The psychological impact of the COVID-19 pandemic on adults and children in the United Arab Emirates: a nationwide cross-sectional study

Caregiver Worry of Infection and Family Co-existence Difficulty and Association With Change in Children's Internalizing and Externalizing Symptoms During the Initial COVID-19 Lockdown in the UK and Turkey

The study examined whether caregiver worry of COVID-19 infection and co-existence difficulty differentially predicted child mental health and wellbeing during the lockdown in two culturally different countries that were severely affected by the pandemic: the UK and Turkey. Co-existence difficulty is the hardship experienced by family members living all together in the same house at the same time during the lockdown period. Participants were 1849 caregivers of children between 5- and 12-years old living in the UK (n = 995) and Turkey (n = 854), who completed an electronic survey distributed via social networks during the initial phase of the COVID-19 lockdown (July and August 2020). Caregivers completed a set of questionnaires on child and family wellbeing and on whether the child's internalizing and externalizing symptoms changed during the lockdown as compared to before. Worry of COVID-19 infection was higher amongst caregivers in the Turkish sample and was associated with higher levels of child internalizing symptoms during the lockdown in the Turkish sample, however there were no statistically significant differences in the size of the impact of worry of infection on the children's internalizing symptoms between the two countries. Co-existence difficulty independently predicted increase in children's internalizing and externalizing symptoms during the lockdown in both samples. Families in the UK experienced a higher level of difficulty with co-existence compared to the families living in Turkey but the magnitude of the impact of co-existence difficulty on children's outcomes between the two samples was not significantly different.The findings suggest that public health strategies should aim to reduce social anxiety and invest in the development of programs aimed at supporting families to overcome the challenges of co-existence during times of public health crisis.

Racial and ethnic differences in distress, discrimination, substance use coping, and nicotine use among parents during COVID-19

This study identified contributing factors for tobacco-related inequities among parents (N = 331) during COVID-19. Compared to non-Hispanic White parents, Asian, Black, and multiracial parents experienced greater discrimination. Parents with a nicotine use history experienced greater discrimination and substance use coping relative to tobacco abstainers. Among parents who used nicotine during the pandemic (n = 45), experiencing financial loss, having COVID-19, and greater worries were positively associated with nicotine reductions during COVID-19. Being female, increased family members with COVID-19, discrimination, and substance use coping were negatively associated with nicotine reductions. Tobacco interventions that reduce substance use coping and increase alternative coping are needed.

The Psychological Impact of COVID-19: A Comparative Analysis of Pre-Lockdown and During-Lockdown Periods Among Saudi General Population

Background

Prior research has revealed substantial psychological impacts of COVID-19 among the general population. However, there is a noticeable gap in studies addressing the enduring anxiety levels before and during lockdown periods of the COVID-19 pandemic.

Objective

The study assessed and compared the psychological impact of the COVID-19 pandemic before and during lockdown periods among the general population in Saudi Arabia.

Methods

A validated and reliable General Anxiety Disorder (GAD)-7 instrument was used to quantify stress levels by measuring anxiety. Nonprobability snowball sampling was used to collect data from 516 participants residing in Saudi Arabia. The difference in scores for each of the seven related questions of GAD-7 was determined using a non-parametric Wilcoxon rank test.

Results

A mild level of anxiety was consistently observed both before and during the lockdown, as indicated by GAD-7 scores of 6.17 (SD = 5.5) before the lockdown and 6.42 (SD = 5.7) during the lockdown. There were no differences in GAD-7 scores before 6.17 (SD = 5.5) and during 6.42 (SD = 5.7) the lockdown periods. However, levels of moderate anxiety increased by 5% during the lockdown period. Anxiety levels before and during lockdown were significantly associated with gender (χ2 (3, n = 516) =11.23 p = 0.01) and employment status (χ2 (3, n = 516) = 9.41 p = 0.024). Among the GAD-7 questionnaire items, item number 1 ("Feeling nervous, anxious, or on edge") (p= 0.00) and item number 7 ("Feeling afraid as if something awful might happen") (p= 0.025) showed a significant association with anxiety levels before and during the lockdown periods.

Conclusion

The enduring prevalence of mild anxiety, persisting both before and during the lockdown periods, underscores the profound impact of COVID-19 on the mental health of the general population in Saudi Arabia.

Factors associated with an increased risk of anxiety among adolescents during the COVID-19 lockdown in the French Grand Est area

The COVID-19 pandemic has impacted adolescent mental health worldwide. The current study aims to assess the feelings of French adolescents and the factors related to anxiety among these adolescents during the first lockdown due to COVID-19. A sample of 284 French adolescents from the Grand Est region aged 12-18 years completed an online survey evaluating their pandemic-related anxiety symptoms, behaviors, and feelings regarding the contingent strategies of lockdown that were taken and their living and learning conditions, family relationships, and social support. The Generalized Anxiety Disorder Scale (GAD-6) was used to assess anxiety. Data on parents' mental health status were also collected. A word cloud was generated to visualize respondents' feelings according to word use frequency. Cross-sectional analysis with linear regression was performed to identify the factors associated with a higher level of anxiety in adolescents. Higher anxiety scale scores were observed among females than among males (β = 1.2; P = 0.0005), among adolescents experiencing conflicts at home (β = 0.9; P = 0.03) and difficulties in isolation (β = 1.1; P = 0.02) than among those who did not report any difficulty, and among those working less than 2 h a day (β = 1.1; P = 0.003) than among those working more. Anxiety scale scores were lower in adolescents with higher family social support (β = -0.66; P < 0.001) and those with parents with no anxiety (β = -2.28; P < 0.001), lower anxiety (β = -1.38; P = 0.018), and higher mental health-related quality of life (β = -0.04; P = 0.03). These findings suggest a need to support interventions targeting parents' anxiety, develop strategies to increase family support, and establish consistent work schedules for children.

Understanding the Impact of the COVID-19 Pandemic on Mental Health among a Sample of University Workers in the United Arab Emirates

Research on the mental health of university staff during the COVID-19 pandemic has uncovered a high prevalence of probable anxiety, depression, and post-traumatic stress disorder among academic and non-academic staff in many parts of the world. This study aimed to assess the prevalence of anxiety, depressive symptoms, and resilience among a sample of faculty and staff members working in the Higher College of Technology campuses in the UAE. From September to November 2021, a cross-sectional study was carried out using an online survey. The Generalized Anxiety Disorder 7-item scale, The Patient Health Questionnaire (9-items), and the Connor-Davidson Resilience Scale were used to assess anxiety, depression, and resilience. The impact of COVID-19 was assessed using a designated list of questions. The results demonstrated that the COVID-19 pandemic had impacted the mental health of the studied sample of university workers, with almost 16% of the participants having moderate-to-severe depression and anxiety symptoms. This study highlighted significant differences in the participants' depressive and anxiety symptoms due to sociodemographic differences. Depression and anxiety symptoms were most prevalent among females, those of UAE nationality, and never-married workers, with females scoring 5.81 on the PHQ-9 compared to only 4.10 in males, p = 0.004 *. UAE-national participants had significantly higher mean PHQ-9 scores than their non-national counterparts (6.37 ± 5.49 SD versus 4.77 ± 5.1 SD, respectively, p = 0.040 *). Overall, the total mean scores of all participants were below the assumed cut-off threshold of having a high resilience level (29.51 ± 7.53 SD). The results showed a significant difference in severe depression symptoms as a result of the impact of COVID-19. These results could imply that the COVID-19 pandemic might have augmented negative mental health impacts on this sample of university workers. This study highlighted some areas where the responsible authorities can intervene to further protect and enhance the mental health of university workers, particularly after the COVID-19 pandemic.

Impact of Covid-19 on Psychosocial Well-Being of School-Going Children: A Cross-Sectional Study

INTRODUCTION

The mandated closure of schools due to Covid-19 is likely to have a negative impact on school-going children. This study aimed to assess the psychosocial well-being of school children during the pandemic in eastern India.

METHODS

This cross-sectional study was conducted in the outpatient pediatric department of tertiary care teaching hospitals. Children between the ages of 4 and 14 were enrolled. The main outcome measures included the Emotional Symptoms Scale, Conduct Problem Scale, Hyperactivity Scale, Peer Problem Scale, and Prosocial Scale from the Strength and Difficulties Questionnaire (SDQ), as well as the Children's Hope Scale.

