Anxiety Linked to COVID-19: A Systematic Review Comparing Anxiety Rates in Different Populations

Prospective exploration of the role of combined internalizing symptoms in self-reported memory among older adults during the COVID-19 pandemic

OBJECTIVES

A growing literature suggests depression and anxiety increase risk of cognitive decline. However, few studies have examined their combined effects on cognition, among older adults, especially during periods of high stress.

METHOD

Based on a sample of community dwelling older adults (N = 576), we evaluated the effects of pre-pandemic anxiety and depressive symptoms, obtained in September 2018, to changes in self-reported memory (SRM) assessed 3 months into the COVID-19 pandemic.

RESULTS

In separate models, we found participants with depression scores at least 1-SD above the mean and participants with anxiety scores at least 2-SD above the mean to report a significant decline in SRM. Moderation analyses revealed those with high depressive symptoms (at or above the mean) showed a decrease in SRM regardless of anxiety. The extent to which high pre-pandemic anxiety symptoms influenced SRM is dependent on whether pre-pandemic depression was at or above the mean.

CONCLUSIONS

Pre-pandemic depression predicted a decline in SRM regardless of anxiety. Moderation analyses revealed that the extent to which anxiety symptoms influenced SRM was dependent on depression being at or above the mean. Those with high anxiety and depression are at highest risk of experiencing cognitive consequences related to stressful exposures like COVID-19.

Network analysis for inter-relationships of the suboptimal health status with depression and anxiety during the COVID-19 pandemic: A perspective of predictive, preventive, and personalized health

BACKGROUND

The Coronavirus Disease-2019 (COVID-19) pandemic has had a profound impact on suboptimal health status, depression, and anxiety, necessitating a comprehensive understanding of their inter-relationships at the national level. This study aims to investigate the inter-relationships among suboptimal health status, depression, and anxiety using a network analysis approach.

METHODS

We conducted a national survey between June 20 and August 31, 2022. Three network models were constructed and analyzed to independently examine the inter-relationships among suboptimal health status, depression, and anxiety.

RESULTS

A total of 26,152 participants were included in this study. The study network analysis indicated that item 9 (i.e., Slow response) exhibited the highest node strength within the suboptimal health status questionnaire-short form (SHSQ-SF) network, followed by item 5 (i.e., Breathlessness at rest). Additionally, positive correlations were observed between depression and anxiety severity and most of the SHSO-SF items.

CONCLUSIONS

This study provided valuable insights into inter-relationships between suboptimal health status, depression, and anxiety, informing the development of comprehensive intervention strategies for the general population. These findings have important implications for promoting the well-being and mental health of individuals during and beyond the COVID-19 pandemic.

Parental burnout during COVID-19: The moderating role of anxiety and family functioning

Parental burnout (PB) is characterised by parental exhaustion resulting from exposure to chronic parental stress. Due to the social and economic changes resulting from the COVID-19 pandemic that impacted families, there is a significant scientific interest in identifying factors related to PB within the pandemic context. This study aimed to analyse the relationships between parental stress (parental concerns, parental satisfaction, lack of control, and fears and anxieties), family functioning, psychological morbidity (anxiety and depression), and burnout in parents. The sample consisted of 253 parents, legal guardians or primary caregivers of children aged between 0 and 6 years. Results revealed that the child's age, psychological morbidity (depression), and parental stress were significant predictors of PB. Anxiety and family functioning played a moderating role in the relationship between parental satisfaction and PB. According to the results, intervention programs should focus on anxiety symptoms and family functioning to mitigate the effects of parental stress on PB.

Mental Health Status of New Police Trainees before and during the COVID-19 Pandemic

This study aimed to investigate the mental health of new police trainees during the coronavirus disease 2019 (COVID-19) pandemic in Korea. Two groups of police trainees were surveyed considering the distribution of gender, age, and education level: those who joined the school before COVID-19 and those who joined during the outbreak. Mental health indicators, including insomnia, depression, and anxiety, were compared between the two groups. The prevalence of insomnia, depression, and anxiety significantly varied in the group that joined during COVID-19 compared with the group that joined before. Specifically, insomnia showed a significant change in women, with a higher rate of 2.6%. Although the prevalence of depression was initially low, it increased from 0.4% to 1.3% during the pandemic. Anxiety rates also showed notable differences, particularly among women, with a higher rate of 4.7%. The highest differences in prevalence were observed in the low-income group, with a rate of 7.7% for anxiety. The findings highlight the vulnerability of police officers to psychosocial effects during disasters such as pandemics. Disaster preparedness programs or education can be integrated into new police officer training institutions to help manage mental health changes and promote overall well-being.

Covid-19 psychological pressures, depression and FOMO: the mediating role of online social support and emotional regulation

BACKGROUND

The spread of the coronavirus has led to significant anxiety among university students, resulting in various mental health problems that could potentially impact their academic performance.

METHOD

To examine the mediating role of emotional regulation and online social support in the relationships between COVID-19 psychological pressures, depression, and the fear of missing out (FoMO) among young adult university students, a cross-sectional research design was employed using an online survey. The sample consisted of 521 full-time university students from China, currently enrolled in undergraduate and postgraduate programs.

