressed emotion was anger (16.35 ± 5.15). The average stress level in the studied group was 20.5 ± 5.3. The level of perceived stress did not differentiate the level of emotional control. It was found that the higher level of the knowledge about the pandemic and methods of prevention, the higher emotional control, especially in the anxiety subscale (high level of knowledge - 18.26 ± 5.36 vs. low level of knowledge - 15.09 ± 3.6; p = 0.02). People reporting difficulties in reconciling remote work with home duties were less able to control anger (14.63 ± 4.98) than people without such problems (16.71 ± 4.12; p = 0.007).

Conclusion

Proper education improving knowledge about COVID-19 and methods of prevention may enhance the control of emotions in the population. Possible future preventive measures aimed at limiting the spread of SARS-CoV-2 infections or other infectious diseases should also take into account possible excessive mental burden caused by private and professional duties.

Personality and Risk-Perception Profiles with Regard to Subjective Wellbeing and Company Management: Corporate Managers during the Covid-19 Pandemic

This study examined the role of the Big Five personality traits and risk perception profiles among a sample of corporate managers concerning their subjective wellbeing (SWB) and corporate management practices during the Covid-19 pandemic. Two hundred and fifty-five chief executive officers (CEOs) and chief financial officers (CFOs) of companies listed on the main market of the Warsaw Stock Exchange (WSE) in Poland participated in the study by completing the Satisfaction with Life Scale, Positive and Negative Affect Scale, Ten-Item Personality Inventory, Stimulation-Instrumental Risk Inventory, and a business survey on the Covid-19 pandemic's impact on company management. Latent profile analysis revealed the existence of diverse profiles among the participants regarding personality traits and risk perception, which were variously related to their SWB and managerial practices during the pandemic. It seems that individual differences in personality traits and risk perception not only matter for the individual life satisfaction of managers but may also translate into effective company management in times of crisis. The results of our study may be an adjunct to understanding underlying sources of managerial biases in corporate management as well as to developing more effective methods of psychological counseling of corporate managers, a topic that remains still a highly understudied research area.

The prevalence of adjustment disorder and predisposing factors in infertile women

BACKGROUND

Infertility is a stressful life event that increases the risk of developing mental disorders, particularly adjustment disorder (AD). Given the paucity of data on the prevalence of AD symptoms in infertility, the purpose of this study was to ascertain the prevalence, clinical presentation, and risk factors for AD symptoms in infertile women.

METHOD

In a cross-sectional study, 386 infertile women completed questionnaires including the Adjustment Disorder New Module-20 (ADNM), the Fertility Problem Inventory (FPI), the Coronavirus Anxiety Scale (CAS), and the Primary Care Posttraumatic Stress Disorder (PC-PTSD-5) at an infertility center between September 2020 and January 2022.

RESULT

The results indicated that 60.1% of infertile women exhibited AD symptoms (based on ADNM > 47.5). In terms of clinical presentation, impulsive behavior was more common. No significant relationship was observed between prevalence and women's age or duration of infertility. Infertility stress (β = 0.27, p < 0.001), coronavirus anxiety (β = 0.59, p = 0.13), and a history of unsuccessful assisted reproductive therapies (β = 2.72, p = 0.008) were several predisposing factors for AD symptoms in infertile women.

CONCLUSIONS

The findings suggest that all infertile women be screened from the start of infertility treatment. Additionally, the study suggests that infertility specialists should focus on combining medical and psychological treatments for individuals predisposed to AD, particularly infertile women who exhibit impulsive behaviors.

Reports analysis of psychotropic drugs related adverse reactions in Australia and Poland during the COVID 19 pandemic

BACKGROUND

The COVID-19 pandemic has caused significant changes to the global health care system AIMS: It is unknown whether the COVID-19 pandemic influenced the occurrence of adverse drug reactions (ADR) of antidepressive agents, benzodiazepines, and antipsychotics plus mood stabilizers (AaMS). The study was designed in order to compare the incidence of ADR during the COVID-19 pandemic with the period preceding the pandemic in Poland and Australia, different in terms of their COVID-19 prevention strategy.