RESULTS

Out of 169 children aged 4-14, 104 (61.5%) were male, 140 (82.8%) were from urban areas, 66 (39.1%) had a family member who was a healthcare worker or frontline worker, and 12 (7.1%) had experienced the death of a family member due to Covid-19. Anxiety-related and depressive symptoms were observed in 81 (47.9%) and 70 (41.4%) children, respectively. Psychosocial difficulties with a 'clinically significant problem likely' were observed in 26 (15.4%) children, more common in males (16.35%, P=0.035) and older children (12-14 years). Children from families with healthcare/frontline workers, Covid-affected families, loss of job in the earning member, and uninvolved parenting style were associated with more psychosocial difficulties. The mean (SD) hope score was 22.46 ± 6.42 in children above eight years.

CONCLUSION

The psychosocial well-being of school-going children is adversely affected during Covid-19, particularly in families with frontline workers, loss of job, and death of family members due to Covid-19. The poor hope score in children aged 8 years and above indicates an adverse impact on their ability to achieve future goals.

Course of child social-emotional and sleep symptoms, parental distress and pandemic-related stressors during COVID-19

Research on the longitudinal courses of child social-emotional symptoms and sleep during the COVID-19 pandemic within societies would be of key value for promoting child well-being in global crises. We characterized the course of children's social-emotional and sleep symptoms before and throughout the pandemic in a Finnish longitudinal cohort of 1825 5- to 9-year-old children (46% girls) with four follow-up points during the pandemic from up to 695 participants (spring 2020-summer 2021). Second, we examined the role of parental distress and COVID-related stressful events in child symptoms. Child total and behavioral symptoms increased in spring 2020 but decreased thereafter and remained stable throughout the rest of the follow-up. Sleep symptoms decreased in spring 2020 and remained stable thereafter. Parental distress was linked with higher child social-emotional and sleep symptoms. The cross-sectional associations between COVID-related stressors and child symptoms were partially mediated by parental distress. The findings propose that children can be protected from the long-term adverse influences of the pandemic, and parental well-being likely plays a mediating role between pandemic-related stressors and child well-being. Further research focusing on the societal and resilience factors underlying family and child responses to the pandemic is warranted.

Anxiety disorders among children and adolescents during COVID-19 lockdowns and school closures: a cross-sectional study in Kuwait

Introduction

Investigating the epidemiology of mental health disorders resulting from COVID-19 intervention measures, primary school closures, and social isolation in children and adolescents needs to be prioritized over adults at the post-pandemic stage. Most preliminary psychosocial studies conducted during the pandemic have demonstrated that younger age groups are the most vulnerable to such implications. Thus, this study aims to estimate the probable prevalence of specific anxiety disorders in children and quantify their relationships with relevant demographic risk factors.

Methods

We used a cross-sectional study comprising 430 children aged between 8- and 18 years old living in Kuwait during the period of school closures as well as full and partial lockdowns. The survey included questions about participants' characteristics, children's anxiety using the Screen for Child Anxiety Related Emotional Disorders Questionnaire (SCARED) scale, and children's emotions and behaviours using the Strengths and Difficulties Questionnaire (SDQ). Univariate and multivariate logistic regression analyses were used to summarize the demographic and characteristics of the participants and their association with general, social, and generalized anxieties, as well as behavioural and emotional difficulties.

Results

We inferred that 24.83% of our participants had at least one anxiety disorder, while 20.19% were classified as abnormal on the SDQ scale. Our multivariate analysis revealed that lockdown duration and sex of the child were consistently significant predictors (p-values < 0.05) of the broad spectrum of selected mental disorders. Additionally, we inferred notable increases in the likelihood of mental disorders associated with the increased duration of lockdowns.

Conclusions

Our findings revealed preliminary insights into the vulnerability of young populations to the indirect negative impacts of strict public health measures during pandemic emergencies. Thus, authorities should consider such implications when planning and implementing similar interventions in future pandemics.

Prevalence and factors associated with mental illness symptoms among school students post lockdown of the COVID-19 pandemic in the United Arab Emirates: A cross-sectional national study

Limited data exists on the mental health of children in the United Arab Emirates (UAE). This study aimed to fill this gap by examining the prevalence of anxiety, depression, and risk for Post-Traumatic Stress Disorder (PTSD) among school students in post-lockdown of the COVID-19 pandemic. A sample of 3,745 school students participated, responding to standardized tests (Mood and Feeling Questionnaire-Child Self-Report, Screen for Child Anxiety Related Disorders-Child Version, and Children's Revised Impact of Event Scale-8). Findings showed that the risk for PTSD was the most prevalent (40.6%), followed by symptoms of anxiety (23.3%), and depression (17.1%). For gender differences, symptoms of the three conditions (depression, anxiety, and PTSD) were higher in female students (9.2%) compared to male peers (7.7%) (p = 0.09). Moreover, symptoms of depression and anxiety were found to be higher among late adolescents (p<0.05). Further analysis revealed that having medical problems was a positive predictor for anxiety (OR = 2.0, p<0.01) and risk for PTSD (OR = 1.3, p = 0.002); similarly, witnessing the death of a close family member due to COVID-19 (OR for depression, anxiety, and PTSD = 1.7, p<0.01) were positive predictors associated with PTDS, depression, and anxiety. The study concluded that post COVID-19 lockdown, symptoms of anxiety, depression, and risk for PTSD were found to be prevalent among school students in the UAE. Researchers put forward recommendations on the initiation of a national school mental health screening program, the provision of follow-up services for vulnerable students, and the integration of a mental health support system in the disaster preparedness plans.

Beyond the filter: Impact of popularity on the mental health of social media influencers

Objective

This study examines the emotional state and interpersonal relationships of social media influencers, focusing on the psychological effects of their popularity and engagement. Despite increased awareness of mental health issues, influencers remain underrepresented in research. Barriers such as low mental health literacy, stigma, access issues, and the pressure to maintain virtual personas highlight the need for this investigation. This research addresses these gaps by systematically examining the impact of social media on influencers' mental health.

Methods

An online survey was conducted using the positive and negative affect schedule (PANAS) and the Relationship Structures Questionnaire (ECR-RS). The target audience was social media influencers from various countries, with a specific focus on the United Arab Emirates (UAE). Participants were recruited from 2 November 2022, to 1 March 2023, through email, SMS, and direct messages on social media platforms. Statistical analyses included t-tests, ANOVA, and Pearson correlation coefficients.

Results

A total of 161 social media influencers completed the survey. A significant association was found between extended social media usage and heightened negative emotions among influencers spending more than 5 hours daily on these platforms (p < .05). Influencers earning less than $10,000 from social media reported the lowest negative feeling scores. However, higher income levels correlated with increased relationship avoidance and anxiety scores (e.g., p < .01 for avoidance and anxiety from parents and best friends). Additionally, an increase in the number of followers was associated with increased negative emotions (p = .001).

Conclusion

Our study provides compelling insights into the well-being, emotions, and relationship quality of social media influencers. It underscores the urgency of prioritizing their mental well-being on a global scale, helping them navigate the challenges of their digital careers while maintaining a positive impact on their audiences.

Assessment of Knowledge, Perceptions, and Attitudes During the Global Mpox Outbreak in June 2022: A Cross-Sectional Study From the United Arab Emirates

Objectives: To examine knowledge, worry, anxiety, and vaccine acceptance for mpox among UAE adults. Methods: An online survey, advertised on academic and social media platform in June 2022 collected data from 959 participants (aged 18 and above) on mpox beliefs, risks, knowledge, worry, anxiety, COVID-19 infection, vaccination, and willingness to receive the mpox vaccine. Bivariate and logistic regression analysis identified associations and predictors between variables. Results: 56% had optimal knowledge of mpox transmission and symptoms. 54% were worried, and 27% experienced anxiety related to the outbreak. Knowledge scores were higher among women, healthcare workers, and those with reliable information sources. High perceived infection risk, changes in precautionary measures, and belief in difficult treatment predicted more worry and anxiety. Higher worry and two or more doses of the COVID-19 vaccine predicted higher likelihood of taking the mpox vaccine. Conclusion: The UAE population showed low knowledge and high worry and anxiety during the global mpox outbreak. Increasing public awareness through targeted educational campaigns is vital. Promoting better understanding of infectious diseases, addressing concerns, and encouraging vaccine uptake can prepare for future outbreaks.

