COVID-19 and gender differences in mental health in low- and middle-income countries: Young working women are more vulnerable

The Role of Self-Compassion and Attributions in the Mental Health of Older Adolescents amid the COVID-19 Pandemic

This study aimed to examine the relationship among self-compassion, attributional styles, and mental health and their components in older adolescents in the context of the COVID-19 pandemic. The role of each component of self-compassion (self-kindness, common humanity, mindfulness, self-judgment, isolation, and over-identification) and attributions (globality, stability, self-worth, and negative consequences) in predicting mental health was also analyzed. There were 322 participants aged 18 to 22 that participated in an online survey. The participants filled out a form that consisted of sociodemographic questions, COVID-19-related questions, the Self-Compassion Scale, the Mental Health Continuum-short form-and the Cognitive Styles Questionnaire-very short form. The results indicated moderate levels of self-compassion, attributions, and mental health in participants. Furthermore, gender differences in self-compassion were confirmed, meaning that male participants had higher total levels of self-compassion, and certain differences were observed on attribution subscales, but not on well-being subscales. Self-compassion and mental health were found to be positively correlated with each other and negatively correlated with negative attributions. Of the four attributional components, stability and negative consequences were revealed to be significant negative predictors in the first step but lost their significance with the inclusion of self-compassion components in the second step of the analysis. Regarding the six components of self-compassion, self-kindness, recoded isolation, and common humanity were significant positive predictors in the second step of the analysis. COVID-19-related items did not show any significant intergroup differences. Our findings contribute to a better understanding of the relationship between positive mental health, self-compassion, and attributions in older adolescents so that they can be used as theoretical support for related interventions, especially during and after times of crisis, such as a pandemic.

COVID-19 survivors: the link between C-reactive protein and psychopathologies

Objective

To investigate several psychiatric implications in survivors of coronavirus disease 2019 (COVID-19), while also exploring its correlation with C-reactive protein (CRP), an important non-specific acute phase reactant in infection and in the presence of psychopathologies.

Methods

This study was conducted in February-June 2021 at Universitas Sumatera Utara Hospital and Haji General Hospital, Medan, Indonesia. In total, 182 patients with COVID-19 admitted for hospital treatment were screened for psychiatric symptoms. Sociodemographic and clinical data, including CRP level, were screened. Anxiety and depression scores were measured using the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory-II (BDI-II), respectively. The same screening was repeated 4 weeks after hospital discharge. Unpaired t-test was used to assess gender differences in clinical data and psychiatric symptoms, and Pearson's correlation test was used to investigate the link between CRP level and the symptoms of anxiety and depression.

Results

In terms of psychopathological symptoms, patient-reported rates of insomnia, anxiety and depression were 94%, 78% and 34%, respectively. Females had significantly higher baseline scores for both anxiety (mean ± standard deviation: 23.79 ± 5.44 vs 20.56 ± 4.90 in males) and depression (20.04 ± 5.29 vs 18.56 ± 3.90 in males) (P=0.000). Interestingly, 4 weeks after hospital discharge, female COVID-19 survivors still had higher anxiety scores than male COVID-19 survivors (8.02 ± 4.72 vs 5.20 ± 2.98, respectively) (P=0.0001). During the interview, patients reported that they were worried about experiencing COVID-19 symptoms again (89%), re-infection (56%), and not having proper first aid at home (64%). A higher CRP level was significantly correlated with higher anxiety and depression scores (baseline CRP-BAI: r=0.623; baseline CRP-BDI-II: r=0.680; follow-up CRP-BAI: r=0.632; follow-up CRP-BDI-II: r=0.621; P=0.001).

Conclusion

This study found that worse inflammation fostered worse psychiatric symptoms. Therefore, psychiatric liaison is important not only for patients with COVID-19 but also for COVID-19 survivors. Early assessment of COVID-19-related psychopathology is recommended so that treatment can be tailored as early as possible.

The Indirect Effect of Sleep on the Association Between Protracted Social Stressors and Psychological Distress Among Hong Kong Young People

PURPOSE

Hong Kong youth and young adults experienced unprecedented stress amid social unrest and the COVID-19 pandemic. Few studies have examined how these stressors were related to psychological distress among youth and young adults. This study assessed how psychological distress is associated with stress from social unrest, financial circumstances, and the COVID-19 pandemic, and whether poor sleep quality may explain these associations.

