Editorial

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5 pages, 307 KiB

Open AccessEditorial

The Short-Term Consequences of COVID-19 on Mental Health: State of the Art from Available Studies

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Gaia Sampogna

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Maurizio Pompili

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Andrea Fiorillo

Int. J. Environ. Res. Public Health 2022, 19(23), 15860; https://doi.org/10.3390/ijerph192315860 - 29 Nov 2022

Cited by 6 | Viewed by 1014

Abstract

Since the outbreak of the COVID-19 pandemic, the consequences on mental health have been found to be considerable, with potential effects on the general population and in high-risk groups, with a variety of physiopathological mechanisms [...] Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

5 pages, 302 KiB

Open AccessEditorial

Mental Health in the Time of COVID-19 Pandemic: A Worldwide Perspective

by

Gaia Sampogna

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Maurizio Pompili

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Andrea Fiorillo

Int. J. Environ. Res. Public Health 2022, 19(1), 161; https://doi.org/10.3390/ijerph19010161 - 24 Dec 2021

Cited by 16 | Viewed by 4483

Abstract

Major infectious disease outbreaks, such as the novel coronavirus (COVID-19) pandemic, create significant distress for the general population, and pose a heavy burden on the healthcare systems called to care for affected individuals and contain the spread of the disease [...] Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

4 pages, 286 KiB

Open AccessEditorial

Eating Disorders in the Era of the COVID-19 Pandemic: What Have We Learned?

by

Palmiero Monteleone

Int. J. Environ. Res. Public Health 2021, 18(23), 12381; https://doi.org/10.3390/ijerph182312381 - 25 Nov 2021

Cited by 10 | Viewed by 2350

Abstract

Eating disorders (EDs), including anorexia nervosa, bulimia nervosa, binge-eating disorder and other less frequent syndromes [...] Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

Research

Jump to: Editorial, Review, Other

25 pages, 736 KiB

Open AccessArticle

Effects of Health Anxiety, Social Support, and Coping on Dissociation with Mediating Role of Perceived Stress during the COVID-19 Pandemic

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László Róbert Kolozsvári

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Int. J. Environ. Res. Public Health 2023, 20(8), 5491; https://doi.org/10.3390/ijerph20085491 - 12 Apr 2023

Viewed by 1266

Abstract

Background: Our study aimed to examine whether health anxiety, social support, and ways of coping relate to dissociation directly or only through the mediation of perceived stress, moderated by the time of measurement (lockdown). We investigated the effect of perceived stress on different [...] Read more.

Background: Our study aimed to examine whether health anxiety, social support, and ways of coping relate to dissociation directly or only through the mediation of perceived stress, moderated by the time of measurement (lockdown). We investigated the effect of perceived stress on different forms (sub-scales) of dissociation. Methods: A cross-sectional survey was conducted by an online form at two points in time: the beginning and the later stage of the COVID-19 pandemic. Results: We received a total of 1711 responses. Perceived stress moderately correlated with dissociation in both international and Hungarian samples. Health anxiety showed a strong direct and indirect correlation with dissociation. Regarding social support, the support of family significantly decreased the dissociative experiences in the Hungarian sample mediated by perceived and direct stress. In the international sample, goal-oriented coping strategies strongly decreased all dissociation scales in the first measurement, through the mediation of perceived stress. As for the Hungarian sample, positive thinking was found to decrease dissociation by decreasing perceived stress. Conclusion: health anxiety, coping, and social support appeared to influence dissociation directly and through the mediation of perceived stress. Social support, mainly support of the family and problem-focused coping strategies may decrease the level of stress, this way decreasing dissociative behavior. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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14 pages, 369 KiB

Open AccessArticle

Investigating Functioning Profile of Adolescents with Anorexia before and during the COVID-19 Pandemic: A Cross-Sectional Study on Mentalizing, Alexithymia, and Impulsiveness

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Fabiola Bizzi

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Anna Riva

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Simone Charpentier Mora

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Int. J. Environ. Res. Public Health 2023, 20(4), 3670; https://doi.org/10.3390/ijerph20043670 - 19 Feb 2023

Viewed by 1217

Abstract

Anorexia nervosa (AN) usually emerges in adolescence when important changes occur in cognitive, emotional, and social processes. Mentalizing, alexithymia, and impulsiveness represent key dimensions for the understanding and interpretation of psychological difficulties in AN. The outbreak of the COVID-19 pandemic has impacted adolescents [...] Read more.

Anorexia nervosa (AN) usually emerges in adolescence when important changes occur in cognitive, emotional, and social processes. Mentalizing, alexithymia, and impulsiveness represent key dimensions for the understanding and interpretation of psychological difficulties in AN. The outbreak of the COVID-19 pandemic has impacted adolescents with AN, showing a worsening of the disease. The main aims of the present paper are (1) to compare adolescents with AN before and during the COVID-19 pandemic and (2) to explore the relationship between mentalizing, alexithymia, impulsiveness, and psychological difficulties related to eating disorders in adolescents with AN during the COVID-19 pandemic. One hundred and ninety-six AN female adolescents (N = 94 before COVID-19; N = 102 during COVID-19) participated in this study. The results show that adolescents with AN during the COVID-19 pandemic had a more impaired functioning profile than the before COVID-19 group. Mentalizing, alexithymia, and impulsiveness had a predictive role on psychological difficulties related to eating disorders in adolescents with AN during the COVID-19 pandemic. In conclusion, our data reveal that the COVID-19 pandemic has likely represented a stress condition that affects mental health; worsening the severity of adolescents with AN clinical condition. Lastly, predictive patterns suggest the existence of a link between difficulties in the ability to face the problems of the present time using effective strategies and the severity of psychological symptoms. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

27 pages, 1373 KiB

Open AccessArticle

Transformational Leadership, Employee Engagement, Job Satisfaction, and Psychological Well-Being among Hotel Employees after the Height of the COVID-19 Pandemic: A Serial Mediation Model

by

Magdy Sayed Ahmed Abolnasser

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Ahmed Hassan Abdou

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Thowayeb H. Hassan

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Amany E. Salem

Int. J. Environ. Res. Public Health 2023, 20(4), 3609; https://doi.org/10.3390/ijerph20043609 - 17 Feb 2023

Cited by 6 | Viewed by 5208

Abstract

Over the past few years, great attention has been given to the impacts of the COVID-19 pandemic and its consequences on employee psychological well-being (PWB), particularly in the hospitality industry. Like many aspects of human life, employee PWB is influenced by multiple factors. [...] Read more.

Over the past few years, great attention has been given to the impacts of the COVID-19 pandemic and its consequences on employee psychological well-being (PWB), particularly in the hospitality industry. Like many aspects of human life, employee PWB is influenced by multiple factors. One of the factors that may affect employee PWB is transformational leadership (TLS). Accordingly, we aim through this study to empirically (1) examine the direct effect of transformational leadership on employee PWB and (2) investigate the potential independent and serial mediation effects of employee engagement (EEG) and job satisfaction (JS) on the TLS-PWB relationship after the height of the COVID-19 pandemic. Data were gathered using an online questionnaire from a convenience sample of 403 front-line employees from five-star hotels in Saudi Arabia. The partial least squares structural equation modeling (PLS-SEM) with the bootstrapping technique was utilized to test the study hypotheses. Based on the demands–resources (JD-R) theory, the findings of this study reveal a significant positive effect of TLS on hotel employees’ PWB. Additionally, drawing on the stimulus–organism–response (S-O-R) model, the two main contributions of this study are: (1) EEG and JS serially and independently have a significant partial mediational effect on the TLS-PWB relationship among hotel employees, and (2) EEG has a greater impact on the TLS-PWB relationship as an intervening variable than the two other mediators (JS, as well as EEG and JS serially). Based on these findings, hotel management should mainly consider developing and encouraging TLS behavior among their managers to promote EEG and increase JS among their followers, which consequently enhances their PWB and alleviates negative psychological outcomes due to experiencing a disaster such as the COVID-19 pandemic. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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21 pages, 552 KiB

Open AccessArticle

Impact of COVID-19 Pandemic on Mental Health and Socioeconomic Aspects in Greece

by

Tasos Stylianou

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Konstantinos Ntelas

Int. J. Environ. Res. Public Health 2023, 20(3), 1843; https://doi.org/10.3390/ijerph20031843 - 19 Jan 2023

Cited by 1 | Viewed by 1447

Abstract

The global outbreak of the COVID-19 pandemic has spread worldwide, affecting almost all countries and territories. COVID-19 continues to impact various spheres of our life, such as the economy, industries, global market, agriculture, human health, health care, and many others. The aim of [...] Read more.

The global outbreak of the COVID-19 pandemic has spread worldwide, affecting almost all countries and territories. COVID-19 continues to impact various spheres of our life, such as the economy, industries, global market, agriculture, human health, health care, and many others. The aim of this study was to investigate the impact of the COVID-lockdowns on people’s mental health in Greece. A descriptive, cross-sectional study was conducted in several urban, semi-urban and rural areas. The survey of 252 Greek people was conducted in spring 2022, and 46.8% of them were female and the other 53.2% were male. Ages were between 19 and 60 years old. Some of the main findings were that most of the participants feel their mental health got worse than before (about 80%), participants with kids were more affected than those who did not have any kids because they had bigger responsibilities and the pandemic might have caused them a lot of problems to deal with. The higher the income, the less they are affected, and people whose jobs did not change dramatically were also less likely to not be much mentally affected. Moreover, the percentage of smokers whose mental health became worse was greater than that among those who did not smoke. The same happened with those who consumed alcohol. Finally, we used the GBM algorithm to find three important predictors and we applied k-means to have a clear picture of the different clusters and how a number of participants are connected according to their answers. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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14 pages, 1938 KiB

Open AccessArticle

The Effects and Differences of Social Support, Depression, and Vital Exhaustion during the COVID-19 Pandemic among International and Domestic University Students

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László Robert Kolozsvári

Int. J. Environ. Res. Public Health 2023, 20(2), 1502; https://doi.org/10.3390/ijerph20021502 - 13 Jan 2023

Cited by 1 | Viewed by 1336

Abstract

Background: Our study aimed to assess the differences between domestic and international students in terms of social support, vital exhaustion, and depression during the period of COVID-19 and to examine the relationships and potential effects of these factors on each other. Methods: The [...] Read more.

Background: Our study aimed to assess the differences between domestic and international students in terms of social support, vital exhaustion, and depression during the period of COVID-19 and to examine the relationships and potential effects of these factors on each other. Methods: The online cross-sectional survey was conducted via Google Forms^® at three time intervals during the pandemic. Results: Here, 1320, 246, and 139 students completed our questionnaires in the different time intervals. The international students reported significantly lower values in terms of perceived social support. Concerning depression, the international female students reported higher values than the domestic female students. Significant correlations were found in both samples between vital exhaustion and depression, as well as between perceived social support and depression. Conclusion: In this study, the international students reported lower levels of perceived social support and higher levels of depression, particularly among females. The correlations between depression, social support, and vital exhaustion might highlight protective and risk factors. These findings emphasize the importance of addressing social support and mental health among university students, especially among international students who have a difficult time finding social support during times of stress, such as during the COVID-19 pandemic. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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14 pages, 1010 KiB

Open AccessArticle

A Retrospective Longitudinal Analysis of Mental Health Admissions: Measuring the Fallout of the Pandemic

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Int. J. Environ. Res. Public Health 2023, 20(2), 1194; https://doi.org/10.3390/ijerph20021194 - 10 Jan 2023

Cited by 3 | Viewed by 1427

Abstract

Background: In this research article, we review the infrequently considered long-term impact of the pandemic on inpatient mental health, by reviewing the clinical parameters of all psychiatric admissions to Mount Carmel Hospital, our region’s main psychiatric healthcare facility, from 2019–2021. Methods: 4292 patients [...] Read more.

Background: In this research article, we review the infrequently considered long-term impact of the pandemic on inpatient mental health, by reviewing the clinical parameters of all psychiatric admissions to Mount Carmel Hospital, our region’s main psychiatric healthcare facility, from 2019–2021. Methods: 4292 patients were admitted during the research period of this retrospective longitudinal analysis. Taking 2019 as the pre-COVID reference year, we compared mean monthly admissions from 2020 and 2021, looking at patient demographics, status under the Mental Health Act, diagnosis, and self-injurious behaviour. Results: While the pandemic was reflected in a moderate increase in mean monthly presentations with suicidal ideation and suicidal self-injury, presentations in 2020 otherwise remained largely stable. This contrasted with a surge in presentations in 2021 with mood disorders, schizophrenia, anxiety, personality disorders, and autism spectrum disorders. Furthermore, presentations involving self-injurious behaviour continued to grow. Involuntary admissions also increased significantly in 2021. Conclusions: This paper highlights the pernicious long-term impact of the pandemic on mental health presentations, demonstrated by an increase in hospital admissions and more serious presentations. These findings should be considered in the guidance for responses to any future pandemic, giving attention to the evidence of the impact of restrictive measures on mental health. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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13 pages, 356 KiB

Open AccessArticle

Prevalence and Predictors of Anxiety among Stable Hospitalized COVID-19 Patients in Malaysia

by

Muhammad Azri Adam Bin Adnan

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Mohd Shaiful Azlan Bin Kassim

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Norhafizah Bt Sahril

and

Mohamad Aznuddin Bin Abd Razak

Int. J. Environ. Res. Public Health 2023, 20(1), 586; https://doi.org/10.3390/ijerph20010586 - 29 Dec 2022

Cited by 1 | Viewed by 1159

Abstract

The COVID-19 pandemic has created anxiety among hospitalized SARS-CoV-2 patients. Therefore, this study aimed to determine the prevalence of anxiety and its associated factors among stable inpatient COVID-19 patients in Malaysia. Method: A cross-sectional study was conducted using a web-based online survey involving [...] Read more.

The COVID-19 pandemic has created anxiety among hospitalized SARS-CoV-2 patients. Therefore, this study aimed to determine the prevalence of anxiety and its associated factors among stable inpatient COVID-19 patients in Malaysia. Method: A cross-sectional study was conducted using a web-based online survey involving 401 patients from Malaysia’s leading COVID-19 hospitals from 15th April until 30th June 2020, who were chosen using quota sampling. The General Anxiety Disorders 7 items (GAD-7) scale, the Coping Orientation to Problems Experienced Inventory (Brief-COPE) and a socio-demographic profile questionnaire were used. Descriptive analysis and multiple logistic regression were performed using SPSS v23 to determine the prevalence of anxiety and its associated factors. Result: The results showed that the prevalence of anxiety was 7.0%. Multiple logistic regression analysis revealed that female gender (p < 0.05), a fear of infection (p < 0.05), a lack of information (p < 0.05), a maladaptive coping mechanism of behavioral disengagement (p < 0.001) and self-blame (p < 0.001) were significantly associated with anxiety. Meanwhile, adaptive coping mechanisms via instrumental support (p < 0.001) were a significant protective predictor of anxiety. Conclusions: COVID-19 infection has had a significant influence on the mental health of patients. Findings in our study provide baseline data on the prevalence of anxiety among stabilized COVID-19 inpatients in Malaysia. Despite the relatively low prevalence, the data have the potential to improve the present mental health monitoring system and the deployment of suitable treatments in dealing with similar circumstances. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

17 pages, 1925 KiB

Open AccessArticle

Associations between Depression and Self-Reported COVID-19 Symptoms among Adults: Results from Two Population-Based Seroprevalence Studies in Switzerland

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, Specchio-COVID19 Study Group and the Corona Immunitas Ticino Working Group

Int. J. Environ. Res. Public Health 2022, 19(24), 16696; https://doi.org/10.3390/ijerph192416696 - 12 Dec 2022

Cited by 2 | Viewed by 1251

Abstract

(1) Mental health may modulate the perceived risk of SARS-CoV-2 infection. However, it is unclear how psychological symptoms may distort symptom perception of COVID-19 and SARS-CoV-2 infection. We assessed whether depressive symptoms predicted self-reported COVID-19 symptoms, independently of serologically confirmed SARS-CoV-2 infection. (2) [...] Read more.

(1) Mental health may modulate the perceived risk of SARS-CoV-2 infection. However, it is unclear how psychological symptoms may distort symptom perception of COVID-19 and SARS-CoV-2 infection. We assessed whether depressive symptoms predicted self-reported COVID-19 symptoms, independently of serologically confirmed SARS-CoV-2 infection. (2) Participants (aged 20–64) in the Geneva (N = 576) and Ticino (N = 581) Swiss regions completed the Patient Health Questionnaire before being tested for anti-SARS-CoV-2 IgG antibodies and recalled COVID-19-compatible symptoms on two occasions: April–July 2020 (baseline), and January–February 2021 (follow-up). We estimated prevalence ratios for COVID-19 symptoms by depression scores in interaction with serological status. (3) At baseline, in Geneva, higher depression predicted higher probability of reporting systemic, upper airways, and gastro-intestinal symptoms, and fever and/or cough; in Ticino, higher depression predicted systemic, upper airways, and gastro-intestinal symptoms, fever and/or cough, dyspnea, and headache. At follow-up, in Geneva, higher depression predicted higher probability of reporting systemic symptoms and dyspnea; in Ticino, higher depression predicted higher probability of reporting systemic and upper airways symptoms, dyspnea and headache (all p values < 0.05). (4) We found positive associations between depressive symptoms and COVID-19-compatible symptoms, independently of seropositivity. Mental wellbeing has relevant public health implications because it modulates self-reported infection symptoms that inform testing, self-medication, and containment measures, including quarantine and isolation. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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14 pages, 1520 KiB

Open AccessArticle

Before and during the COVID-19 Pandemic, Physical Fitness Association with Mental Health among Higher Education Students: A Multi-Group Analysis Model

by

Ibrahim A. Elshaer

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Mohamed A. Zayed

Int. J. Environ. Res. Public Health 2022, 19(22), 15393; https://doi.org/10.3390/ijerph192215393 - 21 Nov 2022

Cited by 1 | Viewed by 1724

Abstract

The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), created a significant problem people’s health around the world. The mental and physical health of entire populations has been negatively impacted due to the introduction of several [...] Read more.

The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), created a significant problem people’s health around the world. The mental and physical health of entire populations has been negatively impacted due to the introduction of several restriction methods. Maintaining a specific physical activity and fitness level is crucial given the pandemic situation. The connection between physical fitness and mental health has recently received growing attention. In contrast to the message from physiological research, which lauds the general benefits of fitness for physical health, the corresponding psychological literature reveals a more complex relationship. This paper outlines the research evidence, focusing on the relationship between physical fitness and depression, anxiety, and stress before and during the COVID-19 pandemic. Data were obtained from 390 higher education students (measuring their perception before and during the pandemic). They were analyzed by a structural equation modeling multi-group analysis to detect the variance in the test relationship before and during the COVID-19 pandemic. Theoretical and empirical implications are also discussed. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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22 pages, 1006 KiB

Open AccessArticle

Personality, Defenses, Mentalization, and Epistemic Trust Related to Pandemic Containment Strategies and the COVID-19 Vaccine: A Sequential Mediation Model

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Int. J. Environ. Res. Public Health 2022, 19(21), 14290; https://doi.org/10.3390/ijerph192114290 - 01 Nov 2022

Cited by 5 | Viewed by 1692

Abstract

Background: The COVID-19 pandemic has considerably influenced all domains of people’s lives worldwide, determining a high increase in overall psychological distress and several clinical conditions. The study attempted to shed light on the relationship between the strategies adopted to manage the pandemic, vaccine [...] Read more.

Background: The COVID-19 pandemic has considerably influenced all domains of people’s lives worldwide, determining a high increase in overall psychological distress and several clinical conditions. The study attempted to shed light on the relationship between the strategies adopted to manage the pandemic, vaccine hesitancy, and distinct features of personality and mental functioning. Methods: The sample consisted of 367 Italian individuals (68.1% women, 31.9% men; M age = 37, SD = 12.79) who completed an online survey, including an instrument assessing four response styles to the pandemic and lockdown(s), the Personality Inventory for DSM-5-Brief Form, the Defense Mechanisms Rating Scales-Self-Report-30, the Reflective Functioning Questionnaire, and the Epistemic Trust, Mistrust, Credulity Questionnaire. Results: Maladaptive response patterns to pandemic restrictions were related to dysfunctional personality traits, immature defense mechanisms, poor mentalization, and epistemic mistrust or credulity. Moreover, more severe levels of personality pathology were predictive of an extraverted-maladaptive response style to health emergency through the full mediation of low overall defensive functioning, poor certainty of others’ mental states, and high epistemic credulity. Conclusions: Recognizing and understanding dysfunctional psychological pathways associated with individuals’ difficulties in dealing with the pandemic are crucial for developing tailored mental-health interventions and promoting best practices in healthcare services. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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16 pages, 1067 KiB

Open AccessFeature PaperArticle

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

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Angel Christopher Zegarra-López

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Brian Florentino-Santisteban

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Jorge Flores-Romero

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Ariana Delgado-Tenorio

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Adriana Cernades-Ames

Int. J. Environ. Res. Public Health 2022, 19(21), 14240; https://doi.org/10.3390/ijerph192114240 - 31 Oct 2022

Viewed by 1990

Abstract

The present study aims to analyze the prevalence of depressive symptoms and its sociodemographic-associated factors in Peruvian adults. Data was extracted from a nation-wide representative survey in which depression symptoms were measured with the PHQ-9 and sociodemographic information was extracted from household data. [...] Read more.

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

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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12 pages, 570 KiB

Open AccessArticle

COVID-19 and Mental Health of Minority Arab Higher-Education Students in Israel: Social, Economic, and Academic Factors

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Samira Alfayumi-Zeadna

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Lena Gnaim-Abu Touma

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Maya Weinreich

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Norm O’Rourke

Int. J. Environ. Res. Public Health 2022, 19(20), 13466; https://doi.org/10.3390/ijerph192013466 - 18 Oct 2022

Cited by 2 | Viewed by 1358

Abstract

The mental health and well-being of higher-education students is a topic of growing interest. COVID-19 impacted higher education in many ways and the challenges were especially pronounced for minority students. This study examines the impact of COVID-19 on the mental health of Arab [...] Read more.

