The magnitude of COVID-19 related stress, anxiety and depression associated with intense mass media coverage in Saudi Arabia

Impact of social media on mental health of the general population during Covid-19 pandemic: A systematic review

During the COVID-19 pandemic, people are using social media more than usual routine because they rely on online sources to seek health information for themselves and their loved ones. The spread of inaccurate and misleading information via social media has a number of detrimental psychological effects on members of society. The aim of this systematic review was to describe the impact of social media on the mental health of the general population. An extensive systematic search was done till the last month of 2021 for collecting the evidence using the PRISMA technique. The search was mainly focused on the article leading with keywords and search engines used during the course of the study were Pubmed, Semantic Scholar, Mendeley, and Science direct. Articles for this study were selected based on the predetermined eligibility criteria and performed quality assessment by using the NHLBI quality assessment tool. Most of the studies included in this review are found fair (score between 9 and 12) quality. Out of 866 publications, 533 articles were included in the initial screening, after duplication removal 46 full-text articles were assessed for eligibility and 14 studies were selected for systematic review. In most of the studies, maximum participants used social media as a primary source of information. Relatively high rates of symptoms of depression (14.14% to 48.3%), anxiety (7.4% to 47.82%), and prevalence of stress increased to 37.67% are reported after exposure to social media for coverage of COVID-19 news in the general population. Risk factors of psychological distress are associated with female gender, younger age group, marital status, staying alone, and duration of exposure to mass media. Increased exposure to COVID-19 information through mass/social media is associated with highly significant levels of psychological health issues; mitigating the hazardous effect of social media exposure during the COVID-19 pandemic on the psychological health of the general population is an international public health priority.

Mental Health among African American and Latinx Men who have sex with men after the COVID-19 Lockdown in Los Angeles - Findings from the HOPE cohort

This study aimed to examine the depression and anxiety among men of color (primarily African American and Latinx) who have sex with men after the lockdown due to the COVID-19 pandemic. Outcomes included 21-item Beck Depression Inventory (BDI), 7-item Generalized Anxiety Disorder (GAD), and a 10-item COVID-related anxiety measure using a modified H1N1-related anxiety question. Independent variables were food insecurity and belief in government efficiency. Data were analyzed by Regression models with random cluster effects. Food insecurity experiences were significantly associated with higher depression (p < 0.001), higher anxiety (p < 0.001), and higher pandemic-related anxiety (p < 0.001). Higher levels of belief in government efficiency were significantly associated with lower depression (p < 0.05), less anxiety (p < 0.05), and less pandemic-related anxiety (p-value < 0.001). These findings emphasize the importance of establishing trust between government and at-risk communities when issuing public health policies, especially during unforeseen circumstances, as well as to ensure basic human rights, such as food security.

Teachers' Response to Stress, Anxiety and Depression During COVID-19 Lockdown: What Have We Learned From the Pandemic?

BACKGROUND

As a result of national lockdown due to the COVID-19 outbreak, teachers were forced to suspend their classes and replace them with online teaching and home schooling. Additional stressors such as competing family responsibility have increased their worries and mental health problems. The aim of this study was to determine the impact of COVID-19-related worries on teachers' emotional symptoms, considering the mediating role of several protective factors.

METHODS

A total of 614 Chilean teachers (94.60% women) participated in this study using a cross-sectional design and incidental sampling method. Self-report data was collected assessing emotional symptoms, COVID-19-related worries, life satisfaction, affect balance, and resilience. Descriptive analyses, Pearson's correlations, hierarchical regressions, and mediation models were conducted.

RESULTS

The results indicated that emotional symptoms were associated with prepandemic physical and mental health problems, higher levels of worries and negative affect, as well as lower levels of life satisfaction and resilience. Results from the mediation models showed that the negative impact of COVID-19-related worries on emotional symptoms was alleviated by affect balance and resilience.

CONCLUSIONS

These findings highlight the importance of addressing the risk and protective factors for teachers' mental health during exceptional situations such as the ongoing pandemic.

Overexposure to COVID-19 information amplifies emotional distress: a latent moderated mediation model

An infodemic has accompanied the COVID-19 pandemic. This study explores whether overexposure to COVID-19-related information amplifies emotional distress. A cross-sectional online survey was conducted in China during the outbreak and after the peak of the pandemic (N = 1313). A latent moderated mediation model was built to analyze this relationship. COVID-19 information exposure was found to relate positively with emotional distress, and risk perception mediated the association between them. Additionally, psychological resilience moderated the mediating effects of risk perception. However, five factors of resilience differed in their moderating effects. This study offers theoretical and practical implications apropos clinical intervention and public health management.

