Depression, Anxiety, Stress, and Their Associations With Quality of Life in a Nationwide Sample of Psychiatrists in China During the COVID-19 Pandemic

Exploring the factors contributing to parent stress symptoms during the COVID-19 pandemic in Europe: An ABC-X model approach

The COVID-19 pandemic has had a significant impact on the mental health and well-being of families worldwide, with parents particularly at risk for stress and other psychological symptoms. In this study, we sought to understand the factors contributing to parent stress symptoms during the early stages of the pandemic in 23 European countries (N = 40,138) using the double ABC-X model. We examined whether the relationship between stressor pile-up and perceived stress was mediated by family satisfaction and relationship satisfaction and whether family resiliency beliefs impacted these mediated relationships. Our results showed a direct association between stressor pile-up and parent stress symptoms, but we did not find evidence for the mediating role of family satisfaction or relationship satisfaction in this relationship. We also found that family resiliency beliefs did not moderate the indirect effects of family satisfaction and relationship satisfaction on parent stress symptoms. These findings suggest that the ABC-X model may not fully capture the processes affecting parents' experience of stress during the pandemic and that alternative models such as the vulnerability-stress-adaptation model may be more relevant. Future research should also consider the potential negative impact of resiliency beliefs on mental health and other risk and protective factors such as self-compassion.

Mental health status and quality of life among Thai people after the COVID-19 outbreak: a cross-sectional study

The coronavirus disease 2019 (COVID-19) pandemic has had a profound impact on individuals' mental health and well-being worldwide. This study investigated the prevalences of and association between mental health and quality of life (QOL) in Thailand after the COVID-19 outbreak. A cross-sectional study was conducted among Thai individuals aged ≥ 20 years across all regions. Descriptive statistics, chi-square tests, and multiple logistic regression analyses were performed to examine the association between mental health and QOL. A total of 1,133 participants (mean age: 35.1 ± 17.2 years) completed the survey. The prevalence of depression with PHQ-9 instrument was 19.4%. Depression was significantly associated with those who have had family members die from COVID-19 infection (adjusted odds ratio [AOR] 2.27, 95% confidence interval [CI] [1.13-4.52]). The percentages of depression, anxiety, and stress with DASS-21 instrument were 32.4%, 45.4%, and 24.1%, respectively. Smokers and alcohol consumption had approximately 1.5-time higher risk of stress compared with non-smokers and no alcohol consumption (AOR = 1.50, 95% CI [1.01-2.24], AOR = 1.48, 95% CI [1.09-2.02], respectively). An association was observed between socioeconomic factors such as job and income loss and mental health outcomes. Depression, anxiety, and stress were significantly negatively associated with QOL. This study demonstrates a strong association between mental health and QOL among Thai people after the COVID-19 outbreak. The findings underscore the need for interventions targeting lifestyles, including those addressing alcohol consumption and smoking, especially among those who have had family members die from COVID-19 infection and mental health support services that can address depression, anxiety, and stress to improve the overall well-being of the population.

The interplay among burnout, and symptoms of depression, anxiety, and stress in Chinese clinical therapists

Burnout, depression, anxiety, and stress negatively impact the well-being and retention of healthcare professionals. The interplay of these symptoms is understudied. Utilizing network analysis, this study examined the interrelationships among these symptom clusters in clinical therapists in China. An anonymous survey was conducted among clinical therapists from 41 tertiary psychiatric hospitals in China. Burnout was assessed using the Maslach Burnout Inventory-Human Service Survey (MBI-HSS), while symptoms of depression, anxiety, and stress were assessed via the Depression, Anxiety, and Stress Scale-21 (DASS-21). Analyses were performed to identify central symptoms and bridge symptoms of this network. A total of 419 participants were included in this survey. The prevalence rate for burnout, depression, anxiety, and stress was 19.8%, 22.2%, 17.9%, and 8.6%, respectively. Network analysis indicated that stress symptoms had the highest expected influence values, closely followed by emotional exhaustion from MBI-HSS. Notably, emotional exhaustion emerged as the strongest bridge of expected influence. The stability of the expected influence and bridge expected influence was robust, with coefficients at 0.75. The study's findings underscore the importance of recognizing the central symptoms and bridge symptoms, which could lead to more effective early detection and intervention for burnout, depression, anxiety, and stress among clinical therapists.

Influence of social support and coping strategies on psychological stress among frontline medical personnel during the Yangbi Earthquake: a cross-sectional analysis

Objectives

This study aimed to investigate the psychological stress experienced by frontline medical staff during the Yangbi Earthquake and to understand how coping strategies and social support influence stress responses.

