Prevalence and correlates of fatigue and its association with quality of life among clinically stable older psychiatric patients during the COVID-19 outbreak: a cross-sectional study

Network analysis of pandemic fatigue symptoms in samples from five South American countries

BACKGROUND

Pandemic fatigue generates low motivation or the ability to comply with protective behaviors to mitigate the spread of COVID-19.

AIMS

This study aimed to analyze the symptoms of pandemic fatigue through network analysis in individuals from five South American countries.

METHOD

A total of 1,444 individuals from Argentina, Bolivia, Paraguay, Peru, and Uruguay participated and were evaluated using the Pandemic Fatigue Scale. The networks were estimated using the ggmModSelect estimation method and a polychoric correlation matrix was used. Stability assessment of the five networks was performed using the nonparametric resampling method based on the case bootstrap type. For the estimation of network centrality, a metric based on node strength was used, whereas network comparison was performed using a permutation-based approach.

RESULTS

The results showed that the relationships between pandemic fatigue symptoms were strongest in the demotivation dimension. Variability in the centrality of pandemic fatigue symptoms was observed among participating countries. Finally, symptom networks were invariant and almost identical across participating countries.

CONCLUSIONS

This study is the first to provide information on how pandemic fatigue symptoms were related during the COVID-19 pandemic.

The molecular fingerprint of neuroinflammation in COVID-19: A comprehensive discussion on molecular mechanisms of neuroinflammation due to SARS-COV2 antigens

BACKGROUND AND OBJECTIVE

Severe acute respiratory syndrome coronavirus 2 attacks the neural system directly and indirectly via various systems, such as the nasal cavity, olfactory system, and facial nerves. Considering the high energy requirement, lack of antioxidant defenses, and high amounts of metal ions in the brain, oxidative damage is very harmful to the brain. Various neuropathic pain conditions, neurological disorders, and neuropsychiatric complications were reported in Coronavirus disease 2019, prolonged Coronavirus disease 2019, and after Coronavirus disease 2019 immunization. This manuscript offers a distinctive outlook on the interconnectedness between neurology and neuropsychiatry through its meticulous analysis of complications.

DISCUSSION

After recovering from Coronavirus disease 2019, approximately half of the patients reported developing Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Long Coronavirus disease 2019 imaging reports illustrated the hypometabolism in various parts of the brain, such as olfactory bulbs, limbic/paralimbic domains, the brainstem, and the cerebellum. Ninety imaging and neuropathological studies of Coronavirus disease 2019 have shown evidence of white matter, brainstem, frontotemporal, and oculofrontal lesions. Emotional functions, such as pleasant, long/short-term memory, movement, cognition and cognition in decision-making are controlled by these regions. The neuroinflammation and the mechanisms of defense are well presented in the discussion. The role of microglia activation, Inducible NO synthase, Cyclooxygenases ½, Reactive oxygen species, neurotoxic toxins and pro-inflammatory cytokines, such as Interleukin-1 beta, Interleukin-6 and Tumor Necrosis Factor-alpha are highlighted in neuronal dysfunction and death. Nuclear factor kappa-light-chain-enhancer of activated B cells, Mitogen-activated protein kinase, Activator Protein 1, and Interferon regulatory factors are the main pathways involved in microglia activation in Coronavirus disease 2019 neuroinflammation.

CONCLUSION

The neurological aspect of Coronavirus disease 2019 should be highlighted. Neurological, psychological, and behavioral aspects of Coronavirus disease 2019, prolonged Coronavirus disease 2019, and Coronavirus disease 2019 vaccines can be the upcoming issues. We need a global awareness where this aspect of the disease should be more considered in health research.

Prevalence and Patterns of Insomnia Symptoms Among People Aged 65 and Above in Guangdong Province, China

Objective

This survey investigated the prevalence, distribution, and correlative factors of insomnia symptoms among people aged 65 and above in Guangdong Province, China.

Methods

The Guangdong Mental Health Survey was conducted on the elderly in all 21 cities of Guangdong Province from September to December 2021. Multistage stratified cluster sampling was adopted, and 16 377 adult residents were interviewed face-to-face, from which 4001 elderly participants aged 65 and above were included for this study. Complex weighted adjustment methods were applied to weight the data. Multinomial logistic regression was applied to test the independent associations of clinical insomnia symptoms (CIS) and subthreshold insomnia symptoms (SIS) with the factors.