METHOD

We analysed ADR from the three surveyed pharmacological groups of drugs observed in Poland and Australia in the period prior to, and during the COVID-19 pandemic RESULTS: In Poland, a noticeable increase in the reported ADR of the assessed drug groups was observed during the COVID-19 pandemic. The highest was for antidepressive agents, but the reporting of ADR for benzodiazepines and AaMS drugs also increased significantly. In the case of ADR in Australian patients, the increase in the number of reported ADR for antidepressive agents was modest compared to that seen in Poland, but still noticeable, and there was a significant increase in ADR for benzodiazepines CONCLUSIONS: This study showed that the COVID-19 pandemic has had an impact on the incidence of ADR reported among both Polish and Australian patients but the modality of this was different.

Profiles of risk factors for depressive and anxiety symptoms during the COVID-19 pandemic: A latent class analysis

The COVID-19 pandemic has caused a high burden in the general population. The exposure to an accumulation of risk factors, as opposed to a single risk, may have been associated with higher levels of depressive and anxiety symptoms during the pandemic. This study aimed to (1) identify subgroups of individuals with distinct constellations of risk factors during the COVID-19 pandemic and (2) investigate differences in levels of depressive and anxiety symptoms. German participants (N = 2245) were recruited between June-September 2020 through an online survey (ADJUST study). Latent class analysis (LCA) and multiple group analyses (Wald-tests) were conducted to identify profiles of risk factors and examine differences in symptoms of depression (PHQ-9) and anxiety (GAD-2). The LCA included 14 robust risk factors of different domains, for example, sociodemographic (e.g., age), health-related (e.g., trauma), and pandemic-related (e.g., reduced income) factors. The LCA identified three risk profiles: High sociodemographic risk (11.7%), high social and moderate health-related risk (18.0%), and low general risk (70.3%). Individuals with high sociodemographic risk reported significantly higher symptom levels of depression and anxiety than the remaining groups. A better understanding of risk factor profiles could help to develop targeted prevention and intervention programs during pandemics.

The Role of Conspiracy Theories, Perceived Risk, and Trust in Science on COVID-19 Vaccination Decisiveness: Evidence from Cyprus

COVID-19 reminded us of the importance of vaccinating for successfully overcoming health-related crises. Yet, vaccine hesitancy is still present. This study examined the impacts of conspiracy theories, perceived risk, and trust in science on COVID-19 vaccination decisiveness. The study was conducted at the end of the third wave of the pandemic, in July 2021, in Cyprus. Data were collected via an online self-administered anonymous survey using convenience and snowball sampling methods. Participants were 363 adults who completed a set of questionnaires that examined their believability in ten vaccine-related conspiracy theories, their perceived dangerousness of COVID-19, and their level of trust in science and scientists. The results suggest that (a) participants with a high conspiracy theory belief are less likely to be vaccinated, (b) participants who perceive COVID-19 as a dangerous disease are more likely to be vaccinated, and (c) participants with high trust in science are more likely to be vaccinated. The implications of the findings are discussed and can be used by public health officials in their campaigns.

Impact of the COVID-19 pandemic and lockdown on mental health among the general population in Poland and on the availability of psychological support

The objective of this paper was to assess the impact of the COVID-19 pandemic on the mental health of Poles and the availability of psychiatric and psychological support during the pandemic. A prospective, cross-sectional web-based survey design was adopted. It was carried out on a sample of 1080 Polish citizens above 18 years old. The majority of Poles (70%) experienced symptoms of mental disorders during the COVID-19 pandemic. Sleep disturbance (63.79%), anxiety (48.79%), low mood for most of the day (44.63%), sadness, tearfulness (41.29%), and concentration disorders (35.93%) were the mental disorder symptoms reported most often by the survey subjects. To reduce the potential acute and long-lasting effects of the COVID-19 pandemic on mental health, decision-makers of the Polish health system should implement stepped multilevel and multi-target psychological support services.