RESULTS

Findings revealed that more than half (55.09%, n=287) of the university students experienced COVID-19 psychological pressures. These pressures directly contributed to increased levels of depression (β = 0.339, p < .001) and fear of missing out (β = 0.236, p < .001). Moreover, online social support and emotional regulation exhibited partial mediating effects on the association between COVID-19 psychological pressures, depression, and the fear of missing out. The results indicated that COVID-19 psychological pressures were linked to higher levels of depressive symptoms and a greater fear of missing out among university students.

CONCLUSIONS

However, the provision of timely and adequate online social support, as well as the implementation of emotional regulation strategies, mitigated the negative effects of the pandemic on students' social and emotional well-being. Consequently, this led to reduced levels of depression and fear of missing out.

Influence of self-efficiency beliefs on the health and well-being of university students in COVID-19

OBJECTIVE

To analyze general self-efficacy beliefs in university students during the COVID-19 pandemic and their correlation with psychological well-being and anxiety and depressive symptoms.

METHOD

Cross-sectional study, carried out with nursing, medicine and psychology students from a higher education institution in the state of São Paulo, Brazil. The sample consisted of 329 students and data collection took place through a questionnaire and scales, from August to December 2020. Mann-Whitney test and Spearman's correlation coefficient were used for analysis of the variables.

RESULTS

Participants' self-efficacy was median (34.3±7.5). Higher self-efficacy scores were correlated with better psychological well-being (p<0.001; r= -0.582) and absence of anxiety (p<0.001) and depressive (p<0.001) symptoms.

CONCLUSION

High self-efficacy beliefs were associated with better mental health outcomes. Strengthening self-efficacy in universities can help improve students' health behaviors and prevent mental illness.

Symptoms and Engagement in Anti-social Behavior 10 Years After Mild Traumatic Brain Injury Within a Community Civilian Sample: A Prospective Cohort Study With Age-Sex Matched Control Group

OBJECTIVE

To determine if there are longer-term effects on symptoms, health status, mood, and behavior 10 years after a mild traumatic brain injury (mTBI).

DESIGN

Prospective cohort study.

SETTING

Community-based, civilian sample.

PARTICIPANTS

Adults aged ≥16 years at follow-up who experienced an mTBI 10 years ago, and an age and sex-matched non-injured control group.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

mTBI cases and controls were asked to complete self-report assessments of functioning (WHO Disability Assessment Schedule Version 2), symptoms (Rivermead Post-Concussion Symptom Questionnaire), health status (100-point scale), alcohol (Alcohol Use Disorders Identification Test) and substance use (Alcohol, Smoking and Substance Involvement Screening Test), and whether they had engaged in any anti-social behaviors over the past 12 months.

RESULTS

Data were analyzed for 368 participants (184 mTBI cases and 184 age-sex matched controls). Just over a third of mTBI cases (64, 34.8%) reported that they were still affected by their index mTBI 10 years later. After adjusting for education and ethnicity, the mTBI group had statistically higher overall symptom burden (F=22.32, P<.001, ηp2=0.07) compared with controls. This difference remained after excluding those who experienced a recurrent TBI. The mTBI group were more than 3 times as likely to have engaged in anti-social behavior during the previous 12 months (F=5.89, P=.02). There were no group differences in health status, functioning, or problematic alcohol or substance use 10 years post-injury.

CONCLUSIONS

This study provides evidence of potential longer-term associations between mTBI, post-concussion symptoms, and anti-social behavior which warrants further evaluation. Future research should also examine if longer-term effects may be preventable with access to early rehabilitation post-injury.

Cannabis use in the UK: a quantitative comparison of individual differences in medical and recreational cannabis users

There is a paucity of research, especially in the UK, that investigates individual differences in both medical and recreational cannabis users. A cross-sectional survey study design was used to assess recreational cannabis users and medical cannabis users currently living in the UK. Recreational cannabis users were invited to take part via social media. Medical cannabis users were recruited from Sapphire Medical Clinics, London, UK, which provides treatment with prescribed cannabis-based medicinal products. Demographic data and cannabis use frequency, as well as post-traumatic stress disorder symptoms (PCL-5), depression symptoms (Centre for Epidemiological Studies Depression Scale), trait and state anxiety (State-Trait Anxiety Inventory), and cannabis use motives [Comprehensive Marijuana Motives Questionnaire (CMMQ)] were collected. The Chi-square and independent-sample t-tests were used for the comparison of categorical variables and normally distributed continuous variables. Data were analyzed using analyses of variance (ANOVAs) and t-tests. Statistical significance was considered where the value of p was <0.05. The survey was completed by 161 participants. Medical cannabis users were older, consumed cannabis more often, had a higher "Sleep" motive on the CMMQ, and had a higher prevalence in self-reporting current diagnoses of neurological problems, mood disorders, and anxiety disorders (p < 0.05). Recreational cannabis users had higher scores on several motives for use (e.g., "Enjoyment," "Coping," "Experimentation," "Boredom," and "Celebration") and higher state anxiety scores (p < 0.05). The most common motives for cannabis use in both groups were "Enjoyment," "Low Risk," and "Sleep." There were no differences between groups in gender, "Low-Risk" motive, post-traumatic stress disorder symptoms, depression scores, trait anxiety scores, self-reported prevalence of substance use-related disorders, and past consumption of alcohol, tobacco, or caffeine (p > 0.05). The current study not only demonstrates a difference in age and motivations for cannabis consumption between recreational and medical cannabis users but also shows areas of potential overlap, including mental health outcomes, past substance use, and gender. These UK-specific findings indicate that recreational cannabis users experience higher state anxiety, highlighting the need for further evaluation of potential anxiogenic/anxiolytic properties of cannabis. These findings demonstrate the importance of researching individual differences in cannabis users and hold significant implications for future research, clinical practice, and legislation.

