Mental health outcomes of quarantine and isolation for infection prevention: a systematic umbrella review of the global evidence

Parental Perception of Children's Mental Health During the Pandemic: Insights From an Italian Cross-Sectional Study

BACKGROUND

This study explores the impact of the pandemic on children's mental health. It examined the understanding of parents regarding their children's mental condition and their ability to identify issues, 2 years post the outbreak of the COVID-19 pandemic.

METHODS

Using a cross-sectional design, 507 Italian parents reported on their youngest child aged between 2 and 17, totaling 507 children. The outcomes focused on were parental perception of children's mental health deterioration, scores on the Strengths and Difficulties Questionnaire (SDQ) above the clinical cut-off, and parental under-recognition of mental health issues. Descriptive analyses and multivariable logistic regression models were executed (significance at p < .05).

RESULTS

Parents were 88.1% women (median age 41 years, interquartile range [IQR] = 36-47). Their children were 50.3% female [median age 6 years (IQR = 4-11)]. The data revealed 21.1% of parents perceived a deterioration in their children's mental health, while 44.2% had SDQ scores above the cut-off. Parental under-recognition of mental issues was found in 20.1% of cases. Significant correlations were found between parental perception of deterioration, SDQ scores, and factors like parental mental distress and children's sleep issues.

IMPLICATIONS

The findings suggest that schools and verified websites can serve as critical conduits for providing parents with reliable information. By promoting early identification and intervention, such mechanisms can help ensure mental health equity for children.

CONCLUSIONS

The research highlights the effect of the pandemic on children's mental health and the issue of parental under-recognition. The results underscore the importance of public health initiatives that enhance mental health information accessibility and reliability for parents.

Longitudinal changes in depression and anxiety during the COVID-19 pandemic and the impact of COVID-related factors

OBJECTIVE

This study is an investigation of five specific COVID-related stressors and their longitudinal impact on adult depression and anxiety.

METHOD

A total of 592 adults comprised the initial sample at Time 1 in April/May 2020. Follow-ups were conducted about a month later, again in March 2021 and then in March 2022.

RESULTS

Applied linear mixed effect models showed a significant decrease in mean depression scores and anxiety scores from Time 1 to both Times 3 and 4. Neither change over time in anxiety or depression were found to be related to COVID diagnosis, COVID hospitalization, or COVID death. Self-quarantine was related to changes over time in both depression and anxiety, and household quarantine was related to changes over time in depression.

CONCLUSION

While the fallout of the pandemic continues, it is important to understand how these factors may be affecting mental health to better understand where intervention is necessary.

A population health approach to workplace mental health: rationale, implementation and engagement

Objectives

To describe a population health-based program to support employee and dependent mental health and learn from engagement trends.

Methods

Retrospective analysis of a program utilizing an assessment of mental health risk. For scoring "at risk," a Care Concierge is offered to connect users with resources.

Results

Participation was offered to 56,442 employees and dependents. Eight thousand seven hundred thirty-one completed the assessment (15%). Of those, 4,644 (53%) scored moderate or higher. A total of 418 (9%) engaged the Care Concierge. Factors that negatively influenced the decision to engage care included bodily pain, financial concerns. Positive influences were younger age, high stress, anxiety, PTSD and low social support.

Conclusion

Proactive assessment plus access to a Care Concierge facilitates mental healthcare utilization. Several factors influence likelihood to engage in care. A better understanding of these factors may allow for more targeted outreach and improved engagement.

Impact of the COVID-19 pandemic on mental health and viral suppression among persons living with HIV in western Washington

The COVID-19 pandemic and social distancing measures elevated stress levels globally, exacerbating mental health challenges for people with HIV (PWH). We examined the effect of COVID-19-related stress on mental health among PWH in western Washington, exploring whether social support and coping self-efficacy were protective. Data on COVID-19-related stress, mental health, social support, and coping self-efficacy were collected using online surveys during the pandemic. Pre-COVID-19 mental health data were available for a subset of participants and were linked with the survey data. In the total sample (N = 373), COVID-19-stress was associated with elevated depression (PHQ-8, β = 0.21, 95%CI [0.10, 0.32]) and anxiety (GAD-7, β = 0.28, 95%CI [0.17, 0.39]). Among the subset of respondents with pre-pandemic mental health data (N = 103), COVID-19-related stress was associated with elevated PHQ-8 scores (β = 0.35, 95%CI [0.15, 0.56]) and GAD-7 scores (β = 0.35, 95%CI [0.16, 0.54]), adjusted for baseline mental health and other confounders. Coping self-efficacy was negatively associated with GAD-7 scores (β = -0.01, 95%CI [-0.01, 0.00]), while social support was negatively associated with PHQ-8 scores (β = -0.06, 95%CI [-0.12, -0.01]). Viral suppression before and during the pandemic did not differ among participants with available data. While COVID-19-related stress predicted elevated depression and anxiety symptoms among PWH, social support and coping self-efficacy were protective.

The Impact of COVID-19 on Mental Health in Medical Students: A Cross-Sectional Survey Study in Italy

Background: This study aimed to assess the impact of the COVID-19 pandemic in terms of the prevalence of anxiety, depression and stress symptoms in Italian medical students and to identify the associated factors. Design and Methods: A cross-sectional online survey was administered to second-sixth year medical students of the University of Torino, collecting data on the students' sociodemographics, COVID-19 exposure, anxiety, depression and stress symptoms. Three hierarchical regressions adjusted for age, gender and year of study were executed. Results: The sample size was 1359. The prevalence of anxiety, depression symptoms, moderate perceived stress and severe perceived stress was 47.8%, 52.1%, 56.2% and 28.4%, respectively. The factors associated with mental health symptoms were: being a woman, a family history of psychiatric disorders, living off-site, competitive/hostile climates and unsatisfying friendships among classmates, poor relationships with cohabitants, negative judgment of medical school choice, fear of COVID-19 infection, feelings of loneliness, distressing existential reflections, and a worsening psychological condition related to the pandemic. Being in the fourth or sixth year constituted a protective factor for depression symptoms. Conclusions: Mental health in medical students was associated with both COVID-independent and COVID-related factors. Accessibility to effective interventions must be increased to counteract these changes.

COVID-19-Related Stressors and Psychophysical Health Conditions among Italian University Students: A Post Pandemic Insight

The COVID-19 medical emergency has ended worldwide, yet the psychological impact of these years of unprecedented changes on students' lives still needs to be deepened.

METHODS

This study aims to assess and compare COVID-19-related stressors (relationships and academic life; isolation; and fear of contagion) and psychophysical symptoms reported by 637 university students at three times, i.e., April 2020 (n = 197), April 2021 (n = 200), and April 2022 (n = 240). The impact of COVID-19-related stressors on psychophysical symptoms within each time was also tested.

RESULTS

In April 2022, perceived isolation and fear of contagion decreased from the peak registered in April 2021, but stress related to relationships and academic life remained high. An ongoing increase in psychophysical symptoms was found. More than 50% of students reported clinical levels of sleep disorders, depression, psychoticism, and interpersonal sensitivity. In April 2022, students still perceiving stress related to relationships and academic life and isolation were at risk for anxiety, somatization, and sleep disorders. Students still perceiving stress related to fear of contagion were also at risk for depression, obsessive-compulsive symptoms, and psychoticism.

CONCLUSION

The findings emphasized the long-lasting effects of COVID-19-related stress on students' psychophysical health. Interventions must aim at supporting students in dealing with the complex post-pandemic adjustment process.

Self-quarantining, social distancing, and mental health during the COVID-19 pandemic: A multi wave, longitudinal investigation

Social isolation and disconnectedness increase the risk of worse mental health, which might suggest that preventive health measures (i.e., self-quarantining, social distancing) negatively affect mental health. This longitudinal study examined relations of self-quarantining and social distancing with mental health during the COVID-19 pandemic. A U.S. national sample (N = 1,011) completed eight weekly online surveys from March 20, 2020 to May 17, 2020. Surveys assessed self-quarantining, social distancing, anxiety, and depression. Fixed-effect autoregressive cross-lagged models provided a good fit to the data, allowing for disaggregation of between-person and within-person effects. Significant between-person effects suggested those who engaged in more self-quarantining and social distancing had higher anxiety and depression compared to those who engaged in less social distancing and quarantining. Significant within-person effects indicated those who engaged in greater social distancing for a given week experienced higher anxiety and depression that week. However, there was no support for self-quarantining or social distancing as prospective predictors of mental health, or vice versa. Findings suggest a relationship between mental health and both self-quarantining and social distancing, but further longitudinal research is required to understand the prospective nature of this relationship and identify third variables that may explain these associations.

Prevalence of depression, stress and suicide tendency among individuals with long COVID and determinants: a protocol of a systematic review and meta-analysis

BACKGROUND

It is well known that the COVID-19 pandemic has had a devastating impact on mental health, especially among individuals with long COVID. This systematic review and meta-analysis aims to investigate the prevalence of depression, stress and suicide tendencies among individuals with long COVID, as well as to explore the factors that contribute to these conditions.

