Dynamics of psychological responses to COVID-19 in India: A longitudinal study

Mental Health Impacts of COVID-19: Does Prepandemic Cognition and Dementia Status Matter?

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic disrupted daily life and led to sharp shocks in trends for various health outcomes. Although substantial evidence exists linking the pandemic and mental health outcomes and linking dementia and mental health outcomes, little evidence exists on how cognitive status may alter the impact of COVID-19 on mental health.

METHODS

We used prepandemic data from the Longitudinal Aging Study in India-Diagnostic Assessment of Dementia study and 9 waves of data from the Real-Time Insights of COVID-19 in India study (N = 1 182). We estimated associations between measures of prepandemic cognition (continuous cognition based on 22 cognitive tests, dementia status) and mental health measures during the pandemic (Patient Health Questionnaire [PHQ]-4 [9 time points], PHQ-9 [2 time points], Beck Anxiety Inventory [3 time points]), adjusting for age, gender, rural/urban residence, state, education, and prepandemic mental health.

RESULTS

Summarizing across time points, PHQ-9 score was marginally or significantly associated with prepandemic cognition (PHQ-9 difference: -0.38 [-0.78 to 0.14] points per SD higher cognition; p = .06), and prepandemic dementia (PHQ-9 difference: 0.61 [0.11-1.13] points for those with dementia compared to no dementia; p = .02). Associations with BAI were null, whereas associations with PHQ-4 varied over time (p value for interaction = .02) and were strongest during the delta wave, when pandemic burden was highest.

CONCLUSIONS

We present initial evidence that mental health impacts of COVID-19 or other acute stressors may be unequally distributed across strata of cognitive outcomes. In dynamically changing environments, those with cognitive impairment or dementia may be more vulnerable to adverse mental health outcomes.

Systematic review of empiric studies on lockdowns, workplace closures, and other non-pharmaceutical interventions in non-healthcare workplaces during the initial year of the COVID-19 pandemic: benefits and selected unintended consequences

BACKGROUND

We conducted a systematic review aimed to evaluate the effects of non-pharmaceutical interventions within non-healthcare workplaces and community-level workplace closures and lockdowns on COVID-19 morbidity and mortality, selected mental disorders, and employment outcomes in workers or the general population.

METHODS

The inclusion criteria included randomized controlled trials and non-randomized studies of interventions. The exclusion criteria included modeling studies. Electronic searches were conducted using MEDLINE, Embase, and other databases from January 1, 2020, through May 11, 2021. Risk of bias was assessed using the Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I) tool. Meta-analysis and sign tests were performed.

RESULTS

A total of 60 observational studies met the inclusion criteria. There were 40 studies on COVID-19 outcomes, 15 on anxiety and depression symptoms, and five on unemployment and labor force participation. There was a paucity of studies on physical distancing, physical barriers, and symptom and temperature screening within workplaces. The sign test indicated that lockdown reduced COVID-19 incidence or case growth rate (23 studies, p < 0.001), reproduction number (11 studies, p < 0.001), and COVID-19 mortality or death growth rate (seven studies, p < 0.05) in the general population. Lockdown did not have any effect on anxiety symptoms (pooled standardized mean difference = -0.02, 95% CI: -0.06, 0.02). Lockdown had a small effect on increasing depression symptoms (pooled standardized mean difference = 0.16, 95% CI: 0.10, 0.21), but publication bias could account for the observed effect. Lockdown increased unemployment (pooled mean difference = 4.48 percentage points, 95% CI: 1.79, 7.17) and decreased labor force participation (pooled mean difference = -2.46 percentage points, 95% CI: -3.16, -1.77). The risk of bias for most of the studies on COVID-19 or employment outcomes was moderate or serious. The risk of bias for the studies on anxiety or depression symptoms was serious or critical.

CONCLUSIONS

Empiric studies indicated that lockdown reduced the impact of COVID-19, but that it had notable unwanted effects. There is a pronounced paucity of studies on the effect of interventions within still-open workplaces. It is important for countries that implement lockdown in future pandemics to consider strategies to mitigate these unintended consequences.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration # CRD42020182660.

Between Meanings and Senses-Making Spaces: Agency and Ownership Emergence Formalization from Cultural-Historical Activity Theory Position, for an AI-Friendly Model

Sense of agency and sense of ownership are considered crucial in autonomous systems. However, drawbacks still exist regarding how to represent their causal origin and internal structure, either in formalized psychological models or in artificial systems. This paper considers that these drawbacks are based on the ontological and epistemological duality in mainstream psychology and AI. By shedding light on the cultural-historical activity theory (CHAT) and dialectical logic, and by building on and extending related work, this paper attempts to investigate how the noted duality affects investigating the self and "I". And by differentiating between the space of meanings and the sense-making space, the paper introduces CHAT's position of the causal emergence of agency and ownership by stressing the twofold transition theory being central to CHAT. Furthermore, a qualitative formalized model is introduced to represent the emergence of agency and ownership through the emergence of the contradictions-based meaning with potential employment in AI.

The mental burden of stay-at-home order extensions during COVID-19

This study evaluates the psychological impact of stay-at-home extension orders during COVID-19 and its relationship with individuals' expectations on the duration of the extensions. An online survey was administered to 1259 US adult residents to measure symptoms of post-traumatic stress disorder (PTSD), anxiety and stress induced by different stay-at-home order extensions using hypothetical length scenarios. We find that individuals exposed to two 2-week order extensions exhibit higher levels of stress and anxiety compared to those exposed to a single 4-week extension. We also find that subjects with longer expected extensions exhibit more signs of psychological damage than those with shorter expected extensions. Furthermore, we find that the negative psychological consequences of providing two shorter extensions is observed only among subjects with extension expectations of four weeks or less. Our results demonstrate that people's expectations affect the level of psychological damage caused by lockdown mandates. Our findings suggest that whenever lockdown extensions are necessary, reduced psychological distress may be possible by implementing a one-time restriction, rather than extending multiple smaller extensions perhaps due to manipulation of personal expectations.

Validation of phenomenon and cross-sectional investigation of predictors for a post-COVID-19 surge of osteoporosis outpatients in China

An unexpected surge of osteoporosis outpatients occurred after COVID-19 lockdown was lifted in China. To confirm the observation and identify possible reasons driving patients care seeking behaviors post-pandemic, we compared the outpatient volumes at the osteoporosis clinic in January through May, 2019-2022 and surveyed seven osteoporosis specialists across China to validate the phenomenon before devising an online questionnaire to collect patients' characters and physical activity levels. Univariate and binary logistic regression analyses were calculated to identify predictors of post-lockdown care-seeking. We received 480 valid responses, including 397 (82.7%) patients having visited the clinic after lockdown and 83 (17.3%) having not. Four significant predictors were identified, including being female, experiencing pain, aggravating symptoms, and heightened anxiety during lockdown (P < 0.05). Both groups experienced lower physical activity levels during lockdown, which however was not a significant predictor (P = 0.317). The surge in osteoporosis outpatient visits after COVID-19 lockdown suggests vast latent demand for osteoporosis care accumulated during the pandemic. Four significant factors predict post-lockdown outpatient care-seeking, including being female, experiencing pain and aggravating symptoms, and heightened anxiety levels. Though physical activity levels decreased during lockdown, it failed to predict care-seeking. This demonstrates resilience of osteoporosis patients to resume regular care despite disruption and stress the substantial backlog of unmet healthcare needs.

Association between individual resilience and depression or anxiety among general adult population during COVID-19: a systematic review

BACKGROUND

The coronavirus disease (COVID-19) pandemic exacerbated depression and anxiety worldwide. Resilience is important to maintain mental health during uncertain times, but limited study has systematically reviewed its association with depression or anxiety with an emphasis on the general population.

METHODS

We searched PubMed and Embase for quantitative or mixed-methods studies on the general adult population published between 1 January 2020 and 31 April 2022 (PROSPERO ID: CRD 42022340935). National Institute of the Health quality assessment tools was used to assess the risk of bias. We qualitatively synthesized findings by outcome and study design.

