A cross-sectional study of psychological wellbeing of Indian adults during the Covid-19 lockdown: Different strokes for different folks

Young adults from disadvantaged groups experience more stress and deterioration in mental health associated with polycrisis

The recent polycrisis (COVID-19, Ukraine war, climate change, economic crisis) has been associated with mental health through cumulative stress, with young people being particularly vulnerable. We surveyed 403 college students from Poland to examine their psychological responses to the experienced crises. The results showed that polycrisis was associated with worse mental health of college students from disadvantaged groups (based on gender, sexual orientation, and financial situation) compared to other college students, in four areas: sense of proximity to the crises, stress caused by the crises, sense of responsibility for mitigating the crises, and experiencing everyday moral dilemmas regarding the crises. These young adults also suffered more in terms of negative affectivity, depressive symptoms, and subjective physical and mental health. Our findings suggest that when discussing public mental health perspectives, it is important to consider consequences of cumulative stress and its greater impact on young people from disadvantaged groups.

Mediating factors explain anxiety experienced by women with obesity during the Covid-19 pandemic

The Covid-19 pandemic could be a source of great anxiety, especially for those at higher risk, such as women experiencing obesity. The aim of this study was to measure how some personal characteristics such as BMI (from underweight to class 3 obesity), bariatric surgery (yes or no), comorbidities, or age (as antecedent variables), and mediating factors impacted state anxiety during the Covid-19 Pandemic. Mediating factors were related to subjective knowledge or attitudes (e.g. interest or beliefs and practices around Covid-19, subjective health perception, and confidence in the government). French women (N = 532) were invited to take part in a voluntary online health survey during lockdown in Paris and its suburbs. Results showed that women with higher BMI had higher anxiety scores, primarily because they feel less healthy than other people. Secondly, the larger the body size of the participants was (BMI), the less they reported that information about Covid-19 held their attention. This lack of interest resulted in feelings of anxiety not being generated. Thirdly, the larger their body size was, the less confidence they had in the effectiveness of the proposed measures by the government and therefore, the more anxious they were. Finally, older age predicted higher interest in the pandemic, higher subjective health, and higher confidence in the government. Identifying obesity as a potential risk factor for anxiety disorders is crucial, but measuring the relationship between state anxiety and personal characteristics (e.g. BMI) requires considering mediating variables (e.g. subjective health perception). To reduce anxiety in women with obesity, it appears necessary to focus on psychological programs that can help them improve their perception of their health, as well as the confidence they may have in institutions, especially for younger women.

The mental health impacts of the COVID-19 pandemic among individuals with depressive, anxiety, and stressor-related disorders: A scoping review

OBJECTIVE

A scoping review of studies published in the first year of the COVID-19 pandemic focused on individuals with pre-existing symptoms of depression, anxiety, and specified stressor-related disorders, with the objective of mapping the research conducted.

ELIGIBILITY CRITERIA

(1) direct study of individuals with pre-existing depressive, anxiety, and/or specified stressor-related (i.e., posttraumatic stress, acute stress) disorders/issues; (2) focus on mental health-related pandemic effects, and; (3) direct study of mental health symptoms related to depression, anxiety, or psychological distress.

SOURCES OF EVIDENCE

Database-specific subject headings and natural language keywords were searched in Medline, Embase, APA PsycInfo, and Cumulative Index to Nursing & Allied Health Literature (CINAHL) up to March 3, 2021. Review of potentially relevant studies was conducted by two independent reviewers and proceeded in two stages: (1) title and abstract review, and; (2) full paper review.

DATA CHARTING

Study details (i.e., location, design and methodology, sample or population, outcome measures, and key findings) were extracted from included studies by one reviewer and confirmed by the Principal Investigator.

RESULTS

66 relevant articles from 26 countries were identified. Most studies adopted a cross-sectional design and were conducted via online survey. About half relied on general population samples, with the remainder assessing special populations, primarily mental health patients. The most commonly reported pre-existing category of disorders or symptoms was depression, followed closely by anxiety. Most studies included depressive and anxiety symptoms as outcome measures and demonstrated increased vulnerability to mental health symptoms among individuals with a pre-existing mental health issue.

