Increased Psychological Distress during COVID-19 and Quarantine in Ireland: A National Survey

Coping strategies and psychological distress among mothers during COVID-19 pandemic: The moderating role of social support

The Indonesian government implemented a large-scale social restriction policy as part of the efforts to tackle the COVID-19 pandemic. This policy impacted the population, including mothers, and caused considerable psychological distress. Individual efforts to cope (avoidant and approach coping strategies) and support from significant persons might help handle the distress experienced by mothers. The purpose of this empirical study is to investigate the effect of individual coping strategies on psychological distress and the moderating role of social support among Indonesian mothers. An online survey was administered from 20th to 25th April 2020 to 1534 Indonesian mothers (Mean age 37.12 years; SD 6.63). Brief COPE (28 items), Depression Anxiety Stress Scale/DASS (18 items), and the Multidimensional Scale of Perceived Social Support/MSPSS (12 items) were used to measure coping strategies, psychological distress, and social support, respectively. IBM SPSS 24 software was used to analyze the data. The result showed that moderate and high levels of social support moderated the relationship between approach coping strategies and psychological distress (B = .041, CI .007-.075). When the mother uses approach coping, her psychological distress will decrease further whenever she receives moderate and high level social support. Any level of social support moderated the relationship between avoidant coping and psychological distress (B = -.100, CI -.138-.061). When mother used avoidant coping, her social support at any level served as buffer to her psychological distress. It can be concluded that mothers need to prioritize implementing approach coping strategies to lower their distress. Those who practiced avoidant coping strategies needed social support from their significant persons to decrease their distress.

Assessing Mental Health Outcomes in Quarantine Centres: A Cross-Sectional Study during COVID-19 in Malaysia

During the COVID-19 pandemic, persons under surveillance (PUS) were isolated in quarantine centres instead of at home. However, there is limited knowledge regarding the mental health issues experienced by these persons. This study aimed to assess mental health outcomes and associated factors among PUS and frontline workers at quarantine centres. This study conducted an analysis of secondary data from a cross-sectional survey carried out by the Mental Health and Psychosocial Support Services (MHPSS). The MHPSS employed the Depression, Anxiety, and Stress Scale (DASS-21) to evaluate mental health outcomes across 49 quarantine centres in Malaysia. The study included a total of 4577 respondents. The prevalence of stress, anxiety, and depression was found to be 0.9%, 11.4%, and 10.2%, respectively. Frontline workers and being part of the younger age group were found to be associated with depression, anxiety, and stress. Other factors associated with mental health issues were being female, staying at an institution-type centre, and a longer duration of the stay or work at the centre. In conclusion, assessing the mental health status and its associated factors among quarantine centre occupants is crucial for developing future strategies to safeguard their mental well-being.

Persistent somatic symptoms are key to individual illness perception at one year after COVID-19 in a cross-sectional analysis of a prospective cohort study

OBJECTIVE

Subjective illness perception (IP) can differ from physician's clinical assessment results. Herein, we explored patient's IP during coronavirus disease 2019 (COVID-19) recovery.

METHODS

Participants of the prospective observation CovILD study (ClinicalTrials.gov: NCT04416100) with persistent somatic symptoms or cardiopulmonary findings one year after COVID-19 were analyzed (n = 74). Explanatory variables included demographic and comorbidity, COVID-19 course and one-year follow-up data of persistent somatic symptoms, physical performance, lung function testing, chest computed tomography and trans-thoracic echocardiography. Factors affecting IP (Brief Illness Perception Questionnaire) one year after COVID-19 were identified by regularized modeling and unsupervised clustering.

RESULTS

In modeling, 33% of overall IP variance (R2) was attributed to fatigue intensity, reduced physical performance and persistent somatic symptom count. Overall IP was largely independent of lung and heart findings revealed by imaging and function testing. In clustering, persistent somatic symptom count (Kruskal-Wallis test: η2 = 0.31, p < .001), fatigue (η2 = 0.34, p < .001), diminished physical performance (χ2 test, Cramer V effect size statistic: V = 0.51, p < .001), dyspnea (V = 0.37, p = .006), hair loss (V = 0.57, p < .001) and sleep problems (V = 0.36, p = .008) were strongly associated with the concern, emotional representation, complaints, disease timeline and consequences IP dimensions.

CONCLUSION

Persistent somatic symptoms rather than abnormalities in cardiopulmonary testing influence IP one year after COVID-19. Modifying IP represents a promising innovative approach to treatment of post-COVID-19 condition. Besides COVID-19 severity, individual IP should guide rehabilitation and psychological therapy decisions.

Evaluating the social outcomes of COVID-19 pandemic: empirical evidence from Pakistan

The study aims to assess and analyze the social outcomes of the COVID-19 pandemic. The study uses the discourse of comprehensive literature review to identify the outcomes, Interpretive Structural Modeling (ISM) for developing a structural model and Matrices' Impacts Cruise's Multiplication Appliquée a UN Classement (MICMAC) for analysis, classification of societal outcomes, and corroboration of results of ISM. Data from fifteen experts was collected through a survey questionnaire. As a result of the literature review, a list of sixteen outcomes was generated and verified by a panel of experts. Results of ISM revealed that the outcomes, namely, "emotional instability," "mental health self-harm," loneliness reduced recreational activities, obesity, and "increased screen time" come at the top of the model; therefore, they are less vital outcomes, whereas the most significant outcome which is at the bottom of the model is "employment instability"; hence it has a major impact on the society. The remaining outcomes fall in the middle of the model, so they have a moderate-severe impact. Results of MICMAC validate the findings of ISM. Overall findings of the study reveal that "employment instability" is the crucial social outcome of the COVID-19 pandemic. It is an original attempt based on real-time data, which is helpful for society at large, researchers, the international community, and policymakers because this study provides a lot of new information about the phenomenon. The study includes understanding society at large, policymakers, and researchers by illustrating the complex relations and simplifying the connections among a wide range of social outcomes of COVID-19.

Health-Promoting Factors and Their Relationships with the Severity of Symptoms in Patients with Anxiety Disorders during the COVID-19 Pandemic

BACKGROUND

Anxiety disorders are one of the most common mental disorders in the modern world. The COVID-19 pandemic has led to the onset of many mental disorders in people who did not have them before. It can be suspected that in people who already had anxiety disorders before the pandemic, their quality of life has significantly deteriorated.

AIM

The aim of the study was to assess the relationships between life satisfaction, acceptance of illness, the severity of anxiety and depression symptoms and health behaviors in a group of patients diagnosed with anxiety disorders during the COVID-19 pandemic.

MATERIAL AND METHODS

The study was conducted in the period from March 2020 to March 2022. There were 70 people among the respondents, including 44 women aged 44.06 ± 14.89 years and 26 men aged 40.84 ± 16.72 years. All persons were diagnosed with generalized anxiety disorder. Patients with other co-occurring disorders were excluded, i.e., depression and signs of organic damage to the central nervous system, as were those with cognitive disorders that prevented the completion of the questionnaires. The following scales were used in the study: the Satisfaction with Life Scale (SWLS), Acceptance of Illness Scale (AIS), Health Behavior Inventory (HBI) and Hospital Anxiety and Depression Scale (HADS). Spearman's rank correlation coefficient and the Mann-Whitney U test were used for statistical analyses.

RESULTS

In the Satisfaction in Life questionnaire, the respondents obtained an average score of 17.59 ± 5.74 points. In the AIS scale, the mean score obtained by the patients was 27.10 ± 9.65 points. In the overall Health Behavior Inventory (HBI), the average score was 79.52 ± 15.24 points. In the HADS questionnaire, probants obtained an average of 8.17 ± 4.37 points in the depression subscale and 11.55 ± 4.46 points in the anxiety subscale. In addition, there were significant negative correlations between life satisfaction (SWLS) and the severity of anxiety and depression (HADS). The lower the perceived quality of life, the significantly higher the anxiety and depressive disorders. The result obtained in the Health Behavior Inventory (HBI) as well as in the subscale of Prohealth Activities (PHA) was negatively associated with the severity of anxiety symptoms. Prohealth activities should therefore be developed to prevent anxiety disorders, as well as to promote positive mental attitudes. In the study, the average result obtained in the subscale of positive mental attitudes correlated negatively with both anxiety and depressive symptoms.

CONCLUSIONS

Life during the pandemic was assessed by patients as unsatisfactory. Health-promoting behaviors, and especially positive mental attitudes, may play a protective role in relation to anxiety and depressive symptoms in a situation of increased stress related to the COVID-19 pandemic in a group of patients with anxiety disorders.

