The Psychological Impact of COVID-19 on Chinese Individuals

Covid-19 psychological pressures, depression and FOMO: the mediating role of online social support and emotional regulation

BACKGROUND

The spread of the coronavirus has led to significant anxiety among university students, resulting in various mental health problems that could potentially impact their academic performance.

METHOD

To examine the mediating role of emotional regulation and online social support in the relationships between COVID-19 psychological pressures, depression, and the fear of missing out (FoMO) among young adult university students, a cross-sectional research design was employed using an online survey. The sample consisted of 521 full-time university students from China, currently enrolled in undergraduate and postgraduate programs.

RESULTS

Findings revealed that more than half (55.09%, n=287) of the university students experienced COVID-19 psychological pressures. These pressures directly contributed to increased levels of depression (β = 0.339, p < .001) and fear of missing out (β = 0.236, p < .001). Moreover, online social support and emotional regulation exhibited partial mediating effects on the association between COVID-19 psychological pressures, depression, and the fear of missing out. The results indicated that COVID-19 psychological pressures were linked to higher levels of depressive symptoms and a greater fear of missing out among university students.

CONCLUSIONS

However, the provision of timely and adequate online social support, as well as the implementation of emotional regulation strategies, mitigated the negative effects of the pandemic on students' social and emotional well-being. Consequently, this led to reduced levels of depression and fear of missing out.

Healthcare providers as patients: COVID-19 experience

There is compelling evidence for the psychological effects of the COVID-19 pandemic and earlier epidemics. However, fewer studies have examined the subjective meaning experience of healthcare providers who have survived COVID-19 as patients. This qualitative study aimed to understand further and describe the life experiences of healthcare providers who have survived COVID-19 as patients in Saudi Arabia. Data was collected using unstructured in-depth individual interviews among n = 10 healthcare providers from public hospitals in Saudi Arabia. Data were analyzed based on a phenomenological approach, which resulted in five themes: (i) physical and psychological signs and symptoms; (ii) self-healing, hiding pain, and family; (iii) fear of complications; (iv) disease stigma & long-term psychological outcomes; (v) emotional support, mental well-being & resignation. The overall synthesis showed that healthcare providers, as patients, experience the same difficulties and stressors as the general public. In some cases, these factors are even worse, as family members, colleagues, and employers develop a new type of stigma. Given the impact of social media and the flow of information of any type, more research is needed to examine the sources used to obtain information by the general public, whether these sources are reliable, and how the public can be taught to use only scientific data and not social data. Understanding the experience of healthcare providers as patients during the pandemic has allowed to look at the feelings and needs of people during illness from a new perspective. As expressed by participants, being a healthcare provider does not reduce the fear of the disease and does not mitigate its consequences in the form of stigmatization and isolation.

An exploration of happiness, anxiety symptoms, and depressive symptoms among older adults during the coronavirus pandemic

The COVID-19 pandemic has affected millions of people worldwide. Because of the challenges associated with the pandemic, universal levels of happiness have likely depleted. We know little about how those with prior existing mental health concerns have responded to the pandemic. Using cross-sectional (study 1; N = 1,366) and longitudinal (study 2; N = 262) data, we utilized a stress and resilience perspective to explore mental health symptoms and happiness among older adults before and after the declaration of the pandemic. Results for both studies indicated higher levels of depression and anxiety symptoms predicted lower levels of happiness; however, for those who indicated higher levels of mental health symptoms, post-pandemic declaration happiness levels were higher than pre-pandemic happiness levels. Findings suggest that resilience may be learned throughout a lifetime, and that experiences from prior stressors may show benefits in responding to future ones, even among vulnerable populations.

Factors Affecting Stress and Mental Health During the COVID-19 Pandemic

OBJECTIVE

This study examined the factors influencing the mental health and stress of individuals during the coronavirus disease-2019 (COVID-19) pandemic.

METHODS

A total of 600 participants were enrolled in this anonymous questionnaire survey that included questions on their demographic profiles and experiences related to the COVID-19 pandemic. The COVID-19 Stress Scale for Korean People (CSSK), Warwick- Edinburgh Mental Wellbeing Scale, Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, Insomnia Severity Index, and Multidimensional Scale of Perceived Social Support were used. Data were analyzed using multiple regression to identify the factors affecting the total CSSK scores and the scores of each of the three CSSK subscales.

RESULTS

Multiple regression analyses revealed that the severity of insomnia, sex, degree of income decline, occupation, religion, education level, marital status, residential status, level of social support, and degree of depression and anxiety had significant relationships with COVID-19-related stress.

CONCLUSION

We identified factors affecting stress and mental health in the general population during the COVID-19 pandemic. Our findings may be helpful in providing an individualized approach to managing the mental health of the public. We expect that the results of this study will be used to screen high-risk individuals vulnerable to stress and to establish policies related to the public health crisis.

Time-Series Trends of Depressive Levels of Korean Adults During the 2020 COVID-19 Pandemic in South Korea

OBJECTIVE

This study aimed to observe the changes in people's depressive levels over 9 months since the coronavirus disease of 2019 (COVID-19) outbreak as well as to identify the predictors of people's depressive levels including COVID-19 infection fear in the context of South Korea in 2020.

METHODS

For these purposes, four cross-sectional surveys were periodically implemented from March to December 2020. We randomly recruited 6,142 Korean adults (aged 19 to 70) by using a quota survey. Along with descriptive analysis, which included a one-way analysis of variance and correlations, multiple regression models were built to identify the predictors of people's depressive levels during the pandemic.

RESULTS

Overall, people's depressive levels and fear of COVID-19 infection gradually increased since the COVID-19 outbreak. In addition to demographic variables (i.e., being a female, young age, unemployed, and living alone) and the duration of the pandemic, people's COVID-19 infection fear was associated with their depressive levels.

CONCLUSION

To ameliorate these rising mental health issues, access to mental health services should be secured and expanded, particularly for individuals who present greater vulnerabilities due to socioeconomic characteristics that may affect their mental health.