Investigating the Role of Second Chance Schools and COVID-19 Pandemic on the Mental Health and Self-Image of Greek Adult Students

COVID-19 has globally impacted both physical and mental health. This study aimed to explore the impact of Second Chance Schools (SCS) and the COVID-19 pandemic on the mental health and self-image of Greek SCS students. A total of 251 SCS students from two consecutive study cycles participated, completing the research instruments at the beginning and end of their studies. Participants' anxiety, depressive symptomatology, well-being, self-esteem and self-efficacy were evaluated by means of the GAD-7, PHQ-8, WHO-5 Well-being Index, Rosenberg Self-Esteem Scale and Generalized Self-Efficacy Scale, respectively. The research spanned three years, including a year of universal lockdown, a year with protective measures and a year without anti-COVID-19 measures. Factor analysis, regression analyses and two two-way repeated measures ANOVAs were applied to the collected data. All five psychological dimensions measured by the study's instruments were grouped into two factors, namely mental health and self-image. Well-being positively influenced mental health, while anxiety and depression had a negative impact. On the other hand, self-efficacy and self-esteem positively contributed to self-image. Mental health and self-image were moderately correlated. Pre-SCS values of mental health and self-image predicted a higher percentage of variance in post-SCS values compared to anxiety, depression, well-being, self-efficacy and self-esteem. Moreover, mental health improved after the completion of SCS, but only for participants after the lifting of anti-COVID-19 measures. Conversely, self-image improved for all participants regardless of the presence of anti-COVID-19 measures. Overall, the SCS had a considerable impact on the participants' mental health and self-image, although the effect was influenced by COVID-19.

The Comparative Analysis of Buccal Exfoliated Cells in the Pediatric and Adolescent Age Groups Among the Dravidian Population During the COVID-19 Pandemic: A Cross-Sectional Study

Introduction Adolescence is a distinct stage of development marked by a variety of physiological, behavioral, hormonal, and cellular changes. Objective The objective of this study is to assess the cytomorphometry of buccal exfoliated cells in the age groups 1-10 and 11-19 and detect any changes in their buccal exfoliated cells during the coronavirus disease 2019 (COVID-19) pandemic. Materials and methods Buccal smears were collected from 60 patients of age groups 1-10 (n=30) and 11-19 (n=30). Cytomorphometric analysis was done using the ImageJ software (National Institutes of Health, Bethesda, MD). Statistical analysis was done using an independent t-test. Results The cytomorphometric analysis of buccal smears between age groups 1-10 and 11-19 showed a statistically significant difference in cell size, cell shape, and nuclear-cytoplasmic (N/C) ratio. Conclusion This study helps to understand the physiological changes in this era and thus will aid to compare the physiological to the pathological changes of exfoliated cells in future studies.

Evaluation of public awareness and performance toward the safe use of household disinfectants-cleaners to prevent COVID-19 in the Emirate of Abu Dhabi

Introduction

Disinfection is one of the most effective hygienic practices that would limit the spread of the Coronavirus Disease (COVID-19) through deactivating the coronavirus on contaminated skin, supplies, and surfaces. However, the type and concentration of disinfectants should be carefully selected to avoid damaging surfaces and to limit the side effects of these chemicals on household members and users. The aim of this study is to assess the public levels of awareness and performance concerning the safe use of household cleaning products and disinfectants during the spread of COVID-19 in the Emirate of Abu Dhabi.

Methods

The cross-sectional study was conducted between October and December 2021 among 750 residents of Abu Dhabi, Al Dhafrah, and Al-Ain regions. A google survey was distributed electronically for the online recruitment of the general population. Mann-Whitney and Kruskal-Wallis tests were used to determine whether significant differences exist in the levels of awareness and performance with regard to gender, region, education level, and diagnosis with COVID-19. Spearman correlation was used to test if any correlation existed between levels of awareness and performance. Kruskal-Wallis test was also used to check if significant differences exist in the mean score of performance with respect to irritation-to-poisoning symptoms.

Results

The study population recorded a lower mean score of awareness (5.37 out of 12) than performance (11.75 out of 16). The majority of the study population claimed a minimum of one irritation-to-poisoning symptom during the handling of household cleaners and disinfectants. Significant differences exist in the awareness and performance mean scores among various educational levels (P < 0.001). The level of awareness was statistically significant with regard to infection with SARS-CoV-2 (P < 0.05). Also, the level of performance was significantly different between males and females (P < 0.001). Kruskal-Wallis test showed that the mean score of performance is statistically significant with all the studied irritation-to poisoning symptoms (P < 0.05).

Conclusions

Awareness campaigns and training programs are recommended to address the safe use of household cleaning products and disinfectants in the United Arab Emirates (UAE).

Physical activity and mental health during the COVID-19 pandemic among individuals with amputation

The isolating nature of various COVID-19 mandates may have reduced physical activity (PA) and increased mental health symptomology among individuals with amputation. However, an investigation of mental health across PA levels before and after the onset of COVID-19 among this group has not been conducted. Therefore, the objective of this study was to investigate group differences in depression, anxiety, and post-traumatic stress symptomology among individuals with amputation who reported being physically "active," "somewhat active," or "inactivate" before and during the pandemic. Individuals with an amputation at any level (n = 91; 51% female; age = 52.5±15.5) completed an online questionnaire to assess demographic information, PA levels, and mental health throughout the pandemic. Group differences in self-reported PA before and after COVID-19 onset were assessed by the PA Guidelines for Americans recommendations. The Center for Epidemiologic Studies Depression Scale (CES-D), Generalized Anxiety Disorder (GAD-7), and Posttraumatic Stress Disorder Checklist (PCL-5) scales were used to assess group differences in mental health status. Before and after the onset of COVID-19, 33% and 42.9% of respondents reported that they were inactive, respectively. 58.2% of respondents reported decreased PA since the pandemic's onset. Prior to the pandemic, active individuals reported lower CES-D (14.21 vs. 19.07; Cohen's d: -0.414), GAD-7 (3.82 vs. 5.47; Cohen's d: -0.359), and PCL-5 (15.92 vs. 21.03; Cohen's d: -0.319) scores compared to inactive individuals. After the onset of COVID-19, scores remained lower for active respondents CES-D (12.67 vs. 20.03; Cohen's d: 0.-669), GAD-7 (3.17 vs. 5.87; Cohen's d: -0.598), and PCL-5 (13.39 vs. 19.90; Cohen's d: -0.430). Individuals with amputation reported decreased PA after the onset of COVID-19. Individuals reporting that they were "active" exhibited improved depression and anxiety symptomology scores compared to those reporting that they were "inactive."

Mental Health Status of Indian Migrant Workers in the United Arab Emirates during the COVID-19 Pandemic

Migration has become a de facto phenomenon in the contemporary globalized world and India is not untouched. Indian labourers from the states of Bihar and Uttar Pradesh migrated to the UAE in search of better jobs and prospects. They migrated alone and left behind their families. The distance between them and their family can also create mental disorders; therefore, it becomes necessary to analyze the mental health of the migrant workers during the COVID-19 pandemic. The current study is quantitative and based on a sample survey approach. The researchers collected 416 samples through a structured questionnaire and used the snowball sampling technique. Descriptive statistics, Pearson's correlation coefficient, chi-square test and logistic regression were utilized to analyze and interpret the results. The outbreak of coronavirus disturbed their livelihood resulting in a cut to their salary or earnings; in total, 83% of migrants were affected by the COVID-19 outbreak in terms of loss of their income, out of which 76% were affected by less than AED 1000. The respondents' mental health was worrisome, but they were hopeful for the future. In total, 73.5% of respondents felt nervous, 62% felt depressed, 77% felt lonely, 63.4% had a hard time sleeping, and 63% had difficulties concentrating. The findings of the study draw attention to the policymakers to carry out necessary provisions to the targeted psychologically affected community. The findings also suggest creating awareness among the people by using social networking sites and diagnosing mental disorders on an urgent basis.

Impact of COVID-19 lockdown on smoking and vaping: systematic review and meta-analysis

OBJECTIVES

COVID-19 and the implementation of lockdowns have impacted daily lives worldwide. This systematic review and meta-analysis aimed to investigate the impact of lockdowns on the smoking and vaping behaviours of adults during the pandemic.

STUDY DESIGN

This was a systematic review and meta-analysis.

METHODS

A systematic literature search was conducted up to 28 April 2022 in the following databases: PubMed, Embase and Web of Science.

RESULTS

In total, 77 studies met the inclusion criteria for this review. In 34 studies, an increase in smoking behaviour was reported for the majority of participants; however, in 21 and 18 studies, 'no change' and 'decrease' in smoking were the predominant responses, respectively. The results from the meta-analysis, which examined the change in the number of cigarettes smoked per day, showed no difference between the pre- and post-lockdown periods: 0.81 weighted mean difference (95% confidence interval, -0.59 to 2.21). Regarding vaping, three of seven studies reported an increase in smoking for the majority of participants, whereas 'no change' and 'decrease' were the predominant answers in the other four studies.