METHODS

Participants of a representative phone survey included 1,501 Hong Kong youth and young adults (Mage = 26.1 (4.0); 48.2% female). We examined the associations between psychological distress and three types of stress (social unrest, financial, and COVID-19 stress), and the indirect effect of poor sleep.

RESULTS

Eleven point nine percent, 4.1%, and 9.7% of respondents reported feeling very seriously distressed by social unrest, financial circumstances, and the COVID-19 pandemic, respectively. All three forms of stress were associated with poor sleep. The indirect effects of poor sleep on the association between all three forms of stress and psychological distress were identified. Moderated indirect effect analysis indicated that being female intensified the effect of COVID-19-related stress on psychological distress and that younger female youth and older male youth were more vulnerable to financial stress and social unrest stress (vs. older female youth and younger male youth).

DISCUSSION

Sleep may be one mechanism that accounts for the association between psychological distress and protracted stressors among Hong Kong youth and young adults. These results suggest the importance of prioritizing sleep improvement in mental health interventions during times of societal change.

Stress and coping strategies among higher secondary and undergraduate students during COVID-19 pandemic in Nepal

Coronavirus Disease (COVID-19) pandemic has profoundly affected lives around the globe and has caused a psychological impact among students by increasing stress and anxiety. This study evaluated the stress level, sources of stress of students of Nepal and their coping strategies during the pandemic. A cross-sectional web-based study was conducted during the complete lockdown in July 2020 among 615 college students. Stress owing to COVID-19 and the lockdown was assessed using the Perceived Stress Scale (PSS), and Brief Coping Orientation to Problems Experienced (Brief COPE) was used to evaluate coping strategies. To compare the stress level among participants chi-square test was used. The Student's t-test was used to compare Brief COPE scores among participants with different characteristics. The majority of study participants were female (53%). The mean PSS score was (±SD) of 20.2±5.5, with 77.2% experiencing moderate and 10.7% experiencing a high-stress level. Moderate to high levels of stress were more common among girls (92.6%) than boys (82.7%) (P = 0.001). However, there was a significant difference in perceived stress levels disaggregated by the students' age, fields and levels of study, living status (with or away from family), parent's occupation, and family income. The mean score for coping strategy was the highest for self-distraction (3.3±0.9), whereas it was the lowest for substance use (1.2±0.5). Students with a low level of stress had a higher preference for positive reframing and acceptance, whereas those with moderate to high levels of stress preferred venting. Overall, students experienced high stress during the lockdown imposed as part of governmental efforts to control COVID-19. Therefore, the findings of our study suggest stress management programs and life skills training. Also, further studies are necessary to conduct a longitudinal assessment to analyse the long-term impact of this situation on students' psychological states.

Mobilizing digital technology to implement a population-based psychological support response during the COVID-19 pandemic in Lima, Peru

BACKGROUND

The COVID-19 pandemic caused considerable burden on mental health worldwide. To address this emergency in Peru, Socios en Salud (SES) implemented an innovative digital system for the diagnosis and psychological therapy in vulnerable populations. We describe the development, implementation, and participant outcomes of this intervention.

METHODS

We conducted an intervention in a general population of Lima, Peru using a digital tool, ChatBot-Juntos, incorporating the abbreviated Self-Reporting Questionnaire (SRQ) to screen psychological distress. Participants positive for psychological distress received remote Psychological First Aid (PFA) and grief therapy if needed. Participants with a mental health condition or safety concern were referred to mental health services. SRQ scores were collected 3 months after PFA sessions. Differences between screening and follow-up scores were compared using Wilcoxon sign-rank test.

RESULTS

In total, 2027 people were screened; 1581 (77.9%) screened positive for psychological distress. Nine hundred ninety-seven (63%) people with psychological distress received PFA, and 320 (32.1%) of those were also referred for mental health care. At 3 months after follow-up, SRQ scores were collected for 579 (58%) participants. Significant reduction in SRQ scores was observed 3 months after PFA [median SRQ score changed from 9 to 5 (p < 0.001)], and after PFA plus referral to mental health services [median SRQ score changed from 11 to 6 (p < 0.001)].

CONCLUSION

Digital technology can be used to screen for psychological distress and deliver mental health support for populations affected by the COVID-19 pandemic. More research is needed to determine whether technology contributes to improved mental health outcomes.