METHODS AND ANALYSIS

A comprehensive review of literature will be conducted in various databases of including PubMed, including Medline, Embase, PsycINFO, CINAHL and Cochrane Library. The studies to be included in this review will be published in the English language, and the time frame of included studies will be from the date of inception of COVID-19 until 30 December 2023. Two independent reviewers will identify studies for inclusion based on a screening questionnaire, and the JBI standardised critical appraisal checklist for studies reporting prevalence data will be used to assess the methodological quality. The strength of the body of evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. To analyse the data, a robust Bayesian approach will be applied using the STATA software package (V.14; STATA) and JASP software. The findings of this systematic review and meta-analysis will provide valuable insights into the prevalence of depression, stress and suicide tendencies among individuals with long COVID, as well as the factors that contribute to these conditions.

ETHICS AND DISSEMINATION

There is no research ethics board approval required. The dissemination plan is to publish results in a peer-reviewed academic journal.

PROSPERO REGISTRATION NUMBER

CRD42022346858.

Differential Impact of Emotional and Contextual Factors Associated with COVID-19 on Adolescent Mental Health

Background

During the confinement, there was an increase in the incidence of mental disorders such as depression and anxiety. In this regard, affectivity is of particular interest, as emotions play a fundamental role in overall mental health. The literature on COVID-19 in this population has often focused on the analysis of risk factors for mental health, while less attention has been paid to protective factors. In this paper, we propose an inclusive model of risk and protective factors for adolescent mental health through the indirect effect of negative and positive affect.

Methods

This was a cross-sectional study with a Spanish community sample of 477 adolescents (Mage = 16.23, range:14 to 20 years old; 43.4% were boys; response rate: 100%). We measured the perceived hardness of confinement, worrying about contagion, quality of relationships at home, pleasant activities, affect (positive and negative), and mental health.

Results

The results revealed a positive relationship between the perceived hardness of confinement and worrying about contagion with mental health, through the indirect effect of negative affect, and a positive relationship between home relationships and pleasant activities with mental health through an indirect effect of positive affect.

Conclusion

Our results suggest that different types of emotions generated by the various contextual variables associated with COVID-19 may have a differential impact on mental health. These findings support the inclusive model of risk and protective factors for adolescent mental health. Practical implications, future studies, and limitations are discussed.

The impact of the COVID-19 pandemic on physical activity habits at a residential university

OBJECTIVE

To assess changes in physical activity (PA) after a COVID-19 shutdown on a primarily residential university campus.

METHODS

Eighty students, faculty, and staff (FS) of a university (age: 32.2 ± 13.6 yr) who wore a consumer wearable technology (CWT) device completed an anonymous survey by inputting data for 30 days prior to- and 30 days following an academic break in 2020, in which the university transitioned to remote learning.

RESULTS

Steps decreased after spring break in all subjects (p < .001), but steps were impacted to a greater extent in students. 30-day, weekday, and weekend step averages all decreased in students (p < .001). FS were able to maintain their weekend step averages.

CONCLUSIONS

PA decreased in a university community after the COVID-19 shutdown. Students, no longer active transport for campus life, saw a greater impact on their PA. These changes could have an impact on health status.

Depressive symptoms among people under COVID-19 quarantine or self-isolation in Korea: a propensity score matching analysis

Introduction

This study aims to determine the effect of COVID-19-related hospital isolation or self-isolation on depression using the propensity score matching method.

Methods

Data on 217,734 participants were divided into groups based on whether or not they underwent quarantine for their COVID-19 diagnosis. COVID-19-related anxiety, depressive symptoms, subjective health status, and perceived stress were evaluated.

Results

Based on the calculated propensity score, we matched the quarantined group and non-quarantined group using 1:2 matching with nearest neighbor matching and a caliper width of 0.1. Within the quarantined group, 16.4% of participants experienced significant depressive symptoms, which was significantly higher than that of the non-quarantined group. However, there was no significant difference between the two groups in COVID-19-related anxiety, self-rated health status, and perceived stress. In our multiple logistic regression analysis with related variables corrected, the quarantined group was 1.298 times more likely to have depressive symptoms than the non-quarantined group (95% CI = 1.030-1.634).

Conclusion

Our study confirmed that COVID-19 quarantine is associated with depressive symptoms. These results indicate that healthcare policymakers and healthcare professionals must consider the negative mental and physical effects of quarantine when determining quarantine measures during an infectious disease disaster such as the COVID-19 pandemic.

Impact of the COVID-19 pandemic on the Thai population: Delineating the effects of the pandemic and policy measures

Objectives

This study aimed to determine the impacts of the COVID-19 pandemic and policy measures and delineate the impact of each on a cohort of Thai citizens.

Methods

A cross-sectional study was conducted among 2,500 Thai people from October 2020 to January 2021. A questionnaire collecting demographic information and other data was sent to eligible subjects.

Results

Overall, 51.6% and 49.5% of participants felt the impacts of COVID-19 and policy measures at the highest level, respectively. The study demonstrated that the weighted effect of the impact of the COVID-19 outbreak was statistically (p < .001) greater than that of policy measures on family (0.664 vs 0.618), education (0.562 vs 0.557), and the economy (0.643 vs 0.572). The weighted effect of the impact of policy measures was statistically (p < .001) greater than that of the COVID-19 pandemic on people's daily activities (0.675 vs 0.651), cultural/traditional or community way of life (0.769 vs 0.736), access to healthcare services and infection prevention supplies (0.410 vs 0.390), and mental health (0.625 vs 0.584).

Conclusions

About half of the participants had a high level of impact from both the COVID-19 pandemic and policy measures. The results of this study suggest that policy measures need to be judged with caution, and the government should provide more comprehensive support to reduce the impact on people's lives.

Change in the form of work of psychologists after the outbreak of the COVID-19 pandemic in Poland, and the subjective mental state of this professional group

Objectives. The first wave of the COVID-19 pandemic in Poland in spring 2020 forced psychologists to fight the psychological consequences, which were triggered by drastic life changes among the entire population. This group of professionals had an incredibly difficult role to play in society; the level of their overload in studies was even compared to doctors treating COVID-19. This article aims to analyze the situation of both personal and professional psychologists in the first wave of the pandemic. Methods. During the study, 341 psychologists were surveyed using the snowball method (hybrid access). Data were collected between 12 March and 3 May 2020. The study is part of a large project from all waves of the pandemic. Results. In total, 82.7% of psychologists experienced moderate to high-intensity stress, and 61.29% switched to a remote or hybrid mode of working with patients. Subjectively depressed mood occurred in 16.13%, reduced drive in 27.57% and dyssomnia in 18.77%. A total of 61.58% had concerns about their professional and/or financial future after the pandemic. Conclusion. The challenges during, as well as after, the pandemic period require taking care of individual mental well-being for psychologists. This is a necessary condition for undertaking a committed job.

Experiencing the COVID-19 pandemic as a homeless person in Chennai, India: An interpretative phenomenological analysis

Persons experiencing homelessness (PEHs) have a higher risk of morbidity and mortality compared to the general population and are highly vulnerable during the coronavirus disease (COVID-19) pandemic. Understanding their experience of the pandemic is important for mitigating the effects of the pandemic. Accordingly, we conducted a qualitative study on their lived experiences during the COVID-19 pandemic. Semi-structured interviews were conducted in nine PEHs from Chennai, India, recruited at food stalls between September 14-25, 2020. Data were analyzed using interpretive phenomenological analysis. The participants shared their experiences of the COVID-19 pandemic, its impact on them, and their coping strategies. All the participants were migrant workers living alone, and were the sole breadwinners of their families. Five group experiential themes emerged relating to the experiences of the participants during the COVID-19 pandemic. Most participants reported significant psychosocial stress, but low suicide risk and robust coping mechanisms. They delayed seeking healthcare for non-COVID-19-related problems. Public hospitals were preferred over private hospitals due to cost constraints and prior experience of discrimination. Upward classism was observed as participants blamed the rich for the spread of COVID-19. Initial assumption that COVID-19 would only affect the rich was also reported. Free government testing and quarantine facilities assuaged their medico-psychosocial needs. Engaging in collective activities was a key stress mitigator. We highlight several important policy implications. Firstly, we underscore the importance of involving social workers to facilitate communication between healthcare providers and patients from vulnerable communities. This engagement can help minimize discrimination and promote equitable access to healthcare. Secondly, we emphasize the need for effective public health communication. Specifically, there is a need to address and alleviate concerns about the transmission of COVID-19 within hospital premises. Lastly, the research suggests that government initiatives aimed at fostering community participation should persist both during and after the pandemic.

Prevalence of Obesity and Lifestyle Risk Factors Following Two Years' COVID-19 Related Service Closure at Wellness Center, Primary Health Care

Background

COVID-19 lockdown has affected health behaviors and daily life in unprecedented ways. This study aimed to assess (i) the prevalence of lifestyle behaviors including physical activity, sedentary behavior, sleep, and stress levels during the COVID confinement, and (ii) evaluate anthropometric measures, body composition, cardiopulmonary and muscular endurance among regular Wellness Center attendees, following two years' service closure.

