Anxiety and Depression Among People Under the Nationwide Partial Lockdown in Vietnam

Predictors of COVID-Related stress in a community sample in Turkey: a cross-sectional study

The distinctive mental health features associated with COVID-19 have gained importance as the psychological effects of the pandemic on the community become more visible. This study aims to assess the COVID-related stress status and associated factors in the community sample of Turkey. The sample of this cross-sectional study is composed of 2.065 people between the ages of 18-90. Data were collected through an online survey prepared by Google.docs between October-December, 2020. Mild to moderate stress was found in the community with the most common symptoms of the fear of contamination and danger. Some variables, such as being female and the severity of COVID-19 illness, were associated with higher COVID-related stress. Vulnerable groups associated with high stress should be monitored during the pandemic. The findings of this study will guide the practices of professionals working in the field of public health, healthcare, or mental health in possible future pandemics.

A network analysis of the interrelationships between depression, anxiety, insomnia and quality of life among fire service recruits

Background

Research on the mental health and quality of life (hereafter QOL) among fire service recruits after the end of the COVID-19 restrictions is lacking. This study explored the network structure of depression, anxiety and insomnia, and their interconnections with QOL among fire service recruits in the post-COVID-19 era.

Methods

This cross-sectional study used a consecutive sampling of fire service recruits across China. We measured the severity of depression, anxiety and insomnia symptoms, and overall QOL using the nine-item Patient Health Questionnaire (PHQ-9), seven-item Generalized Anxiety Disorder scale (GAD-7), Insomnia Severity Index (ISI) questionnaire, and World Health Organization Quality of Life-brief version (WHOQOL-BREF), respectively. We estimated the most central symptoms using the centrality index of expected influence (EI), and the symptoms connecting depression, anxiety and insomnia symptoms using bridge EI.

Results

In total, 1,560 fire service recruits participated in the study. The prevalence of depression (PHQ-9 ≥ 5) was 15.2% (95% CI: 13.5-17.1%), while the prevalence of anxiety (GAD-7 ≥ 5) was 11.2% (95% CI: 9.6-12.8%). GAD4 ("Trouble relaxing") had the highest EI in the whole network model, followed by ISI5 ("Interference with daytime functioning") and GAD6 ("Irritability"). In contrast, PHQ4 ("Fatigue") had the highest bridge EI values in the network, followed by GAD4 ("Trouble relaxing") and ISI5 ("Interference with daytime functioning"). Additionally, ISI4 "Sleep dissatisfaction" (average edge weight = -1.335), which was the central symptom with the highest intensity value, had the strongest negative correlation with QOL.

Conclusion

Depression and anxiety were important mental health issues to address among fire service recruits in the post-COVID-19 era in China. Targeting central and bridge symptoms identified in network analysis could help address depression and anxiety among fire service recruits in the post-COVID-19 era.

How to treat subsyndromal anxiety disorder - practical recommendations for implementation in primary care

BACKGROUND

Anxiety is a common and disabling condition that significantly impacts quality of life. Subsyndromal anxiety (SSA) refers to anxiety symptoms that do not meet the full diagnostic criteria for an anxiety disorder but pose a risk for developing such disorders. We aimed to provide practical recommendations for the treatment of SSA in primary care settings.

METHODS

A narrative review was conducted to identify strategies for recognizing and treating patients with SSA.

RESULTS

The recommendations for treating SSA include lifestyle modifications such as exercise and stress reduction techniques, psychotherapy, and pharmacological treatments, including natural compounds like the lavender oil extract Silexan. Regular follow-up care is essential to monitor treatment response and address ongoing symptoms. Additionally, the use of the GAD-7 tool is recommended for accurately identifying patients with SSA.

CONCLUSION

Implementing these recommendations in primary care can lead to effective treatment of SSA, preventing the development of more severe anxiety disorders. An integrative approach, combining lifestyle modifications, psychotherapy, and pharmacotherapy, including natural compounds, offers significant benefits for managing anxiety.

Anxiety and watching the war in Ukraine

On 24 February 2022, Russia attacked Ukraine. Millions of people tuned into social media to watch the war. Media exposure to disasters and large-scale violence can precipitate anxiety resulting in intrusive thoughts. This research investigates factors related to anxiety while watching the war. Since the war began during the ongoing coronavirus pandemic, threat from COVID-19 is seen as a predictor of anxiety when watching the war. A theoretical model is put forward where the outcome was anxiety when watching the war, and predictors were self-reported interference of watching the war with one's studies or work, gender, worry about the war, self-efficacy and coronavirus threat. Data were collected online with independent samples of university students from two European countries close to Ukraine, Germany (n = 348) and Finland (n = 228), who filled out an anonymous questionnaire. Path analysis was used to analyse the data. Findings showed that the model was an acceptable fit to the data in each sample, and standardised regression coefficients indicated that anxiety, when watching the war, increased with interference, war worry and coronavirus threat, and decreased with self-efficacy. Women reported more anxiety when watching the war than men. Implications of the results are discussed.

Symptoms, Mental Health, and Quality of Life Among Patients After COVID-19 Infection: A Cross-sectional Study in Vietnam

OBJECTIVES

This study was conducted to characterize the symptoms, mental health, quality of life (QoL), and associated factors following the coronavirus disease 2019 (COVID-19) infection.

METHODS

This cross-sectional study included 394 participants previously infected with COVID-19 in Ho Chi Minh City, Vietnam. Mental health was assessed using the 21-item Depression, Anxiety, and Stress Scale (DASS-21). Participants self-reported health-related QoL was measured with the EuroQol 5-Dimension 5-Level (EQ-5D-5L) scale.

RESULTS

Among the participants, 76.4% reported experiencing at least one symptom following COVID-19 infection. The most common symptoms were fatigue (42.1%), cognitive dysfunction (42.9%), and hair loss (27.9%). According to the DASS-21 results, the proportions of depression, anxiety, and stress were 28.7%, 26.4%, and 20.6%, respectively. The mean scores on the EQ-5D-5L and the EuroQol Visual Analog Scale were 0.94±0.11 and 84.20±13.11, respectively. Regarding QoL issues, the highest proportion of participants (32.7%) reported experiencing anxiety or depression, followed by pain or discomfort (25.4%). Multivariable logistic regression analysis revealed that factors associated with the presence of symptoms following COVID-19 infection included female (odds ratio [OR], 2.84; 95% confidence interval [CI], 1.65 to 4.91) and having QoL issues (OR, 3.25; 95% CI, 1.71 to 6.19).

CONCLUSIONS

The study investigated the prevalence rates of various symptoms following COVID-19 infection. These findings underscore the need to prioritize comprehensive care for individuals recovering from COVID-19 and to implement strategies to mitigate the long-term impact of the disease on mental health and QoL.

Stakeholder engagement to develop a directory of COVID-19 related mental health services in Vietnam: reflections on a participatory approach

The COVID-19 pandemic led to a rise of mental health issues amongst Vietnamese communities in Vietnam and the diaspora. However, there were few resources and no directory of services available for people seeking mental health support in Vietnam. In response to this need, we initiated an engagement project to improve Vietnamese communities' access to mental health support. This project aimed to involve stakeholders in the development of a directory of resources in order to ensure that it met local needs. The phases of development included: (1) reviewing desk research findings; (2) reviewing the list of mental health support services that we could find; (3) verifying the first draft of the directory; (4) helping disseminate the directory; and (5) updating the directory. In February 2022 the first edition of the mental health directory for Vietnamese and foreigners living in Vietnam was published. In this paper we describe the iterative approach taken to developing a resource that would have maximum utility for the target communities. We describe the process of partnering with people with lived experience, community members and expert stakeholders in this process, and reflect on how this strengthened the outcomes in terms of the relevance of the output, the research uptake and the access for the wider community. We believe that it is important to publish examples of community engagement projects in order to demonstrate good practise and promote increased involvement of communities in research.

The emergence of COVID-19 over-concern immediately after the cancelation of the measures adopted by the dynamic zero-COVID policy in China

Background

This study aimed to report the prevalence of COVID-19 over-concern and its associated factors after the relaxation of the health-protective measures in China.

