Mental Health, Sense of Coherence, and Interpersonal Violence during the COVID-19 Pandemic Lockdown in Germany

Patient-reported outcomes in advanced NSCLC before and during the COVID-19 pandemic: Real-world data from the German prospective CRISP Registry (AIO-TRK-0315)

Patients with lung cancer under treatment have been associated with a high risk of COVID-19 infection and potentially worse outcome, but real-world data on patient-reported outcomes (PROs) are rare. We assess patients' characteristics and PROs before and during the COVID-19 pandemic in an advanced non-small cell lung cancer (NSCLC) cohort in Germany. Patients with locally advanced or metastatic NSCLC from the prospective, multicentre, observational CRISP Registry (NCT02622581) were categorised as pre-pandemic (March 2019 to Feb 2020, n = 1621) and pandemic (March 2020 to Feb 2021, n = 1317). From baseline to month 15, patients' health-related quality of life (HRQoL) was assessed by FACT-L, anxiety and depression by PHQ-4. Association of pandemic status with time to deterioration (TTD) in QoL scales adjusted for potential covariates was estimated using Cox modelling. PROs were documented for 1166 patients (72%) in the pre-pandemic, 979 (74%) in the pandemic group. Almost 60% of patients were male, median age was 66 years, comorbidities occurred in 85%. Regarding HRQoL, mean-change-from-baseline plots hardly differed between both samples. Approximately 15%-21% of patients reported anxiety, about 19%-27% signs of depression. For the pandemic group, TTD was slightly, but statistically significantly, worse for the physical well-being-FACT-G subscale (HR 1.15 [95%CI 1.02-1.30]) and the anxiety-GAD-2 subscale (HR 1.14 [95%CI 1.01-1.29]). These prospectively collected real-world data provide valuable insights into PROs before and during the COVID-19 pandemic in advanced NSCLC. For the patients, the pandemic seemed to be less of a burden than the disease itself, as there was a considerable proportion of patients with anxiety and depression in both groups.

Emerging Trends in Intimate Partner Rape and Marital/Spousal Rape During the Biennium 2020 and 2021, Including the COVID-19 Pandemic in Greece

Intimate partner or marital/spousal rape is a phenomenon with unique characteristics and dynamics. Furthermore, it is an under-explored, under-defined, under-reported, and widely tolerated phenomenon. Gender-based violence and intimate partner violence are the main topics of the present study. The study aimed at exploring the trends in reported intimate partner and marital/spousal rape, within the wider context of reported domestic violence during the years 2020 and 2021 in Greece. Statistical analysis has not indicated positive correlation between the rate of reported domestic violence per year and the rate of reported domestic rape per year, with the former following an upward trend and the latter maintaining an almost steady course. Similarly, the rate of reported victims of intimate partner rape per year remained almost stable within in the 2 years. Importantly however, in 2021, the rate of reported victims of marital rape per year increased remarkably compared to 2020. In 2021, the rates of reported domestic violence per month and reported domestic rape per month indicated remarkable increase over the period May to December 2021. Notwithstanding, the rates mentioned above remained almost stable over the year 2020, showing an upward trend during the summer months. In August 2020 and 2021 the abovementioned rates reached their peak. In both years, the vast majority of victims of domestic rape were females, mostly between 30 and 45 years of age. The present study indicated an increase in rates of reported domestic violence and reported domestic rape per month after the lockdowns, especially after the second long-lasting lockdown that ended in May 2021. This increase, however, might be only apparent. Further research is needed to study the epidemiology of intimate partner and marital rape over a much longer timespan to provide further insight into the dynamics surrounding a public health concern.

Predictors of somatic symptom burden in healthcare professionals during the COVID-19 pandemic: an 8-week follow-up study

BACKGROUND

Literature investigating the impact of COVID-19 on healthcare professionals barely addresses predictors of somatic symptom burden during the COVID-19 pandemic.

AIMS

As biopsychosocial models propose that not only the disease but also sociodemographic and psychosocial factors contribute to the development and maintenance of symptoms, this study investigates the predictive value of these factors for bothersome somatic symptoms in SARS-CoV-2 negative healthcare professionals.

METHODS

German healthcare professionals were assessed with self-rating questionnaires and underwent SARS-CoV-2 IgG antibody tests at baseline and 8 weeks later between April and August 2020. Differences in psychosocial variables between the time points were analyzed and regression analyses were performed to predict somatic symptoms at follow-up.

RESULTS

1185 seronegative healthcare professionals completed both assessments. Previous somatic symptom burden, higher levels of anxiety, being a nurse, younger age, higher psychological symptom burden, lower efficiency, and higher fatigability at baseline predicted somatic symptom burden at follow-up. Comparisons between baseline and follow-up showed a significant improvement in psychological impairment and deterioration of physical exhaustion.

CONCLUSIONS

Our study applies a biopsychosocial perspective to bothersome somatic symptoms during the COVID-19 pandemic and contributes to the identification of potential risk factors as a starting point for future interventions that could support the handling of symptoms.

The effects of COVID-19 on domestic and international security in democratic and authoritarian regimes

While numerous studies have examined how the COVID-19 pandemic has affected health care systems, supply chains, and economies, we do not understand how the pandemic has impacted the security of democratic and authoritarian states from a global standpoint. Thus, this study examines how COVID-19 has affected the security of democratic and authoritarian regimes. In conducting a historical, qualitative review of the security effects of the pandemic, we find that COVID-19 significantly affected domestic and international security for democratic and authoritarian states in both similar and varied ways. Additionally, the manner in which states responded to the pandemic was often conditioned by their regime type and by the nature of the governing leadership during the pandemic. These findings have important implications in considering how COVID-19 affected the security of democratic and authoritarian states, how regime type shapes government responses to infectious disease outbreaks, and how democratic and authoritarian states may respond to future pandemics.

