Disrupted rhythms of life, work and entertainment and their associations with psychological impacts under the stress of the COVID-19 pandemic: A survey in 5854 Chinese people with different sociodemographic backgrounds

Aperiodic and periodic components of resting-state EEG in primary insomnia

BACKGROUND

Insomnia is one of the most prevalent health concerns within the general population, with a multitude of existing electroencephalographic (EEG) spectral studies supporting heightened levels of high-frequency EEG activity as an index of cortical arousal. Nevertheless, traditional spectral analysis has been limited by its inability to distinguish between aperiodic and periodic elements. In contrast, a novel method, Spectral Parameterization (SpecParam), can separate these components and reveal the neural mechanisms of cortical arousal.

METHODS

The aperiodic and periodic activities of 42 insomnia disorder (ID) patients and 45 age- and sex-matched healthy controls (HC) were evaluated during eyes-closed resting state. The associations between behavioral scales and aperiodic/periodic parameters were further examined to elucidate the underlying psychophysiological significance.

RESULTS

We found that the aperiodic exponent was diminished in the ID group compared to the HC group. Additionally, the ID group exhibited an elevated central frequency and a more constrained bandwidth for periodic activity within the alpha band. Within-group correlation analyses revealed that a reduced exponent was associated with worse sleep quality and more frequent failures in inhibitory control within the ID group.

CONCLUSIONS

A smaller exponent within the ID group may reflect impaired inhibitory neuronal activity, potentially leading to cortical hyperarousal. The association of a smaller exponent with deteriorated sleep quality and impaired inhibitory control supports this hypothesis. Furthermore, the increased center frequency of the alpha band across extensive brain regions, along with a narrower alpha bandwidth in the left frontal and right parieto-occipital regions, may represent abnormal manifestations associated with excessive arousal. In summary, these results support the role of aperiodic activity as an index of impaired excitation/inhibition balance in neural activity within in ID group.

The relationship between anxiety symptoms and disturbances in biological rhythms in patients with depression

BACKGROUND

Biological rhythms denote the cyclical patterns of life activities anchored to a 24-hour cycle. Research shows that depression exhibits disturbances in biological rhythms. Yet, the relationship between these biological rhythms and concomitant anxiety symptoms is insufficiently investigated in structured clinical assessments.

METHODS

This multicenter study, carried out in four Chinese hospitals, comprehensively examined the relationship between anxiety and disruptions in biological rhythms among patients with depression. The study encompassed 218 patients diagnosed with depression and 205 matched healthy controls. The Chinese version of the Biological Rhythms Interview of Assessment in Neuropsychiatry was utilized to evaluate the participants' biological rhythms, focusing on four dimensions: sleep, activity, social, and diet.

RESULTS

In patients with depression, there is a significant positive correlation between the severity of anxiety symptoms and the disturbances in biological rhythms. The severity of anxiety and depression, along with the quality of life, are independently associated with disruptions in biological rhythms. The mediation model reveals that anxiety symptoms mediate the relationship between depressive symptoms and biological rhythms.

CONCLUSION

This research highlights the role of anxiety within the spectrum of depressive disorders and the associated disturbances in biological rhythms. Our findings shed light on potential pathways towards more targeted preventive strategies and therapeutic interventions for individuals battling depression and anxiety.

Association between patterns of biological rhythm and self-harm: evidence from the baoxing youth mental health (BYMH) cohort

BACKGROUND

Self-harm, a severe mental health concern among children and adolescents, has varying global prevalence rates. Previous studies have suggested potential associations between specific behavioral aspects of biological rhythm and self-harm risk in these populations.

OBJECTIVE

Our study aimed to elucidate the relationship between biological rhythm patterns and the propensity of self-harm among Chinese children and adolescents using the Baoxing Youth Mental Health (BYMH) cohort.

METHODS

We included 1883 Chinese children and adolescents from the BYMH cohort. The self-report questions used to assess biological rhythm and self-harm. We applied Principal Component Analysis (PCA) to distinguish patterns of biological rhythms. Logistic regression models were conducted to estimate the associations between biological rhythm, as well as biological rhythm patterns and risk of self-harm.

RESULTS

Of the participants, 35.0% reported experiencing lifetime self-harm. PCA revealed six significantly predominant biological rhythm patterns. Elevated risks of self-harm were linked with unhealthy eating practices, daytime tiredness, and unhealthy bedtime snacking. Conversely, patterns emphasizing physical exercise, family meals for breakfast, and nutritious diet exhibited decreased self-harm propensities. These trends persisted across varied self-harm attributes, including type, recency, and frequency of self-harm.

