The impact of the COVID-19 lockdown on depression sufferers: a qualitative study from the province of Zaragoza, Spain

Asthma control associated with anxiety and depression in asthmatic children following post-acute COVID-19

BACKGROUND

Poor asthma control may adversely affect mental health. Our study investigates the correlation between inadequate asthma control, exhaled nitric oxide (FENO) levels, and anxiety and depression among pediatric asthma patients with COVID-19.

METHODS

This prospective case-control study enrolled 520 asthmatic children (8-15 years), including 336 patients diagnosed with COVID-19 after rapid antigen testing at home and 184 age-matched asthmatic patients without COVID-19 infection. FENO and spirometry were performed 1 month after COVID-19 infection. Scores for Child Anxiety-Related Disorders (SCARED) and depression screen derived from Patient Health Questionnaire-9 (PHQ-9) to assess their mental health status. Childhood asthma control test (C-ACT), FENO levels, and spirometry were correlated with the SCARED and PHQ-9 questionnaires.

RESULTS

SCARED subscales, including generalized anxiety disorder, social anxiety disorder, school avoidance, and depression scores from PHQ-9, exhibited a significant increase in asthmatic patients diagnosed with COVID-19 (p < .05). Among asthmatic children with SARS-CoV-2 infection, the poor asthma control group exhibited the highest SCARED and PHQ-9 measurements (p < .01). Multiple linear regression analysis indicated that reduced C-ACT scores and elevated FENO levels in asthmatic children with COVID-19 were significant risk factors for both anxiety and depression scores (p < .05). Lower C-ACT scales were associated with high scores of SCARED (r = -0.471) and PHQ-9 (r = -0.329) in asthmatic children (p < .001).

CONCLUSIONS

The current study emphasizes the need for healthcare professionals to closely monitor asthma control in asthmatic children to prevent heightened risks of depression and anxiety during the ongoing COVID-19 pandemic.

A synthesis of evidence for policy from behavioural science during COVID-19

Scientific evidence regularly guides policy decisions1, with behavioural science increasingly part of this process2. In April 2020, an influential paper3 proposed 19 policy recommendations ('claims') detailing how evidence from behavioural science could contribute to efforts to reduce impacts and end the COVID-19 pandemic. Here we assess 747 pandemic-related research articles that empirically investigated those claims. We report the scale of evidence and whether evidence supports them to indicate applicability for policymaking. Two independent teams, involving 72 reviewers, found evidence for 18 of 19 claims, with both teams finding evidence supporting 16 (89%) of those 18 claims. The strongest evidence supported claims that anticipated culture, polarization and misinformation would be associated with policy effectiveness. Claims suggesting trusted leaders and positive social norms increased adherence to behavioural interventions also had strong empirical support, as did appealing to social consensus or bipartisan agreement. Targeted language in messaging yielded mixed effects and there were no effects for highlighting individual benefits or protecting others. No available evidence existed to assess any distinct differences in effects between using the terms 'physical distancing' and 'social distancing'. Analysis of 463 papers containing data showed generally large samples; 418 involved human participants with a mean of 16,848 (median of 1,699). That statistical power underscored improved suitability of behavioural science research for informing policy decisions. Furthermore, by implementing a standardized approach to evidence selection and synthesis, we amplify broader implications for advancing scientific evidence in policy formulation and prioritization.

Experiences of Home-living Vulnerable Older Adults with Clinical Depression during the COVID-19 Pandemic: A Qualitative Study

OBJECTIVES

Little is known about the diversity of older adults' experiences during the COVID-19 pandemic. We therefore investigated the pandemic experiences of home-living vulnerable older adults with depression, an understudied subpopulation.

METHODS

We conducted unstructured interviews with N= 20 older (60+ years) adults with clinical depression receiving care in their homes in June and again in December 2020. Interviews were coded according to the grounded theory approach.

RESULTS

We identified eight themes. Participants described feeling disconnected before and during the pandemic, which they attributed to their physical impairments and old age. Their social relations with family, medical providers, and caregivers helped them feel connected. Participants did not feel significantly impacted by the COVID-19 pandemic, but they missed social and physical contact. During the pandemic, isolation was normalized. Participants therefore experienced loneliness due to their isolation, but also a sense of togetherness with the rest of society. Isolation within the home was re-framed as cocooning, which provided a sense of autonomy. Participants nevertheless expressed resignation.

CONCLUSIONS

Home-living vulnerable older adults with depression experienced loneliness but also a degree of relief during the pandemic.

CLINICAL IMPLICATIONS

Positively re-framing isolation and the stability of formal caregiving helped participants endure feeling disconnected during the pandemic.

International medical students' acculturation and self-rated health status in Hungary: a cross-sectional study

Background

Over the past few decades, the number of international students has increased dramatically. These students have to adjust to unfamiliar social, cultural, and educational environments. The concept of acculturation has been applied in multiple studies on various health outcomes. This study investigated the relationship between acculturation and self-rated health (SRH) among international medical students.