The COVID-19 pandemic and mental health in Kazakhstan

The COVID-19 pandemic had significant impacts on mental health. We examined factors associated with symptoms of depression and anxiety during the COVID-19 pandemic in Kazakhstan. We surveyed 991 adults in Kazakhstan in July 2021 using multistage stratified sampling. Depression and anxiety were measured with the Patient Health Questionnaire-4. We conducted logistic regression to assess associations between depression and anxiety and sociobehavioral factors. Overall, 12.01% reported depressive symptoms and 8.38% anxiety. Higher likelihood of depression was associated with being female (AOR: 1.64; 95% CI [1.05, 2.55]), having experience with COVID-19 in the social environment (AOR: 1.85; 95% CI [1.1-3.14]), experiencing food insecurity (AOR: 1.80; 95% CI [1.11-2.89]), increased family conflict (AOR: 2.43; 95% CI [1.32-4.48]) and impaired healthcare access (AOR: 2.41; 95% CI [1.32-4.41]). Higher likelihood of anxiety was associated with being female (AOR: 3.43; 95% CI [1.91-6.15]), increased family conflict (AOR: 2.22; 95% CI [1.11-4.44]) and impaired healthcare access (AOR: 2.63; 95% CI [1.36-5.12]). Multiple factors were associated with mental health in Kazakhstan during the COVID-19 pandemic. Further research is needed to determine the extent to which these factors and their associated mental health outcomes may persist.

Screening for and Disclosure of Domestic Violence during the COVID-19 Pandemic: Results of the PRICOV-19 Cross-Sectional Study in 33 Countries

The COVID-19 pandemic left no one untouched, and reports of domestic violence (DV) increased during the crisis. DV victims rarely seek professional help, yet when they do so, they often disclose it to their general practitioner (GP), with whom they have a trusting relationship. GPs rarely screen and hence rarely take the initiative to discuss DV with patients, although victims indicate that offering this opportunity would facilitate their disclosure. This paper aims to describe the frequency of screening for DV by GPs and disclosure of DV by patients to the GP during the COVID-19 pandemic, and to identify key elements that could potentially explain differences in screening for and disclosure of DV. The PRICOV-19 data of 4295 GP practices from 33 countries were included in the analyses, with practices nested in countries. Two stepwise forward clustered ordinal logistic regressions were performed. Only 11% of the GPs reported (much) more disclosure of DV by patients during COVID-19, and 12% reported having screened for DV (much). Most significant associations with screening for and disclosure of DV concerned general (pro)active communication. However, (pro)active communication was performed less frequently for DV than for health conditions, which might indicate that GPs are insufficiently aware of the general magnitude of DV and its impact on patients and society, and its approach/management. Thus, professional education and training for GPs about DV seems highly and urgently needed.

The Association between Physical and Psychological Domestic Violence Experienced during the COVID-19 Pandemic and Mental Health Symptoms

Research has shown that rates of domestic violence generally increased during the coronavirus 2019 (COVID-19) pandemic, likely related to mitigation efforts that promoted staying at home and lockdown protocols. However, the link between pandemic-related domestic violence victimization and mental health outcomes has been less explored. The present study examined the possible association between exposure to domestic physical and psychological violence during the COVID-19 pandemic and depressive and post-traumatic stress symptoms (PTSS) in an online sample of American adults recruited in December 2021. Data from 604 participants were analyzed. Forty-four percent of participants (n = 266) reported experiencing physical domestic violence, psychological domestic violence, or both during the pandemic, with psychological violence more commonly reported than physical violence. Exposure to both forms of violence was associated with higher rates of depressive and post-traumatic stress symptoms. Given the high rates and negative associations between psychological domestic violence and mental health symptoms in this sample, healthcare providers should assess for domestic violence exposure even if no indications of physical abuse are present or if there were not concerns about domestic violence exposure prior to the pandemic. Potential psychological sequalae should also be assessed if a patient has a positive history of domestic violence victimization.

Perpetration of Intimate Partner Violence and COVID-19-Related Anxiety During the Second Lockdown in Portugal: The Mediating Role of Anxiety, Depression, and Stress

Purpose

The restrictions imposed during lockdown by COVID-19 pandemic entailed increased risks for the perpetration of intimate partner violence (IPV). Widespread fear and uncertainty related to the virus and the policies adopted to contain it have been linked to a set of social, emotional, and economic stressors that can increase the risk of IPV. The present study aims to assess the association between COVID-19-related anxiety, psychological distress (depression, anxiety, and stress), and IPV perpetration in the community, as well as to assess the mediating role of psychological distress and depression, anxiety, and stress in the relationship between COVID-19-related anxiety and the perpetration of IPV.

Methods

A sample of 336 participants (282 females, Mage = 34.91, SD = 11.72) was recruited from the Portuguese population through an online self-report questionnaire, completed after the second lockdown (from April and July 2021).

Results

High rates of IPV perpetration during the confinement, in particular psychological and physical IPV, were found. COVID-19-related anxiety and psychological distress (depression, anxiety, and stress) were related to higher levels of IPV perpetration. Psychological distress and stress mediated the relationship between COVID-19-related anxiety and total IPV perpetration and psychological distress and depression mediated the relationship between COVID-19-related anxiety and psychological IPV perpetration.

Conclusions

This study highlights the mediating role of psychological distress on IPV perpetration. Practical implications for intervention policies in IPV perpetration will be discussed.

Mobile opportunity against stress: Open study protocol on the effectiveness of a mobile platform for stress self-management in the post-pandemic era

Mobile health platforms have shown promise in the management of various mental health conditions (including stress, anxiety, and depression) and cognitive behavioral strategies emerged as a popular and effective option offered by the platforms. This paper presents the protocol of a study aimed to test the effectiveness of a mobile platform that uses cognitive-behavioral strategies for stress self-management in the Tuscany region (Italy). The mobile app is adapted to the specific needs of each vulnerable population for which it is designed: young and older people, healthcare professionals, entrepreneurs. The app will be evaluated on the following outcomes: (i) perceived susceptibility and severity of the pandemic situation, perceived benefits, and costs of preventive health behaviors, (ii) knowledge about Covid-19 preventive behaviors and negative consequences of social distancing, (iii) stress and psychopathological symptoms (i.e., anxiety, depression, and post-traumatic stress symptoms) and cognitive distortions. If successful, we expect that the platform could give various groups clinical benefits by providing symptom self-monitoring and early intervention, consolidating the number of mental health programs available, and decreasing barriers to treatment-seeking. This population-level approach has the potential to improve mental health outcomes in pandemic periods for many people.