Methods

A team of seven experts in psychiatry and psychology specializing in COVID-19 mental health research from China, Hong Kong, and overseas reached a consensus on the diagnostic criteria for COVID-19 over-concern. Individuals had to meet at least five of the following criteria: (1) at least five physical symptoms; (2) stocking up at least five items related to protecting oneself during the COVID-19 pandemic; (3) obsessive-compulsive symptoms related to the COVID-19 pandemic; (4) illness anxiety related to the COVID-19 pandemic; (5) post-traumatic stress symptoms; (6) depression; (7) anxiety; (8) stress and (9) insomnia. An online survey using snowball sampling collected data on demographics, medical history, views on COVID-19 policies, and symptoms of COVID-19 over-concern. Multivariate linear regression was performed using significant variables from the previous regressions as independent variables against the presence of COVID-19 over-concern as the dependent variable. Breush-Pagan test was used to assess each regression model for heteroskedasticity of residuals.

Results

1,332 respondents from 31 regions in China participated in the study for 2 weeks from December 25 to 27, 2022, after major changes in the zero-COVID policy. After canceling measures associated with the dynamic zero-COVID policy, 21.2% of respondents fulfilled the diagnostic criteria for COVID-19 over-concern. Factors significantly associated with COVID-19 over-concern were poor self-rated health status (β = 0.07, p < 0.001), concerns about family members getting COVID-19 (β = 0.06, p < 0.001), perceived usefulness of COVID-19 vaccine (β = 0.03, p = 0.012), impact on incomes, employment and studies (β = 0.045, p < 0.001) and impact on families (β = 0.03, p = 0.01).

Conclusion

After removing measures associated with the dynamic zero-COVID policy in China, approximately one-fifth of respondents met the diagnostic criteria for COVID-19 over-concern.

Mental health impact on patients with COVID-19 in the community under a long period of full lockdown in Vietnam

OBJECTIVE

We aimed to investigate the impact on the mental health of patients with COVID-19 in a centralized isolation facility in the community who experienced a long period of full lockdown during the fourth wave of the COVID-19 pandemic in Vietnam.

METHODS

We performed a retrospective cross-sectional study among 125 patients with COVID-19 in a centralized isolation facility in the community of Ho Chi Minh City from September to November 2021. We collected data on depression, anxiety, and stress symptoms, as indicated by scores on the Depression Anxiety Stress Scale-21, as well as sociodemographic characteristics.

RESULTS

The prevalence of depression, anxiety, and stress among patients with COVID-19 was 14.4%, 20.8%, and 20.0%, respectively. Depression scores were significantly and positively correlated with body mass index whereas stress scores were significantly and positively correlated with age.

CONCLUSION

Our findings indicated an increased prevalence of depression, anxiety, and stress among patients with COVID-19 who were in a centralized isolation facility during the fourth COVID-19 wave in Vietnam. Overweight and older age were identified as risk factors for adverse mental health in patients with COVID-19. Psychological intervention programs should be implemented in isolation facilities for individuals with COVID-19 infection.

University lecturers' perceived stress and self-rated health during COVID-19

BACKGROUND

In 2022, many universities transitioned from virtual learning back to in-person teaching. Significant changes in working conditions, along with COVID-19-related anxiety during the pandemic, might impact the well-being of lecturers.

OBJECTIVE

This study aims to assess the perceived stress, self-rated physical and occupational health of Vietnamese lecturers in 2022 compared to the pre-pandemic levels, and to identify their associating factors.

METHOD

This is a cross-sectional study conducted in May-June 2022 through an online survey questionnaire. A sample of 425 university lecturers were included. Participants' stress levels were assessed using the Perceived Stress Scale. Participants were asked to compare their current physical and occupational health with before the pandemic. Explanatory variables included (1) COVID-19 exposure; and (2) perceptions of changes in working environment due to the pandemic. Multivariable ordinal least squared regression analyses were used to estimate the coefficient and 95% confidence intervals for the associations between COVID-19 exposure variables, work conditions, and each outcome.

RESULTS

Our findings indicated that over 60% of participants experienced moderate stress, while nearly half reported worsened physical and occupational health during the pandemic. Gender, age, perceptions of workload, workplace safety, COVID-19 infection, and incentive programs were significant factors associated with higher stress levels and worse self-rated health.

CONCLUSION

To ensure occupational safety and support lecturers as they return to in-person classes, it is crucial to provide appropriate psychological and health support services.

A comparison of anxiety levels before and during the COVID-19 pandemic

The COVID-19 Pandemic upended the lives of nearly everyone worldwide, and recent studies have reported higher rates of anxiety, depression, and other mental health problems. Using a repeated crosssectional design, the current study compares anxiety levels from a representative sample of college students prior-to and during the COVID-19 Pandemic. Additionally, differences in anxiety prior to and following U.S. approval for use of the Pfizer-BioNTtech COVID-19 vaccine were also compared. Findings indicate that state-anxiety levels did not differ significantly prior to and during the Pandemic as well as before the vaccine and during and after the vaccine (M = 43.01, 44.10, 44.77, respectively). Surprisingly, trait anxiety levels were significantly higher during the Pandemic than before (p = .003), and anxiety levels trend down after the approval of the vaccine, but not significantly (M = 45.10, 48.85, 47.58, respectively). Future research should continue to investigate and compare anxiety levels during the COVID-19 Pandemic.

Structural Equation Model for Social Support and Quality of Life Among Individuals With Mental Health Disorders During the COVID-19 Pandemic

BACKGROUND

In light of the COVID-19 pandemic, the distribution of social support for mental health problems has likely become unequal. Family- and community-based social support has been recognized as a promising approach for mental disorders; however, limited global frameworks have been applied to developing countries such as Vietnam.

OBJECTIVE

The aim of this study was to evaluate the quality of life and social support among patients with mental health disorders in Vietnam and to investigate the factors associated with quality of life among these patients.

METHODS

A cross-sectional study was conducted on 222 psychiatric patients in Hanoi from 2020 to 2022. A structured questionnaire was developed based on four standardized scales: Mental Well-Being-5 scale, Multidimensional Scale of Perceived Social Support, EuroQoL-visual analog scale (EQ-VAS), and EuroQoL-5 dimensions-5 levels (EQ-5D-5L) scale. Tobit regression was used to identify factors associated with the EQ-5D-5L and EQ-VAS scores. Structural equation modeling was applied to verify the relationship between quality of life and social support.

RESULTS

The results showed that perceived support from family scored the highest compared to support from friends and significant others. Patients with depression reported the lowest quality of life and perceived social support. Structural equation modeling showed a root mean square error of approximation of 0.055 (90% CI 0.006-0.090), comparative fit index of 0.954, Tucker-Lewis index of 0.892, and standardized root mean squared error of 0.036 (P<.001). The hypothetical model indicated statistically significant correlations between EQ-VAS score and social support (P=.004), EQ-5D-5L and mental well-being (P<.001), and social support and mental well-being (P<.001). Critical deterioration of quality of life and inconsistency in social support for patients with mental illness were also recorded.

CONCLUSIONS

There is a need to enhance social support and service delivery in Vietnam, focusing on occupation and quality of life. The correlations between social support, quality of life, and mental health issues suggest the potential of a clinical-social integrated intervention model of care.

Quantifying the heterogeneous impact of lockdown policies on different socioeconomic classes during the first COVID-19 wave in Colombia

In the absence of vaccines, the most widespread reaction to curb the COVID-19 pandemic worldwide was the implementation of lockdowns or stay-at-home policies. Despite the reported usefulness of such policies, their efficiency was highly constrained by socioeconomic factors determining their feasibility and their associated outcome in terms of mobility reduction and the subsequent limitation of social activity. Here we investigate the impact of lockdown policies on the mobility patterns of different socioeconomic classes in the three major cities of Colombia during the first wave of the COVID-19 pandemic. In global terms, we find a consistent positive correlation between the reduction in mobility levels and the socioeconomic stratum of the population in the three cities, implying that those with lower incomes were less capable of adopting the aforementioned policies. Our analysis also suggests a strong restructuring of the mobility network of lowest socioeconomic strata during COVID-19 lockdown, increasing their endogenous mixing while hampering their connections with wealthiest areas due to a sharp reduction in long-distance trips.

