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Bucaktepe PGE, Akgül F, Çelİk SB. Evaluation of the effects of pandemic-related fears on anxiety and depression: the mediating roles of traumatic stress and loneliness. BMC Psychol 2024; 12:388. [PMID: 38997784 PMCID: PMC11241983 DOI: 10.1186/s40359-024-01880-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 07/01/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND The detrimental mental health effects which emerged from COVID-19 have profoundly affected healthcare workers (HCWs) worldwide. The aim of this study was to investigate the mediating effects of traumatic stress and loneliness on the fears of contracting and dying from COVID-19, and anxiety and depression of HCWs during the pandemic. METHODS A cross-sectional online survey was completed by HCWs in a province of Turkey. The Hospital Anxiety Depression Scale, Impact of Events Scale-Revised and numerical rating scales (for fears of COVID-19 and loneliness) were used and a bootstrap approach was used in the analyses with SPSS PROCESS macro software. RESULTS Of the HCWs evaluated, 150 (34.4%) were doctors, with a mean duration of work experience of 10.6 ± 7.5 years. The results indicated that fear of contracting COVID-19 was directly related to anxiety (β = 0.244, p < 0.001) and depression (β = 0.135, p < 0.01) and that traumatic stress and loneliness mediated the relationships between the fear of contracting COVID-19 and anxiety (β = 0.435, p < 0.001; β = 0.235, p < 0.001, respectively) and depression (β = 0.365, p < 0.001; β = 0.294, p < 0.001, respectively). The fear of dying from COVID-19 was determined to be directly associated with anxiety (β = 0.190, p < 0.001) but not with depression (β = 0.066, p = 0.116), and traumatic stress and loneliness mediated the relationships between the fear of dying from COVID-19 and anxiety (β = 0.476, p < 0.001; β = 0.259, p < 0.001, respectively) and depression (β = 0.400, p < 0.001; β = 0.311, p < 0.001, respectively). CONCLUSIONS The study results demonstrated the important roles of traumatic stress and loneliness in exacerbating the negative consequences of fears of COVID-19 on anxiety and depression, and provide insights for identifying HCWs at greater risk.
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Affiliation(s)
| | - Fethiye Akgül
- Department of Infectious Diseases and Clinical Microbiology, Batman Training and Research Hospital, Batman, Turkey
| | - Sercan Bulut Çelİk
- Batman GAP Family Health Center, Provincial Health Directorate, Batman, Turkey
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Zurutuza JI, Ovando-Diego L, Lezama-Prieto MA, Morales-Romero J, Melgarejo-Gutierrez MA, Ortiz-Chacha CS. Factors Associated With Poor Sleep Quality Among Primary Healthcare Workers During the SARS-CoV-2 Pandemic. Cureus 2024; 16:e56502. [PMID: 38510518 PMCID: PMC10951761 DOI: 10.7759/cureus.56502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2024] [Indexed: 03/22/2024] Open
Abstract
INTRODUCTION Sleep is one of the most important activities for health and the processes related to the central nervous system. Healthcare workers commonly present alterations in the sleep-wake cycle due to complex work schedules because 24-hour attention to the population is required in public health institutions. The increase in care needs caused by the COVID-19 pandemic caused changes in work schedules; as in Mexico, the number of patients requiring consultation in all public health units increased. Chronic partial sleep deprivation (< 7 hours of sleep in the 24-hour cycle) is the most frequent sleep alteration in Mexican health workers. However, it has not been explored whether work modifications due to the pandemic had an impact on the sleep quality of workers. OBJECTIVE We aimed to describe the prevalence of poor sleep quality and the associated factors in workers (clinical and non-clinical) of a primary care medical unit. MATERIAL AND METHODS We conducted an analytical and cross-sectional study during November and December 2022. We used the following tools for studying clinical and non-clinical staff working at a family medicine primary care unit: Pittsburgh Sleep Quality Index, Hamilton Anxiety Scale, Beck Depression Inventory, Maslach Burnout Inventory, and Graffar-Méndez-Castellanos socioeconomic level scale, as well as a data collection sheet and a survey of workers' knowledge, attitudes, fears, and needs regarding COVID-19. RESULTS A total of 233 workers were surveyed. The prevalence of poor sleep quality was 56.7%. A higher score on the Beck Depression Inventory (OR: 1.21, CI 95%: 1.13-1.29), being a doctor (OR: 3.48, CI 95%: 1.5-8.01), and frequent alcohol consumption (OR: 2.4, CI 95%: 1.13-5.2) were identified as risk factors for poor sleep quality. A lower score in the depersonalization dimension of the Maslach Burnout Inventory (OR: 0.5, CI 95%: 0.26-0.99) was identified as a protective factor for poor sleep quality. CONCLUSIONS During the pandemic, the stress of health workers increased due to work alterations that were necessary to treat the greatest number of patients, so their quality of sleep decreased. Unfortunately, the mental health of healthcare workers is often under-assessed in many institutions. Thus, it is relevant to identify risk factors for alterations (especially those of sleep), since by identifying the target population, comprehensive interventions can be carried out, which can reduce the prevalence of burnout, anxiety, and depression, but if not addressed, the alterations can lead to inadequate care for users of health units.
