Socio-Demographic Variables, Fear of COVID-19, Anxiety, and Depression: Prevalence, Relationships and Explanatory Model in the General Population of Seven Latin American Countries

Psychometric network analysis of the Patient Health Questionnaire-4 (PHQ-4) in Paraguayan general population

BACKGROUND

Depression and anxiety are two of the most prevalent and disabling mental disorders worldwide, both in the general population and in outpatient clinical settings.

OBJECTIVE

This study aimed to analyze the psychometric properties of the Patient Health Questionnaire-4 (PHQ-4) based on network analysis metrics.

METHODS

A total of 911 Paraguayans (23.71% women and 76.29% men; mean age 31.25 years, SD = 10.63), selected by non-probabilistic convenience sampling, participated in the study. Network analysis was used to evaluate the internal structure, reliability, and measurement invariance between men and women.

RESULTS

The results revealed that the PHQ-4 is a unidimensional measure through Exploratory Graph Analysis (EGA). Reliability, through structural consistency, identified that 100% of the time, only a single dimension was obtained, and all items remained stable, as they were always replicated within the empirical dimension. The unidimensional structure has shown evidence of configural invariance; therefore, the network structure functioned equally among the different sex groups.

CONCLUSION

The PHQ-4 presented optimal preliminary evidence of validity based on its internal structure, reliability, and invariance between sexes. Therefore, it may be useful as an accurate and brief measure of anxiety and depressive symptoms in the Paraguayan context.

Psychometric evaluation of the Chinese version of new fear of the coronavirus questionnaire

The fear of COVID-19 significantly impacting the health of people globally. This study translated newly developed measurement tool New Fear of the Coronavirus Questionnaire (New_FCQ) into Chinese language and evaluated the psychometric properties of the Chinese version of New_FCQ among Chinese population. A total of 522 participants were included in the study. Internal consistency, construct validity, criterion validity, and concurrent validity of the Chinese version of New_FCQ were assessed in this study. The Chinese version of New_FCQ had excellent internal consistency (α = 0.97) and exploratory factor analysis demonstrated one-dimensional structure of the Chinese version of New_FCQ. The preliminary criterion validity revealed statistically significant differences in the fear of COVID-19 scores based on age and education level (P = .002 and P = .03, respectively). The good concurrent validity also established with the Chinese version Fear of COVID-19 Scale(P < .001). Psychometric proportions of the Chinese version of New_FCQ were established, which exhibited sufficient validity and reliability among Chinese population.

Relationship Between Fear of COVID-19, Conspiracy Beliefs About Vaccines and Intention to Vaccinate Against COVID-19: A Cross-National Indirect Effect Model in 13 Latin American Countries

The present study explored the predictive capacity of fear of COVID-19 on the intention to be vaccinated against COVID-19 and the influence in this relationship of conspiracy beliefs as a possible mediating psychological variable, in 13 Latin American countries. A total of 5779 people recruited through non-probabilistic convenience sampling participated. To collect information, we used the Fear of COVID-19 Scale, Vaccine conspiracy beliefs Scale-COVID-19 and a single item of intention to vaccinate. A full a priori Structural Equation Model was used; whereas, cross-country invariance was performed from increasingly restricted structural models. The results indicated that, fear of COVID-19 positively predicts intention to vaccinate and the presence of conspiracy beliefs about COVID-19 vaccines. The latter negatively predicted intention to vaccinate against COVID-19. Besides, conspiracy beliefs about COVID-19 vaccines had an indirect effect on the relationship between fear of COVID-19 and intention to vaccinate against COVID-19 in the 13 countries assessed. Finally, the cross-national similarities of the mediational model among the 13 participating countries are strongly supported. The study is the first to test a cross-national mediational model across variables in a large number of Latin American countries. However, further studies with other countries in other regions of the world are needed.