Risk and protective factors for posttraumatic stress disorder in trauma-exposed individuals during the COVID-19 pandemic - findings from a pan-European study

HIGHLIGHTS

N =  4,607 trauma-exposed adult participants were recruited from the general population during the first year of the COVID-19 pandemic.The prevalence for probable posttraumatic stress disorder was 17.7%.We identified risk factors (e.g. poor health condition) and protective factors (e.g. social contact) associated with posttraumatic stress disorder.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSION

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

Examining the Longitudinal Associations between Adjustment Disorder Symptoms and Boredom during COVID-19

The COVID-19 pandemic has led to a myriad of stressors, underscoring the relevance of adjustment disorder during these extraordinary times. Boredom-as a feeling and as a dispositional characteristic-is an equally pertinent experience during the pandemic that has been cross-sectionally linked to various mental health difficulties. The current longitudinal study expanded on this work, examining the associations between adjustment disorder symptoms and boredom (both as a feeling and as a trait) over time during the COVID-19 pandemic. Community participants completed questionnaires three times, rating their trait boredom at Time 1 and their feelings of boredom and adjustment disorder symptoms (preoccupation with a pandemic stressor and failure to adapt) over the past week at Times 1-3. Latent growth curve analyses found that an increase in feelings of boredom was significantly associated with increased preoccupation with a pandemic stressor and increased difficulties with adapting over time. Additionally, trait boredom significantly predicted changes in preoccupation and the failure to adapt, such that participants high in trait boredom increasingly struggled with these symptoms over time. Our results suggest that increased feelings of boredom and a trait disposition towards boredom can be detrimental to people's ability to adjust over time to the stressors associated with the pandemic. Boredom, as an aversive state and as a chronic difficulty, may be important to address in treatment approaches for adjustment disorder symptoms during COVID-19.

Burnout among psychotherapists: a cross-cultural value survey among 12 European countries during the coronavirus disease pandemic

The aim of this study was to examine cross-cultural differences, as operationalized by Schwartz's refined theory of basic values, in burnout levels among psychotherapists from 12 European countries during the coronavirus disease (COVID-19) pandemic. We focused on the multilevel approach to investigate if individual- and country-aggregated level values could explain differences in burnout intensity after controlling for sociodemographic, work-related characteristics and COVID-19-related distress among participants. 2915 psychotherapists from 12 countries (Austria, Bulgaria, Cyprus, Finland, Great Britain, Serbia, Spain, Norway, Poland, Romania, Sweden, and Switzerland) participated in this study. The participants completed the Maslach Burnout Inventory-Human Service Survey, the revised version of the Portrait Values Questionnaire, and a survey questionnaire on sociodemographic, work-related factors and the COVID-19 related distress. In general, the lowest mean level of burnout was noted for Romania, whereas the highest mean burnout intensity was reported for Cyprus. Multilevel analysis revealed that burnout at the individual level was negatively related to self-transcendence and openness-to-change but positively related to self-enhancement and conservation values. However, no significant effects on any values were observed at the country level. Male sex, younger age, being single, and reporting higher COVID-19-related distress were significant burnout correlates. Burnout among psychotherapists may be a transcultural phenomenon, where individual differences among psychotherapists are likely to be more important than differences between the countries of their practice. This finding enriches the discussion on training in psychotherapy in an international context and draws attention to the neglected issue of mental health among psychotherapists in the context of their professional functioning.

Stress appraisal as a mediator between the sense of coherence and the frequency of stress coping strategies in women and men during COVID-19 lockdown

The COVID-19 lockdown experience is a unique and unexpected stressful life situation. In our research project, we explored gender differences in the mean level of stress appraisal (SAQ), the frequency of stress coping strategies (COPE), and the sense of coherence (SOC), as well as gender differences in the strength of the relationships between SAQ, COPE, and SOC during the COVID-19 lockdown. Finally, we tested if stressor appraisal (as a threat, harm/loss, or challenge) mediates the relationship between SOC and COPE in women and men respectively. Data were collected during the first wave of the COVID-19 lockdown in Poland in 2020. An online survey was conducted among 326 adults aged between 18 and 72. We observed gender differences in the level of SAQ, COPE, and SOC and gender differences in the significance and strength of the correlations between these variables. SOC had a twofold effect on COPE in men: direct and indirect through SOC-threat and SOC-harm/loss. In women, SOC did not directly predict COPE frequency but affected COPE in an indirect way through SAQ. SAQ is an important factor that modifies the strength of the SOC effect on COPE in women and men during the lockdown.