Methods

A cross-sectional study was undertaken between 1st June 2022 and 30th January 2023. A structured validated questionnaire was utilized to retrospectively collect data related to the closure period, and quantitative objective measurements were obtained at the time of data collection.

Results

A total of 100 adults with a mean age of 49.6 ± 10.5 years, mostly female (80%) and Qatari (76%) participated in the study. The results revealed high rates of low physical activity (47%), sedentary behavior (62%), poor sleep (58%), and stress levels (61% moderate and 5% high). Results also confirmed high prevalence of obesity (57%) marked by BMI and body circumferences, fat mass (34 ± 10.5 kg)/fat percentage (42.7 ± 7.2%) and muscle mass (20.6 ± 5.4 kg)/muscle percentage (25.4 ± 3.9%) above and below normal levels, respectively. The average cardiopulmonary (mean VO2 MAX was 15.5 ± 11 mL O2kg-1min-1) and muscular endurance (pushups per min 19 ± 8.9, L-sit 46 ± 35 secs, plank 42.7 ± 27.8 secs) were distinctly below normal levels for age and sex.

Conclusion

The findings indicate that physically active adults have experienced adverse lifestyle behaviors during the COVID-19 lockdown. Obesity, unfavorable body composition, low cardiopulmonary and muscular endurance were evident. More emphasis should be put on the development of targeted intervention strategies to promote positive lifestyle behaviors during any potential future crises.

Trajectories and determinants of acute stress disorder during the COVID-19 centralized quarantine: A latent class growth analysis

COVID-19 centralized quarantine may cause acute stress disorder (ASD). However, it is unknown how individuals present heterogeneous ASD trajectories during the COVID-19 centralized quarantine and what factors contribute to these patterns. This study aimed to identify the ASD trajectories and their determinants during the centralized quarantine period, and the mediating effects of resilience on these associations. A longitudinal survey with three waves was conducted in a randomly selected quarantine hotel in Shenzhen, China from October to November 2020. A total of 273 participants completed online measures assessing ASD symptoms, Eysenck's personality constructs of extraversion (E), neuroticism (N), psychoticism (P), and resilience on Day 1, and reported ASD symptoms on Days 7 and 14 during their 14-day centralized quarantine periods. Latent class growth analysis identified three trajectories: constantly high symptoms (CHS, 4.76%), decreasing symptoms (DS, 11.72%), and constantly low symptoms (CLS, 83.52%). The CHS and DS subgroups both reported lower E and higher N scores, but not P, compared with the CLS subgroup. Resilience mediated the effects of three personality constructs on ASD trajectories, except for the association between N and DS membership. Our study highlights the heterogeneity in stress responses to the COVID-19 centralized quarantine. The high-risk subgroup with persistent ASD symptoms was characterized by lower E and higher N. The resilience process accounted for the effects of personality in shaping distinct ASD trajectories. Our findings have implications to detect the populations vulnerable to ASD and provide insights for developing timely resilience enhancement intervention programs.

Piloting a new method to estimate action thresholds in medicine through intuitive weighing

OBJECTIVES

In clinical decision-making, physicians take actions such as prescribing treatment only when the probability of disease is sufficiently high. The lowest probability at which the action will be considered, is the action threshold. Such thresholds play an important role whenever decisions have to be taken under uncertainty. However, while several methods to estimate action thresholds exist, few methods give satisfactory results or have been adopted in clinical practice. We piloted the adapted nominal group technique (aNGT), a new prescriptive method based on a formal consensus technique adapted for use in clinical decision-making.

DESIGN, SETTING AND PARTICIPANTS

We applied this method in groups of postgraduate students using three scenarios: treat for rifampicin-resistant tuberculosis (RR-TB), switch to second-line HIV treatment and isolate for SARS-CoV-2 infection.

INTERVENTIONS

The participants first summarise all harms of wrongly taking action when none is required and wrongly not taking action when it would have been useful. Then they rate the statements on these harms, discuss their importance in the decision-making process, and finally weigh the statements against each other.

MAIN OUTCOME MEASURES

The resulting consensus threshold is estimated as the relative weights of the harms of the false positives divided by the total harm, and averaged out over participants. In some applications, the thresholds are compared with an existing method based on clinical vignettes.

RESULTS

The resulting action thresholds were just over 50% for RR-TB treatment, between 20% and 50% for switching HIV treatment and 43% for COVID-19 isolation. These results were considered acceptable to all participants. Between sessions variation was low for RR-TB and moderate for HIV. Threshold estimates were moderately lower with the method based on clinical vignettes.

CONCLUSIONS

The aNGT gives sensible results in our pilot and has the potential to estimate action thresholds, in an efficient manner, while involving all relevant stakeholders. Further research is needed to study the value of the method in clinical decision-making and its ability to generate acceptable thresholds that stakeholders can agree on.

Association of COVID-19 Infection with Sociodemographic, Anthropometric and Lifestyle Factors: A Cross-Sectional Study in an Older Adults' Population Aged over 65 Years Old

BACKGROUND

The COVID-19 pandemic has led to unfavorable disruptions to daily living routines by exerting deleterious effects on several aspects of human mental and physical health and quality of life worldwide. The purpose of the current survey is to explore the potential association of COVID-19 infection with multiple sociodemographic, anthropometric, and lifestyle factors of community-dwelling older adults.

METHODS

This is a cross-sectional survey including 5197 older adults aged over 65 years old from 10 geographically diverse regions of Greece. Relevant questionnaires were used to record study the population sociodemographic factor, while anthropometric parameters were also measured. Validated questionnaires were also applied to assess several lifestyle factors such as depression, anxiety, stress, cognitive status, sleep quality, health-related quality of life, physical activity levels, and Mediterranean diet (MD) adherence.

RESULTS

In multivariate regression analysis, COVID-19 infection was significantly, independently related with urban residence (p = 0.0107), regular smoking (p = 0.0218), overweight status and obesity (p = 0.0036), as well as abdominal obesity (p = 0.0008), higher risk of depression (p = 0.0027), anxiety (p = 0.0045), stress (p = 0.0038), inadequate sleep quality (p = 0.0108), lower physical activity levels (p = 0.0012), reduced MD compliance (p = 0.0009), and poor health-related quality of life (p = 0.0002). In univariate analysis, older adults' age (p = 0.0001), male gender (p = 0.0015), living alone (p = 0.0023), lower educational and economic level (p = 0.0175 and p = 0.0294, respectively), and cognition decline (p = 0.0032) were also related with the presence of COVID-19 infection; however, these associations were considerably attenuated at a non-significant level by adjustment for several confounders in multivariate analysis.

CONCLUSIONS

This is one of the few available studies supporting evidence that COVID-19 infection may be associated with diverse sociodemographic, anthropometric, and lifestyle factors in an older adults' population in Greece. This study highlights the strong demand to provide psychological and nutritional counselling and support to older adults diagnosed with COVID-19 infection in order to ameliorate disease symptoms and severity, emphasizing the adaptation of healthy dietary and lifestyle habits as preventing and supplementary therapeutic factors against COVID-19.

Psychological Impact of COVID-19 and Its Influence on Parental Willingness to Vaccinate Children: A Cross-Sectional Study at a Tertiary Care Hospital in Kolkata

Background COVID-19 has affected the physical and mental health of people globally, and vaccination is seen as a crucial tool in controlling the pandemic. However, the readiness to vaccinate children remains a concern, particularly in India. Aim The study aimed to investigate the association between the psychological impact of COVID-19 and willingness to vaccinate their children among attendees of the COVID-19 vaccination clinic at Nil Ratan Sircar Medical College, Kolkata. Method The study used an observational, cross-sectional design and collected data from 356 participants between August and September 2022. The COVID-19 Perceived Stress Scale-10 was used to assess participants' psychological impact, and willingness to vaccinate was determined using a survey. Results Approximately 64% (n=227) and 71% (n=253) of the participants exhibited a high level of perceived stress and willingness to vaccinate their children. The vaccine acceptance was significantly associated with perceived stress level and other factors such as family type, presence of chronic illness, and history of acquaintances suffering from COVID-19. Conclusion The study highlights the importance of addressing parental stress and anxiety to enhance vaccination rates among children. To achieve this, population-level awareness of vaccine safety measures and benefits should be raised to alleviate stress and increase vaccine uptake.

No Visitors: Family Perceptions of Separation From Hospitalized Loved Ones

BACKGROUND/INTRODUCTION

Restrictions on visitors during the coronavirus disease 2019 (COVID-19) pandemic had major implications for both patients and families, impacting health care outcomes. Policies included mandatory closures, masking, and visiting restrictions both in acute and long-term care. Despite visiting restrictions in health care systems, little is known about its effects.

OBJECTIVES/AIMS

The objective of this study was to elicit perceptions of individuals who were separated from their loved ones during acute care hospitalization during the COVID pandemic.

METHODS

Individuals who experienced separation from hospitalized family members because of the "no-visitor policies" during the COVID-19 pandemic were asked to participate in a study to elicit their perceptions. After institutional review board approval, interviews were completed for those who had loved ones admitted to acute care facilities only. Audiotaped and transcribed interviews were conducted in person, via telephone, or virtually using a primary investigator-developed interview guide. Using the Colaizzi method of analysis, themes were derived.

