COVID-19-related information sources and anxiety levels

Introduction

Timely and accurate information is foundational to moderating and curing the COVID-19 for both the public and the scientific community, while repeated media exposure to crisis-related information raises stress and anxiety among general population.

Objectives

The main goal of the current study was to evaluate the associations between the COVID-19-related information sources and anxiety levels.

Methods

An online web-survey recruited participants who were ≥18 years old and lived in Romanian through an online campaign in May 2021. Participants were asked whether they received COVID-19-related information frequently from the following sources: the Internet, traditional media, medical staff in health care settings or from friends, co-workers, or family members. We also assessed participants’ level of anxiety with Zung Self-Rating Anxiety Scale (SAS) and the cut-off point for anxiety index was set at 45. The associations of each information source with anxiety were examined using multiple regression analyses to control for sex, age, education and other demographic characteristics.

Results

In total, the data of 1559 respondents (1224 female; mean age = 37.03 years and standard deviation (SD)=12.90 years) were analysed. The mean index score for SAS were 44.28 (SD=10.6). The major source of information on COVID-19 was the Internet (59.20%) and medical stuff (58.27%), almost in equal measure, followed by traditional media (48.17%) and friends, co-workers, and family members (30.72%).

Conclusions

Receiving COVID-19 information from the Internet and traditional media was positively correlated with anxiety level (p=0.01), while receiving COVID-19 information from medical-stuff was associated with low levels of anxiety (p=0.03).

Disclosure

No significant relationships.

Prevalence of anxiety and depression among students and employees during the COVID-19 pandemic

Introduction

Facing the COVID-19 pandemic, individuals are experiencing severe mental distress. Following social distancing and economic insecurity, significant increases in mental health concerns have developed.

Objectives

The aims of this study was to report the levels of depressive and anxiety within active population in Romania, and to identify possible risk and protective factors for mental health.

Methods

Data collection occurred between February-March 2021. The online survey included questions regarding socio-demographic characteristics and Hospital Anxiety and Depression Scale (HADS). 620 responses were validated (331 students and 289 workers).

Results

Among active population, risk of anxiety symptoms is lower in those who already were infected with SARS-Cov2 (p=0.026, df=2, Phi=0.109), while positive screening for anxiety or depression in this study was statistically significant associated with younger age (p=0.026, df=4, Phi=0.134) and female gender (p=<0.001, df=2, Phi=0.166). Even though anxiety and depression scores are similar among students and employees, there are different aspects regarding symptomatology between these two groups. Students have experienced more frequently tendency to worry and sudden feelings of panic (p=0.004, df=3, Phi=0.146). Also, their ability to laugh and see the funny side of things is affected (p=0.019, df=3, Phi=0.127) and they feel less enthusiasm about future (p=0.001, df=3, Phi=0.159). Participants living with someone else scored lower on anxiety and depression subscales and those are not influenced by the person with whom they are cohabitating or residing (p=0.020, df=3, Phi=0.138).

Conclusions

Findings from the current study offer initial insights into the rates of anxiety and depression within active population in Romania, one year after the onset of the COVID-19 pandemic.

Disclosure

No significant relationships.

Psychological resilience and anxiety in response to COVID-19

Introduction

In Romania, the first case of COVID-19 was detected on 26 February 2020 and the number of cases has been rising afterward.

Objectives

The goal of this study was to assess anxiety and resilience regarding the COVID-19 pandemic and to analyse possible protective measures and risk factors.

Methods

This is a cross-sectional study and data were collected March and April 2021. Participants filled in the Zung Self-Rating Anxiety Scale and the Connor-Davidson Resilience Scale.

Results

The sample consisted of 440 participants who presented to the general practitioner (female-65.7%) and the most representative age group was 35-64 years old; 18.4% of the participants stated that they were infected; 56.6% reported that they do not know anyone in their entourage who was infected/ has died of COVID-19 (group A), 32.9% knowing people with an infection in their close social environment (group B) and 10.5% had close people who died (group C). Almost half of the respondents (49,3%) scored above the cut-off point of the anxiety index (mild 38.6%, moderate 9.9%, severe 0.8%). As we expected, there is a strong negative correlation between anxiety levels and resilience (Pearson Correlation=-.551, p<0.01). If groups A and B had similarities regarding anxiety levels (44.97 and 44.23), those knowing someone who died of COVID-19 (group C) had a higher anxiety level (47.81%) (p<0.05).

