Psychological Impact and Associated Factors During the Initial Stage of the Coronavirus (COVID-19) Pandemic Among the General Population in Spain

Our lifestyles are back to 'normal', but is our mental health? Longitudinal assessment of psychological distress during the COVID-19 pandemic among Spanish adults: April 2021 to August 2022

The COVID-19 pandemic had a detrimental effect on mental health since its start in 2020 and current data on mental health is limited. This study provides recent longitudinal data on psychological distress among a country-wide sample of adults. We recruited and surveyed 1,956 adults in Spain in April 2021 and August 2022 on sociodemographic- and pandemic-related psychological distress using the General Distress 21-item version of the Depression, Anxiety, and Stress Scale (DASS). Paired sampled t-tests assessed DASS scores by sex from April 2021 to August 2022; and one-way ANOVAs assessed DASS scores across sociodemographic characteristics. Results showed that psychological distress slightly improved across the total sample from April 2021 to August 2022; though females, young adults, students, and individuals with lower income experienced more psychological distress. Increases in severe stress scores were found particularly among men. Our data provides an overview of the psychological distress of Spanish adults 2.5 years into the pandemic and provides novel evidence that though life has resumed a sense of normalcy after the COVID-19 pandemic, the mental health of key populations (e.g., females, young adults, students, low-income) is still suffering and further intervention and resources are needed.

Impact of COVID-19 on individual mental health and maternal health services in Ethiopia: systematic review and meta-analysis

Background

The COVID-19 pandemic has caused a major outbreak in the 21st century and has led to significant mental health hazards worldwide. To address this issue, a systematic review has been conducted to analyze existing literature on the impact of COVID-19 on the psychological well-being of the general population, as well as the associated risk factors.

Methods

A comprehensive search was carried out on PubMed, Embase, Medline, Web of Science, and Scopus databases, covering all available literature up until February 20, 2024. This search was conducted in accordance with the PRISMA guidelines, ensuring a systematic approach. The selection of articles was based on predetermined eligibility criteria, ensuring the inclusion of appropriate and suitable research. In the final analysis, a total of 15 articles focusing on depression and anxiety, 11 articles on stress, and 7 articles on psychological problems were included. These articles specifically examined the outcome variables within the context of English language and specific areas. For the meta-analysis on maternal health services, 11 articles were included for family planning, 25 articles for postnatal care services, 16 articles for institutional delivery, and 14 articles for safe abortion services. These articles were carefully selected for the final pooled analysis.

Result

According to a recent systematic review, anxiety, depression, stress, and psychological distress have been prevalent in Ethiopia during the COVID-19 pandemic, with rates of 40, 41, 23, and 41%, respectively. The review also identified various sociodemographic factors that have impacted the country's response to the pandemic, including female gender, age, marital status, incarceration, low income, and lack of social support. Furthermore, the review found that maternal health services have experienced significant reductions during the pandemic.

Conclusion

The COVID-19 pandemic has led to a significant increase in psychological distress, which in some cases, is severe enough to require clinical treatment. It is crucial to prioritize efforts to address the negative impact of COVID-19 on mental health as a global public health priority. Additionally, it is important to pay attention to maternal health services during COVID-19 mitigation programs.

Associations of Anti-COVID-19 Measures and Lifestyle Changes During the COVID-19 Pandemic With Sleep Patterns in the Netherlands: A Longitudinal Study

Although there is scientific evidence for an increased prevalence of sleep disorders during the coronavirus disease 2019 (COVID-19) pandemic, there is still limited information on how lifestyle factors might have affected sleep patterns. Therefore, we followed a large cohort of participants in the Netherlands (n = 5,420) for up to 1 year (September 2020-2021) via monthly Web-based questionnaires to identify lifestyle changes (physical activity, cigarette smoking, alcohol consumption, electronic device use, and social media use) driven by anti-COVID-19 measures and their potential associations with self-reported sleep (latency, duration, and quality). We used the Containment and Health Index (CHI) to assess the stringency of anti-COVID-19 measures and analyzed associations through multilevel ordinal response models. We found that more stringent anti-COVID-19 measures were associated with higher use of electronic devices (per interquartile-range increase in CHI, odds ratio (OR) = 1.47, 95% confidence interval (CI): 1.40, 1.53), less physical activity (OR = 0.94, 95% CI: 0.90, 0.98), lower frequency of alcohol consumption (OR = 0.63, 95% CI: 0.60, 0.66), and longer sleep duration (OR = 1.11, 95% CI: 1.05, 1.16). Lower alcohol consumption frequency and higher use of electronic devices and social media were associated with longer sleep latency. Lower physical activity levels and higher social media and electronic device use were related to poorer sleep quality and shorter sleep duration.

Health Protection And Improvement Sensitivity For Covid-19 Pandemic: Turkey's Case

This descriptive study was aimed at identifying the anxiety levels of Turkish people in the first three months of the pandemic, the coping methods they use to control this anxiety, and their knowledge and behavior about protection and prevention against COVID-19. The data were collected from 571 individuals. Of the individuals, 84.6% had anxiety. The anxiety levels of those who kept working during the pandemic were significantly higher than were the anxiety levels of those who did not (p < .05). The participants experienced a moderate level of anxiety, and they mostly used relaxation techniques, music therapy, and prayer/worship to cope with anxiety. The knowledge level of the individuals about COVID-19 was moderate.

Understanding the Psychological Risks to Maternal Mental Health, Maternal-Infant Bonding, and Infant Development During the COVID-19 Pandemic

This short review summarizes two recent U.S.-based studies in which researchers evaluated the impact of the COVID-19 pandemic on postpartum outcomes. The first study examined the neurodevelopmental status of infants born to women infected with SARS-CoV-2, and the second examined psychological risks to maternal-infant bonding. Results indicated that pandemic-related stressors likely contributed to diminished maternal-infant health outcomes. It is imperative that nurses stay informed on the latest science exploring the impact the pandemic has had on the health and well-being of pregnant persons and infants.

Exploring the Psychological Impact of Quarantine: An Investigation into Eating Patterns, Emotions, and Loneliness During the COVID-19 Pandemic in Greece

PURPOSE

The implementation of quarantine measures in response to the COVID-19 pandemic presented challenges linked to adverse psychological effects, notably affecting individuals' eating patterns. This study aimed to investigate the eating patterns of individuals during lockdowns compared across sex, age, and income levels, and examine the influence of positive and negative emotions, as well as loneliness, on these patterns.

METHODS

A cross-sectional online study was conducted with 450 participants (aged 18-74 years old). One questionnaire about demographics, the Demographic Questionnaire, and three validated self-report scales (Eating Attitudes Test, comprising the Dieting, Bulimia, and Food Preoccupation, and Oral Control subscales, the Modified Differential Emotions Scale, and the UCLA Loneliness Scale) were employed. Convenience and snowball sampling were used. The data were collected between April and May 2021, primarily through social media platforms, such as Facebook, Instagram, and Twitter. The survey questionnaire was shared via these platforms and users could answer if they wanted. Also, they were asked to send the questionnaire to their close contacts. Additionally, the survey questionnaire was distributed face-to-face to 80 participants. The statistical analyses included linear regression and mediation analyses.

RESULTS

 Abnormal eating patterns (e.g. eating behaviors that tend to have signs of diet such as constant avoidance of fattening foods, the individual's involvement with becoming leaner, extreme control or preoccupation with food, overeating and purging methods) were identified in 25% of the 450 participants participated in this survey, aged 18-74 years. Moderate levels of negative/positive emotions and loneliness were predominantly reported. Female sex was significantly associated with abnormal eating patterns (p=0.010), particularly dietary behaviors (p=0.029). Negative emotions (p=0.032) and loneliness (p=0.001) emerged as predictive factors for overall eating patterns and bulimic behaviors. Negative emotions exhibited a direct correlation with eating patterns, while loneliness played a significant mediating role (p=0.032). Furthermore, the association between negative emotions and bulimia was partially mediated by loneliness (p=0.018).

CONCLUSIONS

This study underscores the pivotal roles of negative emotions and loneliness in shaping eating patterns during quarantine. Multilevel public health interventions are needed to address the negative effects of quarantine and pandemics in general. Screening tests for mental health in the school and job environments could highlight the need for shaping interventions, such as counseling, group empowerment, and family support in order to mitigate the negative impact of the COVID-19 pandemic on eating behaviors and mental health in general.

The privilege of working from home and health disparities during the covid-19 pandemic in major American cities

Working from home (WFH) has been adopted as a key mitigation strategy in the COVID-19 pandemic; yet few research has studied its impact on pandemic outcomes. Using multiple sources of data including cellphone data and online survey during the pandemic, this study investigates the effect of WFH on intra-city health disparities during the COVID-19 pandemic in American cities. Pandemic data for zip code tabulation areas and cellphone mobility data for census block groups in New York City (NYC), Chicago, and Philadelphia are converted to census tract level, which are then merged with 2019 census data. WFH is measured with the proportion of workers who potentially can telework based on employment composition in census tracts and percentages of jobs in each industry that actually WFH during the pandemic. Results show that while infection and death rates are higher in NYC, intra-city disparities in pandemic outcomes are more pronounced in Philadelphia. Poisson regressions show a negative association between WFH and COVID-19 infection and death rates in NYC and Chicago, which is weakened by increased time spent at home during the pandemic and in minority neighborhoods (in NYC). In Philadelphia, WFH is barely relevant for infection rates but has a marginally positive association with death rates, which is also moderated by the time spent at home. This study demonstrates the relative effectiveness of WFH in mitigating pandemic outcomes and underscores the intersectionality between WFH and race/ethnicity and resident behaviors. It provides important policy implications for future pandemic mitigation.