CONCLUSIONS

This study underscores the critical impact of biological rhythms on self-harm risks among Chinese youth. Targeted lifestyle interventions, focusing on improved sleep and dietary habits, could serve as potent preventive measures. Our findings lay the groundwork for future longitudinal studies to further probe these associations, fostering the creation of tailored interventions to curb self-harm and enhance mental well-being in younger populations.

Perceived occupational stress and associated factors among primary school teachers in the second wave of COVID-19 in Ethiopia: a multicenter cross-sectional survey

Background

Occupational stress (OS) is a psychological state that results from people's perceptions of an imbalance between job demands and their abilities to cope with those demands. The COVID-19 pandemic has disrupted the teaching and learning process and compounded the stress level among teachers due to fear of transmission of the virus and school closures or the difficulty with adherence to the COVOD-19 prevention protocol. This survey study therefore aimed to investigate the prevalence of occupational stress and its associated factors among primary school teachers during the second wave of COVID-19 in western Ethiopia.

Method

An institution-based cross-sectional survey was employed from April to May 2021. The survey was conducted in Gimbi town among all 672 primary school teachers in western Ethiopia. The standardized Teacher Occupational Stress Scale was used to measure occupational stress in the past 4 months. The data were collected through a self-administered questionnaire. The collected data were entered into EpiData version 4.6 and analyzed using Stata version 14 software. A multivariable logistic regression analysis was conducted to identify factors associated with occupational stress. The statistical significance was considered at a value of p of < 0.05 and a 95% confidence interval (CI) with an adjusted odds ratio (AOR) to evaluate the strength of associations.

Results

The response rate was 96.8% (N = 651). The majority, 389 (59.8%) of the study participants were males. The mean (±SD) age was 35.8 (±9.3) years. The prevalence of occupational stress in the second wave of COVID-19 in the past 4 months was 50.1% (n = 326) [95% CI (46.1, 53.9)]. Job dissatisfaction [AOR: 2.06, 95% CI (1.43-2.97)] and high-risk perception of COVID-19 infection [AOR: 2.20; 95% CI (1.46-3.31)] were significantly associated with occupational stress.

Conclusion

This survey disclosed a high prevalence of occupational stress among primary school teachers during the second wave of COVID-19. Job dissatisfaction and a high-risk perception of COVID-19 infection were significant predictors of the occurrence of occupational stress in school teachers. Enhancing stress management skills and focusing on primary prevention of identified risk factors were advised to curtail the condition.

Facing arrhythmia. Reconstructing time in the pandemic by the metropolitan creative classes in Poland

This paper shows how the metropolitan creative classes in Poland reacted to the changes in the organization of everyday life caused by the COVID-19 pandemic, especially its temporality and rhythmicity. The pandemic and lockdowns reorganized previous ways of experiencing and managing time. Based on our empirical research and research by other scholars, we have identified some of the most common disruptions of pandemic temporality. However, a vital element of the article is to specify how the social category we studied dealt with these disruptions. In doing so, we show that the response to the breakdown of the previous order of everyday life was to restore a sense of stability actively. We were also interested in the possible, also negative consequences of the findings for the social category under study. The empirical basis for the article are in-depth interviews conducted during the fourth phase of the ongoing research project [title anonymized], which began during the first weeks of the lockdown in Poland.

Sleep quality, social rhythms, and depression among people living with HIV: a path analysis based on social zeitgeber theory

Background

People living with HIV frequently report sleep disturbances. The social zeitgeber theory, which proposes that stressful life events can interfere with sleep and even depression by destabilizing daily routines, provides new insights into identifying predictors of sleep disturbances and improving sleep in people living with HIV.

Objective

To explain the pathways affecting sleep quality in people living with HIV based on social zeitgeber theory.

Methods

A cross-sectional study was conducted to assess sleep quality, social rhythms, depression, social support, and coping styles from December 2020 to February 2021. The hypothetical model was tested and respecified by performing path analysis and a bias-corrected bootstrapping method using IBM AMOS 24 software. The report of this study followed the STROBE checklist.

Results

A total of 737 people living with HIV participated in the study. The final model presented a good fit (goodness of fit = 0.999, adjusted goodness of fit index = 0.984, normed fit index = 0.996, comparative fit index = 0.998, Tucker-Lewis index = 0.988, root mean square error of approximation = 0.030, chi-squared/degree of freedom = 1.646), explaining 32.3% of the variance in sleep quality among people living with HIV. Lower social rhythm stability was directly associated with poorer sleep quality, and depression mediated the relationship between social rhythms and sleep quality. Social support and coping styles affected sleep quality through social rhythms and depression.