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Affiliation(s)
- Jorge I Zurutuza
- Epidemiology and Biostatistics Department, Centro de Investigaciones Biomedicas, Xalapa, MEX
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Villarreal-Zegarra D, Reátegui-Rivera CM, Otazú-Alfaro S, Yantas-Alcantara G, Soto-Becerra P, Melendez-Torres GJ. Estimated impact of the COVID-19 pandemic on the prevalence and treatment of depressive symptoms in Peru: an interrupted time series analysis in 2014-2021. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1375-1385. [PMID: 36884090 PMCID: PMC9993377 DOI: 10.1007/s00127-023-02446-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 02/27/2023] [Indexed: 03/09/2023]
Abstract
PURPOSE The COVID-19 pandemic increased the burden of mental disorders worldwide. Peru has been one of the countries most affected by COVID-19, however, studies evaluating the medium and long-term consequences of the pandemic on Peruvians' mental health are recent and represent a new field of study in proliferation. We aimed to estimate the impact of the COVID-19 pandemic on the prevalence and treatment of depressive symptoms using nationally representative surveys in Peru. METHODS Our study is an analysis of secondary data. We carried out a time series cross-sectional analysis based on the National Demographic and Health Survey of Peru, collected using a complex sampling design. The Patient Health Questionnaire-9 was used to measure mild (5-9 points), moderate (10-14 points), and severe (15 points or more) depressive symptoms. The participants were men and women aged 15 years and older, living in urban and rural areas of all regions of Peru. The main statistical analysis used segmented regression with Newey-West standard errors, taking into account that each year of the evaluation was divided into four measures (quarter measure). RESULTS We included 259,516 participants. An average quarterly increase of 0.17% (95% CI 0.03-0.32%) in the prevalence of moderate depressive symptoms was identified after the onset of the COVID-19 pandemic (approximately an increase of 1583 new cases of moderate depressive symptoms by each quarter). The percentage of cases treated for mild depressive symptoms increased quarterly by an average of 0.46% (95% CI 0.20-0.71%) after the onset of the COVID-19 pandemic (approximately an increase of 1242 new cases treated for mild depressive symptoms by each quarter). CONCLUSION In Peru, increases in the prevalence of moderate depressive symptoms and the proportion of cases treated with mild depressive symptoms were found after the COVID-19 pandemic. Therefore, this study is a precedent for future research assessing the prevalence of depressive symptoms and the proportion of cases receiving treatment during the pandemic and post-pandemic years.
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Affiliation(s)
- David Villarreal-Zegarra
- Escuela de Medicina, Universidad César Vallejo, Trujillo, Peru
- Instituto Peruano de Orientación Psicológica, Lima, Peru
| | - C. Mahony Reátegui-Rivera
- Instituto Peruano de Orientación Psicológica, Lima, Peru
- Unidad de Telesalud, Universidad Nacional Mayor de San Marcos, Lima, Peru
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Valladares-Garrido MJ, Picón-Reátegui CK, Zila-Velasque JP, Grados-Espinoza P, Vera-Ponce VJ, Pereira-Victorio CJ, Valladares-Garrido D, Failoc-Rojas VE. Depression and anxiety in peruvian military personnel during the pandemic context: a cross-sectional study. BMC Public Health 2023; 23:691. [PMID: 37055833 PMCID: PMC10100618 DOI: 10.1186/s12889-023-15612-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 04/05/2023] [Indexed: 04/15/2023] Open
Abstract
BACKGROUND During the COVID-19 pandemic, increased workload and stress could have increased mental health problems (anxiety and depression) in military personnel. However, the number of studies in military members is scarce, especially in regard to mental health. The objective of this study was determine the prevalence and factors associated with depression and anxiety in Peruvian military personnel. METHODS We undertook an analytical cross-sectional study. The survey was distributed face to face between November 02 and 09, 2021, during the second wave of the COVID-19 pandemic among the military personnel. We used some instruments to measure depression (Patient Health Questionnaire, PHQ-9), anxiety (Generalized Anxiety Disorder, GAD-7), insomnia (Insomnia Severity Index, ISI), food insecurity (Household Food Insecurity Access Scale, HFIAS), physical activity (International Physical Activity Questionnaires, IPAQ-S), resilience (abbreviated CD-RISC), and fear of COVID-19 scale. The exclusion criteria included those who did not completely fill out the evaluation instruments. RESULTS We analyzed the data of 615 military personnel that participated in the survey. Of them, 93.7% were male and the median age was 22 years old. There was a prevalence of 29.9% and 22.0% in regard to depression and anxiety symptoms, respectively. In addition, it was found that being married (PR: 0.63; 95% IC: 0.42-0.94), having a relative with mental health problems (PR: 2.16), having experienced food insecurity (PR: 1.48), insomnia (PR: 2.71), fear of COVID-19 (PR: 1.48), and a high level of resilience (PR: 0.65) were factors associated with depression. In regard to anxiety, the factors associated were working for more than 18 months since the beginning of the COVID-19 pandemic (PR: 0.52), a high level of resilience (PR: 0.50; 95% IC: 0.33-0.77), insomnia (PR: 3.32), fear of COVID-19 (PR: 2.43). CONCLUSION We found a prevalence of symptoms of depression and anxiety of 29.9% and 22.0%, respectively. In regard to the factors that attenuate depression, we can mention being married and having resilience; and among the aggravating factors, having a relative with mental health problems, food insecurity, insomnia, and fear of COVID-19. Finally, anxiety increased through working time, insomnia, and fear of COVID-19.