Assessment of Obsessive Thoughts About COVID-19 in 7 Latin American Countries: Structure and Measurement Invariance of the Obsession With COVID-19 Scale

The present study aimed to evaluate the measurement invariance of the Obsession with COVID-19 Scale (OCS) among seven Latin American countries: Bolivia, Brazil, Cuba, El Salvador, Guatemala, Paraguay, and Uruguay. Although the OCS has been used in several countries and languages, there is a need for approaches that better integrate the cross-cultural equivalence of the scale. A total of 3185 people participated in the study. The results indicated the presence of a unidimensional structure and good reliability indices for the OCS in each country. The alignment method indicated that the OCS is an invariant measure of COVID-19 obsession among the populations of seven Latin American countries. The findings based on IRT analysis indicated that all OCS items had adequate discrimination and difficulty parameters. The findings contribute to the understanding of the internal structure of the scale in different countries at the same time, something that has been pending evaluation.

Knowledge, Perception, and Attitudes during the COVID-19 Pandemic in the Peruvian Population

BACKGROUND

Latin American countries have been profoundly affected by COVID-19. Due to the alarming incidence of identified cases, we intended to explore which psychosocial elements may influence poor adherence to the mandatory control measures among the population.

OBJECTIVE

We aimed to assess Peruvians' knowledge, attitudes, and vulnerability perception during the coronavirus outbreak.

METHOD

We collected data from 225 self-selected participants using a web-based cross-sectional survey.

RESULTS

The overall respondents were between 18 and 29 years old (56.8%), female (59.5%), belonged to educated groups, and graduated professionals (69.3%), most of them. Logistic regression showed that Knowledge is highly associated with education (p = 0.031), occupation (p = 0.002), and age (p = 0.016). Our study identified that, although people reported adequate Knowledge by identifying expected symptoms and virus transmission ways in COVID-19 disease. There is a significant perceived susceptibility to contracting the mentioned virus, displaying stigmatized behavior (59.1%) and fear of contracting the virus from others (70.2%). Additionally, it is reported to lack people's confidence in national health authorities regarding sanitary responses (62.7%), preparedness for the disease (76.9%), and the lack of adequate measures to deal with it (51.1%).

CONCLUSION

We found that age, education, and occupation modulate Knowledge. At the same time, only age affected Perception and Attitude. Public policies should consider specific guidelines on knowledge translation and risk communication strategies for both containing psychological responses promptly and ensuring compliance with general control measures by the population.

Psychological factors associated with COVID-19 related anxiety and depression in young adults during the COVID-19 pandemic

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic and the corresponding lockdown have drastically changed our lives and led to high psychological distress and mental health problems. This study examined whether psychological factors such as loneliness, perfectionism, and health anxiety are associated with COVID-19 related anxiety and depression during the pandemic in young Korean adults, after controlling for various socio-demographic factors and early life stress.

METHODS

A total of 189 participants (58.2% women) completed a cross-sectional online survey including the Fear of COVID-19 Scale, Center for Epidemiologic Studies Depression Scale, 3-item Revised UCLA Loneliness Scale, Frost Multidimensional Perfectionism Scale, and Whiteley Index-6. Hierarchical linear regression analyses with three blocks were employed to identify the factors that contributed to COVID-19 related anxiety and depressive symptoms.

RESULTS

Hierarchical regression analyses showed that higher health anxiety was significantly associated with more severe COVID-19 related anxiety (standardized regression coefficient, β = 0.599, p < 0.001). Additionally, higher levels of loneliness (β = 0.482, p < 0.001), perfectionism (β = 0.124, p = 0.035), and health anxiety (β = 0.228, p < 0.001) were significantly associated with higher depression scores. The three psychological factors explained 32.8% of the total variance in depressive symptom scores, after taking all covariates into account.

CONCLUSION

The results showed that health anxiety was a risk factor for both COVID-19 related anxiety and depression in young adults. Loneliness was the strongest predictor of depressive symptoms during the COVID-19 pandemic. These findings highlight the importance of identifying vulnerable individuals and encouraging psychological counselling and social connections to reduce the burden of psychiatric disorders during the pandemic.