The mental health and well-being of higher-education students is a topic of growing interest. COVID-19 impacted higher education in many ways and the challenges were especially pronounced for minority students. This study examines the impact of COVID-19 on the mental health of Arab minority students in Israel in relation to social, academic, and financial factors. We recruited 420 Arab higher-education students enrolled in academic colleges or universities in Israel who completed a battery of online questionnaires. Mental health status was measured by the Depression, Anxiety, and Stress Scale 21 (DASS-21). Moderate to severe symptoms of depression, anxiety, and stress were reported by 49.3%, 45.2%, and 54% of Arab students, respectively. Analyses indicate that low quality of online learning, academic difficulties, and negative economic effects of COVID-19 predicted stress, anxiety, and depression. Women reported higher levels of depression and stress; job loss predicted depression and anxiety; low income predicted depression; and COVID-19-related health concerns predicted anxiety. This study highlights the unique and multiple challenges faced by minority students from disadvantaged backgrounds. Campus programs are needed to address the emotional needs of students. Longitudinal research is needed to more fully understand the impact of COVID-19 on higher-education students. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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14 pages, 395 KiB

Open AccessArticle

Prevalence and Associated Factors of Depression, Anxiety, and Stress in University Students in Paraguay during the COVID-19 Pandemic

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Telmo Raul Aveiro-Róbalo

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Luciana Daniela Garlisi-Torales

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Marisella Chumán-Sánchez

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César J. Pereira-Victorio

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Mariana Huaman-Garcia

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Virgilio E. Failoc-Rojas

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Mario J. Valladares-Garrido

Int. J. Environ. Res. Public Health 2022, 19(19), 12930; https://doi.org/10.3390/ijerph191912930 - 09 Oct 2022

Cited by 6 | Viewed by 2232

Abstract

We aimed to determine the prevalence of depression, anxiety, and stress in university students in Paraguay during the COVID-19 pandemic. A cross-sectional study was conducted among 293 students from four universities in Paraguay in 2021. The DASS-21 mental health scale was used to [...] Read more.

We aimed to determine the prevalence of depression, anxiety, and stress in university students in Paraguay during the COVID-19 pandemic. A cross-sectional study was conducted among 293 students from four universities in Paraguay in 2021. The DASS-21 mental health scale was used to measure the outcomes (depression, anxiety, and stress) and evaluate their association with socio-educational variables. A total of 77.1% of the participants were women and 136 (46.4%) were between 21 and 25 years old. The prevalence of depression, anxiety, and stress was 74.7%, 87.4%, and 57%, respectively. We found that being a woman and studying at a public university was positively associated with depression, anxiety, and stress. Receiving COVID-19 training increases the prevalence of mental health problems. In conclusion, high levels of anxiety, depression, and stress were found in university students during the COVID-19 pandemic. Being a woman, studying at a public university, and receiving training on COVID-19 were factors associated with a higher prevalence of presenting all the mental health problems evaluated. Furthermore, students aged 31 and over had a higher prevalence of depression and stress. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

17 pages, 814 KiB

Open AccessArticle

Psychological Distress among Hospitalized COVID-19 Patients in Denmark during the First 12 Months of the Pandemic

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Int. J. Environ. Res. Public Health 2022, 19(16), 10097; https://doi.org/10.3390/ijerph191610097 - 15 Aug 2022

Cited by 3 | Viewed by 1306

Abstract

This study aimed to investigate psychological distress among patients hospitalized with a COVID-19 diagnosis in Denmark during the first 12 months of the pandemic and to assess changes in psychological distress in the three months following discharge. A single-center prospective observational survey study [...] Read more.

This study aimed to investigate psychological distress among patients hospitalized with a COVID-19 diagnosis in Denmark during the first 12 months of the pandemic and to assess changes in psychological distress in the three months following discharge. A single-center prospective observational survey study among patients hospitalized with a COVID-19 diagnosis between May 2020 and May 2021 was conducted. Participants completed a survey at three time points: at admission, and 1 and 3 months after discharge. Psychological distress was assessed by validated scales measuring symptoms related to depression, anxiety, stress, insomnia, post-traumatic stress disorder (PTSD), and health-related quality of life (HRQoL). In total, 95 patients were included. At admission, the proportion of patients with symptoms of depression was 43%, symptoms of anxiety 32%, moderate/high level of stress 39%, insomnia 52%, and probable/positive PTSD 19%. The burden of symptoms related to depression and anxiety decreased significantly over time, while there was no significant change over time in stress, insomnia, or PTSD. Suboptimal levels of physical and mental HRQoL were detected at admission but improved over time. Patients hospitalized due to COVID-19 during the first year of the pandemic experienced considerable levels of psychological distress at admission, with some improvements within 3 months after discharge. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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15 pages, 527 KiB

Open AccessArticle

In the COVID-19 Era, Effects of Job Stress, Coping Strategies, Meaning in Life and Resilience on Psychological Well-Being of Women Workers in the Service Sector

by

Hee-Kyung Kim

Int. J. Environ. Res. Public Health 2022, 19(16), 9824; https://doi.org/10.3390/ijerph19169824 - 09 Aug 2022

Cited by 6 | Viewed by 2686

Abstract

The purpose of this study is to analyze the factors affecting the psychological well-being by using variables of job stress, coping strategies, meaning of life, and resilience to improve the quality of working life during COVID-19. The subjects were 135 adult women working [...] Read more.

The purpose of this study is to analyze the factors affecting the psychological well-being by using variables of job stress, coping strategies, meaning of life, and resilience to improve the quality of working life during COVID-19. The subjects were 135 adult women working for banks. Data were collected by having the subjects fill out a paper-and-pencil questionnaire, and analyzed through t-test, ANOVA, Pearson’s correlation coefficients, and multiple regression analysis. The subjects’ psychological well-being showed positive correlations with the social support-seeking coping mechanism (r = 0.33, p < 0.001), problem-solving-focused coping mechanism (r = 0.55, p < 0.001), meaning in life (r = 0.45, p < 0.001), and resilience (r = 0.37, p < 0.001). Psychological well-being showed negative correlations with job stress (r = −0.44, p < 0.001) and avoidance-focused coping mechanism (r = −0.28, p = 0.001). The factors affecting the psychological well-being were problem-solving-focused coping mechanism (β = 0.35, p < 0.001), job role stress (β = −0.24, p < 0.001), meaning inlife (β = 0.29, p < 0.001), avoidance-focused coping mechanism (β = −0.23, p < 0.001), and resilience (β = 0.15, p = 0.023). It is necessary to formalize psychological intervention to induce the improvement of the quality of work life by increasing the psychological well-being of working women during the COVID-19 pandemic. It is suggested that intervention is made in consideration of variables identified as influencing factors to increase the psychological well-being of women workers. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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20 pages, 2086 KiB

Open AccessArticle

Effects of COVID-19 on Adolescent Mental Health and Internet Use by Ethnicity and Gender: A Mixed-Method Study

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M. Siyabend Kaya

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Ciara McCabe

Int. J. Environ. Res. Public Health 2022, 19(15), 8927; https://doi.org/10.3390/ijerph19158927 - 22 Jul 2022

Cited by 1 | Viewed by 1859

Abstract

Evidence suggests that mental health problems in young people have been exacerbated by COVID-19, possibly related to a lack of social connection. Young people report using the internet for connecting with their peers and mental health support. However, how they may have used [...] Read more.

Evidence suggests that mental health problems in young people have been exacerbated by COVID-19, possibly related to a lack of social connection. Young people report using the internet for connecting with their peers and mental health support. However, how they may have used the internet for support during COVID-19 is not clear. We wanted to know how mood and internet use may have changed in young people during COVID-19 and if this was different for those with and without depression symptoms. 108 adolescents were recruited. Participants with high and low levels of depressive symptomatology answered questions about their mood, internet use, loneliness and life satisfaction during July and August 2020. We found that the high depression group reported significantly more loneliness and less life satisfaction than the low depression group. We found that most young people used the internet for mental health information during COVID-19 but that the high depression group used the internet more for mental health information than the low depression group. The high depression group also had a worsening of mood compared to the low depression group during COVID-19. We found that Black, Asian and Minority Ethnic participants reported increased use of the internet compared to White participants during COVID-19 and that the role of the family facilitated coping during COVID-19 for some adolescents, but for others, it made the lockdown more difficult. Finally, we found that adolescents perceived school anxiety as stressful as COVID-19. To conclude this study supports the use of the internet as a way to help young people with mental health challenges. It also suggests that the internet is a way to help young people from ethnic minorities, who otherwise might be hard to reach, during challenging times. This study also shows that supportive family units can be important during times of stress for young people and that school anxiety is a major issue for young people in today’s society even outside of the pandemic. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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11 pages, 366 KiB

Open AccessArticle

The Impact of Mental Health and Sociodemographic Characteristics on Quality of Life and Life Satisfaction during the Second Year of the COVID-19 Pandemic—Results of a Population-Based Survey in Germany

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Int. J. Environ. Res. Public Health 2022, 19(14), 8734; https://doi.org/10.3390/ijerph19148734 - 18 Jul 2022

Cited by 5 | Viewed by 1494

Abstract

A decreased quality of life was shown for numerous factors at the beginning of the pandemic. However, it is important to identify people who are at-risk for long-term impairments during the pandemic and its aftermath. Within this study, we aimed to investigate quality [...] Read more.

A decreased quality of life was shown for numerous factors at the beginning of the pandemic. However, it is important to identify people who are at-risk for long-term impairments during the pandemic and its aftermath. Within this study, we aimed to investigate quality of life within a German population-based sample (2515 participants; 51.6% female; mean age 50.09 years) during the second year of the pandemic (2021). Our results showed that the majority reported no pandemic-associated change in quality of life at this state of the pandemic. Higher life satisfaction was associated with fewer mental health problems, no pre-existing somatic and psychiatric disorders, higher income, no income loss during the pandemic, living with others, and younger age. In contrast, in a high-risk group encompassing participants with lower quality of life, only mental health, pre-existing somatic disorders, and living alone had significant associations with quality of life, indicating a smaller scope for improvement in this high-risk group. Age, income loss, and depressive symptoms predicted a decrease in quality of life since the beginning of the pandemic. Our results highlight the importance of mental health, especially in times of pandemic, and underline the need for low-threshold mental health support. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

16 pages, 768 KiB

Open AccessArticle

Health Occupation and Job Satisfaction: The Impact of Psychological Capital in the Management of Clinical Psychological Stressors of Healthcare Workers in the COVID-19 Era

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Stefania Valeria Gruttadauria

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Int. J. Environ. Res. Public Health 2022, 19(10), 6134; https://doi.org/10.3390/ijerph19106134 - 18 May 2022

Cited by 10 | Viewed by 2916

Abstract

The COVID-19 pandemic greatly impacted global health. Frontline healthcare workers involved in the response to COVID-19 faced physical and psychological challenges that threatened their wellbeing and job satisfaction. The pandemic crisis, alongside pre-existing critical issues, exposed healthcare workers to constant emotional fatigue, creating [...] Read more.

The COVID-19 pandemic greatly impacted global health. Frontline healthcare workers involved in the response to COVID-19 faced physical and psychological challenges that threatened their wellbeing and job satisfaction. The pandemic crisis, alongside pre-existing critical issues, exposed healthcare workers to constant emotional fatigue, creating an increased workload and vulnerability to stress. Maintaining such stress levels increased their levels of anxiety, irritability and loneliness. Evidence shows that the Psychological Capital (PsyCap) was a strong protective factor against these stressors. The aim of this study was to analyze the level of job satisfaction among health workers facing the COVID-19 pandemic. The possible antecedent factors to satisfaction and the role that PsyCap plays in preserving and fostering higher levels of job satisfaction were investigated. A total of 527 healthcare workers from different areas of Italy were recruited for the study. The results revealed that psychological stress factors have a considerable impact on job satisfaction. All four predictors (Stress Vulnerability, Anxiety Symptoms, Loneliness and Irritability) had the potential to decrease job satisfaction. Loneliness had a more significant effect than other factors assessed in this study. Moreover, the results showed how PsyCap could decrease the effects of psychological stressors on job satisfaction. Consistent with previous studies, our findings show that PsyCap could alleviate negative impacts in work-related circumstances. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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24 pages, 5542 KiB

Open AccessArticle

The Relationship between Prevention and Panic from COVID-19, Ethical Principles, Life Expectancy, Anxiety, Depression and Stress

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Int. J. Environ. Res. Public Health 2022, 19(10), 5841; https://doi.org/10.3390/ijerph19105841 - 11 May 2022

Cited by 5 | Viewed by 1599

Abstract

The present study aims to assess the relationship between prevention and panic from COVID-19, ethical principles, life expectancy, anxiety, depression, and stress in auditors and financial managers of small- and medium-sized Iraqi firms. In other words, this paper seeks to answer the question [...] Read more.

The present study aims to assess the relationship between prevention and panic from COVID-19, ethical principles, life expectancy, anxiety, depression, and stress in auditors and financial managers of small- and medium-sized Iraqi firms. In other words, this paper seeks to answer the question of whether different types of prevention and panic from COVID-19 can enhance the ethical principles, life expectancy, anxiety, depression, and stress, or not. The study method is practical in its objective and descriptive survey procedure. The study’s statistical population includes 185 employed auditors in audit firms, and 215 financial managers of small- and medium-sized Iraqi firms were selected as a sample of the study using the Cochran Sampling Method. In this paper, PLS tests are used to assess the effect of independent variables on the dependent variable. The results indicate no significant relationship between prevention from COVID-19 and ethical principles and life expectancy. However, the association between prevention from COVID-19 and anxiety, depression, and stress, and between panic from COVID-19 and ethical principles, life expectancy, anxiety, depression, and stress is positive and significant. The higher the panic from COVID-19, the more ethical principles, life expectancy, anxiety, depression, and stress. Since no study has been carried out so far on the effect of prevention and panic from COVID-19, ethical principles, life expectancy, depression, and stress in Iraqi firms, the present study results can provide valuable information and contribute to the development of science and knowledge. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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14 pages, 1045 KiB

Open AccessArticle

The Impact of the COVID-19 Pandemic on Mental Health Care of Children and Adolescents in Switzerland: Results of a Survey among Mental Health Care Professionals after One Year of COVID-19

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Int. J. Environ. Res. Public Health 2022, 19(6), 3252; https://doi.org/10.3390/ijerph19063252 - 10 Mar 2022

Cited by 7 | Viewed by 2828

Abstract

Background: To assess the impact of the COVID-19 pandemic on treatment demand and supply in children and adolescents with mental disorders during the first year of the pandemic from the perspective of child and adolescent psychiatrists and psychologists in Switzerland. Methods: The survey [...] Read more.

Background: To assess the impact of the COVID-19 pandemic on treatment demand and supply in children and adolescents with mental disorders during the first year of the pandemic from the perspective of child and adolescent psychiatrists and psychologists in Switzerland. Methods: The survey was conducted anonymously, in German or French and online in April/May 2021. Mental health professionals working in child and adolescent psychiatry, psychotherapy services or independent practices were contacted by email. Results: N = 454 professionals completed the survey (176 child and adolescent psychiatrists and 276 psychologists). After an initial period of decreased demand during the lockdown in spring 2020, requests for treatment increased, considerably exceeding the demand pre-pandemic and reaching a peak in January/February/March 2021. The vast majority of professionals (78.2%) estimated that there was currently too little supply during the pandemic, which differed from the evaluation of the pre-pandemic situation (37%). A total of 65% of participants indicated that waiting time until the initiation of treatment increased during the pandemic, 41% reported their current workload to be somewhat higher and 44.5% much higher. Conclusions: For the first pandemic year, youth mental health professionals reported a large increase in the treatment demand and waiting time and a worrisome overload of treatment services. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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15 pages, 909 KiB

Open AccessArticle

Associations between Coronavirus Crisis Perception, Perceived Economic Risk of Coronavirus, General Self-Efficacy, and Coronavirus Anxiety at the Start of the Pandemic: Differences by Gender and Race

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Int. J. Environ. Res. Public Health 2022, 19(5), 2872; https://doi.org/10.3390/ijerph19052872 - 01 Mar 2022

Viewed by 1806

Abstract

The coronavirus pandemic has escalated rates of anxiety in the general U.S. population. Understanding how factors associated with coronavirus anxiety at the start of the pandemic differed among populations hardest impacted by coronavirus anxiety is key to effectively remediating negatively associated health outcomes [...] Read more.

The coronavirus pandemic has escalated rates of anxiety in the general U.S. population. Understanding how factors associated with coronavirus anxiety at the start of the pandemic differed among populations hardest impacted by coronavirus anxiety is key to effectively remediating negatively associated health outcomes and to better understand how to address concerns of the public at the start of a global pandemic. This study was a secondary analysis of data from a cross-sectional online survey of 1165 Prolific users between 13 and 15 March 2020. Data were collected from a stratified sample of U.S. adults aged 20 or older and currently living in the United States. The sample was stratified for age, gender, and race. Coronavirus anxiety was assessed as the dependent variable, alongside three independent variables: coronavirus crisis perception, perceived economic risk of coronavirus, and general self-efficacy. Multiple linear regression assessed the associations between the independent variables and coronavirus anxiety. Interactions between independent variables and two sociodemographic variables (i.e., gender, race) were also explored. The models were adjusted for age, gender, race, education, employment, and income. The average age of participants was 45.6 ± 15.7. The majority (76%) identified as White, approximately half identified as female and reported obtaining a bachelor’s degree or higher. Coronavirus crisis perception and perceived economic risk of coronavirus were positively associated with coronavirus anxiety (β = 0.46, 95% CI = 0.41, 1.00; β = 0.14, 95% CI = 0.09, 1.00, respectively). General self-efficacy was negatively associated with coronavirus anxiety (β = −0.15, 95% CI = −1.00, −0.11). Gender and race both moderated the association between coronavirus crisis perception and anxiety. Race moderated the association between perceived economic risk and coronavirus crisis perception. These results provide a foundation to further explore cognitive factors in subgroups disproportionately affected by anxiety during the pandemic. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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11 pages, 683 KiB

Open AccessArticle

Response Efficacy and Self-Efficacy Mediated the Relationship between Perceived Threat and Psychic Anxiety among College Students in the Early Stage of the COVID-19 Pandemic

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Int. J. Environ. Res. Public Health 2022, 19(5), 2832; https://doi.org/10.3390/ijerph19052832 - 28 Feb 2022

Cited by 8 | Viewed by 2071

Abstract

Applying Fear Appeals Theory and Social Learning Theory, this study aims to explore the impact of perceived threat on psychic anxiety among college students in the early stage of the COVID-19 pandemic and the mediating roles of response efficacy and self-efficacy. An empirical [...] Read more.

Applying Fear Appeals Theory and Social Learning Theory, this study aims to explore the impact of perceived threat on psychic anxiety among college students in the early stage of the COVID-19 pandemic and the mediating roles of response efficacy and self-efficacy. An empirical study was conducted using an online cross-sectional survey in the early stage of the COVID-19 pandemic in February 2020. A random sampling method was applied to administer questionnaires to 646 Chinese college students. The results showed that: (1) the perceived threat of the COVID-19 pandemic, including perceived susceptibility and severity, was positively correlated with psychic anxiety; (2) self-efficacy mediated the effect of both perceived susceptibility and severity on psychic anxiety, while the response efficacy only mediated the effect of perceived susceptibility on psychic anxiety; and (3) response efficacy and self-efficacy played a serial mediating role on the relationship between perceived susceptibility and psychic anxiety. This study elucidates the relationship between perceived threat and psychic anxiety from the perspective of cognitive appraisal of threat, showing the role positive efficacy appraisal played in reducing psychic anxiety, which could be induced by the perceived threat of major public health emergencies such as COVID-19 pandemic. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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15 pages, 374 KiB

Open AccessArticle

Experiences of Perinatal Mental Health Care among Minority Ethnic Women during the COVID-19 Pandemic in London: A Qualitative Study

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Int. J. Environ. Res. Public Health 2022, 19(4), 1975; https://doi.org/10.3390/ijerph19041975 - 10 Feb 2022

Cited by 14 | Viewed by 4615

Abstract

(1) Background: Approximately one in five women will experience mental health difficulties in the perinatal period. Women from ethnic minority backgrounds face a variety of barriers that can prevent or delay access to appropriate perinatal mental health care. COVID-19 pandemic restrictions created additional [...] Read more.

(1) Background: Approximately one in five women will experience mental health difficulties in the perinatal period. Women from ethnic minority backgrounds face a variety of barriers that can prevent or delay access to appropriate perinatal mental health care. COVID-19 pandemic restrictions created additional obstacles for this group of women. This study aims to explore minority ethnic women’s experiences of perinatal mental health services during COVID-19 in London. (2) Methods: Eighteen women from ethnic minority backgrounds were interviewed, and data were subject to a thematic analysis. (3) Results: Three main themes were identified, each with two subthemes: ‘Difficulties and Disruptions to Access’ (Access to Appointments; Pandemic Restrictions and Disruption), ‘Experiences of Remote Delivery’ (Preference for Face-to-Face Contact; Advantages of Remote Support); and ‘Psychosocial Experiences’ linked to COVID-19 (Heightened Anxiety; Social Isolation). (4) Conclusions: Women from ethnic minority backgrounds experienced disrupted perinatal mental health care and COVID-19 restrictions compounding their mental health difficulties. Services should take women’s circumstances into account and provide flexibility regarding remote delivery of care. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

23 pages, 2581 KiB

Open AccessArticle

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Int. J. Environ. Res. Public Health 2022, 19(3), 1539; https://doi.org/10.3390/ijerph19031539 - 29 Jan 2022

Cited by 25 | Viewed by 3846

Abstract

COVID-19 pandemic and its related containment measures have been associated with increased levels of stress, anxiety and depression in the general population. While the use of digital media has been greatly promoted by national governments and international authorities to maintain social contacts and [...] Read more.

COVID-19 pandemic and its related containment measures have been associated with increased levels of stress, anxiety and depression in the general population. While the use of digital media has been greatly promoted by national governments and international authorities to maintain social contacts and healthy lifestyle behaviors, its increased access may also bear the risk of inappropriate or excessive use of internet-related resources. The present study, part of the COVID Mental hEalth Trial (COMET) study, aims at investigating the possible relationship between social isolation, the use of digital resources and the development of their problematic use. A cross sectional survey was carried out to explore the prevalence of internet addiction, excessive use of social media, problematic video gaming and binge watching, during Italian phase II (May–June 2020) and III (June–September 2020) of the pandemic in 1385 individuals (62.5% female, mean age 32.5 ± 12.9) mainly living in Central Italy (52.4%). Data were stratified according to phase II/III and three groups of Italian regions (northern, central and southern). Compared to the larger COMET study, most participants exhibited significant higher levels of severe-to-extremely-severe depressive symptoms (46.3% vs. 12.4%; p < 0.01) and extremely severe anxiety symptoms (77.8% vs. 7.5%; p < 0.01). We also observed a rise in problematic internet use and excessive gaming over time. Mediation analyses revealed that COVID-19-related general psychopathology, stress, anxiety, depression and social isolation play a significant role in the emergence of problematic internet use, social media addiction and problematic video gaming. Professional gamers and younger subjects emerged as sub-populations particularly at risk of developing digital addictions. If confirmed in larger and more homogenous samples, our findings may help in shedding light on possible preventive and treatment strategies for digital addictions. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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15 pages, 916 KiB

Open AccessArticle

Mental Health and Wellbeing in Young People in the UK during Lockdown (COVID-19)

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Francesca Miller-Lakin

Int. J. Environ. Res. Public Health 2022, 19(3), 1132; https://doi.org/10.3390/ijerph19031132 - 20 Jan 2022

Cited by 23 | Viewed by 14845

Abstract

This study aimed to assess the levels of mental wellbeing and potential for clinical need in a sample of UK university students aged 18–25 during the COVID-19 pandemic. We also tested the dose-response relationship between the severity of lockdown restrictions and mental wellbeing. [...] Read more.