RESULTS

A total of 2945 studies were screened and 35 studies were included in the narrative analysis (5 on depression, 9 on anxiety, and 21 on both). Overall, 21 studies identified statistically significant inverse associations between resilience and depression, while 24 studies found statistically significant inverse associations between resilience and anxiety. Eight studies reported no statistically significant relationships between resilience with depression or anxiety.

CONCLUSIONS

Resilience was found to be inversely associated with depression and anxiety during the COVID-19 pandemic. The findings highlight the importance of resilience-enhancing intervention in migrating the global mental health burden from outbreaks of infectious diseases.

Social distancing policy and mental health during COVID-19 pandemic: an 18-month longitudinal cohort study in South Korea

Background

Despite the effectiveness of social distancing policies in preventing the spread of Coronavirus Disease 2019 (COVID-19), their impact on mental health remains a concern. Longitudinal studies investigating the psychological effects of social distancing are limited.

Methods

Longitudinal data on psychological variables were collected eight times between May 2020 and November 2021 through online surveys in South Korea.

Results

The participants in the study reported a worsening of depressive and anxiety symptoms, suicide risk, and psychological distress with increasing levels of social distancing. Specifically, during the third wave, when social distancing levels peaked, the highest levels of depression, anxiety, and psychological distress were observed, and the second-lowest levels of vitality were reported. Furthermore, psychological risk factors, such as depressive symptoms, anxiety symptoms, and suicidal risk, were closely associated with vitality levels in daily life.

Discussions

During the pandemic, although social distancing helped prevent the spread of COVID-19, it also led to increased depression, anxiety, suicide risk, psychological distress, and decreased vitality. Engagement at a personal level in fundamental daily activities is important to cope with psychological distress. Our results indicate that commitment to fundamental daily activities and following routines is an important protective factor against psychological distress, notwithstanding COVID-19.

The 'welcomed lockdown' hypothesis? Mental wellbeing and mobility restrictions

The COVID-19 pandemic and its mobility restrictions have been an external shock, influencing mental wellbeing. However, does risk exposure to COVID-19 affect the mental wellbeing effect of lockdowns? This paper examines the 'welcomed lockdown' hypothesis, namely the extent to which there is a level of risk where mobility restrictions are not a hindrance to mental wellbeing. We exploit the differential timing of exposure the pandemic, and the different stringency of lockdown policies across European countries and we focus on the effects on two mental health conditions, namely anxiety and depression. We study whether differences in the individual symptoms of anxiety and depression are explained by the combination of pandemic mortality and stringency of lockdown. We draw on an event study approach, complemented with a Difference-in-Difference (DiD), and Regression Discontinuity Design (RDD). Our estimates suggest an average increase in depression (3.95%) and anxiety (10%) symptoms relative to the mean level on the day that lockdown took effect. However, such effects are wiped out when a country's exhibits high mortality ('pandemic category 5'). Hence, we conclude that in an environment of high mortality, lockdowns no longer give rise to a reduction in mental wellbeing consistent with the 'welcome lockdown' hypothesis.

Trajectories of quality of life and mental health during the Covid-19 lockdown and six months after in Italy. A longitudinal exploration

Aim

Covid-19 pandemic and its relative containment measures have affected populations' quality of life and psychological well-being worldwide. The fear related to the pandemic and the imposed containment measures has acted as a trigger causing a global increase in negative mental health states. Thus, we aimed to explore the relationship between fear of covid-19 and mental health via QoL (the first and the second lockdown in Italy, 2020).

Subject and methods

Through a quantitative cross-lagged path model research design, the study investigates people's fear of Covid-19, quality of life, and negative mental states in a population of 444 Italian adults (Mean=40.7; Standard Deviation=16.9; 80% women), in the period between the first and the second waves of the pandemic.

Results

Results show that participants' Covid-19 fear decreased between waves, contributing to a decrease in negative mental states (stress, anxiety and depression), thus improving the perceived quality of life. Furthermore, quality of life emerged as able to buffer the impact of fear of Covid on people's psychological distress in short and medium terms, confirming its central role in regulating mental distress.

Conclusion

The study suggests important guidelines for developing interventions to support the populations' well-being and mental health.

[Psychological Impact of COVID-19 on Health Workers During the Second Year of the Pandemic in Latin America: Cross-Sectional Survey Study]

Introduction

The coronavirus pandemic continues to affect the mental health of healthcare personnel in Latin America (LA).

Objective

To estimate the prevalence of psychological disturbances and associated risk factors for mental health in healthcare personnel in LA during the second year of the COVID-19 pandemic.

Method

This multicenter cross-sectional study included a total sample of 5437 healthcare professionals from Argentina, Bolivia, Chile, Colombia, Ecuador, and Peru. The PHQ-9, GAD-7, and a brief demographic questionnaire were used. The prevalence of anxiety and depression was estimated based on the cut-off points of the instruments. Two multivariate logistic regressions were performed.

Results

A population burden of anxiety (40.1%) and depression (62.2%) was found in healthcare personnel in LA. Among professionals in Argentina (OR = 1.374; P<.001), those working in state hospitals (OR = 1.536; P<.003), frontline healthcare workers for COVID patients (OR = 1.848; P<.001), general practitioners (OR = 1.335; P<.001), and specialists (OR = 1.298; P<.001), a higher risk of experiencing mental disorders was observed. Among women, younger personnel, and administrative staff, a higher probability of experiencing anxiety and depression was identified.

Conclusions

The burden of mental disorders on healthcare personnel in Latin America is alarming. Psychological support services are necessary, aimed at providing measures for professionals to develop healthy coping mechanisms that mitigate the impact of the pandemic on their well-being and facilitate post-crisis adjustment.

How regulation strategies protected or worsened emotional experience during France's three lockdowns: Prepandemic versus pandemic comparisons and longitudinal approach

The COVID-19 pandemic remains hugely challenging, but its impact on emotional experience, especially over time, has often been neglected. The French Government imposed three COVID lockdowns with varying degrees of strictness that induced different types of emotional discomfort and emotion regulation. The present longitudinal study explored affect and emotion regulation strategies in each of these lockdowns, comparing samples assessed before and during the pandemic. The objective was to understand how government measures influenced subjective experience and how people adjusted their emotion regulation accordingly. The longitudinal lockdown sample comprised 164 participants (M_age = 37.60 years, SD = 12.50). Affect and emotion regulation were assessed in the first week of each of the three lockdowns (20-27 March 2020, 23-30 November 2020, and 19-26 April 2021). The 120 participants in the prepandemic (control) sample were drawn from previous studies focusing on affect and regulation strategies in natural everyday situations. Results indicated that affect deteriorated considerably, compared with prepandemic levels. Whereas activated negative affect (nervous and worried) tended to decrease, deactivated negative affect (sad and bored) increased. Regarding emotion regulation strategies, negative emotion expression was associated with more negative affect and less positive affect, while positive emotion expression and proactive behaviour were associated with a better emotional experience. A multivariate growth curve showed that in the absence of psychological support, stressful situations and repeated lockdowns do not induce people to make better emotion regulation strategy choices. As government restrictions had a negative impact on individuals' emotional experience, support programs should be implemented in future pandemics to promote emotion regulation.

Promoting Emotional and Psychological Well-Being During COVID-19 Pandemic: A Self-Help Virtual Reality Intervention for University Students

Mental health problems are very common among university students, and the situation worsened during the COVID-19 pandemic. The closure of universities, the restrictions imposed, and the reduction of social activities led to considerable changes in students' lives, thus posing new mental health and emotional challenges. Within this context, promoting university students' general well-being, in particular emotional and psychological well-being, becomes essential. In addition to the possibility of online interventions aimed at overcoming distance limitations and reaching people at their home, other advanced technologies such as virtual reality (VR) have demonstrated the potential to improve people's well-being, quality of life, and positive experiences. The study reported in this article is aimed at exploring the feasibility and preliminary effectiveness of a self-help VR intervention lasting 3 weeks in promoting emotional well-being in university students. Forty-two university students voluntarily participated in a six-session intervention. In each session, a different virtual scenario was presented: two relaxing experiences and four transformative experiences based on metaphors or metaphoric ones aimed at encouraging students to be aware of their emotions and positive resources. Students were randomly allocated to an experimental group and to a waiting list group that started the intervention after 3 weeks. Before and after the six sessions, participants completed an assessment by completing online questionnaires. Results showed a significant increase in both emotional well-being and psychological well-being in the experimental group compared to the waiting list group. The majority of participants said that they would recommend the experience to other students.