Mental health-related presentations to a tertiary emergency department during the COVID-19 pandemic

Introduction

The coronavirus disease 2019 (COVID-19) pandemic has caused significant mental distress in populations globally. At the frontline of the pandemic, emergency departments (EDs) are the prime setting to observe the effects of the pandemic on the mental health of the population. We aimed to describe the trend of mental health-related ED attendances at an acute hospital in Singapore before and during the various stages of the COVID-19 pandemic.

Methods

This is a retrospective, descriptive study of patients who presented to the ED between 1 January 2019 and 31 December 2020. Patients diagnosed with mental health-related systematised nomenclature of medicine who visited the ED during this period were identified and were placed into mental health diagnosis categories for analysis. A comparison was made between patients who presented before the pandemic (2019) and during the pandemic (2020).

Results

During the study periods, we identified 1,421 patients, of whom 27 were excluded due to non-mental health-related diagnoses, leaving 1,394 patients for analysis. There was a 36.7% increase in mental health-related ED presentations from 2019 to 2020. The proportion of higher-acuity mental health-related ED attendances and number of suicide attempts also increased.

Conclusion

Our study described an increase in the proportion of high-acuity mental health-related ED attendances during the COVID-19 pandemic. Emergency physicians must be cognisant of the effects of the pandemic on mental health. Further research should be conducted to better equip the healthcare system for handling all aspects of the pandemic.

Changes in diet, exercise and psychology of the quarantined population during the COVID-19 outbreak in Shanghai

BACKGROUND

In March 2022, a severe outbreak of COVID-19 broke out in Shanghai, with the virus spreading rapidly. In the most severe two months, more than 50,000 people were diagnosed with COVID-19. For this reason, Shanghai adopted three-district hierarchical management, requiring corresponding people to stay at home to contain the spread of the virus. Due to the requirements of prevention and control management, the diet, exercise and mental health of the corresponding population are affected to a certain extent.

OBJECTIVES

This article aimed to understand the population in the diet, exercise and psychological changes.

METHODS

This study carried out the research by distributing the electronic questionnaire and carried out the statistical analysis.

RESULTS

People reduced the intake of vegetables and fruits (P = 0.000<0.05), people did about an hour less exercise per week on average (P = 0.000<0.05), the number of steps they took per day decreased by nearly 2000 steps (P = 0.012<0.05), and there were significant changes in the way they exercised.

CONCLUSION

In terms of psychological state, people have some depression, anxiety and easy to feel tired after lockdown. This study can also provide reference for policy adjustment and formulation of normalized epidemic management in the future.

The mental health impact of pandemic COVID-19 crisis on university students in Saudi Arabia and associated factors

INTRODUCTION

New Coronavirus (COVID-19) pandemic has multiple effects. We aimed in this study to assess anxiety, depression, and stress levels among university students in Saudi Arabia and associated factors.

METHOD

We collected 5,140 participations from universities for our cross-sectional study, responders completed the demographic questions, patient health questionnaire 9 (PHQ9) for depression, generalized anxiety disorder 7 (GAD7) for anxiety, and perceived stress scale (PSS) between 24th and 30th of April 2020.

RESULT

80.99% were females and mean age was 21.85 years. 40.8% had significant symptoms of anxiety, 48.8% had significant symptoms of depression, and 86.7% had moderate to high perceived stress. Being Female, younger age, living in eastern region, had a relative or acquaintances with COVID-19, and had chronic medical or mental illness are associated factors with high levels of depression, anxiety, and stress.

DISCUSSION

COVID-19 pandemic negatively affected the mental health of university students. Quick and effective interventions are mandatory.

Factors associated with perceived fear of future pandemics and/or epidemics: a cross-sectional study in Cyprus

This study aims to understand the levels of fear experienced by individuals regarding future pandemics and/or epidemics among the general population of Cyprus and comprehensively examine the diverse factors that influence this perceived fear. The cross-sectional study was conducted from October 1st, 2022, to February 19th, 2023. A proportionate quota sampling method was used for the recruitment, by recruiting a fixed number of participants from each age group, sex, and place of residence. The study collected information on sociodemographic and health-related characteristics, health literacy, trust, COVID-19 vaccination information, and perceived fear of future epidemics and/or pandemics using a self-administered questionnaire. The survey included 1075 participants, with 53.7% of them reporting fear of future pandemics. Logistic regression analysis revealed that women (OR = 2.37, 95% CI 1.78, 3.16) and individuals vaccinated against COVID-19 (OR = 1.57, 95% CI 1.02, 2.43) were significantly more likely to experience fear of future pandemics. Moreover, higher levels of trust (OR = 1.04, 95% CI 1.02, 1.06) and higher health literacy (OR = 1.05, 95% CI 1.03, 1.08) were associated with an increased likelihood of fearing future pandemics. Conversely, unemployment (OR = 0.30, 95% CI 0.13, 0.65) and having a postgraduate education decreased the likelihood of fearing future pandemics (OR = 0.56, 95% CI 0.34, 0.90). The linear regression model revealed that older age (β = - 0.10, 95% CI - 0.14, - 0.05) was negatively associated with a higher score of fear regarding future pandemics. Conversely, being in a vulnerable group (β = 2.02, 95% CI 0.75, 3.28) and having at least one chronic disease (β = 1.76, 95% CI 0.68, 2.84) showed positive associations with increased fear of future epidemics and/or pandemics. The findings emphasize the need for relevant authorities to prioritize mental health and disseminate information in a manner that avoids spreading fear and panic, particularly among vulnerable population groups.

Enhancing human resilience beyond COVID-19-related stress: public responses to multi-benefits of home gardening

The SARS-CoV-2 virus has caused a public health crisis globally. Against the backdrop of global resilience, studies have demonstrated the therapeutic value of home gardening as a measure to strengthen human health. However, there is a lack of comparative studies on its benefits across countries. Studies need to examine the role of home gardening in improving public health in various societies to understand and encourage this practice broadly and effectively. We chose Taiwan, Thailand, and Vietnam as case studies, which have suffered substantial pandemic impacts, with millions of infections and thousands of deaths. We explored and compared the perceptions of people on home gardening and its health benefits during the COVID-19 pandemic. We conducted online surveys in three countries between May 1 and September 30, 2022, with a total of 1172 participants. Data were collated on perceived pandemic stress, challenges and solutions in gardening, home gardening intentions, and mental and physical health benefits. In these countries, we found that perceived pandemic stress positively affects home gardening intentions, whereby the motivation of Vietnamese people is the highest. Challenges hinder gardening intentions, while the solutions only positively affect gardening intentions in Taiwan and Vietnam. Home gardening intentions positively affect mental and physical health, whereby there are higher mental health benefits in Taiwanese people than in Thai people. Our findings potentially support public health recovery and promote healthy lifestyles during the COVID-19 pandemic.

Refraining from interaction can decrease fear of physical closeness during COVID-19

Perception of peripersonal space (PPS) and interpersonal distance (IPD) has been shown to be modified by external factors such as perceived danger, the use of tools, and social factors. Especially in times of social distancing in the context of the COVID-19 pandemic, it is vital to study factors that modify PPS and IPD. The present work addresses the question of whether wearing a face mask as a protection tool and social interaction impact the perception of IPD. We tested estimated IPD in pictures at three distances: 50 cm, 90 cm, and 150 cm in both social interaction (shaking hands) and without interaction and when the two people in the pictures wore a face mask or not. Data from 60 subjects were analyzed in a linear mixed model (on both difference in distance estimation to the depicted distance and in absolute distance estimation) and in a 3 (distance: 50, 90, 150) × 2 (interaction: no interaction, shake hands), × 2 face mask (no mask, mask) rmANOVA on distance estimation difference. All analyses showed that at a distance of 50 and 90 cm, participants generally underestimated the IPD while at an IPD of 150 cm, participants overestimated the distance. This could be grounded in perceived danger and avoidance behavior at closer distances, while the wider distance between persons was not perceived as dangerous. Our findings at an IPD of 90 cm show that social interaction has the largest effect at the border of our PPS, while the face mask did not affect social interaction at either distance. In addition, the ANOVA results indicate that when no social interaction was displayed, participants felt less unsafe when depicted persons wore a face mask at distances of 90 and 150 cm. This shows that participants are on the one hand aware of the given safety measures and internalized them; on the other hand, that refraining from physical social interaction helps to get close to other persons.