A systematic review and meta-analysis of neuroticism and anxiety during the COVID-19 pandemic

Introduction

In response to the global impact of the COVID-19 pandemic, concerns about mental health, particularly anxiety levels, have become prominent. This study aims to explore the relationship between neuroticism, a personality trait associated with emotional instability, and anxiety during the COVID-19 outbreak.

Methods

A comprehensive literature search was conducted using the Cochrane Library, HINARI, Google Scholar, and PUBMED, resulting in the identification of 26 relevant papers. The study protocol has been registered with PROSPERO under the number CRD42023452418. Thorough meta-analysis was performed using Comprehensive Meta-Analysis V4 software.

Results

Meta-analysis revealed a significant positive relationship between anxiety and neuroticism, with 26 studies supporting this association (OR = 3.213, 95% CI 2.352 to 4.391). The findings underscore the importance of considering personality traits, particularly neuroticism, in understanding psychological responses to major global crises such as the COVID-19 epidemic.

Discussion

The observed connection between neuroticism and heightened anxiety levels emphasizes the need for targeted interventions, especially for individuals with high levels of neuroticism. Further research into potential therapeutic approaches for mitigating anxiety consequences in the context of a significant global catastrophe is warranted.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/#CRD42023452418.

Characterising subgroups of people with severe COVID anxiety by latent profile analysis

BACKGROUND

People with severe COVID anxiety have had experiences of the COVID-19 pandemic which are overwhelming, and have led to patterns of behaviours that add little protective benefit but are at the expense of other priorities in life. It appears to be a complex social and psychological phenomenon, influenced by demographic and social factors. Identifying subgroups of people with severe COVID anxiety would better place clinicians to assess and support this distress where indicated.

METHODS

Measurement tools assessing depression, generalised and health anxiety, obsessive-compulsive symptoms, personality difficulty and alcohol use from 284 people living in United Kingdom with severe COVID anxiety were explored with latent profile analysis. Further analyses examined the associations of identified clusters with demographic and social factors and daily functioning, quality of life and protective behaviours.

RESULTS

A model with 4 classes provided the best fit. Distinct patterns of psychopathology emerged which were variably associated with demographic factors and COVID behaviours.

LIMITATIONS

Given the complex aetiology of COVID anxiety a number of factors which might better cluster subgroups are likely to have gone uncollected. Moreover, using data collected at a single time-point limits these results' ability to conclude whether observed relationships were the product of the pandemic or longstanding.

CONCLUSIONS

People living with severe COVID anxiety are a heterogenous group. This analysis adds to evidence that certain health behaviours and demographic factors are inextricably linked to poor mental health in people with COVID anxiety, and that targeting health behaviours with specific intervention might be beneficial.

Anxiety's correlation with sleepiness and memory among security officers during the COVID-19 pandemic

BACKGROUND

In the working population especially among older adults, anxiety problems have grown dramatically. This element has a significant impact on employee absenteeism and problems with physical and mental health. It was widely known that security personnel had several physical and mental difficulties during their various work hours. It is important to investigate the effects of anxiety on them.

OBJECTIVE

The present study aims to provide insights into the prevalence of anxiety disorders and explore the correlations between anxiety symptoms, sleep, and memory during the COVID-19 pandemic.

METHODS

To conduct a cross-sectional study, 42 older adult participants between the ages of sixty to seventy years were chosen and the procedure was explained.Data were gathered by giving instructions on how to complete the self-reported Generalized Anxiety Disorder Assessment -7 (GAD-7), the Epworth Sleepiness Scale, and the revised Everyday Memory Questionnaire.

RESULTS

A total of 36 out of 42 participants (85.71%) experienced moderate to severe anxiety. Anxiety and sleep had a correlation of 0.8, while anxiety and memory had a correlation of 0.87 with a positive EMQ-R relationship. Moreover, there was a statistically significant association between sleep and memory, with a positive correlation of 0.73.

CONCLUSION

The study concludes that, there is a substantial prevalence of anxiety accompanied by notable insomnia and memory problems in elderly security officers. Our findings indicate a clear relationship between sleep disturbances, memory issues, and most prevalent anxiety symptoms. These results emphasize the importance of incorporating mental health assessments and addressing an effective treatment for anxiety.