The Impact of Covid-19 Pandemic and Social Determinants of Health on the Prevalence of Intimate Partner Violence. A Systematic Review

Background

The pandemic has increased the rates of violent behavior towards women by their partners worldwide. Increased time spent living with the abusive partner, working at home and limited social contact combined with socioeconomic characteristics contributed to the increase in this type of violence.

Objective

To investigate the impact of pandemic COVID-19 and social determinants of health (SDOH) on the intimate partner violence (IPV) experienced by women from their partners.

Methods

A systematic review was conducted to investigate the impact of COVID-19 and social determinants of health on violence experienced by women from their partner(s) as a consequence of incarceration. The Pubmed and Scopus databases were searched during December 2022, using the keywords "intimate partner violence", "women", "COVID-19", "socioeconomic factors", "social determinants of health".

Results

Of the 917 studies initially retrieved, 38 studies found an increased prevalence of women's reported violence by their partners, 10 found a low prevalence, and 9 found no difference in prevalence before and during restraint. The most common forms of violence were psychological, physical and sexual. In 30 studies, social determinants such as socioeconomic level, education and living conditions were found to be associated with the prevalence of violence.

Conclusion

There was an increase in violence against women during quarantine which was associated with the effect of social determinants. However, due to research limitations of the studies, additional research is needed to draw firm conclusions that can be generalized to the population.

Fluctuations of psychological states on Twitter before and during COVID-19

The COVID-19 pandemic has been repeatedly associated with poor mental health. Previous studies have mostly focused on short time frames such as around the first lockdown periods, and the majority of research is based on self-report questionnaires. Less is known about the fluctuations of psychological states over longer time frames across the pandemic. Twitter timelines of 4,735 users from London and New York were investigated to shed light on potential fluctuations of several psychological states and constructs related to the pandemic. Moving averages are presented for the years 2020 and 2019. Further, mixed negative binomial regression models were fitted to estimate monthly word counts for the time before and during the pandemic. Several psychological states and constructs fluctuated heavily on Twitter during 2020 but not during 2019. Substantial increases in levels of sadness, anxiety, anger, and concerns about home and health were observed around the first lockdown periods in both cities. The levels of most constructs decreased after the initial spike, but negative emotions such as sadness, anxiety, and anger remained elevated throughout 2020 compared to the year prior to the pandemic. Tweets from both cities showed remarkably similar temporal patterns, and there are similarities to reactions found on Twitter following other previous traumatic events.

The study of psychological traits among Chinese college students during the COVID-19 campus lockdown

To investigate the prevalence of interpersonal sensitivity, anxiety, depression symptoms and associated risk factors among a large-scale sample of college students in China during the COVID-19 campus lockdown. The survey was conducted among undergraduate students at a university in eastern part of China in April 2022. The Chi-square test was used to compare the different variable groups and multivariable analysis was performed for the risk factors associated with interpersonal sensitivity, anxiety, and depression symptoms. A total of 12,922 college students were included, with an average age of (20.96 ± 1.66) years. The prevalence of interpersonal sensitivity, anxiety and depression symptoms in this study was 58.1, 22.7, and 46.8%, respectively. Male (OR = 1.16, p < 0.001), 22–23 years (OR = 1.40, p < 0.001), freshman (OR = 1.35, p = 0.002), and non-only child (OR = 1.15, p < 0.001) were positively associated with interpersonal sensitivity. Male (OR = 1.20, p < 0.001), sophomores (OR = 1.27, p = 0.020) and seniors (OR = 1.20, p = 0.027) were positively associated with anxiety symptoms. Compared with female students, male students (OR = 0.89, p < 0.001) were less likely to have depression symptoms. 22–23 years (OR = 1.37, p < 0.001), sophomores (OR = 1.26, p = 0.009) and non-only child (OR = 1.11, p = 0.009) were positively associated with depression symptoms. In addition, college students aged 18–21 years, learning status, skipping breakfast, roommate relationship and sleep quality were associated with interpersonal sensitivity, anxiety and depression symptoms (all p < 0.05). The findings of this study suggest a high prevalence of interpersonal sensitivity, anxiety and depression symptoms among Chinese college students during the COVID-19 campus lockdown. Younger ages, low grades, poor dormitory relationship, negative learning status, skipping breakfast and poor sleep quality were the risk factors for college students’ mental health, which should be concerned by the relevant departments of school during the campus lockdown.

How things changed during the COVID-19 pandemic's first year: A longitudinal, mixed-methods study of organisational resilience processes among healthcare workers

COVID-19 had a huge impact on healthcare systems globally. Institutions, care teams and individuals made considerable efforts to adapt their practices. The present longitudinal, mixed-methods study examined a large sample of healthcare institution employees in Switzerland. Organisational resilience processes were assessed by identifying problematic real-world situations and evaluating how they were managed during three phases of the pandemic's first year. Results highlighted differences between resilience processes across the different types of problematic situations encountered by healthcare workers. Four configurations of organisational resilience were identified depending on teams' performance and ability to adapt over time: "learning from mistakes", "effective development", "new standards" and "hindered resilience". Resilience trajectories differed depending on professional categories, hierarchical status and the problematic situation's perceived severity. Factors promoting or impairing organisational resilience are discussed. Findings highlighted the importance of individuals', teams' and institutions' meso- and micro-level adaptations and macro-level actors' structural actions.

