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

Background

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

Methods

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

Results

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

Conclusion

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

Anxiety, depression and coping strategies among chronic medical patients with coronavirus disease-2019: a multicenter follow-up cohort study

BACKGROUND

Studies have shown that COVID-19 patients experience high levels of anxiety, depression, and stress during the pandemic. Patients adopt different coping strategies to reduce their psychological distress.

AIM

To compare the immediate and long-term psychological impact of COVID-19 disease on patients with and without chronic medical illnesses (CMI) and identify coping styles of both groups during the peak of COVID-19 disease in Egypt.

METHODS

This is a cohort follow-up study, that included an online survey consisting of General Health Questionnaire-12, Taylor Manifest Anxiety Scale, Beck Depression Inventory and Brief-COPE scale. The Post-Traumatic Stress Disorder (PTSD) Checklist was completed after 6 months. Questionnaires were distributed to adult patients with a confirmed diagnosis of SARS-CoV-2 virus infection during their quarantine in Egypt.

RESULTS

There was no significant difference between the two groups regarding anxiety and depression during the acute infection. Patients without CMI relied significantly on the use of informational support to cope with COVID-19 disease. Patients with CMI continued to show significant depressive symptoms after 6 months without significant PTSD symptoms.

CONCLUSIONS

COVID-19 has similar immediate psychological impact on patients with and without CMI. However, patients with CMI continue to show depression on long-term follow-up.

Evaluating the effectiveness of applying aroma seals to masks in reducing stress caused by wearing masks: A randomized controlled trial

During the COVID-19 pandemic, face masks on patients and healthy people have been recommended to prevent airborne transmission of the virus. This increased the number of people who felt stressed while wearing masks. In this study, we investigated the stress-relieving effects of attaching aroma seals to masks. A double-blind, randomized controlled trial was conducted involving 62 university students. The participants were randomly assigned to two groups and instructed to apply a seal to their masks once a day throughout the study period. The primary measure used was the Depression, Anxiety, and Stress Scale-21 (DASS-21), while the secondary measures included the assessment of breathlessness associated with mask-wearing and the World Health Organization Five Well-Being Index (WHO-5). The intervention group, referred to as the aroma-seal use group, utilized aroma seals infused with orange-lime essential oil with the expectation of experiencing the healing effects of citrus. On the other hand, the non-intervention group, known as the placebo-seal use group, utilized identical seals without any aroma. Results indicated that the aroma-seal use group exhibited significant improvements in both the total DASS-21 scores and depression scores compared to their baseline values by the second week of the intervention. Furthermore, the aroma-seal use group demonstrated a reduced occurrence of breathlessness while wearing masks compared to the placebo-seal group. Additionally, when assessing the item "I have felt calm and relaxed" from the WHO-5 questionnaire, the aroma-seal use group displayed significantly higher scores than the placebo group. Therefore, using aroma seals containing orange-lime essential oil could be beneficial in relieving mental stress and reducing breathlessness while wearing a mask, thus improving mental health.

Prevalence and factors associated with long COVID and mental health status among recovered COVID-19 patients in southern Thailand

Mental health disorders have become a growing public health concern among individuals recovering from COVID-19. Long COVID, a condition where symptoms persist for an extended period, can predict psychological problems among COVID-19 patients. This study aimed to investigate the prevalence of long COVID and mental health status among Thai adults who had recovered from COVID-19, identify the association between the mental health status and long COVID symptoms, and investigate the risk factors associated with the correlation between long COVID and mental health outcomes. A cross-sectional study was conducted among 939 randomly selected participants in Nakhon Si Thammarat province, southern Thailand. The Depression, Anxiety, and Stress Scale-21 was used to investigate mental health symptoms, and a checklist comprised of thirteen common symptoms was used to identify the long COVID among participants. Logistic regression models were used to investigate the risk factors associated with mental health status and long COVID symptoms among participants. Among the 939 participants, 104 (11.1%) had depression, 179 (19.1%) had anxiety, and 42 (4.8%) were stressed. A total of 745 participants (79.3%) reported experiencing at least one symptom of long COVID, with fatigue (72.9%, SE±0.02), cough (66.0%, SE±0.02), and muscle pain (54.1%, SE±0.02) being the most frequently reported symptoms. All long COVID symptoms were significantly associated with mental health status. Shortness of breath, fatigue, and chest tightness were the highest risk factors for mental health status among COVID-19 patients. The final multivariable model indicated that female patients (OR = 1.89), medical history (OR = 1.92), and monthly income lower than 5,000 Thai baht (OR = 2.09) were associated with developing long COVID symptoms and mental health status (all p<0.01). This study provides valuable insights into the potential long-term effects of COVID-19 on mental health and enhances understanding of the mechanisms underlying the condition for predicting the occurrence of mental health issues in Thai COVID-19 patients.

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

BACKGROUND

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

METHOD

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

RESULTS

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

LIMITATIONS

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

CONCLUSION

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

Predicting depression and anxiety of Chinese population during COVID-19 in psychological evaluation data by XGBoost

BACKGROUND

Due to the onset of sudden stress, COVID-19 has greatly impacted the incidence of depression and anxiety. However, challenges still exist in identifying high-risk groups for depression and anxiety during COVID-19. Studies have identified how resilience and social support can be employed as effective predictors of depression and anxiety. This study aims to select the best combination of variables from measures of resilience, social support, and alexithymia for predicting depression and anxiety.

METHODS

The eXtreme Gradient Boosting (XGBoost¹) model was applied to a dataset including data on 29,841 participants that was collected during the COVID-19 pandemic. Discriminant analyses on groups of participants with depression (DE²), anxiety (AN³), comorbid depression and anxiety (DA⁴), and healthy controls (HC⁵), were performed. All variables were selected according to their importance for classification. Further, analyses were performed with selected features to determine the best variable combination.

RESULTS

The mean accuracies achieved by three classification tasks, DE vs HC, AN vs HC, and DA vs HC, were 0.78, 0.77, and 0.89. Further, the combination of 19 selected features almost exhibited the same performance as all 56 variables (accuracies = 0.75, 0.75, and 0.86).

CONCLUSIONS

Resilience, social support, and some demographic data can accurately distinguish DE, AN, and DA from HC. The results can be used to inform screening practices for depression and anxiety. Additionally, the model performance of a limited scale including only 19 features indicates that using a simplified scale is feasible.

Use of virtual meeting and survey technology to assess Covid-19-related mental well-being of healthcare workers

Background and aims

Healthcare workers (HCWs) throughout the world have been exposed to economic and existential stress during the Covid-19 pandemic. The American Medical Association (AMA) has documented that increased healthcare burden correlates with increased stress, burnout, and psychological burden in HCWs. However, limits on personnel, time, and in person interactions make it challenging to assess mental health outcomes during a pandemic. This pilot study used virtual technology to efficiently assess these outcomes.

Setting

Data were collected based on voluntary participation in the Coping with Covid-19 for Caregivers Survey created by AMA. The survey was sent out to approximately 300 participants who included local physicians, medical residents, medical students, and allied health professionals and students who attended a virtual Mental Health Summit.