Restraint stress induced anxiety and sleep in mice

In humans and animals, exposure to changes in internal or external environments causes acute stress, which changes sleep and enhances neurochemical, neuroendocrine, and sympathetic activities. Repeated stress responses play an essential role in the pathogenesis of psychiatric diseases and sleep disorders. However, the underlying mechanism of sleep changes and anxiety disorders in response to acute stress is not well established. In the current study, the effects of restraint stress (RS) on anxiety and sleep-wake cycles in mice were investigated. We found that after RS, the mice showed anxiety-like behavior after RS manipulation and increased the amounts of both non-rapid eye movement (NREM) and rapid eye movement (REM) sleep in the dark period. The increase in sleep time was mainly due to the increased number of episodes of NREM and REM sleep during the dark period. In addition, the mice showed an elevation of the EEG power spectrum of both NREM and REM sleep 2 h after RS manipulation. There was a significant reduction in the EEG power spectrum of both NREM and REM sleep during the darkperiod in the RS condition. The expression of the c-Fos protein was significantly increased in the parabrachial nucleus, bed nucleus of the stria terminalis, central amygdala, and paraventricular hypothalamus by RS manipulation. Altogether, the findings from the present study indicated that neural circuits from the parabrachial nucleus might regulate anxiety and sleep responses to acute stress, and suggest a potential therapeutic target for RS induced anxiety and sleep alterations.

Factors Associated with Dietary Restriction and Emotional and Uncontrolled Eating in Adults from Spanish-Speaking Countries during the COVID-19 Confinement: Results of the CoV-Eat Project

The first COVID-19 confinement has led to changes in the population’s behaviour. However, little has been analysed about the changes in eating behaviour beyond the decrease in adherence to healthy dietary patterns. The aim of the CoV-Eat project was to identify factors related to each of the following eating behaviours (EB): cognitive restraints (CR), uncontrolled eating (UE), and emotional eating (EE) in adults from Spanish-speaking countries. Participants completed an anonymous online survey. EB was assessed using the Three-Factor Eating Questionnaire and the scores were classified into tertiles. Socio-demographic characteristics and lifestyle habits including physical activity, sleep quality, screen use, smoking consumption, and relationship with food were also collected. A total of 9849 participants from 21 countries were included in this study. The median of CR, UE, and EE behaviours was 15, 24, and 9, respectively. We observed that higher age, days of confinement, number of times leaving home in the last week, changes in sleep quality, and their relationship with food were negatively associated with CR, EE, and UE, while being a man was positively associated with an increased in all these EBs. A higher household income was negatively associated with a higher score of CR, and a higher education level (>primary) was positively associated with a medium score of EE. Lower physical activity was a factor negatively associated with a medium score of EE and UE. Higher screen use showed the same negative association for a medium score of EE and UE and a high score of CR. In addition, higher tobacco consumption was found to be a protective factor against having a medium or high score of CR and EE. In conclusion, some sociodemographic characteristics and lifestyle changes may be important factors for EB and should be considered in emergency situations such as confinement to prevent risky eating behaviour.

A Cross-Sectional Study on the Prevalence of Depressive Symptoms and Its Associated Sociodemographic Factors in Peru during the COVID-19 Pandemic

The present study aims to analyze the prevalence of depressive symptoms and its sociodemographic-associated factors in Peruvian adults. Data was extracted from a nation-wide representative survey in which depression symptoms were measured with the PHQ-9 and sociodemographic information was extracted from household data. Depression severity rates were estimated for each symptom, and responses were modeled through the Rating Scale Model to obtain a depression measure used as dependent variable on a Generalized Mixed Linear Model. The most frequent depression symptoms were emotional, such as discouragement, sad mood, hopelessness, and lack of pleasure when doing activities. Our model showed that, after controlling the effects of all the variables considered, the most relevant predictors were gender, education level, physiographic region, age, marital status, and number of coresidents. Higher depression levels were found in women, people who did not complete higher education, participants living in the Highlands, older adults, single participants, and people living alone. Thus, interventions to promote or prevent depression severity during similar situations as the pandemic should focus on specific sociodemographic groups and their particular needs.