How has our primary-care NHS-IAPT provision for PTSD adapted to the pandemic? A service evaluation of recovery pre-COVID-19 and peri-COVID-19

BACKGROUND

Mental health issues have been an ongoing major cause of global disability exacerbated by the COVID-19 pandemic. The unique challenges have been the high contagiousness of COVID-19 and atypical PTSD presentations e.g., ICU-PTSD. This has led to increased demand on mental health services which have had to vary their provision for example working remotely vs. the traditional face-to-face. The pandemic has also exposed the preexisting health inequalities related to sociodemographic variables. In the UK, NHS-IAPT is the main primary-care provider which has suffered these repercussions. Research from COVID-19 and previous viral outbreaks has estimated an increase in the prevalence of PTSD. Although services have been urged to monitor their provision, research on PTSD remains scanty. The current NHS-IAPT service was concerned about these ramifications of the pandemic and also wished to address the gap in the research. The aim was to conduct an evaluation of the impact of the COVID-19 on PTSD recovery. The first question evaluated the impact, and the second question evaluated the associated variables.

METHODS

The study employed a quantitative data analysis method. Data were extracted and analysed from the electronic database, IAPTus. The study evaluated PTSD recovery rates during pre-pandemic and peri-pandemic periods. The comparisons determined the impact of the pandemic as well as what recovery variables were significant. The data were analysed statistically using both descriptive statistics and inferential statistics (t-test and Chi-square). The data were analyzed in reference to the national NHS-IAPT standards via NHS-Digital.

RESULTS

The findings suggest that the pandemic had no significant impact on overall PTSD recovery rates, which also aligned with the national standards. These recovery rates fell below the target national standard of 50% regardless of the pandemic. Several client, service and treatment variables were shown to be associated with PTSD recovery rates.

CONCLUSIONS

This evaluation highlights a pre-existing problem around the persistently low PTSD recovery rates. It also identifies variables that warrant further research in order to improve PTSD service-provision and mitigate any long-term pandemic impacts. This study also provides information for other services wishing to enhance their PTSD recovery rates.

Telehealth program for symptomatic COVID-19 patients in Mindanao, Philippines: a whole-of-system, pragmatic interventional study on patient monitoring from isolation facilities to community reintegration

The COVID-19 pandemic is impacting individuals and society's physical and mental health. Despite the lack of any definite and effective therapeutic regimen, public health measures such as quarantine and isolation have been instituted to contain this pandemic. However, these mitigating measures have also raised issues regarding isolated patients' mental and psychological well-being. Several stakeholders were engaged in this approach, including the university, the local health office, the tertiary hospital, and the local communities. This intervention addresses concerns regarding the health status of isolated individuals due to COVID-19 infection, making the program available to anyone who agrees to participate. This was done through telehealth services delivered via phone calls and SMS. The university provided technical support and telehealth manpower through medical students. The local health unit manages the isolation facilities, while the referral hospital offers specialty care for isolated patients through teleconsultation. Finally, the local community is the one that reintegrates discharged patients into their communities. Three hundred forty-four (344) participants were provided seven sessions on telehealth education and tracking of their COVID-19 prescribed practices and mental health. The mean age of the patients was 37 years; half were females, and 15% had comorbidities. Regarding their mental health status, the level of depression dropped from 6% to 1% (p<0.0001), the level of anxiety dropped from 12% to 2% (p<0.0001), and the level of stress dropped from 3% to 0% (p<0.0001) from the first day of admission to 2 weeks after discharge. Moreover, a general trend of statistically significant increase in various practices was noted: wearing face masks, physical distancing, disinfecting frequently held objects, hand hygiene, and self-monitoring for COVID-19 symptoms. Those with progressing symptoms of COVID-19 were referred immediately to the referral hospital. There were also no reports of complications of co-morbidities during their stay in the isolation facilities or social isolation upon community reintegration. The study concludes that telehealth services have the potential to address many challenges in providing continuous healthcare services to isolated patients until they are reintegrated into their community. Furthermore, a whole-of-society approach is necessary to provide holistic care to patients affected by the pandemic.

Differences in Depression, Anxiety, and Stress in Relation to Changes in Living Conditions, Work Conditions, and Daily Life During the COVID-19 Pandemic in Jordan

Introduction

The COVID-19 pandemic was associated with numerous changes in daily life conditions that could affect the psychological response of individuals worldwide.

Objective

The study aimed to describe and examine differences in depression, anxiety, and stress in relation to living conditions during the COVID-19 pandemic.

Methods

A cross-sectional design was used. Purposive snowball sampling was employed to include 642 participants. Arabic versions of the Depression, Anxiety, and Stress Scales were used to collect data. Descriptive statistics, t-test, ANOVA, and Pearson's correlation were used to analyze the data.

Results

The total mean scores of depression, anxiety, and stress were 12.26 (SD = 10.53), 9.04 (SD = 9.34), and 13.49 (SD = 10.72), respectively. Of the study sample, 122 (19.5%), 139 (22.2%), and 99 (15.9%) had severe to extremely severe levels of depression, anxiety, and stress, respectively. Significant differences were found in depression, anxiety, and stress in relation to age, chronic diseases, and house size.

Conclusion

The findings showed an increased prevalence of depression and anxiety during the COVID-19 pandemic. Mental health practitioners need to recognize the impact of pandemics on youth, females, low-income populations, and individuals with chronic diseases. Preventive mental health services among these populations, such as screening and counseling, would help reduce the health risks.

Professional and Psychological Influence of the COVID-19 Pandemic on the Training of Medical Residents

OBJECTIVES

Coronavirus disease 2019 (COVID-19) has profoundly impacted residency and fellowship training and education. However, how and to what extent the COVID-19 pandemic in Lebanon compromised the daily involvement of trainees on the clinical and ethical levels is currently unknown, which this study will shed light on.

METHODS

We conducted a cross-sectional survey (30 questions) targeting medical residents delivering healthcare services in Lebanon. Residents from different specialties were included in the study to assess the effect of the pandemic on their education and the ethical obstacles they faced when dealing with patients.

RESULTS

A total of 221 postgraduate medical students participated in our study. Results showed that about half of the residents (52.1%) were only able to do a basic physical examination rather than a full examination as a mandatory requirement in the residency curriculum. The majority (60%) agreed that the doctor-patient relationship is contravened. In addition, almost all residents suffered from fear and emotional distress that affected their education (83.7%).

CONCLUSION

The findings of this study identify the effect of COVID-19 on residents' training, which affects treatment outcomes and greatly impacts the mental well-being of both healthcare workers and patients.

Impact of the COVID-19 pandemic on the Thai population: Delineating the effects of the pandemic and policy measures

Objectives

This study aimed to determine the impacts of the COVID-19 pandemic and policy measures and delineate the impact of each on a cohort of Thai citizens.

Methods

A cross-sectional study was conducted among 2,500 Thai people from October 2020 to January 2021. A questionnaire collecting demographic information and other data was sent to eligible subjects.

Results

Overall, 51.6% and 49.5% of participants felt the impacts of COVID-19 and policy measures at the highest level, respectively. The study demonstrated that the weighted effect of the impact of the COVID-19 outbreak was statistically (p < .001) greater than that of policy measures on family (0.664 vs 0.618), education (0.562 vs 0.557), and the economy (0.643 vs 0.572). The weighted effect of the impact of policy measures was statistically (p < .001) greater than that of the COVID-19 pandemic on people's daily activities (0.675 vs 0.651), cultural/traditional or community way of life (0.769 vs 0.736), access to healthcare services and infection prevention supplies (0.410 vs 0.390), and mental health (0.625 vs 0.584).

Conclusions

About half of the participants had a high level of impact from both the COVID-19 pandemic and policy measures. The results of this study suggest that policy measures need to be judged with caution, and the government should provide more comprehensive support to reduce the impact on people's lives.

Predictors of Intention to Vaccinate or Continue to Vaccinate Children Against SARS-CoV-2 During the Fifth Wave of the COVID-19 Pandemic in the USA

The Centre for Disease Control recommends vaccination of children against SARS-CoV-2 to reduce the severity of COVID-19 disease and reduce the likelihood of associated complications. Vaccination of children requires the consent of parents or guardians, and levels of consent may ebb and flow over the course of the pandemic. This exploratory study examines predictors of parental intentions to vaccinate their children and the speed with which they would have them vaccinated during the fifth wave of the pandemic when vaccines were just being approved for use in children using a convenience sample of 641 parents reporting on 962 children. Multi-level regression analyses demonstrated regional differences in likelihood, with those in the Northeast reporting higher likelihood than those in the West. Parents with a conservative belief system were less likely to want to have their children vaccinated. Parents were more likely to have their child vaccinated if the child had COVID-19-related health risks, their child had a more complete vaccination history, and COVID-19 was perceived to be a greater threat to oneself and one's family. Faster intended vaccination speed was associated with regional urbanicity, liberal belief systems, more complete vaccination histories, and parental COVID-19 vaccination history. Higher levels of parental anxiety and lower levels of perceived vaccine danger were associated with increased speed. The severity of the COVID-19 pandemic within one's county was marginally related to speed, but not likelihood. These results underscore the importance of regular assessment of parental intentions across the pandemic, for practitioners to probe parental anxiety levels when discussing vaccination, to explicitly address risk/benefit analyses when communicating with parents, and to target previously routine unvaccinated parents and those in more rural areas to increase vaccine uptake. Comparisons are made with Galanis et al.'s (2022) recent meta-analysis on the topic.