CONCLUSIONS

The results show that lockdowns led most participants to increase smoking/vaping, whereas a decrease or cessation of smoking/vaping was only reported in the minority of participants. Attention should be given to the non-communicable diseases that could arise as a result of the increase in smoking/vaping during lockdowns, and further research in this area is needed.

Efficacy of coping mechanisms used during COVID-19 as reported by parents of children with autism

The COVID-19 pandemic's alterations to daily life have been especially challenging for families with Autism Spectrum Disorder (ASD), worsening the core features of ASD and overall mental health. With the increased need for effective coping, the current retrospective study used data from a survey regarding parent reports of how often their child with ASD used certain coping strategies (frequency), as well as the extent to which they felt their child benefitted from their use (efficacy) in mitigating stress during the pandemic. This retrospective study Repeated measures ANOVAs were conducted to evaluate whether there were significant differences in both frequency and efficacy ratings for each coping strategy, for the entire sample as well as for three children's age groups. Using Spearman's rank-order correlations, correlation coefficients between the frequency and efficacy of each coping strategy were explored. Results revealed that maladaptive strategies were used more frequently than adaptive strategies, while parent routine as the most frequently used and efficacious for all age groups. Additionally, for adaptive strategies, humor and focusing on the positive had the strongest correlations between frequency and efficacy ratings amongst all age groups. Of the maladaptive strategies, repetitive behaviors, rumination, and isolation had the strongest correlations for the youngest, middle, and oldest age groups, respectively. Further, for each age group, the adaptive coping strategies had stronger correlations between frequency and efficacy than the maladaptive ones. It is our hope that the results of this study will lay the foundation for developing adaptive coping strategies to alleviate stress in children with ASD. Further investigations using a larger cohort are warranted to determine effective coping strategies for individuals with ASD across a range of situations, including acute stressors (such as future public health emergencies and natural disasters), as well as common daily stressors.

Parents' depression and anxiety associated with hyperactivity-inattention and emotional symptoms in children during school closure due to COVID-19 in France

Several risk factors of children's mental health issues have been identified during the pandemic of COronaVIrus Disease first appeared in 2019 (COVID-19). This study aims to fill the knowledge gap regarding the association between parents' and children's mental health issues during the COVID-19 school closure in France. We conducted a cross-sectional analysis of data collected in the SAPRIS-ELFE study during the COVID-19 pandemic in France. Using multinomial logistic regressions, we estimated associations between parents' and children's mental health issues. Symptoms of anxiety were assessed by the General Anxiety Disorder-7 (GAD-7) and depression by the Patient Health Questionnaire-9 (PHQ-9) for the parents. Hyperactivity/inattention and emotional symptoms in children were assessed by the Strengths and Difficulties Questionnaire (SDQ). The sample included 3496 children aged 8 to 9 years, of whom 50.0% were girls. During the school closure, 7.1% of responding parents had moderate to severe levels of anxiety and 6.7% had moderate to severe levels of depression. A total of 11.8% of the children had an abnormal hyperactivity/inattention score and 6.6% had an abnormal emotional symptoms score. In multivariate regression models, parental moderate to severe level of anxiety and moderate to severe level of depression were associated with abnormal hyperactivity-inattention score (adjusted Odds Ratio (aOR) 3.31; 95% Confidence Interval (CI) 2.33-4.70 and aOR 4.65; 95% CI 3.27-6.59, respectively) and abnormal emotional symptoms score in children (aOR 3.58; 95% CI 2.33-5.49 and aOR 3.78; 95 CI 2.47-5.78 respectively). Children whose parents have symptoms of anxiety and/or depression have an increased likelihood of symptoms of hyperactivity/inattention and emotional symptoms during school closures in France due to COVID-19. Our findings suggest that public health initiatives should target parents and children to limit the impact of such crises on their mental health issues.

Mental Health Is a Family Affair-Systematic Review and Meta-Analysis on the Associations between Mental Health Problems in Parents and Children during the COVID-19 Pandemic

As a multidimensional and universal stressor, the COVID-19 pandemic negatively affected the mental health of children, adolescents, and adults worldwide. In particular, families faced numerous restrictions and challenges. From the literature, it is well known that parental mental health problems and child mental health outcomes are associated. Hence, this review aims to summarize the current research on the associations of parental mental health symptoms and child mental health outcomes during the COVID-19 pandemic. We conducted a systematic literature search in Web of Science (all databases) and identified 431 records, of which 83 articles with data of over 80,000 families were included in 38 meta-analyses. A total of 25 meta-analyses resulted in significant small to medium associations between parental mental health symptoms and child mental health outcomes (r = 0.19 to 0.46, p < 0.05). The largest effects were observed for the associations of parenting stress and child mental health outcomes. A dysfunctional parent-child interaction has been identified as a key mechanism for the transmission of mental disorders. Thus, specific parenting interventions are needed to foster healthy parent-child interactions, to promote the mental health of families, and to reduce the negative impacts of the COVID-19 pandemic.

The Effects of Medications and the Roles of Pharmacists on the Recovery of Patients with COVID-19 Infection: An Epidemiological Study from the United Arab Emirates

Patients infected with coronavirus have new experiences and hence new needs from the healthcare sector. Acknowledging patients' experiences can exhibit promising outcomes in coronavirus management. Pharmacists are considered a vital pillar in managing patients' experiences during their infection. A cross-sectional study was conducted to assess the experiences of COVID-19-infected individuals and the roles of pharmacists in the United Arab Emirates. The survey was face- and content-validated after being developed. Three sections were included in the survey (demographics, experiences of infected individuals, and the roles of pharmacists). Data were analyzed using the Statistical Package for the Social Sciences. The study participants (n = 509) had a mean age of 34.50 (SD = 11.93). The most reported symptoms among participants were fatigue (81.5%), fever (76.8%), headache (76.6%), dry cough (74.1%), muscle or joint pain (70.7%), and sore throat (68.6%). Vitamin C was the most used supplement (88.6%), followed by pain relievers (78.2%). Female gender was the only factor associated with symptom severity. About 79.0% agreed that the pharmacist played an important and effective role during their infection. The most reported symptom was fatigue, with females reporting more severe symptoms. The role of the pharmacist proved to be vital during this pandemic.

Mental and social burden of COVID-19 on the Iraqi people

BACKGROUND

COVID-19 pandemic has affected all crucial aspects of daily life, including; food security, education, gender relation, mental health, and environmental air pollution, in addition to the impact of the lockdown that had far-reaching effects in different strata of life.

AIMS

To study the impact of COVID-19 on people with respect to their mental and social suffering and consequences.

METHODS

This cross sectional study was conducted during the period from November 2020 through August 2021. A sample of 1,000 attendants to four teaching hospitals and eight PHCCs, was collected. The mental and social sequels of COVID-19 were assessed for all participants whether previously infected or not.

RESULTS

Out of the total sample (1,000), 389 had a history of infection with COVID-19. The main mental symptoms reported were depression (67.8%), and anxiety (46.9%), males and females equally reported symptoms of anxiety, while depressive symptoms were reported more among females (59.9%), Fear and worries of the participants about their health and their families' was the main reason for mental symptoms (94.7%).

CONCLUSIONS

Symptoms of depression and anxiety in time of COVID-19 are prevalent. Suspending educational activities was the most social burden that affect people while increase the price of food and cessation of work were the main causes of economic burden.

Generalized anxiety disorder in Berlin school children after the third COVID-19 wave in Germany: a cohort study between June and September 2021

BACKGROUND

During the COVID-19 pandemic, children and adolescents worldwide have disproportionally been affected in their psychological health and wellbeing. We conducted a cohort study among German school children, aiming at assessing levels of general anxiety disorder (GAD) and identifying associated factors in the second pandemic year.

METHODS

A cohort of 660 students from 24 Berlin schools was recruited to fill in questionnaires including the GAD-7 tool on anxiety symptoms at three time points between June and September 2021. To adjust for non-random attrition, we applied inverse probability weighting. We describe reported GAD levels stratified by time point, sex, and school type and report odds ratios from univariate logistic regression.