Limitation

The cross-sectional study design precludes making assumptions about causality among factors.

Conclusion

This study validates and extends the applicability of the social zeitgeber theory in the HIV context. Social rhythms have direct and indirect effects on sleep. Social rhythms, sleep, and depression is not simply linked in a cascading sequence but is theoretically linked in a complex way. More studies are needed to explore the predictors of social rhythms, and interventions for stabilizing social rhythms have the potential to alleviate sleep disturbances and depression in people living with HIV.

Effectiveness of mind-body exercise via Baduanjin on physical and psychological outcomes in patients with pulmonary ground-glass nodules: A non-randomized controlled pilot study

BACKGROUND

With the increasing incidence and mortality of lung cancer, ground-glass nodules (GGNs) have become an ongoing public health concern. In clinical practice, the physical and psychological distress of GGN patients is easy to overlook during the follow-up after diagnosis. Such patients typically have limited medical options and few of these options involve mind-body exercises.

OBJECTIVE

The purpose of this pilot study was to explore the effectiveness of the mind-body exercise Baduanjin on physical and psychological outcomes among GGN patients.

DESIGN

We conducted a prospective, non-randomized, controlled, assessor-blinded trial (ClinicalTrials.gov: NCT03420885).

SETTING

This trial was conducted at three medical sites, both located in Shanghai, China, between April 2017 and January 2020.

PARTICIPANTS

Patients with GGN.

INTERVENTION

Sixty GGN participants were divided into a health education control group only receiving health education (n = 30) and a Baduanjin intervention group receiving health education plus a Baduanjin training program (n = 30). Both groups were treated for 16 weeks.

OUTCOME MEASUREMENTS

Outcomes were assessed at baseline and week 16. The primary outcomes included pulmonary function (FVC, FVC%, FEV₁, FEV₁/FVC, PEF) and psychological condition (SAS score, SDS score). The secondary outcome was quality of life (SF-36).

RESULTS

Compared with the health education control group, the Baduanjin intervention group had significant improvements in pulmonary function (FVC, FVC%, FEV₁), psychological outcomes (SAS score, SDS score), and quality of life (SF-36). The significant differences in pre-intervention and post-intervention between groups were as follows: FVC (MD = 0.21, 95%CI: 0.10 to 0.33, P = 0), FVC% (MD = 6.90, 95%CI: 3.10 to 10.70, P = 0.001), FEV₁ (MD = 0.18, 95%CI: 0.07 to 0.29, P = 0.001); SAS score (MD = -4.90, 95%CI: -8.28 to -1.52, P = 0.005), SDS score (MD = -5.83, 95%CI: -9.46 to -2.21, P = 0.002); physical component summary (PCS) of SF-36 (MD = 5.03, 95%CI: 2.54 to 7.51, P = 0), mental component summary (MCS) of SF-36 (MD = 5.78, 95%CI: 2.64 to 8.92, P = 0.001). Linear regression analysis was performed to study the influence of confounder variables on the improvements of primary outcomes, and no significant change was found. Moreover, Pearson correlation coefficient analysis demonstrated that ameliorations in lung function (FVC, FVC%, FEV₁, FEV₁/FVC, and PEF) were significantly associated with a decrease in anxious symptoms and depressive symptoms.

CONCLUSION

GGN patients in the Baduanjin intervention group showed greater benefits in pulmonary function and psychological outcomes than those in the health education control group, and the effectiveness was stable. The findings support Baduanjin as an effective, safe, enjoyable, and promising complementary intervention for management of GGN in patients with physical and psychological distress.

A propensity score matching study: The prevalence of mental health problems among pregnant women at first antenatal care increased in Chongqing during the first wave of the COVID-19 pandemic

Background

The 2019 coronavirus disease (COVID-19) pandemic increased the risks of mental health challenges, especially anxiety and depression. However, the impact of COVID-19 on mental health during pregnancy has not been fully established. Therefore, we investigated the impact of the COVID-19 pandemic on maternal mental health.

Methods

Two cohorts of pregnant women at their first antenatal care in the First Affiliated Hospital of Chongqing Medical University were enrolled in this study. One cohort was enrolled before the COVID-19 outbreak, from 1 June to 31 December 2019 (n = 5,728, pre-COVID-19 group), while the other was enrolled during the COVID-19 pandemic, from 24 January to 23 March 2020 (n = 739, COVID-19 pandemic group). Symptoms of depression, anxiety, and somatization disorders were assessed by the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-15 (PHQ-15), with a cutoff point of 10 for moderate-to-severe depression, anxiety, and somatoform symptoms. The propensity score matching method (1:1) was used to balance differences in demographic characteristics between groups. A chi-square analysis was performed to compare differences in demographic characteristics between the groups.