Mediating Role of Viral Anxiety and Insomnia in Relationship Between Work-Related Stress and Depression Among Cold Chain Workers During COVID-19 Pandemic

BACKGROUND

Here we investigated whether cold chain workers' insomnia, work-related stress, and viral anxiety contributed to their depression. Furthermore, we investigated the role of viral anxiety in mediating the association between work-related stress and depressive symptoms.

METHODS

All 200 invited cold chain workers voluntarily responded to an online survey. All were working at a market in Taiyuan, Shanxi Province, China, and responsible for testing nucleic acids in imported cold chain foods and disinfecting outer packaging at government request. We collected their demographic variables and rated their symptoms using the Stress and Anxiety to Viral Epidemics-6 Items (SAVE-6), Patient Health Questionnaire-9, Insomnia Severity Index (ISI), Perceived Stress Scale (PSS), and Maslach Burnout Inventory - General Survey (MBI-GS).

RESULTS

Cold chain workers' depression was significantly correlated with higher SAVE-6 (r = 0.450, P < 0.01), ISI (r = 0.603, P < 0.01), MBI-GS (r = 0.481, P < 0.01), and PSS (r = 0.390, P < 0.01) scores. SAVE-6 score was significantly correlated with ISI (r = 0.462, P < 0.01), MBI-GS (r = 0.305, P < 0.01), and PSS (r = 0.268, P < 0.01) scores. Linear regression revealed that their depression was predicted by SAVE-6 (β = 0.183, P = 0.003), ISI (β = 0.409, P < 0.001), and MBI-GS (β = 0.236, P = 0.002, adjusted R² = 0.440, F = 40.04, P < 0.001) scores. Mediation analysis showed that their burnout directly influenced their depression, while viral anxiety or insomnia severity mediated the influence of burnout on depression.

CONCLUSION

The study showed that burnout was a direct cause of depression and that viral anxiety and insomnia severity mediated the relationship between burnout and depression.

Factors associated with late gestational age of diagnosis and/or delayed referral of fetuses with major structural malformations: A study in a tertiary care hospital in South India

OBJECTIVES

To evaluate the factors related to delayed diagnosis or referral of women with major congenital malformations in a tertiary care hospital in South India, with a specific emphasis on the socioeconomic and psychosocial aspects.

METHODS

A retrospective analysis was conducted on 107 pregnant women with confirmed fetal anomalies at Jawaharlal Institute of Postgraduate Medical Education and Research. Both qualitative and quantitative data were collected on factors related to the patient, physician, and healthcare system that could have contributed to the delay.

RESULTS

In our study of 107 patients, 98.1% had at least one antenatal check-up before 20 weeks. Among them, 75.2% (79/107) were advised to undergo a mid-trimester anomaly scan, and 70.8% (56/79) actually underwent the scan. However, 62.5% (35/56) of those who had the scan performed at the appropriate time had undetected abnormalities. Retrospective analysis showed that 28.5% (10/35) of these anomalies could have been detected as early as 12-14 weeks of gestation. Additionally, 24.3% (26/107) of women were advised to undergo scans at or after 20 weeks and 4.7% (5/107) had anomalies detected during the scan but were unaware about the findings until subsequent visits. Inadequate healthcare professional training, busy schedules, lack of awareness, and communication gaps were identified as potential reasons for delayed diagnosis. Psychosocial factors such as denial, fear, emotional distress, and anxiety also influenced decision-making and contributed to delayed medical care.

CONCLUSION

Addressing healthcare provider training, communication between the healthcare professionals and the patients, and psychosocial factors are essential to prevent delays and improve pregnancy management. Future interventions should focus on awareness, providing comprehensive information, and support for parents facing fetal anomalies.

The pandemic's unseen wounds: COVID-19's profound effects on mental health

Objective

This review aims to explore the impact of the COVID-19 pandemic on mental health, with a focus on the physiological and psychological consequences, including comorbidities. The goal is to understand the direct and indirect populations affected by mental distress and identify potential interventions.

Methodology

A comprehensive literature search was conducted using various databases, including Google Scholar, ResearchGate, ScienceDirect, PubMed, PLoS One, and Web of Science. The search utilized relevant keywords to investigate the direct and indirect impacts of COVID-19 on mental health. The selected articles were critically evaluated and analyzed to identify key findings and insights.

Main findings

Mental health, being an intrinsic component of overall well-being, plays a vital role in physiological functioning. The COVID-19 pandemic, caused by the emergence of the novel SARS-CoV-2 virus, has had a devastating global impact. Beyond the respiratory symptoms, individuals recovering from COVID-19 commonly experience additional ailments, such as arrhythmia, depression, anxiety, and fatigue. Healthcare professionals on the frontlines face an elevated risk of mental illness. However, it is crucial to recognize that the general population also grapples with comparable levels of mental distress.

Conclusion

The COVID-19 pandemic has underscored the significance of addressing mental health concerns. Various strategies can help mitigate the impact, including counselling, fostering open lines of communication, providing mental support, ensuring comprehensive patient care, and administering appropriate medications. In severe cases, treatment may involve the supplementation of essential vitamins and antidepressant therapy. By understanding the direct and indirect impacts of COVID-19 on mental health, healthcare providers and policymakers can develop targeted interventions to support individuals and communities affected by the pandemic. Continued research and collaborative efforts are essential to address this pervasive issue effectively.

Physical activity and sedentary time distribution among adult residents during COVID-19 circuit breaker movement restrictions in Singapore: a public health perspective

Introduction

Social lockdowns and quarantines have been enforced in various populations to mitigate the spread of coronavirus disease 2019 (COVID-19) in the community. This study investigated the impact of COVID-19 lockdown, known as circuit breaker movement restrictions (CBMR), on physical activity (PA) and sedentary time (ST) distribution patterns among Singapore residents aged 21-65 years.

Methods

This was a cross-sectional retrospective study that utilised a 44-item questionnaire that included sections to determine PA and ST distribution patterns before and during CBMR. It also included information on sleep duration, PA preference and routine, awareness of local initiatives and perceptions on barriers towards PA during the CBMR period.

Results

There was an overall decrease in PA and a significant increase in physical inactivity and ST during the CBMR period. A greater proportion of participants reported sleeping for longer hours, suggesting positive adaptations in sleep habits during CBMR. Majority were unaware of online exercise initiatives and programmes offered during the CBMR period, and >50% of the respondents never used an online resource for exercise. Singapore residents seemed to prefer outdoor and facility-based venues for exercise and PA, and closure of facilities was the primary barrier for PA during the CBMR period.

Conclusion

Reduced PA and increased ST during CBMR reflect negative lifestyle adaptations and may have adverse public health implications. Increased sleep duration suggests successful coping, which may consequently lead to physical and mental health benefits. While Singapore adult residents may be flexible with certain aspects of being physically active, they seemed less adaptive to changes in type of exercise, facility and environment.

Two-year follow-up of post-traumatic stress disorder symptoms in healthcare workers after the COVID-19 pandemic in China

OBJECTIVES

This study aimed to conduct a 2-year follow-up of mental disorders in healthcare workers (HCWs) in a region of China outside the epidemic's core zone who happened to be directly or possibly exposed to persons with COVID-19.

MATERIAL AND METHODS

A cognitive analysis scale was utilized in the evaluation the mental or emotional state of HCWs at Xuzhou Medical University's affiliated hospital in the city of Xuzhou, China (a non-core epidemic area) 2 years after the first assessment during the COVID-19 pandemic. A total of 165 HCWs were selected as the study subjects. In accordance to the exposure risk of COVID-19 patients, the subjects were separated into 2 categories: a group with a high risk HCW (HHCW) (HCWs working in COVID-19-positive wards; N = 91) and a group with a minimal risk HCW (LHCW) (HCWs who worked in wards without COVID-19 patients at the same hospital; N = 75). The clinical as well as demographic information of every HCWs were collected.

RESULTS

The demographic data revealed significant differences in terms of occupation, remuneration, and selfless concerns amidst both categories (p < 0.05). There lacked a statistically notable difference in the occurrence of PTSD between the 2 groups. Data was analyzed for factors associated with PTSD, and the results showed that psychological resilience, job risk, and stress in the workplace were risk factors for PTSD. Additionally, the results of the logistic regression analysis showed that psychological resilience was a significant shared risk factor for PTSD in HCWs after the COVID-19 pandemic.

CONCLUSIONS

The 2-year follow-up showed no statistical difference in the incidence of PTSD between the HHCW group and the LHCW group. Workplace stress, occupational hazards, and psychological resilience were the major contributing risk factors for PTSD in HCWs. Int J Occup Med Environ Health. 2023;36(3):324-32.

Impact of COVID-19 on Mothers Raising Children with Special Needs: Insights from a Survey Study

Home confinement during the COVID-19 outbreak had psychological effects that continue to be explored by researchers. This study investigated factors influencing the mental health of mothers caring for special needs children in Italy's first lockdown. Specifically, we investigated the relationships between emotional states of depression, anxiety, stress, perceived distress related to home confinement, coping strategies, and other contextual variables (such as opportunities for distance learning and remote working) in a group of 68 mothers of children with special needs and 68 matched mothers of typically developing children. Data from an online survey showed no significant difference between the two groups. However, the research revealed that being a remote worker was a significant predictor of reduced stress in mothers of children with special needs, while distance learning was a significant predictor of reduced stress in mothers of typically developing children. In addition, the study found that hyperarousal symptoms were predictive of stress in mothers of children with special needs, while intrusive thoughts and avoidance coping were predictive of stress in mothers of typically developing children. In conclusion, further research is needed to develop effective support and intervention strategies for families with children with special needs and to deeply investigate the impact of flexible work arrangements and social aid on the mental health of mothers in non-emergency settings.