Perceived household financial decline and physical/mental health among adolescents during the COVID-19 crisis: Focusing on gender differences

COVID-19 has worsened adolescents' mental and physical health. Several studies have reported that the effect may be greater in girls; however, relevant socio-ecological factors have not been examined. This study aimed to examine the factors associated with physical and mental health status among adolescents and the moderating role of gender on the relationship between physical and mental health status and perceived household financial decline. We analyzed the cross-sectional 2020 Korea Youth Risk Behavior Web-based Survey (KYRBS) collected between August and November 2020 in South Korea. It included 54,809 adolescents (28,269 males and 26,540 females), on average aged 15.1. We conducted ordinary least squares (OLS) regressions to examine the factors associated with physical and mental health outcomes. Gender differences were observed in associated factors. Then, we tested the moderating effect of gender by including an interaction term between gender and perceived household financial decline due to the COVID-19 pandemic. Perceived household financial decline due to COVID-19 negatively affected both groups. Perceiving moderate and severe financial decline due to COVID-19 is negatively associated with self-rated health among female adolescents than male counterparts. Female adolescents were also more vulnerable to mental health outcomes (i.e., distress, anxiety, and loneliness) when they perceived severe or moderate household financial decline due to COVID-19 compared to their male peers. Our findings suggest that female adolescents are more vulnerable to household financial shocks due to COVID-19, especially in households that have experienced a severe decline. We suggest the need for gender-sensitive policy interventions for adolescent mental health.

Urban greenspace helps ameliorate people's negative sentiments during the COVID-19 pandemic: The case of Beijing

The COVID-19 pandemic has had negative effects on people's mental health worldwide, especially for those who live in large cities. Studies have reported that urban greenspace may help lessen these adverse effects, but more research that explicitly considers urban landscape pattern is needed to understand the underlying processes. Thus, this study was designed to examine whether the resident sentiments in Beijing, China changed before and during the pandemic, and to investigate what urban landscape attributes - particularly greenspace - might contribute to the sentiment changes. We conducted sentiment analysis based on 25,357 geo-tagged microblogs posted by residents in 51 neighborhoods. We then compared the resident sentiments in 2019 (before the COVID-19) with those in 2020 (during the COVID-19) using independent sample t-tests, and examined the relationship between resident sentiments and urban greenspace during the COVID-19 pandemic phases using stepwise regression. We found that residents' sentiments deteriorated significantly from 2019 to 2020 in general, and that urban sentiments during the pandemic peak times showed an urban-suburban trend that was determined either by building density or available greenspace. Although our analysis included several other environmental and socioeconomic factors, none of them showed up as a significant factor. Our study suggests the effects of urban greenspace and building density on residents' sentiments increased during the COVID-19 pandemic and that not all green spaces are equal. Increasing greenspace, especially within and near neighborhoods, seems critically important to helping urban residents to cope with public health emergencies such as global pandemics.

Double jeopardy: How lower levels of support during COVID-19 exacerbated the relationship between loneliness and distress

While the relationship between loneliness and psychological distress is well documented, the mechanisms underlying this relationship are less clear. One factor known to be related to loneliness as well as psychological distress, is social support, with some studies suggesting that support-both received and provided-can serve as a mechanism to reduce the distress associated with loneliness. In this paper we examine the mediating role of both aspects of support in the relationship between loneliness and psychological distress in the COVID-19 context. We used a multi-country dataset collected at two timepoints during the pandemic; the first during the early stages (N = 6,842, 11 countries) and the second collected for a subset of countries (N = 1,299, 3 countries) 3 months later. Across all eleven countries, results revealed significant positive associations between loneliness and distress. Furthermore, using longitudinal data, we investigated the directionality of this relationship and found that increased loneliness over time was associated with increased psychological distress. The data also showed that both feeling unsupported and feeling unable to provide support to others mediated this relationship. These findings point to the need to facilitate people's ability to draw effective social support and help others-particularly at times when social connectedness is threatened-as a way of alleviating the psychological distress that commonly presents with loneliness.

Does COVID-19 related symptomatology indicate a transdiagnostic neuropsychiatric disorder? - Multidisciplinary implications

The clinical presentation that emerges from the extensive coronavirus disease 2019 (COVID-19) mental health literature suggests high correlations among many conventional psychiatric diagnoses. Arguments against the use of multiple comorbidities for a single patient have been published long before the pandemic. Concurrently, diagnostic recommendations for use of transdiagnostic considerations for improved treatment have been also published in recent years. In this review, we pose the question of whether a transdiagnostic mental health disease, including psychiatric and neuropsychiatric symptomology, has emerged since the onset of the pandemic. There are many attempts to identify a syndrome related to the pandemic, but none of the validated scales is able to capture the entire psychiatric and neuropsychiatric clinical presentation in infected and non-infected individuals. These scales also only marginally touch the issue of etiology and prevalence. We suggest a working hypothesis termed Complex Stress Reaction Syndrome (CSRS) representing a global psychiatric reaction to the pandemic situation in the general population (Type A) and a neuropsychiatric reaction in infected individuals (Type B) which relates to neurocognitive and psychiatric features which are part (excluding systemic and metabolic dysfunctions) of the syndrome termed in the literature as long COVID. We base our propositions on multidisciplinary scientific data regarding mental health during the global pandemic situation and the effects of viral infection reviewed from Google Scholar and PubMed between February 1, 2022 and March 10, 2022. Search in-clusion criteria were “mental health”, “COVID-19” and “Long COVID”, English language and human studies only. We suggest that this more comprehensive way of understanding COVID-19 complex mental health reactions may promote better prevention and treatment and serve to guide implementation of recommended administrative regulations that were recently published by the World Psychiatric Association. This review may serve as a call for an international investigation of our working hypothesis.

Understanding the stress and coping experiences of undergraduate university students in the COVID-19 context: A qualitative study

Background: The various psychological challenges experienced by university students have been well- characterised. The university experience can be stressful, which can negatively impact on mental health. Student stress was further exacerbated by the COVID-19 pandemic due to the lack of on-campus learning and peer contact. This study aims to understand the stress experiences and coping strategies of undergraduate university students in Ireland during the COVID-19 pandemic and to explore the differences between first-year and returning students’ experiences. Methods: Undergraduate students at the National University of Ireland, Galway, took part in online semi-structured interviews via Microsoft Teams. Interviews were recorded, transcribed verbatim, and analysed using inductive reflexive thematic analysis. Results: Nineteen students were interviewed (10 first-years and 9 returning students). Three themes were developed in relation to perceived stressors: (1) ‘The unknown. The dragon. The fear of getting sick’ with sub-themes, ‘Fear of COVID-19’ and ‘Chronic uncertainty and negative media messages’; (2) ‘Online learning is overwhelming’ with sub-themes ‘Difficulties with university workload’ and ‘One place, same screen, same things’; (3) ‘Social isolation’ with sub-themes ‘Lack of peer contact’ and ‘Fear of missing out’. Two themes in relation to coping were also developed: (1) ‘Help each other, keep each other afloat’ and (2) ‘Focusing on the positives in a shared storm.’ First-year students described additional stressors not experienced by returning students such as navigating university for the first time remotely and making friends virtually. Conclusion: All students struggled with various additional stressors due to the COVID-19 situation, particularly first-year students who experienced additional stressors while adjusting to university in a pandemic context. All students described coping strategies to help manage stress, which may be useful in developing future interventions and mental health supports for university students.

Health-related quality of life, health literacy and COVID-19-related worries of 16- to 17-year-old adolescents and parents one year into the pandemic: a cross-sectional study

Background

The uncertain and challenging situation caused by the COVID-19 pandemic affects adolescents and their parents in an exceptional way. More knowledge of health-related quality of life (HRQoL), health literacy (HL) and COVID-19-related worries in adolescents and parents 1 year into the pandemic is needed. The present study aimed to describe HRQoL, HL and COVID-19-related worries of 16- to 17-year-old adolescents and parents of adolescents. Further, to assess the strength of associations between gender, HL, COVID-19-related worries and HRQoL.

Methods

A cross-sectional study involving 215 adolescents and 320 parents was conducted, exploring HRQoL, HL, COVID-19-related worries and sociodemographic variables. KIDSCREEN-10 and RAND-36 were used to measure HRQoL. Data were analyzed using bivariate methods, multiple linear regression and robust regression.

Results

Adolescents’ HRQoL was notably lower compared to previous Norwegian studies and European norms. Parents’ HRQoL was comparable to Norwegian norms. Adolescents and parents reported moderate-to-high HL and high degrees of COVID-19-related worries. Females reported significantly lower HRQoL and more worries compared to males. In adolescents, higher HL was significantly associated with higher HRQoL. COVID-19-related worries were not significantly associated with HRQoL. In parents, higher HL in the “understand health information” domain was significantly associated with higher HRQoL for mental well-being (mental component sum scores [MCS]) and with lower HRQoL for physical well-being (physical component sum scores [PCS]). Being worried a lot about infecting others and about family/friends becoming sick was significantly associated with higher MCS and lower MCS, respectively. COVID-19-related worries were not significantly associated with PCS.