Results

The pooled estimate of insomnia symptoms was 13.44% [95% confidence interval (CI): 12.2 %-14.7%]. The 1-month weighted prevalence of SIS and CIS were 11.15% (95% CI: 10.05%-12.37%) and 2.28% (95%CI: 1.77%-2.94%), respectively. Multinomial logistic regression analysis revealed that urban residence, irregular diet, low body mass index, chronic disease, napping 3-4/week, early changes in dementia, symptoms of subthreshold depression, subthreshold generalized anxiety, and generalized anxiety disorder were positively associated with SIS. Additionally, living in urban areas, having chronic diseases, symptoms of subthreshold depression, major depressive disorder, subthreshold generalized anxiety, generalized anxiety disorder were positively associated with CIS.

Conclusion

Insomnia symptoms, including CIS and SIS, were prevalent among the elderly in Guangdong Province. Given the high burden of CIS and SIS, policymakers and healthcare professionals must explore and treat the related factors accordingly.

Relationship between subjective and objective fatigue and sleep characteristics in individuals with anxiety and mood disorders: An exploratory study

OBJECTIVE

Fatigue and sleep disturbances are important symptoms of anxiety and mood disorders (AMD). Studies about the relationship between these variables usually rely on self-report assessments. Therefore, the aim of our exploratory study was to investigate the independent correlations between subjective and objective fatigue and sleep characteristics in individuals with AMD.

METHODS

In sum, 233 individuals with AMD attending a stress-related disorders day care unit (78.5 % females, mean age 39.0 years old) participated in a cross-sectional study. Participants completed the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Multidimensional Fatigue Inventory-20, and Pittsburgh Sleep Quality Index self-report questionnaires, as well as an exercise capacity workload test for assessing objective fatigue and polysomnography monitoring for evaluation of sleep structure.

RESULTS

In individuals with AMD, exercise capacity workload was associated with lower percent of stage 1 sleep (β = - 0.17, p = 0.006), REM latency (β = -0.13, p = 0.042), and wake after sleep onset (β = -0.12, p = 0.039). General fatigue was associated with a higher percent of body movements (β = 0.12, p = 0.047), as well as mental fatigue was associated with a higher percent of body movements (β = 0.13, p = 0.029), and a higher score on the PSQI (β = 0.21, p = 0.002).

CONCLUSIONS

Objective sleep characteristics were associated with objective assessment of fatigue, while subjective sleep quality was associated with subjectively assessed mental fatigue.

Prevalence, correlates, and network analysis of depression and its associated quality of life among ophthalmology nurses during the COVID-19 pandemic

Background

Nurses in Ophthalmology Department (OD) had a high risk of infection during the novel coronavirus disease 2019 (COVID-19) pandemic. This study examined the prevalence, correlates, and network structure of depression, and explored its association with quality of life (QOL) in Chinese OD nurses.

Methods

Based on a cross-sectional survey, demographic and clinical data were collected. Depression was measured with the 9-item Self-reported Patient Health Questionnaire (PHQ-9), and QOL was measured using the World Health Organization Quality of Life Questionnaire-brief version (WHOQOL-BREF). Univariate analyses, multivariate logistic regression analyses, and network analyses were performed.

Results

Altogether, 2,155 OD nurses were included. The overall prevalence of depression among OD nurses was 32.71% (95%CI: 30.73-34.70%). Multiple logistic regression analysis revealed that having family or friends or colleagues who were infected (OR = 1.760, p = 0.003) was significantly associated with higher risk of depression. After controlling for covariates, nurses with depression reported lower QOL (F(1, 2,155) = 596.784, p < 0.001) than those without depression. Network analyses revealed that 'Sad Mood', 'Energy Loss' and 'Worthlessness' were the key central symptoms.

Conclusion

Depression was common among OD nurses during the COVID-19 pandemic. Considering the negative impact of depression on QOL and daily life, regular screening for depression, timely counselling service, and psychiatric treatment should be provided for OD nurses, especially those who had infected family/friends or colleagues. Central symptoms identified in network analysis should be targeted in the treatment of depression.