Mental Health Conditions According to Stress and Sleep Disorders

The purpose of this study was to compare associations between stress and sleep disorders (insomnia, hypersomnia, and sleep apnea), identify potential modifying effects, and compare associations between stress and types of sleep disorders with selected mental health conditions. Analyses were based on 21,027 employees aged 18–64 years in 2020 who were insured by the Deseret Mutual Benefit Administrators (DMBA). The risk of stress (2.3%) was significantly greater in women, singles, and those with dependent children. The risk of a sleep disorder was 12.1% (2.1% for insomnia, 1.0% for hypersomnia, and 10.1% for sleep apnea). The risk of stress was significantly greater for those with a sleep disorder (136% overall, 179% for insomnia, and 102% for sleep apnea after adjusting for age, sex, marital status, dependent children, and sleep disorders). The risk of stress among those with sleep apnea was significantly greater for singles than for married individuals. Approximately 9.5% had anxiety, 8.5% had depression, 2.0% had ADHD, 0.6% had bipolar disorder, 0.4% had OCD, and 0.1% had schizophrenia. Each of these mental health conditions was significantly positively associated with stress and sleep disorders. Bipolar disorder and schizophrenia were more strongly associated with stress and sleep disorders than were the other mental health conditions. Insomnia was more strongly associated with anxiety, bipolar disorder, OCD, and schizophrenia than was sleep apnea.

Embitterment during the COVID-19 Pandemic in Reaction to Injustice, Humiliation, and Breach of Trust

The COVID-19 pandemic has not only had an impact on the health of many people, but also on politics, the economy, and everyday life at large. It has been shown that some people respond with anxiety and depression, which is not surprising. Another reaction in the context of COVID-19 is embittered fights and disruptions between family members, friends, and neighbors, but also problems on a societal and political level, mutual public insults, political demonstrations, and even aggressive outbursts with a high number of participants. This calls for a separate explanation. One trigger may be embitterment, an emotion known to anybody in reaction to injustice, humiliation, and breach of trust, in association with helplessness. It comes along with a nagging desire to fight back and is usually accompanied by aggressive fantasies and combatively impulses towards the wrongdoer. This emotion also spreads indiscriminately to other people and the world. There are few initial studies which show that there is a significant increase in the rate of embitterment during the COVID-19 pandemic. Increased embitterment was related to financial losses, concern about restricted societal freedom, job insecurity, oppositional attitudes, helplessness, dissatisfaction with life, and inclination to join anti-COVID-19 demonstrations. These findings suggest that it is important to foster resilience against stressors, be it because of the virus itself, restrictions in daily freedom, negative comments by other persons, or imbalanced press releases. Of importance is also to abstain from insulting comments towards people who do not follow the mainstream, to allow adjustment of rules to given situations, and to take people along by listening to their grievances, instead of leaving demonstrations on the street as the only method to voice concerns.

The potential impact of Covid-19 on CNS and psychiatric sequels

Due to its high prevalence and fatality, the current Severe Acute Respiratory Syndrome-coronavirus-2 (SARS-CoV-2) virus, which first emerged in China in 2019, quickly spread around the world and immediately became a serious global health concern. Although respiratory issues were initially the most prominent symptom of coronavirus disease 2019 (COVID-19), it became obvious rapidly that COVID-19, like many other coronavirus family members, could affect the central nervous system (CNS). During the pandemic, CNS involvement expressed itself in a variety of forms, including insomnia, anosmia, headaches, encephalopathies, encephalitis, cerebrovascular accidents, cognitive and memory impairment, and increased psychiatric disorders. Almost everyone who has been infected has at least one of these neurological symptoms, demonstrating that the virus has a high ability to impact the CNS. As the coronavirus pandemic passes its second year, the manifestations it can cause in the long run, such as its psychological sequels, have not yet been thoroughly studied. Given the high importance of this issue in today's society and due to the lack of reliable knowledge about the COVID-19 landscape on psychiatric disorders, we intend to investigate coronavirus's possible effect on mental illnesses based on available literature. Because the majority of the psychological effects of the coronavirus can continue for a long period after the pandemic ends, our research can give insight into potential psychiatric sequels associated with COVID-19.

The impact of the COVID-19 pandemic on the development of anxiety disorders - a literature review

Introduction: The COVID-19 is a disease caused by the SARS-CoV-2 virus. A number of psychological symptoms have been identified in people living during the COVID-19 pandemic. Most of them are associated with widely understood anxiety disorders, which have always been a significant problem for mental health.