Moral obligation to follow anti-COVID-19 measures strengthens the mental health cost of pandemic burnout

BACKGROUND

It has been observed that people become gradually exhausted by receiving COVID-19-related information and adhering to the corresponding preventive measures as the pandemic unfolds. This phenomenon is known as pandemic burnout. Emerging evidence shows that pandemic burnout is related to poor mental health. This study extended the trendy topic by examining the idea that moral obligation, a crucial motivation driving people to follow the preventive measures, would amplify the mental health cost of pandemic burnout.

METHODS

Participants were 937 Hong Kong citizens (88 % females, 62.4 % aged 31-40 years). They participated in a cross-sectional online survey reporting on pandemic burnout, moral obligation, and mental health problems (i.e., depressive symptoms, anxiety, and stress).

RESULTS

Findings of moderation model analyses showed that higher levels of pandemic burnout and moral obligation were related to more mental health problems. Importantly, the "pandemic burnout-mental health problems" links were moderated by moral obligation, with those who felt more morally obliged to follow the measures reporting poorer mental health than those who felt less morally obliged to do so.

LIMITATIONS

The cross-sectional design of the study may constrain the evidence about the directions and causality of the relationships. Participants were only recruited from Hong Kong and females were over-represented, thus limiting the generalizability of the findings.

CONCLUSIONS

People who experience pandemic burnout while feeling more morally obliged to follow the anti-COVID-19 measures are at greater risk of mental health problems. They might need more mental health support from medical professionals.

Effects of psychological distress and life satisfaction on COVID-related traumatic stress: An international, cross-sectional study

BACKGROUND

This study examines the individual impacts of psychological distress (i.e., depression and anxiety) and life satisfaction on COVID-related traumatic stress in an international sample of heterosexual versus LGBQ+ adults.

METHOD

Between July and August 2020, a cross-sectional electronic survey (n = 2482) was launched in five countries (India, Italy, Saudi Arabia, Spain, and United States) assessing sociodemographic characteristics as well as psychological, behavioral, and social factors related to health outcomes during the COVID-19 pandemic.

RESULTS

Significant differences between LGBQ+ participants and heterosexual participants were found for depression (p < .001) and anxiety (p < .001). Depression was associated with COVID-related traumatic stress among heterosexual participants (p < .001) but not LGBQ+ participants. Both anxiety (p < .001) and life satisfaction (p = .003) were also associated with COVID-related traumatic stress in both groups. Hierarchical regression models demonstrated significant effects of COVID-related traumatic stress for adults outside the United States (p < .001); less than full-time employment (p = .012); and for greater levels of anxiety, depression, and life satisfaction, respectively (all ps < .001).

LIMITATIONS

Given the stigma of being LGBQ+ that remains in many countries, participants in may have been reluctant to identify as a sexual minority and therefore indicated a heterosexual sexual orientation.

CONCLUSION

The impact of sexual minority stress among LGBQ+ may play a role in COVID-related post-traumatic stress. Large-scale global disasters such as pandemics, contribute to disparities in psychological distress among LGBQ+ individual, however, sociodemographic factors such as country and urbanicity may play mediating or moderating roles.

The psychological impact of the COVID-19 pandemic in the elderly in southwest China: A longitudinal study based on generalized estimating equations

The objectives of this study were to assess the trends in anxiety and depression levels in older adults nearly 10 months after the outbreak of coronavirus disease 2019 (COVID-19) and explore its determinants. A longitudinal study was performed between October 2019 and December 2020. The Patient Health Questionnaire 9-Item Scale and the Generalized Anxiety Disorder 7-Item Scale were used to assess depression and anxiety. Data were collected before (wave 1), during (wave 2), and 10 months after the COVID-19 outbreak (wave 3). The prevalence of depressive symptoms in the elderly was found to be 18.9%, 28.1%, and 35.9% at wave 1, wave 2, and wave 3 respectively. The prevalence of depressive symptoms at wave 1 was lower than that at wave 2 (χ ²  = 15.544, P < 0.001) and wave 3 (χ ² = 44.878, P < 0.001). There was no significant change in the prevalence of anxious symptoms (wave 1, 28.5%, wave 2, 30.3%, and wave 3, 30.3%). Older adults who were single/divorced/widowed had higher levels of anxiety compared with those who were married (OR = 2.306 95%CI 1.358-3.914, P = 0.002). The pandemic appeared to be associated with increases in depressive symptoms in older persons. Targeted interventions could be carried out among those with higher risk of maladjustment.

Effects of Cognitive Appraisals on Perceived Self-Efficacy and Distress during the COVID-19 Lockdown: An Empirical Analysis Based on Structural Equation Modeling

During the COVID-19 lockdown, individuals and households had to responsibly manage the difficulties and problems caused by the restrictions on their mobility, such as the interruptions to work schedules, insecure food supplies, and the procurement of services and health care. The perceptions of risk as well as the fear of disease were strongly linked to worry, defined as a sequence of thoughts that evoke negative emotions and elevated levels of anxiety and distress. This study evaluated how different cognitive appraisals of an individual's sources of worry could influence their perceived self-efficacy and directly or indirectly moderate their perceived general distress. A sample of 544 participants completed a survey that included questions based on the generalized self-efficacy scale, the sources of concern during the epidemic, the cognitive appraisal scale in emergency, and perceived discomfort. Subsequently, a structural-equation-modeling (SEM) analysis was performed to test the moderating role of cognitive appraisals and perceived self-efficacy on participants' overall distress during a lockdown. Overall, the model reported acceptable fit values and confirmed the hypotheses of the study. An individual's worries activated either a dysfunctional threat appraisal, which prompted a fear-and-closure response that then increased their overall state of distress; or two other functional appraisals (i.e., adaptive or supportive) that contributed to significantly improving the individual's self-efficacy. Higher self-efficacy was shown to be associated with lower levels of perceived distress. For the purposes of prevention and distress containment, it would be appropriate to promote psycho-educational interventions that promote the adoption of appraisal strategies that are functional and beneficial for perceived self-efficacy.

The relationships between trait anger, forgiveness, and subjective well-being during the COVID-19 pandemic: a moderated mediating model under lockdown situation

Although previous studies have found relationships between anger, forgiveness, and well-being, none have examined whether forgiveness mediates the relationship between trait anger and subjective well-being. To address this gap, this study constructed and tested a relevant moderated mediating model. We also considered the moderating effects of the COVID-19 lockdown situation, which has indirectly deteriorated well-being. The participants included 1,274 individuals who were recruited in April 2022. In sum, the results showed negative relationships between the trait anger and forgiveness and well-being, with a positive association between forgiveness and well-being. Moreover, forgiveness mediated the association between trait anger and subjective well-being, whereas the lockdown situation regulated the effects of trait anger on forgiveness and subjective well-being; specifically, forgiveness and well-being were more susceptible to trait anger among individuals under the lockdown situation. These findings suggest that forgiveness mediates the relationship between trait anger and well-being, while trait anger negatively predicts forgiveness and subjective well-being. Furthermore, the lockdown situation increases the negative predictive effects of anger on forgiveness and subjective well-being.

Supplementary information

The online version contains supplementary material available at 10.1007/s12144-023-04500-9.