Effect of Functional Electrical Stimulation on Muscle Mass, Fatigue, and Quality of Life in Older Patients With COVID-19: A Randomized Clinical Trial Study

OBJECTIVE

This study aimed to evaluate the effects of functional electrical stimulation (FES) on muscle strength, fatigue, muscle mass, and quality of life (QoL) in older patients with COVID-19.

METHODS

Older patients with COVID-19 were randomly divided into the following 2 groups: real FES (intervention group, n = 20) and sham FES (control group, n = 20). These patients received FES concurrent with the voluntary contraction of muscles for 10 consecutive sessions. Ultrasound imaging, pressure biofeedback, Chalder fatigue scale, and QoL were utilized to measure muscle mass, muscle strength, chronic fatigue, and QoL, respectively. Evaluations were performed at the beginning, immediately, and 1 month after the end of intervention.

RESULTS

All variables showed statistically significant improvement immediately and 1 month after the intervention in the real FES group (P < .05). However, the tibialis anterior muscle mass and fatigue significantly improved immediately after the intervention in the sham FES group. However, the tibialis anterior and rectus femoris muscles strength and rectus femoris muscle mass were not significantly changed immediately and 1 month after the intervention (P > .05). There were significant differences in muscle mass, physical fatigue, muscle strength, and QoL between groups with more efficacy of real FES (P < .05).

CONCLUSION

For this sample of patients, FES improved fatigue, muscle strength, muscle mass, and QoL in older adults with COVID-19.

Extending the EQ-5D: the case for a complementary set of 4 psycho-social dimensions

OBJECTIVES

The EQ-5D is the most widely applied preference-based health-related quality of life measure. However, concerns have been raised that the existing dimensional structure lacks sufficient components of mental and social aspects of health. This study empirically explored the performance of a coherent set of four psycho-social bolt-ons: Vitality; Sleep; Personal relationships; and Social isolation.

METHODS

Cross-sectional surveys were conducted with online panel members from five countries (Australia, Canada, Norway, UK, US) (total N = 4786). Four bolt-ons were described using terms aligned with EQ nomenclature. Latent structures among all nine dimensions are studied using an exploratory factor analysis (EFA). The Shorrocks-Shapely decomposition analyses are conducted to illustrate the relative importance of the nine dimensions in explaining two outcome measures for health (EQ-VAS, satisfaction with health) and two for subjective well-being (the hedonic approach of global life satisfaction and an eudemonic item on meaningfulness). Sub-group analyses are performed on older adults (65 +) and socially disadvantaged groups.

RESULTS

Strength of correlations among four bolt-ons ranges from 0.34 to 0.49. As for their correlations with the EQ-5D dimensions, they are generally much less correlated with four physical health dimensions than with mental health dimensions (ranged from 0.21 to 0.50). The EFA identifies two latent factors. When explaining health, Vitality is the most important. When explaining subjective well-being, Social isolation is second most important, after Anxiety/depression.

CONCLUSION

We provide evidence that further complementing the current EQ-5D-5L health state classification system with a coherent set of four bolt-on dimensions that will fill its psycho-social gap.

Preliminary evidence that fatigue contributes to anhedonia in stable individuals diagnosed with schizophrenia

OBJECTIVES

Anhedonia and fatigue are trans-diagnostic symptoms commonly observed in schizophrenia. Anhedonia is a core negative symptom with a strong relationship with depression and is associated with diminished global functioning. Similarly, fatigue is also associated to depression and research across psychiatric illnesses indicate that fatigue may persist even when primary symptoms are treated. Although fatigue is common in people diagnosed with schizophrenia, it is under studied within this population. The objective of this exploratory study was to investigate the association of fatigue and anhedonia by controlling for depression in a sample of individuals diagnosed with schizophrenia.

METHOD

Fifty-one stable individuals diagnosed with schizophrenia from the University Department of Adult Psychiatry in Montpellier took part in this study. Participants completed questionnaires on fatigue impact and depression, and were assessed for symptom severity. Following data collection, statistical analyses were conducted in order to explore associations between clinical variables and fatigue impact. Based on the results obtained, a hierarchical linear regression was conducted in order to investigate whether fatigue impact contributed to the variance of negative symptoms.