Materials and methods: The available literature was reviewed on the Pubmed platform and from other sources. The analysis included original studies, reviews, meta-analyzes and internet sources. The aim of the study was to review the literature on the relationship between the COVID-19 pandemic and the occurrence and severity of symptoms of anxiety disorders.

Results: The studies conducted so far show that the COVID-19 pandemic has had a significant impact on the mental state of people around the world, especially in the area of anxiety disorders. Many studies indicate an increase in the prevalence of symptoms of generalized anxiety disorder. Research also indicates a greater incidence of post-traumatic stress disorder and panic disorder in society. Symptoms of somatization were also quite often observed in patients. However, the state of published studies indicates that the pandemic did not significantly affect the severity of symptoms associated with social phobia. In the context of phobic disorders, a new type has been formulated: COVID-19-related phobia.

Conclusions: The conducted literature review shows that the current COVID-19 pandemic is associated with an increase in the prevalence of symptoms of anxiety disorders in the general population. The multifaceted nature of the issue of anxiety disorders in the COVID-19 pandemic clearly indicates the need to continue research in this area.

PTSD is not the emblematic disorder of the COVID-19 pandemic; adjustment disorder is

BACKGROUND

Posttraumatic stress disorder (PTSD) has been hailed by some as the emblematic mental disorder of the COVID-19 pandemic, assuming that PTSD's life-threat criterion was met de facto. More plausible outcomes like adjustment disorder (AD) have been overlooked.

METHODS

An online cross-sectional survey was launched in the initial stage of the pandemic using a convenience sample of 5 913 adults to compare the prevalence of COVID-related probable PTSD versus probable AD. The abridged Impact of Event Scale - Revised (IES-6) assessed the severity of trauma- and stressor-related symptoms over the previous week. Demographic and pandemic-related data (e.g., receiving a formal diagnosis of COVID-19, job loss, loss of loved one, confinement, material hardship) were collected. A Classification and Regression Tree analysis was conducted to uncover the pandemic experiences leading to clinical 'caseness'. Caseness was defined by a score > 9 on the IES-6 symptom measure and further characterized as PTSD or AD depending on whether the Peritraumatic Distress Inventory's life-threat item was endorsed or not.

RESULTS

The participants were predominantly Caucasian (72.8%), women (79.2%), with a university degree (85%), and a mean age of 42.22 (SD = 15.24) years; 3 647 participants (61.7%; 95%CI [60.4, 63.0]) met the threshold for caseness. However, when perceived life-threat was accounted for, only 6.7% (95%CI [6.1, 7.4]) were classified as PTSD cases, and 55% (95%CI [53.7, 56.2]) as AD cases. Among the AD cases, three distinct profiles emerged marked by the following: (i) a worst personal pandemic experience eliciting intense fear, helplessness or horror (in the absence, however, of any life-threat), (ii) a pandemic experience eliciting sadness/grief, and (iii) worrying intensely about the safety of significant others.

CONCLUSIONS

Studies considering the life-threat criterion as met de facto during the pandemic are confusing PTSD for AD on most counts. This misconception is obscuring the various AD-related idioms of distress that have emerged during the pandemic and the actual treatment needs.

The Impact of COVID-19 on the Mental Well-Being of College Students

The COVID-19 pandemic has caused an overall increase in stress and depression in society. The aim of the present research was to evaluate the psychological condition of college students during the COVID-19 pandemic and explore factors influencing their daily functioning. The study focused on four main aspects such as mental well-being, sexuality, concern about financial status, and trust in medical authorities. The study was based on a specially designed survey. The questionnaire was created using Google Forms and shared on social media sites. A total of 630 students participated in the survey, 17 surveys were excluded due to incomplete data and 613 surveys (97.30%) were considered for the final analysis. During isolation, 68.0% of students experienced fear of missing out (FOMO). A total of 73.4% were frustrated due to spending a lot of time in front of a computer. A significant decrease in motivation to study was reported by 78.1% of the respondents. Students showed significantly different attitudes towards sexuality. Concern about the financial situation was reported by 48.7% of respondents. The state of the Polish economy was of concern to 86.4% of respondents. A total of 74.5% of students declared concern about their career development. During the pandemic, 59.0% of respondents became concerned about their health. The attitude towards vaccination was described as positive by 82.5% of the respondents. The percentage of respondents experiencing negative psychological effects relative to the overall epidemiological situation of COVID-19 is troubling. Given the unexpected length and severity of the pandemic, we suggest that students’ concerns be more thoroughly understood and addressed.