This study aimed to assess the levels of mental wellbeing and potential for clinical need in a sample of UK university students aged 18–25 during the COVID-19 pandemic. We also tested the dose-response relationship between the severity of lockdown restrictions and mental wellbeing. We carried out a prospective shortitudinal study (one month between baseline and follow up) during the pandemic to do this and included 389 young people. We measured a range of facets of mental wellbeing, including depression, depressogenic cognition (rumination), wellbeing, stress and sleep disturbance. Our primary outcome was ‘probable depression’ as indexed by a score of ≥10 on the patient health questionnaire (PHQ-8). The prevalence of probable depression was significantly higher than pre-pandemic levels (55%) and did not decrease significantly over time (52%). Higher levels of lockdown severity were prospectively associated with higher levels of depressive symptoms. Nearly all students had at least one mental wellbeing concern at either time point (97%). The evidence suggests that lockdown has caused a wellbeing crisis in young people. The associated long-term mental, social, educational, personal and societal costs are as yet unknown but should be tracked using further longitudinal studies. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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11 pages, 637 KiB

Open AccessArticle

Predictors of the Development of Mental Disorders in Hospitalized COVID-19 Patients without Previous Psychiatric History: A Single-Center Retrospective Study in South Korea

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Int. J. Environ. Res. Public Health 2022, 19(3), 1092; https://doi.org/10.3390/ijerph19031092 - 19 Jan 2022

Cited by 4 | Viewed by 2069

Abstract

The objective of this study was to investigate the predictors for new-onset mental disorders among patients with mild to moderate COVID-19 illness during hospitalization. A retrospective cohort study was performed in patients with confirmed COVID-19 admitted to a nationally designated hospital between 1 [...] Read more.

The objective of this study was to investigate the predictors for new-onset mental disorders among patients with mild to moderate COVID-19 illness during hospitalization. A retrospective cohort study was performed in patients with confirmed COVID-19 admitted to a nationally designated hospital between 1 February and 30 June 2020. Demographic, clinical, psychological assessments, and psychiatric outcomes were obtained from electronic medical record review. Multivariate logistic regression analysis was used to identify predictors of new-onset mental disorders. Among 185 patients, 130 had no history of mental disorders or cognitive impairment at the time of admission. Of 130 patients, 29 (22.3%) were newly diagnosed with mental disorders during hospitalization. The following factors were significantly associated with an increased risk of a psychiatric diagnosis: Charlson comorbidity index core ≥1 (adjusted odds ratio (aOR) = 5.115, 95% confidence interval (CI): 1.737–15.058), length of stay (aOR per 1-day increase = 1.067, 95% CI: 1.035–1.100), and self-reported depressive symptoms at the time of admission (aOR = 5.357, 95% CI: 1.745–16.444). The predictive accuracy of combining these risk factors was relatively high (area under curve = 0.851, 95% CI: 0.778–0.923). These potential risk factors could help to predict the new-onset mental disorder among hospitalized patients with COVID-19. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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14 pages, 343 KiB

Open AccessArticle

Relationships between Occupational Stress, Change in Work Environment during the COVID-19 Pandemic, and Depressive and Anxiety Symptoms among Non-Healthcare Workers in Japan: A Cross-Sectional Study

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Int. J. Environ. Res. Public Health 2022, 19(2), 983; https://doi.org/10.3390/ijerph19020983 - 16 Jan 2022

Cited by 9 | Viewed by 2990

Abstract

This study aims to clarify the effect of occupational stress and changes in the work environment on non-healthcare workers’ (HCWs) mental health during the third wave of the COVID-19 pandemic in Japan. A web-based, cross-sectional survey was conducted from 16 to 17 December [...] Read more.

This study aims to clarify the effect of occupational stress and changes in the work environment on non-healthcare workers’ (HCWs) mental health during the third wave of the COVID-19 pandemic in Japan. A web-based, cross-sectional survey was conducted from 16 to 17 December 2020. Data from 807 non-HCWs were included. We evaluated occupational stress using the Generic Job Stress Questionnaire (GJSQ). Depressive and anxiety symptoms were assessed using the Japanese version of the Patient Health Questionnaire-9 and the Generalized Anxiety Disorder 7-item scale, respectively. We collected demographic variables, work-related variables, and the variables associated with COVID-19. The adjusted odds ratios for depressive and anxiety groups were estimated using multivariate logistic regression analyses, adjusted for all the demographic variables, work-related variables, COVID-19-related variables, and the six subdivided GJSQ subscales. The results confirm a relationship between variance in workload, job future ambiguity, social support from coworkers, having contact with COVID-19 patients, and depressive and anxiety symptoms. Paying attention to job future ambiguity, the variance in workload at the workplace and individual perspectives, promoting contact and support among coworkers using online communication tools, and reducing contact with COVID-19 patients, will be useful for decreasing the depressive and anxiety symptoms among non-HCWs. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

13 pages, 315 KiB

Open AccessArticle

The Impact of COVID-19 on Young People’s Mental Health in the UK: Key Insights from Social Media Using Online Ethnography

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Rachel Winter

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Anna Lavis

Int. J. Environ. Res. Public Health 2022, 19(1), 352; https://doi.org/10.3390/ijerph19010352 - 30 Dec 2021

Cited by 15 | Viewed by 6659

Abstract

There is increasing evidence of the psychological impact of COVID-19 on various population groups, with concern particularly focused on young people’s mental health. However, few papers have engaged with the views of young people themselves. We present findings from a study into young [...] Read more.

There is increasing evidence of the psychological impact of COVID-19 on various population groups, with concern particularly focused on young people’s mental health. However, few papers have engaged with the views of young people themselves. We present findings from a study into young people’s discussions on social media about the impact of COVID-19 on their mental health. Real-time, multi-platform online ethnography was used to collect social media posts by young people in the United Kingdom (UK), March 2020–March 2021, 1033 original posts and 13,860 associated comments were analysed thematically. Mental health difficulties that were described as arising from, or exacerbated by, school closures, lost opportunities or fraught family environments included depression, anxiety and suicidality. Yet, some also described improvements to their mental health, away from prior stressors, such as school. Young people also recounted anxiety at the ramifications of the virus on others. The complexities of the psychological impact of COVID-19 on young people, and how this impact is situated in their pre-existing social worlds, need recognising. Forging appropriate support necessitates looking beyond an individualised conceptualisation of young people’s mental health that sets this apart from broader societal concerns. Instead, both research and practice need to take a systemic approach, recognising young people’s societal belonging and social contexts. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

15 pages, 398 KiB

Open AccessArticle

Mental Health and Psychological Impact during COVID-19 Pandemic: An Online Survey of Portuguese Higher Education Students

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Int. J. Environ. Res. Public Health 2022, 19(1), 337; https://doi.org/10.3390/ijerph19010337 - 29 Dec 2021

Cited by 13 | Viewed by 4018

Abstract

The COVID-19 pandemic has had significant psychological impact on vulnerable groups, particularly students. The present study aims to investigate the mental and psychological impact of the COVID-19 pandemic and associated factors in a sample of Portuguese higher education students. An online cross-sectional study [...] Read more.

The COVID-19 pandemic has had significant psychological impact on vulnerable groups, particularly students. The present study aims to investigate the mental and psychological impact of the COVID-19 pandemic and associated factors in a sample of Portuguese higher education students. An online cross-sectional study was conducted among 1522 higher education students selected by convenience sampling. The survey assessed mental health symptoms as well as sociodemographic variables, health-related perceptions, and psychological factors. Results were fitted to binary and multivariable logistic regression models. The overall prevalences of stress, anxiety, and depression were 35.7%, 36.2%, and 28.5%, respectively. Poor mental health outcomes were related with being female, having no children, living with someone with chronic disease, facing hopelessness, and lacking resilient coping. Future studies focusing on better ways to promote mental health and wellbeing among students are warranted. It is necessary to gather more evidence on the post-pandemic mental health using robust study designs and standardized assessment tools. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

17 pages, 601 KiB

Open AccessArticle

Help-Seeking as a Maladaptive Coping Style in the Pandemic Scenario: What Worked and What Did Not for Facing This New Stressor

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Int. J. Environ. Res. Public Health 2022, 19(1), 319; https://doi.org/10.3390/ijerph19010319 - 29 Dec 2021

Cited by 11 | Viewed by 1854

Abstract

The spread of COVID-19 and its related confinement measures were important stressors for a large part of the global population, with massive effects on both physical and mental health. Assessing how individuals coped with such a stressor and which strategies were effective is [...] Read more.

The spread of COVID-19 and its related confinement measures were important stressors for a large part of the global population, with massive effects on both physical and mental health. Assessing how individuals coped with such a stressor and which strategies were effective is one of the main challenges for psychological research. In this study, we aimed to investigate the coping strategies implied during the COVID-19 lockdown and their effectiveness. We recruited 374 Italian participants through convenience sampling during the first pandemic wave (April 2020). We administered to our participants an online battery of questionnaires including the Brief COPE, the use of alternative coping strategies proposed by the WHO to help people facing lockdown stress, and a range of psychological symptoms. An exploratory factor analysis conducted on the subscales of the Brief COPE revealed a three-factor structure. Following the previous literature, we named these factors engagement, disengagement, and help-seeking coping styles. In the pandemic scenario, the engagement and disengagement styles revealed the typical correlation patterns with psychological symptoms (i.e., the engagement was adaptive while the disengagement was maladaptive). Instead, contrary to previous literature, help-seeking was positively related to psychological symptoms, suggesting a mismatch between searching for help and finding it during the lockdown. This result supports the importance of evaluating the effectiveness of coping strategies in the pandemic scenario, to give more compelling and precise advice to the population. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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19 pages, 1544 KiB

Open AccessArticle

Acute Stress in Health Workers during Two Consecutive Epidemic Waves of COVID-19

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Kathrine Jáuregui Renaud

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Davis Cooper-Bribiesca

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Elizabet Martínez-Pichardo

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José A. Miguel Puga

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Dulce M. Rascón-Martínez

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Luis A. Sánchez Hurtado

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Tania Colin Martínez

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Eliseo Espinosa-Poblano

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Juan Carlos Anda-Garay

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Jorge I. González Diaz

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Etzel Cardeña

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Francisco Avelar Garnica

Int. J. Environ. Res. Public Health 2022, 19(1), 206; https://doi.org/10.3390/ijerph19010206 - 25 Dec 2021

Cited by 8 | Viewed by 2729

Abstract

The COVID-19 pandemic has provoked generalized uncertainty around the world, with health workers experiencing anxiety, depression, burnout, insomnia, and stress. Although the effects of the pandemic on mental health may change as it evolves, the majority of reports have been web-based, cross-sectional studies. [...] Read more.

The COVID-19 pandemic has provoked generalized uncertainty around the world, with health workers experiencing anxiety, depression, burnout, insomnia, and stress. Although the effects of the pandemic on mental health may change as it evolves, the majority of reports have been web-based, cross-sectional studies. We performed a study assessing acute stress in frontline health workers during two consecutive epidemic waves. After screening for trait anxiety/depression and dissociative experiences, we evaluated changes in acute stress, considering resilience, state anxiety, burnout, depersonalization/derealization symptoms, and quality of sleep as cofactors. During the first epidemic wave (April 2020), health workers reported acute stress related to COVID-19, which was related to state anxiety. After the first epidemic wave, acute stress decreased, with no increase during the second epidemic wave (December 2020), and further decreased when vaccination started. During the follow-up (April 2020 to February 2021), the acute stress score was related to bad quality of sleep. However, acute stress, state anxiety, and burnout were all related to trait anxiety/depression, while the resilience score was invariant through time. Overall, the results emphasize the relevance of mental health screening before, during, and after an epidemic wave of infections, in order to enable coping during successive sanitary crises. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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16 pages, 359 KiB

Open AccessArticle

“Family Connections”, a DBT-Based Program for Relatives of People with Borderline Personality Disorder during the COVID-19 Pandemic: A Focus Group Study

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Isabel Fernández-Felipe

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Amanda Díaz-García

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José Heliodoro Marco

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Azucena García-Palacios

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Verónica Guillén Botella

Int. J. Environ. Res. Public Health 2022, 19(1), 79; https://doi.org/10.3390/ijerph19010079 - 22 Dec 2021

Cited by 5 | Viewed by 3309

Abstract

The COVID-19 pandemic has had a significant impact on the family environment due to the difficulties that have been generated by job losses, deaths, increase rates of family and domestic violence, poor mental health outcomes, and estrangement in personal relationships. “Family Connections” (FC) [...] Read more.

The COVID-19 pandemic has had a significant impact on the family environment due to the difficulties that have been generated by job losses, deaths, increase rates of family and domestic violence, poor mental health outcomes, and estrangement in personal relationships. “Family Connections” (FC) is an internationally renowned DBT-based program that supports the families and caregivers of people with borderline personality disorder. The study took place at a Specialized Health Centre in Spain. A focus group with seven participants was organized for people who had previously attended an FC group. The participants were asked about their experiences during the confinement periods that was caused by COVID-19 as well as their experiences and opinions on relatives, skills practiced, their need to and the advantages of attending the group, and satisfaction with the FC group. The qualitative research web program Dedoose was used for the thematic analysis of the data. The results showed that the participants experienced various experiences during confinement; validation and radical acceptance were determined to be the most useful skills; the importance of professionals and the content as well as the sincerity of attendees and having a safe space were determined to be the greatest benefits of the programs; and the participants all indicated great satisfaction of the program. This study allowed us to explore the experiences of family members of people with BPD with their loved ones during the confinement period caused by the COVID-19 pandemic. We evaluated the use of the FC program skills in the family environment during confinement, and we analyzed the acceptability and satisfaction with the FC program. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

12 pages, 339 KiB

Open AccessArticle

Phenomenology of the COVID-19 Pandemic Experience in Patients Suffering from Chronic Schizophrenia—A Qualitative Analysis

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Katarzyna Kotlarska

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Benita Wielgus

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Łukasz Cichocki

Int. J. Environ. Res. Public Health 2022, 19(1), 56; https://doi.org/10.3390/ijerph19010056 - 22 Dec 2021

Cited by 7 | Viewed by 2537

Abstract

Many studies have shown that the COVID-19 pandemic can have a great influence on mental health. However, there is still not enough research to fully understand how people suffering from schizophrenia experience crisis situations such as a pandemic. This qualitative study aims to [...] Read more.

Many studies have shown that the COVID-19 pandemic can have a great influence on mental health. However, there is still not enough research to fully understand how people suffering from schizophrenia experience crisis situations such as a pandemic. This qualitative study aims to explore this subject. Ten outpatients suffering from schizophrenia were interviewed in a semi-structured format using an interview designed by the authors for the purpose of this study. The interviews were transcribed, and a conventional qualitative content analysis was conducted. The general themes identified in the content analysis were organized into four categories: first reactions to information about the pandemic; subjective assessment of the pandemic’s impact on patients’ mental health; patients’ attitudes towards the temporary limitations and lockdowns; psychiatric treatment and psychotherapy during the pandemic. A variety of different experiences were observed, but the general conclusion arising from the study suggests that the majority of the interviewed patients coped quite well with the pandemic and that the observed reactions were similar to the reactions of other groups described in the literature. The study also confirmed the importance of the continuity of psychiatric care for patients with schizophrenia. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

19 pages, 1010 KiB

Open AccessArticle

Exploring the Protective Function of Positivity and Regulatory Emotional Self-Efficacy in Time of Pandemic COVID-19

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Gian Vittorio Caprara

Int. J. Environ. Res. Public Health 2021, 18(24), 13171; https://doi.org/10.3390/ijerph182413171 - 14 Dec 2021

Cited by 14 | Viewed by 2688

Abstract

Despite several empirical studies on the 2019 coronavirus disease (COVID-19) pandemic that have highlighted its detrimental effect on individuals’ mental health, the identification of psychological factors that may moderate its impact on individuals’ behavior and well-being remains partly unexplored. The present study was [...] Read more.

Despite several empirical studies on the 2019 coronavirus disease (COVID-19) pandemic that have highlighted its detrimental effect on individuals’ mental health, the identification of psychological factors that may moderate its impact on individuals’ behavior and well-being remains partly unexplored. The present study was conceived to examine the mediation role of regulatory emotional self-efficacy in the relationship between positivity and anxiety, depression, and perceived self-efficacy in complying with the containment measures to contrast the COVID-19 spread. Furthermore, the moderation role of age was tested. A sample of 1258 participants (64.2% women; M_age = 42.09, SD = 13.62) enrolled from the Italian general population answered an online survey aimed at investigating the role of individual differences in facing the COVID-19 pandemic. We opted for a snowball recruiting procedure to find participants. The online survey was disseminated through email invitation and using social media platforms (i.e., Facebook, Instagram). A multi-group path analysis model was performed using Mplus 8.4 to explore the hypothesized relations among variables. The following criteria were employed to evaluate the goodness of fit: χ² likelihood ratio statistic, CFI and TLI > 0.95, RMSEA < 0.06 and SRMR < 0.08. The findings corroborated the protective role of both positivity and regulatory emotional self-efficacy in reducing individuals’ anxiety and depressive symptoms, as well as in fostering individuals’ capabilities in complying with the containment measures imposed by the government to reduce the risk of illness and to contain the spread of the virus COVID-19. Specifically, regulatory emotional self-efficacy beliefs partially mediated the relations between positivity and anxiety and depressive symptoms and fully mediated the effect of positivity on perceived self-efficacy beliefs in complying with the containment measures. These paths were equal across ages. The results of the present study appear relevant to implementing psychological interventions aimed to reduce the deleterious effects of the COVID-19 pandemic on mental health through the promotion of individuals’ optimistic orientation and emotion regulation. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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12 pages, 750 KiB

Open AccessArticle

Maternal Mental Health following Ultrasonographic Detection of Fetal Structural Anomaly in the Midst of the COVID-19 Pandemic

by

Nur Rowaidah Roslan

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Mohd Fadhli Mohd Fauzi

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Lim Wan Teng

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Abdul Ghani Nur Azurah

Int. J. Environ. Res. Public Health 2021, 18(24), 12900; https://doi.org/10.3390/ijerph182412900 - 07 Dec 2021

Cited by 2 | Viewed by 2189

Abstract

Prenatal ultrasonographic detection of fetal structural anomaly may adversely affect maternal mental health throughout pregnancy, particularly in the current COVID-19 pandemic. This study aims to prospectively assess maternal stress, anxiety, and depression following ultrasonographic detection of fetal structural anomaly from diagnosis until delivery [...] Read more.

Prenatal ultrasonographic detection of fetal structural anomaly may adversely affect maternal mental health throughout pregnancy, particularly in the current COVID-19 pandemic. This study aims to prospectively assess maternal stress, anxiety, and depression following ultrasonographic detection of fetal structural anomaly from diagnosis until delivery during the COVID-19 pandemic. A total of 141 pregnant women at a tertiary hospital who underwent detailed scans between 16 and 24 gestational weeks were included and categorized into the study (anomaly finding, n = 65) and comparison (normal finding, n = 76) groups. Self-administered questionnaires of 10-item Perceived Stress Scale (PSS-10) and Hospital Anxiety and Depression Scale (HADS) were used to assess maternal stress, anxiety, and depression at prior detection (T₁), two-to-four weeks post-detection (T₂), one-to-two weeks prior to delivery (T₃), and one-to-two weeks post-delivery (T₄). Repeated measures of analysis of variance (ANOVA) were conducted to assess time-, between-group, and time–group interaction effect. In general, maternal stress improved, but anxiety worsened, while depression persisted, over the time from T₁ to T₄. The average maternal stress and anxiety levels were significantly higher among groups with fetal anomaly. The maternal stress and anxiety level were significantly affected within one-to-two weeks post-detection of fetal structural anomaly. In conclusion, maternal mental health parameters were affected differently during the COVID-19 pandemic, with higher vulnerability of stress and anxiety among pregnant women with fetal structural anomaly particularly within one-to-two weeks post-detection. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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17 pages, 1766 KiB

Open AccessArticle

Impacts of the COVID-19 Pandemic on Family Mental Health in Canada: Findings from a Multi-Round Cross-Sectional Study

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Monique Gagné Petteni

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Corey McAuliffe

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Anne M. Gadermann

Int. J. Environ. Res. Public Health 2021, 18(22), 12080; https://doi.org/10.3390/ijerph182212080 - 17 Nov 2021

Cited by 13 | Viewed by 3843

Abstract

Pandemic-related disruptions, including school, child care, and workplace closures, financial stressors, and relationship challenges, present unique risks to families’ mental health. We examined the mental health impacts of the coronavirus disease 2019 (COVID-19) pandemic among parents with children <18 years old living at [...] Read more.

Pandemic-related disruptions, including school, child care, and workplace closures, financial stressors, and relationship challenges, present unique risks to families’ mental health. We examined the mental health impacts of the coronavirus disease 2019 (COVID-19) pandemic among parents with children <18 years old living at home over three study rounds in May 2020 (n = 618), September 2020 (n = 804), and January 2021 (n = 602). Data were collected using a cross-sectional online survey of adults living in Canada, nationally representative by age, gender, household income, and region. Chi-square tests and logistic regression compared outcomes between parents and the rest of the sample, among parent subgroups, and over time. Parents reported worsened mental health compared with before the pandemic, as well as not coping well, increased alcohol use, increased suicidal thoughts/feelings, worsened mental health among their children, and increases in both negative and positive parent–child interactions. Mental health challenges were more frequently reported among parents with pre-existing mental health conditions, disabilities, and financial/relationship stressors. Increased alcohol use was more frequently reported among younger parents and men. Sustained mental health challenges of parents throughout nearly a year of the pandemic suggest that intervention efforts to support family mental health may not be adequately meeting families’ needs. Addressing family stressors through financial benefit programs and virtual mental health supports should be further explored. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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11 pages, 357 KiB

Open AccessArticle

‘It’s Easily the Lowest I’ve Ever, Ever Got to’: A Qualitative Study of Young Adults’ Social Isolation during the COVID-19 Lockdowns in the UK

by

Chloe C. Dedryver

and

Cécile Knai

Int. J. Environ. Res. Public Health 2021, 18(22), 11777; https://doi.org/10.3390/ijerph182211777 - 10 Nov 2021

Cited by 11 | Viewed by 3877

Abstract

(1) Background: Social connectivity is key to young people’s mental health. Local assets facilitate social connection, but were largely inaccessible during the pandemic. This study consequently investigates the social isolation of young adults and their use of local assets during the COVID-19 lockdowns [...] Read more.