Methods

The AMA developed survey included questions about demographics, overall stress, fear of infection and transmission of the virus, perceived anxiety or depression due to Covid-19, work overload, childcare issues, and sense of meaning and purpose. The AMA allows for up to five additional questions to be added to their survey, therefore five questions regarding support service utilization, perseverance, and resilience during the Covid-19 pandemic, and two items to further understand students' areas of medical interest. The survey was administered using an online platform through the AMA. The data were analyzed using descriptive statistics.

Results

There were 81 survey respondents. Based on the results of the survey, "high stress" was found in 52 (64%) participants. 66 (81%) were afraid (moderately or to a great extent) of exposure or transmission, 61 (75%) described high levels of anxiety or depression, and 67 (84%) noted work overload. Despite this increase in stress, most respondents (77%) said they were not likely to reduce their devoted hours to clinical care or research in the next 12 months, and 81% answered that they would not leave their practice or research within two years.

Conclusion

Covid-19 has negatively affected the well-being of HCWs. This is a similar trend seen during other times of healthcare strain. Mental health support, work modulation, and various provisions should be explored as means to reduce Covid-19-related negative impacts. The use of an online summit and online data collection methods were appropriate for collecting data on the impact of the Covid-19 pandemic on mental health. This pilot study supports the larger scale implementation of this technology for health informatics research.

The capacity to adapt: Documenting the relationship between stressors and probable depression, anxiety, and posttraumatic stress at two time points during the COVID-19 pandemic

BACKGROUND

Psychological adaptability, or the reduction of psychiatric symptoms in the context of ongoing stressors, is well-documented. The present study assessed relationships between COVID-19 related stressors and depression, anxiety, and post-traumatic stress (PTS) during April and July 2020.

METHODS

Prevalence of, and changes in, symptom severity levels in April vs. July were measured with ANOVA F-tests. Logistic regressions were used to assess the odds of probable diagnosis.

RESULTS

Symptom distributions skewed lower in July, as compared to April for all three diagnostic categories. From April to July, prevalence of probable anxiety and depression decreased across all levels of stress, prevalence of PTS increased for high stress, and decreased for medium and low stress levels. In July, only high stress related to higher odds of probable diagnoses, as compared to April when both medium and high stress did.

LIMITATIONS

Due to use of cross-sectional self-report data, the present findings could not establish causality between variables, and provide probable, rather than clinical, diagnoses.

CONCLUSION

Findings emphasize adaptability phenomena during COVID-19 and highlight the nuanced impact of ongoing stress.

Stress and the impact of stressful events are lesser among raja yoga meditators – A cross sectional study during COVID-19 pandemic from India

This research work presents a study on the relationship between stress & related events with meditation practice and other socio-demographic variables during COVID 19 pandemic among healthy adults. In this cross-sectional survey design, healthy adults with and without practice of Raja yoga meditation completed stress, anxiety & depression related questions (Depression Anxiety & stress Scale, DASS 21) and its impact (Impact of Event Scale-Revised, IES-R) along with other socio-demographic including COVID infection or contact related information. Data was assessed for difference in DASS 21 scores and IES-R scores between Raja yoga meditators (n = 802) & non-meditators (n = 357). An analysis was performed to study the predictors of DASS 21 and IES-R scores. We conclude that healthy Raja yoga meditation practitioners differ from non-meditators in terms of stress/anxiety/depression and its impact during COVID 19 pandemic and meditation practice predicts mental health better along with other sociodemographic variables.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSION

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

Issues behind the Utilization of Community Mental Health Services by Ethnic Minorities in Hong Kong

This study collected data on the utilization rates of community mental health services among ethnic minorities and explained the results from the frontline social workers' perspective. Information about users' ethnicity was collected from 11 community mental health service providers from 2015 to 2018. This was followed by two sessions of focus groups conducted with 10 frontline social workers from six community mental health centers in Hong Kong. A hybrid analysis model was employed to analyze the qualitative data. The average utilization rates of community mental health services by ethnic minorities were 0.49%, 0.58%, and 0.68% in the years 2015-16, 2016-17, and 2017-18, respectively, showing that ethnic minorities who comprised 8% of the population were significantly underrepresented. It is worth noting that supply-side and demand-side factors are interrelated, suggesting the low utilization rate may be overcome by implementing a proactive social work service strategy.

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

BACKGROUND AND OBJECTIVES

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

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

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

Experiences of parents of children with psychiatric disorder from Covid-19 pandemic and its related quarantine: A qualitative study

Introduction

Owing to the considerable mortality caused by Covid-19, different countries have made some decisions for dealing with this virus, one of which was quarantine. It was shown that a range of behavioral and emotional changes may exacerbate in children while staying more at home, and parents may then experience these positive or negative behavioral changes. The present study was conducted to examine the experiences of families with children with psychiatric disorders in a psychiatric outpatient clinic in Iran.

Method

The phenomenological method, which is a qualitative approach, was used in this study. The population was the parents of children with psychiatric disorders referred to the pediatric psychiatric clinic of Imam Hossein Hospital. Sampling was purposeful, which continued until data saturation. Finally, the number of included participants reached 14. As well, the Colaizzi method was used for data analysis.

Results

The results of this study included 12 secondary codes and 10 tertiary codes, which were divided into three main thematic groups as follows: effective factors for improving behavior, effective factors for worsening behavior, and affective factors on creating a new behavior during quarantine.

Conclusion

In conclusion, quarantine, social restrictions, closure of schools, and online classes can affect the mental health status of children and adolescents in different ways, especially in children with a history of psychiatric disorders.

The impact of provincial lockdown policies and COVID-19 case and mortality rates on anxiety in Canada

AIM

COVID-19 has had significant mental health impacts internationally and anxiety rates are estimated to have tripled during the pandemic, but the specific causes remain underexplored. This study's purpose was to investigate the associations of sociodemographic factors, COVID-19-related policies, and COVID-19 case/mortality rates with levels of anxiety among Canadians during the pandemic.

METHODS

This study used linear regression models populated with three integrated sources of data: a repeated cross-sectional survey (n = 7008), Oxford COVID-19 Government Response Tracker data, and COVID-19 case/mortality rates. Sociodemographic factors included were age, gender, race, province, income, education, rurality, household composition, and factors related to employment.

RESULTS

Local COVID-19 case and mortality rates and stay-at-home orders were positively associated with anxiety symptom severity. Anxiety was most severe among those who: were female, Indigenous, or Middle Eastern; had postsecondary education; lived with others; and became unemployed or had working hours altered during the pandemic. Anxiety was less severe among: older adults; male, Caucasians, and black individuals; those with high incomes, and; those for whom employment did not change during the pandemic.

CONCLUSION

Anxiety was primarily driven by socioeconomic factors among Canadians during the COVID-19 pandemic. Policies that alleviate socioeconomic uncertainty for groups that are most vulnerable may reduce the long-term harm of the pandemic and associated lockdown policies.