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Affiliation(s)
- Mario J. Valladares-Garrido
- Escuela de Medicina, Universidad Cesar Vallejo, Piura, Peru
- Oficina de Epidemiología, Hospital Regional Lambayeque, Chiclayo, Peru
| | | | - J. Pierre Zila-Velasque
- Facultad de Medicina Humana, Universidad Nacional Daniel Alcides Carrión, Pasco, Peru
- Red Latinoamericana de Medicina en la Altitud e Investigación (REDLAMAI), Pasco, Peru
| | - Pamela Grados-Espinoza
- Facultad de Medicina Humana, Universidad Nacional Daniel Alcides Carrión, Pasco, Peru
- Red Latinoamericana de Medicina en la Altitud e Investigación (REDLAMAI), Pasco, Peru
| | - Víctor J. Vera-Ponce
- Instituto de Investigación en Ciencias Biomédicas, Universidad Ricardo Palma, Lima, 15039 Peru
- Universidad Tecnológica del Perú, Lima, 15046 Peru
| | | | - Danai Valladares-Garrido
- Escuela de Medicina, Universidad Cesar Vallejo, Piura, Peru
- Unidad de Epidemiología y Salud Ambiental, Hospital de Apoyo II Santa Rosa, Piura, Peru
| | - Virgilio E. Failoc-Rojas
- Research Unit for Generation and Synthesis Evidence in Health, Universidad San Ignacio de Loyola, Lima, Peru
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Huarcaya-Victoria J, Alarcon-Ruiz CA, Barzola-Farfán W, Cruzalegui-Bazán C, Cabrejos-Espinoza M, Aspilcueta-Montoya G, Cornero-Quispe F, Salazar-Bellido J, Villarreal B. One-year follow-up of depression, anxiety, and quality of life of Peruvian patients who survived COVID-19. Qual Life Res 2023; 32:139-149. [PMID: 35939252 PMCID: PMC9358105 DOI: 10.1007/s11136-022-03208-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2022] [Indexed: 01/17/2023]
Abstract
PURPOSE To assess health-related quality of life (HRQoL) and its associated factors in patients who survived COVID-19 and to assess a prospective evaluation of the prevalence and severity of their depression and anxiety symptoms. METHODS We followed up a sample of hospitalized patients who survived COVID-19 at 3 and 12 months after discharge. We assessed HRQoL (Euroqol-5D-5L) through telephone interviews. Any problem in any dimension of Euroqol-5D-5L was considered as low HRQoL. The depression and anxiety symptoms were measured using the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 tools, respectively. We estimated the adjusted prevalence ratios (aPR) to low HRQoL using Poisson regression and the changes on their depression and anxiety symptoms during the follow-up. RESULTS We included 119 patients with a mean follow-up time of 363.6 days. 74% of the participants had low HRQoL at one year after hospital discharge and were associated with being ≥ 41 years old (aPR: 1.95), having a previous history of psychiatric diagnoses before COVID-19 infection (aPR: 1.47), having any COVID-19 symptom during the follow-up at one year (aPR: 1.84), and having a family member who had died from COVID-19 during the first wave (aPR: 1.24). In addition, the clinically relevant depression symptoms were frequent, and they increased from 3 (14.3%) to 12 months (18.5%). CONCLUSION One year after COVID-19 hospitalization discharge, patients had low HRQoL, and their depression symptoms increased. These findings acknowledge the need to provide services that adequately address mental health sequels and HRQoL to reduce the burden of the COVID-19.