Methods

A cross-sectional study was conducted among international medical students at the University of Szeged, Hungary between April and October 2021. A total of 326 participants filled out questionnaires about sociodemographic characteristics, acculturation, and SRH. The modified Stephenson multigroup acculturation scale (SMAS) was used to assess the acculturation status; the scale defined acculturation as the degree of dominant society immersion (DSI, 12 items) and ethnic society immersion (ESI, 16 items). To measure SRH, participants were asked to rate their current general health and mental health. The data were analyzed by using descriptive statistics and the multiple logistic regression model.

Results

32.5% of the students reported having poor general and 49.7% poor mental health. We have found that acculturation was associated with SRH in multivariable logistic regression models controlling for sociodemographic characteristic. Bidimensional acculturation, such as ESI and DSI significantly influenced SRH as the likelihood of poor general health decreased (OR = 0.50; 95% CI = 0.31–0.81, P = 0.005), when the ESI was higher, whereas the likelihood of poor mental health decreased (OR = 0.52; 95% CI = 0.35–0.79, P = 0.002) if students had a greater DSI.

Conclusion

Both types of immersion can affect the students’ SRH. If the student could integrate better into their own ethnic group, their general health was better, and if they could strongly integrate into the Hungarian society, their mental health was more favorable. Acculturation measures should be promoted by academics and public health professionals in order to better understand their role in the behaviors, health outcomes, and health care use of medical international students. These findings will help professionals shape culturally sensitive prevention and counselling strategies for international student populations.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-14334-y.

Effectiveness of a lifestyle modification programme in the treatment of depression symptoms in primary care

Background

Depression symptoms are prevalent in the general population, and their onset and continuation may be related to biological and psychosocial factors, many of which are related to lifestyle aspects. Health promotion and lifestyle modification programmes (LMPs) may be effective on reducing the symptoms. The objective of this study was to analyse the clinical effectiveness of a LMP and a LMP plus Information and Communication Technologies, when compared to Treatment as Usual (TAU) over 6 months. The interventions were offered as an adjuvant treatment delivered in Primary Healthcare Centers (PHCs) for people with depression symptoms.

Methods

We conducted an open-label, multicentre, pragmatic, randomized clinical trial. Participants were recruited from several PHCs. Those participants visiting general practitioner for any reason, who also met the inclusion criteria (scoring 10 to 30 points on the Beck II Self-Applied Depression Inventory) were invited to take part in the study. TAU+LMP consisted of six weekly 90-min group sessions focused on improving lifestyle. TAU+LMP + ICTs replicated the TAU+LMP format, plus the addition of a wearable smartwatch to measure daily minutes walked and sleep patterns. A total of 188 participants consented to participate in the study and were randomized. We used linear mixed models, with a random intercept and an unstructured covariance to evaluate the impact of the interventions compared to TAU.

Results

Both interventions showed a statistically significant reduction on depressive symptoms compared to TAU (TAU+LMP vs. TAU slope difference, b = −3.38, 95% CI= [−5.286, −1.474] p = 0.001 and TAU+LMP+ICTs vs. TAU slope difference, b = −4.05, 95% CI = [−5.919, −2.197], p < 0.001). These reductions imply a moderate effect size. In the TAU+LMP+ICTs there was a significant increase regarding minutes walking per week (b = 99.77) and adherence to Mediterranean diet (b = 0.702). In the TAU+LMP there was a significant decrease regarding bad sleep quality (b = −1.24).

Conclusion

TAU+LMPs administered in PHCs to people experiencing depression symptoms were effective on reducing these symptoms compared to TAU. They also have a positive impact on changing several lifestyle factors. These findings indicate that these interventions can be promising strategies for PHCs.

Influence of COVID-19 pandemic and vaccination on the menstrual cycle: A retrospective study in Hungary

Observations of women and clinicians indicated that the prevalence of menstrual cycle problems has escalated during the COVID-19 pandemic. However, it was not clear whether the observed menstrual cycle changes were related to vaccination, the disease itself or the COVID-19 pandemic-induced psychological alterations. To systematically analyze this question, we conducted a human online survey in women aged between 18 and 65 in Hungary. The menstrual cycle of 1563 individuals were analyzed in our study in relation to the COVID-19 vaccination, the COVID-19 infection, the pandemic itself and the mental health. We found no association between the COVID-19 vaccination, the vaccine types or the COVID-19 infection and the menstrual cycle changes. We also evaluated the menstrual cycle alterations focusing on three parameters of the menstrual cycle including the cycle length, the menses length and the cycle regularity in three pandemic phases: the pre-peak, the peak and the post-peak period in Hungary. Our finding was that the length of the menstrual cycle did not change in any of the periods. However, the menses length increased, while the regularity of the menstrual cycle decreased significantly during the peak of the COVID-19 pandemic when comparing to the pre- and post-peak periods. In addition, we exhibited that the length and the regularity of the menstrual cycle both correlated with the severity of depression during the post-peak period, therefore we concluded that the reported menstrual cycle abnormalities during the peak of COVID-19 in Hungary might be the result of elevated depressive symptoms.