Depression, anxiety and stress among people infected with COVID-19 in Dhaka and Chittagong cities

Background

Covid-19 is an acute respiratory infectious disease caused by novel coronavirus 2019. Many individuals have suffered or are experiencing psychological symptoms due to feelings of isolation, insecurity and instability triggered by Covid-19. This study aimed to explore the perceived psychological distress and associated factors among people infected with Covid-19 in Dhaka and Chittagong cities.

Methods

Using the face-to-face interview method, a survey was conducted from 23 April to 22 May 2021 on a questionnaire on depression, anxiety and stress scale (DASS-21), socio-demographic, economic and health factors. Among those who had ever been infected with Covid-19, a total of 2092 respondents (1180 from Dhaka and 912 from Chittagong) were randomly selected and interviewed. χ2 test for independence of attributes was employed to observe the association of various socioeconomic, cultural, demographic and health factors with psychological distress. Moreover, multinomial logistic regression analysis was performed to explore the factors that contributed to psychological distress.

Results

Among participants from Dhaka, of three mental health conditions, the prevalence was higher for anxiety (80.0%), followed by stress (64.2%) and depression (59.8%), respectively. Anxiety was also more prevalent (57.3) among respondents in Chittagong, followed by depression (47.7%) and stress (39.5%). As the coexistence of symptoms, 52.8% of respondents in Dhaka, 34.4% in Chittagong experienced depression, anxiety and stress simultaneously. Moreover, in both Dhaka and Chittagong, all three psychological symptoms were strongly correlated in pairs. Multivariate analysis revealed that the most consistent factors associated with mild to moderate (MM), and severe to extremely severe (SES) depression were respondents from Chittagong who were illiterate or primary educated (OR = 0.166, CI: 0.076–0.364 for MM and OR = 0.041, CI: 0.013–0.131 for SES), male (OR = 0.999, CI: 0.666–1.496 for MM and OR = 0.395, CI: 0.249–0.625 for SES), single (OR = 0.393, CI: 0.157–0.982 for MM and OR = 0.121, CI: 0.049–0.303 for SES) and married (OR = 0.403, CI: 0.177–0.916 for MM and OR = 0.075, CI: 0.033–0.167 for SES), had a family of size ≤ 4 (OR = 0.253, CI: 0.140–0.458 for MM and OR = 0.114, CI: 0.059–0.218 for SES) and a family of size 5–6 (OR = 0.151, CI: 0.084–0.272), and no family members at risk being infected with Covid-19 (OR = 0.699, CI: 0.487–1.002 for MM and OR = 0.332, CI: 0.199–0.522 for SES). The analysis yielded similar findings for the other two mental health subscales, such as anxiety and stress. For respondents in Dhaka, the effect of factors other than sex on psychological distress was the opposite in Chittagong. Overall, psychological distress during the outbreak was greater among respondents in Dhaka than in Chittagong if respondents were not classified based on various characteristics.

Conclusion

This study showed that in both Dhaka and Chittagong, a substantially large portion of Covid-19-infected respondents experienced all three psychological distress (e.g., depression, anxiety and stress). Regardless of the dissimilarity between the results in Dhaka and Chittagong, better mental health support was needed for women in both cities.

Psychosocial factors associated with mental health and quality of life during the COVID-19 pandemic among low-income urban dwellers in Peninsular Malaysia

Background and aims

Mental well-being among low-income urban populations is arguably challenged more than any other population amid the COVID-19 pandemic. This study investigates factors associated with depression and anxiety symptoms and quality of life among Malaysia’s multi-ethnic urban lower-income communities.

Methods

This is a community-based house-to-house survey conducted from September to November 2020 at the Petaling district in Selangor, Malaysia. Five hundred and four households were identified using random sampling, and heads of eligible households were recruited. Inclusion criteria were age ≥18 years with a monthly household income ≤RM6960 (estimated $1600) without acute psychiatric illness. The PHQ-9, GAD-7 and EQ-5D were used for depression, anxiety, and quality of life, respectively. Multivariable logistic regression was performed for the final analysis.

Results

A total of 432 (85.7%) respondents with a mean age of 43.1 years completed the survey. Mild to severe depression was detected in 29.6%, mild to severe anxiety in 14.7%, and problematic quality of life in 27.8% of respondents. Factors associated with mild to severe depression were younger age, chronic health conditions, past stressful events, lack of communication gadgets and lack of assets or commercial property. While respiratory diseases, marital status, workplace issues, financial constraints, absence of investments, substance use and lack of rental income were associated with mild to severe anxiety. Attributing poverty to structural issues, help-seeking from professionals, and self-stigma were barriers, while resiliency facilitated good psychological health. Problematic quality of life was associated with depression, older age, unemployment, cash shortage, hypertension, diabetes, stressful life events and low health literacy.

Conclusions

A high proportion of the sampled urban poor population reported mild to severe anxiety and depression symptoms. The psychosocial determinants should inform policymakers and shape future work within this underserved population.

COVID-19 Burnout Subject to the Dynamic Zero-COVID Policy in Hong Kong: Development and Psychometric Evaluation of the COVID-19 Burnout Frequency Scale

We sought to develop and validate a self-assessment burnout scale of the Chinese general population during the COVID-19 pandemic in the context of a dynamic zero-COVID policy. Factors relevant to individuals’ burnout during the prolonged COVID-19 pandemic were identified in the literature and through the reviews of an expert panel. A convenience sample of 1087 was randomly divided into two subsamples and the scale’s psychometric properties were assessed. Findings suggested that the COVID-19 BFS has adequate reliability (α = 0.90) along with factorial, concurrent, and convergent validity. Results of confirmatory factor analysis (CFA) supported the one-factor structure of the scale. Concurrent validity results indicate a significant positive correlation between COVID-19 BFS and the Fear of COVID-19 Scale (r = 0.131, p < 0.001), suggesting that individuals with higher levels of burnout may also have higher levels of fear of COVID, or vice versa. The scale was also correlated positively with being against the dynamic zero-COVID strategy (r = 0.340, p < 0.001), indicating that a higher level of burnout may be associated with individuals who are against the dynamic zero-COVID strategy. The results suggest the five-item COVID-19 BFS is a valid and reliable scale for the measurement of burnout frequency of the Chinese general population in relation to the prolonged COVID-19 pandemic in a dynamic zero-COVID policy context.

The impact of COVID-19 pandemic on psychopathological symptoms in mothers and their school-age children before, during and after the COVID-19 pandemic peak

The COVID-19 pandemic had an impact on children's and caregivers' mental health. We investigated psychopathological symptoms in a group of non-at-risk and a group of at-risk mothers and their school-age children from the pre-pandemic period to the lockdown period and to the post-lockdown period. We used the SCL-90/R to assess mothers' psychological symptoms, the CBCL 1½-5, and the CBCL 6-18 for the perceived children's emotional-behavioral functioning. Analysis of variance was conducted to assess significant differences in the groups over the three assessment points. Linear regressions were run to investigate the effect of maternal psychological symptoms on their children's functioning. In the non-at-risk group, maternal psychopathological symptoms significantly varied during the pandemic. Children's Aggression scores decreased after the lockdown, while Depression scores significantly increased during lockdown and after. The mothers in the at- risk group presented overall decreasing scores over the three assessment points. Children's Aggression scores did not increase during lockdown. Depression scores did not show significant changes over the three assessment points. Overall, our results showed that mothers' psychopathological risk did not influence specific areas of children's emotional/behavioral functioning, but it had an effect on the general offspring psychological well-being.