Conclusions

Our results indicate that the pandemic has a major negative impact on adolescents’ HRQoL. Parents’ HRQoL remained unchanged and comparable to previous studies. Our study demonstrates that HL, gender and COVID-19-related worries are significantly associated with adolescents’ and parents’ HRQoL, indicating that efforts aimed at increasing their HL might indirectly affect their HRQoL as well and that gender-specific interventions or strategies could be beneficial.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13737-1.

Health and health inequalities impact assessment for non-clinical measures to control COVID-19 in the Basque Country and Navarre (Spain)

This article describes the results of a health and health inequalities impact assessment of the COVID-19 pandemic control measures in the regions of the Basque Country and Navarre in Spain. A literature review was conducted on Pubmed and Web of Science (WoS) databases, in addition to individual semi-structured interviews and focus groups with experts, key informants and different profiles of citizens. A wide variety of social determinants of health have been affected by the measures, which included individual health-related behaviors, service disruption in formal care, educational settings, and health care provision. These changes have particularly affected certain population groups including children and adolescents, older people, those with health conditions and disabilities together with caregivers, women, as well as people with low levels of education, income, and resources. In future scenarios it will be necessary to pay attention to the potential impacts of policy responses on health inequalities to avoid an increase in existing health gaps.

Conflicto trabajo-familia de mujeres en situación de teletrabajo a partir de la contingencia sanitaria por COVID-19 en Chile

Objetivo. El presente artículo expone las características que ha tenido la interacción entre el trabajo pagado y no pagado para las mujeres chilenas que, a partir de la crisis sanitaria por COVID-19, han debido comenzar a desempeñar sus empleos desde sus hogares. Metodología. Se trabajó con un cuestionario mixto online (N=1137) aplicado entre abril y junio de 2020. Se analizan las respuestas a un cuestionario likert y se profundiza en el análisis de las preguntas abiertas del mismo. Resultados. Las participantes tienen una percepción negativa del teletrabajo en pandemia, evidenciando conflictos en la relación trabajo/familia, sobrecarga de tiempos y uso desbalanceado de espacios, escasa corresponsabilidad familiar y laboral. Finalmente, es posible reconocer variados recursos narrativos de resistencia a la construcción patriarcal de los roles de género y reconocimiento de la situación vivida como un asunto que afecta a una gran cantidad de mujeres en Chile. Conclusiones. Nuestros resultados dan cuenta de la existencia de un conflicto que ha afectado la interacción entre la vida laboral y familiar de las mujeres, quienes han debido enfrentarse a un escenario de implementación de medidas de aislamiento social y al inicio de una modalidad de teletrabajo caracterizada por su improvisación, lo que las ha obligado afrontar la crisis mediante el despliegue de recursos propios, capacidades de autoorganización y aprendizajes individuales, con fuertes costos para su salud mental.

Household Mealtimes During the 2020 COVID-19 Lockdown in Aotearoa New Zealand: The Influence of Household Type and Psychological Distress

COVID-19 lockdown meant disruptions to daily routines for households in Aotearoa New Zealand. The research presented here investigates how mealtimes changed for people living in New Zealand during the first COVID-19 lockdown in mid-2020 and sought to determine if household composition type and psychological distress impacted the frequency of engaging in several mealtime behaviors. The COVID Kai Survey collected data using an anonymous, online survey and asked questions on sociodemographic characteristics including household composition, frequency of engaging in different mealtime behaviors before and during lockdown, and psychological distress, which was measured using the Kessler 6 screening tool. The findings of this study shows an increase in the perceived importance of mealtimes (n = 807, 26.9% before lockdown, n = 1,154, 38.5% during lockdown) and an increase in the proportion of the survey respondents who stated that they frequently ate meals at the dinner table (n = 1,343, 44.8% before lockdown, n = 1,481, 49.4% during lockdown). There was a decrease, across all household composition types, in the proportion of respondents who ate out frequently at a restaurant or café (n = 878, 29.3% before lockdown, n = 5, 0.2% during lockdown, P < 0.001). The use of meal kits, e-dining, and eating meals in front of screens is also presented and discussed. All results are discussed with reference to Aotearoa New Zealand’s stringent lockdown restrictions. Respondents who experienced psychological distress during lockdown were 1.47 times more likely to consider mealtimes an important part of their day and respondents living in households with one adult and at least one child who also experienced psychological distress were 5.95 times more likely to eat dinner at the dinner table than those who did not report psychological distress. Findings of this study further the understanding of the wider societal impact of COVID-19 lockdown on everyday life.

The psychological impact of quarantine due to COVID-19: A systematic review of risk, protective factors and interventions using socio-ecological model framework

Background

Though quarantine is a pertinent control measure for the spread of COVID-19, it is equally important to consider its negative impacts, as it causes severe psychological, emotional, and financial problems not only for those who are quarantined but also for many others who are directly or indirectly connected to those who are quarantined. There appears to be a need to synthesise the available literature evidence on the psychological impact of quarantine experience, especially the multilevel risk factors that make individuals vulnerable to psychological impact and the protective factors to deal with the negative effects of quarantine.

Objective

This systematic review attempted to identify the various psychological impacts associated with the experience of quarantine, the risk and protective factors and list out various psycho-social interventions that can minimise the risks and facilitate the protective factors associated with the experience of quarantine.

Methods

A systematic search adhering to the PRISMA guidelines was performed in four databases PubMed, Scopus, PsycNet, Web of Science and 10518 articles related to COVID-19 and quarantine were obtained. After screening processes and quality assessment using standard checklist 74 articles that fulfilled the eligibility criteria were chosen for the final review.

Findings

Individuals subjected to quarantine had anxiety, depression, post-traumatic stress symptoms, sleep problems, and somatic difficulties. Some of the key risk factors during quarantine are young age, female gender, low money, fear of infection, poor sleep quality, reduced physical activity, increased sedentary behaviours, and a lack of social support. Financial difficulties and stigma remained risk factors even after the quarantine period had ended. Key protective factors were coping skills, home based exercise, leisure, recreational activities, maintaining relationships using social media and availability of mental health services. The findings also highlight the necessity for tele mental health interventions to address the psychological effects of quarantine.

Conclusion

Multilevel interventions are required to minimise the impact of risk factors and enhance protective factors.

Examining the psychological and financial impact of travel restrictions on citizens and permanent residents stranded abroad during the COVID-19 pandemic: international cross-sectional study

OBJECTIVES

This study aimed to evaluate the psychological and financial distress reported by citizens and permanent residents stranded abroad due to international travel restrictions introduced in response to the COVID-19 pandemic.

DESIGN

An international cross-sectional study.

SETTING

A primary analysis of data collected between July and September 2021 through an online survey targeting individuals stranded abroad and unable to return to their country of residence due to international travel restrictions.

RESPONDENTS

A total of 1054 individuals aged 18-84 years.

DATA ANALYSIS

Multivariable logistic regression models were used to explore the relationship between higher levels of depression, anxiety and stress and participant variables.

OUTCOME MEASURES

The survey answered questions regarding COVID-19 travel restriction-related impacts: personal stress, anxiety and depression (using the validated 21-item Depression, Anxiety and Stress Scale (DASS-21) tool), as well as impacts on housing and financial security and demographic data.

RESULTS

A total of 75.4% of respondents reported wanting to return to the Oceania region (75.4%), with 45% stranded in Europe. 64.2% reported financial distress while stranded abroad. 64.4% (x̄=9.43, SD=5.81) reported moderate-to-extremely severe (based on the DASS-21 classification) levels of depression, 41.7% for anxiety (x̄=5.46, SD=4.74), and 58.1% for stress (x̄=10.64, SD=5.26). Multivariable analysis indicated that financial stress, an employment change, being <30 years, having a high perceived risk of contracting COVID-19 abroad and being stranded for >2 months were significantly related to scores of moderate-to-extremely severe depression, anxiety and stress.

CONCLUSION

The study is among the first to explore the psychological and financial distress-related impacts associated with being stranded abroad due to COVID-19 travel restrictions. It highlights a range of unintended consequences that arise from pandemic-related travel restrictions, identifies the health and social needs of a particularly vulnerable population, and provides clues as to the types of support that may be adopted to best support them.

An overview of effects of COVID-19 on mobility and lifestyle: 18 months since the outbreak

The outbreak of SARS-COV-2 has led to the COVID-19 pandemic in March 2020 and caused over 4.5 million deaths worldwide by September 2021. Besides the public health crisis, COVID-19 affected the global economy and development significantly. It also led to changes in people's mobility and lifestyle during the COVID-19 pandemic. In addition to short-term changes, the drastic transformation of the world may account for the potentially disruptive long-term impacts. Recognizing the adverse effects of the COVID-19 pandemic is crucial in mitigating the negative behavioral changes that directly relate to people's psychological and social well-being. It is important to stress that citizens and governments face an uncertain situation since nobody knows exactly how the viruses and cures will develop. Better understanding uncertainties and evaluating behavioral changes contribute to addressing the future of urban development, public transportation, and behavioral strategies to tackle COVID-19 negative consequences. The major sources of impacts on short-term (route, departure time, mode, teleshopping, and teleworking) and medium and long-term (car ownership, work location, choice of job, and residential location) mobility decisions are mostly reviewed and discussed in this paper.