RESULTS

The hierarchical linear regression indicated that when controlling for depression, fatigue impact contributes to ~20% of the variance of anhedonia. Together the social impact of fatigue and depression contribute to 24% of the variation of anhedonia.

CONCLUSION

To the best of our knowledge, this exploratory study is the first to investigate and show that fatigue impact may contribute to anhedonia. We recommend further research to investigate fatigue, its impact on symptomatology, and better categorization of negative symptoms in hopes of developing targeted fatigue treatment interventions.

Examination of non-cognitive variables affecting academic achievement: a conceptual model proposal

Psychological factors have a significant role in better understanding mechanisms that affect students' academic performance. The intense and long-term stress of the pandemic process has made it necessary to rethink the components which effect the academic achievement of pupils. The purpose of this study is to examine the variables that predict the academic achievement of university students during the pandemic process and to present a model on these variables. The study group has 241 students who continue their undergraduate education in Turkey. The data were collected with a self-description form and 6 scales. The partial Least Squares (PLS) Structural Equation Model was used to analyses the developed research model. In consequence of the study, a relationship was obtained between academic procrastination (AP) and multi-screen addiction (MSA). Covid-19 burnout has a crucial effect on AP, multiscreen addiction, and psychological well-being variables. Motivation and self regulation-attention variables are explanatory of AP. This study contributes to expanding the nomological network regarding the effects of Covid-19 on the psychological well-being and behavior of individuals.

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

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.

Perceptions of COVID-19 symptoms, prevention, and treatment strategies among people in seven Arab countries: A cross-sectional study

BACKGROUP

the widespread COVID-19 infection worldwide has resulted in the inability of healthcare facilities to receive all infected patients; therefore, most are treated at home. In addition, factors such as high mortality, types and severity of symptoms, and the prevalence of unreliable information have prompted patients to resort to self-treatment.

OBJECTIVES

To assess prevention, treatment, degree of symptoms, and sources of information among patients with COVID-19 in Arab countries METHOD: A cross-sectional study was conducted in seven Arab countries: Algeria, Egypt, Iraq, Lebanon, Libya, Tunisia, and the United Arab of Emirates. People who have recovered from COVID-19 completed the study questionnaire. Score of symptoms during and after COVID-19 infection has been calculated by giving the participants a list of 13 symptoms.

RESULTS

A total of 3519 participants completed the survey. Mostly females (68.3%), and aged between 18 and 40 years old (59.4%). Prophylaxis treatments, including vaccines and antibiotics, have been used in around 40% of the participants. The total average score of symptoms during the infection period was found 7.31 ± 3.66 out of 13. However, the symptoms score upon recovery was low (0.48 ± 1.11 score). The significant associations with increased incidence of symptoms during infection were reported with older people, married, divorced or widowed, people with chronic diseases, and obese. Moreover, significant associations with decreased symptoms were reported with those who worked in the health sector, non- or ex-smokers, and vaccinated people.

CONCLUSION

The use of medication and other treatments to prevent infection with COVID-19 was common among the participants in the seven countries. Taking the vaccine was the only effect on the number of symptoms experienced by patients. Although nearly two years have passed since the onset of the disease, there is still a need to raise treatment awareness among patients at home.

Psychological impact of COVID-19 lockdown on a population with serious mental illness. A prospective cohort study

Introduction

COVID-19 has spread worldwide since its appearance at the end of 2019. In Spain, 99-day long home confinement was set from March 15th 2020. Previous studies about events requiring situations of isolation suggested that mental health problems may occur among the general population and, more specifically, vulnerable groups such as individuals with serious mental illness (SMI). This study aims to assess the psychological effect of confinement in patients with mental illness admitted to an inpatient psychiatric unit.

Method

In this longitudinal study, IDER (State-Trait Depression Inventory) and STAI (State-Trait Anxiety Inventory) questionnaires were used at two different times (at the beginning and after the lockdown) of the pandemic to evaluate the depression and anxiety symptoms, respectively, in a population of patients who had been previously admitted to the Psychiatry Unit of the Basurto University Hospital.

