Sharp increase in depression and anxiety among Brazilian adults during the COVID-19 pandemic: findings from the PAMPA cohort

Association between handgrip strength, handgrip strength asymmetry, and anxiety in Korean older adults: The Korean National Health and Nutrition Examination Survey 2022

Low handgrip strength (HGS) and HGS asymmetry are associated with age-related physical and mental disorders in older adults. This study aimed to examine the association between HGS-related factors and anxiety to evaluate whether HGS assessments can assist in identifying anxiety risk. In total, 1,750 participants from the Korea National Health and Nutrition Examination Survey of 2022 were included in this study. Individuals whose HGS values were below the 20th percentile of the study population stratified by sex were classified into the low-HGS group. Anxiety was assessed using the generalized anxiety disorder with a 7-item scale. Multiple logistic regression was used to analyze the relationship between HGS level and asymmetry and anxiety, adjusting for covariates. Overall, 70 (8.7%) men and 123 (13.0%) women had anxiety. Elevated odds of anxiety were observed in older women with low HGS (adjusted odds ratio: 2.17, 95% confidence interval: 1.31-3.61). There was a positive correlation between the degree of asymmetrical HGS and anxiety among women. This study found positive associations between low HGS, HGS asymmetry, and anxiety in older Korean women. This population may require specific interventions to help maintain good mental health.

Exploring Anxiety and Depression Among Medical Undergraduates in South Africa: A Cross-Sectional Survey

Background/Objectives: Globally, there has been an increase in the prevalence of anxiety and depression among university students, and medical students are no exception. Medical students are especially susceptible to these mental health challenges, primarily due to multifaceted stressors, which can significantly impact their academic achievements and future career. There is a pressing need for comprehensive research that not only investigates the prevalence of anxiety and depression among medical students but also explores strategies for developing effective mental health interventions and support systems that can enhance the well-being of medical students. Therefore, this study aimed to identify the prevalence and severity of anxiety and depression among medical students at a university in South Africa, evaluating the association of socio-demographic, student, and clinical variables with total general anxiety disorder (GAD-7) and patient health questionnaire (PHQ-9) scores. Methods: A survey-based quantitative cross-sectional study was conducted with 208 medical undergraduate students at a South African university. Participants who provided written consent completed GAD-7 and PHQ-9 questionnaires together with socio-demographic, student, and clinical variable information. The relationship between socio-demographic, student, and clinical variables and total GAD-7 and PHQ-9 scores was determined using the Mann-Whitney U test and Kruskal-Wallis H test. Correlation analysis was used to establish the relationship between total anxiety and depression scores. The threshold for statistical significance was set at p ≤ 0.05. Results: More than half of the participants were female (n = 130; 62.5%), single (n = 123; 59.1%), and belonged to the Pedi ethnic group. A majority of the students were Christian (n = 183; 88.0%), received a bursary (n = 183; 88.0%), and had a rural background (n = 155; 74.5%). However, a small percentage of students reported a history of psychiatric and chronic illnesses (n = 26; 12.5%) and previously received professional psychological support (n = 38; 18.3%). In this study, 38% (n = 79) of the participants reported GAD and 67.8% (n = 141) reported symptoms of depression. Significant associations (p <0.05) were observed between variables such as year of study, repeating a module, and history of psychiatric illness with total GAD-7 and PHQ-9 scores. Correlation analysis revealed a moderate positive correlation (rs = 0.400, df = 206, p < 0.001) between total GAD-7 and PHQ-9 scores. Conclusions: This study identified a high level of depression and anxiety among medical students and found a positive correlation between anxiety and depression scores. Addressing these mental health challenges is crucial not only for the well-being of the students but also for the future of healthcare, as the mental health of medical professionals directly impacts patient care.

Outpatient mental health care during high incidence phases of the COVID-19 pandemic in Germany - changes in utilization, challenges and post-COVID care

BACKGROUND

As only a few studies have examined the impact of the COVID-19 pandemic on the mental health outpatient system so far, the aim of the COVID Ψ Outpatient Survey was to gain insight from outpatient providers in Germany regarding changes in utilization; associated problems and challenges; telemedicine services; interactions with inpatient and nursing home services; and experiences with post-COVID syndromes.

METHODS

Between July and September 2021, we invited 351 randomly selected outpatient mental health specialists to take part in the online survey via e-mail. Additionally, we extended an invitation to professional associations to encourage their members to participate. N = 105 physicians of most regions of Germany took part in the survey.

RESULTS

Survey participants reported changes in utilization during the high incidence phases (HIP) of the pandemic using pre-formulated categories: For the first HIP in spring 2020, 31% of the survey participants reported a decrease > 20% and 5% an increase > 20% of patient contacts. For the third HIP in spring 2021, 4% reported a decrease > 20% of contacts, while 30% an increase > 20%. Participants chose "patient's fears of infection" and "providers protection measures" as reasons for decreases, and "pandemic related anxieties", "economic stressors", and "capacity reductions of the inpatient system" as reasons for increases of patient contact. Many providers introduced telemedicine services. A majority reported consultations for post-COVID syndromes already in spring 2021.

CONCLUSIONS

The survey hinted at changes in utilization, multiple problems but as well good-practice-solutions in the mental health outpatient system during the COVID-19 pandemic.

Prevalence of Anxiety and Depression Symptoms among University Teachers in Ethiopia during the COVID-19 Pandemic

A growing body of evidence suggests an increased prevalence of anxiety and depression among teachers during the COVID-19 pandemic. However, there is little evidence in research documenting the extent of anxiety and depression in the university teacher population and how these relate to feelings of loneliness. This study aims to explore the prevalence of anxiety and depression symptoms among university teachers, identify differences, and further examine the relationships between loneliness and symptoms of anxiety and depression. The study participants included university teachers in the College of Health and Medical Sciences from four purposefully selected public universities who completed a survey questionnaire consisting of items that measured anxiety and depressive symptoms as well as loneliness. The final sample included 148 participants (45 participants [30.4%] located in the center or capital; 125 (83.1%) men; and 90 [62.5%] taught both online and face-to-face). The university teachers' sample mean age = 39.07 had an SD = 7.67. As per the findings of this study, the prevalence of anxiety and depression symptoms was significant (11% and 12.3%) among university teachers in Ethiopia during the COVID-19 pandemic. Also, this study found a significant association between these symptoms and loneliness. Therefore, incorporating relevant strategies to promote mental well-being and targeting individuals who felt lonely were essential for overcoming health-related burdens. Universities should equip teachers with resources to prevent mental health issues and offer need-based counseling services to alleviate them.

Dealing with the challenges of the pandemic - results of a population-based survey during the second year of the COVID-19 pandemic contrasting benefits and burden

BACKGROUND

The pandemic and the associated consequences have been ongoing stressors with severe impacts on the population and particularly on families. Research focusing on groups dealing well with the challenges of the pandemic is scarce. Here, we aimed to identify groups being well-adjusted during the pandemic and associated predictors.

METHODS

A representative sample of the German population (N = 2,515, 51.6% women, 50.09 years), and a subsample of persons with children or adolescents under the age of 18 (N = 453, 60.3% women, 40.08 years) was assessed from July to October 2021. As huge differences in coping with the pandemic are seen, cluster analysis was performed.

RESULTS

Persons in the "well-adjusted cluster" were characterized by higher quality of life, better coping with the pandemic and lower burden of the pandemic. The family subsample well-adjusted cluster was characterized by lower pandemic-associated burden, lower parental stress compared to before the pandemic and a better relationship with the child. Fewer mental health symptoms and less pandemic-associated negative impact on career predicted membership of the well-adjusted cluster in both samples. An interaction between mental health symptoms and the negative impact of COVID-19 on the career was found.

CONCLUSIONS

Our results underscore the importance of mental health and work-related factors for coping with the pandemic.

Exercise as medicine! Physical activity mitigated the impact of the COVID-19 pandemic on depressive symptoms in adults with depression

We investigated the longitudinal association between physical activity (PA) and symptoms of depression and anxiety in people with depression during the COVID-19 pandemic. We used data from baseline (June 2020) to wave 3 (June 2021) of the PAMPA Cohort, an ambispective cohort with adults in south Brazil. The Hospital Anxiety and Depression Scale assessed depressive and anxiety symptoms in all waves. Participants reported frequency (minutes), type (aerobic, strength, combined), and place (out of home, at home) of physical activity at baseline. Generalized linear models were used to investigate the interaction between time and PA, adjusting for possible confounding variables. Subjective memory decline was assessed using multivariate Cox proportional hazard regression models to obtain adjusted hazard ratio (HR) and respective 95% confidence interval (CI). Participants (n = 424) with self-reported clinically diagnosed depression were included. We observed a non-linear increase trajectory of depression during the first year of the COVID-19 pandemic. PA was associated with a slower trajectory of depressive (slope: -1.89; 95%CI: -3.34, -0.43 points) but not anxiety (slope: -1.33; 95%CI: -2.93, 0.25 points) symptoms during the COVID-19 pandemic. Participants who continued physically active from pre-pandemic in wave 1 showed a lower risk of subjective memory decline during follow-up than those who persisted inactive in the same period (HR: 0.52; 95%CI: 0.30, 0.89). PA attenuated the impact of the COVID-19 pandemic on depressive symptoms in adults living with depression in south Brazil. Regularity of physical activity was associated with fewer depression and anxiety symptoms and a lower risk of subjective memory decline.