Results

Prevalence of moderate-to-severe depression, anxiety, and somatoform symptoms among pregnant women at their first antenatal care visit during the COVID-19 pandemic (9.5, 2.2, and 20.8%, respectively) was significantly lower than those before the pandemic (16.3, 4.4, and 25.7%, respectively) (p < 0.05). Compared with the same period before the pandemic, during the pandemic, the number of women newly registered for antenatal care decreased by nearly 50%. There were significant differences in the distributions of demographic characteristics between the groups (p < 0.05). After matching the demographic characteristics, differences in the prevalence of maternal mental health disorders between the groups reversed dramatically. Prevalence of moderate-to-severe depression, anxiety, and somatoform symptoms during the COVID-19 pandemic in this population (2.3, 9.6, and 20.8%, respectively) was significantly higher than those before the pandemic (0.3, 3.9, and 10%, respectively) (p < 0.05).

Conclusion

The COVID-19 pandemic increased mental health risks among pregnant women. As a large proportion of pregnant women with mental health challenges delay their prenatal care or change healthcare facilities after the outbreak of public health emergencies, there is a need to establish a balanced healthcare system in medical institutions at all levels.

Social Rhythm Disruption is Associated with Greater Depressive Symptoms in People with Mood Disorders: Findings from a Multinational Online Survey During COVID-19

OBJECTIVES

Societal restrictions imposed to prevent transmission of COVID-19 may challenge circadian-driven lifestyle behaviours, particularly amongst those vulnerable to mood disorders. The overarching aim of the present study was to investigate the hypothesis that, in the routine-disrupted environment of the COVID-19, amongst a sample of people living with mood disorders, greater social rhythm disruption would be associated with more severe mood symptoms.

METHODS

We conducted a two-wave, multinational survey of 997 participants (MAge=39.75±13.39,Female=81.6%) who self-reported a mood disorder diagnosis (i.e., major depressive disorder or bipolar disorder). Respondents completed questionnaires assessing demographics, social rhythmicity (The Brief Social Rhythm Scale), depression symptoms (Patient Health Questionnaire-9), sleep quality and diurnal preference (The Sleep, Circadian Rhythms and Mood questionnaire) and stressful life events during the COVID-19 pandemic (The Social Readjustment Rating Scale).

RESULTS

The majority of participants indicated COVID-19-related social disruption had affected the regularity of their daily routines to at least some extent (n = 788, 79.1%). As hypothesised, lower social rhythmicity was associated with greater depressive symptoms when tested cross-sectionally (standardised β = -.25, t = -7.94, P = 0.000) and when tested using a 2-level hierarchical linear model across two time points (b = -0.14, t = -3.46, df = 264, P ≤ 0.001).

CONCLUSIONS

These results are consistent with the social zeitgeber hypothesis proposing that mood disorders are sensitive to life events that disrupt social rhythms.

Modelling the COVID-19 Pandemic Effects on Employees' Health and Performance: A PLS-SEM Mediation Approach

The COVID-19 pandemic has resulted in the imposition of certain changes in the management of organizations and in the behavior and actions of employees. The purpose of this paper is to investigate the impact of COVID-19 pandemic effects on employees' health and mental well-being, as well as on their working performance. Moreover, the paper aims to highlight whether health- and work-related stress factors mediate the above relations. For the purpose of data collection, a structured questionnaire was used. The first results of the study showed that the pandemic effects felt by employees did not directly affect their mental and physical well-being. On the other hand, the COVID-19 pandemic effects felt by employees affected their general work performance. The findings of the study may provide a useful perspective for organizations and their employees in order to adopt the most effective measures to minimize the effects generated by the pandemic.

Does having various types of fear related to the COVID-19 disrupt the daily life of individuals?

OBJECTIVES

Unexpected changes in daily routines caused by the coronavirus disease 2019 (COVID-19) pandemic may affect psychological health. This study investigated the association between various types of COVID-19-related fear and the subjective level of disturbance in daily activities experienced by individuals.

METHODS

This cross-sectional study used the Korea Community Health Survey conducted from August through November 2020. COVID-19-related fear included fear of infection, death, public criticism, family members getting infected, and economic loss. The subjective level of disruption in daily activities was measured using a 0-100 numeric rating scale developed by the Korea Disease Control and Prevention Agency. Multivariable linear regression was used to analyze the associations between the independent and dependent variables. A subgroup analysis was performed based on income level.