Gender-dependent impact of COVID-19 lockdown on metabolic and psychological aspects

The first COVID-19 lockdown resulted in enforced quarantine of heavily affected areas with social isolation and related measures by several governments to slow the spread of the disease. The general population experienced several mental and lifestyle changes. Herein, we aimed to evaluate the metabolic and psychological effects induced by lifestyle changes during COVID-19 self-isolation among an Apulian overweight/obese cohort with metabolic disturbances. The study assessed anthropometric data (weight, abdominal circumferences), dietary habits (adherence to the Mediterranean diet, junk food score), lifestyle habits (i.e., smoking, and physical activity), levels of stress and anxiety, and depression. Subjects underwent bioumoral exams before and after self-isolation to monitor glycemic and lipid profiles. A total of 245 subjects (M:F = 118:127) have been included in the study. After lockdown, the number of obese subjects significantly increased in both sexes, and was higher in females than in males (P < 0.0001). Glycemic and lipid profiles worsened, with higher levels of insulinemia, lower levels of HDL cholesterol, and higher levels of triglycerides in females than in males. Adherence to the Mediterranean diet and consumption of junk foods were altered in both groups, especially in females. Psychological aspects were significantly higher in females than in males. Finally, work activities and familial status strongly affected the metabolic and psychological profile. In conclusion, COVID-19 self-isolation induced changes in lifestyle and dietary habits with psychological distress and detrimental effects on metabolic patterns, which were more pronounced in female gender.

Moderated by personal perception: The preventive relationship between home HIIT dance and depression during the COVID-19 pandemic in China

Introduction

Lockdowns during the COVID-19 pandemic were believed to greatly increase the risk of depression among isolated residents in both China and in Western countries. How to effectively reduce this risk has become one of the key issues in the field of public mental health.

Methods

The present study seeks to examine the preventive relationship between doing home HIIT dance-which became popular during Shanghai's COVID-19 lockdown in 2022-and depression, and how such a preventive relationship has been mediated by different personal perception factors using an online survey with 528 samples.

Results

The preventive relationship between doing home HIIT dance and depression was differently mediated by residents' personal perception factors, such as perceived benefits, severity, and self-efficacy, based on the health belief model.

Discussion

These results deepen the research on the psychological effects of doing home HIIT dance on preventing depression, especially in the COVID-19 lockdown period, emphasizing the possible moderation effects of different self-perception factors.

Relationship between subjective well-being and depressive disorders: Novel findings of cohort variations and demographic heterogeneities

This paper uses a large-scale nationally representative dataset, the Chinese General Social Survey, to examine the relationship between subjective well-being and depressive disorders. Statistical results indicate that higher levels of subjective well-being help decrease perceived depression. Robustness checks are carried out using different types of explanatory and dependent variables, various regression models, penalized machine learning methods, instrumental variable approaches, and placebo tests, all of which lend further credence to the above findings. Based on it, heterogeneities in the relationship between subjective well-being and self-rated mental disorders are explored. In respect of variations in age cohorts, it is found that the absolute values of happiness's estimated coefficients are smaller in the 20-30 and 30-40 age groups, while that in the 40-50 age group increase substantially. In older cohorts, the estimates remain at higher levels while fluctuating to some degree. Furthermore, the significantly negative interaction between happiness and age proves that age amplifies subjective well-being's effect on perceived depressive disorders. With age increasing, the impact of happiness on reducing perceived depression tends to be stronger. Therefore, for older people, subjective well-being plays a more important role in suppressing self-rated depression. Heterogeneities of the relationship between happiness and perceived depressive disorders in subgroups with different demographic characteristics are also investigated. It is found that the negative correlation between subjective well-being and self-rated depression is stronger among those with higher educational levels, living in urban areas, being members of the Communist Party of China, having pensions, and owning more housing assets. However, gender, ethnic identity, religious belief, and marital status exert no significant moderating effects.

Stress load of Chinese nurses in Fangcang Shelter Hospitals during the COVID-19 pandemic: A latent profile analysis

The Omicron wave of the COVID-19 pandemic significantly affected Shanghai, China, from March to June 2022. Numbers of Fangcang Shelter Hospitals (FSHs) were conversed from stadiums and exhibition centers to tackle the pandemic. This study aimed to identify the stress load profiles of nurses working in FSHs and explore the characteristics and factors influencing stress load profiles. Totally, 609 out of 700 FSH nurses (with an effective response rate of 87%) participated in an online survey investigating their socio-demographic information, work-related stressors, and stress load. Results of the latent profile analysis identified four classes of stress load, which were labeled as the low (Class 1), mild (Class 2), moderate (Class 3), and high (Class 4) stress load class. Maternity status and self-perceived health condition were significantly different between the four stress load classes by comparisons using the Chi-square test and the Kruskal-Wallis test. The contributors to the stress load profiles were determined by the multinomial logistic regression analysis, including age, education, maternity status, self-perceived health condition, working time in FSHs, and the four dimensions of work-related stressors. Participants who were less healthy (OR = 0.045, 95% CI:0.012,0.171), worked longer time in FSHs (OR = 40.483, 95% CI: 12.103,135.410), faced with more workload (OR = 3.664, 95% CI: 1.047,12.815), and worse working environment (OR = 12.274, 95% CI: 3.029,49.729) were more likely to be classified to the high stress load class. The task arrangement and working environment for FSH nurses should be optimized, and psychological training should be conducted routinely.

A study on differences about the influencing factors of depressive symptoms between medical staff and residents during 2022 city-wide temporary static management period to fighting against COVID-19 pandemic in Shanghai

Objectives

Our study aimed to identify the latent class of depressive symptoms in the Shanghai population during the city-wide temporary static management period and compare differences in the factors influencing depressive symptoms between medical staff and residents.

Methods

An online cross-sectional survey was conducted with 840 participants using questionnaires, including Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Pittsburgh Sleep Quality Index (PSQI), and self-compiled questionnaire (demographic characteristics and internet usage time). Latent class analysis (LCA) was performed based on participants' depressive symptoms. The latent class subgroups were compared using the chi-square test and t-test. Logistic regression was used in our study to analyze the factors influencing depressive symptoms within the medical staff group and residents group and then compare their differences.

Results

Two distinct subgroups were identified based on the LCA: the group with low-depressive symptoms and the group with high-depressive symptoms. There were significant differences between the two groups (P < 0.05) on age, education level, marital status, internet usage time, identity characteristics (medical staff or residents), family income level, living style, overall quality of sleep, and anxiety levels. Furthermore, logistic regression analysis results showed that compared with the residents group, the participants in the group of medical staff with "increasing internet usage time" and the "daytime dysfunction" would have nearly two times the possibility of getting serious depressive symptoms.

Conclusions

There are differences in the factors influencing depression symptoms between medical staff and residents during the 2022 city-wide temporary static management period to fighting against the COVID-19 pandemic in Shanghai. We should pay special attention to those with increasing internet usage time and daytime dysfunction in medical staff working in a special environment such as the COVID-19 pandemic.

Prevalence of and risk factors associated with depression among nursing students acting on the frontline of COVID-19 pandemic: A cross-sectional study

Introduction

The widespread devastation caused by the ongoing waves of COVID-19 imposed a significant burden on the healthcare labor force. At the frontline in the battle against the deadly COVID-19 virus, nursing students in Vietnam were at a much-increased risk of developing mental health conditions. This study aims to identify the prevalence of depression and its related factors, along with coping strategies used by nursing students in the COVID-19 pandemic in Vietnam.

Materials and methods

The study was cross-sectional in nature, with convenient sampling at the epicenters of COVID-19 outbreaks in Vietnam (N = 191) from April to November 2021. After conducting a questionnaire pilot, the data was collected strictly using an internet-based approach. The Depression, Anxiety, and Stress Scale-21 items were used to identify the risk of depression among nursing students. The Chi-square test was used to assess the differences between coping strategies among nursing students. A multivariate logistic regression model was used to identify risk factors associated with depression.