Greater within- and between-day instability is associated with worse anxiety and depression symptoms

BACKGROUND

Depression and anxiety affect hundreds of millions of people worldwide, and their prevalence increased during the COVID-19 pandemic as social schedules were disrupted. This study explores the associations between anxiety and depression and within- and between-day instability of affective, somatic, and cognitive symptoms during the early pandemic stages.

METHODS

Participants (n = 153, ages 18-77, 72 % female) reported daily levels of affective (anxiety/sadness), somatic (appetite/sleepiness), and cognitive (concentration/energy) symptoms for 14-44 days at five timepoints: 0, 3, 6, 9, and 12 h after awakening. At the end of the study, participants completed validated scales for anxiety (GAD-7) and depression (PHQ-9). Symptom instability was assessed using the Absolute Real Variability (ARV) index. Regression models examined within-day instability (WD-I) and between-day instability (BD-I) with GAD-7 and PHQ-9 scores as outcomes.

RESULTS

Greater instability (both WD-I and BD-I) of affective symptoms correlated with elevated GAD-7 and PHQ-9 scores. For somatic and cognitive symptoms, greater BD-I was associated with higher scores.

LIMITATIONS

The study used retrospective daily data, which could benefit from real-time assessments for improved accuracy.

CONCLUSIONS

This study provides empirical evidence of a connection between greater anxiety and depression severity and increased instability in daily mood and physiological symptoms. The findings underscore the importance of consistent symptom monitoring to understand overall mental health trajectories. Additionally, it highlights the role of daily routines in stabilizing the circadian system, potentially regulating physiological and psychological processes and reducing symptom instability.

A systematic review on the relationship between socioeconomic conditions and emotional disorder symptoms during Covid-19: unearthing the potential role of economic concerns and financial strain

BACKGROUND

Covid-19 has disrupted the lives of many and resulted in high prevalence rates of mental disorders. Despite a vast amount of research into the social determinants of mental health during Covid-19, little is known about whether the results are consistent with the social gradient in mental health. Here we report a systematic review of studies that investigated how socioeconomic condition (SEC)-a multifaceted construct that measures a person's socioeconomic standing in society, using indicators such as education and income, predicts emotional health (depression and anxiety) risk during the pandemic. Furthermore, we examined which classes of SEC indicators would best predict symptoms of emotional disorders.

METHODS

Following PRISMA guidelines, we conducted search over six databases, including Scopus, PubMed, etc., between November 4, 2021 and November 11, 2021 for studies that investigated how SEC indicators predict emotional health risks during Covid-19, after obtaining approval from PROSPERO (ID: CRD42021288508). Using Covidence as the platform, 362 articles (324 cross-sectional/repeated cross-sectional and 38 longitudinal) were included in this review according to the eligibility criteria. We categorized SEC indicators into 'actual versus perceived' and 'static versus fluid' classes to explore their differential effects on emotional health.

RESULTS

Out of the 1479 SEC indicators used in these 362 studies, our results showed that 43.68% of the SEC indicators showed 'expected' results (i.e., higher SEC predicting better emotional health outcomes); 51.86% reported non-significant results and 4.46% reported the reverse. Economic concerns (67.16% expected results) and financial strains (64.16%) emerged as the best predictors while education (26.85%) and living conditions (30.14%) were the worst.

CONCLUSIONS

This review summarizes how different SEC indicators influenced emotional health risks across 98 countries, with a total of 5,677,007 participants, ranging from high to low-income countries. Our findings showed that not all SEC indicators were strongly predictive of emotional health risks. In fact, over half of the SEC indicators studied showed a null effect. We found that perceived and fluid SEC indicators, particularly economic concerns and financial strain could best predict depressive and anxiety symptoms. These findings have implications for policymakers to further understand how different SEC classes affect mental health during a pandemic in order to tackle associated social issues effectively.

A comparative study of anxiety and depression among healthcare workers and non-healthcare workers in Johor, Malaysia during the Covid-19 era

The outbreak of Coronavirus disease 2019 (Covid-19) has a significant impact on the mental health of the global population. Updates are needed regarding the mental health status among the local population since limited studies were done so far. This research compared the prevalence of anxiety and depression symptoms among HCWs and non-HCWs. We also evaluated the factors associated with anxiety and depression symptoms among these 2 groups. This was a cross-sectional study conducted between September to December 2022. Online questionnaire was distributed to HCWs from 2 tertiary government hospitals. Non-HCWs from various occupational fields were recruited randomly. Generalised Anxiety Disorder 7 (GAD-7) and Patient Health Questionnaire 9 (PHQ-9) were used to screen for anxiety and depression symptoms respectively. Data were analyzed using IBM SPSS version 28.0. 200 questionnaires were distributed to HCWs and non-HCWs respectively. The response rate was 74.5% from HCWs and 82.5% from non-HCWs (P = .07). A total of 236 individuals (105 HCWs and 131 non-HCWs) were included in the study. Majority were female, married, highly educated and worked more than 8 hours per day. There was no significant difference for the prevalence of anxiety (37.2% vs 44.3%, P = .34) and depression symptoms (37.3% vs 35.1%, P = .75) between HCWs and non-HCWs. Among HCWs, poor workplace support (P = .009) and low income (P = .04) were associated with anxiety symptoms. Younger age (P = .02), single status (P = .01) and poor workplace support (P = .006) were associated with depression symptoms. More non-HCWs with a higher educational level were having anxiety and depression symptoms. Single status (P = .03), working away from home (P = .02), poor family support (P = .03) and quarantine as Covid-19 close contact (P = .04) were also associated with depression symptoms among non-HCWs. There is no significant difference between HCWs and non-HCWs experiencing possible anxiety or depressive symptoms in this study. However, attention should be paid to address associated factors identified among each group to promote good mental health.

The relationship between mobile phone addiction and depression, anxiety, and sleep quality in medical students

This study investigates the prevalence of mobile phone addiction among medical students and its relationship with depression, anxiety, and sleep quality. The study was conducted at Mashhad University of Medical Sciences from 2019 to 2021, and it included medical students at four different levels of training. Participants were selected using a stratified random sampling method. All subjects completed the Mobile Phone Addiction Scale, Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory, and Beck Anxiety Inventory through online electronic self-report questionnaires. Overall, 355 medical students were included in the study, with 203 (57.2%) being female. Mild and severe mobile phone addiction was reported by 83.7 and 2.5% of the students, respectively. Furthermore, the study's findings revealed significantly higher sleep quality disorder, depression, and anxiety scores among students with severe mobile phone addiction compared to other participants ( P  < 0.001, P  = 0.007, and P  < 0.001, respectively). Although mobile phone addiction was prevalent, severe addiction was rare among medical students. Nevertheless, severe addiction was associated with an increased prevalence of mental health problems and sleep disturbances, emphasizing the importance of interventions aimed at reducing mobile phone addiction and improving mental health.

Healthcare provider perceptions and reported practices regarding opioid prescription for patients with chronic cancer pain

PURPOSE

Data indicates that clinicians might be under-prescribing opioids for patients with chronic cancer pain, and this could impact adequate pain management. Few studies have sought to understand healthcare provider (HCP) perceptions and practices regarding the prescription of opioids for chronic cancer pain. We assessed HCP perceptions and practices regarding opioid prescription for patients with chronic cancer pain since the onset of the COVID-19 pandemic.

METHODS

An anonymous cross-sectional survey was conducted among 186 HCPs who attended an opioid educational event in April 2021 and 2022.

RESULTS

Sixty-one out of 143 (44%) opioid prescribers reported reluctance to prescribe opioids for chronic cancer pain. In a multivariate logistic model, younger participants (log OR - 0.04, 95% CI - 0.085, - 0.004; p = 0.033) and pain medicine clinicians (log OR - 1.89, CI - 3.931, - 0.286; p = 0.034) were less reluctant, whereas providers who worry about non-medical opioid use were more reluctant to prescribe opioids (log OR 1.58 95% CI 0.77-2.43; p < 0.001). Fifty-three out of 143 (37%) prescribers had experienced increased challenges regarding opioid dispensing at pharmacies, and 84/179 (47%) of all respondents reported similar experience by their patients. Fifty-four out of 178(30%) were aware of opioid-related harmful incidents to patients or their families, including incidents attributed to opioid misuse by a household or family member.

CONCLUSION

A considerable number of opioid prescribers were reluctant to prescribe opioids for patients with chronic cancer pain. Many reported challenges regarding dispensing of opioids at the pharmacies. These may be unintended consequences of policies to address the opioid crisis. Future measures should focus on addressing regulatory barriers without undermining the gains already made to combat the opioid crisis.

The Quality of Life of Urban Omani People During the COVID-19 Pandemic in A'Seeb Wilayat: A Cross-sectional Study

Objectives

COVID-19 is an emergent disease with significant global concern, which might have a negative effect on quality of life. This study aimed to determine the impact of the COVID-19 pandemic on the quality of life of people (with or without COVID-19) attending primary health centers in A'Seeb Wilayat in Muscat, Oman.