Revealing the spatiotemporal characteristics of the general public's panic levels during the pandemic crisis in China

The existing crisis management research mostly reveals the patterns of the public's panic levels from the perspectives of public management, sociology, and psychology, only a few studies have revealed the spatiotemporal characteristics. Therefore, this study investigates the spatial distribution and temporal patterns and influencing factors on the general public's panic levels using the Baidu Index data from a geographic perspective. The results show that: (1) The public's panic levels were significantly correlated with the spatial distance between the epicenter and the region of investigation, and with the number of confirmed cases in different regions when the pandemic began to spread. (2) Based on the spatial distance between the epicenter and the region, the public's panic levels in different regions could be divided into three segments: core segment (0-500 km), buffer segment (500-1300 km), and peripheral segment (>1300 km). The panic levels of different people in the three segments were consistent with the Psychological Typhoon Eye Effect and the Ripple Effect can be detected in the buffer segment. (3) The public's panic levels were strongly correlated with whether the spread of the infectious disease crisis occurred and how long it lasted. It is suggested that crisis information management in the future needs to pay more attention to the spatial division of control measures. The type of crisis information released to the general public should depend on the spatial relationship associated with the place where the crisis breaks out.

The effect of perceived organizational support on the prohibitive voice behavior of knowledgeable talents during the COVID-19 pandemic: Exploring moderating role of the digitalization level

This study focuses on the effect of perceived organizational support on the prohibitive voice of knowledgeable talents and on the factors influencing that voice during the COVID-19 pandemic in China. Grounding our research in social exchange theory and the Chinese sociocultural background, we collected data from 714 questionnaires from universities in Zhejiang Province and analysize by linear regression and found, first, that perceived organizational support significantly increased the prohibitive voice of knowledgeable talents and, second, that in the relationship between perceived organizational support and the prohibitive voice of those talents, the level of digitalization level of an organization has a positive the effect of perceived organizational support on prohibitive voice behavior. This study enriches the theory of voice behavior, helps universities understand the behavioral patterns of knowledgeable talents and guides the cultivation of an atmosphere with prohibitive voice behavior.

Musculoskeletal Components of Post-Acute Sequelae of SARS-CoV-2 Infections

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Musculoskeletal (MSK) sequelae of severe acute respiratory syndrome coronavirus 2 infections seem to be common.

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Mechanisms of such effects are becoming clear.

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There is a complex interplay of biopsychosocial effects associated with MSK symptoms after acute coronavirus disease 2019.

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Additional research should focus on completely describing the breadth of these MSK sequelae and related psychosocial symptoms.

Psychosis during the COVID-19 pandemic: A systematic review of case reports and case series

BACKGROUND

Preliminary data suggest that patients with COVID-19 may experience psychiatric symptoms, including psychosis. We systematically reviewed the literature to evaluate the concurrence of new-onset psychosis or exacerbation of clinically stable psychosis through case reports and case series.

METHODS

Six databases were searched, followed by an electronic and manual search of the relevant articles. Studies were identified using predetermined eligibility criteria. We evaluated the demographic characteristics, clinical history, course of illness, management, and prognosis of the patients in these studies.

RESULTS

Case reports and case series, altogether consisting of 57 unique cases were included. The mean patient age for onset of psychotic symptoms was 43.4 years for men and 40.3 years for women. About 69% of patients had no prior history of psychiatric disorders. Most patients had mild COVID-19-related symptoms, with only 15 (26.3%) presenting with moderate to severe COVID-19-related disease and complications. The most commonly reported psychotic symptoms were delusions and hallucinations. Patients with psychotic symptoms were treated with antipsychotics, benzodiazepines, valproic acid, and electroconvulsive treatment. In 36 cases, psychotic symptoms resolved completely or improved significantly. Ten cases had partial improvement with residual psychotic symptoms, and one patient died due to cardiac arrest.

CONCLUSION

Most patients responded to a low-to-moderate dose of antipsychotics with a quick recovery. However, the residual psychiatric symptoms highlight the need for careful monitoring and longer follow-up. Clinicians should be mindful of the occurrence of psychosis due to COVID-19 infection in a subset of COVID-19 patients that can be misdiagnosed as a psychotic disorder alone.

THE RELATIONS BETWEEN FEAR OF COVID-19, ANXIETY OF DEATH, AND MEANING OF LIFE AMONG NURSING STUDENTS

Abstract Aim of the study was to determine the effects of socio-demographic factors on fear of COVID-19, death anxiety, and meaning of life among nursing students, and to explain the relations between fear of COVID-19, death anxiety, and meaning of life. The study was conducted with 262 students on 7-27 October 2020 in a descriptive-correlational and cross-sectional design. According to the correlation analysis, a moderate and positive relationship was detected between Fear of COVID-19 Scale (CFS) and Turkish Death Anxiety Scale (TDAS) total score and subscale scores. The mean age of the students who participated in the study was found to be 20.63±2.31, 64.1% were female. It was found that 29% of the students had sleep problems in this period, and 7.6% were diagnosed with COVID-19, and 85.9% of themhad their close friends and relatives diagnosed with COVID-19. The majority of the students (n=16) who were diagnosed with COVID-19 passed this process under quarantine at home without treatment, 59.2% of them stated that someone in their close circle had a positive COVID-19 test, and 31.7% lost a relative due to COVID-19. The model that was created in the multiple linear regression analysis which was made to determine the effects of TDAS and Meaning of Life Questionnaire (MLQ) on CFS was found to be statistically significant (F:54.91, p

COVID-19 effects on women's home and work life, family violence and mental health from the Women's Health Expert Panel of the American Academy of Nursing

BACKGROUND

The COVID-19 pandemic exaggerated women's roles in families as primary caretakers and overseers of family health. This is compounded by possible loss of work and resultant loss of health insurance.

PURPOSE

We examine how pandemic-related factors have altered women's roles and created stressors challenging stress adaptation and typical coping strategies, including how registered nurses have faced unique challenges.

FAMILY VIOLENCE AND PANDEMIC-RELATED MENTAL HEALTH CHALLENGES

Enforced stay-athome orders exaggerated by work-from-home has amplified family violence worldwide. Besides COVID-19 protective measures increasing greater contact with abusers, they limited women's access to help or support. Pandemic-related issues increased anxiety, anger, stress, agitation and withdrawal for women, children, and registered nurses.

DISCUSSION

More evidence about pandemic-related impacts on women's home and work lives, especially the scope of stressors and emotional/mental health manifestations is urgently needed. Policies to support interventions to improve mental health resilience are paramount.

