Habituating to pandemic anxiety: Temporal trends of COVID-19 anxiety over sixteen months of COVID-19

Coronavirus anxiety and its relationship to mood and cognition in post-acute sequelae of COVID-19

Background: Subjective and objective cognitive dysfunction may be observed in patients with post-acute sequelae of COVID-19 (PASC), and are associated with depression and general anxiety. Coronavirus anxiety (CA) is associated with subjective cognition, depression, and general anxiety in community samples. We determined the base rate of CA in patients with PASC and its relation to mood, subjective and objective cognition. Design and Methods: Participants were 79 patients with PASC referred for clinical neuropsychological evaluation, who completed the Coronavirus Anxiety Scale (CAS), BDI-II, BAI, BRIEF-A, and cognitive tests. Results: Base rate of clinically elevated CAS was low (5.1%), whereas BDI-II (78.6%), BAI (80%), and BRIEF-A Global Executive Composite (GEC; 60.3%) were high. Objective dysfunction was most common for Color-Word Interference (20.8%) and Trail Making Test (TMT) Part-B (23.1%). Greater CA was associated with worse depression, general anxiety, BRIEF-A GEC, and TMT Part-A. Higher GAI accounted for the CAS and BRIEF-A GEC association. Longer time since pandemic onset was only associated with decreasing CA. Exploratory factor analysis supported a unidimensional structure for the CAS. Conclusions: Clinically elevated CA is rare in patients with PASC seen for neuropsychological evaluation. Higher CA is associated with worse mood and subjective executive dysfunction, though the latter was accounted for by general anxiety. Patients with PASC who endorse a high level of CA would likely benefit from interventions to reduce emotional distress.

How Health Anxiety is Associated with Perceived Risk of Reinfection Among COVID-19 Infected People After the Epidemic Control Measures Lifted in China: A Multiple Mediating and Multi-Group Analysis

Background

After the lifting of epidemic control measures in China at the end of 2022, the number of COVID-19 infections has increased dramatically. Such an upsurge may intensify people's health anxiety and raise concerns about the risk of reinfection. While numerous studies have shown the correlation between them during the COVID-19, research on their underlying mechanism remains limited.

Purpose

This study aims to test the relationship and mechanism between health anxiety and perceived risk of reinfection among COVID-19 infected people from different occupational backgrounds.

Methods

A cross-sectional study was conducted from December 24th to 28th, 2022, after the epidemic control measures were lifted. A total of 1122 Chinese individuals were infected with COVID-19 (67.91% females, M age = 28.13) completed measures of health anxiety, perceived risk of reinfection, fear of COVID-19, online health information seeking (OHIS), and COVID-19 information fear of missing out (FOMO). Data were analyzed using multiple-mediation model and multi-group analysis.

Results

Health anxiety, perceived risk of reinfection, fear of COVID-19, OHIS and COVID-19 information FOMO were positively and significantly related to each other (r ranged from 0.25 to 0.77, all p < 0.001). Fear of COVID-19 (β = 0.27, p < 0.01), OHIS (β = 0.10, p < 0.001), and COVID-19 information FOMO (β = -0.05, p < 0.01) fully mediated the relationship between health anxiety and perceived risk of reinfection, the path of chaining mediation is also significant. Discrepancies in mediation models surfaced across the three types of work groups.

Conclusion

Findings suggest fear of COVID-19, OHIS and COVID-19 information FOMO may play significant mediating roles in explaining the relationship between health anxiety and perceived risk of reinfection. Interventions to reduce the perceived risk of reinfection should aim to improve the quality of online health information and individuals' online health literacy and reduce fear of COVID-19 during and after the pandemic.