Methods

This cross-sectional study was conducted in four randomly selected primary health centers in A'Seeb Wilayat from 17 July 2021 to 31 January 2022. All Omani men and women, aged ≥ 18 years, regardless of their COVID-19 infection status, who were able to read and use online questionnaire, were included. The consecutive sampling method was applied. An online self-administered and validated Arabic version of the Short Form-12 was used to determine the impact of the COVID-19 pandemic on mental and physical quality of life.

Results

A total of 701 participants were included with a mean age of 25.3 years. Two-thirds of the participants (n = 473, 67.5%) reported being physically affected by the COVID-19 pandemic (score of ≤ 50) and more than half (n = 392, 55.9%) had been mentally affected (score of ≤ 42). Univariate analysis revealed a significant association between physical impact and educational level, low family income, chronic diseases, and alcohol consumption. Gender, young age, being single, low income, and chronic diseases were significant risk factors for mental impact.

Conclusions

Physical and mental impacts are very common during the COVID-19 pandemic. Several risk factors were identified. Public health programs need to be implemented to mitigate the negative impact of COVID-19 on quality of life.

Examining associations between remote work and anxiety and depression: a longitudinal survey study in Israel

Introduction

Accumulating evidence points at increases in mental health problems during the COVID-19 pandemic, which has been attributed, among other things, to social distancing policies, such as the shift to remote work from home (henceforth: remote work). The current study examines whether changes during the COVID-19 pandemic in working environments from on-site to remote work (or vice versa) are associated with changes in anxiety and depressive symptoms among Israeli employees with different demographic characteristics.

Methods

We administered three consecutive online surveys between January and November 2021 among 2389 Israelis who work. We conducted panel regression models with individual fixed effects using anxiety and depressive symptoms as outcomes and remote work as exposure, while accounting for sociodemographic variables. We repeated this analysis among subgroups defined by demographic characteristics.

Results

Symptoms of anxiety (Generalized Anxiety Disorder-7) and depression (Patient Health Questionnaire-9) decreased from 4.27 and 5.98 in January to 3.35 and 4.57 in November 2021, respectively. Increased risk for anxiety and depressive symptoms were significantly associated with remote work. These associations were significant among non-partnered adults and among adults with no children, but not among partnered adults and those with children. Remote work was significantly associated with anxiety among men and with depression among women.

Conclusions

Remote work is associated with anxiety and depression and these associations vary across different sociodemographic groups.

Healthcare provider perceptions and reported practices regarding opioid prescription for patients with chronic pain

PURPOSE

Data indicates that clinicians might be under-prescribing opioids for patients with chronic cancer pain, and this could impact adequate chronic pain management. Few studies have sought to understand healthcare provider (HCP) perceptions and practices regarding the prescription of opioids for chronic pain. We assessed HCP perceptions and practices regarding opioid prescription for patients with chronic pain since the onset of the COVID-19 pandemic.

METHODS

An anonymous cross-sectional survey was conducted among 186 HCPs who attended an opioid educational event in April 2021 and 2022.

RESULTS

61/143(44%) opioid prescribers reported reluctance to prescribe opioids for chronic pain. In a multivariate logistic model, younger participants (log OR -0.04, 95% CI: -0.085, -0.004; p = 0.033) and pain medicine clinicians (log OR -1.89, CI: -3.931, -0.286; p = 0.034) were less reluctant, whereas providers who worry about non-medical opioid use (NMOU) were more reluctant to prescribe opioids (log OR 1.58 95% CI: 0.77-2.43; p < 0.001). 53/143(37%) respondents had experienced increased challenges regarding opioid dispensing at pharmacies, and 84/179(47%) reported similar experience by their patients. 54/178(30%) HCPs were aware of opioid-related harmful incidents to patients or their families, including incidents attributed to opioid misuse by a household or family member.

CONCLUSION

A significant number of opioid prescribers were reluctant to prescribe opioids for patients with chronic pain. Many reported challenges regarding dispensing of opioids at the pharmacies. These may be unintended consequences of policies to address the opioid crisis. Future measures should focus on addressing regulatory barriers without undermining the gains already made to combat the opioid crisis.

Sense of coherence and social support as predictors of mental health during COVID-19 pandemic

OBJECTIVES

to verify the role of sense of coherence, sense of national coherence, social support and trust in institutions to predict mental health in Brazilians during the COVID-19 pandemic.

METHODS

a cross-sectional study, carried out from November, 2020 to January, 2021 via an online survey. Standardized instruments were used. The sample consisted of 1,630 Brazilians. Pearson's correlation and linear regression were performed in data analysis.

RESULTS

sense of coherence was the only predictor of anxiety [β= -0.61; p<0.001], explaining 38% of the variance in its scores, while sense of coherence [β= 0.52; p<0.001], sense of national coherence [β= 0.16; p<0.001], and social support [β= 0.15; p<0.001] predicted positive mental health and together explained 51% of its variance.

CONCLUSIONS

the findings suggest that sense of coherence, sense of national coherence and social support represent important predictors for mental health and that strengthening these resources, could potentially promote Brazilians' mental health.

Suicide risk among undergraduate students in Brazil in the periods before and during the COVID-19 pandemic: results of the SABES-Grad national survey

BACKGROUND

Undergraduate students present high rates of psychological distress, including suicide risk. Due to the coronavirus disease 2019 (COVID-19) pandemic, this scenario may have been aggravated. Thus, the objective of the current study was to evaluate changes in the suicide risk rate from the period before to during the COVID-19 pandemic, as well as the factors associated with this outcome among Brazilian undergraduate students.

METHODS

This was a nationwide survey carried out in Brazil with a cross-sectional design, including two data collection periods: a single-center in-person collection in 2019 and another multicenter online collection in 2020/2021. Data were collected using self-administered instruments. The outcome was a high risk of suicide, measured through the Mini International Neuropsychiatric Interview. Analyses were carried out on data from two periods, i.e. before and during the pandemic (bivariate analysis and interaction tests), and a model of associated factors (multivariate analysis using Poisson regression) was developed including all participating universities distributed in the five regions of Brazil.

RESULTS

In total, 6716 Brazilian undergraduate students participated (996 in 2019 and 5720 in 2020/2021). The prevalence of a high suicide risk rose from 11.3% to 17.0%, especially among women and poorer individuals. The prevalence of a high risk of suicide among Brazilian undergraduates was 19.6% and was associated with several socioeconomic, academic, pandemic, and mental health factors.

CONCLUSIONS

The prevalence of a high suicide risk increased from prepandemic to during the pandemic, appearing to be largely influenced by social determinants, in conjunction with the implications of the COVID-19 pandemic.

Assessment of Anxiety among People with Various Physical Activity Levels during Lockdown in Karachi, Pakistan

Background  The purpose of this study is to make it easier to counsel the general public on how to promote their psychological health and better lifestyle by boosting their physical activity in the event of more devastating future waves of coronavirus disease 2019. Coronavirus disease is a viral infection first reported in Wuhan, China, which led to a worldwide pandemic and lockdown. In addition to physical health, the uncertainty of situation and fear of infection have further affected the mental health of the individuals. Lockdown has also halted the physical activity of people further adding into the stress and anxiety. Methods  A sample size of 376 was required, but a convenient sampling technique collected 400 responses due to overwhelming Participation. A well-structured questionnaire was used for data collection, which contained sections such as a demographics section. We used the International Physical Activity Questionnaire scale to measure various physical activity levels and the generalized anxiety disorder scale to measure anxiety levels, because of their considerate validity and feasibility. Later both of our variables were compared to find out the correlation of anxiety levels with different physical activity levels. Results  Mean Anxiety and its prevalence rates in the sample were 7.32 ± 5.767 and 33%. On performing Pearson correlation, increasing age was found to be a risk factor for Anxiety. One-way analysis of variance showed a significant difference between Physical Activity and Anxiety. In the post-hoc Tukey test, a considerable difference in anxiety level was found between people with no physical activity and vigorous physical activity. Conclusion  During the lockdown period, the mean anxiety was found to be 7.0 ± 5.56 with prevalence rate of 33% among the people with no, low, moderate or vigorous physically active levels was found to be associated with better perceived mental health status which suggests the need to promote physically active style to cope with anxiety and awareness sessions to be conducted especially among those who could not maintain a physically active lifestyle. Also, among the general population e-Health programs could provide an appropriate way to promote a physically active lifestyle.

Relationship between lifestyle changes due to the COVID-19 pandemic and depression: Nationwide population-based research using Community Health Survey data in South Korea

AIMS

This study evaluated the association between depression and lifestyle changes due to the COVID-19 pandemic and evaluated this association in patients with chronic diseases.

METHODS

Data were obtained from the 2020 Community Health Survey in South Korea. This study included 212,806 participants and perceived changes in life patterns (sleep, food, and exercise) after the COVID-19 outbreak were measured. People with hypertension or diabetes were categorized as patients with chronic diseases and depression was defined as a score of ≥10 on the Patient Health Questionnaire-9.

RESULTS

Compared with before the COVID-19 pandemic, increased or decreased sleep, the consumption of instant food, and decreased physical activity were associated with increased depression. Compared with the general population, patients with chronic diseases showed increased depression, with or without medication. Additionally, among patients with chronic diseases not taking medication, increased physical activity was associated with reduced depression, whereas reduced physical activity was associated with increased depression in both younger and older groups.