RESULTS

Of the 11 completed interviews, 100% of participants were female, and all were residents of Texas. Themes derived from this pilot project were advocacy, communication, emotional upheaval, human factors, isolation, and abandonment.

CONCLUSIONS

Findings from patient interviews support previous published studies. Ideas for improved patient and family experience discussed by the authors include personal protective equipment for significant others, consideration of visitation policies for those patients without decision-making capabilities, and increased accessibility to communication aids for both patients and families.

The impact of COVID-19 and the confinement on the secondary level students of the Eastern region of Morocco

Context

In March 2020, Morocco announced the first COVID-19 case and implemented preventive measures, including home confinement.

Aims

Monitoring the psychological effects and prevalence among high- and middle-school students.

Settings and Design

This study is cross-sectional, carried online.

Methods and Materials

The survey was conducted by publishing an online questionnaire between May 14, 2020 and June 14, 2020, which included inquiries about socio-demographic data, the conditions of home confinement, activities carried out during confinement, and medical history and sleep patterns. To assess depressive disorder, anxiety disorders, and stress, the survey employed the "DSRS-c," "SCARED," and "PSS10" scales, respectively.

Statistical Analysis Used

Data were received on Google forms coded by Excel 2010 and analyzed by IBM SPSS Statistics 22.

Results

Out of the 689 participants, 73.7% were females; the mean age was 16.08 years (standard deviation 1.48). 94.8% of subjects reported changes in sleep habits, and 41.4% of adolescents had high levels of depressive symptoms, while 50.7% had high levels of anxiety symptoms. Several factors were significantly associated with anxiety and depressive symptoms, including being a girl (P = 0.000), being a high-school student (P = 0.011), economic struggles during the pandemic (P = 0.003), doubting the necessity of home confinement (P = 0.000), spending over 3 hours a day on social networks and video games (P = 0.000), dropping out of remote learning (P = 0.000), having a psychiatric history (P = 0.000), having chronic illnesses in the family (P = 0.002), and changes in sleep habits (P = 0.000).

Conclusions

The study found high prevalence of depression, anxiety, and stress symptoms among students during the pandemic, emphasizing the need for mental health awareness and support.

Impact of COVID-19 on the mental health of children and young people: an umbrella review

BACKGROUND

Over the past 3 years, a multitude of studies have highlighted the impact of the COVID-19 pandemic on the mental health of children and young people (CYP). In this umbrella review, we synthesise global evidence on the impact of COVID-19 on the mental health of CYP from existing systematic reviews with and/or without meta-analysis.

METHODS

Adopting the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we evaluated 349 citations and identified 24 eligible reviews with medium to high methodological quality to be reviewed narratively.

RESULTS

Most of the reviews reported a high prevalence of anxiety disorders, depression, suicidal behaviour, eating disorders and other mental health problems. Most studies that used data at multiple time points indicate a significant increase in mental health problems in CYP, particularly in females and older adolescents.

CONCLUSIONS

Multipronged psychosocial care services, policies and programmes are needed to alleviate the burden of mental health problems in CYP as a consequence of the COVID-19 pandemic and associated global health measures.

PROSPERO REGISTRATION NUMBER

CRD42021276312.

COVID-19-Evidence of the Impact of Literacy and Salutogenic Behaviours in Positive Mental Health: A Cross-Sectional Study

Positive mental health is defined as the ability to perceive and interpret the context of a situation and to adapt to it whenever necessary. Considering the pandemic situation, identifying the factors that may have the greatest impact on quality of life and consequently, on positive mental health is paramount. The objective of this study was to assess the impact of health literacy on the adoption of behaviours that promote positive mental health during COVID-19. A descriptive, cross-sectional and correlational study was conducted on a sample of 770 patients using a questionnaire for sociodemographic characterization, the Positive Mental Health Questionnaire and the Mental Health Knowledge Questionnaire. Concerning health-promoting behaviours, those who sleep enough hours, exercise regularly, eat healthy and are more aware of mental health promotion activities, or have greater mental health literacy, have higher positive mental health scores. Thus, having more knowledge of mental health and adopting health-promoting behaviours improve positive mental health.

Communication to promote and support physical distancing for COVID-19 prevention and control

BACKGROUND

This review is an update of a rapid review undertaken in 2020 to identify relevant, feasible and effective communication approaches to promote acceptance, uptake and adherence to physical distancing measures for COVID-19 prevention and control. The rapid review was published when little was known about transmission, treatment or future vaccination, and when physical distancing measures (isolation, quarantine, contact tracing, crowd avoidance, work and school measures) were the cornerstone of public health responses globally. This updated review includes more recent evidence to extend what we know about effective pandemic public health communication. This includes considerations of changes needed over time to maintain responsiveness to pandemic transmission waves, the (in)equities and variable needs of groups within communities due to the pandemic, and highlights again the critical role of effective communication as integral to the public health response.

OBJECTIVES

To update the evidence on the question 'What are relevant, feasible and effective communication approaches to promote acceptance, uptake and adherence to physical distancing measures for COVID-19 prevention and control?', our primary focus was communication approaches to promote and support acceptance, uptake and adherence to physical distancing.

SECONDARY OBJECTIVE

to explore and identify key elements of effective communication for physical distancing measures for different (diverse) populations and groups.

SEARCH METHODS

We searched MEDLINE, Embase and Cochrane Library databases from inception, with searches for this update including the period 1 January 2020 to 18 August 2021. Systematic review and study repositories and grey literature sources were searched in August 2021 and guidelines identified for the eCOVID19 Recommendations Map were screened (November 2021).

SELECTION CRITERIA

Guidelines or reviews focusing on communication (information, education, reminders, facilitating decision-making, skills acquisition, supporting behaviour change, support, involvement in decision-making) related to physical distancing measures for prevention and/or control of COVID-19 or selected other diseases (sudden acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), influenza, Ebola virus disease (EVD) or tuberculosis (TB)) were included. New evidence was added to guidelines, reviews and primary studies included in the 2020 review.

DATA COLLECTION AND ANALYSIS

Methods were based on the original rapid review, using methods developed by McMaster University and informed by Cochrane rapid review guidance. Screening, data extraction, quality assessment and synthesis were conducted by one author and checked by a second author. Synthesis of results was conducted using modified framework analysis, with themes from the original review used as an initial framework.

MAIN RESULTS

This review update includes 68 studies, with 17 guidelines and 20 reviews added to the original 31 studies. Synthesis identified six major themes, which can be used to inform policy and decision-making related to planning and implementing communication about a public health emergency and measures to protect the community. Theme 1: Strengthening public trust and countering misinformation: essential foundations for effective public health communication Recognising the key role of public trust is essential. Working to build and maintain trust over time underpins the success of public health communications and, therefore, the effectiveness of public health prevention measures. Theme 2: Two-way communication: involving communities to improve the dissemination, accessibility and acceptability of information Two-way communication (engagement) with the public is needed over the course of a public health emergency: at first, recognition of a health threat (despite uncertainties), and regularly as public health measures are introduced or adjusted. Engagement needs to be embedded at all stages of the response and inform tailoring of communications and implementation of public health measures over time. Theme 3: Development of and preparation for public communication: target audience, equity and tailoring Communication and information must be tailored to reach all groups within populations, and explicitly consider existing inequities and the needs of disadvantaged groups, including those who are underserved, vulnerable, from diverse cultural or language groups, or who have lower educational attainment. Awareness that implementing public health measures may magnify existing or emerging inequities is also needed in response planning, enactment and adjustment over time. Theme 4: Public communication features: content, timing and duration, delivery Public communication needs to be based on clear, consistent, actionable and timely (up-to-date) information about preventive measures, including the benefits (whether for individual, social groupings or wider society), harms (likewise) and rationale for use, and include information about supports available to help follow recommended measures. Communication needs to occur through multiple channels and/or formats to build public trust and reach more of the community. Theme 5: Supporting behaviour change at individual and population levels Supporting implementation of public health measures with practical supports and services (e.g. essential supplies, financial support) is critical. Information about available supports must be widely disseminated and well understood. Supports and communication related to them require flexibility and tailoring to explicitly consider community needs, including those of vulnerable groups. Proactively monitoring and countering stigma related to preventive measures (e.g. quarantine) is also necessary to support adherence. Theme 6: Fostering and sustaining receptiveness and responsiveness to public health communication Efforts to foster and sustain public receptiveness and responsiveness to public health communication are needed throughout a public health emergency. Trust, acceptance and behaviours change over time, and communication needs to be adaptive and responsive to these changing needs. Ongoing community engagement efforts should inform communication and public health response measures.

AUTHORS' CONCLUSIONS

Implications for practice Evidence highlights the critical role of communication throughout a public health emergency. Like any intervention, communication can be done well or poorly, but the consequences of poor communication during a pandemic may mean the difference between life and death. The approaches to effective communication identified in this review can be used by policymakers and decision-makers, working closely with communication teams, to plan, implement and adjust public communications over the course of a public health emergency like the COVID-19 pandemic. Implications for research Despite massive growth in research during the COVID-19 period, gaps in the evidence persist and require high-quality, meaningful research. This includes investigating the experiences of people at heightened COVID-19 risk, and identifying barriers to implementing public communication and protective health measures particular to lower- and middle-income countries, and how to overcome these.