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Affiliation(s)
- Jeff Huarcaya-Victoria
- Unidad de Psiquiatría de Enlace, Departamento de Psiquiatría, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima, Peru
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Filial Ica, Peru
| | - Christoper A Alarcon-Ruiz
- Unidad de Investigación Para La Generación Y Síntesis de Evidencia en Salud, Universidad San Ignacio de Loyola, Av. la Fontana 550, La Molina, 15024, Lima, Peru.
| | | | | | | | | | | | | | - Beltrán Villarreal
- Unidad de Psiquiatría de Enlace, Departamento de Psiquiatría, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima, Peru
- Departamento de Psiquiatría, Escuela de Medicina Humana, Universidad Nacional Mayor de San Marcos, Lima, Peru
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Shiffman N, Gluska H, Margalit S, Mayer Y, Daher R, Elyasyan L, Elia N, Sharon Weiner M, Miremberg H, Kovo M, Biron-Shental T, Gabbay-Benziv R, Helpman L. Postpartum post-traumatic stress symptoms during the COVID-19 period: exposure and fear as mediating factors. Eur J Psychotraumatol 2023; 14:2228151. [PMID: 37534932 PMCID: PMC10402867 DOI: 10.1080/20008066.2023.2228151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/29/2023] [Accepted: 04/11/2023] [Indexed: 08/04/2023] Open
Abstract
Background: Post-traumatic stress symptoms (PTSS) following childbirth are common within a stressful environment and are mitigated by social support. During the COVID-19 pandemic, an increase in such symptoms has been reported. The current study aims to longitudinally model the influence of general and pandemic-specific risk and protective factors on the temporal unfolding of symptoms among postpartum women.Methods: Participants were 226 women following a liveborn, term birth during the first lockdown in Israel. Participants completed questionnaires 10 weeks (T1) and 6 months (T2) after delivery. PATH analyses included predictors of symptoms in T1: demographics, exposure to traumatic events, medical complications during delivery or pregnancy, exposure to COVID-19-related events and their subjective impact, fear of COVID-19, and social support. Predictors of symptoms in T2 were: T1 predictors, both as direct effects and mediated by T1 PTSS, as well as predictors measured again in T2.Results: Results showed the suggested model fit the data. The effect of COVID-19-related fear and subjective impact at T1 on symptoms at T2 were fully mediated by PTSS in T1, as were the effects of marriage and high social support at T1. COVID-19-related fear at T2 positively predicted symptoms at T2, while social support at T2 had the opposite effect. Medical complications during pregnancy negatively predicted symptoms in T2 only.Discussion: Persistent fear appears to be a risk factor and supports a consistent buffer in postpartum PTSS during the COVID-19 pandemic. Medical complications during pregnancy served as a protective factor, possibly due to habituation to medical settings.
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Affiliation(s)
- Noga Shiffman
- Psychiatry and Mental Health Division, Rambam Medical Center, Haifa, Israel
- The Ruth and Bruce Rappaport Faculty Medicine, Haifa, Israel
| | - Hadar Gluska
- Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Shiri Margalit
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Yael Mayer
- Department of Counseling and Human Development, Faculty of Education, University of Haifa, Haifa, Israel
| | - Rawan Daher
- The Ruth and Bruce Rappaport Faculty Medicine, Haifa, Israel
- Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel
| | - Lior Elyasyan
- The Ruth and Bruce Rappaport Faculty Medicine, Haifa, Israel
- Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel
| | - Nofar Elia
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, Israel
| | - Maya Sharon Weiner
- Psychiatry and Mental Health Division, Rambam Medical Center, Haifa, Israel
- The Ruth and Bruce Rappaport Faculty Medicine, Haifa, Israel
| | - Hadas Miremberg
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, Israel
| | - Michal Kovo
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, Israel
| | - Tal Biron-Shental
- Psychiatry and Mental Health Division, Rambam Medical Center, Haifa, Israel
- The Ruth and Bruce Rappaport Faculty Medicine, Haifa, Israel
| | - Rinat Gabbay-Benziv
- The Ruth and Bruce Rappaport Faculty Medicine, Haifa, Israel
- Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel
| | - Liat Helpman
- Department of Counseling and Human Development, Faculty of Education, University of Haifa, Haifa, Israel
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Wang X, Zhang N, Pu C, Li Y, Chen H, Li M. Anxiety, Depression, and PTSD among College Students in the Post-COVID-19 Era: A Cross-Sectional Study. Brain Sci 2022; 12:1553. [PMID: 36421876 PMCID: PMC9688529 DOI: 10.3390/brainsci12111553] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/01/2022] [Accepted: 11/08/2022] [Indexed: 08/15/2023] Open
Abstract
In the post-COVID-19 era, significant changes have taken place regarding the epidemic, the economy, family and social life. However, it remains unclear how these changes encompass the psychological symptoms of college students. We carried out a cross-sectional study to investigate anxiety, depression, and post-traumatic stress disorder (PTSD) symptoms among college students from 10 November 2020, to 16 November 2020. The questionnaire included a self-designed canvas, Generalized Anxiety Disorder 7 (GAD-7), Patient Health Questionnaire 9 (PHQ-9), and Impact of Event Scale (IES-R). Factors associated with psychological symptoms were estimated by ordered and non-conditional logistic regression analysis. Of 4754 participants, 25.0%, 29.7%, 3.4%, 15.3%, 17.1%, and 2.9% reported anxiety, depression, PTSD symptoms, one, any two, and all three, respectively. In cases with anxiety or depression symptoms, there was a 9.11% comorbidity with PTSD. Factors associated with fears of being infected, social, family, and economic changes increased the risk of psychological symptoms in college students caused by COVID-19. Female college students, identified with anxiety or depression symptoms, were at a lower risk of developing PTSD symptoms (OR, 0.61, 95% CI: 0.43-0.86). Non-medical majors at university, rural residence, higher educational background, fear of taking public transport, and deterioration of family relationships increased the risk for PTSD symptoms among male respondents with anxiety or depression symptoms due to COVID-19. Factors correlated with psychological symptoms had expanded from the fear of being infected to extensive social, family, and economic changes caused by COVID-19. Therefore, screening and interventions for psychological symptoms should be consistently strengthened and more targeted to college students in the post-COVID-19 era.