Methods

From days 3 to 14 post-earthquake, online questionnaires were administered to frontline medical staff to assess perceived social support, coping strategies, and psychological stress responses using the Perceived Social Support Scale (PSSS), Trait Coping Strategies Questionnaire (TCSQ), and Stress Response Questionnaire (SRQ). Data analysis included correlation analysis to explore relationships between variables, multiple linear regression to identify key predictors of stress, and path analysis to determine direct and indirect effects.

Results

A total of 253 valid questionnaires were analyzed, with a participant composition of 81.82% females and 18.18% males, and the majority being nurses (62.06%). Psychological stress responses varied by gender and age, with females and older age groups showing higher physical stress responses (P < 0.05). Correlation and regression analyses indicated that negative coping and lower levels of social support were associated with increased stress responses (P < 0.05). Path analysis revealed that intra-family and extra-family support influenced stress responses directly and indirectly through coping strategies (P < 0.05).

Conclusion

This study suggests that perceived social support directly influences stress responses in frontline medical personnel during disasters, with coping strategies mediating this effect. Future research should explore these dynamics over time through longitudinal studies.

An EEG-based marker of functional connectivity: detection of major depressive disorder

Major depressive disorder (MDD) is a prevalent psychiatric disorder globally. There are many assays for MDD, but rapid and reliable detection remains a pressing challenge. In this study, we present a fusion feature called P-MSWC, as a novel marker to construct brain functional connectivity matrices and utilize the convolutional neural network (CNN) to identify MDD based on electroencephalogram (EEG) signal. Firstly, we combine synchrosqueezed wavelet transform and coherence theory to get synchrosqueezed wavelet coherence. Then, we obtain the fusion feature by incorporating synchrosqueezed wavelet coherence value and phase-locking value, which outperforms conventional functional connectivity markers by comprehensively capturing the original EEG signal's information and demonstrating notable noise-resistance capabilities. Finally, we propose a lightweight CNN model that effectively utilizes the high-dimensional connectivity matrix of the brain, constructed using our novel marker, to enable more accurate and efficient detection of MDD. The proposed method achieves 99.92% accuracy on a single dataset and 97.86% accuracy on a combined dataset. Moreover, comparison experiments have shown that the performance of the proposed method is superior to traditional machine learning methods. Furthermore, visualization experiments reveal differences in the distribution of brain connectivity between MDD patients and healthy subjects, including decreased connectivity in the T7, O1, F8, and C3 channels of the gamma band. The results of the experiments indicate that the fusion feature can be utilized as a new marker for constructing functional brain connectivity, and the combination of deep learning and functional connectivity matrices can provide more help for the detection of MDD.

The impact of COVID-19 pandemic on healthcare workers under the "Ten New Guidelines" in Taizhou, China

Purpose

We explored the influence of the "Ten new guidelines" on healthcare workers' preparedness, work impact, personal life impact, concerns, and support in Taizhou, China.

Methods

A hospital-based self-administered online survey was conducted to investigate the levels of COVID-19 related experience among healthcare workers in December 2022. In total, 472 out of 2080 healthcare workers (22.7 % response rate) completed the questionnaires with valid responses. Stepwise linear regression was used to investigate the independence of factors associated with preparedness, work impact, personal life impact, concerns, and support.

Results

The results revealed that working position (p < 0.001), pressure (p = 0.005), and negative affect (p < 0.001) were significantly associated with preparedness. Working position (p = 0.015), number of children (p = 0.040), working years (p = 0.019), COVID-19 risk perception (p < 0.001), work overload (p < 0.001), and negative affect (p < 0.001) were significantly associated with work impact. In addition, COVID-19 risk perception (p < 0.001), work overload (p < 0.001), pressure (p = 0.002), history of COVID-19 infection (p = 0.008), and awareness of possible infectious time (p = 0.031) were significantly associated with personal life impact. COVID-19 risk perception (p < 0.001), negative affect (p < 0.001), and work overload (p = 0.020) were significantly associated with concerns. Sex (p = 0.020) and negative affect (p = 0.016) were significantly associated with support.

Conclusion

Negative affect was the most significant factor associated with COVID-19 related questions among healthcare workers under "Ten new guidelines" during COVID-19 pandemic.