A social network analysis: mental health scales used during the COVID-19 pandemic

Introduction

The focus on psychological issues during COVID-19 has led to the development of large surveys that involve the use of mental health scales. Numerous mental health measurements are available; choosing the appropriate measurement is crucial.

Methods

A rule-based named entity recognition was used to recognize entities of mental health scales that occur in the articles from PubMed. The co-occurrence networks of mental health scales and Medical Subject Headings (MeSH) terms were constructed by Gephi.

Results

Five types of MeSH terms were filtered, including research objects, research topics, research methods, countries/regions, and factors. Seventy-eight mental health scales were discovered.

Discussion

The findings provide insights on the scales used most often during the pandemic, the key instruments used to measure healthcare workers' physical and mental health, the scales most often utilized for assessing maternal mental health, the tools used most commonly for assessing older adults' psychological resilience and loneliness, and new COVID-19 mental health scales. Future studies may use these findings as a guiding reference and compass.

The influences of dormitory exercise on negative emotions among quarantined Chinese college students during the COVID-19 pandemic

Objectives

This study explores the influences of different types of dormitory exercise on the negative emotions of quarantined Chinese college students during the COVID-19 pandemic.

Methods

In a 3-week intervention, participants self-selected into a rope skipping group (RSG), an aerobic exercise group (AEG), and a resistance exercise group (REG), while participants in the control group (CG) engaged, by choice, in no physical exercise. Exercise frequency was three times a week for 45 min, with an intensity of 60-80% of maximum heart rate. Before and after the intervention, all participants completed the Self-rating Anxiety Scale (SAS) and the Self-rating Depression Scale (SDS). Student's t-test was used for intra-group comparisons, while ANOVA was used for inter-group comparisons.

Results

Within the three exercise groups, there were some differences in the decrease levels of anxiety and depression, statistically significant at (p < 0.05); by contrast, the levels of anxiety and depression slightly increased in the CG group, again with statistical significance (p < 0.05). Comparing each of the RSG, AEG, and REG with the CG, we found some statistically significant differences in decreasing levels of anxiety and depression (p < 0.05). A comparison of the RSG and REG with the AEG also revealed some significant differences in levels of anxiety and depression (p < 0.05). However, the RSG and REG did not significantly differ in levels of anxiety and depression (p < 0.05).

Conclusion

Long-term and strict dormitory quarantine led to different levels of anxiety and depression among quarantined college students. The three different types of medium-intensity dormitory exercise evidently decreased anxiety and depression levels of quarantined college students, but aerobic exercise had the greatest influence, while rope skipping and resistance exercise had equivalent effects.

The Impact of the Covid-19 Pandemic on Patients with Obsessive Compulsive Disorder (OCD)

Objective

An intense desire to avoid contamination is one of the most common symptoms of Obsessive-Compulsive Disorder (OCD). In March 2020, when the COVID-19 outbreak was classified as a pandemic, authorities announced measures to control its spread, including hand washing, quarantine, social distancing and lockdowns. The disease spreads rapidly and has potentially serious complications, and adherence to the recommendations was strongly encouraged. These measures, both by their direct effect and as a consequence of their impact on care provision may trigger complications in patients with OCD.

Method

An online survey was completed by 102 patients with a confirmed OCD diagnosis. The survey collected demographic data, medical and psychiatric history, and asked COVID-19 related questions, OCD-related questions, and included the Self-reported Yale-Brown Obsessive-Compulsive Symptom Checklist (Y-BOCS-II).

Results

The results reveal that new OCD patterns started during the COVID-19 pandemic, including pathological doubt/checking (2.0%), a need for symmetry, order or precision (2.9%), religious pattern (2.9%), somatic/health pattern (4.9%), and a contamination/washing pattern (5.9%), which was the most reported among all patterns. The results also show an increase in overall severity of OCD (36.3%), and (27.5%) of participants also reported an increase in the overall severity of anxiety.

Conclusions

The questionnaire completed by patients previously diagnosed with OCD revealed that during the COVID-19 pandemic there was an increase in the severity of symptoms, with the greatest effect being in individuals with contamination/ washing patterns.

Associations between changes in social contact pattern and the mental health status of Chinese adults: cross-sectional findings

The study aims to examine the associations between social contact pattern changes and mental health status, including depression, anxiety, and loneliness, among Chinese adults in the context of coronavirus disease 2019 (COVID-19). Data on social contact patterns before and after the outbreak of COVID-19 were obtained from 3511 participants. Mental health (ie, depression, anxiety, and loneliness) was assessed by the 9-item Patient Health Questionnaire, Dark Future Scale, and the 9-scale Three-Item Loneliness Scale, respectively. Poisson regression analyses revealed that the participants who had increased in-person communication were more likely to have mental disorders [depression: prevalence ratio (PR)=1.13, 95% confidence interval (CI): 1.02, 1.26; anxiety: PR=1.15, 95% CI: 1.01, 1.30]. The current study concluded that the in-person communication increase before and after the outbreak of COVID-19 was associated with mental disorders among Chinese adults.

Breastfeeding Practices and Postpartum Depression in Mexican Women during the COVID-19 Pandemic: A Cross-Sectional Study

Background: Breastfeeding is a characteristic process of mammals that ensures delivery of an adequate nutritional supply to infants. It is the gold standard food source during an infant's first months of life. Since the onset of the COVID-19 pandemic in 2020, people in quarantine have experienced a wide range of feelings, which may make isolation challenging in terms of maternal health. This study focused on the prevalence of breastfeeding practices and postpartum depression (PPD) among Mexican women during the COVID-19 pandemic. Materials and Methods: This cross-sectional study included 586 postpartum women who completed an online survey 4-8 weeks after delivery from April to December 2020 in Guadalajara, Mexico. The aim was to identify potentially depressed mothers according to the Edinburgh Postnatal Depression Scale (EPDS) and describe their breastfeeding practices. Results: The mean maternal age was 30.4 ± 4.6 years, the mean EPDS score was 9.6 ± 5.0, and the PPD prevalence according EPDS scores was 27.1%. Exclusive breastfeeding (EBF) was reported by 32.3% of mothers in the first 48 h and by 70.3% of mothers 48 h after delivery. EBF was associated with a lower prevalence of PPD during the first 48 h (p = 0.015) and after the first 48 h (p = 0.001) after delivery. Skin-to-skin contact (SSC) was reported by 385 (65.7%) mothers. PPD was less frequent in mothers practicing SSC (20.3%) than it was in those not practicing SSC (40.3%) (p = 0.001). A higher percentage of mothers practiced SSC breastfed (66.9%) and used EBF (150, 79.4%) (p = 0.012 and 0.001, respectively). Conclusions: Results suggest that the pandemic emergency and restrictions imposed on the population significantly affected the well-being of mothers after birth, and that these effects may have posed risks to the mental health and emotional stability of postpartum mothers. Therefore, encouraging BF or EBF and SSC may improve or limit depressive symptoms in postpartum mothers.

Prevalence and Factors Associated with Depression Among Older Adults During the COVID-19 Pandemic: A Cross-Sectional Study in Urban Areas in Thailand

Purpose

This study examined the prevalence of and factors associated with depression symptoms among Thai older adults during the COVID-19 pandemic.

Patients and Methods

A cross-sectional survey was conducted among older adults in urban areas in Bangkok, Thailand, between July and October 2021. The 15-item Thai Geriatric Depression Scale (TGDS-15) was used to determine the prevalence of depression symptoms, and multiple logistic regression was conducted to identify the associated factors.

Results

A total 156 older adults survey responses were received. The largest group of participants (80.8%) was aged below 70, women (50.6%), married (67.9%), retired (41%), having sufficient income (67.9%), living with their families (89.1%). More than half (71.8%) had an underlying disease, with hypertension being the most common (39.1%). In addition, 17.3% of the participants had received compulsory COVID-19 vaccination. Only 0.6% had a history of COVID-19 infection. The prevalence of depression among Thai older adults was 20.5%. Univariate analysis demonstrated occupation and income sufficiency was associated with depression symptoms. The results of the multivariate analysis found that the "non-worker" group was 3.54 times more likely to experience depression symptoms than the reference group (OR = 3.54, 95% CI = 1.25-10.02, p = 0.018) when controlling for the confounding factors.

Conclusion

This study highlights the importance of addressing depression symptoms among Thai older adults, in which occupation and income sufficiency were the main variable factors for depression. Our study further suggested that the importance of interventions such as increasing job availability and establishing financial aid policies may ameliorate depression symptoms among older adults, especially in high-risk groups during the pandemic situation such as the COVID-19.

The impact of COVID-19 pandemic lockdown on smoking habits and lifestyle: A cross-sectional study

Background and Aims

Throughout the COVID-19 lockdown, the resultant psychological disturbances led to more tobacco consumption and deteriorated smoking behaviors among smokers. In this study, we aimed to investigate the impact of the COVID-19 pandemic on the smoking behaviors of the Jordanian population.

