[Posstraumatic stress disorder in nurses during the COVID-19 pandemic]

Aim

To analyse the prevalence of post-traumatic stress disorder (PTSD) in nursing staff and the variables that may contribute to its development.

Method

Cross-sectional study using a self-administered questionnaire given to nurses, nursing assistants and nursing supervisors in June 2020. It included sociodemographic, mental health, occupational, COVID-19 related variables, Modified Risk Perception Scale (modified RPS) score, Brief Resilience Scale (BRS) and Davidson Trauma Scale (DTS) score for the assessment of PTSD. Descriptive, bivariate, and multivariate analyses were performed.

Results

Of the 344 participants, 88.7% were women and 93.6% cared for infected patients; 45.9% had PTSD (DTS≥40). The variables associated with PTSD were previous PTSD symptoms (OR=6.1, 95% CI [2.68-14.03]), death of a family member or friend due to COVID-19 (OR=2.3, 95% CI [1.22-4.39]), and higher scores on the modified RPS (OR= 1.1, 95% CI [1.07-1.31]). Higher BRS scores were associated with a lower risk of PTSD (OR=0.4, 95% CI [0.31-0.68]).

Conclusions

The prevalence of PTSD in nursing staff is high, mainly in professionals with previous PTSD symptoms, family members or friends deceased from COVID-19, high risk perception and/or low resilience.

Mobility restrictions and mental health among young adults during the COVID-19 pandemic in Ecuador

OBJECTIVE

To study the association between mobility restriction and mental health outcomes among Ecuadorian young adults.

METHOD

The present is a cross-sectional study that included a non-probabilistic sample of mostly highly educated young adults. Socio-demographic and mental health data were collected through an online survey, between May and June 2020, when confinement was mandatory in Ecuador. Data on mobility was extracted from Google Community Mobility Reports. Four aspects of the participants' mental health were evaluated: eating behavior (emotional eating), depression, sleep quality and sense of coherence as a proxy of resilience, using previously validated instruments. Data were analyzed using multiple linear regression models in R.

RESULTS

Sample included 8426 young adults, with a mean age of 22.85 (standard deviation: 4.43), most of whom were women (n=5943, 70.53%). During mandatory confinement, in Ecuador mobility in general was reduced by nearly 50% in comparison to January/February, 2020. Less healthy eating behavior, depression, worse sleep quality and lower sense of coherence were associated with higher mobility restriction to workplaces and groceries/pharmacies. Women and youngsters more often showed depression, less healthy eating behavior, worse quality of sleep and lower sense of coherence in comparison with men and older respondents.

CONCLUSIONS

Mobility restrictions during COVID-19 pandemic were associated with worse self-reported mental health in a sample of young highly-educated Ecuadorian adults. Women and youngsters were the most affected. Our findings highlight the need of implementing health promotion measures directed to ameliorate the effects of confinement on mental health, focusing on women and youngsters.

Resilience as a mediator factor in the relationship between childhood trauma and mood disorder: A community sample of young adults

BACKGROUND

Studies on the field of mood disorders has mainly focusing on the risk factors associated to develop the illness or the clinical factors associated with the clinical progression. Less attention was given to factors such as resilience that may be associated with better outcomes in the course of mood disorders. In this study, we assessed the mediation effect of resilience on the relationship between childhood trauma and mood disorders, as well as the severity of depressive symptoms in a population-based sample.

METHODS

This is a cross-sectional study with a community sample of young adults with bipolar disorder (BD), major depressive disorder (MDD), and community controls without any mood disorder. The trauma experiences during childhood were assessed by Childhood Trauma Questionnaire (CTQ). The severity of depressive symptoms was assessed using the Montgomery-Asberg Depression Rating Scale (MADRS) and to assess the resilience was used the Resilience Scale (RS-25).

RESULTS

All subtypes of trauma were associated with both MDD and BD, however, only physical and emotional abuse differentiated BD from MDD subjects. Bootstrapping-enhanced mediation analyses indicated that resilience partly mediated the association of childhood trauma to both mood disorder and severity of depression.

LIMITATION

The employed mediation analyses are cross-sectional in nature, which limits any firm conclusions regarding causality.

CONCLUSIONS

The findings support the clinical assumption that resilient subjects may be partly protected against the detrimental long-term effects of childhood trauma. This study provides important information regarding the relationships among childhood trauma, resilience, and mood disorder.

Resilience Mediates the Longitudinal Relationships Between Social Support and Mental Health Outcomes in Multiple Sclerosis

OBJECTIVES

To investigate the longitudinal relationships between social support and subsequent mental health outcomes in individuals with multiple sclerosis (MS), and to examine resilience as a mediator between social support and subsequent mental health outcomes in this population.

DESIGN

Observational, longitudinal cohort study. Participants were assessed at 4 time points over 12 months in the context of a previously reported randomized controlled trial.

SETTING

Telephone-based measures administered to community-based participants.

PARTICIPANTS

Individuals (N=163) with MS and 1 or more of the following symptoms: depression, fatigue, and pain.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Mental health outcomes included (1) depressive symptomatology, assessed using the Patient Health Questionnaire-9; (2) anxious symptomatology, assessed using the short form of the Emotional Distress-Anxiety Scale from the Patient-Reported Outcomes Measurement Information System; and (3) general mental health status, assessed using the Mental Component Summary score from the Short Form-8 Health Survey. Resilience was assessed using the Connor-Davidson Resilience Scale.

RESULTS

At any given time, social support from significant others, family members, and friends was significantly associated with subsequent mental health outcomes for all 3 measures assessed (all P values <.05). Resilience measured concomitantly with social support significantly mediated the relationships between social support and subsequent mental health outcomes. After controlling for resilience, most of the direct relationships between social support and mental health outcomes were no longer significant.

CONCLUSIONS

There are significant longitudinal relationships between social support, resilience, and mental health outcomes for people with MS. Given the mediating role of resilience in supporting better mental health outcomes, future clinical research and practice may benefit from an emphasis on resilience-focused psychological interventions.