How the COVID-19 pandemic divides society: Towards a better understanding of differences between supporters and opponents of the COVID-19 pandemic lockdown in Germany

Implemented COVID-19 containment measures have been fiercely discussed in Germany and corona-related protests have emerged. We assessed mental health in response to the lockdown in Germany and aimed at detecting factors differentiating opponents and supporters of the COVID-19 containment measures. Using a cross-sectional online survey (n = 1219) with a mixed-methods approach, we found increased levels of anxiety and depressive symptoms (PHQ-4 and GAD-7), overall lower well-being (WHO-5), worsened sleep, increased prevalence of interpersonal violence (5.2%) as well as more pronounced irritability including anger and aggression compared to pre-COVID-19 times for all participants. Moreover, opponents demonstrated a more pronounced mental burden with more depression and anxiety, more anger and coping difficulties compared to supporters. In line with previous research, we found opponents to be well-educated, financially stable and strongly estranged by their political institutions. Additionally, applying regression analysis, we found anxiety and negative self-concept to differentiate between opponents and supporters of the COVID-19 pandemic lockdown. Qualitative data confirms an increase in mental burden. Taken together, we identify a more vulnerable group opposing COVID-19 containment measures. Our results inform the public about opponents' motives, concerns and needs and open another perspective on the effects of the COVID-19 pandemic and its related containment measures.

How Did Corona Crisis Managers in Germany Make Sense of the Psychosocial Situation?

Alongside its immediate consequences for physical health, the current Coronavirus pandemic and the associated containment measures have led to multiple psychosocial consequences for the population. While virus containment is the main motive of crisis management, there is, so far, little evidence on how crisis management actors consider findings about the psychosocial state of the German population. This paper therefore examines the role of psychosocial consequences within the work of crisis management organizations during the Corona pandemic in Germany. Against the theoretical background of the sensemaking concept, 14 qualitative interviews were conducted with decision-makers from municipal and state administrations, public health departments, aid organizations, and critical infrastructure organizations. Our results indicate that crisis managers perceive aspects related to the psychosocial situation as relevant, but in a very selective way. They use different and often non-scientific sources to acquire knowledge about the psychosocial consequences. In sum, these aspects do not play a major role in decision-making processes. We argue that the perception and processing of psychosocial consequences depend in particular on the organizational context such as goals, plausibility assumptions, identity conceptions, and problem frames. In order to extend theoretical models of psychosocial crisis management, more detailed knowledge of sensemaking processes in crisis management organizations is necessary.

Sexual Health During COVID-19: A Scoping Review

INTRODUCTION

The COVID-19 pandemic impacted profoundly on the wellbeing and social interactions of the world population, and all dimensions of sexual health were potentially affected by globally implemented preventive measures.

OBJECTIVES

The scoping review aimed to compile existing research investigating possible effects of COVID-19 lockdowns on adult sexual health, that is, sexual behavior, functioning, and satisfaction. Further, studies on the interplay between mental health and sexual well-being during the pandemic were reviewed.

METHODS

The review was conducted in accordance with guidelines established by the Joanna Briggs Institute and the Extension for Scoping Reviews (PRISMA-ScR) Checklist. On October 11-12, 2021, PubMed, Embase, PsycInfo, Cinahl, Cochrane, Sociological Abstracts and Scopus were systematically searched for relevant peer-reviewed papers employing quantitative methodology. Additionally, unpublished ("grey") research studies on the subject were retrieved. The screening, data extraction, and analysis of evidence were conducted by 4 independent reviewers using an iterative approach.

RESULTS

Based on 107 studies included, the scoping review showed that the pandemic had had a wide impact on all dimensions of sexual health. Except for solo sex activities, mainly negative COVID-19 implications were identified, although findings were, in sum, characterized by complexity and unpredictability. Thus, sexual behavior, functioning, and satisfaction during the pandemic appeared to be mitigated by a broad range of sociodemographic and contextual factors. Finally, sexual health seemed deeply entwined with overall mental health.

CONCLUSION

The scoping review revealed a broad range of COVID-19-related effects on sexual health, including an overall decline in partnered sex and a concurrent increase in solo sex activities. It also emphasized a need for future research to shed light on possible long-term consequences of the pandemic in various population groups and on all aspects of sexual health. Toldam NE, Graugaard C, Meyer R, et al. Sexual Health During COVID-19: A Scoping Review. Sex Med Rev 2022;10:714-753.

Coping profiles and differences in well‐being during the COVID‐19 pandemic: A latent profile analysis

During the current COVID-19 pandemic, people need to cope with multiple stressors which may affect their well-being. This study aimed (1) to identify latent coping profiles in the German general population, and (2) to investigate differences between these profiles in well-being. In total, N = 2326 German participants were recruited as part of the European Society of Traumatic Stress Studies (ESTSS) ADJUST study from June to September 2020 using an online survey. Coping strategies were assessed using the Brief-COPE and the Pandemic Coping Scale; well-being was assessed using the WHO-5 Well-Being Index. Coping profiles were identified using latent profile analysis; differences between profiles were examined using the automatic BCH method and multiple group analyses. Five coping profiles were identified that included different types and numbers of coping strategies: (1) High functional coping (17.84%), (2) Moderate functional coping (40.63%), (3) High functional and religious coping (9.07%), (4) Low functional coping (22.06%), (5) Moderate functional and dysfunctional coping (10.40%). The identified profiles significantly differed in well-being (χ²  = 503.68, p <0.001). Coping profiles indicating high functional coping were associated with greater well-being compared to coping profiles indicating low (χ²  = 82.21, p <0.001) or primarily dysfunctional (χ²  = 354.33, p <0.001) coping. These results provide insight into how people differ in their coping strategies when dealing with stressors in an early phase of the COVID-19 pandemic. The study indicates higher levels of well-being in coping profiles with more frequent use of functional strategies. To promote well-being in the general population, it might be beneficial to train functional coping strategies in appropriate interventions that are associated with increased well-being.

Individual changes in stress, depression, anxiety, pathological worry, posttraumatic stress, and health anxiety from before to during the COVID-19 pandemic in adults from Southeastern Germany

BACKGROUND

Many studies have previously compared the prevalence or sample means of distress and mental health problems from before to during the COVID-19 pandemic, while results on changes at the individual-level, and regarding multiple outcome measures are demanded.