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Affiliation(s)
- Xing Wang
- School of Life Sciences, Nanchang University, Nanchang 330036, China
- Clinical Medical Experiment Center, Nanchang University, Nanchang 330036, China
| | - Nan Zhang
- Department of Psychology, School of Public Policy and Administration, Nanchang University, Nanchang 330031, China
| | - Changqin Pu
- Queen Mary College, Nanchang University, Nanchang 330006, China
| | - Yunyue Li
- Queen Mary College, Nanchang University, Nanchang 330006, China
| | - Hongguang Chen
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100083, China
| | - Mengqian Li
- Department of Psychosomatic Medicine, Gao Xin Hospital of the First Affiliated Hospital of Nanchang University, Nanchang 330029, China
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Zhang Z, Wang X, Wang W, Zhang J, Shan L, Li Y. The impact of the coronavirus disease 2019 pandemic on abortion access and pre-abortion mental health in Shanghai. Int J Gynaecol Obstet 2022; 160:1035-1041. [PMID: 36278866 PMCID: PMC9874749 DOI: 10.1002/ijgo.14516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 10/07/2022] [Accepted: 10/13/2022] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To understand the barriers to abortion in Shanghai during the COVID-19 pandemic, and to compare pre-abortion mental health status before and during the crisis. METHODS In this case-control study, two groups of women seeking abortion (age ≥18 years, pregnancy duration <98 days) were recruited from March to September, 2021 (n = 1070) and from February to April 2022 (n = 625). The evaluation included COVID-19-related abortion stress questions, the Symptom Checklist-90 Revised questionnaire, the Pittsburgh Sleep Quality Index (PSQI), and the Family Environment Scale Chinese version. The researchers conducted interviews and collected questionnaires. RESULTS The median pregnancy duration at abortion among women during the pandemic was 65 days, compared with 51 days in the pre-pandemic group (P < 0.001). Anxiety and depression symptoms increased during the crisis (P < 0.001). Sleep disturbances were more common. Higher PSQI scores were related to increased anxiety and depression symptoms. A more negative family climate was described during the pandemic. CONCLUSION During the COVID-19 pandemic, abortion access was delayed and pre-abortion mental disorders increased. More attention should be paid to the mental health of women seeking abortions, and innovations should be promoted to ensure abortion services without delay.