Seeking Causality in the Links between Time Perspectives and Gratitude, Savoring the Moment and Prioritizing Positivity: Initial Empirical Test of Three Conceptual Models

We provide an initial empirical test of three conceptual models reflecting possible patterns of causality effects in the relationships between time perspective (TP), gratitude, savoring the moment, and prioritizing positivity (referred to as well-being boosters, WBBs), and mental well-being. The first one, trait-behavior model, states trait TPs increase the tendency to use specific WBBs in order to increase mental well-being. The second model, the accumulation model, proposes that a regular practice of particular WBBs fosters adaptive TPs which in turn impact well-being. The third model, the feedback loop, suggests that WBBs and positive TPs reciprocally strengthen one another and together contribute to higher mental well-being. Participants (N = 206; M_age = 30.90, SD = 8.39, 74% females) filled questionnaires measuring TPs, WBBs, and well-being twice, in a one-year interval. Using cross-lagged panel analyses we examined the direction of causation in the relationships among the variables. Past-Positive had a significant cross-lagged effect on gratitude, Present-Fatalistic had a significant effect on savoring. Both Past-Negative and Present-Fatalistic perspectives displayed significant causal effects on well-being. The results partly support the trait-behavior model. However, given that the second wave was conducted shortly after the onset of the COVID-19 pandemic, further studies are required to better understand the interplay between the studied traits.

Predicting transitions between longitudinal classes of post-traumatic stress disorder, adjustment disorder and well-being during the COVID-19 pandemic: protocol of a latent transition model in a general Dutch sample

BACKGROUND

A growing body of literature shows profound effects of the COVID-19 pandemic on mental health, among which increased rates of post-traumatic stress disorder (PTSD) and adjustment disorder (AD). However, current research efforts have largely been unilateral, focusing on psychopathology and not including well-being, and are dominated by examining average psychopathology levels or on disorder absence/presence, thereby ignoring individual differences in mental health. Knowledge on individual differences, as depicted by latent subgroups, in the full spectrum of mental health may provide valuable insights in how individuals transition between health states and factors that predict transitioning from resilient to symptomatic classes. Our aim is to (1) identify longitudinal classes (ie, subgroups of individuals) based on indicators of PTSD, AD and well-being in response to the pandemic and (2) examine predictors of transitioning between these subgroups.

METHODS AND ANALYSIS

We will conduct a three-wave longitudinal online survey study of n≥2000 adults from the general Dutch population. The first measurement occasion takes place 6 months after the start of the pandemic, followed by two follow-up measurements with 6 months of intervals. Latent transition analysis will be used for data analysis.

ETHICS AND DISSEMINATION

Ethical approval has been obtained from four Dutch universities. Longitudinal study designs are vital to monitor mental health (and predictors thereof) in the pandemic to develop preventive and curative mental health interventions. This study is carried out by researchers who are board members of the Dutch Society for Traumatic Stress Studies and is part of a pan-European study (initiated by the European Society for Traumatic Stress Studies) examining the impact of the pandemic in 11 countries. Results will be published in peer-reviewed journals and disseminated at conferences, via newsletters, and media appearance among (psychotrauma) professionals and the general public.

The mediating role of resilience in the effects of physical exercise on college students' negative emotions during the COVID-19 epidemic

Due to its suddenness and unpredictability, COVID-19 caused strife and effects on public mental health, resulting in a surge of negative emotions. The study explores the relationship between physical exercise and negative emotions in home-based college students during the COVID-19 epidemic, as well as the mediating role of resilience, thus providing a new basis for understanding the role of physical exercise in improving negative emotions in college students; A total of 1214 college students were investigated with the Physical Exercise Questionnaire, Negative Emotion Scale and Resilience Scale; Both physical exercise and resilience were significantly negatively correlated with negative emotions in college students (r = - 0.25, - 0.33, P < 0.001), and there was a significant positive correlation between physical exercise and resilience (r = 0.47, P < 0.001). Physical exercise had a direct effect on the negative emotions of college students (β = - 0.14, P < 0.001). Resilience had a partial mediating effect between physical exercise and the negative emotions of the college students, with a mediating effect value of 0.14 and a mediating effect contribution rate of 50.00%; The study found that physical exercise not only directly affected the negative emotions of college students but also improved their resilience by slowing down their negative emotions and promoting their mental health.