COVID-19 Quarantine Impact on Wellbeing and Cognitive Functioning During a 10-Week High-Intensity Functional Training Program in Young University Students

Physical exercise can improve cognitive functioning and wellbeing; however, the degree of change in either of these two variables seems to be related to the exercise intensity or type. Therefore, new physical training (PT) programs have been developed to increase exercise efficiency. One such example is high-intensity functional training (HIFT), which has proven to be a time-efficient and highly effective strategy to improve physical fitness. This study analyzed whether HIFT can affect reaction time (RT) and vitality, as well as positive and negative affect. Forty-two college students participated in the study, 21 in the experimental group and 21 in the control group. The experimental group completed 10 weeks of training, five of which were supervised, and the remainder consisted of online training during the COVID-19 quarantine. Participants were evaluated at the beginning, at the end of the 5 weeks of supervised training, and after the 5 weeks of online training. HIFT improved RT without changes in psychological wellbeing during the entire period of training supervised and online. Therefore, during the HIFT program, the quarantine situation did not adversely affect this population’s wellbeing, but it did negatively affect adherence to the training program.

Female Reproductive Health Disturbance Experienced During the COVID-19 Pandemic Correlates With Mental Health Disturbance and Sleep Quality

The COVID-19 pandemic has adversely affected population mental health. Periods of psychological distress can induce menstrual dysfunction. We previously demonstrated a significant disruption in women's reproductive health during the first 6 months of the pandemic. The present study investigates longer-term reproductive and mental health disturbances. A cross-sectional online survey was completed by 1335 women of reproductive age in April 2021. It included validated standardized measures of depression (PHQ-9), anxiety (GAD-7) and sleep quality (PSQI). 581 (56%) of women reported an overall change in their menstrual cycle since the beginning of the pandemic. There was no change in median cycle length [28 days (28-30)] or days of menses [5 (4-5)], but there was a wider variability in minimum (p<0.0001) and maximum (p<0.0001) cycle length. There was a significant increase in heavy menstrual bleeding, painful periods and missed periods compared to pre-pandemic (all p<0.0001). 64% of women reported worsening pre-menstrual symptoms. Rates of severe depression, anxiety and poor sleep were more than double those from large scale representative community samples. Poor sleep quality was an independent predictor of overall change in menstrual cycle (OR=1.11, 95%CI 1.05-1.18), and missed periods (OR=1.11, 95%CI 1.03-1.19) during the pandemic. Increased anxiety was independently associated with a change from non-painful to painful periods (OR=1.06, 95%CI 1.01-1.11) and worsening of pre-menstrual symptoms (OR=1.06, 95%CI 1.01-1.07) during the pandemic. The COVID-19 pandemic continues to bear a significant impact on female reproductive health. Increased levels of psychological distress and poor sleep are associated with menstrual cycle disruption.

Mindfulness as a Protective Factor Against Depression, Anxiety and Psychological Distress During the COVID-19 Pandemic: Emotion Regulation and Insomnia Symptoms as Mediators

Objectives

Research has linked mindfulness to improved mental health, yet the mechanisms underlying this relationship are not well understood. This study explored the mediating role of emotion regulation strategies and sleep in the relationship between mindfulness and symptoms of depression, anxiety and psychological distress during the COVID-19 pandemic.

Methods

As detailed in this study’s pre-registration (osf.io/k9qtw), a cross-sectional research design was used to investigate the impact of mindfulness on mental health and the mediating role of emotion regulation strategies (i.e., cognitive reappraisal, rumination and suppression) and insomnia. A total of 493 participants from the general population answered an online survey and were included in the final analysis. The online survey consisted of the short form of the Five-Facets Mindfulness Questionnaire (FFMQ-SF), the Impact of Event Scale-revised (IES-R), the Generalised Anxiety Disorder Scale (GAD-7), the Patient Health Questionnaire (PHQ-8), the Emotion Regulation Questionnaire (ERQ), the short form of the Rumination Response Scale (RSS-SF), and the Insomnia Severity Index (ISI).

Results

Structural equation modelling revealed that mindfulness was related to lower symptoms of depression, anxiety and psychological distress, both directly and indirectly. Mindfulness was negatively associated with rumination and insomnia. As hypothesised, models revealed that the associations between mindfulness and depression, anxiety and psychological distress were significantly mediated by its negative associations with rumination and insomnia. Our findings also demonstrated that rumination was related to increased insomnia symptoms, which in turn was associated with increased mental health problems, indicating a mediated mediation. Mindfulness was also positively associated with cognitive reappraisal and negatively associated with suppression, which were, respectively, negatively and positively associated with depressive symptoms, and thus functioned as specific mediators of the association between mindfulness and depression.

Conclusion

Our findings suggest that rumination and insomnia operate transdiagnostically as interrelated mediators of the effects of mindfulness on mental health, whereas cognitive reappraisal and suppression function as specific mediators for depression. These insights emphasise the importance of targeting emotion regulation and sleep in mindfulness interventions for improving mental health. Limitations and implications for practice are discussed.

Depression During COVID-19 Quarantine in South Korea: A Propensity Score-Matched Analysis

Background

Quarantine, a public health measure used to control the coronavirus disease 2019 (COVID-19) pandemic, has been linked to an increased risk of developing adverse psychological sequelae. This study sought to investigate whether quarantining during the COVID-19 pandemic was associated with depression among Koreans.

Methods

Data were obtained from the Seoul COVID-19 Study of Quarantine (SCS-Q) and the 2019 Korea Community Health Survey (KCHS). Using propensity scores estimated based on sociodemographic and health conditions, 919 individuals undergoing quarantine in the SCS-Q were matched with 919 individuals who did not experience quarantine in the 2019 KCHS. Depressive symptoms were measured using the Korean version of the Patient Health Questionnaire-9 (PHQ-9), where major depression is defined as a PHQ-9 score ≥ 10. Logistic regression models were adjusted for sociodemographic and health-related factors.

Results

Depression prevalence was higher in quarantined individuals than in the control group (7.8 vs. 3.8%, p &lt; 0.001). Logistic regression analyses revealed that quarantining was associated with higher likelihoods of having major depression [odds ratio (OR) = 2.28, 95% confidence interval (CI): 1.49, 3.51] after adjusting for relevant covariates.

Limitations

Due to the online nature of the SCS-Q, this study included a limited number of elderly participants, limiting the generalizability of the findings to the general Korean population.

Conclusions

The findings suggest that Koreans undergoing COVID-19 quarantine are at higher risk of depression. While further investigation is warranted, public health measures to control infectious disease outbreaks, such as quarantine, would benefit from incorporating strategies to address unintended adverse psychological effects, such as depression.

Psychological Flexibility Mediates Wellbeing for People with Adverse Childhood Experiences during COVID-19

BACKGROUND

The psychological impact of COVID-19 is multifaceted, both acute and chronic, and has not affected everyone equally.

METHOD

This longitudinal study compared those with and without Adverse Childhood Experiences (ACEs) on measures of psychological distress and wellbeing over time.

RESULTS

All groups (No ACE, Low ACE, and High ACE) had similar levels of distress at Time 1, with significant increases in psychological distress for those with ACEs over time, but not for those without. Psychological Flexibility was strongly and significantly associated with decreases in psychological distress and improved wellbeing. It significantly mediated the relationship between ACE and wellbeing.

CONCLUSIONS

Those with ACEs report significantly increased psychological distress over time, compared to those without ACE during the COVID-19 pandemic. Evidence-based interventions using Psychological Flexibility may improve mental health and wellbeing to help further mediate its effects.

Psychometric Properties of the Bangla Version of the Stress and Anxiety to Viral Epidemics-6 Items Scale Among the General Population in Bangladesh

BACKGROUND

Any disease outbreak creates psychological stress and anxiety among the public [e.g., Coronavirus Disease 2019 (COVID-19)]. There are several scales that assess anxiety specifically related to the COVID-19 pandemic. The Stress and Anxiety to Viral Epidemics-6 items (SAVE-6) scale is a reliable and valid tool to assess anxiety in any viral pandemic. The present study aims to validate the SAVE-6 scale in the Bangla language and culture, to assess such anxiety among the general Bangladeshi people.

METHODS

The SAVE-6 scale was translated into Bangla from English using the forward-backward translation procedure. A total of 357 Bangladeshi citizens participated via an online structured questionnaire. The items included questions on personal information, COVID-19 and vaccination, psychiatric history, the Bangla version of the SAVE-6 scale, the Generalized Anxiety Disorder-7 items (GAD-7) scale, and the Patient Health Questionnaire-9 items (PHQ-9) scale.