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Affiliation(s)
- Zhifang Zhang
- Department of Obstetrics and Gynecology, Shanghai General HospitalShanghai Jiao Tong University, School of MedicineShanghaiChina
| | - Xiaoyun Wang
- Department of Obstetrics and Gynecology, Shanghai General HospitalShanghai Jiao Tong University, School of MedicineShanghaiChina
| | - Wei Wang
- Department of Obstetrics and Gynecology, Shanghai General HospitalShanghai Jiao Tong University, School of MedicineShanghaiChina
| | | | - Liyun Shan
- Department of Obstetrics and Gynecology, Shanghai General HospitalShanghai Jiao Tong University, School of MedicineShanghaiChina
| | - Yanli Li
- Department of Obstetrics and Gynecology, Shanghai General HospitalShanghai Jiao Tong University, School of MedicineShanghaiChina
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Anampa-Canales MM, Huancahuire-Vega S, Newball-Noriega EE, Morales-García WC, Galvez CA. Food insecurity associated with self-reported mental health outcomes in Peruvian households during the COVID-19 pandemic. Front Nutr 2022; 9:1005170. [DOI: 10.3389/fnut.2022.1005170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 10/20/2022] [Indexed: 11/06/2022] Open
Abstract
BackgroundThe global pandemic of COVID-19 and the social distancing efforts implemented worldwide to limit its spread have disrupted the economy, increased food insecurity, and mental health problems.ObjectivesThe aim of this study was to determine the association between food insecurity and mental health outcomes (stress, depression, and anxiety) in Peruvian households during the COVID-19 pandemic.Materials and methodsA cross-sectional investigation was conducted with 525 participants of both sexes (68% women), over 18 years of age and from the three geographic regions of Peru: Coast (54.9%), Highlands (28.4%), and Jungle (16.8%). The data were collected during the year 2021, between July 6 and September 22 through a self-administered online survey designed to assess socio-demographic, socioeconomic, food insecurity, and mental health outcomes (depression, anxiety, and stress).ResultsThe majority of households (71.4%) experienced some degree of food insecurity. Mild food insecurity was the most frequent, affecting 49.1%, followed by moderate 15.4%, and severe 6.9%. Regarding mental health outcomes, 24.8% manifested depression, 26.7% anxiety, and 15.3% stress. With respect to the association between the level of food insecurity and anxiety, this was highly significant (p < 0.01). Households with mild, moderate and severe food insecurity are 2.04, 4.5, and 10.44 times, respectively, more likely to have moderate-severe anxiety. On the other hand, the mild food insecurity was not associated with moderate-severe depression. In contrast, households with moderate and severe food insecurity are 2.8 and 5.7 times, respectively, more likely to have moderate-severe depression. Finally, households with moderate food insecurity are 5.9 times more likely to have moderate-severe stress, and households with severe food insecurity are 8.5 times more likely to have moderate-severe stress, both having a highly significant association (p < 0.01).ConclusionIn conclusion, during the second wave of the COVID-19 pandemic in Peru, household food insecurity was independently associated with worse mental health outcomes. Monitoring of both food insecurity and mental health will be important as the COVID-19 pandemic continues.
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Villarreal-Zegarra D, Paredes-Angeles R, Mayo-Puchoc N, Vilela-Estada AL, Copez-Lonzoy A, Huarcaya-Victoria J. An explanatory model of depressive symptoms from anxiety, post-traumatic stress, somatic symptoms, and symptom perception: the potential role of inflammatory markers in hospitalized COVID-19 patients. BMC Psychiatry 2022; 22:638. [PMID: 36210450 PMCID: PMC9548421 DOI: 10.1186/s12888-022-04277-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 08/05/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The context of the COVID-19 pandemic has harmed the mental health of the population, increasing the incidence of mental health problems such as depression, especially in those who have had COVID-19. Our study puts forward an explanatory model of depressive symptoms based on subjective psychological factors in those hospitalized for COVID-19 with and without biological markers (i.e., inflammatory markers). Therefore, we aim to evaluate the hypotheses proposed in the model to predict the presence of depressive symptoms. METHOD We conducted a cross-sectional study, using a simple random sampling. Data from 277 hospitalized patients with COVID-19 in Lima-Peru, were collected to assess mental health variables (i.e., depressive, anxiety, post-traumatic stress, and somatic symptoms), self-perception of COVID-19 related symptoms, and neutrophil/lymphocyte ratio (NLR) such as inflammatory marker. We performed a structural equation modeling analysis to evaluate a predictive model of depressive symptoms. RESULTS The results showed a prevalence of depressive symptoms (11.2%), anxiety symptoms (7.9%), somatic symptoms (2.2%), and symptoms of post-traumatic stress (6.1%) in the overall sample. No association was found between the prevalence of these mental health problems among individuals with and without severe inflammatory response. The mental health indicators with the highest prevalence were sleep problems (48%), low energy (47.7%), nervousness (48.77%), worry (47.7%), irritability (43.7%) and back pain (52%) in the overall sample. The model proposed to explain depressive symptoms was able to explain more than 83.7% of the variance and presented good goodness-of-fit indices. Also, a different performance between the proposed model was found between those with and without severe inflammatory response. This difference was mainly found in the relationship between anxiety and post-traumatic stress symptoms, and between the perception of COVID-19 related symptoms and somatic symptoms. CONCLUSIONS Results demonstrated that our model of mental health variables may explain depressive symptoms in hospitalized patients of COVID-19 from a third-level hospital in Peru. In the model, perception of symptoms influences somatic symptoms, which impact both anxiety symptoms and symptoms of post-traumatic stress. Thus, anxiety symptoms could directly influence depressive symptoms or through symptoms of post-traumatic stress. Our findings could be useful to decision-makers for the prevention of depression, used to inform the creation of screening tools (i.e., perception of symptoms, somatic and anxiety symptoms) to identify vulnerable patients to depression.