Citizens' reactions to global crises: a longitudinal study during the COVID-19 pandemic in Israel

This paper investigated citizens' reactions to global crises using the COVID-19 pandemic as a natural experiment. Theories in this field are controversial and thus knowledge on such reactions, their evolution, drivers, and consequences is limited. Building on several socio-psychological foundations such as trust building theories, the fear appeal theory, the theory of planned behavior, and the spillover theory, we explain developments in three major human responses: (1) perceptual and attitudinal responses such as trust in governance and interpersonal trust; (2) emotional responses such as fear of crises; and (3) behavioral responses such as civic engagement. Using a longitudinal design, we tracked the attitudes and behaviors of Israeli citizens over 22 months (7/2019-3/2021) and at four points in time (t1-t4). Findings are based on a time-lagged analysis of 3527 participants (n₁ = 602; n₂ = 750; n₃ = 970; n₄ = 1205), and a more focused analysis of panel data (n_1-4 = 256). In accordance with our theoretical foundations and specific models, we revealed a reaction pattern of shock→recognition→adjustment→reframing. We maintain that our findings improve understanding of citizens' reactions to government policies. They provide unique empirical evidence for resilience among citizens and across social structures which testify to bouncing-back capacities from global crises in various ways. Its lessons may thus direct future studies on the relationship between citizens and governments in other global crises and emergencies.

Supplementary Information

The online version contains supplementary material available at 10.1007/s43545-023-00610-0.

A longitudinal study of depression, anxiety, and stress among Indians during COVID-19 pandemic

The COVID-19 has caused significant public health chaos. Whether infected or uninfected, people have reported significant mental health issues during the COVID-19 pandemic. The present study explored symptoms of depression, anxiety, and stress of uninfected people with the disease over three time periods. A total of 132 participants took part in all the three phases. Data at Time 1 and Time 2 were collected during the national lockdown with 1 month apart, while data at Time 3 were collected immediately once the lockdown was uplifted in India. Participants completed the Depression, Anxiety and Stress Scale-21 online. The results indicated that despite an increase in the average number of COVID-19 cases, depression, anxiety, and stress symptoms decreased over time with the lowest level once the lockdown was ended. These results suggest that the restrictions implemented during the national lockdown led to distress, and not an increase in COVID-19 cases per se.

Facing the pandemic and lockdown: an insight on mental health from a longitudinal study using diaries

We conducted a longitudinal online study to examine attenuated psychotic symptoms (APS) over time in a sample of locked-down individuals. We used (i) questionnaires and (ii) the automatic analysis of the emotional content of narratives. Participants (N = 162) were recruited to complete an online survey 4 times between March and June 2020 (T1, T2, T3, T4). T1 completion coincided with the beginning of the lockdown, and T4 with the pandemic trough. Depression, anxiety, and stress were assessed with the DASS-42 and APS with the PQ-16. Psychosocial data such as the feeling of loneliness and social network size were also collected. The participants wrote daily narratives during the lockdown period. Anxiety and APS were the highest at T1 and decreased over time. APS and APS-associated distress were correlated with the DASS-42 at all times. APS arose acutely at the beginning of the pandemic, despite participants being socio-economically advantaged, and were related with negative emotions.

Assessment of mental health of university students faced with different lockdowns during the coronavirus pandemic, a repeated cross-sectional study

HIGHLIGHTS

Successive lockdowns have a significant impact on the mental health of university students.PhD students have experienced the most significant deterioration in their mental health.The rate of suicidal ideation has increased significantly across the university student population.

Prevalence of anxiety and depressive symptoms during COVID-19 pandemic among the general population in India: A systematic review and meta-analysis

Objective

The novel coronavirus (n COVID-19) has affected every walk of life across the world including India. Several studies have been available on the COVID-19-related anxiety and depressive symptoms in the public health context. However, there is a dearth of evidence of a meta-analysis regarding the pooled estimates of anxiety and depressive symptoms related to this pandemic based on the existing studies conducted among the general population of India. The aim of the study was to estimate the pooled prevalence of COVID-19-related anxiety and depressive symptoms among the general population in India.

Material and Methods

We searched the following electronic bibliographic databases: PubMed, Ovid, Science Direct, and Wiley online library for studies conducted from the onset of the COVID-19 pandemic and until September 25, 2021. We separately analyzed the outcome measures based on the risk of bias assessment. The publication bias was evaluated by funnel plots and Egger's test.

Results

We used a random-effect model due to the significant heterogeneity between the studies (Anxiety symptoms - I2 = 99.40% and Depressive symptoms - I2 = 95.3%). According to the index meta-analysis, the pooled estimates of anxiety and depressive symptoms among general population of India during COVID-19 pandemic are 23.5% (95% CI: 17.4-29.6%; n = 21 studies) and 20.2% (95% CI: 17.2-23.2%; n = 17 studies), respectively. In subgroup analyses, good-quality studies (Score ≥7/9) had a significant effect on the pooled prevalence.

Conclusion

About one-fifth of the general population of India reported having anxiety and depressive symptoms during the COVID-19 pandemic. The pooled estimates varied with the methodological quality of included studies. The present study provides a comprehensive picture of the overall magnitude of anxiety and depressive symptoms due to the COVID-19 outbreak which will guide the policy makers to measure the burden of similar pandemics more judiciously in the future.

COVID-19 and the Adaptive Role of Educators: The Impact of Digital Literacy and Psychological Well-Being on Education—A PLS-SEM Approach

Mobility restrictions during the COVID-19 pandemic raised mental health consequences. This paper examines the triangulation of Digital Literacy (DL), psychological well-being, and effectiveness of remote teaching and learning during the pandemic. Survey responses collected from 518 schoolteachers in Sri Lanka are analyzed with Partial Least Squares – Structural Equation Modeling (PLS-SEM) method. Results indicate that Remote Education (RE) has twisted a stressful life for educators. DL negatively affects the psychological well-being of the teacher. The effectiveness of teaching and learning and teacher engagement depends upon their DL level. Educators’ stress and depression status mediate the outcome of remote teaching and learning mode. Moreover, digital skills count more than the accumulated teaching experience. We emphasize the adaptive role of the teacher for sustainable digital education. The results indicate that augmented education success could be obtained by investing in digital competence. It suggests that upgrading DL is an urgent role and alarms the policymakers and education managers to mitigate the potential mental health and social capital crisis.

Lessons Learned During the COVID-19 Pandemic in Central India: Overlooked Psychological and Social Determinants of Health

Background: The coronavirus disease 2019 (COVID-19) pandemic, which started in 2019, has created unprecedented public health problems, mental health crises, and economic and social problems. These effects have been studied by numerous researchers on the general population but none on hospitalized and discharged COVID-19 patients.

Aim: To assess psychological and social problems among hospitalized and discharged COVID-19 patients.

Methods: During lockdown and post-lockdown in India, we interviewed 500 COVID-19 patients admitted at our tertiary care center during their hospitalization and post-discharge period for psychological and social problems.

Results: The common psychological issues in hospitalized patients during lockdown were anxiety and misconceptions about COVID-19, while insomnia, anxiety, and frustration were common during the post-lockdown period. The typical social problems in hospitalized patients during the lockdown were containment-related issues, discrimination, longer wait for repeat COVID-19 tests, and boredom; whereas issues related to employment and financial matters were common during post-lockdown. Psychological problems comparatively decreased whereas social problems increased after discharge.

Conclusion: Unrehearsed mitigation strategies at the beginning of the pandemic unknowingly led to various psychological and social problems. It was further aggravated by a lack of information and miscommunication.

Long-term psychological profile of general population following COVID-19 outbreak: symptom trajectories and evolution of psychopathological network

AIMS

COVID-19 has long-term impacts on public mental health, while few research studies incorporate multidimensional methods to thoroughly characterise the psychological profile of general population and little detailed guidance exists for mental health management during the pandemic. This research aims to capture long-term psychological profile of general population following COVID-19 by integrating trajectory modelling approaches, latent trajectory pattern identification and network analyses.