Conclusions

The recent COVID-19 pandemic has caused an understandable surge in anxiety among the general population. Low level of resilience is predictive of the phenomenon of having high anxiety in the face of the death of others.

Disclosure

No significant relationships.

Stress and sleep: impact of the main contributing factors to poor sleep experiences during the COVID-19 pandemic

Introduction

The COVID-19 (Coronavirus Disease 2019) pandemic is associated with several stressful factors that can negatively affect peoples’ sleep quality and mental health.

Objectives

The aim of the current study was to prospectively identify decreased sleep quality and associated risk factors in general population during COVID-19 pandemic.

Methods

We conducted a prospective, observational online study on a Romanian sample of 667 respondents aged >18 years. Sleep quality and quantity was evaluated with Athens Insomnia scale (AIS) and the main concerns associated with the pandemic context were evaluated through a multiple-choice question.

Results

The data collected identified important evidence regarding the prevalence and intensity of insomnia. The average score for AIS was 6.13 (cut-off point for was set at 8). However, it is worth noting that 179 respondents (26.8%) meet the criteria for insomnia. Of the 8 self-assessment items, daytime sleepiness was the criterion evaluated with the highest average score (1.01), all other items getting subunit values. A low quality of sleep was linearly related with fear of illness/death (p=0.053), fear of illness/death of close people (p=0.032), social isolation (p<0.001), economic impact (p=0.003), losing the job (p<0.001) and social stigma associated with COVID-19 infection (p=0.009).

Conclusions

More than a qurter of respondes scored above the threshold of 8 at the insomnia scale, while losing the job, social stigma associated with COVID-19 infection and social isolation are the main risk factors for a low quality and quantity of sleep.

Disclosure

No significant relationships.

Compulsory admissions of patients with mental disorders: State of the art on ethical and legislative aspects in 40 European countries

Background.

Compulsory admission procedures of patients with mental disorders vary between countries in Europe. The Ethics Committee of the European Psychiatric Association (EPA) launched a survey on involuntary admission procedures of patients with mental disorders in 40 countries to gather information from all National Psychiatric Associations that are members of the EPA to develop recommendations for improving involuntary admission processes and promote voluntary care.

Methods.

The survey focused on legislation of involuntary admissions and key actors involved in the admission procedure as well as most common reasons for involuntary admissions.

Results.

We analyzed the survey categorical data in themes, which highlight that both medical and legal actors are involved in involuntary admission procedures.

Conclusions.

We conclude that legal reasons for compulsory admission should be reworded in order to remove stigmatization of the patient, that raising awareness about involuntary admission procedures and patient rights with both patients and family advocacy groups is paramount, that communication about procedures should be widely available in lay-language for the general population, and that training sessions and guidance should be available for legal and medical practitioners. Finally, people working in the field need to be constantly aware about the ethical challenges surrounding compulsory admissions.

CORTISOL LEVELS AND SUICIDE IN BIPOLAR I DISORDER

CONTEXT

Hypothalamic-pituitary-adrenal (HPA) axis irregularities have been described both in bipolar disorder and suicidal behaviour, but few studies have examined the relationship between suicidal behaviours and cortisol levels in bipolar disorder.

OBJECTIVE

We compared HPA axis activity in bipolar I (BPD I) individuals with and without suicidal ideation and behaviour through multiple measurement of serum and salivary cortisol.

DESIGN

Cross-sectional, observational study.

SUBJECTS AND METHODS

75 BPD I patients were assigned into 3 groups (no history of suicidal behaviour, history of suicidal ideation, history of suicide attempt), according to the C-SSRS. Socio-demographical and clinical data was obtained by using MINI 6.0 and a semi-structured questionnaire. Salivary samples were collected using Sarstedt Cortisol Salivette synthetic swab system for two consecutive days at 08:00, 16:00, 23:00 and salivary cortisol concentrations were determined by ELISA technique. A unique 1mg dose of dexamethasone was administered on the first day, at 23:00, after the collection of the saliva sample. Blood was collected on the first day at 8:00 AM and basal morning serum cortisol levels were determined by immunoassay with fluorescence detection.

RESULTS

Cortisol parameters in our BPD I sample did not vary significantly in respect to suicidal history. However, patients with a history of suicidal ideation have significantly higher total cortisol outputs than patients with no history of suicidal behaviour in the 18 to 40 age category compared with the above 40 age category.