CONCLUSIONS

This study found that unhealthy lifestyle changes during the COVID-19 pandemic were associated with increased depression. Maintaining a certain lifestyle is important for mental health. Chronic disease patients need appropriate disease management, including physical activity.

Mental condition and physical activity of individuals working during the COVID-19 pandemic in Poland

OBJECTIVES

The study assessed quality of life and depression in working people during COVID-19 pandemic, relative to their physical activity.

MATERIAL AND METHODS

The study involved 1194 people living in south-eastern Poland, and assessed life satisfaction (Life Satisfaction Questionnaire - 9 [LISAT-9]), quality of life (World Health Organization Quality of Life - BREF [WHOQoL-BREF]), depression (Beck Depression Inventory [BDI]) and physical activity.

RESULTS

The respondents on average scored 4.32 in LISAT-9; respectively 66.2, 68.3, 69.6 and 63.5 in physical, psychological, social and environment domains of WHOQoL-BREF and 9.2 in BDI. Regularly performed physical activity positively affected the scores in all the psychometric tests in women with higher and secondary education and in men with vocational education. Women presented lower life satisfaction, poorer quality of life and higher level of depression than men. The psychometric scores were also differentiated by type of employment and job. Depression was identified in 44% of all the respondents.

CONCLUSIONS

Individuals who are economically active during the pandemic report good quality of life and no or only mild signs of depression. Working people with higher education cope more effectively with adversities of the pandemic, compared to those with lower education. Int J Occup Med Environ Health. 2023;36(2):274-90.

Increased Depression and the Worsening of Depressive Symptoms Associated with Physical Inactivity during the COVID-19 Pandemic: A Two-Phase Cross-Sectional Study

The COVID-19 pandemic has increased the incidence of depression and other mental disorders in the general population, influenced by various individual and contextual factors. Physical activity (PA) interventions offer a promising approach to mitigating the negative mental health effects of the pandemic. This study aims to analyze the association between PA and depressive symptoms. A total of 785 individuals aged 37.4 ± 13.2 years (72.5% female) were evaluated at two different time points: the first between 2018 and 2019, and the second during the COVID-19 pandemic in 2020. Depressive symptoms, demographic, and socioeconomic data were assessed using the Beck Depression Inventory to estimate depressive symptoms. Frequency analysis and binary and multinomial regression were employed for data analysis. The prevalence of mild depressive symptoms increased from 23.1% before the pandemic to 35.1% during the pandemic. Our findings reveal that practicing PA before the pandemic was a protective factor (OR: 0.19; 95% CI: 0.13, 0.30; p < 0.001) against mild depressive symptoms. Additionally, individuals who continued to practice PA during the pandemic had a lower chance of presenting mild (OR: 0.21; 95% CI: 0.15, 0.30) and moderate/severe (OR: 0.15; 95% CI: 0.08, 0.27) symptoms. Furthermore, our study shows that PA, which was already a protective factor before the pandemic, remained protective during the pandemic, even for those with the highest levels of depression.

The Effects of the COVID-19 Pandemic on Women's Mental Helath in Turkey and What these Effects Suggest

Objective: The COVID-19 pandemic has deeply affected societies and individuals in all aspects, including mental and physical health. In this study, we aimed to determine the effects of COVID 19 pandemic on anxiety and depression levels and related factors in women. Methods: As a descriptive cross-sectional study, it was conducted with a total of 728 women between December 2020 and March 2021. Data were collected by Google survey using the descriptive information form, the Coronavirus Anxiety Scale (CAS), and the Hospital Anxiety and Depression Scale (HADS). Results: Having concerns about own health had a strong effect on coronavirus-related anxiety (p&lt;0.001, η2 = 0.037) and the anxiety dimension of Hospital Anxiety and Depression Scale (HADS) (p&lt;0.001, η2 = 0.098). Marital relationships had a strong effect on HADS depression dimension scores (p&lt;0.001, η2 = 0.067). Conclusion: The younger women, those who had problematic marital relationship and those who were exposed to domestic violence had higher anxiety and depression scores. Relevant measures should be taken to reduce the concerns of more risky groups, especially women, in the health system and should be considered in future planning on this subject.

Effect of the COVID-19 pandemic on depression, perceived stress and hypochondria of frontline dental staff (FDS): A cohort study

BACKGROUND

The coronavirus 2019 (COVID-19) pandemic had several mental effects on medical staff.

OBJECTIVE

This study intended to evaluate deviations in Frontline Dental Staff (FDS) depression, perceived stress and hypochondria during the COVID-19 outbreak, and to assess whether the existence of potential risk-factors influenced these symptoms over time.

METHODS

This prospective cohort study surveyed FDS three periods from February 1, 2021 to April 8, 2022. FDSs' mental health was assessed through Beck Depression Inventory, Cohen Perceived Stress and the Evans Self-Illness Questionnaires; multivariate linear regression were used to identify potential factors associated with changes on each outcome (depression, perceived stress and hypochondria) over time. All analyses were performed in STATA ver.14.

RESULTS

In a total of 635 FDS, about 69%, 83%, and 71% reported relative depression, 77%, 87%, and 64% reported moderate to high stress level, and 60%, 76% and 74% reported moderate hypochondriac from first, second, and third survives, respectively. The mean and standard deviation of the variables increased dramatically at second survive (July 17 to October 21, 2021) and decreased again at third survive significantly. Being female, working in public sector, and low socioeconomic level were main predictors of higher levels of depression (p < 0.001) and perceived stress (p < 0.001). Perceived stress was a strong predictor of high-level depression (t  =  7.79, p < 0.001).

CONCLUSION

FDSs' depression, stress and hypochondria were high and positively associated with being female, working in public-sector, and low socioeconomic level. To increase the effectiveness and decrease work burnout, psychological support should be provided.

Short-term impact of COVID-19 pandemic on low back pain: data from the PAMPA Cohort, Brazil

BACKGROUND

To evaluate the short-term impact of COVID-19 pandemic on low back pain (LBP) outcomes in southern Brazil.

METHODS

Data from the PAMPA Cohort were analyzed. Adults were recruited between June and July 2020 in the Rio Grande do Sul state using online-based strategies. Participants responded a self-reported, online questionnaire on LBP with two timepoints: before (retrospectively) and during COVID-19 pandemic. We assessed LBP experience, LBP-related activity limitation (no/yes), and LBP intensity (0 to 10 [strongest pain]).

RESULTS

From a total sample of 2,321 respondents (mean age: 37.6 ± 13.5; 75.4% women), the prevalence of LBP did not change significantly from before (74.7% [95%CI 72.3; 76.9]) to the first months of pandemic (74.2% [95%CI 71.9; 76.3]). However, an increased pain levels (β: 0.40; 95%CI 0.22; 0.58) and a higher likelihood for activity limitation due to LBP was observed (PR 1.14; 95%CI 1.01; 1.29). Longitudinal analyzes showed that age, gender, BMI, chronic diseases, physical activity, and anxiety and depression symptoms, were associated with LBP in the first pandemic months.

CONCLUSION

Although the prevalence of LBP did not change at the first months of COVID-19 pandemic, LBP-induced impairment in daily activities and pain intensity was higher when compared to before the pandemic.

Prevalence of anxiety during the COVID-19 pandemic: A systematic review and meta-analysis of over 2 million people

INTRODUCTION

Uncertainty, disruptions in daily routines, and concerns for the health and well-being during the COVID-19 pandemic are likely associated with increases in generalized anxiety. The present study aimed to systematically review the literature in order to identify the update prevalence of anxiety in the general population during the COVID-19 pandemic.

METHODS

A systematic review and meta-analysis. It included studies that assessed the prevalence of anxiety among the general population during the COVID-19 pandemic.

RESULTS

In total, we included 194 studies. The general prevalence of anxiety was 35.1 %, affecting approximately 851,000 participants. The prevalence in low and middle-income countries (35.1 %; 95%CI: 29.5 % to 41.0 %) was similar compared to high-income countries (34.7 %; 95%CI: 29.6 % to 40.1 %). In studies that provided the proportion of cases in each level of anxiety disorder, mild-to-moderate anxiety affected one quarter of the participants. One in ten cases with anxiety during the COVID-19 may be living with severe or extremely anxiety disorder. Most instruments estimated similar prevalence of anxiety disorders with notable difference in the prevalence estimated by the Generalized Anxiety Disorder 2-item (GAD-2), Zung Self-Rating Anxiety Scale (SAS), and State-Trait Anxiety Inventory (STAI).

CONCLUSION

One in three adults were living with anxiety disorder during the COVID-19 pandemic worldwide.

Prevalence of psychiatric symptoms and associated factors in the adult population from the area affected by the tailings dam rupture - Brumadinho Health Project

OBJECTIVE

To examine the prevalence of psychiatric symptoms and associated factors in the adult population of Brumadinho (MG), after the dam collapse.