RESULTS

Both exploratory factor analysis and confirmatory factor analysis (CFA) were used to explore and confirm the single factor structure of the SAVE-6 scale in Bangla to be the same as that of the SAVE-6 scale. Multigroup CFA revealed invariance across sex, experience of being quarantined, experience of being infected, and presence of depression. Item analysis results showed good discrimination indices and internal consistency and reliability. The graded response model outputs also confirmed the validity and reliability of this scale, which had significant correlations with the GAD-7 and PHQ-9.

CONCLUSION

Overall, the Bangla version of the SAVE-6 is a psychometrically good scale to assess viral pandemic-related anxiety.

What Matters for Depression and Anxiety During the COVID-19 Quarantine?: Results of an Online Cross-Sectional Survey in Seoul, South Korea

BACKGROUND

Amid the COVID-19 pandemic, quarantine measures are key to containing the spread of the virus. Millions of people have been required to quarantine throughout the pandemic; the quarantine itself is considered detrimental to mental health conditions.

OBJECTIVE

This study aims to investigate the factors associated with depression and anxiety among quarantined people in Seoul, South Korea.

METHODS

An online cross-sectional survey was administered from October to November 2020 involving people who were living in Seoul, aged 19 years or above, under a 2-week mandatory quarantine. Their mental health status was measured using the Patient Health Questionnares-9 (PHQ-9) and the General Anxiety Disorder-7 (GAD-7).

RESULTS

Overall, 1,135 respondents were finally included, resulting in a 22.0% response rate. After controlling for potential confounders, variables, such as the "second half of quarantine period" (OR = 1.78 95% CI: 1.10-2.88), "female" (OR = 1.91 95% CI: 1.16-3.16), and "having pre-existing depression" (OR = 8.03 95% CI: 2.96-21.78) were significantly associated with depression while being quarantined. Those with correct knowledge about the rationale behind for the quarantine (OR = 0.39 95% CI: 0.21-0.72), an understanding of quarantine rules (OR = 0.68 95%CI: 0.52-0.91), and those who felt supported by others (OR = 0.74 95% CI: 0.55-0.99) were less likely to develop depression while quarantining. Similarly, anxiety was significantly associated with the second week (OR = 4.18 95% CI: 1.44-12.09), those with an unstable job status (OR = 3.95 95% CI: 1.60-9.79), perceived support (OR = 0.66, 95% CI: 0.45-0.96), and the fear of being infected (OR = 7.22 95% CI: 1.04-49.95).

CONCLUSIONS

This study highlights the need to develop precautionary measures to prevent depression and anxiety among people undergoing COVID-19 quarantine. In particular, individuals with depression prior to quarantine should be carefully monitored during the quarantine. Further studies with larger populations are needed.

Depression, anxiety, and happiness in dog owners and potential dog owners during the COVID-19 pandemic in the United States

Major life events, such as the COVID-19 pandemic, affect psychological and physiological health. Social support, or the lack thereof, can modulate these effects. The context of the COVID-19 pandemic offered a unique opportunity to better understand how dogs may provide social support for their owners and buffer heightened symptoms of stress, anxiety and depression and contribute to happiness during a major global crisis. Participants (768 pet dog owners and 767 potential pet dog owners) answered an online survey, including validated depression, anxiety, happiness psychometric scales, attitude to and commitment towards pet, and perceived social support. Potential pet dog owners were defined as individuals who did not own a dog at the time of the survey but would be very or extremely interested in owning one in the future. Dog owners reported having significantly more social support available to them compared to potential dog owners, and their depression scores were also lower, compared to potential dog owners. There were no differences in anxiety and happiness scores between the two groups. Dog owners had a significantly more positive attitude towards and commitment to pets. Taken together, our results suggest that dog ownership may have provided people with a stronger sense of social support, which in turn may have helped buffer some of the negative psychological impacts caused by the COVID-19 pandemic.

The impact of the first wave of the Covid-19 pandemic on parents of children with externalising difficulties in ireland: A longitudinal cohort study

BACKGROUND

This longitudinal cohort study aimed to examine the impact of the first wave of the COVID-19 pandemic in Ireland on parents of children with externalising difficulties, in comparison to parents of children without such difficulties.

METHOD

Parents of 159 children completed online self-report measures at three time points during the first wave of the COVID-19 pandemic; (a) Delay and Mitigation Phase (March 2020 to May 2020), (b) Reopening of Society Phase (June 2020 to July 2020) and (c) Wave 2 Case Acceleration Phase (September 2020 to October 2020). Participants were allocated to the clinical group if they met the clinical cut off point on the Conduct or Hyperactivity/Inattention subscales of the Strengths and Difficulties Questionnaire at Time 1.

RESULTS

Parents of children with externalising difficulties experienced significantly higher levels of stress, lower levels of wellbeing and engaged in higher levels of avoidant-focused coping strategies longitudinally. There was a significant difference between outcomes at the different phases of the COVID-19 pandemic, for stress related to parenting, personal/family stress related to the impact of the COVID-19 and type of coping strategies employed. Children with externalising difficulties, in comparison to children without externalising difficulties, showed significantly greater adjustment over time for behavioural and emotional difficulties, as reported by their parents.

CONCLUSIONS

Results provide important information regarding the trajectory of psychological outcomes in parents of children with externalising difficulties over the first wave of the COVID-19 pandemic, highlighting the need for increased parental supports during, and after, the COVID-19 pandemic.

Psychological distress resulting from the COVID-19 confinement is associated with unhealthy dietary changes in two Italian population-based cohorts

Purpose

To examine the relationship between psychological distress resulting from the COVID-19 lockdown and dietary changes.

Methods

Cross-sectional analysis from 2 retrospective Italian cohorts recruited from May to September 2020: (1) The Moli-LOCK cohort consists of 1401 participants from the Moli-sani Study (n = 24,325) who were administered a telephone-based questionnaire to assess lifestyles and psychological factors during confinement; (2) the ALT RISCOVID-19 is a web-based survey of 1340 individuals distributed throughout Italy who self-responded to the same questionnaire using Google® forms.

Psychological distress was measured by assessments of depression (PHQ-9 and depressive items from the Screening Questionnaire for Disaster Mental Health- SQD-D), anxiety (GAD-7), stress (PSS-4), and post-traumatic stress disorder (SQD-P). Diet quality was assessed either as changes in consumption of ultra-processed foods (UPF) or adherence to Mediterranean diet (MD).

Results

In ALT RISCOVID-19, increased UPF intake was directly associated with depression (both PHQ-9 and SQD-D; p < 0.0001), anxiety (p < 0.0001), stress (p = 0.001) and SQD-P (p = 0.001); similar results were obtained in the Moli-LOCK cohort except for perceived stress. When psychometric scales were analysed simultaneously, only depression (SQD-D) remained associated with UPF (both cohorts). In both cohorts, psychological distress poorly influenced changes toward an MD, except for depression (SQD-D) that resulted inversely associated in the ALT RISCOVID-19 participants (β = − 0.16; 95% CI − 0.26, − 0.06).

Conclusions

Psychological distress from the COVID-19 confinement is directly associated with unhealthy dietary modifications in two Italian cohorts. In view of possible future restrictive measures to contain pandemic, public health actions are warranted to mitigate the impact of psychological distress on diet quality.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00394-021-02752-4.

Increased Prevalence of Neuropsychiatric Disorders during COVID-19 Pandemic in People Needing a Non-Deferrable Neurological Evaluation

Background: The novel coronavirus disease of 2019 (COVID-19) outbreak provoked a profound healthcare system reorganization. This study aimed to compare the reasons for requesting a non-deferrable neurological evaluation before the COVID-19 pandemic and during the lockdown. Methods: Retrospective observational study including non-deferrable neurological outpatients before the pandemic (pre-COVID-19 group, n = 223) and during the Italian second wave of the COVID-19 pandemic (LOCKDOWN group, n = 318). Results: The number of patients sent for cerebrovascular disorders, headache, and vertigo significantly dropped between the pre-COVID-19 era and the lockdown period. While in the pre-COVID-19 group, the most frequent diagnosis was cerebrovascular disorder; neuropsychiatric disorders ranked first in the LOCKDOWN group. Moreover, the percentage of appropriate non-deferrable neurological evaluations significantly increased in the LOCKDOWN group compared with the pre-COVID-19 group. Discussion: Our study shows a significant increase of neuropsychiatric disorders in non-deferrable neurologic evaluations during the Italian second wave of the COVID-19. Overall, cases were more severe and required a more complex management during the lockdown compared with the pre-COVID era. These findings confirm that a careful approach to prevent the psychological consequences of the pandemic is needed, and long-term rearrangements of the healthcare system are desirable to guarantee appropriate management.

A multicenter survey on the aspects of everyday life in adult patients with primary antibody deficiencies treated with immunoglobulin G replacement during the COVID-19 pandemic

Introduction

The COVID-19 pandemic has changed many aspects of everyday life. Patients with primary immunodeficiency (PID) are in a particularly difficult situation. The purpose of the present study was to contribute to the very limited research on the everyday aspects of functioning in PID patients during the COVID-19 pandemic.