RESULTS

In total, 551 participants (83%) filled in at least one questionnaire at any time point. At the first time point in June 2021, 25% of the children and adolescents reported anxiety symptoms with a GAD-7 score ≥ 5, decreasing to 16% in August 2021 directly after the summer holidays and rising again to 26% in September 2021. The majority of reported anxiety levels belonged to the least severe category. Being female, attending secondary school, coming from a household with lower education or with lower income level, and being vaccinated against COVID-19 were significantly linked with reporting anxiety symptoms. Preceding COVID-19 infection and anxiety were negatively associated.

CONCLUSION

Overall, anxiety in school children was lower in mid-2021 than in the first pandemic year, but still double compared to pre-pandemic data. Reporting of anxiety symptoms during the second pandemic year was especially high in females and in secondary school students. Policy makers should pay additional attention to the mental health status of school children, even as the pandemic situation might stabilize.

COVID-19: Psychological distress, fear, and coping strategies among community members across the United Arab Emirates

BACKGROUND

The COVID-19 pandemic impacted the psychosocial well-being of the United Arab Emirates [UAE] population like other communities internationally.

OBJECTIVES

We aimed to identify the factors associated with psychological distress, fear, and coping amongst community members across the UAE.

METHODS

We conducted a cross-sectional online survey across the UAE during November 2020. Adults aged ≥18 years, living in the UAE who were able to respond to an online questionnaire in English or Arabic were considered eligible to participate in the study. We used standard validated tools to measure psychological distress, fear and coping. Kessler Psychological Distress Scale [K10] was used to assess psychological distress, Fear of COVID-19 Scale [FCV-19S] was used to assess the level of fear, and Brief Resilient Coping Scale [BRCS] was used to assess the coping strategies.

RESULTS

A total of 417 individuals participated in this study with a mean age of 29 [± 10.7] years. More than half of the participants experienced high to very high levels of psychological distress [55%] and a quarter experienced high levels of fear of COVID-19 [23.3%] with almost a third of them [36.2%] having low resilient coping. About 37.4% of the participants had work-related mental health impacts and 32.4% were perceived to have moderate to a great deal of distress due to a change of employment status during the pandemic. One in ten participants [9.4%] reported increased smoking. Increased smoking [AOR 8.66, 95% CIs 1.08-69.1,], increased alcohol drinking [AOR 2.39, 95% CIs 1.05-5.47] and higher levels of fear of COVID-19 [AOR 2.93, 95% CIs 1.83-4.67] were associated with moderate to very high levels of psychological distress. Being female [AOR 1.82, p = 0.030], having a pre-existing mental health condition [AOR 9.88, 95% p = 0.027], engaging in high-risk behaviors such as increased smoking [AOR 21.14, p = 0.003], increased alcohol drinking [AOR 1.48, p = 0.359] in the previous four weeks, and higher levels of fear of COVID-19 [AOR 4.18, p <0.001] were associated with moderate to very high levels of psychological distress. Also, being a smoker [AOR, 0.840, p = 0.011], and having a high level of fear [AOR 0.372, p = 0.001] were found to be associated with low resilient coping.

CONCLUSION

Community members in the UAE are at a higher risk of psychosocial distress and fear during the COVID-19 pandemic. Thus, healthcare providers and policymakers would need to be more alert to provide specific mental health support strategies for their wellbeing.

On return to school: disorder symptoms, stress at home and evaluations of school COVID-19 measures

Background: Social restrictions during the COVID-19 pandemic had a major impact on the mental health of children. Yet, analyses on the mental health of younger children in the later course of the pandemic are scarce. The present study assessed 8- to 11-year-olds' internalising disorder symptoms during the last three weeks, from the third week of February through to the first week of March, of the 2021 national lockdown.Method: One hundred and forty-five pupils, including a subset of keyworkers' children who had face-toface schooling, completed the validated Revised Child Anxiety and Depression scales, items on COVID-related stress at home, and evaluations of home-learning and school's measures for reopening.Results: Symptoms increased with age in months and/or number of siblings. Girls reported more symptoms and home stress than boys did. Pupils who had face-to-face schooling were more satisfied with school measures and less satisfied with home learning compared with those who only had home learning. Hierarchical regression analyses corroborated the contributions of sociodemographic characteristics and found that home stress and school measures evaluations were associated most with major depression, generalised anxiety, and social phobia.Conclusion: Findings can contribute to mental health practice by promoting school communications and family and educator awareness of stressors, vulnerabilities and symptoms to boost pupils' readiness for school returns.

Mental Disorders and Level of Resilience in Eight High-Altitude Cities of Peru during the Second Pandemic Wave: A Multicenter Population-Based Study

COVID-19 has led us to take preventive measures, such as social isolation, to reduce the high transmissibility of the disease. This could have affected the mental health of various population groups and the development of resilience as a mitigator. A cross-sectional analytical study was conducted with 700 participants from eight cities. The dependent variables were depression, anxiety, and post-traumatic stress disorder (PTSD). The independent variable was resilience. Generalized logistic regressions were used to identify the associations between the variables. The population consisted mostly of university students (65.0%); the rest of the population was distributed among workers of public or private institutions, housewives, and others (35.0%). High prevalences of anxiety (72.7%), depression (64.1%), and PTSD (15.1%) were found, as well as a median (interquartile range) resilience score of 24 points was determined. Factors associated with a high prevalence of PTSD were having lost employment and having a family member who died from COVID-19. For depression, associated factors were severe food insecurity and hypersomnia. For anxiety, associated factors were were having a deceased family member with COVID-19 and mild food insecurity. Our results show that, during the pandemic, the general population had a higher prevalence of mental disorders. In addition, anxiety was the most prevalent of the dependent variables. Special attention should be paid to the factors influencing the development of mental disorders and mental health prevention and promotion programs should be established.

Impact of COVID-19 pandemic on the mental health of university students in the United Arab Emirates: a cross-sectional study

BACKGROUND

The COVID-19 pandemic had a significant impact on the mental well-being of students worldwide. There is a scarcity of information on the mental health impact of the COVID-19 pandemic on university students in the United Arab Emirates (UAE). This study aimed to investigate the mental health impact of the COVID-19, including depression, anxiety and resilience among a sample of university students in the UAE.

METHODS

A cross-sectional study using an online survey was conducted from September to November 2021. The patient health questionnaire (PHQ-9), generalized anxiety disorder-7 (GAD-7) and Connor-Davidson Resilience Scale (CD-RISC-10) were used to assess depression, anxiety, and resilience. The COVID-19 impact was assessed using a list of questions.

RESULTS

Only, 798 students completed the survey and were analyzed for this study. Overall, 74.8% of the students were females, 91.2% were never married, and 66.3% were UAE-nationals. Based on PHQ-9 and GAD-7 cut-off scores (≥ 10), four out of ten of the students self-reported moderate to severe depression (40.9%) and anxiety (39.1%). Significantly higher mean PHQ-9 and GAD-7 scores were found among students who were impacted by COVID-19 than those non-impacted (mean PHQ-9 = 9.51 ± 6.39 and 6.80 ± 6.34; p = 0.001, respectively) and (mean GAD-7 = 9.03 ± 6.00 and 8.54 ± 6.02; respectively, p < 0.001). Female students who were impacted by COVID-19 had statistically significant higher depression and anxiety scores (mean PHQ-9 of 9.14 ± 5.86 vs. 6.83 ± 6.25, respectively; p < 0.001) than the non-impacted females (mean GAD-7 of 9.57 ± 6.32 vs. 5.15 ± 3.88, respectively; p = 0.005). Never married students had significantly higher PHQ-9 and GAD-7 scores than ever-married (9.31 ± 6.37 vs. 6.93 ± 5.47, P = 0.003) and (8.89 ± 6.11 vs. 7.13 ± 5.49, respectively; p = 0.017).

CONCLUSIONS

The results of this study demonstrate that the COVID-19 pandemic has negatively impacted the mental health of this sample of university students in terms of depression and anxiety. The results highlight the need to adopt culturally appropriate interventions for university students and focus on vulnerable groups.

Mothers' and fathers' stress and severity of depressive symptoms during the COVID-19 pandemic: actor-partner effects with parental negative emotions as a moderator

BACKGROUND

In the face of the coronavirus disease 2019 (COVID-19) pandemic, families with young children are bombarded with new challenges and stressors. This study examined the additive and interactive effects of parental stress and negative emotions during COVID-19 on parents' severity of depressive symptoms.

METHODS

Participants were 221 Chinese families involving maritally intact mothers and fathers of preschool-aged children.