Scoping review of the methodology of large health surveys conducted in Spain early on in the COVID-19 pandemic

Background

The use of health surveys has been key in the scientific community to promptly communicate results about the health impact of COVID-19. But what information was collected, where, when and how, and who was the study population?

Objective

To describe the methodological characteristics used in large health surveys conducted in Spain early on in the COVID-19 pandemic.

Methods

Scoping review. Inclusion criteria: observational studies published between January 2020 and December 2021, with sample sizes of over 2,000 persons resident in Spain. Databases consulted: PubMed, CINAHL, Literatura Latinoamericana y del Caribe en CC de la Salud, Scopus, PsycINFO, Embase, Sociological Abstracts, Dialnet and Web of Science Core Collection. We analyzed the characteristics of the literature references, methodologies and information gathered in the surveys selected. Fifty five studies were included.

Results

Sixty percentage of the studies included had mental health as their main topic and 75% were conducted on the general adult population. Thirteen percentage had a longitudinal design, 93% used the internet to gather information and the same percentage used non-probability sampling. Thirty percentage made some type of sampling correction to reduce coverage or non-response biases, but not selection biases. Sixty seven percentage did not state the availability of their data.

Conclusions

Consistent with the extensive use of non-probability sampling without any bias correction in the extraordinary setting created by COVID-19, quality population frameworks are required so that probability and representative samples can be extracted quickly to promptly address other health crises, as well as to reduce potential coverage, non-response and particularly selection biases by utilizing reweighting techniques. The low data accessibility despite the huge opportunity that COVID-19 provided for Open Science-based research is striking.

Hidden faces, altered perceptions: the impact of face masks on interpersonal perception

The pandemic has made wearing masks commonplace, prompting researchers to investigate their effects on interpersonal perception. Findings indicate masks obstruct face identification and expression recognition, with lower face cues being most affected. When judging attractiveness, masks can enhance the appeal of less attractive faces, but reduce the appeal of more attractive faces. Trust and speech perception outcomes are inconclusive. Future studies could focus on individual differences in how masks influence our perception of others.

COVID-19 pandemic: Evaluating its psychological impact and individuals' depression, anxiety, and stress levels

Background

The COVID-19 pandemic is a global public health problem affecting mental health, and basic data are required for evidence-based mental health interventions. This study aimed to identify the prevalence of psychological impacts, anxiety, depression, stress, and any associated risk factors in individuals living in Turkey during the COVID-19 pandemic.

Materials and methods

The population of this descriptive study consisted of individuals over the age of 18 living in Turkey. The data were collected between July-September 2020 using the snowball sampling method. The study was completed with 1733 participants. The data were collected using the Impact of Events Scale-Revised and the Depression Anxiety Stress Scale. Statistical analyses included percentage, mean, standard deviation, a Chi-square test, a Mann Whitney U test, Kruskal Wallis and Tamhane's T2 post hoc, and Spearman's correlation. P < 0.05 was considered statistically significant.

Results

45.1% had moderate or severe psychological effects; 42.7% had a moderate or severe depression, 31.7% had moderate or severe anxiety, and 28.5% had moderate or severe stress levels. Being a woman, being single, unemployment, smoking, the presence of chronic diseases, being young (<35), being a university graduate, having a household size of 5 or more, a low income, having poor health, and being underweight were significantly correlated with some psychological impact, depression, anxiety, and stress levels of people.

Conclusion

During the pandemic period, almost half of the respondents were found to experience some psychological impact of the pandemic and have negative moderate to severe mental health levels. Risk groups for mental health were identified.

Occupational stress of elementary school teachers after eased COVID-19 restrictions: a qualitative study from China

Background

On December 7, 2022, China optimized its virus response and significantly shifted its epidemic policy by downgrading COVID management and gradually restoring offline teaching in schools. This shift has brought many impacts on teachers.

Aims

Through qualitative research of thematic analysis, this paper studies the occupational pressure of primary school teachers in China after the shift in epidemic policy.

Methods

Two recruitment methods are adopted for this study. One was to email the principals of several primary schools in Zhejiang Province to introduce the research project and indicate the idea of recruiting participants. With their help, we have found teachers who volunteer to participate. The second was to release recruitment information in the network forum (e.g., online teacher forums) to find volunteer participants. Through semi-structured interviews and diaries, 18 primary school teachers from different regions and schools in Zhejiang Province were interviewed. All responses in the interviews were transcribed anonymously. Braun and Clarke's thematic analysis was used to analyze the participants' responses.

Results

Eighteen participants took part in the research project. Forty-five final codes, generated from 89 codes initially obtained from the dataset, are classified into five final themes: uncertainty, overburdened, neglected, worry about students, and influence, which reflect the professional stress of primary school teachers following the epidemic prevention policies relaxed.

Conclusion

Five themes were identified in the research. The problems described by the participants include burdensome offline activities, being disturbed out of hours, and appearing understaffed for the infection. These problems harmed the participants' mental health, including anxiety, fatigue, stress, and other adverse psychological conditions. Awareness and attention to the psychological situation of primary school teachers after the eased COVID control are crucial. We believe protecting teachers' mental health is necessary, especially in this particular period.

Mediator role of resilience in the relationship between neuroticism and psychological symptoms: COVID-19 Pandemic and supermarket employees

The current research aimed to examine the relationship between personality traits, resilience, and psychological symptom levels of front-line supermarket employees during the COVID-19 pandemic. Three-hundred and ten (310) supermarket employees participated in the research between March and May 2021. Participants filled out the questionnaire sets online The Demographic Information Form, Symptom Checklist, Five Factor Inventory and Resilience Scale for Adults were presented as questionnaire sets. Pearson Correlation Analyses were conducted to determine the relationships between variables, Multiple Regression and mediation analyses were conducted to discover the predictors of symptom level. It was found that personality traits, resilience and psychological symptom levels are related to each other. Conscientiousness, neuroticism, openness and resilience are significant predictors of psychological symptom level. In addition, resilience plays a mediating role in the relationship between neuroticism and psychological symptom levels. The findings were discussed within the framework of the relevant literature and COVID-19 research findings.

The magnitude and associated factors of anxiety and depression among non-communicable chronic disease patients during COVID-19 pandemic in a resource-limited setting

Objective

To assess the magnitude and associated factors of depression and anxiety among chronic disease patients during the COVID-19 pandemic at the University of Gondar Comprehensive and Specialized Hospital, Northwest Ethiopia 2021.

Methods

A cross-sectional study was done from June 1 to August 30, 2021 among non-communicable chronic disease patients. A systematic random sampling technique was used to collect data from 400 patients. Data were entered into EPI Info and to SPSS version 23 for analysis. Descriptive data analysis was done and bivariable and multi-variable logistic regression was used to identify factors. Variables with a p-value of 0.05 were considered statically significant.

Results

The mean age of the respondents was 51.3 ± 0.8 years. The prevalence of anxiety and depression among non-communicable chronic disease patients was 17.9% (95%CI 14.2, 21.7) and 16.3% (95%CI 12.6, 20.1)) respectively. Being female (AOR = 2.56, 95% CI: 1.21, 5.41), divorced (AOR = 3.42, 95% CI: 1.02-11.50), and ever cigarette smoking (AOR = 5.00, 95% CI: 1.66-14.90) were significantly associated with depression. Whereas, ever cigarette smoking (AOR = 2.74, 95% CI: 1.04, 7.21), number of closed contacts (AOR = 1.16, 95% CI: 1.03, 1.31), and poor social support (AOR = 2.98, 95% CI: 1.16, 7.65) were significantly associated with the anxiety.

Conclusion

The magnitude of depression and anxiety was high. Thus, appropriate action should be taken to identify those patients and integration of psychiatric care into the usual care of non-communicable chronic disease patients is vital.

So far but yet so near: Examining the buffering effect of perceived social support on the psychological impact of Spanish lockdown

The main objective of this study was to examine the moderating or buffering effect of social support (SS) perceived by university students on the psychological impact of lockdown on mental health. Specifically, a total of 826 participants (622 women) completed an online survey that included standardized measures of anxiety (Generalised Anxiety Disorder-7), depression (Patient Health Questionnaire-9), and irritability (Brief Irritability Test), as well as measures of stressors, perceived SS, and self-perceived change in mental health. The results of hierarchical regression analyses suggest that SS contributes toward attenuating the negative impact of academic stressors, general overload, and interpersonal conflict on the indicators of psychological well-being; however, moderation analysis only confirms the buffering effect for symptoms of anxiety. In conclusion, it is suggested that SS networks need to be strengthened as a basic means of protecting health and well-being during unexpected disasters.

Prevalence and Associated Factors of Depressive Symptoms Among Mizan-Tepi University Students During the COVID-19 Pandemic

BACKGROUND

Depression is an extremely common and widespread problem among university students. A better understanding of the magnitude and determinants of depressive symptoms is required to create appropriate interventions for those groups. This study aimed to assess the prevalence and predictors of depressive symptoms among Mizan-Tepi University students during the pandemic lockdown.