METHODS

We included 2,740 participants with information about symptoms of post-traumatic stress disorder (PTSD), depression, anxiety, thoughts of death/self-harm, and poor sleep quality collected in 2021. Prevalence values of all conditions were estimated to compare the prevalence of psychiatric symptoms with the participants' sociodemographic characteristics and place of residence. Pearson's c2 test was used, with Rao Scott's correction. Crude and adjusted logistic regressions estimated odds ratios and 95% confidence intervals to assess the association between psychiatric symptoms and participants' characteristics.

RESULTS

The most common condition was depressive symptoms (29.3%), followed by post-traumatic stress symptoms (22.9%) and anxious symptoms (18.9%). Regarding the association between participants' characteristics in the adjusted analysis, being a female and living in a mining area was positively associated with symptoms of PTSD, depression, anxiety, thoughts of death/self-harm, and poor sleep quality. A positive association was also found between high school education and post-traumatic stress symptoms. In contrast a negative association was found between being aged ≥60 years and symptoms of PTSD, depression, and anxiety.

CONCLUSION

High prevalence values were found for all psychiatric symptoms after the dam failure in Brumadinho. Being a female, living in the mining area, being ≥60 years old, and having an educational level were all associated with the psychiatric symptoms investigated.

Physical activity and the incidence of depression during the COVID-19 pandemic in Brazil: Findings from the PAMPA cohort

We examined the longitudinal association between physical activity (PA) and the incidence of self-reported diagnosed depression in adults in southern Brazil during the COVID-19 pandemic. Data from the PAMPA (Prospective Study About Mental and Physical Health) cohort was used. Data collection for baseline was carried out on June-July 2020, with two follow-up assessments taking place six months apart. An online, self-reported questionnaire assessed depression and PA. Depression was assessed by asking participants whether they were ever diagnosed with depression. We included 441 participants (women: 75.9%; mean age [SD]: 38.0 [13.5]) in southern Brazil. Over the follow-up, 21.8% (95% confidence interval [CI]: 18.1%-25.9%) were diagnosed with depression. Insufficiently active (<150 min per week of physical activity) (Incidence rate [IR]: 61.9; 95%CI: 39.5-102.4; p = 0.047) and active (≥150 min per week of physical activity) (IR: 50.4; 95%CI: 31.9-84.0; p = 0.015) participants had reduced IR of depression per 1000 persons-year at risk compared to inactive ones (0 min per week of physical activity) (IR: 99.9; 95%CI: 79.7-126.8). In the adjusted analyses, participants in the insufficient active (hazard ratio [HR]: 0.58; 95%CI: 0.34-0.98) and active (HR: 0.53; 95%CI: 0.31-0.93) group had a lower risk of developing depression than the inactive group. PA both at and out of home reduced the risk of incident depression (HR: 0.49; 95%CI: 0.25-0.98) compared to no physical activity. Endurance (HR: 0.52; 95%CI: 0.28-0.97) and endurance plus strengthening (HR: 0.40; 95%CI: 0.17-0.95) PA reduced the risk of incident depression compared to none. Being physically active during pandemic, regardless of the amount of PA practiced, reduced the incidence of depression in adults in southern Brazil.

Prevalence of anxiety and depression among pregnant women during the COVID-19 pandemic: a meta-analysis

PURPOSE

Coronavirus disease (COVID-19) is a newly emerged respiratory illness, which has spread around the world. Pregnant women are exposed to additional pressure due to the indirect adverse effects of this pandemic on their physical and mental health. Since the psychological wellness framework is weak in developing countries, it is likely that geographical factors affect the prevalence. Therefore, the goal of this meta-analysis is to investigate the prevalence of anxiety and depression among pregnant women during the COVID-19 pandemic.

METHODS

We searched databases including PubMed/MEDLINE, Web of Science, Cochrane Library for articles. The quality of studies was determined based on the STROBE checklist. I2 and Cochrane Q-test were used to determine heterogeneity. Fixed effects and/or random effects models were also employed to estimate pooled prevalence.

RESULTS

Since heterogeneity was fairly high in all analyses, the random effect model was used. According to the results of random effects in the meta-analysis, the pooled prevalence was 18.7% (95% CI: 0.06-0.36%; I2=99%,P<0.001) for anxiety and 25.1% (95% CI: 0.18-0.33%; I2=97%, P<0.001) for depression. The results of continent subgroup analysis showed that the prevalence of anxiety was higher in western country (38%) than in Asia country (7.8%). The prevalence of anxiety in Italy (38%), Canada (56%), Pakistan (14%), Greece (53%), Sri Lanka (17.5%), and China (0.3-29%) and Iran 3.8% as well as the prevalence of depression in Canada (37%), Belgium (25%), Turkey (35.4%), Sri Lanka (19.5%), and China (11-29%) has been reported.

CONCLUSION

Covid-19 may impose extra pressure on the emotional wellbeing of pregnant women. Therefore, there is an urgent need for resources to help mitigate anxiety and depression in pregnant women.

Maternal Competence, Maternal Burnout and Personality Traits in Italian Mothers after the First COVID-19 Lockdown

This study aimed to investigate the maternal sense of competence and maternal burnout in Italian mothers during the COVID-19 pandemic. The sample was composed of 278 mothers of children/adolescents aged 4 to 17 years old. Participants were recruited after the end of the first spring total Italian lockdown (June-October 2020) through online advertisements on websites and social media. We hypothesized a model in which a specific personality trait, such as neuroticism, affected maternal competence by the mediating role of maternal burnout. Results showed that neuroticism was directly and negatively predictive of perception of maternal competence, and it was negatively associated with maternal burnout, specifically specific antecedents that were strictly related to parental burnout. ANOVA results highlighted that the maternal level of education affected maternal competence in terms of satisfaction. In contrast, the working regimen during the first lockdown for COVID-19 affected maternal competence in terms of efficacy. Maternal burnout was affected by atypical child development in terms of both common (job burnout, stress management abilities) and specific (parental burnout) antecedents. COVID-19 strongly increased the risk of maternal burnout, resulting in mothers having a poor perception of their own competency. This is particularly the case in the presence of a neurotic personality.

The effects of changes in daily life due to the COVID-19 pandemic on the depressive symptoms among community-dwelling older adults in Korea

This study aims to identify the effects of daily life changes due to the coronavirus disease 2019 pandemic on the depressive symptoms among community-dwelling older adults. This cross-sectional and secondary data analysis study collected and analysed the data of 72 335 older adults aged older than 65 who participated in the 2020 Korean Community Health Survey. Changes in daily life due to the coronavirus disease 2019 pandemic were measured by changes in physical activity, sleep duration, consumption of instant foods or soda drinks, alcohol consumption, smoking, and social contact compared to before the pandemic as perceived by the participants. The Patient Health Questionnaire-9 was used to assess depressive symptoms, and multiple logistic regression analysis was conducted to explore the relationship between the two. After adjusting for socio-demographic and health-related factors, changes in daily life due to the coronavirus disease 2019 pandemic that affected depressive symptoms in older adults living in the community were observed. This study confirmed that changes in daily life due to the coronavirus disease 2019 pandemic negatively affected the mental health of older adults. Thus, there is a need to improve social support and care systems, by including non-face-to-face programmes using remote communication technology. It will allow older adults to maintain their daily lives and mental health during the COVID-19 pandemic.

The Impact of Mental Health and Sociodemographic Characteristics on Quality of Life and Life Satisfaction during the Second Year of the COVID-19 Pandemic—Results of a Population-Based Survey in Germany

A decreased quality of life was shown for numerous factors at the beginning of the pandemic. However, it is important to identify people who are at-risk for long-term impairments during the pandemic and its aftermath. Within this study, we aimed to investigate quality of life within a German population-based sample (2515 participants; 51.6% female; mean age 50.09 years) during the second year of the pandemic (2021). Our results showed that the majority reported no pandemic-associated change in quality of life at this state of the pandemic. Higher life satisfaction was associated with fewer mental health problems, no pre-existing somatic and psychiatric disorders, higher income, no income loss during the pandemic, living with others, and younger age. In contrast, in a high-risk group encompassing participants with lower quality of life, only mental health, pre-existing somatic disorders, and living alone had significant associations with quality of life, indicating a smaller scope for improvement in this high-risk group. Age, income loss, and depressive symptoms predicted a decrease in quality of life since the beginning of the pandemic. Our results highlight the importance of mental health, especially in times of pandemic, and underline the need for low-threshold mental health support.

The socio-economic and health effects of COVID-19 among rural and urban-slum dwellers in Ghana: A mixed methods approach

Background

Vulnerable populations such as rural and urban-slum dwellers are more likely to suffer greatly from the deleterious effects of the novel Coronavirus disease 2019 (COVID-19). However, in Ghana, most COVID-19 mitigating packages are not focused on vulnerable populations.

Methods

Concurrent mixed methods design was used to examine the socio-economic and health effects of COVID-19 among rural and urban-slum dwellers in Ghana. Four hundred respondents were sampled for the quantitative arm of the study, while 46 In-depth Interviews (IDIs) were conducted with community members and government officials. Sixty-four community members participated in Focus Group Discussions (FGDs) and non-participant observation was carried out for three months. Quantitative data were analysed using frequencies, percentages, Pearson Chi2 and ordered logistic regression. Interviews were recorded using digital recorders and later transcribed. Transcribed data (IDIs, FGDs) and observation notes were uploaded onto a computer and transferred to qualitative software NVivo 12 to support thematic coding and analysis.