CONCLUSION

These findings suggest that improved mental health supports are needed during the pandemic and point to future research needs, including reviews of other diagnostic categories and reviews of research published in subsequent years of the pandemic.

Health, Wellbeing, and Social Interaction: An International and Demographic Analysis of Perceived Life Changes and the Positives and Negatives of the COVID-19 Lockdown

Research suggests that people's experiences of COVID-19 lockdowns have been detrimental to their lives and wellbeing. The current research compared the experiences and perceptions on health, wellbeing and social interaction of 300 UK adults and 450 adults in California. Individuals reported whether aspects of their life had changed for the better, worse, or not at all during lockdown in April 2020, and what the "best" and "worst" things about lockdown were. There were more similarities than differences in the regional comparison of perceptions of changes in specific aspects of 'health and wellbeing' and 'social interaction'. Both regions reported the same number and nature of best and worst things about lockdown. Overarching themes of 'health, self and wellbeing', 'being with others', and 'concerns with daily living' were identified. Although reports of life changes and the positives and negatives of lockdown were similar across different demographic groups, some differences were present by age, sex, relationship, and family-status. Incorporating knowledge of unified and positive experiences of lockdown can be useful in informing future lockdown restrictions and supporting the population when restrictions are lifted.

Sexual life of Spanish women during the lockdown by COVID-19: Differences according to sexual orientation?

The COVID-19 pandemic may have exacerbated the sexual health differences that already existed among women based on their sexual orientation. Therefore, a total of 971 Spanish women aged 18-60 years (84 % heterosexual and 16 % with a minority sexual orientation) answered an ad hoc online questionnaire about sexual behavior during April 2020. Compared to heterosexual women, sexual minority women showed a greater increase in sexual frequency, masturbated more, had more sex with a housemate, and engaged in more online sexual activities during lockdown. The emotional impact of the pandemic, having privacy, and age showed a relationship with the quality of sexual life, but not sexual orientation. Based on these results, women's sexual lives are not as closely related to their sexual orientation as they are to other variables. Therefore, it seems more necessary to address issues affecting women in general during lockdown than to focus on their specific sexual orientation.

Quantitative Framework for Establishing Low-Risk Inter-District Travel Corridors During COVID-19

Aspirations to slow down the spread of novel Coronavirus (COVID-19) resulted in unprecedented restrictions on personal and work-related travels in various nations across the globe in 2020. As a consequence, economic activities within and across the countries were almost halted. As restrictions loosen and cities start to resume public and private transport to revamp the economy, it becomes critical to assess the commuters' travel-related risk in light of the ongoing pandemic. The paper develops a generalizable quantitative framework to evaluate the commute-related risk arising from inter-district and intra-district travel by combining nonparametric data envelopment analysis for vulnerability assessment with transportation network analysis. It demonstrates the application of the proposed model for establishing travel corridors within and across Gujarat and Maharashtra, two Indian states that have reported many COVID-19 cases since early April 2020. The findings suggest that establishing travel corridors between a pair of districts solely based on the health vulnerability indices of the origin and destination discards the en-route travel risks from the prevalent pandemic, underestimating the threat. For example, while the resultant of social and health vulnerabilities of Narmada and Vadodara districts is relatively moderate, the en-route travel risk exacerbates the overall travel risk of travel between them. The study provides a quantitative framework to identify the alternate path with the least risk and hence establish low-risk travel corridors within and across states while accounting for social and health vulnerabilities in addition to transit-time related risks.

Plight of migrant construction-site workers during the COVID-19 lockdown in 2020: A qualitative exploration in Bhavnagar, Western India

BACKGROUND

During the unexpected lockdown implemented in early 2020 in reaction to the coronavirus 2019 (COVID-19) pandemic, a considerable section of India's population of migrant construction-site workers were stuck.