(1) Background: Social connectivity is key to young people’s mental health. Local assets facilitate social connection, but were largely inaccessible during the pandemic. This study consequently investigates the social isolation of young adults and their use of local assets during the COVID-19 lockdowns in the UK. (2) Methods: Fifteen semi-structured Zoom interviews were undertaken with adults aged 18–24 in the UK. Recruitment took place remotely, and transcripts were coded and analysed thematically. (3) Results: Digital assets were key to young people’s social connectivity, but their use was associated with stress, increased screen time and negative mental health outcomes. The lockdowns impacted social capital, with young people’s key peripheral networks being lost, yet close friendships being strengthened. Finally, young people’s mental health was greatly affected by the isolation, but few sought help, mostly out of a desire to not overburden the NHS. (4) Conclusions: This study highlights the extent of the impact of the pandemic isolation on young people’s social capital and mental health. Post-pandemic strategies targeting mental health system strengthening, social isolation and help-seeking behaviours are recommended. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

10 pages, 317 KiB

Open AccessArticle

Burnout of Healthcare Workers Amid the COVID-19 Pandemic: A Follow-Up Study

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Int. J. Environ. Res. Public Health 2021, 18(21), 11581; https://doi.org/10.3390/ijerph182111581 - 04 Nov 2021

Cited by 16 | Viewed by 2994

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has posed a significant challenge to the modern healthcare system and led to increased burnout among healthcare workers (HCWs). We previously reported that HCWs who engaged in COVID-19 patient care had a significantly higher prevalence of burnout [...] Read more.

The coronavirus disease 2019 (COVID-19) pandemic has posed a significant challenge to the modern healthcare system and led to increased burnout among healthcare workers (HCWs). We previously reported that HCWs who engaged in COVID-19 patient care had a significantly higher prevalence of burnout (50.0%) than those who did not in November 2020 (period 1). We performed follow-up surveys in HCWs in a Japanese national university hospital, including basic demographics, whether a participant engaged in care of COVID-19 patients in the past 2 weeks, and the Maslach Burnout Inventory in February 2021 (period 2) and May 2021 (period 3). Periods 1 and 3 were amid the surges of COVID-19 cases, and period 2 was a post-surge period with a comparatively small number of COVID-19 patients requiring hospitalization. Response rates to the surveys were 33/130 (25.4%) in period 1, 36/130 (27.7%) in period 2, and 56/162 (34.6%) in period 3, respectively. While no consistent tendency in the prevalence of burnout based on variables was observed throughout the periods, the prevalence of burnout tends to be higher in periods 1 and 3 in those who engaged in COVID-19 patient care in the last 2 weeks (50.0%, 30.8%, 43.1% in period 1, 2, and 3, respectively). Given the prolonged pandemic causing stigmatization and hatred against HCWs leading to increased prevalence of burnout, high-level interventions and supports are warranted. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

17 pages, 704 KiB

Open AccessArticle

Mental Health Screening of Healthcare Professionals Who Are Candidates for Psychological Assistance during the COVID-19 Pandemic

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Int. J. Environ. Res. Public Health 2021, 18(21), 11167; https://doi.org/10.3390/ijerph182111167 - 24 Oct 2021

Cited by 4 | Viewed by 2939

Abstract

Healthcare professionals (HCPs) are among those most affected by the COVID-19 health emergency, with many presenting symptoms of anxiety and depression. Research shows that one of the factors involved in mitigating the impact of stressful situations is the use of cognitive emotional regulation [...] Read more.

Healthcare professionals (HCPs) are among those most affected by the COVID-19 health emergency, with many presenting symptoms of anxiety and depression. Research shows that one of the factors involved in mitigating the impact of stressful situations is the use of cognitive emotional regulation mechanisms. The aims of this study were (a) to describe the functional and dysfunctional cognitive emotional regulation mechanisms (FRMs and DRMs) by gender, (b) to screen the main group of healthcare professionals who are candidates to receive psychological assistance based on FRMs and DRMs, and (c) to determine the HCP profile of candidates for psychological assistance. A cross-sectional descriptive study was conducted. Data were obtained from an adhoc questionnaire—the Cognitive Emotional Regulation Questionnaire (CERQ-18), the Generalized Anxiety Disorder scale (GAD-7), and the nine-item Patient Health Questionnaire (PHQ-9). The representative sample comprised 1452 HCPs. The results revealed significant differences between men and women in the use of DRMs. Women showed a higher use of catastrophizing (≤0.001) and rumination (0.008). The screening procedure detected that 7.5% (109 cases) of the HCPs were candidates to receive psychological support. According to the results of this study, age group (30–39 years old), professional activity (being a nurse or nursing assistant), and having psychological symptoms of anxiety and depression are variables that independently increase the probability of requiring psychological assistance. The gender variable was not found to be an independent factor when it comes to receiving psychological support. In conclusion, it is necessary to consider the influence of cognitive emotional regulation strategies employed by HCPs in the screening of candidates for psychological assistance and design effective interventions to reverse the emotional distress caused by COVID-19. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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12 pages, 789 KiB

Open AccessArticle

Socioeconomic Status and COVID-19-Related Psychological Panic in China: The Role of Trust in Government and Authoritarian Personality

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Int. J. Environ. Res. Public Health 2021, 18(20), 10888; https://doi.org/10.3390/ijerph182010888 - 16 Oct 2021

Cited by 2 | Viewed by 2316

Abstract

Although the health and economic risks of COVID-19 may differ for higher- and lower-socioeconomic-status (SES) populations, some studies found that people with lower SES do not necessarily experience more psychological panic. In this research, we examine how SES is related with psychological panic [...] Read more.

Although the health and economic risks of COVID-19 may differ for higher- and lower-socioeconomic-status (SES) populations, some studies found that people with lower SES do not necessarily experience more psychological panic. In this research, we examine how SES is related with psychological panic during the COVID-19 pandemic using a large nationwide Chinese sample. Participants were 933 adults (mean age = 30.04, SD = 8.19) who completed an online questionnaire between 11 and 12 February 2020. Lower SES individuals have higher trust in government and thus experience less psychological panic, and the indirect effect of this trust suppresses the direct negative association between SES and psychological panic. In addition to this difference in trust in government between lower- and higher-status individuals, the indirect effect of the trust only exists among people with low (not high) authoritarian personalities. This study provides evidence that political trust may serve as a buffer, suppressing the negative association between SES and psychological panic; thus, policies and actions enhancing political trust are vital to support the mental health of individuals with lower SES during the pandemic, especially for citizens with low authoritarian personalities. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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12 pages, 335 KiB

Open AccessArticle

Prevalence and Risk Factors of Psychiatric Symptoms among Swiss Elite Athletes during the First Lockdown of the COVID-19 Pandemic

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Int. J. Environ. Res. Public Health 2021, 18(20), 10780; https://doi.org/10.3390/ijerph182010780 - 14 Oct 2021

Cited by 5 | Viewed by 2010

Abstract

The COVID-19 pandemic and the associated first lockdown measures may have had a relevant impact on the mental health of competitive athletes. This study aimed to evaluate the prevalence of various mental health issues in a Swiss elite athletes’ cohort during the first [...] Read more.

The COVID-19 pandemic and the associated first lockdown measures may have had a relevant impact on the mental health of competitive athletes. This study aimed to evaluate the prevalence of various mental health issues in a Swiss elite athletes’ cohort during the first lockdown of the pandemic, and to assess their association with different potential risk factors. Elite athletes from different disciplines were interviewed during the first lockdown in spring 2020 by means of an online questionnaire on symptoms of existing anxieties, depression and sleep disorders, as well as on training circumstances and physical performance before and during the lockdown. Additionally, the economic situation, secondary occupations and current physical health problems were surveyed. A total of 203 (92 female, 111 male) athletes met the inclusion criteria and participated in the survey. Training volume and intensity decreased significantly during lockdown from 3.1 to 2.7 h/day. Financial existential fears increased and were associated with higher training volumes and higher trait anxiety scores. Depressive symptoms and insomnia were present but not exceptionally frequent during the lockdown. Depressive symptoms were associated with higher anxiety scores, higher insomnia severity scores, lower training intensity and worse coping with the measures taken by the authorities against the pandemic. Changes in training and daily habits due to the first lockdown may have affected the mental health of elite athletes. Longitudinal studies should, however, further investigate the long-term effects of the pandemic on mental health. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

16 pages, 684 KiB

Open AccessArticle

Psychosocial Impact of the COVID-19 Pandemic on Healthcare Workers and Initial Areas of Action for Intervention and Prevention—The egePan/VOICE Study

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Int. J. Environ. Res. Public Health 2021, 18(19), 10531; https://doi.org/10.3390/ijerph181910531 - 07 Oct 2021

Cited by 14 | Viewed by 3115

Abstract

Introduction: Epidemics lead to an increase in occupational stress and psychological strain among healthcare workers. However, the impact of a pandemic outbreak on healthcare systems is yet to be clearly defined. Therefore, this work aims to describe and analyze specific areas of workload [...] Read more.

Introduction: Epidemics lead to an increase in occupational stress and psychological strain among healthcare workers. However, the impact of a pandemic outbreak on healthcare systems is yet to be clearly defined. Therefore, this work aims to describe and analyze specific areas of workload among different groups of healthcare workers during the first wave of the COVID-19 pandemic. Methods: A sample of N = 8088 persons working in the German-speaking healthcare sector participated in the VOICE/egePan online survey, which addressed the impact of the COVID-19 pandemic during the second quarter of 2020. We used 15 self-constructed items, based on the work of Matsuishi et al. (2012), to identify potential COVID-19-specific topics. Results: N = 7542 records of healthcare workers were analyzed. Of these, 60.80% reported, retrospectively, an increase in stress since the outbreak of the pandemic. Problem areas tended to be indicated more frequently by the women surveyed than by the men. Nurses, paramedics and medical technicians reported the highest fear of infecting others while physicians reported the highest fear of physical or mental exhaustion. With respect to age, older respondents indicated less fear and felt more protected. Men and people living alone were more likely to use dysfunctional coping strategies. Migrants reported a higher fear of becoming infected or infecting others as well as they reported about increased levels of smoking. Discussion: Retrospectively, the COVID-19 pandemic led to an increase in stress among healthcare workers. Problem areas have different focuses with regard to different living situations, environmental conditions and professions. In order to lay the best basis for healthy and efficient work, it seems necessary to take measures especially tailored to the needs of different groups of healthcare workers. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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18 pages, 701 KiB

Open AccessArticle

Mental Health during COVID-19 Pandemic among Caregivers of Young Children in Kenya’s Urban Informal Settlements. A Cross-Sectional Telephone Survey

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Emmanuel Kepha Obulemire

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Anil Khamis

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Amina Abubakar

Int. J. Environ. Res. Public Health 2021, 18(19), 10092; https://doi.org/10.3390/ijerph181910092 - 25 Sep 2021

Cited by 12 | Viewed by 3868

Abstract

The emergence of COVID-19 has profoundly affected mental health, especially among highly vulnerable populations. This study describes mental health issues among caregivers of young children and pregnant women in three urban informal settlements in Kenya during the first pandemic year, and factors associated [...] Read more.

The emergence of COVID-19 has profoundly affected mental health, especially among highly vulnerable populations. This study describes mental health issues among caregivers of young children and pregnant women in three urban informal settlements in Kenya during the first pandemic year, and factors associated with poor mental health. A cross-sectional telephone survey was administered to 845 participants. Survey instruments included the Patient Health Questionnaire-9, General Anxiety Disorder-7 scale, COVID-19 Anxiety Scale, and questions on the perceived COVID-19 effects on caregiver wellbeing and livelihood. Data were analyzed using descriptive statistics, and univariate and multivariate analysis. Caregivers perceived COVID-19 as a threatening condition (94.54%), affecting employment and income activities (>80%). Caregivers experienced discrimination (15.27%) and violence (12.6%) during the pandemic. Levels of depression (34%), general anxiety (20%), and COVID-19 related anxiety (14%) were highly prevalent. There were significant associations between mental health outcomes and economic and socio-demographic factors, violence and discrimination experiences, residency, and perceptions of COVID-19 as a threatening condition. Caregivers high burden of mental health problems highlights the urgent need to provide accessible mental health support. Innovative and multi-sectoral approaches will be required to maximize reach to underserved communities in informal settlements and tackle the root causes of mental health problems in this population. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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11 pages, 746 KiB

Open AccessArticle

Depression as Compared to Level of Physical Activity and Internet Addiction among Polish Physiotherapy Students during the COVID-19 Pandemic

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Anna Zalewska

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Monika Gałczyk

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Marek Sobolewski

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Irena Białokoz-Kalinowska

Int. J. Environ. Res. Public Health 2021, 18(19), 10072; https://doi.org/10.3390/ijerph181910072 - 25 Sep 2021

Cited by 18 | Viewed by 3850

Abstract

Objectives: The aim of the survey was to assess the level of depression correlated with physical activity and internet addiction among physiotherapy students of Polish universities during the COVID-19 pandemic. Methods: The survey was carried out via the internet among Polish physiotherapy students [...] Read more.

Objectives: The aim of the survey was to assess the level of depression correlated with physical activity and internet addiction among physiotherapy students of Polish universities during the COVID-19 pandemic. Methods: The survey was carried out via the internet among Polish physiotherapy students (141 respondents). The level of depression was assessed by the Beck Depression Inventory, physical activity by the International Physical Activity Questionnaire (IPAQ) in Polish and the level of internet addiction by the Kimberly Young Questionnaire. Results: It was found that 31% of those surveyed stated that they suffered from moderate or severe depression. The overwhelming majority of the respondents (92%) considered the level of their internet addiction as low. More physical activity had a positive effect on mental health. The overuse of the internet exacerbated depressive symptoms. Conclusions: The prevalence of depression observed in students is mainly related to distant learning systems. Therefore, regular physical activity is recommended as it is associated with a lower level of depression. It is also advisable to provide students with necessary psychological care. Excessive use of social media is not recommended to elevate mood as it makes depression symptoms worse. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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19 pages, 654 KiB

Open AccessArticle

Psychological Distress of International Students during the COVID-19 Pandemic in China: Multidimensional Effects of External Environment, Individuals’ Behavior, and Their Values

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Tao Xu

Int. J. Environ. Res. Public Health 2021, 18(18), 9758; https://doi.org/10.3390/ijerph18189758 - 16 Sep 2021

Cited by 11 | Viewed by 3416

Abstract

The COVID-19 epidemic has had a significant impact on society. In particular, it has had a strong impact on college students, including international students. Through an online questionnaire survey, it is found that the psychological distress experienced by international students is the result [...] Read more.

The COVID-19 epidemic has had a significant impact on society. In particular, it has had a strong impact on college students, including international students. Through an online questionnaire survey, it is found that the psychological distress experienced by international students is the result of a combination of the external environment (including the lockdown measures, social distancing, and social support) and internal factors such as values and behavior. The analysis shows that the new teaching mode and the corresponding changes in learning behavior are significantly associated with the psychological distress brought about by the COVID-19 epidemic. In addition, the influence of international students’ values also plays a significant role in their psychological distress. Collective values are conducive to the alleviation of psychological distress, while individual values have the opposite effect. At the same time, the study also reveals that if there is sufficient social support, isolation (due to lockdown or social distancing early or later on) is not necessarily directly related to psychological distress. However, only formal social support can effectively alleviate psychological distress, while informal social support does not play a similar role. These conclusions have certain policy significance for the prevention of and response to epidemics in other countries. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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18 pages, 382 KiB

Open AccessArticle

Relationships between Psychopathology, Psychological Process Variables, and Sociodemographic Variables and Comparison of Quarantined and Non-Quarantined Groups of Malaysian University Students in the COVID-19 Pandemic

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Nicholas Tze Ping Pang

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Sandi James

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Nelbon Giloi

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Syed Sharizman Syed Abdul Rahim

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Azizan Omar

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Mohammad Saffree Jeffree

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Firdaus Hayati

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Mei Ching Lim

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Mohd Amiruddin Mohd Kassim

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Jun Rong Ng

Int. J. Environ. Res. Public Health 2021, 18(18), 9656; https://doi.org/10.3390/ijerph18189656 - 14 Sep 2021

Cited by 8 | Viewed by 2657

Abstract

The COVID-19 pandemic has had considerable psychological health impacts across the globe. This study aimed to establish the psychological process variables underlying psychopathology in Malaysian public university students during the national Movement Control Order (MCO). The aim was to craft structured and sustainable [...] Read more.

The COVID-19 pandemic has had considerable psychological health impacts across the globe. This study aimed to establish the psychological process variables underlying psychopathology in Malaysian public university students during the national Movement Control Order (MCO). The aim was to craft structured and sustainable psychological support programs with these students. We conducted a cross-sectional study involving Malaysian university students subjected to the Malaysian MCO. Structured questionnaires measuring sociodemographic factors, measures of depression, anxiety, stress, psychological mindedness, psychological flexibility and state mindfulness were employed. A total of 515 students participated in this study with 12 students (2.3%) being quarantined at the time. Many of them scored ‘moderate’ or above on the Depression, Anxiety and Stress Scale (DASS) with 20.2%, 25.0% and 14.2%, respectively. Quarantined students had higher depressive symptoms, with female students scoring significantly higher for depression, anxiety, and stress. Multiple regressions suggested gender and quarantine status predicted depression scores. However, only gender significantly predicted anxiety and stress. Psychological flexibility and psychological mindedness (Insight subscale) are significantly correlated with depression, anxiety, and stress, with psychological mindedness predicting all three psychopathologies. This study demonstrates that gender, psychological flexibility, and psychological mindedness are key demographic and psychological factors impacting students. Targeting psychological flexibility and psychological mindedness may enable timely prevention and intervention programs for our students to support their mental and physical health as we move through, and out of, the pandemic. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

14 pages, 928 KiB

Open AccessArticle

Age and Emotional Distress during COVID-19: Findings from Two Waves of the Norwegian Citizen Panel

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Int. J. Environ. Res. Public Health 2021, 18(18), 9568; https://doi.org/10.3390/ijerph18189568 - 10 Sep 2021

Cited by 4 | Viewed by 2536

Abstract

Older adults face the highest risk of COVID-19 morbidity and mortality. We investigated a one-year change in emotions and factors associated with emotional distress immediately after the onset of the pandemic, with emphasis on older age. Methods: The online Norwegian Citizen Panel includes [...] Read more.

Older adults face the highest risk of COVID-19 morbidity and mortality. We investigated a one-year change in emotions and factors associated with emotional distress immediately after the onset of the pandemic, with emphasis on older age. Methods: The online Norwegian Citizen Panel includes participants drawn randomly from the Norwegian Population Registry. Emotional distress was defined as the sum score of negative (anxious, worried, sad or low, irritated, and lonely) minus positive emotions (engaged, calm and relaxed, happy). Results: Respondents to both surveys (n = 967) reported a one-year increase in emotional distress, mainly driven by elevated anxiety and worrying, but we found no difference in change by age. Multilevel mixed-effects linear regression comparing older age, economy-, and health-related factors showed that persons in their 60s (ß −1.87 (95%CI: −3.71, −0.04)) and 70s/80s (ß: −2.58 (−5.00, −0–17)) had decreased risk of emotional distress relative to persons under 60 years. Female gender (2.81 (1.34, 4.28)), expecting much lower income (5.09 (2.00, 8.17)), uncertainty whether infected with SARS-Cov2 (2.92 (1.21, 4.63)), and high self-rated risk of infection (1.77 (1.01, 2.53)) were associated with high levels of emotional distress. Conclusions: Knowledge of national determinants of distress is crucial to tailor accurate public health interventions in future outbreaks. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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16 pages, 378 KiB

Open AccessArticle

The Impact of the COVID-19 Pandemic on Students’ Mental Health and Sleep in Saudi Arabia

by

Azizah Alyoubi

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Elizabeth J. Halstead

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Zoe Zambelli

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Dagmara Dimitriou

Int. J. Environ. Res. Public Health 2021, 18(17), 9344; https://doi.org/10.3390/ijerph18179344 - 04 Sep 2021

Cited by 33 | Viewed by 6332

Abstract

Background: Mental health problems are prevalent among university students in Saudi Arabia. This study aimed to investigate the impact of the COVID-19 pandemic on university students’ mental health and sleep in Saudi Arabia. Method: A total of 582 undergraduate students from Saudi Arabia [...] Read more.

Background: Mental health problems are prevalent among university students in Saudi Arabia. This study aimed to investigate the impact of the COVID-19 pandemic on university students’ mental health and sleep in Saudi Arabia. Method: A total of 582 undergraduate students from Saudi Arabia aged between 18 and 45 years old (M = 20.91, SD = 3.17) completed a cross-sectional online questionnaire measuring depression, anxiety, stress, resilience, and insomnia during the COVID-19 pandemic (2020). Analysis included an independent samples t-test, one-way ANOVA, and Hierarchical regression analysis. Results: Undergraduate students reported high levels of depression, anxiety, and perceived stress and low levels of resilience (p < 0.001) during the pandemic. In addition, students reported experiencing insomnia. A hierarchical regression analysis indicated that lower resilience, high levels of insomnia, having a pre-existing mental health condition, and learning difficulties (such as dyslexia, dyspraxia, or dyscalculia) were significantly associated with high levels of depression and stress. In addition, lower resilience, a high level of insomnia, and pre-existing mental health conditions were significantly associated with high levels of anxiety. Finally, a lower level of psychological resilience and a high level of insomnia were significantly associated with increased levels of depression, anxiety and stress within university students. Conclusion: This study has provided evidence that a lower level of psychological resilience and insomnia were associated with mental health problems among undergraduate students in Saudi Arabia, thus enhancing psychological resilience and interventions to support sleep and mental health are vital to support student well-being outcomes throughout the pandemic. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

13 pages, 859 KiB

Open AccessArticle

Living Space and Job Prospects and Their Relationship with Subjective Well-Being during COVID-19 Confinement in Spain: The Mediator Role of Resilience

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Fernando Molero

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Patricia Recio

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Encarnación Sarriá

Int. J. Environ. Res. Public Health 2021, 18(17), 9198; https://doi.org/10.3390/ijerph18179198 - 31 Aug 2021

Cited by 5 | Viewed by 1925

Abstract

The objective of this study was to examine the relationships of participants’ home characteristics (living space) and job prospects after the coronavirus disease 2019 (COVID-19) pandemic to their subjective psychological well-being (SWB) (in terms of both affective and cognitive aspects). We also examined [...] Read more.