METHODS

Longitudinal data were collected from a nationwide sample of 18 804 adults in 12 months after COVID-19 outbreak in China. Patient Health Questionnaire-9, Generalised Anxiety Disorder-7 and Insomnia Severity Index were used to measure depression, anxiety and insomnia, respectively. The unconditional and conditional latent growth curve models were fitted to investigate trajectories and long-term predictors for psychological symptoms. We employed latent growth mixture model to identify the major psychological symptom trajectory patterns, and ran sparse Gaussian graphical models with graphical lasso to explore the evolution of psychopathological network.

RESULTS

At 12 months after COVID-19 outbreak, psychological symptoms generally alleviated, and five psychological symptom trajectories with different demographics were identified: normal stable (63.4%), mild stable (15.3%), mild-increase to decrease (11.7%), mild-decrease to increase (4.0%) and moderate/severe stable (5.5%). The finding indicated that there were still about 5% individuals showing consistently severe distress and approximately 16% following fluctuating psychological trajectories, who should be continuously monitored. For individuals with persistently severe trajectories and those with fluctuating trajectories, central or bridge symptoms in the network were mainly 'motor abnormality' and 'sad mood', respectively. Compared with initial peak and late COVID-19 phase, aftermath of initial peak might be a psychologically vulnerable period with highest network connectivity. The central and bridge symptoms for aftermath of initial peak ('appetite change' and 'trouble of relaxing') were totally different from those at other pandemic phases ('sad mood').

CONCLUSIONS

This research identified the overall growing trend, long-term predictors, trajectory classes and evolutionary pattern of psychopathological network of psychological symptoms in 12 months after COVID-19 outbreak. It provides a multidimensional long-term psychological profile of the general population after COVID-19 outbreak, and accentuates the essentiality of continuous psychological monitoring, as well as population- and time-specific psychological management after COVID-19. We believe our findings can offer reference for long-term psychological management after pandemics.

Anxiety and depression among adult tobacco users during the COVID-19 restrictions in India

Background

The world witnessed a highly contagious and deadly disease, COVID-19, toward the end of 2019. India is one of the worst affected countries. We aimed to assess anxiety and depression levels among adult tobacco users and people who recently quit tobacco during COVID-19 lockdown in India.

Materials and methods

The study was conducted across two Indian cities, Delhi and Chennai (July-August, 2020) among adult tobacco users (n = 801). Telephonic interviews were conducted using validated mental health tools (Patient Health Questionnaire-PHQ-9 and Generalized Anxiety Disorder-GAD-7) to assess the anxiety and depression levels of the participants. Descriptive analysis and multiple logistic regression were used to study the prevalence and correlates of depression and anxiety.

Results

We found that 20.6% of tobacco users had depression symptoms (3.9% moderate to severe); 20.7% had anxiety symptoms (3.8% moderate to severe). Risk factors associated with depression and anxiety included food, housing, and financial insecurity.

Conclusion

During COVID-19 lockdown, mental health of tobacco users (primarily women) was associated with food, housing and financial insecurity. The Indian Government rightly initiated several health, social and economic measures to shield the most vulnerable from COVID-19, including a ban on the sale of tobacco products. It is also necessary to prioritize universal health coverage, expanded social security net, tobacco cessation and mental health services to such vulnerable populations during pandemic situations.

“This is Going to Stay”: A Longitudinal Mixed Method Pilot Study on the Psychological Impact of Living Through a Pandemic

Living through the COVID-19 pandemic has been proven to have psychological impacts among individuals in both sport and non-sport populations. However, there is little available research comparing athlete and non-athlete populations in this context, especially among a non-western sample. This study employs a novel, longitudinal mixed method sequential explanatory research design to compare the impact of the COVID-19 pandemic between athlete and non-athlete populations and the role of physical activity. Phase A was a quantitative study measuring the psychological impact using the Impact of Event Scale-Revised among both groups ( n   =  32). Phase B was a qualitative study, with a sample ( n  =  7) participating in experiential interviews, exploring the lived experiences of participants over a 7-month period since Phase A was completed. Results indicated that athletes had lower psychological impact of the pandemic compared to non-athletes. Reflexive thematic analysis indicated that over the 7-month longitudinal period, athletes and non-athletes had different experiences across the themes of ‘Appraisal and Coping’, ‘Cognitions’, and ‘Impact of the Pandemic’. Findings show A) a clear longitudinal impact of COVID-19 over a 7-month period; B) there is a clear contrast between sport and non-sport populations, with participants indicating sport and physical activity to be a protective factor limiting negative psychological impact. Findings are discussed with recommendations for physical activity and sport for reducing psychological impact among both athletes and non-athletes.

Activity system, schizotypal personality, and mentalization: A study between halted activity and COVID-19 conducted in Henan, China

The pandemic-related lifestyle has potentially imposed crucial disturbances on daily and long-term activities, which, in turn, were associated with thought disturbance. This study investigates how the characteristics of the activity system during pandemic-related restrictions are associated with other psychomental aspects. By focusing on PTSD, mentalization, and schizotypal personality, and by inquiring about the main components of the activity system of 852 college students (Zhengzhou, Henan, China)- including the goals orienting their activity, goals' terms and types, the motivation levels and sources, the activity type and engagement time, the flow of the activity, and how due to pandemic lifestyle-results revealed that the activity system's components have significant associations with PTSD, reflective function, and schizotypal traits. Additionally, some of the activity system's elements have a significant predictive role regarding schizotypal traits. The study considered that the life narrative during the pandemic has been disturbed; hence, this may have a crucial effect on mind coherence. Additionally, the outcomes from the pandemic context will support mental health interventions in other similar contexts where the life narrative is severely affected.

A prospective study revealing a compounded burden of COVID-19, sex, and clinical diagnosis of alcohol use disorder and HIV infection on quality of life, anxiety, and alcohol use

The COVID-19 pandemic led to unprecedented restrictions to mitigate disease spread, leading to consequences affecting mental health. Many studies examining COVID-19 pandemic effects on well-being and mental health initiated inquiry after the pandemic onset, whereas we used self-report questionnaires obtained before the pandemic to re-assess the same functions during the pandemic. Participants were drawn from our ongoing longitudinal studies of people with HIV infection, alcohol use disorder (AUD), HIV + AUD comorbidity, and controls. We used phone or mail contact to invite all to participate in our COVID phone survey, which included three self-report questionnaires: Health-related Quality of Life (QoL), State-Trait Anxiety Inventory (STAI), and Alcohol Use Disorder Identification Test (AUDIT). Of 218 eligible participants, 86 responded (July 2020-March 2021): clinical (29 men, 23 women; 17 AUD, 21 HIV, 14 HIV + AUD); control (17 men, 17 women). QoL scores declined, and anxiety symptoms increased from pre-COVID surveys in all groups; clinical women reported greater negative changes than the other groups. QoL subscales revealed COVID-related declines in emotional well-being in all groups, with clinical women reporting additional declines in energy, physical and social functioning, health, and pain increase. Clinical men also reported health declines. Although AUDIT scores were stable in all groups between assessments, changes in AUDIT scores were inversely correlated with QoL scores in clinical women; in clinical men, changes in STAI scores were inversely correlated with QoL scores. Although all groups were adversely affected by the pandemic, the negative effects were greater in the clinical group regardless of diagnosis and greatest in clinical women.

Impact of a Long Lockdown on Mental Health and the Role of Media Use: Web-Based Survey Study

BACKGROUND

Due to the COVID-19 pandemic, the Czech population experienced a second lockdown lasting for about half a year, restricting free movement and imposing social isolation. However, it is not known whether the impact of this long lockdown resulted in habituation to the adverse situation or in the traumatization of the Czech population, and whether the media and specific media use contributed to these effects.

OBJECTIVE

The aim of this study was to elucidate the effect of the long lockdown on the mental health of the Czech population, and the role of exposure to COVID-19 news reports and specific forms of media news use in mental health.

METHODS

We conducted two consecutive surveys in the early (November 2020) and late (March/April 2021) phases of the nationwide lockdown on the same nationally representative group of Czech adults (N=1777) participating in a longitudinal panel study.