Higher Subjective Burden in Psychiatric Compared to Somatic Healthcare Workers in Germany During the first wave of the COVID-19 Pandemic

The COVID-19 pandemic has posed unprecedented challenges for health care workers (HCWs) worldwide. While the adverse effects of the pandemic on the well-being of HCWs in general have now been established, little is known about the impact on HCWs of psychiatric hospitals (PHCWs). PHCWs are of special interest, given that they faced both an increase in infection rates among psychiatric patients as well as in mental strain of the general public due to consequences of the pandemic. The aim of the present study was to investigate how the pandemic affected PHCWs as well as possible differences between PHCWs and other health care workers (OHCWs) in Germany during the first wave of the pandemic. We conducted a country-wide anonymous online survey early during the first pandemic wave between April 15th and May 1st, 2020, to assess different aspects of subjective burden and perceived stress using 5-point Likert-scale questions. We analysed data of 1530 PHCWs and 2114 OHCWs and showed that PHCWs reported higher subjective burden and stress compared to OHCWs (p<0.001). Overall, nurses from both groups of HCWs showed higher ratings in subjective burden and stress than physicians. These higher ratings for subjective burden were even more pronounced for nurses working in psychiatric hospitals. Future research is needed to investigate the causes for PHCWs' increased stress and subjective burden, especially when taking into account the long-term effects of the pandemic, which may lead to further challenges and an ever-increasing workload, especially for PHCWs.

Depression severity mediates stigma and quality of life in clinically stable people with schizophrenia in rural China

BACKGROUND

Depressive symptoms associated with schizophrenia are closely related to stigma and quality of life(QOL). There is, however, no thorough research on the connection between the three. This study sought to investigate the possible factors influencing depressive symptoms in people with schizophrenia (PWS) in rural Chaohu, China, and to further explore the role of depression severity in stigma and lifestyle quality.

METHODS

Eight hundred twenty-one schizophrenia patients accomplished the entire scale, including the 9-item Patient Health Questionnaire (PHQ-9), the Social Impact Scale (SIS), and the World Health Organization on Quality of Life Brief Scale(WHOQOL-BREF). A straightforward mediation model was employed to determine if the intensity of the depression could act as a mediator between stigma and QOL.

RESULTS

Two hundred seventy-nine schizophrenia patients (34%) had depressive symptoms (PHQ ≥ 10), and 542 patients (66%) did not (PHQ < 10). Logistic regression showed that marital status, job status, physical exercise, standard of living, and stigma contributed to the depressed symptoms of schizophrenia. Depression severity partially mediated the effect between stigma and QOL, with a mediating effect of 48.3%.

CONCLUSIONS

This study discovered a significant incidence of depressed symptoms associated with schizophrenia, with depression severity serving as a mediator variable connecting stigma and QOL and partially moderating the association.

Factors associated with depression among healthcare workers during the COVID-19 pandemic: a systematic review and meta-analysis

The COVID-19 pandemic has had a profound impact on the mental health of healthcare workers (HCWs). We aimed to identify the factors associated with depression among HCWs during the pandemic. We conducted literature search using eight electronic databases up to July 27 2022. Observational studies with more than 200 participants investigating correlates of depression in HCWs after COVID-19 outbreak were included. We used fixed- and random-effects models to pool odds ratios (ORs) across studies, and Cochran's chi-squared test and I 2 statistics to assess study heterogeneity. Publication bias was evaluated by funnel plots. Thirty-five studies involving 44,362 HCWs met the inclusion criteria. Female (OR=1.50, 95% CI [1.23,1.84]), single (OR=1.36, 95% CI [1.21,1.54]), nurse (OR=1.69, 95% CI [1.28,2.25]), history of mental diseases (OR=2.53, 95% CI [1.78,3.58]), frontline (OR=1.79, 95% CI [1.38,2.32]), health anxiety due to COVID-19 (OR=1.88, 95% CI [1.29,2.76]), working in isolation wards (OR=1.98, 95% CI [1.38,2.84]), and insufficient personal protective equipment (OR=1.49, 95% CI [1.33,1.67]) were associated with increased risk of depression. Instead, HCWs with a positive professional prospect (OR=0.34, 95% CI [0.24,0.49]) were less likely to be depressed. This meta-analysis provides up-to-date evidence on the factors linked to depression among HCWs during the COVID-19 pandemic. Given the persistent threats posed by COVID-19, early screening is crucial for the intervention and prevention of depression in HCWs.