Epidemiology in Middle School Science Curricula: a COVID-19 Pre-post Intervention

It is of great importance that science educators teach COVID-19 and related pandemics to boost students' scientific literacy. A mixed methods research design (pre-post test instrument [N = 86] and semi-structured interviews [N = 11]-August 2020 to June 2021) evaluated the ability of an intervention (12 h, three-session, 3-day, online workshop) to augment middle school inservice science teachers' (Eastern Saudi Arabian province) ability to teach about medical terminology and the epidemiology of diseases. Teachers' cognitive gains were measured through evaluating their knowledge, comprehension, and application of workshop content before and after the intervention. Descriptive statistics and inferential t tests revealed statistically significant cognitive differences overall (p < .01) (posttest mean = 26.26/30, SD 2.83, t value 18.51) and along knowledge (posttest mean = 5.72/7), comprehension (mean = 7.50/8), and application (mean = 13.05/15). A high effect size coefficient n2 indicated a large effect on cognitive gains. Thematic analysis about participants' subsequent efforts teaching workshop content to students revealed positive and negative experiences. The former included improved student engagement with the curriculum, community connections via project-based learning, and opportunities to teach colleagues about COVID-19. The latter concerned insufficient time, an obligation to teach the current curriculum without adding COVID-19 content, and administrative resistance. Recommendations pertain to augmenting the workshop curriculum and likeminded research initiatives.

Regional Comparison of Diabetes Psychosocial Comorbidities Among Americans With Type 1 Diabetes During the COVID-19 Pandemic

PURPOSE

The purpose of this study was to compare diabetes psychosocial comorbidities among adults with type 1 diabetes (T1D) across the United States during the onset of COVID-19 pandemic.

METHODS

Adults with T1D from 4 main US geographic regions including South (n = 367), West (n = 234), Northeast (n = 250), and Midwest (n = 247) completed a cross-sectional online survey between April and June 2020. Data collection was done on psychosocial measures, glycemic variability, sociodemographic characteristics, and various challenges related to the COVID-19 pandemic. Chi-square, Fisher's exact, Kruskal-Wallis tests, ordinary least squares, proportional odds, and ordinal logistic regression methods were used for data analysis.

RESULTS

In the South, 51.2% of participants had moderate to high levels of diabetes distress, and this was significantly (P = .03) higher than other regions. Northeast region had the lowest prevalence of moderate to severe diabetes burnout (19.8%), but this was not significantly different compared to the other regions. Participants in the South had also the highest mean score on the 8-item Patient Health Questionnaire, with 30.3% of them reporting moderate to severe depressive symptoms. However, there were no significant differences in depressive symptoms among the regions. Glycemic control, demographic characteristics, and COVID-19-related challenges were associated with different psychosocial comorbidities in different regions.

CONCLUSIONS

When providing information and support to individuals with diabetes in time of crisis like the COVID pandemic, providers should consider psychosocial aspects of diabetes care. Diabetes disparities and contextual factors vary geographically in the United States; these factors may impact the psychosocial comorbidities of diabetes in each region.

COVID-19 infodemic and depressive symptoms: The impact of the exposure to news about COVID-19 on the general Paraguayan population

INTRODUCTION

The COVID-19 pandemic has led to an increase of social stressors and mental health issues in the general population as well as among mentally ill patients. A COVID-19- related "infodemic", including too much information in digital and physical environments, has been recognized globally.

AIM

This study aimed to describe the impact of COVID-19 infodemic (exposure to news related to COVID-19) in terms of depressive symptoms in the Paraguayan general population.

METHODS

This was a descriptive and cross-sectional study. An online survey, designed in Google Forms, has been launched nationwide through the most popular social networks (Facebook, Twitter, Instagram) and messaging applications (WhatsApp, Telegram) in April (1st-30th) 2021. The Mental Health Inventory-5 (MHI-5) was employed for detecting depressive symptoms.

RESULTS

The survey included 1102 responders aged 35.4 ± 12.9 years old, 74.9% were women. MHI-5 mean score was 44.07 ± 14.16 in the general population with 34.4% (n = 379) of responders suffering from severe symptoms of depression (>52, as cut-off point). 53.5% of sample reported to have been exposed between 1 and 3 h to COVID-19 news, daily. An OR 1.933 (95% CI 1.48 - 2.52) was found between the exposure to news and depressive symptoms.

CONCLUSIONS

This study suggests that people exposed to a higher number of hours of COVID-19 news were 93.3% more likely to develop depressive symptoms.