RESULTS

Our findings showed that the self-reported symptoms of anxiety and depression increased in the second observation period, confirming the negative effect of the pandemic lockdown as it unfolded, suggesting that restrictive measures and continuous exposure to a collective stressor did not result in the strengthening of resilience but rather in ongoing traumatization. The results also suggest a negative role of the media's coverage of the COVID-19 pandemic in mental health during the early, and particularly late, phases of the lockdown. Furthermore, we found several risk and protective factors of specific media news use. The media practice in news consumption connected to social media use was the strongest predictor of exacerbated mental health symptoms, particularly in the late phase of the lockdown. Moreover, news media use characterized by internalization of information learned from the news, as well as negative attitudes toward media news, were associated with higher levels of anxiety and depression. Conversely, the use of infotainment, together with an in-depth and contextual style of reading news articles, were related to improvement of mental health.

CONCLUSIONS

Our study showed that the long lockdown resulted in traumatization rather than habituation, and in more pronounced effects (both negative and positive) of media use in mental health.

The trajectories of anxiety and depression during the COVID-19 pandemic and the protective role of psychological flexibility: A four-wave longitudinal study

BACKGROUND

Published reports on the adverse mental health impacts of the initial phase of the COVID-19 pandemic suggest an emerging global mental health crisis. However, the trajectories of these mental health impacts over multiple COVID-19 peaks and corresponding lockdowns are unknown. This study explored the trajectories of anxiety and depression over two consecutive lockdowns during the first nine months of the pandemic in Europe (April 2020-January 2021) and examined whether they varied as a function of different psychological flexibility and inflexibility profiles.

METHODS

A total of 569 Italians completed online surveys at four assessment points. Trajectories of anxiety and depression were examined with latent growth modeling and according to different psychological flexibility and inflexibility profiles.

RESULTS

Anxiety increased linearly throughout the study period, whereas depression displayed a quadratic trajectory evidencing a decrease with the easing of the first lockdown followed by an increase during the second lockdown. Furthermore, two profiles were identified that displayed different anxiety and depression trajectories. Compared to the psychologically flexible profile, the psychologically inflexible profile reported significantly higher anxiety and depression which remained higher across the study period.

LIMITATIONS

A reliance on self-report measures and convenience sampling constitute key study limitations.

CONCLUSIONS

Results suggest that high psychological inflexibility is a risk factor for prolonged elevated anxiety and depression during the COVID-19 pandemic, whereas high psychological flexibility is a protective factor. Psychological flexibility and inflexibility should be targeted by preventive public health interventions that harness evidence-based strategies shown to effectively target these factors.

COVID Feel Good: Evaluation of a Self-Help Protocol to Overcome the Psychological Burden of the COVID-19 Pandemic in a German Sample

The COVID-19 pandemic has severe consequences for physical as well as mental well-being. In times of restricted social contact, online self-help programs offer a low-threshold first aid to cope with the psychological burden. This current study evaluates the online self-help protocol “COVID Feel Good” in a German sample. The multicentric study was designed as a single cohort with a waiting list control condition. The convenience sample consisted of 38 German individuals who experienced at least two months of restrictions during the COVID-19 pandemic. The 7-day self-help protocol included the VR video “Secret Garden” as well as a social or cognitive exercise each day. General distress, depression, anxiety, stress, and hopelessness were assessed as primary outcomes. Social connectedness and fear of coronavirus were measured as secondary outcomes. Results showed a significant decrease in all primary outcomes except for hopelessness. Furthermore, the results indicated a significant improvement in social connectedness. Treatment effects on general distress, depression, stress, and anxiety persisted for two weeks after participation. The present study indicates that VR-based self-help protocols can mitigate the psychological burden associated with the pandemic, supporting recent findings.

From the First to the Second Wave of COVID-19: Anxiety, De-Pressive, and Post-Traumatic Stress Symptoms in the Italian Population

In the early stages of the COVID-19 outbreak, high rates of clinically relevant anxiety, depression, and post-traumatic stress symptoms (PTSS) have been reported in the Italian population. The persistence of the pandemic and related restrictive measures highlight the need for a reassessment of psychopathological symptoms. The present longitudinal study consisted of two evaluations conducted during the two waves of infection. Participants were asked to complete the State-Trait Anxiety Inventory-Form Y1 (STAI Y1), the Beck Depression Inventory (BDI-II), and the PTSD Checklist for DSM-5 (PCL-5). There were no significant differences in depressive symptoms and PTSS scores reported by participants between T0 and T1, with single-case analysis revealing that in 71% and 69% of the participants, depressive symptoms and PTSS symptoms, respectively, remained stable during this period. On the contrary, mean scores comparison showed a significant decrease in anxiety levels, with 19% of participants in whom anxiety symptoms improved at single-case analysis. Taken together, these results suggest that depressive symptoms and PTSS not only occurred in a high percentage of participants but also tended to remain stable over time, thus warranting the importance of large-scale psychological screening and interventions to prevent the chronicization of these symptoms and their evolution to psychopathological disorders.

The Global Prevalence of Depression, Anxiety, Stress, and Insomnia Among General Population During COVID-19 Pandemic: A Systematic Review and Meta-analysis

This study aimed to examine research findings related to depression, anxiety, stress, and insomnia during the COVID-19 pandemic. This study also explored periodic changes in the prevalence of depression, anxiety, stress, and insomnia among the general people during this pandemic. We performed a meta-analysis by searching articles from several sources (PubMed, MEDLINE, and Google Scholar). We used the random-effects models, subgroup analysis, and heterogeneity test approaches. Results show that the prevalence of depression, stress, and insomnia increased during March to April 2020 (30.51%, 29.4%, and 25%, respectively) compared to the study period before February 2020 (25.25%, 16.27%, and 22.63%, respectively) and followed in May to June 2020 (16.47%, 5.1%, and 19.86, respectively). The prevalence of depression and anxiety from k = 30 studies was 28.18% (95% CI: 23.81–32.54) and 29.57% (95% CI: 24.67–34.47), respectively. And the prevalence of stress (k = 13) was 25.18% (95% CI: 14.82–35.54), and the prevalence of insomnia (k = 12) was 23.50% (95% CI: 16.44–30.57). These prevalence estimates during the pandemic are very high compared to normal times. Hence, the governments and policymakers should apply proven strategies and interventions to avoid psychological adversity and improve overall mental health during the COVID-19 pandemic.

Changes in the mental health status of the general Chinese population during the COVID-19 pandemic: A longitudinal study

The study is based on a longitudinal evaluation of the public, during the initial COVID-19 outbreak in China and 8 months after. It aimed to explore the changes in the mental health of the public at the beginning of the pandemic and during the regular epidemic prevention and control. An online survey questionnaire was used to collect data during the initial COVID-19 outbreak (February 10, 2020-February 18, 2020; T1) and 8 months after the outbreak (October 21, 2020-December 29, 2020; T2). Psychological distress was assessed using the Patient Health Questionnaire-9 (PHQ-9), Self-rating Anxiety Scale (SAS), and Post-traumatic Stress Disorder Checklist (PCL-5). A chi-square test was used to compare the changes in the depression and anxiety scores at T1 and T2, and the correlation between symptoms was analyzed through Spearman's rank correlation. In T1, 1,200 people were recruited, while 168 people responded in T2. Depression (48.2-31.0%; p=0.001) and anxiety (17.9-9.5%; p = 0.026) symptoms decreased over time; two participants developed post-traumatic stress disorder (PTSD) in T2. The scores of the PHQ-9 scale and the SAS scale were both positively correlated with the score of the PCL-5 scale and negatively correlated with sleep time. During the COVID-19 pandemic, part of the general population's anxiety and depression significantly reduced with time, and they rarely developed PTSD. PTSD occurrence was related to severe depression and anxiety.

COVID-19 and psychological distress among the general population of India: Meta-Analysis of observational studies

Background:

There is scanty evidence regarding the magnitude of COVID-19-related psychological distress (PD) among the general population of India.

Objectives:

This study aimed to estimate the pooled prevalence of PD among the general public of India during the COVID-19 pandemic.

Material and Methods:

We conducted a meta-analysis of 21 online surveys conducted across the Indian subcontinent and published between 2020 and 2021.