Unravelling habituation for COVID-19-related information: A panel data study in Japan

This study examines people's habituation to COVID-19-related information over almost three years. Using publicly available data from 47 Japanese prefectures, I analyse how human mobility responded to COVID-19-related information, such as the number of COVID-19-infected cases, the declaration of a state of emergency (DSE), and several doses of vaccine using an interactive effects model, which is a type of panel data regression. The results show that Japanese citizens were generally fearful and cautious during the first wave of the unknown infection. As such, a 1% week-on-week increase in the number of infected cases results in a decrease in human mobility by 1.09-percentage-point (pp) week-on-week. However, they gradually became habituated to similar infection information during the subsequent waves, which is reflected in 0.71 pp and 0.29 pp decreases in human mobility in the second and third waves. Nevertheless, the level of habituation decreased in response to the different types of the infection, such as new variants in the fourth wave, with 0.50 pp decrease. By contrast, regarding the DSE, it is more plausible to consider that human mobility responds to varying requests rather than habituate them. Whereas a rapid vaccination program could alleviate people's concerns. I also find spatial spillovers of infection information on human mobility using a spatial weight matrix included in the regression model. However, there is no evidence of DSE or vaccination spatial spillovers, likely because both are valid only in one's own prefecture. The implementation of flexible human mobility control policies by closely monitoring human mobility can prevent excessive or insufficient mobility control requests. Such a flexible policy can efficiently suppress infection spread and prevent economic activity reduction more than necessary. These implications are useful for evidence-based policymaking during future pandemics.

Intrarelationships between suboptimal health status and anxiety symptoms: A network analysis

BACKGROUND

Suboptimal health status is a global public health concern of worldwide academic interest, which is an intermediate health status between health and illness. The purpose of the survey is to investigate the relationship between anxiety statuses and suboptimal health status and to identify the central symptoms and bridge symptoms.

METHODS

This study recruited 26,010 participants aged <60 from a cross-sectional study in China in 2022. General Anxiety Disorder-7 (GAD-7) and suboptimal health status short form (SHSQ-9) were used to quantify the levels of anxiety and suboptimal health symptoms, respectively. The network analysis method by the R program was used to judge the central and bridge symptoms. The Network Comparison Test (NCT) was used to investigate the network differences by gender, place of residence, and age in the population.

RESULTS

In this survey, the prevalence of anxiety symptoms, SHS, and comorbidities was 50.7 %, 54.8 %, and 38.5 %, respectively. "Decreased responsiveness", "Shortness of breath", "Uncontrollable worry" were the nodes with the highest expected influence. "Irritable", "Exhausted" were the two symptom nodes with the highest expected bridge influence in the network. There were significant differences in network structure among different subgroup networks.

LIMITATIONS

Unable to study the causal relationship and dynamic changes among variables. Anxiety and sub-health were self-rated and may be limited by memory bias.

CONCLUSIONS

Interventions targeting central symptoms and bridge nodes may be expected to improve suboptimal health status and anxiety in Chinese residents. Researchers can build symptom networks for different populations to capture symptom relationships.

Intimate partner violence and women's mental health during the COVID-19 pandemic in Brazil

OBJECTIVES

Intimate partner violence (IPV) increased extensively around the world during the pandemic, causing severe harm to women's mental health. However, there are no studies showing these effects in Brazil. The objectives of this study were to assess perpetration of IPV and presence of depression and suicidal ideation in women living in Brazil during the coronavirus disease 2019 (COVID-19) pandemic.

METHODS

Cross-sectional online survey including women living in Brazil from July 2020 to June 2021. Participants answered a 43-item self-administered questionnaire exploring their characteristics and life changes due to the pandemic (CoRonavIruS Health Impact Survey [CRISIS]), IPV (World Health Organization Violence Against Women [WHO-VAW]), and depressive symptoms or suicidal ideation (Patient Health Questionnaire-9 [PHQ-9]). We used Poisson multiple regression analyses with robust variance to model associations between IPV and mental health outcomes, considering aspects of social vulnerability as covariates.

