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A longitudinal study on clinically relevant self-reported depression, anxiety and acute stress features among Italian community-dwelling adults during the COVID-19 related lockdown: Evidence of a predictive role for baseline dysfunctional personality dimensions. J Affect Disord 2021; 282:364-371. [PMID: 33421864 PMCID: PMC7834264 DOI: 10.1016/j.jad.2020.12.165] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 11/24/2020] [Accepted: 12/23/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND Although necessary for public health, quarantine has been documented to cause post-traumatic stress symptoms, anxiety, and depression. We designed the present longitudinal study to evaluate the psychological impact of quarantine in Italian community-dwelling adult participants. METHODS A sample of 304 Italian community-dwelling adult participants (75.7% female; mean age = 35.28 years) was administered self-reported measures of depression, anxiety and acute stress symptoms at the beginning and at the end of the lockdown. Potential predictors of clinically relevant symptoms at the end of the lockdown were assessed. Specifically, data on gender, civil status, education level, occupation, and area of residence, as well as maladaptive personality domains were collected. RESULTS More than 43% of participants suffered from the early impact of the lockdown; at the end of the lockdown roughly 32% of participants still reported any clinically relevant depression anxiety, and/or acute stress disorder condition. Clinically relevant acute stress reaction at the beginning of lockdown was a particularly important risk factor for experiencing clinically relevant acute stress, depression, and anxiety at the end of the lockdown. Maladaptive personality domains represent non-trivial predictors of participants' self-reports of clinically relevant depression, anxiety, and acute stress conditions at the end of the lockdown. LIMITATIONS Excess of female participants and the impossibility of evaluating if participants suffered from any internalizing disorder before the COVID-19 quarantine represent major limitations of our study. CONCLUSIONS Our findings suggest assessment of internalizing disorder symptoms during quarantine may be helpful in identifying people who may benefit from early treatment interventions.
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Jin Y, Li Y, Li XY, Zhao YJ, Cheung T, Ungvari GS, Li M, An FR, Xiang YT. Prevalence of Fatigue and Its Association With Quality of Life Among Frontline Clinicians in Ophthalmology and Otolaryngology Departments During the COVID-19 Pandemic. Front Psychiatry 2021; 12:678917. [PMID: 34305678 PMCID: PMC8298998 DOI: 10.3389/fpsyt.2021.678917] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 06/02/2021] [Indexed: 01/10/2023] Open
Abstract
Background: The coronavirus disease 2019 (COVID-19) pandemic has caused psychological distress and heavy burden in medical professionals. This study examined the prevalence of fatigue and its association with quality of life (QOL) in clinicians working in ophthalmology and otolaryngology departments during the COVID-19 pandemic in China. Methods: This was a cross-sectional national online survey conducted between March 15 and March 20, 2020 in China. The severity of fatigue, depression and QOL were measured using the Numeric Rating Scale (NRS), the 9-item Patient Health Questionnaire (PHQ-9), and the World Health Organization Quality of Life Questionnaire-Brief Version (WHOQOL-BREF), respectively. Results: In total, 3,912 clinicians completed the survey (2,155 in ophthalmology department, and 1,757 in otolaryngology department); 2,049 [52.4%; 95% confidence interval (CI) = 50.8-53.9%] reported fatigue (NRS score ≥ 4). Multiple logistic regression analysis revealed that junior clinicians [Odds ratio (OR) = 0.82, 95% CI = 0.68-1.00, P = 0.045] had lower risk of fatigue; while clinicians working in tertiary hospitals (OR = 1.23, 95% CI = 1.02-1.49, P = 0.029), and the presence of more severe depressive symptoms (PHQ-9 total score ≥ 5; OR = 7.40, 95% CI = 6.29-8.70, P < 0.001) were independently associated with higher risk of fatigue. After controlling for covariates, clinicians with fatigue had significantly lower QOL compared with those without [F (1, 3, 911) = 283.75, P < 0.001]. Conclusion: Fatigue was common in clinicians working in ophthalmology and otolaryngology departments during the COVID-19 pandemic. Considering the negative impact of fatigue on clinicians' QOL, health authorities and policymakers should conduct regular screening for fatigue and develop preventive strategies for frontline clinicians working under excessive stress.