RESULTS

Participants who reported fear of infection (β=-3.37, p<0.001), death (β=-0.33, p=0.030), public criticism (β=-1.63, p<0.001), a family member getting infected (β=-1.03, p<0.001), and economic loss (β=-3.52, p<0.001) experienced more disturbances in daily activities. The magnitude of this association was most significant in the lowest-income group.

CONCLUSIONS

Individuals reporting COVID-19-related fear experienced higher levels of subjective disruption in daily activities.

Risk and resilience of vulnerable families in Hong Kong under the impact of COVID-19: an ecological resilience perspective

PURPOSE

Hong Kong has experienced four waves of COVID-19 since the first case was confirmed in January 2020. Several studies have highlighted the psychological impacts of the outbreak in Hong Kong but have largely ignored the protective factors that contribute to resilience among vulnerable families. This study adopted an ecological resilience framework to explore the impact of this epidemic on members of families with youth with a delinquent tendency/mental health concerns and the ecological protective factors for these vulnerable families.

METHODS

Random sampling based on a sampling frame provided by one of the largest local social service organizations in Hong Kong led to the recruitment of 407 respondents who were interviewed using a battery of standardized questionnaires.

RESULTS

The results showed that 30.6% and 11.5% of respondents reported a moderate and a severe level of psychological distress, respectively, almost double the percentages reported in a previous study conducted in Hong Kong before the COVID-19 outbreak. Around 36.6% of respondents indicated they had encountered financial problems and almost 40% indicated aggravated financial circumstances since the outbreak. Hierarchical regression analysis revealed that financial stress was the strongest predictor of psychological distress. Structural equation modeling indicated that family support, indoor leisure activities and community resources significantly mediated the negative influence of COVID-19-related stressors on psychological distress of family members.

CONCLUSION

Family leisure activities, family support, community spirit and mutual help within the context of social-distancing restrictions may need to be promoted to benefit vulnerable families in Hong Kong under the COVID-19 epidemic.

Relationship between menopausal symptoms and perceived stress during the COVID-19 pandemic

This study aimed to examine the relationship between menopausal symptoms and perceived stress in middle-aged women during the COVID-19 pandemic. In this cross-sectional study, data were collected online from 239 middle-aged women using the Personal Information Form, Menopause Rating Scale (MRS) and Perceived Stress Scale-14 (PSS-14). A positive correlation was found between the total MRS score and the total PSS-14 score. The COVID-19 pandemic usually restrict access to healthcare visit. The COVID-19 pandemic has created an urgent need to implement specific menopausal programs to promote the psychological health of middle-aged women and reduce stress during this or similar crises.

Association of Chronic Low Back Pain With Personal Space Regulation

Background: While most previous studies regarding patients with chronic low back pain (CLBP) mainly focused on pain, disability, psychological damage, and intervention measures, the effect of CLBP on personal space remains unclear. The study aimed to assess the personal space of patients with CLBP and healthy controls, explored the differences between the two groups, and examined whether pain, dysfunction, anxiety, and depression affected the personal space regulation. Methods: The cross-sectional study recruited 24 patients with CLBP and 24 healthy controls at Shanghai Shangti Orthopedic Hospital and Shanghai University of Sport, Shanghai, China, from December 2018 to January 2019. A stop-distance paradigm was applied to measure the comfortable and uncomfortable distance under four conditions. A self-rating anxiety scale (SAS) and a self-rating depression scale (SDS) were used to examine the anxiety and depression levels of all participants. The pain intensity and dysfunction in the CLBP group were evaluated by the numeric rating scale and Roland-Morris questionnaire (RMDQ), respectively. Results: When approaching another individual or when being approached, the interpersonal distance under all the conditions in the CLBP group significantly differed from that in the healthy control group with larger space distances (p < 0.01). Gender had a significant main effect on the regulation of personal space in patients with CLBP (p < 0.05). The average pain intensity, scores on RMDQ, SAS, and SDS had a significant positive correlation with the interpersonal distance under the Same or Opposite Gender condition (p < 0.05). Conclusion: People with CLBP show an atypical personal space behavior and indeed have a greater interpersonal distance to strangers. The higher the pain intensity, dysfunction, anxiety, and depression, the greater the interpersonal distance in patients with CLBP. In the future, the effect and underlying neural mechanisms of pain and negative emotions on social withdrawal in patients should be examined.