RESULTS

We found high frequencies of IPV (33.3%), depression (36.1%), and suicidal ideation (19.8%) among the participants. IPV was significantly associated with depression (prevalence ratio [PR] = 1.502, p = 0.001 for one type of IPV; PR = 2.702, p < 0.001 for two or three types of IPV) and with suicidal ideation (PR = 2.264, p < 0.001 for one type of VPI; PR = 3.272, p < 0.001 for two or three types of IPV). Food insecurity, being black, lower educational levels, and being in a relationship with a person of the same gender were associated with one or both mental health outcomes.

CONCLUSIONS

We demonstrated associations between IPV and higher frequencies of depression and suicidal ideation in women living in Brazil during the COVID-19 pandemic, highlighting the urgency of strengthening strategies to protect women during adversity.

Psychometric properties of the Greek versions of the Pandemic-Related Pregnancy Stress Scale and the Pandemic-Related Postpartum Stress Scale and associated risk factors during the second year of the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic has affected perinatal mental health. Reliable tools are needed to assess perinatal stress during pandemic situations.

AIMS

To assess the psychometric properties of the Greek versions of the Pandemic-Related Pregnancy Stress Scale (PREPS) and the Pandemic-Related Postpartum Stress Scale (PREPS-PP) and to explore the associations between women's characteristics and perinatal stress during the second pandemic wave.

METHODS

The PREPS and PREPS-PP were completed by 264 pregnant and 188 postpartum women, respectively, who also completed the State-Trait Anxiety Inventory (STAI) and the Edinburgh Perinatal Depression Scale (EPDS).

RESULTS

The internal consistency was similar for PREPS and PREPS-PP. It was good for preparedness stress (a = 0.77 and α = 0.71, respectively) and infection stress (α = 0.83 for both scales) but low for positive appraisal (α = 0.46 and α = 0.41, respectively). Of the pregnant women, 55.33% and 55.27%, respectively, reported scores of ≥40 on STAI-S and STAI-T, and the respective percentages for the postpartum women were 47.34% and 46.80%. In addition, 14.39% of the pregnant women and 20.74% of the postpartum women scored ≥13 on the EPDS. Higher preparedness stress on PREPS and PREPS-PP was associated with primiparity (P = 0.022 and P = 0.021, respectively) and disrupted perinatal care (P = 0.069 and P = 0.007, respectively). In postpartum women, higher infection stress was associated with chronic disease (P = 0.037), primiparity (P = 0.02) and perceived risk of infection (P = 0.065). Higher score on infection stress was associated with disrupted perinatal care in both groups (P = 0.107 and P = 0.010, respectively).

CONCLUSIONS

The Greek versions of PREPS and PREPS-PP are valid tools for the assessment of women at risk of perinatal stress during a health crisis.

A network analysis of anxiety and depression symptoms among Chinese nurses in the late stage of the COVID-19 pandemic

Background

Nurses are at high risk for depression and anxiety symptoms after the outbreak of the COVID-19 pandemic. We aimed to assess the network structure of anxiety and depression symptoms among Chinese nurses in the late stage of this pandemic.

Method

A total of 6,183 nurses were recruited across China from Oct 2020 to Apr 2021 through snowball sampling. We used Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder scale-7 (GAD-7) to assess depression and anxiety, respectively. We used the Ising model to estimate the network. The index "expected influence" and "bridge expected influence" were applied to determine the central symptoms and bridge symptoms of the anxiety-depression network. We tested the stability and accuracy of the network via the case-dropping procedure and non-parametric bootstrapping procedure.

Result

The network had excellent stability and accuracy. Central symptoms included "restlessness", "trouble relaxing", "sad mood", and "uncontrollable worry". "Restlessness", "nervous", and "suicidal thoughts" served as bridge symptoms.

Conclusion

Restlessness emerged as the strongest central and bridge symptom in the anxiety-depression network of nurses. Intervention on depression and anxiety symptoms in nurses should prioritize this symptom.