Methods

The survey included 85 adult PID patients treated with immunoglobulin replacement therapy in four reference centers for immunology. Everyday functioning of the patients as well as their opinion concerning new solutions in medical care were analyzed.

Results

During the pandemic, the percentage of patients experiencing fear/anxiety has increased from 47% to 70%. The wide dissemination of information about the SARS-CoV-2 in the media has increased anxiety in 40% of the patients. Patients diagnosed with PID were most afraid of the exposure to contact with strangers, especially in public places. As many as 67 respondents (79%) considered the introduction of restrictions concerning social functioning as good. Only every fifth person learned about the pandemic from reliable sources. Eighty three percent of the patients receiving immunoglobulin substitution experienced less fear of SARS-CoV-2 infection. The patients positively evaluated the solutions related to the direct delivery of drugs to the place of residence in order to continue home IgRT therapy. Fifty three respondents (62.5%) believed that the possibility of a remote consultation was a very good solution.

Conclusion

It is necessary to increase educational activities concerning the pandemic provided by health care professionals, as patients obtain information mainly from the media and the Internet, which adversely affects the feeling of anxiety. The pandemic, in addition to the very negative impact on patients and the deterioration of their daily functioning, has made patients appreciate their life more, devote more time to family and friends, and do things they like.

Predictors of Mental Health Status among Quarantined COVID-19 Patients in Saudi Arabia

BACKGROUND

The negative psychological impact of COVID-19 in the general population has been well documented. Similar studies among those who were infected and who underwent quarantine remain scarce, particularly in the Arab region. The present study aims to fill this gap.

METHODS

In this cross-sectional study, suspected/confirmed COVID-19 individuals who were quarantined in the Ministry of Health (MOH) facilities were invited to participate in an online survey. All consenting participants answered a generalized questionnaire that included demographic characteristics, as well as a five-part questionnaire that assessed the symptoms of depression, anxiety, insomnia, and distress.

RESULTS

A total of 335 suspected/confirmed COVID-19 individuals (198 males and 137 females) participated. Being female is associated with increased risk of depression (odds ratio OR 1.8 (confidence interval, CI 1.1-3.1; p = 0.03)) as well as being employed by the government (OR 2.8 (CI 1.1-7.0; p = 0.03)). Level of education (OR 2.3 (CI 1.0-5.4; p = 0.049)) and employment in government (OR 3.0 (CI 1.2-7.8; p = 0.02)) were significantly associated with distress. Increasing age (45 years and above) appeared to be protective against distress (OR 0.2 (CI 0.02-0.69; p = 0.008)), as well anxiety and sleep pattern (OR 0.3 p < 0.05).

CONCLUSION

Findings of the present study highlight that infected COVID-19 populations are at higher risk for acute and detrimental psychological well-being during quarantine and/or self-isolation. Identification of the coping mechanisms of older adults during periods of distress may prove beneficial in the pandemic preparedness of younger generations.

Associations Between the Perceived Severity of the COVID-19 Pandemic, Cyberchondria, Depression, Anxiety, Stress, and Lockdown Experience: Cross-sectional Survey Study

Background

The outbreak of the COVID-19 pandemic has caused great panic among the public, with many people suffering from adverse stress reactions. To control the spread of the pandemic, governments in many countries have imposed lockdown policies. In this unique pandemic context, people can obtain information about pandemic dynamics on the internet. However, searching for health-related information on the internet frequently increases the possibility of individuals being troubled by the information that they find, and consequently, experiencing symptoms of cyberchondria.

Objective

We aimed to examine the relationships between people’s perceived severity of the COVID-19 pandemic and their depression, anxiety, and stress to explore the role of cyberchondria, which, in these relationship mechanisms, is closely related to using the internet. In addition, we also examined the moderating role of lockdown experiences.

Methods

In February 2020, a total of 486 participants were recruited through a web-based platform from areas in China with a large number of infections. We used questionnaires to measure participants’ perceived severity of the COVID-19 pandemic, to measure the severity of their cyberchondria, depression, anxiety, and stress symptoms, and to assess their lockdown experiences. Confirmatory factor analysis, exploratory factor analysis, common method bias, descriptive statistical analysis, and correlation analysis were performed, and moderated mediation models were examined.

Results

There was a positive association between perceived severity of the COVID-19 pandemic and depression (β=0.36, t=8.51, P<.001), anxiety (β=0.41, t=9.84, P<.001), and stress (β=0.46, t=11.45, P<.001), which were mediated by cyberchondria (β=0.36, t=8.59, P<.001). The direct effects of perceived severity of the COVID-19 pandemic on anxiety (β=0.07, t=2.01, P=.045) and stress (β=0.09, t=2.75, P=.006) and the indirect effects of cyberchondria on depression (β=0.10, t=2.59, P=.009) and anxiety (β=0.10, t=2.50, P=.01) were moderated by lockdown experience.

Conclusions

The higher the perceived severity of the COVID-19 pandemic, the more serious individuals’ symptoms of depression, anxiety, and stress. In addition, the associations were partially mediated by cyberchondria. Individuals with higher perceived severity of the COVID-19 pandemic were more likely to develop cyberchondria, which aggravated individuals’ depression, anxiety, and stress symptoms. Negative lockdown experiences exacerbated the COVID-19 pandemic’s impact on mental health.

Psychological Distress and Happiness of Men Who Have Sex With Men and Transgender People During the Coronavirus Disease-19 Pandemic: Is There a Need for Public Health Policy Intervention?

Since the global onset of COVID-19 in early 2020, the disease has significantly impacted mental health. This impact is likely to be further exacerbated for groups who were already marginalized. This paper shares results from a broader study of men who have sex with men (MSM) and transgender people in Bali, Indonesia and includes a focus on psychological distress and happiness during the COVID-19 pandemic; applying sociodemographic and epidemiological characteristics as potential mediators. Psychological distress and the level of happiness were measured by The Kessler Psychological Distress (K10) and the Subjective Happiness Scale (SHS). A cross-sectional survey was conducted from July to September 2020. Of the 416 participants, complete data were available for 363 participants. The majority of participants were aged 26-40 years, currently single, were born outside Bali, were currently living in an urban area, and over one-third were living with HIV. While all were MSM, the majority identified as homosexual/tend to be homosexual (71.3%), however 54 (14.9%) identified themselves as heterosexual. The majority (251, 69.1%) reported moderate to very high psychological distress during the COVID-19 pandemic. The binary logistic regression analysis identified five factors to be significantly associated with higher psychological distress: being a student, reporting higher levels of stigma, had ever experienced discrimination, felt better prior to the COVID-19 pandemic, and less happy than the average person. When homosexual were compared with heterosexual participants, those who identified themselves as being homosexual reported significantly lower psychological distress compared to those identified themselves as heterosexual, which may be associated with these participants not disclosing their status as MSM and the stigma around MSM. Those who considered themselves to be less happy than the average person (316, 87.1%) were more likely to live with a partner and to report moderate to very high psychological distress. Based on the findings, interventions should focus on strategies to reduce stigma, provide non-discriminatory services, and improve access to essential health services.

Facing the "new normal": How adjusting to the easing of COVID-19 lockdown restrictions exposes mental health inequalities

BACKGROUND

Re-establishing societal norms in the wake of the COVID-19 pandemic will be important for restoring public mental health and psychosocial wellbeing as well as economic recovery. We investigated the impact on post-pandemic adjustment of a history of mental disorder, with particular reference to obsessive-compulsive (OC) symptoms or traits.

METHODS

The study was pre-registered (Open Science Framework; https://osf.io/gs8j2/). Adult members of the public (n = 514) were surveyed between July and November 2020, to identify the extent to which they reported difficulties re-adjusting as lockdown conditions eased. All were assessed using validated scales to determine which demographic and mental health-related factors impacted adjustment. An exploratory analysis of a subgroup on an objective online test of cognitive inflexibility was also performed.

RESULTS

Adjustment was related to a history of mental disorder and the presence of OC symptoms and traits, all acting indirectly and statistically-mediated via depression, anxiety and stress; and in the case of OC symptoms, also via COVID-related anxiety (all p < 0.001). One hundred and twenty-eight (25%) participants reported significant adjustment difficulties and were compared with those self-identifying as "good adjusters" (n = 231). This comparison revealed over-representation of those with a history or family history of mental disorder in the poor adjustment category (all p < 0.05). 'Poor-adjusters' additionally reported higher COVID-related anxiety, depression, anxiety and stress and OC symptoms and traits (all p < 0.05). Furthermore, history of mental disorder directly statistically mediated adjustment status (p < 0.01), whereas OC symptoms (not OC traits) acted indirectly via COVID-related anxiety (p < 0.001). Poor-adjusters also showed evidence of greater cognitive inflexibility on the intra-extra-dimensional set-shift task.

CONCLUSION

Individuals with a history of mental disorder, OC symptoms and OC traits experienced greater difficulties adjusting after lockdown-release, largely statistically mediated by increased depression, anxiety, including COVID-related anxiety, and stress. The implications for clinical and public health policies and interventions are discussed.