Stressful Life Events and Depression During the Recurrent Outbreak of COVID-19 in China: The Mediating Role of Grit and the Moderating Role of Gratitude

Purpose

COVID-19 has been exerting tremendous influence on an individual’s physical behavior and mental health. In China, prolonged isolation may lead to depression among college students during the recurrent outbreak of COVID-19. We conducted this study to explore the relationship among stressful life events, grit, gratitude, and depression in college students during the recurrent outbreak of COVID-19.

Methods

We investigated 953 college students from across China, with an average age of 20.38 (SD=1.39) years. Participants completed four scales (Stressful Life Events Scale, Oviedo Grit Scale, Gratitude Questionnaire, and Patients’ Health Questionnaire Depression Scale-9 item).

Results

The present study found that (1) stressful life events were positively correlated with depression in college students; (2) grit mediated the positive relationship between stressful life events and depression; (3) gratitude moderated the relationship between grit and depression, and such that there was a stronger association between grit and depression for college students with high gratitude.

Conclusion

This study was of great significance for studying the relationship between stressful life events and depression in Chinese college students during the recurrent outbreak of COVID-19. Results indicated that grit and gratitude of college students may be the main targets of depression prevention and intervention. The research conclusion has theoretical and reference value for solving and preventing depression in college students during the recurrent outbreak of COVID-19.

Mental health status of students during coronavirus pandemic outbreak: A cross-sectional study

Introduction

University students have been extensively affected with psychological problems due to outbreak of COVID-19 pandemic given their special position and status. In this study, we intend to examine the prevalence of depression, anxiety and stress among a group of students.

Methods

This cross-sectional study was performed in medical Sciences universities of Mazandaran Province. 352 students were recruited by simple available sampling method. Data collection tools were Standard Mental Health Questionnaire (DASS-21) and demographic information questionnaire. Data analysis was done using SPSS software through descriptive and analytical statistics.

Results

The mean age of students was 22.44 ± 3.4 and 54.3% of them were females. 33.6, 28.4, and 27.3% of students had moderate to extremely severe levels of symptoms of depression, anxiety, and stress, respectively. There was a significant relationship between total mental health score with physical activity (p < 0.04) and with smoking (p < 0.02). There was also a significant relationship between smoking and depression (p < 0.01).

Conclusion

Considering the fact that anxiety, stress and depression are common among medical sciences students of Mazandaran Province, necessary measures must be taken to improve their mental health status.

Psychosocial effects of the quarantine during the first wave of the COVID-19 pandemic on the residents of the island of Brač

BACKGROUND

An unprecedented health and economic crisis in small island communities during the COVID-19 pandemic indicated the importance of studying its harmful effects on residents' mental health.

OBJECTIVES

To examine the differences in negative affectivity, perceived stressors, and social support both on the quarantined and not quarantined islands.

METHODS

A web-based survey and correlational cross-sectional research design were used, based on a nonprobabilistic convenience sampling method to select 613 Croatian islands' residents during May 2020. The participants completed the Depression, Anxiety and Stress Scale (DASS-21) and the General Information Questionnaire, data on their exposures to stressors during the COVID-19 pandemic and the perceived social support.

RESULTS

Compared with the nonquarantined residents of other islands, the island of Brač residents scored significantly higher on the symptoms of depression (M = 11.61; t = 2.13, P < 0.05) and stress (M = 13.06; t = 3.21, P = 0.001) subscales, receiving more support from religious communities (t = 2.34, P = 0.02) and less from the physicians (t = -2.68, P = 0.01). Lower sociodemographic status was associated with higher levels of depression, anxiety, and stress.

CONCLUSION

The COVID-19 pandemic highlighted the urgent need to protect mental health in isolated island areas specially for singles and people of low socioeconomic status.

Negative emotional symptoms during COVID19 confinement: The relationship with reading habits

Background

Coronavirus disease (COVID19) is an ongoing pandemic, which forced governments across the globe to implement confinement measures to limit the spread of the disease. These measures have impacted the daily life and psychological status of people. However, no studies have examined the relationship between changes in psychological status with reading habits during the COVID19 pandemic.

Objectives

The study aims at examining the relationship between changes in reading habits and negative emotional states.

Method

The psychological status was measured using the Depression, Anxiety, Stress Scales (DASS). In addition, the participants reported changes in four types of reading experiences during COVID19 confinement. These reading types are specialized, general knowledge, story/novels, and religious material. An internet-based survey was used to collect the data among adults.

Results

A total of 1711 individuals participated in the study. About 60.0%, 55.1%, 60.5% and 61.0% reported participating in scientific, religious, general, and novel reading, respectively. Additionally, the ANOVA revealed differences (p < 0.05) in DASS scores according to the changes in scientific, religious, newspaper, and novel/story reading. Subgroup post hoc comparisons showed that DASS scores were associated with a no-change or increase in all types of reading habits indicating a main effect of emotional state on all types of reading.

Conclusions

Current results might suggest that the participants who experienced greater negative emotions, tended to either not change or increase their reading habits. Additionally, individuals with lower negative emotion scores reported a decrease in reading during the COVID19 pandemic.

Hierarchical Structure of Depression Knowledge Network and Co-word Analysis of Focus Areas

Contemporarily, depression has become a common psychiatric disorder that influences people's life quality and mental state. This study presents a systematic review analysis of depression based on a hierarchical structure approach. This research provides a rich theoretical foundation for understanding the hot spots, evolutionary trends, and future related research directions and offers further guidance for practice. This investigation contributes to knowledge by combining robust methodological software for analysis, including Citespace, Ucinet, and Pajek. This paper employed the bibliometric methodology to analyze 5,000 research articles concerning depression. This current research also employed the BibExcel software to bibliometrically measure the keywords of the selected articles and further conducted a co-word matrix analysis. Additionally, Pajek software was used to conduct a co-word network analysis to obtain a co-word network diagram of depression. Further, Ucinet software was utilized to calculate K-core values, degree centrality, and mediated centrality to better present the research hotspots, sort out the current status and reveal the research characteristics in the field of depression with valuable information and support for subsequent research. This research indicates that major depressive disorder, anxiety, and mental health had a high occurrence among adolescents and the aged. This present study provides policy recommendations for the government, non-governmental organizations and other philanthropic agencies to help furnish resources for treating and controlling depression orders.

How do people get information for COVID‐19 according to age groups?