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Affiliation(s)
- David Villarreal-Zegarra
- grid.441978.70000 0004 0396 3283Escuela de Medicina, Universidad César Vallejo, Trujillo, Peru ,Instituto Peruano de Orientación Psicológica, Lima, Peru
| | | | | | | | - Anthony Copez-Lonzoy
- Instituto Peruano de Orientación Psicológica, Lima, Peru ,grid.441908.00000 0001 1969 0652Unidad de Investigación en Bibliometría, Universidad San Ignacio de Loyola, Lima, Peru ,PSYCOPERU Peruvian Research Institute of Educational and Social Psychology, Lima, Peru
| | - Jeff Huarcaya-Victoria
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Filial Ica, Peru. .,Departamento de Psiquiatría, Servicio de Psiquiatría de Adultos, Unidad de Psiquiatría de Enlace, Hospital Nacional Guillermo Almenara Irigoyen, Lima, Perú.
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Karanikola M, Mpouzika M, Papathanassoglou E, Kaikoushi K, Hatzioannou A, Leontiou I, Livadiotis C, Christophorou N, Chatzittofis A. Work-Related Traumatic Stress Response in Nurses Employed in COVID-19 Settings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191711049. [PMID: 36078761 PMCID: PMC9518142 DOI: 10.3390/ijerph191711049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 08/25/2022] [Accepted: 08/29/2022] [Indexed: 05/27/2023]
Abstract
Nurses may be at a higher risk of experiencing work-related traumatic stress response during the COVID-19 pandemic compared to other clinicians. This study aimed to investigate the correlations between work-related trauma symptoms and demographic factors, psychosocial hazards and stress response in a census sample of nurses working in COVID-19 settings in Cyprus. In this nationwide descriptive and cross-sectional study, data were collected between April and May 2020 using a questionnaire that included sociodemographic, educational and employment and work-related variables, as well as a modified version of the Secondary Traumatic Stress Scale (STSS) for the assessment of work-related trauma symptoms during the pandemic. Overall, 233 nurses participated (with a response rate of 61.3%) and 25.7% of them reported clinical work-related trauma symptoms (STSS-M > 55; actual scale range: 17-85). The mean value for emotional exhaustion was 7.3 (SD: 2.29; visual scale range: 1-10), while the value for distress that was caused by being avoided due to work in COVID-19 units was 6.98 (SD: 2.69; visual scale range: 1-10). Positive associations were noted between trauma symptoms and both emotional exhaustion and distress from being avoided by others due to work in a COVID-19 setting and a negative association was also found between trauma symptoms and satisfaction from organizational support variables (all p < 0.002). Working in COVID-19 settings during the pandemic is a stressful experience that has been linked to psychologically traumatic symptoms Thus, supportive measures are proposed for healthcare personnel, even in countries with low COVID-19 burden.
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Affiliation(s)
- Maria Karanikola
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol 3041, Cyprus
| | - Meropi Mpouzika
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol 3041, Cyprus
| | | | | | - Anna Hatzioannou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol 3041, Cyprus
| | - Ioannis Leontiou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol 3041, Cyprus
| | - Chris Livadiotis
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol 3041, Cyprus
| | | | - Andreas Chatzittofis
- Medical School, University of Cyprus, Nicosia 1065, Cyprus
- Department of Clinical Sciences/Psychiatry, Umeå University, 901 85 Umeå, Sweden
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Abstract
The measures put in place to contain the rapid spread of COVID-19 infection, such as quarantine, self-isolation, and lockdown, were supportive but have significantly affected the mental wellbeing of individuals. The primary goal of this study was to review the impact of COVID-19 on mental health. An intensive literature search was conducted using PsycINFO, PsyciatryOnline, PubMed, and the China National Knowledge Infrastructure (CNKI) databases. Articles published between January 2020 and June 2022 were retrieved and appraised. Reviews and retrospective studies were excluded. One hundred and twenty-two (122) relevant articles that fulfilled the inclusion criteria were finally selected. A high prevalence of anxiety, depression, insomnia, and post-traumatic stress disorders was reported. Alcohol and substance abuse, domestic violence, stigmatization, and suicidal tendencies have all been identified as direct consequences of lockdown. The eminent risk factors for mental health disorders identified during COVID-19 include fear of infection, history of mental illness, poor financial status, female gender, and alcohol drinking. The protective factors for mental health include higher income levels, public awareness, psychological counseling, social and government support. Overall, the COVID-19 pandemic has caused a number of mental disorders in addition to economic hardship. This strongly suggests the need to monitor the long-term impact of the COVID-19 pandemic on mental health.