OBJECTIVE

Our objective was to explore the lived experiences and consequent perceptions of migrant workers related to the COVID-19 lockdown and the consequences on their lives.

METHODS

We conducted structured in-depth interviews (IDIs) with twelve migrant construction-site workers in Bhavnagar, Western India, from November to December 2020, using qualitative research methods. All IDIs were conducted with participant's consent, audio-recorded, transcribed in English, inductively coded, and thematically analyzed.

RESULTS

The primary financial challenges mentioned by the migrant workers in the interviews were unemployment, monetary issues, and a difficult sustenance. The social concerns were described as anxious migrant exodus, discrimination, mistreatment, lack of social assistance, inability to fulfil their family's expectations, lack of safe transportation arrangements by the authorities during the exodus, inadequacies in the public distribution system, law and order, and apathy of their employers. The psychological repercussions were described using terms like "fear," "worry," "loneliness," "boredom," "helplessness," and "trapped." Monetary compensation, job opportunities at the native place, and a well-managed migrant exodus were reportedly their key expectations from the government. Healthcare issues mentioned during the lockdown included a lack of facilities to treat common ailments, substandard care, and repeated COVID-19 testing prior to departure.

CONCLUSION

The study highlights the need to have rehabilitation mechanisms such as targeted cash transfers, ration kits, and safe transportation services for migrant workers through inter-sectoral coordination for mitigating hardship.

Experiences of COVID-19 among Chinese-speaking lesbian, gay and bisexual people in Hong Kong: an inductive thematic analysis of survey response data

As social inequalities during the COVID-19 pandemic have been recognised, emerging research showed that lesbian, gay and bisexual (LGB) people may be additionally affected during the pandemic. This paper adds to the understanding of the experiences of LGB people during the pandemic with a focus on Hong Kong, where issues of space significantly influence LGB people’s lives in this city with high population density. As part of a larger community study of LGB lives in Hong Kong, COVID-19-related impact on 434 Chinese-speaking LGB people was explored. Data collection was conducted from 20 May to 30 June 2020. Inductive thematic analysis of the open-text response survey data found that the LGB participants described both negative and positive impacts brought by COVID-19. Such impacts could be dimensionalised into those related to personal space and privacy, romantic and sexual space, and community space. It was also found that the experiences of COVID-19 among LGB people in Hong Kong were intersectional, along the lines of living arrangement and relationship status. Such findings make unique contributions to the emerging literature. First, there needs to be a more nuanced understanding of sexual minority individuals’ experiences during COVID-19 across cultural contexts. Second, COVID-19 was described as having brought positive impact in addition to its widely known negative impact.

LGBTQ+ Loss and Grief in a Cis-Heteronormative Pandemic: A Qualitative Evidence Synthesis of the COVID-19 Literature

LGBTQ+ people are no stranger to loss and grief, particularly during times of pandemic such as the 1980s-90s HIV/AIDS pandemic and now, the COVID-19 pandemic. Current COVID-19 loss and grief research remains relatively silent on LGBTQ+ peoples' loss and grief experiences. The aim of this research was to conduct a qualitative evidence synthesis of LGBTQ+ people's COVID-19 loss and grief experiences reported in the literature. A systematic search and inclusion strategy identified 22 relevant articles for review. Inductive thematic synthesis resulted in five loss-focused themes across the articles: (1) loss of work and livelihood, (2) loss of social and kinship connection, (3) loss of LGBTQ+ community connection, (4) loss of physical and mental health supports and (5) loss of LGBTQ+ identity authenticity, affirmation and visibility. Discussion of these themes highlights the many layered and often disenfranchised nature of LGBTQ+ people's loss during the COVID-19 pandemic.

Epidemics, Lockdown Measures and Vulnerable Populations: A Mixed-Methods Systematic Review of the Evidence of Impacts on Mother and Child Health in Low-and Lower-Middle-Income Countries

BACKGROUND

The aim of this research was to synthetise the existing evidence on the impact of epidemic-related lockdown measures on women and children's health in low- and lower-middle-income countries (LLMICs).