The objective of this study was to examine the relationships of participants’ home characteristics (living space) and job prospects after the coronavirus disease 2019 (COVID-19) pandemic to their subjective psychological well-being (SWB) (in terms of both affective and cognitive aspects). We also examined the role of participants’ resilience as a possible mediator in the relationships among the aforementioned variables. The sample comprised 474 Spanish adults who completed an online questionnaire between 14 and 24 April 2020, when COVID-19 confinement was very strict in Spain. We proposed a path analysis model including the described variables. The model presented a good fit (χ² = 7.41, df = 5, p = 0.376, comparative fit index = 0.996, Tucker–Lewis index = 0.987; root mean square error of approximation = 0.032). The results indicated that living space and future job prospects predicted resilience, which, in turn, was related to SWB. Moreover, the bootstrapping results revealed a mediating effect of resilience that showed indirect relationships between living space and SWB and between job prospects and SWB. Our results underline the importance of environmental (living space) and job-related variables to predict SWB as well as the mediating role that resilience may play during the confinement period. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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12 pages, 604 KiB

Open AccessArticle

Self-Compassion and Rumination Type Mediate the Relation between Mindfulness and Parental Burnout

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Int. J. Environ. Res. Public Health 2021, 18(16), 8811; https://doi.org/10.3390/ijerph18168811 - 20 Aug 2021

Cited by 5 | Viewed by 3498

Abstract

The COVID-19 lockdown increased the day-to-day challenges faced by parents, and thereby may have increased parental burnout risk. Therefore, identifying parental burnout protection factors is essential. This study aimed to assess the protective role of the following factors which can be increased through [...] Read more.

The COVID-19 lockdown increased the day-to-day challenges faced by parents, and thereby may have increased parental burnout risk. Therefore, identifying parental burnout protection factors is essential. This study aimed to assess the protective role of the following factors which can be increased through mindfulness practice: trait mindfulness, self-compassion, and concrete vs. abstract ruminations. A total of 459 parents (M_age = 40; 98.7% female) completed self-reported questionnaires at two-time points to assess the predictive role of mindfulness on parental burnout, self-compassion and rumination type, and the mediating role of self-compassion and rumination type in the relation between mindfulness and parental burnout. Results showed that trait mindfulness, self-compassion, and rumination type at Time 1 predicted levels of parental burnout at Time 2. Self-compassion (indirect effects: b = − 22, 95% CI = [−38, −05], p < 0.01), concrete ruminations (indirect effects: b = −20, 95% CI = [−32, −09], p < 0.001), and abstract ruminations (indirect effects: b = −0.54, 95% CI = [−71, −37], p < 0.001) partially mediated the relation between trait-mindfulness and parental burnout. These findings showed that trait mindfulness, self-compassion, and concrete (vs. abstract) ruminations may help prevent parental burnout in the context of the COVID-19 pandemic. These results contribute to the field of research on parental burnout prevention and will allow for the development of effective approaches to mental health promotion in parents. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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14 pages, 1303 KiB

Open AccessArticle

Social Support and Dietary Habits as Anxiety Level Predictors of Students during the COVID-19 Pandemic

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Int. J. Environ. Res. Public Health 2021, 18(16), 8785; https://doi.org/10.3390/ijerph18168785 - 20 Aug 2021

Cited by 7 | Viewed by 2651

Abstract

The COVID-19 pandemic is a public health emergency concern and a challenge to students’ mental health due to changes in education and social isolation. The aim of this research was to expand knowledge about the relations that shape the level of anxiety amongst [...] Read more.

The COVID-19 pandemic is a public health emergency concern and a challenge to students’ mental health due to changes in education and social isolation. The aim of this research was to expand knowledge about the relations that shape the level of anxiety amongst men and women who are studying during the pandemic in terms of the relations towards their sense of social support and their nutritional behaviors. A State–Trait Anxiety Inventory was used to measure anxiety level, alongside supplementary questions such as the feeling of support from close ones, concentration of attention on nutrition during the pandemic and externally derived factors (university, specialization). Analysis of the regression was applied to the examination of the dependency between the anxiety level (in both forms of its occurrence—as state-anxiety and as trait-anxiety). We observed that the pandemic situation affected a level of state-anxiety above average (mean value of 46–48 points) even when students felt social support. Nutrition habits and chosen education type are associated with trait-anxiety level, which was also elevated (mean values of 49–50 points). Chosen factors had a partial influence on the anxiety level of students, therefore their mental health should concern shaping positive nutrition habits and social support. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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11 pages, 819 KiB

Open AccessArticle

Changes in Depressive Symptoms, Stress and Social Support in Mexican Women during the COVID-19 Pandemic

by

Nadya Y. Rivera Rivera

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Laura McGuinn

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Erika Osorio-Valencia

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Sandra Martinez-Medina

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Lourdes Schnaas

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Rosalind J. Wright

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Martha Maria Téllez-Rojo

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Robert O. Wright

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Marcela Tamayo-Ortiz

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Maria José Rosa

Int. J. Environ. Res. Public Health 2021, 18(16), 8775; https://doi.org/10.3390/ijerph18168775 - 19 Aug 2021

Cited by 5 | Viewed by 2306

Abstract

The aim of this study was to examine changes in depression, stress and social support levels before and during the COVID-19 pandemic in women living in Mexico City. We studied 466 women enrolled in the Programming Research in Obesity, Growth, Environment and Social [...] Read more.

The aim of this study was to examine changes in depression, stress and social support levels before and during the COVID-19 pandemic in women living in Mexico City. We studied 466 women enrolled in the Programming Research in Obesity, Growth, Environment and Social Stressors (PROGRESS) study who completed the Edinburgh Depression Scale (EDS) questionnaire prior (2018–2019) and during the lockdown period of the pandemic (May–November 2020). Psychosocial stress and social support for both time periods were ascertained using the Crisis in Family Systems (CRISYS) questionnaire and the Social Support Network (SSN) Scale, respectively. Associations between stress, social support and change in EDS score/depression were analyzed using generalized linear models adjusting for covariates. Higher stress (>median) during the pandemic was associated with an increase in EDS score (β: 2.13; 95% CI (1.06, 3.19), p < 0.001), and higher odds of depression (OR: 3.75; 95% CI (2.17, 6.50), p < 0.001), while social support was associated with lower odds of depression (OR: 0.56, 95% CI (0.32, 0.97), p = 0.037). Higher levels of stress during the pandemic were associated with depression. Social support may act as a buffer for the effects of psychosocial stress. Future studies should examine the long-term effects of stress associated with the pandemic on mental and overall health. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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16 pages, 374 KiB

Open AccessArticle

Predictors of Mental Health Outcomes in Grocery Store Workers amid the COVID-19 Pandemic and Implications for Workplace Safety and Moral Injury

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Melissa Janson

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Jill D. Sharkey

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Daniel A. del Cid

Int. J. Environ. Res. Public Health 2021, 18(16), 8675; https://doi.org/10.3390/ijerph18168675 - 17 Aug 2021

Cited by 8 | Viewed by 2767

Abstract

Limited research exists on the mental health (MH) of grocery store workers (GSWs), who have been on the frontlines throughout the COVID-19 pandemic. A disaster MH conceptual model incorporating demographics, disaster exposure and threat (COVID-19 fear and workplace threat perception), perceived stress, and [...] Read more.

Limited research exists on the mental health (MH) of grocery store workers (GSWs), who have been on the frontlines throughout the COVID-19 pandemic. A disaster MH conceptual model incorporating demographics, disaster exposure and threat (COVID-19 fear and workplace threat perception), perceived stress, and social support (lack of from family and friends) was utilized to predict MH outcomes (anxiety, depression, and post-traumatic stress symptoms; PTSS) of GSWs. GSWs (n = 842) were recruited through a regional union in California. The participants were diverse (62.1% female) and were 18–69 years of age (M = 41.5, SD = 13.9). They completed an online survey regarding COVID-19 fear, workplace threat perception, perceived stress, lack of social support, and workplace needs/recommendations for support. Three hierarchical linear regression models were run assessing each MH outcome. Thematic analysis coding and an inductive approach were utilized for analyzing open-ended responses of workplace needs/recommendations. Females and younger GSWs (ages 18–29 years old) on average, reported higher MH symptoms than males and older age groups, respectively. COVID-19 fear and perceived stress were significant predictors of anxiety, while COVID-19 fear, workplace threat perception, and perceived stress significantly predicted depression and PTSS, explaining almost half of the variance for each model. Social support and demographics were not predictive of MH outcomes. Almost half of GSWs (40%) requested increased safety protections in the workplace. Feelings of fear of COVID-19, threat in the workplace, and overall perceived stress are predictive of GSWs’ MH outcomes. Increasing feelings of safety in the workplace and reducing stress may lessen MH symptoms. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

15 pages, 347 KiB

Open AccessArticle

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Int. J. Environ. Res. Public Health 2021, 18(16), 8647; https://doi.org/10.3390/ijerph18168647 - 16 Aug 2021

Cited by 19 | Viewed by 3378

Abstract

Several countries, including India, imposed mandatory social distancing, quarantine, and lockdowns to stop the spread of the SARS-CoV-2 virus. Although these measures were effective in curbing the spread of the virus, prolonged social distancing, quarantine, and the resultant economic disruption led to an [...] Read more.

Several countries, including India, imposed mandatory social distancing, quarantine, and lockdowns to stop the spread of the SARS-CoV-2 virus. Although these measures were effective in curbing the spread of the virus, prolonged social distancing, quarantine, and the resultant economic disruption led to an increase in financial stress and mental health concerns. Prior studies established a link between the first lockdown and an increase in mental health issues. However, few studies investigated the association between post-lockdown financial hardship, job loss, and mental health. In this study, we examined the association between COVID-19-related financial hardship, job loss, and mental health symptoms approximately nine months after the end of the first nationwide lockdown in India. Job loss was associated with higher reporting of mental health symptoms among men (aIRR = 1.16) while financial hardship was associated with poor mental health symptoms among women (aIRR = 1.29). Conversely, social support and government aid were associated with better mental health symptoms among women. Our findings highlight the need for financial assistance and job creation programs to aid families in the recovery process. There is also an urgent need for improving the availability and affordability of mental health services in rural areas. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

9 pages, 1242 KiB

Open AccessArticle

Women Suffered More Emotional and Life Distress than Men during the COVID-19 Pandemic: The Role of Pathogen Disgust Sensitivity

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Int. J. Environ. Res. Public Health 2021, 18(16), 8539; https://doi.org/10.3390/ijerph18168539 - 12 Aug 2021

Cited by 18 | Viewed by 3734

Abstract

The outbreak of the COVID-19 has brought upon unprecedented challenges to nearly all people around the globe. Yet, people may differ in their risks of social, economic, and health well-being. In this research, we take a gender-difference approach to examine whether and why [...] Read more.

The outbreak of the COVID-19 has brought upon unprecedented challenges to nearly all people around the globe. Yet, people may differ in their risks of social, economic, and health well-being. In this research, we take a gender-difference approach to examine whether and why women suffered greater emotional and life distress than men at the early stage of the COVID-19 outbreak in China. Using a large nationwide Chinese sample, we found that compared to men, women reported higher levels of anxiety and fear, as well as greater life disturbance during the COVID-19 pandemic. Importantly, that women suffered more was partly explained by their higher level of pathogen disgust sensitivity. Our findings highlight the important consequences of gender differences in response to the threat of the COVID-19 pandemic and suggest that policymakers pay more attention to gender inequalities regarding COVID-19 responses. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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14 pages, 837 KiB

Open AccessArticle

Traumatic Distress of COVID-19 and Depression in the General Population: Exploring the Role of Resilience, Anxiety, and Hope

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Finiki Nearchou

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Ellen Douglas

Int. J. Environ. Res. Public Health 2021, 18(16), 8485; https://doi.org/10.3390/ijerph18168485 - 11 Aug 2021

Cited by 16 | Viewed by 4242

Abstract

International evidence published so far shows that the COVID-19 pandemic has negatively impacted on global mental health. Specifically, there is some research suggesting that the psychological distress related to depression, anxiety and posttraumatic stress has impacted on the psychological well-being of the general [...] Read more.

International evidence published so far shows that the COVID-19 pandemic has negatively impacted on global mental health. Specifically, there is some research suggesting that the psychological distress related to depression, anxiety and posttraumatic stress has impacted on the psychological well-being of the general population. Yet, there is limited evidence on the relational paths between COVID-19 traumatic distress and depression. Participants of this cross-sectional study were 456 adults 18 years old or older from the general population (Mean age = 41.2 years, SD = 11.7) who completed an online questionnaire including measures assessing depression, anxiety, resilience, hope and traumatic distress related to COVID-19. Structural equation modelling was applied to examine the proposed mediation model. The results confirmed the proposed model, with traumatic distress of COVID-19, resilience, anxiety and hope explaining a considerable amount of variance (59%) in depression scores. Traumatic distress of COVID-19 was a strong positive predictor of depression, while anxiety, hope and resilience were both joint and unique mediators of this relationship. Exposure to the COVID-19 pandemic is strongly associated with depression in adults of the general population. The co-occurrence of anxiety may negatively contribute to experiencing higher levels of depression, while resilience and hope may act as buffers against depression associated with the impact of this pandemic. Our findings suggest that wide community-based interventions designed to promote resilience, build hope and reduce anxiety may help mitigate depression associated with exposure to the COVID-19 pandemic. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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13 pages, 379 KiB

Open AccessArticle

Impact of the COVID-19 Pandemic on the Mental Health of Nurses and Auxiliary Nursing Care Technicians—A Voluntary Online Survey

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Eduardo Sánchez-Sánchez

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J. Ángel García-Álvarez

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Esperanza García-Marín

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María Gutierrez-Serrano

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Maria José M. Alférez

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Guillermo Ramirez-Vargas

Int. J. Environ. Res. Public Health 2021, 18(16), 8310; https://doi.org/10.3390/ijerph18168310 - 05 Aug 2021

Cited by 14 | Viewed by 3992

Abstract

Pandemics impose an immense psychological burden on healthcare workers due to a combination of workplace stressors and personal fears. Nurses and auxiliary nursing care technicians (ANCTs) are on the front line of this pandemic and form the largest group in healthcare practice. The [...] Read more.

Pandemics impose an immense psychological burden on healthcare workers due to a combination of workplace stressors and personal fears. Nurses and auxiliary nursing care technicians (ANCTs) are on the front line of this pandemic and form the largest group in healthcare practice. The aim of this study is to determine the symptoms of depression and/or anxiety among nurses and ANCTs during the periods known as the first wave (March–June) and second wave (September–November) of theCOVID-19 pandemic in Spain. An observational cross-sectional study was carried out using an anonymous, self-administered questionnaire among nurses and ANCTs practising in Spain. During the first period, 68.3% and 49.6% of the subjects presented anxiety and depression, respectively, decreasing in the second period (49.5% for anxiety and 35.1% for depression). There were statistically significant differences between the different categories and periods (p < 0.001). The COVID-19 pandemic has negatively influenced mental health in nurses and ANCTs. Mental health should be monitored and coping strategies promoted to improve the health, productivity and efficiency of these professionals. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

13 pages, 1712 KiB

Open AccessArticle

Validation and Cultural Adaptation of Explanatory Model Interview Catalogue (EMIC) in Assessing Stigma among Recovered Patients with COVID-19 in Saudi Arabia

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Lamia A. Al-Zamel

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Shatha F. Al-Thunayan

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Int. J. Environ. Res. Public Health 2021, 18(16), 8261; https://doi.org/10.3390/ijerph18168261 - 04 Aug 2021

Cited by 8 | Viewed by 2472

Abstract

Stigma is a negative feeling affecting many patients with various health conditions, especially the contagious ones such as COVID-19. The Explanatory Model Interview Catalogue (EMIC) is one of the valid and reliable stigma-measuring tools; however, it has not been translated and validated in [...] Read more.

Stigma is a negative feeling affecting many patients with various health conditions, especially the contagious ones such as COVID-19. The Explanatory Model Interview Catalogue (EMIC) is one of the valid and reliable stigma-measuring tools; however, it has not been translated and validated in Arabic. Therefore, the aim of this study was to translate and validate the EMIC in Arabic among a sample of Arabic-speaking adults who recently recovered from COVID-19 in Saudi Arabia. The 12 items of the EMIC scale were forward- and backward-translated and reviewed by all authors to check the face and content validity prior to approving the final version of the Arabic 12-item EMIC. A total of 174 participants aged ≥18 years who contracted COVID-19 and recovered as of 29 July 2020 were interviewed. The Cronbach’s alpha of the Arabic version of the 12-item EMIC was 0.79, indicating an acceptable level of internal consistency. Using principal component analysis with varimax rotation, two factors explained more than 60% of the variance of the translated EMIC scale. The mean EMIC score was 5.91, implying a low level of stigma among participants. Married participants (β = 2.93; 95%CI 0.88 to 4.98, p = 0.005) and those with a family history of mental illness (β = 2.38; 95%CI 0.29 to 4.46, p = 0.025) were more likely to have higher EMIC scores in comparison to their counterparts who were unmarried and had no family history of mental illness. On the contrary, older adults were less likely to have high EMIC scores (β = −0.11; 95%CI −0.21 to −0.01, p = 0.03). Future studies with larger samples of patients with COVID-19 and various health conditions should be conducted to examine the validity and reliability of the Arabic version of the EMIC among different patient populations and to unveil the factors that may play a role in patients’ feelings of stigmatization in this part of the world. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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10 pages, 661 KiB

Open AccessArticle

Sleep Quality and Mood State in Resident Physicians during COVID-19 Pandemic

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Int. J. Environ. Res. Public Health 2021, 18(15), 8023; https://doi.org/10.3390/ijerph18158023 - 29 Jul 2021

Cited by 14 | Viewed by 2127

Abstract

Since the novel coronavirus (SARS-CoV-2) has spread worldwide, healthcare workers—resident physicians in particular—have been hugely involved in facing the COVID-19 pandemic, experiencing unprecedented challenges in fighting the disease. We aimed to evaluate the prevalence of poor sleep quality, daytime sleepiness, and alterations in [...] Read more.

Since the novel coronavirus (SARS-CoV-2) has spread worldwide, healthcare workers—resident physicians in particular—have been hugely involved in facing the COVID-19 pandemic, experiencing unprecedented challenges in fighting the disease. We aimed to evaluate the prevalence of poor sleep quality, daytime sleepiness, and alterations in mood state profiles in this category. This cross-sectional study, conducted in 2020, enrolled 119 subjects from a university hospital in southern Italy. Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), and Profile of Mood States (POMS) questionnaires were administered to physicians divided into four areas: anesthesiology, medicine, service, and surgery. In the overall sample, approximately 45% reported poor sleep quality, although only nine subjects (8%) reported an ESS score that suggested excessive daytime sleepiness. Alterations in mood profiles were also observed; the Vigor and Fatigue factors were the most altered. In particular, anesthesiologists seem to be the most affected category, showing a profound decrease in Vigor with a concomitant increase in Fatigue. Considering the possible consequences of the COVID-19 pandemic, preventive measures should be adopted, especially those aimed at facilitating a better turnover of physicians, optimizing the working schedule, and improving the organization of work. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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12 pages, 610 KiB

Open AccessArticle

A Study of the Association between the Stringency of Covid-19 Government Measures and Depression in Older Adults across Europe and Israel

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Gina Voss

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Andreia F. Paiva

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Alice Delerue Matos

Int. J. Environ. Res. Public Health 2021, 18(15), 8017; https://doi.org/10.3390/ijerph18158017 - 29 Jul 2021

Cited by 14 | Viewed by 4147

Abstract

Background: The COVID-19 pandemic is having major adverse consequences for the mental health of individuals worldwide. Alongside the direct impact of the virus on individuals, government responses to tackling its spread, such as quarantine, lockdown, and physical distancing measures, have been found [...] Read more.

Background: The COVID-19 pandemic is having major adverse consequences for the mental health of individuals worldwide. Alongside the direct impact of the virus on individuals, government responses to tackling its spread, such as quarantine, lockdown, and physical distancing measures, have been found to have a profound impact on mental health. This is manifested in an increased prevalence of anxiety, depression, and sleep disturbances. As older adults are more vulnerable and severely affected by the pandemic, they may be at increased psychological risk when seeking to protect themselves from COVID-19. Methods: Our study aims to quantify the association between the stringency of measures and increased feelings of sadness/depression in a sample of 31,819 Europeans and Israelis aged 65 and above. We hypothesize that more stringent measures make it more likely that individuals will report increased feelings of sadness or depression. Conclusions: We found that more stringent measures across countries in Europe and Israel affect the mental health of older individuals. The prevalence of increased feelings of sadness/depression was higher in Southern European countries, where the measures were more stringent. We therefore recommend paying particular attention to the possible effects of pandemic control measures on the mental health of older people. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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18 pages, 369 KiB

Open AccessArticle

Fear of COVID-19 and COVID-19 Stress and Association with Sociodemographic and Psychological Process Factors in Cases under Surveillance in a Frontline Worker Population in Borneo

by

Nicholas Tze Ping Pang

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Gracyvinea Nold Imon

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Elisa Johoniki

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Mohd Amiruddin Mohd Kassim

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Azizan Omar

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Syed Sharizman Syed Abdul Rahim

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Firdaus Hayati

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Mohammad Saffree Jeffree

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Jun Rong Ng

Int. J. Environ. Res. Public Health 2021, 18(13), 7210; https://doi.org/10.3390/ijerph18137210 - 05 Jul 2021

Cited by 15 | Viewed by 3092

Abstract

COVID-19 stress and fear of COVID-19 is an increasingly researched construct in the general population. However, its prevalence and association with sociodemographic factors and psychological process variables has not been explored in frontline workers under surveillance in a Bornean population. This study was [...] Read more.