Evaluation of a Modified Mindfulness-Based Stress Reduction Intervention for Adults with Cerebral Palsy and Anxiety and/or Emotion Regulation Difficulties-A Randomised Control Trial

Mindfulness-Based Stress Reduction (MBSR) has not yet been evaluated for people with cerebral palsy (CP). The aims of this randomised control trial were to investigate whether a modified telehealth MBSR program could improve mindfulness and reduce depression, anxiety, and emotion regulation difficulties among adults with CP with elevated anxiety and/or emotional regulation difficulties. Participants (n = 31) with elevated anxiety and/or emotion regulation difficulties and no/mild intellectual impairment were randomised to a modified telehealth MBSR program (90 min weekly, 9 weeks) group or a wait-list group. Measurements were collected prior to (T1), after (T2), and 8 weeks post-intervention (T3). The primary outcome was the mean between-group difference in the change in Cognitive and Affective Mindfulness Scale-R (CAMS-R) scores in T1-T2. The secondary outcomes included mean within-group differences over time for the CAMS-R total scores, Depression Anxiety and Stress Scale-21 subscales, and Difficulties in Emotion Regulation Scale (DERS) total t-score. We found no statistically significant between-group difference in mean change in mindfulness scores for T1-T2 (primary outcome). Secondary outcomes: The MBSR intervention group had improved CAMS-R scores with respect to T1-T2 and T1-T3; improved mean scores for Depression and Stress subscales for T1-T2; and improved DERS t-scores for T1-T2 and T1-T3. In conclusion, this study found no significant between-group difference for the primary outcome of mindfulness. The MBSR program was successfully modified for adults with CP and was effective in improving depression, stress, and emotion regulation. ACTRN12621000960853.

Longitudinal exploration of biopsychosocial profiles in individuals with anorexia nervosa

BACKGROUND

Previous work in individuals with Anorexia Nervosa (AN) has demonstrated a range of psycho-social difficulties such as increased anxiety, depression, obsessive-compulsive symptoms, as well as difficulties in work and with interpersonal interactions. However, making inferences regarding the stability of these psycho-social difficulties from previous studies is challenging, due to lack of a control group and known frequentist statistical issues.

METHODS

134 participants, 40 healthy controls (HC) and 94 participants with AN, completed self-reported measures designed to explore eating disorder concerns, body mass index, mood symptoms, work and social functioning as well as traits associated with autism at two time points, two years apart. A principal component analysis and Bayesian mixed effects models were used to build and explore group differences in bio-psychosocial profiles at time points.

RESULTS

The Bayesian models demonstrated evidence for individuals with AN having higher scores for a component representing psycho-social difficulties and lower scores for a component representing biological difficulties compared to HC, at both time points. There was no evidence of a group difference for a component representing autism.

CONCLUSIONS

Our results demonstrate that persistent psycho-social difficulties are a feature in individuals with AN.

Fear of COVID-19, Perceived Stress, and PTSD: The Serial Mediating Role of Sense of Coherence

The literature has identified that a sense of coherence plays a protective role in the relationship between adverse events and mental health. The current study examines the role of a sense of coherence (SOC) in the relationship between fear of COVID-19, perceived stress, and dimensions of post-traumatic stress disorder (PTSD). Participants (n = 322) were students at a metropolitan university in South Africa who completed the Fear of COVID-19 Scale, the Perceived Stress Scale, the 13-item Sense of Coherence Scale, and the PTSD Checklist. Path analysis was used to conduct a serial mediation analysis. The results show that SOC mediates the relationship between perceived stress and the dimensions of PTSD but does not mediate the relationship between fear of COVID-19 and PTSD. Furthermore, the relationship between fear of COVID-19 and dimensions of PTSD was mediated by serial perceived stress and sense of coherence, supporting the hypothesis that higher levels of fear of COVID-19 leads to higher levels of perceived stress. However, while high levels of fear of COVID-19 increase perceived stress, SOC significantly mediates the subsequent impact on PTSD symptoms.

Anxiety symptoms before and during the COVID-19 pandemic: A longitudinal examination of Canadian young adults

The COVID-19 pandemic has resulted in many changes that may impact anxiety symptoms (i.e., general anxiety and somatization), particularly for young adults who were at higher risk for anxiety than older adults. We examined anxiety symptoms before (age 19, 20, 21, and 22) and during the pandemic (age 23 and 24) in a cohort of Canadian young adults (n = 396). Latent growth curve models were performed for general anxiety and somatization and the pandemic time points were estimated as structured residuals to quantify the change from participants' expected trajectories. We also examined whether fear of COVID-19 predicted the changes in anxiety symptoms during the pandemic. Results indicated that a history of general anxiety and somatization positively predicted fear of COVID-19 during the pandemic and negatively predicted pandemic change from predicted values for both general anxiety and somatization. Increased COVID-19 fear was related within time to increases in general anxiety at ages 23 and 24 and increases in somatization at age 24. We also found that the proportion of individuals in the subclinical/clinical range of somatization was higher from age 23-24, but not from age 22-23 and there were no differences for general anxiety. Results highlight the need to consider within-person change and development in evaluating anxiety symptom changes and predictors of changes in anxiety symptoms.