Methods

A cross-sectional online survey was designed using the Google Forms service and distributed by social media platforms. Responses were collected starting from November 12, 2020, until November 24, 2020.

Results

A total of 2511 respondents completed the survey, 77.3% were females. Males were significantly smoking more than females (p < 0.0001). Smoking was significantly more common among respondents who were older than 18 years old, married, held master's and PhD degrees, and working in non-health-related fields (p < 0.0001). Participants who smoke were more likely to adopt an unhealthy lifestyle during the pandemic. Females who started smoking last year were 2.6-fold more than males (p < 0.0001). We also noticed that there is a significant relationship between those who started smoking and are <18 years, living in a family consisting of seven members or more, being unemployed, having a diploma or bachelor's degree in a health-related major, having no chronic illnesses, increasing of daily meals or night meals, almost daily sugar intake, starting to follow social media account concerning physical activity, exercising once or twice a week, and sleeping more hours per day since the beginning of the pandemic (p < 0.01).

Conclusion

The results of our study showed that the lockdown had a significant impact on people's lifestyles including smoking habits. Most of our sample's smoker participants experienced a change in their smoking level mostly, an increase. While those who had a decrease in their smoking level experienced a somehow healthier lifestyle regarding nutrition and other aspects.

Trade-off Between Quarantine Length and Compliance to Optimize COVID-19 Control

BACKGROUND

Guidance on COVID-19 quarantine duration is often based on the maximum observed incubation periods assuming perfect compliance. However, the impact of longer quarantines may be subject to diminishing returns; the largest benefits of quarantine occur over the first few days. Additionally, the financial and psychological burdens of quarantine may motivate increases in noncompliance behavior.

METHODS

We use a deterministic transmission model to identify the optimal length of quarantine to minimize transmission. We modeled the relation between noncompliance behavior and disease risk using a time-varying function of leaving quarantine based on studies from the literature.

RESULTS

The first few days in quarantine were more crucial to control the spread of COVID-19; even when compliance is high, a 10-day quarantine was as effective in lowering transmission as a 14-day quarantine; under certain noncompliance scenarios a 5-day quarantine may become nearly protective as 14-day quarantine.

CONCLUSION

Data to characterize compliance dynamics will help select optimal quarantine strategies that balance the trade-offs between social forces governing behavior and transmission dynamics.

Psychosocial comorbidities of diabetes during the COVID-19 pandemic in Iran

BACKGROUND

The psychosocial impacts of the COVID-19 pandemic are mainly focused on the general population, while pandemics do not impact the mental health of the entire population uniformly, especially vulnerable populations with underlying health conditions. This study aimed to investigate diabetes psychosocial comorbidities among Iranians with type 1 diabetes (T1D) during the COVID-19 pandemic. This study aimed to investigate diabetes psychosocial comorbidities among Iranians with type 1 diabetes (T1D) during the COVID-19 pandemic.

MATERIALS AND METHODS

This was a cross-sectional study of 212 adults with T1D in different cities in Iran. Study participants completed an online survey in April-June 2020. The survey collected self-reported data on diabetes psychosocial comorbidities (i.e. diabetes burnout, diabetes distress, and depressive symptoms). Demographic and COVID-19 data before and during the pandemic were also collected. Responses were analyzed using ordinary least squares and logistic regression methods.

RESULTS

Around 17.5% reported being tested for COVID-19 virus, 8% were diagnosed positive, 10.8% were hospitalized, and 92.9% followed precaution recommendations during the pandemic. Participants had high levels of diabetes distress (57.1%), depressive symptoms (60.8%), and diabetes burnout (mean score = 3.1 out of 5). During the pandemic, trouble paying for the very basic needs was a consistent factor increasing the risk of diabetes distress, diabetes burnout, and depressive symptoms. Lack of access to diabetes care was only associated with diabetes burnout, while diabetes hospitalization/emergency department (ED) visit was associated with diabetes distress. Existing diabetes disparities before the pandemic were also associated with higher scores of diabetes psychosocial comorbidities [accessing diabetes supplies and medications (P < 0.0001) and places for physical exercise (P < 0.0333)].

CONCLUSION

The negative impact of the COVID-19-related changes on individuals with diabetes, as one of the most vulnerable populations, must be recognized alongside the physical, financial, and societal impact on all those affected. Psychological interventions should be implemented urgently in Iran, especially for those with such characteristics.

Changes in dietary habit and physical activity among the diabetic patients of Bangladesh during COVID-19: A cross-sectional study

In an effort to avert further Covid-19 transmission, the Bangladesh government took several initiatives which disrupted the routine food intake and exercise of diabetic patients. This study sought to examine the difference in dietary and exercise habits of diabetic patients between their pre-pandemic status and during COVID-19 which may be attributed to the observed poor health outcomes during the study period. This was a cross-sectional study that enrolled 604 diabetic patients using a convenience sampling technique who were attending outpatient clinics of the three selected hospitals in Bangladesh. A validated semi-structured questionnaire was used to collect information regarding eating habit and physical activity of the respondents pre- and during COVID-19 pandemic via direct interview. McNemar-Bowker test was used to assess the changes in dietary and physical activity behaviors. The current study reveals that 93.9% of the respondents were type-2 diabetic patients. During the pandemic, there was a decrease in the consumption of rice, bread, meat, fish, eggs, and dessert, while the consumption of cereals, milk, and potato/starchy vegetables increased. There was also a decrease in the frequency of drinking tea or coffee, while the consumption of soft drinks remained relatively stable. The level and duration of physical activity significantly decreased among the respondents during the pandemic. This study explored the changes in dietary habits and physical activity among the study population which not only disrupt the metabolic control of the diabetic patients but also pose a significant threat to their overall health. Therefore, it is critical to prioritize measures that support diabetic patients to maintain healthy dietary habit and to engage in regular physical activity during unprecedented times such as COVID-19 pandemic.

Mental Health: Pandemics, Epidemics and Tau Protein

Background

It is well established that a wide range of psychological disorders are influenced by the way people live, with lifestyle-related factors playing a substantial role. During the past decade, the effects of major disasters on mental health have drawn a lot of attention.

Aim

In this review, we compare clinical studies reporting a link between COVID-19 and other pandemics and mental health. Importantly, we also shed light on Tau protein and neurotransmitters as neurobiological factors that might explain this link.

Methods

A thorough PubMed search was done to gather and summarize published data on the COVID-19 pandemic's effect on mental health. Additionally, these studies were compared to previous research published on PubMed, triggering other pandemic and epidemic impacts on mental health.

Results

The COVID-19 epidemic has had the biggest impact on raising awareness about mental health. Moreover, the past century has seen an increase in the frequency of disease outbreaks like MERS-CoV, Ebola, and Influenza, which all had an impact on mental health. However, the exact role of these epidemics on mental health and brain functions is poorly understood.

Conclusion

Future research on the underlying pathways may yield essential information for the treatment and prevention of prospective mental diseases in light of the ongoing decline in mental health during the past 10 years.

Personal and contextual variables predict music consumption during the first COVID-19 lockdown in Canada

The global COVID-19 lockdowns shattered familiar routines, plunging individuals into a disorienting emotional landscape characterized by loss, uncertainty, and a deep yearning for social bonds. Many employed coping strategies such as cleaning, dancing, and mindfulness-based practices to ameliorate negative emotions. Music listening was one of the most widely used coping strategies, moderated by personal and contextual variables. We obtained data from a Canadian national survey conducted in April 2020 to examine the role of personal (sex, age, education level, pre-pandemic income, minority status, feelings about music, and Schwartz's "personal values") and contextual variables (level of worry, changes to income, COVID-19 status and risk, having children at home, and internet access) in predicting music listening for stress relief, changes to music listening, changes to music watching, and music discovery. Our results indicate that women, younger adults, individuals who like or love music, and those reporting high levels of worry were more likely to listen to music to relieve stress. Personal variables were more significantly associated with music listening for stress relief than contextual variables.

A Case of New-Onset Obsessive-Compulsive Disorder and Schizophrenia in a 14-Year-Old Male following the COVID-19 Pandemic

The post-COVID-19 era has introduced novel cases of psychiatric complications that are either organic or purely psychological in nature due to social isolation. This report details a case of new-onset obsessive-compulsive disorder (OCD) and schizophrenia following the COVID-19 pandemic. The novelty of this case lies in the onset of the patient's symptoms in the context of the COVID-19 pandemic, without prior predisposing risks in the environmental, social, or biological aspects. We provided therapeutic treatment to the patient in an inpatient setting, while examining the patient to decipher the root cause of his symptoms. While there is substantial data suggesting exacerbations of OCD during the COVID-19 pandemic in the general population and a new onset of schizophrenia due to the virus itself, very little is known about the prevalence of either OCD or schizophrenia after the pandemic. With this in mind, we hope to provide more information regarding new-onset psychosis and OCD within the adolescent population. A considerable amount of studies and data are needed in this subset of the population.