DISCUSSION

Path analysis indicated that mothers' parental stress interacted with their negative emotions, such that their stress was related to their severity of depressive symptoms only when negative emotions were high. By comparison, fathers' stress and negative emotions were additively associated with their severity of depressive symptoms. Supporting the cumulative risk model, parental stress during COVID-19 and negative emotions were linked to parents' severity of depressive symptoms additively or interactively, depending on the gender of the parent. These findings inform practitioners about the relevance of parents' stress and negative emotions to their severity of depressive symptoms during the pandemic.

The impact of COVID-19 pandemic on depression and anxiety symptoms: Findings from the United Arab Emirates Healthy Future (UAEHFS) cohort study

BACKGROUND

Significant concerns about mental health were raised during the COVID-19 pandemic. We investigated the prevalence of depression and anxiety symptoms among the participants of the United Arab Emirates Healthy Future Study (UAEHFS); a national cohort study. We further explored the change in the prevalence of depression symptoms among those with comparable pre-pandemic data.

METHODS

A sample of UAEHFS participants were invited to complete a COVID-19 online questionnaire during the first wave of the pandemic. Depression and anxiety symptoms were assessed using the Patient Health Questionnaire Depression Scale (PHQ-8) and the Generalized Anxiety Disorder-7 Scale (GAD-7) respectively. Unpaired analyses were done to examine the effect of COVID-19 on depression and anxiety symptoms during the pandemic. Paired analysis was conducted to examine the change in depression symptoms.

RESULTS

During the pandemic, we reported a prevalence of 32.8% (95% CI: 27.0, 39.1) for depression and 26.4% (95% CI: 21.0, 32.6) for anxiety symptoms. Younger people reported higher levels of depression (40.4%) and anxiety (34.5%) symptoms. Females reported higher levels of depression (36.5%) and anxiety (32.7%) symptoms. In paired analysis, the prevalence of depression symptoms during the pandemic was 34% (95% CI: 26.5, 42.4) compared to 29.9% (95% CI: 22.7, 38.1) before the pandemic. No statistically significant difference was observed, p-value = 0.440. Adjusted multivariate logistic regression models for PHQ-8 and GAD-7 during the pandemic showed that participants, who were experiencing flu-like symptoms, had higher odds of reporting depression symptoms compared to those without symptoms. Additionally, age was significantly negatively associated with anxiety symptoms.

CONCLUSIONS

Overall, we found that depression and anxiety symptoms were more prevalent among young people and females. However, we did not find a significant change in the prevalence of depression symptoms among those with comparable pre-pandemic data. Identifying vulnerable groups and understanding trajectories through longitudinal studies would help with planning for effective mental health interventions for the current and future pandemics.

Mental health status of doctors and nurses in a Nigerian tertiary hospital: A COVID-19 experience

Background

Healthcare professionals (HCPs) working to save lives during the coronavirus disease 2019 (COVID-19) pandemic are under tremendous physical and psychological pressure, therefore facing the risk of developing challenges with mental health.

Aim

This study aimed primarily to determine the prevalence and factors associated with depression, anxiety and stress among HCPs in a tertiary hospital in Lagos State during the COVID-19 pandemic.

Setting

Lagos State University Teaching Hospital (LASUTH), Ikeja, Lagos, Nigeria.

Methods

This was a descriptive cross-sectional study conducted between June and July 2021 among 1452 doctors and nurses in LASUTH, Ikeja, Lagos, Nigeria, selected by the multistage sampling method. Depression, anxiety and stress were assessed using the Patient Health Questionnaire, Generalised Anxiety Disorder and Perceived Stress Scale, respectively.

Results

The majority of respondents were female (72.5%), with two-thirds being nurses. The prevalence of depression, anxiety and stress was 9.8%, 5.0% and 62.4%, respectively. Nurses showed a higher prevalence of these mental health conditions as compared with doctors. Younger HCPs, nurses, those that lost a colleague to COVID-19, and those whose family members were infected with COVID-19 were more likely to be depressed. Nurses and those afraid of being infected were more likely to experience anxiety. Younger HCPs, nurses, history of anxiety and/or depression and previous COVID-19 infection were identified as factors associated with stress.

Conclusion

Stress was the most prevalent mental health condition with nurses being the most affected of the HCPs and at a greater risk of developing challenges with mental health. Psychosocial interventions and stress management techniques are recommended to minimise the risks.

Contribution

This study adds to the few studies on the mental health of HCPs during COVID-19 and calls for in-depth surveys to understand psychosocial challenges among HCPs in Nigeria.

Mental Health Status of French School-Aged Children's Parents during the COVID-19 Lockdown and Its Associated Factors

The COVID-19 pandemic has led to widespread social isolation. This study aimed to determine anxiety levels among parents of school-aged children and investigate the associated factors. Data on sociodemographic characteristics, living and working conditions, family relationships, social support (MSPSS) and health status (SF-12) were collected from French parents through an online survey. The Generalized Anxiety Disorder Scale (GAD-7) was used to assess anxiety. Logistic regression analysis was performed to identify the factors associated with moderate to severe anxiety. Among 698 parents, 19.2% experienced moderate to severe anxiety. A low level of resilience (OR = 4.3, 95% CI: 2.7-6.7) and confirmed COVID-19 cases involving hospitalization (OR = 3.8, 95% CI: 2.0-7.3) among individuals in one's household or in the family circle were found to be the main risk factors for moderate to severe anxiety. Other factors were also identified: a level of education less than high school (OR = 2.1, 95% CI: 1.3-3.2), conflicts at home (OR = 2.3, 95% CI: 1.4-3.7), noises outside the home (OR = 2.0, 95% CI: 1.0-3.9), confirmed cases not involving hospitalization (OR = 1.8, 95% CI: 1.0-3.1) and suspected cases (OR = 1.9, 95% CI: 1.0-3.8). Family support was a protective factor. These findings suggest some need for support programs to help parents cope with public health crises and work-family challenges.

Parents' reasons to vaccinate their children aged 5–11 years against COVID-19 in Italy

Objectives

The aims of this cross-sectional study were to investigate why parents decide to vaccinate, as well as the determinants, their children aged 5–11 years against COVID-19 in Italy.

Methods

The survey was conducted from January through May 2022. All parents/guardians who came in randomly selected days to immunization centers for the administration of the first dose of the COVID-19 vaccine to their child were asked to complete a questionnaire about socio-demographic characteristics, attitudes toward COVID-19 infection and vaccination, reason(s) regarding their decision to vaccinate their child, and source(s) of information.

Results

A total of 358 questionnaires were collected. Parent's perception that COVID-19 is a severe illness for the child, assessed using a 10-point Likert scale, was 7.5. The overall mean scores of the risk perception for their child of having the COVID-19 before and after the vaccination were 8.1 and 6.3. A significantly higher parents' level of risk perception for their child of having the COVID-19 after the vaccination has been observed among those not having a university degree, those with the child having at least one chronic medical condition, and those who perceived that COVID-19 is a severe illness for the child. The mean value of respondent trust in the information provided by the pediatricians on a 10-point scale Likert type was 7.6. Female, not having a university degree, higher perception that COVID-19 is a severe disease, not having received information about the vaccination from pediatricians, and needing information had a significantly higher concern of side effects after the vaccination. The most common reasons for vaccinating their children included wanting to protect the child against COVID-19, to attend the school with less risk, to prevent the transmission to family members, and to practice sport and other activities with less risks. Participants with a university degree were more likely to have vaccinated their child for attending the school and practicing sport and other activities with less risks.

Conclusions

More publicity should be promoted among parents of children aged 5–11 years which would increase the coverage rates and thus lower the transmission of SARS-CoV-2 and reduce the occurrence of COVID-19.

COVID-19 vaccination coverage among adolescents aged 12-17 years in three provinces of eastern China: A cross-sectional survey, 2021

High vaccination coverage is essential to prevent and control the spread of the COVID-19 epidemic. Currently, the real-world acceptance of COVID-19 vaccines among adolescents aged 12-17 years in China has not been reported. We aimed to assess the acceptance rate of COVID-19 vaccination among adolescents in eastern China and to identify factors associated with the intention to get vaccinated against COVID-19. We conduct a cross-sectional questionnaire survey among adolescents from three provinces in the eastern part of China from 16 August to 28 October 2021. The questionnaires were distributed to 2,100 students, and 2,048 students completed the questionnaires. The results showed that 98.4% (2,016/2,048) of adolescents had received at least one dose of the COVID-19 vaccine and 1.6% (32/2,048) declined the vaccination. The participants from rural districts, or whose parents were vaccinated, were more likely to accept the vaccine. The main reason for declining vaccination was worry about vaccine safety (25%). The main adverse event after the vaccination was pain at the injection site. In conclusion, the vaccine coverage rate reached 98.4% among the adolescents in this study, which met the criteria for herd immunity to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The high vaccination rate is beneficial to the prevention and control of the COVID-19 pandemic.