Results

Majority of the respondents confirmed the deleterious socio-economic and health effects of COVID-19 on jobs and prices of food. Other effects were fear of visiting a health facility even when unwell, depression and anxiety. Young people (18–32 years), males, urban-slum dwellers, married individuals, the employed and low-income earners (those who earn GHC10/$1.7 to GHC100/ $17), were more likely to suffer from the socio-economic and health effects of COVID-19. Urban-slum dwellers coped by relying on family and social networks for food and other basic necessities, while rural dwellers created locally appropriate washing aids to facilitate hand washing in the rural communities.

Conclusion

COVID-19 and the government’s mitigation measures had negative socio-economic and health effects on vulnerable communities. While vulnerable populations should be targeted for the government’s COVID-19 mitigating packages, special attention should be given to young people (18–32 years), males, urban-slum dwellers, married individuals and low-income earners. Communities should be encouraged to maintain coping strategies adopted even after COVID-19.

Factors Associated With Increased Opioid Use During the COVID-19 Pandemic: A Prospective Study of Patients Enrolled in Opioid Agonist Treatment

OBJECTIVES

The opioid use disorder (OUD) crisis in North America has become "an epidemic within a pandemic" in the context of the COVID-19 virus. We aimed to explore the association between the COVID-19 pandemic and changes in opioid use patterns among patients receiving treatment for OUD.

METHODS

We used prospectively collected data from 456 patients attending 31 opioid agonist clinics across Ontario, Canada. All included participants underwent routine urine drug screens (UDSs) both before and after the onset of the COVID-19 pandemic. A paired sample t -test was used to compare the proportion of opioid-positive UDSs collected pre- and post-pandemic, and linear regression analysis was used to explore factors associated with this change.

RESULTS

Participants had a mean age of 39.9 years (standard deviation = 10.9), 52%were male, and 81%were receivingmethadone treatment. The percentage of opioid-positive UDSs increased significantly during the pandemic, on average by 10.6% (95% confidence interval [CI] 8.17, 12.95, P < 0.001). Continued opioid use before the pandemic was associated with 9.43% increase, on average, in the percentage of opioid-positive UDSs during the pandemic (95% CI 3.79, 15.07). Self-reported past-month cocaine (adjusted betacoefficient 6.83, 95% CI 0.92, 12.73) and amphetamine (adjusted beta-coefficient 13.13, 95% CI 5.15, 21.1) use at study entry were also associated with increases in opioid-positive UDSs.

CONCLUSIONS

Increased opioid use is one measure of the negative impact the COVID-19 pandemic has had on individuals with OUD, an already marginalized population. Understanding factors associated with worse outcomes is essential to ensuring that treatment programs appropriately adapt to better serve this population during the pandemic.

Embitterment during the COVID-19 Pandemic in Reaction to Injustice, Humiliation, and Breach of Trust

The COVID-19 pandemic has not only had an impact on the health of many people, but also on politics, the economy, and everyday life at large. It has been shown that some people respond with anxiety and depression, which is not surprising. Another reaction in the context of COVID-19 is embittered fights and disruptions between family members, friends, and neighbors, but also problems on a societal and political level, mutual public insults, political demonstrations, and even aggressive outbursts with a high number of participants. This calls for a separate explanation. One trigger may be embitterment, an emotion known to anybody in reaction to injustice, humiliation, and breach of trust, in association with helplessness. It comes along with a nagging desire to fight back and is usually accompanied by aggressive fantasies and combatively impulses towards the wrongdoer. This emotion also spreads indiscriminately to other people and the world. There are few initial studies which show that there is a significant increase in the rate of embitterment during the COVID-19 pandemic. Increased embitterment was related to financial losses, concern about restricted societal freedom, job insecurity, oppositional attitudes, helplessness, dissatisfaction with life, and inclination to join anti-COVID-19 demonstrations. These findings suggest that it is important to foster resilience against stressors, be it because of the virus itself, restrictions in daily freedom, negative comments by other persons, or imbalanced press releases. Of importance is also to abstain from insulting comments towards people who do not follow the mainstream, to allow adjustment of rules to given situations, and to take people along by listening to their grievances, instead of leaving demonstrations on the street as the only method to voice concerns.

Psychological Impact of the COVID-19 Pandemic on Families of People with Severe Mental Disorders Participating in Community Peer Support Groups in Brazil

People with severe mental disorders are at increased risk of dying from COVID-19 and more susceptible to the impacts of the pandemic. This study aims to understand how the families of patients with severe mental disorders followed up in community peer support groups experienced the beginning of the pandemic in Brazil and how they fared during the period of restricted physical contact. Family members (n = 82) and patients (n = 27) belonging to community groups in Rio de Janeiro responded to an online survey that included assessments of quality of life and well-being along with open-ended questions. Thematic analysis of the answers showed that the majority of remarks were positive, despite the concerns, fears, and feelings common at the time. Positive feelings were also mentioned significantly. These findings demonstrate that this population was adaptive and resilient in coping with the restrictions on physical contact. The main concerns and difficulties of this population are discussed.

Major depressive episode in mothers during the COVID-19 pandemic: a population-based study in the Southern Brazil

The COVID-19 pandemic has changed individuals and families, causing adverse psychological effects, especially in young adults, women, and parents. This study aimed to verify the prevalence of current major depressive episode (CMDE) in mothers of preschoolers (up to five years old) and its associated stressors during the COVID-19 pandemic in a municipality in the Southern Brazil. This is a cross-sectional, population-based study with mothers. All mothers were interviewed by telephone call during the COVID-19 pandemic. We used the Mini-International Neuropsychiatric Interview (M.I.N.I. Plus) to assess the presence of CMDE. Statistical analysis was conducted using the chi-square test and a multivariate logistic regression. We evaluated 666 mothers. The prevalence of CMDE was 12.3%. Mothers with financial losses had 2.1 (95%CI: 1.3-3.4) more odds of presenting CMDE than those financially stable. We observed that financial losses were determinant for the higher prevalence of depression in mothers.

Assessment of fear, anxiety, obsession and functional impairment due to COVID-19 amongst health-care workers and trainees: A cross-sectional study in Nepal

Background:

The emergence of the COVID-19 epidemic threw the world into turmoil. The medical community bore the brunt of the pandemic's toll. Long work hours, and a lack of personal protective equipment (PPE) and social support all had an influence on mental health.

Methods:

This cross-sectional study was conducted among Lumbini Medical College Teaching Hospital students and employees in Palpa, Nepal. Data entailing their demographic details, pre-existing comorbidities, or death in the family due to COVID-19 was collected using a self-administered survey. In addition, the level of fear, anxiety, obsession, and functional impairment due to COVID-19 was recorded using previously validated respective scales.

Results:

In total, 403 health-care workers and trainees participated in our study. The mean age of the study participants was 23±4 years, and more than half of them (n=262, 65%) were females. A significant association was found between fear score with age (p-value=0.04), gender (p-value <0.01) and occupation (p-value<0.001). The participants suffering from chronic diseases (p-value=0.36), were not found to be significantly obsessed with COVID-19. Age (p-value=0.34), was not found to be significantly associated with higher anxiety levels. Nursing students suffered from a significantly greater functional impairment than other health-care professionals (mean rank score=269.15, p-value < 0.001). A moderately positive correlation was observed between fear, anxiety, obsession, and functional impairment scales.

Conclusion:

This study revealed various socio-demographic characteristics as risk factors for psychological stress in the people related to the health-care profession of Nepal during the COVID-19 pandemic. A viable answer to this quandary might be adequate psychosocial intervention by health-care authorities, increased social support, and the introduction of better mental health management measures for the front-line health-care workers.

Mental disorder symptoms during the COVID-19 pandemic in Latin America - a systematic review and meta-analysis

AIMS

There is a lack of evidence related to the prevalence of mental health symptoms as well as their heterogeneities during the coronavirus disease 2019 (COVID-19) pandemic in Latin America, a large area spanning the equator. The current study aims to provide meta-analytical evidence on mental health symptoms during COVID-19 among frontline healthcare workers, general healthcare workers, the general population and university students in Latin America.

METHODS

Bibliographical databases, such as PubMed, Embase, Web of Science, PsycINFO and medRxiv, were systematically searched to identify pertinent studies up to August 13, 2021. Two coders performed the screening using predefined eligibility criteria. Studies were assigned quality scores using the Mixed Methods Appraisal Tool. The double data extraction method was used to minimise data entry errors.

RESULTS

A total of 62 studies with 196 950 participants in Latin America were identified. The pooled prevalence of anxiety, depression, distress and insomnia was 35%, 35%, 32% and 35%, respectively. There was a higher prevalence of mental health symptoms in South America compared to Central America (36% v. 28%, p < 0.001), in countries speaking Portuguese (40%) v. Spanish (30%). The pooled prevalence of mental health symptoms in the general population, general healthcare workers, frontline healthcare workers and students in Latin America was 37%, 34%, 33% and 45%, respectively.

CONCLUSIONS

The high yet heterogenous level of prevalence of mental health symptoms emphasises the need for appropriate identification of psychological interventions in Latin America.