Trait Empathy Modulates Patterns of Personal and Social Emotions During the COVID-19 Pandemic

The COVID-19 pandemic has caused profound consequences on people's personal and social feelings worldwide. However, little is known about whether individual differences in empathy, a prosocial trait, may affect the emotional feelings under such threat. To address this, we measured 345 Chinese participants' personal emotions (e.g., active, nervous), social emotions (i.e., fearful and empathetic feelings about various social groups), and their empathy traits during the COVID-19 pandemic. Using the representational similarity analysis (RSA), we calculated the pattern similarity of personal emotions and found the similarity between the positive and negative emotions was less in the high vs. low empathy groups. In addition, people with high (vs. low) empathy traits were more likely to have fearful and sympathetic feelings about the disease-related people (i.e., depression patients, suspected COVID-19 patients, COVID-19 patients, flu patients, SARS patients, AIDS patients, schizophrenic patients) and showed more pattern dissimilarity in the two social feelings toward the disease-related people. These findings suggest a prominent role of trait empathy in modulating emotions across different domains, strengthening the polarization of personal emotions as well as enlarging social feelings toward a set of stigmatized groups when facing a pandemic threat.

Adjustment Processes After the First Wave of the COVID-19 Pandemic: A Grounded Theory Study Based on Clinical Psychologists' Experience

Background

Anxiety, depression, and post-traumatic stress have been reported among the general population during the first wave of the COVID-19 pandemic. However, the adjustment after the emergency phase remains under-investigated. This study aims to understand the adjustment processes of the population after the emergency phase of the pandemic.

Methods

We conducted a grounded theory based on the experience of 24 clinical psychologists who provided extensive support to the population during the pandemic in different Italian regions. Three online focus groups were conducted. The transcripts of the focus groups were analyzed through a process of open, axial, and selective coding. Data collection terminated once thematic saturation was reached.

Results

Repositioning emerged as the evolutionary task people were confronted with in the face of a New Reality. Repositioning meant dealing with and integrating unpleasant Emotional Experiences deriving from the lockdown and reopening (i.e., unsafety, emotional exhaustion, loneliness, uncertainty, loss, and disconnection) through different Coping Strategies. Repositioning was facilitated or hindered by contextual and individual Intervening Conditions and led to two Adjustment Outcomes: growth or block.

Conclusion

Results suggest that repositioning was the core task people had to face after the emergency phase of COVID-19. Proactive psychological interventions may support the population in repositioning in order to prevent maladjustment and encourage post-traumatic growth.

Depression before and during-COVID-19 by Gender in the Korean Population

This study explored the association between Coronavirus disease (COVID-19) and depression by comparing Patient Health Questionnaire-9 (PHQ-9) results pre-pandemic (2019) and after the start of the pandemic (2020). Data of 444,051 participants (200,206 male (45.1%); 243,845 female (54.9%)) were obtained from the Korean Community Health Survey conducted from 2019 to 2020. The independent variable of interest in this study was the year, divided into binary categories, 2019 and 2020. The dependent variable was depression, measured by the PHQ-9 scale. This dependent variable was also binary, dividing those who are considered depressed or not by a cut-off score of 10. A logistic regression model was employed to examine the association. Our results reveal that compared to participants in 2019, patients from the study sample of 2020 were marginally more likely to be depressed, especially female patients (male OR: 1.092, 95% CI [0.998 to 1.195], female OR: 1.066, 95% CI [1.002 to 1.134]). Moreover, using the participants from the year 2019 as a reference group, those who appeared anxious in response to the COVID-19-related questions in the survey showed more tendency to have a PHQ-9 score of 10 or more. Compared to participants from the 2019 group, those from 2020 more likely to be depressed were those with no-one to contact in case of emergency due to COVID-19 (male OR: 1.45, 95% CI [1.26 to 1.66], female OR: 1.46, 95% CI [1.33 to 1.60]), and individuals with concerns regarding economic loss (male OR: 1.18, 95% CI [1.07 to 1.30], female OR: 1.11, 95% CI [1.04 to 1.18]) and infection of a vulnerable family member at home due to COVID-19 (male OR: 1.16, 95% CI [1.05 to 1.28], female OR: 1.09, 95% CI [ 1.02 to 1.16]).

Mental well-being during stages of COVID-19 lockdown among pregnant women and new mothers

Background

Pregnancy and early motherhood are sensitive times where epidemic disease outbreaks can affect mental health negatively. Countries and health care systems handled the pandemic and lockdowns differently and knowledge about how the COVID-19 pandemic affected the mental well-being of pregnant women and new mothers is limited and points in different directions.

Aim

To investigate symptoms of anxiety and depression in a population of pregnant women and new mothers in various stages of infection pressure and lockdown during the first 15 months of the COVID-19 pandemic in Denmark.

Methods

The study population was nested an inception cohort of women recruited in their first trimester of pregnancy. Data about mental health of the woman were obtained in relation to pregnancy and child development (first trimester, 8 weeks postpartum and 5 months postpartum), and data were analysed cross-sectionally according to calendar time (periods defined by infection rate and lock-down during the COVID-19 pandemic).

Results

No differences in reported levels of depressive symptoms between the six examined time periods of the pandemic were observed. Specifically, symptoms remained unchanged after the first lock-down. No major changes in anxiety symptoms were observed in relation to increased infection pressure or lockdowns, but a small increase was observed during the second lockdown in women 8 weeks postpartum.

Conclusion

No clear change in mood among pregnant women was seen between during the stages of COVID-19 pandemic in Denmark.

Assessing the Psychological Impact of the Pandemic COVID -19 in Uninfected High-Risk Population

Purpose

To assess the impact of the COVID-19 pandemic on the psyche of uninfected people with chronic diseases in the Elduim community, White Nile State, Sudan, during the COVID -19 pandemic.

Methods

We used a generalized anxiety disorder scale (GAD -7) and a patient health questionnaire (PHQ-9) for psychological assessment. The study included two hundred thirty-four participants; all participants with a chronic disease but not infected with COVID -19 were between 24 and 65 years of age. Residents of the study area were randomly selected. Descriptive statistics and a t-test were used for associations with a p-value of 0.05 or less.

Results

This study found that anxiety rated by GAD 7 was either mild (18, 7.7%), moderate (98, 41.9%), or severe (41, 17.5%) among participants. PHQ 9-rated depression showed 22 (9.4%) mild depression, most of them in participants aged 36–44 years. Participants with kidney disease showed major depression 11 (42.31%). Factors that significantly affected anxiety scores were age 24–35 years (P =0.002), university graduates (P < 0.000), married (P < 0.000), those with diabetes and hypertension (P =0.041), and urban residents (P < 0.023). Those who had secondary education were married and smoked were significantly more likely to have major depression than those with another educational status (p < 0.05).