METHODS

A mixed-methods systematic review was conducted of qualitative, quantitative and mixed-methods evidence. Between 1st and 10th of November 2021, seven scientific databases were searched. The inclusion criteria were that the paper provided evidence on the impact of lockdown and related measures, focused on LLMICs, addressed impacts on women and child's health, addressed epidemics from 2000-2020, was peer-reviewed, provided original evidence, and was published in English. The Joanne Briggs Institute's critical appraisal tools were used to assess the quality of the studies, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for reporting. The evidence from the papers was grouped by type of lockdown measure and categories of impact, using a narrative data-based convergent synthesis design.

RESULTS

The review process identified 46 papers meeting the inclusion criteria from 17 countries that focussed on the coronavirus disease 2019 (COVID-19) and Ebola epidemics. The evidence on the decrease of utilisation of health services showed plummeting immunisation rates and faltering use of maternal and perinatal services, which was linked to a growth of premature deaths. Impacts on the mental health of children and women were convincingly established, with lockdowns associated with surges in depression, anxiety and low life satisfaction. Vulnerability may be compounded by lockdowns, as livelihoods were disrupted, and poverty levels increased.

CONCLUSION

Limitations included that searches were conducted in late-2020 as new research was being published, and that some evidence not published in English may have been excluded. Epidemic-related lockdown measures carry consequences for the health of women and children in lower-income settings. Governments will need to weigh the trade-offs of introducing such measures and consider policies to mitigate their impacts on the most vulnerable.

Internet addiction, depression, anxiety and stress among first year medical students after COVID-19 lockdown: A cross sectional study in West Bengal, India

Objectives

1. To assess the impact of COVID-19 lockdown on Internet addiction on first year medical students. 2. To evaluate the associations, if any, between internet addiction, anxiety, depression and stress.

Methods

Internet addiction, depression, anxiety and stress among medical students across West Bengal have been studied using Young's Internet Addiction Test (IAT) scale and the Depression, Anxiety and Stress Scale (DASS-21). A web-based questionnaire was made and circulated via different social media platforms. All interested candidates who gave consent were included in the study. All statistical analyses were done using SPSS version 25.0.

Results

The study population consisted of 37.2% of males and 63.8% of females. 80.23% of the participants showed moderate levels of internet addiction. Strong positive correlation was found between anxiety and stress (r = 0.83, P < 0.05), depression and anxiety (r = 0.92, P < 0.05) and between depression and stress (r = 0.86, P < 0.05).

Conclusion

The unprecedented ramifications of lockdown are incessant, with internet addiction, magnification in depression, anxiety and stress to name a few. Internet addiction coupled with psychological disorders still remains a matter of concern for medical students.

Re-examining the relationship between interpersonal reactivity index sub-scales and mental well-being: Implications of the pandemic

The pandemic has severely impacted people's Mental Well-being (MWB) globally. Pre-pandemic studies have widely linked MWB with empathy. Against the backdrop of pandemic, we intend to re-examine this association between empathy, as widely measured by the Interpersonal Reactivity Index (IRI) sub-scales: perspective taking, empathic concerns, and personal distress with MWB. For this, a survey using a non-experimental research design was carried out during the 2020 lockdown. We used the Structural Equation Modeling approach to analyse the data. All the standardized scales have been tested for unidimensionality, reliability, and validity. We also resort to a self-administered questionnaire consisting of questions related to day-to-day activities to support the empirical findings. Results demonstrate a positive relationship between perspective taking and empathic concern with MWB and a negative relationship between personal distress and MWB. The response to the self-administered questionnaire corroborates with our model results and presents the scope of interpreting the findings. In continuation, limitations, contributions, and future scope conclude this essay.