An explanatory model of depressive symptoms from anxiety, post-traumatic stress, somatic symptoms, and symptom perception: the potential role of inflammatory markers in hospitalized COVID-19 patients

BACKGROUND

The context of the COVID-19 pandemic has harmed the mental health of the population, increasing the incidence of mental health problems such as depression, especially in those who have had COVID-19. Our study puts forward an explanatory model of depressive symptoms based on subjective psychological factors in those hospitalized for COVID-19 with and without biological markers (i.e., inflammatory markers). Therefore, we aim to evaluate the hypotheses proposed in the model to predict the presence of depressive symptoms.

METHOD

We conducted a cross-sectional study, using a simple random sampling. Data from 277 hospitalized patients with COVID-19 in Lima-Peru, were collected to assess mental health variables (i.e., depressive, anxiety, post-traumatic stress, and somatic symptoms), self-perception of COVID-19 related symptoms, and neutrophil/lymphocyte ratio (NLR) such as inflammatory marker. We performed a structural equation modeling analysis to evaluate a predictive model of depressive symptoms.

RESULTS

The results showed a prevalence of depressive symptoms (11.2%), anxiety symptoms (7.9%), somatic symptoms (2.2%), and symptoms of post-traumatic stress (6.1%) in the overall sample. No association was found between the prevalence of these mental health problems among individuals with and without severe inflammatory response. The mental health indicators with the highest prevalence were sleep problems (48%), low energy (47.7%), nervousness (48.77%), worry (47.7%), irritability (43.7%) and back pain (52%) in the overall sample. The model proposed to explain depressive symptoms was able to explain more than 83.7% of the variance and presented good goodness-of-fit indices. Also, a different performance between the proposed model was found between those with and without severe inflammatory response. This difference was mainly found in the relationship between anxiety and post-traumatic stress symptoms, and between the perception of COVID-19 related symptoms and somatic symptoms.

CONCLUSIONS

Results demonstrated that our model of mental health variables may explain depressive symptoms in hospitalized patients of COVID-19 from a third-level hospital in Peru. In the model, perception of symptoms influences somatic symptoms, which impact both anxiety symptoms and symptoms of post-traumatic stress. Thus, anxiety symptoms could directly influence depressive symptoms or through symptoms of post-traumatic stress. Our findings could be useful to decision-makers for the prevention of depression, used to inform the creation of screening tools (i.e., perception of symptoms, somatic and anxiety symptoms) to identify vulnerable patients to depression.

The COLIBAS Study—COVID-19 Lockdown Effects on Mood, Academic Functioning, Alcohol Consumption, and Perceived Immune Fitness: Data from Buenos Aires University Students

A recent study was conducted in the Netherlands to evaluate the impact of the 2019 coronavirus (COVID-19) pandemic and its associated lockdown periods on academic functioning, mood, and health correlates such as alcohol consumption. The study revealed that lockdowns were associated with a significantly poorer mood and a reduced perceived immune fitness. Overall, a reduction was seen in alcohol consumption during the lockdown periods. Academic functioning in terms of performance was unaffected; however, a significant reduction in interactions with other students and teachers was reported. There was, however, great variability between students as follows: both an increase and a reduction in alcohol consumption were reported, as well as improvements and poorer academic functioning. The aim of the current online study was to replicate these findings in Argentina. To this extent, a modified version of the survey was conducted among students at the University of Buenos Aires, which was adapted to the local lockdown measures. The survey assessed possible changes in self-reported academic functioning, mood, and health correlates, such as alcohol consumption, perceived immune functioning, and sleep quality compared to before the COVID-19 pandemic. Retrospective assessments were made for four periods, including (1) the period before COVID-19, (2) the first lockdown period (March–December 2020), (3) summer 2021 (January-March 2021, no lockdown), and (4) the second lockdown (from April 2021 to July 2021). This article describes the content of the survey and the corresponding dataset. The survey was completed by 508 participants.