Prevalence and factors associated with mental health problems in Saudi general population during the coronavirus disease 2019 pandemic: A systematic review and meta-analysis

This systematic review and meta-analysis generates evidence of the prevalence and associated factors of common mental disorders (i.e., depression, anxiety, and stress) related to the pandemic among the Saudi general population. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a comprehensive literature search was performed in the respective databases (e.g., PubMed, Scopus, Web of Science), from 22 July to 17 August 2021, and identified a total of 220 articles. Adhering to the inclusion criteria (i.e., original research concerning the prevalence and/or associated factors of depression and/or anxiety and/or stress disorders among the general Saudi population, published in English peer-reviewed journals), 15 studies were included in this review which consisted of a total of 262,656 participants. The overall prevalence of depression, anxiety, and stress was 30% (95% confidence interval [CI]: 22% to 38%, I²  = 99.58%), 20% (95% CI: 16% to 24%, I²  = 99.32%), and 29% (95% CI: 11% to 47%, I²  = 99.76%), respectively. Risk factors of mental health problems were found to be female sex, younger age group, single/divorced marital status, lower education, lower income, non-Saudis, unemployment status, students, being in a small family and living with elderly of the sociodemographic factors. Smokers, less physical activities, lower resilience, reduced immune status, chronic health problems, and psychiatric illness history were associated with a higher degree of mental health problems. In addition, coronavirus disease 2019 (COVID-19)-related risk factors of mental illness included lack of knowledge, fear, worry and concern, family member or friends' infection or death, lockdown restrictions, quarantine, confirmed or suspected of COVID-19 infection, and even pandemic effects. In conclusion, appropriate mental health preventive approaches for the Saudi general people are highly needed, where this review can be worthy of help by providing in detailed information to the respective authorities.

COVID-19 infodemic and adult and elderly mental health: a scoping review

OBJECTIVE

to map scientific knowledge about the repercussions of the infodemic on adult and elderly mental health in the context of the COVID-19 pandemic.

METHOD

this is a scoping review, developed using the Joanna Briggs Institute (JBI) methodology, which included 33 articles. These articles were analyzed according to average age, gender and education level; place and period of the studies; exposure time to COVID-19 information; main signs and symptoms related to mental health; main sources of information; suggestions for mitigating the effects of the infodemic; and knowledge gaps.

RESULTS

the most present repercussions of the infodemic on the adult and elderly mental health were anxiety, depression and stress, and the most affected group was young adults and females.

CONCLUSION

future studies with more robust designs are needed to investigate the repercussions of the infodemic on people's mental health in the medium and long term, as well as to assess the effects, feasibility, cost-benefit and meaning of interventions in population groups, especially in the elderly population.

Psychometric Validation of the Arabic Fear of Illness and Virus Evaluation

Global infectious pandemics can affect the psychology and behavior of human beings. Several tools were developed to evaluate the psychological impact of such outbreaks. The present study aimed to examine the psychometric properties of the Arabic translated version of Fear of Illness and Virus Evaluation scale (FIVE). FIVE is a 35-item tool consisting of four subscales that measure Fears about Contamination and Illness, Fears about Social Distancing, Behaviors Related to Illness and Virus Fears and Impact of Illness and Virus Fears. The tool was translated into Arabic by using a forward-backward translation. The online questionnaire contained the following sections: demographics, FIVE, Fear of COVID-19 Scale (FCV-19S) and face validity questions. Non-probability convenient sampling technique was used to recruit participants via a mobile instant messaging application. Reliability, concurrent validity, face validity and factor analysis were examined. The data consisted of 509 adult participants who reside in Saudi Arabia. The internal consistency of the Arabic FIVE subscales was high (0.84-0.91) with strong concurrent validity indicated by positive correlations of FIVE subscales with FCV-19S. Factor analysis suggested slightly different factor structures (Fears of Getting Sick, Fears that Others Get Sick, Fears of the Impact on Social Life and Behaviors Related to Illness and Virus Fears). Our data showed a better fit using the proposed structures. The Arabic version of the FIVE showed robust validity and reliability qualities to assess fear of COVID-19 on Arabic adult population.

Exposure to COVID-19-Related Information and its Association With Mental Health Problems in Thailand: Nationwide, Cross-sectional Survey Study

BACKGROUND

The COVID-19 pandemic has had a negative impact on both the physical and mental health of individuals worldwide. Evidence regarding the association between mental health problems and information exposure among Thai citizens during the COVID-19 outbreak is limited.

OBJECTIVE

This study aimed to explore the relationship between information exposure and mental health problems during the COVID-19 pandemic in Thailand.

METHODS

Between April 21 and May 4, 2020, we conducted a cross-sectional, nationwide online survey of the general population in Thailand. We categorized the duration of exposure to COVID-19-related information as follows: <1 h/day (reference group), 1-2 h/day, and ≥3 h/day. Mental health outcomes were assessed using the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7 scale, the Perceived Stress Scale-10, and the Insomnia Severity Index for symptoms of depression, anxiety, perceived stress, and insomnia, respectively. Multivariable logistic regression models were used to evaluate the relationship between information exposure and the risk of developing the aforementioned symptoms. An ancillary analysis using multivariable multinomial logistic regression models was also conducted to assess the possible dose-response relationship across the severity strata of mental health problems.