Findings

The percentage of nursing students affected by depression was 21.5%, and almost half of the nursing students (49.2%) had no coping strategies for dealing with mental health concerns. Among the remaining nursing students, video-based mental consultation was the most popular method (25.7%). Being females (AOR: 2.7, 95% CI: 1.1-6.7), collecting bio-samples (AOR: 2.9, 95% CI: 1.4-6.2), providing support to vaccination spots (AOR: 2.3, 95% CI: 1.1-5.1), and not vaccinating against COVID-19 (AOR: 3.1, 95% CI: 1.1-9.1) were found as risk factors for depression among nursing students.

Conclusion

Our research revealed a significant number of nursing students suffering from depressive symptoms and underscoring the need for more effective methods of dealing with this condition. Depression management and coping skills focusing on female populations and those whose direct contacts with infectious sources should be implemented in the nursing curricula and continuous training credits. Those trainings, would support future nurses in handling crisis situations better.

Predictors of Psychological Distress across Three Time Periods during the COVID-19 Pandemic in Poland

BACKGROUND

Since the onset of COVID-19, public health policies and public opinions changed from stringent preventive measures against spread of COVID-19 to policies accommodating life with continued, diminished risk for contracting COVID-19. Poland is a country that demonstrated severe psychological impact and negative mental health. The study aims to examine psychological impact and changes in levels of depression, anxiety, and stress among three cross-sectional samples of Polish people and COVID-19-related factors associated with adverse mental health.

METHODS

In total, 2324 Polish persons participated in repeated cross-sectional studies across three surveys: Survey 1 (22 to 26 March 2020), Survey 2 (21 October to 3 December 2020), and Survey 3 (3 November to 10 December 2021). Participants completed an online survey, including Impact of Event Scale-Revised (IES-R), Depression, Anxiety, and Stress Scale (DASS-21), demographics, knowledge, and concerns of COVID-19 and precautionary measures.

RESULTS

A significant reduction of IES-R scores was seen across surveys, while DASS-21 scores were significantly higher in Survey 2. There was significant reduction in the frequency of following COVID-19 news, recent COVID-19 testing, and home isolation from Survey 1 to 3. Being emale was significantly associated with higher IES-R and DASS-21 scores in Surveys 1 and 2. Student status was significantly associated with higher DASS-21 across surveys. Chills, myalgia, and fatigue were significantly associated with high IES-R or DASS-21 scores across surveys. Frequency of wearing masks and perception that mask could reduce risk of COVID-19 were significantly associated with higher IES-R and DASS-21 scores.

CONCLUSION

Conclusions: The aforementioned findings indicate a reduction in the level of the measured subjective distress andin the frequency of checking COVID-19 news-related information across three periods during the pandemic in Poland.

Experience of the COVID-19 pandemic in Wuhan leads to a lasting increase in social distancing

On 11th Jan 2020, the first COVID-19 related death was confirmed in Wuhan, Hubei. The Chinese government responded to the outbreak with a lockdown that impacted most residents of Hubei province and lasted for almost three months. At the time, the lockdown was the strictest both within China and worldwide. Using an interactive web-based experiment conducted half a year after the lockdown with participants from 11 Chinese provinces, we investigate the behavioral effects of this 'shock' event experienced by the population of Hubei. We find that both one's place of residence and the strictness of lockdown measures in their province are robust predictors of individual social distancing behavior. Further, we observe that informational messages are effective at increasing compliance with social distancing throughout China, whereas fines for noncompliance work better within Hubei province relative to the rest of the country. We also report that residents of Hubei increase their propensity to social distance when exposed to social environments characterized by the presence of a superspreader, while the effect is not present outside of the province. Our results appear to be specific to the context of COVID-19 and are not explained by general differences in risk attitudes and social preferences.

Impact of COVID-19 anxiety on functional foods consuming intention: role of electronic word of mouth

Purpose

The COVID-19 pandemic, which involving mass quarantines in many nations, has affected consumer health consciousness behaviors, including food consumption. This study aimed to investigate the impact of COVID-19 anxiety on functional food consumption within the framework of changes in health concerns and electronic word-of-mouth communication through digital platforms, paying special attention to the moderating effect of trust on eWOM information.

Design

/methodology/approach: This cross-sectional study included 527 participants. The data were analyzed using a structural equation modeling approach. Mediating moderating effects were tested using bootstrapping and multigroup methods.

Findings

Anxiety about the COVID-19 virus has a great impact on individuals' health concerns, word-of-mouth information seeking, and functional food consumption intention. Mediating effects of health consciousness and eWOM on functional food consumption intention were also observed. The anxiety about the COVID-19 virus and health consciousness triggers eWOM communication, and is a strong driver of intention to purchase functional foods if people trust the eWOM information source.

Originality/value

While scholars have demonstrated the impact of COVID-19 on human behavior, a largely uninvestigated issue is the effect of COVID-19 virus anxiety on health product consumption. This is one of the first studies to examine the interrelationships among COVID-19 anxiety, health consciousness, eWOM, and functional food consumption intention.This study provides valuable insights into consumer behavior during the COVID-19 pandemic. Future research should consider the effect of COVID-19 virus anxiety on health-related issues and nutritional behavioral consequences. Based on the results, implications for managers and researchers are proposed.

COVID-Bot, an Intelligent System for COVID-19 Vaccination Screening: Design and Development

BACKGROUND

Coronavirus continues to spread worldwide, causing various health and economic disruptions. One of the most important approaches to controlling the spread of this disease is to use an artificial intelligence (AI)-based technological intervention, such as a chatbot system. Chatbots can aid in the fight against the spread of COVID-19.

OBJECTIVE

This paper introduces COVID-Bot, an intelligent interactive system that can help screen students and confirm their COVID-19 vaccination status.

METHODS

The design and development of COVID-Bot followed the principles of the design science research (DSR) process, which is a research method for creating a new scientific artifact. COVID-Bot was developed and implemented using the SnatchBot chatbot application programming interface (API) and its predefined tools, which are driven by various natural language processing algorithms.

RESULTS

An evaluation was carried out through a survey that involved 106 university students in determining the functionality, compatibility, reliability, and usability of COVID-Bot. The findings indicated that 92 (86.8%) of the participants agreed that the chatbot functions well, 85 (80.2%) agreed that it fits well with their mobile devices and their lifestyle, 86 (81.1%) agreed that it has the potential to produce accurate and consistent responses, and 85 (80.2%) agreed that it is easy to use. The average obtained α was .87, indicating satisfactory reliability.

CONCLUSIONS

This study demonstrates that incorporating chatbot technology into the educational system can combat the spread of COVID-19 among university students. The intelligent system does this by interacting with students to determine their vaccination status.

Trajectories in life satisfaction before and during COVID-19 with respect to perceived valence and self-efficacy

Actions taken by governments to counteract the spread of the COVID-19 pandemic led to profound restrictions in daily lives, especially for adolescents and young adults, with closed schools and universities, travel restrictions, and reduction in social contacts. The purpose of the current study is to investigate the development of life satisfaction with assessments before and during the pandemic, including separate measurement occasions during a strict lockdown and when the implemented restrictions were relaxed again. Data are based on the German Personality Panel (GePP) with 1,920 young adults, assessed on four measurement occasions over a period of three years. Using latent change score modeling, we investigate the outbreak of the COVID-19 pandemic with respect to its perception as a critical life event over time. Further, we examine the influence of self-efficacy on change in life-satisfaction, as the belief in one's innate abilities has been shown to promote health related behavior and buffers against effects of negatively perceived critical life events. While average life satisfaction remained stable across time, we found a main effect of perceived positive valence and self-efficacy on latent change in life satisfaction at the within person level. Expressions of self-efficacy did not moderate the influence of the perception of the pandemic on self-reported life satisfaction. This study provides an important contribution to the recent COVID-19 literature as well as to the debate on stability and change of self-reported life satisfaction.

Food insecurity and level of depression among patients with chronic diseases, and associated factors during the COVID-19 lockdown: a cross-sectional study in rural Rwanda

OBJECTIVES

We aimed to describe access to food and symptoms of depression among patients with chronic diseases or their caregivers, and assess associated factors during the COVID-19 lockdown in rural Rwanda.

DESIGN

A cross-sectional study.