Relationships between mastery, forgiveness, optimism, and resilience, and PTSD and anxiety during the COVID-19 pandemic

The COVID-19 pandemic has had devastating emotional consequences. The present study aimed to examine the relationships between personal resources and emotional distress while accounting for COVID-19-related variables. Seven hundred and seventy-seven (N = 777) participants completed demographic, mastery, forgiveness, optimism, resilience, PTSD, and anxiety questionnaires. A stepped hierarchical multiple regression revealed that mastery, forgiveness, cultural group, age, acquaintance with a person who died of COVID-19, and having been infected with COVID-19 contributed significantly to the explained variance in PTSD symptoms. Mastery, forgiveness, optimism, age, and acquaintance with a person who died of COVID-19 contributed significantly to the explained variance in anxiety. However, resilience was not found to significantly contribute to the explained variance in PTSD symptoms or anxiety. This study demonstrates the importance of being aware of both PTSD symptoms and anxiety associated with COVID-19. Thus, it is suggested that therapy programs should pay special attention to mastery and forgiveness as coping resources. In addition, among medical and mental-health personnel awareness should be given to individuals who have been in close acquaintance with those who died of COVID-19, those with COVID-19 risk factors, and those who have been infected. Special attention should also be paid to minority groups as they might tend to experience more emotional distress and trauma symptoms.

One-Year Follow-Up of Seroprevalence of SARS-CoV-2 Infection and Anxiety among Health Workers of a French Cancer Center: The PRO-SERO-COV Study

Infection of SARS-CoV-2 among health workers (HWs) in contact with cancer patients has been a major issue since the beginning of the pandemic. We aimed to assess the serological immune status of SARS-CoV-2 infection among these HWs. A prospective cohort study was initiated in the comprehensive cancer center of the Nouvelle-Aquitaine region (NA, France). Volunteer HWs working on March 2020 without active infection or symptoms of COVID-19 completed a self-questionnaire and had a blood test at inclusion, at 3 and 12 months. Positive serological status of SARS-CoV-2 infection was defined by anti-nucleocapsid antibodies and/or IgG anti-spike antibodies, except at 12 months due to vaccine. Half of the HWs were included (N = 517) and 89% were followed for three months (N = 500) and one year (N = 462). Seroprevalence of SARS-CoV-2 infection was 3.5% (95% CI: 1.9-5.1), 6.2% (95% CI: 4.1-8.3), and 10% (95% CI: 7.2-12.7) on June-September 2020, September 2020-January 2021, and June-October 2021, respectively. At 12 months, 93.3% had detectable antibodies with 80% vaccinated in the first three months of vaccine availability. The COVID-19-free policy of the institution, respect for barrier gestures, high and early vaccination of HWs, and low prevalence of SARS-CoV-2 in NA may explain the low rate of seropositivity among the HWs of the Institut Bergonié.

Anxiety in Brief: Assessment of the Five-Item Trait Scale of the State-Trait Anxiety Inventory in South Africa

The current study examined the psychometric properties of a short form of the trait scale of the Spielberger State-Trait Anxiety Inventory. Participants consisted of a convenience sample of students (n = 322) who completed the five-item version of the trait scale of the State-Trait Anxiety Inventory, the Perceived Stress Scale, the nine-item version of the Beck Hopelessness Scale, the 10-item version of the Center for Epidemiological Studies Depression Scale, and the Post-Traumatic Stress Disorder Checklist. We used classical test theory and item response theory (Rasch and Mokken analyses) to examine the psychometric properties of a previously proposed five-item version of this scale. These approaches confirmed that the five-item measure of anxiety had satisfactory reliability and validity, and also confirmed that the five items comprised a unidimensional scale.

Interventions for generalized anxiety disorder

PURPOSE OF REVIEW

To provide an overview of recently published work on anxiety, focusing on generalized anxiety disorder (GAD) and its treatment.

RECENT FINDINGS

Self-reported anxiety symptoms were highly prevalent during the COVID-19 global pandemic in both the general population and in selected groups. There remains divided opinion about whether internet-based cognitive behavioural therapy (CBT) is noninferior to face-to-face CBT for GAD. A systematic review of drug treatment for GAD showed efficacy for selective serotonin reuptake inhibitors (SNRIs), agomelatine, and quetiapine. There may be a place for repetitive transcranial magnetic stimulation in the treatment of GAD. There was some evidence of efficacy for complementary therapies, including physical exercise, yoga, acupuncture, and Withania somnifera (ashwagandha). However, a systematic review of cannabidiol and tetrahydrocannabinol found insufficient evidence of efficacy in anxiety disorders.

SUMMARY

Antidepressants and quetiapine show efficacy in the treatment of GAD. Internet-based psychological interventions have a place in the treatment of GAD when face-to-face treatment is inaccessible. There is increasing evidence for the use of physical exercise in the management of GAD. Some other complementary therapies, including cannabinoids, require further, methodologically sound, research.

Mental health concerns and network structures of psychological helpline help-seekers during the COVID-19 pandemic in China: Pandemic stage differences

BACKGROUND

The present study aimed to investigate the pandemic stage differences of mental health helpline help-seekers emotional responses, psychiatric symptoms, and related network structures during the COVID-19 pandemic in China.