RESULTS

Of the 4322 eligible participants, 4004 (92.6%) completed the online survey. Of them, 1481 (37.0%), 1644 (41.1%), and 879 (22.0%) participants were exposed to COVID-19-related information for less than 1 hour per day, 1 to 2 hours per day, or 3 or more hours per day, respectively. The major source of information related to the COVID-19 pandemic was social media (95.3%), followed by traditional media (68.7%) and family members (34.9%). Those exposed to information for 3 or more hours per day had a higher risk of developing symptoms of depression (adjusted odds ratio [OR] 1.35, 95% CI 1.03-1.76; P=.03), anxiety (adjusted OR 1.88, 95% CI 1.43-2.46; P<.001), and insomnia (adjusted OR 1.52, 95% CI 1.17-1.97; P=.001) than people exposed to information for less than 1 hour per day. Meanwhile, people exposed to information for 1 to 2 hours per day were only at risk of developing symptoms of anxiety (adjusted OR 1.35, 95% CI 1.08-1.69; P=.008). However, no association was found between information exposure and the risk of perceived stress. In the ancillary analysis, a dose-response relationship was observed between information exposure of 3 or more hours per day and the severity of mental health problems.

CONCLUSIONS

These findings suggest that social media is the main source of COVID-19-related information. Moreover, people who are exposed to information for 3 or more hours per day are more likely to develop psychological problems, including depression, anxiety, and insomnia. Longitudinal studies investigating the long-term effects of COVID-19-related information exposure on mental health are warranted.

Media Exposure to COVID-19 Predicted Acute Stress: A Moderated Mediation Model of Intolerance of Uncertainty and Perceived Social Support

Background: Previous studies have found that disaster-related media exposure could predict acute stress responses. However, few studies have investigated the relationship between media exposure to COVID-19 and acute stress, and less is known about the mechanisms that translate media exposure to COVID-19 into acute stress. The current study explored the impact of media exposure to COVID-19 on acute stress, and examined the mediating role of intolerance of uncertainty (IU) and the moderating role of perceived social support (PSS). Methods: A total of 1,483 Chinese participants (M age = 27.93 years, SD = 8.45) completed anonymous online questionnaires regarding media exposure to COVID-19, IU, PSS, and acute stress during the COVID-19 outbreak in China. Results: Media exposure to COVID-19 was positively related to acute stress, and IU partially mediated this relationship. The direct effect of media exposure to COVID-19 on acute stress, and the relationship between IU and acute stress, were both moderated by PSS. The impacts of both media exposure to COVID-19 and IU on acute stress were stronger for individuals with low PSS. Limitations: This study collected data in a shorter timeframe, and no assessments occurred during the follow-up, which may prevent us from detecting the changes of the relationships between variables over time. Meanwhile, the self-report method limited the validity of the data due to subjective reporting bias. Conclusions: These findings contribute to a better understanding of how and when pandemic-related media exposure affects acute stress, and provide new perspectives for the prevention to reduce psychological problems following traumatic events.

Guidelines: Discharge Instructions for Covid-19 Patients

INTRODUCTION/OBJECTIVES

Clinicians treating COVID-19 patients face a major challenge in providing an effective relationship with patients who are discharged to return to home in order to optimize patient self-management after discharge. The purpose of these discharge instructions is to assist and provide guidance for physicians, nurses, and other health care personnel involved in discharging COVID-19 patients to home after encounters at hospitals, emergency departments, urgent care settings, and medical offices.

METHODS

A systematic literature-search of studies evaluating both symptoms and signs of COVID-19 was performed in order to establish specific optimal performance criteria in monitoring a patient's status with regard to disease safety. These optimal performance criteria parameters were considered with regard to the severity of morbidity and mortality. Strategies used to develop the discharge instructions included review of a broad spectrum of literature to develop the discharge criteria.

RESULTS

These guidelines are presented for patient education and should achieve the essential goals including: enabling patients to understand their medical situation, preventing complications, supporting patients by providing instructions, helping patients make more effective use of available health services, and managing patient stress by giving patients comfort through the knowledge of specific recommendations including how to respond to situations.

CONCLUSION

The COVID-19 pandemic requires clinicians to efficiently teach their patients self-management strategies and to provide a safe educated response to the patient and the surrounding community environment. The primary goal of the patient education discharge-instructions (PEDI) is to provide self-management strategies for preventing complications and disease transmission.