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Huarcaya-Victoria J, Villarreal-Rao B, Luna M, Rojas-Mendoza W, Alarcon-Ruiz CA, Villarreal-Zegarra D, Vilela-Estrada AL, Ramírez S. Factors Associated with Mental Health Outcomes in Hospital Workers during the COVID-19 Pandemic: A Mixed-Methods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095346. [PMID: 35564741 PMCID: PMC9103531 DOI: 10.3390/ijerph19095346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 04/05/2022] [Accepted: 04/06/2022] [Indexed: 11/30/2022]
Abstract
Background: We investigated some of the factors associated with depression, perceived stress, and anxiety in clinical and nonclinical healthcare workers of two hospitals. Methods: A mixed-methods approach was used. The sample included clinical (physicians, nurses, and others) and nonclinical (security and cleaning staff) healthcare workers of two tertiary hospitals in Peru. Participants completed an online self-survey. In the qualitative analysis, data were subjected to thematic analysis. Results: We analyzed data from 613 participants, of which 8.6%, 9.0%, and 78.2% had moderate-to-severe anxiety, depression, and perceived stress, respectively. Having a previous mental health problem, being concerned about losing one’s job, having at least two COVID-19 symptoms in the preceding two weeks, and being afraid of infecting family members increased the prevalence of experiencing moderate-to-severe depression and anxiety. The qualitative analysis allowed us to identify five recurring factors that caused a negative impact on workers’ lives during the pandemic: emotional distress linked to hospital experiences of suffering and death, modification of routines, fear of COVID-19, exacerbation of mental disorders, and physical problems associated with emotional distress. Conclusions: Clinical and nonclinical healthcare workers in Peru have experienced depression, anxiety, and stress during the COVID-19 pandemic. Future research and interventions are necessary to improve psychological support for hospital workers.
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Affiliation(s)
- Jeff Huarcaya-Victoria
- Departamento de Psiquiatría, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima 15033, Peru; (B.V.-R.); (M.L.)
- Correspondence:
| | - Beltran Villarreal-Rao
- Departamento de Psiquiatría, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima 15033, Peru; (B.V.-R.); (M.L.)
| | - Matilde Luna
- Departamento de Psiquiatría, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima 15033, Peru; (B.V.-R.); (M.L.)
| | - Wendoline Rojas-Mendoza
- Departamento de Salud Mental, Hospital Nacional Edgardo Rebagliati Martins, EsSalud, Lima 15072, Peru;
| | | | - David Villarreal-Zegarra
- Dirección de Investigación, Desarrollo e Innovación, Instituto Peruano de Orientación Psicológica, Lima 15046, Peru; (D.V.-Z.); (A.L.V.-E.)
| | - Ana L. Vilela-Estrada
- Dirección de Investigación, Desarrollo e Innovación, Instituto Peruano de Orientación Psicológica, Lima 15046, Peru; (D.V.-Z.); (A.L.V.-E.)
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Niazi AUR, Alekozay M, Najm AF. RESEARCH ARTICLEPrevalence and associated factors of depression, anxiety and stress among coronavirus disease 2019 (COVID-19) patients in Heart, Afghanistan. GLOBAL HEALTH JOURNAL 2022; 6:85-90. [PMID: 35223130 PMCID: PMC8863950 DOI: 10.1016/j.glohj.2022.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/28/2022] [Accepted: 02/21/2022] [Indexed: 11/20/2022] Open
Abstract
Objectives Coronavirus disease 2019 (COVID-19) pandemic has been associated with a great level of psychological distresses in people around the world. This study aims to assess the prevalence of depression, anxiety and stress among COVID-19 patients and identify the associated factors, in Herat Province of Afghanistan. Methods This cross-sectional study was conducted on 459 hospitalized patients between May and September 2021. Data was collected with a structured questionnaire on depression, anxiety and stress scale, which was the validated Dari-version. Chi-square test was adopted to analyze the associations of the prevalence of the mental disorders and the factors. Results The mean age of participants was 38.05; 51.9% (238/459) were male and 84.1% (386/459) were married. Median scores for depression, anxiety and stress were 5.0, 8.0, and 10.0, respectively. Gender, general health condition, nutritional status, COVID-19 clinical manifestation and concurrent comorbidities (except diabetes and hypertension) were significantly associated with mental disorders; while association between marital status and these psychological disorders was not significant. Moreover, a significant difference was observed in the level of anxiety between healthcare workers and other respondents. Conclusion This is the first study to report the high prevalence of depression, anxiety and stress among COVID-19 patients in Herat, which indicates the negative effect of mental health for COVID-19 patients globally and highlights the need for urgent and appropriate interventions to improve mental health of people during the pandemic.
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Affiliation(s)
- Aziz-Ur-Rahman Niazi
- Department of Public Health and Infectious Diseases, Faculty of Medicine, Herat University, Herat, Afghanistan
| | - Mina Alekozay
- Department of Public Health and Infectious Diseases, Faculty of Medicine, Herat University, Herat, Afghanistan
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