Conclusion

COVID 19 pandemic had a significant impact on the psyche of uninfected people with chronic diseases in Sudan, and significant associated factors were identified. Unique interventions are strongly recommended to reduce the psychological impact of the COVID 19 pandemic.

Psychological distress during the COVID-19 pandemic in the population of Argentina

ABSTRACT

In addition to the implications that this pandemic has had on physical health, there are other circumstances that threaten the mental health of the population, such as lockdown measures to prevent the spread of the virus, uncertainty, and the increase in infections and deaths. For this reason, this study explored indicators of psychological distress in the Argentine population, as well as its relationship with sociodemographic and health variables.Cross-sectional observational study, with data collection from May to August 2020. A total of 1112 people over the age of 18 who responded to various measurement instruments through an online questionnaire participated. A bivariate analysis and logistic regression were carried out in order to determine predictive factors of psychological distress.The data revealed that 60.9% of the sample presented psychological distress. A greater number with this condition was observed in women, apart from younger people, with a greater number of symptoms associated with the disease and with worse self-perceived health. There was no evidence of association between psychological distress and contact with people infected with coronavirus disease 2019 or with material suspicious of being infected.This research provided an overview of the mental health status of a significant population sample in Argentina, months after the onset of the coronavirus disease 2019 pandemic. These findings complement those found in other national and international studies, allowing the accumulation of evidence that states the need to demand to draw attention to the mental health of the population, especially the most vulnerable groups, on behalf of the public authorities.

Effects of School Resumption on College Students' Mental Health During the COVID-19 Pandemic

The current study aimed to investigate the effects of school resumption on college students' mental health during the coronavirus disease 2019 (COVID-19) pandemic. We used the Perceived Stress Scale (PSS-10), Patient Health Questionnaire-9 (PHQ-9), and Self-Rating Anxiety Scale (SAS) to assess stress, depression, and anxiety, respectively, between same-age college students returning to school and those not returning to school. Of 1,598 students who completed the baseline survey (S1), 836 students completed a follow-up survey 10 months after school resumption (S2). There were statistically significant differences in stress and mild anxiety between male and female students (p < 0.01). Comparison of PSS-10, PHQ-9, and SAS scores by perceived impact of COVID-19 showed significant differences (Welch test, p < 0.01). The correlation between PHQ-9 and SAS scores in school resumption and non-school resumption groups was relatively strong (adjusted R2 = 0.49 vs. 0.5). Multivariate linear regression showed that only PSS-10 (p < 0.01) and SAS (p < 0.05) scores significantly differed between returning and non-returning students. School resumption was an independent risk factor for PSS-10 and SAS scores. PSS-10, PHQ-9, and SAS scores were significantly higher in S1 than in S2 (p < 0.01). During the COVID-19 pandemic, stress, anxiety, and depression were prevalent among college students; however, stress and anxiety were generally lower among college students returning to school than among non-returning students. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

Impact of the COVID-19 Pandemic on Stress, Sleep, and Oral Health in University Students

Background: The COVID-19 pandemic, a disease caused by Sars-CoV-2, has become a worldwide stressor, especially as it represents a new viral infection, which spreads quickly and easily, without prior knowledge about vaccination, and absence, to this moment, of a medication that is totally effective against the disease.

Objective: The aim of this observational study was to provide a general evaluation, through a questionnaire applied to students in the health field of the Federal University of Rio de Janeiro, on the psychological impacts and behavioral changes generated by the COVID-19 pandemic on oral health, especially the triggering or exacerbation of bruxism and temporomandibular disorders (TMD).

Methods: In order to verify the impacts of the pandemic on the health of UFRJ healthcare students, a non-randomized survey was performed with 370 students.

Results: It was found that 72% of the students had their sleep routine altered, 65% had greater difficulty in keeping their spirits up, there was a statistically significant increase in emotional stress, headaches, and daytime teeth clenching.

Conclusion: It was possible to conclude that the outbreak of COVID-19 resulted in psychological, physiological and behavioral impacts on students.

COVID-19 and Risk Factors of Anxiety and Depression in South Korea

OBJECTIVE

The aims of this study were to explore the prevalence of and identify predictors of anxiety and depression related to coronavirus disease of 2019 (COVID-19) in South Korea.

METHODS

The analysis is based on a quota survey design and a sampling frame that permitted recruitment of a national sample of 1,014 individuals between March 17-31, 2020. Several standardized measurements were used, including GAD-7, PHQ-9, COVID-19 related fear, restrictions in deaily life, as well as sociodemographic information and physical and psychosocial needs during the pandemic. Multiple logistic regression was conducted to analyze the influence of sociodemographic factors, fear, and physical/psychosocial needs on anxiety and depression.

RESULTS

Significant numbers of the respondents were identifiable anxiety (19.0%) and depression group (17.5%), respectively. This indicates that the depression and anxiety prevalence rate after the COVID-19 is substantially high compared to the depression rate of 2.6% in 2020 and 2.8% in 2018 both reported in the Korea Community Health Survey and the anxiety rate of 5.7% reported in 2016 Survey of Mental Disorders in Korea. Multiple logistic regression results showed age, COVID-19 related fear, and the level of restrictions in daily as significant factors in understanding and predicting the anxiety group. Likfewise, the COVID-19 related fear, restrictions in daily life, and need for economic support were important predictors in predicting the depression group.

CONCLUSION

Findings on predictors for greater vulnerability to anxiety and depression has important implications for public mental health in the context of the COVID-19 pandemic.