Posttraumatic Stress Disorder and Adjustment Disorder in Lithuanian Healthcare in 2018-2020: A Nation-Wide Cohort Study of the Effects of COVID-19 Pandemic

Multiple empirical studies have revealed significant pandemic effects of COVID-19 on mental health in various populations. This study aimed to analyze the incidences of posttraumatic stress disorder (PTSD) and adjustment disorder (AjD) in national healthcare in 2018-2020 in one of the European countries-Lithuania-and estimate the effect of the COVID-19 pandemic on PTSD and AjD incidences in 2020. The national healthcare registry was used for estimations of diagnosis of PTSD, AjD, and major depressive disorder (MD). The study revealed that stress-related disorders PTSD and AjD are diagnosed rarely, resulting in a considerable gap between the expected prevalence and incidences of these diagnoses in healthcare in Lithuania. Moreover, a significant decline in mental disorders incidence in healthcare in 2020, in comparison to 2018 and 2019, was found, revealing that the COVID-19 pandemic had a negative impact on access to healthcare services and increased barriers for mental disorders treatment. The study indicates that major developments in building up knowledge about the effects of trauma and life stressors on mental health are needed in Lithuania and other countries to increase awareness about stress-related disorders and improve care for trauma survivors, in particular in the context of the pandemics or other large-scale disasters.

Body Image During Pregnancy in the Era of Coronavirus Disease 2019: The Role of Heterogeneous Patterns of Perceived Social Support

Objective: The aim of this study was to explore the profiles of pregnant women on perceived social support with regard to sociodemographic variables, coronavirus disease 2019 (COVID-19)-related distress issues, and body image. We compared the aforementioned relationships within the study variables between pregnant women and a control group of non-pregnant women. Method: The study sample comprised 345 women, 157 pregnant women, and 188 women in the control group. Participants filled out paper-and-pencil or online psychometric questionnaires to assess the variables analyzed in our research. Results: Latent profile analysis revealed six profiles of pregnant women based on perceived social support, which varied in terms of body image evaluation. The high-support profile differed from the profiles with the lowest scores in all support domains. Significant differences in body image between the profiles of pregnant women and the control group were noted. Conclusion: Understanding the mechanisms through which women can attain more body satisfaction during pregnancy is an important research topic that can inspire planning for more effective psychological help, especially in the context of the COVID-19 pandemic and related psychological distress.

Risk and protective factors, stressors, and symptoms of adjustment disorder during the COVID-19 pandemic - First results of the ESTSS COVID-19 pan-European ADJUST study

Background

The COVID-19 pandemic exposes individuals to multiple stressors, such as quarantine, physical distancing, job loss, risk of infection, and loss of loved ones. Such a complex array of stressors potentially lead to symptoms of adjustment disorder.

Objective

This cross-sectional exploratory study examined relationships between risk and protective factors, stressors, and symptoms of adjustment disorder during the first year of the COVID-19 pandemic.

Methods

Data from the first wave of the European Society of Traumatic Stress Studies (ESTSS) longitudinal ADJUST Study were used. N = 15,563 participants aged 18 years and above were recruited in eleven countries (Austria, Croatia, Georgia, Germany, Greece, Italy, Lithuania, the Netherlands, Poland, Portugal, and Sweden) from June to November 2020. Associations between risk and protective factors (e.g. gender, diagnosis of a mental health disorder), stressors (e.g. fear of infection, restricted face-to-face contact), and symptoms of adjustment disorder (ADNM-8) were examined using multivariate linear regression.

Results

The prevalence of self-reported probable adjustment disorder was 18.2%. Risk factors associated with higher levels of symptoms of adjustment disorder were female gender, older age, being at risk for severe COVID-19 illness, poorer general health status, current or previous trauma exposure, a current or previous mental health disorder, and longer exposure to COVID-19 news. Protective factors related to lower levels of symptoms of adjustment disorder were higher income, being retired, and having more face-to-face contact with loved ones or friends. Pandemic-related stressors associated with higher levels of symptoms of adjustment disorder included fear of infection, governmental crisis management, restricted social contact, work-related problems, restricted activity, and difficult housing conditions.