Network analysis of the relationships between conspiracy beliefs towards COVID-19 vaccine and symptoms of fear of COVID-19 in a sample of latin american countries

The present study examined how conspiracy beliefs about COVID-19 vaccines specifically relate to symptoms of fear of COVID-19 in a sample of four South American countries. A total of 1785 people from Bolivia, Colombia, Ecuador, and Peru participated, responding to a sociodemographic survey, the Fear of COVID-19 scale (FCV-19 S) and the Vaccine Conspiracy Beliefs Scale-COVID-19 (VCBS-COVID-19). Network analysis identified the most important symptoms of fear and conspiracy beliefs about COVID-19 vaccines (nodes) and the associations between them (edges). In addition, the robustness of the network of these indicators of centrality and the possible differences in the structure and connectivity of the networks between the four countries were evaluated. The results suggest that the nodes with the highest centrality were items 2 and 5 of the FCV-19 S and item 2 of the VCBS-COVID-19. Likewise, item 6 is the belief that most predicts conspiracy beliefs about vaccines against COVID-19; while item 6 was the symptom that most predicts fear of COVID-19. The findings strongly support cross-cultural similarities in the networks across the four countries rather than differences. Although it was expected that a higher presence of symptoms of fear of COVID-19 may lead people to compensate for their fear by believing in conspiratorial ideas about vaccines and, consequently, rejecting the COVID-19 vaccine, the results do not clearly show this relationship. This could lead other researchers to generate evidence to explain the differences between Latin American countries and countries in other contexts in terms of vaccination rates. This evidence could be useful to develop policies favoring vaccination against COVID-19 that are more contextualized to the Latin American region, characterized by social instability and economic recession during the pandemic.

Factors affecting climacteric women with SARS-CoV-2 infection: A multinational Latin America study (REDLINC XI)

Objective

To evaluate the association between factors, especially those linked to the climacteric, and a history of COVID-19 infection.

Methods

This was an observational, cross-sectional, and analytical study in which women from ten Latin American countries, aged 40–64, who attended a routine health check-up were invited to participate. A positive history for COVID-19 was based on reverse transcription-polymerase chain reaction reports. We evaluated sociodemographic, clinical, lifestyle, anthropometric variables, and menopausal symptoms using the Menopause Rating Scale (MRS).

Results

A total of 1238 women were included for analysis, of whom 304 (24.6 %) had a positive history for COVID-19. The median [interquartile range: IQR] age of participants was 53 [IQR 12] years, duration of formal education was 16 [6] years, body mass index 25.6 [5.1] kg/m², and total MRS score 10 [13]. In a logistic regression model, factors positively associated with COVID-19 included postmenopausal status and having a family history of dementia (OR: 1.53; 95 % CI: 1.13–2.07, and 2.40; 1.65–3.48, respectively), whereas negatively associated were use of menopausal hormone therapy (current or past), being a housewife, and being nulliparous (OR: 0.47; 95 % CI: 0.30–0.73; 0.72; 0.53–0.97 and 0.56; 0.34–0.92, respectively). Smoking, being sexually active, and use of hypnotics were also factors positively associated with COVID-19.

Conclusion

Postmenopausal status and a family history of dementia were more frequent among women who had had COVID-19, and the infection was less frequent among current or past menopause hormone therapy users and in those with less physical contact.

Demographic Influences on Perceived Stressors of Construction Workers during the COVID-19 Pandemic

Construction work is one of the most stressful occupations in the world, and the COVID-19 pandemic has only exacerbated this reality. This research conducted a detailed investigation on the perceived stressors of different demographic groups among construction workers. Empirical data were collected using a structured questionnaire in the Chinese construction industry. The empirical data were processed using both an independent sample t-test and an Analysis of Variance (ANOVA). The findings indicated that male workers reported greater workloads than did females. Married workers experienced more pandemic fear and job insecurity, and they were more sensitive to the poor working environment. Highly-educated workers were inclined to be more satisfied with organizational pandemic responses, and had lower job insecurity and role ambiguity, but they experienced heavier workloads. In addition, the differences in work experience and age were statistically significant with regards to job insecurity. This research contributes to the body of knowledge by giving a comprehensive understanding of demographic influences on perceived stressors among construction workers. It also provides valuable insights to identify sensitive demographic groups and promote their health and wellbeing during and after the pandemic.