METHODS

This online study investigated individual changes in stress and mental health from before the COVID-19 pandemic to the first lockdown in adults from Southeastern Germany. This region was selected as it was where SARS-CoV-2 was first documented in Germany, and also due to the implementation of strict stay-at-home orders and social contact prohibitions. From April 10-27, 2020, we collected state measures and their clinical relevance for the subareas of perceived stress: worries, tension, joy, and demands. We also collected information regarding the following mental health problems: depression, anxiety, pathological worry, posttraumatic stress disorder (PTSD), and health anxiety; as well as retrospective measures of how participants felt they have changed in comparison to before the pandemic, ranging from worse to better.

RESULTS

The analytical sample comprised 396 adult participants. On average, participants experienced increases in worries, tension, and lack of joy, and increases in mental health problems, but a decrease in demands. Perceived increases in symptoms of depression (26.0%) and PTSD (25.5%) were significantly more frequent than in symptoms of anxiety (particularly acute fear and panic) (5.6%), pathological worry (9.8%), and health anxiety (7.3%) (ps<.001). One per 10 participants (10.4%) reported an increase in depressive symptoms, and nearly two per 10 (18.4%) an increase in PTSD symptoms and additionally showed a clinically relevant symptom strain during lockdown. Interestingly, mainly non-specific PTSD symptoms associated with a general stress reaction were experienced to be increased.

CONCLUSION

The findings suggest a dissociation of perceived changes in subareas of stress and mental health with a particular experience of increases in depressive and general stress symptoms and a decrease in external demands. This points to a need for a more differentiated view on the impact of the COVID-19 pandemic on stress and mental health, and for targeted interventions for mental health problems arising frequently during the pandemic.

The Impact of the COVID-19 Pandemic on Sexual Health in Cis Women Living in Germany

BACKGROUND

Preliminary research shows a substantial impact of the COVID-19 pandemic on women's sexual health, whereby empirical work on sexual well-being of minoritized sexual identities is still rare.

AIM

The objective of this study was to explore sexual health in heterosexual, lesbian and bisexual cis women during the first wave of COVID-19 pandemic in Germany.

METHODS

An anonymous nationwide online survey was conducted among cis women during the first nationwide lockdown in Germany from April 20th to July 20th, 2020. The questionnaire was distributed via e-mail, online chats and social-media platforms.

OUTCOMES

Demographic variables and self-report measures from the Sexual Behavior Questionnaire (SBQ-G) "before the pandemic" and "since the pandemic" were collected.

RESULTS

A total of 1,368 cis women participants were included: heterosexual women (n = 844), lesbian women (n = 293), bisexual women (n = 231). Results indicate overall decrease in frequency of sexual contacts and masturbation during the COVID-19 pandemic. Regarding differences before and during the pandemic lesbian women showed significant changes in sexual arousal whereas heterosexual women showed significant changes in all dimensions except capability to enjoy sexual intercourse. The data of bisexual women showed significant changes in almost all dimensions except for frequency of sexual intercourse and sexual arousal. Results of the multiple regression analysis revealed that being younger than 36 years-old, and being in a relationship as well as being heterosexual (compared with being lesbian) is positively associated with general satisfaction with sexual life during the pandemic.

CLINICAL IMPLICATIONS

The findings suggest that during a pandemic sexual and mental health care for (cis) women should be provided and address the specific needs of sexual minority groups.

STRENGTHS & LIMITATIONS

This is the first study to describe sexual behavior in heterosexual, lesbian and bisexual women during the COVID-19 pandemic in Germany. Limitations, however, include the fact that the data described were obtained at only one time point so there is a possibility of recall bias, and that the results cannot be generalized because of the underrepresentation of women over age 46.

CONCLUSION

This study examined the impact of the COVID-19 pandemic and resulting social constraints on the sexual health of particular groups of lesbian and bisexual women, which may improve preparedness for future public health and policy crises. Batz F, Lermer E, Hatzler L, et al. The Impact of the COVID-19 Pandemic on Sexual Health in Cis Women Living in Germany. J Sex Med 2022;19:907-922.

Psychological impact of the quarantine during the COVID-19 pandemic on the general European adult population: a systematic review of the evidence

AIMS

Due to the coronavirus disease 2019 (COVID-19) different countries implemented quarantine measures to limit the spread of the virus. Many studies analysed the mental health consequences of restrictive confinement, some of which focused their attention on specific populations. The general public's mental health also requires significant attention, however. This study aimed to evaluate the effects of the COVID-19 quarantine on the general population's mental health in different European countries. Risk and protective factors associated with the psychological symptoms were analysed.

METHODS

A systematic search was conducted on four electronic databases (PubMed, PsycINFO, Scopus and Google Scholar). Studies published up until 20th April 2021, and following eligibility criteria were selected for this review. One thousand three hundred thirty-five (1335) studies were screened, 105 of which were included. Via network analysis, the current study investigated the pathways that underlie possible risk factors for mental health outcomes.

RESULTS

Anxiety, depression, distress and post-traumatic symptoms are frequently experienced during the COVID-19 quarantine and are often associated with changes in sleeping and eating habits. Some socio-demographic and COVID-19-related variables were found to be risk factors for an individual's wellbeing. In particular, being female, young, having a low income, being unemployed and having COVID-19-like symptoms or chronic disorders, were found to be the most common risk factors for mental health symptoms.

CONCLUSIONS

The COVID-19 pandemic represented an unprecedented threat to mental health globally. In order to prevent psychological morbidity and offer support tailored to short-, medium- and long-term negative outcomes, it is essential to identify the direct and indirect psychosocial effects of the lockdown and quarantine measures, especially in certain vulnerable groups. In addition to measures to reduce the curve of viral transmission, policy makers should urgently take into consideration provisions to alleviate hazards to mental health.

Personality disorders (PD) and interpersonal violence (IV) during COVID-19 pandemic: a systematic review

Not only did the ongoing CoronaVIrus Disease-19 (COVID-19) pandemic cause a massive number of casualties, but also there is growing concern that the burden of its psychological aftermaths will only show up years down the road. This systematic review summarises the existing literature reporting the impact of COVID-19 on personality disorders (PDs)-related violence. MEDLINE and APA PsycINFO were independently searched for relevant studies by two authors. Eligible studies had to be identifiable through database searching, published and fully accessible. This systematic review was conducted according to Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. An initial pool of 241 studies were found, out of which 69 met the selection criteria and were, therefore, included. The majority reported a worse Mental Health Outcome (MHO) during the pandemic as related to dysfunctional personality and positive personality traits predicting a better outcome. Furthermore, increased levels of interpersonal violence (IV) and self-directed violence were reported. Further research should be conducted on the reciprocal interaction of PDs and IV during the time of pandemic. Nevertheless, the dramatic impact of restrictive measures on PDs has still to be appropriately addressed.