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Affiliation(s)
- Yu Jin
- College of Education for the Future, Beijing Normal University, Beijing, China
| | - Yue Li
- Department of Nursing, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Xiu-Ya Li
- Department of Otorhinolaryngology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yan-Jie Zhao
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, China.,Centre for Cognitive and Brain Sciences, University of Macau, Macao, China.,Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao, China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, China
| | - Gabor S Ungvari
- Division of Psychiatry, School of Medicine, University of Western Australia/Graylands Hospital, Perth, WA, Australia.,University of Notre Dame Australia, Fremantle, WA, Australia
| | - Michael Li
- The Hong Kong Academy for Performing Arts, Hong Kong, China
| | - Feng-Rong An
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital, Advanced Innovation Center for Human Brain Protection, School of Mental Health, Capital Medical University, Beijing, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, China.,Centre for Cognitive and Brain Sciences, University of Macau, Macao, China.,Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao, China
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Hashem H, Abufaraj M, Tbakhi A, Sultan I. Obstacles and Considerations Related to Clinical Trial Research During the COVID-19 Pandemic. Front Med (Lausanne) 2020; 7:598038. [PMID: 33425945 PMCID: PMC7785796 DOI: 10.3389/fmed.2020.598038] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 11/24/2020] [Indexed: 12/14/2022] Open
Abstract
The response to the COVID-19 pandemic from the research and science community has been vigorous, with information being released faster than that of any other event in human history. Articles related to the virus were being rapidly published by January 2020. A small fraction of these publications comprised reports of prospective clinical trials (0.25%), and many of these trials have imparted conflicting conclusions, leading to confusion among the public and the scientific community. Additionally, the pandemic has raised many serious scientific and ethical concerns related to clinical research. In this review, we divided the conduct of clinical research trials into three steps and critically reviewed each step, along with the challenges and obstacles arising amid the ongoing crisis. The clinical research steps we reviewed include (1) clinical trial design factors such as social and scientific value, feasibility, single vs. multicenter trials, randomization, control groups, endpoints, off-label and compassionate use of medications, data analysis, and verifying the integrity of data; (2) ethical issues such as committee approvals, efficiency, virtual visits and remote monitoring, informed consent, shipping investigational products, and external monitoring and audits; and (3) publication and sharing of preprints, press releases, social media, and misinformation. The COVID-19 pandemic is adversely affecting existing clinical trials for other ailments and diseases, including cancer, with most trials being delayed or deferred. Although urgency is needed to communicate effective treatment and prevention strategies for COVID-19, research efforts should maintain the same high-quality core ethical principles that governed human subject research before the pandemic. Despite the catastrophic devastation caused by the pandemic, the adoption of more flexible, cost-effective methods of conducting clinical trials (without compromising ethical conduct, safety, or data integrity, while maintaining research efficiency) represents a potential silver lining. Streamlining clinical research will help to congruently address other important health issues, despite the ongoing COVID-19 crisis.
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Affiliation(s)
- Hasan Hashem
- Division of Pediatric Hematology Oncology, Department of Pediatrics, King Hussein Cancer Center (KHCC), Amman, Jordan
| | - Mohammad Abufaraj
- Division of Urology, Department of Special Surgery, Jordan University Hospital, Amman, Jordan
| | - Abdelghani Tbakhi
- Department of Cellular Therapy and Applied Genomics, King Hussein Cancer Center (KHCC), Amman, Jordan
| | - Iyad Sultan
- Division of Pediatric Hematology Oncology, Department of Pediatrics, King Hussein Cancer Center (KHCC), Amman, Jordan
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Dine CB. Socio-ethical Dimension of COVID-19 Prevention Mechanism-The Triumph of Care Ethics. Asian Bioeth Rev 2020; 12:539-550. [PMID: 33717344 PMCID: PMC7747343 DOI: 10.1007/s41649-020-00143-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/27/2020] [Accepted: 07/30/2020] [Indexed: 10/31/2022] Open
Abstract
The psycho-social day-to-day experience of COVID-19 pandemic has shone some light on the wider scope of health vulnerability and has correspondingly enlarged the ethical debate surrounding the social implications of health and healthcare. This emerging paradigm is neither a single-handed problem of biomedical scientists nor of social analysts. It instead needs a strategically oriented collaborative and interdisciplinary preventive effort. To that effect, this article presents some socio-ethical reflections underscoring the judicious use of the insight from care ethics as an asset in minimizing the possible propagation of the COVID-19 virus and the escalation of its vulnerability in the day-to-day human interaction. It further emphasizes that if this insight is overlooked, the effects of the diverse facets of the "shadow pandemics" of COVID-19-fallouts on both the affected and the infected-may equally be deadly.
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