METHODS

The data was collected by a large-scale psychological helpline in response to the COVID-19 pandemic in mainland China. Counselor-reported information about the help-seekers pandemic-related emotional responses and psychiatric symptoms were recorded. A total of 26,870 callers' data from February 28, 2020, to April 23, 2021, were collected in the present study. A linear probability model and network analysis were conducted to determine the differences in help-seekers mental health concerns and network structures between the pandemic (stage I, from February 28, 2020, to April 28, 2020, N = 9821) and the regular prevention and control period (stage II, from April 29, 2020, to April 23, 2021, N = 17,049).

RESULTS

Results revealed that anger, sadness, and obsession symptoms increased in stage II while symptoms of anxiety, somatization, and feelings of fear and stress were relieved. The network analysis results demonstrated both stage I and II networks centered on anxiety firmly. In stage II, the connection between anxiety and hypochondria and fear's strength centrality descended significantly.

LIMITATIONS

The mental health outcomes of callers only included the counselor-reported data.

CONCLUSIONS

The mental health concerns of helpline callers showed pandemic-related stage differences.

The Effects of Medications and the Roles of Pharmacists on the Recovery of Patients with COVID-19 Infection: An Epidemiological Study from the United Arab Emirates

Patients infected with coronavirus have new experiences and hence new needs from the healthcare sector. Acknowledging patients' experiences can exhibit promising outcomes in coronavirus management. Pharmacists are considered a vital pillar in managing patients' experiences during their infection. A cross-sectional study was conducted to assess the experiences of COVID-19-infected individuals and the roles of pharmacists in the United Arab Emirates. The survey was face- and content-validated after being developed. Three sections were included in the survey (demographics, experiences of infected individuals, and the roles of pharmacists). Data were analyzed using the Statistical Package for the Social Sciences. The study participants (n = 509) had a mean age of 34.50 (SD = 11.93). The most reported symptoms among participants were fatigue (81.5%), fever (76.8%), headache (76.6%), dry cough (74.1%), muscle or joint pain (70.7%), and sore throat (68.6%). Vitamin C was the most used supplement (88.6%), followed by pain relievers (78.2%). Female gender was the only factor associated with symptom severity. About 79.0% agreed that the pharmacist played an important and effective role during their infection. The most reported symptom was fatigue, with females reporting more severe symptoms. The role of the pharmacist proved to be vital during this pandemic.

COVID-19 Anxiety and Wellbeing at Work in Finland during 2020-2022: A 5-Wave Longitudinal Survey Study

The COVID-19 pandemic impacted workers globally during 2020-2022 and it has had major psychological implications for workers' wellbeing. This longitudinal study analyzed risk and protective factors predicting COVID-19 anxiety among workers in Finland. Longitudinal national sample of Finnish workers (n = 685) participated in a five-wave study conducted in 2020-2022, covering multiple waves of the COVID-19 pandemic and its aftermath. Our outcome measure was COVID-19 anxiety. Predictors were psychological distress, work exhaustion, technostress, and loneliness. Models also controlled for self-regulation; social support at work and remote working; and socio-demographic background factors. Both within-person and between-person effects were analyzed using multilevel hybrid regression models. COVID-19 anxiety varied between time points which is explained by changes in circumstances during the pandemic. Highest anxiety was expressed in the middle of the Delta variant surge and lockdown in spring 2021. Within-person changes in psychological distress, work exhaustion, technostress, self-regulation, and perceived loneliness were all associated with COVID-19 anxiety. Between-person results showed that distressed, exhausted, technostressed, and lonely workers expressed more anxiety than others. Remote workers reported higher anxiety over time than others. Those who had reported high self-regulation reported lower anxiety than others. Female gender and younger age were associated with higher anxiety. COVID-19 anxiety continues to be an important phenomenon with a magnitude of consequences on people and numerous industries. This study showed that general mental health and work stressors predict COVID-19 anxiety. Promoting social support and workers' self-regulation skills can be beneficial for overcoming anxiety during and after the pandemic.

Were there losses in social support during the pandemic? Testing the impact of COVID-19 on psychological adjustment to trauma in United States adults

Introduction

Social support is a key protective factor in the psychological adjustment of individuals to traumatic events. However, since March 2020, extant research has revealed evidence of increased loneliness, social isolation, and disconnection, likely due to COVID-19 pandemic-related recommendations that restricted day-to-day contact with others.

Methods

In this investigation, we applied a case-control design to test the direct impacts of the pandemic on social support in United States adults recovering from a significant injury caused by PTSD-qualifying, traumatic events (e.g., motor vehicle crashes, violence, etc.). We compared individuals who experienced trauma during the pandemic, the "cases" recruited and evaluated between December 2020 to April 2022, to trauma-exposed "controls," recruited and evaluated pre-pandemic, from August 2018 through March 9, 2020 (prior to changes in public health recommendations in the region). Cohorts were matched on key demographics (age, sex, education, race/ethnicity, income) and injury severity variables. We tested to see if there were differences in reported social support over the first 5 months of adjustment, considering variable operationalizations of social support from social network size to social constraints in disclosure. Next, we tested to see if the protective role of social support in psychological adjustment to trauma was moderated by cohort status to determine if the impacts of the pandemic extended to changes in the process of adjustment.