Conclusions

We identified stressors, risk, and protective factors that may help identify individuals at higher risk for adjustment disorder.

Association between mental health trajectories and somatic symptoms following a second lockdown in Israel: a longitudinal study

OBJECTIVES

To identify mental health prospective trajectories before and after a second lockdown during the COVID-19 pandemic and their associations with somatic symptoms.

DESIGN

Prospective Study.

SETTING

Population-based study drawn from a probability-based internet panel of over 100 000 Israelis.

PARTICIPANTS

Adults aged 18 years or more, representative of the adult Israeli population. The participants were measured at two time points (time 1 (T1) pre-second lockdown N=1029; response rate=76.17%; time 2 (T2) post-second lockdown N=764; response rate=74.24%).

MAIN OUTCOME MEASURES

Trajectories of anxiety and adjustment disorder based on clinical cut-off score for probable diagnoses across T1-T2, somatic symptoms at T2. The four trajectories: stable-low, (no probable diagnosis), stable-high (stable probable diagnosis), exacerbation (no probable diagnosis at T1, probable diagnosis at T2), recovery (probable diagnosis at T1, no probable diagnosis at T2).

RESULTS

Three anxiety trajectories predicted probable somatic symptoms (stable-high OR=6.451; exacerbation OR=5.379; recovery OR=2.025) compared with the stable-low trajectory. The three adjustment disorder trajectories also predicted somatic symptoms (stable-high OR=4.726; exacerbation OR=6.419; recovery OR=4.666) compared with the stable-low trajectory.

CONCLUSIONS

Our data show elevated somatic symptoms among those whose mental health trajectories were poor, exacerbated and those who recovered following the second lockdown. The presentation of somatic symptoms may mask psychological vulnerabilities, even among those who appear to have recovered from the stressor. This indicates that lockdown may be a double-edged sword and should be carefully administered given these populations vulnerabilities.

[Clinical features of asthenia in the context of adjustment disorders]

OBJECTIVE

To study asthenic symptoms in patients with adjustment disorders and to assess the efficacy of cytoflavin in their treatment.

MATERIAL AND METHODS

The study included 100 patients, aged 20 to 43 years, with a diagnosis of adjustment disorder. Clinical, neurophysiological and parametric methods were used. An asthenic state scale, the Multidimensional Fatigue Inventory (MFI-20), a digital rating scale (a 10-point variant) and the Headache Impact Test (HIT-6), the Psychological Stress Measure (PSM-25), the Cognitive Emotion Regulation Questionnaire, the Test of Variables of Attention (TOVA) were administered. Cytoflavin was used in a dose of 2 tab. 2 times a day for 25 days for the treatment of patients from the study group.

RESULTS

In the study group, 48.0% of patients had a pronounced degree of asthenia, and 52% had a moderate one. The clinical improvement was achieved in 73.0%. In the subgroup with moderate asthenia, the improvement was recorded in 88.5% of cases, in the subgroup of patients with severe asthenia in 56.3% of patients. There was a significant decrease in the severity of indicators on the scales of general asthenia, decreased activity and mental asthenia; a significant decrease in the integral indicator of mental tension, a significant improvement in the indicator of attention, a decrease in the frequency and intensity of headache. The improvement in the functional state of the brain in the form of a decrease in the power of the alpha rhythm in the anterior cerebral cortex was shown.

CONCLUSION

The results of the study allow us to conclude that the use of cytoflavin is effective in the treatment of adjustment disorders.

Defense Mechanisms and Borderline Personality Organization Among COVID-19 Believers and Non-believers During Complete Lock-Down

The aim of the current study was to investigate whether a specific social perception of the pandemic-believing or not in COVID-19-predicts borderline personality organizations and whether this relationship is mediated by more primitive maladaptive mechanisms-splitting, denial, and dissociation. The online study included 720 organization aged 25-45. Participants were diverse in terms of place of residence, being in a relationship, and education level. Approximately 30% of the general population reported not believing in the COVID-19 pandemic. Non-believers scored slightly higher on borderline symptoms and used more maladaptive defense mechanisms than believers. Individuals who deny COVID-19 are more likely to show characteristics of borderline personality organization. Splitting is an important mechanism in this relationship.