Results:

Overall estimates of PD among the general public during the COVID-19 pandemic by the random-effects model is 33.3% (95% confidence interval: 23.8%-42.8%; n = 21 studies). The level of heterogeneity was high among the included studies (I2 = 99.67%). In subgroup analysis, it was found that the survey tool and the methodological quality had a significant effect on the overall prevalence estimates. Approximately 33% of the general public reported to have PD during the COVID-19 pandemic in India, although the overall prevalence varied based on survey tools and quality of studies.

Conclusion:

As the pandemic crisis seems to be ebbing across the world, the current findings are a wake-up call to devise pragmatic strategies to curtail the burden of similar pandemics and to successfully meet the challenges ahead.

Influence of the COVID-19 Pandemic on Parenting Stress Across Asian Countries: A Cross-National Study

Background: In a previous study, we demonstrated that the accumulation of parenting stress during prolonged school closures and restrictions on daily activities due to the COVID-19 pandemic in Japan indicates the need for mental health intervention for parents at higher risk of parenting stress. However, few studies have focused on parenting stress in other Asian countries, although they have experienced higher numbers of infections. The aim of the present study was to investigate whether parenting stress among caregivers increased across Asia due to school closures and restrictions on activities during the COVID-19 pandemic and to examine whether there were any country-specific, cross-country, or cross-regional risk factors for increased parenting stress. Methods: We conducted an online survey immediately after the number of new cases in India significantly increased (September-November 2020). We measured parenting stress, anxiety, and fear associated with the COVID-19 crisis, as evaluated by the Parenting Stress Index, Short-Form (PSI-SF), and the Coronavirus Anxiety Scale (CAS), across three Asian countries-India (n = 142), Malaysia (n = 69), and Japan (n = 182)-in addition to the United States (n = 203). We also investigated whether respondents had adverse childhood experiences (ACE) as a risk factor for parenting stress. Results: For all countries, we found significant increases in participants' current parenting stress levels, compared to what they recalled regarding their lives before COVID-19-related restrictions and school closures were enacted. Textual analysis qualitatively identified common terms related to parenting stress across all countries. We also found a statistical model that indicated ACE in parents was a critical risk factor for higher parenting stress via increasing anxiety and fear related to the pandemic. Conclusion: These results indicate the need to improve the mental health of caregivers who are at risk for higher levels of parenting stress during the COVID-19 pandemic in Asian countries as well as Western countries. These results indicate that there is a need to improve the mental health of caregivers who are at risk for higher levels of parenting stress during the COVID-19 pandemic globally.

Living Alone or Together During Lockdown: Association with Mood, Immune Fitness and Experiencing COVID-19 Symptoms

Purpose

The aim of this study was to evaluate whether or not living alone or together throughout the lockdown had an impact on mood, perceived immune fitness, as well as the presence and severity of COVID-19 symptoms.

Methods

N = 505 participants completed an online survey, which included questions on living situations, as well as mood, perceived immune fitness and COVID-19 symptom presence and severity. These factors were assessed retrospectively for the time periods before and during the COVID-19 pandemic.

Results

An overall decrease in mood was observed for both those living alone and together during the lockdown period. However, significantly larger increases in feelings of loneliness were observed for the group living alone. Furthermore, both groups reported decreases in perceived immune fitness, whereas only the group living alone reported a significant increase in COVID-19 symptom presence and severity. Moreover, significant correlations were found between perceived immune fitness, anxiety, and loneliness. These correlations were strongest in the group living alone. Lastly, positive correlations were found between perceived immune fitness and mood outcomes with being active, optimistic and the ability to cope with stress. Increased optimism, being more active and the adequate ability to cope with stress were associated with a reduced negative impact on perceived immune fitness.

Conclusion

The first COVID-19 lockdown period in the Netherlands was a challenging period for both people who lived alone and those living together, resulting in decreases in mood and poorer perceived immune fitness. Those living alone were, however, more heavily impacted by the lockdown restrictions. This was further reflected by the increased presence and severity of COVID-19 symptoms in people who lived alone during the first COVID-19 lockdown in The Netherlands.

Fatores estressores e protetores da pandemia da Covid-19 na saúde mental da população mundial: uma revisão integrativa

RESUMO Este artigo visou analisar os fatores protetores e estressores da pandemia na saúde mental no Brasil e internacionalmente. Foi realizada uma revisão integrativa da literatura a partir da busca por publicações científicas indexadas nas bases de dados Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs) e Medical Literature Analysis and Retrieval Sistem on-line (Medline) no período de janeiro a dezembro de 2020. Foram analisados 29 artigos por autor, ano, país de estudo, metodologia; fatores estressores e protetores relacionados com a saúde mental. Conclui-se que pessoas que são submetidas às medidas restritivas impostas pelo período de pandemia da Covid-19 se mostram vulneráveis a problemas de saúde mental. Porém, apresar do impacto global, ainda são poucos os estudos que avaliaram os fatores psicossociais relacionados.

Stressors and protective factors of the COVID-19 pandemic in the mental health of the world population: an integrative review

ABSTRACT This paper aimed to analyze the mental health protective factors and stressors of the pandemic in Brazil and internationally. We conducted an integrative literature review by searching for scientific publications indexed in the LILACS and MEDLINE databases from January to December 2020. Twentynine papers have been analyzed by author, year, country of study, methodology; mental health stressors and protective factors related. We concluded that people subjected to restrictive measures imposed by the COVID-19 pandemic are vulnerable to mental health problems. However, very few studies have evaluated the related psychosocial factors despite the global impact.

Domestic violence and psychological problems in married women during COVID-19 pandemic and lockdown: A community-based survey

BACKGROUND

Following the declaration of Coronavirus disease-2019 as a pandemic, a nation-wide lockdown was announced in India. This led to increase in psychological problems, especially in women.

OBJECTIVES

To assess the prevalence of psychological problems and domestic violence (DV) in married women during the pandemic and lockdown in a panchayat in Southern India and to study the association of socio-demographic and clinical variables with psychological problems.

MATERIALS AND METHODS

A cross-sectional study was undertaken in 209 married women of 18-55 years residing in a village panchayat of northern Kerala, India. Socio-demographic variables and clinical variables, like depressive symptoms, anxiety symptoms, perceived stress and DV, among others, were evaluated. The participants were interviewed by trained community health workers in the post-lockdown period.

RESULTS

The prevalence of depressive symptoms was found to be 10.0 %, anxiety symptoms 7.2 % and perceived stress 66.0 %. Severe DV was reported by 6.2 %; but at least one form of DV was experienced by 25.8 % of the women. Significant positive correlation was observed for DV with depression and anxiety. DV was also found to be a significant predictor of depression (adjusted OR [aOR] = 4.26, P = 0.006) and anxiety (aOR=4.34, P=0.02). Being a homemaker (aOR=4.51, P = 0.03) and having past history of mental illness (aOR=5.39, P = 0.03) were also found to increase the risk for depression significantly.

CONCLUSION

There is a high prevalence of psychological problems in married women during the pandemic and lockdown. DV was found to be a significant predictor of depression and anxiety in this population.

Comparison of Experiences in Two Birth Cohorts Comprising Young Families with Children under Four Years during the Initial COVID-19 Lockdown in Australia and the UK: A Qualitative Study

This study aims to understand the experience and impact of the initial COVID-19 lockdown in young families with children aged below 4 years. Free text questions were administered to participants in the ORIGINS (Australia) and Born in Bradford (UK) cohort studies to collect qualitative information on worries, concerns and enjoyable experiences during the pandemic. A total of 903 (400 for ORIGINS and 503 for BiB) participants completed the two surveys during April 2020. Despite varying in geography, levels of socio-economic disadvantage and their situational context during the pandemic, respondents from both cohorts reported similar worries and challenges during the lockdown period, including: employment/finances, health anxiety, mental health and social isolation, caring for children and child development. Families across the globe experienced both positive and negative immediate impacts of COVID-19. Population-based data can be used to inform the development of support services, public health campaigns and universal interventions to assist families in future health crises.