How has public perception of food safety and health risks changed a year after the pandemic and vaccines roll out?

The recent coronavirus pandemic (COVID-19) has caused unprecedented turmoil and spurred fears that have profoundly changed the public's social and health behaviours, including the perception of food safety risks. One year after the pandemic and the global vaccination campaign, the public perception of food safety and the changes in their hygiene behaviour, health risks concerns, and trust were studied in Jordan, Lebanon, and Tunisia using a cross-sectional online survey. The results of 538 subjects showed a rise in the frequency of hygiene practices, notably in handwashing. Sixty-four percent of the participants were vaccinated, a proportion made up mainly of the Jordanians and Lebanese. For 66% and 64% of the two population groups, respectively, there were no longer trust concerns about COVID-19 health risks following vaccination, whereas the worries about getting COVID-19 persisted for others. Only 47% of participants trusted eating food prepared by vaccinated food handlers. A great majority of the Tunisians (81%) showed varying degrees of concern about COVID-19 transmission from food and the lowest vaccination rate (33%). The current study demonstrated that the impact of vaccination policy positively affects public perception of food-related risks during the pandemic. On the other hand, 33% of the surveyed Jordanians and Tunisians lost trust in the health authorities' management of the pandemic, and 45% of the Lebanese still don't trust them. Communication strategies on health and food safety with the public still represent a challenge for these and probably other countries in the Middle East and North Africa (MENA). Strategies for building and maintaining public trust are crucial to curb persistent fear of food, hence, avoiding potential stigmatization affecting the food economy by promoting health awareness and positive changes in food safety perceptions for safer practices.

Psychological Distress, Anxiety, Family Violence, Suicidality, and Wellbeing in Pakistan During the COVID-19 Lockdown: A Cross-Sectional Study

Background and Objectives

The purpose of this study was to draw the attention toward the implications of COVID-19 and the related restrictions imposed worldwide especially in Pakistan. The primary objective was to highlight the levels of psychological distress, anxiety, family violence, suicidality, and well-being due to COVID-19 and the secondary objective was to associate it to social demographic factors.

Materials and Methods

It is designed as a cross-sectional study by employing an online questionnaire in the English language and obtaining responses using a snowball sampling technique. We used three validated measures including Kessler Psychological Distress Scale (K10), Generalized Anxiety Disorder (GAD-7) index and World Health Organization Well-Being Index (WHO-5).

Results

A sample of 420 participants was recruited from across Pakistan, with most participants were females (79%), students (89.8%) and belonging to Punjab (54%). Nearly one-fourth of the participants (23.8%) scored above the minimum value set for moderate or high psychological distress (K10 > 12). There was a higher prevalence of distress among females and resident of province Punjab. The majority of individuals reported that they were living with their family (94.5%) and more than half (52.6%) were neutral regarding their satisfaction with their living conditions. 40.5% believed that the lockdown has had a negative impact on their mental health. 31.4% have reported that they themselves have experienced abuse from a family member. 48.6% scored high on the GAD-7 scale and low wellbeing score was found among 80.2%. Students were found to be more vulnerable to mental illness and anxiety.

Conclusion

With the lockdown restrictions, psychosocial distress has become prevalent in Pakistan.

Adolescent Positivity and Future Orientation, Parental Psychological Control, and Young Adult Internalising Behaviours during COVID-19 in Nine Countries

The COVID-19 pandemic disrupted many young adults’ lives educationally, economically, and personally. This study investigated associations between COVID-19-related disruption and perception of increases in internalising symptoms among young adults and whether these associations were moderated by earlier measures of adolescent positivity and future orientation and parental psychological control. Participants included 1329 adolescents at Time 1, and 810 of those participants as young adults (M age = 20, 50.4% female) at Time 2 from 9 countries (China, Colombia, Italy, Jordan, Kenya, the Philippines, Sweden, Thailand, and the United States). Drawing from a larger longitudinal study of adolescent risk taking and young adult competence, this study controlled for earlier levels of internalising symptoms during adolescence in examining these associations. Higher levels of adolescent positivity and future orientation as well as parent psychological control during late adolescence helped protect young adults from sharper perceived increases in anxiety and depression during the first nine months of widespread pandemic lockdowns in all nine countries. Findings are discussed in terms of how families in the 21st century can foster greater resilience during and after adolescence when faced with community-wide stressors, and the results provide new information about how psychological control may play a protective role during times of significant community-wide threats to personal health and welfare.

Delving the role of nutritional psychiatry to mitigate the COVID-19 pandemic induced stress, anxiety and depression

BACKGROUND

The distressing COVID-19 pandemic has had a substantial impact on public mental health, and the importance of food and nutrients in several aspects of mental health has been recognized. People in isolation or quarantine suffer from severe stress, anger, panic attack, and anxiety.

SCOPE AND APPROACH

Although, people who have improved and progressed through medications or vaccines have reduced anxiety levels to some extent yet the efficacy of these measures, in the long run, remains a question. The review depicts that such negative emotional reactions were particularly higher in elderly individuals in the first wave than in other phases. The emotional and behavioral response to the COVID-19 pandemic is multifactorial. From different research studies, it has been found that stress scores were considerably higher for those engaging in unhealthy eating practices. This factor relies not only on external components but on personal and innate ones as well. In the present pandemic, the sustainable development of the food system would have been a major issue; this should be carefully restored to avoid a food crisis in the future.

KEY FINDINGS AND CONCLUSIONS

Changes in mind-body interactions are triggered by psychosocial stresses such as interpersonal loss and social rejection. Physiological response (in terms of psychological stress) in COVID-19 affected patients varies due to individual physical health status. This review explores the relationship between nutrition and mental health as what we eat and think is interlinked with the gut-brain-axis. The role of dietary components along with the Mediterranean diet, DASH diet and use of psychobiotics in improving psychological distress in pandemic induced stress, anxiety and depression has also been discussed.

Coping with COVID-19 Prolonged and Cumulative Stressors: the Case Example of Egypt

The current study aimed to explore how COVID-19-traumatized populations cope using a coping model based on wills to exist, live, and survive (WTELS) that leads to positive coping and posttraumatic growth (PTG). We used data from 11 Arab countries (N = 2732), including Egypt (N = 831), and included measures for COVID-19 stressors (COVID-fear, economic, lockdown, and grief stressors), WTELS, resilience, religiosity, spirituality, social support, and PTG. We conducted ANOVA on the main sample to explore the differences between Arab countries, hierarchical regressions, and path analysis on the Egyptian subsample to test a model of the effects on WTELS. In the path model, WTELS was the independent variable. Other coping strategies were mediating variables, and COVID-19 stressor types were outcome variables. ANOVA on the main sample indicated that Egypt was the highest on COVID-19 stressors (infection fears, economic, lockdown, and grief stressors), actual infection, and WTELS. Hierarchical regression indicated that social support, resilience, and WTELS were positive predictors of PTG, with WTELS had the highest effect size (β = .41) and WTELS being a negative predictor of COVID-19 stressors, while resilience and social support were not. Path analysis indicated that WTELS predicted higher religiosity, spirituality, social support, resilience, and lower COVID-19 stressors. Religiosity predicted higher spirituality, social support, and resilience and lower COVID-19 stressors. Interfaith spirituality predicted higher resilience and lower COVID-19 grief stressors. The results validated the central role of WTELS. Results helped to identify potentially effective interventions with COVID-19 victims that focus on WTELS, spirituality, and religiosity.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s11469-021-00712-x.

Educational Impact on Ecuadorian University Students Due to the COVID-19 Context

The mobility restrictions imposed in different countries due to the pandemic of Sars-CoV2 has hugely impacted different areas in the world. In this work, impacts on the social areas of Ecuadorian university students such as education, economy, physical and mental health, and access to telecommunications are analyzed. For this work, in a snapshot between May to September 2020, 1841 students from 6 public and 5 private universities from Ecuador were surveyed through 47 questions, which were grouped into 7 mutually exclusive dimensions. The Partial Least Squares Structural Equation Model (PLS-SEM) was used to analyze the correlations between the responses of the questions and the relations between dimensions. Dimensional relations were used to analyze how students perceive online classes, teachers’ preparation, mood, and the impact on their learning process due to their decreasing family income. Among the most important results, we found that 63.78% of students want to return to on-site classes regardless of their conditions of Internet connection and their available learning tools (computers, tablets, or cellphones). The results also show that family income has influenced how students access the Internet, Internet connection, technological resources for online learning, and mood. Regarding the relations between variables, we found that older students and students from higher semesters think that online classes are better than face-to-face classes and want to continue in online education.