Mental health and well-being of LGBTQ+ people during the COVID-19 pandemic

The COVID-19 pandemic has had a profound negative impact on the mental health of the general population. The COVID-19 pandemic and its related containment measures have increased structural disadvantages faced by marginalized communities, such as LGBTQ+ people. LGBTQ+ is an acronym used to identify lesbian, gay, bisexual, transgender and queer people plus all community members using different terms to describe their sexual orientation or gender identity. It is likely that the COVID-19 pandemic has exposed them to increased minority stress, which can also affect their physical health. Since the beginning of the pandemic, the few available studies on the mental health of LGBTQ+ have reported frequent worries about the future, negative emotions, and feelings of uncertainty. Moreover, they have faced further difficulties such as undertaking hormone therapy, accessing to health facilities or living with family members not accepting their condition. The COVID-19 pandemic has added a significant burden to the well-being of LGBTQ+ people, and therefore there is the need to provide them with dedicated supportive interventions in order to promote the early detection of mental health problems or of full-blown mental disorders.

The Effect of the COVID-19 Pandemic on the Assessment of Sexual Life-Repeated Cross-Sectional Surveys among Polish Adults in 2017, 2020 and 2021

The study aims to investigate whether assessment of sexual life remained stable during the COVID-19 pandemic. Two surveys were conducted among Polish adults aged 18–70 years in June 2020 (n = 2042; perspective of last 2–3 months) and in June 2021 (n = 2418; last 12 months). Data from 2017 (n = 1980) were used as a reference point. Four questions allowed for defining five sexual life assessment profiles (k-means cluster analysis). Their characteristics were presented using 12 variables and 16 factors that contributed to difficulties in sexual life. The 2020 survey showed a temporary increase in the importance of sexual life and the frequency of sexual intercourse. However, the percentage of respondents representing the most favorable profile decreased significantly over the consecutive survey periods (47.1%, 34.2%, and 32.3%, respectively). Pandemic-induced fatigue and stress as well as the permanent presence of others at home were reported as two main factors negatively affecting the frequency of sexual intercourse during the pandemic. Respondents who assessed their sexual life as poor were more likely to consider illness, depression, and low self-esteem as factors negatively impacting their sexual life in 2021 than a year earlier. The results confirmed that as the pandemic drew on, the assessment of sexual life changed compared to the time around the first lockdown.

Thriving in a pandemic: Determinants of excellent wellbeing among New Zealanders during the 2020 COVID-19 lockdown; a cross-sectional survey

OBJECTIVE

The COVID-19 pandemic and associated restrictions are associated with adverse psychological impacts but an assessment of positive wellbeing is required to understand the overall impacts of the pandemic.

METHODS

The NZ Lockdown Psychological Distress Survey is an on-line cross-sectional survey of 3487 New Zealanders undertaken during a strict lockdown for COVID-19. The lockdown extended from 25 March 2020 to 28 April 2020 and the survey was undertaken between 15 April 2020 and 27 April 2020. The survey measured excellent wellbeing categorised by a WHO-Five Well-being Index (WHO-5) score ≥22. The survey also contained demographic and pre-lockdown questions, subjective and objective lockdown experiences, and questions on alcohol use. The proportion of participants with excellent wellbeing is reported with multivariate analysis examining the relative importance of individual factors associated with excellent wellbeing.

RESULTS

Approximately 9% of the overall sample (303 participants) reported excellent wellbeing during the New Zealand lockdown. In the multivariable analysis, excellent wellbeing status was positively associated with increasing age (p<0.001), male gender (p = 0.044), Māori and Asian ethnicity (p = 0.008), and lower levels of education (certificate/diploma level qualification or less) (p<0.001). Excellent wellbeing was negatively associated with smoking (p = 0.001), poor physical (p<0.001) and mental health (p = 0.002), and previous trauma (p = 0.033).

CONCLUSION

Nine percent of New Zealanders reported excellent wellbeing during severe COVID-19 pandemic restrictions. Demographic and broader health factors predicted excellent wellbeing status. An understanding of these factors may help to enhance wellbeing during any future lockdowns.