Inequalities in the receipt of healthcare practitioner counseling for adults after COVID-19 in southern Brazil

Health counseling is a prevention and health promotion action, especially in the context of a pandemic, for both preventing disease and maintaining health. Inequalities may affect receipt of health counseling. The aim was to provide an overview of the prevalence of receiving counseling and to analyze income inequality in the receipt of health counseling.

METHODS

This was a cross-sectional telephone survey study with individuals aged 18 years or older with diagnosis of symptomatic COVID-19 using RT-PCR testing between December 2020 and March 2021. They were asked about receipt of health counseling. Inequalities were assessed using the Slope Index of Inequality (SII) and Concentration Index (CIX) measures. We used the Chi-square test to assess the distribution of outcomes according to income. Adjusted analyses were performed using Poisson regression with robust variance adjustment.

RESULTS

A total of 2919 individuals were interviewed. Low prevalence of health counseling by healthcare practitioner was found. Participants with higher incomes were 30% more likely to receive more counseling.

CONCLUSIONS

These results serve as a basis for aggregating public health promotion policies, in addition to reinforcing health counseling as a multidisciplinary team mission to promote greater health equity.

Mindfulness and COVID-19-Related Stress: Staying Present During Uncertain Times

Objectives

The SARS-CoV-2 (COVID-19) pandemic is recognized as a mass traumatic event in which COVID-19-related stress (CS) can indicate other trauma- and/or stressor-related disorder. The facets of mindfulness (observing, describing, acting with awareness, nonjudging, and nonreacting) have been linked to reductions in stress-related symptoms and thus may protect against CS. We extended previous research by evaluating mindfulness facets as resilience skills negatively related to CS.

Method

Undergraduate students (n = 495) completed an online battery of questionnaires. A subsample of students endorsing clinically elevated CS (n = 165) was also evaluated. We utilized hierarchical regression to account statistically for the mindfulness facets in addition to indicators of psychological distress (e.g., negative affect, neuroticism, dissociation) and social desirability. We performed analyses twice, once in the overall sample, and once in the high CS subsample.

Results

Less observing and greater nonjudging related to reduced CS while other study variables were controlled for in the overall sample. In contrast, acting with awareness and nonjudging negatively related to CS in the subsample, but were not related to CS when we accounted for psychological-distress variables that positively related to CS in the analysis.

Conclusions

Although variables indicative of psychological distress robustly contribute to CS, observing, acting with awareness, and nonjudging may be mindfulness skills that can be targeted to buffer clinically significant CS.

Preregistration

This study was not pre-registered.

The Contribution of Meaning Making and Religiosity to Individuals' Psychological Wellbeing During the COVID-19 Pandemic: Prosocial Orientation Matters

The COVID-19 pandemic has dramatically affected individuals' psychological well-being worldwide, thus representing a challenge for flourishing among emerging adults. To understand psychological processes involved in the positive adaptation to this challenge, the present study examined the role of meaning in life and religious identity as crucial resources for flourishing in a sample of 255 Italian emerging adults. Specifically, as in the midst of a stressful event individuals may experience the potential for flourishing through the process of search for meaning, the study examined the mediated role of existential, spiritual/religious and prosocial orientations as the three primary trajectories for building meaning. Results from path analytic mediation models revealed a positive influence of presence of meaning and in-depth exploration on flourishing. Findings also suggested the contribution of prosocial orientation in building meaning and, ultimately, in increasing flourishing. Implications are discussed.

Effectiveness of Drama-Based Intervention in Improving Mental Health and Well-Being: A Systematic Review and Meta-Analysis during the COVID-19 Pandemic and Post-Pandemic Period

As a creative form of psychotherapy, drama appears to assist individuals in the COVID-19 pandemic and post-pandemic period in altering crisis conditions and challenging negative perspectives. Drama-based intervention is presented as an option for addressing mental health issues in clinical and general populations by utilising various multidisciplinary sources, such as psychodrama and role playing. In this study, a systematic review and meta-analysis were employed to assess the impact of drama on mental health and well-being during the COVID-19 pandemic and post-pandemic. Four electronic databases (PubMed, Cochrane, Web of Science, and ScienceDirect) were extensively searched from December 2019 to October 2022. Quality assessment and Risk of Bias tool of the Cochrane Collaboration were performed. Using a random effect model, standardised mean difference (SMD) values and 95% confidence intervals (CI) were calculated. In the final analysis, 25 studies involving 797 participants were included. The study revealed that drama-based interventions have the potential to improve mental health (e.g., trauma-related disorders) and well-being (e.g., psychological well-being), which could position drama as an adjunctive method of mental health care. This original review offered the newer, more comprehensive recommendations for drama-based intervention based on evidence.

Between Care and Coercion: Asylum Seekers’ Experiences With COVID-19 Containment and Mitigation Measures in German Reception Centres

Objectives: COVID-19 containment and mitigation measures have been criticised for amplifying pre-existing individual and structural vulnerabilities among asylum seekers. We qualitatively explored their experiences with and attitudes towards pandemic measures to inform people-centred responses in future health emergencies.

Methods: We interviewed eleven asylum seekers in a German reception centre (July-December 2020). The semi-structured interviews were recorded, transcribed, and analysed thematically with an inductive-deductive approach.

Results: Quarantine was experienced as burdensome by participants. Shortcomings in social support, everyday necessities, information, hygiene, and daily activities exacerbated the strains of quarantine. Interviewees held different opinions about the usefulness and appropriateness of the various containment and mitigation measures. These opinions differed by individual risk perception and the measures’ comprehensibility and compatibility with personal needs. Power asymmetries related to the asylum system furthermore impacted on preventive behaviour.

Conclusion: Quarantine can amplify mental health burdens and power asymmetries and can therefore constitute a considerable stressor for asylum seekers. Provision of diversity-sensitive information, daily necessities, and accessible psychosocial support is required to counteract adverse psychosocial impacts of pandemic measures and safeguard wellbeing in this population.

The Impact of the COVID-19 Pandemic on the Registration and Care Provision of Mental Health Problems in General Practice: Registry-Based Study

BACKGROUND

The impact of the COVID-19 pandemic on mental health in general practice remains uncertain. Several studies showed an increase in terms of mental health problems during the pandemic. In Belgium, especially during the first waves of the pandemic, access to general practice was limited. Specifically, it is unclear how this impacted not only the registration of mental health problems itself but also the care for patients with an existing mental health problem.

OBJECTIVE

This study aimed to know the impact of the COVID-19 pandemic on (1) the incidence of newly registered mental health problems and (2) the provision of care for patients with mental health problems in general practice, both using a pre-COVID-19 baseline.

METHODS

The prepandemic volume of provided care (care provision) for patients with mental health problems was compared to that from 2020-2021 by using INTEGO, a Belgian general practice morbidity registry. Care provision was defined as the total number of new registrations in a patient's electronic medical record. Regression models evaluated the association of demographic factors and care provision in patients with mental health problems, both before and during the pandemic.

RESULTS

During the COVID-19 pandemic as compared to before the COVID-19 pandemic, the incidence of registered mental health problems showed a fluctuating course, with a sharp drop in registrations during the first wave. Registrations for depression and anxiety increased, whereas the incidence of registered eating disorders, substance abuse, and personality problems decreased. During the 5 COVID-19 waves, the overall incidence of registered mental health problems dropped during the wave and rose again when measures were relaxed. A relative rise of 8.7% and 40% in volume of provided care, specifically for patients with mental health problems, was seen during the first and second years of the COVID-19 pandemic, respectively. Care provision for patients with mental health problems was higher in older patients, male patients, patients living in center cities (centrumsteden), patients with lower socioeconomic status (SES), native Belgian patients, and patients with acute rather than chronic mental health problems. Compared to prepandemic care provision, a reduction of 10% was observed in people with a low SES.

CONCLUSIONS

This study showed (1) a relative overall increase in the registrations of mental health problems in general practice and (2) an increase in care provision for patients with mental health problems in the first 2 years of the COVID-19 pandemic. Low SES remained a determining factor for more care provision, but care provision dropped significantly in people with mental health problems with a low SES. Our findings suggest that the pandemic in Belgium was also largely a "syndemic," affecting different layers of the population disproportionately.

Association of disrespectful care after childbirth and COVID-19 exposure with postpartum depression symptoms- a longitudinal cohort study in Nepal

BACKGROUND

The COVID-19 pandemic has led to unprecedented mental stress to women after childbirth. In this study, we assessed the association of disrespectful care after childbirth and COVID-19 exposure before/during labour with postpartum depression symptoms assessed at 7 and 45 days in Nepal.

METHODS

A longitudinal cohort study was conducted in 9 hospitals of Nepal among 898 women. The independent data collection system was established in each hospital to collection information on disrespectful care after birth via observation, exposure to COVID-19 infection before/during labour and other socio-demographic via interview. The information on depressive symptoms at 7 and 45 days was collected using the validated Edinburg Postnatal Depression Scale (EPDS) tool. Multi-level regression was performed to assess the association of disrespectful care after birth and COVID-19 exposure with postpartum depression.