METHODS

From September 11th to September 25th, 2020, 779 Mizan-Tepi University students participated in this web-based cross-sectional study. The link was created with a Google Form, and the questionnaire was distributed to participants via e-mail, WhatsApp, Telegram, and other social media accounts. To determine the prevalence and determinants of depressive symptoms, both descriptive and inferential analyses were used. The chi-squared test of association and logistic regression were used to identify predictors of depressive symptoms among university students. We used (IBM) SPSS version 20 for all statistical analyses.

RESULTS

The prevalence of depressive symptoms among university students was 39.5%. According to results of multivariable binary logistic regression, being female (AOR = 0.339, 95%CI: 0.220-0.522), being an alcoholic (AOR = 2.101, 95%CI: 1.452-3.041), smoking (AOR = 2.088, 95%CI: 1.460-2.986), being quarantined for 14 days (AOR = 1.775, 95%CI: 1.231-2.560), frequently using social media (AOR = 1.510, 95%CI: 1.063-2.145), fearing COVID-19 (AOR = 5.058, 95%CI: 3.508-7.292), having sleeping problems (AOR = 1.703, 95%CI: 1.051-2.760), having a family member infected with COVID-19 (AOR = 1.829, 95%CI: 1.211-2.763), being exposed to COVID-19 (AOR = 1.748, 95%CI: 1.114-2.743), monthly disposable income ≥ 501 ETB (AOR = 0.531, 95%CI: 0.359-0.784), having a higher level of hope (AOR = 0.158, 95%CI:0.056-0.447), and having high social support (AOR = 0.546, 95%CI: 0.374-0.797) were significantly associated with depressive symptoms among students.

CONCLUSION

In this study, the prevalence of depressive symptoms was found to be high among university students. Being an alcoholic, smoking, quarantined for 14 days, frequently using social media, fearing COVID-19, having sleep problems, having a family member infected with COVID-19, and being exposed to COVID-19 were all associated with an increased risk of developing depressive symptoms, while being a female, having a high level of disposable monthly income, hope, and social support decreased the risk of depressive symptoms among university students. Interventions should be put in place to promote mental health among university students.

COVID-19 anxiety and quality of life among adolescent pregnant women: a cross-sectional study

OBJECTIVES

To determine the relationship between the COVID-19 anxiety and the quality of life among adolescent pregnant women in Dashtiari city, Iran.

METHODS

In this cross-sectional study, 216 adolescent pregnant women in Dashtiari city, Iran in 2021 who met the inclusion criteria participated in a multi-stage sampling. Data collection tools included: demographic information, COVID-19 Anxiety Scale and a questionnaire of quality of life. Finally, the obtained data were analyzed in SPSS software version 21 using descriptive, Chi-square, Tukey and logistic regression tests.

RESULTS

The results showed that 74 (34.3%) adolescent pregnant women had weak COVID-19 anxiety, 23 (10.6%) had moderate COVID-19 anxiety and 119 (55.1%) had severe COVID-19 anxiety. The results also showed that gestational age (OR=2.2, p=0.03), history of COVID-19 infection among adolescent pregnant women (OR=1.6, p=0.02), history of family and friends (OR=1.7) (p=0.04), quality of life (OR=4.3, p=0.001), increases the probability of COVID-19 anxiety.

CONCLUSIONS

Considering the psychological consequences of the post-COVID-19 era and the psychological events that occur in this period, by identifying and predicting these issues, strategies should be considered for optimal intervention and reduction of injuries in the post-crisis era.

Teachers’ Emotional Intelligence, Burnout, Work Engagement, and Self-Efficacy during COVID-19 Lockdown

Teachers’ psychological well-being is a crucial aspect that influences learning in a classroom climate. The aim of the study was to investigate teachers’ emotional intelligence, burnout, work engagement, and self-efficacy in times of remote teaching during COVID-19 lockdown. A sample of 65 teachers (Mage = 50.49), from early childhood through lower secondary education, were recruited during a period of school closure to answer self-report questionnaires and other measures assessing study variables. Results showed that during the COVID-19 pandemic, teachers reported higher levels of burnout and lower levels of self-esteem due to multiple challenges related to remote teaching and the growing sense of insecurity regarding health safety in the school environment. However, the negative effects of COVID-19 on teachers’ self-efficacy, work engagement, and burnout varied according to their own levels of emotional intelligence. These results demonstrate that emotional intelligence may support teachers in facing these challenges.

Association between patient-related factors and avoided consultations due to fear of COVID-19 during the first lockdown in northern Germany: Results of a cross-sectional observational study

Introduction

During the COVID-19 pandemic, many people were anxious about a coronavirus infection due to the high infection rate and the mortality risk associated with the disease. Fear of COVID-19 might have influenced patients’ utilisation of medical services, even if it meant that a postponed therapy had severe consequences. Our aims were to analyse (a) to what extent fear of COVID-19 contributes to forgone consultations, (b) if patient characteristics, health literacy and social support influence the effect of fear of COVID-19 on the utilisation behaviour and (c) whether interactions between these possible predictor variables are responsible for a higher extent of avoided consultations due to fear of COVID-19.

Methods

We conducted a retrospective, cross-sectional observational study in an emergency department. The study was based on personal standardized interviews of patients. The interviews took place between July 15 and August 5, 2020. Patients over the age of 18 were included if there was no urgent need for treatment on the day of the interview, no severe functional limitations, sufficient knowledge of German, ability to consent and health problems requiring treatment between March 13 and June 13, 2020. Differences between patient subgroups were described and analysed using the t-test and chi² test. Data were analysed by logistic regression including socio-demographic data, health literacy and social support assessed by standardised instruments. Additionally, we assessed interactions between possible predictor variables by a descriptive tree analysis.

Results

103 patients participated in personal standardized interviews. 46 patients (44.6%) reported that at least one necessary consultation did not take place in the observation period. Among those, 29 patients (63.0%) avoided consultations due to fear of COVID-19. Women had 3.36 times higher odds (95% confidence interval: 1.25 to 9.04, p = 0.017) for avoiding a consultation due to fear of COVID-19. There were no other statistically significant predictors in our analysis.

Discussion

Almost half of the required consultations did not take place. Avoidance of consultations needs to be closely monitored during the pandemic. Policy makers as well as health care providers should give consideration to the collateral effects of COVID-19 and COVID-19-related reactions of patients, especially women.

Conclusion

In the course of the COVID-19 pandemic, physicians should ensure that their patients take advantage of necessary consultations in order to avoid negative effects of a delayed examination or treatment. Particular attention should be paid to anxious female patients. Studies are needed to analyse the association between health literacy, social support and avoidance of consultations triggered by fear of COVID-19.

Symptoms and risk factors of depression and PTSD in the prolonged COVID-19 pandemic: a longitudinal survey conducted from 2020 to 2022 in Japan

BACKGROUND

The present study aimed to explore changes in depression and posttraumatic stress disorder (PTSD) among the general population during the prolonged COVID-19 pandemic and to investigate risk factors and adaptive/nonadaptive strategies.

METHODS

A web-based longitudinal survey was conducted across five timepoints from 2020 to 2022 in Japan. Depressive symptoms were measured using the Patient Health Questionnaire-9 (PHQ-9), PTSD was measured using Impact of Event Scale-Revised (IESR), and coping strategies were measured using Brief Coping Orientation to Problems Experienced (Brief COPE). Higher scores of PHQ-9 and IESR indicate more symptoms and Higher score of Brief COPE indicate that these means of coping are used very frequently.

RESULTS

A total of 1,366 participants (mean age = 52.76, SD = 15.57) were analyzed. Regarding levels of depression, PHQ-9 scores in 2022 were lower than in 2020 and 2021 (all p < 0.01). Regarding levels of PTSD, IESR scores in 2022 were lower than in 2021 among females (p < 0.001). Being younger (β = -0.08 and - 0.13, both p < 0.01) and engaging in self-blame (β = 0.12 and 0.18, both p < 0.01) increased PHQ-9 scores regardless of sex. For males, not working (β = 0.09, p = 0.004) and having suffered an economic impact (β = 0.07, p = 0.003) were risk factors for depressive symptoms, and active coping (β = -0.10, p = 0.005) was associated with decreased depressive symptoms. For females, substance use (β = 0.07, p = 0.032) and behavioral disengagement (β = 0.10, p = 0.006) increased depressive symptoms, and females did not show strategies that decreased the symptoms.

CONCLUSIONS

Levels of depression might have increased in the early stages of the pandemic and decreased in January 2022. Although males need to improve their economic situation to decrease depressive symptoms, adaptive strategies might be difficult to identify due to the prolonged pandemic among both sexes. In addition, the pandemic might be a depressive event but not a traumatic event among the general population, at least in Japan.