Impact of the COVID-19 pandemic on student' sleep patterns, sexual activity, screen use, and food intake: A global survey

Background

The education sector experienced substantial impacts during the COVID-19 pandemic resulting from worldwide restrictions.

Purpose

To examine differences in the sleep patterns, sexual activity, screen use, and food intake of students and non-students during the COVID-19 pandemic.

Methods

This was a global cross-sectional study conducted in the second half of 2020 using multiple social media platforms to recruit study participants globally. A close-ended questionnaire was administered anonymously in English, French, Spanish, Portuguese, and Arabic to adults ages 18 and older. The outcome variables considered in analyses were changes in sleep pattern, sexual activity, screen use, and food intake. The explanatory variable was student status categorized as students vs. non-student. T-test, chi-square, and Mann Whitney U tests were used to assess differences between student and non-student populations. One logistic regression model was built for each outcome variable. Country of residence and country income level were included in the adjusted models.

Results

There were 17,008 participants of which 3,793 (22.3%) were students. Of the total sample, 4,889 (28.7%) reported changes in sleep, 4,642 (31.8%) reported increases in sexual activity, 10,278 (70.7%) reported increases in screen use, and 5,662 (40.2%) reported increases in food intake during the pandemic. Compared to non-students, students had significantly higher odds of reporting changes in sleep (AOR = 1.52), increases in sexual activity (AOR = 1.79), and increases in screen use (AOR = 1.36) but lower odds of reporting increase in food intake (AOR = 0.87).

Conclusion

Students displayed higher risk of experiencing changes in sleep, sexual behavior, and screen use during the COVID-19 pandemic. This has the potential to lead to broader adverse effects on students’ overall wellbeing. The findings and implications raise further obligations on the education sector to put extra-curricular support systems in place that address COVID-19 related behavior changes that have the potential to adversely impact students’ wellbeing.

Sexual health (excluding reproductive health, intimate partner violence and gender-based violence) and COVID-19: a scoping review

OBJECTIVES

The COVID-19 pandemic has exposed and exacerbated existing socioeconomic and health disparities, including disparities in sexual health and well-being. While there have been several reviews published on COVID-19 and population health disparities generally-including some with attention to HIV-none has focused on sexual health (ie, STI care, female sexual health, sexual behaviour). We have conducted a scoping review focused on sexual health (excluding reproductive health (RH), intimate partner violence (IPV) and gender-based violence (GBV)) in the COVID-19 era, examining sexual behaviours and sexual health outcomes.

METHODS

A scoping review, compiling both peer-reviewed and grey literature, focused on sexual health (excluding RH, IPV and GBV) and COVID-19 was conducted on 15 September 2020. Multiple bibliographical databases were searched. Study selection conformed to Joanna Briggs Institute (JBI) Reviewers' Manual 2015 Methodology for JBI Scoping Reviews. We only included English-language original studies.

RESULTS

We found that men who have sex with men may be moving back toward pre-pandemic levels of sexual activity, and that STI and HIV testing rates seem to have decreased. There was minimal focus on outcomes such as the economic impact on sexual health (excluding RH, IPV and GBV) and STI care, especially STI care of marginalised populations. In terms of population groups, there was limited focus on sex workers or on women, especially women's sexual behaviour and mental health. We noticed limited use of qualitative techniques. Very few studies were in low/middle-income countries (LMICs).

CONCLUSIONS

Sexual health research is critical during a global infectious disease pandemic and our review of studies suggested notable research gaps. Researchers can focus efforts on LMICs and under-researched topics within sexual health and explore the use of qualitative techniques and interventions where appropriate.