COVID-19 stress and fear of COVID-19 is an increasingly researched construct in the general population. However, its prevalence and association with sociodemographic factors and psychological process variables has not been explored in frontline workers under surveillance in a Bornean population. This study was a cross-sectional study using a sociodemographic questionnaire incorporating two specific epidemiological risk variables, namely specific questions about COVID-19 surveillance status (persons under investigation (PUI), persons under surveillance (PUS), and positive cases) and the nature of frontline worker status. Furthermore, five other instruments were used, with three measuring psychopathology (namely depression, anxiety and stress, fear of COVID-19, and stress due to COVID-19) and two psychological process variables (namely psychological flexibility and mindfulness). Kruskal–Wallis and Mann–Whitney tests were performed to assess if there were significant differences in psychopathology and psychological process variables between sociodemographic and epidemiological risk variables. Hierarchical multiple regression was further performed, with depression, anxiety, and stress as dependent variables. There were significant differences in the fear of COVID-19 between positive cases, PUI, and PUS. The fear of COVID-19 scores were higher in positive cases compared to in PUS and PUI groups. Upon hierarchical multiple regression, mindfulness and psychological flexibility were significant predictors of depression, anxiety, and stress after controlling for sociodemographic and epidemiological risk factors. This study demonstrates that exposure to COVID-19 as persons under investigation or surveillance significantly increases the fear of COVID-19, and brief psychological interventions that can positively influence mindfulness and psychological flexibility should be prioritized for these at-risk groups to prevent undue psychological morbidity in the long run. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

12 pages, 931 KiB

Open AccessArticle

Mediator Effect of Affinity for E-Learning on Mental Health: Buffering Strategy for the Resilience of University Students

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Int. J. Environ. Res. Public Health 2021, 18(13), 7098; https://doi.org/10.3390/ijerph18137098 - 02 Jul 2021

Cited by 9 | Viewed by 3996

Abstract

The pandemic affected the quality of life and wellness of the population, changing living habits through restriction measures. This study aimed to analyze the psychological impact of the fear of the COVID-19 pandemic and the adoption of e-learning for university students. The study [...] Read more.

The pandemic affected the quality of life and wellness of the population, changing living habits through restriction measures. This study aimed to analyze the psychological impact of the fear of the COVID-19 pandemic and the adoption of e-learning for university students. The study was articulated in two research applications: the first application was a rapid review on the psychological effects of the pandemic on the emotional dimension of undergraduate students; the second application was an observational study on the effect of e-learning adoption in the pandemic emergency. In the first step, we performed a systematic search of MEDLINE through PubMed and the Web of Science [Science Citation Index Expanded (SCI-EXPANDED); Social Sciences Citation Index (SSCI); Emerging Sources Citation Index (ESCI)] of all scientific literature published from May 2020 to February 2021. The reviewed articles suggest the impact of the pandemic and lockdown measures on university students due to several mental symptoms, including anxiety, stress, depression, event-specific distress, and a decrease in psychological well-being. Psychological symptoms were related to the experience of several stressors, such as the risk for a reduction of academic perspectives, massive e-learning adoption, economic issues, social restrictions, and implications for daily life related to the COVID-19 outbreak. The second scientific application was conducted to evaluate the affinity for e-learning on a sample composed of Italian undergraduates exposed to massive e-learning adoption. The results evidence the positive influence of e-learning in academic programs for the wellbeing of undergraduates. The mediator effect of the affinity of youth for e-learning can be considered to have had a buffering effect for professional advancement and for the mental health of university students in a public health emergency. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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12 pages, 345 KiB

Open AccessArticle

The Psychological and Quality of Life Impacts on Women in Hong Kong during the COVID-19 Pandemic

by

Maria Shuk Yu Hung

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Stanley Kam Ki Lam

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Liliane Chui King Chan

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Sisi Pui Shan Liu

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Meyrick Chum Ming Chow

Int. J. Environ. Res. Public Health 2021, 18(13), 6734; https://doi.org/10.3390/ijerph18136734 - 23 Jun 2021

Cited by 14 | Viewed by 3100

Abstract

The coronavirus (COVID-19) pandemic has caused a global health crisis. The adverse impacts on Asian women, including those in Hong Kong, are substantial. This cross-sectional online study examined the impacts of COVID-19 on Hong Kong women, including psychological effects, self-belief in coping, and [...] Read more.

The coronavirus (COVID-19) pandemic has caused a global health crisis. The adverse impacts on Asian women, including those in Hong Kong, are substantial. This cross-sectional online study examined the impacts of COVID-19 on Hong Kong women, including psychological effects, self-belief in coping, and quality of life, and was conducted over 4 weeks from July to August 2020. Females aged over 18, living in Hong Kong, and that could read Chinese, were included. Among 417 participants, 50.8% were aged below 50, 66.7% were married, 57.1% were caregivers, 61.4% had a family income of <USD 2600, and 70.3% attained higher secondary education or above. The results show that 32.2%, 42.4%, and 44.9% of participants had negative emotions of stress, anxiety, and depression. There are significant negative correlations between emotional state and different aspects of quality of life, but positive correlations between general self-efficacy and different aspects of quality of life. COVID-19 induced significant psychological and quality of life impacts on females in Hong Kong. The policymakers, healthcare professionals, and social support organizations should establish appropriate strategies and policies to support women during the COVID-19 pandemic or similar future crises. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

10 pages, 318 KiB

Open AccessArticle

Identifying Predictors of University Students’ Wellbeing during the COVID-19 Pandemic—A Data-Driven Approach

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Sebastian Kellett-Renzella

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Yann Chye

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Kim Cornish

Int. J. Environ. Res. Public Health 2021, 18(13), 6730; https://doi.org/10.3390/ijerph18136730 - 22 Jun 2021

Cited by 43 | Viewed by 6206

Abstract

Background: The COVID-19 pandemic has posed risks to public mental health worldwide. University students, who are already recognised as a vulnerable population, are at elevated risk of mental health issues given COVID-19-related disruptions to higher education. To assist universities in effectively allocating resources [...] Read more.

Background: The COVID-19 pandemic has posed risks to public mental health worldwide. University students, who are already recognised as a vulnerable population, are at elevated risk of mental health issues given COVID-19-related disruptions to higher education. To assist universities in effectively allocating resources to the launch of targeted, population-level interventions, the current study aimed to uncover predictors of university students’ psychological wellbeing during the pandemic via a data-driven approach. Methods: Data were collected from 3973 Australian university students ((median age = 22, aged from 18 to 79); 70.6% female)) at five time points during 2020. Feature selection was conducted via least absolute shrinkage and selection operator (LASSO) to identify predictors from a comprehensive set of variables. Selected variables were then entered into an ordinary least squares (OLS) model to compare coefficients and assess statistical significance. Results: Six negative predictors of university students’ psychological wellbeing emerged: White/European ethnicity, restriction stress, perceived worry on mental health, dietary changes, perceived sufficiency of distancing communication, and social isolation. Physical health status, emotional support, and resilience were positively associated with students’ psychological wellbeing. Social isolation has the largest effect on students’ psychological wellbeing. Notably, age, gender, international status, and educational level did not emerge as predictors of wellbeing. Conclusion: To cost-effectively support student wellbeing through 2021 and beyond, universities should consider investing in internet- and tele- based interventions explicitly targeting perceived social isolation among students. Course-based online forums as well as internet- and tele-based logotherapy may be promising candidates for improving students’ psychological wellbeing. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

22 pages, 929 KiB

Open AccessArticle

Suicidal Ideation and Predictors of Psychological Distress during the COVID-19 Pandemic in Eswatini: A Population-Based Household Telephone Survey

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Mduduzi Colani Shongwe

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Song-Lih Huang

Int. J. Environ. Res. Public Health 2021, 18(13), 6700; https://doi.org/10.3390/ijerph18136700 - 22 Jun 2021

Cited by 6 | Viewed by 3026

Abstract

The unpredictability of the COVID-19 pandemic can induce psychological distress in individuals. We investigated perceived stressors, prevalence of psychological distress and suicidal ideation, and predictors of psychological distress among adults during the COVID-19 pandemic in Eswatini. This study was a cross-sectional, population-based household [...] Read more.

The unpredictability of the COVID-19 pandemic can induce psychological distress in individuals. We investigated perceived stressors, prevalence of psychological distress and suicidal ideation, and predictors of psychological distress among adults during the COVID-19 pandemic in Eswatini. This study was a cross-sectional, population-based household telephone survey of 993 conveniently sampled adults (18+ years) from all the four administrative regions of Eswatini. Data were collected between 9 June and 18 July 2020 during the first wave of the COVID-19 pandemic, when the country was under a partial lockdown. COVID-19-related psychological distress was assessed using the Kessler 6-item Psychological Distress Scale (K6). We performed weighted modified Poisson regression analyses to identify significant predictors of moderate/severe psychological distress (K6 scores: ≥5). The weighted prevalences of moderate (K6 scores: 5–12) and severe psychological distress (K6 scores: ≥13) were 41.7% and 5.4%, respectively. Participants reported several perceived COVID-19-related stressors, including worries and fears of the contagion-specific death, serious need for food and money, and concerns about loss of income or business. The weighted prevalence of suicidal ideation was 1.5%. Statistically significant predictors of increased risk for moderate/severe psychological distress included living in the Hhohho and Manzini regions; feeling not well informed about COVID-19; feeling lonely; having received COVID-19 food or financial relief from the government; feeling burdened by the lockdown; being married; and being youth (18–24 years). The results call for the government to urgently augment the provision of mental health services during the pandemic. Mental health practitioners and programs may use several stressors and risk factors identified in this study to inform interventions and government policies aimed at reducing psychological distress induced by the pandemic. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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10 pages, 480 KiB

Open AccessArticle

Hopelessness and Post-Traumatic Stress Symptoms among Healthcare Workers during the COVID-19 Pandemic: Any Role for Mediating Variables?

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Int. J. Environ. Res. Public Health 2021, 18(12), 6579; https://doi.org/10.3390/ijerph18126579 - 18 Jun 2021

Cited by 15 | Viewed by 3548

Abstract

The Coronavirus-19 (COVID-19) pandemic has many psychological consequences for the population, ranging from anxious-depressive symptoms and insomnia to complex post-traumatic syndromes. This study aimed to evaluate the impact of the Covid-19 pandemic on the mental well-being of healthcare workers, focusing on the association [...] Read more.

The Coronavirus-19 (COVID-19) pandemic has many psychological consequences for the population, ranging from anxious-depressive symptoms and insomnia to complex post-traumatic syndromes. This study aimed to evaluate the impact of the Covid-19 pandemic on the mental well-being of healthcare workers, focusing on the association between hopelessness, death anxiety, and post-traumatic symptomatology. Eight hundred forty-two healthcare workers were recruited between 21 March 2020 and 15 May 2020. A specific questionnaire was administered to assess socio-demographic and clinical characteristics, together with psychometric scales: Beck Hopelessness Scale, Death Anxiety Scale (DAS), and Davidson Trauma Scale (DTS). Respondents with hopelessness scored higher in the DAS and DTS than respondents without hopelessness. Furthermore, death anxiety was identified as a potential mediator of the significant association between hopelessness and post-traumatic symptomatology. The impact of death anxiety should be recognized in vulnerable populations, such as frontline healthcare workers. Therefore, pharmacological and non-pharmacological strategies could be useful to attenuate the negative psychological consequences and reduce the burden worldwide. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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10 pages, 1113 KiB

Open AccessArticle

Trends in the Use of Anxiolytics in Castile and Leon, Spain, between 2015–2020: Evaluating the Impact of COVID-19

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Miryam Sánchez Díaz

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María Luisa Martín-Calvo

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Ramona Mateos-Campos

Int. J. Environ. Res. Public Health 2021, 18(11), 5944; https://doi.org/10.3390/ijerph18115944 - 01 Jun 2021

Cited by 10 | Viewed by 2752

Abstract

Anxiolytics (N05B) are one of the most widely used pharmacological groups. This study aimed to analyze the progression of the consumption of anxiolytics (ATC classification: N05B) dispensed in pharmacies in Castile and Leon, Spain, from 2015 to 2020, with a special focus on [...] Read more.

Anxiolytics (N05B) are one of the most widely used pharmacological groups. This study aimed to analyze the progression of the consumption of anxiolytics (ATC classification: N05B) dispensed in pharmacies in Castile and Leon, Spain, from 2015 to 2020, with a special focus on the possible impact of COVID-19 on the use of these drugs. A quantitative-qualitative analysis of usage was carried out using the total number of packs and the packs per 1000 inhabitants. Overall, the use of anxiolytics grew by 14.41% during 2015–2020. The most commonly used drugs were the short-acting benzodiazepine derivatives lorazepam (whose use increased by 15.18%) and alprazolam (whose use increased by 21.40%), and the dispensing of the long-acting derivative diazepam increased the most, by 31.83%. Anxiolytics consumption increased significantly in 2020 and peaked in March. The pattern of use remained the same in 2020. The consumption of anxiolytics has continued to increase in Castile and Leon over the last six years. The COVID-19 pandemic situation affected the dispensing of these drugs, causing a sharp increase in prescriptions, especially during March, when the confinement of the population was initiated. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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11 pages, 333 KiB

Open AccessArticle

Knowledge, Emotions and Stressors in Front-Line Healthcare Workers during the COVID-19 Outbreak in Mexico

by

Yazmín Hernández-Díaz

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Alma Delia Genis-Mendoza

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Ana Fresán

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Thelma Beatriz González-Castro

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Carlos Alfonso Tovilla-Zárate

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Isela Esther Juárez-Rojop

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María Lilia López-Narváez

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José Jaime Martínez-Magaña

and

Humberto Nicolini

Int. J. Environ. Res. Public Health 2021, 18(11), 5622; https://doi.org/10.3390/ijerph18115622 - 25 May 2021

Cited by 8 | Viewed by 2337

Abstract

The aim of this study was to explore the knowledge, emotions and perceived stressors by healthcare workers who were in contact with infected patients during the COVID-19 outbreak. An online cross-sectional survey was applied. Data were collected from N = 263 healthcare workers [...] Read more.

The aim of this study was to explore the knowledge, emotions and perceived stressors by healthcare workers who were in contact with infected patients during the COVID-19 outbreak. An online cross-sectional survey was applied. Data were collected from N = 263 healthcare workers in Tabasco State, Mexico. We developed and administered a questionnaire, which consisted of sociodemographic characteristics, plus four sections. The sections evaluated were (1) knowledge of COVID-19; (2) feelings/emotions during the COVID-19 outbreak; (3) factors that caused stress and (4) factors that helped to reduce stress. Surveyed individuals were divided into three groups: physicians, nurses and other healthcare workers. When we evaluated their knowledge of COVID-19 we observed that the majority of healthcare workers in the three groups reported that they knew about COVID-19. Physicians indicated that they felt insecure about practicing their profession (62.5%) due to the high risk of being in contact with SARS-CoV-2. With regards to stressor factors, the risk of transmitting COVID-19 to their families was the main factor causing moderate to high stress (95.4%). Finally, we found that “your profession puts your life at risk” was the only factor associated with feeling nervous and scared (PR: 3.15; 95% CI: 1.54–6.43). We recommended health education campaigns, introductory courses on COVID-19 and other infectious diseases, management protocols and the provision of protection equipment to health workers in order to reduce personal and professional fears of contagion and to improve the health system in Mexico when facing epidemics. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

10 pages, 326 KiB

Open AccessArticle

Stress Perceived by University Health Sciences Students, 1 Year after COVID-19 Pandemic

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Yolanda Marcén-Román

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Angel Gasch-Gallen

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Irene Isabel Vela Martín de la Mota

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Estela Calatayud

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Isabel Gómez-Soria

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Beatriz Rodríguez-Roca

Int. J. Environ. Res. Public Health 2021, 18(10), 5233; https://doi.org/10.3390/ijerph18105233 - 14 May 2021

Cited by 22 | Viewed by 5084

Abstract

Today’s COVID-19 situation can affect university Health Sciences students’ psychological health. This study aimed to analyze the stress caused by the impact of the COVID-19 pandemic on Health Sciences students from the University of Zaragoza (Spain) almost 1 year after the pandemic began. [...] Read more.

Today’s COVID-19 situation can affect university Health Sciences students’ psychological health. This study aimed to analyze the stress caused by the impact of the COVID-19 pandemic on Health Sciences students from the University of Zaragoza (Spain) almost 1 year after the pandemic began. This cross-sectional descriptive study was conducted with a sample of 252 university students who completed a self-administered online questionnaire. It evaluated the impact of perceived stress with a modified scale (PSS-10-C), and assessed anxiety and depression on the Goldberg scale. Students presented stress (13.1%), anxiety (71.4%) and depression (81%). Females (81.7%) and the third-year Occupational Therapy students (p = 0.010) reported perceived stress. Nursing students perceived less stress (OR: 0.148; 95% CI: 0.026 to 0.842). University students developed stress and anxiety due to COVID-19 almost 1 year after the pandemic began. Psychological support measures for these groups should be prioritized. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

14 pages, 1023 KiB

Open AccessArticle

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Aleksandra Kasperczyk

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Sławomir Kasperczyk

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Antonio Ventriglio

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Gianluigi Vendemiale

Int. J. Environ. Res. Public Health 2021, 18(10), 5051; https://doi.org/10.3390/ijerph18105051 - 11 May 2021

Cited by 31 | Viewed by 4602

Abstract

Safety of healthcare workers in hospitals is a major concern during the COVID-19 pandemic. Being exposed for several working hours per day to infected patients, nurses dealing with COVID-19 face several issues that lead to physical/psychological breakdown. This study focused on burnout and [...] Read more.

Safety of healthcare workers in hospitals is a major concern during the COVID-19 pandemic. Being exposed for several working hours per day to infected patients, nurses dealing with COVID-19 face several issues that lead to physical/psychological breakdown. This study focused on burnout and its associated factors in nurses working in an Italian University Hospital during the first wave of COVID-19 pandemic. We designed a web-based cross-sectional study addressed to nurses working at the University Hospital in Foggia, Italy. The online questionnaire was organized in sections aimed at collecting demographic and occupational variables, including the Maslach Burnout Inventory (MBI) and the Oldenburg Burnout Inventory (OBI). Two hundred and ninety-three nurses agreed to participate. According to MBI, we reported moderate/high emotional exhaustion in 76.5%, depersonalization in 50.2%, and personal gratification in 54.6% of participants. COVID-19-related burnout measured by OBI resulted medium/high in 89.1% of participants. Among demographic and occupational factors, a multivariate regression analysis identified emotional support, consideration of leaving job, and workload as predictive of burnout in nurses. In conclusion, this study suggests that the improvement of employer and family support to nurses, as well as reduction of workload and job-related stress, would contribute to reducing burnout in nurses during COVID-19 pandemics. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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17 pages, 1098 KiB

Open AccessArticle

Sudden Changes and Their Associations with Quality of Life during COVID-19 Lockdown: A Cross-Sectional Study in the French-Speaking Part of Switzerland

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Manon Duay

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Margot Morgiève

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Hélène Niculita-Hirzel

Int. J. Environ. Res. Public Health 2021, 18(9), 4888; https://doi.org/10.3390/ijerph18094888 - 04 May 2021

Cited by 2 | Viewed by 3386

Abstract

The lockdown due to the COVID-19 pandemic has led to various sudden changes in a large number of individuals. In response, the question of how individuals from different social and economic strata cope with those changes has arisen, as well as how much [...] Read more.

The lockdown due to the COVID-19 pandemic has led to various sudden changes in a large number of individuals. In response, the question of how individuals from different social and economic strata cope with those changes has arisen, as well as how much they have affected their mental well-being. Choosing strategies that cope with both the pandemic and the well-being of the population has also been a challenge for different governments. While a large number of studies have investigated the mental health of people from different populations during the COVID-19 pandemic, few have explored the number and type of changes experienced during lockdown by the general population, alongside their relationships with health-related quality of life (HRQoL). To fill this research gap, an observational cross-sectional study on those associations was conducted in the French-speaking part of the Swiss general population. Data were collected from 431 participants during the first four weeks of lockdown due to COVID-19. Multivariate regressions were used to identify the sociodemographic profile of the population that experienced different types and numbers of changes during this period, the association of those changes with the HRQoL—mental and physical—and infection beliefs, and the perception of the governmental measures. We show that the more changes people experienced, the lower their mental HRQoL; however, adherence to governmental measures has helped people to cope with the imposed changes, even though the number of unexpected and unwished changes have strained their mental HRQoL. The low-income population experienced financial difficulties and changes in their food intake more frequently, while dual-citizenship or non-Swiss individuals declared conflictual situations more frequently. Sport practice had a positive association with mental HRQoL; nevertheless, a decrease in sport practice was frequently reported, which correlated with a lower mental HRQoL. Risk perception of COVID-19 increased with lower physical HRQoL score, which supports the efficiency of governmental communication regarding the pandemic. Our results support that government measures should be accompanied by effective and targeted communication about the risk of infection, in order to encourage all strata of the general population to follow such measures and adapt to the changes without unduly affecting their mental health. The usage of such tools might help to reduce the impact of policy-imposed changes on the mental HRQoL of the general population, by inducing voluntary changes in informed and engaged populations. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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14 pages, 394 KiB

Open AccessArticle

Exploring the Frequency of Anxiety and Depression Symptoms in a Brazilian Sample during the COVID-19 Outbreak

by

Fabiana Silva Ribeiro

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Flávia H. Santos

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Luis Anunciação

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Lucas Barrozo

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Jesus Landeira-Fernandez

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Anja K. Leist

Int. J. Environ. Res. Public Health 2021, 18(9), 4847; https://doi.org/10.3390/ijerph18094847 - 01 May 2021

Cited by 11 | Viewed by 3964

Abstract

The COVID-19 pandemic is a public health emergency of international concern, and the main measures to contain the spread of the coronavirus causing COVID-19 were social distancing, quarantine, and self-isolation. Although these policies are effective in containing the spread of the virus, they [...] Read more.

The COVID-19 pandemic is a public health emergency of international concern, and the main measures to contain the spread of the coronavirus causing COVID-19 were social distancing, quarantine, and self-isolation. Although these policies are effective in containing the spread of the virus, they might represent a challenge to psychological well-being, increasing levels of depressive and anxiety-related symptoms. Aims: We explored the frequency of anxiety and depression symptoms during COVID-19 restrictions and associations with sociodemographic factors in a Brazilian sample. Method: Data of a total of 936 Brazilian adults (68.2% women) aged 18 to 77 years old (M = 38.95, SD = 13.91) were collected through an online survey. Results: In general, we observed a frequency of 17.36% for severe anxiety and 66.13% for severe depression symptoms, in which younger participants (18–39 years old) and women showed higher scores in anxiety and depression scales compared to older age groups. Logistic regressions showed that women were more likely to present severe symptoms of anxiety (20.4%) compared to men (10.9%), as well as respondents in the educational sector (24.3%) compared to those in the health sector (10%). Conclusions: We highlight the importance of mental health professionals in developing strategies to help younger adults to mitigate the effects of social restriction. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

9 pages, 346 KiB

Open AccessArticle

Prevalence of Depression, Anxiety, and Perceived Stress in Postpartum Mexican Women during the COVID-19 Lockdown

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Blanca Vianey Suárez-Rico

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Guadalupe Estrada-Gutierrez

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Maribel Sánchez-Martínez

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Otilia Perichart-Perera

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Carolina Rodríguez-Hernández

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Carla González-Leyva

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Erika Osorio-Valencia

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Arturo Cardona-Pérez

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Addy Cecilia Helguera-Repetto

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Salvador Espino y Sosa

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Mario Solis-Paredes

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Enrique Reyes-Muñoz

Int. J. Environ. Res. Public Health 2021, 18(9), 4627; https://doi.org/10.3390/ijerph18094627 - 27 Apr 2021

Cited by 39 | Viewed by 4366

Abstract

The COVID-19 lockdown represents a new challenge for mental health researchers and clinical practitioners. This cross-sectional study aimed to investigate the prevalence of depression, anxiety, and perceived stress in postpartum Mexican women. The study included 293, 4–12-week postpartum women over the age of [...] Read more.