The race for a COVID-19 vaccine: where are we up to?

INTRODUCTION

A novel strain of coronavirus, SARS-CoV-2, has triggered a global pandemic of coronavirus disease (COVID-19) in late 2019. In January 2020, the WHO declared this pandemic a public health emergency. This pandemic has already caused over 5.3 million deaths from more than 272 million infections. The development of a successful vaccine is an urgent global priority to halt the spread of SARS-CoV-2 and prevent further fatalities. Researchers are fast-tracking this process, and there have already been significant developments in preclinical and clinical phases in a relatively short period of time. Some vaccines have been approved either for emergency use or mass application in recent months.

AREAS COVERED

Herein, we provide a general understanding of the fast-tracked clinical trial procedures and highlight recent successes in preclinical and clinical trials to generate a clearer picture of the progress of COVID-19 vaccine development.

EXPERT OPINION

A good number of vaccines have been rolled out within a short period a feat unprecedented in medical history. However, the emergence of new variants over time has appeared as a new threat, and the number of infections and casualties is still on the rise and this is going to be an ongoing battle.

Increase in depression and anxiety disorder diagnoses during the COVID-19 pandemic in children and adolescents followed in pediatric practices in Germany

The coronavirus pandemic and related restrictions impacted the daily lives of children and youth, partly due to the closure of schools and the absence of outdoor activities. The aim of this study was to investigate, quantify, and critically discuss the effect of the pandemic and related restrictions on consultations pertaining to depression and anxiety disorders in children and adolescents. This retrospective cross-sectional study was based on medical record data from the Disease Analyzer database (IQVIA) and included all children and adolescents aged 2-17 years with at least one visit to one of 168 German pediatric practices between April 2019 and December 2019 (n = 454,741) or between April 2020 and December 2020 (n = 417,979). The number of children and adolescents with depression and anxiety disorder diagnoses per practice and the prevalence of these diagnoses were compared for April 2020-December 2020 versus April 2019-December 2019. The number of children and adolescents with depression and anxiety diagnoses per practice increased in April 2020-December 2020 compared to the same period in 2019 (anxiety: + 9%, depression: + 12%). The increase was much greater in girls than in boys (anxiety: + 13% vs. + 5%; depression + 19% vs. + 1%). The prevalence of anxiety disorder increased from 0.31 to 0.59% (p < 0.001), and that of depression from 0.23 to 0.47% (p < 0.001). The biggest increases were observed for girls (anxiety from 0.35 to 0.72% (+ 106%, p < 0.001), depression from 0.28 to 0.72% (+ 132%, p < 0.001). This study shows an increase in the number of pediatric diagnoses of depression and anxiety disorders in the pandemic year 2020 compared to the previous year.

Risk of Behavioural and Emotional Disorders in Lithuanian School Aged Children as Assessed with SDQ During the Second Lockdown due to COVID-19

As a result of the outbreak of COVID-19 and consequent restrictions, the distance education was introduced in Lithuania in 2020 spring (the first lockdown, lasted for around 3 months) and 2020 autumn (the second lockdown, still lasting, June 2021). The prevalence of children’s mental health problems during the first lockdown was similar to pre-epidemic rates in Lithuania, but the prolonged lockdown (and therefore school closure) might have more negative consequences on children’s mental health. This study aimed to reveal the incidence of mental health problems as rated by parents with a Strengths and Difficulties Questionnaire during the second lockdown in school aged children. This research sample included data of 514 children (46% girls), aged 7 to 14 years old (mean age 10.15 years, SD = 3.47). The children’s mental health problems were assessed using a Lithuanian version of the Strengths and Difficulties Questionnaire, parental form, in April–May 2021. Results revealed that 29.6% of Lithuanian children had scores in the clinical (abnormal) range of emotional problems and 21.6% – of conduct problems. Based on total difficulties score, 31.6% of children get in clinical range of emotional and behavioural problems, as rated by parents by the end of the second lockdown. The results are compared to pre-pandemic epidemiological rates of emotional and behavioural problems reported and those documented after the first quarantine in Lithuania and highlight important findings for professionals and policy makers about the detrimental effects of prolonged lockdown and school closure on children’s mental health.

Predictors of Mental Health Status among Quarantined COVID-19 Patients in Saudi Arabia

BACKGROUND

The negative psychological impact of COVID-19 in the general population has been well documented. Similar studies among those who were infected and who underwent quarantine remain scarce, particularly in the Arab region. The present study aims to fill this gap.

METHODS

In this cross-sectional study, suspected/confirmed COVID-19 individuals who were quarantined in the Ministry of Health (MOH) facilities were invited to participate in an online survey. All consenting participants answered a generalized questionnaire that included demographic characteristics, as well as a five-part questionnaire that assessed the symptoms of depression, anxiety, insomnia, and distress.

RESULTS

A total of 335 suspected/confirmed COVID-19 individuals (198 males and 137 females) participated. Being female is associated with increased risk of depression (odds ratio OR 1.8 (confidence interval, CI 1.1-3.1; p = 0.03)) as well as being employed by the government (OR 2.8 (CI 1.1-7.0; p = 0.03)). Level of education (OR 2.3 (CI 1.0-5.4; p = 0.049)) and employment in government (OR 3.0 (CI 1.2-7.8; p = 0.02)) were significantly associated with distress. Increasing age (45 years and above) appeared to be protective against distress (OR 0.2 (CI 0.02-0.69; p = 0.008)), as well anxiety and sleep pattern (OR 0.3 p < 0.05).

CONCLUSION

Findings of the present study highlight that infected COVID-19 populations are at higher risk for acute and detrimental psychological well-being during quarantine and/or self-isolation. Identification of the coping mechanisms of older adults during periods of distress may prove beneficial in the pandemic preparedness of younger generations.

Psychosocial Impact of COVID-19 Pandemic in Libya: A Cross-Sectional Study

Background: Since the outbreak of COVID-19 were announced in Wuhan, China, the virus has spread in most countries. After one year of restrictive measures applied by governments, it is unclear how this prolonged social distancing has affected the mental health of individuals in Libya. Therefore, the present study aims to assess the levels of perceived stress, depression, sleep disturbance, and self-efficacy associated with the pandemic in Libya and their association with the demographic factors. Methods: A cross-sectional study was conducted between October 10 and November 10, 2020 in 21 cities in Libya using an online survey. The survey collected socio-demographic variables and other important psychological variables using valid scales: namely, the Perceived Stress scale, the PROMIS Depression scale, the PROMIS Sleep Disturbance scale, and self-efficacy 6-item scale. Additionally, data were collected regarding eating and smoking habits, housing and living situations, and the preparedness of the public to manage the upcoming waves of the pandemic. Results: The questionnaire was accessed 746 times, and a total of 683 completed questionnaires were analyzed (response rate of 91.6%), with ages ranging from 18 to 94 years (Mean ± SD = 27.09 ± 10.57). Among the respondents, 58.4% were females and 77% were from the age group 18-29 years. The perceived stress, depression, and sleep disturbance symptoms were high in overall population. For stress, 52.7 and 17.1% of respondents reported moderate and high stress, and for sleep quality 28.8 and 8.1% reported moderate and high sleep disturbance, respectively. For depression, the overall median score was 20 (out of 40). The perceived stress, depression, and sleep disturbance were more prevalent among females and the younger age groups (18-29 years old). The overall self-efficacy median total score was 6.67 (out of 10), with a significantly higher median total score for males than females (7 vs. 6.33, p = 0.001). About 14.5% of the respondents were regular cigarette smokers, and most of them (79.8%) described their smoking habits during the previous month as more than typical. In addition, the reported eating habits of almost half of the respondents (43%) had changed, with about one-third (29.6%) reporting that their eating habits had become less healthy during the pandemic. Conclusion: The findings of this research suggest increased levels of stress, depression, and sleep disturbances as well as COVID-19-related fear during the pandemic, especially among young females. This alarming finding urgently calls for safe and low-barrier interventions to help mentally burdened individuals. This study makes a significant contribution in providing essential data on the psychological and social impacts on the Libyan population due to the COVID-19 pandemic.