Psychiatric impacts of the COVID-19 global pandemic on U.S. sexual and gender minority young adults

The COVID-19 pandemic has caused unprecedented isolation and mental health effects; few studies have characterized this in sexual and gender (SGM) minority young people, a particularly vulnerable population. This cross-sectional study sought to analyze the mental health outcomes of SGM young people (18-30 years) during the early stages of the pandemic in the United States (April 13-June 18, 2020) and to explore how factors related to SGM identity impact mental health, such as lifetime discrimination, family support, and pre-existing mental health conditions. An online survey collected socio-demographic information and assessed for both mental health (depression (PHQ-8), anxiety (GAD-7), PTSD (PCL-C)) and COVID-19-related outcomes (COVID-19-related worries and COVID-19-related grief). Out of 981 participants, 320 (32.6%) identified as SGM. SGM had significantly higher levels of depression and PTSD symptoms as well as COVID-19-related worries and grief than non-SGM, even after controlling for family support, lifetime discrimination, and pre-existing mental health diagnoses. These findings suggest that not only has the COVID-19 pandemic disproportionately impacted SGM mental health, but that minority stress factors cannot fully explain this impact. Thus, clinicians and societal stakeholders (schools, employers, policymakers) must think beyond traditional minority stress factors (family support, discrimination) and pre-pandemic disparities to support this vulnerable population as the pandemic progresses.

COVID-19 pandemic and psychological wellbeing among health care workers and general population: A systematic-review and meta-analysis of the current evidence from India

Introduction

Coronavirus disease 2019 (COVID-19) was declared as pandemic and measures adopted for its control included quarantine of at-risk, isolation of infected along with other measures such as lockdown, restrictions on movement, and social interactions. Both the pandemic and these measures have the potential to cause mental health problems among individuals.

Objective

The present study aimed to investigate and estimate the prevalence of psychological well-being, particularly from an Indian perspective using systematic review and meta-analysis of existing literature.

Methods

We searched in the PubMed database, starting from the onset of the current pandemic and until 10th October 2020 to synthesize evidence on mental health outcomes from India. DerSimonian and Laird method of the random-effects meta-analysis was employed and heterogeneity between studies was assessed using the Chi-square based Cochran's Q statistic and I-squared (I²) statistics.

Results

The pooled prevalence of stress in nine studies was 60.7% (95% CI: 42.3%–77.7%), depression in eight studies was 32.7% (95% CI: 24.6%–41.3%), anxiety in six studies was 34.1% (95% CI: 26.3%–42.3%) and sleep disturbances in six studies was 26.7% (95% CI: 13.9%–41.8%). As expected, high heterogeneity was observed in the above-mentioned outcomes. Sub-group analysis showed that Health Care Workers (HCWs) had a higher prevalence of stress, anxiety, depression & psychological distress in comparison to the general population.

Conclusion

A significant impact on psychological well-being during COVID-19 was observed in India as common adverse outcomes were stress (61%), psychological distress (43%), anxiety (34%), depression (33%), and sleep disturbances (27%). Thus the COVID-19 pandemic represents an unprecedented threat to mental health, which should become a priority for public health strategies.

Sleep Quality and Physical Activity as Predictors of Mental Wellbeing Variance in Older Adults during COVID-19 Lockdown: ECLB COVID-19 International Online Survey

BACKGROUND

The COVID-19 lockdown could engender disruption to lifestyle behaviors, thus impairing mental wellbeing in the general population. This study investigated whether sociodemographic variables, changes in physical activity, and sleep quality from pre- to during lockdown were predictors of change in mental wellbeing in quarantined older adults.

METHODS

A 12-week international online survey was launched in 14 languages on 6 April 2020. Forty-one research institutions from Europe, Western-Asia, North-Africa, and the Americas, promoted the survey. The survey was presented in a differential format with questions related to responses "pre" and "during" the lockdown period. Participants responded to the Short Warwick-Edinburgh Mental Wellbeing Scale, the Pittsburgh Sleep Quality Index (PSQI) questionnaire, and the short form of the International Physical Activity Questionnaire.