Longitudinal Distress among Brazilian University Workers during Pandemics

The present study aimed to examine changes in mental distress in Brazilian university workers during the pandemic. All workers (n ≃ 1850) of an institution were invited to respond to a survey that took place in three stages, with collections in May (n = 407), June/July (n = 258), and August (n = 207) 2020, and included questions on demographic, health, general and psychological support, and psychometric assessment of mental distress (Clinical Outcome Routine Evaluation- CORE-OM) combined with an open question about major concerns. The results of the Multilevel Modeling analysis pointed to the absence of significant differences across the repeated measures of distress. The only variable associated with increased psychological distress over time was a lower level of support for household chores. Qualitative analysis of the reported major concerns was carried out with a sub-sample who showed reliable deterioration in CORE-OM across time (n = 17). The diversity of concerns reported by this group reinforced that work–life imbalance contributes to mental distress of university workers during the pandemic. Low response rate, although not unexpected due to the circumstances, limits the generalization of findings. The present data suggest that in addition to issues related to contagion and specific restricted measures to contain the spread of the disease, the personal reorganization of life required to maintain activities at home and work can be an important contributor to pandemic-related psychological distress.

Challenges in Feeding Children Posed by the COVID-19 Pandemic: a Systematic Review of Changes in Dietary Intake Combined with a Dietitian's Perspective

PURPOSE OF REVIEW

To examine the evidence that the dietary quality of children changed between the period preceding the COVID-19 pandemic and the first year during the pandemic.

RECENT FINDINGS

A systematic review of the evidence for dietary changes occurring as a result of the pandemic-related restrictions, in Part I of this article, yielded 38 original research articles. These articles had conflicting results, some describing improvements in overall quality and some describing deteriorations. As a whole the studies were characterized by a low study quality, and children were poorly represented. Taken together, these studies do not provide enough evidence to draw conclusions about whether dietary habits changed or not as a result of the pandemic. However, in a wider, narrative review of the psychosocial changes occurring as a result of the COVID-19 pandemic, and the known associations of these factors with a dietary intake in Part II, we conclude that there is a reason to expect that the dietary quality of children might have been adversely affected by the COVID-19 pandemic. One the one hand, the literature fails to provide conclusive evidence on changes in the dietary quality of children resulting from the COVID-19 pandemic. On the other hand, the broader literature supports the hypothesis that children's dietary quality will have declined during the pandemic. Taken together, we urgently need more high-quality research on children's changes in dietary intake occurring over the pandemic. This will provide important information on whether any potential long-term consequences of such changes, if they exist, need to be examined and ameliorated.

COVID-19-Related Financial Hardship, Job Loss, and Mental Health Symptoms: Findings from a Cross-Sectional Study in a Rural Agrarian Community in India

Several countries, including India, imposed mandatory social distancing, quarantine, and lockdowns to stop the spread of the SARS-CoV-2 virus. Although these measures were effective in curbing the spread of the virus, prolonged social distancing, quarantine, and the resultant economic disruption led to an increase in financial stress and mental health concerns. Prior studies established a link between the first lockdown and an increase in mental health issues. However, few studies investigated the association between post-lockdown financial hardship, job loss, and mental health. In this study, we examined the association between COVID-19-related financial hardship, job loss, and mental health symptoms approximately nine months after the end of the first nationwide lockdown in India. Job loss was associated with higher reporting of mental health symptoms among men (aIRR = 1.16) while financial hardship was associated with poor mental health symptoms among women (aIRR = 1.29). Conversely, social support and government aid were associated with better mental health symptoms among women. Our findings highlight the need for financial assistance and job creation programs to aid families in the recovery process. There is also an urgent need for improving the availability and affordability of mental health services in rural areas.

Long-term Effects of the COVID-19 Pandemic on Public Sentiments in Mainland China: Sentiment Analysis of Social Media Posts

Background

The COVID-19 outbreak has induced negative emotions among people. These emotions are expressed by the public on social media and are rapidly spread across the internet, which could cause high levels of panic among the public. Understanding the changes in public sentiment on social media during the pandemic can provide valuable information for developing appropriate policies to reduce the negative impact of the pandemic on the public. Previous studies have consistently shown that the COVID-19 outbreak has had a devastating negative impact on public sentiment. However, it remains unclear whether there has been a variation in the public sentiment during the recovery phase of the pandemic.

Objective

In this study, we aim to determine the impact of the COVID-19 pandemic in mainland China by continuously tracking public sentiment on social media throughout 2020.

Methods

We collected 64,723,242 posts from Sina Weibo, China’s largest social media platform, and conducted a sentiment analysis based on natural language processing to analyze the emotions reflected in these posts.

Results

We found that the COVID-19 pandemic not only affected public sentiment on social media during the initial outbreak but also induced long-term negative effects even in the recovery period. These long-term negative effects were no longer correlated with the number of new confirmed COVID-19 cases both locally and nationwide during the recovery period, and they were not attributed to the postpandemic economic recession.

Conclusions

The COVID-19 pandemic induced long-term negative effects on public sentiment in mainland China even as the country recovered from the pandemic. Our study findings remind public health and government administrators of the need to pay attention to public mental health even once the pandemic has concluded.

COVID-19 and psychological distress: Lessons for India

Purpose

The COVID-19 pandemic has undoubtedly altered the routine of life and caused unanticipated changes resulting in severe psychological responses and mental health crisis. The study aimed to identify psycho-social factors that predicted distress among Indian population during the spread of novel Coronavirus.

Method

An online survey was conducted to assess the predictors of distress. A global logistic regression model was built, by identifying significant factors from individual logistic regression models built on various groups of independent variables. The prediction capability of the model was compared with the random forest classifier.

Results

The respondents (N = 1060) who are more likely to be distressed, are in the age group of 21-35 years, are females (OR = 1.425), those working on site (OR = 1.592), have pre-existing medical conditions (OR = 1.682), do not have health insurance policy covering COVID-19 (OR = 1.884), have perceived seriousness of COVID-19 (OR = 1.239), have lack of trust in government (OR = 1.246) and whose basic needs’ fulfillment are unsatisfactory (OR = 1.592). The ones who are less likely to be distressed, have higher social support and psychological capital. Random forest classifier correctly classified 2.3% and 17.1% of people under lower and higher distress respectively, with respect to logistic regression.

Conclusions

This study confirms the prevalence of high distress experienced by Indians at the time of COVID-19 and provides pragmatic implications for psychological health at macro and micro levels during an epidemiological crisis.

"Stay at Home" in Italy during the COVID-19 Outbreak: A Longitudinal Study on Individual Well-Being among Different Age Groups

The restrictions imposed by the Italian government because of the coronavirus outbreak have been shown to be demanding on the Italian population. Data were collected at four different time points from 29 March 2020 to 3 May 2020 and during the final follow-up survey on 12 October 2020. In the present study, we provided longitudinal evidence on the relationship between the lockdown and mental health dimensions, such as emotional state, perceived stress, and time perspective, for three age groups. The results allowed us to observe their psychological status from different perspectives at five different time points. Notably, a negative effect of the lockdown individual well-beings emerged as a trend, and differences in individual adaptation strategies to a prolonged stressful situation were observed at the follow-up. Indeed, pairwise comparisons between age groups showed that the young adult group (18-23 years old) seemed to be the most psychologically affected by the lockdown. The findings are discussed according to the most recent literature on the topic. To the best of our knowledge, this is one of the first longitudinal studies carried out in Italy concerning the general psychological effects of the coronavirus lockdown.

Underlying the triple burden effects on women educationists due to COVID-19

COVID-19 causes a pandemic situation that increased the paid or unpaid responsibilities (home and job) on women and brought significant changes in their lifestyle, resulting in psychological and emotional stress. This paper draws attention to the triple burden on the women during this time when certain roles are supposed to be performed by the women regardless she is employed or homemaker. The paper highlights the challenges faced by women educationists in making themselves comfortable with the work-life balance with emerging challenges such as new technology-based innovative teaching methods and various learning software's, apps, platforms, etc.. The paper employs in-depth interviews of teachers belonging to three categories i.e. primary, secondary, and higher education. The findings reported that female teachers agreed that pandemic had affected their daily life schedule. This leaves a deep effect on their mental and psychological health due to multiple attentions they pay towards home management, child & elders extra care, challenges due to work from home pattern of organizations, increased attention to students due to online teaching, etc. The paper presents the implications for the society and government to understand the women's pressure so that a happy and satisfied life is there for all with no gender discrimination.