Age-Related Differences in Anxiety and Depression Diagnosis among Adults in Puerto Rico during the COVID-19 Pandemic

Residents of Puerto Rico bear a significant burden of mental health disorders, which the COVID-19 pandemic may have exacerbated. However, age-specific data on these disorders during the pandemic in Puerto Rico are scarce. This study evaluated age-related differences in the self-reported diagnosis of depression and anxiety among adults ≥18 years residing in Puerto Rico during the pandemic. An anonymous online survey was administered from December 2020 to February 2021 via Google Forms to measure self-reported sociodemographic and behavioral characteristics and physician-diagnosed mental health disorders. Multivariable logistic regression models were conducted for each self-reported mental health diagnosis after adjusting for sex, education, income, marital status, chronic diseases, and smoking. Out of 1945 adults, 50% were aged 40 years and over. Nearly 24% of responders self-reported an anxiety diagnosis, whereas 15.9% reported depression. Compared to individuals 50 years and over, those 18-29 y, 30-39 y, and 40-49 y had significantly higher odds of an anxiety diagnosis (OR = 1.84, 95% CI = 1.34-2.55; OR = 1.50, 95% CI = 1.09-2.07; and OR = 1.37, 95% CI = 1.01-1.87, respectively). However, no association between age and depression diagnosis was found. Despite anxiety and depression being frequent disorders during the pandemic in this sample, younger adults bear a higher burden of anxiety. Further research is needed to allocate appropriate mental health resources during emergencies according to population subgroups.

Factors Affecting Health-Related Quality of Life among Healthcare Workers during COVID-19: A Cross-Sectional Study

Background and Objectives: Healthcare workers are threatened by psychological well-being and mental health problems in disasters related to new infectious diseases, such as COVID-19, and this can also have a negative impact on health-related quality of life. Health-related quality of life of healthcare workers should not be neglected because it is closely related to patient safety. This study aimed to identify the relationship between mental health problems, psychological safety, sleep quality, and health-related quality of life of healthcare workers and factors that influence health-related quality of life during the COVID-19 pandemic. Materials and Methods: Data were collected from 301 healthcare workers working in five general hospitals with more than 300 beds in two provinces from 5 July 2021 to 16 July 2021. Data were analyzed using SPSS WIN 27.0. The data were analyzed using t-test, one-way analysis of variance, and stepwise multiple regression. Results: Our results showed that there was a significant difference in regular exercise, religion, economic status, and sleep quality. The DASS-21 stress, economic status, and alcohol consumption were factors affecting the total health-related quality of life. In the subcategories, the physical component score was influenced by DASS-21 stress and economic status, while the mental component score was influenced by DASS-21 depression, economic status, alcohol consumption, and sleep quality. Conclusions: Health care workers need continuous and active monitoring of their health level and quality of life, as they are at a risk of increasing work burden and infection due to prolonged exposure to COVID-19 as well as mental health issues such as stress and depression. Additionally, at the individual level, active participation in various programs that can raise awareness of health-related quality of life along with physical health promotion activities should be encouraged. At the organizational level, it is necessary to prepare a compensation system, such as adjusting the workload of healthcare workers and ensuring break time; at the government level, disaster-related policies are needed to ensure a safe working environment for health care workers.

Night shifts, insomnia, anxiety, and depression among Chinese nurses during the COVID-19 pandemic remission period: A network approach

Background

The outbreak of the COVID-19 pandemic imposed a heavy workload on nurses with more frequent night shifts, which led to higher levels of insomnia, depression, and anxiety among nurses. The study aimed to describe the symptom-symptom interaction of depression, anxiety, and insomnia among nurses and to evaluate the impact of night shifts on mental distress via a network model.

Methods

We recruited 4,188 nurses from six hospitals in December 2020. We used the Insomnia Severity Index, Patient Health Questionnaire-9, and Generalized Anxiety Disorder Scale-7 to assess insomnia, depression, and anxiety, respectively. We used the gaussian graphical model to estimate the network. Index expected influence and bridge expected influence was adapted to identify the central and bridge symptoms within the network. We assessed the impact of night shifts on mental distress and compared the network structure based on COVID-19 frontline experience.

Results

The prevalence of depression, anxiety, and insomnia was 59, 46, and 55%, respectively. Nurses with night shifts were at a higher risk for the three mental disorders. "Sleep maintenance" was the central symptom. "Fatigue," "Motor," "Restlessness," and "Feeling afraid" were bridge symptoms. Night shifts were strongly associated with sleep onset trouble. COVID-19 frontline experience did not affect the network structure.

Conclusion

"Sleep maintenance," "Fatigue," "Motor," and "Restlessness" were important in maintaining the symptom network of anxiety, depression, and insomnia in nurses. Further interventions should prioritize these symptoms.