The Effect of the COVID-19 Pandemic on the Assessment of Sexual Life-Repeated Cross-Sectional Surveys among Polish Adults in 2017, 2020 and 2021

The study aims to investigate whether assessment of sexual life remained stable during the COVID-19 pandemic. Two surveys were conducted among Polish adults aged 18–70 years in June 2020 (n = 2042; perspective of last 2–3 months) and in June 2021 (n = 2418; last 12 months). Data from 2017 (n = 1980) were used as a reference point. Four questions allowed for defining five sexual life assessment profiles (k-means cluster analysis). Their characteristics were presented using 12 variables and 16 factors that contributed to difficulties in sexual life. The 2020 survey showed a temporary increase in the importance of sexual life and the frequency of sexual intercourse. However, the percentage of respondents representing the most favorable profile decreased significantly over the consecutive survey periods (47.1%, 34.2%, and 32.3%, respectively). Pandemic-induced fatigue and stress as well as the permanent presence of others at home were reported as two main factors negatively affecting the frequency of sexual intercourse during the pandemic. Respondents who assessed their sexual life as poor were more likely to consider illness, depression, and low self-esteem as factors negatively impacting their sexual life in 2021 than a year earlier. The results confirmed that as the pandemic drew on, the assessment of sexual life changed compared to the time around the first lockdown.

'I Think it Just Made Everything Very Much More Intense': A Qualitative Secondary Analysis Exploring The Role Of Friends and Family Providing Support to Survivors of Domestic Abuse During The COVID-19 Pandemic

The COVID-19 pandemic, and associated social restrictions, have amplified women's experiences of domestic abuse (DA). In usual times, female DA survivors reach out to those around them (friends, family members, neighbors, and colleagues) for support. Accessing of both professional and informal support by survivors has increased during the pandemic. Informal supporters are often deeply invested and immersed in situations of DA because of the closeness of relationships. The accounts of informal supporters are rarely sought, yet these are people who may have a considerable awareness of what is happening. The aim of this study was to explore how the pandemic had impacted people's assessment of abusive situations and their ability to provide informal support. This paper reports a secondary analysis of qualitative data collected in 2020 in England. The data were gathered in 18 in-depth interviews with people who knew a female friend, relative, neighbor, or colleague who had experienced DA. The age range of participants was 25-69 years, three were men and fifteen were women. A reflexive thematic analysis was carried out. Findings indicated: (i) the pandemic had changed people's ability to read situations and assess risk (ii) perpetrators were exploiting the pandemic to further abuse (iii) within the context of the pandemic there was additional challenge to offering support (iv) informal supporters found creative ways to remain in-touch and to continue offering support. Further research with informal supporters is needed to ascertain how best to support and equip people, without imposing an impossible burden.

Changes in Prevalence and Severity of Domestic Violence During the COVID-19 Pandemic: A Systematic Review

BACKGROUND

To contain the spread of COVID-19, governmental measures were implemented in many countries. Initial evidence suggests that women and men experience increased anger and aggression during COVID-19 lockdowns. Not surprisingly, media reports and initial empirical evidence highlight an increased risk for domestic violence (DV) during the pandemic. Nonetheless, a systematic review of studies utilizing participants' reports of potential changes in DV prevalence and severity during the pandemic as compared to pre-pandemic times is needed.

OBJECTIVE

To examine empirical, peer-reviewed studies, pertaining to the potential change in prevalence and severity of different types of DV during the COVID-19 pandemic, as reported by study participants.

DATA SOURCES

Electronic EMBASE, MEDLINE, PsycINFO, and CINAHL searches were conducted for the period between 2020 and January 5, 2022. References of eligible studies were integrated by using a snowballing technique.

STUDY SELECTION

A total of 22 primary, empirical, peer-reviewed studies published in English or German were included.

RESULTS

Of the 22 studies, 19 were cross-sectional whereas 3 included both pre-pandemic and during pandemic assessments. Data synthesis indicates that severity of all types of DV as well as the prevalence of psychological/emotional and sexual DV increased for a significant number of victims in the general population during the pandemic. Evidence for changes in prevalence regarding economic/financial, physical, and overall DV remains inconclusive. There was considerable between-study variation in reported prevalence depending on region, sample size, assessment time, and measure.

CONCLUSIONS

Data synthesis partly supports the previously documented increase in DV. Governmental measures should consider the availability of easily accessible, anonymous resources. Awareness and knowledge regarding DV need to be distributed to improve resources and clinical interventions.

A cross-sectional study of the psychological impact of the COVID-19 pandemic on undergraduate and graduate students in Japan

Background

Due to the COVID-19 pandemic, a state of emergency was declared in Japan and university classes were suspended, causing concern about the deterioration of the mental health of isolated students. This study aimed to understand students’ mental health status during the COVID-19 pandemic and suggest measures to prevent depressive anxiety among them.

Method

Undergraduate and graduate students at one national and two private universities in the Kansai region were surveyed. The Kessler Psychological Distress Scale-6 was used to assess the students’ mental health. Questions were included to assess students’ awareness of COVID-19 and changes in lifestyle habits, including drinking, smoking, gaming, and other addictive habits. The University of Tokyo Health Sociology's version of the Sense of Coherence Scale was used to assess the ability to cope with stressors.

Results

More than 50% of undergraduate and graduate students felt more than mild depressive anxiety and approximately 11% felt severe depressive anxiety, indicating that anxiety about the future worsened the levels of depressive anxiety. Life with reversed day and night schedules was associated with the worsening of depressive anxiety levels, but a high sense of coherence was associated with decreased levels of depressive anxiety.