Physical and mental health impact of the COVID-19 pandemic at first year in a Spanish adult cohort

The COVID-19 pandemic and the political and health measures have profoundly affected the health of our populations. However, very few studies have been published assessing its impact using a prospective cohort. The aim of this study is to describe the impact on physical and mental health due to the COVID-19 pandemic in the general population in Spain, and according to COVID-19 clinical status, during the first year of the pandemic. A longitudinal cohort study with two online surveys were performed on a representative sample of the adult Spanish population before (N = 2005, October/November 2019) and during the pandemic (N = 1357, November/December 2020). We assessed disability using the World Health Organisation Disability Assessment Schedule (WHODAS), major depressive episode (MDE) and suicidal thoughts and behaviours (STB), using an adapted version of the Composite International Diagnostic Interview (CIDI 3.0); generalised anxiety disorder (GAD) using the GAD-7 scale; post-traumatic stress disorder (PTSD) symptoms using the PTSD checklist for DSM-5 (PCL-5). For physical health, there was a statistically significant loss of weight (mean/SD) (T0, 73.22/15.56 vs. T1, 71.21/11.94), less use of tobacco (T0, 11.4% vs. T1, 9.0%) and decreased disability (mean/SD) (T0, 21.52/9.22 vs. T1, 19.03/7.32). For mental health, there was a significant increase in MDE (T0, 6.5% vs. T1, 8.8%) and in the prevalence of GAD (T0, 13.7% vs. T1, 17.7%). The prevalence of STB (T0, 15.1% vs. T1, 7.1%) significantly decreased. Individuals who declared they had been diagnosed with COVID-19 (3.6%) showed a worsening in physical health and an increase in mental health problems and PTSD symptoms. Although suicide risk during the first year of the pandemic was significantly less, many suicide risk factors increased: such as the incidence and persistence of MDE and GAD, the presence of PTSD symptoms in those diagnosed with COVID-19, and a worsening in self-assessed health status. We expect an increase in STB in the population in the long-term. Future research should gather information about the long-term impact of the pandemic.

Weight gain, poor mental health and increased sedentary hours among Malaysian adults during the COVID-19 pandemic

BACKGROUND

The Movement Control Orders (MCO) in Malaysia due to the COVID-19 pandemic had a profound impact on the lifestyle behaviours, weight changes, and mental health of the population.

AIM

To determine the changes in physical activity, sedentary behaviour, body weight status and mental health status among Malaysian adults before and during the pandemic.

METHODS

A total of 338 Malaysian adults participated in this cross-sectional online study. Sociodemographic and anthropometric data were self-reported. Physical activity and sedentary behaviour were assessed using International Physical Activity Questionnaire-Short Form (IPAQ-SF) while the Perceived Stress Scale (PSS-10), Patient Health Questionnaire (PHQ-9) and Generalised Anxiety Disorder Assessment (GAD-7) were used to examine stress, depression and anxiety, respectively. All statistical analysis was performed using SPSS version 28.0.

RESULTS

The results showed an average weight gain of 0.6 kg among the participants with 45.5% of them experiencing weight gain. In addition, sedentary behaviour (p < 0.001), PSS-10 score (p < 0.001), PHQ-9 score (p = 0.002) and GAD-7 score (p = 0.001) were significantly increased during the COVID-19 pandemic whereas the level of physical activity was significantly decreased (p = 0.003) during the pandemic. Weight changes during the pandemic were found to be associated with age, sedentary hours, and PHQ-9 score. Through binary logistic regression, sedentary hours (AOR = 1.068, 95% CI = 1.002-1.139, p = 0.043) were identified to be a risk factor for weight gain during the pandemic.

CONCLUSION

The findings suggested that public health interventions to prevent weight gain should focus on strategies to increase physical activity for sedentary lifestyles.

A network analysis on biopsychosocial factors and pain-related outcomes assessed during a COVID-19 lockdown

Psychological stress, social isolation, physical inactivity, and reduced access to care during lockdowns throughout a pandemic negatively impact pain and function. In the context of the first COVID-19 lockdown in Spain, we aimed to investigate how different biopsychosocial factors influence chiropractic patients' pain-related outcomes and vice-versa. A total of 648 chiropractic patients completed online questionnaires including variables from the following categories: demographics, pain outcomes, pain beliefs, impact of the COVID-19 pandemic, stress/anxiety and self-efficacy. Twenty-eight variables were considered in a cross-sectional network analysis to examine bidirectional associations between biopsychosocial factors and pain outcomes. Subgroup analyses were conducted to estimate differences according to gender and symptom duration. The greatest associations were observed between pain duration and pain evolution during lockdown. Participants' age, pain symptoms' evolution during lockdown, and generalized anxiety were the variables with the strongest influence over the whole network. Negative emotions evoked by the pandemic were indirectly associated with pain outcomes, possibly via pain catastrophizing. The network structure of patients reporting acute pain showed important differences when compared to patients with chronic pain. These findings will contribute to identify which factors explain the deleterious effects of both the pandemic and the restrictions on patients living with pain.

Mental Health Support in Higher Education during the COVID-19 Pandemic: A Case Study and Recommendations for Practice

Background: The COVID-19 pandemic has caused changes in the lives of many university students around the globe, including students at Maria Curie-Skłodowska University in Lublin, Poland. Isolation, a sense of threat, and the transition to remote learning resulted in numerous, mainly psychological, negative consequences for students. The university aimed to provide students with effective assistance during the COVID-19 pandemic. The question now is whether it has succeeded or failed. This study demonstrates good practices in mental health support at Maria Curie-Skłodowska University during the pandemic and post-pandemic period. Methods: The study was conducted between October and December 2022. The case study method and purposive sampling were used in the study. A total of 19 participants took part in this study. Of the respondents, 16 were females, 3 were males. Ages ranged between 26 and 55 years. Results: Research has shown that the university provided students with various forms of mental health support. During the COVID-19 pandemic, in the 2020/2021 academic year, students and university staff were provided with pedagogical, psychological, and/or psychotherapeutic consultations. Among the main problems reported by students and staff were anxiety, lowered mood, depressive conditions, failure to cope with stress, relationship problems at university, a spectrum of pandemic-related problems, life crises, and discrimination related to sexual orientation. Support was provided via web platforms, social networking websites, and by phone, directly and free of charge. Conclusions: The impact of the pandemic has exposed strengths and weaknesses in the management of the mental health support system at the university. It also showed new needs and directions of support. The university has new goals; one of the greatest is preparing students for the challenges of the future.

A Pilot Study on Blood Components in COVID-19 Affected Subjects: A Correlation to UPR Signalling and ER-Stress

Abstract

The endoplasmic reticulum (ER) is the site for protein synthesis, its folding and secretion. An intricate set of signalling pathways, called UPR pathways, have been evolved by ER in mammalian cells, to allow the cell to respond the presence of misfolded proteins within the ER. Breaching of these signalling systems by disease oriented accumulation of unfolded proteins may develop cellular stress. The aim of this study is to explore whether COVID-19 infection is responsible for developing this kind of endoplasmic reticulum related stress (ER-stress). ER-stress was evaluated by checking the expression of ER-stress markers e.g. PERK (adapting) and TRAF2 (alarming). ER-stress was correlated to several blood parameters viz. IgG, pro- and anti-inflammatory cytokines, leukocytes, lymphocytes, RBC, haemoglobin and PaO₂/FiO₂ ratio (ratio of arterial oxygen partial pressure to fractional inspired oxygen) in COVID-19 affected subjects. COVID-19 infection was found to be a state of protein homeostasis (proteostasis) collapse. Changes in IgG levels showed very poor immune response by the infected subjects. At the initial phase of the disease, pro-inflammatory cytokine levels were high and anti-inflammatory cytokines levels were low; though they were partly compromised at later phase of the disease. Total leukocyte concentration increased over the period of time; while percentage of lymphocytes were dropped. No significant changes were observed in cases of RBC counts and haemoglobin (Hb) levels. Both RBC and Hb were maintained at their normal range. In mildly stressed group, PaO₂/FiO₂ ratio (oxygenation status) was in the higher side of normal range; whereas in other two groups the ratio was in respiratory distress syndrome mode. Virus could induce mild to severe ER-stress, which could be the cause of cellular death and systemic dysfunction introducing fatal consequences.

Graphical Abstract

Schematic representation of SARS-CoV-2 infection and related consequences.

Prevalence and factors associated with self-reported anxiety in adults during the COVID-19 pandemic in Argentina, Brazil, Peru, Mexico, and Spain: A cross-sectional Ibero-American study

The present study evaluated the factors associated with the perception of anxiety during the first wave of covid-19 in Ibero-American countries. This cross-sectional study was carried out with 5.845 participants of both sexes, over 18 years of age, and residents of four Latin American countries-Argentina (16.7%), Brazil (34.5%), Mexico (11.1%), and Peru (17.5%), and one European country-Spain (20.1%). Data were collected in 2020, between April 1st and June 30th in Spain and between July 13th and September 26th in the Latin American countries. We used an online questionnaire with sociodemographic, lifestyle, self-reported anxiety, and covid-19 related questions. The chi-square statistical test and Multivariate logistic regressions were performed to analyze the factors associated with self-reported anxiety. The presence of self-reported anxiety was found in 63.8% of the participants during the isolation period. The association occurred mainly in women (OR:1.52; CI: 1.3-1.7), those aged 18 to 29 years (OR: 1.51; CI: 1.2-1.9) and 30 to 49 years (OR: 1.56; CI: 1.3-1.9), residents of Argentina (OR: 1.55 CI: 1.2-1.9), Brazil (OR: 2.38; CI: 2.0-2.8) and Mexico (OR: 1.52; CI: 1.2-1.9), those who gained weight (OR:1.71 CI: 1.5-1.9) or lost weight (OR: 1.40; CI: 1.2-1.6), and those who reported having slept more (OR: 1.56; CI: 1.3-1.8) or less (OR: 2.89; CI: 2.5-3.4). We conclude that the prevalence of self-reported anxiety in Ibero-American countries was high during the period studied, highlighting a higher likelihood of its occurrence in Brazil, in those who began to sleep less and gained weight.