Prevalence and Predictors of Intention to be Vaccinated Against COVID-19 in Thirteen Latin American and Caribbean Countries

The presence of a significant number of people who do not intend to be vaccinated could negatively impact efforts to control the COVID-19 pandemic. Therefore, this study sought to determine the prevalence of intention to be vaccinated against COVID-19 and associated sociodemographic and psychosocial factors in thirteen countries in Latin America and the Caribbean (LAC). A total of 5510 people from 13 LAC countries participated. Frequencies, percentages, bivariate analyses using chi-square tests, and Poisson regression analysis with robust variance were used. The countries with the highest prevalence of intention to be vaccinated were Brazil (96.94%), Cuba (89.59%), Chile (84.59%), and Mexico (78.33%). On the other hand, the countries with the lowest prevalence were El Salvador (54.01%), Paraguay (55.87%), and Uruguay (56.40%). Prevalence is also reported according to some sociodemographic and health variables. It was found that country, male sex, hours exposed to information about COVID-19, university education, living in an urban area, belief in the animal origin of the virus, perceived likelihood of contracting COVID-19, perceived severity of COVID-19, and concern about infecting others significantly predicted intention to be vaccinated in the 13 LAC countries. While most countries had a high prevalence of intention to be vaccinated, there are still subgroups that have levels of intention that may be insufficient to predict the presence of community immunity. In this sense, knowing the estimates of vaccination intention rates, as well as the associated sociodemographic and psychological factors, can be used to plan actions and interventions that will inform about the safety and benefits of vaccines, as well as strengthen trust in health authorities.

Psychological Distress in the Galapagos Islands During the COVID-19 Pandemic

Objectives: to explore the emotional impact of the COVID-19 pandemic in the Galapagos Islands.

Methods: an online survey of 369 participants, conducted on October of 2020, was used to assess levels of depression, anxiety, and stress, as well as specific behavioral and emotional reactions to the pandemic.

Results: the prevalence of anxiety was 4% and depression 3.65%. Perceived stress level was higher, with 52% of the sample reporting moderate amounts. Women had higher levels of depression and perceived stress. Financial distress, interpersonal conflicts, feelings of isolation and fear of contagion of COVID-19 were all associated with higher levels of anxiety, depression, and stress.

Conclusion: prevalence of anxiety and depression is lower in the Galápagos Islands during the pandemic compared to other regions, while stress levels are more significant and may warrant intervention. Despite being low, anxiety and depression were associated with potentially problematic behaviors and emotional reactions.

Second Wave of COVID-19 Pandemic in Argentinian Population: Vaccination Is Associated With a Decrease in Depressive Symptoms

BACKGROUND

Since the irruption of the coronavirus disease 2019 (COVID-19) the planet has submerged in a time of concern and uncertainty, with a direct impact on people's mental health. Moreover, the recurrent outbreaks that periodically harry different regions of the world constantly refocus people's concerns to the pandemic. Yet, each new wave heats the diverse countries in different situations, including the advances in their vaccination campaigns. In this research, we studied the levels of the general anxiety disorder (GAD) and depression in the Argentine population across the first and second waves of infections that occurred in our country.

METHODS

We conducted an on-line survey, within each peak of the pandemic. People were asked to self-report GAD and depression symptoms using the GAD-7 and PHQ-9 questioners, inform their vaccination status, the frequency they performed physical activity as well as working condition and modality. Here, we identified the more vulnerable groups and evaluated factors that could mitigate the rise of these mental disorders, focusing on vaccination.

RESULTS

Our data shows that reported GAD and depression levels were higher during the second wave than during the first one. More importantly, vaccinated people were less depressed than non-vaccinated people, while GAD levels remained equivalent in both groups. Other factors directly associated with lower GAD and depression levels were performing frequent physical activity and being employed, regardless of the employment modality. These observations were replicated in different age ranges and genders.

CONCLUSION

This work evidences GAD and depression in different pandemic waves in Argentina, as well the factors that may contribute to reducing the magnitude of these disorders, including vaccination.