This study highlights how people get important information on COVID‐19 according to age groups by employing social network analysis for Twitter. First, people have different key players according to the age groups. For example, while universities and journals play a crucial role in the adults' networks, news media have a significant impact on the elderly's networks. Second, people have different characteristics of social network groups according to age. For example, people belong to small groups, and barely communicate with others across the groups in the teens' networks, whereas people in each group have strong communication networks with other groups in the elderly's networks. Third, this study shows that people utilise different domains to share COVID‐19 information according to age. For example, while twitter.com ranks first in the children, teens, and elderly's networks, cnn.com places first in the adults' networks.

People have different key players according to age

People have different characteristics of social network groups according to age

People utilise different domains to share COVID‐19 information according to age

Governments and policymakers should understand the characteristics of social networks for COVID‐19 according to age

The psychological distress and COVID-19 pandemic during lockdown: A cross-sectional study from United Arab Emirates (UAE)

Background

The pandemic resulted in the societal changes as conflicts and instability were the common concerns experienced by families because of the lockdown. However, the psychological impact of the COVID-19 on the United Arab Emirates (UAE) population is not studied extensively.

Objective

The study evaluates the psychological impact of lockdown during the pandemic on the people in the UAE.

Material and methods

This study was cross-sectional in nature and was conducted using a questionnaire consisting of 35-items. The questions were related to social, psychological, and personal aspects. Multivariate Linear regression was used to find the outcomes between independent variables.

Results

The mean value of social phobia was 2.56 ± .620, followed by the mean score of anxiety (2.47 ± .666), stress (2.44 ± .631), and depression (2.42 ± .682). The higher the respondents experienced the scores, the more depression, anxiety, and stress. Demographics such as marital status, age, and occupation and education level have a statistically significant association with social phobia, anxiety, depression, and stress.

Conclusion

The study concludes that the lockdown more psychologically impacted males, older people, and unemployed individuals during the pandemic.

Status of yoga and mental health among Brazilian practitioners during COVID-19: An internet-based cross-sectional survey

This study aimed to describe yoga practice and verify its association with depression, anxiety, and stress during the COVID-19 pandemic among Brazilian practitioners. A cross-sectional anonymous online survey was conducted in all regions of Brazil using a snowball sampling strategy among yoga practitioners. A total of 860 participants (87% female, aged: 19–82 years) completed the survey. Sociodemographic data, lifestyle factors, yoga practice during the pandemic, and the Depression Anxiety and Stress Scale (DASS-21) scores were collected between July 9 and July 15, 2021. Overall, 9.5%, 9.3%, and 5.6% of participants exhibited some traits (mild to severe) of depression, anxiety, and stress, respectively. Hatha yoga (48%) was the most commonly practiced yoga style. In the adjusted analysis, a higher yoga experience (> 5 years) was associated with better anxiety (odds ratio; bootstrap 95% confidence interval: 2.42; 1.32, 4.49) and stress status (1.80; 1.06, 3.00) than beginners (< 1 year). Practitioners who reported higher time and days of yoga practice during the study period were more likely to show normal levels of depression (odds ratio: 2.56–6.49; p ​< ​0.05), anxiety (odds ratio: 3.68–8.84; p ​< ​0.05), and stress (odds ratio: 2.15–5.21; p ​< ​0.05). Moreover, the maintenance of practice frequency during the pandemic was associated with higher odds of normal levels of depression (2.27; 1.39–3.79), anxiety (1.97; 1.25–3.10), and stress (1.97; 1.32–2.96). In conclusion, our findings indicated that a higher level of yoga practice was associated with better mental health levels during the COVID-19 pandemic.

The prevalence of depression among iran-iraq war veterans, combatants and former prisoners of war: A systematic review and meta-analysis

By exposing individuals to trauma, wars can cause a host of psychiatric disorders. This study aimed to collect and compare the studies conducted to estimate the prevalence of depression among veterans, former prisoners of war (POWs) and military personnel in the Iran-Iraq war (1980-1988). In this systematic review, a search was conducted using relevant keywords in major national and international databases, personal archives and national academic libraries. We screened 135 records using their abstracts and selected a total of 56 studies for full-text review. Eventually, 19 studies were included in our systematic review and meta-analysis. The estimated pooled prevalence of depression among Iranian veterans and POWs was 22.4% (95% confidence interval = 15.0-32.0). Although the results indicated disparities in the prevalence of depression among veterans and POWs, the aggregate estimated prevalence was much higher than what has been reported for military personnel. Effective policies and strategies are required for prevention and treatment of depression and related psychiatric complications among veterans and former POWs.

Psychological Well-Being During the Second Wave of COVID-19 Pandemic: The Mediation Role of Generalized Anxiety

Introduction

The outbreak of the COVID-19 has largely impacted individuals’ health and lifestyles. This study aimed to investigate people’s psychological well-being during the second phase of the COVID-19 pandemic.

Methods

We selected six indicators of psychological well-being: fear of COVID-19, loneliness, social interaction anxiety, generalized anxiety, PTSD, and depression. A sample of 231 Italian participants (56.3% women), with a mean age of 32.7 (SD=12.61), completed an online survey from February to March 2021, during the so called “second wave”. It included the Fear of COVID-19 Scale (FCV-19S), the UCLA Loneliness Scale- Version 3, the Generalized Anxiety Disorder 7-item Scale (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), the Impact of Event Scale–Revised (IES-R), and the Social Interaction Anxiety Scale (SIAS).

Results

Apart from loneliness, women reported lower levels of psychological well-being than men. Fairly good associations between all the detected variables were found. Based on a mediation model evaluation (in which generalized anxiety was introduced as a mediator in the relationship between fear of COVID-19, PTSD, loneliness, social interaction anxiety, and depression), except for social interaction anxiety, total and partial mediation effects suggested that generalized anxiety played a crucial role in exacerbating depressive symptoms during the pandemic.

Conclusion

Our outcomes may expand the knowledge about the psychological well-being during the pandemic experience, with a focus on the mediating role of generalized anxiety.

Mental health of students amidst the COVID-19 pandemic: An empirical study

Purpose

Considering the severity of the global outbreak of coronavirus (COVID-19) on the whole of humanity, particularly in this case on the physical and mental health of students, this study strives to explore the role of financial worries, employment anxiety and COVID-19 knowledge on depression and mental health among students in Bangladesh.

Design/methodology/approach

In the study, a deductive reasoning approach was employed, together with a self-administered questionnaire survey. Questionnaires were sent to the respondents via different social media and by email by creating a Google form link. We finally received 387 responses students aged over 18 years who had internet access in order to complete the survey. To analyze the data, structural equation modeling via AMOS was used.

Findings

The results showed that employment anxiety, financial worry, and knowledge on COVID-19 positively influence depression, and finally depression negatively influences the mental health of the students. Thus, our findings supported all of the proposed hypotheses.

Originality/value

The research enriches the existing literature pool by contributing empirical substantiation on the role of employment anxiety, financial worries and knowledge of COVID-19 in depression, and the impact of depression on mental health.