Psychological impact of COVID-19 on speech and language therapists working with adult dysphagia: A national survey

BACKGROUND

Speech and language therapists (SLTs) working with dysphagia have had to radically alter diagnostic and rehabilitation services during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, hereafter referred to as coronavirus disease (COVID-19). Given the aerosol-generating procedures inherent in swallow assessment and interventions, these SLTs have also been particularly susceptible to virus exposure.

AIMS

To investigate the psychological impact of COVID-19 on SLTs working with adult dysphagia across the Republic of Ireland and to identify the personal and professional factors associated with depression, anxiety, stress and post-traumatic stress disorder (PTSD). To explore SLT perspectives regarding their experiences during the COVID-19 pandemic.

METHODS & PROCEDURES

A cross-sectional 34-item online survey was developed and piloted. The survey collected demographic details and professional factors and it incorporated the Depression, Anxiety, and Stress Scale-21 (DASS-21) and the Impact of Event Scale-Revised (IES-R). The survey also sought SLT perspectives regarding their experiences during the pandemic. It was distributed to Irish SLT managers, the Irish Association of Speech and Language Therapists (IASLT) and the Irish Dysphagia Special Interest Group (SIG) for dissemination.

OUTCOMES & RESULTS

A total of 94 SLTs working with adults with dysphagia across Ireland responded. In total, 60% of respondents screened positive for depression, anxiety, stress and/or PTSD. Based on the DASS-21, 38% screened positive for depression (mean score = 8.0; SD = 6.3), 36% screened positive for anxiety (mean score = 6.5; SD = 6.0), and 49% screened positive for stress (mean score = 15.4; SD = 6.9). A total of 26% of respondents screened positive for PTSD (mean IES-R total score = 22.6; SD = 16.0). Factors associated with depression, anxiety, stress and PTSD were young age (p = 0.002), limited clinical experience (p = 0.01) and not living with children (p = 0.02). A thematic analysis of SLT perspectives identified four main themes: 'fear of COVID-19 infection and transmission', 'uncertainty regarding policies and procedures', 'changes in SLT roles and responsibilities' and 'increased workload'.

CONCLUSIONS & IMPLICATIONS

This study highlights the psychological impact of COVID-19 on SLTs working with adults with dysphagia in Ireland and identifies SLTs who are at risk of depression, anxiety, stress and PTSD during the COVID-19 pandemic. Findings may assist employers to identify staff who require psychological support and long-term follow-up during this pandemic and any future health emergencies.

WHAT THIS PAPER ADDS

What is already known on the subject Depression, anxiety, stress and PTSD are prevalent among nurses and other healthcare professionals internationally as a result of the COVID-19 pandemic and associated factors have been identified in previous research. Despite this, no research has been conducted to establish the psychological impact of the first surge of COVID-19 on SLTs working with dysphagia in relation to depression, anxiety, stress and PTSD and the associated factors. What this paper adds to existing knowledge A total of 60% of SLTs working with adults with dysphagia in this survey presented with depression, anxiety, stress and/or PTSD. Associated personal and professional factors amongst respondents included young age, limited clinical experience and not living with children. The perspectives of SLTs on their experiences during the first surge of COVID-19 are also explored. What are the potential or actual clinical implications of this work? The findings from this study may assist SLT managers to identify SLTs who are at a higher risk of depression, anxiety, stress and PTSD to ensure appropriate support can be provided.

The Moderation Effects of Comparative Thinking Between Gratitude and Negative Affect During the COVID-19 Outbreak

The aim of this research was to examine the moderation effects of comparative thinking (CT) across the relationship between gratitude and affect during the COVID-19 outbreak. To this purpose, multiple regression as well as moderation analyses were carried out. Age and sex were also addressed as variables of interest as described in previous literature. A sample of 306 north Americans was recruited by crowdsourcing platform ProA to obtain a representative sample based on age and gender. The participants filled in a questionnaire based on comparative thinking in relation to the emotional experience experienced before and during the COVID-19 outbreak, positive and negative affect schedule for positive and negative affect, as well as Gratitude Questionnaire - Six Items Form scores for gratitude. The main results of the current study related to the COVID-19 outbreak can be listed as follows: (i) no differences between CT groups in the gratitude trait, but differences in positive and negative affect did occur; (ii) regression models that included age, gratitude, and affect variables predicted negative and positive affects but gender did not reach the statistical level; (iii) two moderation models predicted affect from gratitude, with the CT variable moderating this effect; this moderation effect was also statistically significant in predicting negative affect but it was not statistically significant in predicting positive affect. These results might be of interest for training programs in applied levels and theoretical models of gratitude.

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

Background

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

Objective

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

Methods

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

Results

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

Conclusions

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

Taylor L, Shevlin M, McHugh L, Carr A, Burke T. A remote self-directed psychological intervention for the public: The PAUSE programme protocol

Background: This protocol outlines procedures for the development and evaluation of a remotely accessible intervention tool known as the ‘Psychology And yoU: Self-Enhancement programme’ (i.e., PAUSE programme). The PAUSE programme aims to support and promote psychological well-being using positive psychological concepts and principles. The programme has been developed in the context of the coronavirus disease 2019 pandemic, where effective and evidence-based remote interventions are needed. The PAUSE programme will provide users with valuable tools and skills that they may choose to implement in their daily lives, in order to foster and support positive mental well-being. The programme includes six modules: Well-being and Happiness; Healthy Body and Mind; Being Grateful and Savouring Life; Thought and Action; Strengthening Relationships; and Overcoming Challenges. Methods: Participants will be recruited using media outlets, social media, and professional networking websites in Ireland. Those who choose to participate in this study will be asked to complete a set of measures at baseline, immediate follow-up, and six weeks post-intervention. This will allow for changes in subjective well-being scores to be analysed and interpreted over time. This study adopts a Groups x Time design, with participants being randomly assigned to either an intervention or wait-list control group. Ethical approval is currently under review at the host institution. Dissemination: The dissemination strategy will follow the Evidence-based model for the Transfer and Exchange of Research Knowledge (EMTReK) and study findings will be prepared in line with various formats (e.g. study newsletters, conferences/meetings) in order to meet the needs of different audiences. Targeted and timely dissemination activities are anticipated, and the team intends to disseminate research in an ongoing manner, throughout the lifetime of the project. Registration: This RCT protocol is pre-results and has been registered with an international database resulting in an International Standard Randomised Controlled Trials Number (ISRCTN14772616)

Psychological Distress Among Ethiopian Pregnant Women During COVID-19: Negative Correlation with Self-Efficacy

BACKGROUND

Since the onset of coronavirus disease 2019, the mental health of individuals has been negatively affected, especially among vulnerable groups.

OBJECTIVE

The aim of this study was to explore the association of psychological distress with self-efficacy and other correlates among Ethiopian pregnant women.

METHODS

A cross-sectional study was carried out among 384 pregnant women from August 1 to 15, 2020. Pandemic-related psychological distress was measured by the Impact of Event Scale Revised (IES-R). Hospital anxiety and depression scale (HADS), generalized self-efficacy scale (GSES), and fear of COVID-19 scale (FCoV-19S) were employed to examine independent variables. A consecutive sampling technique was employed and the data were analyzed by SPSS version 23.0. Categorical variables were presented in terms of frequencies and percentages; and mean with SD was employed to express continuous variables. Multiple regressions were performed; and for statistical significance, p < 0.05 and 95% CI were considered.

RESULTS

The participants had 31.3 (SD±7.7) mean age and those participants between the ages of 25-34 were dominant. The mean score of IES-R scale was 45.1 (±17.4) indicating severe psychological distress. The IES-R mean score for primiparous women was significantly higher than the mean score of multiparous women. Psychological distress has a strong positive correlation with symptoms of anxiety, depression and fear of COVID-19. In contrast, a negative relationship was found between psychological distress and participants' self-efficacy.

CONCLUSION

The results indicate that the current pandemic has imposed severe psychological distress among pregnant women. The presence of anxiety, depressive symptoms, and pandemic-related fears were identified as positive predictors. In contrast, better self-efficacy of the pregnant women was linked to lower psychological distress. For health-care professionals, broadening the focus and collaboration among service-delivering units are important in halting undesirable outcomes of the pandemic.

Impact of COVID-19 on the Mental Health and Distress of Community-Dwelling Older Adults

The purpose of this study was to examine the mental health of community-dwelling older adults as they adapted their everyday health behaviors during the COVID-19 pandemic. In response to a telephone survey, 126 older adults described perceived changes in physical and mental health, and adaptations in their everyday health behaviors. Descriptive statistics, bivariate correlations, and multiple regressions revealed that participants experienced changes in mental and physical health, reduced health service access, lower social engagement, and increased coping behaviors. Greater negative social impact of the pandemic was associated with higher levels of COVID-19 distress. Reduced mental health was significantly related to reductions in health service access, health changes, and fewer adaptive coping behaviors.