The COVID-19 lockdown represents a new challenge for mental health researchers and clinical practitioners. This cross-sectional study aimed to investigate the prevalence of depression, anxiety, and perceived stress in postpartum Mexican women. The study included 293, 4–12-week postpartum women over the age of 18. The Edinburgh Postpartum Depression Scale (EPDS), Trait-State Trait Anxiety Inventory (T-STAI), and Ten Perceived Stress Scale (PSS-10), which are all questionnaires validated for the Mexican population, were applied using a web-based online survey. Prevalence and 95% confidence intervals (CIs) were calculated. The mean ± standard deviation (SD) of the maternal age was 29.9 ± 6.3 years; the EPDS score: 11 ± 6, T-STAI score: 41.7 ± 12.3, and PSS-10 score: 17.1 ± 7. The prevalence (95% CI) of the postpartum depression symptoms was 39.2% (34–45%), trait anxiety symptoms were found among 46.1% (32–43%) of the participants, and moderate and high perceived stress were in 58% (52–64) and 10.9% (7.8–15) of the participants, respectively. The prevalence of depressive symptoms, generalized anxiety, and perceived stress was higher among postpartum Mexican women during the COVID-19 outbreak than before the lockdown. Our findings highlight the importance of monitoring perinatal mental health during pandemics and the need to design effective psychologic interventions for these patients. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

13 pages, 457 KiB

Open AccessArticle

The Impact of Intolerance of Uncertainty on Negative Emotions in COVID-19: Mediation by Pandemic-Focused Time and Moderation by Perceived Efficacy

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Int. J. Environ. Res. Public Health 2021, 18(8), 4189; https://doi.org/10.3390/ijerph18084189 - 15 Apr 2021

Cited by 15 | Viewed by 3330

Abstract

The COVID-19 global pandemic has resulted in a large number of people suffering from emotional problems. However, the mechanisms by which intolerance of uncertainty (IU) affects negative emotions during the COVID-19 pandemic remain unclear. This study aimed to explore the mediating role of [...] Read more.

The COVID-19 global pandemic has resulted in a large number of people suffering from emotional problems. However, the mechanisms by which intolerance of uncertainty (IU) affects negative emotions during the COVID-19 pandemic remain unclear. This study aimed to explore the mediating role of pandemic-focused time and the moderating role of perceived efficacy in the association between IU and negative emotions during the COVID-19 pandemic based on the uncertainty-time-efficacy-emotion model (UTEE). 1131 participants were recruited to complete measures of COVID-19 IU, pandemic-focused time, perceived efficacy, negative emotions and demographic variables during the COVID-19 pandemic. The results showed that COVID-19 IU was significantly and positively associated with negative emotions, and this link could be mediated by pandemic-focused time. Moreover, the direct effect of COVID-19 IU on negative emotions was moderated by perceived efficacy. Specifically, the direct effect of COVID-19 IU on negative emotions was much stronger for individuals with lower levels of perceived efficacy. The current study further extended the previous integrative uncertainty tolerance model. Furthermore, the study suggested that policy makers and mental health professionals should reduce the general public’s negative emotions during the pandemic through effective interventions such as adjusting COVID-19 IU, shortening pandemic-focused time and enhancing perceived efficacy. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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19 pages, 734 KiB

Open AccessArticle

Patterns of Psychological Responses among the Public during the Early Phase of COVID-19: A Cross-Regional Analysis

Int. J. Environ. Res. Public Health 2021, 18(8), 4143; https://doi.org/10.3390/ijerph18084143 - 14 Apr 2021

Cited by 16 | Viewed by 5445

Abstract

This study aimed to compare the mediation of psychological flexibility, prosociality and coping in the impacts of illness perceptions toward COVID-19 on mental health among seven regions. Convenience sampled online survey was conducted between April and June 2020 from 9130 citizens in 21 [...] Read more.

This study aimed to compare the mediation of psychological flexibility, prosociality and coping in the impacts of illness perceptions toward COVID-19 on mental health among seven regions. Convenience sampled online survey was conducted between April and June 2020 from 9130 citizens in 21 countries. Illness perceptions toward COVID-19, psychological flexibility, prosociality, coping and mental health, socio-demographics, lockdown-related variables and COVID-19 status were assessed. Results showed that psychological flexibility was the only significant mediator in the relationship between illness perceptions toward COVID-19 and mental health across all regions (all ps = 0.001–0.021). Seeking social support was the significant mediator across subgroups (all ps range = <0.001–0.005) except from the Hong Kong sample (p = 0.06) and the North and South American sample (p = 0.53). No mediation was found for problem-solving (except from the Northern European sample, p = 0.009). Prosociality was the significant mediator in the Hong Kong sample (p = 0.016) and the Eastern European sample (p = 0.008). These findings indicate that fostering psychological flexibility may help to mitigate the adverse mental impacts of COVID-19 across regions. Roles of seeking social support, problem-solving and prosociality vary across regions. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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14 pages, 322 KiB

Open AccessArticle

“At Least until the Second Wave Comes…”: A Twitter Analysis of the NHS and COVID-19 between March and June 2020

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Int. J. Environ. Res. Public Health 2021, 18(8), 3943; https://doi.org/10.3390/ijerph18083943 - 09 Apr 2021

Cited by 4 | Viewed by 2471

Abstract

In the UK, tweets around COVID-19 and health care have primarily focused on the NHS. Recent research has identified that the psychological well-being of NHS staff has been adversely impacted as a result of the COVID-19 pandemic. The aim of this study was [...] Read more.

In the UK, tweets around COVID-19 and health care have primarily focused on the NHS. Recent research has identified that the psychological well-being of NHS staff has been adversely impacted as a result of the COVID-19 pandemic. The aim of this study was to investigate narratives relating to the NHS and COVID-19 during the first lockdown (26 March–4 July 2020). A total of 123,880 tweets were collated and downloaded bound to the time period of the first lockdown in order to analyse the real-time discourse around COVID-19 and the NHS. Content analysis was undertaken and tweets were coded to positive and negative sentiments. Five main themes were identified: (1) the dichotomies of ‘clap for carers’; (2) problems with PPE and testing; (3) peaks of anger; (4) issues around hero worship; and (5) hints of a normality. Further research exploring and documenting social media narratives around COVID-19 and the NHS, in this and subsequent lockdowns, should help in tailoring suitable support for staff in the future and acknowledging the profound impact that the pandemic has had. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

11 pages, 540 KiB

Open AccessArticle

Validation of the Korean Version of the COVID-19 Phobia Scale (K-C19PS)

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Int. J. Environ. Res. Public Health 2021, 18(7), 3747; https://doi.org/10.3390/ijerph18073747 - 03 Apr 2021

Cited by 9 | Viewed by 2248

Abstract

The purpose of this study was to evaluate the reliability and validity of a Korean version of the 20-item COVID-19 phobia tool, which was developed through a translation-reverse translation process. These data were collected from 226 persons using a self-reported questionnaire. Exploratory and [...] Read more.

The purpose of this study was to evaluate the reliability and validity of a Korean version of the 20-item COVID-19 phobia tool, which was developed through a translation-reverse translation process. These data were collected from 226 persons using a self-reported questionnaire. Exploratory and confirmatory factor analyses were used to test construct validity. Finally, for 19 out of 20 items, the item-level convergence and differential validity were confirmed. In addition, the reliability and validity of the tool as a whole has been verified. For the subscales, Cronbach’s α was 0.90 for psychological, 0.87 for psychosomatic, 0.86 for economic, and 0.87 for social. Appropriate reliability was confirmed. Correlations between the COVID-19 phobia tool and fear of COVID-19 confirmed validity. The Korean version of the COVID-19 phobia tool is an appropriate scale for measuring the fear of COVID-19 and relevant psychological characteristics. Therefore, future studies in areas such as health and nursing could use this tool as required. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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12 pages, 1236 KiB

Open AccessArticle

Pathways Improving Compliance with Preventive Behaviors during the Remission Period of the COVID-19 Pandemic

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Jingjing Wang

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Nanyue Rao

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Buxin Han

Int. J. Environ. Res. Public Health 2021, 18(7), 3512; https://doi.org/10.3390/ijerph18073512 - 28 Mar 2021

Cited by 6 | Viewed by 2354

Abstract

The COVID-19 pandemic poses a significant threat to people’s lives. Compliance with preventive behaviors, recommended by public health authorities, is essential for infection control. In the remission stage, one year after the initial COVID-19 outbreak in China, we advanced a moderated parallel mediation [...] Read more.

The COVID-19 pandemic poses a significant threat to people’s lives. Compliance with preventive behaviors, recommended by public health authorities, is essential for infection control. In the remission stage, one year after the initial COVID-19 outbreak in China, we advanced a moderated parallel mediation model of the link between risk perception and compliance with preventive behaviors as well as a serial mediation model of the link between optimism and compliance with preventive behaviors, explaining the roles of various psychosocial factors in these associations. In January 2021, 200 participants under 50 years of age, located in 80 Chinese cities, participated in an online survey assessing risk perception, compliance with preventive behaviors, fear, anxiety, political trust, government dependency, and dispositional optimism. The results showed that the effect of risk perception on compliance with preventive behaviors was mediated by political trust and fear, and was moderated by government dependency. Anxiety and fear serially mediated the effect of optimism on compliance with preventive behaviors. Our study provided implications for future research to reduce negative emotions, strengthen confidence in the government, and sustain moderate government dependency accompanied by individual self-efficacy. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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12 pages, 1802 KiB

Open AccessArticle

The Impact of the COVID-19 Pandemic on Vulnerable People Suffering from Depression: Two Studies on Adults in France

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Int. J. Environ. Res. Public Health 2021, 18(6), 3250; https://doi.org/10.3390/ijerph18063250 - 21 Mar 2021

Cited by 17 | Viewed by 3153

Abstract

This study investigated the difficulties experienced by people suffering from depression in coping with the stressful context of the COVID-19 pandemic and the lockdown. Two large samples of the French population were classified on the basis of their depressive symptoms and completed an [...] Read more.

This study investigated the difficulties experienced by people suffering from depression in coping with the stressful context of the COVID-19 pandemic and the lockdown. Two large samples of the French population were classified on the basis of their depressive symptoms and completed an online questionnaire on their emotions and their behaviors during the lockdown. Results showed that, compared to participants with no or mild mental health-related symptoms, participants with moderate to severe depressive symptoms suffered from greater psychological effects of the pandemic and the lockdown (fear, anxiety, sadness, sleep quality, loss of daily routine). However, health risk behaviors (smoking, drinking, non-compliance with lockdown and barrier gestures) and perceived vulnerability did not differ between the participant groups, although more severely depressed participants tended to be less respectful of health guidelines. In addition, the most heightened effects on the depressed participants were boredom and the feeling of social isolation, which was not compensated by the search for social affiliation. Supporting people with depression should be a public health priority because they suffer psychologically more than others from the pandemic and the lockdown. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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12 pages, 778 KiB

Open AccessArticle

COVID-19 and Health-Related Quality of Life: A Community-Based Online Survey in Hong Kong

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Int. J. Environ. Res. Public Health 2021, 18(6), 3228; https://doi.org/10.3390/ijerph18063228 - 20 Mar 2021

Cited by 20 | Viewed by 4181

Abstract

The COVID-19 pandemic itself and related public health measurements have had substantial impacts on individual social lives and psychological and mental health, all to the detriment of health-related quality of life (HRQoL). There have been extensive studies investigating the mental health of people [...] Read more.

The COVID-19 pandemic itself and related public health measurements have had substantial impacts on individual social lives and psychological and mental health, all to the detriment of health-related quality of life (HRQoL). There have been extensive studies investigating the mental health of people in different populations during the COVID-19 pandemic. However, few studies have explored the impact of COVID-19 and its association with HRQoL. To fill this research gap and provide further empirical evidence, this study examined the impact of COVID-19 on Hong Kong people and evaluated its association with HRQoL. A total of 500 participants were randomly recruited to complete an online questionnaire on their concerns related to COVID-19. This entailed responding to the World Health Organization Quality of Life-BREF instrument. Data were collected between 24 April and 3 May 2020. Independent t-tests and multiple linear regressions were used to examine the association between the impact of COVID-19 and HRQoL. Overall, 69.6% of participants were worried about contracting COVID-19, and 41.4% frequently suspected themselves of being infected. Furthermore, 29.0% were concerned by the lack of disinfectants. All of these findings were associated with poorer HRQoL in the physical and psychological health, social relationships, and environment domains. On the other hand, 47.4% of participants were concerned that they may lose their job because of the pandemic, while 39.4% were bothered by the insufficient supply of surgical masks. These two factors were associated with poorer HRQoL in the physical and psychological health and environment domains. The adverse impact of COVID-19 on individuals is multifactorial, affecting all aspects of HRQoL. In addition to enhancing anti-epidemic efforts, it is equally important to implement public health and social welfare measures, thereby diminishing the adverse impact of COVID-19 on overall well-being. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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14 pages, 679 KiB

Open AccessArticle

Assessing the Psychological Impacts of COVID-19 in Undergraduate Medical Students

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Alyssa A. Guo

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Marissa A. Crum

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Lauren A. Fowler

Int. J. Environ. Res. Public Health 2021, 18(6), 2952; https://doi.org/10.3390/ijerph18062952 - 13 Mar 2021

Cited by 38 | Viewed by 5713

Abstract

Medical education has been uniquely affected by the Novel Coronavirus Disease 2019 (COVID-19). As the pandemic’s psychological impacts on medical students remain unclear, this study assessed COVID-19’s impacts on undergraduate medical students’ stress and anxiety. A nationwide, online survey was administered via email [...] Read more.

Medical education has been uniquely affected by the Novel Coronavirus Disease 2019 (COVID-19). As the pandemic’s psychological impacts on medical students remain unclear, this study assessed COVID-19’s impacts on undergraduate medical students’ stress and anxiety. A nationwide, online survey was administered via email chains between June-August 2020 to first-fourth year medical students in the United States. Demographics, 4-point Perceived Stress Scale that measures stress, 7-point Generalized Anxiety Disorder Scale that measures anxiety, and the impacts of social, health, and academic stressors due to COVID-19 were collected. Of the 852 students who participated, 66.1% experienced mild, moderate, or severe anxiety. Mean PSS-4 score was 7.25/16. Stress was highest in second- through fourth-year students. Students with preexisting mental health conditions had significantly higher stress and anxiety scores, and higher percentage of stress attributed to COVID-19. Trust in government institutions during COVID-19 was the highest stressor in first- and second-year students. Delay/availability of standardized exams was the highest stressor for third-year students. Impact on rotations/residencies was the highest stressor for fourth-year students. Understanding how students’ anxiety and stress have changed due to COVID-19 will allow educators to identify students in need and guide recommendations on the implementation of psychological interventions and support strategies. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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11 pages, 346 KiB

Open AccessArticle

Loneliness and Its Associated Factors Nine Months after the COVID-19 Outbreak: A Cross-National Study

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Int. J. Environ. Res. Public Health 2021, 18(6), 2841; https://doi.org/10.3390/ijerph18062841 - 11 Mar 2021

Cited by 25 | Viewed by 4645

Abstract

COVID-19 has been a global healthcare concern impacting multiple aspects of individual and community wellness. As one moves forward with different methods to reduce the infection and mortality rates, it is critical to continue to study the impact that national and local “social [...] Read more.

COVID-19 has been a global healthcare concern impacting multiple aspects of individual and community wellness. As one moves forward with different methods to reduce the infection and mortality rates, it is critical to continue to study the impact that national and local “social distancing” policies have on the daily lives of individuals. The aim of this study was to examine loneliness in relation to risk assessment, measures taken against risks, concerns, and social media use, while adjusting for sociodemographic variables. The cross-sectional study collected data from 3474 individuals from the USA, the UK, Norway, and Australia. Loneliness was measured with the de Jong Gierveld Loneliness Scale. Multiple linear regression was used in the analysis of associations between variables. The results showed that concerns about finances were more strongly associated with social loneliness, while concerns about the future was more strongly associated with emotional loneliness. Longer daily time spent on social media was associated with higher emotional loneliness. In conclusion, pandemic-related concerns seem to affect perceptions of loneliness. While social media can be used productively to maintain relationships, and thereby prevent loneliness, excessive use may be counterproductive. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

11 pages, 341 KiB

Open AccessArticle

Effects of Lifestyle Changes on the Mental Health of Healthcare Workers with Different Sense of Coherence Levels in the Era of COVID-19 Pandemic

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Int. J. Environ. Res. Public Health 2021, 18(6), 2801; https://doi.org/10.3390/ijerph18062801 - 10 Mar 2021

Cited by 20 | Viewed by 4325

Abstract

Sense of coherence (SOC) is a psychological factor that contributes to mental health maintenance under stressful environment. Likewise, level of SOC might affect mental health among healthcare workers during the COVID-19 pandemic differently. In this study, we investigated the relationships between lifestyle changes [...] Read more.

Sense of coherence (SOC) is a psychological factor that contributes to mental health maintenance under stressful environment. Likewise, level of SOC might affect mental health among healthcare workers during the COVID-19 pandemic differently. In this study, we investigated the relationships between lifestyle changes and mental health (General Health Questionnaire-12: GHQ-12) among different level of SOC (weak, moderate, or strong by SOC-13). The data of 898 healthcare workers from cross-sectional survey dataset were extracted and analyzed. As results, based on GHQ-12 score, 86.1% of 244 participants with weak SOC, 60.1% of 606 participants with moderate SOC, and 31.3% of 48 participants with strong SOC had poor mental health. Both SOC levels and lifestyle changes (except alcohol consumption) had significant main effects on the GHQ-12 score. Analysis on the association between lifestyle changes and mental health status stratified by SOC level reveled that among participants with weak SOC, those who increased their leisure and activity time had reduced odds of poor mental health than those who made no changes (OR: 0.08, CI: 0.01 to 0.64). Healthcare workers with weak SOC were at risk of poor mental health during the COVID-19 pandemic, and lifestyle changes may improve their mental health. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

8 pages, 302 KiB

Open AccessArticle

Burnout of Healthcare Workers amid the COVID-19 Pandemic: A Japanese Cross-Sectional Survey

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Int. J. Environ. Res. Public Health 2021, 18(5), 2434; https://doi.org/10.3390/ijerph18052434 - 02 Mar 2021

Cited by 50 | Viewed by 6361

Abstract

The coronavirus disease 2019 (COVID-19) global pandemic has drastically changed how we live and work. Amid the prolonged pandemic, burnout of the frontline healthcare professionals has become a significant concern. We conducted a cross-sectional survey study to provide data about the relationship between [...] Read more.

The coronavirus disease 2019 (COVID-19) global pandemic has drastically changed how we live and work. Amid the prolonged pandemic, burnout of the frontline healthcare professionals has become a significant concern. We conducted a cross-sectional survey study to provide data about the relationship between the COVID-19 pandemic and the prevalence of burnout in healthcare professionals in Japan. Healthcare workers in a single Japanese national university hospital participated in the survey, including basic demographics, whether a participant engaged in care of COVID-19 patients in the past 2 weeks and the Maslach Burnout Inventory. Of those, 25.4% fully answered the survey; 33.3% were doctors and 63.6% were nurses, and 36.3% engaged in care of COVID-19 patients in the past 2 weeks. Compared to those belonging to General Medicine, those in Emergency Intensive Care Unit were at higher risk of burnout (odds ratio (OR), 6.7; 95% CI, 1.1–42.1; p = 0.031). Of those who engaged in care of COVID-19 patients, 50% reported burnout while 6.1% did not (OR 8.5, 95% CI; 1.3–54.1; p = 0.014). The burnout of healthcare workers is a significant concern amid the pandemic, which needs to be addressed for sustainable healthcare delivery. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

15 pages, 1520 KiB

Open AccessArticle

“Everything Is Gonna Be Alright with Me”: The Role of Self-Compassion, Affect, and Coping in Negative Emotional Symptoms during Coronavirus Quarantine

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Ana Filipa Beato

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Leonor Pereira da Costa

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Rita Nogueira

Int. J. Environ. Res. Public Health 2021, 18(4), 2017; https://doi.org/10.3390/ijerph18042017 - 19 Feb 2021

Cited by 19 | Viewed by 4508

Abstract

Self-compassion has been associated with less distress, particularly when people face stressful and negative events. This study analyzed the mediation role of coping and affect in the relation between self-compassion and negative emotional symptoms during the quarantine decreed by Portuguese Health Authorities in [...] Read more.

Self-compassion has been associated with less distress, particularly when people face stressful and negative events. This study analyzed the mediation role of coping and affect in the relation between self-compassion and negative emotional symptoms during the quarantine decreed by Portuguese Health Authorities in the first phase of the coronavirus outbreak. A total of 428 Portuguese adults (75% women; M_age = 40.8, SD = 11.6) completed an online survey comprised by the Self-Compassion Scale (predictor); Short Version of Depression, Anxiety and Stress Scale (outcomes); The Positive and Negative Affect Schedule; and Brief-COPE. These instruments were adapted to COVID 19’s epidemic. Parallel mediation analyses demonstrated that self-compassionate participants were at less risk of suffering from symptoms of depression, anxiety, and stress during the quarantine. Plus, the relation between self-compassion and depressive, anxious, and stress symptoms were mediated by negative affect and dysfunctional coping style, but only for symptoms of depression. The findings support coping strategies and affect as links between self-compassion and distress but also the importance of separately analyzing the role of self-compassion, negative affect, and coping on symptoms of anxiety, depression, and stress. Low self-compassion might increase negative affect, maintaining stress responses to face demanding events during the COVID-19 epidemic. Results were discussed in the context of the pandemic outbreak. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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18 pages, 716 KiB

Open AccessArticle

The Role of Employee Relations in Shaping Job Satisfaction as an Element Promoting Positive Mental Health at Work in the Era of COVID-19

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Helena Bulińska-Stangrecka

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Anna Bagieńska

Int. J. Environ. Res. Public Health 2021, 18(4), 1903; https://doi.org/10.3390/ijerph18041903 - 16 Feb 2021

Cited by 62 | Viewed by 24741

Abstract

The COVID-19 pandemic is affecting the mental health of employees. Deterioration of the well-being of workers is also caused by changes in the working environment. Remote working can affect both social interactions and job satisfaction. The purpose of the study is to examine [...] Read more.