COVID-19 Infection Associated with Psychosis in Hemodialysis Patient

Hemodialysis is a medical procedure to correct electrolyte imbalance and remove fluids and waste products from the blood of patients with end-stage renal disease. Dialysis patients are immunosuppressed and hence at risk of complications of coronavirus infection. In addition, dialysis for most patients is performed in-center, with therapy offered three times per week for 3.5 hours per session in sites highly exposed to virus contamination. A weak immune system and low cytokine storm explain why COVID-19 may be less severe in dialysis patients as death due to COVID-19 or effects on comorbidities in COVID-19 patients is due to overresponse against the virus by the immune system and cytokine storm. However, during the frequent trips between the dialysis center and home, the risk of coronavirus infection could be high. Moreover, hemodialysis patients constitute a distinct and high-risk group that is often associated with low immunity, decline or loss of the ability to work, substantial economic burden, the inability to fulfill family responsibilities and participate in an active social life, and suffer from various complications such as muscle weakness, pruritus, fatigue, diabetes, hypertension, and restless legs. These factors are associated with lower quality of life and poor clinical outcomes, leading to a higher risk of psychological problems than in the general population. We report a rare case of new-onset psychosis (mostly delirium) following COVID-19 infection in a middle-aged hemodialysis patient with rapid recovery.

Early indicators and risk factors associated with mental health problems during COVID-19 quarantine: Is there a relationship with the number of confirmed cases and deaths?

BACKGROUND

On March 20 2020, the Argentine Ministry of Health enforced a mandatory quarantine throughout the country in response to the COVID-19 pandemic.

AIMS

The object of this study is to determine the initial impact on mental health of Argentine population, by measuring the prevalence of anxiety, depression, insomnia, and self-perceived stress and by determining the associated risk factors, and to analyze that impact in relation to the number of confirmed cases and deaths.

METHOD

A cross-sectional survey was conducted through a digital questionnaire, which was completed by 1,985 respondents between March 29 and April 12. The prevalence of anxiety, depression, stress and insomnia was measured with the Generalized Anxiety Disorder-7 Scale (GAD-7), the 9-Item Patients Health Questionnaire (PHQ-9); the Perceived Stress Scale (PSS-10) and the Pittsburgh Sleep Quality Index (PSQI), respectively.

RESULTS

The 62.4% of the surveyed population reported signs of psychological distress. It was found that being a woman, being 18 to 27 years old, living with family members or a partner, smoking, and having a poor sleep quality were the significant risk factors.

CONCLUSION

Despite the low number of COVID-19 confirmed cases and deaths at that time, a strong impact on mental health indicators was revealed. The authors of this study recommend the monitoring of the population at risk over time and early interventions in order to avoid long-lasting mental health problems.

The psychological impact and coping of Covid-19 pandemic among Arsi University students -Ethiopia

The foremost initiative of this investigation was to scrutinize the psychological influence of COVID-19 pandemic and the coping strategies of Arsi university students. Descriptive survey method was applied to investigate the intended variables. Data for this study was collected via an internet of 420 students (245 females and 175 males) from those whose email addresses were randomly accessed. Data was collect through questionnaires. Mean, standard deviation and t-test were used to analysis the collected data. The findings revealed that the psychological impacts of covid-19 on both male and female students were high. The results also showed that there was statistically significant difference between males and females in terms of every mean item. Therefore, it is recommended to engage actively in different activities, and relying on reliable sources of information, taking rests and the like are some of the mentioned coping strategies of the students. Finally, besides the transmitting of educational programs through TV, motivational speech, mass consultation/education through mass media like radio and television to reach those students who were dispersed to different parts of the country incorporates additional dimension of combating the psychological pressure of COVID-19.

Chinese College Students' Stress and Anxiety Levels Under COVID-19

The outbreak of COVID-19 at the end of 2019 has had a significant impact on people. While attention is paid to the immense physical harm it has caused, the psychological impact should not be underestimated. The main purpose of this study was to explore the stress, anxiety, and depression levels of different groups of college students during the COVID-19 pandemic. We conducted an online questionnaire survey of college students by using the Perceived Stress Scale (PSS-10), the Patient Health Questionnaire-9 items (PHQ-9), and the Self-rating Anxiety Scale (SAS). A total of 1,586 questionnaires were collected and analyzed in R language. The results showed that students with moderate to severe stress (PSS-10 ≥ 14) accounted for 67.50%; the detection rate of depression (PHQ-9 ≥ 5) reached 43.77%; and 20.60% of students had anxiety (SAS standard score ≥ 50). There were significant differences in PSS-10/SAS among different genders, majors, whether returning to school or not, and those with different psychological experiences (negative or positive, P < 0.05). It is notable that the median of female, medical student, non-resumption of schooling, and negative experience was higher than that of positive experience (P < 0.05). The results of principal component analysis showed that there were significant differences in PHQ-9, PSS-10, and SAS between the resumption of schooling group and the non-resumption group. Therefore, it is inferred that the stress and anxiety level of college students during the COVID-19 pandemic is generally high, especially for those who have not yet resumed school. Long-term negative emotions can easily lead to serious mental diseases such as cognitive impairment. Education departments should attach great importance to the mental health of college students, and it is necessary to provide precise psychological interventions for groups experiencing greater pressure levels and marked anxiety and depression.

Discrimination and Sleep among Asians and Pacific Islanders Adults

STUDY OBJECTIVES

To examine the association between discrimination and sleep duration and difficulty among Asians and Pacific Islanders (APIs) in the United States, and to test nativity and ethnic identity (EI) as effect modifiers.

METHODS

This cross-sectional study of 1,765 adults from the National Epidemiology Study of Alcohol and Related Conditions III, assessed discrimination using the Experiences of Discrimination scale. Discrimimation was classified as low, moderate, and high. Regression models were used to examine self-reported sleep duration and difficulty.

RESULTS

In bivariate analyses, individuals with high discrimination had the shortest sleep and reported sleep difficulty most often. Using linear models adjusted for sociodemographic and health characteristics, moderate and high discrimination were associated with 9 minutes (standard error [SE]: 4.8, p <0.10) and 14.4 minutes (SE: 6.0, p <0.05) less sleep, respectively, relative to low discrimination. Individuals with moderate and high discrimination had higher prevalence of sleep difficulty compared to those with low discrimination (prevalence ratio [PR]: 1.51, 95% confidence interval [CI]: 1.14-1.99 and PR: 1.73, 95% CI: 1.33-2.24, respectively). Interaction effect was observed in sleep difficulty by nativity and EI, but not duration. The association between discrimination and sleep difficulty was stronger among US-born relative to foreign-born participants. Among participants with low EI, moderate and high discrimination were associated with sleep difficulty, whereas among those with high EI, only high discrimination displayed this association.

CONCLUSIONS

Discrimination is associated with sleep duration and difficulty, and varies by nativity and EI. Research is needed to improve sleep among APIs that experience discrimination.[.