Post-COVID-19 condition in the German working population: A cross-sectional study of 200,000 registered stem cell donors

BACKGROUND

The SARS-CoV-2 pandemic has strained health systems worldwide, and infection numbers continue to rise. While previous data have already shown that many patients suffer from symptoms for months after an acute infection, data on risk factors and long-term outcomes are incomplete, particularly for the working population.

OBJECTIVES

We aimed to provide information on the prevalence of post-COVID-19 conditions in a subset of the German working-age population (18-61 years old) and to analyze risk factors.

METHODS

We conducted an online survey with a health questionnaire among registered potential stem cell donors with or without a self-reported history of polymerase chain reaction (PCR)-confirmed SARS-CoV-2 infection. Logistic regression models were used to examine the risks of severity of acute infection, sex, age, body mass index, diabetes mellitus, and arterial hypertension medication on post-COVID-19 symptoms.

RESULTS

A total of 199,377 donors reported evaluable survey questionnaires-12,609 cases had a history of SARS-CoV-2 infection and 186,768 controls had none. Overall, cases reported physical, cognitive, and psychological complaints more frequently compared to controls. Increased rates of complaints persisted throughout 15 months postinfection, for example, 28.4%/19.3% of cases/controls reported fatigue (p <0.0001) and 9.5%/3.6% of cases/controls reported loss of concentration (p <0.0001). No significant differences were observed in the frequency of reported symptoms between 3 and 15 months postinfection. Multivariate analysis revealed a strong influence of the severity of the acute SARS-CoV-2 infection episode and age on the risk for post-COVID-19 conditions.

CONCLUSION

We report the prevalence of post-COVID-19 conditions in mainly unvaccinated individuals with SARS-CoV-2 infections between February 2020 and August 2021. The severity of the acute course and age were major risk factors. Vaccinations may reduce the risk of post-COVID-19 conditions by reducing the risk of severe infections.

Family Well-Being During the COVID-19 Pandemic: The Risks of Financial Insecurity and Coping

During the COVID-19 pandemic, families have experienced unprecedented financial and social disruptions. We studied the impact of preexisting psychosocial factors and pandemic-related financial and social disruptions in relation to family well-being among N = 4091 adolescents and parents during early summer 2020, participating in the Adolescent Brain Cognitive DevelopmentSM Study. Poorer family well-being was linked to prepandemic psychosocial and financial adversity and was associated with pandemic-related material hardship and social disruptions to routines. Parental alcohol use increased risk for worsening of family relationships, while a greater endorsement of coping strategies was mainly associated with overall better family well-being. Financial and mental health support may be critical for family well-being during and after a widespread crisis, such as the COVID-19 pandemic.

COVID-19 pandemic burnout in an Italian sample of anaesthesiologists: coping strategies, resilience and the capability of tolerating the uncertainty as preventing factors

The present study aims to explore the prevalence of burnout characteristics and their association with resilience, coping strategies, and the intolerance of uncertainty dimensions. It also aims to explore the predictive effect of these variables on burnout dimensions, separately. Through the SurveyMonkey platform, 1,009 anaesthesiologists completed the Maslach Burnout Inventory (MBI), Resilience Scale, Intolerance of Uncertainty Scale Short Form (IU), and the Coping Inventory for Stressful Situations (CISS). According to the MBI cut-off, 39.7% and 25.8% of participants scored high in Emotional Exhaustion and Depersonalization, respectively, and 44.2% scored low in Personal Accomplishment. Several significant correlations between burnout dimensions and resilience, coping strategies, and the intolerance of uncertainty emerged. Regarding the linear regression models tested, coping strategies, resilience, and age showed a significant predictive effect on all three of the burnout dimensions. In conclusion, the results showed that individual levels of resilience and one's ability to tolerate uncertainty and task-oriented coping strategies represent significant factors for lower burnout levels in Italian anaesthesiologists during COVID-19 pandemic. These findings highlight the importance of intervention aimed at promoting useful coping strategies and enhancing resilience among healthcare workers.

Burnout in Italian anesthesiologists and intensivists during the COVID-19 pandemic: a national survey

BACKGROUND

COVID-19 pandemic added additional burden upon healthcare systems and anesthesiology and intensive care physicians (AI) who possessed crucial expertise for dealing with the pandemic. Aim of the study was to uncover specific burnout patterns among Italian AI, exploring the hypothesis that burnout has a multicluster structure. Differences in social and professional characteristics between burnout patterns were explored.

METHODS

One thousand and nine AI (658 women) members of the Società Italiana di Anestesia Analgesia Rianimazione e Terapia Intensiva (SIAARTI) working during COVID-19 pandemic participated. Sociodemographic, working information and burnout levels evaluated through Maslach Burnout Inventory (MBI) were collected.

RESULTS

According to the MBI cutoff, 39.7% and 25.8% of participants scored high in emotional exhaustion and depersonalization respectively, and 44.2% scored low in personal accomplishment. Cluster analysis highlighted four burnout profiles: resilience, detachment, burnout, and emotional reserve. The results showed that AI in the Resilience and Emotional Reserve groups were significantly older and more experienced than those in the Detachment and Burnout groups. Additionally, more of the individuals in the Resilience group were working in intensive care units and departments dedicated to COVID-19 patients. The Detachment group was comprised of more AI working in operating units, while the Burnout group contained a higher number of AI working in COVID-19 departments.

CONCLUSIONS

These findings highlight different burnout patterns in Italian AI: older age, more professional experience, and work in intensive care units and departments dedicated to COVID-19 seemed to be protective factors during the pandemic. This appears a first step to promote focused interventions.

Psycho-Emotional Factors Associated with Depressive Symptoms during Lockdown Due to the COVID-19 Pandemic in the Mexican Population

The COVID-19 pandemic has had a significant impact on mental health, leading to the increase of depressive symptoms. Identifying these symptoms and the factors associated with them in women and men will allow us to understand possible mechanisms of action and develop more specific interventions. An online survey was conducted from 1 May to 30 June 2020 using snowball sampling; the final sample comprised 4122 adult inhabitants of Mexico; 35% of the total sample displayed moderate-to-severe depressive symptoms, with a greater proportion of depression being among female respondents. A logistic regression analysis revealed that individuals under 30 years of age, those with high levels of stress due to social distancing, those with negative emotions, and those who reported a significant impact of the pandemic on their lives have a higher risk of depression. Women with a history of mental health treatment and men with a history of chronic disease were also more likely to experience depressive symptoms. Social environment and sex are factors that intervene in the development of depressive symptoms, meaning that appropriate early identification and intervention models should be designed for the care of men and women in highly disruptive situations such as the recent pandemic.

Effect of daily new cases of COVID-19 on public sentiment and concern: Deep learning-based sentiment classification and semantic network analysis

Aim

This study explored the influence of daily new case videos posted by public health agencies (PHAs) on TikTok in the context of COVID-19 normalization, as well as public sentiment and concerns. Five different stages were used, based on the Crisis and Emergency Risk Communication model, amidst the 2022 Shanghai lockdown.

Subject and Methods

After dividing the duration of the 2022 Shanghai lockdown into stages, we crawled all the user comments of videos posted by Healthy China on TikTok with the theme of daily new cases based on these five stages. Third, we constructed the pre-training model, ERNIE, to classify the sentiment of user comments. Finally, we performed semantic network analyses based on the sentiment classification results.

Results

First, the high cost of fighting the epidemic during the 2022 Shanghai lockdown was why ordinary people were reluctant to cooperate with the anti-epidemic policy in the pre-crisis stage. Second, Shanghai unilaterally revised the definition of asymptomatic patients led to an escalation of risk levels and control conditions in other regions, ultimately affecting the lives and work of ordinary people in the area during the initial event stage. Third, the public reported specific details that affected their lives due to the long-term resistance to the epidemic in the maintenance stage. Fourth, the public became bored with videos regarding daily new cases in the resolution stage. Finally, the main reason for the negative public sentiment was that the local government did not follow the central government's anti-epidemic policy.

Conclusion

Our results suggest that the methodology used in this study is feasible. Furthermore, our findings will help the Chinese government or PHAs improve the possible behaviors that displease the public in the anti-epidemic process.

Exploring psychological well-being in business and economics arena: A bibliometric analysis

Background

Recent events like the global pandemic and geopolitics leading to war bring to bear the evergreen importance of psychological well-being (PWB) among workers and how it can further influence business growth and performance. Furthermore, the complexity of today's job requirements has created enormous life pressures for individuals, negatively hurting their PWB.

Method

This article took the format of a literature review of existing research work by pursuing the keywords in the SCOPUS database to retrieve the articles published on PWB in the field of business and economics from 1978 to 2022. The data were analyzed to elaborate, interpret and graphically display the results, in particular, authors, sources, documents, and social structure of the existing bibliography. The Bibliometrix R package is used for robust analysis of retrieved data.

Results

The findings showed that the last decade saw a rise in scholarly work on PWB. However, in 2021, its sharp expansion stalled. It further revealed that academics from four countries had a significant role in accessing PWB in the business and economics fields, namely the United States, the United Kingdom, Australia, and Canada. The reports also indicate themes such as mental health, coronavirus disease 2019 (COVID-19), and depression are emerging themes, whereas niche themes include unemployment, quality of life, and job loss.

Conclusion

This study suggests these new areas be studied in contemporary literature to provide cogent room to improve policy decisions on PWB within the business world.