Conclusion

COVID-19 pandemic triggered isolation which led to worsening the mental health of undergraduate and graduate students. Psychological support for lifestyle and a sense of coherence is necessary to prevent mental health deterioration among isolated students.

Limitations

As we were unable to contact all students, the sample bias may affect interpretation of the data

Mental health of the adult population in Germany during the COVID-19 pandemic. Rapid Review

This rapid review examines how the mental health of adults in the general population in Germany changed during the COVID-19 pandemic. We conducted a systematic literature search and included 68 publications as of July 30 2021. The underlying studies were classified according to their suitability for representative statements for the general population and for estimating changes in mental health over time. In addition, the observation period and operationalisation of outcomes were considered.

The first wave of infection and the summer plateau were mapped by 65% of the studies. Studies that were particularly suitable for representative statements due to their research design showed mixed results, which tend to indicate a largely resilient adult population with a proportion of vulnerable individuals. A predominantly negative development of mental health was described by results from more bias-prone study designs. Routine data analyses showed decreases in outpatient and especially inpatient care, increased use of a crisis service, mixed results for outpatient diagnoses, incapacity to work and mortality as well as indications of shifts in the spectrum of diagnoses. As the current evidence is ambiguous, generalised statements should be reflected in favour of a differentiated view. There is a need for research on the further course of the pandemic, specific risk groups and the prevalence of mental disorders.

[Transgender health and healthcare during the COVID‑19 pandemic: a cross-sectional online survey in German-speaking countries]

BACKGROUND AND OBJECTIVE

Since spring of 2020, the COVID‑19 pandemic has disrupted our day-to-day lives and led to negative consequences in various areas of life, including mental and physical wellbeing. In this article, we take a closer look at the situation of trans people, who - due to experiences with discrimination and marginalization as well as their specific health-related interests - could be characterized by a particular vulnerability.

METHODS

Using an online cross-sectional survey, which we designed collaboratively with experts from the trans community, we investigated the mental and physical health of trans people from German-speaking countries and their access to trans-related healthcare during the COVID‑19 pandemic in the period from 1 May 2020 to 31 January 2021.

RESULTS

Since the beginning of the COVID‑19 pandemic, trans people have experienced barriers in access to gender-affirming treatments, mental health services, and COVID‑19-related medical care. At the same time, trans people reported being affected by chronic diseases disproportionately more often than the general population, including those leading to a higher risk for poorer outcomes of a COVID‑19 infection. Moreover, the participants reported being exposed to many risk factors associated with higher mental distress (e.g., having a chronic illness, belonging to a minority based on a non-heterosexual orientation, or having a low income).

DISCUSSION

The results of this survey indicate that prior vulnerabilities with regards to health problems and the restricted access to an informed and qualified transgender healthcare were exacerbated by the COVID‑19 pandemic.

Mental health of the adult population in Germany during the COVID-19 pandemic. Rapid Review

This rapid review examines how the mental health of adults in the general population in Germany changed during the COVID-19 pandemic. We conducted a systematic literature search and included 68 publications as of July 30 2021. The underlying studies were classified according to their suitability for representative statements for the general population and for estimating changes in mental health over time. In addition, the observation period and operationalisation of outcomes were considered. The first wave of infection and the summer plateau were mapped by 65% of the studies. Studies that were particularly suitable for representative statements due to their research design showed mixed results, which tend to indicate a largely resilient adult population with a proportion of vulnerable individuals. A predominantly negative development of mental health was described by results from more bias-prone study designs. Routine data analyses showed decreases in outpatient and especially inpatient care, increased use of a crisis service, mixed results for outpatient diagnoses, incapacity to work and mortality as well as indications of shifts in the spectrum of diagnoses. As the current evidence is ambiguous, generalised statements should be reflected in favour of a differentiated view. There is a need for research on the further course of the pandemic, specific risk groups and the prevalence of mental disorders.

Humor and Hunger Affect the Response Toward Food Cues

The omnipresence of food cues in everyday life has been linked to troubled eating behavior and rising rates of obesity. While extended research has been conducted on the effects of negative emotions and stress on food consumption, very little is known about how positive emotions affect eating and particularly attention toward food cues. In the present study, we investigated whether humor impacts attentional bias toward food and whether it will affect preferences for healthy and unhealthy food items, depending on the hunger state. To do so, a group of randomly assigned participants watched funny video clips (humor group, N = 46) or neutral ones (control group, N = 49). Afterwards, they performed a modified Posner cueing task with low or high caloric food images serving as cues. We found a significant group × hunger interaction. Compared to the control group, the humor group responded more slowly to food cues when hungry, whereas the opposite was true when participants were satiated. Additionally, our results suggest that hunger possibly directs attention away from healthy food cues and toward unhealthy ones. No group differences were found with respect to food preferences and engagement and disengagement of attention. We discuss the potential of humor in counteracting aversive consequences of hunger on attention allocation toward food. We propose an underlying mechanism involving a combined reduction in cortisol levels and a decrease in activation of the reward system. However, given the novelty of the findings, further research is warranted, both to replicate the results as well as to investigate the suggested underlying processes.

Internal Locus of Control and Sense of Coherence Decrease During the COVID-19 Pandemic: A Survey of Students and Professionals in Social Work

Mental health is severely challenged by the COVID-19 pandemic due to a variety of restrictions in public and private life. Students in particular may face additional and unique stressors: face-to-face classes have been largely replaced by digital formats, leading to further reduced social contacts, thus facilitating the development of psychological symptoms. In this study, we aimed to assess the impact of the current peri-pandemic situation on students' 1) locus of control and 2) sense of coherence, both of which have been linked to mental health in previous work. A total of 403 social work students from Germany participated, providing both retrospective (pre-pandemic) and current (February/March 2021) ratings. Furthermore, 324 social work professionals were included to analyze differences between both groups. Locus of control shifted significantly from internal to external during the pandemic for students and professionals. Furthermore, high mental burden correlated with increased external and decreased internal locus of control. Sense of coherence decreased during the pandemic for the entire sample and correlated with high mental burden. Overall, students showed a stronger drop compared to professionals, primarily due to a more pronounced decrease in perceived meaningfulness (all p < 0.001). In summary, students and professionals responded with increased feelings of powerlessness in the absence of sufficient coping strategies-this could lead to further deterioration of mental health as the pandemic continues. In this context, students appear to be particularly vulnerable to a reduction in sense of coherence. We conclude that interventions to improve coping strategies are urgently needed.