Motherhood and COVID-19: a Digital Psychoeducational Booklet for the Coping with the Pandemic Stressors

During the pandemic of COVID-19, the Brazilian Health Ministry declared that 2-week postnatal women are a high-risk population that demands special assistance. Considering that women at the postnatal period are more susceptible to anxiety and stress symptoms, our objective is to present a digital psychoeducational booklet analyzing its validity to help this target population to cope with the stress from the new coronavirus crisis. Based on the dispositional coping theory and positive psychology, this proposal was developed as a digital booklet to promote the maternal mental health and well-being based on informational and psychoeducational approaches. Information about the COVID-19, as well as coping strategies and positive practices, were presented to provide support for the coping with pandemic stressors. To validate the booklet, 12 women answered a Google Form via WhatsApp that included a free and informed consent form, a general data protocol, and a questionnaire with validity criteria (clarity of written, practical pertinence, theoretical relevance, and presentation). Content validity coefficients (CVC) were calculated for all criteria. The participants were on average 30 years old (A.V.=23–43), and half of them had a high school degree; 50% of them self-declared white and 25% black, and 2 of them declared themselves brown and 1 yellow. All CVC were ≥ 0.96. These findings confirmed that our booklet can be considered a viable, useful, and efficient tool to help puerperium women during the pandemic, providing support for a resilient coping face to this new and critical moment.

An integer programming model to assign patients based on mental health impact for tele-psychotherapy intervention during the Covid-19 emergency

The Covid-19 pandemic challenges healthcare systems worldwide while severely impacting mental health. As a result, the rising demand for psychological assistance during crisis times requires early and effective intervention. This contributes to the well-being of the public and front-line workers and prevents mental health disorders. Many countries are offering diverse and accessible services of tele-psychological intervention; Ecuador is not the exception. The present study combines statistical analyses and discrete optimization techniques to solve the problem of assigning patients to therapists for crisis intervention with a single tele-psychotherapy session. The statistical analyses showed that professionals and healthcare workers in contact with Covid-19 patients or with a confirmed diagnosis had a significant relationship with suicide risk, sadness, experiential avoidance, and perception of severity. Moreover, some Covid-19-related variables were found to be predictors of sadness and suicide risk as unveiled via path analysis. This allowed categorizing patients according to their screening and grouping therapists according to their qualifications. With this stratification, a multi-periodic optimization model and a heuristic are proposed to find an adequate assignment of patients to therapists over time. The integer programming model was validated with real-world data, and its results were applied in a volunteer program in Ecuador.

Comparing Mental Health During the COVID-19 Lockdown and 6 Months After the Lockdown in Austria: A Longitudinal Study

The novel coronavirus disease (COVID-19) has repeatedly been reported to impair mental health. This longitudinal study evaluated mental health at the emergence of the COVID-19 pandemic (t1) and 6 months later (t2) in Austria. Indicators of mental health were depression (PHQ-9), anxiety (GAD-7), sleep quality (ISI), perceived stress (PSS-10), as well as quality of life (WHO-QOL BREF) and well-being (WHO-5). In total, N = 437 individuals participated in both surveys (52.9% women). The number of participants with clinically relevant depressive, anxiety, or insomnia symptoms did not differ statistically significantly between t1 and t2 (p ≥ 0.48). The prevalence of moderate or severe (clinically relevant) (1) depressive symptoms changed from 18.3% to 19.7% (p = 0.48), (2) anxiety symptoms from 16.5 to 15.6% (p = 0.67), and insomnia from 14.6 to 15.6% (p = 0.69) from t1 to t2. Bonferroni-corrected t-tests showed that the stress level (PSS-10) decreased, and well-being (WHO-5) increased. However, effect sizes do not seem to be clinically relevant (Cohen's d < 0.2). Results suggest that detrimental health consequences of the COVID-19 pandemic persisted several months after its outbreak and the end of the lockdown measures, respectively. Regarding well-being and stress, there is a slight trend toward improvement.

Stress and worry in the 2020 coronavirus pandemic: relationships to trust and compliance with preventive measures across 48 countries in the COVIDiSTRESS global survey

The COVIDiSTRESS global survey collects data on early human responses to the 2020 COVID-19 pandemic from 173 429 respondents in 48 countries. The open science study was co-designed by an international consortium of researchers to investigate how psychological responses differ across countries and cultures, and how this has impacted behaviour, coping and trust in government efforts to slow the spread of the virus. Starting in March 2020, COVIDiSTRESS leveraged the convenience of unpaid online recruitment to generate public data. The objective of the present analysis is to understand relationships between psychological responses in the early months of global coronavirus restrictions and help understand how different government measures succeed or fail in changing public behaviour. There were variations between and within countries. Although Western Europeans registered as more concerned over COVID-19, more stressed, and having slightly more trust in the governments' efforts, there was no clear geographical pattern in compliance with behavioural measures. Detailed plots illustrating between-countries differences are provided. Using both traditional and Bayesian analyses, we found that individuals who worried about getting sick worked harder to protect themselves and others. However, concern about the coronavirus itself did not account for all of the variances in experienced stress during the early months of COVID-19 restrictions. More alarmingly, such stress was associated with less compliance. Further, those most concerned over the coronavirus trusted in government measures primarily where policies were strict. While concern over a disease is a source of mental distress, other factors including strictness of protective measures, social support and personal lockdown conditions must also be taken into consideration to fully appreciate the psychological impact of COVID-19 and to understand why some people fail to follow behavioural guidelines intended to protect themselves and others from infection. The Stage 1 manuscript associated with this submission received in-principle acceptance (IPA) on 18 May 2020. Following IPA, the accepted Stage 1 version of the manuscript was preregistered on the Open Science Framework at https://osf.io/g2t3b. This preregistration was performed prior to data analysis.