SETTING AND PARTICIPANTS

A stratified random sampling technique was used to recruit 220 patients enrolled in the HIV, non-communicable diseases, mental health, paediatric development clinic and oncology programmes in three rural districts of Rwanda.

OUTCOME MEASURES

Telephone-based interviews were conducted to collect data on the number of daily meals before and during the COVID-19, and depression was assessed using the Patient Health Questionnaire-9. We used logistic regression analysis to investigate factors associated with households reporting a reduction in daily meals and with the survey respondent reporting symptoms of depression.

RESULTS

Of the participants, 19.1% reported a reduction in daily number of meals for either adults or children in their households during lockdown and 24.6% had depression. Reporting a reduction in daily meals was associated with the district of residence and estimated household's monthly income. Self-reported depression was significantly associated with negative experiences during lockdown, including reporting feeling depressed or fear (AOR 4.82; 95% CI 2.08 to 11.21), loneliness (AOR 4.33; 95% CI 1.32 to 14.13), reduction in daily meals (AOR 4.15; 95% CI 1.56 to 11.00) and lack of access to healthcare (OR 3.29; 95% CI 1.32 to 8.23).

CONCLUSIONS

Our findings suggest that significant reduction in access to food affected rural Rwandans with chronic diseases during COVID-19 lockdown, and the lockdown effect varied by household's pre-pandemic level of vulnerability to food insecurity. Reduction in household meals, as well as other self-reported effects of the lockdown, were associated with worse psychological status of survey respondents. Economic and food support should be considered by governments and non-governmental organisations to protect those most vulnerable including patients with chronic diseases against the effects of pandemics and their associated containment measures.

The emotional state of young people in northern Spain after one year and a half of the COVID-19 pandemic

BACKGROUND AND OBJECTIVES

: Since the beginning of the COVID-19 pandemic, the young population has been suffering from an accumulation of psychological symptoms in northern Spain. The main objectives of this study were (1) to assess whether psychological symptoms persisted after one year and a half of the COVID-19 pandemic in northern Spain sample of young people, and (2) to analyze whether pandemic-specific variables (having a chronic illness, living with a person who has a chronic illness, having been infected with COVID-19, having a close person who has died or believing that people are respecting the measures imposed) are related to psychological symptomatology.

METHODS

: Symptoms of stress, anxiety, and depression were measured using the Depression and Stress Anxiety Scale-21 (DASS-21). An ad hoc online questionnaire was used to collect socio-demographical information related to chronic illnesses of the participants, living with a chronically ill person, contact with a person diagnosed with COVID-19, having people close to them who have died of COVID-19, and their perception of whether or not people respect the health measures.

RESULTS

: Young people have suffered higher stress, anxiety, and depression levels than at the beginning of the pandemic.

CONCLUSIONS

: The present study highlights the importance of addressing young people's mental health, and ensure that future adults emerge from the COVID-19 pandemic in a psychologically strong state.

Identifying Lockdown Relaxation Strategies and Policy Implications to Fight against COVID-19: Medical Experts Perspective from Pakistan

The COVID-19 pandemic, was first identified in Wuhan, China, has had a drastic effect on the world economy and compelled governments to enforce lockdown in territories. However, lockdown is destroying the world economy badly as well as the physical and mental health of people. Therefore, governments must develop Lockdown Relaxation Strategies (LRS) to overcome the negative consequences of lockdown in Pakistan. Identifying LRS is important for public health and economic restoration. Therefore, this work is an initial attempt to develop LRS in a developing country - Pakistan, and prioritize LRS through a novel ISM-MICMAC approach. By taking response from experts, results show that implementation of smart lockdowns in affected areas, meeting minimum criteria of public health standards, limited operations of public transportation are the most important strategies. Results provide a strategic guideline for governments to take necessary measures and allocate resources appropriately.

Predictors of Self-Reported Compliance with COVID-19 Preventive Guidelines: A Quantile Regression Model

The research used an online, convenience cross-sectional sample of adults aged ≥18 years old recruited from Shahroud County, Northeast of Iran. We measured the contribution of multiple determinants for association with behavioral compliance, at the time of the COVID-19 pandemic. The compliance score measured with this questionnaire can be within a range of 5 and 100. Compliance was bounded between 19 and 80 that has been distributed J-shape, so quantile logistic regression model has been fitted for that. Variables related to people's knowledge, including self-reported knowledge and following the news related to COVID-19, were the two main factors that accompanied behavioral compliance at all of its levels in the period of pandemic.

International PRISMA scoping review to understand mental health interventions for depression in COVID-19 patients

Preliminary research indicates that the COVID-19 illness affects the mental well-being of patients. This scoping review, thus, aims to examine the current state of research into mental health treatments for depression symptoms in COVID-19 patients. Select databases were searched on 7/1/2021. Full-text articles involved (1) mental health treatment (2) suicide and/or depression outcomes, (3) a quasi-experimental research trial, and (4) a primary analysis. 11 articles were included in this review. The studies spanned 5 countries, and demonstrated immediate positive effects of mental health treatments and tele-health as a treatment modality for depression in COVID-19 patients. 6 studies were randomized controlled trials. Various treatments were administered, including cognitive behavior therapy, mindfulness, and muscle relaxation. Most interventions were conducted in in-patient units and focused on acute symptoms. There were limitations in the design and description of methodology in many studies, which affects the generalizability and replicability of positive findings. Only two studies included a post-intervention follow-up and one study assessed suicide risk. Thus, this review found there is a pressing need for more research in the area, with greater rigor in study methodology, and for treatments targeting long-term symptoms and suicidality, and outpatient services.

Meta-analysis of prevalence: the psychological sequelae among COVID-19 survivors

OBJECTIVE

This meta-analysis aims to estimate the pooled prevalence of mental disorders among COVID-19 survivors.

METHODS

The databases Pubmed, Google Scholar, ScienceDirect, and medRxiv have been searched up to 1 August 2021 using COVID-19, survivors, mental disorders, and their related MeSH terms. The included studies were either cross-sectional, cohort, or case-control in design. Those studies included COVID-19 survivors after 14 or more days from their COVID-19 recovery and used validated questionnaires to assess their mental health outcomes. The random-effects model was used to pool the data from the incorporated studies. The heterogeneity was assessed using Cochran's Q heterogeneity test and I² statistic.

RESULTS

Twenty-seven studies were included in the data synthesis with a total sample size of 9605 COVID-19 survivors. The prevalence rates for Post-Traumatic Stress Disorder (PTSD), anxiety, psychological distress, depression, and sleeping disorders were 20% (95% CI = 16-24%), 22% (95% CI = 18-27%), 36% (95% CI = 22-51%), 21% (95% CI = 16-28%), and 35% (95% CI = 29-41%), respectively.

CONCLUSIONS

Although we found high heterogeneity across the included studies, our meta-analysis provides evidence that there are psychological sequelae in COVID-19 survivors that require medical assiduity as well as further research on the matter.KEY POINTSIncreased prevalence of psychological sequelae among COVID-19 survivors.The prevalence of PTSD was 20% (95% CI = 16-24%) and of anxiety was 22% (95% CI = 18-27%) among COVID-19 survivors.The prevalence of psychological distress was 36% (95% CI = 22-51%), of depression was 21% (95% CI = 16-28%), and of sleep disorders was 35% (95% CI = 29-41%) among COVID-19 survivors.Future researches are recommended to search for effective and safe methods to mitigate the psychological sequelae in COVID-19 patients.