RESULT

In the study, 16.5% were exposed to COVID-19 before/during labour and 41.8% of them received disrespectful care after childbirth. At 7 and 45 days postpartum, 21.3% and 22.4% of women reported depressive symptoms respectively. In the multi-level analysis, at the 7th postpartum day, women who had disrespectful care and no COVID-19 exposure still had 1.78 higher odds of having depressive symptom (aOR, 1.78; 95% CI; 1.16, 2.72). In the multi-level analysis, at 45^th postpartum day, women who had disrespectful care and no COVID-19 exposure had 1.37 higher odds of having depressive symptoms (aOR, 1.37; 95% CI; 0.82, 2.30), but not statistically significant.

CONCLUSION

Disrespectful care after childbirth was strongly associated with postpartum depression symptoms irrespective of COVID-19 exposure during pregnancy. Caregivers, even during the global pandemic, should continue to focus their attention for immediate breast feeding and skin-to-skin contact, as this might reduce the risk for depressive symptoms postpartum.

How Did the COVID-19 Pandemic Increase Salience of Intimate Partner Violence on the Policy Agenda?

Belgian authorities, like most authorities in European countries, resorted to unprecedented measures in response to the spread of the COVID-19 pandemic between March 2020 and May 2022. This exceptional context highlighted the issue of intimate partner violence (IPV) in an unprecedented way. At a time when many other issues are being put on hold, IPV is being brought to the fore. This article investigated the processes that have led to increasing political attention to domestic violence in Belgium. To this end, a media analysis and a series of semi-structured interviews were conducted. The materials, collected and analyzed by mobilizing the framework of Kingdon's streams theory, allowed us to present the agenda-setting process in its complexity and the COVID-19 as a policy window. The main policy entrepreneurs were NGOs and French-speaking feminist women politicians. Together, they rapidly mobilized sufficient resources to implement public intervention that had already been proposed in the preceding years, but which had been waiting for funding. By doing so, they responded during the peak of the pandemic to requests and needs that had already been expressed in a "non-crisis" context.

Time trends in mental health indicators in Germany's adult population before and during the COVID-19 pandemic

Background

Times of crisis such as the COVID-19 pandemic are expected to compromise mental health. Despite a large number of studies, evidence on the development of mental health in general populations during the pandemic is inconclusive. One reason may be that representative data spanning the whole pandemic and allowing for comparisons to pre-pandemic data are scarce.

Methods

We analyzed representative data from telephone surveys of Germany's adults. Three mental health indicators were observed in ~1,000 and later up to 3,000 randomly sampled participants monthly until June 2022: symptoms of depression (observed since April 2019, PHQ-2), symptoms of anxiety (GAD-2), and self-rated mental health (latter two observed since March 2021). We produced time series graphs including estimated three-month moving means and proportions of positive screens (PHQ/GAD-2 score ≥ 3) and reports of very good/excellent mental health, as well as smoothing curves. We also compared time periods between years. Analyses were stratified by sex, age, and level of education.

Results

While mean depressive symptom scores declined from the first wave of the pandemic to summer 2020, they increased from October 2020 and remained consistently elevated throughout 2021 with another increase between 2021 and 2022. Correspondingly, the proportion of positive screens first decreased from 11.1% in spring/summer 2019 to 9.3% in the same period in 2020 and then rose to 13.1% in 2021 and to 16.9% in 2022. While depressive symptoms increased in all subgroups at different times, developments among women (earlier increase), the youngest (notable increase in 2021) and eldest adults, as well as the high level of education group (both latter groups: early, continuous increases) stand out. However, the social gradient in symptom levels between education groups remained unchanged. Symptoms of anxiety also increased while self-rated mental health decreased between 2021 and 2022.

Conclusion

Elevated symptom levels and reduced self-rated mental health at the end of our observation period in June 2022 call for further continuous mental health surveillance. Mental healthcare needs of the population should be monitored closely. Findings should serve to inform policymakers and clinicians of ongoing dynamics to guide health promotion, prevention, and care.

Distress Signals: Age Differences in Psychological Distress before and during the COVID-19 Pandemic

Psychological distress reached historically high levels in 2020, but why, and why were there pronounced age differences? We address these questions using a relatively novel, multipronged approach, part narrative review and part new data analyses. We first updated previous analyses of national surveys that showed distress was increasing in the US and Australia through 2017 and then re-analyzed data from the UK, comparing periods with and without lockdowns. We also analyzed the effects of age and personality on distress in the US during the pandemic. Results showed distress levels and age differences in distress were still increasing through 2019 in the US, UK, and Australia. The effects of lockdowns in 2020 revealed the roles of social deprivation and fear of infection. Finally, age-related differences in emotional stability accounted for the observed age differences in distress. These findings reveal the limitations of analyses comparing pre-pandemic and pandemic periods without accounting for ongoing trends. They also suggest that differences in personality traits such as emotional stability modulate responses to stressors. This could explain age and individual differences in both increases and decreases in distress in response to changes in the level of stressors such as those occurring prior to and during the COVID-19 pandemic.

COVID-19 Obesity: Differences in Infection Risk Perception, Obesity Stress, Depression, and Intention to Participate in Leisure Sports Based on Weight Change

This study examined the impact of COVID-19 on individuals' weight change and mental health by analyzing differences in risk perception, obesity, stress, depression, and intention to participate in leisure sports during the COVID-19 pandemic. Data were collected in the Republic of Korea between June and August 2022. This study included 374 individuals aged ≥ 20 years who regularly participated in leisure sports. A comparative analysis subdivided the participants into two groups based on weight changes during the pandemic: weight loss and maintenance (Group 1) and weight gain (Group 2). These formed the independent variable. The dependent variables were (a) infection risk perception, (b) obesity stress, (c) depression, and (d) intention to participate in sports. The results revealed statistically significant differences between the two groups in infection risk perception, obesity stress, and depression factors, but not in the intention to participate in sports. This study demonstrated the impact of COVID-19 on weight changes and mental health. These findings can guide future quarantine strategies to control new infectious diseases and policies to prevent obesity and stress.

The impact of leader safety communication on work engagement under pandemic: The effect of OBSE and anxiety based on COVID-19

Introduction

The outbreak of COVID-19 has a great impact on employees daily work and psychology. Therefore, as leaders in organization, how to alleviate and avoid the negative impact of COVID-19 so that employees can maintain a positive working attitude has become a problem to be worthy paying attention.

Methods

In this paper, we adopted a time-lagged cross-sectional design to test our research model empirically. The data from a sample of 264 participants in China were collected using existing scales in recent studies, and were used for testing our hypothesizes.

Results

The results show that leader safety communication based on COVID-19 will positively affect employees' work engagement (b = 0.47, p < 0.001), and organization-based self-esteem plays a full mediating role in the relationship between leader safety communication based on COVID-19 and work engagement (0.29, p < 0.001). In addition, anxiety based on COVID-19 positively moderates the relationship between leader safety communication based on COVID-19 and organization-based self-esteem (b = 0.18, p < 0.01), that is, when anxiety based on COVID-19 is at higher level, the positive relationship between leader safety communication based on COVID-19 and organizational-based self-esteem is stronger, and vice versa. It also moderates the mediating effect of organization-based self-esteem on the relationship between leader safety communication based on COVID-19 and work engagement as well (b = 0.24, 95% CI = [0.06, 0.40]).

Discussion

Based on Job Demands-Resources (JD-R) model, this paper investigates the relationship between leader safety communication based on COVID-19 and work engagement, and examines the mediating role of organization-based self-esteem and the moderating role of anxiety based on COVID-19.

Impact of COVID-19 on Rocky Vista University medical students' mental health: A cross-sectional survey

Background

The COVID-19 pandemic brought immense changes to medical school curriculums world-wide, such as the widespread adoption of virtual learning. We sought to better understand the impact on medical students' mental health at Rocky Vista University College of Osteopathic Medicine, Parker, CO, United States. This study assessed the impact the pandemic had on anxiety and depression levels of medical students. It also assessed the impact of several domains on student mental health during the pandemic and how various sub-groups within the studied population were affected.

Methods

A cross-sectional survey was sent to students through an online anonymous google survey in May to June 2021, centered around the 7-item questionnaire used to screen for Generalized Anxiety Disorder GAD-7, 9-item questionnaire used to screen for depression PHQ-9, and self-designed questions to assess the personal impact of the pandemic. Data obtained were screened for error and analyzed with significance value of p < 0.05.

Results

A total of 152 responses were received (25.5% response rate). Of these, 64.1% identified as female, 75.8% were white, 50.3% were between ages 21-25, and 77.8% were first year medical students. During the pandemic, 79.6% of respondents felt more anxious and 65.1% felt more depressed. 67.8% of students reported feeling social isolation amidst the pandemic. Students living with friends were more likely to see a therapist for depression during the pandemic (p = 0.0169) and prescribed an antidepressant (p = 0.0394). Females and students in relationships were more likely to score higher on GAD-7 (p = 0.0194) and (p = 0.0244), respectively.

Conclusion

This study investigated the effect of the pandemic on medical students' mental health and the need to address this issue. Results suggest that the pandemic had a negative impact on medical student's mental health and that anxiety and depression levels worsened for pre-clinical medical students at Rocky Vista University. As such, it is imperative to incorporate additional resources to protect the well-being of medical students as they progress through their medical careers.