Results

The results of our analyses suggested that there were no significant cohort differences, meaning that whether prior to or during the pandemic, individuals reported similar levels of social support that were generally protective, and similar levels of psychological symptoms. However, there was some evidence of moderation by cohort status when examining the process of adjustment. Specifically, when examining symptoms of post-traumatic stress over time, individuals adjusting to traumatic events during COVID-19 received less benefit from social support.

Discussion

Although negative mental health implications of the pandemic are increasingly evident, it has not been clear how the pandemic impacted normative psychological adjustment processes. These results are one of the first direct tests of the impact of COVID-19 on longitudinal adjustment to trauma and suggest some minimal impacts.

College students' anxiety after returning to school during the COVID-19 epidemic: What should we care

The college students' anxiety during the Coronavirus disease 2019 (COVID-19) epidemic remains unclear. We aimed to evaluate the college students' anxiety after returning to school during the COVID-19 epidemic, to provide reference for the management and nursing care of college students. We conducted a survey from September 15, 2021 to September 30, 2021 investigate the anxiety level of college students. The Self-rating Anxiety Scale was used for anxiety assessment. The Spearman correlation analysis was conducted to evaluate the correlation between students' anxiety and characteristics. Logistic regression analysis was used to explore the influencing factors of concurrent anxiety among college students. A total of 2168 college students were included, the incidence of anxiety was 30.07% in college students during the COVID-19 epidemic. Pearson correlation analyses showed that grade (R = 0.715), main use of computer and mobile phone (R = 0.622), daily exercise (R = 0.735), whether relatives or friends are infected with COVID-19 (R = 0.735) are associated with the anxiety level of college students (all P < .05). Logistic regression analysis indicated that senior year (Odds ratio [OR] = 2.064, 95% confidence interval [CI]: 1.355-3.001), online game (OR = 3.122, 95% CI: 2.562-3.899), relatives or friends are infected with COVID-19 (OR = 2.987, 95% CI: 1.901-3.451) are the independent risk factors of anxiety in college students (all P < .05). Daily exercise (OR = 0.514, 95% CI: 0.205-0.814) was the independent protective factors of anxiety in college students (P = .008). During the COVID-19 epidemic, college students have increased anxiety and there are many influencing factors. Administrators and educators should especially pay attention to the mental health of students with those risk factors to maintain students' physical and mental health.

The burdens of poverty during the COVID-19 pandemic

BACKGROUND

Individuals living at-risk-of-poverty have an increased risk of poor mental health. The pandemic and its societal impacts might have negative effects especially on this group widening the gap between rich and poor and also exacerbate gender gaps, which in turn might impact social cohesion.

AIM

The objective of this longitudinal study was to determine if people living at-risk-of-poverty were more vulnerable to economic and psychosocial impacts of the pandemic and showed poorer mental health. Moreover, gender differences were analyzed.

METHOD

We drew data from a sample of N = 10,250 respondents of two time points (T1 starting from October 2020, T2 starting from March 2021) of the Gutenberg COVID-19 Study. We tested for differences between people living at-risk-of-poverty and more affluent respondents regarding economic impacts, psychosocial stressors, as well as depressiveness, anxiety and loneliness, by comparing mean and distributional differences. To test for significant discrepancy, we opted for chi-square- and t-tests.

RESULTS

The analysis sample compromised N = 8,100 individuals of which 4,2% could be classified as living at-risk-of-poverty. 23% of respondents living at-risk-of-poverty had a decrease in income since the beginning of the pandemic-twice as many as those not living at-risk-of-poverty, who reported more often an increase in income. Less affluent individuals reported a decrease in working hours, while more affluent people reported an increase. Between our survey time points, we found a significant decrease in these economic impacts. Gender differences for economic changes were only found for more affluent women who worked more hours with no change in income. Less affluent respondents were more impacted by psychosocial stressors, depressiveness, anxiety, and loneliness. Gender differences were found particularly with regard to care responsibilities.

DISCUSSION

Our results indicate a widening in the gap between the rich and the poor at the beginning of the pandemic. Gender differences concerning economic changes affect more affluent women, but women in both income groups are more burdened by care responsibilities, which might indicate a heightened resurgence of gender role in times of crisis. This increase in inequality might have impacted social cohesion.

Mental Health Status of French School-Aged Children's Parents during the COVID-19 Lockdown and Its Associated Factors

The COVID-19 pandemic has led to widespread social isolation. This study aimed to determine anxiety levels among parents of school-aged children and investigate the associated factors. Data on sociodemographic characteristics, living and working conditions, family relationships, social support (MSPSS) and health status (SF-12) were collected from French parents through an online survey. The Generalized Anxiety Disorder Scale (GAD-7) was used to assess anxiety. Logistic regression analysis was performed to identify the factors associated with moderate to severe anxiety. Among 698 parents, 19.2% experienced moderate to severe anxiety. A low level of resilience (OR = 4.3, 95% CI: 2.7-6.7) and confirmed COVID-19 cases involving hospitalization (OR = 3.8, 95% CI: 2.0-7.3) among individuals in one's household or in the family circle were found to be the main risk factors for moderate to severe anxiety. Other factors were also identified: a level of education less than high school (OR = 2.1, 95% CI: 1.3-3.2), conflicts at home (OR = 2.3, 95% CI: 1.4-3.7), noises outside the home (OR = 2.0, 95% CI: 1.0-3.9), confirmed cases not involving hospitalization (OR = 1.8, 95% CI: 1.0-3.1) and suspected cases (OR = 1.9, 95% CI: 1.0-3.8). Family support was a protective factor. These findings suggest some need for support programs to help parents cope with public health crises and work-family challenges.