Psychosocial impacts of COVID-19 in the Guinean population. An online cross-sectional survey

Guinea, like many other African countries, has been facing an unprecedented COVID-19 outbreak, since March 2020. In April 2020, Guinean National agency for health security recorded 1351 confirmed cases of COVID-19, including 313 recoveries and 07 deaths. To address this health crisis, some drastic measures were implemented to prevent the spread of COVID-19. Those measures might potentially cause some psychological problems among Guineans. Thus, we conducted this study to assess the psychosocial impacts of COVID-19 in the Guinean population. We carried out an online cross-sectional survey among internet users in Guinea. A free e-survey platform was used, and questionnaires were sent to internet users. The study ran from May 1 through May 10 2020. Participation in the study was voluntary. Data collection was based on sociodemographic information and self-reported questionnaires: Impact of Event Scale-Revised (IES-R) for stress evaluation, Penn state worry questionnaire (PSWQ), and an adapted Social Psychological Measurements of COVID-19. A total of 280 participants took part in the study; responses from 5 participants were deleted because of incompleteness. The average age of participants was 28.9 [95% CI: 28.1;29.6]. Most of participants were male 65.5% [95% CI: 59.5%;71.1%]. Unemployed participants stood for 48.7% [95% CI: 42.7%;54.8%]. IES-R scale for stress evaluation yielded the following findings: 19.6% (mild), 5.23% (moderate) and 9.15% (severe); 82.8% and 17.2% of participants had respectively reported low and moderate worry. No significant statistical association was found between sociodemographic variables and traumatic events (IES-R and PSWQ). However, 82% of our participants had to cope with the negative impacts of COVID-19. Although there were few cases of traumatic events, negative impacts of COVID-19 on study participants deserve to be underlined. So, further investigations are necessary to identify and disentangle specific psychosocial problems in different Guinean socio-cultural contexts.

Nursing students, mental health status during COVID-19 quarantine: evidence from three European countries

BACKGROUND

The SARS-CoV2 pandemic obligated most of the European countries to implement strict measures and lockdowns to minimize the spread of the virus. Universities closed and on-line classes started. However, COVID-19 epidemic has significant impact on mental health of population.

AIM

To assess depression level of nursing students (undergraduate and master) in Greece, Spain and Albania during COVID-19 pandemic as well as to identify possible determinants of depression level.

METHODS

A multicenter cross-sectional study was conducted between April and May 2020. An on-line questionnaire was used to collect the data. The Patient Health Questionnaire-9 was used to evaluate the depression levels of nursing students.

RESULTS

Seven hundred and eighty-seven nursing students participated in the study out of which 83.9% were of female gender, 92.9% single and 94.7% lived with others. One third of the nursing student population experienced mild depression, with higher depression levels noted for Spanish students (59.1%) followed by Albanian (34.5%) and Greek (21.8%) students. Multivariate linear regression analysis identified that Spanish students experienced more depression than Greek and Albanian (p < 0.001). Also, decreased age was associated with increased depression.

CONCLUSION

The impact of lockdown and quarantine on nursing students mental health is clear. Provision of university based mental health interventions should be a priority.

Going through the lockdown: a longitudinal study on the psychological consequences of the coronavirus pandemic

Coronavirus 2019 pandemic lockdown in Italy lasted for 2 months, 1 week and 2 days. During this long period, one of the longest in Europe, the restrictions produced effects on people's psychological well-being, with consequences that also continued after lockdown. The purpose of the study is to investigate these effects and how they changed in the general population over a period of time. We are also interested in exploring people's post-lockdown anxiety and concerns. We conducted an online survey using snowball sampling techniques. The longitudinal study consisted of four administrations covering a period of 10 weeks between April (baseline) and June (last follow-up). Levels of anxiety and depression were assessed by GAD-7 and PHQ-9, coping strategies were assessed by Brief Resilient Coping Scale (BRCS) and social support was assessed by MSPSS. Post-lockdown anxiety was explored by developing a set of ad-hoc questions. PCA was used to determine the principal categories of post-lockdown anxiety/concern resulting from the ad-hoc questions. Longitudinal data, given their nested structure, were analyzed through mixed modeling. Of the 411 responders at baseline, 169 had at least 3 out of 4 data points; the analysis was therefore conducted on this sample. Levels of depression and anxiety were found to be significantly higher in the study sample in comparison with normative samples for each of the fourtime points; levels of coping showed that scores from the study sample were significantly lower than normative data at all-time points. Levels of perceived social support were significantly lower than normative data at the baseline and the first follow-up. The results of the study suggest that the lockdown experience had enduring consequences on the mental health of individuals. Prevention and support interventions to limit the psychological distress caused by COVID-19 should be taken into consideration in countries experiencing a second wave of the pandemic.

Psychological Effects of the COVID-19 Pandemic on Hungarian Adults

We aimed to explore psychological effects of the coronavirus pandemic on Hungarian adults in the time of the national quarantine situation in May 2020.We conducted a cross-sectional observational study with the use of an anonymous online questionnaire that consisted of 65 items. The following measuring instruments were used: Perceived Stress Scale (PSS-10); The General Anxiety Disorder Assessment (GAD)-2; The Patient Health Questionnaire (PHQ)-2; European Quality of Life Visual Analogue Scale (EQ-VAS); Self-administered inventory of complaints (Hungarian questionnaire); Shortened (Hungarian) version of the Ways of Coping Questionnaire; 2 open-ended questions to examine the participants’ mood and ways of coping during the pandemic. The data of 431 participants were analyzed, their average age was 47.53 ± 11.66 years, and the percentage of females was 90%. The mean of participants’ scores were the following: 19.34 ± 7.97 for perceived stress, 73.05 ± 21.73 for health status, and 8.68 ± 4.65 for neurotic complaints. Thirty-four and one-tenth percent of participants were depressed, 36.2% were anxious, and they tended to use problem-focused coping strategies more frequently than emotion-focused ones. We found significant correlations between all of the seven examined psychological variables. Our results highlight the importance of stress management in the psychological support of healthy adults in quarantine situation caused by the coronavirus pandemic.

Evaluation of emotional (depression) and behavioural (nutritional, physical activity and sleep) status of Turkish adults during the COVID-19 pandemic period

OBJECTIVE

To evaluate emotional (depression) and behavioural (nutritional behaviours, physical activity status and sleep patterns) of Turkish adult individuals during the COVID-19 pandemic period.

DESIGN

Cross-sectional online survey. The participants filled out a questionnaire (developed by using Google Forms) that contained descriptive characteristics, nutritional behaviours, sleep patterns, physical activity status, anthropometric measurements, COVID-19-related level of knowledge and the questions of the Center for Epidemiological Studies Depression Scale through e-mail or social media (WhatsApp).

SETTING

Turkey.

PARTICIPANTS

Totally, 1120 adult individuals who completed an online survey between April and May 2020.