Academic and emotional effects of online learning during the COVID-19 pandemic on engineering students

The unprecedented situation of the COVID-19 pandemic has caused the closure of universities worldwide and has forced the transition to online learning. This exceptional context compels us to understand students' experience with online learning. Previous literature identifies relevant factors that intervene in the online education experience and can affect students' academic development. One of the main concerns is the students' mental health, given the lockdown restrictions under which classes have been conducted. Furthermore, the impact of the prolonged lockdown and the pandemic fatigue on university students and their academic experience is still unclear. This study delves into engineering undergraduate students' online education experience during the COVID-19 pandemic and its emotional impact across time. With this aim, a questionnaire was distributed to second, third, and fourth-year engineering undergraduate students at two time points, approximately six months apart. The results show significant differences in students' connection with other students and teachers, workspace conditions, and boredom between time points. Besides, the findings indicate significant correlations between academic development and quality of online classes, adaptation of the course, workspace conditions, and connection with other students and teachers, and also between students' emotions and connection with other students and teachers. Finally, the study identifies best practices carried out during online teaching that will be of value for future courses and engineering education beyond the pandemic situation, amongst which those related to effective communication with teachers stand out.

Psychological Health amidst COVID-19: A Review of existing literature in the Indian Context

The COVID-19 pandemic has emerged as a global health crisis. As of now, the total confirmed cases have exceeded 50 million and total deaths more than 1 million across the world. Such widespread diseases in the past have been associated with a surge in mental health disturbances. In this backdrop, the present review article pertains to discuss the overall impact of COVID-19 pandemic on mental health by synthesizing the existing literature from India, using PRISMA technique. The articles have been retrieved from Google scholar, NCBI and PubMed database. The result obtained on synthesizing the literature indicates that lockdown (home confinement) and social distancing as a measure to mitigate the outbreak of disease have affected physical and mental well-being. There has been an increase in the prevalence of anxiety and depressive disorders due to sustained stress related to COVID-19. It has led to a medico-socio-economic crisis around the world. The pandemic continues to evolve with several countries experiencing multiple waves due to continuous mutations in the virus. Hence, it is essential to carefully observe and monitor the impact of COVID-19 on the onset and progression of poor mental health.

Trajectories of depression, anxiety and pandemic experiences; A longitudinal study of youth in New York during the Spring-Summer of 2020

Initial reports suggest that mental health problems were elevated early in the COVID-19 pandemic. However, few studies have followed-up participants as the pandemic evolved and examined both between and within person predictors of symptom trajectories. In the current study, adolescents and young adults (N=532) in New York were surveyed monthly between March 27^th and July 14^th, 2020, a period spanning the first peak and subsequent decline in COVID-19 infection rates in the region. Surveys assessed symptoms of depression and anxiety using the Child Depression Inventory and the Screen for Child Anxiety Related Disorders, as well as experiences related to the pandemic. Multilevel growth modeling indicated that symptoms of depression and anxiety peaked around late April/early May and then decreased through May-July. Some pandemic experiences followed a similar quadratic trajectory, while others decreased linearly across the study. Specific relationships emerged between some types of pandemic experiences and depression and anxiety symptoms. While symptoms of depression and anxiety in youth may have been elevated early in the pandemic, these findings suggest they subsided across Spring-Summer of 2020, with higher levels of both corresponding to a period of peak infection rates and decreases paralleling the decline in pandemic experiences and COVID-19 infection rates.

Impact of Covid-19 outbreak on psychological health-The case of Bangladesh

BACKGROUND

The outbreak of COVID-19, a profoundly contagious disease has unnerved the world in a calamitous manner from diverse aspects. The present study ventures to expand the literature by exploring loneliness, social isolation, risk perception, financial distress, and psychological distress amidst the lockdown phase of the general population of Bangladesh.

METHODS

Through an online survey among 474 respondents (between April 17th and April 23rd, 2020), data were collected from the Bangladeshi residents (21 years or above). Descriptive and inferential statistical analyses were conducted using IBM Statistical Package for Social Science (SPSS) and Warp-PLS.

RESULTS

Findings suggest a strong positive correlation among the factors and social isolation, risk perception, financial distress are manifested as the predictors of psychological distress. Besides, females, aged people, and lower-income group are found to be more psychologically distressed.

CONCLUSION

This study yields new insights into the psychological facets of a lower-middle-income earning country, Bangladesh.

The impact of COVID-19 on prenatal care in the United States: Qualitative analysis from a survey of 2519 pregnant women

OBJECTIVE

To explore if and how women perceived their prenatal care to have changed as a result of COVID-19 and the impact of those changes on pregnant women.

DESIGN

Qualitative analysis of open-ended prompts included as part of an anonymous, online, cross-sectional survey of pregnant women in the United States.

SETTING

Online survey with participants from 47 states within the U.S.

PARTICIPANTS

Self-identified pregnant women recruited through Facebook, Twitter, and other online sources.

MEASUREMENTS AND FINDINGS

An anonymous, online survey of pregnant women (distributed April 3 - 24, 2020) included an open-ended prompt asking women to tell us how COVID-19 had affected their prenatal care. Open-ended narrative responses were downloaded into Excel and coded using the Attride-Sterling Framework. 2519 pregnant women from 47 states responded to the survey, 88.4% of whom had at least one previous birth. Mean age was 32.7 years, mean weeks pregnant was 24.3 weeks, and mean number of prenatal visits at the point of the survey was 6.5. Predominant themes of the open narratives included COVID-19's role in creating structural changes within the healthcare system (reported spontaneously by 2075 respondents), behavioral changes among both pregnant women and their providers (reported by 429 respondents), and emotional consequences for women who were pregnant (reported by 503 respondents) during the pandemic. Changes resulting from COVID-19 varied widely by provider, and women's perceptions of the impact on quality of care ranged from perceiving care as extremely compromised to perceiving it to be improved as a result of the pandemic.

KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

Women who are pregnant during the COVID-19 pandemic have faced enormous upheaval as hospitals and healthcare providers have struggled to meet the simultaneous and often competing demands of infection prevention, pandemic preparedness, high patient volumes of extremely sick patients, and the needs of 'non-urgent' pregnant patients. In some settings, women described very few changes, whereas others reported radical changes implemented seemingly overnight. While infection rates may drive variable responses, these inconsistencies raise important questions regarding the need for local, state, national, or even global recommendations for the care of pregnant women during a global pandemic such as COVID-19.

Prevalence of psychological disorders in the COVID-19 epidemic in China: A real world cross-sectional study

OBJECTIVE

This study aimed to explore the prevalence of psychological disorders and associated factors at different stages of the COVID-19 epidemic in China.

METHODS

The mental health status of respondents was assessed via the Patient Health Questionnaire-9 (PHQ-9), Insomnia Severity Index (ISI) and the Generalized Anxiety Disorder 7 (GAD-7) scale.

RESULTS

5657 individuals participated in this study. History of chronic disease was a common risk factor for severe present depression (OR 2.2, 95% confidence interval [CI], 1.82-2.66, p < 0.001), anxiety (OR 2.41, 95% CI, 1.97-2.95, p < 0.001), and insomnia (OR 2.33, 95% CI, 1.83-2.95, p < 0.001) in the survey population. Female respondents had a higher risk of depression (OR 1.61, 95% CI, 1.39-1.87, p < 0.001) and anxiety (OR 1.35, 95% CI, 1.15-1.57, p < 0.001) than males. Among the medical workers, confirmed or suspected positive COVID-19 infection as associated with higher scores for depression (confirmed, OR 1.87; suspected, OR 4.13), anxiety (confirmed, OR 3.05; suspected, OR 3.07), and insomnia (confirmed, OR 3.46; suspected, OR 4.71).

LIMITATION

The cross-sectional design of present study presents inference about causality. The present psychological assessment was based on an online survey and on self-report tools, albeit using established instruments. We cannot estimate the participation rate, since we cannot know how many potential subjects received and opened the link for the survey.

CONCLUSIONS

Females, non-medical workers and those with a history of chronic diseases have had higher risks for depression, insomnia, and anxiety. Positive COVID-19 infection status was associated with higher risk of depression, insomnia, and anxiety in medical workers.