Effects of the COVID-19 pandemic on clinically diagnosed psychiatric disorders in persons with type 2 diabetes

AIMS

To examine whether the incidence rates of diagnosed depression, anxiety disorders and stress reactions, as well as prescription rates of antidepressants and anxiolytics were higher during the COVID-19 pandemic than before in persons with type 2 diabetes in Germany. Contrary to earlier studies, clinical diagnoses of psychiatric disorders (ICD classification) were used.

METHODS

The German Disease Analyzer (DA) database is an outpatient database containing routine data on patients´ diseases and treatments provided by a representative panel of physician practices selected from across Germany. We assessed incidence rates of depressive disorders (ICD-10: F32, F33), anxiety disorders (F41) and stress reactions (F43) in quarters from January 2019 to March 2021 in 95,765 people with type 2 diabetes included in the DA in 2019 (mean age 68.9 years, 58% men). Prescription rates of antidepressants and anxiolytics in quarters from January 2020 to March 2021 were compared with prescription rates from 1 year earlier.

RESULTS

During the study period, the incidence rate of newly diagnosed depressive disorders in persons with type 2 diabetes declined slightly, while the incidence rates of anxiety and stress disorders remained largely constant. The rates of new prescriptions for antidepressants and anxiolytics were lower in all quarters of 2020 and in the first quarter of 2021 than in the quarters 1 year earlier. Diabetes-related complications were more prevalent in persons with incident psychiatric disorders than in those without.

CONCLUSIONS

No increase in the incidence rates of clinically diagnosed psychiatric disorders was observed during the COVID-19 pandemic in Germany in persons with type 2 diabetes.

Well-Being and Stress of Children in Teaching by Digital Means during the COVID-19 Pandemic: A Case in Santarém, Brazilian Amazonia

The COVID-19 pandemic has caused and is still causing many infections. An important change brought about by prevention actions was the closing of schools, and the adoption of teaching by digital means in private institutions. In this article, we aim to analyze the subjective well-being and stress of children aged 8 to 12 years in digital education during the COVID-19 pandemic in a city in the Brazilian Amazon. For data collection, we used the Children’s Global Life Satisfaction Scale, the Multidimensional Scale of Life Satisfaction for Children (MSLSC), and the Infantile Stress Scale, all via Google Forms. To analyze the data, we used descriptive statistics, correlation between variables and logistic regression. The Family domain obtained higher scores (4.54 ± 0.45). The Infantile Stress Scale showed that the children were in a normal phase, with some of them in an alert and even resistance phase. There was a strong positive correlation between the Family domain (r = 0.70; p-value < 0.05) and the Self domain (r = 0.70; p-value < 0.001). The higher the value of the predictor variable (Family domain), the lower the chances of a child belonging to the Resistance category. Therefore, the Family domain is an important component of children’s well-being, acting as a protective factor against child stress.

The influence of race, sexual orientation and gender identity on mental health, substance use, and academic persistence during the COVID-19 pandemic: A cross-sectional study from a national sample of college students in the healthy minds study

Purpose

This study seeks to characterize substance use, mental health, and academic persistence in college students during the COVID-19 pandemic, emphasizing variations by race, sexual orientation, and gender identity.

Methods

National samples (n = 146,810) of undergraduate students from the Healthy Minds Study were compared in two time periods: Fall 2017-Winter 2020 (pre-COVID) and March-December 2020. Descriptive statistics were conducted including t-tests/chi square tests comparing differences between time periods. Logistic regressions were estimated for main outcomes: substance use (licit, illicit, none), anxiety and/or depression symptoms, and academic persistence (student confidence that they will finish their degree). Marginal effects of race, sexual orientation, and gender identity were reported for all logistic regressions.

Results

In March-December 2020, students had 1.70 higher odds of screening positive for anxiety and/or depression compared to pre-COVID semesters. Latinx, Black, and "other" race/ethnicity had significantly higher probabilities of screening positive, as did transgender and gender non-conforming (TGNC) and lesbian, gay, bisexual, and queer (LGBQ) students.;Students had 0.43 times lower odds of reporting substance use in March-December 2020. Asian, Black, and Latinx students had significantly lower probabilities of reporting substance use, as did TGNC and LGBQ students.; During the pandemic, most students (86.7%) report at least 1 day of academic impairment (emotional/mental difficulties that hurt academic performance) in the last month due to mental health (up from 79.9% pre-pandemic).

Conclusions

Using the most comprehensive mental health data in college student populations, this is the first study to describe the impact of the pandemic on undergraduate students' substance use, mental health, and academic persistence/impairment.