Psychological Variables Associated with HPV Vaccination Intent in Romanian Academic Settings

The aim of this study was to evaluate (1) the female medical students’ knowledge about HPV infection; (2) the associations between the HPV vaccination intent and coping strategies, health locus of control (HLOC), and sense of coherence; and (3) the specific differences between preclinical and clinical students in terms of the vaccination intent. Participants included 1243 female medicine students (mean age = 21.526, SD = 2.007), who completed The Multidimensional Health Locus of Control (MHLC)—Form A, the Brief COPE Scale, the Sense of Coherence Scale (SOC-13), and two questionnaires measuring the knowledge about the HPV infection and the HPV vaccination intent. Results show a good knowledge about HPV, which progressively increased during the study cycles. Still, the main contributors to vaccination intent are represented by coping strategies and health locus of control. Refusal of vaccination is associated to behavioral disengagement and the use of religion, precontemplation and contemplation to denial, and preparation to planning, positive reframing, and the powerful others component of HLOC. Sense of coherence did not predict vaccination intent. In clinical years, active coping outweighs HLOC in making the decision to get vaccinated. These results could be helpful in designing personalized strategies for addressing vaccine hesitancy in academic communities.

Well-being during COVID-19 pandemic: A comparison of individuals with minoritized sexual and gender identities and cis-heterosexual individuals

BACKGROUND

Preliminary empirical data indicates a substantial impact of the COVID-19 pandemic on well-being and mental health. Individuals with minoritized sexual and gender identities are at a higher risk of experiencing such negative changes in their well-being. The objective of this study was to compare levels of well-being among cis-heterosexual individuals and individuals with minoritized sexual and gender identities during the COVID-19 pandemic.

METHODS

Using data obtained in a cross-sectional online survey between April 20 to July 20, 2020 (N = 2332), we compared levels of well-being (WHO-5) across subgroups (cis-individuals with minoritized sexual identities, individuals with minoritized gender identities and cis-heterosexual individuals) applying univariate (two-sample t-test) and multivariate analysis (multivariate linear regression).

RESULTS

Results indicate overall lower levels of well-being as well as lower levels of well-being in minoritized sexual or gender identities compared to cis-heterosexual individuals. Further, multivariate analyses revealed that living in urban communities as well as being in a relationship were positively associated with higher levels of well-being. Furthermore, a moderation analysis showed that being in a relationship reduces the difference between groups in terms of well-being.

CONCLUSION

Access to mental healthcare for individuals with minoritized sexual and gender identities as well as access to gender-affirming resources should be strengthened during COVID-19 pandemic. Healthcare services with low barriers of access such as telehealth and online peer support groups should be made available, especially for vulnerable groups.

Depression and anxiety in healthcare professionals during the COVID-19 pandemic

Healthcare staff have been at the centre of the fight against the COVID-19 pandemic, facing diverse work-related stressors. Building upon studies from various countries, we aimed to investigate (1) the prevalence of various work-related stressors among healthcare professionals in Germany specific to the COVID-19 pandemic, (2) the psychological effects of these stressors in terms of clinical symptoms, and (3) the healthcare professionals' help-seeking behaviour. To this end, N = 300 healthcare professionals completed an online survey including the ICD-10 Symptom Rating checklist (ISR), event-sampling questions on pandemic-related stressors and self-formulated questions on help-seeking behaviour. Participants were recruited between 22 May and 22 July 2020. Findings were analysed using t tests, regressions and comparisons to large clinical and non-clinical samples assessed before and during the pandemic. Results show that healthcare professionals were most affected by protective measures at their workplace and changes in work procedures. Psychological symptoms, particularly anxiety and depression, were significantly more severe than in a non-clinical pre-pandemic sample and in the general population during the pandemic. At the same time, most professionals indicated that they would not seek help for psychological concerns. These findings indicate that healthcare employers need to pay greater attention to the mental health of their staff.

Rapid Review on the Associations of Social and Geographical Isolation and Intimate Partner Violence: Implications for the Ongoing COVID-19 Pandemic

While the COVID-19 pandemic forced millions of people to stay home and minimize their social contacts, newspaper reports worldwide raised concerns as they reported an increasing rate of intimate partner violence (IPV). One link of the measures enforced to control the pandemic to IPV might be a possible side effect of those measures, namely social and geographical isolation. As there was no scientific data investigating the association of IPV and social and geographical isolation in the context of epidemics or pandemics at the time of conducting this rapid review, we aimed at investigating a broader range of contexts of social as well as geographical isolation and its association with IPV to draw conclusions regarding the COVID-19 pandemic. We searched Embase, PubMed, PsycINFO, and Web of Science (core collection). A research strategy was developed and observational studies were included if they considered men and/or women, estimates of social and geographical isolation, and IPV as a primary outcome. Of the 526 identified studies, 11 were included in this review. The included studies involved 15,695 women and were conducted in the USA, Sweden, Ethiopia, Egypt, Spain, and Turkey. Indicators of social isolation such as lack of social, emotional, or informational support or the frequency and quality of social contacts were narratively assessed. Geographical isolation was primarily assessed by physical distance to the next town or support service. Both social and geographic isolation were found to be associated with an increased risk of IPV. Recommendations made by the individual studies include the following: (a) improving access to social networks outside the victims' own group, (b) improving their economic circumstances, (c) asserting the responsibility for those in contact with the victims, and (d) increasing the focus on access to preventive services and programs need to be taken into account. Therefore, considering the particular infrastructure and legislation of the countries affected by the pandemic, policies need to ensure constant access to shelters and other help services and increase awareness for IPV in the society. In addition, future studies are warranted to assess prevalence rates and risk factors of IPV during the COVID-19 pandemic.