CONCLUSIONS

Total cortisol daily output varies significantly in an age-dependent manner in respect to suicidal thoughts in BPD I individuals.

A Comparison Of The Improving In Major Depressive Symptoms As Reported By Romanian Physicians And Patients In a Prospective, Multicenter, Observational Study

Introduction

Depression leads to substantial suffering for the patients, their families and becomes an economic burden for system [1,2]. Patients and clinicians tend to rate the remission differently [3].

Objectives and methods

We investigate if clinicians and patients rate different the treatment response. This study assed the evolution of major depressive episode (MDE) in patients treated with Agomelatine, in Romania. It was designed as a multicentre, observational study that included 1213 adult patients evaluated in 75 sites in 2014. The design included 3 visits (baseline (V1); visit at 2/3 weeks (V2); visit 6/8 weeks (V3)). The scales used were: MADRS, SHAPS, CGI-I, CGI-S, PGI-I, PGI-S.

Results

The MDE improvement was significant (P < 0.001) for all aspects evaluated. At baseline, more clinicians vs. patients considered the moderately or markedly ill as best descriptors of the state. The difference between the two assessments was even higher for V2 and V3. During V2 clinicians reported “minimally improvement” while patients reported “much improvement” in higher percentage. During V3, both, clinicians and patients reported a “very much improved” clinical status. Of the patients 42.60% reported at V3 “normal”, not at all ill’ in comparison to 34.81% of clinicians who reported the same (P < 0.001).

Conclusions

This could mean that patients are not aware of the severity of their disease. This data could be interpreted in the way that patients are more prone to rate higher the improvements as response to treatment and the clinicians to rate as response a more than 50% decrease of symptomatology.

References not available.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

PLATELET SEROTONIN AS BIOMARKER FOR ASSESSING SUICIDAL BEHAVIOUR IN PATIENTS WITH BIPOLAR I DISORDER

Context

Suicide is a global public health issue. Bipolar disorder (BPD) has the highest suicide risk among individuals suffering from mental disorders. Serotoninergic dysfunctions have been linked to suicidal behaviour and platelet serotonin is recognised as a reliable index for the presynaptic serotonin activity.

Objective

Our aim was to assess whether alterations occur in platelet serotonin concentrations in BPD type I in respect to suicide attempters compared with non-attempters.

Design

This was a cross-sectional, observational study.

Subjects and Methods

Plasma platelet serotonin concentrations were measured using ELISA technique in 71 BPD I patients. The participants were assigned into 3 groups (non-attempters, low lethality and high lethality suicide attempters), according to the Columbia-Suicide Severity Rating Scale. Socio-demographical and clinical data was obtained by using MINI 6.0 and a semi-structured questionnaire designed specifically for this research.

Results

Our study showed significant lower levels of platelet serotonin in suicide attempters compared with non-attempters (p = 0.030) and in high-lethality attempters compared with low-lethality attempters (p = 0.015). The study recorded a higher number of total lifetime and lifetime depressive episodes for suicide attempters with BPD I.

Conclusions

Our results subscribe to the importance of platelet serotonin as a reliable biomarker in suicide risk assessment.

Recommendations on end-of-life care for people with dementia

OBJECTIVE

To establish, in collaboration with national Alzheimer Societies in Europe, practical and consensual recommendations for the end-of-life care of people with dementia. The aim of these recommendations is to provide a basis for understanding and action with regard to end-of-life care not only for family caregivers but also for professionals, policy makers and anyone with an interest in palliative care.

DESIGN

A literature review was carried out by Alzheimer Europe in collaboration with a working group comprised of people from different backgrounds such as family caregivers, physicians, palliative care nurses and members of Alzheimer associations, who also prepared the draft recommendations during 4 sessions. These recommendations were then discussed with external experts and sent to Alzheimer Europe's member associations to be broadly discussed within their countries until a consensus was reached.

SETTING

Alzheimer Europe is an umbrella association of European Alzheimer societies with 34 member associations in 30 different countries.

SUBJECTS

Not applicable.

METHODS

Literature review, workshops, dissemination by e-mail and during conferences, consensus finding.

RESULTS

At the end of 2008, Alzheimer Europe prepared written recommendations on good end-of-life care for people with dementia. We are aware that this topic is challenging and that there is therefore a need for further discussion.

CONCLUSION

In this article we aim to present these recommendations and to invite professionals to consider these important issues and to contribute towards a broader discussion.