Physical activity trajectory in the first 10 months of the COVID-19 pandemic in Southern Brazil: a follow-up study

Background

A continuous tracking of the PA level during the COVID-19 pandemic is important to understand how people’s behaviour has varied along time. The aim of this study was to evaluate the physical activity (PA) trajectory over the first 10 months of the COVID-19 pandemic in the south of Brazil.

Methods

Data from three timepoints of the PAMPA Cohort were used, as follows: (1) pre-COVID-19 (retrospective); (2) Jun/Jul 2020; (3) Dec 2020/Jan 2021. Self-reported PA practice, frequency, duration, as well as place where activities were performed (at or out of home) were assessed.

Results

A reduction in any (from 68.7 to 47.7%), sufficient (from 41.5 to 22.1%) and out of home PA (from 59.4 to 30.1%) was observed from the first (pre-COVID-19) to the second (Jun/Jul 2020) timepoint, followed by an increase in the third timepoint (Dec 2020/Jan 2021) (60.1%, 37.9%, and 54.3% for any, sufficient, and out of home PA, respectively). The PA trajectory was similar, regardless of sex, educational level or income. Only any (p = 0.0007) and sufficient (p = 0.0012) PA showed significant interaction with time by sex. Female participants were less likely to engage in any (OR 0.45 95% CI 0.26; 0.77) and sufficient PA (OR 0.40 95% CI 0.24; 0.66).

Conclusion

During the first 10 months of COVID-19 pandemic there was a marked fluctuation on PA pattern in adults from southern Brazil. An ongoing tracking of PA behaviour during COVID-19 pandemic is important to understand how this behaviour varies. Public policies should focus on increasing PA in a higher standard than pre-COVID levels.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13102-022-00450-0.

Association between food insecurity and major depressive episodes amid Covid-19 pandemic: results of four consecutive epidemiological surveys from southern Brazil

OBJECTIVE

To assess the association between household food insecurity (FI) and major depressive episodes (MDE) amid Covid-19 pandemic in Brazil.

DESIGN

Cross-sectional study carried out with data from four consecutive population-based studies.

SETTING

The study was conducted between May and June 2020, in Bagé, a Brazilian southern city. Household FI was measured using the short-form version of the Brazilian Food Insecurity Scale. Utilising the Patient Health Questionnaire-9, we used two different approaches to define MDE: the cut-off point of ≥ 9 and the diagnostic criteria proposed by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). Association between FI and MDE was analysed using crude and adjusted Poisson regression models.

PARTICIPANTS

1550 adults (≥ 20 years old).

RESULTS

The prevalence of household FI was 29·4 % (95 % CI 25·0, 34·4). MDE prevalence varied from 4·4 % (95 % CI 3·1, 6·0), when we used the DSM-IV-TR criteria to define this condition, to 9·6 % (95 % CI 7·3, 12·5) of the sample, when we used the cut-off point of ≥ 9 as definition. The prevalence of MDE was more than two times higher in those individuals living with FI, independent of the criteria adopted to define the outcome. Adjustment for potential confounders did not change the association's magnitude.

CONCLUSIONS

Household FI has been positively associated with MDE amid Covid-19 pandemic, independent of socio-demographic characteristics of participants. Actions are needed to warrant basic living conditions to avoid FI and hunger and its consequences for the Brazilian population, especially those consequences linked to mental health disorders.

Alcohol Consumption and Smoking During Covid-19 Pandemic: Association with Sociodemographic, Behavioral, and Mental Health Characteristics

The Covid-19 pandemic is related to increased alcohol consumption and smoking. These behaviors may be related to several sociodemographic, behavioral and mental health factors. Thus, the aim of this study was to assess the association between alcohol consumption and cigarette smoking with sociodemographic, behavioral and mental health characteristics. This study used data from two population-based studies conducted in two cities from Southern Brazil amid the Covid-19 pandemic. Individuals aged 18 years or older were included and selected using a multistage sampling procedure. Alcohol consumption and smoking and changes in such consumption during the Covid-19 pandemic were evaluated. Sociodemographic, behavioral, pandemic-related, and mental health variables were also included. A hierarchical model was used to conduct the adjusted analyses, and Poisson regression with robust adjustment was used for variance. A total of 2170 individuals were studied. The prevalence of alcohol consumption and smoking were 9.3% and 14.2%, respectively. The rates of increase in alcohol consumption and smoking during the Covid-pandemic were about 20% and 30%, respectively. They were higher among those with depressive symptoms, feeling of sadness and self-reported stress. Those with poor diet quality had higher prevalence of alcohol consumption (PR: 1.82) and were 1.58 times more likely to smoke. The findings may help stakeholders in health and political systems to better understand the consequences of the Covid-19 pandemic and develop strategies to mitigate these consequences in Brazil and elsewhere.

Effective recommendations towards healthy routines to preserve mental health during the COVID-19 pandemic

Objective:

To assess the adherence to a set of evidence-based recommendations to support mental health during the coronavirus disease 2019 (COVID-19) pandemic and its association with depressive and anxiety symptoms.

Methods:

A team of health workers and researchers prepared the recommendations, formatted into three volumes (1: COVID-19 prevention; 2: Healthy habits; 3: Biological clock and sleep). Participants were randomized to receive only Volume 1 (control), Volumes 1 and 2, Volumes 1 and 3, or all volumes. We used a convenience sample of Portuguese-speaking participants over age 18 years. An online survey consisting of sociodemographic and behavioral questionnaires and mental health instruments (Patient Health Questionnaire-9 [PHQ-9] and Generalized Anxiety Disorder-7 [GAD-7]) was administered. At 14 and 28 days later, participants were invited to complete follow-up surveys, which also included questions regarding adherence to the recommendations. A total of 409 participants completed the study – mostly young adult women holding university degrees.

Results:

The set of recommendations contained in Volumes 2 and 3 was effective in protecting mental health, as suggested by significant associations of adherence with PHQ-9 and GAD-7 scores (reflecting anxiety and depression symptoms, respectively).

Conclusion:

The recommendations developed in this study could be useful to prevent negative mental health effects in the context of the pandemic and beyond.

Occupational Profile, Psychosocial Aspects, and Work Ability of Brazilian Workers During COVID-19 Pandemic: IMPPAC Cohort

BACKGROUND

The IMPPAC cohort (Implications of the COVID-19 pandemic on psychosocial aspects and work ability among Brazilian workers) seeks to understand the impact of the pandemic on Brazilian workers. This article describes the occupational profile, psychosocial aspects, and work ability determined during the baseline and follow-up measurements of the cohort.

METHODS

Workers were invited to participate through media advertisements, social networks, and e-mails. From June to September 2020, 1211 workers were included in the cohort. Follow-up measurements finished on October 2021 with 633 workers. Data were collected through standardized questionnaires using Google Forms. Psychosocial aspects were assessed using the COPSOQ II-Br. Work ability was assessed using the Work Ability Index (WAI).

RESULTS

At baseline and follow-up, high proportion of workers were in the risk zone with regard to work pace, emotional work demands, influence on work, work-family conflict, burnout, and stress. Approximately 75% of the workers reported good to excellent work ability at baseline and follow-up.

CONCLUSION

The occupational profile, psychosocial aspects, and work ability of Brazilian workers from the IMPPAC cohort were described. Psychosocial aspects and WAI were similar at baseline and follow-up.

Longitudinal trajectories of depression and anxiety among adolescents during COVID-19 lockdown in China

BACKGROUND

This study examines the patterns and predictors of depression and anxiety trajectories among adolescents during COVID-19 lockdown in China.

METHODS

A total of 35,516 college students were followed from the pandemic outbreak period, initial remission period, and control period. Participants completed the Patient Heath Questionnaire, Generalized Anxiety Disorder Scale, Perceived Social Support Scale, the Simplified Coping Style Questionnaire, and APGAR-family scale. Distinct patterns of depression and anxiety trajectories were established through grouping participants based on time-varying changes of the cut-off score. Multivariate logistic regressions were used to examine predictors for trajectory membership.

RESULTS

Depression and anxiety prevalence during the COVID-19 outbreak were 21.3% and 11.5% respectively, and symptoms worsened as the lockdown time increased. Five depression/anxiety trajectories were observed: resistance, recovery, relapsing/remitting, delayed-dysfunction and chronic-dysfunction. Gender, academic year, residence location, history of mental health, and COVID-19 community exposure were significant predictors of distinct trajectories for depression or anxiety. Less social support or positive coping, more negative coping, and poorer family function were also risk predictors for not developing delayed or chronic dysfunction.

CONCLUSIONS

Although most adolescents remain euthymic or recover over time, some adolescents, especially those with the risk factors noted above, exhibit delayed or chronic symptoms. Thus, the need for individualized intervention with these adolescents is indicated.

Risk Perception Influence on Vaccination Program on COVID-19 in Chile: A Mathematical Model

The SARS-CoV-2 virus emergency prompted unprecedented safety measures, which were accepted by the population of each country to different degrees, for example, with more or less willingness to use personal protective elements (PPEs). We have developed a mathematical model of the contagion process, based on chilean data, to assess the interaction between biological factors (such as the impact of vaccination) and behavioral factors (such as the population's perception of risk). The model clearly shows that the virus spreads through three waves of contagion, the second being the most prominent, regardless of any alteration in the variables taken into account, which only affect the overall number of people infected. By considering alternative values of the risk perception variable and examining the different possible scenarios, we have also found that the less reaction to change the population has (and the lower the disposition to use PPEs), the higher the waves of contagion and the death toll are.