Results

95 participants completed the IDER questionnaire in the first measurement, with a mean score of 24.56 (SD = 8.18) for state and 23.57 (SD = 8.14) for trait. In the case of STAI, the mean score was 27.86 (SD = 15.19) for the state and 30.49 (SD = 14.71) for the trait. No differences between the first and the second time were found in anxiety and depression levels. People with personality disorders presented high levels of anxiety.

Conclusions

Individuals with a personality disorder showed the highest scores in anxiety and depression. Nevertheless, strict confinement did not affect this population, despite the literature that evidences that the pandemic has worsened people's mental health with SMI.

Distress and Well-Being Among Psychiatric Patients in the Aftermath of the First COVID-19 Lockdown in Israel: A Longitudinal Study

Objectives: Studies assessing the effect of the COVID-19 pandemic on psychiatric patients have mostly focused on cross-sectional evaluations of differences in levels of distress. In this study, we aimed to assess changes in distress and well-being following the COVID-19 pandemic outbreak as compared with pre-pandemic levels, as well as potential predictors of symptomatic deterioration, among psychiatric outpatients treated in a public mental health hospital in Israel.

Methods: Patients evaluated for distress and well-being before the pandemic (n = 55) were re-evaluated at the end of the first lockdown in Israel.

Results: Analyses revealed a significant decrease in the patients’ sense of personal growth. Increases in distress were significantly associated with fear of COVID-19 beyond patient characteristics.

Conclusion: These results suggest that the pandemic has a short-term effect on patients’ well-being, and that fear of the pandemic is associated with elevations in distress.

Phonatory function and characteristics of voice in recovering COVID-19 survivors

Introduction

This study aimed to evaluate the phonatory function of recovered COVID-19 survivors. The universal outbreak of COVID-19 led to the occurrence of otolaryngological manifestations that raised concerns about the assessment of the phonatory function in recovering patients.

Methods

This is a prospective, cross-sectional, case-controlled study carried out on 364 laboratory-confirmed non-critical COVID-19 survivors and 100 as healthy controls. The study participants were classified into two groups according to the disease severity. Group1 comprised 212 survivors who recovered from pneumonia and group 2 was made up of 152 survivors of severe pneumonia. All patients were subjected to an auditory perceptual assessment of the voice (APA) and Maximum Phonation Time (MPT) measurements.

Results

Phonasthenic manifestations were significantly more frequent in COVID-19 survivors than in controls (P < 0.000) with a higher percentage recorded among severe pneumonia survivors (87.5%) than among pneumonia survivors (60.8%) with a P value of < 0.01. Dysphonia and excessively soft loudness were significantly more common among survivors than among controls (P < 0.002 and P < 0.000, respectively) with no significant difference between the patient groups. The MPT was significantly shorter among survivors than among controls (P < 0.000). The mean MPT was 15.97 s in the control group, 10.72 s in the pneumonia group, and 8.88 s in the severe pneumonia group, with the differences between the groups being statistically significant (P < 0.000), suggesting a higher impairment of lung volume and phonatory function in severe cases.

Conclusions

Phonasthenia, dysphonia, and decreased MPT could be otolaryngological manifestations of COVID-19. Laryngeal function assessment should be considered in COVID-19 survivors.

The Acute Impact of the Early Stages of COVID-19 Pandemic in People with Pre-Existing Psychiatric Disorders: A Systematic Review

People with pre-pandemic health conditions are more vulnerable and more likely to suffer greater psychosocial impact due to the current COVID-19 pandemic and the lockdown measures. Thus, the objective of this work was to systematically review the impact of the early stages COVID-19 pandemic on people with pre-existing psychiatric disorders. The search was performed between 23 January and 2 September 2021 in PubMed, PsycINFO, and EMBASE. A total of 4167 published results were identified; however, only 49 were included in this review. Results show that there was considerable heterogeneity among studies, which resulted in a low consensus. However, it seems that the impact of the first stage of the COVID-19 pandemic on psychiatric disorders was two-fold: (1) an overall effect, in which people suffering from psychiatric disorders in general experienced more psychological distress and anxiety when compared to people who had no psychiatric diagnosis, and (2) a condition-specific effect, namely in people suffering from eating disorders and obsessive compulsive disorders. Moreover, the current work highlights that there were also some external factors that were related to worsening symptoms. For instance, unemployment or experiencing work and financial difficulties can be a trigger for greater distress during the pandemic for people with mood disorders, and being alone and in social isolation during the COVID-19 pandemic may actually increase substance use and relapse rates. Further studies are needed to prospectively investigate the long-term effects of the current COVID-19 pandemic on people with (pre)-existing psychiatric conditions and on the onset or deterioration of psychiatric-related symptoms in a larger number of participants, as well as exploring the long-term effects of the current pandemic on mental health.