RESULTS

It was determined that 29·1 % of the individuals showed mild, 34·2 % moderate and 23·4 % severe depression symptoms during the pandemic period. A significant relationship was found between gender, age and educational status, marital status and depression levels of the individuals, respectively (χ2 = 35·292, χ2 = 103·46, χ2 = 24·524 and χ2 = 86·208, P < 0·05). The top three foods consumed most during the pandemic period are tea and coffee (66·6 %), pastry (e.g. cake and cookie) (56·4 %) and desserts (49·6 %). During the pandemic period, 42·5 % of the individuals stated that they slept more and 40·2 % stated that there was no change in their sleep patterns. Daily physical activity durations were determined as 8·25 ± 1·77 h for sleep, 4·21 ± 2·68 h for lying down, 5·42 ± 2·64 h for sitting and 6·16 ± 4·82 h for standing activities.

CONCLUSION

It was determined that the individuals showed different levels of depression symptoms during the pandemic period. Especially, carbohydrate food consumption increased, and physical activity status and sleep patterns changed due to the increased time spent sitting and lying.

Self-Isolation Due to COVID-19 Is Linked to Small One-Year Changes in Depression, Sleepiness, and Insomnia: Results from a Clinic for Sleep Disorders in Shiga Prefecture, Japan

We aimed to analyze (a) the changes in depression, sleepiness, insomnia, and sleep habits in relation to the degree of self-isolation and (b) the effects of changes in sleep habits and social interactions on depression, insomnia, and sleepiness during the coronavirus disease 2019 (COVID-19) pandemic. We enrolled 164 patients who visited the sleep outpatient clinic in Shiga University of Medical Science Hospital. We compared the sleep habits, depression (Patient Health Questionnaire-9: PHQ-9), insomnia (Athens Insomnia Scale: AIS), and sleepiness (Epworth Sleepiness Scale: ESS) of patients during the period from April to July 2019 vs. May 2020 (a period of self-isolation due to COVID-19). A Wilcoxon signed-rank test indicated no significant differences in PHQ-9, ESS, and AIS scores between 2019 and 2020 within both the strong self-isolation group and no/little self-isolation group. With respect to sleep habits, earlier bedtime (p = 0.006) and increased sleep duration (p = 0.014) were found in the strong self-isolation group. The former (p = 0.009) was also found in the no/little self-isolation group, but we found significant differences in sleep duration between the no/little self-isolation group and the strong self-isolation group (p = 0.047). Therefore, self-isolation due to COVID-19 had relatively small one-year effects on depression, sleepiness, and insomnia in a clinical population.

New York State and the Nation: Trends in Firearm Purchases and Firearm Violence During the COVID-19 Pandemic

BACKGROUND

The impacts of social stressors on violence during the coronavirus disease 2019 (COVID-19) pandemic are unknown. We hypothesized that firearm purchases and violence would increase surrounding the pandemic. This study determined the impact of COVID-19 and shelter-in-place (SIP) orders on firearm purchases and incidents in the United States (US) and New York State (NYS).

METHODS

Scatterplots reflected trends in firearm purchases, incidents, and deaths over a 16-month period (January 2019 to April 2020). Bivariate comparisons of SIP and non-SIP jurisdictions before and after SIP (February 2020 vs. April 2020) and April 2020 vs. April 2019 were performed with the Mann-Whitney U test.

RESULTS

The incidence of COVID-19 in the US increased between February and April 2020 from 24 to 1 067 660 and in NYS from 0 to 304 372. When comparing February to March to April in the US, firearm purchases increased 33.6% then decreased 22.0%, whereas firearm incidents increased 12.2% then again increased by 3.6% and firearm deaths increased 23.8% then decreased in April by 3.8%. In NYS, comparing February to March to April 2020, firearm purchases increased 87.6% then decreased 54.8%, firearm incidents increased 110.1% then decreased 30.8%, and firearm deaths increased 57.1% then again increased by 6.1%. In both SIP and non-SIP jurisdictions, April 2020 firearm purchases, incidents, deaths, and injuries were similar to April 2019 and February 2020 (all P = NS).

DISCUSSION

Coronavirus disease 2019-related stressors may have triggered an increase in firearm purchases nationally and within NYS in March 2020. Firearm incidents also increased in NYS. SIP orders had no effect on firearm purchases and firearm violence.

Swiss University Students' Risk Perception and General Anxiety during the COVID-19 Pandemic

University students were confronted with abrupt changes to their daily lives by the COVID-19 lock-down. We investigated Generalized Anxiety Disorder Scale-7 (GAD-7) and anxiety levels, and the association between perceived impact on well-being, studies, and daily lives and anxiety levels, adjusted for gender, age, social class and affiliation. Early in the lock-down all students of the Zurich University of Applied Sciences (N = 12,429) were invited to a voluntary longitudinal health survey. Participation rate was 20% (n = 2437): 70% females, median age 25 yrs. (IQR 23–28). A total of 10% reported a deterioration of well-being compared to pre-Corona. LCA yielded three classes varying in perceived COVID-19 impact: 1 (low, n = 675), 2 (moderate, n = 1098), and 3 (strong, n = 656). Adjusted proportion of moderate to severe anxiety by class were 45% (95% CI: 28.0–62.0), 15.5% (95% CI: 13.1–17.9), and 5.1% (95% CI: 4.7–5.6), respectively. Multivariate regression analyses yielded an OR for moderate to severe anxiety of 3.88 (95% CI: 2.5–6.0, class 2) and 22.43 (95% CI: 14.5–34.6, class 3) compared to class-1. The investigated association implies that containment measures have a selective effect on anxiety in students. The diversity of students’ perception and associated anxiety should be monitored and considered in future response to pandemics.

The psychological impact of COVID-19 on the mental health in the general population

As a result of the emergence of coronavirus disease 2019 (COVID-19) outbreak caused by acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the Chinese city of Wuhan, a situation of socio-economic crisis and profound psychological distress rapidly occurred worldwide. Various psychological problems and important consequences in terms of mental health including stress, anxiety, depression, frustration, uncertainty during COVID-19 outbreak emerged progressively. This work aimed to comprehensively review the current literature about the impact of COVID-19 infection on the mental health in the general population. The psychological impact of quarantine related to COVID-19 infection has been additionally documented together with the most relevant psychological reactions in the general population related to COVID-19 outbreak. The role of risk and protective factors against the potential to develop psychiatric disorders in vulnerable individuals has been addressed as well. The main implications of the present findings have been discussed.