Adaptive coping behaviors were helpful, just as reduced health access and social contact added risk for mental health problems. Suggestions were provided for alleviating mental health needs by increasing social contact and engaging in adaptive coping behaviors.

COVID-19 among young adults in Sweden: self-reported long-term symptoms and associated factors

Aims:

The main aim of the study was to describe self-reported symptoms of COVID-19 and examine if long-term symptoms are associated with lifestyle factors or common chronic diseases among Swedish young adults. A secondary aim was to compare the prevalence of smoking and snuff use before and during the COVID-19 pandemic.

Methods:

The study population includes 1644 participants aged 23–26 years from the Swedish population-based birth cohort BAMSE. From August to November 2020, the participants answered a web questionnaire on COVID-19 symptoms, lifestyle and health. Information on tobacco use was compared against the previous study follow-up in 2016–2019.

Results:

The prevalence of suspected COVID-19 symptoms was 45.3% (n=742), and 80 of these (10.8%) reported long-term symptoms (⩾4 weeks). There was no significant difference in sociodemographic or lifestyle factors in relation to the duration of suspected COVID-19 symptoms. Rhinitis, migraine and lower self-rated health before the pandemic was more common among participants with long-term symptoms. In addition, there was a tendency for higher prevalences of asthma, chronic bronchitis and depression in this group. The prevalence of smoking decreased from 18.9% before the pandemic to 14.7% during the pandemic, while snuff use increased from 12.7% to 22.4% (P<0.001).

Conclusions:

Almost half of Swedish young adults have had symptoms of suspected COVID-19 from February up to August 2020. Among these, one out of 10 have had long-term symptoms for at least 4 weeks. Long-term symptoms of suspected COVID-19 were associated with several common chronic conditions. Smoking may have decreased during the pandemic, while snuff use may have increased.

Precautionary Behavior Practices and Psychological Characteristics of COVID-19 Patients and Quarantined Persons

BACKGROUND

since the coronavirus disease (COVID-19) was first reported in 2019, South Korea has enforced isolation of patients with confirmed cases of COVID-19, as well as quarantine for close contacts of individuals diagnosed with COVID-19 and persons traveling from abroad, in order to contain its spread. Precautionary behavior practices and psychological characteristics of confirmed and quarantined persons were investigated for planning pandemic recovery and preparedness.

METHODS

this study was conducted with 1716 confirmed patients and quarantined persons in Daegu and Busan, regions where a high number of cases were confirmed during the early stage of the COVID-19 outbreak in South Korea. We collected online survey data from 23 April to 20 May 2020, in Daegu, and 28 April to 27 May 2020, in Busan, in cooperation with Daegu and Busan Infectious Disease Control Centers and public health centers in the regions. COVID-19 symptoms, pre-cautionary behavior practices, psychological states, and the need for improvement in isolation/quarantine environments were examined using an online survey.

RESULTS

compared to patients infected with coronavirus, quarantined persons engaged in more hygiene-related behaviors (e.g., hand washing, cough etiquette, and proper mask-wearing) and social distancing. COVID-19 patients had a strong fear of stigma, while quarantined persons had a strong fear of contracting COVID-19. Study participants responded that it was necessary to provide financial support and adequate information during isolation/quarantine.

CONCLUSIONS

the study highlights the importance of precautionary behavior to prevent COVID-19 infection and the need to provide support (both psychological and financial) to patients and quarantined persons, to reinforce effective communication, social solidarity, and public health emergency preparedness (PHEP) in a pandemic situation.

Comorbidity and COVID-19: investigating the relationship between medical and psychological well-being

OBJECTIVE

The unprecedented occurrence of a global pandemic is accompanied by both physical and psychological burdens that may impair quality of life. Research relating to COVID-19 aims to determine the effects of the pandemic on vulnerable populations who are at high risk of developing negative health or psychosocial outcomes. Having an ongoing medical condition during a pandemic may lead to greater psychological distress. Increased psychological distress may be due to preventative public health measures (e.g. lockdown), having an ongoing medical condition, or a combination of these factors.

METHODS

This study analyses data from an online cross-sectional national survey of adults in Ireland and investigates the relationship between comorbidity and psychological distress. Those with a medical condition (n = 128) were compared to a control group without a medical condition (n = 128) and matched according to age, gender, annual income, education, and work status during COVID-19. Participants and data were obtained during the first public lockdown in Ireland (27 March 2020-8 June 2020).

RESULTS

Individuals with existing medical conditions reported significantly higher levels of anxiety (p < .01) and felt less gratitude (p ≤ .001). Exploratory analysis indicated that anxiety levels were significantly associated with illness perceptions specific to COVID-19. Post hoc analysis revealed that psychological well-being was not significantly related to condition type (e.g. respiratory disorders).

CONCLUSION

This research supports individualised supports for people with ongoing medical conditions during the COVID-19 pandemic, and has implications for the consideration of follow-up care specifically for mental health. Findings may also inform future public health policies and post-vaccine support strategies for vulnerable populations.

Individual Differences Facing the COVID-19 Pandemic: The Role of Age, Gender, Personality, and Positive Psychology

Research on individual differences in facing the COVID-19 pandemic seems to be crucial in order to design diverse and highly effective intervention strategies. This study uses a sample of 302 North American participants who were recruited through the crowdsourcing platform ProA; different profiles were established, profiling variables of interest in facing the COVID-19 outbreak. Socio-demographic and psychological (personality traits, gratitude, life purpose, and religiosity) variables were explored. These results are of interest if we want to deepen the study of individual differences at both a theoretical and applied level.

Clinical Factors Associated with Atrial Fibrillation Detection on Single-Time Point Screening Using a Hand-Held Single-Lead ECG Device

Our aim was to assess the prevalence of unknown atrial fibrillation (AF) among adults during single-time point rhythm screening performed during meetings or social recreational activities organized by patient groups or volunteers. A total of 2814 subjects (median age 68 years) underwent AF screening by a handheld single-lead ECG device (MyDiagnostick). Overall, 56 subjects (2.0%) were diagnosed with AF, as a result of 12-lead ECG following a positive/suspected recording. Screening identified AF in 2.9% of the subjects ≥ 65 years. None of the 265 subjects aged below 50 years was found positive at AF screening. Risk stratification for unknown AF based on a CHA2DS2VASc > 0 in males and >1 in females (or CHA2DS2VA > 0) had a high sensitivity (98.2%) and a high negative predictive value (99.8%) for AF detection. A slightly lower sensitivity (96.4%) was achieved by using age ≥ 65 years as a risk stratifier. Conversely, raising the threshold at ≥75 years showed a low sensitivity. Within the subset of subjects aged ≥ 65 a CHA2DS2VASc > 1 in males and >2 in females, or a CHA2DS2VA > 1 had a high sensitivity (94.4%) and negative predictive value (99.3%), while age ≥ 75 was associated with a marked drop in sensitivity for AF detection.

COVID-19 and the Political Economy of Mass Hysteria

In this article, we aim to develop a political economy of mass hysteria. Using the background of COVID-19, we study past mass hysteria. Negative information which is spread through mass media repetitively can affect public health negatively in the form of nocebo effects and mass hysteria. We argue that mass and digital media in connection with the state may have had adverse consequences during the COVID-19 crisis. The resulting collective hysteria may have contributed to policy errors by governments not in line with health recommendations. While mass hysteria can occur in societies with a minimal state, we show that there exist certain self-corrective mechanisms and limits to the harm inflicted, such as sacrosanct private property rights. However, mass hysteria can be exacerbated and self-reinforcing when the negative information comes from an authoritative source, when the media are politicized, and social networks make the negative information omnipresent. We conclude that the negative long-term effects of mass hysteria are exacerbated by the size of the state.

Approach Coping Mitigates Distress of COVID-19 Isolation for Young Men With Low Well-Being in a Sample of 1,749 Youth From Australia and the USA

The unprecedented COVID-19 pandemic has led to lockdowns across the world with people being separated from their loved ones including partners, family, and friends. Here, using a large sample of 1,749 Australians and Americans, we investigated the impact of COVID-19 isolation on younger populations (13-25 years), and the influence of coping strategies and mental well-being on this impact. Overall, COVID-19 isolation had a more negative impact on adolescence (13-17 years) than young adulthood (18-25 years), but with no difference apparent between men and women, or between Australian and American residents. However, a deeper analysis revealed a gender-specific effect: the type of coping strategies differentially influenced the negative impact of COVID-19 isolation on men with various levels of well-being, an interaction effect not apparent in women. For men with lower levels of mental well-being, COVID-19 isolation appeared to have a less negative impact on them if they used more approach-oriented coping strategies (e.g., actively focusing on the problem). Our results provide cross-sectional evidence for a differential impact on young men at low levels of wellbeing by pandemic isolation. In sum, young men and adolescent boys with lower well-being coped better with COVID-19 isolation when they used more approach coping strategies.