Prevalence of post-traumatic stress disorder symptoms among patients with mental disorder during the COVID-19 pandemic

BACKGROUND

The outbreak of the COVID-19 pandemic has caused extensive public health concerns, posing significant challenges to healthcare services. One particular area of concern is the mental health of patients with mental disorder, who are often a neglected group. The aim of this study was to investigate the prevalence of, and associated factors for symptoms of post-traumatic stress disorder (PTSD) among patients with mental disorder in China during the COVID-19 pandemic.

METHODS

Self-reported questionnaires were distributed to patients in four psychiatric hospitals in Beijing, China, between April 28th and May 30th, 2020. Information regarding sociodemographic characteristics, COVID-19 related factors, support, psychosomatic factors, and PTSD symptoms were collected using a series of scales, such as the Impact of Event Scale-Revised, the 7-item Generalized Anxiety Disorder Scale, the 9-item Patient Health Questionnaire depression scale, and so on. Multivariate regression was used to identify factors related to PTSD symptoms.

RESULTS

A total of 1,055 patients with mental disorder were included in the final sample. The prevalence of PTSD symptoms was 41.3%. Hierarchical linear regression demonstrated that fear of the pandemic and anxiety were shared associated factors for both symptoms of PTSD and their subscales. Additionally, age was an associated factor for the total PTSD (β = 0.12, p < 0.01), intrusion (β = 0.18, p < 0.001), and avoidance (β = 0.1, p < 0.05) symptoms; depression was an associated factor for the total PTSD (β = 0.13, p < 0.001), intrusion (β = 0.11, p < 0.01), and hyperarousal (β = 0.19, p < 0.001) symptoms.

CONCLUSIONS

The prevalence of PTSD symptoms was high among patients with mental disorder during the COVID-19 pandemic in China. This study found that age, fear of the pandemic, anxiety and depression are significant associated factors of PTSD symptoms in patients with mental disorder during the pandemic. We call for higher awareness and introduction of PTSD interventions to relieve the psychological stress in these patients.

Biopsychosocial Factors Predicting Pain Among Individuals Experiencing the Novel Coronavirus Disease (COVID-19)

BACKGROUND

Pain is one of the most common symptoms of novel coronavirus disease (COVID-19). Being both a physical and a psychological experience, pain is affected by many factors, including biological, psychological, and social rather than a single variable.

AIMS

To determine the effects of biological, psychological, and social factors on pain level among participants experiencing with the COVID-19.

DESIGN

A web-based, retrospective, and descriptive study SETTING: Social media sources such as Facebook, WhatsApp, Instagram, and E-mail PARTICIPANTS: One hundred forty-nine participants were included.

METHODS

Data were collected based on the biopsychosocial model. Pain level was evaluated using the visual analog scale (VAS). The data were analyzed using descriptive, correlational statistics, and structural equation modeling.

RESULTS

The mean age of participants was 32.87 (SD = 11.32) years. The VAS scores were associated with gender (Z = -2.103, p = .035), and chronic disease status (Z = 3.001, p = .003), and the Chalder Fatigue Scale total score (β = 0.718, p < .001) associated with biological factors. The Coronavirus Anxiety Scale scores among psychological factors showed a direct impact on the VAS scores (β = 0.583, p < .001). The Patterns of Activity Measure-Pain total score examined within social factors directly affected the VAS score. The VAS score did not correlate with age, smoking status, hospitalization status, respiratory support, marital status, education level, employment, and income status.

CONCLUSIONS

The pain level in COVID-19 participants was determined by biological, psychological, and social factors. Females and participants with chronic illness, anxiety, fatigue, and low physical activity were found to experience high levels of pain. Education and counseling programs for pain management should be comprehensively structured and include anxiety reduction programs, and fatigue management.