Psychological Correlates of Health anxiety in Response to the Coronavirus (COVID-19) Pandemic: a Cross-Sectional Online Study in Iran

Current models suggest health anxiety as a fundamental variable associated with fear and anxiety related to COVID-19. The investigation was carried out in separate two studies on the Iranian population. The first study aims to test the COVID-19 Anxiety Inventory (N = 202). The findings indicate a two-factor structure of the scale. Participants (N = 1638) completed the online survey anonymously in the second study, including the COVID-19 Anxiety Inventory, Short Health Anxiety Inventory, The Intolerance of Uncertainty Scale, Anxiety Sensitivity Index-3, Body Vigilance Scale, Depression Anxiety Stress Scales 21, and Contamination Cognitions Scale. Results showed that health anxiety, anxiety sensitivity, and body vigilance would significantly contribute to fears of contracting COVID-19. Moreover, the findings support a central role of intolerance of uncertainty in predicting COVID-19 anxiety. The study results provided both theoretical and practical implications for understanding psychosocial predictors during the COVID-19 pandemic.

The COVID-19 epidemic in Poland and its influence on the quality of life of university students (young adults) in the context of restricted access to public spaces

Aim

The aim of this study was to determine the impact of social distancing, self-isolation and limited access to public spaces during the COVID-19 pandemic on the quality of life and psychological well-being of young people.

Subject and methods

The coronavirus disease 2019 (COVID-19) pandemic caused by the SARS-CoV-2 virus posed a new global challenge in 2020. The new coronavirus emerged locally, but it rapidly spread to all continents and also reached Poland. On 24 March, the Polish Ministry of Health enforced self-isolation measures to contain the transmission of the disease. The new regulations imposed restrictions on civic freedoms, including access to public spaces. These measures significantly affected the daily lives of Polish citizens. Public spaces play a fundamental role in catering to the citizens' basic needs. Access to public spaces is directly correlated with the quality of life, human relations and spontaneous interactions. Young people are highly socially active, and they are frequent users of public spaces. University students (young adults) who transitioned to online learning on 12 March were surveyed remotely with the Microsoft Forms online tool. The questionnaire contained several questions to elicit demographic information about the respondents, as well as 25 closed-ended questions relating to university students' quality of life and access to public spaces during the epidemic. The survey was carried out during the first Polish lockdown in April 2020. The study group was composed of 132 respondents who were university students aged 19-26.

Results

The results revealed a strong correlation between the severity of lockdown measures during the epidemic and the students' activity levels in public spaces, a considerable deterioration in their physical and psychological well-being, and the overall quality of life.

Conclusion

The respondents were significantly affected by the absence of direct social interactions which, in their opinion, can be only partially compensated for by remote contact.

Does cognitive function impairment affect the duration of hospitalization and in-hospital mortality in geriatric patients hospitalized for COVID-19?

AIMS

To assess the effect of cognitive function, performance of activities of daily living (ADLs), degree of depression, and fear of infection among geriatric patients hospitalized in internal medicine wards for COVID-19 on the duration of hospitalization and in-hospital mortality.

METHODS

This observational survey study was conducted during the second, third, and fourth waves of the COVID-19 pandemic. The study included elderly patients of both sexes, aged ≥ 65 years, hospitalized for COVID-19 in internal medicine wards. The following survey tools were used: AMTS, FCV-19S, Lawton IADL, Katz ADL, and GDS15. The duration of hospitalization and in-hospital mortality were also assessed.

RESULTS

A total of 219 patients were included in the study. The results showed that impaired cognitive function in geriatric patients (AMTS) was associated with higher in-hospital mortality among COVID-19 patients. There was no statistical significance between fear of infection (FCV-19S) and risk of death. The impaired ability to perform complex ADLs (Lawton IADL) before the onset of the disease was not associated with higher in-hospital mortality among COVID-19 patients. The diminished ability to perform basic ADLs (Katz ADL) before the onset of the disease was not associated with higher in-hospital mortality in COVID-19. The degree of depression (GDS15) was not associated with higher in-hospital mortality in COVID-19 patients. Statistically, significantly better survival was observed for patients with normal cognitive function (p = 0.005). No statistically significant differences in survival were observed in relation to the degree of depression or independence in performing ADLs. Cox proportional hazards regression analysis showed a statistically significant effect of age on mortality (p = 0.004, HR 1.07).

CONCLUSION

In this study, we observe that cognitive function impairments and the older age of patients treated for COVID-19 in the medical ward increase the in-hospital risk of death.

Music engagement is negatively correlated with depressive symptoms during the COVID-19 pandemic via reward-related mechanisms

The COVID-19 pandemic has deeply affected the mental health of millions of people. We assessed which of many leisure activities correlated with positive mental health outputs, with particular attention to music, which has been reported to be important for coping with the psychological burden of the pandemic. Questionnaire data from about 1000 individuals primarily from Italy, Spain, and the United States during May-June 2020 show that people picked music activities (listening to, playing, singing, etc.) most often as the leisure experiences that helped them the most to cope with psychological distress related with the pandemic. During the pandemic, hours of engagement in music and food-related activities were associated with lower depressive symptoms. The negative correlation between music and depression was mediated by individual differences in sensitivity to reward, whereas the correlation between food-related activities and improved mental health outputs was explained by differences in emotion suppression strategies. Our results, while correlational, suggest that engaging in music activities could be related to improved well-being with the underlying mechanism being related to reward, consistent with neuroscience findings. Our data have practical significance in pointing to effective strategies to cope with mental health issues beyond those related to the COVID-19 pandemic.

The impact of the COVID-19 pandemic on patients with migraine

Objectives

The aim of our work was to assess the impact of the COVID-19 pandemic and quarantine measures on migraine patients in regards to the activity of the disease, the psycho-emotional background of the patients and their quality of life.

Methods

his study included 133 patients with established diagnosis of migraine. All study participants were divided into two clinical groups: A-patients with chronic and episodic forms of migraine, who had a history of positive PCR test for COVID-19, and B-patients with chronic and episodic forms of migraine who did not have a history of coronavirus disease.

Results

We detected increase in the number of antimigraine medication (p = 0.04), frequency of headache attacks (p = 0.01), and the psycho-emotional state deterioration (increase in the Hamilton anxiety scale score) (p = 0.002) in patients after recovery from the coronavirus disease. There was no significant difference in the headache's intensity according to the VAS scale (p = 0.51) as well as in the dynamics of the Beck depression scale score (p = 0.09) before and after the COVID-19 infection.

Conclusion

Patients with a history of migraine who recovered from COVID-19 showed increased frequency of migraine headache attacks and anxiety.

The Prevalence and Predictors of Depressive, Anxiety, and Stress Symptoms Among Tepi Town Residents During the COVID-19 Pandemic Lockdown in Ethiopia

BACKGROUND

As a result of the coronavirus disease 2019 (COVID-19) outbreak, many countries have imposed movement restrictions and implemented lockdowns. However, evidence from a variety of nations showed that the COVID-19 outbreak and its associated quarantine measures triggered a wide range of psychological problems, such as anxiety, depression, and stress in the general population. As a result, the purpose of this study was to determine the prevalence and predictors of depression, anxiety, and stress symptoms among Tepi town residents during the pandemic lockdown.

METHODOLOGY

A community-based cross-sectional survey was conducted among residents of Tepi town from September 15 through September 25, 2020, and residents who have lived in Tepi town for at least 6 months were included. We have employed the depression, anxiety, and stress scale 21 (DASS-21) to evaluate depression, anxiety, and stress. The Chi-squared test of association and logistic regression were used to identify factors associated with depression, anxiety, and stress among residents of Tepi town. For all statistical analysis, we used (IBM) SPSS version 25.

RESULTS

According to the current study, the prevalence of depression, anxiety, and stress symptoms were 37.7%, 39.0%, and 44.2%, respectively, among residents of Tepi town. Estimated odds of having depression, anxiety, and stress were as follows: for being female 6.315, 4.591, and 3.155; smoking 1.787, 1.883, and 1.787; sleep problem 2.613, 2.254, and 1.721; chewing Khat 2.156, 2.053, and 2.110; quarantine for 14 days 2.251, 1.902, and 1.960; and frequent use of social media 3.126, 1.849, and 3.126 times more likely as compared to their corresponding reference group respectively. The odds of developing depression and anxiety respectively were as follows: for alcohol consumption 2.438 and 1.797 times higher than their corresponding reference group respectively. Those exposed to COVID-19 were 3.870 times more likely to develop depression symptoms. Estimated odds of having anxiety and stress symptoms for fear of COVID-19 were 1.776 and 1.835; social interactions altered were 3.197 and 2.069, moderate levels of hope were 2.687 and 2.849 respectively. The odds ratio for those taking traditional preventive medicine, and having family members infected with COVID-19 were 2.475 and 1.837 times more likely to experience anxiety symptoms respectively.

CONCLUSION

In this study, the prevalence of depression, anxiety, and stress symptoms was found to be high among residences in Tepi town. Being female, chewing Khat, smoking, being quarantined for 14 days, frequently using social media, and having sleeping problems were all found to be significantly associated with an increased risk of developing depression, anxiety, and stress symptoms, whereas alcohol consumption and family members infected by COVID-19 were considerably linked to depression and anxiety symptoms. Fear of COVID-19, influence on social interaction and having a moderate level of hope were substantially related to stress and anxiety symptoms, while taking preventive medicine was found to be a significant factor in anxiety symptoms among Tepi town residences. Interventions should be made to improve the mental health of Tepi residents.