RESULTS

Replies from older adults (aged >55 years, n = 517), mainly from Europe (50.1%), Western-Asia (6.8%), America (30%), and North-Africa (9.3%) were analyzed. The COVID-19 lockdown led to significantly decreased mental wellbeing, sleep quality, and total physical activity energy expenditure levels (all p < 0.001). Regression analysis showed that the change in total PSQI score and total physical activity energy expenditure (F(2, 514) = 66.41 p < 0.001) were significant predictors of the decrease in mental wellbeing from pre- to during lockdown (p < 0.001, R2: 0.20).

CONCLUSION

COVID-19 lockdown deleteriously affected physical activity and sleep patterns. Furthermore, change in the total PSQI score and total physical activity energy expenditure were significant predictors for the decrease in mental wellbeing.

A longitudinal study of mental health before and during COVID-19 lockdown in the French population

BACKGROUND

The impact of general population lockdown implemented in the face of the COVID-19 epidemic needs to be evaluated. We describe here a longitudinal study on the mental health of adults in France.

METHODS

We did a secondary analysis of a web-based cohort, initially set up to study home and leisure injuries, in order to measure the consequences of the national lockdown implemented in France from 17 March 2020 to 11 May 2020, and to assess potential vulnerability and resilience factors. Eligible participants were invited to answer an online questionnaire designed to assess their living conditions and health during lockdown. Comparisons were done with answers provided 4.8 years earlier on average.

RESULTS

On 15th April 2020, we sent email invitations to 9598 participants recruited between November 2014 and December 2019 and 1237 volunteers took part in the study by completing the online questionnaire. The proportion of those with anxiety symptoms markedly increased from 17.3 to 20.1%. The average self-rated level of mental health decreased from 7.77 to 7.58. Women, the elderly and the youngest appeared to be more vulnerable. A small living space (less than 30 m²) was associated with an increase in depression symptoms (PHQ-9 score), and poorer self-rated physical health at recruitment was associated with an increase in anxiety symptoms (GAD-7 score). On the contrary, the average self-rated level of physical health markedly increased from 7.44 to 7.94 between recruitment and lockdown, and the proportion of those who reported a level of 9 or 10 jumped from 25.7% at recruitment to 43.1% during lockdown.

CONCLUSIONS

Mental health deteriorated during lockdown in France during the 2020 COVID-19 crisis. Overall, self-rated physical health improved but those who experienced a worse physical health were more likely to report anxiety symptoms.

Emotional distress, psychosomatic symptoms and their relationship with institutional responses: A survey of Italian frontline medical staff during the Covid-19 pandemic

With the advent of Covid-19, health workers have been under constant physical and psychological pressure. Italy was among the first countries to face the health emergency in a period of great uncertainty about the virus and the ways to treat patients. The present study aims to analyse the levels of emotional distress (ED) and psychosomatic symptoms (PS) of Italian frontline health workers during the Covid-19 emergency, and their relationship with the evaluation of the institutional responses received. A survey was available online during the peak of health system overload. Health workers' ED, PS and perceived overall wellbeing were assessed, along with the perceived adequacy of the emotional support, hygiene and safety measures, and protection received from the national government, regional administration and local hospital. A total of 103 questionnaires were collected [Women: 51.5%; mean age, 41.8 years; SD: ±10,7; high-risk zone: 41.7%]. Correlation analyses were applied to investigate the relationship between the measures of emotional distress and psychosomatic symptoms; ANOVA was applied to compare these measures among groups from different risk zones and with different perceived emotional and safety protection. About half of the health workers showed medium or high scores on emotional exhaustion, exceeded the cut-off for medium, high or very high psychosomatic symptom burdens, felt they have never or rarely been protected by the institutional responses and judged the emotional support received as inadequate; 32% judged the safety and hygiene measures as insufficient. Significant associations were found between measures of ED, PS and perceived change in personal wellbeing. Differences in perceived institutional support and adequacy of hygiene and safety measures related to significant differences in PS and perceived change in personal wellbeing. ED and PS were widely experienced by frontline health workers. Physical and psychological symptoms were amplified by the perceived lack of institutional support. Ensuring PS and hygiene and safety measures is essential to prevent worsening of health and psychosomatic symptoms in frontline health workers.