Mental, Physical and Socio-Economic Status of Adults Living in Spain during the Late Stages of the State of Emergency Caused by COVID-19

Research has shown that the confinement measures implemented to curb the spread of COVID-19 can have negative effects on people's lives at multiple levels. The objective of this cross-sectional study was to better understand the mental, physical, and socio-economic status of adults living in Spain during the late stages of the state of emergency caused by COVID-19. Five hundred and forty-four individuals responded to an online survey between 3 June and 30 July 2020. They were asked to report data about their mental and physical health, financial situation, and satisfaction with the information received about the pandemic. Means, percentages, t-test, ANOVAs, and logistic regressions were computed. A third of the participants reported symptoms of anxiety, depression, and stress, and worries about their health and the future. Participants also described mild levels of fatigue and pain during lockdown (66%), and a reduction in household income (39%). Respondents that were female, younger, single, and with lower levels of education reported experiencing a greater impact of the COVID-19 pandemic. The data showed that the negative effects of lockdown were present in the late stages of the state of emergency. The findings can be used to contribute to the development of programs to prevent or mitigate the negative impact of confinement measures.

Gender Differences in Body Appreciation and Its Associations With Psychiatric Symptoms Among Chinese College Students: A Nationwide Survey

BACKGROUND

Body appreciation (BA hereafter), which reflects approval, acceptance, and respect for one's body while also rejecting media-promoted appearance ideals as the only form of human beauty, is an important aspect of positive body image. Much of the BA literature has been conducted on samples from Western nations but less is known about BA or its correlates in Asian cultural contexts wherein concerns with body image are also common. Toward addressing this gap, we examined gender differences in BA and its associations with common psychiatric symptoms (i.e., depressive symptoms, anxiety symptoms, and suicidality) within a national college student sample from China.

METHOD

This cross-sectional, nationwide study was conducted between December 27, 2020, and January 18, 2021, based on snowball sampling. Aside from measures of demographics and background factors, Chinese versions of the Body Appreciation Scale-2 (BAS-2), Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale-7 (GAD-7), and a standard item on suicidal ideation and planning were administered to assess BA, depressive and anxiety symptoms, and suicidality, respectively.

RESULTS

In total, 2,058 college students (665 men, 1,393 women) in China were assessed. An analysis of covariance revealed that the men had a significantly higher average BA level than did women [F _(1,2058) = 13.244, P < 0.001, Cohen's d = 0.193]. Hierarchical multiple regression analyses revealed BA was negatively associated with symptoms of depression, anxiety, and suicidality within the entire sample (depressive symptoms, β = -0.129, P < 0.001; anxiety symptoms, β = -0.101, P < 0.001; suicidality, OR = 0.788 P = 0.020) and among women (depressive symptoms, β = -0.172, P < 0.001; anxiety symptoms, β = -0.131, P < 0.001; suicidality, OR = 0.639 P = 0.001) but not men.

CONCLUSION

Chinese college women reported lower BA than their male peers did. Furthermore, among women but not men, elevations in BA corresponded with protective mental health experiences including lower levels of depressive symptoms, anxiety symptoms and suicidality. Findings underscore the potential utility of including BA in mental health assessments of Chinese college students, especially women. Findings also provide foundations for continued research on interventions to increase BA among at-risk young women in China.

Psychological impact of the COVID-19 pandemic on individuals with serious mental disorders: A systematic review of the literature

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic is having a great impact on individuals from all over the world, particularly on individuals with mental disorders. Several studies found more pronounced psychiatric symptoms, notably symptoms of depression and anxiety.

AIM

To assess the situation of patients with serious mental illness (SMI: Affective disorders and schizophrenia) regarding their mental health outcome during the pandemic.

METHODS

A systematic search using the databases PubMed and MEDLINE was conducted, employing the key words “COVID-19”, “SARS-CoV-2”, “psychiatric/mental disorder/illness”, “affective/mood disorder”, “bipolar disorder”, “(major) depression”, “schizoaffective disorder”, and “schizophrenia”. Studies that had been published up until January 9, 2021 were included. Information of studies in languages other than English and German was mostly taken from their English abstracts.