Risk Factors Affecting Mental Health During The Early Stages Of The Covid-19 Pandemic In High-Risk 50+ Population In The Czech Republic

This study deals with key factors affecting mental health during the COVID-19 pandemic. The results are based on the longitudinal representative 50+ population-based multi-country panel study Survey of Health, Aging and Retirement in Europe (SHARE) in which representative samples of individuals in European countries plus Israel were collected. The goal is to turn the challenges of aging into opportunities as well as provide valid and reliable data for evidence-based policies. A total of 2,631 participants were interviewed by telephone in the Czech Republic during the initial stages of the COVID-19 outbreak in 2020. After a descriptive analysis showed that participants complied well with most preventative and protective COVID-19 measures, subsequent modeling using logistic regression analysis and a decision tree algorithm identified key determinants that have contributed to an understanding of variation in declared feelings of depression. We found that nervousness, previously unexperienced trouble with sleep, and self-rated health status before the COVID-19 outbreak and gender remained significant predictors of depression, from which statistically significant different categories concerning the percentage of depression could be formed. These identified potential risk factors should be considered in planning further supportive strategies for high-risk 50+ population.

One-year changes in the prevalence and positive psychological correlates of depressive symptoms during the COVID-19 pandemic among medical science students in northeast of Iran

Objectives

The COVID‐19 pandemic has imposed a significant psychological burden on many across society especially students studying medical sciences. This study intended to investigate the one‐year changes in the prevalence and correlates of depressive symptoms during the COVID‐19 pandemic among medical science students.

Methods

A cross‐sectional study in Shahroud, Iran administering a convenience sampling method (January to February 2021). Online self‐reported questionnaires included Rosenberg Self‐Esteem Scale, Paloutzian‐Ellison Spiritual Well‐Being Questionnaire, Diener's Satisfaction with Life Scale and the University Student Depression Inventory. Data analyzed using descriptive and inferential statistics (Independent t‐test and Multiple Regression Analysis).

Results

A total of 306 medical science students were investigated in this study. The mean scores 1 year after the outbreak of COVID‐19 were for depression (81.25 ± 26.04), spiritual well‐being (80.98 ± 18.06), self‐esteem (26.89 ± 2.20), and life satisfaction (19.68 ± 6.81). The results indicated that depression mean score was significantly higher in post outbreak assessment (71.92 ± 22.94 vs 81.25 ± 26.04) (P < .001). Fifty percentage of changes in depression can be predicted by studied variables. A high score of depression was directly associated with a higher level of self‐esteem. Moreover, increased interest in the field, scores of spiritual well‐being, and life satisfaction were inversely and significantly associated with depression.

Conclusions

Iran's education system has been significantly affected, with the addition to the COVID‐19 pandemic imposing a psychological burden such as depression, exacerbating this within medical science students compared to a year ago. Spiritual well‐being and life satisfaction as positive psychology constructs were recognized as protective factors against depression during the pandemic. Spiritual and social support should be integrated in psychological interventions within university settings for medical science students.

Online Mental Health Survey for Addressing Psychosocial Condition During the COVID-19 Pandemic in Indonesia: Instrument Evaluation

BACKGROUND

Regular monitoring of the pandemic's psychosocial impact could be conducted among the community but is limited through online media. This study aims to evaluate the self-rating questionnaire commonly used for online monitoring of the psychosocial implications of the coronavirus disease 2019 (COVID-19) pandemic.

METHODS

The data were taken from the online assessment results of two groups, with a total of 765 participants. The instruments studied were Self-Rating Questionnaire (SRQ-20), post-traumatic stress disorder (PTSD), and Center for Epidemiological Studies Depression Scale-10 (CESD-10), used in the online assessment. Data analysis used Rasch modeling and Winsteps applications. Validity and reliability were tested, and data were fit with the model, rating scale, and item fit analysis.

RESULTS

All the scales for outfit mean square (MnSq) were very close to the ideal value of 1.0, and the Chi-square test was significant. Item reliability was greater than 0.67, item separation was greater than 3, and Cronbach's alpha was greater than 0.60; all the instruments were considered very good. The raw variance explained by measures for the SRQ-20, PTSD, and CESD-10 was 30.7%, 41.6%, and 47.6%, respectively. The unexplained eigenvalue variances in the first contrast were 2.3, 1.6, and 2.0 for the SRQ-20, PTSD, and CESD-10, respectively. All items had positive point-measure correlations.

CONCLUSION

The internal consistency of all the instruments was reliable. Data were fit to the model as the items were productive for measurement and had a reasonable prediction. All the scales are functionally one-dimensional.

The Impacts of Psychological Distress on Life Satisfaction and Wellbeing of the Indian General Population During the First and Second Waves of COVID-19: A Comparative Study

The current study aims to understand the impact of psychological distress caused by the COVID-19 pandemic on life satisfaction and wellbeing, in the Indian context. The study also analyses the differences in these effects between the first and second waves of the pandemic. For this purpose, a survey was conducted during the two waves of the pandemic. Eight hundred eighty-four and 925 respondents participated in the first and second waves, respectively. The study showed that depression, anxiety, and stress negatively related to life satisfaction and wellbeing during both waves. The study also showed that the effects were stronger during the second wave compared to the first. Life satisfaction and wellbeing of women were found to be affected to a higher level than those of men, due to psychological distress. The study showed that a combined approach involving coping mechanisms and health care can help manage the psychological issues that arise with crisis situations such as the COVID-19 pandemic.

Prevalence of anxiety, depression, stress, and perceived stress and their relation with resilience during the COVID-19 pandemic, a cross-sectional study

Background and aims

Home quarantine and physical distancing at the time of coronavirus disease 2019 (COVID-19) had a severe effect on the mental health of the populations. Resilience has been reported previously to be a protective factor against anxiety, stress, and depression. This study evaluates the prevalence and severity of depression, anxiety, stress, and perceived stress and their relation with resilience associated with the COVID-19 pandemic among a sample of the general population in Southern Iran.

Methods

In this cross-sectional web-based survey, from April 12 to May 13, 2020, stress, anxiety, depression, perceived stress, and resilience were measured using the Persian version of Depression Anxiety and Stress Scale (DASS-21), Perceived Stress Scale (PSS-14), and Connor-Davidson Resilience Scale (CD-RISC). Statistical analyses were carried out using the IBM Statistical Package for Social Sciences. Mean ± standard deviation (SD) and frequencies were used to describe demographic data. Independent sample t-test, Spearman correlation, and the Pearson correlation coefficient were performed to examine anxiety, depression, stress, and resilience.

Results

Among a total of 538 participants, the overall prevalence of moderate-to-extremely severe depression, anxiety, and stress was found to be 26.1%, 33.2%, and 5.8%, respectively. The overall median PSS and resilience score were 30 and 70, respectively. There was a significant association between higher age and perceived stress. Male and high income were related to higher resilience scores. Perceived stress positively correlates with resilience, whereas depression significantly correlates with anxiety and stress. Individuals with underlying disease demonstrated significantly higher scores for depression and anxiety. Also, perceived stress had a significant but weak, positive correlation with age and the number of quarantine days.