Loneliness and mental well-being in the Polish population during the COVID-19 pandemic: a cross-sectional study

OBJECTIVE

There is a growing concern that the restrictions imposed due to the COVID-19 pandemic could lead to increased loneliness and mental disorders, which are considered a major public health problem. The aim of the study was to assess loneliness, anxiety, depression and irritability in the Polish population during the COVID-19 pandemic.

DESIGN

A cross-sectional study. The study participants completed an online questionnaire using the computer-assisted web interview technique. Data were collected using Revised UCLA Loneliness Scale and Hospital Anxiety and Depression Scale.

SETTING

Poland.

PARTICIPANTS

This study was conducted between 6 October and 12 October 2020, in a representative sample of 890 Polish residents.

PRIMARY OUTCOME MEASURES

Self-reported loneliness; sociodemographic and COVID-19 pandemic factors associated with loneliness, anxiety, depression and irritability.

RESULTS

The analyses showed a moderately high degree of loneliness in 22%, symptoms of anxiety in 27%, depression in 14% and irritability in 33% of the respondents. The increasing severity of anxiety, depression and irritation in the study group was accompanied by higher loneliness. Generally, younger people, both tested positive for SARS-CoV-2 and those who experienced home quarantine, scored higher in both scales.

CONCLUSIONS

It is necessary to identify those most vulnerable to loneliness, anxiety and depression during a crisis to assess health needs and proactively allocate resources during and after the pandemic. Loneliness, anxiety, depression and irritability are important factors to consider in a population of younger, disadvantaged people, who tested positive for SARS-CoV-2, people who were quarantined at home, and people who believe that their physical and mental health is worse than in the pre-pandemic period. It is important to cater for the mental health of individuals during the COVID-19 pandemic and to promote psychological interventions to improve mental well-being in potentially vulnerable social groups.

Cross-cultural validation of the new version of the Coronavirus Anxiety Scale in twelve Latin American countries

The Coronavirus Anxiety Scale (CAS) was recently developed to assess dysfunctional anxiety related to COVID-19. Although different studies reported that the CAS is psychometrically sound, it is unclear whether it is invariant across countries. Therefore, the present study aimed to examine the measurement invariance of the CAS in twelve Latin American countries (Argentina, Bolivia, Chile, Colombia, Cuba, Ecuador, El Salvador, Guatemala, Mexico, Paraguay, Peru, and Uruguay). A total of 5196 people participated, with a mean age of 34.06 (SD = 26.54). Multigroup confirmatory factor analysis (CFA) was used to examine the measurement invariance of the CAS across countries and gender. Additionally, the graded response model (GRM) was used to provide a global representation of the representativeness of the scale with respect to the COVID-19 dysfunctional anxiety construct. The unidimensional structure of the five-item CAS was not confirmed in all countries. Therefore, it was suggested that a four-item model of the CAS (CAS-4) provides a better fit across the twelve countries and reliable scores. Multigroup CFA showed that the CAS-4 exhibits scalar invariance across all twelve countries and all genders. In addition, the CAS-4 items are more informative at average and high levels of COVID-19 dysfunctional anxiety than at lower levels. According to the results, the CAS-4 is an instrument with strong cross-cultural validity and is suitable for cross-cultural comparisons of COVID-19 dysfunctional anxiety symptoms in the general population of the twelve Latin American countries evaluated.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s12144-021-02563-0.

Association of Different Restriction Levels With COVID-19-Related Distress and Mental Health in Somatic Inpatients: A Secondary Analysis of Swiss General Hospital Data

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic and related countermeasures hinder health care access and affect mental wellbeing of non-COVID-19 patients. There is lack of evidence on distress and mental health of patients hospitalized due to other reasons than COVID-19-a vulnerable population group in two ways: First, given their risk for physical diseases, they are at increased risk for severe courses and death related to COVID-19. Second, they may struggle particularly with COVID-19 restrictions due to their dependence on social support. Therefore, we investigated the association of intensity of COVID-19 restrictions with levels of COVID-19-related distress, mental health (depression, anxiety, somatic symptom disorder, and mental quality of life), and perceived social support among Swiss general hospital non-COVID-19 inpatients.

METHODS

We analyzed distress of 873 hospital inpatients not admitted for COVID-19, recruited from internal medicine, gynecology, rheumatology, rehabilitation, acute geriatrics, and geriatric rehabilitation wards of three hospitals. We assessed distress due to the COVID-19 pandemic, and four indicators of mental health: depressive and anxiety symptom severity, psychological distress associated with somatic symptoms, and the mental component of health-related quality of life; additionally, we assessed social support. The data collection period was divided into modest (June 9 to October 18, 2020) and strong (October 19, 2020, to April 17, 2021) COVID-19 restrictions, based on the Oxford Stringency Index for Switzerland.

RESULTS

An additional 13% (95%-Confidence Interval 4-21%) and 9% (1-16%) of hospital inpatients reported distress related to leisure time and loneliness, respectively, during strong COVID-19 restrictions compared to times of modest restrictions. There was no evidence for changes in mental health or social support.

CONCLUSIONS

Focusing on the vulnerable population of general hospital inpatients not admitted for COVID-19, our results suggest that tightening of COVID-19 restrictions in October 2020 was associated with increased COVID-19-related distress regarding leisure time and loneliness, with no evidence for a related decrease in mental health. If this association was causal, safe measures to increase social interaction (e.g., virtual encounters and outdoor activities) are highly warranted.

TRIAL REGISTRATION

www.ClinicalTrials.gov, identifier: NCT04269005.

Impact of the COVID-19 outbreak on mental health status and associated factors among general population: a cross-sectional study from Pakistan

The recent outbreak of coronavirus disease (COVID-19) has significantly affected the mental health of people globally. This study aimed to investigate the mental health status and associated factors among residents of Pakistan. An online questionnaire survey was conducted from April 3 to May 7, 2020, using convenience and snowball sampling techniques. Data regarding demographics, physical health status and contact history during the last 2 weeks were collected. Furthermore, the Depression, Anxiety, and Stress scales (DASS-21) were utilized to measure the mental health of the participants. The analyses included descriptive statistics and regression analysis. Of the 1663 participants who completed this survey, 1598 met the inclusion criteria. The results revealed mild to moderate depression among 390 participants (24.4%), mild to moderate anxiety among 490 participants (30.7%) and mild to moderate stress among 52 participants (3.3%). A majority of the participants rated their health as good (n = 751, 47.0%). Moreover, students reported significantly higher scores on depression (B = 1.29, 95% CI = 0.71-1.88; p < 0.05), anxiety (B = 0.56, 95% CI = -0.06 to 1.18; p < 0.05) and stress (B = 0.56, 95% CI = -0.12 to 1.23; p < 0.05). Physical symptoms, including fever, cough and myalgia, and contact history in the last 14 days reported significant associations with depression, anxiety and stress (p < 0.05). The mental health status of the people was noted to be affected during the COVID-19 outbreak. Assessment of several factors with significant associations with depression, anxiety and stress may aid in developing psychological interventions for vulnerable groups.

Prevalência de sintomas psiquiátricos e seus fatores associados na população adulta da área atingida pelo rompimento da barragem de rejeitos: Projeto Saúde Brumadinho

RESUMO: Objetivo: Examinar a prevalência dos sintomas psiquiátricos e seus fatores associados na população adulta de Brumadinho (MG), após o rompimento da barragem. Métodos: Foram incluídos 2.740 participantes com informações coletadas em 2021 sobre os sintomas de estresse pós-traumático (TEPT), depressão, ansiedade, ideias de morte/automutilação e pior qualidade do sono. Estimaram-se as prevalências de todas as condições. Para a comparação das prevalências dos sintomas psiquiátricos e as características sociodemográficas e local de moradia, empregou-se o teste χ2 de Pearson, com correção de Rao-Scott. Regressões logísticas brutas e ajustadas estimaram os odds ratios e intervalos de confiança de 95%, permitindo a avaliação da associação entre os sintomas psiquiátricos e as características dos participantes. Resultados: Os sintomas depressivos foram a condição mais prevalente (29,3%), seguidos pelos sintomas de TEPT (22,9%) e sintomas ansiosos (18,9%). Com relação à investigação da associação entre as características dos participantes na análise ajustada, observou-se que o sexo feminino e os moradores da área de mineração apresentaram relação positiva com os sintomas de TEPT, depressivos, ansiosos, ideia de morte e pior qualidade de sono. Também se encontraram associação positiva entre a escolaridade de nível médio e os sintomas de TEPT e associação negativa entre aqueles com ≥60 anos e os sintomas de TEPT, depressivos e ansiosos. Conclusão: Altas prevalências foram encontradas para todos os sintomas psiquiátricos após a ruptura da barragem em Brumadinho. Sexo feminino, local de moradia na área de mineração, ≥60 anos e escolaridade foram associados aos sintomas psiquiátricos investigados.