RESULTS

The literature search concluded in the finding of 36 studies containing relevant clinical data. A general impairment of the mental health of individuals with SMI could be detected, particularly in individuals with affective disorders, as compared to those with schizophrenia. Compared to healthy controls, symptoms of anxiety, depression, and stress were more pronounced in individuals with SMI. Relevant factors found that impacted their mental health were age, resilience, and socioeconomic environment, especially the shortage of mental health services, lack of social support, and inadequate information about COVID-19.

CONCLUSION

In light of these results, mental health services should be reinforced, notably the use of telemental health services. Furthermore, supplying individuals with SMI with adequate information about the COVID-19 pandemic and increasing their resilience is important. When researching the impact of the COVID-19 pandemic on individuals with SMI, standardization as well as follow-up studies are needed to enable better comparability and understanding.

Do we experience pandemic fatigue? current state, predictors, and prevention

There is an emerging literature on the mental and physical exhaustion due to the COVID-19 related restrictions. Some individuals seem to exercise fewer precautions recently in comparison to the onset of the pandemic in preventing the spread of the COVID-19. This phenomenon is described as pandemic fatigue. Though acknowledged in conceptual articles and news reports, there is a lack of empirical evidence pertaining to pandemic fatigue. We collected data from 516 adult participants to investigate pandemic fatigue and its relations to fear of coronavirus, intolerance of uncertainty, apathy, and self-care. 34.40% of the participants reported that the level of COVID-19-related precautions they take have decreased in comparison to measures they took at the onset of the pandemic. Additionally, our model examining the role of fear of coronavirus, intolerance of uncertainty, and apathy as mediated by self-care predicting pandemic fatigue demonstrated acceptable to excellent goodness-of-fit indices. The fact that one in every three individuals is taking fewer precautions is not only a threat to the individuals' own health but also to the public. Given that individuals are experiencing pandemic fatigue, governments should consider paying more attention to the biopsychosocial nature of humans in ordering restrictions and planning necessary precautions.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-021-02397-w.

Psychological symptoms during and after Austrian first lockdown in individuals with bipolar disorder? A follow-up control-group investigation

BACKGROUND

The coronavirus disease (COVID-19) pandemic, a global health crisis, has resulted in widespread socioeconomic restrictions including lockdown, social distancing, and self-isolation. To date, little is known about the psychological impact of the COVID-19 pandemic and lockdown on patients with bipolar disorder as a particularly vulnerable group.

METHODS

An online survey was conducted in Austria at two points of measurement (T1 April 2020 during the first lockdown vs. T2 May 2020 at post-lockdown). The sample comprises 20 patients with bipolar disorder (mean age = 49.4 ± 15.6 years) and 20 healthy controls (mean age = 32.7 ± 9.6 years). A 2 × 2 factorial design to compare two time points (T1 vs. T2) and two groups (patients vs. healthy controls) was used. Main outcome measures included the Brief Symptom Inventory-18 (BSI-18) and a (non-validated and non-standardized) assessment to determine COVID-19 fears and emotional distress due to social distancing. Multiple linear regression analyses were used to assess the longitudinal association of COVID-19 fears/emotional distress due to social distancing during lockdown (T1) and psychological symptoms after lockdown (T2).

RESULTS

At T1, results demonstrated higher scores in BSI-18 subscales depression, anxiety and global severity index as well as emotional distress due to social distancing in bipolar patients compared to controls. There was a significant time x group interaction in the BSI-18 subscale somatization showing a decreasing trend in patients with BD compared to controls. No time effects in BSI-18 subscales or COVID-19 fears/emotional distress due to social distancing were observed. Regression analyses showed that COVID-19 fears during lockdown predicted somatization, only in patients.

CONCLUSIONS

There was a connection between the lockdown measures and somatization symptoms observed in patients. When the first steps of easing the social restrictions in May 2020 took place, somatization decreased only in the bipolar compared to the control group. Higher COVID-19 fears during lockdown predicted later symptoms at post-lockdown. Long-term impacts of the COVID-19 pandemic need further investigations to improve current therapeutic approaches and prevent fears and distress during lockdown in individuals with bipolar disorder in times of crisis.