Association of compliance with COVID-19 public health measures with depression

Although previous studies have demonstrated increased depression related to COVID-19, the reasons for this are not well-understood. We investigated the association of compliance with COVID-19 public health measures with depression. Data from the 2020 Korea Community Health Survey were analyzed. The main independent variable was compliance with rules based on three performance variables (social distancing, wearing a mask in indoor facilities, and outdoors). Depression was assessed using Patient Health Questionnaire-9 scores. Of 195,243 participants, 5,101 participants had depression. Bad and moderate performance scores for compliance were associated with depression (Bad score, men: adjusted odds ratio [aOR] = 2.24, 95% confidence interval [CI] = 1.29-3.87; women: aOR = 2.42, 95% CI = 1.42-4.13; moderate score, men: aOR = 1.31, 95% CI = 1.02-1.68; women: aOR = 1.28, 95% CI = 1.07-1.53). In the subgroup analysis, among the quarantine rules, not wearing a mask indoors was the most prominently associated with depression. In participants with a high level of education, non-compliance with quarantine rules was significantly associated with depression. People who do not comply with public health measures are more likely to be depressed. The preparation and observance of scientific quarantine rules can help mental health in the ongoing COVID-19 pandemic and another infectious disease pandemic that may come.

Depression and anxiety among online learning students during the COVID-19 pandemic: a cross-sectional survey in Rio de Janeiro, Brazil

Background

The COVID-19 pandemic introduced a global need to explore the potential and challenges of online education.

Objective

To evaluate the presence of depression and anxiety in university students and their level of satisfaction with online learning during the period of social isolation caused by the COVID-19 pandemic.

Method

A cross-sectional design was used to evaluate 152 online learning students from six different university courses: Medicine, Psychology, Law, Engineering, Physiotherapy, and Business. The evaluation of the participants was carried out through an online survey in Rio de Janeiro, Brazil. Also, the Hospital Anxiety and Depression Scale was used to assess participants mental health.

Results

Most of the participants reported emotional impact, followed by learning impact, financial impact, social impact, and technological impact, with a significant difference in the presence of depressive symptoms, but no significant difference in anxiety. The participants presented moderate anxiety levels, with no significant differences between genders, and mild levels of depressive symptoms with significant differences between genders. Also, younger students were more anxious than older students. In addition, female students with less social contact presented more depressive symtoms.

Conclusion

From a clinical perspective, the findings provide insights into mental health among university students during the COVID-19 pandemic. These findings may help in the development of effective screening strategies and in the formulation of interventions that improve the mental health of students.

Evolving norms: social media data analysis on parks and greenspaces perception changes before and after the COVID 19 pandemic using a machine learning approach

This study provides a novel approach to understand human perception changes in their experiences of and interactions with public greenspaces during the early months of COVID-19. Using social media data and machine learning techniques, the study delivers new understandings of how people began to feel differently about their experiences compared to pre-COVID times. The study illuminates a renewed appreciation of nature as well as an emerging but prominent pattern of emotional and spiritual experiences expressed through a social media platform. Given that most park and recreational studies have almost exclusively examined whether park use increased or decreased during the pandemic, this research provides meaningful implications beyond the simple extensional visit pattern and lends weight to the growing evidences on changing perceptions over and the positive psychological impacts of nature. The study highlights the preeminent roles parks and greenspaces play during the pandemic and guides a new direction in future park development to support more natural elements and nature-oriented experiences from which emotional and spiritual well-being outcomes can be drawn.

Impact of COVID-19 pandemic on physical activity level and screen time is associated with decreased mental health in Brazillian adults: A cross-sectional epidemiological study

The objective was to verify whether the impact of COVID-19 on physical activity and screen time was associated with the impact on quality of life and symptoms of anxiety and depression in a sample of Brazilian adults. The invitation was made through social networks and the collection was carried out through electronic research. There was a decrease in quality of life and physical activity, and an increase in symptoms of anxiety and depression and screen time. These findings are important for new strategies that promote physically active habits during the pandemic .

Psychological strain and suicidal ideation in young university students during Covid-19 outbreak: the mediating roles of rumination and depression

The link between psychological strain and suicidal ideation is well embedded in literature, however, the underlying mechanism is rarely explored. Therefore, this study aimed to examine the relationship between psychological strain, suicidal ideation, rumination, and depression among Pakistani young adults during the Covid-19 outbreak. In addition, it will also try to determine the mediating role of ruminative subtypes and depression in the relationship between psychological strain and suicidal ideation. The sample consists of 400 university students (83 males and 289 females) with the age range from 18 to 30 years (M = 22.25, SD = 2.40). Psychological strain scale, Suicidal Ideation Scale, Beck Depression Inventory, and Ruminative Response Scale were administered to the participants. Results indicated a significant and positive association between the study variables. Psychological strain positively influenced suicidal ideation both directly, and indirectly via brooding and depression. Both variables were found to be serially mediated by the brooding subtype of rumination and depression and not with the reflective subtype. Strain theory of suicide and response style theory also postulated important insights regarding the association of these variables in young adults, among which, strain is serially related to first brooding and then depression, which is eventually related to suicidal ideation. The present study makes a significant contribution to the literature by providing a unique conceptual and theoretical framework to identify suicide at the ideation level before it proceeds to behavior during this unprecedented time of the pandemic outbreak.

Impact of the COVID-19 pandemic on psychological distress and biological rhythm in China’s general population: A path analysis model

Objective

When facing major emergency public accidents, men and women may react differently. Our research aimed to assess the influence of gender difference on social support, information preference, biological rhythm, psychological distress, and the possible interaction among these factors during the COVID-19 pandemic.

Methods

In this cross-sectional study, 3,237 respondents aged 12 years and older finished the online survey. Levels of social support, information preference, biological rhythm, and psychological distress were assessed using validated scales. A path analysis was conducted to explore possible associations among these variables.

Results

The path analysis indicated that women with high levels of social support had a lower possibility of biological rhythm disorders and lower levels of somatization symptoms of psychological distress during the COVID-19 pandemic. The influence of social support on somatization symptoms was exerted via biological rhythm. Women tended to believe both negative and positive information, while men preferred more extreme information.

Conclusion

Our results highlighted gender difference in study variables during the COVID-19 pandemic and the importance of social support in alleviating psychological distress and biological rhythm disorders. Moreover, we confirmed that information preference differed significantly by somatization symptoms of psychological distress, suggesting extra efforts to provide more individualized epidemic information. Longitudinal research is required to further explore casual inferences.

Managing the COVID-19 pandemic in people with mental disorders: An exploratory telephone interview study in a psychiatric outpatient department

BACKGROUND

The COVID-19 pandemic and associated lockdown measures reduced well-being in the general population significantly and led to an increase in anxiety and depression symptoms, however, results on the impact on people with mental disorders are heterogeneous to date. The aim of this study was to investigate the mental health status, social support, perceived stress, and the medical care provision of people with mental disorders during the time period immediately after the first COVID-19 lockdown in spring 2020 in Germany.

METHODS

Participants were people with mental disorders currently receiving treatment in the psychiatric outpatient department of the University Hospital Leipzig, Germany. Structured telephone interviews were administered to assess depressive symptoms, self-rated medical care provision, attitudes and social and emotional aspects of the pandemic (social support, perceived stress, loneliness, resilience, and agreeableness).

RESULTS

A total of N = 106 people completed the telephone interview. The most frequent clinician-rated diagnoses were attention deficit disorder/attention deficit hyperactivity disorder (ADD/ADHD; n = 29, 27.4%) and obsessive-compulsive disorder (OCD; n = 24, 22.6%). The mean Patient Health Questionnaire-9 sum score was 10.91 (SD = 5.71) and the majority of participants (n = 56, 52.8%) reported clinically relevant depressive symptoms. A low self-rated medical care provision was significantly associated with higher depressive symptom load. In a regression analysis, higher perceived stress levels and low medical care provision significantly predicted depressive symptoms. Furthermore, 38.1% (n = 40) reported to feel relieved as a result of the restrictions and, due to previous experience in dealing with crisis, half of the participants (n = 53, 50.5%) stated they were better able to deal with the current situation than the general population.

CONCLUSIONS

This study emphasizes the importance of maintenance of medical care provision for people with mental disorders, as cancelled or postponed treatment appointments and perceived stress were associated with higher depressive symptoms. Regular treatment services showed to have a protective effect. In addition, a majority of people with mental disorders felt prepared for managing the COVID pandemic due to existing crisis management abilities. These resources should also be taken into account for further future treatment considerations.

TRIAL REGISTRATION

German Clinical Trials Register (DRKS00022071).