Conclusion

The occurring COVID-19 pandemic could be the culprit of psychological distress, anxiety, and depression of large population quantities. Our results showed a subordinate overall resilience in the general Iranian population during the COVID-19 pandemic.

Psychosocial responses to COVID-19 among nurses in two hospitals: a mixed method study at Eastern Nepal

BACKGROUND

Most documented studies have focused on mental health status of health care workers during the pandemic but there are very few studies, focusing on mitigation of mental health problems among nurses.

AIM

To study psychosocial responses to COVID-19 and the effectiveness of intervention among nurses.

MATERIALS AND METHODS

A mixed-method study was conducted, including 278 nurses from two COVID-19 hospitals of the province by purposive sampling. Depression, anxiety and stress and a composite measure of personal financial burden scales for quantitative; and interview guide for qualitative data were used. A psychosocial strengthening session was introduced and the effectiveness of the program was assessed after 4-5 weeks of intervention.

RESULTS

Mild, moderate and severe depression was found among 13.7%, 9.4% and 1.1% of the participants correspondingly. Mild, moderate, severe and extremely severe anxiety was found among 21.2%, 8.6%, 3.2% and 2.2% of the participants respectively. Stress was mild among 9% and moderate in 1.4% of the participants. Lack of PPE and fear of transmitting infection were found as frequent causes of problems. Mean scores of depression, anxiety and stress were significantly decreased after the psychosocial strengthening program.

CONCLUSION

Depression, anxiety and stress are common issues of nurses. Common causes of problems were lack of resources, fear of being infected and fear of transmitting to family members. The psychosocial strengthening program was effective in reducing the problems.

The Comparison of China and Iran Response to COVD-19 Pandemic: Lessons Learn for Health Policy

Currently, despite the change in the course of diseases, attention to infectious diseases and their integration has decreased. The prevalence of remerging infectious diseases has led to the need for appropriate preparation programs. There are still problems in controlling infectious diseases with the outbreak of coronavirus. The outbreak of the disease affected many countries in a short period. Therefore, by examining the actions of the two countries, it is possible to gain appropriate experiences in dealing with infectious diseases. This study was conducted using a gray literature review to examine all applied actions for the response to COVID-19 epidemics and their impacts on the prevalence of this disease in China and Iran. Examination of the documents shows that disease prevention is the most critical action, and we have witnessed a decrease in the number of patients with this disease by the introduction of prevention policies. The implementation problems of quarantine programs were meeting the basic needs of the people and continuing to implement this program. The issue of education was also one of the leading problems.

Psychological problems among the university students in Saudi Arabia during the COVID-19 pandemic

BACKGROUND

The 2019 coronavirus disease (COVID-19) pandemic is a public health emergency that represents a challenge to psychological health. This study aimed to assess the psychological conditions among university students in Saudi Arabia during the COVID-19 pandemic.

METHODS

During the period between the 4th and 18th of June 2020, the students of Umm AlQura University in Saudi Arabia were invited to complete an online survey. The survey assessed their sociodemographic characteristics, educational disciplines, and manifestations of psychological health problems including depression, anxiety, and stress as determined by the Arabic version of the Depression Anxiety Stress Scale-21 (DASS-21).

RESULTS

The study included 936 university students (56.4% women and 43.6% men). Of them, 41.1% had depressive symptoms (31.7% mild to moderate and 9.4% severe to very severe), 26.9% had anxiety symptoms (15.8% mild to moderate and 11.1% severe to very severe), and 22.4% had stress symptoms (15.2% mild to moderate and 7.2% severe to very severe). Students who reported having a friend or relative infected with or died of COVID-19, watching or reading news about the pandemic ≥2 hours/day, and not getting emotional support from family, university, and society were more likely to show psychological problems.

CONCLUSION

Symptoms of depression, anxiety, and stress were common among Saudi university students during the COVID-19 pandemic. Psychological counselling and support should be provided to university students in Saudi Arabia.

Anxiety due to COVID-19 among healthcare providers during pandemic: A web-based cross-sectional survey in Iran

AIM

The main purpose of this study was to assess the levels of anxiety, depression, and stress among healthcare providers in Iran.

METHODS

This descriptive cross-sectional survey was performed on healthcare providers selected through the convenience sampling method from April 6 to May 19, 2020, during the COVID-19 pandemic. To this end, a self-report web-based questionnaire made up of a sociodemographic characteristics information form, Depression, Anxiety, and Stress Scale (DASS), and Corona Disease Anxiety Scale (CDAS) was distributed. Descriptive statistics, chi-square test (χ² ), and univariate and multivariate logistic regression models were accordingly practiced to analyze the data using the Statistical Package for Social Sciences (SPSS) software.

RESULTS

Of 1343 healthcare providers, 45.8% and 73.0% had moderate physical and psychological anxiety symptoms, respectively. The logistic regression model similarly demonstrated that anxiety caused by COVID-19 was significantly correlated with the age ranges of 41-50 (P = .007) and 51-60 (P = .014) years as well as male participants (P < .001). In addition, the prevalence rates of depression and stress were, respectively, reported by 35.1% and 27.8%. There was correspondingly a significant relationship between depression and age as well as stress and gender.

CONCLUSIONS

It seems that healthcare managers need to focus more attention on psychological aspects in healthcare providers during this pandemic and plan to teach them about coping strategies.

Evaluation of the mental health of health professionals in the COVID-19 era. What mental health conditions are our health care workers facing in the new wave of coronavirus?

BACKGROUND

The aims of this study were to analyse the mental health and health-related quality of life (HRQoL) of a broad sample of healthcare workers (HCWs) in Spain and to identify potential factors that have a significant effect on their mental health and HRQoL.

METHOD

This prospective cohort study comprised 2089 HCWs who completed the Generalized Anxiety Disorder 7-item (GAD-7) Scale, the Patient Health Questionnaire-9 (PHQ-9), the Impact Event Scale-Revised (IES-R), the Insomnia Severity Index (ISI), and the health-related quality of life Questionnaire (EQ-5D). Sociodemographic and clinical data in relation to Covid-19 were also recorded. Descriptive statistics, univariable analysis and multivariable linear regression models were applied to identify factors associated with mental health and HRQoL.

RESULTS

80.87% of participants were female and 19.13% male; 82.38% were aged under 55 years; 39.13% were physicians and 50.17% were nurses or auxiliaries; 80.42% of the health workers have directly treated patients with Covid-19 and 12.28% have themselves tested positive for Covid-19. 38.58% of HCWs had clinical depression; over half (51.75%) had clinical anxiety; 60.4% had clinical stress; and 21.57% had clinical insomnia. Older professionals (>55 years) reported lower rates of anxiety, depression, insomnia, and stress. Having worked directly with Covid-19 patients appears to be an explanatory variable of suffering greater anxiety, depression, stress and insomnia, and of having a worse HRQoL amongst our HCWs. The group of HCWs suffering the worst mental state were nursing home workers.

CONCLUSIONS

Our study confirms that symptomatology of anxiety, depression, stress, insomnia, and HRQoL were affected amongst HCW during the Covid-19 pandemic.

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.