The COVID-19 pandemic is affecting the mental health of employees. Deterioration of the well-being of workers is also caused by changes in the working environment. Remote working can affect both social interactions and job satisfaction. The purpose of the study is to examine what factors influence job satisfaction in the context of remote work caused by a pandemic. The study analyses whether employee relations and interpersonal trust are related to the level of perceived job satisfaction. The investigation started with a literature review and then research hypotheses have been formulated. Based on an empirical study, carried out on a sample of 220 IT employees during the pandemic, an analysis of the mediating role of trust in links between employee relations and perceived job satisfaction was conducted. The current study found that positive employee relations contribute to the level of job satisfaction. Additionally, trust is an important factor that mediates these relationships. Based on the results of the research, it was possible to describe the mechanism of shaping a supportive work environment during a pandemic. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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11 pages, 1752 KiB

Open AccessArticle

Assessment of the Impact of a Daily Rehabilitation Program on Anxiety and Depression Symptoms and the Quality of Life of People with Mental Disorders during the COVID-19 Pandemic

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Joanna Smolarczyk-Kosowska

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Int. J. Environ. Res. Public Health 2021, 18(4), 1434; https://doi.org/10.3390/ijerph18041434 - 03 Feb 2021

Cited by 5 | Viewed by 3269

Abstract

Community psychiatry is a modern and effective form of care for patients with mental disorders. The aim of the study was to assess the impact of a rehabilitation program at the Mental Health Support Centre in Tarnowskie Góry (Poland) on reducing severity of [...] Read more.

Community psychiatry is a modern and effective form of care for patients with mental disorders. The aim of the study was to assess the impact of a rehabilitation program at the Mental Health Support Centre in Tarnowskie Góry (Poland) on reducing severity of anxiety and depression symptoms, as well as improving overall quality of life during the COVID-19 pandemic. The study involved 35 patients, examined with an authors’ questionnaire on sociodemographic data, the Hospital Scale of Anxiety and Depression (HADS) and the Short Form Health Survey (SF-36). Data was obtained during the first national lockdown and compared to data gathered before the pandemic on the same study group. Imposed restrictions, negative emotional state during lockdown, subjectively assessed higher health risk and a low level of knowledge about the COVID-19 pandemic did not significantly correlate with a severity of depression and anxiety, as well as general quality of life. However, the comparison of the results obtained in HADS and SF-36 scales show a significant improvement in both categories. Rehabilitation activities, including physical training, cognitive exercise and social therapy, reduce the severity of the symptoms and have a positive effect on the overall quality of life in patients suffering from schizophrenia and affective disorders. Therefore, holistic mental health support services may positively affect building an individual resilience. The severity of anxiety symptoms during the COVID-19 pandemic shows a negative correlation with the patient’s age. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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16 pages, 6114 KiB

Open AccessArticle

Anxiety and Panic Buying Behaviour during COVID-19 Pandemic—A Qualitative Analysis of Toilet Paper Hoarding Contents on Twitter

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Int. J. Environ. Res. Public Health 2021, 18(3), 1127; https://doi.org/10.3390/ijerph18031127 - 27 Jan 2021

Cited by 50 | Viewed by 11403

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic had increased population-level anxiety and had elicited panic buying behaviour across the world. The over-hoarding of toilet paper has received a lot of negative public attention. In this work, we used Twitter data to qualitatively [...] Read more.

Background: The coronavirus disease 2019 (COVID-19) pandemic had increased population-level anxiety and had elicited panic buying behaviour across the world. The over-hoarding of toilet paper has received a lot of negative public attention. In this work, we used Twitter data to qualitatively analyse tweets related to panic buying of toilet paper during the crisis. Methods: A total of 255,171 tweets were collected. Of these 4081 met our inclusion criteria and 100 tweets were randomly selected to develop a coding scheme in the initial phase. Random samples of tweets in folds of 100 were then qualitatively analysed in the focused coding phase until saturation was met at 500 tweets analysed. Results: Five key themes emerged: (1) humour or sarcasm, (2) marketing or profiteering, (3) opinion and emotions, (4) personal experience, and (5) support or information. About half of the tweets carried negative sentiments, expressing anger or frustration towards the deficiency of toilet paper and the frantic situation of toilet paper hoarding, which were among the most influential tweets. Discussion: Panic buying of toilet paper was seen during the 2020 pandemic period with a mass amount of related content spread across social media. The spontaneous contagion of fear and panic through social media could fuel psychological reactions in midst of crises. The high level of negative social media posts regarding the toilet paper crisis acts as an emotional trigger of public anxiety and panic. Conclusions: Social media data can provide rapid infodemiology of public mental health. In a pandemic or crisis situation, real-time data could be monitored and content-analysed for authorities to promptly address public concerns. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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13 pages, 904 KiB

Open AccessArticle

Burnout and Depression in Portuguese Healthcare Workers during the COVID-19 Pandemic—The Mediating Role of Psychological Resilience

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Int. J. Environ. Res. Public Health 2021, 18(2), 636; https://doi.org/10.3390/ijerph18020636 - 13 Jan 2021

Cited by 76 | Viewed by 9438

Abstract

During the COVID-19 pandemic, healthcare workers (HCW) have been exposed to multiple psychosocial stressors. Resilience might protect employees from the negative consequences of chronic stress. The aim of this study was to explore the mediating role of resilience in the relationship between depression [...] Read more.

During the COVID-19 pandemic, healthcare workers (HCW) have been exposed to multiple psychosocial stressors. Resilience might protect employees from the negative consequences of chronic stress. The aim of this study was to explore the mediating role of resilience in the relationship between depression and burnout (personal, work-related, and client-related). A cross-sectional study was performed using an online questionnaire distributed via social networks. A survey was conducted comprising standardized measures of resilience (Resilience Scale-25 items), depression (subscale of Depression Anxiety Stress Scales-21 items), and burnout (Copenhagen Burnout Inventory Scale-19 items). A total of 2008 subjects completed the survey, and a hierarchical regression model was estimated for each burnout dimension. The results revealed that depression had not only a directed effect on personal, work- and client-related burnout, but also an indirect small effect on it through resilience. Psychological resilience played a partial mediating role between depression and all burnout dimensions. This partial mediation suggests that there may be other possible variables (e.g., social connection, self-compassion, gratitude, sense of purpose) that further explain the associations. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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13 pages, 883 KiB

Open AccessArticle

Psychological Impact on the Nursing Professionals of the Rioja Health Service (Spain) Due to the SARS-CoV-2 Virus

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Pablo Del Pozo-Herce

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Rebeca Garrido-García

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Iván Santolalla-Arnedo

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Vicente Gea-Caballero

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Pablo García-Molina

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Regina Ruiz de Viñaspre-Hernández

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Francisco José Rodríguez-Velasco

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Raúl Juárez-Vela

Int. J. Environ. Res. Public Health 2021, 18(2), 580; https://doi.org/10.3390/ijerph18020580 - 12 Jan 2021

Cited by 23 | Viewed by 4472

Abstract

Background: The COVID-19 pandemic is a public health emergency that has affected health professionals around the world, causing physical and mental exhaustion with a greater probability of developing mental disorders in professionals who provide healthcare. Objective: The objective of this study was to [...] Read more.

Background: The COVID-19 pandemic is a public health emergency that has affected health professionals around the world, causing physical and mental exhaustion with a greater probability of developing mental disorders in professionals who provide healthcare. Objective: The objective of this study was to know the psychological impact of the SARS-CoV-2 virus on the nursing professionals working for the Rioja Health Service. Methods: We conducted an observational and descriptive cross-sectional study. The nursing staff at the Rioja Health Service were invited to respond to a self-administered questionnaire between June and August 2020. Results: A total of 605 health professionals participated in the questionnaire; 91.9% were women, 63.14% were registered nurses, and 36.28% were auxiliary nurses. Risk factors for mental health professionals were identified in more than 90% of nurses (p = 0.009), affecting their psychological state with feelings of exhaustion, emotional overload (p = 0.002), and less use of coping strategies among women. Younger professionals with less experience had higher levels of stress compared to those with more than five years of experience, who showed a progressive reduction in the impact of stressors (p < 0.001). Professionals with dependent family members presented higher levels of emotional overload and coping problems (p = 0.009). Conclusion: The COVID-19 pandemic has had a significant psychological impact on health professionals in terms of stress, emotional well-being, and the use of coping strategies. Female health professionals with dependents, a temporary contract, and less work experience have been more psychologically affected. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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10 pages, 322 KiB

Open AccessArticle

Reduced Hedonic Tone and Emotion Dysregulation Predict Depressive Symptoms Severity during the COVID-19 Outbreak: An Observational Study on the Italian General Population

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Int. J. Environ. Res. Public Health 2021, 18(1), 255; https://doi.org/10.3390/ijerph18010255 - 31 Dec 2020

Cited by 22 | Viewed by 2819

Abstract

The COVID-19 pandemic has spiked stress-related symptoms worldwide. This study aims to assess depressive symptoms related to the early phase of the COVID-19 outbreak among the Italian general population and to analyze anhedonia and emotion dysregulation as potential predictors of depression severity. Through [...] Read more.

The COVID-19 pandemic has spiked stress-related symptoms worldwide. This study aims to assess depressive symptoms related to the early phase of the COVID-19 outbreak among the Italian general population and to analyze anhedonia and emotion dysregulation as potential predictors of depression severity. Through an online questionnaire, we collected sociodemographic and lockdown-related information; depressive symptoms, hedonic tone, and emotion dysregulation were assessed through the Beck Depression Inventory II, the Snaith–Hamilton Pleasure Scale, and the Difficulties in Emotion Regulation Scale, respectively. In our sample (n = 500), 122 individuals (24.4%) reported depressive symptoms during the COVID-19 outbreak. Individuals with and without depression differed in gender (X² = 4.77, df = 1, p = 0.02) and age (X² = 15.7, df = 4, p = 0.003). Among individuals presenting with depressive symptoms, those reporting close contact with confirmed cases of COVID-19 were at higher risk for severe depression (p = 0.026). Reduced hedonic tone (p = 0.014) and emotion dysregulation (p < 0.001) also predicted depression severity. To the best of our knowledge, these are among the earliest data that focus on the risk for depression among a sizeable sample of the Italian general population during the COVID-19 outbreak. Our results indicate emotion dysregulation and reduced hedonic tone as potential factors predicting COVID-19-related depression severity and provide insight into developing targeted intervention policies. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

11 pages, 334 KiB

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Int. J. Environ. Res. Public Health 2021, 18(1), 220; https://doi.org/10.3390/ijerph18010220 - 30 Dec 2020

Cited by 56 | Viewed by 6765

Abstract

The COVID-19 pandemic has negatively affected the mental health of the general population, and for healthcare workers (HCWs) it has been no different. Religiosity and spirituality are known coping strategies for mental illnesses, especially in stressful times. This study aimed to describe the [...] Read more.

The COVID-19 pandemic has negatively affected the mental health of the general population, and for healthcare workers (HCWs) it has been no different. Religiosity and spirituality are known coping strategies for mental illnesses, especially in stressful times. This study aimed to describe the role of spiritual-religious coping regarding fear and anxiety in relation to COVID-19 in HCWs in Portugal. A cross-sectional quantitative online survey was performed. Socio-demographic and health data were collected as well as the Duke University Religion Index, Spirituality Scale, Fear of COVID-19 Scale, and Coronavirus Anxiety Scale. Two hundred and twenty-two HCWs participated in the study, 74.3% were female and 81.1% were physicians. The median age was 37 years (Q1, Q3: 31, 51.3). Religiosity was neither a significant factor for coronavirus-related anxiety nor it was for fear of COVID-19. Participants with higher levels in the hope/optimism dimension of the Spirituality Scale showed less coronavirus-related anxiety. Female HCWs, non-physicians, and the ones with a previous history of anxiety presented higher levels of fear and/or anxiety related to COVID-19. HCWs’ levels of distress should be identified and reduced, so their work is not impaired. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

12 pages, 706 KiB

Open AccessArticle

Coping Mechanisms: Exploring Strategies Utilized by Japanese Healthcare Workers to Reduce Stress and Improve Mental Health during the COVID-19 Pandemic

by

Masatoshi Tahara

,

Yuki Mashizume

and

Kayoko Takahashi

Int. J. Environ. Res. Public Health 2021, 18(1), 131; https://doi.org/10.3390/ijerph18010131 - 27 Dec 2020

Cited by 65 | Viewed by 14583

Abstract

The COVID-19 pandemic is a major problem affecting the mental health of millions of people, including healthcare workers. In this study, we analyzed risk factors and coping mechanisms that could reduce the risk of poor mental health among healthcare workers during the COVID-19 [...] Read more.

The COVID-19 pandemic is a major problem affecting the mental health of millions of people, including healthcare workers. In this study, we analyzed risk factors and coping mechanisms that could reduce the risk of poor mental health among healthcare workers during the COVID-19 pandemic in Japan. A cross-sectional survey was conducted for 7 days from 30 April 2020 using a web-based questionnaire. The survey assessed various outcome measures, including the General Health Questionnaire-12 (GHQ-12), health status, satisfaction with daily life activities, work, leisure, and new activities, and anxiety over COVID-19. Data from 661 participants were analyzed, and 440 participants (66.6%) showed poor mental health (GHQ-12 ≥ 4). Also, our result showed that female gender, lower levels of communication with friends, and high anxiety were associated with poorer mental health. In contrast, good health status, high work satisfaction, and high satisfaction from new activities were associated with buffering mental health problem. Most participants chose an escape-avoidance coping strategy, and participants with worse mental health were more likely to adopt seeking social support as a coping strategy. These results may support healthcare workers to cope with mental health problems associated with the COVID-19 pandemic. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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10 pages, 752 KiB

Open AccessArticle

Emotional Eating in Relation to Worries and Psychological Distress Amid the COVID-19 Pandemic: A Population-Based Survey on Adults in Norway

by

Mitra Bemanian

,

Silje Mæland

,

Rune Blomhoff

,

Åsgeir Kjetland Rabben

,

Erik Kristoffer Arnesen

,

Jens Christoffer Skogen

and

Lars Thore Fadnes

Int. J. Environ. Res. Public Health 2021, 18(1), 130; https://doi.org/10.3390/ijerph18010130 - 27 Dec 2020

Cited by 62 | Viewed by 7615

Abstract

Population-based studies have revealed a high occurrence of self-reported psychological distress symptoms during the early phases of the coronavirus disease 2019 (COVID-19) pandemic. Stress and negative affect can lead to emotional eating, which in turn can have negative outcomes on health. In this [...] Read more.

Population-based studies have revealed a high occurrence of self-reported psychological distress symptoms during the early phases of the coronavirus disease 2019 (COVID-19) pandemic. Stress and negative affect can lead to emotional eating, which in turn can have negative outcomes on health. In this population-based study, 24,968 Norwegian inhabitants participated in an electronic questionnaire including structured questions on dietary habits, emotional eating, psychological distress symptoms, and COVID-19-related worries. The study took place during April 2020 after around six weeks of interventions to tackle the first wave of the COVID-19 pandemic. Overall, emotional eating was reported in 54% of the population and was markedly more frequent in female participants. Worries related to consequences of the pandemic were associated with increased emotional eating, and the association was stronger for worries related to personal economy—odds ratios (OR) 1.7 (95% confidence interval (CI95%) 1.5–1.9)—compared to worries related to health—OR 1.3 (CI95% 1.2–1.5). Psychological distress had a strong association with emotional eating—OR 4.2 (CI95% 3.9–4.4). Correspondingly, the intake of high-sugar foods and beverages was higher for those with substantial COVID-19-related worries and those with psychological distress compared to the overall population. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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19 pages, 1661 KiB

Open AccessArticle

The Psychological Impact of ‘Mild Lockdown’ in Japan during the COVID-19 Pandemic: A Nationwide Survey under a Declared State of Emergency

by

,

,

,

and

Eric Murillo-Rodriguez

Int. J. Environ. Res. Public Health 2020, 17(24), 9382; https://doi.org/10.3390/ijerph17249382 - 15 Dec 2020

Cited by 115 | Viewed by 9200

Abstract

This study examined the psychological distress caused by non-coercive lockdown (mild lockdown) in Japan. An online survey was conducted with 11,333 people (52.4% females; mean age = 46.3 ± 14.6 years, range = 18–89 years) during the mild lockdown in the seven prefectures [...] Read more.

This study examined the psychological distress caused by non-coercive lockdown (mild lockdown) in Japan. An online survey was conducted with 11,333 people (52.4% females; mean age = 46.3 ± 14.6 years, range = 18–89 years) during the mild lockdown in the seven prefectures most affected by COVID-19 infection. Over one-third (36.6%) of participants experienced mild-to-moderate psychological distress (Kessler Psychological Distress Scale [K6] score 5–12), while 11.5% reported serious psychological distress (K6 score ≥ 13). The estimated prevalence of depression (Patient Health Questionnaire-9 score ≥ 10) was 17.9%. Regarding the distribution of K6 scores, the proportion of those with psychological distress in this study was significantly higher when compared with the previous national survey data from 2010, 2013, 2016, and 2019. Healthcare workers, those with a history of treatment for mental illness, and younger participants (aged 18–19 or 20–39 years) showed particularly high levels of psychological distress. Psychological distress severity was influenced by specific interactional structures of risk factors: high loneliness, poor interpersonal relationships, COVID-19-related sleeplessness and anxiety, deterioration of household economy, and work and academic difficulties. Even when non-coercive lockdowns are implemented, people’s mental health should be considered, and policies to prevent mental health deterioration are needed. Cross-disciplinary public–private sector efforts tailored to each individual’s problem structure are important to address the mental health issues arising from lockdown. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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13 pages, 697 KiB

Open AccessArticle

University Students’ Perceived Peer Support and Experienced Depressive Symptoms during the COVID-19 Pandemic: The Mediating Role of Emotional Well-Being

by

Yao Sun

,

Shiang-Yi Lin

and

Kevin Kien Hoa Chung

Int. J. Environ. Res. Public Health 2020, 17(24), 9308; https://doi.org/10.3390/ijerph17249308 - 12 Dec 2020

Cited by 46 | Viewed by 8005

Abstract

The coronavirus (COVID-19) pandemic has adversely affected individuals’ mental health. Social isolation as a result of social distancing during the pandemic potentially affects the associations among perceived available peer support, emotional well-being, and depression in university students. The present study examined the associations [...] Read more.

The coronavirus (COVID-19) pandemic has adversely affected individuals’ mental health. Social isolation as a result of social distancing during the pandemic potentially affects the associations among perceived available peer support, emotional well-being, and depression in university students. The present study examined the associations among university students’ perceived available peer support, emotional well-being (as indicated negatively by loneliness and negative affects and positively by positive affects and hope), and depressive symptoms. During the third wave of the COVID-19 outbreak in July, 2020, 255 students at a public university in Hong Kong participated in an online-based survey that assessed their perceived available peer support, emotional well-being, and depressive symptoms. Results showed that perceived available peer support negatively contributed to depressive symptoms; both negative and positive indicators of emotional well-being mediated the association between perceived available peer support and depressive symptoms. Our results also suggested that university students showed signs of elevated depressive symptoms during the pandemic. Thus, our study advanced the theoretical understanding of university students’ mental health in the time of a global pandemic. Our study also highlighted the practical needs for preventive efforts and accessible care to support the psychological and emotional needs of young people during the COVID-19 pandemic. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

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9 pages, 314 KiB

Open AccessArticle

Post-Traumatic Stress Disorder and Associated Factors during the Early Stage of the COVID-19 Pandemic in Norway

by

,

,

,

,

and

Int. J. Environ. Res. Public Health 2020, 17(24), 9210; https://doi.org/10.3390/ijerph17249210 - 09 Dec 2020

Cited by 33 | Viewed by 6439

Abstract

The COVID-19 outbreak and the sudden lockdown of society in March 2020 had a large impact on people’s daily life and gave rise to concerns for the mental health in the general population. The aim of the study was to examine post-traumatic stress [...] Read more.

The COVID-19 outbreak and the sudden lockdown of society in March 2020 had a large impact on people’s daily life and gave rise to concerns for the mental health in the general population. The aim of the study was to examine post-traumatic stress reactions related to the COVID-19 pandemic, the prevalence of symptom-defined post-traumatic stress disorder (PTSD), and factors associated with post-traumatic stress in the Norwegian population during the early stages of the COVID-19 outbreak. A survey was administered via social media channels, to which a sample of 4527 adults (≥18 years) responded. Symptom-defined PTSD was measured with the PTSD Checklist for the DSM-5. The items were specifically linked to the COVID-19 pandemic. We used the DSM-5 diagnostic guidelines to categorize participants as fulfilling the PTSD symptom criteria or not. Associations with PTSD were examined with single and multiple logistic regression analyses. The prevalence of symptom-defined PTSD was 12.5% for men and 19.5% for women. PTSD was associated with lower age, female gender, lack of social support, and a range of pandemic-related variables such as economic concerns, expecting economic loss, having been in quarantine or isolation, being at high risk for complications from COVID-19 infection, and having concern for family and close friends. In conclusion, post-traumatic stress reactions appear to be common in the Norwegian population in the early stages of the COVID-19 outbreak. Concerns about finances, health, and family and friends seem to matter. Full article

(This article belongs to the Special Issue Mental Health in the Time of COVID-19)

20 pages, 351 KiB

Open AccessArticle

Mental Health Status of University Healthcare Workers during the COVID-19 Pandemic: A Post–Movement Lockdown Assessment

by

Luke Sy-Cherng Woon

,

Hatta Sidi

,

Nik Ruzyanei Nik Jaafar

and

Mohammad Farris Iman Leong Bin Abdullah

Int. J. Environ. Res. Public Health 2020, 17(24), 9155; https://doi.org/10.3390/ijerph17249155 - 08 Dec 2020

Cited by 53 | Viewed by 5587

Abstract

This study investigated the prevalence and severity of depression, anxiety, and stress and determined the association between various factors, social support, and depression, anxiety, and stress among university healthcare workers in Malaysia after the government lifted the movement control order (MCO) put in [...] Read more.

This study investigated the prevalence and severity of depression,

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