The relationship between the stress experienced by parents and cyberchondria during the pandemic process

Purpose

The purpose of this paper is to examine the relationship between the stress experienced by parents during the pandemic and their cyberchondria. The research was carried out in a descriptive and cross-sectional manner.

Design/methodology/approach

The sample of the research: living in Turkey and has created 432 parents with at least one child between the ages of 6 and 15. Participant information form, parental stress scale and cyberchondria scale were used in the study. Data were collected through online surveys between July 1, 2020, and August 31, 2020.

Findings

In the study, when the scores obtained from the Parental Stress Scale and the Cyberchondria Scale were compared with the demographic characteristics, a significant difference was found between gender, age, marital status, education level, economic status, number of children and presence of chronic diseases (p < 0.05). It was determined that there is a significant difference between the responses of the parents regarding the pandemic process and the Parental Stress Scale and the Cyberchondria Scale (p < 0.05). A positive significant correlation was found between the Parental Stress Scale and the total and subdimensions of the Cyberchondria Scale (p < 0.05).

Research limitations/implications

The research was carried out with only parents with children between the ages of 6 and 15, but it reveals the stress and cyberchondria of the parents during the pandemic.

Originality/value

The results obtained reflect the factors affecting the stress and cyberchondria levels experienced by parents during the pandemic process. Also, as the stress of the parent's increases, it has seen that the level of cyberchondria increases in parallel.

Mental health outcomes among health-care workers in Oman during COVID-19: A cluster analysis

Aim

Despite the much heralded epidemic of adjustment difficulties, health‐care workers (HCW), who are likely to be at risk and impacted with mental health issues, have received scant attention. This study aimed to determine whether definable profiles exist in a cohort of HCWs associated with demographic and mental health problems.

Methods

An online cross‐sectional survey was conducted in Oman. Demographic and mental health data were collected from 8 to 17 April 2020. A total of 1132 participants returned their completed questionnaire. A two‐step cluster analysis was used to split the sample into three clusters.

Results

Cluster A (n = 416) was from HCW in non‐frontline roles, and constituted “low‐risk and least‐impacted”. Cluster B (n = 412) and Cluster C (n = 304) were from frontline HCW and constituted ‘high‐risk and moderate‐impacted’ and ‘high‐risk and high‐impacted’ groups, respectively. HCWs in Cluster C reported more depression (P < 0.001), anxiety (P < 0.001), stress (P < 0.001) and clinical insomnia (P < 0.001) compared with those in the other clusters. HCWs in Cluster C were at the highest risk for mental health problems during the pandemic.

Conclusions

Early psychological interventions targeting this vulnerable group may be beneficial. Management should develop different tailor‐made strategic plans to address different mental health needs for each profile group.

What is already known about this topic?

Nurses, physicians and allied health‐care workers (HCWs) experienced many kinds of psychological problems, including depression, anxiety, stress and insomnia during the COVID‐19 outbreak.

What this paper adds?

The HCWs in Cluster A were more experienced, did not work in the frontline and reported a lower prevalence of depression, anxiety, stress and insomnia. This group was labelled as the ‘low risk and least impacts’ group.

The HCWs in Cluster B were predominantly nurses and doctors working in the frontline and reported a higher prevalence of anxiety and stress. This cluster was labelled as the ‘high risk but moderate impacts’ group.

The HCWs in Cluster C were predominantly nurses who were younger, with less working experience and work in the frontline but reporting a higher prevalence of depression, anxiety, stress and insomnia. This cluster was labelled as the ‘high risk and high impacts’ group.

The implications of this paper:

Management should develop different tailor‐made strategic plans to address different mental health needs for each profile group.

Online cognitive behaviour therapy targeting this vulnerable group may be beneficial during the COVID‐19 pandemic.

Prevalence of depressive symptoms due to COVID-19 and associated factors among healthcare workers in Southern Ethiopia

OBJECTIVES

Globally, novel coronavirus disease 2019 (COVID-19) has spread rapidly since it was first identified and challenging the provision of essential services for low-resource countries. Healthcare workers involved in providing care are at high risk of developing mental health problems. The aim of this was to determine the prevalence of depressive symptoms due to COVID-19 and associated factors among healthcare workers in the West Guji zone in public health facilities, southern Ethiopia.

METHODS

A facility-based cross-sectional study was conducted in public health facilities found in the West Guji zone. A simple random sampling technique was employed to select 283 study subjects. This study was used to assess the prevalence of depression symptoms using Depression, Anxiety and Stress Scale-21, a depression subscale. Descriptive statistics, binary and multiple logistic regressions were used. Adjusted odds ratios (AORs) with 95% confidence interval will be estimated to assess the strength of associations and statistical significance will be declared at a p-value < 0.05.

RESULTS

Out of 283 eligible healthcare workers, 275 respondents had participated in this study with a 97.2% response rate. The prevalence of depressive symptoms was 21.5%. The independent predictors associated with depressive symptoms due to COVID-19 were age (adjusted odds ratio = 2.35, 95% confidence interval = 1.126-3.95), family size (adjusted odds ratio = 3.56, 95% confidence interval = 1.09-11.62), alcohol use (adjusted odds ratio = 4.31, 95% confidence interval = 1.76-10.55), medical illness (adjusted odds ratio = 9.56, 95% confidence interval = 3.71-24.59), having training on COVID-19 (adjusted odds ratio = 0.37, 95% confidence interval = 0.17-0.81), and lack of knowledge on COVID-19 (adjusted odds ratio = 15.34, 95% confidence interval = 6.32-37.21).

CONCLUSION

The prevalence of depressive symptoms among healthcare workers due to COVID-19 was high. Factors associated with depressive symptoms were age, family size, alcohol use, medical illness, having training on COVID-19, and lack of knowledge on COVID-19.

Teachers' Mental Health and Self-Reported Coping Strategies During the COVID-19 Pandemic in Ecuador: A Mixed-Methods Study

PURPOSE

This study assessed the psychological distress, life satisfaction, and perceived stress of Ecuadorian teachers who adopted online learning in response to the COVID-19 pandemic. It also aimed to qualitatively report the coping strategies used to maintain their mental health and well-being.

METHODS

A web-based cross-sectional survey was conducted from June to mid-August 2020.

RESULTS

In total, 394 teachers completed the questionnaire, and from those, 320 also completed an optional open-ended question included in the survey. More than half of the participants reported taking care of children under 11 years and/or adults over 65 years. At the time of the study, most of the participants were teaching in higher education settings. Age was significantly correlated with all the psychological variables, females presented higher levels of perceived stress, and teachers with home care responsibilities presented higher psychological distress as well as perceived stress. Teachers who had previous training and experience with online teaching presented lower levels of distress, perceived stress as well as higher levels of life satisfaction. The most used coping strategies included seeking social support, exercising, and engaging in leisure activities.

CONCLUSION

The results provide useful information to help develop initiatives that promote teacher well-being. Future studies should consider using a more diverse sample and dedicate attention to work-family conflicts as well as social and structural inequalities that may have a toll on teachers' mental health and performance.